Contrast-enhanced breast imaging: Current status and future challenges

医学 乳房成像 乳房磁振造影 乳腺摄影术 模式 放射科 乳腺超声检查 活检 磁共振成像 乳腺活检 乳腺组织 叙述性评论 医学物理学 乳腺癌 医学影像学 重症监护医学 内科学 社会科学 癌症 社会学
作者
T.J.A. van Nijnatten,S Morscheid,Pascal Baltzer,Paola Clauser,R. Alcántara,Christiane Kuhl,Joachim E. Wildberger
出处
期刊:European Journal of Radiology [Elsevier]
卷期号:171: 111312-111312
标识
DOI:10.1016/j.ejrad.2024.111312
摘要

BackgroundContrast-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.MethodsThis 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.ResultsTechnique 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.ConclusionContrast-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.

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