title: Whole-breast volume perfusion images using 256-row multislice computed tomography: visualization of lesions with ductal spread.
abstract: BACKGROUND
  The aim of this study was to apply perfusion techniques to breast tumors using a prototype 256-row multislice computed tomography (CT) scanner (which allows a wide range of 128 mm to be scanned and can provide whole-breast perfusion maps without any dead angles) to improve contrast and assess the possibility of precisely depicting the extent of breast cancer.
  
  
  METHODS
  The study group included seven patients with breast cancer who were scheduled to undergo radical surgery and radiotherapy. Dynamic scanning was performed using a 256-row multislice CT scanner during normal respiration. Volume perfusion images of the entire breast were obtained using the maximum slope method. Perfusion map images and early-phase breast CT images at 54 s were compared by means of pathological examination.
  
  
  RESULTS
  All breast cancers could be distinguished from normal mammary glands based on the perfusion value. The extent of cancer depicted in perfusion images showed excellent agreement with the pathology findings for invasive ductal carcinoma and ductal carcinoma in situ. In three patients, all ductal spread, parts of which were not visualized by early-phase CT, were depicted in volume perfusion images. Simulation analysis suggested that perfusion maps could be generated with fewer scanning points.
  
  
  CONCLUSIONS
  The results of the present study suggest that volume perfusion imaging may be useful for depicting the extent of breast cancer, with excellent sensitivity. Further research is needed to determine the clinical relevance of these findings.
authors.affiliation: Department of Breast Surgery, National Cancer Center Hospital, 1-1 Tsukiji 5-chome, Chuo-ku, Tokyo, 104-0045, Japan. sakashi@ncc.go.jp
authors.forename: Sadako
authors.initials: S
authors.lastname: Akashi-Tanaka
authors.forename: Tadahiko
authors.initials: T
authors.lastname: Shien
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Tsukagoshi
authors.forename: Shintaro
authors.initials: S
authors.lastname: Funabasama
authors.forename: Kunihisa
authors.initials: K
authors.lastname: Miyagawa
authors.forename: Kotoe
authors.initials: K
authors.lastname: Terada
authors.forename: Miwa
authors.initials: M
authors.lastname: Yoshida
authors.forename: Takashi
authors.initials: T
authors.lastname: Hojo
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kinoshita
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Moriyama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000098:blood supply* / Q000473:pathology*; D002278:Carcinoma in Situ / Q000098:blood supply / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000098:blood supply / Q000473:pathology; D003287:Contrast Media; D005260:Female; D006801:Humans; D007472:Iohexol; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging*; D010865:Pilot Projects; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D007472:Iohexol