Cone-Beam CT for Breast Imaging: Radiation Dose, Breast Coverage, and Image Quality

Cone-Beam CT for Breast Imaging: Radiation Dose, Breast Coverage, and Image Quality
Avice O'Connell, David L. Conover, Yan Zhang, Posy Seifert, Wende Logan-Young, Chuen-Fu Linda Lin, Lawrence Sahler, and Ruola Ning
AJR 2010;195:496-509

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RESULTS: 
For a conventional mammographic examination, the average glandular radiation dose ranged from 2.2 to 15 mGy (mean, 6.5 [SD, 2.9] mGy). For cone-beam breast CT, the average glandular dose ranged from 4 to 12.8 mGy (mean, 8.2 [SD, 1.4] mGy). The average glandular dose from cone-beam breast CT was generally within the range of that from conventional mammography. For heterogeneously dense and extremely dense breasts, the difference between the mean dose of conventional mammography and that of cone-beam breast CT was not statistically significant (7.0 vs 8.1 mGy, p = 0.06). Breast tissue coverage was statistically significantly better with cone-beam breast CT than with mammography in the lateral (p < 0.0001), medial (p < 0.0001), and posterior (p = 0.0002) aspects. Mammography had statistically significantly better coverage than cone-beam breast CT in the axilla and axillary tail (p < 0.0001). Overall, most calcifications and all masses detected with mammography were also detected with cone-beam breast CT. The interobserver agreement on cone-beam breast CT was 83.7% in the detectability of imaging findings. The overall interobserver agreement on type of findings, size of findings (<1, 1–4.99, and ≥ 5 mm), and location of findings was 77.2%, 84.8%, and 78.3%, respectively

CONCLUSION:
The results of this study show that cone-beam breast CT can be used to image the entire breast from chest wall to nipple with sufficient spatial and contrast resolution for detection of masses and calcifications at a radiation dose within the range of that of conventional mammography