{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T09:19:23Z","timestamp":1783675163867,"version":"3.55.0"},"reference-count":30,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Med Imag Rad Onc"],"abstract":"ABSTRACT<\/jats:title>\n \n Introduction<\/jats:title>\n We aimed to assess diagnostic performance and accuracy for local staging of CEM combined with DBT (CE\u2009+\u2009DBT) compared to digital mammography (DM) and MRI.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Female patients aged 18\u201370\u2009years with clinical or sonographic suspicion of breast cancer had CE\u2009+\u2009DBT and breast MRI prior to treatment. Diagnostic accuracy, ability to identify additional disease foci, and disease extent estimations were compared for all imaging techniques. Histopathology was the reference standard.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Eighty\u2010seven participants were recruited; 80 included in the study; 69 had cancer. DBT had greater diagnostic sensitivity than DM, but lowest specificity. CEM and CE\u2009+\u2009DBT showed 100% sensitivity. Specificity was lower for CE\u2009+\u2009DBT than CEM alone. MRI sensitivity was higher than DM or DBT, but lower than CEM or CE\u2009+\u2009DBT. MRI specificity was lower than CE\u2010DBT, both separately and in combination. Thirty\u2010nine patients were included in exploratory subset analysis regarding identifying additional foci. DM missed the most cases (8\/10); DBT had higher sensitivity but lower specificity; MRI s sensitivity but with more false positives; CEM had the greatest overall accuracy. Thirty patients were included in unifocal disease extent analysis. MRI, CEM, and CE\u2010DBT all demonstrated strong correlation with pathological size, with MRI showing closest agreement.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Combined CE\u2009+\u2009DBT is feasible within a one\u2010stop clinic appointment and may obviate the need for MRI. CEM demonstrated comparable accuracy to MRI, both for diagnostic accuracy and in local staging. We showed no clear benefit to combining morphological information derived from DBT with functional data of CEM compared to CEM alone.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/1754-9485.70142","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T09:01:07Z","timestamp":1783674067000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Combined Contrast Enhanced Mammography and Digital Breast Tomosynthesis in Patients Suspected of Having Breast Cancer: A Prospective Comparison With Digital Mammography and Breast\n MRI<\/scp>\n \u2014Findings of the\n CONTEST<\/scp>\n Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1037-1174","authenticated-orcid":false,"given":"Sarah L.","family":"Savaridas","sequence":"first","affiliation":[{"name":"Breast Screening and Imaging Department Ninewells Hospital Dundee UK"},{"name":"School of Medicine University of Dundee Dundee UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kulsam","family":"Ali","sequence":"additional","affiliation":[{"name":"School of Medicine University of Dundee Dundee UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Vinnicombe","sequence":"additional","affiliation":[{"name":"Thirlestaine Breast Centre, Gloucestershire NHS FT Gloucestershire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra","family":"Rauchhaus","sequence":"additional","affiliation":[{"name":"School of Medicine University of Dundee Dundee UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Evans","sequence":"additional","affiliation":[{"name":"Department of Radiology Royal Derby Hospital Derby UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nisha","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Radiology Leeds Teaching Hospitals NHS Trust Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally","family":"Bolt","sequence":"additional","affiliation":[{"name":"Department of Radiology Cwm Taf Morgannwg Health Board Llantrisant Wales UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patsy","family":"Whelehan","sequence":"additional","affiliation":[{"name":"Breast Screening and Imaging Department Ninewells Hospital Dundee UK"},{"name":"School of Medicine University of Dundee Dundee UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"issue":"1012","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1259\/bjr\/32906819","article-title":"Measuring the Accuracy of Diagnostic Imaging in Symptomatic Breast Patients: Team and Individual Performance","volume":"85","author":"Britton P.","year":"2012","journal-title":"British Journal of Radiology"},{"key":"e_1_2_11_3_1","doi-asserted-by":"crossref","DOI":"10.1148\/radiol.2461070200","volume-title":"Diagnostic Accuracy of Digital Versus Film Mammography Exploratory Analysis of Selected Population Subgroups in DMIST","author":"Pisano E. 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B.","year":"2023","journal-title":"British Journal of Radiology"},{"key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"5635","DOI":"10.1007\/s00330-025-11502-7","article-title":"Preoperative Estimation of the Pathological Breast Tumor Size in Architectural Distortions: A Comparison of DM, DBT, US, CEM, and MRI","volume":"35","author":"Azcona S\u00e1enz J.","year":"2025","journal-title":"European Radiology"},{"issue":"1","key":"e_1_2_11_18_1","doi-asserted-by":"crossref","first-page":"249","DOI":"10.55730\/1300-0144.5786","article-title":"Dynamic Contrast\u2010Enhanced Mammography and Breast MRI in the Diagnosis of Breast Cancer and Detection of Tumor Size","volume":"54","author":"Tekinhatun M.","year":"2024","journal-title":"Turkish Journal of Medical Sciences"},{"issue":"11","key":"e_1_2_11_19_1","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1016\/j.crad.2016.05.009","article-title":"Contrast\u2010Enhanced Spectral Mammography Improves Diagnostic Accuracy in the Symptomatic Setting","volume":"71","author":"Tennant S. 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I.","year":"2021","journal-title":"European Journal of Radiology"},{"issue":"6","key":"e_1_2_11_29_1","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1097\/RLI.0000000000001138","article-title":"Contrast\u2010Enhanced Digital Breast Tomosynthesis Compared With Contrast\u2010Enhanced Mammography and Magnetic Resonance Imaging in the Assessment of Breast Lesions: A Pilot Study","volume":"60","author":"Clauser P.","year":"2025","journal-title":"Investigative Radiology"},{"issue":"1","key":"e_1_2_11_30_1","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1007\/s13193-024-02090-x","article-title":"Does Contrast\u2010Enhanced Mammography Outperform Digital Breast Tomosynthesis for Detection and Characterization of Breast Lesions or Vice Versa?","volume":"16","author":"Singla V.","year":"2025","journal-title":"Indian Journal of Surgical Oncology"},{"issue":"1","key":"e_1_2_11_31_1","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1148\/radiol.212530","article-title":"Contrast\u2010Enhanced Mammography Versus Contrast\u2010Enhanced Breast MRI: A Systematic Review and Meta\u2010Analysis","volume":"305","author":"P\u00f6tsch N.","year":"2022","journal-title":"Radiology"}],"container-title":["Journal of Medical Imaging and Radiation Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1754-9485.70142","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1754-9485.70142","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1754-9485.70142","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T09:01:11Z","timestamp":1783674071000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1754-9485.70142"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,10]]},"references-count":30,"alternative-id":["10.1111\/1754-9485.70142"],"URL":"https:\/\/doi.org\/10.1111\/1754-9485.70142","archive":["Portico"],"relation":{},"ISSN":["1754-9477","1754-9485"],"issn-type":[{"value":"1754-9477","type":"print"},{"value":"1754-9485","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,10]]},"assertion":[{"value":"2025-12-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"1754-9485.70142"}}