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Soesbe TC, Ahn RW, Ren L, Seiler S, Abadia A, Hallam KA, Lewis MA. Evaluating silicone breast implant rupture with photon-counting CT and volumetric silicone maps. Radiol Case Rep 2024; 19:3425-3428. [PMID: 38881621 PMCID: PMC11176558 DOI: 10.1016/j.radcr.2024.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 05/02/2024] [Accepted: 05/03/2024] [Indexed: 06/18/2024] Open
Abstract
We present a case of an 81-year-old woman who presented to the emergency department with bleeding from a right breast wound. The patient had prior imaging suggestive of bilateral silicone implant rupture and a history of low tolerance for MRI scans. Ultrasound imaging in the emergency setting showed findings in the right breast suggestive of a fistula with free silicone and hematoma. A subsequent photon-counting CT scan with custom silicone-specific segmentation allowed differentiation of silicone from hematoma, provided anatomic assessment and location of the fistula, and revealed bilateral silicone-induced lymphadenopathy.
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Affiliation(s)
- Todd C Soesbe
- Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines BLVD, Dallas, TX 75390-9316, USA
| | - Richard W Ahn
- Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines BLVD, Dallas, TX 75390-9316, USA
| | - Liqiang Ren
- Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines BLVD, Dallas, TX 75390-9316, USA
| | - Stephen Seiler
- Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines BLVD, Dallas, TX 75390-9316, USA
| | - Andres Abadia
- CT R&D Collaborations Siemens Healthineers US, 40 Liberty BLVD, Malvern, PA 19355, USA
| | - Kristina A Hallam
- CT R&D Collaborations Siemens Healthineers US, 40 Liberty BLVD, Malvern, PA 19355, USA
| | - Matthew A Lewis
- Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines BLVD, Dallas, TX 75390-9316, USA
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García-Figueiras R, Oleaga L, Broncano J, Tardáguila G, Fernández-Pérez G, Vañó E, Santos-Armentia E, Méndez R, Luna A, Baleato-González S. What to Expect (and What Not) from Dual-Energy CT Imaging Now and in the Future? J Imaging 2024; 10:154. [PMID: 39057725 PMCID: PMC11278514 DOI: 10.3390/jimaging10070154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 06/09/2024] [Accepted: 06/14/2024] [Indexed: 07/28/2024] Open
Abstract
Dual-energy CT (DECT) imaging has broadened the potential of CT imaging by offering multiple postprocessing datasets with a single acquisition at more than one energy level. DECT shows profound capabilities to improve diagnosis based on its superior material differentiation and its quantitative value. However, the potential of dual-energy imaging remains relatively untapped, possibly due to its intricate workflow and the intrinsic technical limitations of DECT. Knowing the clinical advantages of dual-energy imaging and recognizing its limitations and pitfalls is necessary for an appropriate clinical use. The aims of this paper are to review the physical and technical bases of DECT acquisition and analysis, to discuss the advantages and limitations of DECT in different clinical scenarios, to review the technical constraints in material labeling and quantification, and to evaluate the cutting-edge applications of DECT imaging, including artificial intelligence, qualitative and quantitative imaging biomarkers, and DECT-derived radiomics and radiogenomics.
