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Updated: Aug 6, 2026
05:28
Clinical Imaging of Microwave Mammography
Published on: November 14, 2025
Preoperative Staging of Invasive Lobular Carcinoma: CEM or CE-MRI?
Anna Colarieti1, Pierluca Minelli2, Alice Bonetti1
1Università degli Studi del Piemonte Orientale Amedeo Avogadro Scuola di Medicina, Department of Radiology, Piemonte, Italy, Novara.
Rofo : Fortschritte Auf Dem Gebiete Der Rontgenstrahlen Und Der Nuklearmedizin
|July 16, 2026
Summary
Contrast-enhanced mammography (CEM) and contrast-enhanced MRI (CE-MRI) show similar accuracy for assessing lesion size and bilaterality in invasive lobular carcinoma (ILC). However, CE-MRI is superior for detecting multicentric disease, crucial for surgical planning.
Area of Science:
- Radiology
- Oncology
- Breast Imaging
Background:
- Invasive lobular carcinoma (ILC) presents unique challenges in imaging due to its infiltrative growth pattern.
- Multifocal, multicentric, and bilateral involvement in ILC can lead to underestimation with conventional imaging techniques.
Purpose of the Study:
- To compare the diagnostic performance of contrast-enhanced mammography (CEM) and contrast-enhanced magnetic resonance imaging (CE-MRI) for preoperative locoregional staging of ILC.
- To evaluate the accuracy of CEM and CE-MRI in assessing lesion size, multicentricity, and bilaterality in ILC patients.
Main Methods:
- Retrospective single-center study including 46 patients with histologically confirmed ILC who underwent both CEM and CE-MRI.
- Independent and blinded review of examinations by two dedicated breast radiologists.
- Analysis of lesion number, diameter, multicentricity, and bilaterality using appropriate statistical tests, including Wilcoxon signed-rank test, McNemar's test, Cohen's kappa, and intraclass correlation coefficients.
Main Results:
- CEM and CE-MRI demonstrated strong concordance and no significant differences in lesion size assessment (p > 0.05).
- High agreement was observed for bilaterality detection with both techniques, with no statistically significant differences.
- CE-MRI identified a significantly higher number of multicentric cases compared to CEM (p < 0.05).
- Good to excellent inter-reader agreement was achieved across all assessed parameters.
Conclusions:
- CEM offers comparable performance to CE-MRI for lesion size and bilaterality assessment in ILC.
- CE-MRI remains the superior modality for detecting multicentric disease, which is critical for accurate surgical planning.
- CEM may serve as a valuable complementary imaging tool for ILC staging in specific clinical scenarios.
