Huang Hailiang, Scaduto David A, Liu Chunling, Yang Jie, Zhu Chencan, Rinaldi Kim, Eisenberg Jason, Liu Jingxuan, Hoernig Mathias, Wicklein Julia, Vogt Sebastian, Mertelmeier Thomas, Fisher Paul R, Zhao Wei
Stony Brook Medicine, Department of Radiology, Stony Brook, New York, United States.
Stony Brook Medicine, Department of Family, Population and Preventive Medicine, Stony Brook, New York, United States.
J Med Imaging (Bellingham). 2019 Jul;6(3):031407. doi: 10.1117/1.JMI.6.3.031407. Epub 2019 Feb 13.
Contrast-enhanced digital mammography (CEDM) reveals neovasculature of breast lesions in a two-dimensional contrast enhancement map. Contrast-enhanced digital breast tomosynthesis (CEDBT) provides contrast enhancement in three dimensions, which may improve lesion characterization and localization. We aim to compare CEDM and CEDBT for lesion assessment. Women with breast imaging-reporting and data system 4 or 5 suspicious breast lesion(s) were recruited in our study and were imaged with CEDM and CEDBT in succession under one breast compression. Two radiologists assessed CEDM and CEDBT with both images displayed side-by-side and compared (1) contrast enhancement of lesions and (2) lesion margin using a five-point scale ranging from (CEDM much better) to (CEDBT much better). Biopsy identified 19 malignant lesions with contrast enhancement. Our results show that CEDBT provides better lesion margins than CEDM with limited reduction in contrast enhancement. CEDBT delivers less radiation dose compared to CEDM + DBT. Synthetic CEDM can be generated from CEDBT data and provides lesion contrast enhancement comparable to CEDM. CEDBT has potential for clinical applications, such as treatment response monitoring and guidance for biopsy.
对比增强数字乳腺钼靶摄影（CEDM）在二维对比增强图中显示乳腺病变的新生血管。对比增强数字乳腺断层合成摄影（CEDBT）提供三维对比增强，这可能会改善病变特征的描述和定位。我们旨在比较CEDM和CEDBT对病变的评估。本研究招募了乳腺影像报告和数据系统（BI-RADS）4类或5类可疑乳腺病变的女性，并在一次乳房压迫下依次进行CEDM和CEDBT成像。两位放射科医生对CEDM和CEDBT进行评估，两幅图像并排显示，并比较：（1）病变的对比增强情况；（2）使用从1（CEDM好得多）到5（CEDBT好得多）的五点量表评估病变边缘。活检确定了19个有对比增强的恶性病变。我们的结果表明，CEDBT提供了比CEDM更好的病变边缘，同时对比增强的降低有限。与CEDM + DBT相比，CEDBT的辐射剂量更低。可以从CEDBT数据生成合成CEDM，其提供的病变对比增强与CEDM相当。CEDBT具有临床应用潜力，如治疗反应监测和活检指导。
