Electronic ISSN 2287-0237

VOLUME

CONTRAST ENHANCED SPECTRAL MAMMOGRAPHY (CESM)

SEPTEMBER 2014 - VOL.8 | CASE REPORT

CESM is a technique to detect abnormal contrast enhancement by dynamic iodinated contrast  medium study via  intravenous injection using digital mammographic unit on the basis of subtraction of  low and high energies. The dynamic images are displayed to evaluate the depletion. The breast cancer  will depict the contrast. The result is more sensitive and specific than CE-MRI. The other advantages to CE-MRI are lower cost of equipment, examination, contrast medium, shorter time of study and claustrophobia to MRI. It is recommended for the detection, extension of breast cancer or problem cases.

Keywords:

contrast enhanced spectral mammography (CESM), breast lesions, breast ultrasound, pathological and physiological imaging

MEDIA
Figure 1A:
Digital mammograms in CC and MLO views reveal extremely dense fibroglandular tissue, no detectable convincing lesion.
Figure 1B:
CESM reveals extensive, inhomogeneous enhancement of a larger microlobulated round mass (red arrow) in outer part of right breast and another nearby tiny foci of enhancement (green arrow). Multiple tiny foci in right breast are not excluded.
Figure 1C:
Core needle biopsy (CNB) reveals invasive ductal carcinoma.
Figure 2A:
Digital mammogram in left CC and MLO reveals an irregular shaped hyperdensity mass with spiculation, highly suspected of local recurrence (arrow).
Figure 2B:
CESM reveals no abnormal enhancement, particularly in the suspected area (arrow).
Figure 2C:
CNB reveals only a stromal fibrosis. No malignancy is observed.
Table 1:
Comparison of the sensitivity, specificity and accuracy of CESM with breast CE-MRI.
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