Hasse Felix Christian, Giannakis Athanasios, Wehrse Eckhard, Stiller Wolfram, Wallwiener Markus, Kauczor Hans-Ulrich, Weber Tim F, Heil Jörg, Mokry Theresa
Diagnostic and Interventional Radiology (DIR), Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany.
Division of Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
Diagnostics (Basel). 2024 Jul 19;14(14):1560. doi: 10.3390/diagnostics14141560.
This study aimed to investigate the diagnostic performance of breast mass detection on monoenergetic image data at 40 keV (MonoE40) and on iodine maps (IM) compared with conventional image data (CI). In this prospective single-center case-control study, 50 breast cancer patients were examined using contrast-enhanced dual-layer spectral CT. For qualitative and quantitative comparison of MonoE40 and IM with CI image data, four blinded, independent readers assessed 300 randomized single slices (two slices for each imaging type per case) with or without cancerous lesions for the presence of a breast mass. Detection sensitivity and specificity were calculated and readers rated their subjective diagnostic certainty. For statistical analysis of sensitivity and specificity, a paired -test and ANOVA were used (significance level = 0.05). A total of 50 female patients (median age 51 years, range 28-83 years) participated. IM had the highest overall scores in sensitivity and specificity for breast cancer detection, with 0.97 ± 0.06 and 0.95 ± 0.07, respectively, compared with 0.90 ± 0.04 and 0.92 ± 0.06 in CI. MonoE40 yielded a sensitivity of 0.96 ± 0.02 and specificity of 0.94 ± 0.08. All differences in sensitivity and specificity between MonoE or IM and CI were statistically significant ( < 0.001). The superiority of IM sensitivity and specificity was most pronounced in patients with dense breasts. Spectral CT improved the detection of breast cancer with higher sensitivity and specificity compared to conventional image data in our study.
本研究旨在调查与传统图像数据（CI）相比，40keV单能图像数据（MonoE40）和碘图（IM）对乳腺肿块检测的诊断性能。在这项前瞻性单中心病例对照研究中，50例乳腺癌患者接受了对比增强双层光谱CT检查。为了对MonoE40和IM与CI图像数据进行定性和定量比较，四位不知情的独立阅片者评估了300张随机抽取的单层面图像（每个病例每种成像类型两张），观察有无癌性病变及乳腺肿块的存在情况。计算检测敏感性和特异性，并让阅片者对其主观诊断确定性进行评分。对于敏感性和特异性的统计分析，采用配对t检验和方差分析（显著性水平α = 0.05）。共有50名女性患者参与（中位年龄51岁，范围28 - 83岁）。IM在乳腺癌检测的敏感性和特异性方面总体得分最高，分别为0.97±0.06和0.95±0.07，而CI分别为0.90±0.04和0.92±0.06。MonoE40的敏感性为0.96±0.02，特异性为0.94±0.08。MonoE或IM与CI之间在敏感性和特异性上的所有差异均具有统计学意义（P < 0.001）。IM敏感性和特异性的优势在乳腺致密的患者中最为明显。在我们的研究中，与传统图像数据相比，光谱CT提高了乳腺癌检测的敏感性和特异性。
