ABSTRACT
Contrast-enhanced mammography (CEM) is becoming a widely adopted modality in breast imaging over the past few decades and exponentially so over the last few years, with strong evidence of high diagnostic performance in cancer detection. Evidence is also growing indicating comparative performance of CEM to MRI in sensitivity with fewer false positive rates. As application of CEM ranges from potential use in screening dense breast populations to staging of known breast malignancy, increased familiarity with the modality and its implementation, and disease processes encountered becomes of great clinical significance. This review emphasizes expected normal findings on CEM followed by a focus on examples of the commonly encountered benign and malignant pathologies on CEM.
Subject(s)
Breast Neoplasms , Mammography , Humans , Female , Mammography/methods , Breast Neoplasms/pathology , Breast Density , Contrast Media , Breast/diagnostic imaging , Magnetic Resonance Imaging/methods , Sensitivity and SpecificityABSTRACT
RATIONALE AND OBJECTIVES: Contrast-enhanced spectral mammography (CESM) uses full field digital mammography with the added benefit of intravenous contrast administration to significantly reduce false-positive and false-negative results and improve specificity while maintaining high sensitivity. For CESM to fulfill its purpose, one should be aware of possible artifacts and other factors which may interfere with image quality, and attention should be taken to minimize these factors. MATERIALS AND METHODS: This pictorial demonstration will depict types of artifacts detected and other factors that interfere with image acquisition in our practice since CESM implementation. RESULTS: Many of the artifacts and other factors we have encountered while using CESM have simple solutions to resolve them. CONCLUSION: The illustrated artifacts and other factors interfering with image quality will serve as a useful reference to anyone using CESM.
Subject(s)
Breast Neoplasms/diagnostic imaging , Carcinoma, Ductal, Breast/diagnostic imaging , Mammography/standards , Adult , Aged , Air , Artifacts , Contrast Media/administration & dosage , Female , Humans , Image Enhancement/methods , Injections, Intravenous , Middle Aged , Movement , Patient Positioning/standards , Sensitivity and Specificity , Time FactorsABSTRACT
RATIONALE AND OBJECTIVES: Contrast-enhanced spectral mammography (CESM) combines the benefits of full field digital mammography with the concept of tumor angiogenesis. Technique and practical applications of CESM are discussed. MATERIALS AND METHODS: An overview of the technique is followed by a demonstration of practical applications of CESM in our practice. RESULTS: We have successfully implemented CESM into our practice as a screening, diagnostic, staging, and treatment response tool. CONCLUSION: It is important to understand the technique of CESM and how to incorporate it into practice.
