Florian F Schmitzberger MS, Presenter: 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

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

Magnus Hemmendorff MSc, Abstract Co-Author: Employee, Sectra AB

Elin Moa MS, Abstract Co-Author: Employee, Sectra AB

Mats Danielsson PhD, MSc, Abstract Co-Author: Stockholder, Koninklijke Philips Electronics NV Employee, Koninklijke Philips Electronics NV

Ulrich Bick MD, Abstract Co-Author: Travel support, General Electric Company Travel support, Carestream Health, Inc Speaker, General Electric Company Speaker, Carestream Health, Inc Equipment support, Hologic, Inc Equipment support, MeVis BreastCare GmbH & Co KG Equipment support, Toshiba Corporation License agreement, Hologic, Inc Royalties, Hologic, Inc

Susanne Dorothea Diekmann MD, Abstract Co-Author: Nothing to Disclose

Alexander Poellinger MD, Abstract Co-Author: Nothing to Disclose

Florian Engelken MD, MBChB, Abstract Co-Author: Nothing to Disclose

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

To demonstrate the feasibility of low-dose photon-counting tomosynthesis in combination with a contrast agent (contrast material–enhanced tomographic mammography) for the differentiation of breast cancer.

All studies were approved by the institutional review board, and all patients provided written informed consent. A phantom model with wells of iodinated contrast material (3 mg of iodine per milliliter) 1, 2, 5, 10, and 15 mm in diameter was assessed. Nine patients with malignant lesions and one with a high-risk lesion (atypical papilloma) were included (all women; mean age, 60.7 years). A multislit photon-counting tomosynthesis system was utilized (spectral imaging) to produce both low- and high-energy tomographic data (below and above the k edge of iodine, respectively) in a single scan, which allowed for dual-energy visualization of iodine. Images were obtained prior to contrast material administration and 120 and 480 seconds after contrast material administration. Four readers independently assessed the images along with conventional mammograms, ultrasonographic images, and magnetic resonance images. Glandular dose was estimated.

Contrast agent was visible in the phantom model with simulated spherical tumor diameters as small as 5 mm. The average glandular dose was measured as 0.42 mGy per complete spectral imaging tomosynthesis scan of one breast. Because there were three time points (prior to contrast medium administration and 120 and 480 seconds after contrast medium administration), this resulted in a total dose of 1.26 mGy for the whole procedure in the breast with the abnormality. Seven of 10 cases were categorized as Breast Imaging Reporting and Data System score of 4 or higher by all four readers when reviewing spectral images in combination with mammograms. One lesion near the chest wall was not captured on the spectral image because of a positioning problem.

The use of contrast-enhanced tomographic mammography has been demonstrated successfully in patients with promising diagnostic benefit. Further studies are necessary to fully assess diagnostic sensitivity and specificity.  

Contrast-enhanced tomosynthesis is a promising technique to supplement conventional mammography because the effect of surrounding soft tissue is limited and higher contrast can be achieved.

Schmitzberger, F, Fallenberg, E, Lawaczeck, R, Hemmendorff, M, Moa, E, Danielsson, M, Bick, U, Diekmann, S, Poellinger, A, Engelken, F, Diekmann, F, Development of Low-Dose Photon-counting Contrast-enhanced Tomosynthesis with Spectral Imaging.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11015759.html