Mammography With IV Contrast CEDM combines the techniques of conventional mammography with administration of IV contrast, thus leveraging functional imaging by assessing for lesion vascularity. A dual-energy technique is utilized to acquire the images in the conventional craniocaudal and mediolateral oblique projections. The acquired data are processed, producing a low-energy image and a diagnostic recombined image. There is limited literature regarding the use of CEDM in the screening setting. However, in the diagnostic setting, CEDM has been shown to demonstrate improved sensitivity and specificity over 2-D mammography [28-31]. The greatest improvement in the sensitivity and specificity is seen in women with dense breast tissue [29,30]. At this time, there is limited but emerging literature regarding the use of mammography with IV contrast for supplemental screening in high-risk women with nondense breasts. Jochelson et al [47] screened 318 high-risk women using both CEDM and MRI [47]. Both techniques detected carcinomas not visualized on mammography, 2 using CEDM and 3 using MRI. MRI Breast Without IV Contrast Abbreviated There is no relevant literature regarding the use of AB-MRI breast without IV contrast for supplemental screening in high-risk women with nondense breasts. MRI Breast Without and With IV Contrast Abbreviated AB-MRI performed with IV contrast is an abbreviated breast MRI examination. It is similar to a full MRI examination yet does not have a standard protocol; however, at minimum, it must include a precontrast and one postcontrast sequence. A T2-weighted sequence may also be included. There is limited relevant literature regarding the use of AB-MRI breast without and with IV contrast in high-risk women with nondense breasts. In 2 retrospective studies comparing the full diagnostic protocol with an abbreviated protocol in high-risk women, the authors found both protocols to have similar sensitivity [48,49].
Supplemental Breast Cancer Screening Based on Breast Density. Mammography With IV Contrast CEDM combines the techniques of conventional mammography with administration of IV contrast, thus leveraging functional imaging by assessing for lesion vascularity. A dual-energy technique is utilized to acquire the images in the conventional craniocaudal and mediolateral oblique projections. The acquired data are processed, producing a low-energy image and a diagnostic recombined image. There is limited literature regarding the use of CEDM in the screening setting. However, in the diagnostic setting, CEDM has been shown to demonstrate improved sensitivity and specificity over 2-D mammography [28-31]. The greatest improvement in the sensitivity and specificity is seen in women with dense breast tissue [29,30]. At this time, there is limited but emerging literature regarding the use of mammography with IV contrast for supplemental screening in high-risk women with nondense breasts. Jochelson et al [47] screened 318 high-risk women using both CEDM and MRI [47]. Both techniques detected carcinomas not visualized on mammography, 2 using CEDM and 3 using MRI. MRI Breast Without IV Contrast Abbreviated There is no relevant literature regarding the use of AB-MRI breast without IV contrast for supplemental screening in high-risk women with nondense breasts. MRI Breast Without and With IV Contrast Abbreviated AB-MRI performed with IV contrast is an abbreviated breast MRI examination. It is similar to a full MRI examination yet does not have a standard protocol; however, at minimum, it must include a precontrast and one postcontrast sequence. A T2-weighted sequence may also be included. There is limited relevant literature regarding the use of AB-MRI breast without and with IV contrast in high-risk women with nondense breasts. In 2 retrospective studies comparing the full diagnostic protocol with an abbreviated protocol in high-risk women, the authors found both protocols to have similar sensitivity [48,49].