Florian F Schmitzberger MS, Abstract Co-Author: Nothing to Disclose

Ruediger Lawaczeck PhD, Abstract Co-Author: Consultant, Bayer AG

Diane Miriam Renz MD, Abstract Co-Author: Nothing to Disclose

Eva Maria Fallenberg MD, Abstract Co-Author: Research grant, Bayer AG Research grant, Siemens AG Research grant, General Electric Company Speaker, Siemens AG Speaker, General Electric Company Speaker, Bayer AG Travel support, Bayer AG

Felix Diekmann MD, Abstract Co-Author: Research Grant, Bayer AG Research Grant, Koninklijke Philips Electronics NV

Vera Froeling MD, Presenter: Nothing to Disclose

MRI allows for better examination of partially obstructed lesions of the breast than traditional mammography, however at a relatively low spatial resolution. Interpreting the kinetics of a contrast-agent over time supplies additional diagnostic criteria, eg. washout for malignant lesions. Spectral imaging tomosynthesis provides similar benefits when interpreting partially obstructed lesions, at higher resolution, compared to MRI. This pilot-study investigated if similar kinetics patterns to MRI can be observed using an iodine-containing contrast agent for spectral imaging.  

Contrast-agent kinetics were evaluated preoperatively for 21 patients (mean age 64 years) with 21 suspect lesions for both MRI (Magnevist®, 5 timepoints) and spectral imaging tomosynthesis. Spectral imaging was performed with a prototype provided by Sectra Mamea (Stockholm, Sweden) using a low dose protocol (ca. 0.5 mGy AGD per Scan). A kinetics simulation was used to optimize the contrast medium protocol, resulting in timepoints before, 120 sec and 480 sec after contrast medium injection (1.5 ml/kg body weight Ultravist® 300, flow 3 ml/sec). A comparison of contrast-agent kinetics was performed between MRI and spectral imaging.  

In MRI 4/21 (19%) of cases did show washout, 6/21 (29%) a plateau phase and 11/21 (52%) protracted enhancement. Spectral imaging showed washout in 4/21 (19%), a plateau phase in 14/21 (67%) and protracted enhancement in 3/21 (14%) of the cases. A statistically significant correlation was observed between lesion enhancement patterns in MRI and spectral imaging (Spearman's rho = 0.6, p=0.005).  

Initial experience indicates that imaging criteria similar to the interpretation of contrast-agent kinetics in MRI could be used in contrast enhanced spectral imaging tomosynthesis. Similar enhancement patterns known from MRI (washout, plateau and protracted enhancement) may be observed as well.  

A three-scan series of contrast-enhanced low-dose spectral imaging tomosynthesis may allow for interpretation of contrast-agent kinetics similar to MRI.  

Schmitzberger, F, Lawaczeck, R, Renz, D, Fallenberg, E, Diekmann, F, Froeling, V, Evaluation of Contrast Agent Kinetics for Contrast-enhanced Spectral Imaging of Breast Lesions in Comparison to MRI.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11015581.html