Quantitative Assessment of Iodine Intensity of Different Types of Lesions in the Low-Energy (LE) Images of Contrast-Enhanced Spectral Mammography (CESM)

Review Data

Q: Is the topic relevant to the journal area of interest? Is it contemporary and interesting for

researchers?

A: Very good

Abstract & Keywords

Q: Are all required components included in the abstract? Are the keywords appropriately chosen?

A: Excellent

Goal

Q: Is the goal explicitly stated in the Introduction? Is its formulation clear and unambiguous?

A: Very good

Structure

Q: Is the paper's structure coherent? Is it in coherence with the goal of the paper?

A: Very good

Tools and Methods

Q: Are methods the author uses adequate and well used?

A: Good

Discussion & Conclusion

Q: Is it related to the results presented before? Do you consider them as coherent?

A: Very good

Comments:

The present study quantitatively assessed the intensity of iodine in lesions with different tissue compositions in order to determine the enhancement variation according to iodine concentration in different types of lesions. The Discussion puts forth the rationale for taking up the study, effectively describes the relevant literature and enlists the implications of the findings from the present study in that context. Contrast-enhanced spectral mammography (CESM) is a superior imaging tool to non-contrast conventional mammography in the detection of breast lesions. The study finally Concludes that contrast enhancement intensity on low-energy (LE) images has relevance to the tissue composition of the lesion and it is good at identifying different lesions without performing additional full field digital mammography (FFDM) examination prior to the CESM procedure.

Literature

Q: Does the author utilize relevant literature?

A: Very good

Author's knowledge

Q: What is the level of author’s knowledge? Does the author utilize all recent contributions relevant to the topic?

A: Very good

Length

Q: Is the length of the paper adequate to the significance of the topic? Do you suggest shortening the paper without losing its value?

A: Good

Figures & Tables

Q: Does the author use them suitably? Are legend and notations clear?

A: Very good

Writing style

Q: Is it clear and understandable?

A: Very good

Further comments on the paper

Comments: The present study aims to compare the degree of intensity according to different lesion types with different iodine concentrations in low-energy (LE) images and to establish the lesion type which can identify with high intensity in LE images. The study further found that iodine in the fatty tissue mass has the highest intensity than the glandular and fatty tissue + glandular tissue lesions. The study confirmed that a low concentration of iodine in lesions provides better visualization in LE images and that the contrast intensity of different lesions do not significantly change with the composition of the breast except at an iodine concentration of 1.0 mgI/cm3.

Q: Would you recommend this manuscript for further publication?

A: Yes - Suitable to be published

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