Institute for Diagnostic and Interventional Radiology, University Medical Center Göttingen, Robert-Koch-Street 40, 37075, Göttingen, Germany.
Diagnostic Breast Center Göttingen, Bahnhofsallee 1d, Göttingen, Germany.
Eur Radiol. 2018 Sep;28(9):3731-3741. doi: 10.1007/s00330-018-5376-4. Epub 2018 Mar 28.
To evaluate the diagnostic accuracy of contrast-enhanced (CE) cone-beam breast computed tomography (CBBCT) in dense breast tissue and compare it to non-contrast (NC) CBBCT, mammography (MG) and magnetic resonance imaging (MRI).
This prospective institutional review board-approved study included 41 women (52 breasts) with American College of Radiology (ACR) density types c or d and Breast Imaging Reporting and Data System (BI-RADS) 4 or 5 assessments in MG or ultrasound (US). Imaging modalities were independently evaluated by two blinded readers.
A total of 100 lesions (51 malignant, 6 high-risk, and 43 benign) were identified. For readers 1/2, respectively, and p values comparing CE-CBBCT to other modalities: diagnostic accuracy (AUC) for CE-CBBCT was 0.83/0.77, for MRI 0.88/0.89 (p = 0.2272/0.002), for NC-CBBCT 0.73/0.66 (p = 0.038/ 0.0186) and for MG 0.69/0.64 (p = 0.081/0.0207). CE-CBBCT sensitivity (0.88/0.78) was 37-39% higher in comparison to MG (0.49/0.41, p < 0.001 both) but inferior to MRI (0.98/0.96, p = 0.0253/0.0027). CE-CBBCT specificity (0.71/0.71) was numerically higher compared to MRI (0.61/0.69, p = 0.0956/0.7389).
CBBCT diagnostic performance varied with the respective reader and experience. CE-CBBCT improved AUC and sensitivity in comparison to MG and NC-CBBCT, and was comparable to MRI in dense breast tissue. In tendency, specificity was higher for CE-CBBCT than MRI.
• CE-CBBCT diagnostic accuracy (AUC) was comparable to MRI in dense breasts. • CE-CBBCT improved sensitivity and AUC in comparison to MG and NC-CBBCT. • CE-CBBCT has inferior sensitivity but higher specificity than MRI. • CE-CBBCT is a potential imaging alternative for patients with MRI contraindications.
评估对比增强（CE）锥形束乳腺计算机断层扫描（CBBCT）在致密乳腺组织中的诊断准确性，并与非对比（NC）CBBCT、乳房 X 线摄影术（MG）和磁共振成像（MRI）进行比较。
这项前瞻性机构审查委员会批准的研究纳入了 41 名美国放射学院（ACR）密度类型 C 或 D 且 MG 或超声（US）中 BI-RADS 4 或 5 评估为 4 或 5 的女性（52 只乳房）。两位盲法读者分别独立评估成像方式。
共发现 100 个病灶（51 个恶性，6 个高危，43 个良性）。对于读者 1/2，以及比较 CE-CBBCT 与其他方式的诊断准确性（AUC）：CE-CBBCT 的 AUC 分别为 0.83/0.77，MRI 为 0.88/0.89（p=0.2272/0.002），NC-CBBCT 为 0.73/0.66（p=0.038/0.0186），MG 为 0.69/0.64（p=0.081/0.0207）。与 MG（0.49/0.41，p<0.001）相比，CE-CBBCT 的敏感性（0.88/0.78）分别提高了 37-39%，但低于 MRI（0.98/0.96，p=0.0253/0.0027）。CE-CBBCT 的特异性（0.71/0.71）在数值上高于 MRI（0.61/0.69，p=0.0956/0.7389）。
CBBCT 的诊断性能因各自的读者和经验而异。与 MG 和 NC-CBBCT 相比，CE-CBBCT 提高了 AUC 和敏感性，与 MRI 相比，在致密乳腺组织中具有可比性。在趋势上，CE-CBBCT 的特异性高于 MRI。
在致密乳腺中，CE-CBBCT 的诊断准确性（AUC）与 MRI 相当。
与 MG 和 NC-CBBCT 相比，CE-CBBCT 提高了敏感性和 AUC。
CE-CBBCT 的敏感性低于 MRI，但特异性高于 MRI。
CE-CBBCT 是 MRI 禁忌患者的一种潜在影像学替代方法。
