2 Milisievert Low Dose Dedicated Breast CT with Iterative Model Reconstruction Technique in Evaluation of Breast Mass: Feasibility Study in Comparison with MRI

Yong Guo; Jiang Yan; Qingjun Wang; Jing Zhang; Lijing Shi; Yingying Hu; Yun Zhang

doi:doi:10.11648/j.ijmi.20180603.11

| Peer-Reviewed

2 Milisievert Low Dose Dedicated Breast CT with Iterative Model Reconstruction Technique in Evaluation of Breast Mass: Feasibility Study in Comparison with MRI

Yong Guo, Jiang Yan, Qingjun Wang, Jing Zhang, Lijing Shi, Yingying Hu, Yun Zhang

Published in International Journal of Medical Imaging (Volume 6, Issue 3)

Received: 9 July 2018 Accepted: 23 November 2018 Published: 20 December 2018

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Objective To investigate the feasibility of low dose dedicated computed tomography (CT) with IMR technique compared with magnetic resonance imaging (MRI) in preoperative evaluation of breast cancer. Methods Dedicated CT and breast MRI were performed in 21 patients with diagnosed breast mass for preoperative evaluation. A dedicated protocol combined with chest diagnostic CT and dynamic scans of breast was developed with the use of IMR technique as well as optimization of scan parameters to ensure acceptable radiation dose. Image quality evaluations of CT images were performed using a five-point scale. The number, site and size (maximum diameter) of breast lesion were recorded respectively in CT and MRI images. The enhancement patterns of breast lesion were classified to 3 types (washout, plateau, and persistence) according to time intensity curve derived from CT and time signal curve derived from MRI, respectively. Pearson’s correlation, Bland-Altman analysis, and Cohen’s kappa test were used for statistical assessment. Results The mean effective radiation dose of dedicated breast CT, with the image quality diagnostic acceptable for evaluation of breast lesion and pulmonary structures, was (2.15±0.39) mSv, which was no more than a routine chest diagnostic CT. Results of breast lesion number and lesion site obtained by CT and MRI was consistent, with a total of 24 lesions detected in 21 patients. The mean lesion size was (26.5±12.1) mm in CT and (26.1±12.9) mm in MR, respectively. CT showed an excellent correlation with MRI for lesion size (r=0.99, n=24, p<0.0001). Limits of agreement determined by Bland-Altman analysis for lesion extent was (-3.0mm, 3.8mm). Good agreement was observed between CT and MRI for lesion enhancement patterns (kappa value = 0.936, p=0.000). Conclusion Dedicated breast CT imaging with acceptable radiation dose enabled diagnostic image quality and showed good agreement with breast MR imaging in preoperative evaluation of breast cancer.

Published in	International Journal of Medical Imaging (Volume 6, Issue 3)
DOI	10.11648/j.ijmi.20180603.11
Page(s)	18-24
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

