Emerging mammographic breast imaging technique using iodinated contrast
As with MR, cancers and lesions with ↑ vascular flow and angiogenesis will demonstrate preferential contrast uptake
Subtraction utilized to ↑ contrast resolution
CET can be performed, but images are limited by noise; most studies use CEM
IMAGING
CEM Technique
Indications
Imaging Findings and Interpretation
DIfferential Diagnosis
Advantages
Limitations
Artifacts
Selected References
Houben IP et al: Contrast-enhanced spectral mammography in the evaluation of breast suspicious calcifications: diagnostic accuracy and impact on surgical management. Acta Radiol. 284185118822639, 2019
Covington MF et al: The future of contrast-enhanced mammography. AJR Am J Roentgenol. 210(2):292-300, 2018
Kim EY et al: Diagnostic Value of contrast-enhanced digital mammography versus contrast-enhanced magnetic resonance imaging for the preoperative evaluation of breast cancer. J Breast Cancer. 21(4):453-62, 2018
Lewin J: Comparison of contrast-enhanced mammography and contrast-enhanced breast MR imaging. Magn Reson Imaging Clin N Am. 26(2):259-63, 2018
Patel BK et al: Contrast-enhanced spectral mammography is comparable to MRI in the assessment of residual breast cancer following neoadjuvant systemic therapy. Ann Surg Oncol. 25(5):1350-6, 2018
Patel BK et al: Contrast enhanced spectral mammography: a review. Semin Ultrasound CT MR. 39(1):70-9, 2018
Perry H et al: Contrast-enhanced mammography: A systematic guide to interpretation and reporting. AJR Am J Roentgenol. 1-10, 2018
Sorin V et al: Contrast-enhanced spectral mammography in women with intermediate breast cancer risk and dense breasts. AJR Am J Roentgenol. 211(5):W267-74, 2018
Travieso-Aja MDM et al: Factors affecting the precision of lesion sizing with contrast-enhanced spectral mammography. Clin Radiol. 73(3):296-303, 2018
Zhu X et al: Diagnostic value of contrast-enhanced spectral mammography for screening breast cancer: Systematic review and meta-analysis. Clin Breast Cancer. 18(5):e985-95, 2018
Bennani-Baiti B et al: MRI for the assessment of malignancy in BI-RADS 4 mammographic microcalcifications. PLoS One. 12(11):e0188679, 2017
Fallenberg EM et al: Contrast-enhanced spectral mammography vs. mammography and MRI - clinical performance in a multi-reader evaluation. Eur Radiol. 27(7):2752-64, 2017
Gluskin J et al: Contamination artifact that mimics in-situ carcinoma on contrast-enhanced digital mammography. Eur J Radiol. 95:147-54, 2017
Houben IPL et al: Contrast-enhanced spectral mammography as work-up tool in patients recalled from breast cancer screening has low risks and might hold clinical benefits. Eur J Radiol. 94:31-7, 2017
Iotti V et al: Contrast-enhanced spectral mammography in neoadjuvant chemotherapy monitoring: a comparison with breast magnetic resonance imaging. Breast Cancer Res. 19(1):106, 2017
Jochelson MS et al: Comparison of screening CEDM and MRI for women at increased risk for breast cancer: A pilot study. Eur J Radiol. 97:37-43, 2017
Cheung YC et al: Dual-energy contrast-enhanced spectral mammography: enhancement analysis on BI-RADS 4 Non-mass microcalcifications in screened women. PLoS One. 11(9):e0162740, 2016
Chou CP et al: Contrast-enhanced tomosynthesis: the best of both worlds or more of the same? Eur J Radiol. 85(2):509, 2016
Kamal RM et al: Can we apply the MRI BI-RADS lexicon morphology descriptors on contrast-enhanced spectral mammography? Br J Radiol. 20160157, 2016
Luczyńska E et al: Comparison of the mammography, contrast-enhanced spectral mammography and ultrasonography in a group of 116 patients. Anticancer Res. 36(8):4359-66, 2016
Tagliafico AS et al: Diagnostic performance of contrast-enhanced spectral mammography: systematic review and meta-analysis. Breast. 28:13-9, 2016
