Dynamic helical CT mammography of breast cancer

PurposeThe purpose of this study was to determine whether dynamic helical computed tomography (CT)-mammography could assist in selecting the most appropriate surgical method in women with breast cancer.Materials and MethodsPreoperative contrast-enhanced helical CT scanning of the breast was performed on 133 female patients with suspicion of breast cancer at the same time as clinical, mammographic, and/or ultrasonographic examinations. The patients were scanned in the prone position with a specially designed CT-compatible device. A helical scan was made with rapid intravenous bolus injection (3 ml/s) of 100 ml of iodine contrast material. Three-dimensional maximum intensity projection (MIP) images were reconstructed, and CT findings were correlated with surgical and histopathological findings.ResultsHistopathological analysis revealed 84 malignant lesions and seven benign lesions. The sensitivity, specificity, and accuracy levels of the CT scanning were 94.6%, 58.6%, and 78.9%. Helical scanning alone revealed additional contralateral carcinomas in three of four patients and additional ipsilateral carcinomas in three of five patients. However, the technique gave false-positive readings in 24 patients. The preoperative CT-mammogram altered the surgical method in six patients.ConclusionDynamic helical CT-mammography in the prone position may be one of the choices of adjunct imaging in patients with suspected breast cancer scheduled for surgery.

[1]  F. Sardanelli,et al.  Dynamic helical CT of breast tumors. , 1998, Journal of computer assisted tomography.

[2]  I. Gribbestad,et al.  Contrast-enhanced magnetic resonance imaging of the breast. , 1992, Acta oncologica.

[3]  S E Harms,et al.  MR imaging of the breast with rotating delivery of excitation off resonance: clinical experience with pathologic correlation. , 1993, Radiology.

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

[5]  S G Orel MR imaging of the breast. , 2000, Radiologic clinics of North America.

[6]  A. Luini,et al.  Comparing radical mastectomy with quadrantectomy, axillary dissection, and radiotherapy in patients with small cancers of the breast. , 1982, The New England journal of medicine.

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

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

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

[10]  M A Helvie,et al.  Women with breast cancer: histologic findings in the contralateral breast. , 1997, Radiology.

[11]  L D Buadu,et al.  Breast lesions: correlation of contrast medium enhancement patterns on MR images with histopathologic findings and tumor angiogenesis. , 1996, Radiology.

[12]  A. Osborn,et al.  Safety and Efficacy of Iopromide in Cerebral Arteriography , 1994, Investigative radiology.

[13]  M D Schnall,et al.  Staging of suspected breast cancer: effect of MR imaging and MR-guided biopsy. , 1995, Radiology.

[14]  R. Osteen,et al.  Strategies for breast‐conserving surgery , 1995 .

[15]  S J Dwyer,et al.  Computed tomographic mammography using a conventional body scanner. , 1982, AJR. American journal of roentgenology.

[16]  N. Ohuchi,et al.  Management of ductal carcinoma in situ with nipple discharge. Intraductal spreading of carcinoma is an unfavorable pathologic factor for breast‐conserving surgery , 1994, Cancer.

[17]  S. Heywang-Köbrunner,et al.  Contrast-enhanced magnetic resonance imaging of the breast. , 1994, Investigative radiology.

[18]  R. Daffner,et al.  Magnetic resonance imaging in the diagnosis of breast disease. , 1986, AJR. American journal of roentgenology.

[19]  W. Lawrence,et al.  Experience with opposite breast biopsy in patients with operable breast cancer , 1976, Cancer.

[20]  J. Folkman,et al.  Tumor angiogenesis and metastasis--correlation in invasive breast carcinoma. , 1991, The New England journal of medicine.

[21]  E Grabbe,et al.  Breast carcinoma: effect of preoperative contrast-enhanced MR imaging on the therapeutic approach. , 1999, Radiology.