Authors: Marc B I Lobbes Ulrich Lalji Janneke Houwers Estelle C Nijssen Patty J Nelemans Lori van Roozendaal Marjolein L Smidt Esther Heuts Joachim E Wildberger
Publish Date: 2014/04/03
Volume: 24, Issue: 7, Pages: 1668-1676
Abstract
Feasibility studies have shown that contrastenhanced spectral mammography CESM increases diagnostic accuracy of mammography We studied diagnostic accuracy of CESM in patients referred from the breast cancer screening programme who have a lower disease prevalence than previously published papers on CESMDuring 6 months all women referred to our hospital were eligible for CESM Two radiologists blinded to the final diagnosis provided BIRADS classifications for conventional mammography and CESM Statistical significance of differences between mammography and CESM was calculated using McNemar’s test Receiver operating characteristic ROC curves were constructed for both imaging modalitiesOf the 116 eligible women 113 underwent CESM CESM increased sensitivity to 1000 +31 specificity to 877 +457 PPV to 762 +365 and NPV to 1000 +29 as compared to mammography Differences between conventional mammography and CESM were statistically significant p 00001 A similar trend was observed in the ROC curve For conventional mammography AUC was 0779 With CESM AUC increased to 0976 p 00001 In addition good agreement between tumour diameters measured using CESM breast MRI and histopathology was observedThe scientific guarantor of this publication is Dr M Lobbes The authors of this manuscript declare relationships with the following companies M Lobbes has received a speaking fee from GE Healthcare for two presentations on CESM However GE Healthcare did not provide any funding for this study The authors had full control of data collection data analysis and manuscript preparation at all times The authors state that this work has not received any funding One of the authors P Nelemans has significant statistical expertise Institutional review board approval was not required because in the Netherlands research covered by the Medical Research Involving Human Subjects Act must be submitted to an accredited medical ethics committee for approval Our medical ethics committee concluded that the research proposal of the current study does not under Dutch law require medical ethics approval because no extra burden is placed on research subjects Written informed consent was waived by the institutional review board Methodology retrospective diagnostic study performed at one institution
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