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Affiliation(s)
- Roberto García-Figueiras
- Department of Radiology, Hospital Clínico Universitario de Santiago, Choupana, 15706 Santiago de Compostela, Spain
| | - Laura Oleaga
- Department of Radiology, Hospital Clinic, C. de Villarroel, 170, 08036 Barcelona, Spain
| | | | - Gonzalo Tardáguila
- Department of Radiology, Hospital Ribera Povisa, Rúa de Salamanca, 5, Vigo, 36211 Pontevedra, Spain
| | | | - Eliseo Vañó
- Department of Radiology, Hospital Universitario Nuestra Señora, del Rosario, C. del Príncipe de Vergara, 53, 28006 Madrid, Spain
| | - Eloísa Santos-Armentia
- Department of Radiology, Hospital Ribera Povisa, Rúa de Salamanca, 5, Vigo, 36211 Pontevedra, Spain
| | - Ramiro Méndez
- Department of Radiology, Hospital Universitario Nuestra Señora, del Rosario, C. del Príncipe de Vergara, 53, 28006 Madrid, Spain
- Department of Radiology, Hospital Universitario Clínico San Carlos, Calle del Prof Martín Lagos, 28040 Madrid, Spain
| | | | - Sandra Baleato-González
- Department of Radiology, Hospital Clínico Universitario de Santiago, Choupana, 15706 Santiago de Compostela, Spain
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3
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Neubauer C, Gebler O, Wilpert C, Scherwitz M, Efinger N, Bamberg F, Windfuhr-Blum M, Neubauer J. Photon-counting CT of degenerative changes and rupture of silicone breast implants: a pilot study. Eur Radiol Exp 2024; 8:36. [PMID: 38480588 PMCID: PMC10937890 DOI: 10.1186/s41747-024-00434-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 01/11/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Accurate assessment of breast implants is important for appropriate clinical management. We evaluated silicone properties and diagnostic accuracy for characterizing silicone implants and detecting degenerative changes including rupture in photon-counting computed tomography (PCCT). METHODS Over 16 months, we prospectively included patients with silicone implants and available breast magnetic resonance imaging (MRI) who received thoracic PCCT performed in prone position. Consensus reading of all available imaging studies including MRI served as reference standard. Two readers evaluated all implants in PCCT reconstructions for degenerative changes. In a subgroup of implants, mean density of silicone, adjacent muscle, and fat were measured on PCCT reconstructions. Contrast-to-noise ratios (CNRs) were calculated for implant-to-muscle and implant-to-fat. RESULTS Among 21 subjects, aged 60 ± 13.1 years (mean ± standard deviation) with 29 implants PCCT showed the following: high accuracy for linguine sign, intraimplant fluid (all > 0.99), peri-implant silicone (0.95), keyhole sign (0.90), and folds of the membrane (0.81); high specificity for linguine sign, intraimplant fluid, keyhole sign, folds of the membrane (all > 0.99), and peri-implant silicone (0.98); and high sensitivity for linguine sign and intraimplant fluid (all > 0.99). In a subgroup of 12 implants, the highest CNR for implant-to-muscle was observed on virtual unenhanced reconstructions (20.9) and iodine maps (22.9), for implant-to-fat on iodine maps (27.7) and monoenergetic reconstructions (31.8). CONCLUSIONS Our findings demonstrate that silicone breast implants exhibit distinct contrast properties at PCCT, which may provide incremental information for detection of degenerative changes and rupture of implants. RELEVANCE STATEMENT Thoracic photon-counting computed tomography is a promising modality for the diagnostic assessment of silicone breast implants. KEY POINTS • Thoracic photon-counting computed tomography demonstrates unique contrast properties of silicone breast implants. • Iodine map reconstructions reveal strong contrast-to-noise ratios for implant-to-muscle and implant-to-fat. • Thoracic photon-counting computed tomography shows high diagnostic accuracy in detecting implant degeneration and rupture. TRIAL REGISTRATION German Clinical Trials Register number DRKS00028997, date of registration 2022-08-08, retrospectively registered.
