Possibility to discriminate benign from malignant breast lesions detected on dual-layer spectral CT-evaluation

Şimşir, Begüm Demirler; Krug, Kathrin Barbara; Burke, Christina; Hellmich, Martin; Maintz, David; Coche, Emmanuel

doi:10.1016/j.ejrad.2021.109832

Cited by 8 publications

(9 citation statements)

References 23 publications

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“…In the current study, the ROIs were drawn on the solid portion of tumors based on 40 keV images, which can improve the accuracy of the segmentation. Although spectral CT selective quantification has been evaluated in other body regions ( 38 ), it has not been used in breast cancer for this particular purpose but instead for prediction of locoregional stage ( 39 ), nature of breast masses ( 40 ), and distant metastases ( 15 ).…”

Section: Discussionmentioning

confidence: 99%

“…Two experienced radiologists (LL and FZ) with 8 years and 15 years of experience in breast and chest radiology, respectively, who were blinded to the correlative clinical data and ALN pathologic status, independently performed the measurements using viewer software on an AW 4.6 workstation. Spectral parameters were measured by placing a region of interest (ROI), which encompassed the entire mass on VPs, including CT values of monochromatic images (40,50,60, and 70 keV), the iodine concentration, and the effective atomic number of tumors. The normalized iodine concentration was defined as the iodine concentration of the mass divided by the iodine concentration of the aorta.…”

Section: Quantitative Spectral Ct Parameters Of Breast Massesmentioning

confidence: 99%

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Iodine map histogram metrics in early-stage breast cancer: prediction of axillary lymph node metastasis status

Zeng¹,

Chen²,

Lin³

et al. 2022

Quant Imaging Med Surg

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Background: Variations in axillary lymph node (ALN) metastatic potential between different breast cancers lead to microscopical alterations in tumor perfusion heterogeneity. This study investigated the usefulness of histogram metrics from iodine maps in the preoperative diagnosis of metastatic ALNs in patients with earlystage breast cancer.Methods: Between October 2020 and November 2021 enhanced spectral computed tomography (CT) was performed in female patients with breast cancer. Quantitative spectral CT parameters and histogram parameters (mean, median, maximum, minimum, 10th percentiles, 90th percentiles, kurtosis, skewness, energy, range, and variance) from iodine maps were compared between patients with metastatic and nonmetastatic ALNs. Continuous variables were compared using Student's t-test or Mann-Whitney U test.Categorical variables were compared using Pearson's chi-square tests or Fisher's exact tests. Associations between ALN status and imaging features were evaluated using Mann-Whitney U test and receiver operating characteristic (ROC) curve analysis.Results: This study included 113 female patients (62 and 51 in the ALN-negative and ALN-positive groups, respectively). Tumor size, molecular subtypes, and location differed significantly between the ALN-negative and ALN-positive groups (P<0.05). None of the quantitative spectral CT parameters of mass between metastatic and nonmetastatic ALN groups were significantly different (P>0.05). Histogram parameters of iodine maps for breast cancers, including maximum, 10th percentile, range, and energy, were significantly higher in the metastatic ALNs group compared with the nonmetastatic ALNs group (P<0.05). Multivariable logistic regression analyses showed that tumor location and energy were independent predictors of metastatic ALNs in breast cancers. The combination of independent predictors yielded an area under the curve (AUC) of 0.824 (sensitivity 72.5%; specificity 74.2%).Conclusions: Whole-lesion histogram parameters derived from spectral CT iodine maps may be used as a complementary noninvasive means for the preoperative identification of ALN metastases in patients with early-stage breast cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Quantitative Spectral Ct Parameters Of Breast Massesmentioning

confidence: 99%

Iodine map histogram metrics in early-stage breast cancer: prediction of axillary lymph node metastasis status

Zeng¹,

Chen²,

Lin³

et al. 2022

Quant Imaging Med Surg

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“…15 • The iodine content of malignant masses was significantly higher than that of benign lesions in iodine-maps. 10 • Quantitative parameters of DECT may allow estimating the benign or malignant nature of breast masses, such as NIC, λ Hu , nZeff. 10,15,17,38 • When determining the difference between benign and malignant breast lesions or metastatic lymph nodes, venous phase λ Hu has the highest diagnostic value.…”

