Peng Han MD, MBBS, Presenter: Nothing to Disclose

Zhao Xiang Ye, Abstract Co-Author: Nothing to Disclose

To evaluate the contrast enhancement and the optimal enhancement timing for contrast-enhanced cone-beam breast computed tomography (CE-CBBCT) in differentiating benign and malignant breast lesions.

Twenty-one subjects were enrolled under an Institutional Review Board (IRB) approved study protocol in Tianjin Cancer Hospital, China, and had CE-CBBCT before biopsy and treatment. All subjects were female. They were between 36 and 68 years old with a median age of 52.2. The subjects received diagnostic mammography or ultrasound within two weeks and were categorized as BIRADS 4 or 5.The CE-CBBCT exam included one pre-contrast scan and two post-contrast scans (initiated at 40 seconds and 120 seconds from the start of injecting contrast material). All statistical analyses were performed in SPSS.

Twenty-four lesions（5 benign，19 malignant）in the 21 subjects were proved by pathology. Malignant lesions were enhanced by 34.7 HU±22.5 at 40 seconds and 74.5 HU±26.8 at 120 seconds ( P <0.001); Benign lesions were enhanced by 18.0 HU±9.5 at 40 seconds and 33.8 HU±11.0 at 120 seconds(P <0.05). Normal breast tissue was enhanced by 8.7 HU±7.7 and 12.9 HU±7.2, respectively at 40s and 120s (P<0 .001). Among the 21 subjects, mammography identified 10 subjects with mass, and 11 with asymmetry or architectural distortion. CE-CBBCT identified 17 subjects with mass and 4 with ductal and segmental enhancement. Lesion margins were more conspicuous on CE-CBBCT than mammography (p<0.05). All subjects were identified on CE-CBBCT. Eleven subjects with multiple lesions were not seen on mammography. 9 of them had lesions with diameters less than 1.5mm. The smallest lesion was 0.6mm.

Both benign and malignant lesions had more enhancements at 120s than 40s after the contrast injection. Malignant lesions had more enhancement compared to benign lesions. CE-CBBCT may improve the conspicuity of breast lesions, detect minimal disease in the case of multiple lesions, and improve the early detection and diagnosis of breast cancer.

Cone-beam breast CT is a dedicated breast CT with low radiation dose and short scan time. True three-dimensional breast image can be reconstructed after a circular scan of the breast.

Han, P, Ye, Z, Clinical Application and Analysis of Contrast-enhanced Cone-beam Breast CT (CE-CBBCT) in Differentiating Benign and Malignant Breast Lesions.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13020001.html