Differentiation of Malignant and Benign Incidental Breast Lesions Detected by Chest Multidetector-Row Computed Tomography: Added Value of Quantitative Enhancement Analysis

PLoS One. 2016 Apr 29;11(4):e0154569. doi: 10.1371/journal.pone.0154569. eCollection 2016.

Abstract

To retrospectively determine the association between breast lesion morphology and malignancy and to determine the optimal value of lesion enhancement (HU, Hounsfield units) to improve the diagnostic accuracy of breast cancer in patients with incidental breast lesions (IBLs). A total of 97 patients with 102 IBLs detected from July 2009 to December 2012 were enrolled in this study. Two radiologists analyzed CT images for the presence of malignancy based on the morphology of the lesions alone and in combination with an enhancement value (HU) analysis. There were 36 malignant and 66 benign IBLs. When the morphology and enhancement values were combined, the sensitivity, specificity, and accuracy were 92%, 97%, and 95%, respectively, for reader 1 and 89%, 94%, and 92%, respectively, for reader 2. The addition of HU values led to correct changes in the diagnosis; specifically, the accuracy of the diagnosis of reader 1 and reader 2 improved by 6.9% and 11.8%, respectively. The addition of the enhancement value (HU) to the CT morphology improved the diagnostic accuracy in the differentiation of malignant from benign IBLs by using the region of interest (ROI) to measure the HU within the most suspicious part of the lesion.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / pathology
  • Carcinoma, Ductal, Breast / diagnostic imaging
  • Carcinoma, Intraductal, Noninfiltrating / diagnostic imaging
  • Contrast Media
  • Diagnosis, Differential
  • Female
  • Fibroadenoma / diagnostic imaging
  • Humans
  • Incidental Findings
  • Middle Aged
  • Multidetector Computed Tomography / methods*
  • Multidetector Computed Tomography / statistics & numerical data
  • Observer Variation
  • Radiographic Image Enhancement / methods
  • Retrospective Studies
  • Sensitivity and Specificity

Substances

  • Contrast Media

Grants and funding

HHH received the funding partly from Tri-Service General Hospital (TSGH-C105-044 and TSGHIRB No.1-103-05-036) and Ministry of Science and Technology, R. O. C. (MOST 104-2314-B-016-025). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.