{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T19:34:09Z","timestamp":1762544049543,"version":"3.41.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T00:00:00Z","timestamp":1732492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"cost of contrast materials"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To assess the positive predictive value-3 (PPV3) and negative predictive value (NPV) of contrast-enhanced mammography (CEM) when added to the diagnostic workup of suspicious breast findings.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This prospective study was IRB approved. We recruited 99 women with abnormal findings on digital breast tomosynthesis (DBT) and\/or US to undergo CEM prior to biopsy. Based on final pathology outcomes, PPV3 and NPV were calculated and compared using N-1 chi-squared tests with P-values and 95% CIs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Final pathologic outcome yielded 56.6% (56\/99) benign, 5.1% (5\/99) benign with upgrade potential (BWUP), and 38.4% (38\/99) malignant lesions. Final pathologic outcomes for the 63 positive CEMs yielded 33.3% (21\/63) benign, 6.3% (4\/63) BWUP, and 60.3% (38\/63) malignant lesions. Adding CEM to the diagnostic workup significantly increased PPV3 from 38.4% (38\/99) to 60.3% (38\/63) (P\u2009&amp;lt;.01; 95% CI, 6.1-36.2). Negative predictive value was 100% (36\/36) for CEM, 92.9% (13\/14; P\u2009=\u2009.1; 95% CI, -4.2 to 31.4) for DBT, and 75.9% (22\/29; P\u2009&amp;lt;.05; 95% CI, 8.8-42.1) for US. The number of unnecessary biopsies could be reduced by 36.4% (from 100% [99\/99] to 63.6% [63\/99]).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Adding CEM to the diagnostic workup of suspicious breast findings could improve PPV3 to prevent unnecessary biopsies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jbi\/wbae081","type":"journal-article","created":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T19:49:26Z","timestamp":1732564166000},"page":"280-290","source":"Crossref","is-referenced-by-count":1,"title":["Can Contrast-Enhanced Mammography Improve Positive Predictive Value for Diagnostic Workup of Suspicious Findings? A Single-Arm Prospective Study"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2140-6806","authenticated-orcid":false,"given":"Jason","family":"Shames","sequence":"first","affiliation":[{"name":"Department of Breast Imaging, Thomas Jefferson University , Philadelphia, PA ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6858-9497","authenticated-orcid":false,"given":"Adrien","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Breast Imaging, Thomas Jefferson University , Philadelphia, PA ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Sciotto","sequence":"additional","affiliation":[{"name":"Department of Breast Imaging, Thomas Jefferson University , Philadelphia, PA ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Zorn","sequence":"additional","affiliation":[{"name":"Department of Breast Imaging, Thomas Jefferson University , Philadelphia, PA ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theresa","family":"Kaufman","sequence":"additional","affiliation":[{"name":"Department of Breast Imaging, Thomas Jefferson University , Philadelphia, PA ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annina","family":"Wilkes","sequence":"additional","affiliation":[{"name":"Department of Breast Imaging, Thomas Jefferson University , Philadelphia, PA ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Sevrukov","sequence":"additional","affiliation":[{"name":"Department of Breast Imaging, Thomas Jefferson University , Philadelphia, PA ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chhavi","family":"Kaushik","sequence":"additional","affiliation":[{"name":"Department of Breast Imaging, Thomas Jefferson University , Philadelphia, PA ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ripple","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Breast Imaging, Thomas Jefferson University , Philadelphia, PA ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne","family":"Pascarella","sequence":"additional","affiliation":[{"name":"Department of Breast Imaging, Thomas Jefferson University , Philadelphia, PA ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashlee","family":"Byrd","sequence":"additional","affiliation":[{"name":"Department of Breast Imaging, Thomas Jefferson University , Philadelphia, PA ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lydia","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Breast Imaging, Thomas Jefferson University , Philadelphia, PA ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,11,25]]},"reference":[{"volume-title":"Contrast enhanced digital mammography: 510(k) premarket notification. 