Value of Contrast-Enhanced Spectral Mammography Combined with Clinical Indicators in the Differentiation of Benign and Malignant Breast Lesions
10.3969/j.issn.1005-5185.2024.12.008
- VernacularTitle:对比增强能谱乳腺X线摄影联合临床指标鉴别乳腺病灶良恶性的价值
- Author:
Yijing ZHOU
1
;
Mingge ZHOU
;
Yufeng LI
;
Bao LIU
Author Information
1. 苏州大学附属第三医院、常州市第一人民医院医学影像科,江苏 常州 213003
- Publication Type:Journal Article
- Keywords:
Mammography;
Breast neoplasms;
Differential diagnosis
- From:
Chinese Journal of Medical Imaging
2024;32(12):1237-1242
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To investigate the value of the breast imaging reporting and data system (BI-RADS) score of low-energy image combined with enhancement score and clinical indicators in the differentiation of benign and malignant breast lesions based on contrast-enhanced spectral mammography (CESM). Materials and Methods A total of 193 female patients,who underwent CESM examination in the Third Affiliated Hospital of Soochow University from January 2018 to June 2023,with BI-RADS score of Class 3 or higher based on low-energy image were retrospectively collected. According to the surgical or puncture pathological results,all patients were divided into malignant and benign groups. The general information,imaging features and enhancement degree between the two groups were compared,respectively. Logistic regression was used to construct a predictive model (Model 3) for the combination of BI-RADS score based on low-energy image,enhancement score and clinical indicators. The predictive performance of Model 3 was evaluated and compared with Model 1 (BI-RADS score based on low-energy image) and Model 2 (BI-RADS score based on low-energy image+enhancement score). Results Of 193 patients,73 were benign and 120 were malignant. There were significant differences in age (t=3.75,P<0.001),menopausal history (x2=14.00,P<0.001),BI-RADS score based on low-energy image (x2=77.36,P<0.001) and enhancement score (x2=36.34,P<0.001) between the malignant and benign groups. The area under the curve (AUC) of Model 1,Model 2 and Model 3 were 0.852,0.859 and 0.871,respectively. The AUC,net reclassification improvement,integrated discrimination improvement and decision curve of Model 3 were better than those of Model 1 and Model 2. The optimal cutoff value for Model 3 was 0.595,with a corresponding sensitivity of 82.2％ and specificity of 83.3％. Conclusion In the suspected breast cancer patients of category 3 and above of BI-RADS based on low-energy image,the combination of enhancement score and clinical indicators based on BI-RADS score of low-energy image is helpful to improve the efficiency of CESM in diagnosing breast cancer.
