Contrast-Enhanced Digital Mammography

Mar 25th, 2014Dec 31st, 1969
Webinar
https://www.icpme.us
Phone:607-257-5860, ext. 29
A one-hour live webinar with Dr. John Lewin on the role of contrast-enhanced mammography as an adjunct to to FFDM for supplemental diagnostic breast imaging
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The patient was a woman in her 50s with suspected recurrence of invasive lobular breast cancer. A, maximum intensity projection image from FDG-PET/CT demonstrating avid foci in the chest (red arrow). Transaxial CT (B) and transaxial fused FDG-PET/CT image (C) showing that the chest avidity corresponds to FDG-avid lung nodules (red arrows) suspicious for malignancy. The lung nodule was subsequently biopsied but found to represent benign granulomatous inflammation and thus a false positive on FDG-PET/CT. D, maximum intensity projection image from FES-PET/CT demonstrating multifocal uptake suspicious for malignancy. E, transaxial CT and fused FES-PET/CT demonstrating no FES-avidity in the biopsy proven benign granulomatous lung nodules (red arrows), thus true negative on FES-PET/CT. FES-avidity in nodes (white arrow) is suspicious for malignancy. F, transaxial CT and fused FES-PET/CT demonstrates gastric avidity (blue arrow) suspicious for malignancy. G, transaxial CT and fused FES PET/CT demonstrates FES-avid osseous foci (yellow arrow) suspicious for malignancy. This osseous focus was subsequently biopsied and proved to be an osseous metastasis and thus true positive on FES-PET/CT.
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Imaging in a 56-year-old woman with heterogeneously dense breasts (BIRADS C). (A) Left craniocaudal (left) and mediolateral oblique (right) digital mammograms show no abnormality. (B) Left craniocaudal (LCC, top) and left mediolateral oblique (LMLO, bottom) mammograms with retrospectively applied AI (Lunit Insight MMG, version 1.1.7.1; Lunit) show the lesion was given abnormality scores of 97% and 71%, respectively. The color bar indicates pixel-level abnormality scores corresponding to heatmap contour lines. Breast ultrasound performed the same day was considered negative (not shown). (C) Left craniocaudal (left) and mediolateral oblique (right) digital mammograms acquired nine months later show an irregular mass (arrows) in the left breast, which correlates with the heatmap areas scored as 97% and 71% by AI in the earlier screening mammogram (B). The radiopaque round marker denotes the site of the palpable abnormality indicated by the patient. (D) Transverse ultrasound imaging shows an irregular mass (arrow) in the left breast. The patient was treated with breast-conserving surgery, and the mass was proven to be invasive lobular carcinoma. Image courtesy of the RSNA.
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