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European Radiology
Published in: European Radiology 9/2018

01-09-2018 | Breast

Contrast-enhanced cone-beam breast-CT (CBBCT): clinical performance compared to mammography and MRI

Authors: Susanne Wienbeck, Uwe Fischer, Susanne Luftner-Nagel, Joachim Lotz, Johannes Uhlig

Published in: European Radiology | Issue 9/2018

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Abstract

Objectives

To evaluate the diagnostic accuracy of contrast-enhanced (CE) cone-beam breast computed tomography (CBBCT) in dense breast tissue and compare it to non-contrast (NC) CBBCT, mammography (MG) and magnetic resonance imaging (MRI).

Methods

This prospective institutional review board-approved study included 41 women (52 breasts) with American College of Radiology (ACR) density types c or d and Breast Imaging Reporting and Data System (BI-RADS) 4 or 5 assessments in MG or ultrasound (US). Imaging modalities were independently evaluated by two blinded readers.

Results

A total of 100 lesions (51 malignant, 6 high-risk, and 43 benign) were identified. For readers 1/2, respectively, and p values comparing CE-CBBCT to other modalities: diagnostic accuracy (AUC) for CE-CBBCT was 0.83/0.77, for MRI 0.88/0.89 (p = 0.2272/0.002), for NC-CBBCT 0.73/0.66 (p = 0.038/ 0.0186) and for MG 0.69/0.64 (p = 0.081/0.0207). CE-CBBCT sensitivity (0.88/0.78) was 37-39% higher in comparison to MG (0.49/0.41, p < 0.001 both) but inferior to MRI (0.98/0.96, p = 0.0253/0.0027). CE-CBBCT specificity (0.71/0.71) was numerically higher compared to MRI (0.61/0.69, p = 0.0956/0.7389).

Conclusions

CBBCT diagnostic performance varied with the respective reader and experience. CE-CBBCT improved AUC and sensitivity in comparison to MG and NC-CBBCT, and was comparable to MRI in dense breast tissue. In tendency, specificity was higher for CE-CBBCT than MRI.

Key Points

• CE-CBBCT diagnostic accuracy (AUC) was comparable to MRI in dense breasts.
• CE-CBBCT improved sensitivity and AUC in comparison to MG and NC-CBBCT.
• CE-CBBCT has inferior sensitivity but higher specificity than MRI.
• CE-CBBCT is a potential imaging alternative for patients with MRI contraindications.
Appendix
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Metadata
Title
Contrast-enhanced cone-beam breast-CT (CBBCT): clinical performance compared to mammography and MRI
Authors
Susanne Wienbeck
Uwe Fischer
Susanne Luftner-Nagel
Joachim Lotz
Johannes Uhlig
Publication date
01-09-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 9/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5376-4

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