Segmented Coronal Breast Maximum Intensity Projection Images Derived From Contrast-Enhanced Chest Computed Tomography: A Proof-of-Concept Study on Cancer Detectability.

OBJECTIVE

This pilot study aimed to evaluate whether segmented coronal breast maximum intensity projection (MIP) images generated from contrast-enhanced CT (CE-CT) could improve the detectability of breast lesions incidentally visualized in clinical settings where the breast is not the primary imaging target.

METHODS

This retrospective study included 71 patients with breast cancer who underwent CE-CT for preoperative staging before surgery. Three radiologists independently assessed the presence or absence of breast lesions using a 3-tiered scoring system on both segmented coronal breast MIP and 5-mm axial images. Reading times were recorded. Readers then compared paired breast MIP and axial images and indicated which reconstruction type was more effective for breast lesion detection. The Wilcoxon signed-rank test with Bonferroni correction was used to compare reading times, and the McNemar-Bowker test was used to compare 3-tiered lesion detectability scores.

RESULTS

Segmented coronal breast MIP images were read faster than axial images by 2 of the 3 readers (median [interquartile range]: 4 [4-7] vs 9 [8-11] seconds and 3 [2-6] vs 11 [9-14.5] seconds; P < .001). No significant difference was found for the third reader (P = .446). For lesion detectability, breast MIP images were significantly superior to axial images for reader 1 (P = .029), reader 2 (P = .043), and reader 3 (P = .004). Breast MIP images were preferred in 76.1% (54/71), 95.8% (68/71), and 83.1% (59/71) of cases, respectively.

CONCLUSION

Segmented coronal breast MIP images from CE-CT may improve lesion detectability and reduce interpretation time compared with conventional axial images.