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Affiliation(s)
- Claudia Neubauer
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - Oliver Gebler
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Caroline Wilpert
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Maxim Scherwitz
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Niklas Efinger
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Fabian Bamberg
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Marisa Windfuhr-Blum
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jakob Neubauer
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Yalon M, Sae-Kho T, Khanna A, Chang S, Andrist BR, Weber NM, Hoodeshenas S, Ferrero A, Glazebrook KN, McCollough CH, Baffour FI. Staging of breast cancer in the breast and regional lymph nodes using contrast-enhanced photon-counting detector CT: accuracy and potential impact on patient management. Br J Radiol 2024; 97:93-97. [PMID: 38263843 PMCID: PMC11027279 DOI: 10.1093/bjr/tqad042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 01/25/2024] Open
Abstract
OBJECTIVES To describe the feasibility and evaluate the performance of multiphasic photon-counting detector (PCD) CT for detecting breast cancer and nodal metastases with correlative dynamic breast MRI and digital mammography as the reference standard. METHODS Adult females with biopsy-proven breast cancer undergoing staging breast MRI were prospectively recruited to undergo a multiphasic PCD-CT using a 3-phase protocol: a non-contrast ultra-high-resolution (UHR) scan and 2 intravenous contrast-enhanced scans with 50 and 180 s delay. Three breast radiologists compared CT characteristics of the index malignancy, regional lymphadenopathy, and extramammary findings to MRI. RESULTS Thirteen patients underwent both an MRI and PCD-CT (mean age: 53 years, range: 36-75 years). Eleven of thirteen cases demonstrated suspicious mass or non-mass enhancement on PCD-CT when compared to MRI. All cases with metastatic lymphadenopathy (3/3 cases) demonstrated early avid enhancement similar to the index malignancy. All cases with multifocal or multicentric disease on MRI were also identified on PCD-CT (3/3 cases), including a 4 mm suspicious satellite lesion. Four of five patients with residual suspicious post-biopsy calcifications on mammograms were detected on the UHR PCD-CT scan. Owing to increased field-of-view at PCD-CT, a 5 mm thoracic vertebral metastasis was identified at PCD-CT and not with the breast MRI. CONCLUSIONS A 3-phase PCD-CT scan protocol shows initial promising results in characterizing breast cancer and regional lymphadenopathy similar to MRI and detects microcalcifications in 80% of cases. ADVANCES IN KNOWLEDGE UHR and spectral capabilities of PCD-CT may allow for comprehensive characterization of breast cancer and may represent an alternative to breast MRI in select cases.
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Affiliation(s)
- Mariana Yalon
- Department of Radiology, Mayo Clinic, Rochester, MN, 55905, United States
| | - Tiffany Sae-Kho
- Department of Radiology, Mayo Clinic, Rochester, MN, 55905, United States
| | - Akriti Khanna
- Department of Radiology, Mayo Clinic, Rochester, MN, 55905, United States
| | - Shaojie Chang
- Department of Radiology, Mayo Clinic, Rochester, MN, 55905, United States
| | - Boleyn R Andrist
- Department of Radiology, Mayo Clinic, Rochester, MN, 55905, United States
| | - Nikkole M Weber
- Department of Radiology, Mayo Clinic, Rochester, MN, 55905, United States
| | - Safa Hoodeshenas
- Department of Radiology, Mayo Clinic, Rochester, MN, 55905, United States
| | - Andrea Ferrero
- Department of Radiology, Mayo Clinic, Rochester, MN, 55905, United States
| | | | | | - Francis I Baffour
- Department of Radiology, Mayo Clinic, Rochester, MN, 55905, United States
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Janszen G, Arnoldi M, Vinci V, Klinger M, Di Landro L. On the Safety of Implanted Breast Prostheses in Accidental Impacts. MATERIALS (BASEL, SWITZERLAND) 2023; 16:4807. [PMID: 37445121 DOI: 10.3390/ma16134807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/29/2023] [Accepted: 07/02/2023] [Indexed: 07/15/2023]
Abstract
The employment of breast silicone implants, both in aesthetic and reconstructive medicine, is widespread thanks to their recognized biocompatibility and durability. Some critical situations, for example, in the case of accidental impacts, may induce concerns by potential patients about their use. Dynamic tests reproducing frontal impacts at speeds up to 90 km/h, with anthropomorphic dummies carrying 330 cc prostheses and wearing safety belts, were conducted. Tests showed a significant probability of internal gel loss following implant damage at the highest speed. Moreover, considering that prostheses may remain implanted for many years, the effects of accelerated aging at 37 °C, 60 °C, 75 °C and 90 °C in physiological solution were also investigated. Tensile tests of the shell material and compressive tests of the full prosthesis showed evidence of variation in the prostheses' mechanical characteristics after aging, which affects their stiffness, deformability and strength. These results stress the importance of medical investigations for possible damages of the implanted prostheses in the case of an accident.
