ABSTRACT
INTRODUCTION: Left ventricular (LV) and right ventricular (RV) volumetric and functional parameters are important biomarkers for morbidity and mortality in patients with heart failure. PURPOSE: To retrospectively determine reference mean values of LV and RV volume, function and mass normalised by age, gender and body surface area (BSA) from retrospectively electrocardiographically gated 64-slice cardiac computed tomography (CCT) by using automated analysis software in healthy adults. MATERIALS AND METHODS: The study was approved by the institutional review board with a waiver of informed consent. Seventy-four healthy subjects (49% female, mean age 49.6 ± 11) free of hypertension and hypercholesterolaemia with a normal CCT formed the study population. Analyses of LV and RV volume (end-diastolic, end-systolic and stroke volumes), function (ejection fraction), LV mass and inter-rater reproducibility were performed with commercially available analysis software capable of automated contour detection. General linear model analysis was performed to assess statistical significance by age group after adjustment for gender and BSA. Bland-Altman analysis assessed the inter-rater agreement. RESULTS: The reference range for LV and RV volume, function, and LV mass was normalised to age, gender and BSA. Statistically significant differences were noted between genders in both LV mass and RV volume (P-value < 0.0001). Age, in concert with gender, was associated with significant differences in RV end-diastolic volume and LV ejection fraction (P-values 0.027 and 0.03). Bland-Altman analysis showed acceptable limits of agreement (±1.5% for ejection fraction) without systematic error. CONCLUSION: LV and RV volume, function and mass normalised to age, gender and BSA can be reported from CCT datasets, providing additional information important for patient management.
Subject(s)
Aging/physiology , Body Surface Area , Heart Ventricles/diagnostic imaging , Radiographic Image Interpretation, Computer-Assisted/standards , Stroke Volume/physiology , Tomography, X-Ray Computed/standards , Ventricular Function/physiology , Adult , Aged , Female , Humans , Male , Middle Aged , Observer Variation , Organ Size/physiology , Reference Values , Reproducibility of Results , Sensitivity and Specificity , Sex Characteristics , United StatesABSTRACT
OBJECTIVE: The purpose of this article is to review both expected and unexpected thoracic CT manifestations of nonsurgical breast cancer treatment with multimodality imaging correlation. Specific topics include the spectrum of posttherapy changes attributed to chemotherapy and radiation therapy and the spread of breast cancer. CONCLUSION: Thoracic CT is an important tool commonly used for breast cancer staging and surveillance and for diagnostic indications such as shortness of breath and chest pain. Imaging findings can be related to progression of disease or to associated conditions, such as pulmonary embolism. The hallmarks of breast cancer spread in the thorax include pulmonary nodules, enlarged lymph nodes, pleural effusions, thickening or nodularity, and sclerotic or lytic skeletal lesions. Less common findings including pulmonary lymphangitic tumor spread and pericardial metastasis. The findings also may represent the sequelae of surgery, radiation therapy, or chemotherapy for breast cancer. Knowledge of various treatment methods and their expected and unexpected CT findings is important for recognizing treatment-related abnormalities to avoid confusion with breast cancer spread and thereby minimize the risk that unnecessary further diagnostic imaging will be performed.
Subject(s)
Antineoplastic Agents/adverse effects , Breast Neoplasms/therapy , Radiation Injuries/etiology , Radiotherapy, Conformal/adverse effects , Thoracic Diseases/diagnostic imaging , Thoracic Diseases/etiology , Tomography, X-Ray Computed/methods , Aged , Antineoplastic Agents/therapeutic use , Breast Neoplasms/complications , Breast Neoplasms/diagnostic imaging , Female , Humans , Middle Aged , Radiation Injuries/diagnostic imaging , Radiography, Thoracic/methodsABSTRACT
OBJECTIVE: The purpose of this article is to discuss the surgical treatment of breast cancer and its resultant thoracic CT and multimodality imaging manifestations. CONCLUSION: Many breast cancer patients undergo cross-sectional imaging at some point during or after treatment. Thoracic CT is an important modality performed for staging and surveillance. Thoracic CT examinations often show findings related to patients' surgical or adjuvant treatment. The postsurgical changes visible on thoracic CT may include those related to lumpectomy, mastectomy, breast reconstruction, and axillary surgery. Postsurgical complications may also be seen, including fluid collections, infection, fat necrosis, and lymphedema. Recognition and appropriate interpretation of the posttherapeutic spectrum of findings are important to avoid unnecessary diagnostic imaging and minimize patient anxiety.
