Contrast-enhanced Spectral Mammography

Bhimani, Chandni; Li, Luna; Liao, Lydia; Roth, Robyn; Tinney, Elizabeth; Germaine, Pauline

doi:10.1016/j.acra.2016.08.024

Cited by 25 publications

(16 citation statements)

References 9 publications

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“…Like other imaging modalities, CEM imaging artifacts can occur ( Fig. 4), challenging interpretation [25][26][27]. Rim and skin line artifacts, due to scatter radiation from non-uniform thickness of breast tissue and skin, can mimic enhancement.…”

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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“…Some FN lesions had a copious post biopsy hematoma at the site of the index lesion which generated a characteristic artifact called “negative contrast enhancement” or “eclipse sign”, thus preventing correct visualization of the BC and interpretation of the images [ 28 , 29 ]. In these cases, only the artifact generated by the hematoma was visible with no other area of enhancement near it.…”

Section: Methodsmentioning

confidence: 99%

Which clinical, radiological, histological, and molecular parameters are associated with the absence of enhancement of known breast cancers with Contrast Enhanced Digital Mammography (CEDM)?

et al. 2020

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Background CEDM has demonstrated a diagnostic performance similar to MRI and could have similar limitations in breast cancer (BC) detection. Purpose The aim of our study was to systematically analyze the characteristics of the lesions with the absence of enhancement with CEDMs, called false-negatives (FNs), in order to identify which clinical, radiological, histological and molecular parameters are associated with the absence of enhancement of known BCs with CEDMs, and which types of BC are most likely to cause FNs in CEDMs. We also tried to evaluate which parameters instead increased the probability of showing enhancement in the same context. Materials and methods Included in our study group were 348 women with 348 diagnosed BCs performing CEDM as preoperative staging. Two breast-imaging radiologists reviewed the CEDM exams. The absence of perceptible contrast enhancement at the index cancer site was indicative of an FN CEDM, whereas cases with appreciable enhancement were considered true positives (TPs). Dichotomic variables were analyzed with Fisher’s exact probability test or, when applicable, the chi-square test. Binary logistic regression was performed on variables shown to be significant by the univariate analysis in order to assess the relationship between predictors (independent variables) and TFNs (outcome). Results Enhancement was observed in 317 (91.1%) of the 348 BCs. From the 31 (8.9%) lesions which were FNs, we excluded 12 (38.7%) which showed an artifact generated by the post biopsy hematoma and 6 (19.4%) which were outside the CEDM field of vision. We thus obtained 13 (41.9%) BCs considered “True False Negatives” (TFNs), i.e. BCs which showed no enhancement despite being within the CEDM field of vision and failed to show post biopsy hematoma artifacts. We found that the TFNs frequently have a unifocal disease extension, diameter <10 mm, a lower number of luminal B HER2-subtypes, a higher number of DCIS, and an index lesion with microcalcifications. Conclusions The parameters we found to be associated with no enhancement of known BCs with CEDMs were: unifocal disease extension, DCIS histotype, lesion dimensions <10 mm, and index lesion with microcalcifications. The characteristics that instead increase the probability of showing enhancement were US mass, Luminal B HER2 negative molecular subtype, the presence of an invasive ductal component, and lesion dimensions ≥10 mm.

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“…This is a software-processing artefact also known as "breast-within-a-breast artefact" [5]. It occurs due to a rapid difference of scattered radiation between different breast thicknesses separating the central and peripheral regions causing the software-processing algorithm to create a false exaggerated boundary.…”

Section: Halo Artefactmentioning

confidence: 99%

“…Dromain et al [12] suggested that this may be attributed to patient motion, due to the short interval between the low-and high-energy exposures. However, there are some authors [5] who attribute it to cardiac pulsations transmitted through the chest wall as it more commonly seen in the lower quadrants of MLO projections of the left breast. Reducing patient anxiety might reduce this artefact; however, it does not compromise the image quality.…”

Section: Ripple Artefactmentioning

confidence: 99%

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Artefacts in contrast enhanced digital mammography: how can they affect diagnostic image quality and confuse clinical diagnosis?

et al. 2020

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Contrast-enhanced digital mammography (CEDM) is a diagnostic tool for breast cancer detection. Artefacts are observed in about 10% of CEDM examinations. Understanding CEDM artefacts is important to prevent diagnostic misinterpretation. In this article, we have described the artefacts that we have commonly encountered in clinical practice; we hope to ease the recognition and help troubleshoot solutions to prevent or minimise them.

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Contrast-enhanced Spectral Mammography

Cited by 25 publications

References 9 publications

Contrast-enhanced mammography: past, present, and future

Contrast-enhanced mammography: past, present, and future

Which clinical, radiological, histological, and molecular parameters are associated with the absence of enhancement of known breast cancers with Contrast Enhanced Digital Mammography (CEDM)?

Artefacts in contrast enhanced digital mammography: how can they affect diagnostic image quality and confuse clinical diagnosis?

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