Characterization of Benign and Malignant Breast Lesions With Computed Tomography Laser Mammography (CTLM)

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Abstract
The aim of this study was to characterize benign and malignant breast lesions with computed tomography-laser mammography (CTLM). In a prospective study, 100 female patients with 105 breast lesions classified as BIRADS IV to V at mammography underwent mammography, CTLM, and histologic verification at our institution. CTLM images were analyzed by radiologists with knowledge of the lesion's position but who were blinded to histology and morphologic findings from mammography. Two radiologists independently evaluated whether there was increased absorption, a sign of malignancy, on CTLM and assessed the appearance (volumes or linear branching) and shape (round or irregular) of the lesions. Histologic analysis revealed 55 benign (52.4%) and 50 malignant (47.6%) breast lesions. Increased absorption was observed significantly more often in malignant than in benign lesions (70.0% vs. 32.7%, P = 0.028). Invasive cancer showed increased absorption in 76.2%, and ductal carcinoma in situ in 37.5%. Common morphologic characteristics of increased absorption were "volumes" (85.7% of malignant and 77.8% of benign lesions) with round shape (78.1% of malignant and 73.3% of benign lesions). Our data indicate that CTLM, when used as an adjunct to mammography, may provide additional information to characterize benign and malignant breast lesions.