Contrast-enhanced breast imaging: Current status and future challenges
European Journal of Radiology, vol. 171, pp. 111312
Abstract
BACKGROUND: Contrast-enhanced breast MRI and recently also contrast-enhanced mammography (CEM) are available for breast imaging. The aim of the current overview is to explore existing evidence and ongoing challenges of contrast-enhanced breast imaging. METHODS: This narrative provides an introduction to the contrast-enhanced breast imaging modalities breast MRI and CEM. Underlying principle, techniques and BI-RADS reporting of both techniques are described and compared, and the following indications and ongoing challenges are discussed: problem-solving, high-risk screening, supplemental screening in women with extremely dense breast tissue, breast implants, neoadjuvant systemic therapy (NST) response monitoring, MRI-guided and CEM- guided biopsy. RESULTS: Technique and reporting for breast MRI are standardised, for the newer CEM standardisation is in progress. Similarly, compared to other modalities, breast MRI is well established as superior for problem-solving, screening women at high risk, screening women with extremely dense breast tissue or with implants; and for monitoring response to NST. Furthermore, MRI-guided biopsy is a reliable technique with low long-term false negative rates. For CEM, data is as yet either absent or limited, but existing results in these settings are promising. CONCLUSION: Contrast-enhanced breast imaging achieves highest diagnostic performance and should be considered essential. Of the two contrast-enhanced modalities, evidence of breast MRI superiority is ample, and preliminary results on CEM are promising, yet CEM warrants further study.
Authors 7
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Thiemo J. A. van Nijnatten corresponding
Maastricht University Medical Centre · Maastricht University
Affiliation as printed
Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; GROW - School for Oncology and Reproduction, Maastricht University Medical Center+, Maastricht, the Netherlands. Electronic address: Thiemo.nijnatten@mumc.nl
Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
GROW – School for Oncology and Reproduction, Maastricht University Medical Center+, Maastricht, the Netherlands
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Affiliation as printed
Department of Diagnostic and Interventional Radiology, University Hospital Aachen, Aachen, Germany
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Affiliation as printed
Department of Biomedical Imaging and Image-Guided Therapy, Division of General and Pediatric Radiology, Medical University of Vienna, Vienna, Austria
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Affiliation as printed
Department of Biomedical Imaging and Image-Guided Therapy, Division of General and Pediatric Radiology, Medical University of Vienna, Vienna, Austria
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Affiliation as printed
Radiology and Nuclear Medicine Department, Hospital del Mar, Barcelona, Spain
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Affiliation as printed
Department of Diagnostic and Interventional Radiology, University Hospital Aachen, Aachen, Germany
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Maastricht University Medical Centre · Maastricht University
Affiliation as printed
Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center+, Maastricht, the Netherlands
Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center+, Maastricht, the Netherlands
Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
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