scholarly journals Positive molecular breast imaging: challenges and problem solving with contrast-enhanced spectral mammography

2019 ◽  
Vol 12 (10) ◽  
pp. e230043
Author(s):  
Jeremy SL Ong ◽  
Felicity Whitewood ◽  
Donna B Taylor ◽  
Deepthi Dissanayake
Keyword(s):  
Problem Solving ◽  
Breast Imaging ◽  
Cross Correlation ◽  
High Sensitivity ◽  
Full Field ◽  
Molecular Breast Imaging ◽  
Full Field Digital Mammography ◽  
Contrast Enhanced ◽  
Hypervascular Lesion ◽  
Anatomical Information

Molecular breast imaging (MBI) is a relatively new technique with high sensitivity for breast cancer detection. However, because it only provides limited anatomical information, cross-correlation of MBI findings with conventional breast imaging modalities such as full field digital mammography can be challenging. We report a case of a positive MBI study in a supplemental screening setting, where cross-correlation of MBI, ultrasound, mammogram and biopsy findings was difficult. Contrast-enhanced spectral mammography (CESM) demonstrated a hypervascular lesion at the biopsy clip, helping to prove imaging/histopathological concordance. This case highlights the challenges of incorporating MBI into conventional imaging workup, as well as the use of CESM in problem solving.

scholarly journals Current Status of Contrast Enhanced Mammography: A Comprehensive Review

2021 ◽  
pp. 084653712110290
Author(s):  
Anat Kornecki
Keyword(s):  
Breast Imaging ◽  
Dual Energy ◽  
Current Status ◽  
Resonance Imaging ◽  
Comprehensive Review ◽  
Full Field ◽  
Dce Mri ◽  
Full Field Digital Mammography ◽  
Contrast Enhanced ◽  
Diagnostic Setting

Objectives: The purpose of this article is to provide a detailed and updated review of the physics, techniques, indications, limitations, reporting, implementation and management of contrast enhanced mammography. Background: Contrast enhanced mammography (CEM), is an emerging iodine-based modified dual energy mammography technique. In addition to having the same advantages as standard full-field digital mammography (FFDM), CEM provides information regarding tumor enhancement, relying on tumor angiogenesis, similar to dynamic contrast enhanced magnetic resonance imaging (DCE-MRI). This article reviews current literature on CEM and highlights considerations that are critical to the successful use of this modality. Conclusion: Multiple studies point to the advantage of using CEM in the diagnostic setting of breast imaging, which approaches that of DCE-MRI.

Emerging Breast Imaging Technologies

2018 ◽  
Author(s):  
Heidi R. Umphrey
Keyword(s):  
Breast Cancer ◽  
Breast Imaging ◽  
High Sensitivity ◽  
Molecular Techniques ◽  
Added Value ◽  
Breast Cancers ◽  
Imaging Technologies ◽  
Molecular Breast Imaging ◽  
Contrast Enhanced ◽  
Cancer Care Continuum

Emerging breast imaging technologies may provide improved care across the entire breast cancer care continuum; however, assessment of these technologies and their added value will require further development and research. Contrast-enhanced mammography was first described in 1985, utilizing digital subtraction angiography of the breast. Molecular techniques in breast imaging are expanding as advances in technology allow for decreased radiotracer dose and reveal high sensitivity for the detection of breast cancers. Molecular breast imaging (MBI) tools may have a role as we develop personalized breast imaging protocols based on risk. This chapter, appearing in the section on breast cancer overview, describes the new emerging technologies in breast imaging, including contrast-enhanced spectral mammography and molecular breast imaging.

scholarly journals Does contrast-enhanced mammography have an impact on the detection of cancer in patients with risk of developing breast cancer?

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Lamiaa Mohamed Bassam Hashem ◽  
Nancy Osama Abd El Hamid ◽  
Rasha Mohamed Kamal ◽  
Sahar Mahmoud Mansour ◽  
Shaimaa Lasheen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Imaging ◽  
Precancerous Lesions ◽  
Imaging Modality ◽  
Positive Family History ◽  
Full Field ◽  
Full Field Digital Mammography ◽  
Contrast Enhanced ◽  
Increased Risk ◽  
History Of

Abstract Background Contrast-enhanced mammography (CEM) has been discovered to be more sensitive and specific than two-dimensional full-field digital mammography (FFDM) in both screening and diagnostic settings. The aim of the study was to assess the additive role of CEM in the detection and characterization of breast lesions in women with increased risk of developing breast cancer. This prospective study included 283 female patients with increased risk of developing breast cancer (i.e., positive family history of breast cancer, personal history of breast cancer, and heterogeneously dense mammary parenchyma) coming for either screening (n = 127/283 (49.1%)) or diagnostic (n = 156/283 (55.1%)) purpose. All patients had FFDM and CEM done, and the findings were evaluated independently; final Breast Imaging Reporting And Data System (BIRADS) classification was given for each modality. Results were then compared with histopathology or ultrasound findings with routine follow-up for normal and typically benign findings. Results In this study, 283 women with mean age of 48 were enrolled. Among the studied cases regardless to a specific risk factor, 15/283 (5.3%) were diagnosed as normal, 13/283 (4.6%) as inflammatory lesions, 72/283(25.4%) as benign lesions, 6/283 (2.1%) as benign precancerous lesions, and 177/283 (62.5%) as malignant. The overall sensitivity and specificity of the CEM were 92.7 and 71.43 %, respectively, while FFDM were 80.90 and 59.05%, respectively. Conclusion Contrast-enhanced mammography is a valuable screening and diagnostic imaging modality in patients with increased risk of developing breast cancer with diagnostic indices higher than mammography resulting in a significantly higher cancer detection rate.

