Computed Tomography–Galactography Virtual Endoscopy: A Better Imaging Method for the Diagnosis of Pathologic Nipple Discharge

Background: The preoperative diagnosis of pathologic nipple discharge (PND) in clinical settings remains challenging. Computed tomography-galactography virtual endoscopy (CT-G VE) was used for the intracavity imaging of discharging lactiferous ducts in a three-dimensional space, and the diagnostic p...

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Main Authors: Nan Ma, Jiang Zhu, Yawen Wang, Kai Zhang, Song Zhao, Yongfeng Liang, Yan Deng, Rong Ma
Format: Article
Language:English
Published: IMR Press 2023-04-01
Series:Clinical and Experimental Obstetrics & Gynecology
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Online Access:https://www.imrpress.com/journal/CEOG/50/4/10.31083/j.ceog5004081
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author Nan Ma
Jiang Zhu
Yawen Wang
Kai Zhang
Song Zhao
Yongfeng Liang
Yan Deng
Rong Ma
author_facet Nan Ma
Jiang Zhu
Yawen Wang
Kai Zhang
Song Zhao
Yongfeng Liang
Yan Deng
Rong Ma
author_sort Nan Ma
collection DOAJ
description Background: The preoperative diagnosis of pathologic nipple discharge (PND) in clinical settings remains challenging. Computed tomography-galactography virtual endoscopy (CT-G VE) was used for the intracavity imaging of discharging lactiferous ducts in a three-dimensional space, and the diagnostic performance of CT-G VE was compared with that of ultrasonography and galactography. Methods: This study included 41 patients with single-orifice PND who underwent ultrasonography, galactography, and CT-G VE before surgery. The postoperative histopathologic results were regarded as the gold standard for diagnosis. Qualitative data were analyzed using Fisher’s precision probability test. Receiver operating characteristic (ROC) curve analysis was performed for ultrasonography, galactography, and CT-G VE to evaluate their diagnostic performances for the detection of PND diseases. Results: CT-G VE provided clear intracavity images of the discharging lactiferous ducts. The results of CT-G VE could be divided into five categories: negative, polypoid-solitary, polypoid-multiple, combined, and superficial types. The types were related to the histopathologic results. The detection ability of CT-G VE for high-risk and malignant lesions was higher than that of ultrasonography (p = 0.0056) and galactography (p = 0.0008). The detection abilities of CT-G VE alone and CT-G VE combined with ultrasonography were comparable. The cut-off point for CT-G VE was the polypoid-solitary type. The average effective dose for a single patient undergoing both chest CT and CT-G VE at the same time was 1.66 ± 0.78 msV. Conclusions: The diagnostic performance of CT-G VE was better than that of ultrasonography and galactography in detecting high-risk and malignant lesions of PND. This study proposed a grading system to aid decision-making and communication between clinicians in clinical practice.
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spelling doaj-art-7bf3b1b8c95c4d56aceb551f3da0e67f2025-08-20T02:06:57ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632023-04-015048110.31083/j.ceog5004081S0390-6663(23)02053-5Computed Tomography–Galactography Virtual Endoscopy: A Better Imaging Method for the Diagnosis of Pathologic Nipple DischargeNan Ma0Jiang Zhu1Yawen Wang2Kai Zhang3Song Zhao4Yongfeng Liang5Yan Deng6Rong Ma7Department of Breast Surgery, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, ChinaDepartment of Breast Surgery, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, ChinaDepartment of Breast Surgery, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, ChinaDepartment of Breast Surgery, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, ChinaDepartment of Breast Surgery, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, ChinaDepartment of Radiology, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, ChinaDepartment of Radiology, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, ChinaDepartment of Breast Surgery, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, ChinaBackground: The preoperative diagnosis of pathologic nipple discharge (PND) in clinical settings remains challenging. Computed tomography-galactography virtual endoscopy (CT-G VE) was used for the intracavity imaging of discharging lactiferous ducts in a three-dimensional space, and the diagnostic performance of CT-G VE was compared with that of ultrasonography and galactography. Methods: This study included 41 patients with single-orifice PND who underwent ultrasonography, galactography, and CT-G VE before surgery. The postoperative histopathologic results were regarded as the gold standard for diagnosis. Qualitative data were analyzed using Fisher’s precision probability test. Receiver operating characteristic (ROC) curve analysis was performed for ultrasonography, galactography, and CT-G VE to evaluate their diagnostic performances for the detection of PND diseases. Results: CT-G VE provided clear intracavity images of the discharging lactiferous ducts. The results of CT-G VE could be divided into five categories: negative, polypoid-solitary, polypoid-multiple, combined, and superficial types. The types were related to the histopathologic results. The detection ability of CT-G VE for high-risk and malignant lesions was higher than that of ultrasonography (p = 0.0056) and galactography (p = 0.0008). The detection abilities of CT-G VE alone and CT-G VE combined with ultrasonography were comparable. The cut-off point for CT-G VE was the polypoid-solitary type. The average effective dose for a single patient undergoing both chest CT and CT-G VE at the same time was 1.66 ± 0.78 msV. Conclusions: The diagnostic performance of CT-G VE was better than that of ultrasonography and galactography in detecting high-risk and malignant lesions of PND. This study proposed a grading system to aid decision-making and communication between clinicians in clinical practice.https://www.imrpress.com/journal/CEOG/50/4/10.31083/j.ceog5004081pathologic nipple dischargecomputed tomographygalactographyvirtual endoscopyultrasonography
spellingShingle Nan Ma
Jiang Zhu
Yawen Wang
Kai Zhang
Song Zhao
Yongfeng Liang
Yan Deng
Rong Ma
Computed Tomography–Galactography Virtual Endoscopy: A Better Imaging Method for the Diagnosis of Pathologic Nipple Discharge
Clinical and Experimental Obstetrics & Gynecology
pathologic nipple discharge
computed tomography
galactography
virtual endoscopy
ultrasonography
title Computed Tomography–Galactography Virtual Endoscopy: A Better Imaging Method for the Diagnosis of Pathologic Nipple Discharge
title_full Computed Tomography–Galactography Virtual Endoscopy: A Better Imaging Method for the Diagnosis of Pathologic Nipple Discharge
title_fullStr Computed Tomography–Galactography Virtual Endoscopy: A Better Imaging Method for the Diagnosis of Pathologic Nipple Discharge
title_full_unstemmed Computed Tomography–Galactography Virtual Endoscopy: A Better Imaging Method for the Diagnosis of Pathologic Nipple Discharge
title_short Computed Tomography–Galactography Virtual Endoscopy: A Better Imaging Method for the Diagnosis of Pathologic Nipple Discharge
title_sort computed tomography galactography virtual endoscopy a better imaging method for the diagnosis of pathologic nipple discharge
topic pathologic nipple discharge
computed tomography
galactography
virtual endoscopy
ultrasonography
url https://www.imrpress.com/journal/CEOG/50/4/10.31083/j.ceog5004081
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