The Future of Contrast-Enhanced Mammography : American Journal of Roentgenology : Vol. 210, No. 2 (AJR)

February 2018, Volume 210, Number 2

FOCUS ON: Women's Imaging

Clinical Perspective

The Future of Contrast-Enhanced Mammography

Matthew F. Covington^1,², Victor J. Pizzitola¹, Roxanne Lorans¹, Barbara A. Pockaj³, Donald W. Northfelt⁴, Catherine M. Appleton² and Bhavika K. Patel¹

+ Affiliations:

¹Department of Radiology, Mayo Clinic, Scottsdale, AZ.

²Department of Radiology, Mallinckrodt Institute of Radiology, Washington University in St. Louis, 510 South Kingshighway Blvd, St. Louis, MO 63110.

³Department of General Surgery, Mayo Clinic, Scottsdale, AZ.

⁴Department of Oncology, Mayo Clinic, Scottsdale, AZ.

Citation: American Journal of Roentgenology. 2018;210: 292-300. 10.2214/AJR.17.18749

ABSTRACT :

OBJECTIVE. The purpose of this article is to discuss facilitators of and barriers to future implementation of contrast-enhanced mammography (CEM) in the United States.

CONCLUSION. CEM provides low-energy 2D mammographic images analogous to digital mammography and contrast-enhanced recombined images that allow assessment of neovascularity similar to that offered by MRI. The utilization of CEM in the United States is currently low but could increase rapidly given the many potential indications for its clinical use.

Keywords: contrast-enhanced digital mammography, contrast-enhanced mammography, contrast-enhanced spectral mammography

Based on a presentation at the Society of Breast Imaging 2017 annual meeting, Los Angeles, CA.

1. Lee-Felker SA, Tekchandani L, Thomas M, et al. Newly diagnosed breast cancer: comparison of contrast-enhanced spectral mammography and breast MR imaging in the evaluation of extent of disease. Radiology 2017; 285:389–400 [Google Scholar]

2. Lewis TC, Pizzitola VJ, Giurescu ME, et al. Contrast-enhanced digital mammography: a single-institution experience of the first 208 cases. Breast J 2017; 23:67–76 [Google Scholar]

3. Ali-Mucheru M, Patel B, Pockaj B, et al. Contrast-enhanced digital mammography in the surgical management of breast cancer. Ann Surg Oncol 2016; 23(suppl 5):649–655 [Google Scholar]

4. Fallenberg EM, Dromain C, Diekman F, et al. Contrast-enhanced spectral mammography versus MRI: initial results in the detection of breast cancer and assessment of tumour size. Eur Radiol 2014; 24:256–264 [Google Scholar]

5. Fallenberg EM, Schmitzberger FF, Amer H, et al. Contrast-enhanced spectral mammography vs mammography and MRI: clinical performance in multireader evaluation. Eur Radiol 2017; 27:2752–2764 [Google Scholar]

6. Luczyńska E, Heinze-Paluchowska S, Hendrick E, et al. Comparison between breast MRI and contrast-enhanced spectral mammography. Med Sci Monit 2015; 21:1358–1367 [Google Scholar]

7. Jochelson MS, Dershaw DD, Sung JS, et al. Bilateral contrast-enhanced dual-energy digital mammography: feasibility and comparison with conventional digital mammography and MR imaging in women with known breast carcinoma. Radiology 2013; 266:743–751 [Google Scholar]

8. Patel BK, Gray RJ, Pockaj BA. Potential cost savings of contrast-enhanced digital mammography. AJR 2017; 208:[web]W231–W237 [Abstract] [Google Scholar]

9. Bhimani C, Matta D, Roth RG, et al. Contrast-enhanced spectral mammography: technique, indications and clinical applications. Acad Radiol 2017; 24:84–88 [Google Scholar]

10. Cheung YC, Lin YC, Wan YL, et al. Diagnostic performance of dual-energy contrast-enhanced subtracted mammography in dense breasts compared to mammography alone: interobserver blind-reading analysis. Eur Radiol 2014; 24:2394–2403 [Google Scholar]

11. Mori M, Akashi-Tanaka S, Suzuki S, et al. Diagnostic accuracy of contrast-enhanced spectral mammography in comparison to conventional full-field digital mammography in a population of women with dense breasts. Breast Cancer 2017; 24:104–110 [Google Scholar]

12. Fallenberg EM, Dromain C, Diekmann F, et al. Contrast-enhanced spectral mammography: does mammography provide additional clinical benefits or can some radiation exposure be avoided? Breast Cancer Res Treat 2014; 146:371–381 [Google Scholar]

13. Berg WA. Current status of supplemental screening in dense breasts. J Clin Oncol 2016; 34:1840–1843 [Google Scholar]

14. Lee JM, McMahon PM, Kong CY, et al. Cost-effectiveness of breast MR imaging and screen-film mammography for screening BRCA1 gene mutation carriers. Radiology 2010; 254:793–800 [Google Scholar]

