Paper Proffered Program Diagnostic and Interventional Radiology Physics

Electromagnetic Interference Artifacts In Mammography Due to Left Ventricular Assist Devices.

Abstract
Purpose

To evaluate the presence and severity of electromagnetic interference (EMI) artifacts from left ventricular assist devices (LVADs) in mammography.

Methods

We examined mammograms of 21 patients (1-7 exams/patient) acquired after implantation of an LVAD. Exams were performed on GE (N=12) or Hologic (N=43) systems. Two physicists scored artifacts as “no artifact”, “mild”, “moderate”, or “severe”. We examined correlations between artifact severity and the mammography system vendor, view (LMLO, LCC, RMLO, or RCC), and presentation (2D, DBT, or synthetic 2D).

Results

Artifacts appeared primarily in images of the left breast. Of these, artifacts appeared in 77% of synthetic 2D images and 76% of DBT images from Hologic systems. These were rated as “severe” in 31% of synthetic 2D and 38% of DBT images. Five patients were given BIRADS scores of 0 due to the EMI artifacts and required repeat imaging. In contrast, artifacts appeared in over 90% of synthetic 2D and DBT images taken on GE systems, but all these artifacts were rated as “mild”. Artifacts appeared in 81% of 2D left breast images taken on Hologic systems but were only rated as “mild” or “moderate” in severity. No artifacts appeared in any 2D images from GE systems. Artifacts were generally most severe on LMLOs and least severe on RMLOs for both vendors and all presentations.

Conclusion

LVAD-induced EMI artifacts that appear in synthetic 2D images from Hologic systems can interfere with interpretation of the image. To reduce the need for repeat imaging, we recommend these patients be imaged on GE systems, where artifacts do not appear in 2D images and are mild in DBT and synthetic 2D images. If only Hologic systems are available, 2D images should be included in the protocol as their artifacts are less pronounced compared to DBT and synthetic 2D.

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