CPT® Code 0635T

1. Indications

Computed tomography of the breast is indicated for various clinical scenarios where detailed imaging of breast tissue is required. The following conditions may warrant the use of this procedure:

• Breast Abnormalities The procedure is performed to evaluate any detected abnormalities in the breast, such as masses, calcifications, or other suspicious findings that may require further investigation.
• Assessment of Tumors CT scans can assist in the assessment of known breast tumors, helping to determine their size, shape, and extent, which is crucial for treatment planning.
• Follow-Up Imaging This imaging technique may be used for follow-up evaluations of previously identified lesions to monitor changes over time.
• Preoperative Planning CT imaging can provide valuable information for surgical planning in patients undergoing breast surgery, ensuring that the surgical team has a clear understanding of the anatomy involved.

2. Procedure

The procedure for performing a computed tomography scan of the breast involves several key steps to ensure accurate imaging and patient safety. The following outlines the procedural steps:

• Step 1: Patient Positioning The patient is positioned comfortably on the examination table, typically lying on their back. Proper positioning is essential to ensure that the breast being examined is adequately aligned with the CT scanner for optimal imaging.
• Step 2: Initial Scan An initial pass through the CT scanner is conducted to determine the starting position for the imaging. This preliminary scan helps the technician to calibrate the machine and set the appropriate parameters for the subsequent imaging process.
• Step 3: CT Imaging Once the initial scan is complete, the table begins to move slowly through the scanner. During this phase, multiple X-ray beams are emitted and detected as they rotate around the breast. The amount of radiation absorbed by the breast tissue is measured, and this data is collected for processing.
• Step 4: Image Processing The collected data is processed by a computer program, which generates 2D cross-sectional images of the breast. These images are displayed on a monitor for review.
• Step 5: 3D Rendering (if performed) If indicated, complex 3D rendering techniques are applied to the 2D images. This may include shaded surface rendering, volumetric rendering, maximum intensity projections (MIPs), and fusion imaging, providing a more comprehensive view of the breast anatomy.
• Step 6: Administration of Contrast Material If the procedure requires, contrast material may be administered after the initial imaging. This allows for the acquisition of additional sections that can enhance the visibility of certain structures or abnormalities within the breast.
• Step 7: Review and Interpretation After the imaging is complete, the physician reviews the CT scan results, notes any abnormalities, and provides a written interpretation of the findings, which is essential for further clinical decision-making.

3. Post-Procedure

After the completion of the computed tomography scan of the breast, patients may be monitored briefly to ensure there are no immediate adverse reactions, especially if contrast material was administered. Patients are typically advised to resume normal activities unless otherwise instructed by their healthcare provider. The physician will review the images and provide a written report detailing the findings, which may be discussed with the patient in a follow-up appointment. It is important for patients to understand that any further diagnostic steps or treatments will be based on the results of the CT scan and the physician's interpretation.