1. DUAL ENERGY CONTRAST ENHANCED SPECTRAL MAMMOGRAM: AS A PROBLEM SOLVING TOOL IN EQUIVOCAL CASES Dr.Kalpana Devi K.R., Dr. Francis G., Dr. Murali K., Dr. Madan R., Dr. Subhapradha, Dr Geetha S Nair, MIOT hospitals, Manapakkam, Chennai.

2. ABSTRACT

3. Aim : To assess the role of Dual energy contrast enhanced mammography as a problem solving tool in equivocal cases.

4. Materials and Methods: 44 consented women with equivocal findings on conventional mammogram underwent two view Dual energy contrast enhanced digital mammography using our digital mammography system (Senographe DS, GE Healthcare). All the images were interpreted by two well qualified radiologist independently. Confidence of presence and probablity of cancer was plotted in a three point scale and all the patients were assigned BIRADS scoring. Histopathology was taken as gold standard.

5. Result : Among the lesions included in the study, 77.3% were malignant/ precancerous and 22.7 % were benign/inconclusive. Sensitivity of contrast enhanced mammogram was high without loss in specificity. 20 % of lesions not seen on conventional mammogram were identified only on contrast enhanced mammogram. In addition on contrast enhanced mammography true extent of the lesion was made out in 15.9 % of cases, Multifocality was established in 9.1 % of cases and ductal extension was demonstrated in 6.8 % of cases. The measurement of agreement –kappa- between observer 1 and 2 was 0.837.

6. Conclusion: Dual energy contrast enhanced mammogram is an excellent complementory tool to standard mammogram in identifying lesions in dense breast and in triaging lesions in case of multiple suspicious / benign pathologies. In a BIRADS 3 lesion, it has definite role in upgrading or down grading its BIRADS.

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