Contrast-enhanced mammography: How does it work?

Contrast-enhanced mammography (CEM) is an imaging technique that uses iodinated contrast medium to improve visualization of breast lesions and assessment of tumor neovascularity. Through modifications in x-ray energy, high-and low-energy images of the breast are combined to highlight areas of contrast medium pooling. The use of contrast material introduces different workflows, artifacts, and risks related to the contrast medium dose. In addition, the need to acquire multiple images in each view introduces different workflows, artifacts, and risks associated with the radiation dose. Although CEM and conventional mammography share many underlying principles, it is important to understand how these two mammographic examinations differ and the mechanisms that facilitate image contrast at CEM.