Temporal Subtraction Versus Dual-Energy Contrast-Enhanced Digital Breast Tomosynthesis: A Pilot Study

In contrast-enhanced DBT (CE-DBT), breast lesion vascularity is characterized by administrating an iodinated vascular contrast agent. In this work, a combined temporal and dual-energy (DE) subtraction CE-DBT technique was performed in 4 women with mammographic findings that warranted biopsy. Lesion enhancement characteristics and morphology obtained with both CE-DBT techniques are correlated to lesion enhancement characteristics and morphology obtained with CE-MRI. The findings are compared to the clinical outcome of the regular DBT exam. Preliminary results show that both temporal and DE CE-DBT provide morphologic and qualitative vascular information concordant with CE-MRI. Temporal subtraction is the most sensitive method since background breast tissue can be completely canceled while with DE CE-DBT tissue background can only be partially canceled. However, the temporal CE-DBT image data suffer from significantly more motion artifacts and therefore possible misdiagnosis.