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Rudnicki W, Heinze S, Piegza T, Pawlak M, Kojs Z, Łuczyńska E. Correlation Between Enhancement Intensity in Contrast Enhancement Spectral Mammography and Types of Kinetic Curves in Magnetic Resonance Imaging. Med Sci Monit 2020; 26:e920742. [PMID: 32173716 PMCID: PMC7071734 DOI: 10.12659/msm.920742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Due to the decreased sensitivity of mammography in glandular breasts, new diagnostic modalities, like contrast-enhanced spectral mammography (CESM) and digital breast tomosynthesis (DBT) have been developed. The aim of this study was to compare qualitative enhancement levels on CESM with type of kinetic enhancement curves on MRI examination. Material/Methods Patients qualified for the CESM examination presented some diagnostic doubts – suspected multifocality, multicentricity, or having dense glandular breast tissue. The enhancement level on CESM was described as weak, medium, or strong. Enhancement on achieved MR images was assessed on the basis of enhancement kinetic curves. The level of enhancement on CESM was associated with enhancement curves type on MRI. All lesions detected on CESM and MRI were histopathologically verified. Results The study involved 107 lesions diagnosed in 94 patients: 71 lesions (66%) appeared to be infiltrating on histopathological examination, 9 lesions (8%) were non-infiltrating cancers, and 27 lesions (25%) were benign. Data analysis revealed that lesions with wash-out curve on MRI most often presented strong enhancement on CESM, while in lesions with progressive enhancement curve, strong enhancement on CESM was the rarest. The relationship between enhancement level on CESM and curve type on contrast-enhanced MRI depends on the nature of the lesion. The type of MRI curve was found to be associated with enhancement level on CESM. Conclusions We compared subjective assessments of contrast enhancement on CESM with enhancement kinetic curves on MRI. The results showed that the level of enhancement on CESM and type of kinetic curves on MRI depends on the lesion type.
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Affiliation(s)
- Wojciech Rudnicki
- Department of Radiology, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Cracow, Poland
| | - Sylwia Heinze
- Department of Radiology, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Cracow, Poland
| | - Tomasz Piegza
- Department of Radiology, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Cracow, Poland
| | - Marta Pawlak
- Department of Radiology, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Cracow, Poland
| | - Zbigniew Kojs
- Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Cracow, Poland
| | - Elżbieta Łuczyńska
- Department of Radiology, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Cracow, Poland
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Qin Y, Liu Y, Zhang X, Zhao S, Zhong H, Huang J, Yu J. Contrast-enhanced spectral mammography: A potential exclusion diagnosis modality in dense breast patients. Cancer Med 2020; 9:2653-2659. [PMID: 32074407 PMCID: PMC7163102 DOI: 10.1002/cam4.2877] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 12/10/2019] [Accepted: 01/11/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND China has an increasing burden of breast cancer. However, with a large population of dense breast patients, the diagnostic efficiency of conventional digital mammography is attenuated. METHODS From July 2017 to October 2018, we retrospectively reviewed 397 dense breast patients who underwent contrast-enhanced spectral mammography (CESM) in West China Hospital. Among them, 53 patients who had both CESM and dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) results and 114 patients who had pathological diagnoses were finally enrolled. All images were reviewed by two independent radiologists according to the 2013 Breast Imaging Reporting and Data System (BI-RADS) with all disagreements handed to an associate professor for final decisions. Correlation analyses between CESM and DCE-MRI were conducted. The diagnostic performance of CESM were investigated. RESULTS The kappa value of the BI-RADS scores between CESM and DCE-MRI was 0.607 (P < .001), indicating high correspondence between CESM and DCE-MRI. As for lesion size measurement, moderate correlation (Kendall's tau coefficient: 0.556, P < .001) was detected between CESM and DCE-MRI. Using pathological diagnoses as the reference standard, the sensitivity, specificity, and area under the curve (AUC) of CESM were 82.4%, 96.4%, and 0.894, respectively. CONCLUSION CESM demonstrated excellent overall diagnostic accuracy and a moderate correlation in lesion size estimation against DCE-MRI in dense breast patients, supporting it to be an alternative to DCE-MRI in breast cancer detection and diagnosis, especially for exclusion diagnosis.
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Affiliation(s)
- Yun Qin
- Department of Radiology, Sichuan University West China Hospital, Chengdu, China
| | - Ying Liu
- Department of Radiology, Sichuan University West China Hospital, Chengdu, China
| | - Xueqin Zhang
- Department of Radiology, Sichuan University West China Hospital, Chengdu, China
| | - Shuang Zhao
- Department of Radiology, Sichuan University West China Hospital, Chengdu, China
| | - Huanhuan Zhong
- Department of Radiology, Sichuan University West China Hospital, Chengdu, China
| | - Juan Huang
- Department of Radiology, Sichuan University West China Hospital, Chengdu, China
| | - Jianqun Yu
- Department of Radiology, Sichuan University West China Hospital, Chengdu, China
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Lewin JM, Patel BK, Tanna A. Contrast-Enhanced Mammography: A Scientific Review. JOURNAL OF BREAST IMAGING 2020; 2:7-15. [PMID: 38424994 DOI: 10.1093/jbi/wbz074] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 10/10/2019] [Indexed: 03/02/2024]
Abstract
In this paper we provide an overview of contrast-enhanced mammography (CEM) and a review of the published literature in order to provide a picture of the current state of the evidence on the performance of CEM. Clinical research was fairly sparse following the demonstration of the technique in research subjects about 18 years ago, but the number of publications rapidly increased following commercialization 9 years ago, and even more so in the last 5 years. Initial studies compared CEM with mammography, and clearly showed that CEM could detect cancers not visible on mammography. More recent studies have primarily focused on comparing the performance of CEM with contrast-enhanced magnetic resonance imaging (MRI) in selected cohorts. These studies have almost uniformly shown CEM and MRI to have similar sensitivities, with sensitivity and accuracy showing more variability from study to study. With increasing clinical use, a large number of retrospective reviews of CEM have appeared, showing utility of CEM in the diagnostic clinical setting. Most recently, a small number of papers have been published looking at CEM for high-risk and dense breast screening, two potentially large applications of the technique, showing it to outperform mammography in both populations. CEM has clearly been shown to have clinical utility, but more prospective studies, including screening studies, are needed to further evaluate its performance, especially in comparison with MRI.
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Amato F, Bicchierai G, Cirone D, Depretto C, Di Naro F, Vanzi E, Scaperrotta G, Bartolotta TV, Miele V, Nori J. Preoperative loco-regional staging of invasive lobular carcinoma with contrast-enhanced digital mammography (CEDM). Radiol Med 2019; 124:1229-1237. [PMID: 31773458 DOI: 10.1007/s11547-019-01116-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 11/15/2019] [Indexed: 12/15/2022]
Abstract
The aim of our study was to assess the performance of contrast-enhanced digital mammography (CEDM) in the preoperative loco-regional staging of invasive lobular carcinoma (ILC) patients, about the valuation of the extension of disease and in measurement of lesions. Then, we selected retrospectively, among the 1500 patients underwent to CEDM at the Breast Diagnostics Department of the Careggi University Hospital of Florence and the National Cancer Institute of Milan from September 2016 to November 2018, 31 women (mean age 57.1 aa; range 41-78 aa) with a definitive histological diagnosis of ILC. CEDM has proved to be a promising imaging technique, being characterized by a sensitivity of 100% in the detection of the index lesion, and of 84.2% in identifying any adjunctive lesions: It was the presence of a non-mass enhancement (NME) to lower the sensitivity of the technique (25% vs. 100% for mass-like enhancements or a mass closely associated with a NME). Specificity in the characterization of additional lesions was 66.7%, and the diagnosis of the extension of disease was correct in 77.4% of cases: NME also led to a decrease in diagnostic accuracy in the evaluation of disease extension up to 40% versus 85% for masses and 80% for masses associated with NME (M/NME). Moreover, in 12/31 (38.7%), CEDM allowed to correctly identify lesions not shown by mammography + ultrasonography + tomosynthesis: In the half of these (6/12), there was a multicentricity, thus allowing an adequate surgical planning change. CEDM was also very accurate in analyzing the maximum diameter of the masses, while it was much less reliable in the case of the M/NME and pure NME. In conclusion, CEDM is a new promising imaging technique in the loco-regional preoperative staging and in the evaluation of disease extension for ILC, especially in case of mass enhancement lesions.
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Affiliation(s)
- Francesco Amato
- Department of Radiology, University of Palermo, Palermo, Italy
| | - Giulia Bicchierai
- Diagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, Largo G. A. Brambilla 3, 50134, Florence, Italy.
| | - Donatello Cirone
- General Management Staff, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Catherine Depretto
- Breast Imaging Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Federica Di Naro
- Diagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, Largo G. A. Brambilla 3, 50134, Florence, Italy
| | - Ermanno Vanzi
- Diagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, Largo G. A. Brambilla 3, 50134, Florence, Italy
| | | | | | - Vittorio Miele
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Jacopo Nori
- Diagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, Largo G. A. Brambilla 3, 50134, Florence, Italy
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Sumkin JH, Berg WA, Carter GJ, Bandos AI, Chough DM, Ganott MA, Hakim CM, Kelly AE, Zuley ML, Houshmand G, Anello MI, Gur D. Diagnostic Performance of MRI, Molecular Breast Imaging, and Contrast-enhanced Mammography in Women with Newly Diagnosed Breast Cancer. Radiology 2019; 293:531-540. [PMID: 31660801 DOI: 10.1148/radiol.2019190887] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Staging newly diagnosed breast cancer by using dynamic contrast material-enhanced MRI is limited by access, high cost, and false-positive findings. The utility of contrast-enhanced mammography (CEM) and 99mTc sestamibi-based molecular breast imaging (MBI) in this setting is largely unknown. Purpose To compare extent-of-disease assessments by using MRI, CEM, and MBI versus pathology in women with breast cancer. Materials and Methods In this HIPAA-compliant prospective study, women with biopsy-proven breast cancer underwent MRI, CEM, and MBI between October 2014 and April 2018. Eight radiologists independently interpreted each examination result prospectively and were blinded to interpretations of findings with the other modalities. Visibility of index malignancies, lesion size, and additional suspicious lesions (malignant or benign) were compared during pathology review. Accuracy of index lesion sizing and detection of additional lesions in women without neoadjuvant chemotherapy were compared. Results A total of 102 women were enrolled and 99 completed the study protocol (mean age, 51 years ± 11 [standard deviation]; range, 32-77 years). Lumpectomy or mastectomy was performed in 71 women (79 index malignancies) without neoadjuvant chemotherapy and in 28 women (31 index malignancies) with neoadjuvant chemotherapy. Of the 110 index malignancies, MRI, CEM, and MBI depicted 102 (93%; 95% confidence interval [CI]: 86%, 97%), 100 (91%; 95% CI: 84%, 96%), and 101 (92%; 95% CI: 85%, 96%) malignancies, respectively. In patients without neoadjuvant chemotherapy, pathologic size of index malignancies was overestimated with all modalities (P = .02). MRI led to overestimation of 24% (17 of 72) of malignancies by more than 1.5 cm compared with 11% (eight of 70) with CEM and 15% (11 of 72) with MBI. MRI depicted more (P = .007) nonindex lesions, with sensitivity similar to that of CEM or MBI, resulting in lower positive predictive value of additional biopsies (13 of 46 [28%; 95% CI: 17%, 44%] for MRI; 14 of 27 [52%; 95% CI: 32%, 71%] for CEM; and 11 of 25 [44%; 95% CI: 24%, 65%] for MBI (overall P = .01). Conclusion Contrast-enhanced mammography, molecular breast imaging, and MRI showed similar detection of all malignancies. MRI depicted more nonindex suspicious benign lesions than did contrast-enhanced mammography or molecular breast imaging, leading to lower positive predictive value of additional biopsies. All three modalities led to overestimation of index tumor size, particularly MRI. © RSNA, 2019 Online supplemental material is available for this article.
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Affiliation(s)
- Jules H Sumkin
- From the Department of Radiology (J.H.S., W.A.B., G.J.C., D.M.C., M.A.G., C.M.H., A.E.K., M.L.Z., G.H.), Division of Imaging Research (D.G.), University of Pittsburgh, School of Medicine, Pittsburgh, Pa; Department of Radiology, Division of Breast Imaging, University of Pittsburgh Medical Center, Magee-Womens Hospital, 200 Lothrop St, PUH Suite E204, Pittsburgh, PA 15213 (J.H.S., W.A.B., G.J.C., D.M.C., M.A.G., C.M.H., A.E.K., M.L.Z., G.H.); Department of Biostatistics, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pa (A.I.B.); and Department of Radiology, Baptist Women's Health Center, Memphis, Tenn (M.I.A.)