Breast Cancer, Computed Tomography, Low Radiation Dose, Iterative Reconstruction

References

[1]	American Cancer Society. Cancer Facts & Figures 2012: Atlanta: American Cancer Society; 2012.
[2]	Harvey JA, Mahoney MC, Newell MS, Bailey L, Barke LD, D'Orsi C, et al. ACR appropriateness criteria palpable breast masse: J Am Coll Radiol. 2013; 10(10): 742-749.e1-3. doi: 10.1016/j.jacr.2013.06.013.
[3]	Berg WA, Gutierrez L, NessAiver MS, Carter WB, Bhargavan M, Lewis RS, et al. Diagnostic accuracy of mammography, clinical examination, US, and MR imaging in preoperative assessment of breast cancer. Radiology. 2004; 233(3): 830-849. doi: 10.1148/radiol.2333031484.
[4]	Holloway CM, Easson A, Escallon J, Leong WL, Quan ML, Reedjik M, et al. Technology as a force for improved diagnosis and treatment of breast disease. Can J Surg. 2010; 53(4): 268-277.
[5]	Sardanelli F, Calabrese M, Zandrino F, Melani E, Parodi R, Imperiale A, et al. Dynamic helical CT of breast tumors. J Comput Assist Tomogr. 1998; 22(3): 398–407.
[6]	Izzo L, Stasolla A, Basso L, Caputo M, Kharrub Z, Marini M, et al. Characterization of tumoral lesions of the breast: preliminary experience with multislice spiral CT. J Exp Clin Cancer Res. 2005; 24(2): 209-215.
[7]	Nishino M, Hayakawa K, Yamamoto A, Nakamura Y, Morimoto T, Mukaihara S, et al. Multiple enhancing lesions detected on dynamic helical computed tomography-mammography. J Comput Assist Tomogr. 2003; 27(5): 771-778.
[8]	Uematsu T, Sano M, Homma K, Shiina M, Kobayashi S. Three-dimensional helical CT of the breast: accuracy for measuring extent of breast cancer candidates for breast conserving surgery. Breast Cancer Res Treat. 2001; 65(3): 249-257.
[9]	Liu Y, Bellomi M, Gatti G, Ping X. Accuracy of computed tomography perfusion in assessing metastatic involvement of enlarged axillary lymph nodes in patients with breast cancer. Breast Cancer Res. 2007; 9(4): R40. doi: 10.1186/bcr1738.
[10]	Khawaja RD, Singh S, Gilman M, Sharma A, Do S, Pourjabbar S, et al. Computed Tomography (CT) of the Chest at Less Than 1 mSv: An Ongoing Prospective Clinical Trial of Chest CT at Submillisievert Radiation Doses with Iterative Model Image Reconstruction and iDose4 Technique. J Comput Assist Tomogr. 2014; 38(4): 613-619. doi: 10.1097/RCT.0000000000000087.
[11]	Khawaja RD, Singh S, Blake M, Harisinghani M, Choy G, Karaosmanoglu A, et al. Ultra-low dose abdominal MDCT: using a knowledge-based Iterative Model Reconstruction technique for substantial dose reduction in a prospective clinical study. Eur J Radiol. 2015; 84(1): 2-10. doi: 10.1016/j.ejrad.2014.09.022.
[12]	Zhang F, Yang L, Song X, Li YN, Jiang Y, Zhang XH, et al. Feasibility study of low tube voltage (80 kVp) coronary CT angiography combined with contrast medium reduction using iterative model reconstruction (IMR) on standard BMI patients. Br J Radiol. 2016; 89(1058): 20150766. doi: 10.1259/bjr.20150766.
[13]	Nakaura T, Iyama Y, Kidoh M, Yokoyama K, Oda S, Tokuyasu S, et al. Comparison of iterative model, hybrid iterative, and filtered back projection reconstruction techniques in low-dose brain CT: impact of thin-slice imaging. Neuroradiology. 2016; 58(3): 245-251. doi: 10.1007/s00234-015-1631-4.
[14]	Gradishar WJ, Anderson BO, Balassanian R, Blair SL, Burstein HJ, Cyr A, et al, Invasive Breast Cancer Version 1.2016, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2016; 14(3): 324-354.
[15]	American College of Radiology. ACR BI-RADS: Magnetic Resonance Imaging. In: ACR Breast Imaging Reporting and Data System, Breast Imaging Atlas. Reston, Va: American College of Radiology. 2013.
[16]	AAPM REPORT NO. 96 The Measurement, Reporting, and Management of Radiation Dose in CT Report of AAPM Task Group 23: CT Dosimetry Diagnostic Imaging Council CT Committee. http://www.aapm.org/pubs/reports/RPT_96.pdf
[17]	Inoue M, Sano T, Watai R, Ashikaga R, Ueda K, Watatani M, et al. Dynamic Multidetector CT of Breast Tumors: Diagnostic Features and Comparison with Conventional Techniques. AJR. 2003; 181(3), 679-686. doi: 10.2214/ajr.181.3.1810679.
[18]	National Lung Screening Trial Research Team. Results of initial low-dose computed tomographic screening for lung cancer. N Engl J Med. 2013; 368(21): 1980-1991. doi: 10.1056/NEJMoa1209120.
[19]	Brown J, Smith RC, Lee CH. Incidental enhancing lesions found on MR imaging of the breast. AJR. 2001; 176(5): 1249–1254. doi: 10.2214/ajr.176.5.1761249.

