对比增强乳腺摄影中真阳性和假阳性结果的特征。

Characterization of True and False Positive Findings on Contrast-Enhanced Mammography.

机构信息

Beth Israel Deaconess Medical Center - radiology dept., Pathology, Boston MA.

出版信息

Acad Radiol. 2022 Nov;29(11):1672-1681. doi: 10.1016/j.acra.2022.01.006. Epub 2022 Feb 18.

DOI:10.1016/j.acra.2022.01.006

PMID:35190261

Abstract

RATIONALE AND OBJECTIVES

The purpose of this paper is to characterize true and false positive findings on contrast-enhanced mammography (CEM) and correlate enhancement pattern and method of detection with pathology outcomes.

MATERIALS AND METHODS

This was an IRB-approved retrospective review of diagnostic CEM performed from December 2015 through December 2019 for which biopsy was recommended. Background parenchymal enhancement, tissue density, finding features, pathologic/clinical outcomes, and method of detection were captured. CEM includes low-energy images (LE), similar to standard 2D mammography, and recombined images (RI) that show enhancement. 'MG-detected' findings were identified on mammography or LE. 'RI-detected' findings were identified due to enhancement on RI. The positive predictive value (PPV2) was calculated on a per-case and a per-finding level. Comparisons were performed using Pearson chi-square and Fisher exact tests.

RESULTS

One hundred sixty CEM cases with 220 findings were evaluated with a case PPV2 of 58.1%. 32.3% (71/220) of lesions were RI-detected. The PPV2 of RI-detected enhancement was 40.8% with subanalysis revealing PPV2 of 22.2%, 32%, and 51.4% for foci, NME, and masses, respectively. The PPV2 of MG-detected enhancement was 73.5% with subanalysis revealing PPV2 of 50%, 54.1%, and 83.8% for foci, NME, and masses, respectively. There were 100 false positives findings, 42 of which were RI-detected.

CONCLUSION

PPV2 of diagnostic CEM is within the range of other diagnostic breast imaging exams. However false positives remain a challenge, especially for RI-detected findings. Additional efforts to improve specificity of RI-detected findings are worthwhile.

摘要

目的

本文旨在描述对比增强乳腺摄影（CEM）中的真阳性和假阳性发现，并将增强模式和检测方法与病理结果相关联。

材料和方法

这是一项经机构审查委员会批准的回顾性研究，对 2015 年 12 月至 2019 年 12 月期间因推荐活检而进行的诊断性 CEM 进行了回顾。记录了背景实质增强、组织密度、发现特征、病理/临床结果以及检测方法。CEM 包括低能图像（LE），类似于标准的 2D 乳腺摄影，以及重组图像（RI），可显示增强。在乳腺摄影或 LE 上识别出“MG 检测到”的发现。由于 RI 上的增强而识别出“RI 检测到”的发现。在病例和发现水平上计算了阳性预测值（PPV2）。使用 Pearson 卡方和 Fisher 精确检验进行比较。

结果

评估了 160 例 CEM 病例和 220 个发现，病例的 PPV2 为 58.1%。32.3%（71/220）的病变为 RI 检测到。RI 检测到的增强的 PPV2 为 40.8%，亚分析显示焦点、非肿块强化和肿块的 PPV2 分别为 22.2%、32%和 51.4%。MG 检测到的增强的 PPV2 为 73.5%，亚分析显示焦点、非肿块强化和肿块的 PPV2 分别为 50%、54.1%和 83.8%。有 100 个假阳性发现，其中 42 个为 RI 检测到。