Initial clinical experience with contrast-enhanced digital breast tomosynthesis.
OBJECTIVE
Contrast-enhanced digital mammography and digital breast tomosynthesis are two imaging techniques that attempt to increase malignant breast lesion conspicuity. The combination of these into a single technique, contrast-enhanced digital breast tomosynthesis (CE-DBT), could potentially integrate the strengths of both. The objectives of this study were to assess the clinical feasibility of CE-DBT as an adjunct to digital mammography, and to correlate lesion enhancement characteristics and morphology obtained with CE-DBT to digital mammography, ultrasound, and magnetic resonance (MR).


METHODS
CE-DBT (GE Senographe 2000D; Milwaukee, WI) was performed as a pilot study in an ongoing National Cancer Institute-funded grant (P01-CA85484) studying multimodality breast imaging. Thirteen patients with ACR BI-RADS category 4 or 5 breast lesions underwent imaging with digital mammography, ultrasound, MR, and CE-DBT. CE-DBT was performed at 49 kVp with a rhodium target and a 0.27-mm copper (Alfa Aesar, Ward Hill, MA) filter. Preinjection and postinjection DBT image sets were acquired in the medial lateral oblique projection with slight compression. Each image set consists of nine images acquired over a 50-degree arc and was obtained with a mean glandular x-ray dose comparable to two conventional mammographic views. Between the precontrast and postcontrast DBT image sets, a single bolus of iodinated contrast agent (1 ml/kg at 2 ml/s, Omnipaque-300; Amersham Health Inc., Princeton, NJ) was administered. Images were reconstructed using filtered-backprojection in 1-mm increments and transmitted to a clinical PACS workstation.


RESULTS
Initial experience suggests that CE-DBT provides morphologic and vascular characteristics of breast lesions qualitatively concordant with that of digital mammography and MR.


CONCLUSIONS
As an adjunct to digital mammography, CE-DBT may be a potential alternative tool for breast lesion morphologic and vascular characterization.
Chen
Sara C
SC
Department of Radiology, Hospital of the University of Pennsylvania, 1 Silverstein, 3400 Spruce Street, Philadelphia, PA 19104, USA.
Carton
Ann-Katherine
AK
Albert
Michael
M
Conant
Emily F
EF
Schnall
Mitchell D
MD
Maidment
Andrew D A
AD
D000328:Adult; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D003287:Contrast Media; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging*; D010865:Pilot Projects; D011856:Radiographic Image Enhancement / Q000295:instrumentation*; D011857:Radiographic Image Interpretation, Computer-Assisted; D014054:Tomography / Q000295:instrumentation*; D014283:Triiodobenzoic Acids
D003287:Contrast Media; D014283:Triiodobenzoic Acids; C044834:iodixanol