Contrast-Enhanced Mammography: A Systematic Guide to Interpretation and Reporting

Perry, Hannah; Phillips, Jordana; Dialani, Vandana; Slanetz, Priscilla J.; Fein‐Zachary, Valerie; Karimova, Evguenia J.; Mehta, Tejas S.

doi:10.2214/ajr.17.19265

Cited by 59 publications

(73 citation statements)

References 53 publications

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“…So far, the order of image acquisition (CC prior to MLO or MLO prior to CC) on CESM was controversial 21 . In published papers, some exposed MLO views first 11,16,22 , while others performed CC views first 12,13 .…”

Section: Discussionmentioning

confidence: 99%

Quantitative Analysis of Enhancement Intensity and Patterns on Contrast-enhanced Spectral Mammography

Liu

Huang

Zhang

et al. 2020

Sci Rep

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CESM is an emerging digital mammography technology with a high breast cancer detection and a limited diagnostic specificity. In order to improve specificity, we quantitatively assessed enhancement intensity of breast lesions with different pathological types and hormonal receptor status and evaluated the consistency of enhancement patterns between CESM and DCE-MRI. A total of 145 lesions were enrolled, consisting of 43 malignant (17 non-infiltrating cancers and 26 infiltrating cancers) and 99 benign lesions. The diagnostic performance of enhancement intensity in the former positions was significantly higher than that in the latter positions (AUC: 0.834 vs. 0.755, p = 0.0008). Infiltrating cancers showed the highest enhancement intensity, while benign lesions the lowest (mean CNR1: 7.6% vs. 2.7%; median CNR1: 6.8% vs. 2.7%). Enhancement intensity of ER or PR positive group was weaker than negative group, while HER-2 positive group was stronger than negative group. 28 patients with 28 lesions performed both CESM and DCE-MRI examinations, showing a coincidence rate of 64.2% and moderate agreement (k = 0.515) between CESM and DCE-MRI. In conclusion, quantitative analysis of enhancement characteristics is feasible to the diagnosis practice on CESM.

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Section: Discussionmentioning

confidence: 99%

Quantitative Analysis of Enhancement Intensity and Patterns on Contrast-enhanced Spectral Mammography

Liu

Huang

Zhang

et al. 2020

Sci Rep

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“…The final diagnosis was sclerosing adenosis mammography machine, and non-visualization of calcification [12]. Contrast-enhanced mammography uses a dual-energy technique performed after contrast administration to identify and characterize lesions based on angiogenesis, as well as morphologic features and density [9]. Also, low-energy images of CEM could detect microcalcifications, architectural distortion, and non-enhancing lesions [12].…”

Section: Discussionmentioning

confidence: 99%

“…CEM is a relatively easy feasible study with high sensitivity and low cost [2]. It provides low-energy images comparable to mammographic images and post-contrast recombined images to evaluate tumor neovascularity [8,9].…”

Section: Introductionmentioning

confidence: 99%

Can contrast-enhanced mammography replace dynamic contrast-enhanced MRI in the assessment of sonomammographic indeterminate breast lesions?

Kamal

Hanafy

Mansour

et al. 2020

Egypt J Radiol Nucl Med

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Background: Dynamic contrast-enhanced MRI of the breast has been used for several years in the assessment of indeterminate mammographic findings. Contrast-enhanced mammography is a relatively novel imaging technique that has shown comparable sensitivity and specificity to MRI. Contrast-enhanced mammography is a relatively easy feasible study with high sensitivity and low cost. Our aim was to assess the feasibility of replacing dynamic contrastenhanced (DCE)-MRI by contrast-enhanced mammography in the assessment of sonomammographic indeterminate lesions (BIRADS 3 and 4). Results: The study included 82 patients with 171 breast lesions. They all performed contrast-enhanced mammography and dynamic contrast-enhanced MRI. DCE-MRI sensitivity and NPV were significantly higher than those of contrast-enhanced mammogram (CEM). The overall accuracy of MRI was better than that of CEM; however, no statistically significant difference could be detected. Conclusion: Contrast-enhanced mammography and dynamic contrast-enhanced MRI improved the characterization of breast lesions. CEM showed slightly lower sensitivity and accuracy compared to MRI; however, because of being relatively easy, available, cheap, and acceptable by women, CEM can replace DC-MRI as a problem-solving tool in the characterization of indeterminate breast lesions.

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“…Although the calculated sensitivity dropped from 80% in the homogeneous fatty breast down to 41% in the dense breast, the specificity of mammography was not significantly changed. Contrast-enhanced mammography uses a dual-energy technique performed after contrast administration to identify and characterize lesions based on angiogenesis, as well as morphologic features and density [5]. Also, low-energy images of CEM could detect microcalcifications, architectural distortion, and non-enhancing lesions [18].…”

Section: Discussionmentioning

confidence: 99%

“…It provides lowenergy images comparable to mammographic images and post-contrast recombined images to evaluate tumor neovascularity. CEM allows better evaluation of calcifications by their visualization on low-energy images combined with enhancement criteria on the contrastenhanced recombined images [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Comparative study between contrast-enhanced mammography, tomosynthesis, and breast ultrasound as complementary techniques to mammography in dense breast parenchyma

Azzam

Kamal

Hanafy

et al. 2020

Egypt J Radiol Nucl Med

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Background: Mammography is accused of having low sensitivity and specificity in dense breast parenchyma. Also, women with dense breasts show an increased risk of developing breast cancer. Breast ultrasound has been used for several years for a better characterization of breast lesions. Contrast-enhanced mammography and tomosynthesis are relative novel imaging techniques that have been implicated in breast cancer detection and diagnosis. We aimed to compare breast tomosynthesis, contrast-enhanced mammography, and breast ultrasound as complementary techniques to mammography in dense breast parenchyma. Results: The study included 37 patients with 63 inconclusive mammography breast lesions. They all performed contrast-enhanced mammography, single-view tomosynthesis, and breast ultrasound. Mammography had a sensitivity of 83%, a specificity of 48%, a positive predictive value of 68%, a negative predictive value of 68%, and a diagnostic accuracy of 68%. Contrast-enhanced mammography had a sensitivity of 89%, a specificity of 89%, a positive predictive value of 91%, a negative predictive value of 86%, and a diagnostic accuracy of 89%. Tomosynthesis had a sensitivity of 86%, a specificity of 81%, a positive predictive value of 86%, a negative predictive value of 81%, and a diagnostic accuracy of 84%. Breast ultrasound had a sensitivity of 97%, a specificity of 85%, a positive predictive value of 90%, a negative predictive value of 96%, and a diagnostic accuracy of 92%. Conclusion: Breast ultrasound, tomosynthesis, and contrast-enhanced mammography showed better performance compared to mammography in dense breasts. However, ultrasound being safe with no radiation hazards should be the second step modality of choice after mammography in the assessment of mammography dense breasts. Adding tomosynthesis to mammography in screening increases its sensitivity. Contrast-enhanced mammography should be reserved for cases with inconclusive sonomammographic results.

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Contrast-Enhanced Mammography: A Systematic Guide to Interpretation and Reporting

Cited by 59 publications

References 53 publications

Quantitative Analysis of Enhancement Intensity and Patterns on Contrast-enhanced Spectral Mammography

Quantitative Analysis of Enhancement Intensity and Patterns on Contrast-enhanced Spectral Mammography

Can contrast-enhanced mammography replace dynamic contrast-enhanced MRI in the assessment of sonomammographic indeterminate breast lesions?

Comparative study between contrast-enhanced mammography, tomosynthesis, and breast ultrasound as complementary techniques to mammography in dense breast parenchyma

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