Contrast-enhanced cone-beam breast-CT (CBBCT): clinical performance compared to mammography and MRI

Wienbeck, Susanne; Fischer, Uwe; Luftner-Nagel, Susanne; Lotz, Joachim; Uhlig, Johannes

doi:10.1007/s00330-018-5376-4

Cited by 55 publications

(51 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…15 The high resolution, but also the possibility to evaluate the images in different planes, increases and facilitates the characterization of lesions regarding suspicious features such as conspicuity, calcifications, and asymmetries, as well as masses. 14,22,23 Due to the retrospective nature of our study, no mammography was performed in addition to B-CT, and previous mammography was available only in a limited number of cases, thus precluding a systematic 2 1 5555 5 5 4444 3 3 4545 3 3 4444 3 3 2 5555N M N M4455N M N M5545N M N M5444N M N M 3 5555 5 5 4455 4 4 4444 4 4 5544 3 3 4 5555N comparison. Nevertheless, our initial data demonstrate a high B-CT performance in terms of image quality.…”

Section: Discussionmentioning

confidence: 99%

Dedicated Breast Computed Tomography With a Photon-Counting Detector

et al. 2019

View full text Add to dashboard Cite

OBJECTIVES: The purpose of this work is to present the data obtained from the first clinical in vivo application of a new dedicated spiral breast computed tomography (B-CT) equipped with a photon-counting detector. MATERIALS AND METHODS: The institutional review board approved this retrospective study. Twelve women referred for breast cancer screening were included and underwent bilateral spiral B-CT acquired in prone position. Additional sonography was performed in case of dense breast tissue or any B-CT findings. In 3 women, previous mammography was available for comparison. Soft tissue (ST) and high-resolution (HR) images were reconstructed. Two independent radiologists performed separately the readout for subjective image quality and for imaging findings detection. Objective image quality evaluation was performed in consensus and included spatial resolution, contrast resolution, signal-to-noise ratio (SNR), and contrast-to-noise ratio. All women were asked to report about positioning comfort and overall comfort during data acquisition. RESULTS: The major pectoral muscle was included in 15 breast CT scans (62.5%); glandular component was partially missing in 2 (8.3%) of the 24 scanned breasts. A thin "ring artifact" was present in all scans but had no influence on image interpretations; no other artifacts were present. Subjective image quality assessment showed excellent agreement between the 2 readers (= 1). Three masses were depicted in B-CT and were confirmed as simple cysts in sonography. Additional 5 simple cysts and 2 solid benign lesions were identified only in sonography. A total of 12 calcifications were depicted with a median size of 1.1 mm (interquartile range, 0.7-1.7 mm) on HR and 1.4 mm (interquartile range, 1.1-1.8 mm) on ST images. Median SNRgl, SNRfat, and contrast-to-noise ratio were significantly higher in ST than in HR reconstructions (each, P < 0.001). A mild discomfort due to positioning of the rib cage on the table was reported by 2 women (16.7%); otherwise, no discomfort was reported. CONCLUSIONS: The new dedicated B-CT equipped with a photon-counting detector provides high-quality images with potential for screening of breast cancer along with minor patient discomfort.

show abstract

Section: Discussionmentioning

confidence: 99%

Dedicated Breast Computed Tomography With a Photon-Counting Detector

et al. 2019

View full text Add to dashboard Cite

show abstract

“…In order to improve detection rates, contrast‐enhanced imaging of the breast has been developed. This method is already established in breast MRI 7–10 and is also increasingly used in mammography 11‐22 and breast CT (BCT) 23–25 …”

Section: Introductionmentioning

confidence: 99%

Investigation of spectral performance for single‐scan contrast‐enhanced breast CT using photon‐counting technology: A phantom study

Ruth

Kolditz²,

Steiding³

et al. 2020

Medical Physics

View full text Add to dashboard Cite

Purpose: Contrast-enhanced imaging of the breast is frequently used in breast MRI and has recently become more common in mammography. The purpose of this study was to make single-scan contrast-enhanced imaging feasible for photon-counting breast CT (pcBCT) and to assess the spectral performance of a pcBCT scanner by evaluating iodine maps and virtual non-contrast (VNC) images. Methods: We optimized the settings of a pcBCT to maximize the signal-to-noise ratio between iodinated contrast agent and breast tissue. Therefore, an electronic energy threshold dividing the x-ray spectrum used into two energy bins was swept from 23.17 keV to 50.65 keV. Validation measurements were performed by placing syringes with contrast agent (2.5 mg/ml to 40 mg/ml) in phantoms with 7.5 cm and 12 cm in diameter. Images were acquired at different tube currents and reconstructed with 300 lm isotropic voxel size. Iodine maps and VNC images were generated using image-based material decomposition. Iodine concentrations and CT values were measured for each syringe and compared to the known concentrations and reference CT values. Results: Maximal signal-to-noise ratios were found at a threshold position of 32.59 keV. Accurate iodine quantification (average root mean square error of 0.56 mg/ml) was possible down to a concentration of 2.5 mg/ml for all tube currents investigated. The enhancement has been sufficiently removed in the VNC images, so they can be interpreted as unenhanced CT images. Only minor changes of CT values compared to a conventional CT scan were observed. Noise was increased by the decomposition by a factor of 2.62 and 4.87 (7.5 cm and 12 cm phantoms) but did not compromise the accuracy of the iodine quantification. Conclusions: Accurate iodine quantification and generation of VNC images can be achieved using contrast-enhanced pcBCT from a single CT scan in the absence of temporal or spatial misalignment. Using iodine maps and VNC images, pcBCT has the potential to reduce dose, shorten examination and reading time, and to increase cancer detection rates.

show abstract

“…When comparing imaging modalities, CE‐CBBCT has been shown to have improved malignancy detection compared with mammograms . Wienbeck, et al have shown that MRI and CE‐CBBCT were more sensitive and accurate compared to noncontrast enhanced studies such as mammogram and NC‐CBBCT, but they are less specific. This suggests CE‐CBBCT may be useful as a screening tool for those who are unable to undergo MRIs.…”

Section: Emerging Technologiesmentioning

confidence: 99%

Screening of populations at high risk for breast cancer

Lee

Reyna

Shaughnessy

et al. 2019

Journal of Surgical Oncology

View full text Add to dashboard Cite

The approach to screening patients at high risk for breast cancer has thus far been challenging to standardize, given limited high-level evidence in this population. The approach has evolved given the development of more effective screening modalities, including digital breast mammography, magnetic resonance imaging, and other emerging technologies. This review will discuss identification of high-risk patients, approaches to genetic counseling and testing, and evidence behind screening modalities and algorithms in this special population.breast cancer, genetic testing, high-risk, screening

show abstract

Contrast-enhanced cone-beam breast-CT (CBBCT): clinical performance compared to mammography and MRI

Cited by 55 publications

References 32 publications

Dedicated Breast Computed Tomography With a Photon-Counting Detector

Dedicated Breast Computed Tomography With a Photon-Counting Detector

Investigation of spectral performance for single‐scan contrast‐enhanced breast CT using photon‐counting technology: A phantom study

Screening of populations at high risk for breast cancer

Contact Info

Product

Resources

About