Comparison of background parenchymal enhancement at contrast-enhanced spectral mammography and breast MR imaging Journal Article


Authors: Sogani, J.; Morris, E. A.; Kaplan, J. B.; D'Alessio, D.; Goldman, D.; Moskowitz, C. S.; Jochelson, M. S.
Article Title: Comparison of background parenchymal enhancement at contrast-enhanced spectral mammography and breast MR imaging
Abstract: Purpose: To assess the extent of background parenchymal enhancement (BPE) at contrast material-enhanced (CE) spectral mammography and breast magnetic resonance (MR) imaging, to evaluate interreader agreement in BPE assessment, and to examine the relationships between clinical factors and BPE. Materials and Methods: This was a retrospective, institutional review board-approved, HIPAA-compliant study. Two hundred seventy-eight women from 25 to 76 years of age with increased breast cancer risk who underwent CE spectral mammography and MR imaging for screening or staging from 2010 through 2014 were included. Three readers independently rated BPE on CE spectral mammographic and MR images with the ordinal scale: minimal, mild, moderate, or marked. To assess pairwise agreement between BPE levels on CE spectral mammographic and MR images and among readers, weighted k coefficients with quadratic weights were calculated. For overall agreement, mean k values and bootstrapped 95% confidence intervals were calculated. The univariate and multivariate associations between BPE and clinical factors were examined by using generalized estimating equations separately for CE spectral mammography and MR imaging. Results: Most women had minimal or mild BPE at both CE spectral mammography (68%-76%) and MR imaging (69%-76%). Between CE spectral mammography and MR imaging, the intrareader agreement ranged from moderate to substantial (k = 0.55-0.67). Overall agreement on BPE levels between CE spectral mammography and MR imaging and among readers was substantial (k = 0.66; 95% confidence interval: 0.61, 0.70). With both modalities, BPE demonstrated significant association with menopausal status, prior breast radiation therapy, hormonal treatment, breast density on CE spectral mammographic images, and amount of fibroglandular tissue on MR images (P < .001 for all). Conclusion: There was substantial agreement between readers for BPE detected on CE spectral mammographic and MR images.
Journal Title: Radiology
Volume: 282
Issue: 1
ISSN: 0033-8419
Publisher: Radiological Society of North America, Inc.  
Date Published: 2017-01-01
Start Page: 63
End Page: 73
Language: English
DOI: 10.1148/radiol.2016160284
PROVIDER: scopus
PMCID: PMC5207122
PUBMED: 27379544
DOI/URL:
Notes: Article -- Export Date: 2 February 2017 -- Source: Scopus
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MSK Authors
  1. Jennifer Kaplan
    27 Kaplan
  2. Elizabeth A Morris
    336 Morris
  3. Maxine Jochelson
    134 Jochelson
  4. Chaya S. Moskowitz
    279 Moskowitz
  5. Debra Alyssa Goldman
    158 Goldman
  6. Julie Anjali Sogani
    5 Sogani