Atlas of Contrast-Enhanced Mammography

Nori, Jacopo; Kaur, Maninderpal; Kornecki, Anat; Meenal, J. Devi; Yaffe, Martin J.

doi:10.1007/978-3-030-56263-2

Cited by 3 publications

(22 citation statements)

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“…8,12,32 Although more common with malignant entities, one must be cognizant that associated enhancement can also be seen within benign areas of microcalcifications. 8,12,18,33 Houben et al 34 reported only minimal improvement in sensitivity and NPV in the assessment of microcalcifications when using CEM compared to FFDM. 34 From the author's experience (AK), CEM might show an occult mass or may help to increase biopsy target accuracy.…”

Section: Microcalcificationsmentioning

confidence: 99%

“…34 From the author's experience (AK), CEM might show an occult mass or may help to increase biopsy target accuracy. Regardless of the presence of enhancement, microcalcifications with malignant or indeterminate morphologic features require tissue sampling 8,12,18,[32][33][34] (Figure 9A, B).…”

Section: Microcalcificationsmentioning

confidence: 99%

“…Some CEM users have suggested the use of a score to quantify lesion enhancement relative to the BPE. 8,37,38 Although this may assist in distinguishing malignant from benign lesions and could support the decision to biopsy, it should be kept in mind that some malignant lesions may show minimal or no enhancement at all. 8(p15), [9][10][11][12][24][25][26][27] Another descriptor that can be utilized is the timing of lesion enhancement in early and delayed images.…”

Section: Other Interpretation Considerationsmentioning

confidence: 99%

“…Some artifacts, such as inadequate positioning, abnormal timing to contrast bolus, contrast spill on the compression plate or detector, or trapped air within skin folds, might be technical in nature. 40 Other artifacts that are more unique to CEM may include: negative contrast enhancement (the absence of enhancement in cysts or coarse calcifications) 8,40 ; rim artifact (also called ''scattered radiation,'' ''halo,'' or ''breast-within-a-breast'' caused by non-uniformity of breast thickness resulting in a halo appearance within the breast) 40 ; ripple artifacts (motion or cardiac pulsations between the LE and HE views) 41 ; and transient retention of contrast in vein (likely related to stasis of contrast caused by compression). 40 CEM images on patients with implants may be suboptimal.…”

Section: Limitationsmentioning

confidence: 99%

“…As an alternative, dual-energy subtraction is now employed. Paired low-energy (LE at 23-32 kVp) and high-energy (HE at 45-49 kVp) images are obtained 4,8(p6),9-12 after the injection. Since the low-energy views are below the K-shell absorption edge (33.2 keV), they are equivalent to FFDM.…”

Section: Physicsmentioning

confidence: 99%

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Current Status of Contrast Enhanced Mammography: A Comprehensive Review

Kornecki

2021

Can Assoc Radiol J

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Objectives: The purpose of this article is to provide a detailed and updated review of the physics, techniques, indications, limitations, reporting, implementation and management of contrast enhanced mammography. Background: Contrast enhanced mammography (CEM), is an emerging iodine-based modified dual energy mammography technique. In addition to having the same advantages as standard full-field digital mammography (FFDM), CEM provides information regarding tumor enhancement, relying on tumor angiogenesis, similar to dynamic contrast enhanced magnetic resonance imaging (DCE-MRI). This article reviews current literature on CEM and highlights considerations that are critical to the successful use of this modality. Conclusion: Multiple studies point to the advantage of using CEM in the diagnostic setting of breast imaging, which approaches that of DCE-MRI.

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Section: Microcalcificationsmentioning

confidence: 99%

Section: Microcalcificationsmentioning

confidence: 99%

Section: Other Interpretation Considerationsmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

Section: Physicsmentioning

confidence: 99%

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Current Status of Contrast Enhanced Mammography: A Comprehensive Review

Kornecki

2021

Can Assoc Radiol J

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High-risk breast lesions: role of multi-parametric DCE-MRI in detection and histopathological upgrade prediction

