Karen K. Lindfors MD, Presenter: Nothing to Disclose

John Michael Boone PhD, Abstract Co-Author: Nothing to Disclose

Thomas Roy Nelson PhD, Abstract Co-Author: Nothing to Disclose

Nikula Shah MS, Abstract Co-Author: Nothing to Disclose

To provide initial clinical assessment of the potential of breast computed tomography, and to compare breast CT images with mammograms of the same patient.

A prototype breast CT scanner has been used for Phase I (normal volunteers) and Phase II (patients with BIRADS 4 and 5 diagnoses) studies. A total of 10 normal volunteers, 5 patients with breast cancer and two with benign diagnoses have been evaluated, for a total of 33 breasts and >9000 individual breast CT images. The breast CT scanner operated at 80 kVp, and the technique factors (mAs) were selected on a patient-by-patient basis to deliver the same mean glandular x-ray dose as 2-view mammography. Image interpretation of the breast CT volume data set was performed using visualization software designed in our laboratory using open GL and dedicated graphics hardware. The CT examinations were compared with the most recent mammogram performed on that patient. Pathologic correlation was performed in women who subsequently underwent breast biopsy.

The breast CT examination of each breast resulted in a volume data set comprising 300 images, each with 512 x 512 pixels (0.5 mm section thickness). While the amount of data available from breast CT is large in comparison to mammography, the availability of efficient visualization software made the image evaluation process manageable. An improved 3-dimensional understanding of the morphology of the lesion was achieved using the breast CT images compared to mammography. Masses (N=5) and microcalcifications (N=3) were seen on CT. Initial impressions were favorable with respect to breast CT, however it was apparent from this exercise that refinements in patient positioning and improvements in soft copy viewing techniques as well as radiologist training will be required to optimally generate and interpret the breast CT image data.

In this initial evaluation, breast CT images were subjectively found to be equivalent to and potentially better than standard breast imaging for the detection and evaluation of breast cancer. Quantitative evaluation of the breast CT images using ROC techniques is in progress.

Lindfors, K, Boone, J, Nelson, T, Shah, N, Initial Clinical Evaluation of Breast Computed Tomography.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4410346.html