MDCT of the Breast

Perrone, Anna; Mele, Luigi; Sassi, Simona; Marini, Massimo; Testaverde, Lorenzo; Izzo, Luciano; Marini, Mario

doi:10.2214/ajr.07.3145

Cited by 34 publications

(26 citation statements)

References 24 publications

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“…In 2009, approximately 190,000 new cases of breast cancer were diagnosed in the United States and over 40,000 women died of the disease [ 8 ] ; the incidence in Europe is 94.3 per 100,000 women [ 9 ] . While mammography is the most efficient way to screen for primary breast cancers, the ability to spot primary breast lesions and metastases on routine CT scans is important, as this may lead to a diagnosis before the patient would have otherwise come to medical attention [ 10 ] , and improve the accuracy of staging for patients with a breast cancer diagnosis.…”

Section: Breast Cancermentioning

confidence: 99%

Blind spots at oncological CT: lessons learned from PET/CT

Esses¹,

Yeframov²,

Bernstine³

et al. 2012

Cancer Imaging

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Improved accuracy in oncological computed tomography (CT) could lead to a decrease in morbidity and improved survival for oncology patients. Visualization of metabolic activity using the glucose analogue [18F]fluorodeoxyglucose (FDG) in combination with the high anatomic resolution of CT in an integrated positron emission tomography (PET)/CT examination has the highest sensitivity and specificity for the detection of primary and metastatic lesions. However, PET/CT costs are high and patient access is limited; thus CT remains the primary imaging modality in oncology patients. We have noted that subtle lesions are more easily detected on CT by radiologists with PET/CT experience. We aimed to provide a brief review of the literature with comparisons of multi-detector computed tomography (MDCT) and PET/CT in primary and metastatic disease with an emphasis on findings that may be overlooked on MDCT in cancer of the breast, lung, colon, and ovaries, and in melanoma, as well as thrombosis in oncology patients. We further reviewed our experience for illustrative comparisons of PET/CT and MDCT studies. Experience in interpreting conventional CT scans alongside PET/CT can help the reader develop an appreciation for the subtle appearance of some lesions on CT that might otherwise be missed. This could improve detection rates, reduce errors, and improve patient management.

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Section: Breast Cancermentioning

confidence: 99%

Blind spots at oncological CT: lessons learned from PET/CT

Esses¹,

Yeframov²,

Bernstine³

et al. 2012

Cancer Imaging

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“…▪ Inoue M et al conducted MDCT examinations using a comparable protocol in 149 patients with suspicion of a breast carcinoma [14]. All 173 detected breast lesions were histologically verified.…”

Section: Discussionmentioning

confidence: 99%

“…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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“…Recognized side effects of these procedures include nipple deformity, necrosis, and periareolar anesthesia in some cases (20%) (21)(22)(23) . There are many advanced studies and investigations for early detection of breast carcinoma, but all the investigations carry a certain percentage of false negative results in detecting early breast carcinoma, even advanced investigations like MR imaging with different contrast materials are not 100% accurate in excluding early breast carcinoma (23)(24)(25)(26)(27)(28)(29)(30)(31)(32) and this support the advice of this study treating older patients with ductectasia (when breastfeeding is not anticipated) by surgical excision of the major lactiferous ducts (Hadfield operation), in trial to find coexistent ductal carcinoma in situ that may not be detected by mammography nor by ultrasound study of the breast. This study concluded that conservative management of ductectasia of the breast by antibiotics does not relief symptoms.…”

Section: Discussionmentioning

confidence: 99%