ABSTRACT
Contrast-enhanced mammography (CEM) has shown to be superior to full-field digital mammography (FFDM), but current results are dominated by studies performed on systems by one vendor. Information on diagnostic accuracy of other CEM systems is limited. Therefore, we aimed to evaluate the diagnostic performance of CEM on an alternative vendor's system. We included all patients who underwent CEM in one hospital in 2019, except those with missing data or in whom CEM was used as response monitoring tool. Three experienced breast radiologists scored the low-energy images using the BI-RADS classification. Next, the complete CEM exams were scored similarly. Histopathological results or a minimum of one year follow-up were used as reference standard. Diagnostic performance and AUC were calculated and compared between low-energy images and the complete CEM examination, for all readers independently as well as combined. Breast cancer was diagnosed in 23.0% of the patients (35/152). Compared to low-energy images, overall CEM sensitivity increased from 74.3 to 87.6% (p < 0.0001), specificity from 87.8 to 94.6% (p = 0.0146). AUC increased from 0.872 to 0.957 (p = 0.0001). Performing CEM on the system tested, showed that, similar to earlier studies mainly performed on another vendor's systems, both sensitivity and specificity improved when compared to FFDM.
Subject(s)
Breast Neoplasms/diagnosis , Breast/diagnostic imaging , Breast/pathology , Mammography/methods , Adult , Aged , Aged, 80 and over , Biomarkers, Tumor , Breast Neoplasms/epidemiology , Breast Neoplasms/etiology , Clinical Decision-Making , Contrast Media , Disease Management , Female , Humans , Magnetic Resonance Imaging , Mammography/standards , Mass Screening , Middle Aged , ROC Curve , Radiographic Image Enhancement , Reproducibility of Results , Sensitivity and Specificity , Tomography, X-Ray ComputedABSTRACT
At the so-called in-bore, MRI-guided prostate biopsy, the radiologist in the MRI suite manually directs a rectal biopsy needle guide at an abnormality confirmed by a previous prostate MRI. This manual technique of taking a biopsy is time-consuming and thus rather expensive, as the patient has to be moved in and out of the MRI several times. Since 2015, a remote-controlled manipulator robot (RCM) has been available. Using this apparatus the radiologist is able to position the needle guide remotely. This technique is simple to learn and less time-consuming than the in-bore biopsy without the RCM. In this article we discuss the findings from the first 201 patients in the Netherlands from whom robot-guided prostate biopsies have been taken.
