title: Contrast-enhanced digital mammography: initial clinical experience.
abstract: OBJECTIVE
  To investigate the potential of using intravenous contrast material with full-field digital mammography to facilitate the detection and characterization of lesions in the breast.
  
  
  METHODS
  Twenty-two women scheduled for biopsy because they were suspected of having abnormalities at breast imaging underwent imaging with contrast material-enhanced digital mammography. Six sequential images of the affected breast were obtained, with a contrast agent injected intravenously between the time the first and second images were obtained. Image processing included registration and logarithmic subtraction. Lesions were evaluated for the presence, morphology, and kinetics of enhancement. Lesion type, size, and pathologic findings were correlated with the findings at contrast-enhanced digital mammography.
  
  
  RESULTS
  At contrast-enhanced digital mammography, enhancement was observed in eight of 10 patients with biopsy-proved cancers. In one case of ductal carcinoma in situ and one case of invasive ductal carcinoma, enhancement was not observed. No enhancement was seen in seven of 12 cases in which lesions were suspected of being malignant at initial imaging but were benign. Morphology generally correlated with the pathologic diagnosis. The kinetics of lesion enhancement showed similarity to that seen with gadolinium-enhanced magnetic resonance imaging but was not consistent.
  
  
  CONCLUSIONS
  The results of this preliminary study suggest that contrast-enhanced digital mammography potentially may be useful in identification of lesions in the mammographically dense breast. Further investigation of contrast-enhanced digital mammography as a diagnostic tool for breast cancer is warranted.
authors.affiliation: Department of Medical Imaging, University of Toronto, Sunnybrook and Women's College Health Sciences Centre, 2075 Bayview Ave, MG178, Toronto, Ontario, Canada M4N 3M5. roberta.jong@sw.ca
authors.forename: Roberta A
authors.initials: RA
authors.lastname: Jong
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Yaffe
authors.forename: Mia
authors.initials: M
authors.lastname: Skarpathiotakis
authors.forename: Rene S
authors.initials: RS
authors.lastname: Shumak
authors.forename: Nathalie M
authors.initials: NM
authors.lastname: Danjoux
authors.forename: Anoma
authors.initials: A
authors.lastname: Gunesekara
authors.forename: Donald B
authors.initials: DB
authors.lastname: Plewes
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007472:Iohexol; D008327:Mammography; D008875:Middle Aged; D011856:Radiographic Image Enhancement
chemical_list: D003287:Contrast Media; D007472:Iohexol