Background parenchymal enhancement on contrast-enhanced mammography: associations with breast density and patient's characteristics.

IF 9.7 1区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Radiologia Medica Pub Date : 2024-09-01 Epub Date: 2024-07-26 DOI:10.1007/s11547-024-01860-5
Veronica Magni, Andrea Cozzi, Giulia Muscogiuri, Adrienn Benedek, Gabriele Rossini, Marianna Fanizza, Giuseppe Di Giulio, Francesco Sardanelli
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Abstract

Purpose: To evaluate if background parenchymal enhancement (BPE) on contrast-enhanced mammography (CEM), graded according to the 2022 CEM-dedicated Breast Imaging Reporting and Data System (BI-RADS) lexicon, is associated with breast density, menopausal status, and age.

Methods: This bicentric retrospective analysis included CEM examinations performed for the work-up of suspicious mammographic findings. Three readers independently and blindly evaluated BPE on recombined CEM images and breast density on low-energy CEM images. Inter-reader reliability was estimated using Fleiss κ. Multivariable binary logistic regression was performed, dichotomising breast density and BPE as low (a/b BI-RADS categories, minimal/mild BPE) and high (c/d BI-RADS categories, moderate/marked BPE).

Results: A total of 200 women (median age 56.8 years, interquartile range 50.5-65.6, 140/200 in menopause) were included. Breast density was classified as a in 27/200 patients (13.5%), as b in 110/200 (55.0%), as c in 52/200 (26.0%), and as d in 11/200 (5.5%), with moderate inter-reader reliability (κ = 0.536; 95% confidence interval [CI] 0.482-0.590). BPE was minimal in 95/200 patients (47.5%), mild in 64/200 (32.0%), moderate in 25/200 (12.5%), marked in 16/200 (8.0%), with substantial inter-reader reliability (κ = 0.634; 95% CI 0.581-0.686). At multivariable logistic regression, premenopausal status and breast density were significant positive predictors of high BPE, with adjusted odds ratios of 6.120 (95% CI 1.847-20.281, p = 0.003) and 2.416 (95% CI 1.095-5.332, p = 0.029) respectively.

Conclusion: BPE on CEM is associated with well-established breast cancer risk factors, being higher in women with higher breast density and premenopausal status.

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对比增强乳腺 X 射线造影术的背景实质增强:与乳腺密度和患者特征的关系。
目的:评估造影剂增强乳腺 X 线摄影(CEM)的背景实质增强(BPE)是否与乳腺密度、绝经状态和年龄有关(根据 2022 年 CEM 专用的乳腺成像报告和数据系统(BI-RADS)词典进行分级):这项双中心回顾性分析包括对可疑乳腺 X 线造影结果进行的 CEM 检查。三名读片员独立、盲法评估重组 CEM 图像上的 BPE 和低能量 CEM 图像上的乳腺密度。读片者之间的可靠性使用 Fleiss κ 进行估算。进行多变量二元逻辑回归,将乳腺密度和BPE二分为低(a/b BI-RADS类别,最小/轻度BPE)和高(c/d BI-RADS类别,中度/标记BPE):共纳入 200 名妇女(中位年龄 56.8 岁,四分位数范围 50.5-65.6,140/200 名妇女处于绝经期)。有 27/200 名患者(13.5%)的乳腺密度被划分为 a,110/200 名患者(55.0%)的乳腺密度被划分为 b,52/200 名患者(26.0%)的乳腺密度被划分为 c,11/200 名患者(5.5%)的乳腺密度被划分为 d。95/200(47.5%)例患者的 BPE 为轻度,64/200(32.0%)例患者为轻度,25/200(12.5%)例患者为中度,16/200(8.0%)例患者为重度,读数间可靠性相当高(κ = 0.634;95% 置信区间 [CI] 0.581-0.686)。在多变量逻辑回归中,绝经前状态和乳腺密度是高 BPE 的显著正向预测因素,调整后的几率比分别为 6.120 (95% CI 1.847-20.281, p = 0.003) 和 2.416 (95% CI 1.095-5.332, p = 0.029):结论:CEM上的BPE与已确定的乳腺癌风险因素有关,乳腺密度较高和绝经前的妇女BPE更高。
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来源期刊
Radiologia Medica
Radiologia Medica 医学-核医学
CiteScore
14.10
自引率
7.90%
发文量
133
审稿时长
4-8 weeks
期刊介绍: Felice Perussia founded La radiologia medica in 1914. It is a peer-reviewed journal and serves as the official journal of the Italian Society of Medical and Interventional Radiology (SIRM). The primary purpose of the journal is to disseminate information related to Radiology, especially advancements in diagnostic imaging and related disciplines. La radiologia medica welcomes original research on both fundamental and clinical aspects of modern radiology, with a particular focus on diagnostic and interventional imaging techniques. It also covers topics such as radiotherapy, nuclear medicine, radiobiology, health physics, and artificial intelligence in the context of clinical implications. The journal includes various types of contributions such as original articles, review articles, editorials, short reports, and letters to the editor. With an esteemed Editorial Board and a selection of insightful reports, the journal is an indispensable resource for radiologists and professionals in related fields. Ultimately, La radiologia medica aims to serve as a platform for international collaboration and knowledge sharing within the radiological community.
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