Tag: contrast-enhanced mammography

Breast Imaging 2025–26: Risk Models, CEM/MRI Momentum — RSNA Preview

RSNA 2025 is putting real energy behind risk-adjusted screening and the evolving roles of contrast-enhanced mammography (CEM) and breast MRI. For breast programs, the takeaway is practical: risk tools are moving from the research poster to the reading room, and CEM/MRI decisions are becoming operational levers you can plan around—especially for dense-breast pathways and overflow routing to subspecialists.

What’s new at RSNA: risk from the image itself

RSNA’s breast-imaging preview highlights sessions on image-only, 5-year breast cancer risk models, external validation work, and how MRI adds value in multi-modal AI. It also calls out global screening updates and a deeper look at background parenchymal enhancement (BPE) on MRI. RSNA

In parallel, the FDA granted De Novo authorization to the first image-only AI risk platform that predicts 5-year risk directly from a screening mammogram—an inflection point that makes risk-adjusted pathways far more scalable. Coverage from Radiology Business and BCRF explains the authorization and clinical intent. Radiology Business

Why it matters: average-risk guidance in the U.S. now begins screening at age 40 (USPSTF, 2024). Programs can layer image-based risk on top of that baseline to triage who needs annual vs. short-interval follow-up and who merits supplemental imaging. USPSTF

CEM is earning a seat next to MRI

Expect exhibits and sessions positioning CEM as a cost-effective, accessible adjunct—particularly for dense-breast populations and diagnostic workups. RSNA News recently framed CEM as a practical alternative to MRI in some screening/diagnostic scenarios, and new peer-review literature is refining technique (e.g., lower volume/higher-iodine contrast while preserving diagnostic performance). RSNA

On outcomes, the RACER trial in The Lancet Regional Health – Europe reported that using CEM as primary imaging for recalled women improved the accuracy and efficiency of the work-up compared with conventional imaging—evidence that will influence protocols beyond the show floor. The Lancet

MRI still leads for sensitivity—BPE is your underused signal

Breast MRI remains the sensitivity champion for high-risk patients and for problem solving. This year’s RSNA content spotlights BPE—how the level of background enhancement relates to tumor biology and outcomes. Recent reviews (2024–2025) synthesize BPE’s predictive/prognostic value, including associations with pathologic complete response after neoadjuvant therapy and survival in certain subtypes. SpringerLink

Practical move: standardize how you document BPE and incorporate it into structured reports and risk conferences; it’s becoming more than a descriptive footnote.

What to ask vendors at RSNA

  1. Risk engine proof: “Show external validation and calibration plots by density and race; how does your image-only model integrate into our mammography worklist and letters?”
  2. CEM logistics: “Demonstrate CEM acquisition workflows, contrast protocols, and how your viewer handles subtraction/kinetics alongside priors.”
  3. MRI + BPE analytics: “Can we standardize BPE capture in structured reports and trend it across treatment?”

As risk-first screening, CEM, and MRI gain real traction, the winners will be the programs that operationalize them quickly and consistently. If you’re planning your 2026 breast-imaging playbook, stop by Vesta at RSNA to see how our subspecialists, standardized templates, and overflow routing make risk-adjusted pathways usable on day one.

What’s New in Breast Density and Mammography: Fall 2025 Update

Why breast density remains a frontline issue

Breast density continues to be one of the most important—and complex—factors in breast cancer screening. Dense breast tissue not only raises cancer risk but also makes abnormalities harder to detect on mammograms. For hospitals and imaging centers, keeping up with evolving regulations, trial data, and technology is no longer optional. It’s central to compliance, patient communication, and imaging strategy.

FDA updates the national reporting standard

In July 2025, the FDA approved changes to the breast density reporting standard under the Mammography Quality Standards Act (MQSA). This builds on the September 2024 rule requiring that all mammography reports inform patients whether their breasts are “dense” or “not dense.”

Hospitals should review their reporting templates now. The updated language affects how results must be communicated to both patients and referring clinicians. Staying compliant avoids liability and ensures consistent, patient-friendly communication across facilities.

Doctors reviewing breast density mammogram results for Fall 2025 hospital updates.New trial evidence favors MRI and contrast-enhanced mammography

The interim results of the BRAID trial in the U.K. made headlines this summer. Among women with dense breasts and negative mammograms, supplemental abbreviated MRI and contrast-enhanced mammography (CEM) identified significantly more invasive cancers than ultrasound.

  • MRI and CEM: ~15–19 extra cancers detected per 1,000 women screened
  • Ultrasound: ~4 extra cancers detected per 1,000

These findings were reported in the OBG Project’s summary of the BRAID interim results.

While recalls and contrast risks remain a concern, the data strengthen the case for offering advanced supplemental imaging in high-density populations. Hospitals may want to begin planning how to integrate MRI or CEM into workflow, or establish referral pathways for patients with very dense breasts.

MBI joins the conversation

Molecular breast imaging (MBI), when paired with digital breast tomosynthesis, is showing early promise in improving invasive cancer detection in women with dense breasts. Findings from the Density MATTERS trial highlight MBI as a potential alternative for hospitals with limited MRI or CEM capacity.

AI-enabled density assessment and multimodal risk stratification

Artificial intelligence tools are advancing rapidly in breast imaging. A recent clinical study demonstrated that multimodal AI systems can reduce recall rates by over 30% while maintaining sensitivity. Other work shows promise in improving density quantification and developing 5-year breast cancer risk models from imaging features.

Hospitals considering AI adoption should focus on how these tools can streamline workflow, support compliance, and reduce unnecessary patient callbacks.

Shifting clinical culture: from notification to action

At the 2025 Society of Breast Imaging annual meeting, a clear theme emerged: simply notifying patients about dense breast status is not enough. The expectation is shifting toward offering supplemental imaging or providing clear, individualized next steps.

Hospitals that rely on tomosynthesis alone may increasingly be asked to justify why they do not offer MRI, CEM, or other supplemental options.

Key takeaways for hospitals and imaging centers

  • Compliance check: Ensure your reporting language matches the updated FDA standard.
  • Workflow planning: Prepare for increased demand for supplemental imaging in dense-breast populations.
  • Technology assessment: Evaluate the role of MRI, CEM, MBI, and AI tools in your facility.
  • Patient communication: Move beyond dense-breast notification toward structured shared decision-making.
  • Equity focus: Consider insurance coverage and access barriers that could affect your patient population.

Hospitals that adapt now will not only stay compliant but also lead in patient-centered breast cancer screening strategies.