Nottingham Breast Institute, Nottingham University Hospitals, Nottingham, UK.
Br J Radiol. 2022 Apr 1;95(1132):20211287. doi: 10.1259/bjr.20211287. Epub 2022 Jan 20.
Contrast-enhanced spectral mammography (CESM) breast biopsy has been recently introduced into clinical practice. This short communication describes the technique and potential as an alternative to MRI-guided biopsy.
An additional abnormality was detected on a breast MRI examination in a patient with lobular carcinoma. The lesion was occult on conventional mammography, tomosynthesis and ultrasound and required histological diagnosis. Traditionally, this would have necessitated an MRI-guided breast biopsy, but was performed under CESM guidance.
A diagnostic CESM study was performed to ensure the lesion visibility with CESM and then targeted under CESM guidance. A limited diagnostic study, CESM scout and paired images for stereotactic targeting were obtained within a 10 min window following a single injection of iodinated contrast agent. The time from positioning in the biopsy device to releasing compression after biopsy and marker clip placement was 15 min. The biopsy confirmed the presence of multifocal breast cancer.
CESM-guided breast biopsy is a new technique that can be successfully used as an alternative to MRI-guided breast biopsy.
CESM-guided biopsy can be used to sample breast lesions which remain occult on standard mammography and ultrasound.
对比增强光谱乳腺摄影术（CESM）乳腺活检最近已引入临床实践。本简讯介绍了该技术作为 MRI 引导活检替代方法的潜力。
在一位患有小叶癌的患者的乳腺 MRI 检查中发现了一个额外的异常。该病变在常规乳腺 X 线摄影、断层合成和超声上均为隐匿性，需要进行组织学诊断。传统上，这将需要进行 MRI 引导的乳腺活检，但在 CESM 引导下进行。
进行了诊断性 CESM 研究，以确保 CESM 下的病变可见性，然后在 CESM 引导下进行靶向活检。在单次碘造影剂注射后 10 分钟的时间窗内，获得了有限的诊断性 CESM 研究、CESM 探查以及用于立体定向靶向的配对图像。从定位在活检设备到活检后释放压缩和放置标记夹的时间为 15 分钟。活检证实了多灶性乳腺癌的存在。
CESM 引导的乳腺活检是一种新技术，可成功用作 MRI 引导的乳腺活检的替代方法。
CESM 引导的活检可用于取样标准乳腺 X 线摄影和超声仍为隐匿性的乳腺病变。
