Comparison of breast magnetic resonance imaging and contrast enhanced spectral mammography

Aim: The aim of our study was to compare the findings of Breast Magnetic Resonance Imaging and Contrast Enhanced Spectral Mammography Material and Methods: A total of 116 patients admitted to our center with clinical suspicion of breast malignancy or who had suspicious findings on other imaging methods were included in this study. All CESM examinations were performed at our institution. 56.89% of all MRI examinations were performed at other centers. Imaging findings were characterized according to ACR BI-RADS by two observers. While histopathological results of all malignant lesions were available, the final diagnosis of 80.5% of benign lesions was determined by typical imaging findings and follow-up. Malignant and precursor lesions were accepted as positive finding and the performance of two imaging methods were evaluated. Results: This study included 219 lesions: 125/219 (57.07%) malignant and 94/219 (42.92%) benign. Sensitivity and specificity were 98.40% and 81.91%, respectively for CESM, and 100% and 75,33% for MRI. CESM showed no statistically significant difference with histopathology in the evaluation of lesion size which were consistent with MRI. CESM showed similar performance with the MRI in the evaluation of additional foci. Malignant lesions showed higher degree of enhancement compared to benign lesions on CESM. CESM demonstrated similar performance with the MRI in the evaluation of women who have dens breast and suspicious calcifications. Conclusion: CESM is alternative and have comparable diagnostic performance to MRI in the evaluation of breast lesions.