Breast Computed Tomography Diagnostic Performance of the Maximum Intensity Projection Reformations as a Stand-Alone Method for the Detection and Characterization of Breast Findings

Objectives This study aimed to evaluate the diagnostic performance of the maximum intensity projection (MIP) reformations of breast computed tomography (B-CT) images as a stand-alone method for the detection and characterization of breast imaging findings. Materials and Methods A total of 160 women undergoing B-CT between August 2018 and December 2020 were retrospectively included; 80 patients with known breast imaging findings were matched with 80 patients without imaging findings according to age and amount of fibroglandular tissue (FGT). A total of 71 benign and 9 malignant lesions were included. Images were evaluated using 15-mm MIP in 3 planes by 2 radiologists with experience in B-CT. The presence of lesions and FGT were evaluated, using the BI-RADS classification. Interreader agreement and descriptive statistics were calculated. Results The interreader agreement of the 2 readers for finding a lesion (benign or malignant) was 0.86 and for rating according to BI-RADS classification was 0.82. One of 9 cancers (11.1%) was missed by both readers due to dense breast tissue. BI-RADS 1 was correctly applied to 73 of 80 patients (91.3%) by reader 1 and to 74 of 80 patients (92.5%) by reader 2 without recognizable lesions. BI-RADS 2 or higher with a lesion in at least one of the breasts was correctly applied in 69 of 80 patients (86.3%) by both readers. For finding a malignant lesion, sensitivity was 88.9% (95% confidence interval [CI], 51.75%-99.72%) for both readers, and specificity was 99.3% (95% CI, 96.4%-100%) for reader 1 and 100% (95% CI, 97.20%-100.00%) for reader 2. Conclusions Evaluation of B-CT images using the MIP reformations may help to reduce the reading time with high diagnostic performance and confidence.