Evaluation of the Usefulness of Breast CT Imaging in Delineating Tumor Extent and Guiding Surgical Management

Akashi‐Tanaka, Sadako; Sato, Nobuaki; Ohsumi, Shozo; Kimijima, Izo; Inaji, Hideo; Teramoto, Seiichi; Akiyama, Futoshi

doi:10.1097/sla.0b013e31825b6cb1

Cited by 13 publications

(5 citation statements)

References 29 publications

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“…Our study demonstrated that PC-CT has a higher diagnostic significance in detecting adjacent DCIS compared with DM. Our PC-CT data align with prior studies, supporting the notion that CT could be a valuable imaging tool for detecting DCIS 15,24,25 . The relatively poor performance of DM in our study can be explained by the fact that only 5/12 cases (42%) with peritumoral DCIS exhibited calcifications.…”

Section: Discussionsupporting

confidence: 87%

“…Our PC-CT data align with prior studies, supporting the notion that CT could be a valuable imaging tool for detecting DCIS. 15,24,25 The relatively poor performance of DM in our study can be explained by the fact that only 5/12 cases (42%) with peritumoral DCIS exhibited calcifications. This percentage is relatively low compared with other cohorts.…”

Section: Discussionmentioning

confidence: 60%

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Diagnostic Accuracy of Contrast-Enhanced Thoracic Photon-Counting Computed Tomography for Opportunistic Locoregional Staging of Breast Cancer Compared With Digital Mammography

Neubauer,

Wilpert,

Gebler

et al. 2023

Invest Radiol

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Objective Accurate locoregional staging is crucial for effective breast cancer treatment. Photon-counting computed tomography (PC-CT) is an emerging technology with high spatial resolution and the ability to depict uptake of contrast agents in tissues, making it a promising tool for breast cancer imaging. The aim of this study was to establish the feasibility of locoregional staging of breast cancer through contrast-enhanced thoracic PC-CT, assess its diagnostic performance, and compare it with that of digital mammography (DM). Materials and Methods Patients with newly diagnosed breast cancer, DM, and indication of thoracic CT staging were prospectively enrolled in this clinical cohort study over a period of 6 months. Participants underwent contrast-enhanced thoracic PC-CT and breast magnetic resonance imaging in prone position. After blinding to patient data, 2 radiologists independently rated PC-CT and DM regarding the following 6 characteristics: (1) diameter of the largest mass lesion, (2) infiltration of cutis/pectoral muscle/thoracic wall, (3) number of mass lesions, (4) presence/absence of adjacent ductal carcinoma in situ (DCIS), (5) tumor conspicuity, and (6) diagnostic confidence. Reference standard was generated from consensus reading of magnetic resonance imaging combined with all histopathological/clinical data by an independent adjudication committee applying TNM eighth edition. Results Among 32 enrolled female subjects (mean ± SD age, 59 ± 13.0 years), diagnostic accuracy for T-classification was higher for PC-CT compared with DM (0.94 vs 0.50, P < 0.01). Moreover, the correlation of the number of detected tumor masses with the reference standard was stronger for PC-CT than for DM (0.72 vs 0.50, P < 0.01). We observed that PC-CT significantly (P < 0.04) outperformed DM regarding not only sensitivity (0.83 and 0.25, respectively) but also specificity (0.99 and 0.80, respectively) for adjacent DCIS. The κ values for interreader reliability were higher for PC-CT compared with DM (mean 0.88 vs 0.54, respectively; P = 0.01). Conclusions Photon-counting computed tomography outperformed DM in T-classification and provided higher diagnostic accuracy for the detection of adjacent DCIS. Therefore, opportunistic locoregional staging of breast cancer in contrast-enhanced thoracic PC-CT is feasible and could overcome limitations of DM with the potential to improve patient management.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 60%

Diagnostic Accuracy of Contrast-Enhanced Thoracic Photon-Counting Computed Tomography for Opportunistic Locoregional Staging of Breast Cancer Compared With Digital Mammography

Neubauer,

Wilpert,

Gebler

et al. 2023

Invest Radiol

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“…Furthermore, the comprehensive assessment of multiple sequence images can enhance the accuracy of tumor invasion prediction and ultimately improve the success rate of BCS. Breast MRI exhibits a sensitivity of over 90% in detecting invasive breast cancer[ 33 - 37 ]. The American College of Radiology has classified the morphology and characteristics of lesions in detail in the BI-RADS MR system[ 3 ].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of preoperative examination for evaluating margin status in breast cancer

Liu¹,

Zhao²,

Rong³

et al. 2023

World J Clin Cases

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Inflammatory myofibroblastic tumor (IMT) of the biliary tract is rare, and often difficult to diagnose or to distinguish from other tumors due to its atypical clinical presentation and nonspecific radiological features. Histologically, IMTs are (myo)fibroblastic neoplasms with a prominent inflammatory infiltrate. They are characterized by receptor tyrosine kinase gene rearrangements, most often involving an anaplastic lymphoma kinase (ALK ) translocation. The final diagnosis of IMT depends on histopathology and immunohistochemical examination. In this manuscript, we provide a clinical and morphomolecular overview of IMT and the difficulties that may arise in using immunohistochemical and molecular techniques in diagnosing IMT.

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“…CECT remains a cost-effective means to assess the status of axillary lymph nodes among patients with breast cancer despite the progress of positron emission tomography/computed tomography (PET/CT) and magnetic resonance imaging (MRI) [16, 17]. Beginning in January 2008, most surgeons in our institution gradually adopted preoperative CECT for assessment of axillary lymph nodes.…”

Section: Discussionmentioning

confidence: 99%

Contrast enhanced computed tomography is indicative for angiogenesis pattern and display prognostic significance in breast cancer

Zhang

et al. 2014

BMC Cancer

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BackgroundThe Prognostic value of microvessel density in cancer remains unclear. Recent studies have suggested that the uneven distribution of microvessels in tumours caused the variation in sample selection which led to different prognostic outcome. The enhancement pattern of Contrast-enhanced computed tomography (CECT) is determined in part by the microvessel distribution in solid tumors. Therefore, survival analysis of tumors grouping by the enhancement pattern and the pattern of microvessel distribution is important.MethodsSurvival analysis grouped by the tumor enhancement pattern and the microvessel distribution was carried out in 255 patients with invasive ductal carcinoma.ResultsThere were significant differences in overall survival (OS) and disease-free survival (DFS) among the homogeneous, heterogeneous and peripheral enhancement groups. There were significant differences between OS and DFS groups with uniform and uneven distributions of microvessels.ConclusionsThe distribution of microvessels in a tumor is a potential prognostic indicator in patients with breast cancer, and can be assessed by CECT prior the operation.

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Evaluation of the Usefulness of Breast CT Imaging in Delineating Tumor Extent and Guiding Surgical Management

Abstract: This prospective study suggests that breast CT, carried out in the supine position, is useful in the preoperative determination of the optimal surgical procedure.

Cited by 13 publications

References 29 publications

Diagnostic Accuracy of Contrast-Enhanced Thoracic Photon-Counting Computed Tomography for Opportunistic Locoregional Staging of Breast Cancer Compared With Digital Mammography

Diagnostic Accuracy of Contrast-Enhanced Thoracic Photon-Counting Computed Tomography for Opportunistic Locoregional Staging of Breast Cancer Compared With Digital Mammography

Diagnostic value of preoperative examination for evaluating margin status in breast cancer

Contrast enhanced computed tomography is indicative for angiogenesis pattern and display prognostic significance in breast cancer

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