Fig. 5

Examples of dual-energy subtraction (DES) images of contrast-enhanced mammography (CEM) classified by the radiomics models. A-C Examples of benign lesions with high misclassification probabilities. The lesions are annotated with arrowheads. A A 42-year-old woman with a markedly enhanced lesion in the upper quadrant of the right breast. Biopsy revealed a fibroadenoma. The diameter of the lesion is 31.5 mm (mean lesion size of all the benign lesions: 17.1 mm). The patient has marked BPE. B A 47-year-old woman with a moderately enhanced lesion in the outer quadrant of the right breast. Biopsy revealed adenosis with a fibroadenoma. Rim artifacts are present at the location of the lesion (arrows). The patient has marked BPE. C A 35-year-old woman with a moderately enhanced lesion in the lower quadrant of the left breast. Biopsy revealed an intraductal papilloma. Ripple artifacts are present at the location of the lesion (arrow). The patient has mild BPE. D-F Examples of benign lesions with low misclassification probabilities. D A 50-year-old woman with a moderately enhanced lesion in the outer quadrant of the right breast. Biopsy revealed a fibroadenoma. The diameter of the lesion is 10.5 mm. The patient has minimal BPE. E A 55-year-old woman with a mildly enhanced lesion in the outer quadrant of the right breast. Biopsy revealed a fibroadenoma. The diameter of the lesion is 8.0 mm. The patient has minimal BPE. F A 58-year-old woman with a mildly enhanced lesion in the outer quadrant of the left breast. Biopsy revealed a fibroadenoma. The diameter of the lesion is 10.3 mm. The patient has minimal BPE. G-I Examples of malignant lesions with high misclassification probabilities. The lesions are annotated with arrowheads. G A 60-year-old woman with a mildly enhanced lesion in the central area of the left breast. Biopsy revealed IDC with mucous secretion (grade III). The diameter of the lesion is 16.0 mm (mean lesion size of all malignant lesions: 28.8 mm). The patient has minimal BPE. H A 53-year-old woman with a moderately enhanced lesion in the upper quadrant of the right breast. Biopsy revealed IDC (grade II). The diameter of the lesion is 16.3 mm. The patient has minimal BPE with an air trapping artifact in the lesion area (arrow). I A 57-year-old woman with a lesion showing negative enhancement in the outer quadrant of the left breast. Biopsy revealed mucous adenocarcinoma. The diameter of the lesion is 27.5 mm. The patient has minimal BPE with negative enhancement artifacts (eclipse sign) in the lesion area (arrow). J-L Examples of malignant lesions with low misclassification probabilities. J A 58-year-old woman with a markedly enhanced lesion in the upper quadrant of the left breast. Biopsy revealed IDC (grade II). The diameter of the lesion is 31.0 mm. The patient has mild BPE. K A 49-year-old woman with a markedly enhanced lesion in the outer quadrant of the right breast. Biopsy revealed IDC (grade II). The diameter of the lesion is 39.5 mm. The patient has minimal BPE. L A 60-year-old woman with a markedly enhanced lesion in the retro-areola region of the right breast. Biopsy revealed IDC (grade II). The diameter of the lesion is 48.8 mm. The patient has minimal BPE. BPE = background parenchymal enhancement; IDC = invasive ductal carcinoma