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Background <p>Breast cancer is one of the most common cancers worldwide accounting for a significant mortality and morbidity. The effective management begins with early diagnosis. Dual-energy CT (DECT) can serve as a valuable tool in this setting by providing insights into tissue composition, potentially allowing assessment of the tumour’s immunohistochemical characteristics and tumour staging in the same setting.</p> Aim <p>To evaluate the role the DECT parameters in characterizing the immunohistochemical parameters of the cancerous tissues.</p> Materials and Methods <p>The clinically suspected and proven breast cancer patients were included. DECT thorax and abdomen was done in all these patients for staging purposes. Multiple DECT parameters i.e. Iodine concentration (IC<sub>Lesion</sub>) Normalised iodine concentration (NIC), Effective atomic number (Zeff), normalised atomic number (nZeff), and Slope K were calculated by placing region of interest (ROI) over the enhancing portion of the lesion. The immunohistochemical status of the tumor were recorded i.e. Estrogen (ER) / Progesterone (PR) / Herceptin 2 (HER-2) receptor status.</p> Statistical Analysis <p>The diagnostic accuracy of the DECT parameters in predicting the immunohistochemical profile among the breast cancer patients were analysed using the appropriate statistical tests and ROC curves using SPSS version 19.0.</p> Results <p>The p-value of the IC lesion, NIC and slope K was found to be &lt; 0.05 implying statistically significant variation between ER-positive and ER-negative groups. Similarly, statistically significant difference in IC lesion and NIC values were found between PR positive and negative tumours ( <i>p</i> &lt; 0.05). The fundamental principle underlying this study is that ER/PR-positive tumors suppress neoangiogenesis, leading to low vascularity and consequently low iodine density on DECT contrast studies, whereas ER/PR-negative and HER2 positive tumors promote neoangiogenesis, resulting in higher iodine density.</p> Conclusion <p>This study concludes that there is a statistically significant difference in DECT parameters between ER/PR-positive and ER/PR-negative breast carcinomas.</p>

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The Clinical Utility of Dual Energy Computed Tomography Quantitative Parameters in Evaluating Immunohistochemical (IHC) Biomarkers - Estrogen Receptor (ER), Progesterone Receptor (PR) And HER 2 (Herceptin 2 Receptor) in Invasive Breast Cancer: A Prospective Study

  • 期刊论文

  • 发表日期：

    2026年2月23日

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  • Kiruthika Eswaran,
  • Shubhamoy Gantait,
  • Deepak Barathi,
  • Nanda Kishore Maroju,
  • Bhawana Badhe

摘要

Background

Breast cancer is one of the most common cancers worldwide accounting for a significant mortality and morbidity. The effective management begins with early diagnosis. Dual-energy CT (DECT) can serve as a valuable tool in this setting by providing insights into tissue composition, potentially allowing assessment of the tumour’s immunohistochemical characteristics and tumour staging in the same setting.

Aim

To evaluate the role the DECT parameters in characterizing the immunohistochemical parameters of the cancerous tissues.

Materials and Methods

The clinically suspected and proven breast cancer patients were included. DECT thorax and abdomen was done in all these patients for staging purposes. Multiple DECT parameters i.e. Iodine concentration (ICLesion) Normalised iodine concentration (NIC), Effective atomic number (Zeff), normalised atomic number (nZeff), and Slope K were calculated by placing region of interest (ROI) over the enhancing portion of the lesion. The immunohistochemical status of the tumor were recorded i.e. Estrogen (ER) / Progesterone (PR) / Herceptin 2 (HER-2) receptor status.

Statistical Analysis

The diagnostic accuracy of the DECT parameters in predicting the immunohistochemical profile among the breast cancer patients were analysed using the appropriate statistical tests and ROC curves using SPSS version 19.0.

Results

The p-value of the IC lesion, NIC and slope K was found to be < 0.05 implying statistically significant variation between ER-positive and ER-negative groups. Similarly, statistically significant difference in IC lesion and NIC values were found between PR positive and negative tumours ( p < 0.05). The fundamental principle underlying this study is that ER/PR-positive tumors suppress neoangiogenesis, leading to low vascularity and consequently low iodine density on DECT contrast studies, whereas ER/PR-negative and HER2 positive tumors promote neoangiogenesis, resulting in higher iodine density.

Conclusion

This study concludes that there is a statistically significant difference in DECT parameters between ER/PR-positive and ER/PR-negative breast carcinomas.