Background Parenchymal Enhancement at Contrast-Enhanced Spectral Mammography (CESM) as a Breast Cancer Risk Factor

Sorin, Vera; Yagil, Yael; Shalmon, Anat; Gotlieb, Michael; Faermann, Renata; Halshtok-Neiman, Osnat; Sklair‐Levy, Miri

doi:10.1016/j.acra.2019.10.034

Cited by 38 publications

(22 citation statements)

References 28 publications

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“…Scheduling of CEM need not be based on timing of the menstrual cycle which appears to have minimal effect on BPE [21,22]. Similar to MRI, increased BPE levels on CEM may be an indication of breast cancer risk [23] and thus is important to report.…”

Section: Cem Interpretation and Reportingmentioning

confidence: 99%

Contrast-enhanced mammography: past, present, and future

et al. 2021

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Section: Cem Interpretation and Reportingmentioning

confidence: 99%

Contrast-enhanced mammography: past, present, and future

et al. 2021

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“…The nonspecific BPEinduced coloring may therefore reduce the possible role of CAD as a detection tool and help to highlight the challenge of breast MRI interpretation in lactating patients. Additional studies with pathological findings are warranted in order to further evaluate CAD's diagnostic and prognostic capabilities in this unique population (47), as well as the optimal timing upon lactation weaning in the setting of screening among high risk patients (48).…”

Section: Discussionmentioning

confidence: 99%

MRI of the Lactating Breast: Computer-Aided Diagnosis False Positive Rates and Background Parenchymal Enhancement Kinetic Features

et al. 2022

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Rationale and Objectives: To investigate the application of computer-added diagnosis (CAD) in dynamic contrast-enhanced (DCE) MRI of the healthy lactating breast, focusing on false-positive rates and background parenchymal enhancement (BPE) coloring patterns in comparison with breast cancer features in non-lactating patients. Materials and Methods:The study population was composed of 58 healthy lactating patients and control groups of 113 healthy premenopausal non-lactating patients and 55 premenopausal non-lactating patients with newly-diagnosed breast cancer. Patients were scanned on 1.5-T MRI using conventional DCE protocol. A retrospective analysis of DCE-derived CAD properties was conducted using a commercial software that is regularly utilized in our routine radiological work-up. Qualitative morphological characterization and automaticallyobtained quantitative parametric measurements of the BPE-induced CAD coloring were categorized and subgroups' trends and differences between the lactating and cancer cohorts were statistically assessed.Results: CAD false-positive coloring was found in the majority of lactating cases (87%). Lactation BPE coloring was characteristically non-mass enhancement (NME)-like shaped (87%), bilateral (79%) and symmetric (64%), whereas, unilateral coloring was associated with prior irradiation (p <0.0001). Inter-individual variability in CAD appearance of both scoring-grade and kinetic-curve dominance was found among the lactating cohort. When compared with healthy non-lactating controls, CAD false positive probability was significantly increased [Odds ratio 40.2, p <0001], while in comparison with the breast cancer cohort, CAD features were mostly inconclusive, even though increased size parameters were significantly associated with lactation-BPE (p <0.00001).Conclusion: BPE was identified as a common source for false-positive CAD coloring on breast DCE-MRI among lactating population. Despite several typical characteristics, overlapping features with breast malignancy warrant a careful evaluation and clinical correlation in all cases with suspected lactation induced CAD coloring.

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“…The amount of background parenchymal enhancement (BPE) in CEM can also be described as minimal, mild, moderate or marked enhancement, using terminology similar to that of MRI. 48,49 An increase in BPE is associated with increased odds for breast cancer. 48,49 The majority of patients showed to have minimal-to-mild BPE on CEM.…”

Section: Introductionmentioning

confidence: 99%

Contrast-enhanced mammography: what the radiologist needs to know

et al. 2021

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Contrast-enhanced mammography (CEM) is a combination of standard mammography and iodinated contrast material administration. During the last decade, CEM has found its place in breast imaging protocols: after i.v. administration of iodinated contrast material, low-energy and high-energy images are retrieved in one acquisition using a dual-energy technique, and a recombined image is constructed enabling visualisation of areas of contrast uptake. The increased incorporation of CEM into everyday clinical practice is reflected in the installation of dedicated equipment worldwide, the (commercial) availability of systems from different vendors, the number of CEM examinations performed, and the number of scientific articles published on the subject. It follows that ever more radiologists will be confronted with this technique, and thus be required to keep up to date with the latest developments in the field. Most importantly, radiologists must have sufficient knowledge on how to interpret CEM images and be acquainted with common artefacts and pitfalls. This comprehensive review provides a practical overview of CEM technique, including CEM-guided biopsy; reading, interpretation and structured reporting of CEM images, including the accompanying learning curve, CEM artefacts and interpretation pitfalls; indications for CEM; disadvantages of CEM; and future developments.

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Background Parenchymal Enhancement at Contrast-Enhanced Spectral Mammography (CESM) as a Breast Cancer Risk Factor

Cited by 38 publications

References 28 publications

Contrast-enhanced mammography: past, present, and future

Contrast-enhanced mammography: past, present, and future

MRI of the Lactating Breast: Computer-Aided Diagnosis False Positive Rates and Background Parenchymal Enhancement Kinetic Features

Contrast-enhanced mammography: what the radiologist needs to know

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