Cancer Conspicuity on Low-energy Images of Contrast-enhanced Mammography Compared With 2D Mammography
Authors
Konstantopoulos, ChristinaMehta, Tejas S
Brook, Alexander
Dialani, Vandana
Mehta, Rashmi
Fein-Zachary, Valerie
Phillips, Jordana
UMass Chan Affiliations
RadiologyDocument Type
Journal ArticlePublication Date
2022-01-01
Metadata
Show full item recordAbstract
Objective Low-energy (LE) images of contrast-enhanced mammography (CEM) have been shown to be noninferior to digital mammography. However, our experience is that LE images are superior to 2D mammography. Our purpose was to compare cancer appearance on LE to 2D images. Methods In this IRB-approved retrospective study, seven breast radiologists evaluated 40 biopsy-proven cancer cases on craniocaudal (CC) and mediolateral oblique (MLO) LE images and recent 2D images for cancer visibility, confidence in margins, and conspicuity of findings using a Likert scale. Objective measurements were performed using contrast-to-noise ratio (CNR) estimated from regions of interest placed on tumor and background parenchyma. Reader agreement was evaluated using Fleiss kappa. Per-reader comparisons were performed using Wilcoxon test and overall comparisons used three-way analysis of variance. Results Low-energy images showed improved performance for visibility (CC LE 4.0 vs 2D 3.5, P < 0.001 and MLO LE 3.7 vs 2D 3.5, P = 0.01), confidence in margins (CC LE 3.2 vs 2D 2.8, P < 0.001 and MLO LE 3.1 vs 2D 2.9, P < 0.008), and conspicuity compared to tissue density compared to 2D mammography (CC LE 3.6 vs 2D 3.2, P < 0.001 and MLO LE 3.5 vs 2D 3.2, P < 0.001). The average CNR was significantly higher for LE than for digital mammography (CC 2.1 vs 3.2, P < 0.001 and MLO 2.1 vs 3.4, P < 0.001). Conclusion Our results suggest that cancers may be better visualized on the LE CEM images compared with the 2D digital mammogram.Source
Konstantopoulos C, Mehta TS, Brook A, et al. Cancer Conspicuity on Low-energy Images of Contrast-enhanced Mammography Compared With 2D Mammography. Journal of Breast Imaging. 2021;4(1):31-38. doi:10.1093/jbi/wbab085DOI
10.1093/jbi/wbab085Permanent Link to this Item
http://hdl.handle.net/20.500.14038/51587ae974a485f413a2113503eed53cd6c53
10.1093/jbi/wbab085