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European Radiology Experimental
Fig. 6 | European Radiology Experimental

Fig. 6

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

Fig. 6

Case number 4 of Table 3. A 57-year-old patient with bilateral lesions detected on screening mammography, one on the right (grade 2 infiltrating ductal carcinoma with intermediate grade DCIS) and two on the left (both grade 2 infiltrating ductal carcinomas with DCIS). Right breast: T1-weighted post-contrast axial (a, b) and sagittal (c) MRI images;  recombined CC (d) and MLO (e) CEM images. Left breast: T1-weighted post-contrast axial (f, g) and sagittal (h) MRI images; recombined CC (i) and MLO (j) CEM images. Solid arrows point to the sites of the primary lesions initially detected on conventional imaging.  An additional right-sided lesion (dotted arrows) was noted on the MRI, 18 mm inferior to the primary lesion. This lesion was not seen on CEM - it may have been superimposed on the main lesion on the CC view and contrast “wash-out” may have occurred by the time of MLO was acquired. Confirmation of additional lesion (a 7-mm invasive ductal carcinoma grade 2 with low grade DCIS) could have changed the treatment plan. CC Craniocaudal, CEM Contrast-enhanced mammography, DCIS Ductal carcinoma in situ, MLO Mediolateral, MRI Magnetic resonance imaging

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