A Novel CT Body Position For Breast Cancer Patients, Utilizing A Customized Breast Pad - A Viable MRI Substitute, Producing Superior Results Than Standard MDCT Protocols

Author(s): Yordan Spirdonov*

Breast cancer staging with unclear local status after mammography and ultrasonography is by guidelines done with MRI, however, we are faced with a diagnostic and methodologic problem when MRI is contraindicated or impossible to perform. Deformation, distortion, change of density and location of the mammary glands (including their pathologies) occur with standard MDCT in supine position. To replace MRI, we introduced the prone position for staging without MRI on a specially designed CT breast pad (RCD-008478879-0001 and RCD-008478879-0002). The protocol (modus Spirdonov) includes MDCT scanning of the thorax and upper abdomen with contrast with 50-60 seconds delay. We present results of 114 patients with breast cancer scanned on our CT breast pad. Measurements along the midclavicular line in 113 women showed reduction of the anteroposterior mammary gland diameter 2 to 6.8 times when comparing supine CT scanning with prone (modus Spirdonov MDCT). Another finding was the lateral deviation of the mammilla up to 105º. Based on our experience, we concluded that in 9.6% of cases the standard MDCT protocol was inaccurate in determining the cancer location and relation to the surrounding structures. In a comparative group of 19 patients, who had MRI and CT (modus Spirdonov) performed, the results and conclusions were fully concordant and with minimal measurement differences. In summation, MDCT modus Spirdonov, performed on our CT breast pad, surpasses the standard supine position in determining the breast cancer lesion dimensions, location and analysing the surrounding tissues. MDCT modus Spirdonov, when combined with the CT breast pad, is a true alternative to MRI – when MRI is contraindicated or impossible. Goals: To present the results from prone MDCT of thorax and abdomen performed on the CT breast pad for locoregional staging of patients with breast cancer - when MRI is impossible to perform.