Ko Seong Eun, Song Kyoung Doo, Cha Dong Ik
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea.
Abdom Radiol (NY). 2023 Apr;48(4):1320-1328. doi: 10.1007/s00261-023-03857-6. Epub 2023 Mar 7.
To compare the usefulness of multi-phase liver CT and single-phase abdominopelvic CT (APCT) in evaluating liver metastasis in newly diagnosed breast cancer patients.
In this retrospective study, a total of 7621 newly diagnosed breast cancer patients (mean age, 49.7 years ± 10.1; 7598 women) who underwent single-phase APCT (n = 5536) or multi-phase liver CT (n = 2085) for staging workup between January 2016 and June 2019 were included. The staging CTs were categorized as having no metastasis, probable metastasis, or indeterminate lesions. MRI referral rate (proportion of patients underwent additional liver MRI), negative MRI rate (patients without true hepatic metastasis / patients underwent liver MRI), true positive CT rate (patients with true metastasis / patients categorized as probable metastasis), true metastasis rate among CT indeterminate (patients with true metastasis / patients categorized as indeterminate lesions), and overall liver metastasis rate were compared between the two groups. Further, the radiation dose was recorded for every patient.
The proportions of having no metastasis and indeterminate lesions on the results of CT interpretation were significantly different between the two groups (P = 0.006). However, the MRI referral rate, negative MR rate, true positive CT rate, true metastasis rate among CT indeterminate, and overall liver metastasis rate were not significantly different between the two groups. Radiation dose of multi-phase CT was three times higher than that of single-phase CT.
Multi-phase liver CT has little benefit over single-phase APCT in assessing liver metastasis in patients with breast cancer.
比较多期肝脏CT和单相腹盆腔CT（APCT）在评估新诊断乳腺癌患者肝转移方面的效用。
在这项回顾性研究中，纳入了2016年1月至2019年6月期间因分期检查而接受单相APCT（n = 5536）或多期肝脏CT（n = 2085）的7621例新诊断乳腺癌患者（平均年龄49.7岁±10.1；7598例女性）。分期CT被分类为无转移、可能转移或不确定病变。比较两组之间的MRI转诊率（接受额外肝脏MRI检查的患者比例）、MRI阴性率（无真正肝转移的患者/接受肝脏MRI检查的患者）、CT真阳性率（有真正转移的患者/分类为可能转移的患者）、CT不确定病变中的真正转移率（有真正转移的患者/分类为不确定病变的患者）以及总体肝转移率。此外，记录了每位患者的辐射剂量。
两组在CT解读结果上无转移和不确定病变的比例存在显著差异（P = 0.006）。然而，两组之间的MRI转诊率、MRI阴性率、CT真阳性率、CT不确定病变中的真正转移率以及总体肝转移率并无显著差异。多期CT的辐射剂量比单相CT高三倍。
在评估乳腺癌患者的肝转移方面，多期肝脏CT相比单相APCT益处不大。
