Berger Nicole, Marcon Magda, Wieler Jann, Vorburger Denise, Dedes Konstantin J, Frauenfelder Thomas, Varga Zsuzsanna, Boss Andreas
From the Institute of Diagnostic and Interventional Radiology.
Breast Center.
Invest Radiol. 2022 Oct 1;57(10):704-709. doi: 10.1097/RLI.0000000000000863. Epub 2022 Feb 28.
The aim of this study was to investigate the feasibility, the image quality, and the correlation with histology of dedicated spiral breast computed tomography (B-CT) equipped with a photon-counting detector in patients with suspicious breast lesions after application of iodinated contrast media.
The local ethics committee approved this prospective study. Twelve women with suspicious breast lesions found in mammography or B-CT underwent contrast-enhanced spiral B-CT and supplementary ultrasound. For all lesions, biopsy-proven diagnosis and histological workup after surgical resection were obtained including the size of cancer/ductal carcinoma in situ, which were correlated to sizes measured in B-CT. Signal-to-noise ratio and contrast-to-noise ratio were evaluated for tumor, glandular tissue, and fatty tissue.
Of the 12 patients, 15 suspicious lesions were found, 14 were malignant, and 1 benign lesion corresponded to a chronic inflammation. All lesions showed strong contrast media uptake with a signal-to-noise ratio of 119.7 ± 52.5 with a contrast-to-noise ratio between glandular tissue and breast cancer lesion of 12.6 ± 5.9. The correlation of the size of invasive tumors measured in B-CT compared with histological size was significant and strong R = 0.77 ( P < 0.05), whereas the correlation with the size of the peritumoral ductal carcinoma in situ was not significant R = 0.80 ( P = 0.11).
Contrast-enhanced B-CT shows high contrast between breast cancer and surrounding glandular tissue; therefore, it is a promising technique for cancer detection and staging depicting both soft tissue lesions and microcalcifications, which might be a substantial advantage over breast MRI.
本研究旨在探讨配备光子计数探测器的专用螺旋乳腺计算机断层扫描（B-CT）在注射碘化造影剂后对乳腺可疑病变患者的可行性、图像质量以及与组织学的相关性。
本前瞻性研究获得当地伦理委员会批准。12名在乳腺X线摄影或B-CT检查中发现乳腺可疑病变的女性接受了对比增强螺旋B-CT检查和补充超声检查。对所有病变均进行了手术切除后的活检确诊及组织学检查，包括癌/原位导管癌的大小，并与B-CT测量的大小进行相关性分析。对肿瘤、腺体组织和脂肪组织的信噪比和对比噪声比进行了评估。
12例患者共发现15个可疑病变，其中14个为恶性，1个良性病变为慢性炎症。所有病变均显示出强烈的造影剂摄取，信噪比为119.7±52.5，腺体组织与乳腺癌病变之间的对比噪声比为12.6±5.9。B-CT测量的浸润性肿瘤大小与组织学大小的相关性显著且较强，R = 0.77（P < 0.05），而与肿瘤周围原位导管癌大小的相关性不显著，R = 0.80（P = 0.11）。
对比增强B-CT显示乳腺癌与周围腺体组织之间具有高对比度；因此，它是一种用于癌症检测和分期的有前景的技术，可同时显示软组织病变和微钙化，这可能是优于乳腺MRI的一个显著优势。
