Computed tomography laser mammography (ctlm) in the valuation of breast lesions

Purpose: To assess the value of CTLM in the evaluation of breast lesions, to determine the role of parenchyma type and vascular anatomy on CTLM image pattern, and to investigate the impact of bilateral scanning. Materials and Methods: The patients who have been applied for scanning or diagnosing to our Department have been participated to this study. CTLM has been scanned to 212 patients with lesions diagnosed on mammography or US, and 26 patients with radiologically normal breasts. CTLM scans have been assessed independently by two reviewers. The assessments have been made in two steps; at the first step revieweres assessed the images without knowing the location, size of the lesion and the category of BI-RADS; the second step has been made with the knowledge of these informations. Findings: The lesions have been categorized as BI-RADS 2-3-4-5 (n:23, 90, 48, and 68) (72 malignant, 157 benign). The last diagnose has been made with the histopathology in BI-RADS 4-5, and with the follow-up in BI-RADS 3 categories. 72 of the lesions were malign and 157 of the lesions were bening. The agreement between reviewers was %95.1 for the first assessment and %99.5 for the second. Sensitivity, specificity, ppv and npv of CTLM were calculated for the first and second assessments as 46%, 70%, 41%, 73%, and 68%, 80%, 61%, 85%, respectively. It has been observed that if the CTLM has been used as an adjunct to the other radiological modalities, and it has been allowed to effect the diagnose, it has been calculated that the specificity would be decrease from %65 to %55. CTLM indicated positive correlation with the tumor grade; however, the relationship between the dimension of the lesion, breast parenchyma type, the vascular anatomy and positivizm of CTLM.was not significant. Results: Currently, CTLM scanning is not a reliable method even though it has been used as an adjunct method to MG and US scanning for the diagnosies of bening and malign breast lesions