Contrast-enhanced spectral mammography versus MRI: Initial results in the detection of breast cancer and assessment of tumour size
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To compare mammography (MG), contrast-enhanced spectral mammography (CESM), and magnetic resonance imaging (MRI) in the detection and size estimation of histologically proven breast cancers using postoperative histology as the gold standard.
After ethical approval, 80 women with newly diagnosed breast cancer underwent MG, CESM, and MRI examinations. CESM was reviewed by an independent experienced radiologist, and the maximum dimension of suspicious lesions was measured. For MG and MRI, routine clinical reports of breast specialists, with judgment based on the BI-RADS lexicon, were used. Results of each imaging technique were correlated to define the index cancer. Fifty-nine cases could be compared to postoperative histology for size estimation.
Breast cancer was visible in 66/80 MG, 80/80 CESM, and 77/79 MRI examinations. Average lesion largest dimension was 27.31 mm (SD 22.18) in MG, 31.62 mm (SD 24.41) in CESM, and 27.72 mm (SD 21.51) in MRI versus 32.51 mm (SD 29.03) in postoperative histology. No significant difference was found between lesion size measurement on MRI and CESM compared with histopathology.
Our initial results show a better sensitivity of CESM and MRI in breast cancer detection than MG and a good correlation with postoperative histology in size assessment.
• Contrast-enhanced spectral mammography (CESM) is slowly being introduced into clinical practice.
• Access to breast MRI is limited by availability and lack of reimbursement.
• Initial results show a better sensitivity of CESM and MRI than conventional mammography.
• CESM showed a good correlation with postoperative histology in size assessment.
• Contrast-enhanced spectral mammography offers promise, seemingly providing information comparable to MRI.
- Kolb, TM, Lichy, J, Newhouse, JH (2002) Comparison of the performance of screening mammography, physical examination, and breast US and evaluation of factors that influence them: an analysis of 27,825 patient evaluations. Radiology 225: pp. 165-175 CrossRef
- Pisano, ED, Gatsonis, C, Hendrick, E (2005) Diagnostic performance of digital versus film mammography for breast-cancer screening. N Engl J Med 353: pp. 1773-1783 CrossRef
- Tabar, L, Vitak, B, Chen, TH (2011) Swedish two-county trial: impact of mammographic screening on breast cancer mortality during 3 decades. Radiology 260: pp. 658-663 CrossRef
- Allen, SA, Cunliffe, WJ, Gray, J (2001) Pre-operative estimation of primary breast cancer size: a comparison of clinical assessment, mammography and ultrasound. Breast 10: pp. 299-305 CrossRef
- Fasching, PA, Heusinger, K, Loehberg, CR (2006) Influence of mammographic density on the diagnostic accuracy of tumor size assessment and association with breast cancer tumor characteristics. Eur J Radiol 60: pp. 398-404 CrossRef
- Fischer, U, Kopka, L, Grabbe, E (1999) Breast carcinoma: effect of preoperative contrast-enhanced MR imaging on the therapeutic approach. Radiology 213: pp. 881-888 CrossRef
- Liberman, L, Morris, EA, Kim, CM (2003) MR imaging findings in the contralateral breast of women with recently diagnosed breast cancer. AJR Am J Roentgenol 180: pp. 333-341 CrossRef
- Hollingsworth, AB, Stough, RG, O'Dell, CA, Brekke, CE (2008) Breast magnetic resonance imaging for preoperative locoregional staging. Am J Surg 196: pp. 389-397 CrossRef
- Schell, AM, Rosenkranz, K, Lewis, PJ (2009) Role of breast MRI in the preoperative evaluation of patients with newly diagnosed breast cancer. AJR Am J Roentgenol 192: pp. 1438-1444 CrossRef
- Mann, RM, Loo, CE, Wobbes, T (2010) The impact of preoperative breast MRI on the re-excision rate in invasive lobular carcinoma of the breast. Breast Cancer Res Treat 119: pp. 415-422 CrossRef
- Mann, RM, Veltman, J, Barentsz, JO, Wobbes, T, Blickman, JG, Boetes, C (2008) The value of MRI compared to mammography in the assessment of tumour extent in invasive lobular carcinoma of the breast. Eur J Surg Oncol 34: pp. 135-142 CrossRef
- Mann, RM, Kuhl, CK, Kinkel, K, Boetes, C (2008) Breast MRI: guidelines from the European Society of Breast Imaging. Eur Radiol 18: pp. 1307-1318 CrossRef
- Dromain, C, Balleyguier, C, Muller, S (2006) Evaluation of tumor angiogenesis of breast carcinoma using contrast-enhanced digital mammography. AJR Am J Roentgenol 187: pp. W528-537 CrossRef
