van Nijnatten, Thiemo J. A.Morscheid, StephanieBaltzer, Pascal A. T.Clauser, PaolaAlcantara da Silva, RodrigoKuhl, Christiane K.Wildberger, Joachim E.2024-10-152024-10-152024van Nijnatten TJA, Morscheid S, Baltzer PAT, Clauser P, Alcantara R, Kuhl CK, et al. Contrast-enhanced breast imaging: Current status and future challenges. Eur J Radiol. 2024 Feb;171:111312. DOI: 10.1016/j.ejrad.2024.1113120720-048Xhttp://hdl.handle.net/10230/61396Background: Contrast-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. Methods: This 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. Results: Technique 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. Conclusion: Contrast-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.application/pdfeng© 2024 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).info:eu-repo/semantics/articlehttp://dx.doi.org/10.1016/j.ejrad.2024.111312Breast MRIBreast imagingContrast-enhanced mammographyinfo:eu-repo/semantics/openAccess