Breast mass assessment on chest CT: Axial, sagittal, coronal or maximal intensity projection?

The goal of this work is to determine the optimal projection to detect breast masses on Chest CT.

Institutional Review Board (HIPPA compliant) approval was obtained with a waiver of consent. 10 image pairs of Chest CT images containing breast masses were selected for review by 10 chest radiologists: the pairs consisted of axial, sagittal, coronal and axial MIP images (MIP images) with each projection compared to a MIP and with one another. For each pair, the image where the mass was most conspicuous was recorded.

MIPs were preferred to any cross sectional projection 82% of the time; sagittal (63%) or coronal (63%) images were preferred to the axial projection. When sagittal and coronal images were compared there was no preference.

MIP images should be obtained and reviewed for breast pathology; sagittal or coronal projections may provide additional information.