DIAGNOSTIC PERFORMANCE OF CONTRAST-ENHANCED SPECTRAL MAMMOGRAPHY: COMPARISON WITH CONTRAST-ENHANCED DYNAMIC MR IMAGING IN PATIENTS WITH SUSPECTED BREAST CANCER

Yıl 2024, Cilt: 25 Sayı: 2, 160 – 167, 29.04.2024

Kamber Göksu , Ahmet Vural , Fatma Nur Soylu Boy

https://doi.org/10.18229/kocatepetip.1255616

Öz

OBJECTIVE: To compare the diagnostic performance of contrast-enhanced spectral mammography (CESM) with dynamic contrast-enhanced magnetic resonance (MR) imaging in terms of the detection of BI-RADS 4 and 5 lesions suspected of breast cancer.
MATERIAL AND METHODS: 92 patients with ACR BI-RADS 4 and 5 lesions underwent CESM, MR Imaging, and consequent core biopsy. Two readers assessed the index lesions which were classified as mass lesions, non-mass lesions, and microcalcifications, and scored using a 7-point scoring system.
RESULTS: A total of 98 index lesions were detected, including bilateral lesions in six patients. In histopathological analysis, 56 of the lesions were benign (56/98, 57%,) and 42 of the lesions were malignant (42/98, 43%). 55 of the lesions were classified as mass lesions, 18 as non-mass lesions, and 25 as microcalcifications. CESM scored 28 of the lesions (28,6%) as benign, and 70 (71,4%) of the lesions were malignant whereas these results were 30 (30,6%) and 68 (69,4%) for MR Imaging examinations, respectively. The sensitivity of both CESM and MR imaging for depicting the index cancer was 95 % for both modalities. In ROC (Receiver Operating Characteristic) analysis, AUC (Area Under the Curve) was 0.93 (%95 CI:0.870-0.977) for CESM and 0.94 (%95 CI:0.882-0.982) for MR Imaging. There was no statistically significant difference in AUC values between CESM and MR Imaging (p=0.332; p>0.05).
CONCLUSIONS: The diagnostic performance of CESM is similar when compared to MR imaging in the detection of index cancers in patients with BI-RADS 4 and 5 lesions. CESM may be used as a confidential diagnostic tool in this regard.

Anahtar Kelimeler

Contrast-enhanced mammography, Spectral mammography, Digital mammography, Breast MRI, Breast cancer.

