New Trends in Breast Imaging
- Screening mammography for breast cancer detection has led to the development of various imaging modalities. Some utilize ionizing and others non-ionizing radiation. The well-known advantages of X-rays have resulted in various imaging modalities with the intention of enhancing safety and efficacy. Digital mammography spawned the development of several derived technologies, including digital breast tomosynthesis (DBT) and contrast-enhanced digital mammography (CEDM) . Combining DBT with CEDM has been shown to limit the effect of surrounding soft tissue and achieving higher contrast between malignancy and surrounding tissue .
- One of the most promising areas of health innovation is the application of artificial intelligence (AI) in biomedical imaging. Medical imaging has always been an integral part of disease diagnosis and treatment decision-making. Innovations in medical imaging techniques have led to a surge in the volume of increasingly complex imaging investigations.
- Contrast-enhanced mammography (CEM) was introduced in 2011 as a modality able to increase mammography’s diagnostic performance. A CEM examination consists of an intravenous administration of an iodinated contrast agent, followed by a dual-energy mammography of both breasts in two views as minimum (Fig. 1). Different CEM units from different vendors are currently available and the imaging protocol was published earlier . Multiple studies have shown that this approach increases the diagnostic accuracy of mammography significantly [2,3], even matching the performance of breast MRI .
- The aim of any population screening programme is to reduce mortality while minimising harm to the individual and at an acceptable financial cost to the health economy . When specifically discussing breast screening, reducing mortality depends not on overall cancer detection but on identifying small high grade invasive cancers  and high grade DCIS . Tabar  showed that in the Swedish 2 counties study much of mortality reduction was due to grade 3 cancer detection (P < 0.001) and more deaths prevented from grade 3 tumors (n = 95) than grade 1 and 2 tumors combined (n = 48).