Contrast Enhanced Mammography
Digital mammography technology is continuing to progress. A new method is gaining more and more attention, especially for the diagnostic workup of recalled women: contrast-enhanced dual energy mammography (CEM). It combines contrast-enhanced (CE) imaging, which is familiar from computed tomography (CT), angiography, and magnetic resonance imaging (MRI), with the dual energy (DE) imaging used with CT and dual energy X-ray absorptiometry (DXA). The clinical value of CEM continues to be comprehensively studied.
What do our clinical experts have to say?
It’s important to understand how the method works and the experiences with CEM in the clinical routine so far. A webinar and a white paper aim to deepen these topics.
The latest on contrast media examinations in breast imaging - Interview
Dr. Ritse Mann gives an answer on the current European recommendations for contrast media examinations and the associated political issues. (ECR, March, 2023)
The latest on contrast media examinations in breast imaging
Adventures with Contrast Enhanced Mammography
Dr. Noel Bergquist, an assistant professor at the University of Tennessee at Knoxville's Breast Center, presents a diverse series of cases, after a brief review of Siemens' Titanium Contrast Enhanced Mammography (TICEM). (Clinical Focus Talks, Nov. 2021)
The clinical use of Wide-Angle Tomosynthesis and Titanium Contrast Enhanced Mammography
This online seminar by Associate Prof. Dr. Luis Pina (Pamplona / Spain) explains the benefits of a morphological vs. functional breast imaging (50° Wide-Angle Tomosynthesis and TiCEM) . When to use DBT / CEM in the diagnostic process incl. clinical cases. Includes studies and current clinical discussions (June 2020).
Related Publications on Contrast Enhanced Mammography
2. Sistermanns M, Kowall B, Hörnig M, Beiderwellen K, Uhlenbrock D. Motion Artifact Reduction in Contrast-Enhanced Dual-Energy Mammography - A Multireader Study about the Effect of Nonrigid Registration as Motion Correction on Image Quality. Rofo. 2021 Mar 18
Related abstracts
Clinical utility of Contrast-Enhanced Dual Energy Mammography (CEDEM)
Luis Javier Pina Insausti; Pamplona, Spain
Abstract: Contrast-Enhanced Dual Energy Mammography (CEDEM) is a development of digital mammography. By using dual energy (conventional low-energy mammography plus high-energy mammography) after the administration of a bolus of intravenous iodinated contrast medium, a morpho-functional image of the breast is acquired. This technique joins the high spatial resolution of conventional digital mammography with functional information based on neoangiogenesis. The indications of this technique for clinical use include: problem–solving technique after inconclusive mammography, preoperative assessment of breast cancer, follow-up of scars after conservative treatment, and follow-up of intermediate-risk patients (borderline histological lesions, such as lobular carcinoma in situ, atypical ductal or lobular hyperplasia, and positive family history of breast cancer). In fact, the majority of indications are those of MRI, including the contraindications for MRI (pacemakers, claustrophobic patients, etc.). Nevertheless, CEDEM has some limitations: The sensitivity is lower for ductal carcinomas in situ, lesions out of the field of view of the detector are missed, and some benign lesions can enhance after contrast administration. CEDEM is contraindicated for patients allergic to iodine as well as for patients with renal insufficiency.
Learning objectives:
1. To become familiar with Contrast-Enhanced Dual Energy Mammography (CEDEM)
2. To learn the main indications for this technique
3. To learn the main limitations of CEDEM
The latest on contrast media examinations in breast imaging
Paola Clauser, Vienna, Austria
The benefit of contrast media-based imaging in breast diagnostics has been an ongoing topic of clinical discussion in recent years and has called for a variety of multi-faceted discussions in the physicians' community.
We will approach the topic by first highlighting the frequently changing recommendations in the guidelines for screening dense breasts.
Renowned experts in the fields of ultrasound, mammography, and magnetic resonance imaging will then bring you up to date on the clinical and scientific results of contrast media examinations.
Using CEM in the Daily Practice: How and When
Learning Objectives:
- To review CEM technique and methods to ensure a good image quality
- To define clinical scenarios in which CEM ensures the highest added value
- To discuss current limitations to a wider implementation in the clinical practice
Adventures with Contrast Enhanced Mammography
Noël M. Bergquist; Knoxville, TN, USA
Abstract: Are you considering adding Contrast Enhanced Mammography to your department? Have you just started and would like to see how others are using it? Perhaps, You've been using it for a while, but would like to compare our workflow with yours? Dr. Noel Bergquist, an assistant professor at the University of Tennessee at Knoxville's Breast Center, will present a diverse series of cases, after a brief review of Siemens' Titanium Contrast Enhanced Mammography (TICEM). The majority of current uses will be covered in the included 8 - 10 cases.
