A preliminary application research of dual-energy spectral CT in breast cancer diagnosis

Background: The objective of this study was to retrospectively analyze the application of dual-energy spectral computerized tomography (DECT) to accurately diagnose breast cancer and lymph node metastasis. Materials and Methods: Between May 2018 and December 2019, 37 patients (22 with breast cancer and 15 with normal breast cancer) who underwent spectral CT imaging were analyzed. Metastatic lymph nodes were identified in 14 patients with breast cancer. Twelve patients who underwent traditional CT were included randomly as the control group to compare the radiation dose with spectral CT. Monochromatic levels with an optimal contrast-to-noise ratio for normal breast tissue were obtained. Quantitative parameters of spectral CT were compared between normal breast and breast cancer patients. The spectral curve, histogram, and scatter plot features of metastatic lymph nodes and primary lesions were analyzed. Results: The monochromatic level with the optimal contrast-to-noise ratio of the breast was approximately 65keV. All quantitative parameters, including values at 40keV???140keV, the concentrations of iodine, spectral curve slope (??HU), and relative iodine concentration were increased in breast cancer compared to those in healthy breasts. Metastatic lymph nodes were more consistent with primary breast cancer lesions in the spectral curve, histogram, and scatter plot, especially in the venous phase. Additionally, the radiation of spectral CT was decreased compared to that of traditional CT. Conclusion: Spectral CT can be used to identify breast cancer and metastatic lymph nodes.