Rationale and Objectives
Our goals were to apply perfusion CT technique to breast tumor and to evaluate the correlation between arterial perfusion value and other tumor characteristics.
Materials and Methods
Thirty-one female patients with primary breast tumors were included in this study. A single-slice dynamic CT was performed after an intravenous bolus injection of contrast material (40 ml; 370 mg I/ml) at 8 ml/sec. The parameters were calculated on a pixel-by-pixel basis by using maximum slope method, and quantitative maps of arterial perfusion were created. Statistical correlation between tumor size, patient age, and perfusion were assessed. Differences in perfusion between scirrhous and nonscirrhous carcinoma were also assessed.
Results
Perfusion CT images were successfully created for 24 patients (mean age, 55.9 years old; range, 36−85 years). In five patients, dynamic CT was not performed due to lack of visualization of the breast tumor on unenhanced CT. In two patients, reliable perfusion CT image could not be created because of motion artifact. The mean perfusion for 24 tumors was 33.1 ± 16.9 ml/min/100 ml (mean ± SD; range, 14−78), and the tumor perfusion did not correlate with patient’s age or tumor size (21.0 ± 10.2 mm; range, 10−45 mm). The mean perfusion of nonscirrhous carcinoma (45.8 ml/min/100 ml; n = 11) was higher than that of scirrhous carcinoma (22.7 ml/min/100 ml; n = 11; P < .001).
Conclusion
Determination of the perfusion of breast carcinoma is feasible by dynamic CT and can be performed during a routine CT study without much supplementary burden on the patient. There are differences in blood flow between scirrhous and nonscirrhous breast carcinoma, and further research is needed to determine the impact of this finding.
The aim of functional CT is functional analysis of CT image in addition to anatomical analysis. After an intravenous bolus injection of iodinated contrast material, tissue and vessel attenuation changes can be observed during first pass by rapid image acquisition at a given anatomical level. Time-density curves can then be constructed not only for observer-defined regions of interest (ROIs) but also on a pixel-by-pixel basis. Within the limits of some assumptions ( ), tissue perfusion can be estimated based on the observed density changes; the time course of the iodine concentration change is a measure of the regional perfusion, and this concentration has a linear correlation to CT number increase. Although there have been many reports using perfusion CT in various organs ( ), to the best of our knowledge, there has been no study of perfusion CT of breast tumors.
The aims of this study were to apply perfusion CT techniques to breast tumors and to evaluate the correlation between arterial perfusion value and other tumor characteristics such as histopathological diagnosis.
Materials and methods
Subjects
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CT Imaging
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Perfusion Measurement
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Pathological Diagnosis
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Statistical Analysis
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Results
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Table 1
Linear Regression Analyses Between Tumor Perfusion, and Maximum Tumor Size and Patient Age
Variables Mean ± SD Range_R_ 2 P value Maximum size (mm) 21.0 ± 10.2 10–45 0.02 .55 Age (y) 55.9 ± 11.8 36–85 0.02 .50
Tumor perfusion was not correlated with maximum tumor size or patient age. SD = standard deviation.
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Table 2
Tumor perfusion values of scirrhous and nonscirrhous carcinoma of breast or positive and negative lymph node metastasis
Variable Tumor Perfusion (mean ± SD)P -value Scirrhous Nonscirrhous Pathology 22.7 ± 6.8 ⁎ 45.8 ± 16.5 ⁎ .0004 Positive Negative Lymph node metastas 26.4 ± 10.2 ⁎ 38.8 ± 18.8 ⁎ .10
Tumor perfusion of scirrhous carcinoma was lower than that of nonscirrhous carcinoma of breast. There was no difference in tumor perfusion between patients with and without lymph node metastasis. SD = standard deviation.
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Discussion
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Conclusion
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Acknowledgement
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