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The aim of this study is the clinical establishment of a native and contrast-enhanced computer tomography of the breast. The early detection of breast cancer is still a great challenge. Even though the implementation of the digital mammography combined with the mandatory screening-programs lead to significant improvements, sensitivity and specificity of these examinations need to be clearly classified as improvable. Generally, it is stated that the necessary transit from 2-D projected images to 3-D tomography will be crucially advantageous as magnetic resonance imaging has already shown. Similar or even major advantages can be expected by new approaches regarding CT with very high local resolution, better than 100µm in 3D and lower dose, under 5 Milligray (mGy), as demanded for a screening. A device that meets these demands and is also applicable for dynamic scans after intravenous administration of a contrast agent, has been developed with the support by the European Union (EU), German Research Foundation (DFG) and Federal Ministry of Education and Research (BMBF). Publications on technical and experimental results are already available. An evaluation in the clinical use is missing yet. The primary aim of this study is to evaluate systematically the performance of the native and dynamic, contrast-enhanced CT of the breast.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Native and dynamic contrast-enhanced CT | Experimental | Patients will undergo a native high-resolution and a dynamic contrast-enhanced CT, both sides respectively. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Native and dynamic contrast-enhanced CT | Device |
|
| Measure | Description | Time Frame |
|---|---|---|
| Sub-Study 1: comparison of a-posteriori sensitivity using the native, contrast-enhanced or dynamic contrast-enhanced breast CT. | By using the images diagnostic criteria for identification and characterization of the pathologic and physiologic changes of the female breast will be elaborated. | 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| Comparison of biological value of the diagnosed carcinoma in dependence with its detection mode. | Detection mode means the prospective visibility of a carcinoma in one or more independent imaging methods, respectively. Biological value will be calculated by amount of high and intermediate grade vs. low grade lesions, status of Ki-67 values, distribution of luminal a, luminal b, Her2/neu and basal, distribution of receptor status |
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Inclusion Criteria:
Sub Study 1:
Substudy 2:
Exclusion Criteria:
Substudy 1:
additionally the following criteria apply, if conducting the dynamic contrast-enhanced breast-CT
Substudy 2:
additionally the following criteria apply, if conducting the dynamic contrast-enhanced breast-CT:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Verena Deserno, Dipl.-Biol., M.A. | Contact | +49 241 80-80092 | vdeserno@ukaachen.de |
| Name | Affiliation | Role |
|---|---|---|
| Christiane Kuhl, Univ.-Prof. Dr. med. | Klinik für Diagnostische und Interventionelle Radiologie | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21361181 | Background | Weigel M, Vollmar SV, Kalender WA. Spectral optimization for dedicated breast CT. Med Phys. 2011 Jan;38(1):114-24. doi: 10.1118/1.3523599. | |
| 22482646 | Background | Nowak T, Hupfer M, Althoff F, Brauweiler R, Eisa F, Steiding C, Kalender WA. Time-delayed summation as a means of improving resolution on fast rotating computed tomography systems. Med Phys. 2012 Apr;39(4):2249-60. doi: 10.1118/1.3697533. |
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| 2 years |
| Substudy 2: sensitivity of the native and the contrast-enhanced or dynamic contrast-enhanced high-resolution low-dose CT in comparison to the conventional examination procedures | 2 years |
| Sub-study 2: specificity of the native and the contrast-enhanced or dynamic contrast-enhanced high-resolution low-dose CT in comparison to the conventional examination procedures | 2 years |
| Substudy 2: Positive Predictive Value (PPV) of the native and the contrast-enhanced or dynamic contrast-enhanced high-resolution low-dose CT in comparison to the conventional examination procedures | 2 years |
| Substudy 2: Negative Predictive Value (NPV) of the native and the contrast-enhanced or dynamic contrast-enhanced high-resolution low-dose CT in comparison to the conventional examination procedures | 2 years |
| 22316498 | Background | Beister M, Kolditz D, Kalender WA. Iterative reconstruction methods in X-ray CT. Phys Med. 2012 Apr;28(2):94-108. doi: 10.1016/j.ejmp.2012.01.003. Epub 2012 Feb 10. |
| 20177029 | Background | Kuhl C, Weigel S, Schrading S, Arand B, Bieling H, Konig R, Tombach B, Leutner C, Rieber-Brambs A, Nordhoff D, Heindel W, Reiser M, Schild HH. Prospective multicenter cohort study to refine management recommendations for women at elevated familial risk of breast cancer: the EVA trial. J Clin Oncol. 2010 Mar 20;28(9):1450-7. doi: 10.1200/JCO.2009.23.0839. Epub 2010 Feb 22. |
| 18477789 | Background | Kuhl CK. The "coming of age" of nonmammographic screening for breast cancer. JAMA. 2008 May 14;299(18):2203-5. doi: 10.1001/jama.299.18.2203. No abstract available. |
| 17693177 | Background | Kuhl CK, Schrading S, Bieling HB, Wardelmann E, Leutner CC, Koenig R, Kuhn W, Schild HH. MRI for diagnosis of pure ductal carcinoma in situ: a prospective observational study. Lancet. 2007 Aug 11;370(9586):485-92. doi: 10.1016/S0140-6736(07)61232-X. |