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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

Threshold gold thickness detected as a function of gold disk diameter for a range of phantom thicknesses corresponding to breast thicknesses from (A) 32 mm to (E) 90 mm. The solid and dashed lines are data fits. In (C) the acceptable and achievable limits of the EUREF guidelines are also shown
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Fig3: Threshold gold thickness detected as a function of gold disk diameter for a range of phantom thicknesses corresponding to breast thicknesses from (A) 32 mm to (E) 90 mm. The solid and dashed lines are data fits. In (C) the acceptable and achievable limits of the EUREF guidelines are also shown

Mentions: The settings used in the CDMAM phantom measurements (Table 2) and the resulting AGD values (compare Table 2 to Fig. 2) are representative for settings used in the patient groups. Furthermore, the AGD values used in all measurements are well below the achievable dose levels reported in the EUREF guidelines [6], except for one that is well below the acceptable limit. Figure 3 shows the threshold thickness of the observed gold disks versus the gold disk diameter, for each phantom thickness. The threshold contrast visibility for both systems is well below the achievable limit values for a standard breast thickness of 60 mm (50 mm PMMA equivalent) stated in the EUREF guidelines [6]. For all breast thicknesses no significant differences in detection threshold thickness were found between the FFDM and LE curves (p-values of 0.29, 0.10, 0.13, 0.42 and 0.12 for breast thickness of 30, 45, 60, 75 and 90 mm, respectively).Fig. 3


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)

Threshold gold thickness detected as a function of gold disk diameter for a range of phantom thicknesses corresponding to breast thicknesses from (A) 32 mm to (E) 90 mm. The solid and dashed lines are data fits. In (C) the acceptable and achievable limits of the EUREF guidelines are also shown
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig3: Threshold gold thickness detected as a function of gold disk diameter for a range of phantom thicknesses corresponding to breast thicknesses from (A) 32 mm to (E) 90 mm. The solid and dashed lines are data fits. In (C) the acceptable and achievable limits of the EUREF guidelines are also shown
Mentions: The settings used in the CDMAM phantom measurements (Table 2) and the resulting AGD values (compare Table 2 to Fig. 2) are representative for settings used in the patient groups. Furthermore, the AGD values used in all measurements are well below the achievable dose levels reported in the EUREF guidelines [6], except for one that is well below the acceptable limit. Figure 3 shows the threshold thickness of the observed gold disks versus the gold disk diameter, for each phantom thickness. The threshold contrast visibility for both systems is well below the achievable limit values for a standard breast thickness of 60 mm (50 mm PMMA equivalent) stated in the EUREF guidelines [6]. For all breast thicknesses no significant differences in detection threshold thickness were found between the FFDM and LE curves (p-values of 0.29, 0.10, 0.13, 0.42 and 0.12 for breast thickness of 30, 45, 60, 75 and 90 mm, respectively).Fig. 3

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