CEDM

Abstract: Contrast-enhanced digital mammography (CEDM) is a diagnostic tool for breast cancer detection. Artefacts are observed in about 10% of CEDM examinations. Understanding CEDM artefacts is important to prevent diagnostic misinterpretation. In this article, we have described the artefacts that we have commonly encountered in clinical practice; we hope to ease the recognition and help troubleshoot solutions to prevent or minimise them.

Abstract: Community economic development models (CEDM) have become the latest fashion in the field of regional development policy. However, CEDM means different things to different people, including institutional building at the community level, economic development in a specific geographical area, bottom-up rather than top-down development or the development of a community enterprise. This paper focuses on the most contentious aspect of this approach to regional development policy - capacity and opportunity - in order to draw some conclusions and recommendations about the viability of CEDM for regional communities. It draws on research literature from Canada and Australia to inform this debate.

Abstract: OBJECTIVE The objective of this study was to assess to the role of contrast-enhanced digital mammography (CEDM) as a screening tool in women at intermediate risk for developing breast cancer due to a personal history of lobular neoplasia without additional risk factors MATERIALS AND METHODS In this institutional review board-approved, observational, retrospective study, we reviewed our radiology department database to identify patients with a personal history of breast biopsy yielding lobular neoplasia who underwent screening CEDM at our institution between December 2012 and February 2019 A total of 132 women who underwent 306 CEDM examinations were included All CEDM examinations were interpreted by dedicated breast imaging radiologists in conjunction with a review of the patient's clinical history and available prior breast imaging In statistical analysis, sensitivity, specificity, NPV, positive likelihood ratio, and accuracy of CEDM in detecting cancer were determined, with pathology or 12-month imaging follow-up serving as the reference standard RESULTS CEDM detected cancer in six patients and showed an overall sensitivity of 100%, specificity of 88% (95% CI, 84-92%), NPV of 100%, and accuracy of 88% (95% CI, 84-92%) The positive likelihood ratio of 833 suggested that CEDM findings are 83 times more likely to be positive in an individual with breast cancer when compared with an individual without the disease CONCLUSION CEDM shows promise as a breast cancer screening examination in patients with a personal history of lobular neoplasia Continued investigation with a larger patient population is needed to determine the true sensitivity and positive predictive value of CEDM for these patients

Abstract: Contrast-enhanced digital mammography (CEDM) reveals neovasculature of breast lesions in a two-dimensional contrast enhancement map. Contrast-enhanced digital breast tomosynthesis (CEDBT) provides contrast enhancement in three dimensions, which may improve lesion characterization and localization. We aim to compare CEDM and CEDBT for lesion assessment. Women with breast imaging-reporting and data system 4 or 5 suspicious breast lesion(s) were recruited in our study and were imaged with CEDM and CEDBT in succession under one breast compression. Two radiologists assessed CEDM and CEDBT with both images displayed side-by-side and compared (1) contrast enhancement of lesions and (2) lesion margin using a five-point scale ranging from −2 (CEDM much better) to +2 (CEDBT much better). Biopsy identified 19 malignant lesions with contrast enhancement. Our results show that CEDBT provides better lesion margins than CEDM with limited reduction in contrast enhancement. CEDBT delivers less radiation dose compared to CEDM + DBT. Synthetic CEDM can be generated from CEDBT data and provides lesion contrast enhancement comparable to CEDM. CEDBT has potential for clinical applications, such as treatment response monitoring and guidance for biopsy.