ReviewInsights into imaging2019
Technique, protocols and adverse reactions for contrast-enhanced spectral mammography (CESM): a systematic review.
Review in Insights into imaging, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 74 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
74 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Diagnostic accuracy of contrast-enhanced spectral mammography for breast lesions: A systematic review and meta-analysis.Breast (Edinburgh, Scotland) · 2020Pooled it
- Cost-effectiveness of contrast-enhanced mammography compared to conventional imaging in the work-up after screening (RACER trial).European radiology · 2026Trial
- Added value of contrast-enhanced mammography (CEM) in staging of malignant breast lesions-a feasibility study.World journal of surgical oncology · 2020Trial
- Early, delayed, or combined contrast-enhanced mammography for detecting residual disease after neoadjuvant chemotherapy in breast cancer.European radiology · 2026Article
- ROI-Based Quantitative Analysis in Contrast-Enhanced Mammography: A Feasibility Study for Reproducible Enhancement Assessment.Diagnostics (Basel, Switzerland) · 2026Article
- Autologous fat transfer-related calcifications and enhancement on contrast-enhanced mammography mimicking malignancy.Radiology case reports · 2026Article
- Contrast-enhanced mammography in the setting of neoadjuvant therapy from a multidisciplinary perspective.Insights into imaging · 2026Review
- How to optimise breast cancer staging with contrast-enhanced mammography: current evidence and clinical implications.Insights into imaging · 2026Review
- Advances in Breast Cancer Diagnostics: From Screening to Precision Medicine.Diagnostics (Basel, Switzerland) · 2026Review
- Effectiveness of Contrast-Enhanced Spectral Mammography Following Contrast-Enhanced Computed Tomography in Breast Cancer Diagnosis.Diagnostics (Basel, Switzerland) · 2026Article
- Contrast-enhanced mammography-guided biopsy and localization: initial outcome and a single institution's experience.Quantitative imaging in medicine and surgery · 2026Article
- Comparative Analysis of Radiation Dose in Advanced X-Ray Mammographic Modalities and Evaluation of Potential Influencing Factors.The Indian journal of radiology & imaging · 2026Article
- Clinical Performance of Contrast-Enhanced Mammography Versus Breast MRI in Women at Increased Breast Cancer Risk.Cancers · 2026Article
- Revealing artifacts in contrast-enhanced mammography: prevalence and implications for diagnostic accuracy.Quantitative imaging in medicine and surgery · 2026Article
- RADS ALPHABET: news and tips for young and general radiologists.Insights into imaging · 2026Article
- Contrast-enhanced mammography-guided biopsy: principles, challenges, and opportunities.Insights into imaging · 2025Review
- Contrast-Enhanced Mammography: Advances, Challenges, and Case-Based Insights.Korean journal of radiology · 2025Review
- Deep learning in multi-modal breast cancer data fusion: a literature review.Quantitative imaging in medicine and surgery · 2025Review
- 조영증강 유방촬영술: 현재의 임상적 활용과 미래 방향에 대한 종합적 고찰.Journal of the Korean Society of Radiology · 2025Review
- Contrast-enhanced mammography: a success story with open issues and fascinating perspectives.European radiology · 2025Article
14 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We reviewed technical parameters, acquisition protocols and adverse reactions (ARs) for contrast-enhanced spectral mammography (CESM). A systematic search in databases, including MEDLINE/EMBASE, was performed to extract publication year, country of origin, study design; patients; mammography unit/vendor, radiation dose, low-/high-energy tube voltage; contrast molecule, concentration and dose; injection modality, ARs and acquisition delay; order of views; examination time. Of 120 retrieved articles, 84 were included from 22 countries (September 2003-January 2019), totalling 14012 patients. Design was prospective in 44/84 studies (52%); in 70/84 articles (83%), a General Electric unit with factory-set kVp was used. Per-view average glandular dose, reported in 12/84 studies (14%), ranged 0.43-2.65 mGy. Contrast type/concentration was reported in 79/84 studies (94%), with Iohexol 350 mgI/mL mostly used (25/79, 32%), dose and flow rate in 72/84 (86%), with 1.5 mL/kg dose at 3 mL/s in 62/72 studies (86%). Injection was described in 69/84 articles (82%), automated in 59/69 (85%), manual in 10/69 (15%) and flush in 35/84 (42%), with 10-30 mL dose in 19/35 (54%). An examination time < 10 min was reported in 65/84 studies (77%), 120 s acquisition delay in 65/84 (77%) and order of views in 42/84 (50%) studies, beginning with the craniocaudal view of the non-suspected breast in 7/42 (17%). Thirty ARs were reported by 14/84 (17%) studies (26 mild, 3 moderate, 1 severe non-fatal) with a pooled rate of 0.82% (fixed-effect model). Only half of CESM studies were prospective; factory-set kVp, contrast 1.5 mL/kg at 3 mL/s and 120 s acquisition delay were mostly used; only 1 severe AR was reported. CESM protocol standardisation is advisable.
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