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Contrast-enhanced Digital Mammography

Mammography Remains the Gold Standard for screening but…
There is clear evidence that mammography detects early breast cancers and that screening large populations reduces mortality. However, mammography is an imperfect screening tool.[1] The specificity and sensitivity of mammography can be limited, especially for high-risk women with a BRCA gene mutation or dense breast tissue.[2]

Approved by the FDA in 2011, contrast-enhanced digital mammography (CEDM) is an extension of the existing indication for diagnostic mammography. The technique uses iodinated contrast in conjunction with a dual energy image acquisition to produce contrast-enhanced images. CEDM can be used as an adjunct following mammography and/or ultrasound exams to localize a known or suspected lesion.

References
[1] Drukteinis JS, Mooney BP, Flowers CI, Gatenby RA. Beyond Mammography: New Frontiers in Breast Cancer Screening. Am J Med. 2013 Jun; 126(6): 472–479.

[2] Jochelson MS, Dershaw DD, Sung JS, et al. Bilateral contrast-enhanced dual-energy digital mammography: feasibility and comparison with conventional digital mammography and MR imaging in women with known breast carcinoma. Radiology. 2013;266(3):743-751.

Related Reading
Francescone MA, Jochelson MS, Dershaw DD, et al. Low energy mammogram obtained in contrast-enhanced digital mammography (CEDM) is comparable to routine full-field digital mammography (FFDM).  Eur J Radiol. 2014;83(8):1350-1355.

Carton AK, Gavenonis SC, Currivan JA, Conant EF, Schnall MD, Maidment AD. Dual-energy contrast-enhanced digital breast tomosynthesis-a feasibility study. Br J Radiol. 2010;83(988):344-350.

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Osteoporosis Update 2015: It’s all about the fractures

Osteoporosis is Common
About 54 million Americans have osteoporosis and low bone mass. Studies suggest that approximately one in two women and up to one in four men age 50 and older will sustain a fracture due to osteoporosis.  

Osteoporosis is Serious
Osteoporosis-related fractures are most likely to occur in the hip, spine, and wrist. Since osteoporosis causes the bones of the spine to break and collapse, posture is affected, causing patients to become stooped or hunched. Twenty percent of seniors who break a hip will die within one year from complications related to the broken bone or surgery to repair it. Many of those who survive need long-term nursing home care.

Osteoporosis is Costly
Osteoporosis fractures is responsible for two million broken bones and $19 billion in related costs every year. By 2025, experts predict that osteoporosis will be responsible for approximately three million fractures and $25.3 billion in medical expenditures annually.

Related  Reading
Reisman JA, Bogoch ER, Dell R, Harrington JT, et al. Making the first fracture the last fracture: ASBMR task force report on secondary fracture prevention. J Bone Miner Res. 2012 Oct;27(10):2039-2046.

Miller AN, Lake AF, Emory CL. Establishing a Fracture Liaison Service: An Orthopaedic Approac. J Bone Joint Surg Am. 2015 Apr 15;97(8):675-681.

Siris ES, Adler R, Bilezikian J, et al. The clinical diagnosis of osteoporosis: a position statement from the National Bone Health Alliance Working Group. Osteoporos Int. 2014;25(5):1439-1443.