title: Evaluation of tumor angiogenesis of breast carcinoma using contrast-enhanced digital mammography.
abstract: OBJECTIVE
  The purpose of this article is to assess the accuracy of contrast-enhanced digital mammography in the detection of breast carcinoma and to correlate the findings on the images with those of histologic analysis using microvessel quantification.
  
  
  METHODS
  Twenty patients with a suspicious breast abnormality underwent contrast-enhanced digital mammography using a full-field digital mammography unit that was modified to detect iodinated enhancement. For each patient, a total of six contrast-enhanced craniocaudal views were acquired from 30 seconds to 7 minutes after the injection of a bolus of 100 mL of an iodinated contrast agent. Image processing included a logarithmic subtraction and the analysis of enhancement kinetic curves. Contrast-enhanced digital mammography findings were compared with histologic analysis of surgical specimens, including intratumoral microvessel density quantification evaluated on CD34-immunostained histologic sections obtained from all patients.
  
  
  RESULTS
  An area of enhancement was depicted on contrast-enhanced digital mammograms in 16 of the 20 histologically proven breast carcinomas. Excellent correlation was seen between the size of enhancement and the histologic size of tumors, which ranged from 9 to 22 mm. Early enhancement with washout was observed in four cases, early enhancement followed by a plateau in four cases, gradual enhancement in seven cases, and unexpected decrease of enhancement in one case. Intratumoral microvessel density ranged from 11.7 to 216.6 microvessels per square millimeter. A poor correlation was found between data measured on contrast-enhanced digital mammography and intratumoral microvessel density measured on CD34-immunostained histologic sections.
  
  
  CONCLUSIONS
  Contrast-enhanced digital mammography is able to depict angiogenesis in breast carcinoma. Breast compression and projective images acquisition alter the quantitative assessment of enhancement parameters.
authors.affiliation: Department of Radiology, Institut Gustave Roussy, 39 rue Camille Desmoulin, Villejuif Cedex, France 94805. dromain@igr.fr
authors.forename: Clarisse
authors.initials: C
authors.lastname: Dromain
authors.forename: Corrine
authors.initials: C
authors.lastname: Balleyguier
authors.forename: Serge
authors.initials: S
authors.lastname: Muller
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Mathieu
authors.forename: France
authors.initials: F
authors.lastname: Rochard
authors.forename: Paule
authors.initials: P
authors.lastname: Opolon
authors.forename: Robert
authors.initials: R
authors.lastname: Sigal
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging*; D003287:Contrast Media; D006801:Humans; D007472:Iohexol; D008327:Mammography; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging*; D011856:Radiographic Image Enhancement
chemical_list: D003287:Contrast Media; D007472:Iohexol