Noha El Said
Cairo University, Giza, Egypt
CEDM is a recent development of digital mammography using the intra-venous injection of an iodinated contrast agent in conjunction with a mammography examination. Aim of the study: to evaluate the potential role for adding contrast enhanced dual energy mammography to improve the diagnosis of breast cancer. Results: revealed that sensitivity was higher for MX+CEDM (90.57) than that was for mammography alone (77.36) compared to pathology with loss in specificity as for MX+ CEDM was 75% and for mammography alone was 83.33%. Also the good diagnostic accuracy of CEDM+ MX for the detection of breast carcinoma, which here superior to mammography alone. CEDM also allowed a gain for the negative predictive value with a significant reduction in the false negatives.
The present study revealed the important role of CEDM in patients with multifocal / multicentric lesions that can easily detects the extension and number of them clearly, as among ten patients with 22 multifocal histologically proven lesions, all were detected by MX+CEDM (100 %) versus 16 (72.73 %) lesions detected by mammography alone.
The present study revealed also the important role of CEDM in post operative follow up to detect residual or recurrence of malignancy. The study shows that sensitivity of CEDM is 71.4% higher than mammography alone 42.85% with no loss in specificity 70%.
The potential clinical applications are the clarification of mammographically equivocal lesions, the detection of occult lesions on standard mammography,
CONCLUSION:
The addition of dual energy contrast enhanced mammography technique to digital Mammography can significantly
improve diagnostic quality and cancer detection rate particularly in dense breast and the determination of the extent and
number of lesions as well as in post operative follow up.