Universität zu Köln

Simsir, Begum Demirler, Krug, Kathrin Barbara, Burke, Christina, Hellmich, Martin, Maintz, David and Coche, Emmanuel ORCID: 0000-0002-2532-3004 (2021). Possibility to discriminate benign from malignant breast lesions detected on dual-layer spectral CT-evaluation. Eur. J. Radiol., 142. CLARE: ELSEVIER IRELAND LTD. ISSN 1872-7727

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Abstract

Objectives: Intramammary mass lesions are reportedly present in up to 5.8% of all contrast enhanced CTexaminations of the female chest. We aimed to assess whether their biological relevance can be estimated using spectral CT-datasets. Methods: In this bicentric retrospective study patients with breast masses visualized on spectral CT-examinations from 07/2017 to 06/2019 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 monoenergeticimages (40 keV, 100 keV) and Zeffective-maps were evaluated by two independent readers. Statistical analysis derived from the Regions of interest (ROIs) was done by calculating the Areas under the Receiver operating characteristic (ROC) curve (AUC) and Youden-indices. Results: 106 breast masses (malignant/benign: 81/25, 76.4%/23.6%) were included. The mean AUCs of the variables iodine content (reader 1/2:0.97;0.98), monoenergetic curve-slope (0.97;0.96) and Zeffective (0.98;0.98) measured in the target lesions (TL) showed superior results compared to those derived from the variable density (0.92;0.93) (p < 0.001). 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 (p < 0.001). 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 (optimal cutpoint 0.1, sensitivity 95.5%, 98.9%, specificity 91.7%). Conclusions: Our preliminary results suggest that spectral CT-datasets might allow to estimate the biological dignity of breast masses detected on clinically indicated chest-examinations.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Simsir, Begum Demirler UNSPECIFIED UNSPECIFIED UNSPECIFIED Krug, Kathrin Barbara UNSPECIFIED UNSPECIFIED UNSPECIFIED Burke, Christina UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellmich, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Maintz, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Coche, Emmanuel UNSPECIFIED orcid.org/0000-0002-2532-3004 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-592613
DOI:	10.1016/j.ejrad.2021.109832
Journal or Publication Title:	Eur. J. Radiol.
Volume:	142
Date:	2021
Publisher:	ELSEVIER IRELAND LTD
Place of Publication:	CLARE
ISSN:	1872-7727
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ENERGY CT; CANCER; PRINCIPLES; CHEST Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/59261