Arts and Sciences CT Approach to the incidental discovery of early-stage breast cancer on a chest CT 33393 Key words: Breast cancer. CT. Mammography Abstract Recently, we have treated two patients in our hospital in whom early-stage breast cancer was accidentally detected when a conventional chest computed tomography (CT) scan was performed after data were acquired with a 64-slice CT scanner. In our hospital, the mammary gland on conventional chest CT images (for lung diseases, injury, etc.) may not be considered if not interpreted by a radiologist. Thus, we decided that the mammary gland would be checked by a radiographer post-scanning, and the CT findings which were a Category 3 or more, as defined by mammography, would be considered as suspected cancer by mutual agreement with surgeons specializing in breast cancers. In addition, we have established the following protocol: (1) assistance for radiographic interpretation of the mammary gland; (2) report to a physician who ordered the CT scan; and (3) consulting with the outpatient department. In this study, we describe the incidental discovery of early-stage breast cancer in two patients report the outcomes of implementing our systematic protocol for the early detection of breast cancer in order to determine its usefulness. 64 CT CT 2CT CTMMG 3 21 CT 70 80% 25% 1 CT 2 2 CT 1 2 1-1 176 CT7mm 7 5mm invasive ductal carcinoma, papillotubular carcinoma, f CT1N0M0 Stage CT Fig.1 2 C MPR 7mm 1-2 245 Nobuyuki Fujimoto 33393 Social care corporation yu-sei association midorigaoka hospital, radiology department, radiological technologist 38 1 15 6 CT 10 1014 2015. vol.62 no.756
Fig.1 CT Fig.2 CT Long diameter 7.0mm 03 MMG 4 DCIS solid and comedo type T1N0M0 Stage CT Fig.3 5 A 10mm 2mm 3 4 MPR5 6 MMG Fig.6 7 1-32 CT 2 Fig.3 CT Fig.4 CT enlarged Fig.5 CT Fig.6 MMG Fig.7 MMG enlarged 11 1015
1 Tis DCIS LCIS 2 IDC ILC 2.0cm 2 MMG MMG CT 0.5mmCT 45 7mm76 MMG MMG 3 2 2 4 5 6 CT CT MMG 3 2-1 CTMMG 3 2-1-1 1mm 0.5mm CT 1mm CT 1mm 2mm3 0.5mm MMG2 2-1-2 5mm 5mm X 2 CT FAD 2-1-1 2 CT MMG 3 2mm 3 1 5mm 2-2 WL WW 7 CTWL0 40 WW300 400 WL20 WW300 WL 20 WW350 WL0 20 WW300 400 MPR CTFOV 12 1016 2015. vol.62 no.756
CT Arts and Sciences 2-3 2080 2-4 CT20 2 2 CT Table 1 system After normal chest CT imaging of a female Observation of the mammary gland by a CT expert Report immediately to the instructing physician any fi ndings of suspected breast cancer After thorough discussions with a breast surgeon, the instructing physician recommends the patient to see a breast surgeon For fi ndings of suspected breast cancer in patients ranging from 20-80 years of age, keep track of what happens subsequently 3 CT CT WL WW MPR 20 80 Table 1 CTCT FOV CT Table 2 4 23 11 1 24 10 311 4-1 2080CT CT500 Fig.8 03 Table 2 CT Scanner Tube Voltage Aquilion64 (Toshiba Medical Systems) 135kV Scan parameters Tube Current Collimation Auto Exposure Control (AEC) AEC Setting> SD: 8 Kernel: FC13 SliceThickness: 7mm 1 32mm Pitch 0.84 (=27/32) Rotation Time 0.5s/r Fig.8 No. of patients in target 500 cases by age 13 1017
4-2 7 MMG5 1 13 1 2 7 1 74 CTMMG 4 CT DCIS TisN0M0 2.3cm CT Fig.9 10 C MPR 8.4mm MMG Fig.11 1 45 CT MMG CT Fig.12 13 C MPR 7.6mm MMG Fig.14 3 1 178 T1N0M0 Fig.9 CT Fig.10 CT Long diameter 8.4mm Fig.11 MMG Fig.12 CT Fig.13 CT Long diameter 7.6mm Fig.14 MMG 14 1018 2015. vol.62 no.756
CT Arts and Sciences Fig.15 CT Fig.16 CT Long diameter 7.4mm Fig.17 MMG 03 Fig.18 CT Fig.19 CT Fig.20 MMG CT Fig.15 16 MPR C 7.4mm MMG Fig.17 FAD 263 CT Fig.18 19 5mm 10mm MMG Fig.20 359 CT Fig.21 22 C MPR 8mm MMG Fig.23 2 156 15 1019
Fig.21 CT Fig.22 CT Long diameter 8.0mm Fig.23 MMG Fig.24 CT Fig.25 CT Long diameter 13.5mm Fig.26 CT Fig.27 CT Long diameter 11.9mm CT Fig.24 25 A MPR 13.5mm 259 CT Fig.26 27 D MPR 11.9mm 5 1 Table 3 1 0.4% 1.4% 19 8 8.6% 16 1020 2015. vol.62 no.756
CT Arts and Sciences Table 3 Results for our hospital over 1 year No. diagnosed 500 No. of cancers discovered No. of detailed examinations No. of detailed examinations diagnosed 2 0.4% 7 1.4% 5 71% CT 71% 5 2 1 CT CT CT CT CT CT CT 6 2 1 OECD Health Data 2009 2 2006/5 HP http://home.hiroshima-u.ac.jp/katachan/tutorial 3 42-44 2003. 4 3 67-91 2004. 5 17-422001. 6 211-242 2004. 7 VERSUS CT 159 2006. 8 HP http://ganjoho.jp/professional/pre_scr/screening/ screening.html 03 17 1021