The Clinical Study Of Computed Tomographic Laser Mammography

SectionⅠComputed Tomographic Laser Mammography and Images features in Normal BreastsObjective:The objective of this study was to investigate the scan technique of CTLM(computed tomographic laser mammography) and analysis the images features in normal breasts.Materials and Methods:The study involved 150 female Volunteers(20-69 years of age;median age:42years) underwent CTLM scan from September 2007 to June 2008.Result:The breasts diameter of 150 women were from 52mm-126mm.The slices of these breasts is from 9-50 and 1mm,2mm and 4mm slice thickness were be set.The normal vessel were shown areas of high absorption like ribbons(53 cases),branches(66 cases), stars(11cases),cones or cylinders(39 cases).9 cases shown deep vessels.Conclusion:Our study indicated that the skill of CTLM was the foundation of quality images.It was important for technicians to chose the suitable scan conditions according the size and shape of the breasts. The images features in normal breasts were regular and characteristic. SectionⅡComputed tomographic laser mammography, (CTLM),as an Adjunct to Mammography in Patients with Dense BreastsPurpose:The objective of this study was to evaluate the utility of CTLM,(computed tomographic laser mammography),as an adjunct to mammography in women with dense breast tissue(Breast Imaging Reporting and Data System[BI-RADS]density category 3 or 4).Materials and Methods:The study involved 155 women scheduled for biopsy or surgery from January 2008 to August 2008. Breasts density was evaluated initially with Mammography. Parenchymal patterns of"heterogeneously dense"(BI-RADS Grade 3:51 to 75%fibroglandular) and "extremely dense",(BI-RADS Grade 4:＞75% fibroglandular),were used to classify breast density.CTLM examination was performed subsequently to mammography on patients with dense breasts.We then compared the findings of mammography alone,CTLM alone,and CTLM adjunct to mammography(mammography+CTLM), with pathology.Sensitivity,specificity and positive predictive values were calculated by using standard methods.Between-group differences were evaluated with the x~2 test for categorical variables.Result:155 women were classified by mammography into 74 heterogeneously dense breasts and 81 extremely dense breasts. Pathologic analysis revealed 79 malignant and 76 benign breast lesions. Angiogenesis was observed significantly more often in malignant than in benign lesions(79.75%VS.31.57%x2=36.550 p=0.000),Among extremely dense breasts the sensitivity of mammography alone,CTLM alone,and mammography+CTLM was respectively,35.13%,78.37%,81.57%.The sensitivity of mammography VS mammography+CTLM was 35.13%VS.81.57%(x~2=13.071 p=0.000).The specificity of mammography alone,CTLM alone,mammography+CTLM was 89.19%,72.97%,78.13%.Among heterogeneously dense breasts the sensitivity of mammography alone,CTLM alone,mammography+CTLM was 66.67%,80.95%,95.34%.The sensitivity of mammography VS mammography+CTLM was 66.67%VS 95.34%(x~2=11.131 p=0.001). The Specificity of mammography alone,CTLM alone, mammography+CTLM was 87.18%,64.10%,55.26%.The sensitivity of CTLM in heterogeneously dense breasts VS extremely dense breasts was (78.37%vs 80.95%x~2=0.446 p=0.504).The specificity in these cases was 72.97%vs 64.10%x~2=0.0001 p=1.0)Conclusion:CTLM provides information about angiogenesis.It does not appear to be affected by breast density and when used as an adjunct to mammography in heterogeneously and extremely dense breasts,increases diagnostic sensitivity CTLM could successfully distinguish malignant from benign lesions of dense breast.This study suggests that in clinical practice,using CTLM as an adjunct to mammography may help solve the dense breast problem.