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Affiliation(s)
- Gerardus Janszen
- Department of Aerospace Science and Technology, Politecnico di Milano, 20156 Milano, Italy
| | - Michela Arnoldi
- Department of Aerospace Science and Technology, Politecnico di Milano, 20156 Milano, Italy
| | - Valeriano Vinci
- Department of Biomedical Sciences, Humanitas University, 20090 Milan, Italy
- IRCCS Humanitas Research Hospital, 20089 Milan, Italy
| | - Marco Klinger
- IRCCS Humanitas Research Hospital, 20089 Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, 20126 Milano, Italy
| | - Luca Di Landro
- Department of Aerospace Science and Technology, Politecnico di Milano, 20156 Milano, Italy
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6
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Kim HB, Han HH, Eom JS. Magnetic Resonance Imaging Surveillance Study of Silicone Implant-based Breast Reconstruction: A Retrospective Observational Study. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5031. [PMID: 37305200 PMCID: PMC10256406 DOI: 10.1097/gox.0000000000005031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 04/06/2023] [Indexed: 06/13/2023]
Abstract
This study aimed to evaluate the results of magnetic resonance imaging (MRI) surveillance of implant-based breast reconstruction in patients with breast cancer. Methods This retrospective observational study analyzed patients who underwent implant-based breast reconstruction and MRI surveillance by a single surgeon from March 2011 to December 2018, in a single center. All patients were informed about the recommendation of the Food and Drug Administration for MRI surveillance, and they choose to undergo MRI 3 years after surgery. Results The compliance rate for MRI surveillance was 56.5% (169/299). MRI surveillance was performed at a mean of 45.8 (4.04 years) ± 11.5 months after surgery. One patient (0.6%) showed an abnormal finding of an intracapsular rupture of the silicone implant. Conclusions MRI surveillance for implant rupture in implant-based breast reconstruction showed a low incidence of silent implant rupture (0.6%), whereas the compliance of MRI was relatively high (56.5%). These results raise questions about whether taking an MRI in 3-4 years is suitable for imaging surveillance of breast silicone implants. Screening recommendations should be more evidence-based, and more studies are needed to prevent unnecessary screening and patient burden.
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Affiliation(s)
- Hyung Bae Kim
- From the Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyun Ho Han
- From the Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jin Sup Eom
- From the Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Schoberleitner I, Augustin A, Egle D, Brunner C, Amort B, Zelger B, Brunner A, Wolfram D. Is It All about Surface Topography? An Intra-Individual Clinical Outcome Analysis of Two Different Implant Surfaces in Breast Reconstruction. J Clin Med 2023; 12:jcm12041315. [PMID: 36835850 PMCID: PMC9967160 DOI: 10.3390/jcm12041315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/23/2023] [Accepted: 02/04/2023] [Indexed: 02/10/2023] Open
Abstract
The most common long-term complication of silicone breast implants (SMI) remains capsular fibrosis. The etiology of this exaggerated implant encapsulation is multifactorial but primarily induced by the host response towards the foreign material silicone. Identified risk factors include specific implant topographies. Of note, breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) has only been observed in response to textured surface implants. We hypothesize that reduction of SMI surface roughness causes less host response and, hence, better cosmetic outcomes with fewer complications for the patient. A total of 7 patients received the routinely used CPX®4 breast expander (~60 µM Ra) and the novel SmoothSilk® (~4 µM Ra), fixed prepectoral with a titanized mesh pocket and randomized to the left or right breast after bilateral prophylactic NSME (nipple-sparing mastectomy). We aimed to compare the postoperative outcome regarding capsule thickness, seroma formation, rippling, implant dislocation as well as comfortability and practicability. Our analysis shows that surface roughness is an influential parameter in controlling fibrotic implant encapsulation. Compared intra-individually for the first time in patients, our data confirm an improved biocompatibility with minor capsule formation around SmoothSilk® implants with an average shell roughness of 4 µM and in addition an amplification of host response by titanized implant pockets.
