Contrast-enhanced mammography superior to full-field digital mammography: Study

Contrast-enhanced mammography is an emerging breast imaging modality introduced in 2011 the diagnostic accuracy of which has been found superior to full-field digital mammography (FFDM), even matching the performance of breast MRI, in some studies.

A new study has confirmed the  superiority and improved sensitivity and specificity of Contrast-enhanced mammography (CEM) compared to full-field digital mammography (FFDM).Neeter and peers conducted this work to assess CEM's diagnostic performance on a system from a different vendor.

The findings of this study has been published in Nature on 15th November, 2021.

Except for individuals with incomplete data or for whom CEM was used as a response monitoring technique, researchers included all patients who received CEM at one institution in 2019. The low-energy pictures were graded by three expert breast radiologists using the BI-RADS classification. Following that, the entire set of CEM tests was scored in the same manner. As a reference standard, histopathological findings or a minimum of one year of follow-up were employed. Diagnostic performance and AUC were determined and compared between low-energy pictures and the whole CEM examination, both separately and in combination, for all readers.

Breast cancer was discovered in 23.0% of the patients (35/152). Overall CEM sensitivity rose from 74.3 to 87.6% when compared to low-energy pictures, and specificity increased from 87.8 to 94.6%. The AUC rose from 0.872 to 0.957.

In summary, as compared to FFDM, CEM done on a Hologic system enhanced both sensitivity and specificity. The reported diagnostic performance is within the 95 percent confidence interval of summary ROC curves from a previously published meta-analysis. As a result, it can be fairly stated that the kind of CEM unit does not appear to be a deciding factor in experiments that use equipment from several suppliers.

Reference:

Neeter, L.M.F.H., Raat, H.P.J., Meens-Koreman, S.D. et al. The diagnostic value of contrast-enhanced 2D mammography in everyday clinical use. Sci Rep 11, 22224 (2021). https://doi.org/10.1038/s41598-021-01622-7