Clinical utility of contrast-enhanced spectral mammography as an adjunct for tomosynthesis-detected architectural distortion

Objective: Supplement tomosynthesis-detected architectural distortions (AD) with CESM to better characterize malignant vs benign lesions. Methods: Retrospective review CESM prior to biopsied AD. Pathology: benign, radial scar, or malignant. Results: 49 lesions (45 patients). 29 invasive cancers, 1 DCIS (range, 0.4-4.7 cm); 9 radial scars; 10 benign. 37 (75.5%) ADs had associated enhancement. PPV 78.4% (29/37), sensitivity 96.7% (29/30); specificity, 57.9% (11/19); NPV, 91.7% (11/12). False-positive rate 21.6% (8/37); false-negative rate, 83% (1/12). Accuracy 81.6% (40/49). Conclusions: High sensitivity and NPV of CESM in patients with AD is promising as an adjunct tool in diagnosing malignancy and avoiding unnecessary biopsy, respectively. (C) 2017 Elsevier Inc. All rights reserved.