Diagnostic performance of contrast-enhanced spectral mammography for breast imaging reporting and data system 4 calcifications / 中国医学影像技术

ABSTRACT

Objective To assess the diagnostic performance of contrast-enhanced spectral mammography (CESM) for breast imaging reporting and data system (BI-RADS) 4 calcifications comparing with full-field digital mammography (FFDM). Methods Patients with mammographic calcifications without associated mass or distortions, which were originally reported as BI-RADS 4 were enrolled, and the lesions were divided into FFDM group (n=48) or CESM group (n=31) according to the examination they received. The diagnosis of benign or malignant calcifications was made based on distribution and morphology on FFDM and the presence of enhancement on CESM. Taking pathology results as golden standards, the diagnostic efficacy was assessed and compared between FFDM and CESM. Results The diagnostic sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were 69.23% (9/13), 77.14% (27/35), 52.94% (9/17), 87.10% (27/31) and 75.00%(36/48) for FFDM group, and 90.00% (9/10), 95.24% (20/21), 90.00% (9/10), 95.24% (20/21) and 93.55% (29/31) for CESM group, respectively. PPV and accuracy of CESM were significantly higher than those of FFDM (χ2=3.891, 4.444, P=0.049, 0.035). Conclusion Compared with FFDM, CESM can improve diagnostic performance on BI-RADS 4 mammographic calcifications.