Clinical assessment of image quality, usability and patient comfort in dedicated spiral breast computed tomography

To investigate aspects of image quality, feasibility and patient comfort in dedicated spiral breast computed tomography (B-CT) in a large patient cohort.

This retrospective study was approved by the institutional review board. 2418 B-CT scans from 1222 women examined between 04/16/2019 and 04/13/2022 were analyzed. Patients evaluated their comfort during the examination, radiographers carrying out the scans evaluated the patient's mobility and usability of the B-CT device, whereas radiologists assessed lesion contrast, detectability of calcifications, breast coverage and overall image quality. For semi-quantitative assessment, a Likert-Scale was used and statistical significance and correlations were calculated using ANOVAs and Spearman tests.

Comfort, mobility and usability of the B-CT were rated each with either "no" or "negligible" complaints in >99%. Image quality was rated with "no" or "negligible complaints" in 96.7%. Lesion contrast and detectability of calcifications were rated either "optimal" or "good" in 92.6% and 98.4%. "Complete" and "almost complete" breast coverage were reported in 41.9%, while the pectoral muscle was found not to be covered in 56.0%. Major parts of the breast were not covered in 2.1%. Some variables were significantly correlated, such as age with comfort (ρ = -0.168, p < .001) and mobility (ρ = -0.172, p < .001) as well as patient weight with lesion contrast (ρ = 0.172, p < .001) and breast coverage (ρ = -0.109, p < .001).

B-CT provides high image quality and contrast of soft tissue lesions as well as calcifications, while covering the pre-pectoral areas of the breast remains challenging. B-CT is easy to operate for the radiographer and comfortable for the majority of women.