Can Contrast-Enhanced Mammography Improve Positive Predictive Value for Diagnostic Workup of Suspicious Findings? A Single-Arm Prospective Study.

IF 2 Q3 ONCOLOGY

Journal of Breast Imaging Pub Date : 2024-11-25 DOI:10.1093/jbi/wbae081

Jason Shames, Adrien Nguyen, Maria Sciotto, Lisa Zorn, Theresa Kaufman, Annina Wilkes, Alexander Sevrukov, Chhavi Kaushik, Ripple Patel, Suzanne Pascarella, Ashlee Byrd, Lydia Liao

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引用次数: 0

Abstract

Objective: To assess the positive predictive value-3 (PPV3) and negative predictive value (NPV) of contrast-enhanced mammography (CEM) when added to the diagnostic workup of suspicious breast findings.

Methods: This prospective study was IRB approved. We recruited 99 women with abnormal findings on digital breast tomosynthesis (DBT) and/or US to undergo CEM prior to biopsy. Based on final pathology outcomes, PPV3 and NPV were calculated and compared using N-1 chi-squared tests with P-values and 95% CIs.

Results: Final pathologic outcome yielded 56.6% (56/99) benign, 5.1% (5/99) benign with upgrade potential (BWUP), and 38.4% (38/99) malignant lesions. Final pathologic outcomes for the 63 positive CEMs yielded 33.3% (21/63) benign, 6.3% (4/63) BWUP, and 60.3% (38/63) malignant lesions. Adding CEM to the diagnostic workup significantly increased PPV3 from 38.4% (38/99) to 60.3% (38/63) (P <.01; 95% CI, 6.1-36.2). Negative predictive value was 100% (36/36) for CEM, 92.9% (13/14; P = .1; 95% CI, -4.2 to 31.4) for DBT, and 75.9% (22/29; P <.05; 95% CI, 8.8-42.1) for US. The number of unnecessary biopsies could be reduced by 36.4% (from 100% [99/99] to 63.6% [63/99]).

Conclusion: Adding CEM to the diagnostic workup of suspicious breast findings could improve PPV3 to prevent unnecessary biopsies.

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对比度增强型乳腺 X 射线照相术能否提高可疑发现诊断工作的阳性预测值？单臂前瞻性研究。

目的评估对比增强乳腺 X 线造影术（CEM）在对可疑乳腺检查结果进行诊断时的阳性预测值-3（PPV3）和阴性预测值（NPV）：这项前瞻性研究已获得 IRB 批准。我们招募了 99 名数字乳腺断层扫描（DBT）和/或 US 检查结果异常的女性，让她们在活检前接受 CEM 检查。根据最终病理结果计算PPV3和NPV，并使用N-1卡方检验比较P值和95% CI：最终病理结果显示，良性病变占 56.6%（56/99），良性病变占 5.1%（5/99），恶性病变占 38.4%（38/99）。63 例 CEM 阳性病例的最终病理结果为：33.3%（21/63）良性、6.3%（4/63）BWUP 和 60.3%（38/63）恶性病变。在诊断检查中加入 CEM 可使 PPV3 从 38.4%（38/99）显著增加到 60.3%（38/63）（P 结论：在诊断检查中加入 CEM 可使 PPV3 从 38.4%（38/99）显著增加到 60.3%（38/63））：在可疑乳腺检查结果的诊断工作中加入 CEM 可提高 PPV3，避免不必要的活检。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Breast Imaging Multiple-

CiteScore

3.40

自引率

20.00%

发文量