Kaynakça

• 1. Tabar L, Vitak B, Chen TH et al. Swedish two-county trial: impact of mammographic screening on breast cancer mortality during 3 decades. Radiology.2011;260:658–63.
• 2. Cozzi A, Magni V, Zanardo M, Schiaffino S, Sardanelli F. Contrast-enhanced mammography: a systematic review and meta-analysis of diagnostic performance. Radiology. 2022;302:568-81.
• 3. Shahraki Z, Ghaffari M, Nakhaie Moghadam M, et al. Preoperative evaluation of breast cancer: Contrast- enhanced mammography versus contrast-enhanced magnetic resonance imaging: A systematic review and meta-analysis. Breast Dis. 2022;41:303-15.
• 4. Kim JJ, Kim JY, Suh HB, et al. Characterization of breast cancer subtypes based on quantitative assessment of intratumoral heterogeneity using dynamic contrast-enhanced and diffusion-weighted magnetic resonance imaging. Eur Radiol. 2022;32: 822–33.
• 5. Gelardi F, Ragaini EM, Sollini M, et al. Contrast-Enhanced Mammography versus Breast Magnetic Resonance Imaging: A Systematic Review and Meta-Analysis. Diagnostics. 2022;12:1890.
• 6. Milon A, Wahab CA, Kermarrec E, Bekhouche A, Taourel P, Thomassin-Naggara I. Breast MRI: Is Faster Better? AJR Am J Roentgenol. 2019;11:1-14.
• 7. Dromain C, Balleyguier C, Muller S, et al. Evaluation of tumor angiogenesis of breast carcinoma using contrast-enhanced digital mammography. AJR Am J Roentgenol. 2006;187:528-37.
• 8. Lobbes MB, Smidt ML, Houwers J, Tjan-Heijnen VC, Wildberger JE. Contrast enhanced mammography: techniques, current results, and potential indications. Clin Radiol. 2013;68:935-44.
• 9. Zuley ML, Bandos AI, Abrams GS, et al. Contrast Enhanced Digital Mammography (CEDM) Helps to Safely Reduce Benign Breast Biopsies for Low to Moderately Suspicious Soft Tissue Lesions. Acad Radiol. 2020;27:969- 76.
• 10. International Atomic Energy Agency. International Action Plan for the Radiological Protection of Patients. https://www-ns.iaea.org/downloads/rw/radiation-safety/PatientProtActionPlangov2002-36gc46-12.pdf , Date of access: 15.01.2023.
• 11. Jochelson MS, Dershaw DD, Sung JS, et al. Bilateral contrast-enhanced dual-energy digital Mammography: feasibility and comparison with conventional digital mammography and MR imaging in women with known breast carcinoma. Radiology. 2013;266:743-51.
• 12. Fallenberg EM, Schmitzberger FF, Amer H, et al. Contrast-enhanced spectral mammography vs. mammography and MRI – clinical performance in a multi-reader evaluation. Eur Radiol. 2017;27:2752-64.
• 13. Lee-Felker SA, Tekchandani L, Thomas M, et al. Newly Diagnosed Breast Cancer: Comparison of Contrast- enhanced Spectral Mammography and Breast MR Imaging in the Evaluation of Extent of Disease. Radiology. 2017;285:389-400.
• 14. Fallenberg EM, Dromain C, Diekmann F, et al. Contrast-enhanced spectral mammography versus MRI: Initial results in the detection of breast cancer and assessment of tumour size. Eur Radiol. 2014;24:256-64.
• 15. Chou CP, Lewin JM, Chiang CL, et al. Clinical evaluation of contrast-enhanced digital mammography and contrast enhanced tomosynthesis–Comparison to contrast-enhanced breast MRI. Eur J Radiol. 2015;84:2501- 8.
• 16. Xing D, Lv Y, Sun B, et al. Diagnostic Value of Contrast-Enhanced Spectral Mammography in Comparison to Magnetic ResonanceImaging in Breast Lesions. J Comput Assist Tomogr. 2019;43:245-51.
• 17. Xiang W, Rao H, Zhou L. A meta-analysis of contrast-enhanced spectral mammography versus MRI in the diagnosis of breast cancer. Thorac Cancer. 2020;11: 1423-32.
• 18. Daniaux M, Gruber L, De Zordo T, et al. Preoperative staging by multimodal imaging in newly diagnosed breast cancer: Diagnostic performance of contrast-enhanced spectral mammography compared to conventional mammography, ultrasound, and MRI. Eur J Radiol. 2023;163:e110838.
• 19. Rudnicki W, Piegza T, Rozum-Liszewska N, et al. The effectiveness of contrast-enhanced spectral mammography and magnetic resonance imaging in dense breasts. Pol J Radiol. 2021;86:159-64.
• 20. Steinhof-Radwańska K, Lorek A, Holecki M, et al. Multifocality and Multicentrality in Breast Cancer: Comparison of the Efficiency of Mammography, Contrast-Enhanced Spectral Mammography, and Magnetic Resonance Imaging in a Group of Patients with Primarily Operable Breast Cancer. Curr Oncol. 2021;28:4016-30.

