open access

Vol 92, No 2 (2021)
Research paper
Published online: 2021-01-13
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Analysis of background parenchymal enhancement (BPE) on contrast enhanced spectral mammography compared with magnetic resonance imaging

Elzbieta Luczynska1, Marta Pawlak2, Tomasz Piegza2, Tadeusz J. Popiela3, Sylwia Heinze2, Sonia Dyczek4, Wojciech Rudnicki5
DOI: 10.5603/GP.a2020.0169
·
Pubmed: 33448005
·
Ginekol Pol 2021;92(2):92-97.
Affiliations
  1. University of Rzeszow, Faculty of Medicine, Rzeszow, Poland, Poland
  2. Maria Sklodowska-Curie National Research Institute of Oncology in Cracow, Poland, Poland
  3. Chair of Radiology, Jagiellonian University Medical College, Cracow, Poland, Poland
  4. University Hospital in Cracow, Poland
  5. Jagiellonian University Medical College, Cracow, Poland

open access

Vol 92, No 2 (2021)
ORIGINAL PAPERS Gynecology
Published online: 2021-01-13

Abstract

Objectives: With the growing number of new breast cancer cases in women, new methods of imaging arise. Contrast enhanced spectral mammography (CESM) and magnetic resonance imaging (MRI) are comparable methods regarding sensitivity. The aim of this study is to check if analysis of background parenchymal enhancement on CESM can improve its usefulness.
Material and methods: A total of 64 patients with breast lesions found previously on ultrasound or mammography underwent MRI and CESM within less than one month. On MRI the contrast enhancement kinetics and visual BPE were evaluated. On CESM the enhancement of lesions was noted as well as a quantitative level of BPH. The gathered data was analysed in terms of patterns and relations.
Results: A total of 66 lesions were identified both on MRI and CESM, including 11 (17%) benign and 55 (83%) malignant lesions. Among malignant lesions 13 (20%) were assessed as intraductal and 42 (64%) as infiltrating carcinomas. The study showed correlation between the level of enhancement on CESM and the type of kinetic curve on MRI and lesion enhance-ment on CESM as well as confirmed the fact that the BPE is a destimulant in both methods of imaging.
Conclusions: Evaluation of BPE level on CESM can help reading radiologists to define a lesion as malignant with higher probability than based only on the qualitative lesion enhancement level.

Abstract

Objectives: With the growing number of new breast cancer cases in women, new methods of imaging arise. Contrast enhanced spectral mammography (CESM) and magnetic resonance imaging (MRI) are comparable methods regarding sensitivity. The aim of this study is to check if analysis of background parenchymal enhancement on CESM can improve its usefulness.
Material and methods: A total of 64 patients with breast lesions found previously on ultrasound or mammography underwent MRI and CESM within less than one month. On MRI the contrast enhancement kinetics and visual BPE were evaluated. On CESM the enhancement of lesions was noted as well as a quantitative level of BPH. The gathered data was analysed in terms of patterns and relations.
Results: A total of 66 lesions were identified both on MRI and CESM, including 11 (17%) benign and 55 (83%) malignant lesions. Among malignant lesions 13 (20%) were assessed as intraductal and 42 (64%) as infiltrating carcinomas. The study showed correlation between the level of enhancement on CESM and the type of kinetic curve on MRI and lesion enhance-ment on CESM as well as confirmed the fact that the BPE is a destimulant in both methods of imaging.
Conclusions: Evaluation of BPE level on CESM can help reading radiologists to define a lesion as malignant with higher probability than based only on the qualitative lesion enhancement level.

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Keywords

breast cancer; mri; cesm; diagnostic imaging; breast; cancer; mammography

About this article
Title

Analysis of background parenchymal enhancement (BPE) on contrast enhanced spectral mammography compared with magnetic resonance imaging

Journal

Ginekologia Polska

Issue

Vol 92, No 2 (2021)

Article type

Research paper

Pages

92-97

Published online

2021-01-13

DOI

10.5603/GP.a2020.0169

Pubmed

33448005

Bibliographic record

Ginekol Pol 2021;92(2):92-97.

Keywords

breast cancer
mri
cesm
diagnostic imaging
breast
cancer
mammography

Authors

Elzbieta Luczynska
Marta Pawlak
Tomasz Piegza
Tadeusz J. Popiela
Sylwia Heinze
Sonia Dyczek
Wojciech Rudnicki

References (11)
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  2. Kalager M, Haldorsen T, Bretthauer M, et al. Improved breast cancer survival following introduction of an organized mammography screening program among both screened and unscreened women: a population-based cohort study. Breast Cancer Res. 2009; 11(4): R44.
  3. Fallenberg EM, Schmitzberger FF, Amer H, et al. Contrast-enhanced spectral mammography vs. mammography and MRI - clinical performance in a multi-reader evaluation. Eur Radiol. 2017; 27(7): 2752–2764.
  4. Covington MF, Pizzitola VJ, Lorans R, et al. The Future of Contrast-Enhanced Mammography. AJR Am J Roentgenol. 2018; 210(2): 292–300.
  5. Barra FR, Sobrinho AB, Barra RR, et al. Contrast-Enhanced Mammography (CEM) for Detecting Residual Disease after Neoadjuvant Chemotherapy: A Comparison with Breast Magnetic Resonance Imaging (MRI). Biomed Res Int. 2018; 2018: 8531916.
  6. Morris EA, Comstock CE, Lee CH. et al.. ACR BI-RADS® Magnetic Resonance Imaging. In: ACR BI-RADS® Atlas, Breast Imaging Reporting and Data System. American College of Radiology, Reston, VA 2013.
  7. King V, Brooks JD, Bernstein JL, et al. Background parenchymal enhancement at breast MR imaging and breast cancer risk. Radiology. 2011; 260(1): 50–60.
  8. Sorin V, Yagil Y, Shalmon A, et al. Background Parenchymal Enhancement at Contrast-Enhanced Spectral Mammography (CESM) as a Breast Cancer Risk Factor. Acad Radiol. 2020; 27(9): 1234–1240.
  9. Savaridas SL, Taylor DB, Gunawardana D, et al. Could parenchymal enhancement on contrast-enhanced spectral mammography (CESM) represent a new breast cancer risk factor? Correlation with known radiology risk factors. Clin Radiol. 2017; 72(12): 1085.e1–1085.e9.
  10. Kim G, Phillips J, Cole E, et al. Comparison of Contrast-Enhanced Mammography With Conventional Digital Mammography in Breast Cancer Screening: A Pilot Study. J Am Coll Radiol. 2019; 16(10): 1456–1463.
  11. Zhao S, Zhang X, Zhong H, et al. Background Parenchymal Enhancement on Contrast-Enhanced Spectral Mammography: Influence of Age, Breast Density, Menstruation Status, and Menstrual Cycle Timing. Sci Rep. 2020; 10(1): 8608.

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