Maha Hussein Helal MD, Presenter: Nothing to Disclose

Mai Zaglol MBBCh, Abstract Co-Author: Nothing to Disclose

Lamia Adel MD, Abstract Co-Author: Nothing to Disclose

Omnia Mokhtar MD, Abstract Co-Author: Nothing to Disclose

Sahar Mansour MD, Abstract Co-Author: Nothing to Disclose

Nelly Alieldin MD, Abstract Co-Author: Nothing to Disclose

Iman Godda MD, Abstract Co-Author: Nothing to Disclose

Rasha Mohamed Kamal MD, Abstract Co-Author: Nothing to Disclose

Noha Abdel Shafey MD, Abstract Co-Author: Nothing to Disclose

nagat mansour khalifa, Abstract Co-Author: Nothing to Disclose

Contrast-enhanced mammography and tomosynthesis are promising applications of digital mammography required to increase conspicuity of the different breast lesions. We aimed to compare the performance of these applications in staging of breast cancer to detect the proper modality required for accurate pre-operative evaluation.

Ethics committee approval was obtained in this retrospective analysis where examinations of 115 masses in 103 cases were done. Evaluation methods included regular digital mammography, 3-D tomosynthesis and contrast enhanced spectral mammography.For acquisition the system attains a "Combo-mode" imaging technique (2D+3D imaging) that acquires a traditional digital mammogram and a tomosynthesis scan in the same compression. For contrast -enhanced images: low (22–33 kVp) and high (44–49 kVp) energy exposures were taken in the same projections after IV injection of contrast agent. Evaluated masses were biopsied and proved malignancy (70 masses) were further evaluated regarding lesions’ extension, size, multiplicity and related calcifications.

Tomosynthesis provided near estimation of cancer extension to pathology data (n=58, 83%) followed by contrast-enhanced (n=32, 46%) and regular mammography (n=51, 73%). Contrast-enhanced mammography presented the least assessment for calcifications, yet the most accurate size estimation with a median value of 0.4 compared to 0.5 and 1.5 for tomosynthesis and regular mammography respectively. Multiplicity was better demonstrated by contrast mammography equally with sensitivity of 92% followed by tomosynthesis (77%) and regular mammography (54%). The combined analysis of the three modalities provided an estimated accuracy of 88% in the pre-operative evaluation of breast cancer.

The combined application of tomosynthesis and contrast-enhanced digital mammogram enhance the performance of the standard mammogram and present an informative method in staging breast cancer.

Digital mammography (DM) is still limited by overlapped densities that may provide false negative/positive diagnosis. Advanced applications of DM: tomosynthesis and contrast-enhanced mammography could improve the performance and provide better evaluation of breast lesions.

Helal, M, Zaglol, M, Adel, L, Mokhtar, O, Mansour, S, Alieldin, N, Godda, I, Kamal, R, Abdel Shafey, N, khalifa, n, The Impact of Merging New Modalities of Digital Mammography on the Proper Staging of Breast Cancer.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14011071.html