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June 5, 2019

July 1, 2021




Nila Alsheik, MD
Section Chief, Division Breast Imaging
Co-Medical Director, Advocate Caldwell Breast Center

Advocate Lutheran General Hospital
Park Ridge, IL





Equipment Requirements
PC: Win7/Win8, Pentium processor or faster, at least 2GB RAM, Internet Explorer version 10/11, Mozilla FireFox version 33.0.

MAC: OS version 10.8/10.9, Intel processor, at least 2GB RAM, Safari version 6.2, FireFox 33.0


5107-104A The Role of Contrast-enhanced Mammography in
Value-based Breast Imaging ARCHIVE

A free online lecture recorded May 21, 2019, with Dr. Nila Alsheik for radiologists, radiologic technologists, nurses, and referring physicians

Available for CME, CNE, and CE credit

Format: Archived Webinar
Credit: 1.0 AMA PRA Category 1
  1.0 ANCC Contact hour
  1.0 ARRT Category A
Tuition:  FREE

Course Overview
In an era of low reimbursement and high demand for supplemental breast imaging exams, breast imagers require current and reliable information on cost-effective, accurate, and safe breast cancer imaging tools. Contrast-enhanced mammography (CEM) has been shown to provide comparable information to contrast-enhanced MRI at far less cost and greater availability [1,2,3]. CEM has also shown greater diagnostic accuracy than mammography alone or mammography + ultrasound [4,5], and CEM radiation dose falls below the dose limit set by Mammography Quality Standards Act regulations [6].

Dr. Alsheik will discuss clinical indications and patient selection; pre-screening requirements for patients who undergo contrast administration; operational workflow and barriers to implementation; and, finally, patient acceptance of contrast-enhanced mammography for supplemental imaging.

1. Fallenberg EM, Dromain C, Diekmann F, et al. Contrast-enhanced spectral mammography versus MRI: Initial results in the detection of breast cancer and assessment of tumour size. Eur Radiol. 2014;24(1):256-264.
2. Sleeba T, Subapradha A, Ramachandran M, Krishnaswami M. Role of dual-energy contrast-enhanced digital mammography as a problem-solving tool in dense breasts: A case report. Indian J Radiol Imaging. 2013;23(3):219-222.
3. Patel BK, Gray RJ, Pockaj BA. Potential Cost Savings of Contrast-Enhanced Digital Mammography. . AJR Am J Roentgenol. 2017;5:1-7.
4. Dromain C, Thibault F, Muller S, et al. Dual-energy contrast-enhanced digital mammography: initial clinical results. Eur Radiol. 2011;21(3):565-574.
5. Dromain C, Thibault F, Diekmann F, et al. Dual-energy contrast-enhanced digital mammography: initial clinical results of a multireader, multicase study. Breast Cancer Res. 2012;14(3):R94
6. James JR, Pavlicek W, Hanson JA, Boltz TF, Patel BK. Breast Radiation Dose With CESM Compared With 2D FFDM and 3D Tomosynthesis Mammography. AJR Am J Roentgenol. 2017;208(2):362-372.

Educational Objectives
At the conclusion of this activity, participants should be better able to:

  • Evaluate the role of contrast-enhanced mammography (CEM) as a supplemental breast imaging modality
  • Discuss the clinical indications for performing CEM
  • List the pre-screening requirements for performing CEM
  • Describe operational workflow and any barriers to implementing CEM into practice
  • Cite the benefits of CEM for patients who undergo CEM, including cost, patient comfort, and availability of real-time results

Joint Accreditation Statement
In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and International Center for Postgraduate Medical Education. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

Physician Continuing Medical Education
The Postgraduate Institute for Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

SA-CME: This activity meets the criteria for self-assessment toward the purpose of fulfilling requirements in the American Board of Radiology (ABR) Maintenance of Certification Program.

The European Accreditation Council for CME (EACCME®)
The UEMS-EACCME® has mutual recognition agreements with the American Medical Association (AMA) for live event and e-learning materials. For more information go to

Continuing Nursing Education
The maximum number of hours awarded for this Continuing Nursing Education activity is 1.0 contact hours.

Radiologic Technologists
This program has been approved by the American Society of Radiologic Technologists (ASRT) for 1.0 hour of ARRT Category A continuing education credit.

How to Enroll and Participate
There are no fees or prerequisites to participate in this program. Estimated time to complete this activity is one hour.


  • Click on the blue link. Complete the precourse questions and SUBMIT.
  • Click on the blue link again to view the recording.

How to Receive a Certificate of Credit
Log-in to your account at

  • View the entire educational activity session. At the conclusion of the lecture, close the Vimeo window.
  • Return to the course in your account at
  • From the COURSE HOME page, click the button for POSTTEST and for EVALUATION.
  • A passing grade of at least 75% is required to receive credit. You may take the test up to three times.
  • Upon receipt of a passing grade, you will be able to print a certificate of credit from your account at

Your certificate of credit will remain in your account at as a permanent record of your participation.


Nila Alsheik, MD
Section Chief, Division Breast Imaging
Co-Medical Director, Advocate Caldwell Breast Center
Advocate Lutheran General Hospital

Park Ridge, IL

Following graduation from The Warren Alpert Medical School of Brown University, Dr. Alsheik completed Diagnostic Radiology Residency, Neuroradiology and Breast Imaging Fellowships from the University of Wisconsin School of Medicine and Public Health.

Currently, Dr. Alsheik is Chief of Breast Imaging at Advocate Lutheran General Hospital and the Chair of the Breast Imaging Medical Directors Committee for Advocate Health Care, the largest nonprofit health system in Illinois. She represents Advocate Health Care as the Principal Investigator in their collaborative research efforts with the Breast Cancer Surveillance Consortium and the Metropolitan Chicago Breast Cancer Registry. Clinical interests focus on value-based breast imaging in the era of dense breast inform legislation and radiology resource utilization.

Disclosure Information
Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to PIM policy. The existence or absence of COI for anyone in a position to control content will be disclosed to participants prior to the start of each activity.

Nila Alsheik, MD, has received consulting fees from Bard Medical and has provided contracted research for Hologic, Inc.

ICPME and PIM planners and managers have no disclosures.                    

Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications. 

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

For questions regarding this program, please contact ICPME:

Jointly provided by


This activity is supported by an independent educational grant from Hologic, Inc.

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.