Cite This Article

Plain Text BibTeX RIS

APA Style

Yong Guo, Jiang Yan, Qingjun Wang, Jing Zhang, Lijing Shi, et al. (2018). 2 Milisievert Low Dose Dedicated Breast CT with Iterative Model Reconstruction Technique in Evaluation of Breast Mass: Feasibility Study in Comparison with MRI. International Journal of Medical Imaging, 6(3), 18-24. https://doi.org/10.11648/j.ijmi.20180603.11

Copy | Download

ACS Style

Yong Guo; Jiang Yan; Qingjun Wang; Jing Zhang; Lijing Shi, et al. 2 Milisievert Low Dose Dedicated Breast CT with Iterative Model Reconstruction Technique in Evaluation of Breast Mass: Feasibility Study in Comparison with MRI. Int. J. Med. Imaging 2018, 6(3), 18-24. doi: 10.11648/j.ijmi.20180603.11

Copy | Download

AMA Style

Yong Guo, Jiang Yan, Qingjun Wang, Jing Zhang, Lijing Shi, et al. 2 Milisievert Low Dose Dedicated Breast CT with Iterative Model Reconstruction Technique in Evaluation of Breast Mass: Feasibility Study in Comparison with MRI. Int J Med Imaging. 2018;6(3):18-24. doi: 10.11648/j.ijmi.20180603.11

Copy | Download

@article{10.11648/j.ijmi.20180603.11,
  author = {Yong Guo and Jiang Yan and Qingjun Wang and Jing Zhang and Lijing Shi and Yingying Hu and Yun Zhang},
  title = {2 Milisievert Low Dose Dedicated Breast CT with Iterative Model Reconstruction Technique in Evaluation of Breast Mass: Feasibility Study in Comparison with MRI},
  journal = {International Journal of Medical Imaging},
  volume = {6},
  number = {3},
  pages = {18-24},
  doi = {10.11648/j.ijmi.20180603.11},
  url = {https://doi.org/10.11648/j.ijmi.20180603.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20180603.11},
  abstract = {Objective To investigate the feasibility of low dose dedicated computed tomography (CT) with IMR technique compared with magnetic resonance imaging (MRI) in preoperative evaluation of breast cancer. Methods Dedicated CT and breast MRI were performed in 21 patients with diagnosed breast mass for preoperative evaluation. A dedicated protocol combined with chest diagnostic CT and dynamic scans of breast was developed with the use of IMR technique as well as optimization of scan parameters to ensure acceptable radiation dose. Image quality evaluations of CT images were performed using a five-point scale. The number, site and size (maximum diameter) of breast lesion were recorded respectively in CT and MRI images. The enhancement patterns of breast lesion were classified to 3 types (washout, plateau, and persistence) according to time intensity curve derived from CT and time signal curve derived from MRI, respectively. Pearson’s correlation, Bland-Altman analysis, and Cohen’s kappa test were used for statistical assessment. Results The mean effective radiation dose of dedicated breast CT, with the image quality diagnostic acceptable for evaluation of breast lesion and pulmonary structures, was (2.15±0.39) mSv, which was no more than a routine chest diagnostic CT. Results of breast lesion number and lesion site obtained by CT and MRI was consistent, with a total of 24 lesions detected in 21 patients. The mean lesion size was (26.5±12.1) mm in CT and (26.1±12.9) mm in MR, respectively. CT showed an excellent correlation with MRI for lesion size (r=0.99, n=24, p<0.0001). Limits of agreement determined by Bland-Altman analysis for lesion extent was (-3.0mm, 3.8mm). Good agreement was observed between CT and MRI for lesion enhancement patterns (kappa value = 0.936, p=0.000). Conclusion Dedicated breast CT imaging with acceptable radiation dose enabled diagnostic image quality and showed good agreement with breast MR imaging in preoperative evaluation of breast cancer.},
 year = {2018}
}

