title: Comparison between breast MRI and contrast-enhanced spectral mammography.
abstract: BACKGROUND
  The main goal of this study was to compare contrast-enhanced spectral mammography (CESM) and breast magnetic resonance imaging (MRI) with histopathological results and to compare the sensitivity, accuracy, and positive and negative predictive values for both imaging modalities.
  
  
  METHODS
  After ethics approval, CESM and MRI examinations were performed in 102 patients who had suspicious lesions described in conventional mammography. All visible lesions were evaluated independently by 2 experienced radiologists using BI-RADS classifications (scale 1-5). Dimensions of lesions measured with each modality were compared to postoperative histopathology results.
  
  
  RESULTS
  There were 102 patients entered into CESM/MRI studies and 118 lesions were identified by the combination of CESM and breast MRI. Histopathology confirmed that 81 of 118 lesions were malignant and 37 were benign. Of the 81 malignant lesions, 72 were invasive cancers and 9 were in situ cancers. Sensitivity was 100% with CESM and 93% with breast MRI. Accuracy was 79% with CESM and 73% with breast MRI. ROC curve areas based on BI-RADS were 0.83 for CESM and 0.84 for breast MRI. Lesion size estimates on CESM and breast MRI were similar, both slightly larger than those from histopathology.
  
  
  CONCLUSIONS
  Our results indicate that CESM has the potential to be a valuable diagnostic method that enables accurate detection of malignant breast lesions, has high negative predictive value, and a false-positive rate similar to that of breast MRI.
authors.affiliation: Department of Radiology, Cancer Centre and Institute of Oncology, Cracow, Poland.
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Łuczyńska
authors.affiliation: Department of Radiology, Cancer Centre and Institute of Oncology, Cracow, Poland.
authors.forename: Sylwia
authors.initials: S
authors.lastname: Heinze-Paluchowska
authors.affiliation: Department of Radiology, University of Colorado - Denver, School of Medicine, Aurora, CO, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Hendrick
authors.affiliation: Department of Radiology, Cancer Centre and Institute of Oncology, Cracow, Poland.
authors.forename: Sonia
authors.initials: S
authors.lastname: Dyczek
authors.affiliation: Department of Pathology, Cancer Centre and Institute of Oncology, Cracow, Poland.
authors.forename: Janusz
authors.initials: J
authors.lastname: Ryś
authors.affiliation: Department of Surgical Oncology, Cancer Centre and Institute of Oncology, Cracow, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Herman
authors.affiliation: Department of Oncological Gyneacology, Cancer Centre and Institute of Oncology, Cracow, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Blecharz
authors.affiliation: Department of Radioteraphy, Cancer Centre and Institute of Oncology, Cracow, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Jakubowicz
mesh_terms: D001941:Breast Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D018275:Carcinoma, Lobular / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D003287:Contrast Media; D003937:Diagnosis, Differential; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D018226:Fibroadenoma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D008279:Magnetic Resonance Imaging; D008327:Mammography / Q000379:methods*; D011237:Predictive Value of Tests; D012372:ROC Curve; D011829:Radiation Dosage; D012680:Sensitivity and Specificity; D047368:Tumor Burden
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide