<b>Dynamic Multidetector CT of Breast Tumors:</b> Diagnostic Features and Comparison with Conventional Techniques

Inoue, Masatoshi; Sano, Toshiko; Watai, Ryousuke; Ashikaga, Ryuuichirou; Ueda, Kazuki; Watatani, Masahiro; Nishimura, Yasumasa

doi:10.2214/ajr.181.3.1810679

Cited by 83 publications

(82 citation statements)

References 24 publications

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“…In our study, the total calculated radiation dose of one CT examination ranged from 9.5 to 13.5 mGy because the CTDI vol ranged from 3.1 to 4.5 mGy for each breath-hold acquisition. The radiation dose of our technique was markedly lower than that of previous studies [26,30], although it was three to four times higher than that received during standard two-view mammography.…”

Section: Mdct Of Whole-breast Vascularitymentioning

confidence: 59%

“…Therefore, CT could be an excellent alternative, particularly in the presence of MRI contraindications. Furthermore, MDCT has some advantages [25][26][27]: The patient can be supine, thus allowing surgical simulation for breast conservation using a 3D display; MDCT permits access to the lung, thoracic wall, lymph nodes, liver, and bones in a single study and simultaneous scanning of both breasts, which allows comparison of the affected breast with the contralateral breast; and MDCT allows an easier approach to imaging-guided needle aspiration and hookwire localization. In addition, because the surrounding fat appears as low density, iodinated contrast enhancement of the breast tumor is easily recognized with proper window width and level settings without using a subtraction technique or fat suppression [27].…”

Section: Discussionmentioning

confidence: 99%

“…Many signs of malignancy have been described by CT of the breast. Inoue et al [26] first reported the diagnostic features of breast cancer on MDCT, and they included irregular margins, irregular shape, and rim enhancement. Other findings on CT suggestive of malignancy included thickening of overlying skin, presence of axillary lymph node enlargement, invasion of the pectoralis muscle, and pleural effusion [28].…”

Section: Mdct Of Whole-breast Vascularitymentioning

confidence: 99%

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Correlation of Whole-Breast Vascularity with Ipsilateral Breast Cancers Using Contrast-Enhanced MDCT

Kang

Kim

et al. 2008

American Journal of Roentgenology

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ing tumor. However, vascularity can increase not only within a breast cancer lesion but also in the ipsilateral breast as a whole. Recently, some studies have estimated whole-breast vascularity by laser Doppler perfusion imaging [15], PET [16], and MRI [17][18][19] and found an association between breast cancer and an ipsilateral increase of blood flow.Although contrast-enhanced CT of the breast has been used for assessment of axillary lymph node metastasis [20,21], diagnosis of local recurrence after breast-conserving surgery [22], or imaging intraductal extension of breast cancer preoperatively [23], it can also show tumor vascularity. Especially, MDCT can display high-quality angiographic images because of improved temporal and spatial resolution. However, to the best of our knowledge, there has been no study on imaging vascularity of breast cancer using con- AJR 2008; 190:496-504 0361-803X/08/1902-496 © American Roentgen Ray Society A ngiogenesis (also known as neovascularization) is the formation of new capillaries from the existing vascular network [1]. Because vascular blood flow provides nutrients for tumor growth and a mechanism for hematogenous spread of malignant cells [2,3], tumor angiogenesis has been reported to be an independent prognostic indicator in breast cancer [4][5][6][7][8]. Although tumor vasculature has mostly been investigated by immunohistochemical methods using factor VIII staining of endothelial cells to determine microvessel density (MVD) [9,10], this invasive method is difficult to reproduce and standardize [11]. Many imaging angiogenesis methods in vivo have recently been developed, including color Doppler sonography [12] and contrast-enhanced MRI [13,14], and most of them have focused on measurement of angiogenesis in the immediate vicinity of the grow- OBJECTIVE. The purpose of our study was to assess the increase in whole-breast vascularity in patients with unilateral breast cancer and correlate that increase with prognostic factors of breast cancer. Wo m e n's I m ag i ng • O r ig i n a l R e s e a rc h MATERIALS AND METHODS.We performed 16-MDCT on 143 consecutive patients with histologically confirmed breast cancer. One hundred three of these 143 patients were finally enrolled in the study after exclusion of patients with bilateral breast cancer, previous history of neoadjuvant chemotherapy, breast surgery, or lack of surgical confirmation. Breast vascularity was assessed according to the number, length, and conspicuity of vessels on maximum-intensity-projection images. Increase of whole-breast vascularity of the cancer-bearing breast was categorized as not increased, mild, moderate, or prominent compared with the contralateral breast. Breast vascularity was then correlated to prognostic factors including tumor size, lymph node status, cancer stage, nuclear and histologic grade, presence of an extensive intraductal component, presence of hormone receptors, and expression of C-erb-B2.RESULTS. In 77 (74.8%) of 103 patients, breast cancers were found to be associated with i...

