Possibility to discriminate benign from malignant breast les
Intramammary mass lesions are reportedly present in up to 5.8?% of all contrast-enhanced CT examinations of the female chest. The quantitative map-based evaluation of the variables “iodine content”, “monoenergetic curve-slope” and “Zeffective” showed superior results compared to normal density-based CT images.

Researchers aimed to assess whether their biological relevance can be estimated using spectral CT datasets.

In this bicentric retrospective study patients with breast masses visualized on spectral CT examinations were included. Lesions were characterized as malignant or benign based on histology and/or a stable follow-up of >2 years. Conventional CT images, iodine density maps, virtual monoenergetic images, and Zeffective-maps were evaluated by two independent readers. 106 breast masses were included.

- The mean AUCs of the variables “iodine content”, “monoenergetic curve-slope” and “Zeffective” measured in the target lesions (TL) showed superior results compared to those derived from the variable “density”.

- The ratios “TL to aorta” calculated for the variables “iodine content”, “monoenergetic curve-slope” and “Zeffective” showed superior results compared to normal breast tissue and muscle.

- The optimal cutpoint for the “iodine content” in the TL was 0.7-0.9 mg/ml sensitivity 96.6%, specificity 91.7%.

- The best diagnostic results were achieved by normalizing the iodine content in the TL to that in the aorta.

The preliminary results suggest that spectral CT datasets might allow estimating the biological dignity of breast masses detected on clinically indicated chest examinations.

European Journal of Radiology
Source: https://doi.org/10.1016/j.ejrad.2021.109832
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