title: Contrast-enhanced spectral mammography: comparison with conventional mammography and histopathology in 152 women.
abstract: OBJECTIVE
  The goal of the study was to compare conventional mammography (MG) and contrast-enhanced spectral mammography (CESM) in preoperative women.
  
  
  METHODS
  The study was approved by the local Ethics Committee and all participants provided informed consent. The study included 152 consecutive patients with 173 breast lesions diagnosed on MG or CESM. All MG examinations and consults were conducted in one oncology centre. Non-ionic contrast agent, at a total dose of 1.5 mL/kg body weight, was injected intravenous. Subsequently, CESM exams were performed with a mammography device, allowing dual-energy acquisitions. The entire procedure was done within the oncology centre. Images from low and high energy exposures were processed together and the combination provided an "iodine" image which outlined contrast up-take in the breast.
  
  
  RESULTS
  MG detected 157 lesions in 150 patients, including 92 infiltrating cancers, 12 non-infiltrating cancers, and 53 benign lesions. CESM detected 149 lesions in 128 patients, including 101 infiltrating cancers, 13 non-infiltrating cancers, and 35 benign lesions. CESM sensitivity was 100% (vs. 91% for MG), specificity was 41% (vs. 15% for MG), area under the receiver operating characteristic curve was 0.86 (vs. 0.67 for MG), and accuracy was 80% (vs. 65% for MG) for the diagnosis of breast cancer. Both MG and CESM overestimated lesion sizes compared to histopathology (p < 0.001).
  
  
  CONCLUSIONS
  CESM may provide higher sensitivity for breast cancer detection and greater diagnostic accuracy than conventional mammography.
authors.affiliation: Department of Radiology, Centre of Oncology, Maria Sklodowska-Curie Memorial Institute, Krakow 31-115, Poland.
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Luczyńska
authors.affiliation: Department of Radiology, Centre of Oncology, Maria Sklodowska-Curie Memorial Institute, Krakow 31-115, Poland.
authors.forename: Sylwia
authors.initials: S
authors.lastname: Heinze-Paluchowska
authors.affiliation: Department of Radiology, Centre of Oncology, Maria Sklodowska-Curie Memorial Institute, Krakow 31-115, Poland.
authors.forename: Sonia
authors.initials: S
authors.lastname: Dyczek
authors.affiliation: Department of Gynecologic Oncology, Centre of Oncology, Maria Sklodowska-Curie Memorial Institute, Krakow 31-115, Poland.
authors.forename: Pawel
authors.initials: P
authors.lastname: Blecharz
authors.affiliation: Department of Tumour Pathology, Centre of Oncology, Maria Sklodowska-Curie Memorial Institute, Krakow 31-115, Poland.
authors.forename: Janusz
authors.initials: J
authors.lastname: Rys
authors.affiliation: Department of Radiotherapy, Centre of Oncology, Maria Sklodowska-Curie Memorial Institute, Krakow 31-115, Poland.
authors.forename: Marian
authors.initials: M
authors.lastname: Reinfuss
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology*; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008327:Mammography / Q000592:standards*; D008875:Middle Aged; D012372:ROC Curve; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media
keywords: Breast cancer; Contrast enhanced spectral mammography; Mammography