510(k) summary","author":"Hologic, Inc","key":"2025052712541269600_CIT0001"},{"issue":"1","key":"2025052712541269600_CIT0002","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1148\/radiol.2291021276","article-title":"Dual-energy contrast-enhanced digital subtraction mammography: feasibility","volume":"229","author":"Lewin","year":"2003","journal-title":"Radiology"},{"issue":"1098","key":"2025052712541269600_CIT0003","doi-asserted-by":"publisher","first-page":"20180245","DOI":"10.1259\/bjr.20180245","article-title":"Added value of contrast-enhanced mammography in assessment of breast asymmetries","volume":"92","author":"Wessam","year":"2019","journal-title":"Br J Radiol"},{"key":"2025052712541269600_CIT0004","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1016\/j.clinimag.2017.07.003","article-title":"Clinical utility of contrast-enhanced spectral mammography as an adjunct for tomosynthesis-detected architectural distortion","volume":"46","author":"Patel","year":"2017","journal-title":"Clin Imaging"},{"issue":"11","key":"2025052712541269600_CIT0005","doi-asserted-by":"publisher","first-page":"1148","DOI":"10.1016\/j.crad.2016.05.009","article-title":"Contrast-enhanced spectral mammography improves diagnostic accuracy in the symptomatic setting","volume":"71","author":"Tennant","year":"2016","journal-title":"Clin Radiol"},{"issue":"1098","key":"2025052712541269600_CIT0006","doi-asserted-by":"publisher","first-page":"20180929","DOI":"10.1259\/bjr.20180929","article-title":"Contrast enhanced digital mammography versus magnetic resonance imaging for accurate measurement of the size of breast cancer","volume":"92","author":"Youn","year":"2019","journal-title":"Br J Radiol"},{"key":"2025052712541269600_CIT0007","doi-asserted-by":"publisher","first-page":"8531916","DOI":"10.1155\/2018\/8531916","article-title":"Contrast-enhanced mammography (CEM) for detecting residual disease after neoadjuvant chemotherapy: a comparison with breast magnetic resonance imaging (MRI)","volume":"2018","author":"Barra","year":"2018","journal-title":"Biomed Res Int"},{"issue":"1","key":"2025052712541269600_CIT0008","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1148\/radiol.2019182660","article-title":"Performance of dual-energy contrast-enhanced digital mammography for screening women at increased risk of breast cancer","volume":"293","author":"Sung","year":"2019","journal-title":"Radiology"},{"issue":"5","key":"2025052712541269600_CIT0009","doi-asserted-by":"publisher","first-page":"e985","DOI":"10.1016\/j.clbc.2018.06.003","article-title":"Diagnostic value of contrast-enhanced spectral mammography for screening breast cancer: systematic review and meta-analysis","volume":"18","author":"Zhu","year":"2018","journal-title":"Clin Breast Cancer"},{"issue":"3","key":"2025052712541269600_CIT0010","doi-asserted-by":"publisher","first-page":"568","DOI":"10.1148\/radiol.211412","article-title":"Contrast-enhanced mammography: a systematic review and meta-analysis of diagnostic performance","volume":"302","author":"Cozzi","year":"2022","journal-title":"Radiology"},{"issue":"8","key":"2025052712541269600_CIT0011","doi-asserted-by":"publisher","first-page":"e7128","DOI":"10.1002\/cam4.7128","article-title":"Diagnostic performance of contrast-enhanced mammography for suspicious findings in dense breasts: a systematic review and meta-analysis","volume":"13","author":"Lin","year":"2024","journal-title":"Cancer Med"},{"issue":"4","key":"2025052712541269600_CIT0012","doi-asserted-by":"publisher","first-page":"e222499","DOI":"10.1148\/radiol.222499","article-title":"National performance benchmarks for screening digital breast tomosynthesis: update from the Breast Cancer Surveillance Consortium","volume":"307","author":"Lee","year":"2023","journal-title":"Radiology"},{"volume-title":"ACR BI-RADS\u00ae Atlas, Breast Imaging Reporting and Data System","year":"2013","author":"D\u2019Orsi","key":"2025052712541269600_CIT0013"},{"issue":"2","key":"2025052712541269600_CIT0014","first-page":"65","article-title":"Determination of serum creatinine prior to iodinated contrast media: is it necessary in all patients","volume":"4","author":"Choyke","year":"1998","journal-title":"Tech Urol"},{"issue":"1","key":"2025052712541269600_CIT0015","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1148\/radiol.2021201948","article-title":"Contrast-enhanced mammography: state of the art","volume":"299","author":"Jochelson","year":"2021","journal-title":"Radiology"},{"volume-title":"Contrast enhanced mammography (CEM): (a supplement to ACR BI-RADS Mammography 2013)","year":"2022","author":"Lee","key":"2025052712541269600_CIT0016"},{"issue":"10","key":"2025052712541269600_CIT0017","doi-asserted-by":"publisher","first-page":"1006","DOI":"10.1007\/s11547-019-01056-2","article-title":"Diagnostic performance of contrast-enhanced dual-energy spectral mammography (CESM): a retrospective study involving 644 breast lesions","volume":"124","author":"Travieso-Aja","year":"2019","journal-title":"Radiol Med"},{"issue":"12","key":"2025052712541269600_CIT0018","doi-asserted-by":"publisher","first-page":"3495","DOI":"10.3390\/cancers12123495","article-title":"Contrast-enhanced mammography for screening women after breast conserving surgery","volume":"12","author":"Gluskin","year":"2020","journal-title":"Cancer"},{"issue":"15","key":"2025052712541269600_CIT0019","doi-asserted-by":"publisher","first-page":"2520","DOI":"10.3390\/diagnostics13152520","article-title":"Diagnostic