Evaluation of contrast-enhanced digital mammography
Evaluation of contrast-enhanced digital mammography
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DOI：
10.1016/j.ejrad.2009.10.002
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发表时间：
2011-04-01
影响因子：
3.3
通讯作者：
Poellinger, Alexander
中科院分区：
文献类型：
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作者：
Diekmann, Felix;Freyer, Martin;Poellinger, Alexander
目的：本前瞻性研究的目的是评估对比增强数字乳房x线摄影（CEDM）相对于传统乳房x线摄影的诊断价值。材料和方法：我们分析了70例患者的数据，共80个病变（30个恶性病变，50个良性病变）。使用适合显示碘造影剂的改良成像系统（GE senograph 2000D带铜滤光片），从每位患者获得一系列对比度增强图像。在拍摄掩膜图像后，以4 ml/s的速率以1 ml/kg体重的剂量给药造影剂。然后以60秒的间隔在颅尾投影平面上捕获三张对比度增强图像。从对比度增强图像中对数减去掩模图像。我们对三位读者进行了诊断质量的ROC分析。结果：与单纯的常规乳房x线造影相比，加用数字动态对比造影平均多检出5.66个恶性病变。敏感性从常规乳房x光检查的平均0.43增加到对比乳房x光检查的平均0.62。即使在致密的乳腺实质中，敏感性也从平均0.35-0.59增加。在对所有读者的多读者- roc分析中，所有病例的AUC差异p = 0.02 （BI-RADS）均具有统计学意义。Wilcoxon测试显示，读者I和II主要使用CEDM将增强病变升级到更高的BI-RADS类别或更高的恶性概率。在ROC分析中，这两位读者从CEDM中获益最多。结论：总的来说，我们认为在常规乳房x线摄影的基础上增加动态数字减影乳房x线摄影可以显著提高诊断质量。在乳腺组织致密的情况下，敏感性的增加尤为明显。2009爱思唯尔爱尔兰有限公司版权所有。
Purpose: The goal of this prospective study was to evaluate the possible diagnostic benefits of contrast-enhanced digital mammography (CEDM) over conventional mammography.Materials and methods: Our analysis included data from 70 patients with a total of 80 lesions (30 malignant and 50 benign). A series of contrast-enhanced images was acquired from each patient using a modified imaging system (GE Senographe 2000D with copper filter) suitable for displaying iodine contrast medium. After the mask image had been taken, the contrast medium was administered using a dosage of 1 ml/kg body weight at a rate of 4 ml/s. Three contrast-enhanced images in the cranio-caudal projection plane were then captured at intervals of 60 s. The mask image was logarithmically subtracted from the contrast-enhanced images. We performed a ROC analysis of diagnostic quality with three readers.Results: On average, 5.66 more malignant lesions were detected with the addition of digital dynamic contrast mammography versus conventional mammography alone. The sensitivity was increased from an average of 0.43 in conventional mammography to an average of 0.62 with contrast mammography. Even in dense breast parenchyma, the sensitivity increased from an average of 0.35-0.59.In the multi-reader-ROC analyses of all readers, the differences in the AUC with p = 0.02 (BI-RADS) proved statistically significant in all cases. The Wilcoxon test showed that Readers I and II primarily used the CEDM to upgrade enhancing lesions to a higher BI-RADS category or a higher probability of malignancy. These two readers benefited most from the CEDM in the ROC analysis.Conclusion: Overall, we conclude that the addition of dynamic digital subtraction mammography to conventional mammography can significantly improve diagnostic quality. The increased sensitivity is particularly pronounced in the case of dense breast tissue. (C) 2009 Elsevier Ireland Ltd. All rights reserved.