Dynamic helical CT of breast tumors.

PURPOSE The purpose of our study was to test dynamic helical CT (hCT) in the evaluation of breast tumors. METHOD Thirty-six patients with 39 suspected lesions underwent breast hCT before and 1, 3, and 8 min after intravenous contrast medium administration. A marked enhancement (> or = 100%) at 1 or 3 min without increase at 8 minutes was considered as the primary indicator for malignancy. Twenty carcinomas, one metastatic non-Hodgkin lymphoma, six fibroadenomas, and six other benign findings were histologically assessed. Six cases had negative fine needle aspiration cytology and at least a 2 year negative follow-up. RESULTS hCT showed a 100% sensitivity and 83.3% specificity. Considering carcinomas and fibroadenomas, significant differences were found for the percent enhancement at 1 min (p = 0.002) as well as for the density increase or decrease at 3 versus 1 min (p = 0.0035), at 8 versus 1 min (p = 0.0027), and at 8 versus 3 min (p = 0.0180). CONCLUSION hCT proved to have a high diagnostic efficacy in evaluating breast tumors. Even though it involves some exposure to radiation, it should be considered in patients in whom MR is contraindicated.

[1]  J T Ennis,et al.  Breast disease: tissue characterization with Gd-DTPA enhancement profiles. , 1990, Radiology.

[2]  M D Schnall,et al.  MR imaging-guided localization and biopsy of breast lesions: initial experience. , 1994, Radiology.

[3]  J. H. Gallagher,et al.  Computed tomographic evaluation of the breast. , 1978, AJR. American journal of roentgenology.

[4]  J L Floiras,et al.  Contrast-enhanced CT: value for diagnosing local breast cancer recurrence after conservative treatment. , 1996, Radiology.

[5]  D. Kopans,et al.  CT evaluation of local and regional breast cancer recurrence. , 1985, AJR. American journal of roentgenology.

[6]  A. Rosenberg,et al.  CT-pathologic correlation of axillary lymph nodes in breast carcinoma. , 1991, Journal of computer assisted tomography.

[7]  C. White,et al.  CT appearance of the normal and abnormal breast with mammographic correlation. , 1994, Clinical imaging.

[8]  B Asselain,et al.  Tumor recurrence versus fibrosis in the irradiated breast: differentiation with dynamic gadolinium-enhanced MR imaging. , 1993, Radiology.

[9]  M D Schnall,et al.  Suspicious breast lesions: MR imaging with radiologic-pathologic correlation. , 1994, Radiology.

[10]  E. Fishman,et al.  Distribution of metastases in breast carcinoma: CT evaluation of the abdomen. , 1991, Clinical imaging.

[11]  R. Spillane,et al.  Computed tomography-guided needle localization of nonpalpable breast lesions: review of 24 cases. , 1996, Academic radiology.

[12]  E. Fishman,et al.  Detection of internal mammary lymph node enlargement: comparison of CT scans and conventional roentgenograms. , 1991, Clinical imaging.

[13]  S. Heywang,et al.  MR imaging of the breast using gadolinium-DTPA. , 1986, Journal of computer assisted tomography.

[14]  A. Roberts,et al.  Pulsed versus conventional thrombolytic infusion techniques. , 1994, Radiology.

[15]  J. Meyer,et al.  Computed tomographic demonstration of internal mammary lymph-node metastasis in patients with locally recurrent breast carcinoma. , 1981, Radiology.

[16]  C. Stelling,et al.  Fibroadenomas: histopathologic and MR imaging features. , 1987, Radiology.

[17]  K. Shaffer,et al.  Imaging of Regional Spread of Breast Cancer by Internal Mammary Lymphoscintigraphy, CT, and MRI , 1992, Clinical nuclear medicine.

[18]  M. Mauro,et al.  The role of computed tomography in the evaluation of postmastectomy locally recurrent breast cancer , 1988 .

[19]  J. Cooke,et al.  A comparison of radiation doses to the breast in computed tomographic chest examinations for two scanning protocols. , 1989, Clinical radiology.

[20]  S H Heywang,et al.  Gd-DTPA enhanced MR imaging of the breast in patients with postoperative scarring and silicon implants. , 1990, Journal of computer assisted tomography.

[21]  J. Munzenrider,et al.  Computerized body tomography in breast cancer. I. Internal mammary nodes and radiation treatment planning , 1979 .

[22]  S. Heywang,et al.  MR imaging of the breast with Gd-DTPA: use and limitations. , 1989, Radiology.

[23]  B. Carter,et al.  Computed tomography of the chest wall. , 1980, Radiology.

[24]  Computed tomography of the breast: a valuable adjunct to mammography in selected cases. , 1995 .

[25]  P. V. van Waes,et al.  Computed tomography of breast lesions: comparison with x-ray mammography. , 1983, Journal of computer assisted tomography.

[26]  C. Moran,et al.  Thymolipoma: analysis of 27 cases. , 1994, Radiology.

[27]  W. Kaiser,et al.  MR imaging of the breast: fast imaging sequences with and without Gd-DTPA. Preliminary observations. , 1989, Radiology.

[28]  K Ewen,et al.  CT scanning of the breast in problem cases. , 1989, Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al].