Hussein

EL-Dhurani²,

Abdelnaby³

et al. 2022

Egypt J Radiol Nucl Med

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Background High-risk breast lesions represent 3–21% of all breast lesions and are non-obligate precursors of malignancy. Various studies have evaluated the value of DCE-MRI including DWI and ADC mapping in the detection of high-risk breast lesions, differentiating them from malignant lesions and predicting upgrade risk after surgical excision reducing misdiagnosis and overtreatment. This study is a retrospective review of all image-guided breast biopsy procedures performed in 2021 at our institution, identified 68 patients with histopathologically proven high-risk breast and available MRI examinations with no concurrent ipsilateral malignancy. Image analysis of MRI examinations included morphological criteria, enhancement pattern, dynamic curves, DWI and ADC mapping assessment. Since our knowledge of high-risk breast lesions is still growing, this study is important to evaluate the merits of DCE-MRI in the assessment of high-risk breast lesions, to allow optimization of treatment, better limit it to those women at risk, and avoid overtreatment in women at low risk. Results The mean ADC value of high-risk breast lesions was not significantly different from that of malignant breast lesions (p value = 0.015). Non-mass enhancement and type III enhancing curve proved to be significant indicators of high-risk breast lesions upgrade in surgical pathology. Cut-off average ADC value for differentiating upgraded high-risk lesions from non-upgraded high-risk lesions proved 1.24 mm2/sec with sensitivity and specificity of 94 & 100%, respectively. Discussion Management of high-risk breast lesions is important in the screening setting, as they are non-obligate precursors of malignancy, and also function as risk indicators. Frequency and upgrade rates of high-risk lesions detected by MRI provide a reference for clinical management. DCE-MRI has a high negative predictive value in predicting the upgrade risk of high-risk lesions. In this study, non-mass enhancement and type III curve were proven to be indicators of high-risk lesion upgrade. Limitations of the study included small number of patients and limited follow-up period. Conclusions The use of multi-parametric DCE-MRI including DWI and ADC mapping provides complementary information to detect high-risk breast lesions and predict their upgrade rate.

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The Value of Contrast-Enhanced Digital Mammography Compared to Magnetic Resonance Imaging in the Analysis of Mammographically Detected Suspicious Breast Lesions

Klarić

Zujić

Šribar

2023

Med. Flum. (Online)

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Cilj: Princip oslikavanja na kontrastnoj digitalnoj mamografiji (CEDM) temelji se na istom principu kao kod magnetske rezonancije (MR), tj. u prikazu neovaskularizacije. Cilj našega rada je usporedba osjetljivosti CEDM-a u detekciji malignih lezija u dojci s MR-om te određivanje osjetljivosti i specifičnosti navedenih metoda. Ispitanici i metode: Uključeno je 56 ispitanika (55 žena i jedan muškarac; medijan dobi 63,51 godina; raspon 40 – 88 godina) kod kojih je temeljem nalaza na digitalnoj mamografiji postavljena sumnja na maligni proces u dojci. Kod svih ispitanika učinjen je ultrazvuk dojki, MR i CEDM te biopsija suspektne lezije. Indikacija za CEDM je nejasna ili suspektna sjena, distorzija, asimetrija ili nakupina patoloških mikrokalcifikata na digitalnoj mamografiji. Rezultati: Kod 13 (23,21 %) ispitanika došlo je do kontrastne imbibicije lezija na CEDM-u i MR-u. Od ukupnog broja ispitanika, kod njih 15 (26,78 %) dijagnosticirana je maligna lezija, a u 17,85 % došlo je do kontrastne imbibicije samo na CEDM procedure, od kojih je 7 lezija bilo maligno (invazivni karcinom te duktalni karcinom in situ s invazivnom komponentom). Specifičnost i osjetljivost MR-a iznosi 97,1 %, i 85,7 % (ROC-AUC = 0,914, PPV 92,3 %, NPV 94,3 %). Specifičnost i osjetljivost CEDM-a iznosi 94,1 %, odnosno 100 % (ROC-AUC = 0,971, PPV 91,3 %, NPV 100 %). Zaključak: CEDM je procedura jednakovrijedna MR-u u detekciji suspektnih lezija u dojci te može zamijeniti MR u procjeni proširenosti bolesti kada MR nije dostupan ili je kontraindiciran. CEDM je komplementarna dijagnostička metoda MR-u kada se MR ne može napraviti te pokazuje dobru korelaciju u detekciji malignih lezija u dojci.

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Atlas of Contrast-Enhanced Mammography

Cited by 3 publications

References 0 publications

Current Status of Contrast Enhanced Mammography: A Comprehensive Review

Current Status of Contrast Enhanced Mammography: A Comprehensive Review

High-risk breast lesions: role of multi-parametric DCE-MRI in detection and histopathological upgrade prediction

The Value of Contrast-Enhanced Digital Mammography Compared to Magnetic Resonance Imaging in the Analysis of Mammographically Detected Suspicious Breast Lesions

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