Contrast-enhanced Digital Mammography: Initial Clinical Experience

Jong, Roberta A.; Yaffe, Martin J.; Skarpathiotakis, Mia; Shumak, Rene; Danjoux, Nathalie M; Gunesekara, Anoma; Plewes, Donald B.

doi:10.1148/radiol.2283020961

Cited by 249 publications

(176 citation statements)

References 28 publications

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“…22 patients with suspect abnormalities found on conventional mammography or ultrasound [10]. The results showed the ability of temporal CEDM to show cancers and suggested a potential to identify cancers in dense breasts.…”

Section: Breast Tumoursmentioning

confidence: 83%

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Dual-energy contrast-enhanced digital mammography: initial clinical results

Dromain

Thibault

Muller³

et al. 2010

Eur Radiol

239

158

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Objective To assess the diagnostic accuracy of Dual-Energy Contrast-Enhanced Digital Mammography (CEDM) as an adjunct to mammography (MX) versus MX alone and versus mammography plus ultrasound (US). Materials and methods 120 women with 142 suspect findings on MX and/or US underwent CEDM. A pair of low-and high-energy images was acquired using a modified full-field digital mammography system. Exposures were taken in MLO at 2 min and in CC at 4 min after the injection of 1.5 ml/kg of an iodinated contrast agent. One reader evaluated MX, US and CEDM images during 2 sessions 1 month apart. Sensitivity, specificity, and area under the ROC curve were estimated. Results The results from pathology and follow-up identified 62 benign and 80 malignant lesions. Areas under the ROC curves were significantly superior for MX+CEDM than it was for MX alone and for MX+US using BI-RADS. Sensitivity was higher for MX+CEDM than it was for MX (93% vs. 78%; p<0.001) with no loss in specificity. The lesion size was closer to the histological size for CEDM. All 23 multifocal lesions were correctly detected by MX+CEDM vs. 16 and 15 lesions by MX and US respectively. Conclusion Initial clinical results show that CEDM has better diagnostic accuracy than mammography alone and mammography+ultrasound.

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Section: Breast Tumoursmentioning

confidence: 83%

“…Clinical feasibility and initial experiences with CEDM have been reported for two techniques: temporal subtraction and dual energy [10][11][12][13]. Temporal subtraction CEDM involves a mask and a series of exposures, taken respectively before and after injection of contrast agent.…”

Section: Introductionmentioning

confidence: 99%

Dual-energy contrast-enhanced digital mammography: initial clinical results

Dromain

Thibault

Muller³

et al. 2010

Eur Radiol

239

158

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“…Jong, Yaffe and Skarpathiotakis, et al [6] presented their initial clinical experience with CEDM and believed that CEDM could potentially be useful in identifying lesions in the mammographically dense breast. Their paper was published in 2003, and they suggested that further investigation is certainly warranted.…”

Section: Discussionmentioning

confidence: 99%

Initial Experience with Contrast Enhanced Digital Mammography (SenoBright)—In a Comprehensive Clinical Breast Center

Elliott¹,

Baucom²,

Elliott³

et al. 2017

JCT

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Objective: The purpose of initiating contrast enhanced digital mammography in our center was to evaluate the complimentary benefit of this technology with screening digital mammography and real time ultrasound in equivocal cases and high risk patients with dense breast. The intended goal was to reduce the incidence of further diagnostic and invasive procedures. Methods: Patients thought to be candidates who had good renal function confirmed by serum Blood Urea Nitrogen (BUN) and Creatinine were offered the procedure, and 225 patients had the procedure during the period of March 2013 through November 2014. The contrast enhanced digital mammograms (SenoBright) are performed on the Senograph Essential Unit. A total of 8 images are obtained: 4 conventional digital mammograms and 4 contrast enhanced digital mammograms. The patients with a positive SenoBright study had a tissue diagnosis of the lesion obtained by either a stereotactic needle biopsy, ultrasound guided core biopsy, or ultrasound directed open excisional biopsy. Results: The 225 patients who had the procedure included high risk patients with dense breast (41), patients with abnormal mammograms (92), and patients with equivocal clinical, mammographic and real time ultrasound findings (92). 31 studies were interpreted as positive and 194 as negative. 33 biopsies were performed, with 31 patients having a positive study and 2 patients with a negative study. 22 cancers were detected. Conclusion: We found that the addition of dynamic contrast enhanced digital subtraction mammography (SenoBright) was helpful in distinguishing malignant from non-malignant lesions. It was also effective in demonstrating multifocal lesions and identifying non-palpable occult carcinomas in the dense breast. It proved to be a valuable complimentary adjunctive diagnostic modality for a comprehensive clinical breast center.

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“…Digital mammography, however, requires rigorous training for the radiologist and has a learning curve. The addition of intravenous contrast during digital mammography may help increase the detection rate of occult lesions in mammographically dense breasts [18].…”

Section: Screening Mammographymentioning

confidence: 99%

“…Positron emission tomography (PET) imaging after injection of radioactive tracer ( [18]F-fluorodeoxyglucose [FDG]) combines functional and anatomic imaging, which may enable improved cancer detection in dense breasts, improved differentiation of cancers from scar tissue, and improved definition of extent of disease prior to surgery. In a prospective, multicenter trial, PET imaging had 93% sensitivity and 83% specificity for index lesions (i.e., the lesions that prompted study entry) [40].…”

Section: Investigational Screening Modalitiesmentioning

confidence: 99%