Contrast-enhanced digital mammography lesion morphology and a phantom for performance evaluation

Abstract

Contrast-enhanced digital mammography (CEDM), promises to improve diagnostic accuracy as an adjunct to mammography, especially for women with dense breasts. Here we review 98 enhancing lesions from a previously published dual-energy CEDM study of 120 women to identify enhancing lesion morphologies and to characterize their sizes and margins as detected in CEDM. We have designed a phantom based on these clinical data that incorporates realistic enhancing lesion morphologies for CEDM evaluation. The phantom includes elements of four lesion types observed in CEDM, which broadly follow analogous categories developed from the MRI Breast Imaging, Reporting and Data System (BI-RADS) lexicon. This phantom uses solid iodinated plastic features with accurate iodine concentrations for detection sensitivity experiments. We believe that comparisons of the lesion morphologies through quantitative metrics and reader studies will be useful to test lesion classification and discrimination tasks that can contribute to CEDM performance evaluation. © 2014 Springer International Publishing.