The new horizons of advanced imaging, especially in oncology, will increasingly have to consider not only the aspect of diagnostic efficacy but also that of energy and biological sustainability for patients. This study represents a first approach in the evaluation of energetically and biologically sustainable diagnostic lines for patients with MBC, in particular, important results were highlighted as described below:

1. Reduction of electricity consumption and CO₂ emissions by -55% per patient with DL2 vs DL1 and a reduction of electricity consumption and CO₂ emissions by 7% per patient with DL1 vs DL3.
2. DL1 highlights complete absence of radiant dose to the patient instead of DL2 and DL3.
3. DL1 doesn’t need for contrast medium in the compared to the conventional one (DL3).

These results emphasise the importance of searching for the best and innovative diagnostic lines to balance diagnostic efficacy with energy and biological sustainability that could help not only radiology departments to become greener, but also the patients who would be ensured quality and sustainable care.