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, 0.4-4.7cm); 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, 8.3% (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.