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28 February 2008

Evaluation of laser computer mammography (CTLM) usefulness in differentiation benign and malignant breast lesions

Barbara Bobek-Billewicz, Marek K. Jurkowski, K. Steinhof-Radwańska, Ewa Stobiecka

Pol J Radiol 2008; 73(1): 27-31 :: ID: 677287

Abstract

Background: To evaluate the usefulness of the CTLM method in differentiation between benign and malignant neoplasms in female breast tissue (benign and malignat breast lesions). Material/Methods: Retrospective analysis of 482 lesions in female breast tissue, verified histopathologically on the basis of material obtained by core biopsy. In this study, the CTLM diagnosis was established prior to biopsy, so the radiologist describing the CTLM examination was unaware of the histopathology finding; he/she was however familiar in most cases with the outcome of mammography, was involved in performing/evaluating the mammography and/or performed an ultrasound examination. CTLM examinations not applicable for evaluation because of artifacts were excluded from the analysis. A CTLM examination result was counted as positive, i.e. the presence of angiogenesis was detected, when an area of enhanced laser light absorption was visible and that area was not a normal vascular structure. Results: In 2005, angiogenesis was observed in 25 out of 65 malignant lesions (38.46%) and in 40 cases (61.54%) areas of enhanced laser light absorption were not detected. Among 142 benign lesions, in 57 cases (40.14%) enhanced laser light absorption (ELLA) was observed, whereas in 85 cases (59.86%) it was absent. Coefficients calculated for data acquired in 2005 were as follows: sensitivity = 38%, specificity = 60%, positive predictive value (PPV) = 30%, negative predictive value (NPV) = 68%, diagnostic accuracy = 53%. In 2006, angiogenesis was detected in 46 out of 97 cases (47.42%), whereas in the remaining 51 (52.58%) cases ELLA was not observed. Among 178 benign lesions, in 46 cases (25.84%) ELLA was observed, whereas in 132 cases (74,16%) it was not. Coefficients calculated for data acquired in 2006 were: sensitivity = 47%, specificity = 74%, positive predictive value (PPV) = 50%, negative predictive value (NPV) = 72%, diagnostic accuracy = 65%. The presented data reveal that an increase of absorption of laser light was observed by us more often in cases of malignant lesions that of benign ones (47.42% vs. 25.84%, p<0.001, data from 2006). Conclusions: The obtained results demonstrate that indeed a positive CTLM reading is observed more often in malignant rather than benign lesions, and that the examination is a valuable method adjunct to classic X-ray mammography.

Keywords: CTLM, breast cancer, optical imaging, laser technique

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750