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European Radiology Experimental
Fig. 4 | European Radiology Experimental

Fig. 4

From: Contrast-enhanced mammography (CEM) versus MRI for breast cancer staging: detection of additional malignant lesions not seen on conventional imaging

Fig. 4

Case number 2 of Table 3. A 41-year-old woman with a palpable lump in the right breast. Recombined MLO (a) and CC (b) CEM images and first contrast-enhanced subtracted T1-weighted axial (c) and sagittal (d) MRI images. The index malignant lesion was a triple-negative, grade 3 invasive ductal carcinoma, seen here as a 15-mm ill-defined, irregularly shaped, heterogeneously enhancing mass (dotted arrows) at the 11 o’clock position in the right breast. Sagittal (e) and axial (f) post-contrast T1-weighted subtracted images from the MRI study demonstrate an additional lesion in the right lower outer quadrant, a 34-mm segmental area of non-mass enhancement (solid arrows), not visible on CEM. This additional lesion was 30-mm low-grade DCIS. The degree of enhancement of the index lesion on MRI is subjectively much greater than that shown on CEM. The noncalcified DCIS shows minimal enhancement on MRI. CC Craniocaudal, CEM Contrast-enhanced mammography, DCIS Ductal carcinoma in situ, MLO Mediolateral, MRI Magnetic resonance imaging

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