KONTRASTLI SPEKTRAL MAMOGRAFİNİN TANISAL PERFORMANSI: MEME KANSERİNDEN ŞÜPHELENİLEN HASTALARDA KONTRASTLI DİNAMİK MR GÖRÜNTÜLEME İLE KARŞILAŞTIRMA

Yıl 2024, Cilt: 25 Sayı: 2, 160 – 167, 29.04.2024

Kamber Göksu , Ahmet Vural , Fatma Nur Soylu Boy

https://doi.org/10.18229/kocatepetip.1255616

Öz

AMAÇ: Meme Kanseri şüphesi bulunan BI-RADS 4 ve 5 lezyonların tespiti açısından, kontrastlı spektral mamografinin (KSM) tanısal performansını, dinamik kontrastlı manyetik rezonans (MR) görüntüleme ile karşılaştırmaktır.
GEREÇ VE YÖNTEM: ACR BI-RADS 4 ve 5 lezyonları olan 92 hastaya KSM, MR Görüntüleme ve ardından kor biyopsi uygulandı. Kitlesel lezyonlar, kitlesel olmayan lezyonlar ve mikrokalsifikasyonlar olarak sınıflandırılan lezyonlar iki radyolog tarafından incelendi ve 7 puanlık bir puanlama sistemi kullanılarak değerlendirildi.
BULGULAR: Altı hastada bilateral olmak üzere toplam 98 lezyon saptandı. Histopatolojik incelemede lezyonların 56’sı benign (56/98, %57) ve 42’si malign (42/98, %43) idi. Lezyonların 55’i kitle lezyonu, 18’i kitle dışı lezyon ve 25’i mikrokalsifikasyon olarak sınıflandırıldı. KSM lezyonların 28’ini (%28,6) benign, 70’ini (%71,4) malign olarak skorlarken, bu sonuçlar MR Görüntüleme ile değerlendirmede sırasıyla 30 (%30,6) ve 68 (%69,4) idi. Var olan kanseri göstermek için hem KSM hem de MR görüntülemenin duyarlılığı her iki modalite için %95 idi. ROC (Receiver Operating Characteristic) analizinde AUC (Area Under the Curve), KSM için 0,93 (%95 CI:0,870-0,977) ve MR Görüntüleme için 0,94 (%95 CI:0,882-0,982) idi. KSM ve MR Görüntüleme arasında AUC değerlerinde istatistiksel olarak anlamlı bir fark yoktu (p=0,332; p>0,05).
SONUÇ: KSM’nin tanısal performansı, BI-RADS 4 ve 5 lezyonları olan hastalarda indeks kanserlerin saptanmasında MR görüntüleme ile karşılaştırıldığında benzerdir. KSM bu konuda güvenilir bir tanı aracı olarak kullanılabilir.

Anahtar Kelimeler

Kontrastlı mamografi, Spektral mamografi, Dijital mamografi, Meme MRG, Meme kanseri.

