Cone beam breast CT with multiplanar and three dimensional visualization in differentiating breast masses compared with mammography

Binghui Zhao; Xiaohua Zhang; Weixing Cai; David Conover; Ruola Ning

doi:10.1016/j.ejrad.2014.05.032

Cone beam breast CT with multiplanar and three dimensional visualization in differentiating breast masses compared with mammography

Eur J Radiol. 2015 Jan;84(1):48-53. doi: 10.1016/j.ejrad.2014.05.032. Epub 2014 Jul 15.

Authors

Binghui Zhao¹, Xiaohua Zhang², Weixing Cai³, David Conover⁴, Ruola Ning⁵

Affiliations

¹ Department of Radiology, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China.
² Department of Electrical and Computer Engineering, University of Rochester, Rochester, NY 14627, USA.
³ Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA.
⁴ Koning Corporation, West Henrietta, NY 14586, USA.
⁵ Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA. Electronic address: ruola_ning@urmc.rochester.edu.

PMID: 25439008
DOI: 10.1016/j.ejrad.2014.05.032

Abstract

Objective: This pilot study was to evaluate cone beam breast computed tomography (CBBCT) with multiplanar and three dimensional (3D) visualization in differentiating breast masses in comparison with two-view mammograms.

Methods: Sixty-five consecutive female patients (67 breasts) were scanned by CBBCT after conventional two-view mammography (Hologic, Motarget, compression factor 0.8). For CBBCT imaging, three hundred (1024 × 768 × 16b) two-dimensional (2D) projection images were acquired by rotating the x-ray tube and a flat panel detector (FPD) 360 degree around one breast. Three-dimensional CBBCT images were reconstructed from the 2D projections. Visage CS 3.0 and Amira 5.2.2 were used to visualize reconstructed CBBCT images.

Results: Eighty-five breast masses in this study were evaluated and categorized under the breast imaging reporting and data system (BI-RADS) according to plain CBBCT images and two-view mammograms, respectively, prior to biopsy. BI-RADS category of each breast was compared with biopsy histopathology. The results showed that CBBCT with multiplanar and 3D visualization would be helpful to identify the margin and characteristics of breast masses. The category variance ratios for CBBCT under the BI-RADS were 23.5% for malignant tumors (MTs) and 27.3% for benign lesions in comparison with pathology, which were evidently closer to the histopathology results than those of two-view mammograms, p value <0.01. With the receiver operating characteristic (ROC) curve analysis, the area under the curve (AUC) of CBBCT was 0.911, larger than that (AUC 0.827) of two-view mammograms, p value <0.01.

Conclusion: CBBCT will be a distinctive noninvasive technology in differentiating and categorizing breast masses under BI-RADS. CBBCT may be considerably more effective to identify breast masses, especially some small, uncertain or multifocal masses than conventional two-view mammography.

Keywords: Breast neoplasm; Cone beam computed tomography; Malignant; Pathologic calcification.

Publication types

Comparative Study
Evaluation Study
Research Support, N.I.H., Extramural

MeSH terms

Adult
Aged
Area Under Curve
Biopsy
Breast / pathology*
Breast Neoplasms / diagnostic imaging
Breast Neoplasms / pathology*
Cone-Beam Computed Tomography*
Female
Humans
Imaging, Three-Dimensional*
Mammography* / methods
Middle Aged
Pilot Projects
ROC Curve
Retrospective Studies

Abstract

Publication types

MeSH terms

Grants and funding