Clinical utility of dual-energy contrast-enhanced spectral mammography for breast microcalcifications without associated mass: a preliminary analysis

Yun Chung Cheung*, Hsiu Pei Tsai, Yung Feng Lo, Shir Hwa Ueng, Pei Chin Huang, Shin Chih Chen

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

62 Scopus citations

Abstract

Objective: To assess the utility of dual-energy contrast-enhanced spectral mammography (DE-CESM) for evaluation of suspicious malignant microcalcifications. Methods: Two hundred and fifty-six DE-CESMs were reviewed from 2012–2013, 59 cases fulfilled the following criteria and were enrolled for analysis: (1) suspicious malignant microcalcifications (BI-RADS 4) on mammogram, (2) no related mass, (3) with pathological diagnoses. The microcalcification morphology and associated enhancement were reviewed to analyse the accuracy of the diagnosis and cancer size measurements versus the results of pathology. Results: Of the 59 microcalcifications, 22 were diagnosed as cancers, 19 were atypical lesions and 18 were benign lesions. Twenty (76.9 %) cancers, three (11.55 %) atypia and three (11.55 %) benign lesions revealed enhancement. The true-positive rate of intermediate- and high-concern microcalcifications was significantly higher than that of low-concern lesions (93.75 % vs. 50 %). Overall, the diagnostic sensitivity of enhancement was 90.9 %, with 83.78 % specificity, 76.92 % positive predictive value, 93.94 % negative predictive value and 86.4 % accuracy. Performance was good (AUC = 0.87) according to a ROC curve and cancer size correlation with a mean difference of 0.05 cm on a Bland-Altman plot. Conclusions: DE-CESM provides additional enhancement information for diagnosing breast microcalcifications and measuring cancer sizes with high correlation to surgicohistology. Key Points: • DE-CESM provides additional enhancement information for diagnosing suspicious breast microcalcifications. • The enhanced cancer size closely correlates to microscopy by Bland-Altman plot. • DE-CESM could be considered for evaluation of suspicious malignant microcalcifications.

Original languageEnglish
Pages (from-to)1082-1089
Number of pages8
JournalEuropean Radiology
Volume26
Issue number4
DOIs
StatePublished - 01 04 2016

Bibliographical note

Publisher Copyright:
© 2015, European Society of Radiology.

Keywords

  • Breast cancer
  • Breast microcalcification
  • Dual-energy Contrast-enhanced Spectral Mammography
  • Mammography
  • Surgical planning

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