Initial Experience with Dual-Energy Contrast-Enhanced Digital Breast Tomosynthesis in the Characterization of Breast Cancer

An assessment is ongoing of the ability of dual energy contrast-enhanced digital breast tomosynthesis (CE-DBT) to depict the morphologic and vascular characteristics of breast cancer in comparison with breast MRI and digital mammography (DM). Eight patients with newly diagnosed breast cancer were imaged with an automated dual-energy CE-DBT system. High energy/low energy image pairs of the index breast were obtained at 1 pre- and 3 post-contrast timepoints. Post-contrast images were obtained after intravenous administration of Visipaque (1 mL/kg). Anatomic images were reconstructed using filtered backprojection, and contrast-enhanced images were generated using simple backprojection followed by temporal or dual-energy subtraction. Dual-energy CE-DBT was able to demonstrate the index malignant lesion in 7 of 8 patients (9 of 10 lesions). Morphologic characteristics including margin detail and associated microcalcifications were qualitatively concordant with DM. Vascular characteristics were identifiable qualitatively on post-processed images in some cases, and judged to be qualitative concordant with breast MRI.