| | - Wendie A Berg
- From the Department of Radiology (J.H.S., W.A.B., G.J.C., D.M.C., M.A.G., C.M.H., A.E.K., M.L.Z., G.H.), Division of Imaging Research (D.G.), University of Pittsburgh, School of Medicine, Pittsburgh, Pa; Department of Radiology, Division of Breast Imaging, University of Pittsburgh Medical Center, Magee-Womens Hospital, 200 Lothrop St, PUH Suite E204, Pittsburgh, PA 15213 (J.H.S., W.A.B., G.J.C., D.M.C., M.A.G., C.M.H., A.E.K., M.L.Z., G.H.); Department of Biostatistics, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pa (A.I.B.); and Department of Radiology, Baptist Women's Health Center, Memphis, Tenn (M.I.A.)
| | - Gloria J Carter
- From the Department of Radiology (J.H.S., W.A.B., G.J.C., D.M.C., M.A.G., C.M.H., A.E.K., M.L.Z., G.H.), Division of Imaging Research (D.G.), University of Pittsburgh, School of Medicine, Pittsburgh, Pa; Department of Radiology, Division of Breast Imaging, University of Pittsburgh Medical Center, Magee-Womens Hospital, 200 Lothrop St, PUH Suite E204, Pittsburgh, PA 15213 (J.H.S., W.A.B., G.J.C., D.M.C., M.A.G., C.M.H., A.E.K., M.L.Z., G.H.); Department of Biostatistics, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pa (A.I.B.); and Department of Radiology, Baptist Women's Health Center, Memphis, Tenn (M.I.A.)
| | - Andriy I Bandos
- From the Department of Radiology (J.H.S., W.A.B., G.J.C., D.M.C., M.A.G., C.M.H., A.E.K., M.L.Z., G.H.), Division of Imaging Research (D.G.), University of Pittsburgh, School of Medicine, Pittsburgh, Pa; Department of Radiology, Division of Breast Imaging, University of Pittsburgh Medical Center, Magee-Womens Hospital, 200 Lothrop St, PUH Suite E204, Pittsburgh, PA 15213 (J.H.S., W.A.B., G.J.C., D.M.C., M.A.G., C.M.H., A.E.K., M.L.Z., G.H.); Department of Biostatistics, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pa (A.I.B.); and Department of Radiology, Baptist Women's Health Center, Memphis, Tenn (M.I.A.)
| | - Denise M Chough
- From the Department of Radiology (J.H.S., W.A.B., G.J.C., D.M.C., M.A.G., C.M.H., A.E.K., M.L.Z., G.H.), Division of Imaging Research (D.G.), University of Pittsburgh, School of Medicine, Pittsburgh, Pa; Department of Radiology, Division of Breast Imaging, University of Pittsburgh Medical Center, Magee-Womens Hospital, 200 Lothrop St, PUH Suite E204, Pittsburgh, PA 15213 (J.H.S., W.A.B., G.J.C., D.M.C., M.A.G., C.M.H., A.E.K., M.L.Z., G.H.); Department of Biostatistics, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pa (A.I.B.); and Department of Radiology, Baptist Women's Health Center, Memphis, Tenn (M.I.A.)
| | - Marie A Ganott
- From the Department of Radiology (J.H.S., W.A.B., G.J.C., D.M.C., M.A.G., C.M.H., A.E.K., M.L.Z., G.H.), Division of Imaging Research (D.G.), University of Pittsburgh, School of Medicine, Pittsburgh, Pa; Department of Radiology, Division of Breast Imaging, University of Pittsburgh Medical Center, Magee-Womens Hospital, 200 Lothrop St, PUH Suite E204, Pittsburgh, PA 15213 (J.H.S., W.A.B., G.J.C., D.M.C., M.A.G., C.M.H., A.E.K., M.L.Z., G.H.); Department of Biostatistics, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pa (A.I.B.); and Department of Radiology, Baptist Women's Health Center, Memphis, Tenn (M.I.A.)
