Clinical Feasibility of Dual-Layer CT With Virtual Monochromatic Image for Preoperative Staging in Patients With Breast Cancer: A Comparison With Breast MRI.

IF 4.4 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Korean Journal of Radiology Pub Date : 2024-09-01 DOI:10.3348/kjr.2023.1312
Bokdong Yeo, Kyung Min Shin, Byunggeon Park, Hye Jung Kim, Won Hwa Kim
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Abstract

Objective: Dual-layer CT (DLCT) can create virtual monochromatic images (VMIs) at various monochromatic X-ray energies, particularly at low keV levels, with high contrast-to-noise ratio. The purpose of this study was to assess the clinical feasibility of contrast-enhanced chest DLCT with a low keV VMI for preoperative breast cancer staging, in comparison to breast MRI.

Materials and methods: A total of 152 patients with 155 index breast cancers were enrolled in the study. VMIs were generated from contrast-enhanced chest DLCT at 40 keV and maximum intensity projection (MIP) with three-dimensional (3D) reconstruction was performed for both bilateral breast areas. Two radiologists reviewed in consensus the 3D MIP images of the chest DLCT with VMI and breast MRI in separate sessions with a 3-month wash-out period. The detection rate and mean tumor size of the index cancer were compared between the chest DLCT with VMI and breast MRI. Additionally, the agreement of tumor size measurement between the two imaging modalities were evaluated.

Results: Of all index cancers, 84.5% (131/155) were detected in the chest DLCT with VMI, while 88.4% (137/155) were detected in the breast MRI (P = 0.210). The Bland-Altman agreement between the chest DLCT with VMI and breast MRI was a mean difference of -0.05 cm with 95% limits of agreement of -1.29 to 1.19 cm. The tumor size in the chest DLCT with VMI (2.3 ± 1.7 cm) was not significantly different from that in the breast MRI (2.4 ± 1.6 cm) (P = 0.106).

Conclusion: The feasibility of chest DLCT with VMI was demonstrated for preoperative tumor staging in breast cancer patients, showing comparable cancer detectability and good agreement in tumor size measurement compared to breast MRI. This suggests that chest DLCT with VMI can serve as a potential alternative for patients who have contraindications to breast MRI.

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双层 CT 虚拟单色图像用于乳腺癌患者术前分期的临床可行性:与乳腺磁共振成像的比较。
目的:双层 CT(DLCT)可以在各种单色 X 射线能量下生成虚拟单色图像(VMI),尤其是在低 keV 水平下,具有较高的对比度-噪声比。本研究的目的是评估对比增强胸部 DLCT 与低 keV VMI 在乳腺癌术前分期方面的临床可行性,并与乳腺 MRI 进行比较:该研究共纳入了 152 名患有 155 例指数乳腺癌的患者。对比增强胸部 DLCT 在 40 keV 下生成 VMI,并对双侧乳房区域进行最大强度投影(MIP)和三维(3D)重建。两名放射科医生分别对胸部 DLCT 的三维 MIP 图像、VMI 和乳腺 MRI 进行了一致审查,并有 3 个月的冲洗期。比较了胸部 DLCT 与 VMI 和乳腺 MRI 的检出率和指标癌的平均肿瘤大小。此外,还评估了两种成像方式对肿瘤大小测量的一致性:在所有指标癌中,84.5%(131/155)在胸部 DLCT 和 VMI 中检测到,88.4%(137/155)在乳腺 MRI 中检测到(P = 0.210)。胸部 DLCT 与 VMI 和乳腺 MRI 之间的 Bland-Altman 一致度平均相差-0.05 厘米,95% 的一致度范围为-1.29 至 1.19 厘米。胸部 DLCT 与 VMI 的肿瘤大小(2.3 ± 1.7 厘米)与乳腺 MRI 的肿瘤大小(2.4 ± 1.6 厘米)无显著差异(P = 0.106):结论:胸部 DLCT 和 VMI 用于乳腺癌患者术前肿瘤分期的可行性得到了证实,与乳腺 MRI 相比,胸部 DLCT 的癌症检测能力相当,肿瘤大小测量的一致性也很好。这表明,对于有乳腺磁共振成像禁忌症的患者来说,胸部 DLCT 与 VMI 可以作为一种潜在的替代方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Korean Journal of Radiology
Korean Journal of Radiology 医学-核医学
CiteScore
10.60
自引率
12.50%
发文量
141
审稿时长
1.3 months
期刊介绍: The inaugural issue of the Korean J Radiol came out in March 2000. Our journal aims to produce and propagate knowledge on radiologic imaging and related sciences. A unique feature of the articles published in the Journal will be their reflection of global trends in radiology combined with an East-Asian perspective. Geographic differences in disease prevalence will be reflected in the contents of papers, and this will serve to enrich our body of knowledge. World''s outstanding radiologists from many countries are serving as editorial board of our journal.
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