Structured Reporting in Constrast Enhanced Mammography.

Congress:

ECR 2020

Poster Number:

C-14792

Type:

Educational Exhibit

Keywords:

Performed at one institution, Not applicable, Education and training, Structured reporting, Contrast agent-intravenous, Mammography, Contrast agents, Breast

Authors:

B. Raghavan¹, S. Viswanathan², N. Varghese¹, B. C R¹, G. SIVARAMALINGAM³, S. singh¹; ¹Chennai/IN, ²chennai,, Tamil nadu/IN, ³CHENNAI, tamilnadu/IN

DOI:

10.26044/ecr2020/C-14792

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-14792

Fig. 1: Indications of CESM.

Fig. 2: CESM examination scheme (courtesy of GE healthcare)

Table 1: CESM Reporting Template

Fig. 6: Background parenchymal enhancement patterns: A. minimal B. mild C. moderate

Learning objectives

To illustrate structured reportring in contrast enhanced mammography by using the Lexicon of Birads.

Background

Contrast-enhanced spectral mammography (CESM) combines the benefits of conventional digital mammography with lesion conspicuity offered by intravenous iodinated contrast. It is based on the the inherent difference in x-ray attenuation of breast tissue and iodine (k-edge, 33.2 keV). This provides an element of functional imaging to CESM that is similar to contrast enhanced breast MRI, based on neovascularity of tumors. The combination of morphologic and physiologic information provided by CESM provides superior sensitivity and specificity in diagnosing breast cancer when compared with digital mammography alone....

Findings and procedure details

At our institution, CESM has been in clinical use since August 2019 and we have analysed50 cases in this preliminary study, based on the indications given (fig 1). Studies have shown the low energy images of CESM to be non inferior to conventional mammogram imagesdespite the presence of intravenous iodinated contrast and low energy CESM images may be used for interpretation in place of the FFDM[1,2]. Hence, we used the xray mammographic lexicon and template for interpreting the low energy images. Regarding the second group...

Conclusion

This educational material was an attempt to illustrate structured reporting in CESMcombining the BIRADS lexicons of Mammogram and MRI. We found from our study that mammography lexicon is best suited for the low energy images as they describe the morphology best & contrast enhancement patterns can be analysed using MRI Birads lexicon. However there are limitations to the study as follows: Not all indications of CESM could be assessed due to less number of patients, especially response asessment as it was done with PET CT...

Personal information and conflict of interest

B. Raghavan; Chennai/IN - nothing to disclose S. Viswanathan; Chennai,, TAMIL NADU/IN - nothing to disclose N. Varghese; Chennai/IN - nothing to disclose B. C R; Chennai/IN - nothing to disclose G. Sivaramalingam; Chennai, TAMILNADU/IN - nothing to disclose S. Singh; Chennai/IN - nothing to disclose

References

Lalji UC, Jeukens CR, Houben I, et al. Evaluationof low-energy contrast-enhanced spectral mammography images by comparing them to full-field digital mammography using EUREF image quality criteria. Eur Radiol 2015; 25:2813–2820 Francescone MA, Jochelson MS, Dershaw DD et al (2014) Low energy mammogram obtained in contrast-enhanced digital mammography (CEDM) is comparable to routine full-field digital mammography (FFDM). Eur J Radiol 83:1350–1355 Tohamey, Yasmin & Youssry, Sherihan & Aziz, Asmaa. (2018). Interpretation of patterns of enhancement on contrast-enhanced spectral mammography: An approach to a standardized scheme. The...