Mapping The Diagnostic Spectrum: Systematic Review and Meta-Analysis on CESM VS MRI for Breast Lesions

Background: Breast cancer represents a major public health challenge and requires novel diagnostic approaches. Contrast-enhanced mammography (CEM) combined with magnetic resonance imaging (MRI) is one of the major imaging approaches in the assessment of breast lesions. Aim and objective: The study aimed to answer the question:” Why is it essential to comprehend the differences in sensitivity, specificity and accuracy for contrast-enhanced mammography and MRI in the diagnosis of breast lesions and how these parameters will assist in clinical scenarios and patient outcomes?”. Methods: This was a systematic review and meta-analyses including 1272 subjects done to find out studies published between 2015 to 2024 on the comparison between contrast-enhanced spectral mammography (CESM) and MRI for the detection of breast lesions. Electronic database search was done in PubMed, Scopus, and Embase, and 12 articles were finally selected. Results: MRI was more sensitive (91% to 100%) and specific (23% to 100%) compared with CEM, which demonstrated sensitivity (65% to 100%) and specificity (28% to 100%). The estimated overall accuracy for MRI was 85.4%, and for CEM, it was 80.7%, with MRI being especially good at detecting invasive viruses of the breast. Conclusion: The key findings of our study were that although both CEM and MRI could diagnose breast cancer, there was a significant difference between the two tests in sensitivity and specificity, with MRI scoring better on both counts. MRI was the gold standard for breast imaging, particularly in higher-risk patient populations.