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Non-contrast and portal venous phase computed tomography in breast cancer hepatic metastases: comparison of tumor measurements and impact on response assessment

BACKGROUND: For many common malignancies, including breast cancer, evaluation for metastatic disease using multiphase computed tomography (CT) has fallen out of favor and been replaced by studies performed only in the portal venous phase. However, differences in tumor vascularity could produce diffe...

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Autores principales: Flemming, Brian, Kovacs, Mark D, Hardie, Andrew, Picard, Melissa, Burchett, Philip F, Collins, Heather, Sheafor, Douglas H
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7917424/
https://www.ncbi.nlm.nih.gov/pubmed/33717503
http://dx.doi.org/10.1177/2058460121998015
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author Flemming, Brian
Kovacs, Mark D
Hardie, Andrew
Picard, Melissa
Burchett, Philip F
Collins, Heather
Sheafor, Douglas H
author_facet Flemming, Brian
Kovacs, Mark D
Hardie, Andrew
Picard, Melissa
Burchett, Philip F
Collins, Heather
Sheafor, Douglas H
author_sort Flemming, Brian
collection PubMed
description BACKGROUND: For many common malignancies, including breast cancer, evaluation for metastatic disease using multiphase computed tomography (CT) has fallen out of favor and been replaced by studies performed only in the portal venous phase. However, differences in tumor vascularity could produce differences in appearance on post-contrast imaging. PURPOSE: To assess non-contrast phase and portal venous phase computed tomography in detection and measurement of hepatic metastases from breast carcinoma. MATERIALS AND METHODS: A total of 75 CT scans from 52 breast cancer patients were independently assessed by three body imagers for lesion presence, number and size. Readers randomly assessed portal venous phase or combined phase images at one session with cross-over reads performed four to six weeks later. RESULTS: In the 58% of cases where index lesions measured larger on combined phase, the mean difference in lesion size was 5.7 mm. In this group, combined phase reads demonstrated an 8.4 mm increase in sum of largest diameters, and a mean percentage sum of largest diameters increase of 19% compared to portal venous phase-only reads. CONCLUSION: Addition of non-contrast phase images results in increased index lesion size in most patients with hepatic metastases from breast cancer. If only the portal venous phase is utilized, there is potential for incorrectly diagnosing disease progression on follow-up due to underestimation of lesion size.
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spelling pubmed-79174242021-03-11 Non-contrast and portal venous phase computed tomography in breast cancer hepatic metastases: comparison of tumor measurements and impact on response assessment Flemming, Brian Kovacs, Mark D Hardie, Andrew Picard, Melissa Burchett, Philip F Collins, Heather Sheafor, Douglas H Acta Radiol Open Original Article BACKGROUND: For many common malignancies, including breast cancer, evaluation for metastatic disease using multiphase computed tomography (CT) has fallen out of favor and been replaced by studies performed only in the portal venous phase. However, differences in tumor vascularity could produce differences in appearance on post-contrast imaging. PURPOSE: To assess non-contrast phase and portal venous phase computed tomography in detection and measurement of hepatic metastases from breast carcinoma. MATERIALS AND METHODS: A total of 75 CT scans from 52 breast cancer patients were independently assessed by three body imagers for lesion presence, number and size. Readers randomly assessed portal venous phase or combined phase images at one session with cross-over reads performed four to six weeks later. RESULTS: In the 58% of cases where index lesions measured larger on combined phase, the mean difference in lesion size was 5.7 mm. In this group, combined phase reads demonstrated an 8.4 mm increase in sum of largest diameters, and a mean percentage sum of largest diameters increase of 19% compared to portal venous phase-only reads. CONCLUSION: Addition of non-contrast phase images results in increased index lesion size in most patients with hepatic metastases from breast cancer. If only the portal venous phase is utilized, there is potential for incorrectly diagnosing disease progression on follow-up due to underestimation of lesion size. SAGE Publications 2021-02-27 /pmc/articles/PMC7917424/ /pubmed/33717503 http://dx.doi.org/10.1177/2058460121998015 Text en © The Foundation Acta Radiologica 2021 https://creativecommons.org/licenses/by-nc/4.0/ Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Article
Flemming, Brian
Kovacs, Mark D
Hardie, Andrew
Picard, Melissa
Burchett, Philip F
Collins, Heather
Sheafor, Douglas H
Non-contrast and portal venous phase computed tomography in breast cancer hepatic metastases: comparison of tumor measurements and impact on response assessment
title Non-contrast and portal venous phase computed tomography in breast cancer hepatic metastases: comparison of tumor measurements and impact on response assessment
title_full Non-contrast and portal venous phase computed tomography in breast cancer hepatic metastases: comparison of tumor measurements and impact on response assessment
title_fullStr Non-contrast and portal venous phase computed tomography in breast cancer hepatic metastases: comparison of tumor measurements and impact on response assessment
title_full_unstemmed Non-contrast and portal venous phase computed tomography in breast cancer hepatic metastases: comparison of tumor measurements and impact on response assessment
title_short Non-contrast and portal venous phase computed tomography in breast cancer hepatic metastases: comparison of tumor measurements and impact on response assessment
title_sort non-contrast and portal venous phase computed tomography in breast cancer hepatic metastases: comparison of tumor measurements and impact on response assessment
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7917424/
https://www.ncbi.nlm.nih.gov/pubmed/33717503
http://dx.doi.org/10.1177/2058460121998015
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