An Overview of the Literature on CEDM

Abstract

Conducting a literature review on contrast-enhanced digital mammography (CEDM) is not easy due to the variety of abbreviations and acronyms referring to this procedure and due to the limited articles available in international biomedical databases (less than 100 to date). Among the most notable limitations of CEDM studies are their heterogeneity and sampling design, as well as their small sample population sizes. We focused on the dual-energy technique, as the temporal subtraction technique has become obsolete. The majority of studies conducted were concerned with assessing sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV); the key focus of many studies was comparison among CEDM, full-field digital mammography (FFDM) and magnetic resonance imaging (MRI) in terms of accuracy and diagnostic performance in breast imaging. CEDM showed an increase in diagnostic performance over FFDM alone, was comparable to MRI in terms of sensitivity and NPV and had a higher specificity and higher PPV. In addition, CEDM was examined as an additional imaging tool for problem-solving associated with suspicious lesions detected by conventional imaging techniques, such as microcalcifications, architectural distortions and the evaluation of dense breasts, with very promising results. Finally, we analysed the average glandular dose (AGD), and all results obtained were below the limits set by the regulations of the Mammography Quality Standards Act, thus positioning CEDM as a new valuable diagnostic technique in breast imaging.