Hepatic lesions deemed too small to characterize at CT: Prevalence and importance in women with breast cancer Journal Article
| Authors: | Khalil, H. I.; Patterson, S. A.; Panicek, D. M. |
| Article Title: | Hepatic lesions deemed too small to characterize at CT: Prevalence and importance in women with breast cancer |
| Abstract: | PURPOSE: To retrospectively evaluate the prevalence and clinical importance of hepatic lesions considered too small to characterize (TSTC) at initial computed tomography (CT) in women with breast cancer. MATERIALS AND METHODS: Approval for this retrospective study was obtained from the institutional review board, which waived the requirement for informed consent. For each woman who received a diagnosis of breast cancer between 1998 and 2002, the authors reviewed the report of the first contrast material-enhanced CT examination that included assessment of the liver. For women with no definite liver metastasis and at least one hepatic lesion considered TSTC, reports of follow-up imaging examinations were reviewed for a change in lesion size; medical records and images were reviewed if there was a change in lesion size. The 95% confidence intervals (CIs) were calculated for best- and worst-case analyses of cases in which different assumptions were used to classify a lesion as benign. RESULTS: Of 7692 women, 1012 (13.2%) underwent contrast-enhanced CT including liver assessment. The mean age of the 1012 women was 54.6 years (range, 20.7-89.1 years). The median time from diagnosis of breast cancer to initial CT examination was 14.1 weeks (range, -3.7 to 296 weeks). The presence of at least one hepatic lesion deemed TSTC was reported in 277 of 941 women (29.4%) in whom no definite hepatic metastasis was reported. Subsequent imaging examinations were performed in 191 of the 277 women (69.0%) (median time from initial CT to last follow-up imaging examination, 54 weeks; range, 0.3-302 weeks). Those examinations revealed the lesions were unchanged in 175 (91.6%) women, no longer visible in eight (4.2%), and larger in six (3.1%). In two women (1.0%), change could not be determined. The enlarging hepatic lesions deemed TSTC represented metastatic breast cancer (three patients), metastatic pancreatic cancer (one patient), or cysts (one patient); in one patient, the etiology was not known. Results of best- and worst-case analyses showed that the lesions were benign in 96.9% (95% CI: 93%, 99%) and 92.7% (95% CI: 88%, 96%) of women, respectively. CONCLUSION: In 92.7%-96.9% of women with breast cancer and hepatic lesions deemed TSTC but no definite liver metastases at initial CT, the lesions represented a benign finding. © RSNA, 2005. |
| Keywords: | adult; human tissue; aged; aged, 80 and over; middle aged; retrospective studies; major clinical study; review; liver neoplasms; pancreas cancer; follow up; computer assisted tomography; breast cancer; image analysis; tumor volume; prevalence; tomography, x-ray computed; breast neoplasms; retrospective study; liver metastasis; contrast enhancement; medical record; informed consent; breast metastasis; tumor classification; decision trees; calculation |
| Journal Title: | Radiology |
| Volume: | 235 |
| Issue: | 3 |
| ISSN: | 0033-8419 |
| Publisher: | Radiological Society of North America, Inc. |
| Date Published: | 2005-06-01 |
| Start Page: | 872 |
| End Page: | 878 |
| Language: | English |
| DOI: | 10.1148/radiol.2353041099 |
| PUBMED: | 15833992 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 26" - "Export Date: 24 October 2012" - "CODEN: RADLA" - "Source: Scopus" |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work