Juan Jose Cordones, Presenter: Nothing to Disclose

Carolina Ramirez Lozano MD, Abstract Co-Author: Nothing to Disclose

Jose Luis Cardenas, Abstract Co-Author: Nothing to Disclose

Johanna Marisol Silva MD, Abstract Co-Author: Nothing to Disclose

Carmen Bermejo, Abstract Co-Author: Nothing to Disclose

Angeles Cruz Diaz MD, Abstract Co-Author: Nothing to Disclose

To describe how CESM changed BI-RADS category of lesions previously evaluated with conventional imaging modalities reviewing the cases performed in our institution from March 2011 to February 2013.

We reviewed the indications of 95 patients with CESM performed at our institution and we analyzed how the BI-RADS category was modified according to the lack, presence and degree of enhancement on CESM in a total of 108 lesions, comparing it with the BI-RADS obtained in mammography and/or ultrasound. We correlated radiologic findings with histopathological findings (80) or radiologic follow-up of at least one year when no biopsy was performed (28).

We consider the performance of CESM indicated in the following situations: lack of conclusive findings on mammography and / or ultrasound ( 33), mismatch between different imaging modalities or between histologic and radiologic diagnosis (30) , postsurgical changes making it difficult to rule out local recurrence on conventional tests (13 ) , planning interventional procedures in cases of multiple lesions (18 ) , and dense breasts with suspicious lesions (14). In 29 of 108 lesions, CESM determined a change in the BI-RADS category previously obtained with other radiological modalities. 80 lesions were biopsied and 28 went into radiological follow up. 95% of non enhancing lesions and 67 % of those with low intensity enhancement were benign. Presence of malignant cells was confirmed in 93 % of high intensity enhancing lesions.

Although studies with significant samples are needed to establish clear indications of CESM, our experience proves it is useful to various diagnostic scenarios as a complementary tool, determining in a significant number of cases a change in the diagnostic management of injuries. Accessibility is a remarkable advantage of this modality.

CESM could be a useful tool in the assessment of lesions of questionable findings, evaluation of dense breast and as a complementary tool to mammography and ultrasound in the study of scars. Accessibility is a remarkable advantage of this exploration since we can use it in the same diagnostic act and requires little room occupancy time. 

Cordones, J, Ramirez Lozano, C, Cardenas, J, Silva, J, Bermejo, C, Cruz Diaz, A, BI-RADS Classification before and after Contrast Enhanced Spectral Mammography. Possible Indications and Usefulness as a Complementary Tool in Management of Breast Lesions.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14010763.html