Contrast-enhanced spectral mammography in patients with MRI contraindications

2017 ◽  
Vol 59 (7) ◽  
pp. 798-805 ◽  
Author(s):  
Vivien Richter ◽  
Valerie Hatterman ◽  
Heike Preibsch ◽  
Sonja D Bahrs ◽  
Markus Hahn ◽  
...  
Keyword(s):  
Problem Solving ◽  
Diagnostic Accuracy ◽  
Breast Imaging ◽  
Diagnostic Yield ◽  
Therapy Response ◽  
Lesion Size ◽  
Size Estimation ◽  
Imaging Data ◽  
Technical Problems ◽  
Contrast Enhanced

Background Contrast-enhanced spectral mammography (CESM) is a novel breast imaging technique providing comparable diagnostic accuracy to breast magnetic resonance imaging (MRI). Purpose To show that CESM in patients with MRI contraindications is feasible, accurate, and useful as a problem-solving tool, and to highlight its limitations. Material and Methods A total of 118 patients with MRI contraindications were examined by CESM. Histology was obtained in 94 lesions and used as gold standard for diagnostic accuracy calculations. Imaging data were reviewed retrospectively for feasibility, accuracy, and technical problems. The diagnostic yield of CESM as a problem-solving tool and for therapy response evaluation was reviewed separately. Results CESM was more accurate than mammography (MG) for lesion categorization (r = 0.731, P < 0.0001 vs. r = 0.279, P = 0.006) and for lesion size estimation (r = 0.738 vs. r = 0.689, P < 0.0001). Negative predictive value of CESM was significantly higher than of MG (85.71% vs. 30.77%, P < 0.0001). When used for problem-solving, CESM changed patient management in 2/8 (25%) cases. Superposition artifacts and timing problems affected diagnostic utility in 3/118 (2.5%) patients. Conclusion CESM is a feasible and accurate alternative for patients with MRI contraindications, but it is necessary to be aware of the method’s technical limitations.

scholarly journals The effect of scatter and glare on image quality in contrast-enhanced breast imaging using an a-Si/CsI(Tl) full-field flat panel detector

2009 ◽  
Vol 36 (3) ◽  
pp. 920-928 ◽  
Author(s):  
Ann-Katherine Carton ◽  
Raymond Acciavatti ◽  
Johnny Kuo ◽  
Andrew D. A. Maidment
Keyword(s):  
Image Quality ◽  
Breast Imaging ◽  
Flat Panel ◽  
Full Field ◽  
Flat Panel Detector ◽  
Contrast Enhanced

Assessing tumor extent on contrast-enhanced spectral mammography versus full-field digital mammography and ultrasound

2017 ◽  
Vol 46 ◽  
pp. 78-84 ◽  
Author(s):  
Bhavika K. Patel ◽  
Sandra Alheli Garza ◽  
Sarah Eversman ◽  
Yania Lopez-Alvarez ◽  
Heidi Kosiorek ◽  
...  
Keyword(s):  
Digital Mammography ◽  
Full Field ◽  
Full Field Digital Mammography ◽  
Contrast Enhanced ◽  
Tumor Extent

Radiation Exposure of Contrast-Enhanced Spectral Mammography Compared With Full-Field Digital Mammography

2014 ◽  
Vol 49 (10) ◽  
pp. 659-665 ◽  
Author(s):  
Cécile R.L.P.N. Jeukens ◽  
Ulrich C. Lalji ◽  
Eduard Meijer ◽  
Betina Bakija ◽  
Robin Theunissen ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Digital Mammography ◽  
Full Field ◽  
Full Field Digital Mammography ◽  
Contrast Enhanced

scholarly journals Contrast-Enhanced Mammography for Screening Women after Breast Conserving Surgery

Cancers ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3495
Author(s):  
Jill Gluskin ◽  
Carolina Rossi Saccarelli ◽  
Daly Avendano ◽  
Maria Adele Marino ◽  
Almir G. V. Bitencourt ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Conserving Surgery ◽  
Low Energy ◽  
Breast Cancer Patients ◽  
Full Field ◽  
Full Field Digital Mammography ◽  
Institutional Review ◽  
Asymptomatic Patients ◽  
Contrast Enhanced ◽  
One Year

To investigate the value of contrast-enhanced mammography (CEM) compared to full-field digital mammography (FFDM) in screening breast cancer patients after breast-conserving surgery (BCS), this Health Insurance Portability and Accountability Act-compliant, institutional review board-approved retrospective, single-institution study included 971 CEM exams in 541 asymptomatic patients treated with BCS who underwent screening CEM between January 2013 and November 2018. Histopathology, or at least a one-year follow-up, was used as the standard of reference. Twenty-one of 541 patients (3.9%) were diagnosed with ipsi- or contralateral breast cancer: six (28.6%) cancers were seen with low-energy images (equivalent to FFDM), an additional nine (42.9%) cancers were detected only on iodine (contrast-enhanced) images, and six interval cancers were identified within 365 days of a negative screening CEM. Of the 10 ipsilateral cancers detected on CEM, four were detected on low-energy images (40%). Of the five contralateral cancers detected on CEM, two were detected on low-energy images (40%). Overall, the cancer detection rate (CDR) for CEM was 15.4/1000 (15/971), and the positive predictive value (PPV3) of the biopsies performed was 42.9% (15/35). For findings seen on low-energy images, with or without contrast, the CDR was 6.2/1000 (6/971), and the PPV3 of the biopsies performed was 37.5% (6/16). In the post-BCS screening setting, CEM has a higher CDR than FFDM.

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