Artefacts in contrast enhanced digital mammography: How it can affect diagnostic image quality and confuse clinical diagnosis?

Congress:

ECR 2020

Poster Number:

C-06738

Type:

Educational Exhibit

Keywords:

Breast, Mammography, Contrast agent-intravenous, Artifacts, Not applicable, Performed at one institution

Authors:

G. BICCHIERAI¹, C. Vignoli¹, D. De Benedetto¹, F. Di Naro¹, M. kaur Gill², V. Miele³, J. Nori¹; ¹FIRENZE/IT, ²Klang/MY, ³Florence/IT

DOI:

10.26044/ecr2020/C-06738

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-06738

Fig. 8: Figure 7 Misregistration artefact. A woman with a history of previous right...

Fig. 3: Figure 2 Contrast splatter. CEDM was performed in a 55-year-old woman for...

Fig. 6: Figure 5 Negative Contrast Enhancement. a) CEDM recombined image presents an...

Fig. 5: Figure 4 Breast implant artefact. A CEDM was performed for suspected...

Fig. 1: Figure 1 Motion artefact. A ductal carcinoma-in-situ was diagnosed in the left...

Fig. 7: Figure 6 Ripple Artefact. CEDM performed for preoperative staging. The...

Learning objectives

To identify thepossible artefacts that may occur during aContrast Enhanced Digital Mammography (CEDM) study Toanalyze the possible causes of the various types of CEDM’s artefacts ToDiscuss the assessment and possible rectification of these artefactsto prevent diagnostic misinterpretation

Background

Contrast-enhanced digital mammography (CEDM) is an evolution of the full-field digital mammography (FFDM); it uses a dual-energy acquisition after the administration of an intravenous contrast media andtake advantage of the tumor angiogenesis and the contrast leakage from vessels into the tumor interstitium similarly to breast MRI.Several studies have evidenced a CEDM sensitivity which is as high as that of MRI, but with a higher CEDM specificity. Furthermore it is less expensive than MRI andcan potentially combine the high sensitivity of MRI and the lower cost...

Findings and procedure details

At Senology Unit of the AOU Careggi, Florence, we introduced CEDM into clinical practice since September 2016. From September 2016 to September 2019 more than 1300 CEDM examinations were performed. We useda mammography system, which has the capability of performing FFDM, tomosynthesis and CEDM examinations. We retrospectively analyzed our radiological database and evaluated the artefacts encountered during our work. [6] The most common artifacts found in our clinical practice were: 1.Artefacts visible in both CEDM and FFDM images Based on previous literature, it has already...

Conclusion

Image artefacts are common on CEDM examinations and it is important to recognize them so that radiologists can differentiate abnormal enhancement from artefacts. It is important that the technologist, radiologist, and physicist become familiar and investigate the CEDM artefacts further as and when they occur, to optimize the image quality and avoid interpretive pitfalls.

Personal information and conflict of interest

G. Bicchierai; Florence/IT - nothing to disclose C. Vignoli; Florence/IT - nothing to disclose D. de Benedetto; Florence/IT - nothing to disclose F. Di Naro; Florence/IT - nothing to disclose V. Miele; Florence/IT - nothing to disclose J. Nori; Florence/IT - nothing to disclose M. Kaur Gill; Klang/MY - nothing to disclose

References

References 1.Nori J, Kaur M (2018) Contrast-Enhanced Digital Mammography (CEDM). doi: https://doi.org/10.1007/978-3-319-94553-8 2.E.M. Fallenberg, F.F. Schmitzberger, H. Amer, et Al. Contrast-enhanced spectral mammography versus mammography and MRI—clinical performance in a multireader evaluation, Eur. Radiol. 7 (2017): 2752-64. 3.Lalji, U. C., et al. (2015). "Evaluation of low-energy contrast-enhanced spectral mammography images by comparing them to full-field digital mammography using EUREF image quality criteria." Eur Radiol 25(10): 2813-2820. 4.Bhimani C, Li L, Liao L, et al (2017) Contrast-enhanced Spectral Mammography: Modality-Specific Artefacts and Other Factors Which May...