Comparison of diagnostic values between digital breast tomosynthesis and contrast-enhanced mammography for BI-RADS 4 breast lesions

WANG Mei; ZHANG Ziyan; ZHU Jianguo; LIU Fei; LI Haige

Abstract：Objective To analyze the values of contrast-enhanced mammography(CEM),full-field digital mammography(FFDM),and digital breast tomosynthesis(DBT)in the size assessment and differential diagnosis of BI-RADS 4 lesions.Methods A total of 124 patients with 136 BI-RADS 4 breast lesions confirmed by pathology were enrolled in this study.All pa-tients underwent FFDM,DBT and CEM examinations before surgery.The correlation and agreement between FFDM,DBT,CEM and histopathologic tumor size were evaluated by Spearman correlation analysis and Bland-Altman analysis.The receiver-operating characteristic curve(ROC)was plotted to analyze the diagnostic efficacy of FFDM,DBT and CEM in differentiating benign and malignant breast lesions of BI-RADS 4 category.Results The values measured by FFDM,DBT and CEM were posi-tively correlated with the pathological measurement(r=0.856,r=0.892 and 0.902,all P<0.001).For size differences,the mean for histopathology versus FFDM,DBT and CEM was 0.21 cm,0.11 cm and 0.24 cm.The sensitivity of FFDM,DBT and CEM for assessment of benign and malignant breast lesions were 65.22%,79.71%and 85.51%,the specificity were 77.61%,77.61%and 88.06%,and the accuracy were 71.32%,78.68%and 86.76%,correspondingly.The area under the curve(AUC)of CEM was significantly higher than FFDM and DBT(both P<0.01)),while,there was no significantly difference between the AUC of DBT and FFDM(P>0.05).Conclusions DBT is superior to FFDM and CEM for the evaluation of breast lesions size of BI-RADS 4 category.The differential diagnostic efficiency of CEM is superior to FFDM and DBT.