Abstract P1-02-10: Contrast enhanced spectral mammography (CESM) is a new breast imaging contrast study: A review of indications, protocol, interpretation and pitfalls

Abstract

Abstract Purpose: This presentation is to discuss the indications, protocol, interpretation and pitfalls of CESM using illustrations of breast malignant and benign cases performed in our institution, after a brief literature review. CESM characteristics for both benign and malignant lesions are defined after comparison to other imaging studies and correlation to final tissue diagnosis. Methods: 1000 CESM cases including 100 breast cancer and 200 benign lesions were retrospectively analyzed. These cases were performed in our institution from October 2012 to March 2014. GE Senographe Essential Full Field Digital System (SenoBright) was utilized for CESM studies. Both low and high energy images were obtained after intravenous 75-100cc Isovue 370 administration at flow rate of 1.5-2cc per second. Both low energy and subtracted images were reviewed on GE Centricity Imagecast on 5 megapigxel monitor. Abnormal CESM lesions underwent further evaluation and tissue sampling for a final diagnosis to determine the presence of breast cancer. Results: CESM is one of the contrast studies. It provides both morphologic and functional information of breast lesions. The sensitivity of CESM for cancer detection was 93-100% per patient in contrast to 95-100% of breast MRI. There are morphological and enhancement features for both malignant and benign lesions on CESM. CESM could pick up lesions when regular digital mammography and ultrasound are negative. CESM is a part of diagnostic study on selected patients. It has a short duration exam time and results are easily accessible. Some CESM artifacts are unique and commonly occurred. Conclusion: CESM is a new breast imaging contrast study. The sensitivity for breast cancer detection is comparable to breast MRI. With its easy accessibility and cost effectiveness, CESM may play an important role in breast cancer detection in conjunct with diagnostic mammography and breast ultrasound. Recognition of CESM artifacts helps to increase diagnostic accuracy. Citation Format: Lydia Liao, Luna Li, Pauline Germaine, Elizabeth Tinney, Kristin Brill, Karen Hendershott. Contrast enhanced spectral mammography (CESM) is a new breast imaging contrast study: A review of indications, protocol, interpretation and pitfalls [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-02-10.