Contrast Enhanced Spectral Mammography: A Review

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Contrast-enhanced spectral mammography (CESM) combines low-energy 2D imaging with post-contrast analysis.
• CESM assesses tumor neovascularity, similar to MRI, but with mammographic capabilities.
• Current utilization of CESM in the US is low but shows potential for rapid growth.

Purpose of the Study:

• To review the historical background, indications, and diagnostic accuracy of CESM.
• To highlight CESM's role in breast cancer detection and diagnosis.
• To discuss the increasing adoption of CESM for indications previously managed by MRI.

Main Methods:

• Literature review and analysis of historical data on CESM.
• Comparison of CESM's sensitivity and specificity with contrast-enhanced MRI.
• Examination of clinical applications and implementation ease.

Main Results:

• CESM demonstrates sensitivity and specificity on par with contrast-enhanced breast MRI.
• CESM is being adopted for problem-solving, staging, and neoadjuvant chemotherapy response assessment.
• The technique offers a viable alternative to MRI for several breast imaging scenarios.

Conclusions:

• CESM is a valuable and growing technique for breast cancer evaluation.
• Its comparable performance and ease of implementation support its expanded clinical use.
• CESM presents a promising alternative to MRI for specific breast imaging indications.