Ability of Dual-Energy CT to Detect Silicone Gel Breast Implant Rupture and Nodal Silicone Spread

Glazebrook, Katrina N.; Doerge, Stefan; Leng, Shuai; Drees, Tammy A.; Hunt, Katie N.; Zingula, Shannon N.; Pruthi, Sandhya; Geske, Jennifer R.; Carter, Rickey E.; Fletcher, Joel G.

doi:10.2214/ajr.18.20138

Cited by 21 publications

(16 citation statements)

References 25 publications

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“…nZ eff is a quantitative indicator of the compound atom of a compound or a mixture of various materials. A previous study [32] demonstrated that DECT allowed the confident evaluation of silicone within breast soft tissues in reconstructed images. However, the clinical significance of nZ eff applied to tumors is not clear.…”

Section: Discussionmentioning

confidence: 99%

Dual-energy CT quantitative parameters for evaluating Immunohistochemical biomarkers of invasive breast cancer

et al. 2021

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Background Estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) and Ki67 are the most useful immunohistochemical biomarkers of invasive breast cancer. The purpose of this study is to investigate the possibility of quantitative parameters derived from dual-energy CT (DECT) to discriminate immunohistochemical biomarkers of invasive breast cancer. Methods This prospective study enrolled 120 patients with invasive breast cancer who underwent preoperative contrast-enhanced DECT for staging purposes from June 2019 to January 2020. DECT quantitative parameters, including normalized iodine concentration (NIC), the slope of the spectral Hounsfield unit curve (λHu), and the normalized effective atomic number (nZeff), were obtained from reconstructed images. DECT quantitative parameters were compared with the expression status, and the correlations with the value of immunohistochemical biomarkers were evaluated. Inter-observer reproducibility analysis was performed to assess the measurement reproducibility of quantitative parameters. The diagnostic performance of the quantitative parameters was analyzed by receiver operating characteristic curve. Results The ER-negative group tended to display higher venous phase NIC and nZeff compared with the ER-positive group (individually, p = 0.003, 0.011; area under the curve [AUC] of 0.65, 0.60). The PR-negative group demonstrated higher arterial and venous phase NIC compared with the PR-positive group (individually, p = 0.022, 0.005; AUC of 0.63, 0.65). NIC was correlated negatively with the value of ER and PR expression (r = − 0.175 ~ − 0.265, p = 0.002 ~ 0.042). The HER2-positive group tended to display higher venous phase nZeff than the HER2-negative group (p = 0.022; AUC of 0.59). The Ki67 high-proliferation group demonstrated higher arterial phase, venous phase NIC and nZeff than the Ki67 low-proliferation group (p < 0.001 ~ 0.005; AUC of 0.67 ~ 0.75). Both the NIC and nZeff were correlated positively with the value of Ki67 (r = 0.240 ~ 0.490, p < 0.001 ~ 0.014). Conclusions NIC and nZeff derived from DECT could be used to discriminate expression status and may associate with the value of immunohistochemical biomarkers of invasive breast cancer.

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Section: Discussionmentioning

confidence: 99%

Dual-energy CT quantitative parameters for evaluating Immunohistochemical biomarkers of invasive breast cancer

et al. 2021

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“…The potential of dual-energy CT in the assessment of implant integrity has been shown in the literature. [ 37 , 38 ] The linguine sign, [ 13 ] which represents the collapsed implant shell in the gel showing a high sensitivity and specificity for an intracapsular rupture, [ 39 ] was identified with the B-CT, in spite of the single energy spectrum applied.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of a spiral breast computed tomography system equipped with photon counting detector technology in patients with implants

Ruby

Shim²,

Berger³

et al. 2020

Medicine

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To evaluate the value of a breast computed tomography (CT) (B-CT) in assessing breast density, pathologies and implant integrity in women with breast implants. This retrospective study was approved by the local ethics committee. B-CT images of 21 women with implants (silicone/saline; 20 bilateral, 1 unilateral) who underwent opportunistic screening or diagnostic bilateral B-CT were included. Breast density, implant integrity, extensive capsular fibrosis, soft tissue lesions and micro-/macrocalcifications were rated. In 18 of the 21 women, an additional ultrasound and in two patients breast magnetic resonance imaging was available for comparison. The average dose was calculated for each breast using verified Monte Carlo simulations on 3D image data sets. Breast density was nearly completely fatty (ACR a) in two patients, scattered fibroglandular (ACR b) in five, heterogeneously dense (ACR c) in ten and very dense (ACR d) in four women. In three women showed a unilateral positive Linguine sign indicative of an inner capsule rupture. Extensive capsular fibrosis was found in three women. In three women, soft tissue lesions were depicted, which revealed to be cysts (n = 2) and lymph nodes (n = 1) on subsequent sonography. Diffuse, non-clustered microcalcifications were found in nine women. Eleven women showed cutaneous or intramammary macrocalcifications. Average dose was 6.45 mGy (range 5.81–7.28 mGy). In women with implants, B-CT presents a promising modality for evaluating breast density, implant integrity, extensive capsular fibrosis, soft tissue lesions and micro-/macrocalcifications without the need of breast compression utilizing a lower dose compared to doses reported for conventional four-view mammography.

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“…Instead, CT can reliably identify and track growth of these lymph nodes, however is not specific for silicone 1 . Silicone‐specific MRI can also be used to characterise these nodes, although it may not exhibit high signal if nodes are variably infiltrated 3,4 . PET‐CT is not particularly useful as inflammatory cells such as foreign‐body giant cells have enhanced glycolysis, showing increased FDG uptake that can be mistaken for malignant tissue 5 .…”

Section: Figmentioning

confidence: 99%

“…PET‐CT is not particularly useful as inflammatory cells such as foreign‐body giant cells have enhanced glycolysis, showing increased FDG uptake that can be mistaken for malignant tissue 5 . Lastly, dual‐energy CT (DECT) shows promise, with superior visualisation of IM nodes without the poor water suppression and cardiac ghosting found on MRI 4 …”

Section: Figmentioning

confidence: 99%

Enlarging internal mammary silicone lymphadenopathy mimicking breast metastases

Kam

Mehta

et al. 2020

J Med Imag Rad Onc

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Ability of Dual-Energy CT to Detect Silicone Gel Breast Implant Rupture and Nodal Silicone Spread

Cited by 21 publications

References 25 publications

Dual-energy CT quantitative parameters for evaluating Immunohistochemical biomarkers of invasive breast cancer

Dual-energy CT quantitative parameters for evaluating Immunohistochemical biomarkers of invasive breast cancer

Diagnostic value of a spiral breast computed tomography system equipped with photon counting detector technology in patients with implants

Enlarging internal mammary silicone lymphadenopathy mimicking breast metastases

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