Cone-beam breast CT a reliable modality for assessing breast density

Cone-beam breast CT (CBBCT) is an effective imaging modality for assessing a patient’s breast density, according to a new study published in Academic Radiology.  

“A number of studies have reported that CBBCT yields greater benefits with minimal side effects when compared to other imaging techniques, thus boosting CBBCT's potential in breast imaging,” wrote Zhaoxiang Ye, MD, with the Tianjin Medical University in Tianjin, China, and colleagues. “Furthermore, CBBCT offers a more effective diagnostic evaluation of breast masses than mammography in spite of overlying tissue or microcalcifications.”

The authors analyzed breast density assessments of 130 patients performed by a team of five radiologists. Radiologists studied two-view mammograms and CBBCT images, referring to the fifth edition of the American College of Radiology’s Breast Imaging Reporting and Data System (BI-RADS). One month later, three other radiologists, with different levels of experience, repeated the exercise.

Overall, the inter-reader agreement for the CBBCT images was 0.781. For mammograms, it was 0.744. In addition, intrareader reliability was 0.856 for the CBBCT images and 0.786 for the mammograms.

“Although mammography has been widely used for breast cancer detection, there are some limitations such as overlapping of breast tissue, breast compression, and detection in dense breast tissue,” the authors wrote. “Therefore, it is imperative to utilize additional imaging methods for dense-breasted women. As an emerging imaging modality, CBBCT with 3D visualization shows the potential for assessing the breast density.”

The researchers also noted a “statistically significant difference” among radiologists with different levels of professional experience.

“There was a statistically significant difference among radiologists with different levels of experience, and higher density categories were reported more often by experienced reader,” the authors wrote.