Digital Breast Tomosynthesis for Upgraded BIRADS Scoring towards the True Pathology of Lesions Detected by Contrast-Enhanced Mammography

Ahuva Grubstein*, Tal Friehmann, Marva Dahan, Chen Abitbol, Ithai Gadiel, Dario M. Schejtman, Tzippy Shochat, Eli Atar, Shlomit Tamir

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To determine the added value of digital breast tomosynthesis (DBT) in the assessment of lesions detected by contrast-enhanced mammography (CEM). Material and methods: A retrospective study was conducted in a tertiary university medical center. All CEM studies including DBT performed between January 2016 and December 2020 were included. Lesions were categorized and scored by four dedicated breast radiologists according to the recent CEM and DBT supplements to the Breast Imaging Reporting and Data System (BIRADS) lexicon. Changes in the BIRADS score of CEM-detected lesions with the addition of DBT were evaluated according to the pathology results and 1-year follow-up imaging study. Results: BIRADS scores of CEM-detected lesions were upgraded toward the lesion’s pathology with the addition of DBT (p > 0.0001), overall and for each reader. The difference in BIRADS scores before and after the addition of DBT was more significant for readers who were less experienced. The reason for changes in the BIRADS score was better lesion margin visibility. The main BIRADS descriptors applied in the malignant lesions were spiculations, calcifications, architectural distortion, and sharp or obscured margins. Conclusions: The addition of DBT to CEM provides valuable information on the enhancing lesion, leading to a more accurate BIRADS score.

Original languageEnglish
Pages (from-to)806-815
Number of pages10
JournalTomography
Volume10
Issue number5
DOIs
StatePublished - May 2024

Keywords

  • breast imaging
  • contrast-enhanced mammography
  • digital breast tomosynthesis

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