Contrast Agents in Breast MRI (Journal Article)

Filippo Pesapane; Adriana Sorce; Ottavia Battaglia; Carmen Mallardi; Luca Nicosia; Luciano Mariano; Anna Rotili; Valeria Dominelli; Silvia Penco; Francesca Priolo; Gianpaolo Carrafiello; and Enrico Cassano

ABSTRACT

Contrast-enhanced breast MRI (CE-MRI) is an important tool for diagnosing and managing patients with breast cancer. It is most often used to determine how far the cancer has spread locally, to screen high-risk patients, monitor treatment response, and assess any issues with breast implants. Gadolinium (Gd)-based contrast agents (GBCAs) improve MRI quality by making tumors easier to identify and showing structural details and blood-flow changes linked to tumor growth. CE-MRI also has some limitations, including high cost, limited availability, longer scan times, and concerns regarding the retention of Gd in the body. As a result, safer and more effective contrast agents are being developed, and new imaging methods, including dynamic CE-MRI and diffusion-weighted imaging, have improved staging accuracy and treatment planning. Developing and employing abbreviated breast MRI protocols is also ongoing, which are designed to reduce imaging costs and scan time, making breast MRI more accessible to all. This course will review breast MRI imaging protocols and strategies, dynamic contrast-enhanced MRI, and abbreviated breast MRI protocols, as well as provide a detailed review of current and new GBCAs used in breast CE-MRI, as well as the benefits and drawbacks.

EDITORIAL NOTE: This article is an Open Access article reused under the terms and conditions of the Creative Commons Attribution (CC BY) license 4.0 (https://creativecommons.org/licenses/by/4.0/).

Original publication: Pesapane F, Sorce A, Battaglia O, et al. Contrast agents in breast MRI: state of the art and future perspectives. Biomedicines. 2025;13:829.