Clinical application of the first version of the BI-RADS lexicon for contrast enhanced mammography: a pictorial essay

Abstract

Introduction. A standardized lexicon of morphology descriptors is essential for interpreting and reporting contrast enhanced mammography (CEM). This pictorial essay describes representative clinical cases using the first version of the BI-RADS® lexicon for CEM. Material and Methods. Clinical cases, BI-RADS categories 1 to 6 with CEM examination, were eligible. CEM included low-energy (LE) and high-energy recombined (RC) images. Breast ultrasound (US) findings are also described. Biopsy histopathology of BI-RADS categories 4, 5, and 6 are reported. The first version of the BI-RADS® lexicon was used for CEM reading, interpretation, and structured reporting. Results. We performed a detailed imaging morphologic analysis of all breast characteristics in clinical cases BI-RADS 1 to 6 using the first version of the BI-RADS® lexicon for CEM. We describe normal, benign, or suspected malignant findings on US, LE and RC images of 8 clinical cases. Dense breasts were detected in 6 (75.0%) of the 8 cases. The presence of mass(es), radial scar, asymmetry, non-mass lesion, and microcalcifications are described. The histopathologic diagnosis in BI-RADS categories 4, 5, and 6 are shown. Conclusion. CEM increased the diagnostic accuracy in cases with nonconclusive results, suspicious malignant findings, or newly diagnosed breast cancer with the added value of using the first version of the BI-RADS® lexicon for CEM.

Keywords

• Contrast enhanced mammography. CEM. BI-RADS categories. Recombined images. Low-energy CEM. High-energy CEM.