Clinical Application of Multidetector Row Computed Tomography in Patient With Breast Cancer

Abstract

Although multidetector row computed tomography is not the primary method of evaluating breast cancer, it could be performed as an excellent alternative, especially in the presence of magnetic resonance contraindications. Moreover, computed tomography can still have an important role in evaluation of nodal status, thoracic invasion, and distant metastasis because of the large area covered in a single examination. Our experience together with literature indicates that multidetector row computed tomography is a powerful supplementary method for evaluation of patients with breast cancer.Key Words: breast, breast neoplasm, multidetector row computed tomography (J Comput Assist Tomogr 2008;32:583Y598) T he first use of computed tomography (CT) in patients with breast cancer had been reported in 1977, using specially designed CT.1,2 Since then, a few reports have described the use of standard CT body scanners for diagnosis of breast lesions and reported an increase of CT values after contrast enhancement.3Y5 However, the conventional CT has restrictively been used under specific circumstances, such as dense breast, visualizing lesions located adjacent to the chest wall, presence of metastatic axillary lymph node (LN), CT-guided biopsy or localization, and planning for radiotherapy, because of limitation due to radiation exposure. 5 In 1989, helical CT was developed, and it reduced the motion artifact, magnified contrast enhancement effect, and improved the quality of multiplanar reconstruction or 3-dimensional image.6Y8 Multidetector row CT (MDCT) was first clinically available in 1998. It can detect smaller lesion and produces more detailed information about the extent of breast cancer because of faster scanning, a wider area of scan coverage, and higher resolution of the volume data than single helical CT. However, very few studies are now going on about the preoperative evaluation and staging workup in patients with breast cancer using MDCT. Therefore, we present our various experiences of MDCT in breast cancers. SUBJECTS AND METHODS PatientsDuring a 4-year period between March 2003 and March 2007, a total of 144 women underwent MDCT at our institute. Subjects comprised 139 women with histologically proven primary breast cancer, 3 women who were clinically suspected of having a tumor recurrence, and 2 women who underwent CT-guided biopsy for suspicious lesions on breast magnetic resonance imaging (MRI).Because of the problem of radiation exposure, we carefully applied the indication for MDCT. We first restricted the application of MDCT examination to only preoperative patients with histologically proven breast cancer. Because CT is not the primary method of evaluating specific breast lesions, we did not perform MDCT to differentiate malignancy from benign breast lesion. At our hospital during the study period, 1509 women were clinically suspected of having breast cancer based on physical examination, mammography, or ultrasonography, and 637 of them were diagnosed as primary breast cancer by percutaneous...

Predictive Value of Preoperative Multidetector-Row Computed Tomography for Axillary Lymph Nodes Metastasis in Patients With Breast Cancer

“…They can scan large anatomic areas several times faster than single-detector helical CT scanners (18, 26). Moreover, through thinner collimation, MDCT markedly improves the spatial and time resolution of images acquired to detect lesions (18, 26, 27). Therefore, there is potential usefulness of MDCT as a method for accurate evaluation of ALN status.…”

“…MDCT can obtain high-quality multiplanar images in fast scan time and allow three-dimensional reconstruction (17). Furthermore, preoperative MDCT can be performed with the patient in the supine position, which facilitates simultaneous localization of the lesion, and evaluation of its extent, as well as examination of the skin, chest wall, and regional lymph nodes, including both axillae, internal mammary, and supraclavicular chains (5, 8, 18). However, preoperative MDCT for evaluating ALN status in patients with breast cancer remains under-investigated (18, 19).…”

Radiologic-Pathologic Correlation of Ductal Carcinoma in Situ

“…In a different study, in which the detectability of the intraductal component of invasive ductal carcinomas at multidetector CT was compared with that at MR imaging in the same patients, investigators found that the lesion detectability at multidetector CT (61%) was inferior to that at MR imaging (75%) (23). In general, CT has lower sensitivity but higher specificity than MR imaging because the lesion appearance leads to overestimation of fibrocystic changes at MR imaging (25).…”

Potential of the Non-Contrast-Enhanced Chest CT Radiomics to Distinguish Molecular Subtypes of Breast Cancer: A Retrospective Study

“…At present, it is not uncommon to use radiomics methods to predict the molecular subtypes of breast cancer, and many encouraging results have been obtained, most of which are based on the radiomics features of breast mammography, ultrasound, or MRI for model development and validation ( 9 – 11 ). CT also plays an important role in the clinical practice of breast cancer ( 12 ). Although most of the current guidelines do not recommend the utilization of chest CT as a routine examination for breast cancer diagnosis or early screening ( 13 , 14 ), in the actual diagnosis and treatment activities, because of the incidence of lung and bone metastasis in breast cancer patients, especially for patients with late clinical stage, chest CT is still one of the routine examinations in most patients.…”