Tennant SL et al: Contrast-enhanced spectral mammography improves diagnostic accuracy in the symptomatic setting. Clin Radiol. 71(11):1148-55, 2016
Yagil Y et al: Challenges in contrast-enhanced spectral mammography interpretation: artefacts lexicon. Clin Radiol. 71(5):450-7, 2016
Chou CP et al: Clinical evaluation of contrast-enhanced digital mammography and contrast enhanced tomosynthesis--comparison to contrast-enhanced breast MRI. Eur J Radiol. 84(12):2501-8, 2015
Hobbs MM et al: Contrast-enhanced spectral mammography (CESM) and contrast enhanced MRI (CEMRI): Patient preferences and tolerance. J Med Imaging Radiat Oncol. 59(3):300-5, 2015
Lobbes MB et al: The quality of tumor size assessment by contrast-enhanced spectral mammography and the benefit of additional breast MRI. J Cancer. 6(2):144-50, 2015
Cheung YC et al: Diagnostic performance of dual-energy contrast-enhanced subtracted mammography in dense breasts compared to mammography alone: interobserver blind-reading analysis. Eur Radiol. 24(10):2394-403, 2014
Fallenberg EM et al: Contrast-enhanced spectral mammography versus MRI: Initial results in the detection of breast cancer and assessment of tumour size. Eur Radiol. 24(1):256-64, 2014
Jeukens CR et al: Radiation exposure of contrast-enhanced spectral mammography compared with full-field digital mammography. Invest Radiol. 49(10):659-65, 2014
Lobbes MB et al: Contrast-enhanced spectral mammography in patients referred from the breast cancer screening programme. Eur Radiol. 24(7):1668-76, 2014
Jochelson MS et al: Bilateral contrast-enhanced dual-energy digital mammography: feasibility and comparison with conventional digital mammography and MR imaging in women with known breast carcinoma. Radiology. 266(3):743-51, 2013
Emerging mammographic breast imaging technique using iodinated contrast
As with MR, cancers and lesions with ↑ vascular flow and angiogenesis will demonstrate preferential contrast uptake
Subtraction utilized to ↑ contrast resolution
CET can be performed, but images are limited by noise; most studies use CEM
IMAGING
CEM Technique
Indications
Imaging Findings and Interpretation
DIfferential Diagnosis
Advantages
Limitations
Artifacts
Selected References
Houben IP et al: Contrast-enhanced spectral mammography in the evaluation of breast suspicious calcifications: diagnostic accuracy and impact on surgical management. Acta Radiol. 284185118822639, 2019
Covington MF et al: The future of contrast-enhanced mammography. AJR Am J Roentgenol. 210(2):292-300, 2018
Kim EY et al: Diagnostic Value of contrast-enhanced digital mammography versus contrast-enhanced magnetic resonance imaging for the preoperative evaluation of breast cancer. J Breast Cancer. 21(4):453-62, 2018
Lewin J: Comparison of contrast-enhanced mammography and contrast-enhanced breast MR imaging. Magn Reson Imaging Clin N Am. 26(2):259-63, 2018
Patel BK et al: Contrast-enhanced spectral mammography is comparable to MRI in the assessment of residual breast cancer following neoadjuvant systemic therapy. Ann Surg Oncol. 25(5):1350-6, 2018
Patel BK et al: Contrast enhanced spectral mammography: a review. Semin Ultrasound CT MR. 39(1):70-9, 2018
Perry H et al: Contrast-enhanced mammography: A systematic guide to interpretation and reporting. AJR Am J Roentgenol. 1-10, 2018
Sorin V et al: Contrast-enhanced spectral mammography in women with intermediate breast cancer risk and dense breasts. AJR Am J Roentgenol. 211(5):W267-74, 2018
Travieso-Aja MDM et al: Factors affecting the precision of lesion sizing with contrast-enhanced spectral mammography. Clin Radiol. 73(3):296-303, 2018
