Contrast Enhanced Spectral Mammography

Contrast-enhanced mammography depicts areas in the breast associated with hypervascularized breast lesions, after an iodinated contrast agent has been injected.

Conventional mammography energy levels are only slightly sensitive to the presence of iodine in the breast. Atypical clinical concentration of iodine in the breast results in a low signal intensity, and is hardly distinguishable from the background breast morphology. To obtain images that efficiently highlight iodine, cancellation of the background breast tissue is necessary .

One option to cancelling the background breast tissue and spotlight iodine enhanced areas is Contrast Enhanced Spectral Mammography (CESM), a technique based on dual-energy acquisitions, where two images are acquired using distinct low-energy (LE – standard mammography KV and filtration) and high-energy (HE – higher KV with strong filtration) X-ray spectra. The differences between X-ray attenuation of iodine and breast tissues at these two energy levels are exploited to suppress the background breast tissue.

The GE SenoBright Contrast- Enhanced Spectral Mammography (CESM) system allows CESM to be performed as an adjunct to inconclusive mammography and ultrasound, highlights areas of unusual blood flow patterns which may be cause for increased suspicion. Using an iodine contrast agent, SenoBright takes two images per view at different X-ray exposures. It then recombines them to highlight the contrast-enhanced areas— all in a simple, quick, procedure that takes less than ten minutes— much like a regular mammography exam. SenoBright is available with the  new GE Senographe Essential and Senographe DS systems and as an upgrade for these systems.

 The Senobright system features a  powerful X-ray tube and generator and a fast-reading digital detector, as well as a proprietary recombination algorithm. Image acquisition is fully automated. The spectral data necessary to create two images per view, are acquired automatically. These are a standard mammographic image showing tissue density, and a contrast-enhanced image in exactly the same position with the background signal subtracted out.