RSNA 2016

Abstract Archives of the RSNA, 2016


SSK16-06

High-resolution Low-dose Breast CT Performance Tests on Surgical Specimens in Comparison with Digital Mammography and Breast Tomosynthesis

Wednesday, Nov. 30 11:20AM - 11:30AM Room: S403B



Ann-Christin Roessler, MSc, Erlangen, Germany (Presenter) Nothing to Disclose
Evelyn Wenkel, MD, Erlangen, Germany (Abstract Co-Author) Speakers Bureau, Siemens AG
Christian Steiding, PhD, Erlangen, Germany (Abstract Co-Author) Employee, CT Imaging GmbH
Veikko Ruth, MSc, Erlangen, Germany (Abstract Co-Author) Nothing to Disclose
Daniel Kolditz, PhD, Erlangen, Germany (Abstract Co-Author) Employee, CT Imaging GmbH
Willi A. Kalender, PhD, Erlangen, Germany (Abstract Co-Author) Founder, CT Imaging GmbH; CEO, CT Imaging GmbH
PURPOSE

Using dedicated breast computed tomography (bCT) for detection and diagnosis of breast cancer is a novel approach in breast imaging. Existing bCT systems showed comparable performance to digital mammography (DM) and breast tomosynthesis (BT) in detection of lesions especially if contrast media were applied but do not have sufficient resolution to detect microcalcifications (µCa) smaller than 300 µm. The purpose of the study was to compare a novel high-resolution low-dose bCT system to clinical DM and BT.

METHOD AND MATERIALS

30 surgical specimens were evaluated for this study. 14 of the specimens were lumpectomies, 16 total mastectomies. All women had a pre-operatively diagnosed breast cancer or DCIS. Specimens were investigated directly after surgery with DM, BT, bCT and pathology examination (ground truth). DM and BT were used with standard clinical settings, bCT with a tube voltage of 60 kV. Dose was kept below 5 mGy for bCT. 3 breast imaging experts examined the randomized data sets. Time for image viewing was recorded. Sensitivity and specificity for detection of lesions and calcifications were calculated.

RESULTS

Histology revealed 17 invasive cancers and 10 DCIS in the specimens (27 lesions in total). 16 of the specimens contained calcifications. 73 % of the specimens were rated as heterogeneously or extremely dense in DM. Mean time for image viewing was 77 s for DM, 122 s for BT and 131 s for BCT. Sensitivity for lesions was 41 % for DM, 52 % for BT and 70 % for bCT. Sensitivity for calcifications was 75 % for DM, 69 % for BT and 94 % for bCT. Specificity for lesions was 71 % for DM, 29 % for BT and 71 % for bCT. Specificity for calcifications was 67 % for all modalities.

CONCLUSION

For detection of lesions as well as calcifications, bCT showed superior sensitivity compared to DM and BT. Radiologists are not used to inspect bCT images in clinical routine, viewing times nevertheless were still comparable to those of BT. Sensitivity and specificity for lesion detection could potentially be increased further using contrast media.

CLINICAL RELEVANCE/APPLICATION

Dedicated high-resolution low-dose bCT proved to be superior to DM and BT especially for detection of calcifications and lesions in dense breasts.