ISSN: 1899-0967
Polish Journal of Radiology
Established by prof. Zygmunt Grudziński in 1926 Sun
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1/2021
vol. 86
 
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Breast radiology
abstract:
Original paper

The effectiveness of contrast-enhanced spectral mammography and magnetic resonance imaging in dense breasts

Wojciech Rudnicki
1
,
Tomasz Piegza
2
,
Natalia Rozum-Liszewska
3
,
Mateusz Górski
3
,
Tadeusz J. Popiela
4
,
Pawel Basta
5
,
Sylwia Heinze
2
,
Elzbieta Luczynska
6

1.
Electroradiology Department, Faculty of Health Sciences, Jagiellonian University Collegium Medicum, Krakow, Poland
2.
Maria Sklodowska-Curie National Research Institute of Oncology in Cracow, Poland
3.
University Hospital in Krakow, Krakow, Poland
4.
Chair of Radiology, Jagiellonian University Medical College, Krakow, Poland
5.
Jagiellonian University Medical College, Krakow, Poland
6.
Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
Pol J Radiol 2021; 86: e159-e164
Online publish date: 2021/03/15
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Introduction
Breast cancer is the most common cause of death from neoplastic disease in women. Among all breast anatomy types, glandular type is the most problematic concerning evaluation. While digital mammography still remains the basic diagnostic tool, one must be aware of its limitations in dense breasts. Although magnetic resonance imaging (MRI) has greatly improved sensitivity, its specificity is low. Moreover, there are contraindications for MRI for some patients, so a substitute has been searched for. This study was performed to check if contrast-enhanced spectral mammography (CESM) can be a viable option for patients with dense breasts.

Material and methods
The study involved 121 patients with abnormalities detected on base-line diagnostic imaging (ultrasound or mammography). The patients had subsequent examinations, both CESM and MRI performed within a maximum 2-month time interval. The sensitivity and specificity of both methods in the whole group as well as in specific breast structure types were measured and compared.

Results
Contrast enhancement was visible in all 121 cases on MRI, while on CESM lack of enhancement was noted in 13 cases. All of those 13 lesions turned out to be benign. There were 40 (33%) benign and 81 (69%) malignant tumours. The analysed group included 53 (44%) glandular type breast patients, 39 (32%) mixed type, and 29 (23%) fatty type. Although MRI proved to be slightly more effective in dense breasts, both methods showed similar results in the whole study group.

Conclusions
CESM can be used with confidence in patients with glandular breast type when MRI is not available or there are reported contraindications to MRI.

keywords:

cancer, breast, diagnostic imaging, MRI, CESM

 
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