To evaluate the diagnostic accuracy of Magnetic Resonance Imaging (MRI) and Contrast-Enhanced Mammography (CEM) and to determine which better estimates lesion size. Between September 2017 and November 2023, 139 histopathologically confirmed lesions from 95 patients who underwent MRI and CEM were retrospectively analyzed. BI-RADS categories and lesion diameters were reassessed. Sensitivity, specificity, and area under the curve (AUC) were calculated. Breast density, background parenchymal enhancement, and discrepancies in lesion size compared to histopathology were evaluated. Among 139 lesions (117 malignant, 22 benign), MRI detected 112 true positives (TPs) and 5 false negatives (FNs); CEM reported 98 TPs and 19 FNs. For benign lesions, MRI showed 8 false positives (FPs) and 14 true negatives (TNs); CEM, 2 FPs and 20 TNs. Sensitivity was 95.7% for MRI vs. 83.8% for CEM ( p = 0.002); specificity was 63.6% vs. 90.9%, respectively ( p = 0.058). AUC was 0.90 for MRI and 0.86 for CEM ( p = 0.45). Both techniques tended to overestimate tumor size (+ 3.35 mm MRI, + 4.04 mm CEM), with no significant difference in accuracy ( p = 0.389). MRI showed higher sensitivity than CEM for detecting malignant lesions, although their accuracy was similar. Both techniques tend to overestimate tumor size.
Barrio-Piqueras et al. (Thu,) studied this question.