Copy | Download

TY - JOUR
T1 - 2 Milisievert Low Dose Dedicated Breast CT with Iterative Model Reconstruction Technique in Evaluation of Breast Mass: Feasibility Study in Comparison with MRI
AU - Yong Guo
AU - Jiang Yan
AU - Qingjun Wang
AU - Jing Zhang
AU - Lijing Shi
AU - Yingying Hu
AU - Yun Zhang
Y1 - 2018/12/20
PY - 2018
N1 - https://doi.org/10.11648/j.ijmi.20180603.11
DO - 10.11648/j.ijmi.20180603.11
T2 - International Journal of Medical Imaging
JF - International Journal of Medical Imaging
JO - International Journal of Medical Imaging
SP - 18
EP - 24
PB - Science Publishing Group
SN - 2330-832X
UR - https://doi.org/10.11648/j.ijmi.20180603.11
AB - Objective To investigate the feasibility of low dose dedicated computed tomography (CT) with IMR technique compared with magnetic resonance imaging (MRI) in preoperative evaluation of breast cancer. Methods Dedicated CT and breast MRI were performed in 21 patients with diagnosed breast mass for preoperative evaluation. A dedicated protocol combined with chest diagnostic CT and dynamic scans of breast was developed with the use of IMR technique as well as optimization of scan parameters to ensure acceptable radiation dose. Image quality evaluations of CT images were performed using a five-point scale. The number, site and size (maximum diameter) of breast lesion were recorded respectively in CT and MRI images. The enhancement patterns of breast lesion were classified to 3 types (washout, plateau, and persistence) according to time intensity curve derived from CT and time signal curve derived from MRI, respectively. Pearson’s correlation, Bland-Altman analysis, and Cohen’s kappa test were used for statistical assessment. Results The mean effective radiation dose of dedicated breast CT, with the image quality diagnostic acceptable for evaluation of breast lesion and pulmonary structures, was (2.15±0.39) mSv, which was no more than a routine chest diagnostic CT. Results of breast lesion number and lesion site obtained by CT and MRI was consistent, with a total of 24 lesions detected in 21 patients. The mean lesion size was (26.5±12.1) mm in CT and (26.1±12.9) mm in MR, respectively. CT showed an excellent correlation with MRI for lesion size (r=0.99, n=24, p<0.0001). Limits of agreement determined by Bland-Altman analysis for lesion extent was (-3.0mm, 3.8mm). Good agreement was observed between CT and MRI for lesion enhancement patterns (kappa value = 0.936, p=0.000). Conclusion Dedicated breast CT imaging with acceptable radiation dose enabled diagnostic image quality and showed good agreement with breast MR imaging in preoperative evaluation of breast cancer.
VL - 6
IS - 3
ER -

Copy | Download

Author Information

Yong Guo

Department of Radiology, Navy General Hospital, Beijing, China
Jiang Yan

Clinical Science, Philips Healthcare, Shanghai, China
Qingjun Wang

Department of Radiology, Navy General Hospital, Beijing, China
Jing Zhang

Department of Radiology, Navy General Hospital, Beijing, China
Lijing Shi

Department of Radiology, Navy General Hospital, Beijing, China
Yingying Hu

Department of Radiology, Navy General Hospital, Beijing, China
Yun Zhang

Department of Radiology, Navy General Hospital, Beijing, China

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Yong Guo, Jiang Yan, Qingjun Wang, Jing Zhang, Lijing Shi, et al. (2018). 2 Milisievert Low Dose Dedicated Breast CT with Iterative Model Reconstruction Technique in Evaluation of Breast Mass: Feasibility Study in Comparison with MRI. International Journal of Medical Imaging, 6(3), 18-24. https://doi.org/10.11648/j.ijmi.20180603.11

