Assessment of Indeterminate Breast lesions (BIRADS 4): Utility of Contrast Enhanced Mammography

Abstract

ontrast-enhanced mammography combines X-ray mammography with intravenous administration of iodinated contrast agent. It was first attempted using a temporal subtraction technique where images are obtained before and after contrast injection, but this approach was soon abandoned due to difficulties in co-registration of unenhanced and contrast-enhanced images. In the last two decades, contrast-enhanced mammography (CEM) has been introduced, based on dual-energy breast exposure (about 26–33 kVp and 44–50 kVp) after contrast administration, so that the pre-contrast exposure was no longer needed. CEM allows for the visualization of enhancing findings over the normal unenhancing breast tissue, exploiting the increased contrast uptake of malignancies.