Accuracy of contrast-enhanced spectral mammography compared with MRI for invasive breast cancers: Prospective study in population of predominantly underrepresented minorities

Autor: Daniel Stahl, Mary Yamashita, Sandy C Lee, Bhushan Desai, Steven Cen, Linda Hovanessian-Larsen, Xiaomeng Lei
Rok vydání: 2021
Předmět:
Zdroj: Clinical imaging. 80
ISSN: 1873-4499
Popis: Objectives This prospective study compares contrast-enhanced spectral mammography (CESM) with contrast-enhanced breast MRI in assessing the extent of newly diagnosed breast cancer in a multiethnic cohort. Methods This study includes 41 patients with invasive breast cancer detected by mammography or conventional ultrasound imaging from May 2017 to March 2020. CESM and MRI scans were performed prior to any treatment. Results are compared with each other and to histopathology. Detection of the malignant lesion was assessed by sensitivity, specificity, PPV, NPV. Consistency of malignant tumor size measurement was compared between modalities using Intraclass Correlation Coefficient (ICC). Results In a multiethnic cohort with over 65% Hispanic and African-American women, the sensitivity of detecting malignant lesions for CESM is 93.1% (77.23%, 99.15%) and MRI is 96.55% (82.24%, 99.91%). The PPV for CESM 96.43% (81.65%, 99.91%) is better compared to MRI 82.35% (65.47%, 93.24%). CESM is as effective as MRI in evaluating index cancers and multifocal/multicentric/contralateral disease. CESM has greater specificity and PPV since MRI tends to overcall benign lesions. There is a good agreement of tumor size between CESM to surgery and MRI to surgery with ICC of 0.85 (95% CI 0.69, 0.93) and 0.87 (95% CI 0.74, 0.94), respectively. There is good agreement of malignancy detection between CESM and MRI with Kappa of 0.74 (95% CI 0.52, 0.95). Conclusions CESM is an effective imaging modality for evaluating the extent of disease in newly diagnosed invasive breast cancers and a good alternative to MRI in a multiethnic population.
Databáze: OpenAIRE
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