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Evaluation of low-energy contrast-enhanced spectral mammography images by comparing them to full-field digital mammography using EUREF image quality criteria.

Lalji UC, Jeukens CR, Houben I, Nelemans PJ, van Engen RE, van Wylick E, Beets-Tan RG, Wildberger JE, Paulis LE, Lobbes MB - Eur Radiol (2015)

Bottom Line: Contrast-enhanced spectral mammography (CESM) examination results in a low-energy (LE) and contrast-enhanced image.No significant differences in image quality scores were observed between LE and FFDM images for 17 out of 20 criteria.Dose and contrast detail measurements did not reveal any physical explanation for these observed differences.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.

ABSTRACT

Objective: Contrast-enhanced spectral mammography (CESM) examination results in a low-energy (LE) and contrast-enhanced image. The LE appears similar to a full-field digital mammogram (FFDM). Our aim was to evaluate LE CESM image quality by comparing it to FFDM using criteria defined by the European Reference Organization for Quality Assured Breast Screening and Diagnostic Services (EUREF).

Methods: A total of 147 cases with both FFDM and LE images were independently scored by two experienced radiologists using these (20) EUREF criteria. Contrast detail measurements were performed using a dedicated phantom. Differences in image quality scores, average glandular dose, and contrast detail measurements between LE and FFDM were tested for statistical significance.

Results: No significant differences in image quality scores were observed between LE and FFDM images for 17 out of 20 criteria. LE scored significantly lower on one criterion regarding the sharpness of the pectoral muscle (p < 0.001), and significantly better on two criteria on the visualization of micro-calcifications (p = 0.02 and p = 0.034). Dose and contrast detail measurements did not reveal any physical explanation for these observed differences.

Conclusions: Low-energy CESM images are non-inferior to FFDM images. From this perspective FFDM can be omitted in patients with an indication for CESM.

Key points: • Low-energy CESM images are non-inferior to FFDM images. • Micro-calcifications are significantly more visible on LE CESM than on FFDM. • There is no physical explanation for this improved visibility of micro-calcifications. • There is no need for an extra FFDM when CESM is indicated.

No MeSH data available.


Related in: MedlinePlus

Average glandular dose (AGD) of the complete patient group values plotted against compressed breast thickness for the full-field digital mammography (FFDM) (open red circles) and low-energy (LE) (solid black triangles) exposures
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Fig2: Average glandular dose (AGD) of the complete patient group values plotted against compressed breast thickness for the full-field digital mammography (FFDM) (open red circles) and low-energy (LE) (solid black triangles) exposures

Mentions: Figure 2 presents the AGD values of FFDM and LE exposures as a function of compressed breast thickness of all patients. The average pairwise difference of the AGD values was 42 %, where the AGD of the LE was higher than that of FFDM (Table 2). Pairwise analysis showed that not only for the whole patient population but also for all breast thickness categories, the LE AGD values were significantly higher than the FFDM AGD values (Table 2 and 3). Both LE CESM and FFDM AGD-values were in compliance with the acceptable limits of the EUREF guidelines [6].Fig. 2


Evaluation of low-energy contrast-enhanced spectral mammography images by comparing them to full-field digital mammography using EUREF image quality criteria.

Lalji UC, Jeukens CR, Houben I, Nelemans PJ, van Engen RE, van Wylick E, Beets-Tan RG, Wildberger JE, Paulis LE, Lobbes MB - Eur Radiol (2015)

Average glandular dose (AGD) of the complete patient group values plotted against compressed breast thickness for the full-field digital mammography (FFDM) (open red circles) and low-energy (LE) (solid black triangles) exposures
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4562003&req=5

Fig2: Average glandular dose (AGD) of the complete patient group values plotted against compressed breast thickness for the full-field digital mammography (FFDM) (open red circles) and low-energy (LE) (solid black triangles) exposures
Mentions: Figure 2 presents the AGD values of FFDM and LE exposures as a function of compressed breast thickness of all patients. The average pairwise difference of the AGD values was 42 %, where the AGD of the LE was higher than that of FFDM (Table 2). Pairwise analysis showed that not only for the whole patient population but also for all breast thickness categories, the LE AGD values were significantly higher than the FFDM AGD values (Table 2 and 3). Both LE CESM and FFDM AGD-values were in compliance with the acceptable limits of the EUREF guidelines [6].Fig. 2

Bottom Line: Contrast-enhanced spectral mammography (CESM) examination results in a low-energy (LE) and contrast-enhanced image.No significant differences in image quality scores were observed between LE and FFDM images for 17 out of 20 criteria.Dose and contrast detail measurements did not reveal any physical explanation for these observed differences.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.

ABSTRACT

Objective: Contrast-enhanced spectral mammography (CESM) examination results in a low-energy (LE) and contrast-enhanced image. The LE appears similar to a full-field digital mammogram (FFDM). Our aim was to evaluate LE CESM image quality by comparing it to FFDM using criteria defined by the European Reference Organization for Quality Assured Breast Screening and Diagnostic Services (EUREF).

Methods: A total of 147 cases with both FFDM and LE images were independently scored by two experienced radiologists using these (20) EUREF criteria. Contrast detail measurements were performed using a dedicated phantom. Differences in image quality scores, average glandular dose, and contrast detail measurements between LE and FFDM were tested for statistical significance.

Results: No significant differences in image quality scores were observed between LE and FFDM images for 17 out of 20 criteria. LE scored significantly lower on one criterion regarding the sharpness of the pectoral muscle (p < 0.001), and significantly better on two criteria on the visualization of micro-calcifications (p = 0.02 and p = 0.034). Dose and contrast detail measurements did not reveal any physical explanation for these observed differences.

Conclusions: Low-energy CESM images are non-inferior to FFDM images. From this perspective FFDM can be omitted in patients with an indication for CESM.

Key points: • Low-energy CESM images are non-inferior to FFDM images. • Micro-calcifications are significantly more visible on LE CESM than on FFDM. • There is no physical explanation for this improved visibility of micro-calcifications. • There is no need for an extra FFDM when CESM is indicated.

No MeSH data available.


Related in: MedlinePlus