CEM immediately after contrast-enhanced CT: a one-step staging of breast cancer.
Breast neoplasms
Contrast media
Mammography (contrast-enhanced)
Neoplasms staging
Tomography (x-ray computed)
Journal
European radiology experimental
ISSN: 2509-9280
Titre abrégé: Eur Radiol Exp
Pays: England
ID NLM: 101721752
Informations de publication
Date de publication:
01 Apr 2024
01 Apr 2024
Historique:
received:
17
08
2023
accepted:
17
01
2024
medline:
1
4
2024
pubmed:
1
4
2024
entrez:
31
3
2024
Statut:
epublish
Résumé
Contrast-enhanced mammography (CEM) is a promising technique. We evaluated the diagnostic potential of CEM performed immediately after contrast-enhanced computed tomography (CE-CT). Fifty patients with breast cancer underwent first CE-CT and then CEM without additional contrast material injection. Two independent radiologists evaluated CEM images. The sensitivity of CEM for detecting index and additional malignant lesions was compared with that of mammography/ultrasonography by the McNemar test, using histopathology as a reference standard. Interobserver agreement for detection of malignant lesions, for classifying index tumors, and for evaluating index tumor size and extent was assessed using Cohen κ. Pearson correlation was used for correlating index tumor size/extent at CEM or mammography/ultrasonography with histopathology. Of the 50 patients, 30 (60%) had unifocal disease while 20 (40%) had multicentric or multifocal disease; 5 of 20 patients with multicentric disease (25%) had bilateral involvement, for a total of 78 malignant lesions, including 72 (92%) invasive ductal and 6 (8%) invasive lobular carcinomas. Sensitivity was 63/78 (81%, 95% confidence interval 70.27-88.82) for unenhanced breast imaging and 78/78 (100%, 95.38-100) for CEM (p < 0.001). The interobserver agreement for overall detection of malignant lesions, for classifying index tumor, and for evaluating index tumor size/extent were 0.94, 0.95, and 0.86 κ, respectively. For index tumor size/extent, correlation coefficients as compared with histological specimens were 0.50 for mammography/ultrasonography and 0.75 for CEM (p ≤ 0.010). CEM acquired immediately after CE-CT without injection of additional contrast material showed a good performance for local staging of breast cancer. When the CEM suite is near to the CE-CT acquisition room, CEM acquired immediately after, without injection of additional contrast material, could represent a way for local staging of breast cancer to be explored in larger prospective studies. • CEM represents a new accurate tool in the field of breast imaging. • An intravenous injection of iodine-based contrast material is required for breast gland evaluation. • CEM after CE-CT could provide a one-stop tool for breast cancer staging.
Sections du résumé
BACKGROUND
BACKGROUND
Contrast-enhanced mammography (CEM) is a promising technique. We evaluated the diagnostic potential of CEM performed immediately after contrast-enhanced computed tomography (CE-CT).
METHODS
METHODS
Fifty patients with breast cancer underwent first CE-CT and then CEM without additional contrast material injection. Two independent radiologists evaluated CEM images. The sensitivity of CEM for detecting index and additional malignant lesions was compared with that of mammography/ultrasonography by the McNemar test, using histopathology as a reference standard. Interobserver agreement for detection of malignant lesions, for classifying index tumors, and for evaluating index tumor size and extent was assessed using Cohen κ. Pearson correlation was used for correlating index tumor size/extent at CEM or mammography/ultrasonography with histopathology.
RESULTS
RESULTS
Of the 50 patients, 30 (60%) had unifocal disease while 20 (40%) had multicentric or multifocal disease; 5 of 20 patients with multicentric disease (25%) had bilateral involvement, for a total of 78 malignant lesions, including 72 (92%) invasive ductal and 6 (8%) invasive lobular carcinomas. Sensitivity was 63/78 (81%, 95% confidence interval 70.27-88.82) for unenhanced breast imaging and 78/78 (100%, 95.38-100) for CEM (p < 0.001). The interobserver agreement for overall detection of malignant lesions, for classifying index tumor, and for evaluating index tumor size/extent were 0.94, 0.95, and 0.86 κ, respectively. For index tumor size/extent, correlation coefficients as compared with histological specimens were 0.50 for mammography/ultrasonography and 0.75 for CEM (p ≤ 0.010).
