Comparison of false-positive versus true-positive findings on contrast-enhanced digital mammography Journal Article
| Authors: | Amir, T.; Hogan, M. P.; Jacobs, S.; Sevilimedu, V.; Sung, J.; Jochelson, M. S. |
| Article Title: | Comparison of false-positive versus true-positive findings on contrast-enhanced digital mammography |
| Abstract: | BACKGROUND. Contrast-enhanced digital mammography (CEDM) has been shown to outperform standard mammography while performing comparably to contrast-enhanced MRI. OBJECTIVE. The purpose of our study was to compare imaging characteristics of false-positive and true-positive findings on CEDM. METHODS. This retrospective study included women who underwent baseline screening CEDM between January 2013 and December 2018 assessed as BI-RADS category 0, 3, 4, or 5 and who underwent biopsy with histopathologic diagnosis or had a 2-year imaging follow-up. Lesion characteristics were extracted from CEDM reports. A true-positive finding was defined as a lesion in which biopsy yielded malignancy. A false-positive finding was defined as a lesion in which biopsy yielded benign or benign high-risk pathology or in which 2-year imaging follow-up was negative. RESULTS. Of 157 patients (median age, 52 years), 24 had a total of 26 true-positive lesions, and 133 had a total of 147 false-positive lesions. Of the 26 true-positive lesions, one (4%) exhibited only a mammographic finding on low-iodine images, 13 (50%) exhibited only a contrast finding on iodine images, and 12 (46%) exhibited both a mammographic finding on low-energy images and a contrast finding on iodine images. A true-positive result was more likely (p = .02) for lesions present on both low-energy images and iodine images (31%) than on low-energy images only (4%) or iodine images only (12%). Among lesions present on both low-energy and iodine images, a true-positive result was more likely (p < .001) when the type of mammographic finding was an asymmetry (46%) or calcification (80%) than a mass (11%) or distortion (0%). A true-positive result was more likely (p = .01) among those with, versus those without, an ultrasound correlate (36% vs 9%) and also was more likely (p = .02) among those with, versus those without, an MRI correlate (18% vs 2%). Of 25 false-positive calcifications, 24 had no associated mammographic enhancement; of five true-positive calcifications, four had mammographic enhancement. CONCLUSION. A low-energy mammographic finding with associated enhancement or a finding with a sonographic or MRI correlate predicts a true-positive result. Calcifications with associated enhancement had a high malignancy rate. Nonetheless, half of true-positive lesions enhanced on iodine images without a mammographic finding on low-energy images. CLINICAL IMPACT. These observations inform radiologists’ management of abnormalities detected on screening CEDM. © American Roentgen Ray Society |
| Keywords: | middle aged; retrospective studies; breast cancer; diagnostic imaging; breast neoplasms; retrospective study; mammography; image enhancement; breast tumor; contrast medium; contrast media; iodine; radiographic image enhancement; procedures; false-positive; humans; human; female; contrast-enhanced digital mammography; breast screening |
| Journal Title: | American Journal of Roentgenology |
| Volume: | 218 |
| Issue: | 5 |
| ISSN: | 0361-803X |
| Publisher: | American Roentgen Ray Society |
| Date Published: | 2022-05-01 |
| Start Page: | 797 |
| End Page: | 808 |
| Language: | English |
| DOI: | 10.2214/ajr.21.26847 |
| PUBMED: | 34817195 |
| PROVIDER: | scopus |
| PMCID: | PMC9110098 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 June 2022 -- Source: Scopus |
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