 Thanks so much for your lecture, Dr. Phillips. At this time, we will open the floor for some questions. You can submit those through the Q&A feature and we will try to get through as many as we can. We have a few coming in and I will go ahead and open this up. How much iodinated contrast do we administer for CEM? So the dose of contrast is largely, so it's weight-based and so the actual dose is built around the patient who walks in the door. So we weigh the patients and the imaging units, you plug in the weight and it tells you what the dose should be. Often enough, institutions have a maximum dose that they administer, so our maximum dose is 150 ccs. ML, I should say. So I'm sorry, the weight-based calculation is 1.5 ccs per kilogram. If you work up in the asymmetry with CEM and see no enhancement, how confident can you be that the asymmetry is benign? Does it become by-rads three or by-rads two? So this is a really great question and it's one of the challenges of contrast mammos. What do you do with these enhanced, what we call now enhancing asymmetries, which are areas of enhancement on one view only. And the answer is, is really, you need to be concerned about it. I would not blow these off. So typically what we do now is you look at your low-energy images and you see if there's a mammocorrelate to help you figure out is this enhancement, perhaps it's associated with an area on the 2D mammogram that's been there for 10 years, in which case, yes, it's enhancing, but you're using the other features to tell you, no, no, it's enhancing associated with a benign by name. But if you are not able to get a low-energy correlate, then you would do a targeted ultrasound. But I would say you do not necessarily call it a by-rads three or by-rads two, you would want to work it out. And then if you absolutely have no correlate on your mammore ultrasound, then what we had been doing before CM biopsy was actually sending the patient to MR to further evaluate it. And now that CM biopsy is around, you can do a CM biopsy. Very rarely do I follow it. Can you clarify, does CEM only use 2D and not TOMO images? Yeah, that's a great question. So CEM is a planar exam, it's just 2D. So when the exam is applied, think about your 2D mammos and that's exactly how it's done. There's no TOMO sweep. There are people that are talking about contrast-enhanced TOMO synthesis where during the TOMO sweep, you're performing your dual-energy images. There are people that have studied that, but that's not available now. Got it. We've got two questions in the insurance reimbursement billing area. Can you speak to your experience on this? Do you have to get pre-authorization prior to performing? No. Okay. No, it's billed as a diagnostic mammogram plus the administration of contrast. So it's just a dive mammow and then the contrast often enough, depending on where you work, hospital or non-hospital related, you may or may not get reimbursed for the contrast. The contrast is roughly like $12. So at the moment, that is how it's billed and there's not typically an insurance coverage issue. I hope that I've answered, the people that have questions about reimbursement, I hope I've answered them. We all would like to get reimbursed more and have a dedicated CCT code for it, but that's not the thing yet. All right. Does the compression affect the enhancement? I think whoever asked that question, I'm interested to know what you're specifically asking about. So the degree of compression I can't answer, I can only say that a contrast mammogram is done where you administer the contrast of the patient sitting and then you do the mammogram. So the patient gets put in compression after the contrast is administered. That is how these exams are done. And so at the moment, it does not seem to impact our ability of seeing the enhancement. Now, I cannot answer the question about like the degree of compression and how it impelled me. In your experience with any surgeons, have they liked CEM versus pre-op MRI? Oh my God. Our surgeons love it. Every surgeon that I spoke into has loved it. And I think that the challenge, the reason why the surgeons love it is because one of the challenges of MRI is, yes, MRI is an amazing tool and I really don't want to diminish it because it's been an amazing boon for our field. It finds many cancers, but it also finds a lot of non-cancers. And these women are going for more biopsies, more stress, which is associated with more stress. And so our surgeons are really liking it because if we see an abnormality, we can do something about it. There are fewer false positives, fewer extra visits. And so they appreciate the ability to identify just what we need to know and not anything more. Surgeons love it. And it doesn't delay care. You know, you can do it right in the mammoth suite. Can we do dynamic contrast enhanced study, enhancement curve with CEM? So that is not a part of the exam currently. We do not do that currently. There are a number of studies that have looked at looking at how the breast takes up contrast or how a lesion takes up contrast over time to help us differentiate cancer from not cancer. That has not been included in our current interpretation of the exam. It's not as consistent as it is with MRI where you're looking at the breast, you know, you're looking at every portion of the breast at the same time, you know, at the same time over multiple time periods. What do you do with multiple small foci of less than five millimeters of enhancement? On MRI or on contrast mammoth? I think it's about contrast mammoth. So this isn't also an interesting question because with MRI, when MRI was started, there were a lot more follow-ups and the reason why there were more follows for this specific indication is because we didn't have the data to say, oh, this is just BPE versus not. And I would say at the moment, the standard practice for this is variable among practices and how comfortable you are. If you were to see multiple scattered enhancing foci, none of which stood out as being definitively different than everything else, I would just call it a by-rides too in background. If there was one that really looked a little bit different or if I couldn't tell, is there something here that I'm missing and I'm questioning certain areas then I would do a follow-up and comfortable doing a follow-up because I don't have the same amount of data, long-term data to say, oh, this is really just all background, being able to differentiate background from it, from an abnormal enhancement. So I would say the short answer is I am comfortable if I see multiple scattered areas of enhancement, which we call foci, less than five millimeters, all throughout the breath, calling it marked BPE and not doing more for it. If there's one specific area I'm questioning something, I would also feel comfortable doing a follow-up. Thank you. All right, I'll ask two more questions and we'll let you go. You've got tons of questions here. Do you always repeat CEM after biopsy to confirm cliff placement? Is that after CEM biopsy? If it's after CEM biopsy, I'm not able to answer that question. We don't routinely, in general, I do not perform CEM after biopsy to confirm cliff placement. And for CEM biopsy, I can't answer that because I don't do those. So I cannot tell you what I would normally do. Is there a recommended timeframe for image acquisition in CEM after contrast administration? So the standard thought is that two minutes from the start of the injection is when you start acquiring the pictures. And you want to image within 10 minutes to make sure that the contrast material that's in the breast is still there. Hasn't washed out yet. Okay, one more question. In young patients with breast cancer, do you prefer MR over CEM? So for newly diagnosed breast cancer, I would say that currently my answer largely has to do with logistics. And it has to do with when the patient's gonna be able to come in for the MR, when the patient's gonna be able to come in for contrast. Often enough, if I see a young woman who's coming in, we will do the contrast mammal right at the time of the diagnostic exam. And so I don't actually have to bring the patient back for a contrast mammal or an MRI. If I've already done a workup and then I've diagnosed the cancer and I'm now doing a contrast study for extended disease, it really would be a logistical choice. And the location of the cancer. So if the cancer is located deep within the breast or medial, then I would choose MRI. Thank you, Dr. Phillips for answering all those questions. And thank you for your lecture today. That was wonderful. Appreciate you being here. Absolutely, I'm happy to. If anybody has any other questions, I don't know, I really have not been following to see what other questions there are, but anybody should feel free to reach out.