Barriers to Implementation of Contrast-Enhanced Mammography in Clinical Practice: AJR Expert Panel Narrative Review

Thiemo J A van Nijnatten; Marc B I Lobbes; Andrea Cozzi; Bhavika K Patel; Margarita L Zuley; Maxine S Jochelson

doi:10.2214/AJR.22.28567

Barriers to Implementation of Contrast-Enhanced Mammography in Clinical Practice: AJR Expert Panel Narrative Review

Thiemo J A van Nijnatten^*, Marc B I Lobbes, Andrea Cozzi, Bhavika K Patel, Margarita L Zuley, Maxine S Jochelson

^*Corresponding author for this work

Research output: Contribution to journal › (Systematic) Review article › peer-review

Abstract

Accumulating evidence shows that contrast-enhanced mammography (CEM) has higher diagnostic performance than digital mammography and ultrasound and comparable diagnostic performance to MRI for various indications. CEM also offers certain practical advantages for patients. Nevertheless, the clinical implementation of CEM has been limited because of a range of factors. This AJR Expert Panel Narrative Review explores such factors hindering CEM implementation. These factors include the following: the risks of iodinated contrast media, increased radiation exposure, indications for which CEM is not the preferred test or for which further evidence is needed, workflow adjustments needed when performing CEM examinations, incomplete availability of CEM-guided biopsy systems, and reimbursement challenges. Considerations that currently mitigate or are expected to mitigate these factors are also highlighted.

Original language	English
Pages (from-to)	3-6
Number of pages	4
Journal	American Journal of Roentgenology
Volume	221
Issue number	1
Early online date	30 Nov 2022
DOIs	https://doi.org/10.2214/AJR.22.28567
Publication status	Published - 1 Jul 2023

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10.2214/AJR.22.28567

Cite this

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title = "Barriers to Implementation of Contrast-Enhanced Mammography in Clinical Practice: AJR Expert Panel Narrative Review",

abstract = "Accumulating evidence shows that contrast-enhanced mammography (CEM) has higher diagnostic performance than digital mammography and ultrasound and comparable diagnostic performance to MRI for various indications. CEM also offers certain practical advantages for patients. Nevertheless, the clinical implementation of CEM has been limited because of a range of factors. This AJR Expert Panel Narrative Review explores such factors hindering CEM implementation. These factors include the following: the risks of iodinated contrast media, increased radiation exposure, indications for which CEM is not the preferred test or for which further evidence is needed, workflow adjustments needed when performing CEM examinations, incomplete availability of CEM-guided biopsy systems, and reimbursement challenges. Considerations that currently mitigate or are expected to mitigate these factors are also highlighted.",

author = "{van Nijnatten}, {Thiemo J A} and Lobbes, {Marc B I} and Andrea Cozzi and Patel, {Bhavika K} and Zuley, {Margarita L} and Jochelson, {Maxine S}",

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AU - van Nijnatten, Thiemo J A

AU - Lobbes, Marc B I

AU - Cozzi, Andrea

AU - Patel, Bhavika K

AU - Zuley, Margarita L

AU - Jochelson, Maxine S

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AB - Accumulating evidence shows that contrast-enhanced mammography (CEM) has higher diagnostic performance than digital mammography and ultrasound and comparable diagnostic performance to MRI for various indications. CEM also offers certain practical advantages for patients. Nevertheless, the clinical implementation of CEM has been limited because of a range of factors. This AJR Expert Panel Narrative Review explores such factors hindering CEM implementation. These factors include the following: the risks of iodinated contrast media, increased radiation exposure, indications for which CEM is not the preferred test or for which further evidence is needed, workflow adjustments needed when performing CEM examinations, incomplete availability of CEM-guided biopsy systems, and reimbursement challenges. Considerations that currently mitigate or are expected to mitigate these factors are also highlighted.

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