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This research aims to evaluate the effectiveness of combining 3D automated breast ultrasound (ABUS) with contrast-enhanced spectral mammography (CESM) in assessing breast lesions.

May 28, 2026Open Access

The additive value of 3D automated breast ultrasound and contrast enhanced spectral mammography in the assessment of suspicious breast lesions

Key Points

This research aims to evaluate the effectiveness of combining 3D automated breast ultrasound (ABUS) with contrast-enhanced spectral mammography (CESM) in assessing breast lesions.
Randomly selected 106 patients with BIRADS IV-V lesions from mammography.
Evaluated using CESM and 3D ABUS by two blinded experienced radiologists.
Compared sensitivity and specificity between the combined test and CESM alone.
Combined test showed 80% sensitivity versus 40% for CESM alone.
Specificity was 70% for both CESM and the combined tests.
ABUS detected suspicious lesions with 61% accuracy compared to 40% for CESM.

Abstract

Abstract Background Worldwide, breast cancer is the most commonly diagnosed cancer among women accounting for over a million cases each year. Mammography still remains the gold standard for early detection of breast cancer. Contrast Enhanced Spectral Mammography (CESM) allows better estimation of the lesion size and detection of multifocal breast cancers. Automated breast ultrasound (ABUS) is an innovation of breast ultrasound that attains 3-D images of the entire breast overcoming the limitations of hand-held ultrasound. The aim is to evaluate the impact of 3D ABUS in correlation with CESM on the characterization and assessment of disease extent. Design both observers were blinded to the pathological data of each patient. Results Regarding primary outcome of our study in assessment of tumor size, extension and multiplicity, the use of ABUS after CESM showed significant increase in the sensitivity of the test (80% for combined test versus 40% for CESM alone), while it showed almost no significant difference in specificity (70% for CESM and Combined tests).The ABUS also showed more accuracy in detection of suspicious lesions (61%) than the CESM (40%.) Conclusion ABUS is considered a revolution in breast scanning by ultrasound imaging that can be used as a non-invasive complementary tool to CESM in assessment of suspicious breast lesions showing increased accuracy of study and patient outcome upon combing both of them.

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