Validating accurate placement of non-wire localization markers in non- palpable breast tumors using breast CT: a feasibility study

Abstract

Abstract Background Dedicated photon-counting breast CT is an emerging imaging technology for imaging the breast without the need for compression of the breast and with a radiation dose comparable to that of mammography. In this study, we assessed the feasibility of using breast CT to confirm the accurate placement of localization markers in nonpalpable breast tumors before breast-conserving surgery. Methods We first evaluated the artifacts caused by 5 different metallic markers in 2 different phantoms and applied a computer algorithm to effectively remove the beam hardening artifacts. Next, we tested the potential of dedicated photon-counting breast CT combined with the artifact-removing algorithm to assess accurate marker placement in 5 patients with nonpalpable breast tumors. Results In the phantoms, all markers caused beam-hardening artifacts, but the computer algorithm successfully removed them. In the patients, the correct placement of the markers was visualized with breast CT and confirmed postsurgery, as all markers and tumors were present in the surgical specimen. Conclusion Dedicated photon-counting breast CT is an effective modality for demonstrating accurate placement of localization markers.