Donna B Taylor, Meredith A Kessell, Paul M Parizel
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引用次数: 0
Abstract
Imaging research pathways focus increasingly on the development of individualised approaches to breast cancer detection, diagnosis and management. Detection of breast cancer with X-ray mammography may fail in some cancer subtypes with limited changes in morphology/tissue density and in women with dense breasts. International organisations offer recommendations for contrast-enhanced breast imaging, as it provides superior sensitivity for screening, local staging and assessment of neoadjuvant treatment response, when compared with standard X-ray mammography (including tomosynthesis) and breast ultrasound. Arguably, the evidence base is stronger for contrast-enhanced MRI (CE-MRI). Unfortunately, patient access to breast MRI in rural and remote areas is limited by practical limitations and equipment licensing restrictions. Moreover, breast MRI is an expensive test, likely to be out of reach for many women. Contrast-enhanced mammography (CEM) offers an attractive alternative to improve patient access to functional breast imaging. It is a new type of digital, dual energy X-ray mammography that can be performed on most modern units, following a relatively inexpensive hard- and software upgrade. In this paper, we review the rapidly accumulating evidence that CEM can provide similar diagnostic accuracy to CE-MRI, though at a significantly lower cost and offering greater comfort to the patient. The adoption of CEM can help meet the anticipated increased demand for CE-MRI.
影像学研究途径越来越注重开发个性化的乳腺癌检测、诊断和管理方法。对于形态/组织密度变化有限的某些癌症亚型以及乳房致密的妇女,X 射线乳房 X 光造影术可能无法检测出乳腺癌。国际组织推荐对比增强乳腺成像,因为与标准 X 光乳腺摄影(包括断层合成)和乳腺超声相比,对比增强乳腺成像在筛查、局部分期和评估新辅助治疗反应方面具有更高的灵敏度。可以说,对比增强核磁共振成像(CE-MRI)的证据基础更为雄厚。遗憾的是,在农村和偏远地区,由于实际条件的限制和设备许可的限制,患者难以获得乳腺磁共振成像。此外,乳腺核磁共振成像是一项昂贵的检查,许多妇女可能无法负担。对比增强乳腺 X 线照相术(CEM)为改善患者接受乳腺功能成像提供了一个极具吸引力的替代方案。它是一种新型的数字双能量 X 射线乳腺造影术,只需进行相对便宜的硬件和软件升级,即可在大多数现代化设备上进行。在本文中,我们回顾了快速积累的证据,这些证据表明,CEM 可以提供与 CE-MRI 相似的诊断准确性,但成本大大降低,而且能给患者带来更大的舒适感。采用 CEM 有助于满足预期增加的 CE-MRI 需求。
期刊介绍:
Journal of Medical Imaging and Radiation Oncology (formerly Australasian Radiology) is the official journal of The Royal Australian and New Zealand College of Radiologists, publishing articles of scientific excellence in radiology and radiation oncology. Manuscripts are judged on the basis of their contribution of original data and ideas or interpretation. All articles are peer reviewed.