Hepatic metastases from breast carcinoma: Comparison of noncontrast, arterial-dominant, and portal-dominant phase spiral CT

Purpose: The purpose of this work was to determine the relative value of no ncontrast (NC), arterial-dominant (AD), and portal-dominant (PD) phase imag es in spiral CT of the liver for breast cancer metastases. Method: Forty-four spiral CT scans in 18 patients with hepatic metastases f rom breast cancer were retrospectively reviewed by three radiologists. Subj ective evaluation!; of overall lesion conspicuity and margination were grad ed on a 5 point scale for NC, AD, and PD phase images, and the three phases were also ranked for demonstration of overall tumor volume. Those scans wi th hypervascular lesions were separately analyzed, resulting in three group s (all, hypervascular, hypovascular). Results: For lesion conspicuity and margination for the entire study group, AD phase images showed the lowest grades (1.97 and 1.83), whereas the PD p hase showed the highest grade (3.34 and 3.14; p < 0.0001) followed by NC (2 .36 and 2.42; p < 0.0001). For the hypervascular subgroup, the AD phase als o showed the lowest grades (2.39 and 2.24). In no case did the AD phase sho w more lesions than the combination of NC and PD phases. For depiction of o verall tumor volume, the AD phase had the lowest ranking (2.51) compared wi th the NC and PD phases (1.71 and 1.78; p < 0.001). For the hypervascular s ubgroup, the AD phase had the lowest ranking (2.33) compared with the NC an d PD phases (1.39 and 2.27; p < 0.0001). Conclusion: The AD phase is not required for lesion detection in spiral CT for hepatic metastases from breast carcinoma. The NC phase depicts the maxi mal tumor volume.