Posy Jane Seifert DO, Presenter: Investigator, FUJIFILM Holdings Corporation Investigator, Koning Corporation Investigator, Hologic, Inc

Patricia Somerville MD, Abstract Co-Author: Investigator, FUJIFILM Holdings Corporation Investigator, Koning Corporation Investigator, Hologic, Inc

Stamatia V. Destounis MD, Abstract Co-Author: Investigator, Siemens AG Investigator, FUJIFILM Holdings Corporation Investigator, Hologic, Inc Investigator, U-Systems, Inc Investigator, Koning Corporation Researcher, Siemens AG Researcher, FUJIFILM Holdings Corporation Researcher, Hologic, Inc Researcher, U-Systems, Inc Researcher, Koning Corporation

Philip F. Murphy MD, Abstract Co-Author: Investigator, FUJIFILM Holdings Corporation Investigator, Koning Corporation Investigator, Hologic, Inc

Wende W. Young MD, Abstract Co-Author: Investigator, FUJIFILM Holdings Corporation Investigator, Koning Corporation Investigator, Hologic, Inc

Assess the value of CBBCT in the evaluation of breast lesions as compared to MR.

Following IRB approval, BIRADS 4 & 5 patients were consented to have a non-contrast CBBCT or Contrast Enhanced CBBCT prior to undergoing breast needle biopsy. All patients had complete diagnostic work-up and underwent a unilateral CBBCT scan. Patients consented for CECBBCT were given an intravenous contrast injection. Pertinent patient, imaging and pathology information was recorded.

Enrollment consisted of 133 BIRADS 4 &5 patients; 119 patients underwent CBBCT imaging. 52 patients proceeded to MR imaging following a positive biopsy to evaluate the extent of their disease. 2 were excluded: 1 due to artifacts on the CT image, and another was unable to be imaged with MR due to size limitations. Therefore, the study cohort consisted of 50 patients. In 74% (37/50) of lesions, CBBCT and MR imaging were concordant; there were discordant results in 26% (13/50) of lesions. Of the discordant results, the original lesion was seen on 92% (12/13) of both MR and CBBCT exams. However, in 15.39% (2/13) of the discordant lesions, CT revealed cancerous lesions not seen on MR; both of these patients were imaged with contrast enhanced CBBCT. In 38.47% (5/13) of these lesions, MR revealed additional lesions not seen on CT; all of these cases were non-contrast CBBCT exams. MR was able to image lymph node involvement in 30.77% (4/13) of these discordant cases, whereas CBBCT was unable to image this posterior tissue. Both CT and MR were able to image lesions which were not seen on mammography (2/13).  

In this small study, CECBBCT shows promise in the diagnostic evaluation of patients, particularly in identifying extent of disease. This may prove to be an alternative to breast MR in patients who are claustrophobic, have contraindications due to implantable devices or are limited secondary to size. Limitations in imaging posterior axillary tissue on CBBCT is well documented in this study; further work on table ergonomics is needed. Continued investigation of CBBCT is necessary for statistical significance and evaluation.

Clinical experience of CBBCT in the diagnostic setting.

Seifert, P, Somerville, P, Destounis, S, Murphy, P, Young, W, A Comparison of Cone Beam Breast Computed Tomography (CBBCT) to MRI of the Breast.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9008887.html