15. Pataky R, Armstrong L, Chia S, et al. Cost-effectiveness of MRI of breast cancer screening in BRCA 1/2 mutation carriers. BMC Cancer 2013; 13:339 [Google Scholar]

16. Chou CP, Lewin JM, Chiang CL, et al. Clinical evaluation of contrast-enhanced digital mammography and contrast enhanced tomosynthesis: comparison to contrast-enhanced breast MRI. Eur J Radiol 2015; 84:2501–2508 [Google Scholar]

17. Francescone MA, Jochelson MS, Dershaw DD, et al. Low energy mammogram obtained in contrast-enhanced digital mammography (CEDM) is comparable to routine full-field digital mammography (FFDM). Eur J Radiol 2014; 83:1350–1355 [Google Scholar]

18. Friedewald SM, Rafferty EA, Rose SL, et al. Breast cancer screening using tomosynthesis in combination with digital mammography. JAMA 2014; 311:2499–2507 [Google Scholar]

19. Chen SC, Carton AK, Albert M, et al. Initial clinical experience with contrast-enhanced digital breast tomosynthesis. Acad Radiol 2007; 14:229–238 [Google Scholar]

20. Patel BK, Garza SA, Eversman S, Lopez-Alvarez Y, Kosiorek H, Pockaj BA. Assessing tumor extent on contrast-enhanced spectral mammography versus full-field digital mammography and ultrasound. Clin Imaging 2017; 46:78–84 [Google Scholar]

21. Hobbs MM, Taylor DB, Buzynski S, et al. Contrast-enhanced spectral mammography (CESM) and contrast enhanced MRI (CEMRI): patient preferences and tolerance. J Med Imaging Radiat Oncol 2015; 59:300–305 [Google Scholar]

22. American College of Radiology Committee on Drugs and Contrast Media. ACR manual on contrast media: version 10.3. American College of Radiology website. www.acr.org/~/media/ACR/Documents/PDF/QualitySafety/Resources/Contrast-Manual/Contrast_Media.pdf?db=web. Published 2017. Accessed June 21, 2017 [Google Scholar]

23. Caro JJ, Trindade E, McGregor M. The risks of death and of severe nonfatal reactions with high-vs low-osmolality contrast media: a meta-analysis. AJR 1991; 156:825–832 [Abstract] [Google Scholar]

24. Davenport MS, Cohan RH. The evidence for and against corticosteroid prophylaxis in at risk patients. Radiol Clin North Am 2017; 55:413–421 [Google Scholar]

25. Kim MH, Lee SY, Lee SE, et al. Anaphylaxis to iodinated contrast media: clinical characteristics related with development of anaphylactic shock. PLoS One 2014; 9:e100154 [Google Scholar]

26. Katayama H, Yamaguchi K, Kozuka T, Takashima T, Seez P, Matsuura K. Adverse reactions to ionic and nonionic contrast media: a report from the Japanese Committee on the Safety of Contrast Media. Radiology 1990; 175:621–628 [Google Scholar]

27. Ho JM, Jafferjee N, Covarrubias GM, Ghesani M, Handler B. Dense breasts: a review of reporting legislation and available supplemental screening options. AJR 2014; 203:449–456 [Abstract] [Google Scholar]

28. Kerlikowske K, Zhu W, Hubbard RA, et al. Outcomes of screening mammography by frequency, breast density, and postmenopausal hormone therapy. JAMA Intern Med 2013; 173:807–816 [Google Scholar]

29. Siegel JA, Pennington CW, Sacks B. Subjecting radiologic imaging to the linear no-threshold hypothesis: a non sequitur of non-trivial proportion. J Nucl Med 2017; 58:1–6 [Google Scholar]

30. Dromain C, Thibault F, Diekmann F, Fallenberg EM, Jong RA, Koomen M. Dual-energy contrast-enhanced digital mammography: initial clinical results of a multireader, multicase study. Breast Cancer Res 2012; 14:R94 [Google Scholar]

31. Jeukens CR, Lalji UC, Meijer E, et al. Radiation exposure of contrast-enhanced spectral mammography compared with full-field digital mammography. Invest Radiol 2014; 49:659–665 [Google Scholar]

32. James JR, Pavlicek W, Hanson JA, Boltz TF, Patel BK. Breast radiation dose with CESM compared with 2D FFDM and 3D tomosynthesis mammography. AJR 2017; 208:362–372 [Abstract] [Google Scholar]

33. Badr S, Laurent N, Regis C, et al. Dual-energy contrast-enhanced digital mammography in routine clinical practice in 2013. Diagn Interv Imaging 2014; 95:245–258 [Google Scholar]

34. Hruska CB, O'Connor MK. Curies, and grays, and sieverts, oh my: a guide for discussing radiation dose and risk of molecular breast imaging. J Am Coll Radiol 2015; 12:1103–1105 [Google Scholar]

35. Saslow D, Boetes C, Burke W, et al. American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography. CA Cancer J Clin 2007; 57:75–89 [Google Scholar]

36. Porter ME. What is value in health care? N Engl J Med 2010; 363:2477–2481 [Google Scholar]

Address correspondence to M. F. Covington ([email protected]).