Kaynakça

• 1. Tabar L, Vitak B, Chen TH et al. Swedish two-county trial: impact of mammographic screening on breast cancer mortality during 3 decades. Radiology.2011;260:658–63.
• 2. Cozzi A, Magni V, Zanardo M, Schiaffino S, Sardanelli F. Contrast-enhanced mammography: a systematic review and meta-analysis of diagnostic performance. Radiology. 2022;302:568-81.
• 3. Shahraki Z, Ghaffari M, Nakhaie Moghadam M, et al. Preoperative evaluation of breast cancer: Contrast- enhanced mammography versus contrast-enhanced magnetic resonance imaging: A systematic review and meta-analysis. Breast Dis. 2022;41:303-15.
• 4. Kim JJ, Kim JY, Suh HB, et al. Characterization of breast cancer subtypes based on quantitative assessment of intratumoral heterogeneity using dynamic contrast-enhanced and diffusion-weighted magnetic resonance imaging. Eur Radiol. 2022;32: 822–33.
• 5. Gelardi F, Ragaini EM, Sollini M, et al. Contrast-Enhanced Mammography versus Breast Magnetic Resonance Imaging: A Systematic Review and Meta-Analysis. Diagnostics. 2022;12:1890.
• 6. Milon A, Wahab CA, Kermarrec E, Bekhouche A, Taourel P, Thomassin-Naggara I. Breast MRI: Is Faster Better? AJR Am J Roentgenol. 2019;11:1-14.
• 7. Dromain C, Balleyguier C, Muller S, et al. Evaluation of tumor angiogenesis of breast carcinoma using contrast-enhanced digital mammography. AJR Am J Roentgenol. 2006;187:528-37.
• 8. Lobbes MB, Smidt ML, Houwers J, Tjan-Heijnen VC, Wildberger JE. Contrast enhanced mammography: techniques, current results, and potential indications. Clin Radiol. 2013;68:935-44.
• 9. Zuley ML, Bandos AI, Abrams GS, et al. Contrast Enhanced Digital Mammography (CEDM) Helps to Safely Reduce Benign Breast Biopsies for Low to Moderately Suspicious Soft Tissue Lesions. Acad Radiol. 2020;27:969- 76.
• 10. International Atomic Energy Agency. International Action Plan for the Radiological Protection of Patients. https://www-ns.iaea.org/downloads/rw/radiation-safety/PatientProtActionPlangov2002-36gc46-12.pdf , Date of access: 15.01.2023.
• 11. Jochelson MS, Dershaw DD, Sung JS, et al. Bilateral contrast-enhanced dual-energy digital Mammography: feasibility and comparison with conventional digital mammography and MR imaging in women with known breast carcinoma. Radiology. 2013;266:743-51.
• 12. Fallenberg EM, Schmitzberger FF, Amer H, et al. Contrast-enhanced spectral mammography vs. mammography and MRI – clinical performance in a multi-reader evaluation. Eur Radiol. 2017;27:2752-64.
• 13. Lee-Felker SA, Tekchandani L, Thomas M, et al. Newly Diagnosed Breast Cancer: Comparison of Contrast- enhanced Spectral Mammography and Breast MR Imaging in the Evaluation of Extent of Disease. Radiology. 2017;285:389-400.
• 14. Fallenberg EM, Dromain C, Diekmann F, et al. Contrast-enhanced spectral mammography versus MRI: Initial results in the detection of breast cancer and assessment of tumour size. Eur Radiol. 2014;24:256-64.
• 15. Chou CP, Lewin JM, Chiang CL, et al. Clinical evaluation of contrast-enhanced digital mammography and contrast enhanced tomosynthesis–Comparison to contrast-enhanced breast MRI. Eur J Radiol. 2015;84:2501- 8.
• 16. Xing D, Lv Y, Sun B, et al. Diagnostic Value of Contrast-Enhanced Spectral Mammography in Comparison to Magnetic ResonanceImaging in Breast Lesions. J Comput Assist Tomogr. 2019;43:245-51.
• 17. Xiang W, Rao H, Zhou L. A meta-analysis of contrast-enhanced spectral mammography versus MRI in the diagnosis of breast cancer. Thorac Cancer. 2020;11: 1423-32.
• 18. Daniaux M, Gruber L, De Zordo T, et al. Preoperative staging by multimodal imaging in newly diagnosed breast cancer: Diagnostic performance of contrast-enhanced spectral mammography compared to conventional mammography, ultrasound, and MRI. Eur J Radiol. 2023;163:e110838.
• 19. Rudnicki W, Piegza T, Rozum-Liszewska N, et al. The effectiveness of contrast-enhanced spectral mammography and magnetic resonance imaging in dense breasts. Pol J Radiol. 2021;86:159-64.
• 20. Steinhof-Radwańska K, Lorek A, Holecki M, et al. Multifocality and Multicentrality in Breast Cancer: Comparison of the Efficiency of Mammography, Contrast-Enhanced Spectral Mammography, and Magnetic Resonance Imaging in a Group of Patients with Primarily Operable Breast Cancer. Curr Oncol. 2021;28:4016-30.

Toplam 20 adet kaynakça vardır.

Ayrıntılar

Kaynak Göster

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