- Dromain, C, Thibault, F, Muller, S (2011) Dual-energy contrast-enhanced digital mammography: initial clinical results. Eur Radiol 21: pp. 565-574 CrossRef
- Dromain, C, Thibault, F, Diekmann, F (2012) Dual-energy contrast-enhanced digital mammography: initial clinical results of a multireader, multicase study. Breast Cancer Res 14: pp. R94 CrossRef
- Sardanelli, F, Boetes, C, Borisch, B (2010) Magnetic resonance imaging of the breast: recommendations from the EUSOMA working group. Eur J Cancer 46: pp. 1296-1316 CrossRef
- Diekmann, F, Freyer, M, Diekmann, S (2011) Evaluation of contrast-enhanced digital mammography. Eur J Radiol 78: pp. 112-121 CrossRef
- Jong, RA, Yaffe, MJ, Skarpathiotakis, M (2003) Contrast-enhanced digital mammography: initial clinical experience. Radiology 228: pp. 842-850 CrossRef
- Lewin, JM, Isaacs, PK, Vance, V, Larke, FJ (2003) Dual-energy contrast-enhanced digital subtraction mammography: feasibility. Radiology 229: pp. 261-268 CrossRef
- Diekmann, F, Diekmann, S, Jeunehomme, F, Muller, S, Hamm, B, Bick, U (2005) Digital mammography using iodine-based contrast media: initial clinical experience with dynamic contrast medium enhancement. Invest Radiol 40: pp. 397-404 CrossRef
- Jochelson, MS, Dershaw, DD, Sung, JS (2013) Bilateral contrast-enhanced dual-energy digital mammography: feasibility and comparison with conventional digital mammography and MR imaging in women with known breast carcinoma. Radiology 266: pp. 743-751 CrossRef
- Dromain, C, Balleyguier, C, Adler, G, Garbay, JR, Delaloge, S (2009) Contrast-enhanced digital mammography. Eur J Radiol 69: pp. 34-42 CrossRef
- Lee, AH, Dublin, EA, Bobrow, LG, Poulsom, R (1998) Invasive lobular and invasive ductal carcinoma of the breast show distinct patterns of vascular endothelial growth factor expression and angiogenesis. J Pathol 185: pp. 394-401 CrossRef
- Teifke, A, Hlawatsch, A, Beier, T (2002) Undetected malignancies of the breast: dynamic contrast-enhanced MR imaging at 1.0 T. Radiology 224: pp. 881-888 CrossRef
- Jansen, SA, Paunesku, T, Fan, X (2009) Ductal carcinoma in situ: X-ray fluorescence microscopy and dynamic contrast-enhanced MR imaging reveals gadolinium uptake within neoplastic mammary ducts in a murine model. Radiology 253: pp. 399-406 CrossRef
- Wiener, E, Woertler, K, Weirich, G, Rummeny, EJ, Settles, M (2007) Contrast enhanced cartilage imaging: comparison of ionic and non-ionic contrast agents. Eur J Radiol 63: pp. 110-119 CrossRef
- Singletary, SE (2002) Surgical margins in patients with early-stage breast cancer treated with breast conservation therapy. Am J Surg 184: pp. 383-393 CrossRef
- McGhan, LJ, Wasif, N, Gray, RJ (2010) Use of preoperative magnetic resonance imaging for invasive lobular cancer: good, better, but maybe not the best?. Ann Surg Oncol 17: pp. 255-262 CrossRef
- Wasif, N, Garreau, J, Terando, A, Kirsch, D, Mund, DF, Giuliano, AE (2009) MRI versus ultrasonography and mammography for preoperative assessment of breast cancer. Am Surg 75: pp. 970-975
- Mann, RM, Hoogeveen, YL, Blickman, JG, Boetes, C (2008) MRI compared to conventional diagnostic work-up in the detection and evaluation of invasive lobular carcinoma of the breast: a review of existing literature. Breast Cancer Res Treat 107: pp. 1-14 CrossRef
- Behjatnia, B, Sim, J, Bassett, LW, Moatamed, NA, Apple, SK (2010) Does size matter? Comparison study between MRI, gross, and microscopic tumor sizes in breast cancer in lumpectomy specimens. Int J Clin Exp Pathol 3: pp. 303-309
- Contrast-enhanced spectral mammography versus MRI: Initial results in the detection of breast cancer and assessment of tumour size
Volume 24, Issue 1 , pp 256-264
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- 1. Clinic of Radiology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
- 2. Department of Radiology, Institut Gustave Roussy, 39, rue Camille Desmoullins, 94805, Villejuif cedex, France
- 3. Department of Medical Imaging, St. Joseph-Stift Bremen, Schwachhauser Heerstraße 54, 28209, Bremen, Germany
- 4. Department of Radiology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
- 5. Institute of Pathology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
- 6. Breast Center, Department of Gynecology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany