title: Comparison of Background Parenchymal Enhancement at Contrast-enhanced Spectral Mammography and Breast MR Imaging.
abstract: Purpose To assess the extent of background parenchymal enhancement (BPE) at contrast material-enhanced (CE) spectral mammography and breast magnetic resonance (MR) imaging, to evaluate interreader agreement in BPE assessment, and to examine the relationships between clinical factors and BPE. Materials and Methods This was a retrospective, institutional review board-approved, HIPAA-compliant study. Two hundred seventy-eight women from 25 to 76 years of age with increased breast cancer risk who underwent CE spectral mammography and MR imaging for screening or staging from 2010 through 2014 were included. Three readers independently rated BPE on CE spectral mammographic and MR images with the ordinal scale: minimal, mild, moderate, or marked. To assess pairwise agreement between BPE levels on CE spectral mammographic and MR images and among readers, weighted κ coefficients with quadratic weights were calculated. For overall agreement, mean κ values and bootstrapped 95% confidence intervals were calculated. The univariate and multivariate associations between BPE and clinical factors were examined by using generalized estimating equations separately for CE spectral mammography and MR imaging. Results Most women had minimal or mild BPE at both CE spectral mammography (68%-76%) and MR imaging (69%-76%). Between CE spectral mammography and MR imaging, the intrareader agreement ranged from moderate to substantial (κ = 0.55-0.67). Overall agreement on BPE levels between CE spectral mammography and MR imaging and among readers was substantial (κ = 0.66; 95% confidence interval: 0.61, 0.70). With both modalities, BPE demonstrated significant association with menopausal status, prior breast radiation therapy, hormonal treatment, breast density on CE spectral mammographic images, and amount of fibroglandular tissue on MR images (P < .001 for all). Conclusion There was substantial agreement between readers for BPE detected on CE spectral mammographic and MR images.©RSNA, 2016.
authors.affiliation: From the Departments of Radiology (J.S., J.B.K., D.D., M.S.J.), Breast Imaging (E.A.M.), and Epidemiology and Biostatistics (D.G., C.S.M.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065.
authors.forename: Julie
authors.identifier: http://orcid.org/0000-0002-0919-4943
authors.initials: J
authors.lastname: Sogani
authors.affiliation: From the Departments of Radiology (J.S., J.B.K., D.D., M.S.J.), Breast Imaging (E.A.M.), and Epidemiology and Biostatistics (D.G., C.S.M.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Morris
authors.affiliation: From the Departments of Radiology (J.S., J.B.K., D.D., M.S.J.), Breast Imaging (E.A.M.), and Epidemiology and Biostatistics (D.G., C.S.M.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065.
authors.forename: Jennifer B
authors.initials: JB
authors.lastname: Kaplan
authors.affiliation: From the Departments of Radiology (J.S., J.B.K., D.D., M.S.J.), Breast Imaging (E.A.M.), and Epidemiology and Biostatistics (D.G., C.S.M.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065.
authors.forename: Donna
authors.initials: D
authors.lastname: D'Alessio
authors.affiliation: From the Departments of Radiology (J.S., J.B.K., D.D., M.S.J.), Breast Imaging (E.A.M.), and Epidemiology and Biostatistics (D.G., C.S.M.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065.
authors.forename: Debra
authors.initials: D
authors.lastname: Goldman
authors.affiliation: From the Departments of Radiology (J.S., J.B.K., D.D., M.S.J.), Breast Imaging (E.A.M.), and Epidemiology and Biostatistics (D.G., C.S.M.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065.
authors.forename: Chaya S
authors.initials: CS
authors.lastname: Moskowitz
authors.affiliation: From the Departments of Radiology (J.S., J.B.K., D.D., M.S.J.), Breast Imaging (E.A.M.), and Epidemiology and Biostatistics (D.G., C.S.M.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065.
authors.forename: Maxine S
authors.initials: MS
authors.lastname: Jochelson
mesh_terms: D000328:Adult; D000368:Aged; D000071060:Breast Density; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007472:Iohexol; D008279:Magnetic Resonance Imaging; D008327:Mammography / Q000379:methods*; D008597:Menstrual Cycle; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D003287:Contrast Media; D007472:Iohexol