CONCLUSIONS
CONCLUSIONS
CEM acquired immediately after CE-CT without injection of additional contrast material showed a good performance for local staging of breast cancer.
RELEVANCE STATEMENT
CONCLUSIONS
When the CEM suite is near to the CE-CT acquisition room, CEM acquired immediately after, without injection of additional contrast material, could represent a way for local staging of breast cancer to be explored in larger prospective studies.
KEY POINTS
CONCLUSIONS
• CEM represents a new accurate tool in the field of breast imaging. • An intravenous injection of iodine-based contrast material is required for breast gland evaluation. • CEM after CE-CT could provide a one-stop tool for breast cancer staging.
Identifiants
pubmed: 38556593
doi: 10.1186/s41747-024-00440-6
pii: 10.1186/s41747-024-00440-6
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
32Informations de copyright
© 2024. The Author(s).
Références
Jochelson MS, Lobbes MB (2021) Contrast-enhanced mammography: state of the art. Radiology 299:36–48. https://doi.org/10.1148/radiol.2021201948
doi: 10.1148/radiol.2021201948
pubmed: 33650905
Fallenberg EM, Dromain C, Diekmann F et al (2014) Contrast-enhanced spectral mammography versus MRI: initial results in the detection of breast cancer and assessment of tumour size. Eur Radiol 24:256–264. https://doi.org/10.1007/s00330-013-3007-7
doi: 10.1007/s00330-013-3007-7
pubmed: 24048724
Francescone MA, Jochelson MS, Dershaw DD et al (2014) Low energy mammogram obtained in contrast-enhanced digital mammography (CEDM) is comparable to routine full-field digital mammography (FFDM). Eur J Radiol 83:1350–1355. https://doi.org/10.1016/j.ejrad.2014.05.015
doi: 10.1016/j.ejrad.2014.05.015
pubmed: 24932846
Lu Z, Hao C, Pan Y, Mao N et al (2020) Contrast-enhanced spectral mammography versus ultrasonography: diagnostic performance in symptomatic patients with dense breasts. Korean J Radiol 21:442–449. https://doi.org/10.3348/kjr.2019.0393
doi: 10.3348/kjr.2019.0393
pubmed: 32193892
pmcid: 7082654
Jochelson MS, Dershaw DD, Sung JS et al (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 266:743–751. https://doi.org/10.1148/radiol.12121084
doi: 10.1148/radiol.12121084
pubmed: 23220903
Cozzi A, Magni V, Zanardo M et al (2022) Contrast-enhanced mammography: a systematic review and meta-analysis of diagnostic performance. Radiology 302:568–581. https://doi.org/10.1148/radiol.211412
doi: 10.1148/radiol.211412
pubmed: 34904875
Kim EY, Youn I, Lee KH et al (2018) Diagnostic value of contrast-enhanced digital mammography versus contrast-enhanced magnetic resonance imaging for the preoperative evaluation of breast cancer. J Breast Cancer 21:453–462. https://doi.org/10.4048/jbc.2018.21.e62
doi: 10.4048/jbc.2018.21.e62
pubmed: 30607168
pmcid: 6310721
Lobbes MB, Prevos R, Smidt M et al (2013) The role of magnetic resonance imaging in assessing residual disease and pathologic complete response in breast cancer patients receiving neoadjuvant chemotherapy: a systematic review. Insights Imaging 4:163–175. https://doi.org/10.1007/s13244-013-0219-y
doi: 10.1007/s13244-013-0219-y
pubmed: 23359240
pmcid: 3609956
Iotti V, Ravaioli S, Vacondio R et al (2017) Contrast-enhanced spectral mammography in neoadjuvant chemotherapy monitoring: a comparison with breast magnetic resonance imaging. Breast Cancer Res 19:106. https://doi.org/10.1186/s13058-017-0899-1
