Abstract
OBJECTIVE. The purpose of this study is to compare the performance of dual-energy CT (DECT) with that of breast MRI for detection of silicone gel breast implant rupture and nodal spread of silicone. SUBJECTS AND METHODS. This prospective study enrolled consecutive patients with current or prior silicone gel implants and clinical suspicion of implant rupture or extracapsular silicone. All patients underwent MRI followed by unenhanced DECT. A breast radiologist not participating in image evaluation established reference standards for implant rupture (intra- or extracapsular) and regional nodal silicone spread (to axillary nodes and internal mammary [IM] and mediastinal nodes) using MRI, surgical findings, and medical records. After undergoing reader training, two radiologists who were blinded to all medical records interpreted randomized images in two sessions, indicating confidence in diagnosis using a 100-point visual scale. RESULTS. A total of 46 patients who had a subpectoral silicone gel implant (n = 31), a subglandular silicone gel implant (n = 14), or a silicone gel implant that was removed (n = 1) underwent MRI and DECT (mean [± SD] volume CT dose index, 8.2 ± 2.0 mGy). Nineteen patients had implant rupture, and 13 of these patients had silicone within the IM or axillary nodes. Pooled data showed no significant difference between MRI and DECT interpretation of intra- or extracapsular rupture of implants (AUC value for intracapsular rupture, 0.958 [for MRI] vs 0.989 [for DECT]; p = 0.28; AUC value for extracapsular rupture, 0.864 [for MRI] vs 0.878 [for DECT]; p = 0.78). No difference was noted in the AUC value for silicone spread to regional lymph nodes: 0.823–0.866 [for MRI] vs 0.892–0.906 [for DECT]; p = 0.34–0.54). CONCLUSION. DECT performs similar to MRI for the detection of silicone gel implant rupture and the presence of silicone in regional lymph nodes, and it may be an alternative for patients who are unable or unwilling to undergo MRI.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 933-942 |
| Number of pages | 10 |
| Journal | American Journal of Roentgenology |
| Volume | 212 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 1 2019 |
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Keywords
- Breast implant
- Dual-energy CT
- Implant rupture
- MRI
- Silicone
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
Cite this
Ability of dual-energy CT to detect silicone gel breast implant rupture and nodal silicone spread. / Glazebrook, Katrina Nesta; Doerge, Stefan; Leng, Shuai; Drees, Tammy A.; Hunt, Katie N.; Zingula, Shannon N.; Pruthi, Sandhya; Geske, Jennifer R.; Carter, Rickey E.; McCollough, Cynthia H; Fletcher, Joel Garland.
In: American Journal of Roentgenology, Vol. 212, No. 4, 01.04.2019, p. 933-942.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Ability of dual-energy CT to detect silicone gel breast implant rupture and nodal silicone spread
AU - Glazebrook, Katrina Nesta
AU - Doerge, Stefan
AU - Leng, Shuai
AU - Drees, Tammy A.
AU - Hunt, Katie N.
AU - Zingula, Shannon N.
AU - Pruthi, Sandhya
AU - Geske, Jennifer R.
AU - Carter, Rickey E.
AU - McCollough, Cynthia H
AU - Fletcher, Joel Garland
PY - 2019/4/1
Y1 - 2019/4/1
N2 - OBJECTIVE. The purpose of this study is to compare the performance of dual-energy CT (DECT) with that of breast MRI for detection of silicone gel breast implant rupture and nodal spread of silicone. SUBJECTS AND METHODS. This prospective study enrolled consecutive patients with current or prior silicone gel implants and clinical suspicion of implant rupture or extracapsular silicone. All patients underwent MRI followed by unenhanced DECT. A breast radiologist not participating in image evaluation established reference standards for implant rupture (intra- or extracapsular) and regional nodal silicone spread (to axillary nodes and internal mammary [IM] and mediastinal nodes) using MRI, surgical findings, and medical records. After undergoing reader training, two radiologists who were blinded to all medical records interpreted randomized images in two sessions, indicating confidence in diagnosis using a 100-point visual scale. RESULTS. A total of 46 patients who had a subpectoral silicone gel implant (n = 31), a subglandular silicone gel implant (n = 14), or a silicone gel implant that was removed (n = 1) underwent MRI and DECT (mean [± SD] volume CT dose index, 8.2 ± 2.0 mGy). Nineteen patients had implant rupture, and 13 of these patients had silicone within the IM or axillary nodes. Pooled data showed no significant difference between MRI and DECT interpretation of intra- or extracapsular rupture of implants (AUC value for intracapsular rupture, 0.958 [for MRI] vs 0.989 [for DECT]; p = 0.28; AUC value for extracapsular rupture, 0.864 [for MRI] vs 0.878 [for DECT]; p = 0.78). No difference was noted in the AUC value for silicone spread to regional lymph nodes: 0.823–0.866 [for MRI] vs 0.892–0.906 [for DECT]; p = 0.34–0.54). CONCLUSION. DECT performs similar to MRI for the detection of silicone gel implant rupture and the presence of silicone in regional lymph nodes, and it may be an alternative for patients who are unable or unwilling to undergo MRI.
AB - OBJECTIVE. The purpose of this study is to compare the performance of dual-energy CT (DECT) with that of breast MRI for detection of silicone gel breast implant rupture and nodal spread of silicone. SUBJECTS AND METHODS. This prospective study enrolled consecutive patients with current or prior silicone gel implants and clinical suspicion of implant rupture or extracapsular silicone. All patients underwent MRI followed by unenhanced DECT. A breast radiologist not participating in image evaluation established reference standards for implant rupture (intra- or extracapsular) and regional nodal silicone spread (to axillary nodes and internal mammary [IM] and mediastinal nodes) using MRI, surgical findings, and medical records. After undergoing reader training, two radiologists who were blinded to all medical records interpreted randomized images in two sessions, indicating confidence in diagnosis using a 100-point visual scale. RESULTS. A total of 46 patients who had a subpectoral silicone gel implant (n = 31), a subglandular silicone gel implant (n = 14), or a silicone gel implant that was removed (n = 1) underwent MRI and DECT (mean [± SD] volume CT dose index, 8.2 ± 2.0 mGy). Nineteen patients had implant rupture, and 13 of these patients had silicone within the IM or axillary nodes. Pooled data showed no significant difference between MRI and DECT interpretation of intra- or extracapsular rupture of implants (AUC value for intracapsular rupture, 0.958 [for MRI] vs 0.989 [for DECT]; p = 0.28; AUC value for extracapsular rupture, 0.864 [for MRI] vs 0.878 [for DECT]; p = 0.78). No difference was noted in the AUC value for silicone spread to regional lymph nodes: 0.823–0.866 [for MRI] vs 0.892–0.906 [for DECT]; p = 0.34–0.54). CONCLUSION. DECT performs similar to MRI for the detection of silicone gel implant rupture and the presence of silicone in regional lymph nodes, and it may be an alternative for patients who are unable or unwilling to undergo MRI.
KW - Breast implant
KW - Dual-energy CT
KW - Implant rupture
KW - MRI
KW - Silicone
UR - http://www.scopus.com/inward/record.url?scp=85063642142&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85063642142&partnerID=8YFLogxK
U2 - 10.2214/AJR.18.20138
DO - 10.2214/AJR.18.20138
M3 - Article
C2 - 30779664
AN - SCOPUS:85063642142
VL - 212
SP - 933
EP - 942
JO - American Journal of Roentgenology
JF - American Journal of Roentgenology
SN - 0361-803X
IS - 4
ER -