# Contrast-enhanced mammography

Source: https://onco.cc/technologies/contrast-enhanced-mammography/  
OnCo record `contrast-enhanced-mammography` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A mammogram taken after an iodine contrast injection, at two X-ray energies, so that a tumour's blood supply shows up as a bright spot. It gives much of what breast MRI gives on a machine most breast units already own.

## Summary

Contrast-enhanced mammography adds an intravenous iodinated contrast injection to a digital mammography unit fitted with dual-energy software: a low- and a high-energy exposure are taken in each view a couple of minutes after injection and subtracted to leave an image of where contrast has pooled, which is where tumours have recruited blood vessels. Hologic (I-View), GE HealthCare (SenoBright HD), Siemens Healthineers (TiCEM) and Fujifilm offer it on their platforms, and contrast-guided biopsy devices followed. It is used to stage newly diagnosed cancers and measure their extent, to solve inconclusive findings on mammography and ultrasound, to monitor response to pre-operative chemotherapy, and, in trials such as CMIST, as a supplemental screening test for women with dense breasts. Its accuracy approaches that of breast MRI for detecting cancer and measuring size, in a ten-minute examination on existing equipment.

The costs are an iodine injection with its small risk of reaction and kidney concerns, a radiation dose somewhat higher than a standard mammogram, compression as in mammography, no view of the axilla or the chest wall, and less evidence than MRI in high-risk screening. Where MRI capacity is scarce, contrast mammography is the practical alternative.

## Fields

- Kind: Technology
- Status: established
- Last checked: 2026-09-17
- Tags: machines-wave2
- Principle: Dual-energy digital mammography acquired after intravenous iodinated contrast is recombined to suppress normal tissue and display iodine uptake, mapping tumour neovascularity on standard mammographic views.
- Since: 2011
- Strengths: Accuracy close to breast MRI for detection and size; Ten-minute examination on existing mammography units; Cheaper and more available than MRI
- Limitations: Iodine contrast risks; Higher radiation dose than standard mammography; Does not image the axilla or chest wall

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Contrast-enhanced_spectral_mammography
- Jochelson and Lobbes, Contrast-enhanced mammography: state of the art (Radiology 2021): https://doi.org/10.1148/radiol.2021201948
- Hologic: I-View contrast enhanced imaging: https://www.hologic.com/hologic-products/breast-health-solutions/i-view-contrast-enhanced-imaging

## Connected records

- technologies: [AI in radiology](https://onco.cc/technologies/radiology-ai-screening/), [AI-assisted mammography screening](https://onco.cc/technologies/ai-mammography-screening/), [Breast MRI coils and abbreviated breast MRI](https://onco.cc/technologies/breast-mri-coils-abbreviated-mri/), [Dual-energy and spectral CT](https://onco.cc/technologies/dual-energy-spectral-ct/), [Elastography and contrast-enhanced ultrasound](https://onco.cc/technologies/ultrasound-elastography-ceus/), [Mammography & tomosynthesis](https://onco.cc/technologies/mammography/)
- cancers: [Breast cancer (all types)](https://onco.cc/cancers/breast-cancer/)
- terms: [Ductal carcinoma in situ (DCIS)](https://onco.cc/terms/dcis/)
- fronts: [Early Detection & Screening](https://onco.cc/fronts/early-detection/), [Imaging](https://onco.cc/fronts/imaging/)
- companies: [FUJIFILM Healthcare](https://onco.cc/companies/fujifilm/), [GE HealthCare](https://onco.cc/companies/ge-healthcare/), [Hologic](https://onco.cc/companies/hologic/), [Siemens Healthineers](https://onco.cc/companies/siemens-healthineers/)

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