title: Computed tomography Hounsfield units can predict breast cancer metastasis to axillary lymph nodes.
abstract: BACKGROUND
  Axillary lymph node (ALN) status is an important prognostic factor for breast cancer. We retrospectively used contrast-enhanced computed tomography (CE-CT) to evaluate the presence of ALN, metastasis based on size, shape, and contrasting effects.
  
  
  METHODS
  Of 131 consecutive patients who underwent CE-CT followed by surgery for breast cancer between 2005 and 2012 in our institution, 49 were histologically diagnosed with lymph node metastasis. Maximum Hounsfield units (HU) and mean HU were measured in non-contrasting CT (NC-CT) and CE-CT of ALNs.
  
  
  RESULTS
  Of 12 examined measurements, we found significant differences between negative and metastatic ALNs in mean and maximum NC-CT HU, and mean and maximum CE-CT HU (P < 0.05). We used a receiver operating curve, to determine cut-off values of four items in which significant differences were observed. The highest accuracy rate was noted for the cut-off value of 54 as maximum NC-CT HU for which sensitivity, specificity, and accuracy rate were 79.6%, 80.5% and 80.2%, respectively.
  
  
  CONCLUSIONS
  CT HU of a patient with breast cancer are absolute values that offer objective disease management data that are not influenced by the screener's ability.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Urata
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8520, Japan. ykijima@m3.kufm.kagoshima-u.ac.jp.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kijima
authors.forename: Munetsugu
authors.initials: M
authors.lastname: Hirata
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Shinden
authors.forename: Hideo
authors.initials: H
authors.lastname: Arima
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nakajo
authors.forename: Chihaya
authors.initials: C
authors.lastname: Koriyama
authors.forename: Takaaki
authors.initials: T
authors.lastname: Arigami
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Uenosono
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Okumura
authors.forename: Kosei
authors.initials: K
authors.lastname: Maemura
authors.forename: Sumiya
authors.initials: S
authors.lastname: Ishigami
authors.forename: Heiji
authors.initials: H
authors.lastname: Yoshinaka
authors.forename: Shoji
authors.initials: S
authors.lastname: Natsugoe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008875:Middle Aged; D011859:Radiography; D015898:Tomography Scanners, X-Ray Computed; D055815:Young Adult