Clinical utility of Contrast-Enhanced Dual Energy Mammography (CEDEM)
Luis Javier Pina Insausti; Pamplona, Spain
Abstract: Contrast-Enhanced Dual Energy Mammography (CEDEM) is a development of digital mammography. By using dual energy (conventional low-energy mammography plus high-energy mammography) after the administration of a bolus of intravenous iodinated contrast medium, a morpho-functional image of the breast is acquired. This technique joins the high spatial resolution of conventional digital mammography with functional information based on neoangiogenesis. The indications of this technique for clinical use include: problem–solving technique after inconclusive mammography, preoperative assessment of breast cancer, follow-up of scars after conservative treatment, and follow-up of intermediate-risk patients (borderline histological lesions, such as lobular carcinoma in situ, atypical ductal or lobular hyperplasia, and positive family history of breast cancer). In fact, the majority of indications are those of MRI, including the contraindications for MRI (pacemakers, claustrophobic patients, etc.). Nevertheless, CEDEM has some limitations: The sensitivity is lower for ductal carcinomas in situ, lesions out of the field of view of the detector are missed, and some benign lesions can enhance after contrast administration. CEDEM is contraindicated for patients allergic to iodine as well as for patients with renal insufficiency.
Learning objectives:
1. To become familiar with Contrast-Enhanced Dual Energy Mammography (CEDEM)
2. To learn the main indications for this technique
3. To learn the main limitations of CEDEM
The latest on contrast media examinations in breast imaging
Paola Clauser, Vienna, Austria
The benefit of contrast media-based imaging in breast diagnostics has been an ongoing topic of clinical discussion in recent years and has called for a variety of multi-faceted discussions in the physicians' community.
We will approach the topic by first highlighting the frequently changing recommendations in the guidelines for screening dense breasts.
Renowned experts in the fields of ultrasound, mammography, and magnetic resonance imaging will then bring you up to date on the clinical and scientific results of contrast media examinations.
Using CEM in the Daily Practice: How and When
Learning Objectives:
- To review CEM technique and methods to ensure a good image quality
- To define clinical scenarios in which CEM ensures the highest added value
- To discuss current limitations to a wider implementation in the clinical practice
Adventures with Contrast Enhanced Mammography
Noël M. Bergquist; Knoxville, TN, USA
Abstract: Are you considering adding Contrast Enhanced Mammography to your department? Have you just started and would like to see how others are using it? Perhaps, You've been using it for a while, but would like to compare our workflow with yours? Dr. Noel Bergquist, an assistant professor at the University of Tennessee at Knoxville's Breast Center, will present a diverse series of cases, after a brief review of Siemens' Titanium Contrast Enhanced Mammography (TICEM). The majority of current uses will be covered in the included 8 - 10 cases.
Clinical utility of Contrast-Enhanced Dual Energy Mammography (CEDEM)
Luis Javier Pina Insausti; Pamplona, Spain
Abstract: Contrast-Enhanced Dual Energy Mammography (CEDEM) is a development of digital mammography. By using dual energy (conventional low-energy mammography plus high-energy mammography) after the administration of a bolus of intravenous iodinated contrast medium, a morpho-functional image of the breast is acquired. This technique joins the high spatial resolution of conventional digital mammography with functional information based on neoangiogenesis. The indications of this technique for clinical use include: problem–solving technique after inconclusive mammography, preoperative assessment of breast cancer, follow-up of scars after conservative treatment, and follow-up of intermediate-risk patients (borderline histological lesions, such as lobular carcinoma in situ, atypical ductal or lobular hyperplasia, and positive family history of breast cancer). In fact, the majority of indications are those of MRI, including the contraindications for MRI (pacemakers, claustrophobic patients, etc.). Nevertheless, CEDEM has some limitations: The sensitivity is lower for ductal carcinomas in situ, lesions out of the field of view of the detector are missed, and some benign lesions can enhance after contrast administration. CEDEM is contraindicated for patients allergic to iodine as well as for patients with renal insufficiency.
Learning objectives:
1. To become familiar with Contrast-Enhanced Dual Energy Mammography (CEDEM)
2. To learn the main indications for this technique
3. To learn the main limitations of CEDEM