Digital Mammography with Contrast Enhancement

Introduction: Contrast enhanced digital mammography (CEDM) uses low energy and high energy exposures to produce a subtracted contrast image. The low-energy image is of the same diagnostic quality as standard 2-dimensional mammography. It is currently performed with a standard full-field digital mammogram (FFDM). CEDM is a quick, well-tolerated, relatively low-cost breast imaging tech nique that combines standard full-field digital mammography with an intravenous, low-osmolar, iodinated contrast medium. Because more than 19% of breast malignancies may be missed by conventional imaging techniques, especially when they are concurrent or collocated with other benign lesions, this review examines CEDM for better diagnosis of the breast masses.The purpose of this review is to determine if the low energy image performed after intravenous iodine injection can replace the standard FFDM.Methods: The keywords that were searched in PubMed, Google scholar and Web of science were Digital mammography, Contrast, Enhancement . Finally, 10 articles from 2014 to 2018 were evaluated.Results: Dual energy contrast-enhanced digital mammography requires intravenous iodine contrast injection prior to obtaining any mammographic images. A low energy exposure (26–30 KVp) and a high energy exposure (45–49 KVp) are sequentially obtained, and a recombination algorithm is used to generate a subtracted image that deletes information on the image not related to contrast enhancement and highlighting sites of contrast enhancement in the breast. CEDM is reportedly as sensitive as magnetic resonance imaging (MRI) and more sensitive than standard digital mammography in identifying breasts containing known cancers, and is more specific than MRI in depicting additional foci of ipsilateral disease. CEDM significantly improves diagnostic accuracy compared to non-contrast mammography. It is clear that utilizing iodinated contrast with mammography facilitates breast lesion visualization. The prior administration of intravenous iodinated contrast is the only difference between the low energy portion of the CEDM study and a standard full-field digital mammogram. Numerous studies have demonstrated increased sensitivity and specificity of CEDM compared with either FFDM. Conclusion: CEDM is a novel modality that continues to show improved sensitivity in breast cancer detection compared with standard mammography.

کلیدواژه ها:

Digital Mammography ، Contrast Media ، Enhancement