Contrast enhanced mammography - revisiting structured reporting with special focus on suggested modifications

Contrast-enhanced mammography (CEM) is an innovative breast imaging technique that combines the strengths of both mammography and MRI. It provides both morphological and functional information, making it a valuable, cost-effective alternative to MRI, especially in resource-limited settings. In this article, we explore the evolving role of CEM, beginning with a brief discussion of its indications, contraindications, and technical nuances. We have described a structured reporting format based on the ACR BI-RADS® CEM lexicon through a series of illustrative examples, to enhance the reader's familiarity with key descriptors and their clinical implications. Furthermore, we delve into the diagnostic challenges associated with CEM, offering practical guidance to the radiologist for accurate image interpretation. Finally, we propose refinements to the existing ACR BI-RADS® CEM lexicon to enhance its utility in clinical practice.