Zhu X et al: Diagnostic value of contrast-enhanced spectral mammography for screening breast cancer: Systematic review and meta-analysis. Clin Breast Cancer. 18(5):e985-95, 2018
Bennani-Baiti B et al: MRI for the assessment of malignancy in BI-RADS 4 mammographic microcalcifications. PLoS One. 12(11):e0188679, 2017
Fallenberg EM et al: Contrast-enhanced spectral mammography vs. mammography and MRI - clinical performance in a multi-reader evaluation. Eur Radiol. 27(7):2752-64, 2017
Gluskin J et al: Contamination artifact that mimics in-situ carcinoma on contrast-enhanced digital mammography. Eur J Radiol. 95:147-54, 2017
Houben IPL et al: Contrast-enhanced spectral mammography as work-up tool in patients recalled from breast cancer screening has low risks and might hold clinical benefits. Eur J Radiol. 94:31-7, 2017
Iotti V et al: Contrast-enhanced spectral mammography in neoadjuvant chemotherapy monitoring: a comparison with breast magnetic resonance imaging. Breast Cancer Res. 19(1):106, 2017
Jochelson MS et al: Comparison of screening CEDM and MRI for women at increased risk for breast cancer: A pilot study. Eur J Radiol. 97:37-43, 2017
Cheung YC et al: Dual-energy contrast-enhanced spectral mammography: enhancement analysis on BI-RADS 4 Non-mass microcalcifications in screened women. PLoS One. 11(9):e0162740, 2016
Chou CP et al: Contrast-enhanced tomosynthesis: the best of both worlds or more of the same? Eur J Radiol. 85(2):509, 2016
Kamal RM et al: Can we apply the MRI BI-RADS lexicon morphology descriptors on contrast-enhanced spectral mammography? Br J Radiol. 20160157, 2016
Luczyńska E et al: Comparison of the mammography, contrast-enhanced spectral mammography and ultrasonography in a group of 116 patients. Anticancer Res. 36(8):4359-66, 2016
Tagliafico AS et al: Diagnostic performance of contrast-enhanced spectral mammography: systematic review and meta-analysis. Breast. 28:13-9, 2016
Tennant SL et al: Contrast-enhanced spectral mammography improves diagnostic accuracy in the symptomatic setting. Clin Radiol. 71(11):1148-55, 2016
Yagil Y et al: Challenges in contrast-enhanced spectral mammography interpretation: artefacts lexicon. Clin Radiol. 71(5):450-7, 2016
Chou CP et al: Clinical evaluation of contrast-enhanced digital mammography and contrast enhanced tomosynthesis--comparison to contrast-enhanced breast MRI. Eur J Radiol. 84(12):2501-8, 2015
Hobbs MM et al: Contrast-enhanced spectral mammography (CESM) and contrast enhanced MRI (CEMRI): Patient preferences and tolerance. J Med Imaging Radiat Oncol. 59(3):300-5, 2015
Lobbes MB et al: The quality of tumor size assessment by contrast-enhanced spectral mammography and the benefit of additional breast MRI. J Cancer. 6(2):144-50, 2015
Cheung YC et al: Diagnostic performance of dual-energy contrast-enhanced subtracted mammography in dense breasts compared to mammography alone: interobserver blind-reading analysis. Eur Radiol. 24(10):2394-403, 2014
Fallenberg EM et al: Contrast-enhanced spectral mammography versus MRI: Initial results in the detection of breast cancer and assessment of tumour size. Eur Radiol. 24(1):256-64, 2014
Jeukens CR et al: Radiation exposure of contrast-enhanced spectral mammography compared with full-field digital mammography. Invest Radiol. 49(10):659-65, 2014
Lobbes MB et al: Contrast-enhanced spectral mammography in patients referred from the breast cancer screening programme. Eur Radiol. 24(7):1668-76, 2014
Jochelson MS et al: Bilateral contrast-enhanced dual-energy digital mammography: feasibility and comparison with conventional digital mammography and MR imaging in women with known breast carcinoma. Radiology. 266(3):743-51, 2013
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