RSNA 2019 MRI Preview

How suitable is CESM as a breast MRI alternative?

By Kate Madden Yee, staff writer

November 6, 2019 --

Tuesday, December 3 | 10:40 a.m.–10:50 a.m. | SSG01-02 | Room S102CD
At this Tuesday morning session, German researchers will explore how suitable contrast-enhanced spectral mammography (CESM) is as an alternative to MRI for breast cancer screening.

"CESM has been proposed as an alternate to MRI for screening as well as staging of breast cancer," noted presenter Dr. Simone Schrading, of University Hospital Aachen, and colleagues "Recent studies suggest that CESM offers a similar sensitivity, yet a significantly higher specificity and positive predictive value compared with MRI. Therefore, we investigated whether one can exploit the superior diagnostic accuracy of CESM for workup of suspicious findings made on breast MRI."

Schrading's team conducted a study that included 53 asymptomatic patients with 53 contrast-enhancing lesions found on breast MRI and categorized as BI-RADS 4. All the women also underwent a CESM exam; four breast radiologists read both the breast MRI and the CESM studies.

Of the 53 suspicious findings detected on MRI, 25 (47.2%) were malignant. CESM, however, indicated the presence of breast cancer in 45 of the 53 patients (85%).

"CESM is not suitable for the noninvasive workup of MRI BI-RADS 4 lesions because false-positive findings on MRI do mostly also enhance on CESM," the group concluded.