Background: Contrast-enhanced mammography (CEM), a dual-energy technique of low and high energy images acquired following intra-venous iodinated contrast administration, was approved by the Food and Drug Administration for clinical use in 2011. Its use as a screening and diagnostic imaging modality is evolving. Studies have shown that CEM has a similar sensitivity to magnetic resonance imaging (MRI) in cancer detection and is therefore an attractive alternative to MRI in certain populations. Findings on digital mammography (DM), ultrasound (US), and MRI are reported using the Breast Imaging and Reporting Data System (BI-RADS®) lexicon. Though the CEM lexicon has not yet been incorporated into the BI-RADS® manual, the American College of Radiology issued a CEM lexicon supplement in 2022.
Learning Objectives: After reviewing the educational exhibit, readers will familiarize themselves with CEM findings on both low-energy and recombined images. Learners will be able to describe the CEM findings with the BIRADS CEM lexicon. Knowledge and use of the BIRADS CEM lexicon will allow learners to determine appropriate BIRADS assessment categories and management of findings.
Abstract Content/Results: This exhibit will provide a pictorial review of the recently published ACR BI-RADS® CEM lexicon. The presentation will include approximately 15-20 cases with emphasis on findings on the recombined images such as background parenchymal enhancement, internal enhancement characteristics of masses, non-mass enhancement, extent of enhancement, enhancing asymmetry, and lesion conspicuity. Application of the BI-RADS® lexicon to determine appropriate assessment categories and recommendations will also be discussed.
Conclusion: Understanding the recently established CEM lexicon will ensure appropriate description of CEM imaging findings. Use of this lexicon can improve standardization of CEM reporting and improve appropriate assessment and management of imaging findings, similar to BI-RADS® based reporting of other modalities.
