Is contrast enhancement required to visualize a known breast tumor in a pre-operative CT scan?

Abstract Background and purpose A pre-operative CT scan with contrast enhancement (CE) has recently been proposed to improve tumorbed delineation in breast conserving therapy. However, it is not clear whether CE is required for visualization of a known breast tumor. The main aims of this study were...

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Bibliographic Details
Published in:Radiotherapy and oncology 2011-08, Vol.100 (2), p.271-275
Main Authors: Boersma, Liesbeth J, Hanbeukers, Bianca, Boetes, Carla, Borger, Jacques, Ende, Piet van den, Haaren, Els van, Houben, Ruud, Jager, Jos, Murrer, Lars, Sastrowijoto, Suprapto, Baardwijk, Angela van
Format: Article
Language:English
Subjects:
Adult
Aged
Breast conserving therapy
Breast Neoplasms - diagnostic imaging
Breast Neoplasms - surgery
Contrast Media
Contrast-enhancement
Female
Hematology, Oncology and Palliative Medicine
Humans
Mammography
Middle Aged
Pre-operative CT scanning
Radiographic Image Enhancement
Sensitivity and Specificity
Tomography, X-Ray Computed - methods
Tumor visibility
Tumorbed delineation
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Summary:Abstract Background and purpose A pre-operative CT scan with contrast enhancement (CE) has recently been proposed to improve tumorbed delineation in breast conserving therapy. However, it is not clear whether CE is required for visualization of a known breast tumor. The main aims of this study were to compare the sensitivity of a CE-CT scan with a native CT scan ( i.e. without CE) and to identify characteristics predictive for the requirement of CE. Patients and methods Both a CE-CT and a native CT were made in 58 breast cancer patients (age 37–75 yr), prior to breast conserving surgery. Visibility of the tumor on CT was scored by three observers (clearly visible/doubtful/not visible). Age, tumor size, palpable tumor yes/no, histology, and visibility on mammography were analyzed with respect to the visibility of the tumor on the native CT. Results The sensitivity for tumor detection was better for CE-CT (95%) than for native CT (83%) ( p < 0.001 ). Only mammographic visibility scores appeared to be significantly correlated with the visibility of the tumor on the native CT ( p = 0.013). Conclusion In most patients CE is not required to visualize a known breast tumor. Mammographic visibility is a good parameter to decide on the use of CE.
ISSN:0167-8140
1879-0887
DOI:10.1016/j.radonc.2011.06.027