Differential Diagnosis of Breast Lesions in Dual-Energy Contrast-Enhanced Spectral Mammography

Review Data

Q: Is the topic relevant to the journal area of interest? Is it contemporary and interesting for

researchers?

A: Excellent

Abstract & Keywords

Q: Are all required components included in the abstract? Are the keywords appropriately chosen?

A: Very good

Goal

Q: Is the goal explicitly stated in the Introduction? Is its formulation clear and unambiguous?

A: Good

Structure

Q: Is the paper's structure coherent? Is it in coherence with the goal of the paper?

A: Good

Comments:

The sentence "Fig. 1 and Fig. 2 illustrate contrast enhancement patterns" should be placed beside "As a result of the analysis 9 patterns of contrast enhancement were identified" in the Results section as the figures correspond to the patterns mentioned in the points.

Tools and Methods

Q: Are methods the author uses adequate and well used?

A: Very good

Discussion & Conclusion

Q: Is it related to the results presented before? Do you consider them as coherent?

A: Good

Comments:

The Results demonstrate an increase in the diagnostic efficiency of the contrast-enhanced spectral mammography (CESM) in the differential diagnosis of breast lesions. The Discussion section throws light upon CESM becoming a worthy alternative to functional visualization of breast lesions. The study concludes that CESM, as compared to MRI, is characterized by lower cost, short study time, ease of implementation and interpretation. The use of CESM can significantly increase both the negative predictive values and the positive predictive values in the differential diagnosis of malignant and benign breast lesions.

Literature

Q: Does the author utilize relevant literature?

A: Very good

Author's knowledge

Q: What is the level of the author’s knowledge? Does the author utilize all recent contributions relevant to the topic?

A: Good

Length

Q: Is the length of the paper adequate to the significance of the topic? Do you suggest shortening the paper without losing its value?

A: Good

Figures & Tables

Q: Does the author use them suitably? Are legend and notations clear?

A: Very good

Writing style

Q: Is it clear and understandable?

A: Good

Further comments on the paper

Comments: This study aims to determine the diagnostic possibilities of contrast-enhanced spectral mammography (CESM) using types of contrast enhancement by malignant and benign lesions. Dual-energy contrast-enhanced spectral mammography is one of the latest methods for the characterization of breast lesions, where structural and functional (i.e., vascularization) assessment are combined. The study includes 332 women examined from February 2018 to June 2020 and proposes a more detailed assessment of the structure of the hypervascular lesions by highlighting the contrast enhancement patterns.

Q: Would you recommend this manuscript for further publication?

A: Yes - Suitable to be published

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