Pulmonary metastases occur in 30% of all malignancies, usually through hematogenous dissemination. In 10-25% of cases, the lungs are the only site of metastasis. The classic CT appearance is that of multiple well-defined nodules, often seen in continuity with an underlying blood vessel. Lung metastases are typically widespread, although solitary metastases are not at all uncommon, particulary in colon, kidney, breast, testicular, and musculoskeletal primaries.
CT of Breast Cancer: facts
Internal mammary adenopathy is an important site of occult metastasis in breast cancer. Involvement is often ipsilateral to the primary tumor and represents a site of regional nodal spread, much like the axilla. Lymphoma represents the other common malignancy to selectively target this nodal chain. Involvement is usually the result of contiguous spread from the anterior mediastinal or paratracheal area to the other mediastinal lymph node groups, including the internal mammary chain. Occasionally, isolated internal mammary nodal involvement is seen.
Dynamic CT-mammography: CT Protocol
- 100 cc of non-ionic contrast injection at 3 cc/sec - Scans were acquired at 30 sec and 2 minutes post start of injection - Images reviewed with axial CT and MIP displays
"Multiple enhancing lesions on CT-mammography in patients with breast cancer were relatively common, and most of them represented multiple cancer lesions. Dynamic CT-mammography is potentially useful in evaluating the spread of breast cancer.”
Multiple Enhancing Lesions Detected on Dynamic Helical Computed Tomography-Mammography Nishino M et al. J Comput Assit Tomogr 2003; 27:771-778
“The CT features of breast lesions are less familiar than are those of mammography and ultrsonography; however, CT can demonstrate many abnormal breast conditions. Also, some breast lesions are better visualized on CT than on mammography.”
Computed Tomography of the Breast: Abnormal Findings with Mammographic and Sonographic Correlation Kim SM et al. J Comput Assist Tomogr 2003;27:761-770
MDCT of Breast Cancer: CT Appearance
- Spiculated and Irregular margin - Irregular shape - Rim enhancement
"Administration of IV contrast material by means of hand injection led to damage of four central venous catheters during a 6 yr period at our institution (0.3% of central venous catheters hand injected during that time)."
Is Hand Injection of Central Venous catheters for Contrast Enhanced CT Safe for Children Donnelly LF et al. AJR 2007;189:1530-1532
"Dedicated breast CT is currently investigational but may eventually have applications in screening or diagnostic evaluation for breast cancer, as a more accessible replacement for breast MR imaging or as a guidance method for robotic breast biopsy or tumor ablation procedures."
Dedicated Breast CT: Initial Clinical Experience Lindfors KK et al. Radiology 2008;246:725-733
"Subjects found CT significantly more comfortable than mammography."
Dedicated Breast CT: Initial Clinical Experience Lindfors KK et al. Radiology 2008;246:725-733
"Overall, CT was equal to mammography for visualization of breast lesions.Breast CT was significantly better than mammography for visualization of masses; mammography outperformed CT for visualization of microcalcifications. No significant differences between CT and mammography were seen among benign versus malignant lesions or for effect of breast density on lesion visualization."
Dedicated Breast CT: Initial Clinical Experience Lindfors KK et al. Radiology 2008;246:725-733
