Contrast-enhanced mammography as an alternative to breast MRI: a narrative review by indication

Description

Breast MRI is what radiologists reach for when a mammogram is not enough: to see through dense tissue, to work out how far a cancer has spread before surgery, to judge whether a tumour is shrinking on chemotherapy. It is also slow and expensive, there is rarely enough of it, and some patients cannot have it at all. Contrast-enhanced mammography keeps being proposed as the cheaper substitute. It is an ordinary mammogram taken after an injection of iodine contrast, at two different energies, and subtracting one image from the other shows where blood is flowing, which is where a tumour tends to be. It takes minutes rather than most of an hour, and it runs on equipment many departments already own. Whether it can genuinely replace MRI depends on what you are asking it to do, and the evidence is solid for some questions and thin for others. This project works through it one clinical indication at a time. The reading list is already built, so week one is reading rather than searching.

Student responsibilities

Read up on breast imaging and how contrast-enhanced mammography works. Take one clinical indication, read the papers already gathered for it, build the table that goes with it, and write that section of the review.