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Affiliation(s)
- Ines Schoberleitner
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria
| | - Angela Augustin
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria
| | - Daniel Egle
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria
| | - Christine Brunner
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria
| | - Birgit Amort
- Department of Radiology, Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria
| | - Bettina Zelger
- Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Müllerstraße 44, A-6020 Innsbruck, Austria
| | - Andrea Brunner
- Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Müllerstraße 44, A-6020 Innsbruck, Austria
| | - Dolores Wolfram
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria
- Correspondence: ; Tel.: +43-512-504-82050
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8
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Fernández-Pérez GC, Fraga Piñeiro C, Oñate Miranda M, Díez Blanco M, Mato Chaín J, Collazos Martínez MA. Dual-energy CT: Technical considerations and clinical applications. RADIOLOGIA 2022; 64:445-455. [PMID: 36243444 DOI: 10.1016/j.rxeng.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 06/20/2022] [Indexed: 06/16/2023]
Abstract
Although dual-energy CT was initially described by Hounsfield in 1973, it remains underused in clinical practice. It is therefore important to emphasize the clinical benefits and limitations of this technique. Iodine mapping makes it possible to quantify the uptake of iodine, which is very important in characterizing tumors, lung perfusion, pulmonary nodules, and the tumor response to new treatments. Dual-energy CT also makes it possible to obtain virtual single-energy images and virtual images without iodinated contrast or without calcium, as well as to separate materials such as uric acid or fat and to elaborate hepatic iron overload maps. In this article, we review some of the clinical benefits and technical limitations to improve understanding of dual-energy CT and expand its use in clinical practice.
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Affiliation(s)
- G C Fernández-Pérez
- Servicio de Radiodiagnóstico, Hospital Universitario Río Hortega, Grupo Recoletas, Valladolid, Spain.
| | - C Fraga Piñeiro
- Técnico Aplicaciones Siemens Healthineers, General Electric Company, Spain
| | - M Oñate Miranda
- Servicio de Radiodiagnóstico, Hospital Universitario Río Hortega, Valladolid, Spain
| | - M Díez Blanco
- Servicio de Radiodiagnóstico, Hospital Universitario Río Hortega, Valladolid, Spain
| | - J Mato Chaín
- Servicio de Radiodiagnóstico, Hospital Universitario Río Hortega, Valladolid, Spain
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Fernández-Pérez G, Fraga Piñeiro C, Oñate Miranda M, Díez Blanco M, Mato Chaín J, Collazos Martínez M. Energía Dual en TC. Consideraciones técnicas y aplicaciones clínicas. RADIOLOGIA 2022. [DOI: 10.1016/j.rx.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Langiano N, Brussa A, Riccardi I, Meroi F, Toso F, Cesselli D, Vetrugno L, Bove T. A Rare Cause of Respiratory Insufficiency in a 30-Year-Old Transgender Woman. Chest 2021; 160:e339-e342. [PMID: 34625180 DOI: 10.1016/j.chest.2021.05.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/22/2021] [Accepted: 05/24/2021] [Indexed: 10/20/2022] Open
Abstract
CASE PRESENTATION A 30-year-old transgender woman who was HIV positive presented to the ED with progressive severe dyspnea and hemoptysis that started 1 day earlier. The patient was undergoing antiretroviral therapy with emtricitabine-rilpivirine-tenofovir with good compliance and feminizing hormone therapy with cyproterone acetate. She was otherwise healthy and was not taking any other medications.
