Use of low-energy contrast-enhanced spectral mammography (CESM) as diagnostic mammography-proof of concept

•Proof of same contrast detail resolution of low-energy CESM compared to FFDM.•Suspicious mammographic findings can be displayed similarly with low-energy CESM and FFDM.•This proof-of-concept study shows feasibility to use of low-energy CESM as diagnostic mammography.•Diagnostic use of CESM can reduce radiation exposure of the breast by avoiding redundant exams.