Dedicated breast CT: initial clinical experience.
OBJECTIVE
To prospectively and intraindividually compare dedicated breast computed tomographic (CT) images with screen-film mammograms.


METHODS
All patient studies were performed according to protocols approved by the institutional review board and Radiation Use Committee; informed consent was obtained. A breast CT scanner prototype was used to individually scan uncompressed breasts in 10 healthy volunteers (mean age, 52.1 years) and 69 women with Breast Imaging Reporting and Data System category 4 and 5 lesions (mean age, 54.4 years). In women with lesions, breast CT images were compared with screen-film mammograms by an experienced mammographer and ranked with a continuous scale of 1-10 (score 1, excellent lesion visualization with CT and poor visualization with mammography; score 5.5, equal visualization with both modalities; and score 10, poor visualization with CT and excellent visualization with mammography). A Wilcoxon signed rank procedure was used to test the null hypothesis that ratings were symmetric at about a score of 5.5 for the entire group and for distinguishing microcalcifications versus masses and other findings and benign versus malignant lesions and for effect of breast density on lesion visualization. Women were asked to compare their comfort during CT with that during mammography on a continuous scale of 1-10. With a Wilcoxon signed rank procedure, the null hypothesis that comfort ratings were symmetric about a score of 5.5 (equal comfort with CT and mammography) was tested.


RESULTS
Overall, CT was equal to mammography for visualization of breast lesions. Breast CT was significantly better than mammography for visualization of masses (P = .002); mammography outperformed CT for visualization of microcalcifications (P = .006). No significant differences between CT and mammography were seen among benign versus malignant lesions or for effect of breast density on lesion visualization. Subjects found CT significantly more comfortable than mammography (P < .001).


CONCLUSIONS
Some technical challenges remain, but breast CT is promising and may have potential clinical applications.
Lindfors
Karen K
KK
Department of Radiology, University of California, Davis Medical Center, Suite 3100, 4860 Y St, Sacramento, CA 95817, USA. kklindfors@ucdavis.edu
Boone
John M
JM
Nelson
Thomas R
TR
Yang
Kai
K
Kwan
Alexander L C
AL
Miller
DeWitt F
DF
D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D003287:Contrast Media; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed
D003287:Contrast Media