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Affiliation(s)
- Nicola Langiano
- Department of Anesthesia and Intensive Care, University-Hospital of Udine, Udine, Italy
| | - Alessandro Brussa
- Department of Anesthesia and Intensive Care, University-Hospital of Udine, Udine, Italy
| | - Ilaria Riccardi
- Department of Anesthesia and Intensive Care, University-Hospital of Udine, Udine, Italy
| | - Francesco Meroi
- Department of Anesthesia and Intensive Care, University-Hospital of Udine, Udine, Italy; Department of Medicine, Anesthesia and Intensive Care Clinic, University of Udine, Udine, Italy
| | - Francesco Toso
- Department of Radiology, University-Hospital of Udine, Udine, Italy
| | - Daniela Cesselli
- Department of Medicine, Institute of Pathology, University of Udine, Udine, Italy
| | - Luigi Vetrugno
- Department of Anesthesia and Intensive Care, University-Hospital of Udine, Udine, Italy; Department of Medicine, Anesthesia and Intensive Care Clinic, University of Udine, Udine, Italy.
| | - Tiziana Bove
- Department of Anesthesia and Intensive Care, University-Hospital of Udine, Udine, Italy; Department of Medicine, Anesthesia and Intensive Care Clinic, University of Udine, Udine, Italy
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11
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Wang X, Liu D, Zeng X, Jiang S, Li L, Yu T, Zhang J. Dual-energy CT quantitative parameters for evaluating Immunohistochemical biomarkers of invasive breast cancer. Cancer Imaging 2021; 21:4. [PMID: 33413654 PMCID: PMC7791709 DOI: 10.1186/s40644-020-00370-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 12/11/2020] [Indexed: 11/14/2022] Open
Abstract
Background Estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) and Ki67 are the most useful immunohistochemical biomarkers of invasive breast cancer. The purpose of this study is to investigate the possibility of quantitative parameters derived from dual-energy CT (DECT) to discriminate immunohistochemical biomarkers of invasive breast cancer. Methods This prospective study enrolled 120 patients with invasive breast cancer who underwent preoperative contrast-enhanced DECT for staging purposes from June 2019 to January 2020. DECT quantitative parameters, including normalized iodine concentration (NIC), the slope of the spectral Hounsfield unit curve (λHu), and the normalized effective atomic number (nZeff), were obtained from reconstructed images. DECT quantitative parameters were compared with the expression status, and the correlations with the value of immunohistochemical biomarkers were evaluated. Inter-observer reproducibility analysis was performed to assess the measurement reproducibility of quantitative parameters. The diagnostic performance of the quantitative parameters was analyzed by receiver operating characteristic curve. Results The ER-negative group tended to display higher venous phase NIC and nZeff compared with the ER-positive group (individually, p = 0.003, 0.011; area under the curve [AUC] of 0.65, 0.60). The PR-negative group demonstrated higher arterial and venous phase NIC compared with the PR-positive group (individually, p = 0.022, 0.005; AUC of 0.63, 0.65). NIC was correlated negatively with the value of ER and PR expression (r = − 0.175 ~ − 0.265, p = 0.002 ~ 0.042). The HER2-positive group tended to display higher venous phase nZeff than the HER2-negative group (p = 0.022; AUC of 0.59). The Ki67 high-proliferation group demonstrated higher arterial phase, venous phase NIC and nZeff than the Ki67 low-proliferation group (p < 0.001 ~ 0.005; AUC of 0.67 ~ 0.75). Both the NIC and nZeff were correlated positively with the value of Ki67 (r = 0.240 ~ 0.490, p < 0.001 ~ 0.014). Conclusions NIC and nZeff derived from DECT could be used to discriminate expression status and may associate with the value of immunohistochemical biomarkers of invasive breast cancer.
