Dual-energy CT for the evaluation of silicone breast implants.
OBJECTIVE
The evaluation of breast implants for rupture is currently the domain of ultrasound and MRI, while mammography is of very limited diagnostic value. Recently, specific visualisation of silicone has become feasible using dual-energy CT. Our objective was to evaluate whether it is feasible to identify silicone in breast implants by dual-energy CT and to reliably diagnose or rule out ruptures.


METHODS
Seven silicone breast implant specimens were examined on dual-source CT at 100- and 140-kV tube potential with a 0.8-mm tin filter (collimation 128 × 0.6 mm, current-time products 165 and 140 mAsref with modulation, rotation time 0.28 s, pitch 0.55). Two patients scheduled for implant removal or replacement were examined with identical parameters.


RESULTS
The silicone of the implant specimens showed a strong dual-energy signal. In one patient, both implants were intact, while a rupture was identified in the other patient. Ultrasound, MRI, surgical findings and histology confirmed the dual-energy CT diagnosis.


CONCLUSIONS
Dual-energy CT may serve as an alternative technique for speedy evaluation of silicone breast implants. Specific clinical studies are required to determine the diagnostic accuracy and define indications for this technique.
Department of Clinical Radiology, University of Munich-Grosshadern Campus, Marchioninistr. 15, 81377 Munich, Germany. thorsten.johnson@med.uni-muenchen.de
Thorsten R C
TR
Johnson
Isabelle
I
Himsl
Karin
K
Hellerhoff
Doris
D
Mayr
Dorothea
D
Rjosk-Dendorfer
Nina
N
Ditsch
Bernhard
B
Krauss
Klaus
K
Friese
Maximilian F
MF
Reiser
Miriam S
MS
Lenhard
D019928:Breast Implantation / Q000379:methods*; D018427:Breast Implants; D019544:Equipment Failure Analysis / Q000379:methods; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods*; D015900:Radiography, Dual-Energy Scanned Projection / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012828:Silicones / Q000032:analysis*; D014057:Tomography, X-Ray Computed / Q000379:methods*
D012828:Silicones