We reviewed technical parameters, acquisition protocols and adverse reactions (ARs) for contrast-enhanced spectral mammography (CESM). A systematic search in databases, including MEDLINE/EMBASE, was performed to extract publication year, country of origin, study design; patients; mammography unit/vendor, radiation dose, low-/high-energy tube voltage; contrast molecule, concentration and dose; injection modality, ARs and acquisition delay; order of views; examination time. Of 120 retrieved articles, 84 were included from 22 countries (September 2003-January 2019), totalling 14012 patients. Design was prospective in 44/84 studies (52%); in 70/84 articles (83%), a General Electric unit with factory-set kVp was used. Per-view average glandular dose, reported in 12/84 studies (14%), ranged 0.43-2.65 mGy. Contrast type/concentration was reported in 79/84 studies (94%), with Iohexol 350 mgI/mL mostly used (25/79, 32%), dose and flow rate in 72/84 (86%), with 1.5 mL/kg dose at 3 mL/s in 62/72 studies (86%). Injection was described in 69/84 articles (82%), automated in 59/69 (85%), manual in 10/69 (15%) and flush in 35/84 (42%), with 10-30 mL dose in 19/35 (54%). An examination time < 10 min was reported in 65/84 studies (77%), 120 s acquisition delay in 65/84 (77%) and order of views in 42/84 (50%) studies, beginning with the craniocaudal view of the non-suspected breast in 7/42 (17%). Thirty ARs were reported by 14/84 (17%) studies (26 mild, 3 moderate, 1 severe non-fatal) with a pooled rate of 0.82% (fixed-effect model). Only half of CESM studies were prospective; factory-set kVp, contrast 1.5 mL/kg at 3 mL/s and 120 s acquisition delay were mostly used; only 1 severe AR was reported. CESM protocol standardisation is advisable.
Technique, protocols and adverse reactions for contrast-enhanced spectral mammography (CESM ): a systematic review / M. Zanardo, A. Cozzi, R.M. Trimboli, O. Labaj, C.B. Monti, S. Schiaffino, L.A. Carbonaro, F. Sardanelli. - In: INSIGHTS INTO IMAGING. - ISSN 1869-4101. - 10:1(2019 Aug 02), pp. 76.1-76.15.
Titolo: | Technique, protocols and adverse reactions for contrast-enhanced spectral mammography (CESM ): a systematic review |
Autori: | |
Parole Chiave: | Breast; Contrast media; Drug-related side effects and adverse reactions; Mammography; Radiation dosage |
Settore Scientifico Disciplinare: | Settore MED/36 - Diagnostica per Immagini e Radioterapia |
Data di pubblicazione: | 2-ago-2019 |
Rivista: | |
Tipologia: | Article (author) |
Digital Object Identifier (DOI): | http://dx.doi.org/10.1186/s13244-019-0756-0 |
Appare nelle tipologie: | 01 - Articolo su periodico |
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