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- Title
Quantitative Analysis of Contrast-enhanced Mammography for Risk Stratification of Benign Versus Malignant Disease and Molecular Subtype.
- Authors
Cain, Natalie; Rahbar, Guita; Park, Esther; Tang, Maxine; Andrews-Tang, Denise; Gupta, Esha; Roth, Antoinette; Lee-Felker, Stephanie; Thomas, Mariam
- Abstract
Objective: To assess quantitative enhancement of benign, high-risk, and malignant lesions and differences in molecular subtype and grade of malignant lesions on contrast-enhanced mammography (CEM). Methods: This IRB-approved retrospective study included women who underwent CEM for diagnostic work-up of a breast lesion between 2014 and 2020. Inclusion criteria were women who had diagnostic work-up with CEM and had BI-RADS 1 or 2 with one year follow-up, BI-RADS 3 with tissue diagnosis or stability for 2 years, or BI-RADS 4 or 5 with tissue diagnosis. An enhancement ratio was calculated for all lesions. This was obtained by drawing a region of interest within the lesion and a second region of interest in the nonenhancing background tissue using a program developed with MATLAB. Descriptive statistics were evaluated using chi-squared tests, Fisher exact tests, and analysis of variance. A logistic regression model was used to predict cancer outcome using the enhancement ratio. Statistical significance was defined as P < 0.05. Results: There were 332 lesions in 210 women that met study criteria. Of the 332 lesions, 50.9% (169/332) were malignant, 5.7% (19/332) were high-risk, and 43.4% (144/332) were benign. Enhancement intensity of malignant lesions was higher than benign lesions. Odds ratio for quantitative enhancement of malignant lesions was 30.15 (P < 0.0001). Enhancement ratio above 1.49 had an 84.0% sensitivity and 84.0% specificity for malignancy. HER2-enriched breast cancers had significantly higher mean enhancement ratios (P = 0.0062). Conclusion: Quantitative enhancement on CEM demonstrated that malignant breast lesions had higher mean enhancement intensity than benign lesions.
- Subjects
BREAST tumor risk factors; RISK assessment; RECEIVER operating characteristic curves; BREAST tumors; FISHER exact test; LOGISTIC regression analysis; TUMOR grading; QUANTITATIVE research; RETROSPECTIVE studies; DESCRIPTIVE statistics; CHI-squared test; LONGITUDINAL method; MAMMOGRAMS; ANALYSIS of variance; DATA analysis software; CONFIDENCE intervals; CONTRAST media; SENSITIVITY &; specificity (Statistics); CLASSIFICATION
- Publication
Journal of Breast Imaging, 2022, Vol 4, Issue 5, p496
- ISSN
2631-6110
- Publication type
Article
- DOI
10.1093/jbi/wbac044