Contrast enhanced mammography: Techniques, current results, and potential indications

Lobbes, Marc; Smidt, Marjolein L.; Houwers, Janneke B.; Tjan‐Heijnen, Vivianne C. G.; Wildberger, Joachim E.

doi:10.1016/j.crad.2013.04.009

Cited by 106 publications

(94 citation statements)

References 26 publications

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“…In both studies, the diagnostic accuracy of CESM was superior to that of conventional mammography, as already reported earlier. 6 Fallenberg et al 8 also studied the correlation between tumor diameter measurement of CESM versus that of MRI, with histopathological measurements as the criterion 13 reported an increase in radiation dose of 20% compared with FFDM. Although the dose range reported for a complete CESM examination (0.7Y3.6 mGy) was comparable with our findings (1.1Y4.4 mGy), we observed a dose increase of 81% compared with our institutional FFDM.…”

Section: Discussionmentioning

confidence: 98%

“…6 In addition, recent studies have shown that CESM's accuracy is comparable with that of breast magnetic resonance imaging (MRI), which is currently considered to be the most accurate imaging modality for breast cancer staging. 7,8 Consequently, CESM might overcome the limitations of conventional mammography and might be considered as an alternative for breast MRI in the future.…”

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confidence: 98%

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Radiation Exposure of Contrast-Enhanced Spectral Mammography Compared With Full-Field Digital Mammography

Jeukens¹,

Lalji²,

Meijer³

et al. 2014

Investigative Radiology

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Section: Discussionmentioning

confidence: 98%

mentioning

confidence: 98%

Radiation Exposure of Contrast-Enhanced Spectral Mammography Compared With Full-Field Digital Mammography

Jeukens¹,

Lalji²,

Meijer³

et al. 2014

Investigative Radiology

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“…The principle of the CESM technique was described elsewhere [7]. In short, a low-energy (LE) and a high-energy image (HE) are obtained of both breasts in the standard mediolateral oblique (MLO) and craniocaudal (CC) views.…”

Section: Methodsmentioning

confidence: 99%

Contrast-enhanced spectral mammography in recalls from the Dutch breast cancer screening program: validation of results in a large multireader, multicase study

et al. 2016

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ObjectivesContrast-enhanced spectral mammography (CESM) is a promising problem-solving tool in women referred from a breast cancer screening program. We aimed to study the validity of preliminary results of CESM using a larger panel of radiologists with different levels of CESM experience.MethodsAll women referred from the Dutch breast cancer screening program were eligible for CESM. 199 consecutive cases were viewed by ten radiologists. Four had extensive CESM experience, three had no CESM experience but were experienced breast radiologists, and three were residents. All readers provided a BI-RADS score for the low-energy CESM images first, after which the score could be adjusted when viewing the entire CESM exam. BI-RADS 1-3 were considered benign and BI-RADS 4-5 malignant. With this cutoff, we calculated sensitivity, specificity and area under the ROC curve.ResultsCESM increased diagnostic accuracy in all readers. The performance for all readers using CESM was: sensitivity 96.9 % (+3.9 %), specificity 69.7 % (+33.8 %) and area under the ROC curve 0.833 (+0.188).ConclusionCESM is superior to conventional mammography, with excellent problem-solving capabilities in women referred from the breast cancer screening program. Previous results were confirmed even in a larger panel of readers with varying CESM experience.Key Points• CESM is consistently superior to conventional mammography • CESM increases diagnostic accuracy regardless of a reader’s experience • CESM is an excellent problem-solving tool in recalls from screening programs

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“…[8]. CESM is similar in concept to enhanced breast MR imaging and could potentially be applicable in situations in which MR imaging is currently used as well as problem solving in cases of mammographic findings that were not depicted in additional mammograms (FFDM) or US scans [9,10].…”

Section: Discussionmentioning

confidence: 99%

Comparing Diagnostic Pathway of Two Patients Squamous Cell Carcinoma of the Breast-Favourable Diagnostic Input of CESM

Pascaline¹

2016

JCPCR

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A The vast majority of diagnosed squamous cell carcinomas (SCC) are located in the skin, few present within internal structures. Primary breast SCC is a rare unusual tumor, constituting less than 0.1% of all breast carcinomas [1]. Literature reviews mention just about 100 cases of breast SCC to date, but most of the cases are included in a variety of histologic patterns reviews in addition to SCC [2]. Clinical and radiologic appearances of breast SCC are not specific which may cause delays in the correct diagnosis of this rare but quite aggressive type of breast cancer. This article demonstrates two cases of breast SCC diagnosed in Kettering Breast Unit in the last five years and difference in their diagnostic pathway due to the utilisation of contrast enhanced mammography for the second patient. IntroductionThe diagnosis of primary SCC of the breast is made in the absence of an associated primary SCC in a second site and in the absence of skin involvement. Squamous cells are normally not found inside the breast, so a primary squamous cell carcinoma of the breast is an exceptional phenomenon. Reported here are two cases of primary breast SCC presenting initially as complex cysts. However, in the literature there are examples of different presentations, for example starting as an abscess [3]. Case 1A 67 years old lady presented with large, painfull lump in the right axillary tail which appeared suddenly after active prolonged gardening. The first ultrasound scan demonstrated a 6 cm cyst/ fluid collection which was suspected to have been caused by a possible rupture of the big pectoralis muscle. Axilla at the first presentation was unremarkable and blood was drained from suspected haematoma. The haematoma refilled after 7 days and forther aspirate was sent to cytology which demonstrated C5 abnormal cells with squamoid features. The patient was referred for repeat ultrasound and core biopsy. Before biopsy of the bizarre by now looking cystic structure (Figure 1) was again drained and the solid looking component of the walls biopsied. Histology reported features in keeping with poorly differentiated squamous cell carcinoma. A dark lymphnode biopsied at the same time proved to be metastatic.Chest CT with contrast demonstrated a large (8.7cm x 7.9cm x 6.4cm) mixed attenuation partly cystic partly solid mass is seen occupying most of the right axilla and demonstrates patchy enhancement. A couple of sub cm lymph nodes are seen in the vicinity (Figure 2 Cytology report statedThe appearance is unusual. If the cyst was truly in the breast and not in a subcutaneous position, the appearance may indicate squamous metaplasia/neoplasia in a cyst that has arisen in fibrocystic disease.Squamous lined cysts of the breast are rare but have been described.Per MDT decision patient was referred for contrast enhanced spectral mammography (CESM )The low energy image identical to conventional FFDM images (Figure 3) demonstrates a moderate/ low density round structure with partially obscured posterior margin.Figure 4 recombined h...

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Contrast enhanced mammography: Techniques, current results, and potential indications

Cited by 106 publications

References 26 publications

Radiation Exposure of Contrast-Enhanced Spectral Mammography Compared With Full-Field Digital Mammography

Radiation Exposure of Contrast-Enhanced Spectral Mammography Compared With Full-Field Digital Mammography

Contrast-enhanced spectral mammography in recalls from the Dutch breast cancer screening program: validation of results in a large multireader, multicase study

Comparing Diagnostic Pathway of Two Patients Squamous Cell Carcinoma of the Breast-Favourable Diagnostic Input of CESM

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