The University Hospital in Krakow, Cracow, Poland.
Department of Radiology, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Cracow, Poland.
Anticancer Res. 2020 May;40(5):2925-2932. doi: 10.21873/anticanres.14270.
BACKGROUND/AIM: Contrast enhanced spectral mammography (CESM) is a novel method of breast cancer diagnosis. Benign lesions are enhanced after contrast injection on both CESM and breast magnetic resonance imaging (MRI). Kinetic curves on breast MRI facilitate differentiation between benign and malignant lesions, while on CESM there is no such possibility and we need to asses lesions based only on their level of enhancement and its patterns. The aim of this study was to compare two subjective assessments of enhancement level on CESM with numerical values measured using the region of interests (ROIs) and to categorize obtained enhancement level values.
Patients with suspicious findings on previously performed examinations were qualified for CESM. The qualitative assessment was based on the subjective classification of visible contrast enhancement as weak, medium or strong. The quantitative assessment was obtained by measurements of an average enhancement value and sigma value within the ellipsoidal shape ROI, inserted into the evaluated contrast enhancing lesion.
The study group included 151 patients with total of 195 lesions diagnosed. It was verified how the classification based on the threshold values of %RS (percentage signal difference between enhancing lesion and background) and SDNR (signal-difference-to-noise Ratio) corresponds to a subjective assessment.
Quantitative assessment of contrast enhancement on CESM is helpful in making decisions whether a lesion requires a biopsy. This can reduce the number of unnecessary biopsy procedures and reduce the cost of diagnostics.
背景/目的：对比增强光谱乳腺摄影术（CESM）是一种新的乳腺癌诊断方法。良性病变在 CESM 和乳腺磁共振成像（MRI）对比注射后增强。乳腺 MRI 的动力学曲线有助于区分良性和恶性病变，而 CESM 则没有这种可能性，我们只能根据病变的增强水平及其模式进行评估。本研究旨在比较 CESM 上两种增强水平的主观评估与使用感兴趣区（ROI）测量的数值，并对获得的增强水平值进行分类。
对先前检查中发现可疑表现的患者进行 CESM 检查。定性评估基于对可见对比增强的主观分类，分为弱、中、强。定量评估是通过在评估的对比增强病变中插入椭圆形 ROI 内的平均增强值和 sigma 值的测量来获得的。
该研究组包括 151 名患者，共诊断出 195 个病变。验证了基于 %RS（增强病变与背景之间的信号差异百分比）和 SDNR（信号差异与噪声比）阈值的分类与主观评估的对应关系。
CESM 上的对比增强定量评估有助于决定是否需要对病变进行活检。这可以减少不必要的活检程序数量，降低诊断成本。
