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05.02.2020 | Breast

Comprehensive analyses with radiological and biological markers of breast cancer on contrast-enhanced chest CT: a single center experience using dual-layer spectral detector CT

verfasst von: Jin Il Moon, Bo Hwa Choi, Hye Jin Baek, Kyeong Hwa Ryu, Sung Eun Park, Ji Young Ha, Eun Jung Jung, Han Shin Lee, Hyo Jung An

Erschienen in: European Radiology | Ausgabe 5/2020

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Abstract

Objectives

To evaluate the predictive value of virtual monoenergetic images (VMIs) by assessing tumor conspicuity on dual-layer spectral detector CT (SDCT) and correlate tumor conspicuity on VMI with prognostic biomarkers in patients with breast cancer.

Methods

Sixty-four patients underwent arterial phase and 90-s delayed phase dual-layer SDCT. A retrospective tumor conspicuity analysis of 14 benign tumors and 65 breast cancers was performed using conventional images (CIs) and VMI at 40 keV (VMI40) on arterial and delayed phase scans (CI_ART, VMI40_ART, CI_DE, VMI40_DE). Mean Hounsfield units (HU) of tumors were measured on VMI40_ART and VMI40_DE. A receiver operating characteristic (ROC) curve analysis was performed to compare diagnostic accuracy between image sets. Estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki67 levels were evaluated using histopathology. Correlations between VMI analyses and histological characteristics of cancers were analyzed.

Results

Cancers on VMI40 had a significantly higher conspicuity score and mean HU than benign tumors (p < 0.001). VMI40_DE showed the highest conspicuity for cancers (mean, 3.79) and the greatest area under the ROC curve (0.817; 95% confidence interval 0.745–0.889). VMI40_DE yielded significantly higher mean HU for cancers than VMI40_ART (p < 0.001). The conspicuity score and mean HU on VMI40_ART were significantly higher in cancers with ER negativity, PR negativity, and Ki67 positivity (p < 0.05).

Conclusions

VMI40_DE may be useful in the diagnosis of breast cancers due to higher tumor conspicuity and better enhancement than VMI40_ART. VMI40_ART may be beneficial for the prediction of poor breast cancer prognoses.

Key Points

• VMI40 improved conspicuity of breast cancer than CI.

• VMI40_DEyielded higher diagnostic performance of breast cancer than VMI40_ART.

• VMI40_ARThas an additional benefit in terms of prognosis prediction in patients with breast cancers.

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Titel: Comprehensive analyses with radiological and biological markers of breast cancer on contrast-enhanced chest CT: a single center experience using dual-layer spectral detector CT
verfasst von: Jin Il Moon
Bo Hwa Choi
Hye Jin Baek
Kyeong Hwa Ryu
Sung Eun Park
Ji Young Ha
Eun Jung Jung
Han Shin Lee
Hyo Jung An
Publikationsdatum: 05.02.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 5/2020
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-019-06615-9

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Comprehensive analyses with radiological and biological markers of breast cancer on contrast-enhanced chest CT: a single center experience using dual-layer spectral detector CT