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Published online before print July 24, 2003, 10.1148/radiol.2283020961
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(Radiology 2003;228:842-850.)
© RSNA, 2003


Breast Imaging

Contrast-enhanced Digital Mammography: Initial Clinical Experience1

Roberta A. Jong, MD, Martin J. Yaffe, PhD, Mia Skarpathiotakis, BASc, Rene S. Shumak, MD, Nathalie M. Danjoux, BSc, Anoma Gunesekara, BSc and Donald B. Plewes, PhD

1 From the Department of Medical Imaging, University of Toronto, Sunnybrook and Women’s College Health Sciences Centre, 2075 Bayview Ave, MG178, Toronto, Ontario, Canada M4N 3M5. From the 2001 RSNA scientific assembly. Received August 1, 2002; revision requested September 23; revision received December 6; accepted January 15, 2003. Supported by a program project grant from the Terry Fox Foundation. Address correspondence to R.A.J. (e-mail: roberta.jong@sw.ca).

PURPOSE: To investigate the potential of using intravenous contrast material with full-field digital mammography to facilitate the detection and characterization of lesions in the breast.

MATERIALS AND METHODS: Twenty-two women scheduled for biopsy because they were suspected of having abnormalities at breast imaging underwent imaging with contrast material–enhanced digital mammography. Six sequential images of the affected breast were obtained, with a contrast agent injected intravenously between the time the first and second images were obtained. Image processing included registration and logarithmic subtraction. Lesions were evaluated for the presence, morphology, and kinetics of enhancement. Lesion type, size, and pathologic findings were correlated with the findings at contrast-enhanced digital mammography.

RESULTS: At contrast-enhanced digital mammography, enhancement was observed in eight of 10 patients with biopsy-proved cancers. In one case of ductal carcinoma in situ and one case of invasive ductal carcinoma, enhancement was not observed. No enhancement was seen in seven of 12 cases in which lesions were suspected of being malignant at initial imaging but were benign. Morphology generally correlated with the pathologic diagnosis. The kinetics of lesion enhancement showed similarity to that seen with gadolinium-enhanced magnetic resonance imaging but was not consistent.

CONCLUSION: The results of this preliminary study suggest that contrast-enhanced digital mammography potentially may be useful in identification of lesions in the mammographically dense breast. Further investigation of contrast-enhanced digital mammography as a diagnostic tool for breast cancer is warranted.

© RSNA, 2003

Index terms: Breast neoplasms, diagnosis • Breast neoplasms, radiography, 00.11 • Breast neoplasms, US, 00.1298 • Contrast media • Radiography, digital, 00.1215




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