Seifert Posy, Conover David, Zhang Yan, Morgan Renee, Arieno Andrea, Destounis Stamatia, Somerville Patricia, Murphy Philip F
Elizabeth Wende Breast Care, LLC., Rochester, New York.
Breast J. 2014 Jul-Aug;20(4):364-74. doi: 10.1111/tbj.12285. Epub 2014 Jun 17.
To investigate the feasibility of noncontrast and contrast-enhanced cone beam breast Computed Tomography (CT) in demonstrating malignant breast lesions in the diagnostic setting. This Institutional Review Board approved, Health Information Portability and Accountability Act compliant, prospective study enrolled BI-RADS four and five patients from 2008 to 2010. Eighty-seven subjects had noncontrast breast CT, 42 had contrast-enhanced breast CT (CE-breast CT) with 70 pathologically confirmed cancer diagnoses. All 70 comprise the study cohort for noncontrast breast CT, and 23 who had CE-breast CT comprise the cohort for CE-breast CT. All had diagnostic work-up. Patient age, breast density, lesion size and characteristics, biopsy method, and core pathology were recorded. A Fisher's exact test was used to detect a difference in detectability. For agreement in size measurement between the imaging modalities, a paired t-test was employed. Reported p-values were based on 2-sided tests. Two one-sided tests were calculated to determine equivalence within ±0.3 cm at a 90% significance level. Noncontrast breast CT identified 67 of 70 malignant lesions, detected by diagnostic work-up. CE-breast CT identified 23 of 23 index malignant lesions and in addition, found three malignant lesions in three cases not previously detected. Noncontrast breast CT demonstrated the index lesion in 67 of 70 cases and CE-breast CT demonstrated the index lesion in all 23 cases. An additional three new malignant lesions not seen with conventional diagnostic work-up were detected. In this preliminary study, breast CT with or without contrast was shown to be accurate at identifying malignant breast lesions in the diagnostic setting.
探讨非增强及增强型锥形束乳腺计算机断层扫描（CT）在诊断环境中显示乳腺恶性病变的可行性。本研究经机构审查委员会批准，符合《健康保险流通与责任法案》要求，为前瞻性研究，纳入了2008年至2010年乳腺影像报告和数据系统（BI-RADS）4类和5类患者。87名受试者接受了非增强乳腺CT检查，42名接受了增强型乳腺CT（CE-乳腺CT）检查，其中70例经病理确诊为癌症。所有70例构成非增强乳腺CT的研究队列，23例接受CE-乳腺CT检查的患者构成CE-乳腺CT队列。所有患者均接受了诊断性检查。记录患者年龄、乳腺密度、病变大小及特征、活检方法和核心病理结果。采用Fisher精确检验检测可检测性的差异。对于不同成像方式之间大小测量的一致性，采用配对t检验。报告的p值基于双侧检验。计算两个单侧检验以确定在90%显著性水平下±0.3 cm范围内的等效性。非增强乳腺CT在70例经诊断性检查发现的恶性病变中识别出67例。CE-乳腺CT在23例主要恶性病变中识别出23例，此外，在3例先前未检测到的病例中发现了3例恶性病变。非增强乳腺CT在70例中的67例显示了主要病变，CE-乳腺CT在所有23例中均显示了主要病变。还检测到3例常规诊断性检查未发现的新恶性病变。在这项初步研究中，无论有无对比剂，乳腺CT在诊断环境中识别乳腺恶性病变方面均显示出准确性。
