0:00

So this is how a contrast mammogram is acquired.

0:03

So again, we start with an

0:04

injection. IV line goes in the arm.

0:06

Um, we inject iodinated contrast material at a dose

0:11

of 1.5 ccs per kilogram, and at a rate of 3 ccs per

0:15

second, 3 ccs per second through a, uh, power injector.

0:19

Two minutes from the start of the injection, we start

0:21

acquiring the standard four images of a mammogram.

0:24

You'll see here.

0:26

Each, um, imaging set—so the low energy and the

0:29

high energy image are considered an imaging set.

0:31

Each of these is actually acquired one minute apart, such

0:34

that the total exam takes roughly five to six minutes.

0:38

If you're gonna perform additional images,

0:41

which sometimes I do—for example, I acquire

0:44

90-degree laterals for my diagnostic exams—

0:46

those happen after the standard four views, and

0:49

they have to happen within 10 minutes because we

0:51

wanna make sure that whatever contrast is in the

0:53

breast, we can see it and it hasn't washed out.

0:58

What's important to remember after the images

1:00

are acquired—they get sent to our workstation,

1:02

as I mentioned before—is that a contrast

1:05

mammogram includes interpretation of both

1:07

the low energy and the recombined images.

1:10

They are both a part of it, so even if you see a

1:15

suspicious abnormality on the low energy images—right,

1:17

calcifications—and there's no enhancement, that is

1:21

still considered a positive contrast-enhanced mammogram.

1:24

And there was actually a meta-analysis that was done

1:27

that looked at data on contrast-enhanced mammo, and

1:29

found that when this—when, um, both the low energy

1:32

and the recombined images are included—enhanced

1:35

in the, uh, interpretation, the sensitivity is 95%

1:39

and the specificity is 81%, which is fairly high.

1:42

So it's really important to remember that

1:44

both are included in your interpretation.