RESUMO
OBJECTIVES: The goal of this work is to determine the optimal projection to detect breast masses on Chest CT. METHODS: Institutional Review Board (HIPPA compliant) approval was obtained with a waiver of consent. 10 image pairs of Chest CT images containing breast masses were selected for review by 10 chest radiologists: the pairs consisted of axial, sagittal, coronal and axial MIP images (MIP images) with each projection compared to a MIP and with one another. For each pair, the image where the mass was most conspicuous was recorded. RESULTS: MIPs were preferred to any cross sectional projection 82% of the time; sagittal (63%) or coronal (63%) images were preferred to the axial projection. When sagittal and coronal images were compared there was no preference. CONCLUSIONS: MIP images should be obtained and reviewed for breast pathology; sagittal or coronal projections may provide additional information.
Assuntos
Mama/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , TóraxRESUMO
The benefits of early diagnosis and treatment of breast cancer are well established. Thoracic CT which is performed with increased frequency for lung cancer screening can diagnose breast cancer earlier then might be possible clinically. The imaged and radiation exposed breasts must be included in their entirety on images which are reviewed by the radiologist. Because of concerns about how altering the field of view might affect image quality, we advocate for inclusion of the entire breast on the soft tissue series, which can be viewed on mediastinal window settings and expose the patient to no additional radiation.
Assuntos
Neoplasias da Mama/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico por imagem , Radiografia Torácica/métodos , Tomografia Computadorizada por Raios X/métodos , Detecção Precoce de Câncer , Feminino , Humanos , Mediastino , Doses de Radiação , Exposição à RadiaçãoRESUMO
PURPOSE: To assess the ability of chest CT to identify patients needing further evaluation of the breasts. METHODS: IRB approval was obtained with a waiver of consent. Women with chest CT and mammogram within 12months formed the cohort. A breast assessment and recommendation CT score (BARCS) analogous to mammographic BI-RADS was created and compared to the mammogram BI-RADS. RESULTS: BARCS and mammographic BI-RADS management recommendations were concordant for 77.1%. 11 invasive cancers were detected; all by mammogram while CT missed 2. CONCLUSION: BARCS score should be studied in prospective trials. Chest CT might be the earliest opportunity to detect breast cancer.