Dual-energy contrast-enhanced digital mammography: initial clinical results of a multireader, multicase study

Dromain, Clarisse; Thibault, Fabienne; Diekmann, Felix; Fallenberg, Eva Maria; Jong, Roberta A.; Koomen, Marcia; Hendrick, R. Edward; Tardivon, A.; Toledano, Alicia Y.

doi:10.1186/bcr3210

Cited by 188 publications

(164 citation statements)

References 29 publications

(38 reference statements)

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“…Dromain, Thibault, and Diekmann, et al [8] from France have published an impressive paper on the procedure. They presented their initial clinical results of a multireader, multicase study.…”

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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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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“…DE X-ray breast imaging has been shown to aid visualization of lesions that are otherwise mammographically occult as well as to provide functional blood flow information consistent with MRIthe current gold standard in functional breast imaging. [1][2][3]7,8 This has led to the development of several DE imaging systems by Hologic® (Bedford, MA), General Electric (GE; Fairfield, CT) and Royal Philips (Amsterdam, Netherlands). 7,9,10 Currently, CEDE breast imaging is performed with an iodinated contrast agent.…”

Section: Contrast-enhanced (Ce) Dual-energy (De) X-ray Breastmentioning

confidence: 99%

“…The raw pixel values were measured in a region of interest (3.5 3 3.5 mm) after the system-specific flat-fielding algorithm was applied. W was then calculated using Equation (3). Multiple regions of interest were used to determine the error in the calculation of W.…”

Section: Validating the Simulation Algorithmmentioning

confidence: 99%

“…DE images can be used to identify tumour neovasculature and morphology, and consequently aid in the detection and diagnosis of breast cancer. [1][2][3][4][5][6][7] The most widely used approach for DE imaging is k-edge imaging. In this technique, two distinct energy spectra [low energy (LE) and high energy (HE)] are placed on either side of the kedge of the contrast material.…”

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confidence: 99%

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Exploring silver as a contrast agent for contrast-enhanced dual-energy X-ray breast imaging

Karunamuni

Tsourkas²,

Maidment³

2014

BJR

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Cite this article as: Karunamuni R, Tsourkas A, Maidment ADA. Exploring silver as a contrast agent for contrast-enhanced dual-energy X-ray breast imaging. Br J Radiol 2014;87:20140081. FULL PAPER Exploring silver as a contrast agent for contrast-enhanced dual-energy X-ray breast imaging Objective: Through prior monoenergetic modelling, we have identified silver as a potential alternative to iodine in dual-energy (DE) X-ray breast imaging. The purpose of this study was to compare the performance of silver and iodine contrast agents in a commercially available DE imaging system through a quantitative analysis of signal difference-to-noise ratio (SDNR). Methods: A polyenergetic simulation algorithm was developed to model the signal intensity and noise. The model identified the influence of various technique parameters on SDNR. The model was also used to identify the optimal imaging techniques for silver and iodine, so that the two contrast materials could be objectively compared. Results: The major influences on the SDNR were the lowenergy dose fraction and breast thickness. An increase in the value of either of these parameters resulted in a decrease in SDNR. The SDNR for silver was on average 43% higher than that for iodine when imaged at their respective optimal conditions, and 40% higher when both were imaged at the optimal conditions for iodine. Conclusion: A silver contrast agent should provide benefit over iodine, even when translated to the clinic without modification of imaging system or protocol. If the system were slightly modified to reflect the lower k-edge of silver, the difference in SDNR between the two materials would be increased. Advances in knowledge: These data are the first to demonstrate the suitability of silver as a contrast material in a clinical contrast-enhanced DE image acquisition system.Contrast-enhanced (CE) dual-energy (DE) X-ray breast imaging provides quantitative functional information with high-resolution anatomical data in a single imaging procedure. DE images can be used to identify tumour neovasculature and morphology, and consequently aid in the detection and diagnosis of breast cancer. [1][2][3][4][5][6][7] The most widely used approach for DE imaging is k-edge imaging. In this technique, two distinct energy spectra [low energy (LE) and high energy (HE)] are placed on either side of the kedge of the contrast material. Through a weighted subtraction of the LE and HE images, it is possible to suppress the anatomical background signal and enhance the visualization of the contrast agent. The total dose of the two images is judiciously allocated so as to maximize the visibility of the contrast agent while providing an anatomical image of diagnostic quality. DE X-ray breast imaging has been shown to aid visualization of lesions that are otherwise mammographically occult as well as to provide functional blood flow information consistent with MRIthe current gold standard in functional breast imaging.

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“…Currently, CEDM is not used as a screening method due to iodine injection which causes discomfort of patients. However, it has been reported that CEDM can be an alternative screening method to breast MRI for a high-risk group [4,5]. Thus, the method to improve detectability of cancer by iodine injection seems to have the potential to be more widely used.…”

Section: Introductionmentioning

confidence: 99%

A Quantification Method for Breast Tissue Thickness and Iodine Concentration Using Photon-Counting Detector

Han

2015

J Digit Imaging

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The purpose of contrast-enhanced digital mammography (CEDM) is to facilitate detection and characterization of the lesions in the breast using intravenous injection of an iodinated contrast agent. CEDM produces iodine images with gray levels proportional to iodine concentration at each pixel, which can be considered as quantification of iodine. While dual-energy CEDM requires an accurate knowledge of the thickness of compressed breast for the quantification, it is known that the accuracy of the built-in thickness measurement is not satisfactory. Triple-energy CEDM, which can provide a third image, can alleviate the limitation of dual-energy CEDM. If triple exposure technique is applied, it can lead to increased risk of motion artifact. An energy-resolving photoncounting detector (PCD) that can acquire multispectral X-ray images can reduce the risk of motion artifact. In this research, an easily implementable method for iodine quantification in breast imaging was suggested, and it was applied to the images of breast phantom with various iodine concentrations. The iodine concentrations in breast phantom simulate lesions filled with different iodine concentrations in the breast. The result shows that the proposed method can quantify the iodine concentrations in breast phantom accurately.

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Dual-energy contrast-enhanced digital mammography: initial clinical results of a multireader, multicase study

Cited by 188 publications

References 29 publications

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

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

Exploring silver as a contrast agent for contrast-enhanced dual-energy X-ray breast imaging

A Quantification Method for Breast Tissue Thickness and Iodine Concentration Using Photon-Counting Detector

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