doi: 10.1186/s13058-017-0899-1
pubmed: 28893303
pmcid: 5594558
Zanardo M, Cozzi A, Trimboli RM et al (2019) Technique, protocols and adverse reactions for contrast-enhanced spectral mammography (CESM): a systematic review. Insights Imaging 10:76. https://doi.org/10.1186/s13244-019-0756-0
doi: 10.1186/s13244-019-0756-0
pubmed: 31376021
pmcid: 6677840
Marino MA, Pinker K, Leithner D et al (2020) Contrast-enhanced mammography and radiomics analysis for noninvasive breast cancer characterization: initial results. Mol Imaging Biol 22:780–787. https://doi.org/10.1007/s11307-019-01423-5
doi: 10.1007/s11307-019-01423-5
pubmed: 31463822
pmcid: 7047570
D’Orsi CJ, Sickles EA, Mendelson EB, Morris EA (2013) ACR BI-RADS atlas, breast imaging reporting and data system. American College of Radiology, Reston
Okada N, Tatsugami F, Sugai M et al (2019) The feasibility of contrast-enhanced spectral mammography immediately after contrast-enhanced CT. Radiol Phys Technol 12:277–282. https://doi.org/10.1007/s12194-019-00518-6
doi: 10.1007/s12194-019-00518-6
pubmed: 31165975
Lee C, Phillips J, Sung J, Lewin J, Newell M (2022) Breast Imaging Reporting and Data System: ACR BI-RADS breast imaging atlas. Contrast enhanced mammography (CEM) (a supplement to ACR BI-RADS® Mammography 2013), 5th edn. American College of Radiology, Reston
Mann RM, Loo CE, Wobbes T et al (2010) The impact of preoperative breast MRI on the re-excision rate in invasive lobular carcinoma of the breast. Breast Cancer Res Treat 119:415–422. https://doi.org/10.1007/s10549-009-0616-6
doi: 10.1007/s10549-009-0616-6
pubmed: 19885731
Houssami N, Turner R, Morrow M (2013) Preoperative magnetic resonance imaging in breast cancer: meta-analysis of surgical outcomes. Ann Surg 257:249–255. https://doi.org/10.1097/SLA.0b013e31827a8d17
doi: 10.1097/SLA.0b013e31827a8d17
pubmed: 23187751
Ryu J, Park HS, Kim S et al (2016) Preoperative magnetic resonance imaging and survival outcomes in T1–2 breast cancer patients who receive breast-conserving therapy. J Breast Cancer 19:423–428. https://doi.org/10.4048/jbc.2016.19.4.423
doi: 10.4048/jbc.2016.19.4.423
pubmed: 28053631
pmcid: 5204049
Pediconi F, Catalano C, Roselli A et al (2007) Contrast-enhanced MR mammography for evaluation of the contralateral breast in patients with diagnosed unilateral breast cancer or high-risk lesions. Radiology 243:670–680. https://doi.org/10.1148/radiol.2433060838
doi: 10.1148/radiol.2433060838
pubmed: 17446524
Cheung YC, Juan YH, Lo YF et al (2020) Preoperative assessment of contrast-enhanced spectral mammography of diagnosed breast cancers after sonographic biopsy: correlation to contrast-enhanced magnetic resonance imaging and 5-year postoperative follow-up. Medicine (Baltimore) 99(5):e19024. https://doi.org/10.1097/MD.0000000000019024
doi: 10.1097/MD.0000000000019024
pubmed: 32000448
Taylor DB, Burrows S, Saunders CM et al (2023) Contrast-enhanced mammography (CEM) versus MRI for breast cancer staging: detection of additional malignant lesions not seen on conventional imaging. Eur Radiol Exp 7:8. https://doi.org/10.1186/s41747-022-00318-5
doi: 10.1186/s41747-022-00318-5
pubmed: 36781808
pmcid: 9925630