Імплементація мамографії з внутрішньовенним контрастуванням у клінічній практиці в Україні на прикладі клінічних випадків

Abstract

Purpose of the study- to estimate efficiency of application of CEM in the early early detection of breast cancer (BC). Material and methods. In the period from August 2021 to May 2023 using the iodine- containing drug “Tomohexol-350” 94 CEM studies were carried out on the basis of the CNE “Kyiv City Clinical Oncology Center” in the radiation diagnostic department on the Selenia Demensions digital mammography system. The age of the patients ranged from 28 to 84 years. According to the anamnesis, 68 women noted different complaints about the condition of the breasts - 72,3%, 26 women had no complaints - 27,7%. Among them, 31(33%) patients were referred by clinicians for a comprehensive breast examination with suspicion of recurrence of breast cancer. Of them, 15(16%) cases had X-ray signs of suspicion breast cancer and were referred for CEM. Results. According to the CEM results, breast cancer recurrence was confirmed in 6 (6,4%) cases. Of these, histologically recurrent breast cancer confirmed in 5 (5,3%) patients. In 1 (1,1%) women, histological examination results determined lipogranu¬loma - hyperfixation of contrast occurred in the focus of inflammation of the paranchima. In 9 (9,6%) patients, the reccurence of breast cancer was not confirmed by CEM results. The diagnostic efficiency of detecting recurrences of breast cancer according to the results of the CEM was 93,3%. Conclusion. Due to the innovative technology that combines low-energy imaging and contrast - enhanced scans, which show the intensity of the accumulation of the iodine - containing drugs breast tissue, CEM has improved the differential diagnosis of benign and malignant breast tumors, reduced the number of invasive interventions by 9,6%, increased the number of detection of preclinical breast cancer by 5,3%. The breast cancer according to the results of the CEM was 93,3%. The inclusion of CEM in the algorithm of screening patients from the cohort of increased risk of developing breast cancer is a promising tool in clinical practice. Key words: contrast - enhanced mammography (CEM), Full - field digital mammography (FFDM), Magnetic Resonance Imaging (MRI), contrast accumulation, recurrence of breast cancer, risk group, screening.