Background: Contrast-enhanced mammography (CEM) combines the benefits of high-resolution digital mammography with the dynamic benefits of intravenous contrast administration and dual-energy subtraction to identify areas of increased blood flow, which can increase detection of breast cancer. With the increasing use of this modality in both the screening and diagnostic settings, it is important to understand artifacts unique to this modality. Many of these artifacts can be corrected to maintain high quality CEM images.
Learning Objectives: • Discuss the technical requirements and protocol for optimal CEM imaging. • Recognize traditional mammographic artifacts that also impact CEM. • Identify artifacts unique to CEM. • Discuss how to prevent of artifacts with emphasis on team approach involving medical physicist and mammography technologist feedback and training.
Abstract Content/Results: This exhibit will provide pictorial review to demonstrate known artifacts described in the medical literature, as well as unique artifacts encountered during the experience at our institution. More common imaging artifacts exhibited will include halo, ripple, rim, air gap, contrast splatter, and venous contrast retention artifacts. Less common artifacts include retained contrast from galactogram, elephant rind artifact with subcutaneous enhancement of skin, and artifact related to breast implants. Artifacts seen in traditional mammography such as motion, antiperspirant, hair, skin folds, skin lesions, and foreign bodies are well established, but it is important to recognize that these are also seen on both low energy and dual energy subtracted CEM images. Many artifacts are avoidable or correctable. A team approach to addressing artifacts should include medical physicist and mammography technologist’s feedback and training.
Conclusion: Identifying and understanding artifacts are essential for maintaining high quality CEM. Limitations imposed by unavoidable imaging artifacts should be recognized. Avoidable imaging artifacts can be remedied by alterations in technique.
