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
Conclusion
This educational material was an attempt to illustrate structured reporting in CESM combining 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 or MRI and we couldn't convince patiens to undergo this additional test.
- Elements like kinetic curves & some patterns of enhancement ( eg. focus) seen in MRI are not well brought out here.
- Image acquisition in CESM had to be well coordinated, to avoid delay and thereby contrast washout, and imaging of the pathological site has to be done first. Few cases had delay between acquisitions due to patient complaining of nausea. Compression has to be adequate to delineate the lesions.
- Few images had rim and other artifacts due to motion.(fig 14). However, image interpretation was not affected due to them.
- Difficulty in interpreting enhancement patterns that can be benign and malignant in the same lesion.