Contrast Enhanced Spectral Mammography (CESM) Indications

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Wilaiporn Bhothisuwan, MD
Pramaporn Kimhamanon, RT


Contrast enhanced spectral mammography (CESM), is a dual energy contrast enhanced digital subtraction mammography.  This technique uses the same principle as MRI of the breast, but CESM uses digital mammography instead of magnetic resonance in MRI. It provides dual energy acquisitions through low and high energies in different filters. The subtraction is obtained by emitting a different energy after a complete non-ionic contrast  media injection after 2 minutes with breast compression and  preprogrammed software without motion artifact. The benefits  include better resolution, and ability to evaluate microcalcifications,  it is more cost-effective, easier to administer with a shorter time of examination.


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Bhothisuwan W, Kimhamanon P. Contrast Enhanced Spectral Mammography (CESM) Indications. BKK Med J [Internet]. 2014Sep.20 [cited 2021Sep.22];8(1):94. Available from:
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