Philip Frans Lodewijk Ardies MD, Presenter: Nothing to Disclose

Lenz Ardies MD, Abstract Co-Author: Nothing to Disclose

Erwin Oomms MD, Abstract Co-Author: Nothing to Disclose

Spectral CT or single source dual-energy CT is a recently introduced scan technique. The purpose of this survey was to discover whether spectral CT has an additional value in the diagnosis and staging of malignant breast lesions and in the follow-up during treatment.

Spectral CT was performed in two group of patients: patients with no suspicion for underlying breast malignancy who had a chest CT for pulmonary or pleural pathology and patients with a chest CT for staging of a suspected or biopsy proven breast malignancy. Spectral CT was also used in the follow-up of patients during treatment for breast malignancy. Spectral CT images were viewed both qualitative as quantitative. Qualitative analysis was done by looking both at grayscale and color coded images, quantitative analysis was performed by measuring iodine content and using spectral attenuation curves. Results were compared to other imaging techniques as MRI and to pathology findings.

Between September 2012 and March 2014 26 patients with biopsy proven breast cancer were staged with a spectral chest CT. Results were compared to MRI and postoperative pathology findings. All lesions (single or multifocal) were found on spectral CT, due to the higher iodine content in the malignant lesion compared to the surrounding breast tissue. Analysis of axillary lymph node involvement was done by comparing iodine content of the nodes with that of the primary lesion and the contralateral nodes. Spectral CT was also helpful in patients with suspected breast pathology with negative mammography and ultrasound when MRI could not be performed and was also able to detect several unsuspected breast malignancies on routine chest CT. Spectral CT was also used in the follow-up of patients during treatment to evaluate not only tumor size but also iodine concentration as a measure for residual tumor activity.

Spectral CT has a clear advantage over conventional CT in detecting breast cancer and can be an important additional tool in selected cases when breast MRI cannot be performed. After treatment of breast cancer spectral CT can evaluate tumor response to treatment both by measuring tumor size and iodine content as a measure for tumor activity.

Spectral CT is a new technique which is used in abdominal and thoracic oncologic imaging. The aim of our survey was to explore the possible use of spectral CT in breast imaging.

Ardies, P, Ardies, L, Oomms, E, Spectral CT and Malignant Breast Lesions: Initial Findings.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045578.html