Diagnostic Performance of Contrast-Enhanced Digital Mammography versus Conventional Imaging in Women with Dense Breasts

• DOI: 10.3390/diagnostics13152520
• Publication Date: 2023-07-28T11:35:24Z
• Authors: Giuliana Moffa; Francesca Galati; Roberto Maroncelli; Veronica Rizzo; Federica Cicciarelli; Marcella Pasculli; Federica Pediconi
• Keywords: McNemar's test; Digital Mammography; Breast imaging

The aim of this prospective study was to compare the diagnostic performance contrast-enhanced mammography (CEM) versus digital (DM) combined with breast ultrasound (BUS) in women dense breasts. Between March 2021 and February 2022, patients eligible for CEM composition category ACR BI-RADS c-d at DM an abnormal finding (BI-RADS 3-4-5) and/or BUS were considered. During CEM, a nonionic iodinated contrast agent (Iohexol 350 mg I/mL, 1.5 mL/kg) power-injected intravenously. Images evaluated independently by two radiologists. Findings classified as 1-3 considered benign, while 4-5 malignant. In case discrepancies, higher DM+BUS. Sensitivity, specificity, positive predictive value (PPV), negative (NPV), accuracy calculated, using histology/≥12-month follow-up gold standards. total, 51 65 lesions included. 59 (90.7%) findings detected DM+BUS, (100%) CEM. inter-reader agreement excellent (Cohen's k = 0.87 DM+BUS 0.97 CEM). showed 93.5% sensitivity (vs. 90.3% DM+BUS), 79.4-82.4% specificity 32.4-35.5% DM+BUS) (McNemar p 0.006), 80.6-82.9% PPV 54.9-56.0% 93.1-93.3% NPV 78.6-80.0% 86.1-87.7% 60.0-61.5% DM+BUS). AUC than (0.865 vs. 0.613 Reader 1, 0.880 0.628, 2) (p < 0.001). conclusion, had better alone together