by
Lisa Chamoff, Contributing Reporter | July 10, 2016
From the July 2016 issue of HealthCare Business News magazine
‘Poor person’s MRI’
For women who are not mutation carriers, contrast-enhanced diagnostic mammography (CEDM) may be an alternative to more expensive MRI exams, especially for facilities without access to MRI equipment. There is ongoing research evaluating this. Jochelson calls this technology, which received FDA clearance in 2011, the “poor person’s MRI.” In contrast-enhanced mammography, two sets of images are obtained at a low- and high-energy level, after the injection of iodinated contrast, the same contrast used for CT scans. Processing of the two images yields a contrast image, which may show a cancer otherwise hidden in the breast. The low energy image is a regular mammogram. GE, Hologic and Siemens produce equipment.
“I’m sitting in a hospital with 13 MRIs,” Jochelson says. “Some places have none.” Moore County Hospital District in Dumas, Texas, is one such place. The rural facility doesn’t have MRI for breast imaging, but uses contrast-enhanced mammography for almost all recall exams, when a patient is recalled for an abnormal finding on a screening mammogram, says Dr. Sean Leong, the director of radiology. “It’s helped my practice so much in differentiating normal [tissue] from cancer,” Leong says. “It’s cut down the number of false positives in the patient population in my practice considerably.”
Ad Statistics
Times Displayed: 2147
Times Visited: 10 Fast-moving cardiac structures have a big impact on imaging. Fujifilm’s SCENARIA View premium performance CT brings solutions to address motion in Coronary CTA while delivering unique dose saving and workflow increasing benefits.
In Leong’s practice, contrast-enhanced mammography has replaced mammographic spot compressions to differentiate superimposed breast tissue from cancer. “There are a lot of questions associated with spot compression diagnostic mammography as only part of the breast is visualized: ‘Is the density there or not there? Did I squeeze that density out of my field of view? Did I even image the right spot?’ “ Leong says. “With CEDM, the entire breast is imaged and concerns that we have with spot compression about not imaging the necessary lesion are laid to rest.”
Before Leong’s practice used contrast enhanced mammography, all new indeterminate breast microcalcifications discovered by screening mammography were biopsied. “Approximately 80 to 90 percent of indeterminate calcifications are benign and 10 to 20 percent are malignant, so our surgeon was biopsying a lot of benign tissue that way,” Leong says. Now, with contrast-enhanced mammography, if there is no enhancing tissue associated with the calcifications, Leong and the other physicians in his practice follow them as if they are probably benign, with a diagnostic mammogram in six months and then subsequent annual screening with mammography.
