Comparison of the diagnostic accuracy of contrast-enhanced mammography and MRI

IF 0.1 Q4 OBSTETRICS & GYNECOLOGY

Revista de Senologia y Patologia Mamaria Pub Date : 2026-01-01 Epub Date: 2026-02-20 DOI:10.1016/j.senol.2026.100748

Miguel Barrio-Piqueras , Patricia Malmierca , César Urtasun-Iriarte , Carmen Mbongo-Habimana , Manuel de la Torre Carretero , Arlette Elizalde , Luis Javier Pina

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Abstract

Objective

To evaluate the diagnostic accuracy of Magnetic Resonance Imaging (MRI) and Contrast-Enhanced Mammography (CEM) and to determine which better estimates lesion size.

Material and methods

Between September 2017 and November 2023, 139 histopathologically confirmed lesions from 95 patients who underwent MRI and CEM were retrospectively analyzed. BI-RADS categories and lesion diameters were reassessed. Sensitivity, specificity, and area under the curve (AUC) were calculated. Breast density, background parenchymal enhancement, and discrepancies in lesion size compared to histopathology were evaluated.

Results

Among 139 lesions (117 malignant, 22 benign), MRI detected 112 true positives (TPs) and 5 false negatives (FNs); CEM reported 98 TPs and 19 FNs. For benign lesions, MRI showed 8 false positives (FPs) and 14 true negatives (TNs); CEM, 2 FPs and 20 TNs. Sensitivity was 95.7% for MRI vs. 83.8% for CEM (p = 0.002); specificity was 63.6% vs. 90.9%, respectively (p = 0.058). AUC was 0.90 for MRI and 0.86 for CEM (p = 0.45). Both techniques tended to overestimate tumor size (+ 3.35 mm MRI, + 4.04 mm CEM), with no significant difference in accuracy (p = 0.389).

Conclusion

MRI showed higher sensitivity than CEM for detecting malignant lesions, although their accuracy was similar. Both techniques tend to overestimate tumor size.

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对比增强乳房x线摄影与MRI诊断准确性的比较

目的评价磁共振成像（MRI）和乳腺造影（CEM）对肿瘤的诊断准确性，确定哪一种能更好地估计病变大小。材料和方法回顾性分析2017年9月至2023年11月期间95例MRI和CEM患者的139个组织病理学证实的病变。重新评估BI-RADS分类和病变直径。计算灵敏度、特异度和曲线下面积（AUC）。评估乳腺密度、背景实质增强、病变大小与组织病理学的差异。结果139例病变（恶性117例，良性22例）中，MRI检出真阳性112例，假阴性5例；CEM报告了98例TPs和19例FNs。良性病变MRI显示假阳性8例，真阴性14例；CEM， 2个FPs和20个tn。MRI的敏感性为95.7%，CEM为83.8% (p = 0.002)；特异性分别为63.6%和90.9% （p = 0.058）。MRI和CEM的AUC分别为0.90和0.86 （p = 0.45）。两种技术都倾向于高估肿瘤大小（MRI + 3.35 mm, CEM + 4.04 mm），准确率无显著差异（p = 0.389）。结论mri对恶性病变的检测灵敏度高于CEM，准确性相近。这两种技术都倾向于高估肿瘤的大小。

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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