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Applying the Contrast-enhanced Mammography BI-RADS Lexicon to Clinical Practice.

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Contrast-enhanced mammography (CEM) improves cancer detection accuracy, offering results similar to MRI. Radiologists should familiarize themselves with CEM interpretation and reporting using updated BI-RADS guidelines for better communication.

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Area of Science:

  • Breast imaging
  • Radiology
  • Functional imaging

Background:

  • Contrast-enhanced mammography (CEM) is a functional imaging technique.
  • It utilizes intravenously administered iodinated contrast material and digital mammography equipment.
  • CEM provides enhanced visualization of breast tissue, similar to MRI.

Purpose of the Study:

  • To review the similarities and differences between the CEM lexicon and existing mammography and MRI lexicons.
  • To provide a framework for radiologists interpreting and reporting CEM cases.
  • To discuss CEM's limitations and role in diagnostic scenarios.

Main Methods:

  • Acquisition of low- and high-energy images during the same breast compression.
  • Processing images using weighted subtraction to create a contrast-enhanced (recombined) image.
  • Systematic review of CEM lexicon using ACR CEM supplement and BI-RADS 5th edition.

Main Results:

  • CEM demonstrates improved diagnostic accuracy compared to standard mammography.
  • Sensitivity and specificity for cancer detection are comparable to MRI.
  • Adoption of a standardized CEM lexicon is critical for effective communication.

Conclusions:

  • Radiologists need to become proficient in interpreting and reporting CEM findings.
  • Familiarity with CEM, leveraging existing mammography and MRI knowledge, is essential.
  • CEM is becoming an essential tool in breast cancer diagnostics due to its accessibility and accuracy.