ISSN: 1899-0967
Polish Journal of Radiology
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1/2020
vol. 85
 
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Breast radiology
abstract:
Original paper

The new method, the old problem – role of contrast-enhanced spectral mammography in the diagnosis of breast cancer among Polish women

Katarzyna Steinhof-Radwańska
1
,
Anna Grażyńska
2
,
Anna Barczyk-Gutkowska
1
,
Maciej Kajor
3
,
Piotr Powązka
4
,
Andrzej Lorek
5
,
Ewa Szlachta-Świątkowska
5
,
Irmina Morawska
2
,
Karolina Okas
2
,
Zuzanna Lelek
2
,
Magdalena Bielińska
2
,
Iwona Gisterek
6
,
Beata Casańas
7
,
Joanna Pilch-Kowalczyk
1

1.
Department of Radiology and Nuclear Medicine, Medical University of Silesia in Katowice, Poland
2.
Students’ Scientific Society, Department of Radiology and Nuclear Medicine, Medical University of Silesia in Katowice, Poland
3.
Department of Pathomorphology and Molecular Diagnostics, Medical University of Silesia in Katowice, Poland
4.
Department of Imaging Diagnostics and Interventional Radiology, University Clinical Center in Katowice, Poland
5.
Department of Oncological Surgery, Medical University of Silesia in Katowice, Poland
6.
Department of Oncology and Radiotherapy, Medical University of Silesia in Zabrze, Poland
7.
Division of Infectious Diseases and International Health, Department of Medicine, Morsani, College of Medicine, University of South Florida, USA
Pol J Radiol 2020; 85: e381-e386
Online publish date: 2020/07/27
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Introduction
The aim of the study was to evaluate spectral mammography (CESM) in diagnosing breast cancer, which is based on sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).

Material and methods
The study included a group of 547 women who underwent spectral mammography and histopathological verification of the lesion, previously seen in mammography and/or ultrasound. In the group of 547 women, 593 focal lesions were diagnosed. All CESM examinations were carried-out with a digital mammography device dedicated to performing dual-energy CESM acquisitions. An intravenous injection of 1.5 ml/kg of body mass of non-ionic contrast agent was performed.

Results
The analysis includes 593 breast lesions, in this group cancer was detected in 327 (55.14%) lesions, and in 256 (43.17%) cases benign lesions were confirmed by histopathological examination and at least 12 months of observation. The method shows differentiation of benign and malignant lesions in the breast: sensitivity of 97.86%, specificity of 59.4%, PPV – 74.76%, NPV – 95.76%.

Conclusions
Spectral mammography could be an ideal method to detect breast cancer. Thanks to the high NPV (95.76%), it facilitates the exclusion of cancer in situations where pathological contrast enhancement is not observed. The unsatisfactory specificity of the study (59.4%) would not make it safe to avoid a core needle biopsy of lesions that undergo contrast enhancement.

keywords:

breast cancer diagnostics, spectral mammography (CESM), mammography (MG)




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