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Dual energy contrast enhanced digital mammography: initial clinical results of a multireader, multicase study

Creators: Dromain, Clarisse, Thibault, Fabienne, Diekmann, Felix, Fallenberg, Eva M, Jong, Roberta A, Koomen, Marcia, Hendrick, R Edward, Tardivon, Anne, Toledano, Alicia

  • File Type: pdf | Filesize: 7.9 MB
  • Date Deposited: 2012-08-23
  • Date Created: 2012-06-14

Abstract Introduction The purpose of this study was to compare the diagnostic accuracy of dual-energy contrast-enhanced digital mammography (CEDM) as an adjunct to mammography (MX) &#177; ultrasonography (US) with the diagnostic accuracy of MX &#177; US alone. Methods One hundred ten consenting women with 148 breast lesions (84 malignant, 64 benign) underwent two-view dual-energy CEDM in addition to MX and US using a specially modified digital mammography system (Senographe DS, GE Healthcare). Reference standard was histology for 138 lesions and follow-up for 12 lesions. Six radiologists from 4 institutions interpreted the images using high-resolution softcopy workstations. Confidence of presence (5-point scale), probability of cancer (7-point scale), and BI-RADS scores were evaluated for each finding. Sensitivity, specificity and ROC curve areas were estimated for each reader and overall. Visibility of findings on MX &#177; CEDM and MX &#177; US was evaluated with a Likert scale. Results The average per-lesion sensitivity across all readers was significantly higher for MX &#177; US &#177; CEDM than for MX &#177; US (0.78 vs. 0.71 using BIRADS, p = 0.006). All readers improved their clinical performance and the average area under the ROC curve was significantly superior for MX &#177; US &#177; CEDM than for MX &#177; US ((0.87 vs 0.83, p = 0.045). Finding visibility was similar or better on MX &#177; CEDM than MX &#177; US in 80% of cases. Conclusions Dual-energy contrast-enhanced digital mammography as an adjunct to MX &#177; US improves diagnostic accuracy compared to MX &#177; US alone. Addition of iodinated contrast agent to MX facilitates the visualization of breast lesions.