Breast cancer is one of the most prevalent cancers in the world,and research on diagnostic techniques for dense glandular breast disease is of great clinical importance.Contrast-enhanced spectral mammography(CESM)combines iodine contrast with conventional mammography and shows the area of the contrast enhancement by obtaining low-energy and high-low-energy silhouettes with low-and high-energy uptake,respectively.In dense breasts,the background of normal breast tissue can be suppressed by dual-energy silhouettes and the interference of the background enhancement of normal glands can be reduced,which can be useful in the identification of benign and malignant diseases,measurement of tumor size,evaluation of the efficacy of neoadjuvant chemotherapy and high-risk screening of breast cancer.As an emerging technology,the application of CESM in breast imaging is still in the developmental stage.This article reviews the imaging principle,clinical application,current research status and application prospect of CESM,and compares the advantages and disadvantages of CESM with those of full-field digital mammography,breast contrast-enhanced MRI,and breast ultrasound.
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