Perfusion CT of Breast Carcinoma:

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.

Key words: Perfusion CT, dynamic CT, breast carcinoma, tumor perfusion