Institute of Medical Physics, University of Erlangen-Nürnberg, Germany.
Invest Radiol. 2019 Jul;54(7):409-418. doi: 10.1097/RLI.0000000000000552.
The purpose of this work is to present the data obtained from the first clinical in vivo application of a new dedicated spiral breast computed tomography (B-CT) equipped with a photon-counting detector.
The institutional review board approved this retrospective study. Twelve women referred for breast cancer screening were included and underwent bilateral spiral B-CT acquired in prone position. Additional sonography was performed in case of dense breast tissue or any B-CT findings. In 3 women, previous mammography was available for comparison. Soft tissue (ST) and high-resolution (HR) images were reconstructed. Two independent radiologists performed separately the readout for subjective image quality and for imaging findings detection. Objective image quality evaluation was performed in consensus and included spatial resolution, contrast resolution, signal-to-noise ratio (SNR), and contrast-to-noise ratio. All women were asked to report about positioning comfort and overall comfort during data acquisition.
The major pectoral muscle was included in 15 breast CT scans (62.5%); glandular component was partially missing in 2 (8.3%) of the 24 scanned breasts. A thin "ring artifact" was present in all scans but had no influence on image interpretations; no other artifacts were present. Subjective image quality assessment showed excellent agreement between the 2 readers (κ = 1). Three masses were depicted in B-CT and were confirmed as simple cysts in sonography. Additional 5 simple cysts and 2 solid benign lesions were identified only in sonography. A total of 12 calcifications were depicted with a median size of 1.1 mm (interquartile range, 0.7-1.7 mm) on HR and 1.4 mm (interquartile range, 1.1-1.8 mm) on ST images. Median SNRgl, SNRfat, and contrast-to-noise ratio were significantly higher in ST than in HR reconstructions (each, P < 0.001). A mild discomfort due to positioning of the rib cage on the table was reported by 2 women (16.7%); otherwise, no discomfort was reported.
The new dedicated B-CT equipped with a photon-counting detector provides high-quality images with potential for screening of breast cancer along with minor patient discomfort.
本研究旨在介绍一种新型专用螺旋乳腺 CT（B-CT）的首次临床体内应用所获得的数据，该 CT 配备了光子计数探测器。
机构审查委员会批准了这项回顾性研究。12 名因乳腺癌筛查而就诊的女性入组，并接受了俯卧位双侧螺旋 B-CT 检查。如果乳房组织致密或 B-CT 有任何发现，将进行额外的超声检查。其中 3 名女性有先前的乳房 X 线照片可供比较。软组织（ST）和高分辨率（HR）图像进行了重建。两名独立的放射科医生分别对主观图像质量和成像结果检测进行了阅读。客观图像质量评估在共识基础上进行，包括空间分辨率、对比分辨率、信噪比（SNR）和对比噪声比。所有女性均被要求报告在数据采集过程中的体位舒适度和整体舒适度。
15 次乳腺 CT 扫描（62.5%）包括了主要胸肌；24 个扫描乳房中，2 个（8.3%）的腺体型部分缺失。所有扫描均存在薄的“环状伪影”，但不影响图像解读；无其他伪影。主观图像质量评估显示两名读者之间具有极好的一致性（κ=1）。B-CT 显示了 3 个肿块，经超声证实为单纯囊肿。仅在超声中还发现了另外 5 个单纯囊肿和 2 个实体良性病变。共显示了 12 个钙化灶，HR 图像上的中位数大小为 1.1mm（四分位间距，0.7-1.7mm），ST 图像上为 1.4mm（四分位间距，1.1-1.8mm）。ST 重建的 SNRgl、SNRfat 和对比噪声比明显高于 HR 重建（均 P<0.001）。两名女性（16.7%）报告因肋骨在桌子上的位置而感到轻度不适；否则，无不适报告。
新型专用 B-CT 配备了光子计数探测器，可提供高质量的图像，具有筛查乳腺癌的潜力，同时患者不适感较小。
