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Breast cancer imaging without gadolinium-based contrast agent: A review of current applications and future trends - 28/01/26

Doi : 10.1016/j.diii.2025.10.004 
Maya Honda a, , Mami Iima b, Masako Kataoka a, Daiju Ueda c, Tsukasa Saida d, Kentaro Nishioka e, Ryo Kurokawa f, Satoru Ide g, Masahiro Yanagawa h, Tadashi Watabe h, Kenji Hirata i, Rintaro Ito j, Seitaro Oda k, Koji Takumi l, Mariko Kawamura m, Shunsuke Sugawara n, Keitaro Sofue o, Akihiko Sakata p, Shinji Naganawa m
a Preemptive Medicine and Lifestyle-related Disease Research Center, Kyoto University Hospital, Kyoto 606-8507, Japan 
b Department of Fundamental Development for Advanced Low Invasive Diagnostic Imaging, Nagoya University Graduate, School of Medicine, Nagoya 466-8550, Japan 
c Department of Artificial Intelligence, Graduate School of Medicine, Osaka Metropolitan University, Osaka 545-8585, Japan 
d Department of Radiology, Institute of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan 
e Radiation Oncology Division, Global Center for Biomedical Science and Engineering, Faculty of Medicine, Hokkaido University, Sapporo 060-0808, Japan 
f Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan 
g Department of Radiology, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan 
h Department of Diagnostic and Interventional Radiology, The University of Osaka, Graduate School of Medicine, Suita 565-0871, Japan 
i Department of Diagnostic Imaging, Graduate School of Medicine, Hokkaido University, Sapporo 060-8648, Japan 
j Department of Innovative BioMedical Visualization, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan 
k Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan 
l Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8520, Japan 
m Department of Radiology, Nagoya University Graduate, School of Medicine, Ngoya 466-8550, Japan 
n Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo 104-0045, Japan 
o Department of Radiology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan 
p Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan 

Corresponding author.

Highlight

Imaging of the breast without gadolinium-based contrast agent addresses safety and sustainability.
Advanced imaging enables detailed non-contrast evaluation of breast tumors.
Novel tracers in molecular imaging allow for noninvasive breast tumor profiling.

Il testo completo di questo articolo è disponibile in PDF.

Abstract

Dynamic contrast-enhanced magnetic resonance imaging remains a cornerstone of breast cancer diagnosis, yet concerns regarding the safety, environmental impact, and cost of gadolinium-based contrast agents are driving the development of gadolinium-based contrast agent-free alternatives. This review outlines emerging non-contrast imaging modalities that support a more sustainable approach to breast cancer diagnosis. Advanced MRI techniques, such as diffusion-weighted imaging and synthetic MRI, provide detailed tissue characterization without the need for contrast agents. In computed tomography (CT), innovations including dual-energy CT and photon-counting detector CT are improving lesion detection and characterization, with photon-counting detector CT offering exceptional spatial resolution. Molecular imaging with positron emission tomography is also advancing beyond 18 F-fluorodeoxyglucose, incorporating dedicated high-resolution systems and novel tracers targeting specific biomarkers, such as 16α- 18 F-fluoro-17β-estradiol for estrogen receptors, fibroblast activation protein inhibitors, and human epidermal growth factor receptor 2–targeted agents. The future of breast imaging is likely to adopt a multimodal strategy, combining these innovations to deliver more accurate, personalized, and sustainable patient care.

Il testo completo di questo articolo è disponibile in PDF.

Keywords : Breast neoplasms, Computed tomography, Gadolinium-based contrast agent, Magnetic resonance imaging, Positron emission tomography

Abbreviations : ADC, BI-RADS, CT, dbPET, DCE, DECT, DKI, DWI, ER, FAPI, FDG, FES, GBAC, HER2, IVIM, MRI, PCD-CT, PET, SiPM, SUV, VMI


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P. 51-61 - febbraio 2026 Ritorno al numero
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