Breast imaging in pregnancy and lactation, and spectral CT sorts accessory spleen from pancreatic tumour on a single phase

The edition in brief

A RadioGraphics review of breast imaging in pregnant and lactating women notes that more women now need screening or diagnosis at these times because of later childbearing and earlier identification of hereditary risk. Mammography is safe but less sensitive because of hormonal density changes; ultrasound is the main tool for symptoms, though its screening role is unproven; MRI is contraindicated in pregnancy but can be used during lactation for high-risk screening or staging. Prompt work-up of symptoms matters because pregnancy-associated breast cancer is rising and delays are common. In 85 patients with hypervascular pancreatic lesions on portal venous phase spectral CT, lesion-to-spleen ratios on iodine density and effective atomic number maps reached AUCs of 0.96 to 0.99 for intrapancreatic accessory spleen, and adding spectral images raised readers' pooled accuracy from 60.7% to 88.1%. The American College of Radiology issued Appropriateness Criteria for suspected diaphragm dysfunction, emphasising real-time assessment of diaphragm movement to confirm the diagnosis and imaging to look for a cause. ASCO's updated breast cancer surveillance guideline, published in July, recommends regular history, examination and mammography, allows virtual or in-person visits, and reserves closer surveillance for those at high risk of recurrence. The pearl: a raised hemidiaphragm on a chest film is a finding to compare and explain, not just report.