Practical uses of contrast‐enhanced spectral mammography in daily work: A pictorial review

Alexander, Sweeka; Dulku, Gurjeet; Hashoul, Sharbell Y.; Taylor, Donna

doi:10.1111/1754-9485.12927

Cited by 5 publications

(5 citation statements)

References 19 publications

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“…Subtraction images improve the diagnostic specificity of low-energy images, providing more precise measurement of tumor size as well as the possibility of identifying multifocal diseases, especially in women with dense breast tissue. Thus, the effectiveness of CESM in breast cancer diagnosis is comparable to MRI and is a promising tool to serve as a basic imaging technique in patients with symptomatic breast cancer or for the detection of multifocal and multicentric breast cancers [ 49 , 50 , 51 ]. As we have shown in our study, CESM is also a useful and effective method in assessing the pathological response to NAC.…”

Section: Discussionmentioning

confidence: 99%

Contrast-Enhanced Spectral Mammography Assessment of Patients Treated with Neoadjuvant Chemotherapy for Breast Cancer

et al. 2021

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Background: Evaluating the tumor response to neoadjuvant chemotherapy is key to planning further therapy of breast cancer. Our study aimed to evaluate the effectiveness of low-energy and subtraction contrast-enhanced spectral mammography (CESM) images in the detection of complete response (CR) for neoadjuvant chemotherapy (NAC) in breast cancer. Methods: A total of 63 female patients were qualified for our retrospective analysis. Low-energy and subtraction CESM images just before the beginning of NAC and as a follow-up examination 2 weeks before the end of chemotherapy were compared with one another and assessed for compliance with the postoperative histopathological examination (HP). The response to preoperative chemotherapy was evaluated based on the RECIST 1.1 criteria (Response Evaluation Criteria in Solid Tumors). Results: Low-energy images tend to overestimate residual lesions (6.28 mm) and subtraction images tend to underestimate them (2.75 mm). The sensitivity of low-energy images in forecasting CR amounted to 33.33%, while the specificity was 92.86%. In the case of subtraction CESM, the sensitivity amounted to 85.71% and the specificity to 71.42%. Conclusions: CESM is characterized by high sensitivity in the assessment of CR after NAC. The use of only morphological assessment is insufficient. CESM correlates well with the size of residual lesions on histopathological examination but tends to underestimate the dimensions.

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Section: Discussionmentioning

confidence: 99%

Contrast-Enhanced Spectral Mammography Assessment of Patients Treated with Neoadjuvant Chemotherapy for Breast Cancer

et al. 2021

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“…Currently, MRI is considered the most sensitive imaging modality for breast cancer detection and is used as a problem-solving tool in dense breast and equivocal cases. Contrast-enhanced mammography technique received FDA approval in 2011 and has been used as a problem-solving tool in clinical practice, such as evaluation of dense breast, screening of high-risk patients as an alternative to MRI, evaluation of breast lesions with equivocal findings on mammogram, local staging of breast cancer, assessment of patients with metastasis elsewhere with occult breast primary, post chemotherapy response evaluation, therapeutic planning, and detection of residual or recurrent breast cancer after breast conserving surgery or excisional biopsy (7,8).…”

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confidence: 99%

Technique and clinical applications of dual-energy contrast-enhanced digital mammography (CEDM) in breast cancer evaluation: a pictorial essay

Sudhir¹,

Koppula²,

Mandava³

et al. 2021

Diagn Interv Radiol

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Contraindications to CEDMCEDM should be avoided in pregnant women, those with history of allergy to iodinated contrast media, and those with renal insufficiency. Contrast administrationA trained technologist obtains the peripheral intravenous access preferably using a 18-gauge needle. A dose of 1.5 mL/kg bodyweight of iodinated contrast media (Omnipaque ABSTRACT This pictorial essay illustrates an overview of the basic technique used in acquiring dual-energy contrast-enhanced digital mammography (CEDM) images and its potential clinical applications in regular practice. CEDM may be used as a low-cost alternative to magnetic resonance imaging (MRI), as a problem-solving tool in clinical practice and for therapeutic planning of breast cancer, which may include high-risk screening, dense breast evaluation, mammographically equivocal lesions, local staging, treatment response evaluation, and post treatment follow-up. We share our experience of CEDM at a tertiary care cancer hospital.

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“…In recent years, the development and clinical implementation of contrast-enhanced spectral mammography (CESM) have shown considerable promise in therapy monitoring. CESM combines iodine-based intravenous contrast agents with dual-energy (low at 24–35 kVp and high 40–47 kVp) [ 51 ] image acquisition to capture morphologic and microvessel density (MVD) features of the breast [ 52 ]. The resulting dual-energy recombined image has high sensitivity for detecting lesions in dense breasts that are otherwise occult on conventional mammography [ 53 ] ( Figure 2 ) [ 54 ].…”

Section: Imaging Of Neoadjuvant Treatment Response In Breast Cancementioning

confidence: 99%

Current Landscape of Breast Cancer Imaging and Potential Quantitative Imaging Markers of Response in ER-Positive Breast Cancers Treated with Neoadjuvant Therapy

Jones

Hathi

Freimanis

et al. 2020

Cancers

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In recent years, neoadjuvant treatment trials have shown that breast cancer subtypes identified on the basis of genomic and/or molecular signatures exhibit different response rates and recurrence outcomes, with the implication that subtype-specific treatment approaches are needed. Estrogen receptor-positive (ER+) breast cancers present a unique set of challenges for determining optimal neoadjuvant treatment approaches. There is increased recognition that not all ER+ breast cancers benefit from chemotherapy, and that there may be a subset of ER+ breast cancers that can be treated effectively using endocrine therapies alone. With this uncertainty, there is a need to improve the assessment and to optimize the treatment of ER+ breast cancers. While pathology-based markers offer a snapshot of tumor response to neoadjuvant therapy, non-invasive imaging of the ER disease in response to treatment would provide broader insights into tumor heterogeneity, ER biology, and the timing of surrogate endpoint measurements. In this review, we provide an overview of the current landscape of breast imaging in neoadjuvant studies and highlight the technological advances in each imaging modality. We then further examine some potential imaging markers for neoadjuvant treatment response in ER+ breast cancers.

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Practical uses of contrast‐enhanced spectral mammography in daily work: A pictorial review

Cited by 5 publications

References 19 publications

Contrast-Enhanced Spectral Mammography Assessment of Patients Treated with Neoadjuvant Chemotherapy for Breast Cancer

Contrast-Enhanced Spectral Mammography Assessment of Patients Treated with Neoadjuvant Chemotherapy for Breast Cancer

Technique and clinical applications of dual-energy contrast-enhanced digital mammography (CEDM) in breast cancer evaluation: a pictorial essay

Current Landscape of Breast Cancer Imaging and Potential Quantitative Imaging Markers of Response in ER-Positive Breast Cancers Treated with Neoadjuvant Therapy

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