Feasibility and performance of contrast-enhanced tomosynthesis compared to contrast-enhanced MRI
Author Block: P. Clauser1, N. Pötsch1, P. Kapetas1, M. Hörnig2, M. Weber1, R-I. Milos1, P. A. Baltzer1, T. H. Helbich1; 1Vienna/AT, 2Forchheim/DE
Purpose: The performance of contrast-enhanced mammography (CEM) is limited by the 2D image acquisition. We hypothesise that contrast-enhanced tomosynthesis (CE-DBT) could allow for improved lesion characterisation, truly comparable to contrast-enhanced magnetic resonance imaging (CE-MRI). The aim of our analysis was to compare the diagnostic performance of a CE-DBT prototype with CE-MRI.
Methods or Background: Women presenting with suspicious findings on mammography, DBT, or ultrasound were invited to participate in the study. Participants underwent CE-DBT of the breast with suspicious findings using a dedicated prototype. The suspicious findings were biopsied and only histologically verified lesions were included in the analysis. Four readers (R1 and R2 non-experienced; R3 and R4 experienced) evaluated the images, blinded to patients’ history, previous imaging, and histology. The readers evaluated CE-MRI and CE-DBT (including DBT and synthetic mammography) in separate sessions and gave a BI-RADS score for each finding. Sensitivity and specificity were calculated and compared.
Results or Findings: We included 84 patients (mean age 56 years, range 39-70) with 91 histologically verified breast lesions (27 benign, 64 malignant). Sensitivity was comparable between CE-DBT and CE-MRI for R3 (both 100%), while sensitivity was higher with CE-MRI than with CE-DBT for the other readers (CE-DBT raging from 89 to 94%, CE-MRI from 97 to 100%). Specificity was overall higher for experienced than for non-experienced readers. Specificity improved with CE-MRI for non-experienced readers, while no significant difference was detected between CE-DBT and CE-MRI for experienced readers.
Conclusion: Our study showed that CE-DBT has a good diagnostic performance for the characterisation of breast lesions, almost comparable to that of CE-MRI of the breast.
Limitations: This was a single centre, cancer enriched dataset.
Funding for this study: Funding for this study was received from Siemens Healthcare GmBH.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: The study was approved by the Ethics Committee and patients gave written informed consent.