Contrast-enhanced Mammography: Successful Clinical Experience

Dual-energy contrast-enhanced breast tomosynthesis holds promise to provide new and supplemental diagnostic information for improved cancer diagnosis. However, as a new imaging method, its implementation requires careful attention to the acquisition and processing techniques to provide best image quality at lowest radiation dose. In that regard, optimization of beam quality is of paramount importance. This study searched for an optimal beam quality using a ray-tracing method followed by a full Monte Carlo simulation with anthropomorphic breast phantoms and reconstruction. The results indicated optimal SdNR for a high-energy tungsten beam at 49 kVp with a 92.5-μm-thick copper filtration and a low-energy tungsten beam at 49 kVp with 95-μm-thick tin filtration. The fact the optimal performance can be achieved at the same kVp provides a significant technical advantage as sequential images do not require kVp switching and the associated complexities.

Contrast-Enhanced Digital Mammography - Radiologic …

Both 2D contrast-enhanceddual-energy mammography and 3D tomosynthesis can be applied.

Contrast-Enhanced Digital Mammography

Contrast-Enhanced Spectral Mammography — Adding the Power of Contrast to the Availability of Mammograms
By Kathy Hardy
Radiology Today
Vol. 13 No. 2 P. 34

Contrast-Enhanced Breast Tomosynthesis:

It’s that same principle—highlighting what’s most important—behind the introduction of SenoBright, GE Healthcare’s contrast-enhanced spectral mammography (CESM) technology. SenoBright, which received FDA 510(k) clearance in October 2011, produces contrast-enhanced images of the breast using an X-ray contrast agent and a dual-energy acquisition technique.

Contrast-Enhanced Spectral Mammography - …

However, digital mammography offers the option of so-called advanced applications, and two of these, contrast-enhanced mammography and tomosynthesis, are promising candidates for improving the detection of breast lesions otherwise obscured by the summation of dense tissue.

Optimization of contrast-enhanced digital breast tomosynthesis

The Achilles Heel of screening mammography is the detection of cancer in women with radiographic dense breasts. While nearly all cancers will be apparent in fatty breasts, only half will be visible in extremely dense breast []. This results, at least in large part, from the masking or camouflaging of noncalcified cancers by surrounding dense tissue. In this chapter, we will discuss several derivative digital technologies being developed to overcome the weakness of conventional mammography (film screen and/or digital mammography). The emphasis will be on digital breast tomosynthesis with secondary discussion of contrast-enhanced digital mammography and combined digital mammographic and ultrasound equipment. It should be emphasized, as of this writing, all the aforementioned technologies are investigational in the United States and none are approved for clinical use by the Food and Drug Administration. The clinical application of these technologies, if any, will be determined by scientific investigation and regulatory approval.

Contrast-Enhanced Digital Mammography Bibliography

This webinar will cover the history and technological components of contrast-enhanced digital mammography (CEDM), its potential uses, and impact on patients and clinical practice.

CEDM, Contrast-Enhanced Digital Mammography | …

Traditionally, dual-energy imaging has been used to decompose a radiographic image into two materials, such as bone and soft tissue. In this study, a different approach was used where the dual-energy technique was optimized to remove the contrast between adipose and glandular tissue and thereby minimize anatomical noise. Our optimization of dual-energy contrast-enhanced tomosynthesis proceeded in a three-stage process. First, the weighting factor for the weighted log subtraction was chosen to remove the contrast between adipose and glandular materials. Second, the distribution of dose between the two single-energy images were optimized to minimize quantum noise. Finally, the optimal beam quality was chosen to maximize the SdNR of the iodinated masses in the dual-energy images. The following describes the theoretical basis for these optimization stages followed by description of each of the components o the study.

Contrast-enhanced Digital Mammography

The purpose of this study was to optimize the radiographic technique for dual-energy contrast-enhanced tomosynthesis. The optimization was based on mass conspicuity for iodinated lesions. A ray-tracing algorithm was used to examine the signal difference to noise ratio (SdNR) of iodinated masses imaged with a wide variety of beam energies, filter materials, and filter thicknesses. The results of the ray-tracing model were verified by a Monte Carlo model that simulated photon transport through a voxelized breast phantom. The mass SdNR was examined as a basis to optimize dual-energy contrast-enhanced tomosynthesis in both the tomosynthesis projections and reconstructed slices.