title: Contrast-enhanced spectral mammography (CESM) and contrast enhanced MRI (CEMRI): Patient preferences and tolerance.
abstract: BACKGROUND
  Contrast-enhanced spectral mammography (CESM) may have similar diagnostic performance to Contrast-enhanced MRI (CEMRI) in the diagnosis and staging of breast cancer. To date, research has focused exclusively on diagnostic performance when comparing these two techniques. Patient experience is also an important factor when comparing and deciding on which of these modalities is preferable. The aim of this study is to compare patient experience of CESM against CEMRI during preoperative breast cancer staging.
  
  
  METHODS
  Forty-nine participants who underwent both CESM and CEMRI, as part of a larger trial, completed a Likert questionnaire about their preference for each modality according to the following criteria: comfort of breast compression, comfort of intravenous (IV) contrast injection, anxiety and overall preference. Participants also reported reasons for preferring one modality to the other. Quantitative data were analysed using a Wilcoxon sign-rank test and chi-squared test. Qualitative data are reported descriptively.
  
  
  RESULTS
  A significantly higher overall preference towards CESM was demonstrated (n = 49, P < 0.001), with faster procedure time, greater comfort and lower noise level cited as the commonest reasons. Participants also reported significantly lower rates of anxiety during CESM compared with CEMRI (n = 36, P = 0.009). A significantly higher rate of comfort was reported during CEMRI for measures of breast compression (n = 49, P = 0.001) and the sensation of IV contrast injection (n = 49, P = 0.003).
  
  
  CONCLUSIONS
  Our data suggest that overall, patients prefer the experience of CESM to CEMRI, adding support for the role of CESM as a possible alternative to CEMRI for breast cancer staging.
authors.affiliation: Royal Perth Hospital Breast Clinic, Royal Perth Hospital, Perth, Western Australia, Australia.
authors.forename: Max M
authors.initials: MM
authors.lastname: Hobbs
authors.affiliation: Royal Perth Hospital Breast Clinic, Royal Perth Hospital, Perth, Western Australia, Australia.|School of Surgery, The University of Western Australia, Crawley, Western Australia, Australia.
authors.forename: Donna B
authors.initials: DB
authors.lastname: Taylor
authors.affiliation: Royal Perth Hospital Breast Clinic, Royal Perth Hospital, Perth, Western Australia, Australia.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Buzynski
authors.affiliation: School of Surgery, The University of Western Australia, Crawley, Western Australia, Australia.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Peake
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000523:psychology; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000009:adverse effects* / Q000379:methods / Q000523:psychology; D008327:Mammography / Q000009:adverse effects* / Q000379:methods / Q000523:psychology; D008875:Middle Aged; D057240:Patient Preference; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media
keywords: CESM; MRI; breast; cancer; preference