Evaluation of contrast-enhanced mammography (CEM) in the preoperative staging of breast cancer: large-scale single center experience, update to 1005 cases.
IF 9.7 1区 医学Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Giulia Bicchierai, Giuliano Migliaro, Francesca Pugliese, Francesco Amato, Diego De Benedetto, Ermanno Vanzi, Federica Di Naro, Cecilia Boeri, Chiara Bellini, Sofia Vidali, Kassandra Toncelli, Simonetta Bianchi, Lorenzo Orzalesi, Vittorio Miele, Jacopo Nori
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引用次数: 0
Abstract
Purpose: The purpose of this study was to assess the diagnostic performance of CEM in the preoperative staging of breast cancer in a large cohort of patients.
Materials and methods: A retrospective review of preoperative staging CEM exams was conducted at our centre between June 2016 and June 2021. We evaluated cases where CEM influenced the type of surgery, necessitated additional biopsies or imaging, and identified additional lesions. The sensitivity, specificity, positive and negative predictive values (PPV and NPV), and accuracy of CEM for the entire sample and each subgroup setting were calculated. A receiver operating characteristic (ROC) curve and multivariate analysis were performed.
Results: 991 women, mean age 61.3 years old [35-93], with 1005 malignant lesions were included. CEM led to additional imaging in 36.7% (364/991) women and to additional biopsies in 18.5% (183/991) women. CEM altered the initial surgical plan based on conventional imaging in 226 out of 991 patients (22.8%). CEM had a sensitivity in the whole population of 91.5% (204/223), specificity of 96.8% (757/782), PPV of 89.1% (204/229), NPV of 97.5% (757/776) and an accuracy of 95.6% (961/1005); the AUC of the ROC curve was 0.941. We found CEM better performed in patients with a low BPE level compared with a high BPE level (ρ = 0.028861). We see that the presence of additional lesions at CEM was the only significant predictor in the model.
Conclusion: This study reaffirms the high diagnostic accuracy of CEM for preoperative breast cancer staging in a large patient cohort.
期刊介绍：
Felice Perussia founded La radiologia medica in 1914. It is a peer-reviewed journal and serves as the official journal of the Italian Society of Medical and Interventional Radiology (SIRM). The primary purpose of the journal is to disseminate information related to Radiology, especially advancements in diagnostic imaging and related disciplines. La radiologia medica welcomes original research on both fundamental and clinical aspects of modern radiology, with a particular focus on diagnostic and interventional imaging techniques. It also covers topics such as radiotherapy, nuclear medicine, radiobiology, health physics, and artificial intelligence in the context of clinical implications. The journal includes various types of contributions such as original articles, review articles, editorials, short reports, and letters to the editor. With an esteemed Editorial Board and a selection of insightful reports, the journal is an indispensable resource for radiologists and professionals in related fields. Ultimately, La radiologia medica aims to serve as a platform for international collaboration and knowledge sharing within the radiological community.
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