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Affiliation(s)
- Xiaoxia Wang
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, 400030, People's Republic of China
| | - Daihong Liu
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, 400030, People's Republic of China
| | - Xiangfei Zeng
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, 400030, People's Republic of China
| | - Shixi Jiang
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, 400030, People's Republic of China
| | - Lan Li
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, 400030, People's Republic of China
| | - Tao Yu
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, 400030, People's Republic of China
| | - Jiuquan Zhang
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, 400030, People's Republic of China.
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12
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Li SJ, Kam NM, Mehta K, Sutherland TR. Enlarging internal mammary silicone lymphadenopathy mimicking breast metastases. J Med Imaging Radiat Oncol 2020; 65:216-218. [PMID: 33179438 DOI: 10.1111/1754-9485.13124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 10/05/2020] [Accepted: 10/12/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Simon J Li
- Medical Imaging Department, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Ning Mao Kam
- Medical Imaging Department, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Kirti Mehta
- Medical Imaging Department, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.,BreastScreen, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Tom R Sutherland
- Medical Imaging Department, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.,Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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13
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Ruby L, Shim S, Berger N, Marcon M, Frauenfelder T, Boss A. Diagnostic value of a spiral breast computed tomography system equipped with photon counting detector technology in patients with implants: An observational study of our initial experiences. Medicine (Baltimore) 2020; 99:e20797. [PMID: 32791669 PMCID: PMC7387031 DOI: 10.1097/md.0000000000020797] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
To evaluate the value of a breast computed tomography (CT) (B-CT) in assessing breast density, pathologies and implant integrity in women with breast implants.This retrospective study was approved by the local ethics committee. B-CT images of 21 women with implants (silicone/saline; 20 bilateral, 1 unilateral) who underwent opportunistic screening or diagnostic bilateral B-CT were included. Breast density, implant integrity, extensive capsular fibrosis, soft tissue lesions and micro-/macrocalcifications were rated. In 18 of the 21 women, an additional ultrasound and in two patients breast magnetic resonance imaging was available for comparison. The average dose was calculated for each breast using verified Monte Carlo simulations on 3D image data sets.Breast density was nearly completely fatty (ACR a) in two patients, scattered fibroglandular (ACR b) in five, heterogeneously dense (ACR c) in ten and very dense (ACR d) in four women. In three women showed a unilateral positive Linguine sign indicative of an inner capsule rupture. Extensive capsular fibrosis was found in three women. In three women, soft tissue lesions were depicted, which revealed to be cysts (n = 2) and lymph nodes (n = 1) on subsequent sonography. Diffuse, non-clustered microcalcifications were found in nine women. Eleven women showed cutaneous or intramammary macrocalcifications. Average dose was 6.45 mGy (range 5.81-7.28 mGy).In women with implants, B-CT presents a promising modality for evaluating breast density, implant integrity, extensive capsular fibrosis, soft tissue lesions and micro-/macrocalcifications without the need of breast compression utilizing a lower dose compared to doses reported for conventional four-view mammography.
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14
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McCollough CH, Boedeker K, Cody D, Duan X, Flohr T, Halliburton SS, Hsieh J, Layman RR, Pelc NJ. Principles and applications of multienergy CT: Report of AAPM Task Group 291. Med Phys 2020; 47:e881-e912. [DOI: 10.1002/mp.14157] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 02/11/2020] [Accepted: 03/10/2020] [Indexed: 12/14/2022] Open
Affiliation(s)
| | - Kirsten Boedeker
- Canon (formerly Toshiba) Medical Systems Corporation 1440 Warnall Ave Los Angeles CA 90024 USA
| | - Dianna Cody
- University of Texas, M.D. Anderson Cancer Center 7163 Spanish Grant Galveston TX 77554‐7756 USA
| | - Xinhui Duan
- Southwestern Medical Center University of Texas 5323 Harry Hines Blvd Dallas TX 75390‐9071 USA
| | - Thomas Flohr
- Siemens Healthcare GmbH Siemensstr. 3 Forchheim BY 91031 Germany
| | | | - Jiang Hsieh
- GE Healthcare Technologies 3000 N. Grandview Blvd. W-1190 Waukesha WI 53188 USA
| | - Rick R. Layman
- University of Texas, M.D. Anderson Cancer Center 7163 Spanish Grant Galveston TX 77554‐7756 USA
| | - Norbert J. Pelc
- Stanford University 443 Via Ortega, Room 203 Stanford CA 94305‐4125 USA
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15
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Sachs JR, Lack CM, West TG, Bunch PM. Unique Characteristics of Intravitreal Silicone Oil on Dual-Energy Computed Tomography. J Comput Assist Tomogr 2020; 44:370-373. [PMID: 31929379 DOI: 10.1097/rct.0000000000000967] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Silicone oil is used as an intravitreal injection to treat retinal detachment. This material can spread into the subarachnoid space, where it may be mistaken for acute hemorrhage on single-energy computed tomography. This report describes the appearance of intravitreal silicone oil on dual-energy computed tomography, emphasizing unique virtual monoenergetic imaging characteristics that allow for confident differentiation of silicone oil from hemorrhage as well as from other potential single-energy mimics, such as calcium and iodine.
