Assessing Accurate Placement of Non-Wire Localization Markers in Non- Palpable Breast Tumors Using Breast CT: A Technical Note

Author(s): Martin Wasser MN, Laurent Coopmans, Daniel Kolditz D, JoukeDijkstra J, Matthias Wetzl M, Nora Voormolen, Jos van der Hage JA.

Background: Dedicated photon-counting breast-CT is an emerging imaging technology for imaging of the breast without need for compression of the breast and with radiation dose comparable to mammography. In this study, we assessed the potential use of breast-CT to confirm accurate placement of localization markers in non-palpable 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 non-palpable 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 post-surgery, 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.