TY - JOUR
AR - RDI-2021-1-101
TI - Differential Diagnosis of Breast Lesions in Dual-Energy Contrast-Enhanced Spectral Mammography
AU - Antonina, V. Chernaya
AU - Roksana , H. Ulyanova
AU -  Petr , V. Krivorotko
AU - Sergey , N. Novikov
AU - Sergey , V. Kanaev
AU -  Anna , S. Artemieva
AU - Lev , N. Shevkunov
AU - Stanislav , A. Tyatkov
AU - Vsevolod , V. Danilov
JO - Radiology and Medical Diagnostic Imaging
PY - 2021
DA - Fri 29, Jan 2021
SN - 2613-7836
DO - http://dx.doi.org/10.31487/j.RDI.2021.01.01
UR - https://www.sciencerepository.org/differential-diagnosis-of-breast-lesions-in-dual-energy-contrast-enhanced_RDI-2021-1-101 
KW - Breast cancer, dual-energy contrast-enhanced spectral, mammography, digital mammography, contrast enhancement patterns, benign breast lesions
AB - 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.