Copy | Download

ACS Style

Yong Guo; Jiang Yan; Qingjun Wang; Jing Zhang; Lijing Shi, et al. 2 Milisievert Low Dose Dedicated Breast CT with Iterative Model Reconstruction Technique in Evaluation of Breast Mass: Feasibility Study in Comparison with MRI. Int. J. Med. Imaging 2018, 6(3), 18-24. doi: 10.11648/j.ijmi.20180603.11

Copy | Download

AMA Style

Yong Guo, Jiang Yan, Qingjun Wang, Jing Zhang, Lijing Shi, et al. 2 Milisievert Low Dose Dedicated Breast CT with Iterative Model Reconstruction Technique in Evaluation of Breast Mass: Feasibility Study in Comparison with MRI. Int J Med Imaging. 2018;6(3):18-24. doi: 10.11648/j.ijmi.20180603.11

Copy | Download

@article{10.11648/j.ijmi.20180603.11,
  author = {Yong Guo and Jiang Yan and Qingjun Wang and Jing Zhang and Lijing Shi and Yingying Hu and Yun Zhang},
  title = {2 Milisievert Low Dose Dedicated Breast CT with Iterative Model Reconstruction Technique in Evaluation of Breast Mass: Feasibility Study in Comparison with MRI},
  journal = {International Journal of Medical Imaging},
  volume = {6},
  number = {3},
  pages = {18-24},
  doi = {10.11648/j.ijmi.20180603.11},
  url = {https://doi.org/10.11648/j.ijmi.20180603.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20180603.11},
  abstract = {Objective To investigate the feasibility of low dose dedicated computed tomography (CT) with IMR technique compared with magnetic resonance imaging (MRI) in preoperative evaluation of breast cancer. Methods Dedicated CT and breast MRI were performed in 21 patients with diagnosed breast mass for preoperative evaluation. A dedicated protocol combined with chest diagnostic CT and dynamic scans of breast was developed with the use of IMR technique as well as optimization of scan parameters to ensure acceptable radiation dose. Image quality evaluations of CT images were performed using a five-point scale. The number, site and size (maximum diameter) of breast lesion were recorded respectively in CT and MRI images. The enhancement patterns of breast lesion were classified to 3 types (washout, plateau, and persistence) according to time intensity curve derived from CT and time signal curve derived from MRI, respectively. Pearson’s correlation, Bland-Altman analysis, and Cohen’s kappa test were used for statistical assessment. Results The mean effective radiation dose of dedicated breast CT, with the image quality diagnostic acceptable for evaluation of breast lesion and pulmonary structures, was (2.15±0.39) mSv, which was no more than a routine chest diagnostic CT. Results of breast lesion number and lesion site obtained by CT and MRI was consistent, with a total of 24 lesions detected in 21 patients. The mean lesion size was (26.5±12.1) mm in CT and (26.1±12.9) mm in MR, respectively. CT showed an excellent correlation with MRI for lesion size (r=0.99, n=24, p<0.0001). Limits of agreement determined by Bland-Altman analysis for lesion extent was (-3.0mm, 3.8mm). Good agreement was observed between CT and MRI for lesion enhancement patterns (kappa value = 0.936, p=0.000). Conclusion Dedicated breast CT imaging with acceptable radiation dose enabled diagnostic image quality and showed good agreement with breast MR imaging in preoperative evaluation of breast cancer.},
 year = {2018}
}

Copy | Download