背景实质增强（BPE）对乳腺造影（CEM）诊断效果的影响

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-04-29 DOI:10.1016/j.ejrad.2025.112145

Sonja Bechyna, Ambra Santonocito, Nina Pötsch, Paola Clauser, Thomas H Helbich, Pascal A.T. Baltzer

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引用次数: 0

摘要

目的探讨背景实质增强（BPE）对乳腺造影（CEM）诊断的影响。材料,方法：在2020年7月至2022年9月期间，对经irb批准的cem患者进行回顾性单中心观察研究。CEM的适应症是通过筛查或诊断性乳房x光检查和/或超声确定的不确定或可疑的乳房病变。使用BI-RADS词典CEM补充对CEM进行评估。BPE由一名监督阅读者评估，并分为轻度/轻度和中度/标记。排除标准包括没有24个月随访的患者，由于技术原因无法获得组织学或CEM图像。图像解释由委员会认证的放射科医生进行。所有读者对患者临床资料和组织病理学结果不知情。统计分析包括Kappa统计和ROC分析。在BI-RADS中计算诊断指标；3截止。假定值& lt;0.05为有统计学意义。结果纳入229例女性患者，平均年龄53.8±10.7岁。49.3%的患者轻度BPE， 36.8%的患者轻度BPE， 12.5%的患者中度BPE， 1.4%的患者有显著性BPE。轻度/轻度BPE患者的总体AUC（0.94±0.01）高于中度/重度BPE患者（0.82±0.04），差异有统计学意义（差异0.12,p = 0.004）。轻度/轻度BPE组的敏感性为90.9%，而中度/重度BPE组为66.7% （p = 0.05）。特异性在轻度/轻度BPE组显著高于中度/显著BPE组，p = 0.0006)。结论bpe显著影响CEM的诊断效能，尤其是敏感性。这突出了评估和报告CEM中BPE的重要性，以提供表明测试结果可靠性的简单度量。

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Impact of Background Parenchymal Enhancement (BPE) on diagnostic performance of Contrast-Enhanced Mammography (CEM) for breast cancer diagnosis

Objectives

This study investigates how background parenchymal enhancement (BPE) impacts diagnostic performance in interpretation of contrast-enhanced mammography (CEM) for breast cancer diagnosis.

Materials & methods

Retrospective IRB-approved single-center observational study on CEM-patients between 07/2020–09/2022. Indications for CEM were inconclusive or suspicious breast lesions identified by screening or diagnostic mammography and/or ultrasound. CEM was evaluated using the BI-RADS lexicon CEM supplement. BPE was assessed by one supervised reader and dichotomized as minimal/mild and moderate/marked. Exclusion criteria included patients without a 24-month follow-up, histology or CEM images were not available for technical reasons. Image interpretation was conducted by board-certified radiologists. All readers were blinded to patient clinical data and histopathology results. Statistical analysis included Kappa statistics and ROC analysis. Diagnostic metrics were calculated at a BI-RADS > 3 cut-off. P-values < 0.05 indicated statistical significance.

Results

229 female patients (mean age 53.8 ± 10.7 years) were included. BPE was minimal in 49.3 %, mild in 36.8 %, moderate in 12.5 %, and marked in 1.4 % of patients. Overall AUC was higher in minimal/mild BPE (0.94 ± 0.01) compared to moderate/marked BPE (0.82 ± 0.04), which proved statistically significant (difference 0.12, p = 0.004). Sensitivity was higher in the minimal/mild BPE group at 90.9 % compared to 66.7 % in the moderate/marked BPE group (p = 0.05). Specificity was significantly higher in the minimal/mild vs. moderate/marked BPE group, p = 0.0006).

Conclusion

BPE significantly affects the diagnostic performance of CEM, particularly sensitivity. This highlights the importance of assessing and reporting BPE in CEM to provide a simple metric indicating the reliability of test results.

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.