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Congress: ECR24
Poster Number: C-14183
Type: EPOS Radiologist (educational)
Authorblock: E. Vall Foraster, P. Miranda Martinez, E. Vila-Trias Jover, H. Puigderrajols Vehils, J. Azcona Sáenz, N. Arenas, R. Alcantara Souza; Barcelona/ES
Disclosures:
Elisenda Vall Foraster: Nothing to disclose
Paulina Miranda Martinez: Nothing to disclose
Elisabet Vila-Trias Jover: Nothing to disclose
Helena Puigderrajols Vehils: Nothing to disclose
Javier Azcona Sáenz: Speaker: Bureau GE Healthcare Speaker: Bard
Natalia Arenas: Speaker: Bard
Rodrigo Alcantara Souza: Speaker: Bard Speaker: Bureau GE Healthcare
Keywords: Breast, Management, Mammography, Contrast agent-intravenous, Diagnostic procedure, Technical aspects, Artifacts
Learning objectives To review the fundamentals of contrast-enhanced mammography technique and its technical aspects.  To depict both false-positives and false-negatives findings related to contrast-enhanced mammography.
Read more Background Contrast-enhanced mammography (CEM) provides unique advantages over conventional techniques by providing structural and functional information about the suspicious lesion.According to the pathophysiology of the growth of malignant lesions, these are in a state of constant neovascularization with increased vascular permeability, which leads to extravasation of contrast media to the surrounding tissue, reflected in CEM as an area of contrast enhancement.Given that there are malignant lesions that do not present contrast enhancement or do so subtly, and also benign lesions that...
Read more Findings and procedure details CAUSES OF FALSE NEGATIVE-FINDINGS:Background parenchymal enhancement (BPE)BPE refers to the normal enhancement of glandular tissue after contrast administration. First described for MRI, it has also been described for CEM and is classified according to BIRADS in: minimal, mild, moderate, and marked. No clear pattern in the variation of BPE during the menstrual cycle has yet been demonstrated at CEM, so there is no current recommendation to time the imaging process around the menstrual cycle.BPE makes lesion detection difficult by obscuring...
Read more Conclusion It is essential for every breast radiologist to be familiar with both false-positives and false-negatives findings related to contrast-enhanced mammography so as not to misdiagnose some lesions and leave some malignant lesions out based only in their lack of or low conspicuity enhancement.
Read more References Lorente-Ramos RM, Azpeitia-Armán J, Oliva-Fonte C, Pérez-Bartolomé A, Azpeitia Hernández J. Contrast-enhanced Mammography Artifacts and Pitfalls: Tips and Tricks to Avoid Misinterpretation. Radiographics. 2023;43(10):e230021. Carnahan MB, Harper L, Brown PJ, et al. False-Positive and False-Negative Contrast-enhanced Mammograms: Pitfalls and Strategies to Improve Cancer Detection. Radiographics. 2023;43(12):e230100.  Amir T, Hogan MP, Jacobs S, Sevilimedu V, Sung J, Jochelson MS. Comparison of False-Positive versus True-Positive Findings on Contrast-enhanced Digital Mammography. AJR Am J Roentgenol 2022;218(5):797–808. Nori J, Gill MK, Vignoli C, et al. Artefacts in contrast...
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