Dual-energy digital mammography is a complementary breast imaging modality.
The technique consists of high-energy and low-energy digital mammograms after administration of iodinated contrast agent.
Breast is exposed to low- and high-energy x-ray beams during a single breast compression in MLO projection. The breast is then released from compression, and the contrast agent injected. After a delay of about 3 minutes, the breast is compressed again, and the low- and high-energy exposures are repeated to create pre- and post-contrast dual-energy images, to evaluate the kinetics of uptake and washout.
The images are subtracted, canceling the soft-tissue contrast common to the two images and isolating the iodine signal in the region of angiogenesis. Low- and high-energy acquisitions are chosen to maximize and minimize, respectively, the ratio of the attenuation of the breast tissue to that of the iodine.
Dual-energy enhanced mammography is a cheap technique useful in identification of lesions in dense breasts, capable of demonstrating cancers that are not visible at standard mammography.
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