Differential Diagnosis of Breast Lesions in Dual-Energy Contrast-Enhanced Spectral Mammography

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Author Info

Antonina V. Chernaya Roksana H. Ulyanova Petr V. Krivorotko Sergey N. Novikov Sergey V. Kanaev Anna S. Artemieva Lev N. Shevkunov Stanislav A. Tyatkov Vsevolod V. Danilov

Corresponding Author

Antonina V. Chernaya
Radiology Department, N.N. Petrov National Medical Research Center of Oncology, Leningradskaya, St. Petersburg, Russia

A B S T R A C T

Background: Dual-energy contrast-enhanced spectral mammography (CESM) is one of the latest methods for breast lesions characterization, where structural and functional (i.e., vascularization) assessment are combined. Nowadays an interpretation of contrast-enhanced images is based only on the degree of contrast enhancement, but we propose a more detailed assessment of the structure of the hypervascular lesions by highlighting the contrast enhancement patterns. Purpose: To evaluate the diagnostic performance of contrast-enhanced spectral mammography (CESM) using the contrast enhancement patterns in malignant and benign lesions. Material and Methods: Study included 332 women examined from February 2018 to June 2020. The mean age of the women was 50 years. Of 428 lesions totally revealed, 172 (40.2%) were histologically verified as malignant and 256 (59.8%) as benign. We proposed 9 types of contrast enhancement patterns to describe lesions: reticular, granular, annular, diffuse-spherical, lacunar, cloud-like, heterogeneous-annular, point, cotton-like. Results: We showed that diagnostic performance of CESM increased sensitivity if an additional diagnostic feature of contrast enhancement pattern was used: sensitivity increased from 79.7% to 94.8% (p = 0.26), specificity from 82.4% to 95.3% (p = 0.013) and accuracy from 81.3 to 95.1% (p = 0.004), in comparison with using of only one feature of contrast enhancement intensity in the differential diagnosis of malignant and benign lesions. Conclusion: Thus, using contrast enhancement pattern allows to increase the efficiency of CESM in breast cancer detection.

Article Info

Article Type

Research Article

Publication history

Received: Mon 04, Jan 2021
Accepted: Mon 18, Jan 2021
Published: Fri 29, Jan 2021

Copyright

© 2023 Antonina V. Chernaya. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.RDI.2021.01.01