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Novel diagnostic procedure
Case report
Positive molecular breast imaging: challenges and problem solving with contrast-enhanced spectral mammography
  1. Jeremy SL Ong1,2,
  2. Felicity Whitewood3,
  3. Donna B Taylor4 and
  4. Deepthi Dissanayake1,4
  1. 1 Medical Imaging, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
  2. 2 Department of Nuclear Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
  3. 3 Breast Unit, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
  4. 4 Department of Diagnostic and Interventional Radiology, Royal Perth Hospital, Perth, Western Australia, Australia
  1. Correspondence to Dr Jeremy SL Ong, Jeremy.ong@health.wa.gov.au

Abstract

Molecular breast imaging (MBI) is a relatively new technique with high sensitivity for breast cancer detection. However, because it only provides limited anatomical information, cross-correlation of MBI findings with conventional breast imaging modalities such as full field digital mammography can be challenging. We report a case of a positive MBI study in a supplemental screening setting, where cross-correlation of MBI, ultrasound, mammogram and biopsy findings was difficult. Contrast-enhanced spectral mammography (CESM) demonstrated a hypervascular lesion at the biopsy clip, helping to prove imaging/histopathological concordance. This case highlights the challenges of incorporating MBI into conventional imaging workup, as well as the use of CESM in problem solving.

  • breast surgery
  • radiology

https://doi.org/10.1136/bcr-2019-230043

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    Footnotes

    • Contributors JSLO contributed to the planning of the manuscript, contributed to the literature review and wrote the initial manuscript draft, and sought opinions for additions and changes to the manuscript from the other coauthors. FW contributed to the planning of the manuscript, contributed to the literature review and assisted with obtaining and formatting of the images. DBT contributed to the literature review and provided expert feedback on the draft manuscript and helped to write the final version. DD contributed to the planning of the manuscript, including the appropriate learning points, contributed to the literature review, provided and formatted some of the images and provided expert feedback on the draft manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Obtained.