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Affiliation(s)
- Jeffrey R Sachs
- From the Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC
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16
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Cicero G, Ascenti G, Albrecht MH, Blandino A, Cavallaro M, D'Angelo T, Carerj ML, Vogl TJ, Mazziotti S. Extra-abdominal dual-energy CT applications: a comprehensive overview. Radiol Med 2020; 125:384-397. [PMID: 31925704 DOI: 10.1007/s11547-019-01126-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 12/27/2019] [Indexed: 12/12/2022]
Abstract
Unlike conventional computed tomography, dual-energy computed tomography is a relatively novel technique that exploits ionizing radiations at different energy levels. The separate radiation sets can be achieved through different technologies, such as dual source, dual layers or rapid switching voltage. Body tissue molecules vary for their specific atomic numbers and electron density, and the interaction with different sets of radiations results in different attenuations, allowing to their final distinction. In particular, iodine recognition and quantification have led to important information about intravenous contrast medium delivery within the body. Over the years, useful post-processing algorithms have also been validated for improving tissue characterization. For instance, contrast resolution improvement and metal artifact reduction can be obtained through virtual monoenergetic images, dose reduction by virtual non-contrast reconstructions and iodine distribution highlighting through iodine overlay maps. Beyond the evaluation of the abdominal organs, dual-energy computed tomography has also been successfully employed in other anatomical districts. Although lung perfusion is one of the most investigated, this evaluation has been extended to narrowly fields of application, such as musculoskeletal, head and neck, vascular and cardiac. The potential pool of information provided by dual-energy technology is already wide and not completely explored, yet. Therefore, its performance continues to raise increasing interest from both radiologists and clinicians.
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Affiliation(s)
- Giuseppe Cicero
- Section of Radiological Sciences, Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Policlinico "G. Martino" Via Consolare Valeria 1, 98100, Messina, Italy.
| | - Giorgio Ascenti
- Section of Radiological Sciences, Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Policlinico "G. Martino" Via Consolare Valeria 1, 98100, Messina, Italy
| | - Moritz H Albrecht
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Alfredo Blandino
- Section of Radiological Sciences, Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Policlinico "G. Martino" Via Consolare Valeria 1, 98100, Messina, Italy
| | - Marco Cavallaro
- Section of Radiological Sciences, Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Policlinico "G. Martino" Via Consolare Valeria 1, 98100, Messina, Italy.,Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Tommaso D'Angelo
- Section of Radiological Sciences, Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Policlinico "G. Martino" Via Consolare Valeria 1, 98100, Messina, Italy
| | - Maria Ludovica Carerj
- Section of Radiological Sciences, Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Policlinico "G. Martino" Via Consolare Valeria 1, 98100, Messina, Italy
| | - Thomas J Vogl
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Silvio Mazziotti
- Section of Radiological Sciences, Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Policlinico "G. Martino" Via Consolare Valeria 1, 98100, Messina, Italy
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