Lydia Liao MD, PhD, Presenter: Nothing to Disclose

Luna Li MD, PhD, Abstract Co-Author: Nothing to Disclose

Pauline Germaine DO, Abstract Co-Author: Nothing to Disclose

Elizabeth Tinney RRA, Abstract Co-Author: Nothing to Disclose

CESM is a new FDA approved diagnostic study using CT contrast to detect breast cancer by providing morphologic and functional information detecting abnormal anatomic structures and angiogensis. CESM has a shorter test time, an increased accessibility and is relatively inexpensive when compared to breast MRI. Our institution is one of the first few centers in the country acquired CESM and we have done more than 1,000 exams including 100 cases of tissue diagnosis proven breast cancer from the end 2012 to present. The focus of this presentation is to discuss CESM mechanism, indications of the protocol, pitfalls including artifacts. The illustration cases in cooperating with history, other imaging study findings and tissue diagnosis focus on the morphology and the enhancement characteristics of both malignant and benign lesions on CESM.

CESM is one of the contrast studies and provides both morphologic and functional information of breast lesions.  Malignant lesions demonstrate most medium to strong enhancement with morphologic characteristics that could be distinguished from benign lesions.  CESM sometime pick up abnormal enhancing lesions even then regular digital mammography and ultrasound are negative.  CESM has some unique artifacts. The most common artifacts are breast-within-breast, halo, and ripple artifact.  

http://abstract.rsna.org/uploads/2014/14011140/14011140_lq9s.pdf

Liao, L, Li, L, Germaine, P, Tinney, E, Contrast Enhanced Spectral Mammography (CESM) - Indications, Protocol, Interpretation and Pitfalls.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14011140.html