CAR Practice Guidelines on Breast Imaging and Interventions: Contrast-Enhanced Mammography

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Contrast-enhanced mammography (CEM) has seen increased clinical adoption and an expanding evidence base since 2016.
• Previous consolidated guidelines from the Canadian Association of Radiologists (CAR) have been updated and divided into five components.
• This guideline focuses specifically on the clinical application of CEM within the broader CAR Breast Practice Guidelines series.

Purpose of the Study:

• To provide updated recommendations on the clinical application of contrast-enhanced mammography (CEM).
• To address indications, technique, contrast administration, interpretation, reporting, quality control, and patient safety for CEM.
• To highlight CEM's role in diagnostic problem-solving, preoperative staging, and screening when MRI is not feasible.

Main Methods:

• Development of updated practice guidelines based on current evidence and clinical adoption.
• Review and synthesis of data regarding CEM indications, techniques, and safety protocols.
• Integration of CEM recommendations within the comprehensive CAR Breast Practice Guidelines series.

Main Results:

• Provides comprehensive recommendations for the clinical use of CEM.
• Defines standards for CEM indications, technique, interpretation, and quality control.
• Emphasizes CEM's utility in specific clinical scenarios, including problem-solving and preoperative staging.

Conclusions:

• CEM is a valuable tool in breast imaging, with established best practices outlined in this guideline.
• The guideline supports the integration of CEM into clinical practice, aligning with national and international standards.
• Clinical judgment remains paramount, considering technological advancements, resources, and patient factors.