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Section: Mdct Of Whole-breast Vascularitymentioning

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Section: Mdct Of Whole-breast Vascularitymentioning

confidence: 99%

See 1 more Smart Citation

Correlation of Whole-Breast Vascularity with Ipsilateral Breast Cancers Using Contrast-Enhanced MDCT

Kang

Kim

et al. 2008

American Journal of Roentgenology

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“…The potential of CT in diagnostic imaging of the breast shown by Uematsu T et al [13], Perrone A. et al [15], and Inoue M et al [14] is taken into consideration in the current development of CT systems specifically designed for breast examinations. The first dedicated CT systems for the breast are currently being introduced by 2 companies (Koning Corporation, New York, USA; CT Imaging GmbH, Erlangen, Germany).…”

Section: Discussionmentioning

confidence: 99%

Focal Breast Lesions in Clinical CT Examinations of the Chest: A Retrospective Analysis

Krug

Houbois

Grinstein

et al. 2017

Fortschr Röntgenstr

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ABSTR AC TPurpose Based on radiological reports, the percentage of breast cancers visualized as incidental findings in routine CT examinations is estimated at ≤ 2 %. In view of the rising number of CT examinations and the high prevalence of breast cancer, it was the goal of the present study to verify the frequency and image morphology of false-negative senological CT findings. Materials and MethodsAll first contrast-enhanced CT examinations of the chest in adult female patients carried out in 2012 were retrospectively included. A senior radiologist systematically assessed the presence of breast lesions on all CT images using the BI-RADS system. All BI-RADS ≥ 3 notations were evaluated by a second senior radiologist. A consensus was obtained in case of differing BI-RADS assessments.Reference diagnoses were elaborated based on all available clinical, radiological and pathological data. The findings of the CT reports were classified according to the BI-RADS system and were compared with the retrospective consensus findings as well as with the reference diagnoses. ResultsThe range of indications comprised a broad spectrum including staging and follow-up examinations of solid tumors/lymphoma (N = 701, 59.9 %) and vascular (190,16.2 %), inflammatory (48, 4.1 %) and pulmonologic (22, 1.9 %) issues. BI-RADS 1/2 classifications were present in 92.5 % and BI-RADS 6 classifications were assessed in 1.7 % of the 1170 included examinations. 68 patients (5.8 %) had at least one lesion retrospectively classified as BI-RADS 3 -5. The histological potential was known in 57 of these lesions as benign (46, 3.9 %) or malignant (11, 0.9 %). 13 BI-RADS 4/5 consensus assessments (1.1 %) were false-positive. 2 of the 10 lesions classified as being malignant based on the further clinical and radiological course were not mentioned in the written CT reports (0.2 %). Both false-negative CT reports were therapeutically and prognostically irrelevant. ConclusionThe relative frequency of BI-RADS 3 -5 findings was 5.8 %. It reflects the situation encountered in clinical imaging for primarily non-senologic questions and therefore differs from what would be expected in a dedicated screening program. The rates of known false-positive BI-RADS 4/5 findings in the retrospective evaluations (1.1 %) and of false-negative findings in the written CT reports (0.2 %) reflect the different diagnostic approaches of image-based senological screening and radiological examinations indicated in order to solve clinical problems not primarily concerning the breast region. Statements regarding the prevalence of clinically occult breast cancers can only be made with caution in the presented, highly selective group of patients due to the often incomplete visualization of breast tissue and the retrospective approach. Key points▪ Intramammary mass and non-mass lesions needing clarification may be present in up to 5.8 % of all contrast enhanced CT-examinations of the female chest. ▪ Irregular forms, unscharp/spiculated margins, inhomogeneous matrices and a pronounced c...

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“…Since an MDCT scan provides improved contrast resolution, a larger field of view, and has cross sectional capability, breast lesions may be viewed more easily with a MDCT scan (1,5,6).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Significance of Incidental Breast Lesions Detected by Chest CT

Kim

Chang

Hwang

et al. 2013

J Korean Soc Radiol

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Dynamic Multidetector CT of Breast Tumors: Diagnostic Features and Comparison with Conventional Techniques

Abstract: The features revealed on MDCT can help to distinguish benign lesions from carcinomas. MDCT can add to the data obtained with mammography or sonography in patients with suspected breast tumors.

Cited by 83 publications

References 24 publications

Correlation of Whole-Breast Vascularity with Ipsilateral Breast Cancers Using Contrast-Enhanced MDCT

Correlation of Whole-Breast Vascularity with Ipsilateral Breast Cancers Using Contrast-Enhanced MDCT

Focal Breast Lesions in Clinical CT Examinations of the Chest: A Retrospective Analysis

Evaluation of the Significance of Incidental Breast Lesions Detected by Chest CT

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