performance of contrast-enhanced digital mammography versus conventional imaging in women with dense breasts","volume":"13","author":"Moffa","year":"2023","journal-title":"Diagnostics (Basel)"},{"issue":"3","key":"2025052712541269600_CIT0020","doi-asserted-by":"publisher","first-page":"595","DOI":"10.2214\/AJR.20.24368","article-title":"Utility of targeted ultrasound to predict malignancy among lesions detected on contrast-enhanced digital mammography","volume":"217","author":"Coffey","year":"2021","journal-title":"AJR Am J Roentgenol"},{"issue":"5","key":"2025052712541269600_CIT0021","doi-asserted-by":"publisher","first-page":"797","DOI":"10.2214\/AJR.21.26847","article-title":"Comparison of false-positive versus true-positive findings on contrast-enhanced digital mammography","volume":"218","author":"Amir","year":"2022","journal-title":"AJR Am J Roentgenol"},{"issue":"4","key":"2025052712541269600_CIT0022","doi-asserted-by":"publisher","first-page":"453","DOI":"10.4048\/jbc.2018.21.e62","article-title":"Diagnostic value of contrast-enhanced digital mammography versus contrast-enhanced magnetic resonance imaging for the preoperative evaluation of breast cancer","volume":"21","author":"Kim","year":"2018","journal-title":"J Breast Cancer"},{"issue":"9","key":"2025052712541269600_CIT0023","doi-asserted-by":"publisher","first-page":"e0162740","DOI":"10.1371\/journal.pone.0162740","article-title":"Dual-energy contrast-enhanced spectral mammography: enhancement analysis on BI-RADS 4 non-mass microcalcifications in screened women","volume":"11","author":"Cheung","year":"2016","journal-title":"PLoS One"},{"issue":"9","key":"2025052712541269600_CIT0024","doi-asserted-by":"publisher","first-page":"1110","DOI":"10.1177\/0284185118822639","article-title":"Contrast-enhanced spectral mammography in the evaluation of breast suspicious calcifications: diagnostic accuracy and impact on surgical management","volume":"60","author":"Houben","year":"2019","journal-title":"Acta Radiol"},{"key":"2025052712541269600_CIT0025","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.breast.2020.08.009","article-title":"Which clinical, radiological, histological, and molecular parameters are associated with the absence of enhancement of known breast cancers with contrast enhanced digital mammography (CEDM)","volume":"54","author":"Bicchierai","year":"2020","journal-title":"Breast"},{"issue":"4","key":"2025052712541269600_CIT0026","doi-asserted-by":"publisher","first-page":"754","DOI":"10.3390\/diagnostics13040754","article-title":"Is the level of contrast enhancement on contrast-enhanced mammography (CEM) associated with the presence and biological aggressiveness of breast cancer","volume":"13","author":"Marzogi","year":"2023","journal-title":"Diagnostics (Basel)"},{"issue":"5","key":"2025052712541269600_CIT0027","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1007\/s12282-024-01599-x","article-title":"Contrast-enhanced mammography in the management of breast architectural distortions and avoidance of unnecessary biopsies","volume":"31","author":"Bellini","year":"2024","journal-title":"Breast Cancer"},{"issue":"12","key":"2025052712541269600_CIT0028","doi-asserted-by":"publisher","first-page":"e230100","DOI":"10.1148\/rg.230100","article-title":"False-positive and false-negative contrast-enhanced mammograms: pitfalls and strategies to improve cancer detection","volume":"43","author":"Carnahan","year":"2023","journal-title":"Radiographics"},{"issue":"7","key":"2025052712541269600_CIT0029","doi-asserted-by":"publisher","first-page":"1774","DOI":"10.3390\/cancers14071774","article-title":"Radiation dose of contrast-enhanced mammography: a two-center prospective comparison","volume":"14","author":"Gennaro","year":"2022","journal-title":"Cancers (Basel)"},{"issue":"2","key":"2025052712541269600_CIT0030","doi-asserted-by":"publisher","first-page":"362","DOI":"10.2214\/AJR.16.16743","article-title":"Breast radiation dose with CESM compared with 2D FFDM and 3D tomosynthesis mammography","volume":"208","author":"James","year":"2017","journal-title":"Am J Roentgenol"}],"container-title":["Journal of Breast Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jbi\/article-pdf\/7\/3\/280\/60811934\/wbae081.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jbi\/article-pdf\/7\/3\/280\/60811934\/wbae081.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T16:54:27Z","timestamp":1748364867000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jbi\/article\/7\/3\/280\/7908491"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,25]]},"references-count":30,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,11,25]]},"published-print":{"date-parts":[[2025,5,17]]}},"URL":"https:\/\/doi.org\/10.1093\/jbi\/wbae081","relation":{},"ISSN":["2631-6110","2631-6129"],"issn-type":[{"type":"print","value":"2631-6110"},{"type":"electronic","value":"2631-6129"}],"subject":[],"published-other":{"date-parts":[[2025,5]]},"published":{"date-parts":[[2024,11,25]]}}}