State-Of-The-Art and Future Advances in Breast Imaging (2025)-R4-CPH11-2025

Video Transcription

Video Summary

The session “State of the Art and Future Advances in Breast Imaging” covered three emerging breast-imaging technologies: contrast-enhanced mammography (CEM), digital breast tomosynthesis (DBT), and dedicated breast CT.<br /><br />CEM uses iodinated contrast and dual-energy subtraction to suppress background tissue and highlight tumor neovascularity, combining standard 2D mammographic morphology with functional enhancement information. Speakers reviewed commercial availability, clinical workflow (contrast injection followed by multiple views within ~8–10 minutes), and practical barriers such as staffing for IV placement and reaction management, plus billing challenges due to the lack of a dedicated CPT code. Evidence to date shows pooled cancer-detection sensitivity >90% in meta-analyses, with ongoing trials evaluating CEM—particularly as an MRI alternative for dense breasts and intermediate/high-risk screening. Future directions include quantitative iodine metrics, contrast-enhanced DBT, improved detectors (dual-layer and photon-counting), and AI/radiomics.<br /><br />DBT’s benefits in screening include reduced recalls and increased cancer detection, but with longer reading times. Innovations include “flying focal spot” motion compensation, AI-enhanced reconstruction and synthetic 2D generation, novel acquisition trajectories (e.g., T-scan) to reduce missing-angle artifacts, multimodality DBT+ultrasound, and AI for risk prediction and triage.<br /><br />Dedicated breast CT (with and without contrast) offers true 3D imaging with improved mass conspicuity and promising contrast-enhanced characterization; key research areas include AI denoising, motion correction, biopsy guidance, photon-counting systems, and dynamic (4D) perfusion imaging.

Keywords

contrast-enhanced mammography (CEM)

digital breast tomosynthesis (DBT)

dedicated breast CT

iodinated contrast dual-energy subtraction

dense breast screening MRI alternative

AI radiomics quantitative iodine metrics

synthetic 2D mammography reconstruction

photon-counting detectors motion correction

dynamic contrast-enhanced perfusion imaging (4D)