Section: Application Value Examples Of Clinical Applicationsmentioning

confidence: 99%

“…10 • Quantitative parameters of DECT may allow estimating the benign or malignant nature of breast masses, such as NIC, λ Hu , nZeff. 10,15,17,38 • When determining the difference between benign and malignant breast lesions or metastatic lymph nodes, venous phase λ Hu has the highest diagnostic value. 12,17,19 To provide as a non-invasive alternate method for staging lymph nodes…”

Section: Application Value Examples Of Clinical Applicationsmentioning

confidence: 99%

Dual‐Energy CT in Breast Cancer: Current Applications and Future Outlooks

Guo,

Liu,

et al. 2023

Precision Radiation Oncology

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Breast cancer is the most prevalent cancerous tumor in women, characterized by different subtypes and varying responses to treatment. The continued evolution of breast cancer diagnosis and management has resulted in a transition from a one‐size‐fits‐all approach to a new era of personalized treatment plans. Therefore, it is essential to accurately identify the biological characteristics of breast tissue in order to minimize unnecessary biopsies of benign lesions and improve the overall clinical process, leading to reduced expenses and complications associated with invasive biopsy procedures. Challenges for future research include finding ways to predict the response of breast cancer patients to adjuvant systemic treatment.Dual‐energy CT (DECT) is a new imaging technology integrating functional imaging and molecular imaging. Over the past decade, DECT has gained relevancy, especially in oncological radiology. This article proposed a literature review of the application and research status of DECT in breast cancer treatment strategy determination and prognosis prediction.

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“…Each measurement was repeated three times and averaged. Then, △CT and λ HU were calculated by the following formulae ( 13 ):…”

Section: Measurement Of Quantitative Dual-energy Ct Parametersmentioning

confidence: 99%

Dual-layer dual-energy CT for improving differential diagnosis of squamous cell carcinoma from adenocarcinoma at gastroesophageal junction

Sheng²,

Li³

et al. 2022

Front. Oncol.

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ObjectiveTo examine the clinical values of dual-energy CT parameters derived from dual-layer spectral detector CT (SDCT) in the differential diagnosis of squamous cell carcinoma (SCC) and adenocarcinoma (AC) of the gastroesophageal junction (GEJ).MethodsTotally 66 patients with SCC and AC of the GEJ confirmed by pathological analysis were retrospectively enrolled, and underwent dual-phase contrast-enhancement chest CT with SDCT. Plain CT value, CT attenuation enhancement (△CT), iodine concentration (IC), spectral slope (λHU), effective atomic number (Zeff) and 40keV CT value (CT40keV) of the lesion in the arterial phase (AP) and venous phase (VP) were assessed. Multivariate logistic regression analysis was performed to evaluate the diagnostic efficacies of different combinations of dual-energy CT parameters. Receiver operating characteristic (ROC) curves were used to analyze the accuracy of dual-energy CT parameters and Delong test was used to compare AUCs.ResultsIC, λHU, Zeff and CT40keV in AP and VP and △CT in VP were significantly higher in the AC group than those in the SCC group (all P<0.05). ROC curve analysis showed that IC, λHU, Zeff and CT40keV in VP had high diagnostic performances, with AUCs of 0.74, 0.74, 0.79 and 0.78, respectively. Logistic regression showed the combination of ICVP, λHU VP, CT40keV VP and Zeff VP had the highest AUC (0.84), with a threshold of 0.40, sensitivity and specificity in distinguishing SCC and AC were 93.1% and 73.0%, respectively. Delong test showed that the AUC of △CTVP was lower than other AUCs of dual-energy CT parameters.ConclusionDual-energy CT parameters derived from SDCT provide added value in the differential diagnosis of SCC and AC of the GEJ, especially the combination of IC, λHU, CT40keV and Zeff in VP.Advances in knowledgeDual-energy CT parameters derived from dual-layer spectral detector CT provide added value to differentiate AC from SCC at the GEJ, especially the combination of effective atomic number, spectral slope, iodine concentration and 40keV CT value in VP.

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Possibility to discriminate benign from malignant breast lesions detected on dual-layer spectral CT-evaluation

Cited by 8 publications

References 23 publications

Iodine map histogram metrics in early-stage breast cancer: prediction of axillary lymph node metastasis status

Iodine map histogram metrics in early-stage breast cancer: prediction of axillary lymph node metastasis status

Dual‐Energy CT in Breast Cancer: Current Applications and Future Outlooks

Dual-layer dual-energy CT for improving differential diagnosis of squamous cell carcinoma from adenocarcinoma at gastroesophageal junction

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