| | - Christiane M Hakim
- From the Department of Radiology (J.H.S., W.A.B., G.J.C., D.M.C., M.A.G., C.M.H., A.E.K., M.L.Z., G.H.), Division of Imaging Research (D.G.), University of Pittsburgh, School of Medicine, Pittsburgh, Pa; Department of Radiology, Division of Breast Imaging, University of Pittsburgh Medical Center, Magee-Womens Hospital, 200 Lothrop St, PUH Suite E204, Pittsburgh, PA 15213 (J.H.S., W.A.B., G.J.C., D.M.C., M.A.G., C.M.H., A.E.K., M.L.Z., G.H.); Department of Biostatistics, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pa (A.I.B.); and Department of Radiology, Baptist Women's Health Center, Memphis, Tenn (M.I.A.)
| | - Amy E Kelly
- From the Department of Radiology (J.H.S., W.A.B., G.J.C., D.M.C., M.A.G., C.M.H., A.E.K., M.L.Z., G.H.), Division of Imaging Research (D.G.), University of Pittsburgh, School of Medicine, Pittsburgh, Pa; Department of Radiology, Division of Breast Imaging, University of Pittsburgh Medical Center, Magee-Womens Hospital, 200 Lothrop St, PUH Suite E204, Pittsburgh, PA 15213 (J.H.S., W.A.B., G.J.C., D.M.C., M.A.G., C.M.H., A.E.K., M.L.Z., G.H.); Department of Biostatistics, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pa (A.I.B.); and Department of Radiology, Baptist Women's Health Center, Memphis, Tenn (M.I.A.)
| | - Margarita L Zuley
- From the Department of Radiology (J.H.S., W.A.B., G.J.C., D.M.C., M.A.G., C.M.H., A.E.K., M.L.Z., G.H.), Division of Imaging Research (D.G.), University of Pittsburgh, School of Medicine, Pittsburgh, Pa; Department of Radiology, Division of Breast Imaging, University of Pittsburgh Medical Center, Magee-Womens Hospital, 200 Lothrop St, PUH Suite E204, Pittsburgh, PA 15213 (J.H.S., W.A.B., G.J.C., D.M.C., M.A.G., C.M.H., A.E.K., M.L.Z., G.H.); Department of Biostatistics, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pa (A.I.B.); and Department of Radiology, Baptist Women's Health Center, Memphis, Tenn (M.I.A.)
| | - Golbahar Houshmand
- From the Department of Radiology (J.H.S., W.A.B., G.J.C., D.M.C., M.A.G., C.M.H., A.E.K., M.L.Z., G.H.), Division of Imaging Research (D.G.), University of Pittsburgh, School of Medicine, Pittsburgh, Pa; Department of Radiology, Division of Breast Imaging, University of Pittsburgh Medical Center, Magee-Womens Hospital, 200 Lothrop St, PUH Suite E204, Pittsburgh, PA 15213 (J.H.S., W.A.B., G.J.C., D.M.C., M.A.G., C.M.H., A.E.K., M.L.Z., G.H.); Department of Biostatistics, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pa (A.I.B.); and Department of Radiology, Baptist Women's Health Center, Memphis, Tenn (M.I.A.)
| | - Maria I Anello
- From the Department of Radiology (J.H.S., W.A.B., G.J.C., D.M.C., M.A.G., C.M.H., A.E.K., M.L.Z., G.H.), Division of Imaging Research (D.G.), University of Pittsburgh, School of Medicine, Pittsburgh, Pa; Department of Radiology, Division of Breast Imaging, University of Pittsburgh Medical Center, Magee-Womens Hospital, 200 Lothrop St, PUH Suite E204, Pittsburgh, PA 15213 (J.H.S., W.A.B., G.J.C., D.M.C., M.A.G., C.M.H., A.E.K., M.L.Z., G.H.); Department of Biostatistics, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pa (A.I.B.); and Department of Radiology, Baptist Women's Health Center, Memphis, Tenn (M.I.A.)
| | - David Gur
- From the Department of Radiology (J.H.S., W.A.B., G.J.C., D.M.C., M.A.G., C.M.H., A.E.K., M.L.Z., G.H.), Division of Imaging Research (D.G.), University of Pittsburgh, School of Medicine, Pittsburgh, Pa; Department of Radiology, Division of Breast Imaging, University of Pittsburgh Medical Center, Magee-Womens Hospital, 200 Lothrop St, PUH Suite E204, Pittsburgh, PA 15213 (J.H.S., W.A.B., G.J.C., D.M.C., M.A.G., C.M.H., A.E.K., M.L.Z., G.H.); Department of Biostatistics, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pa (A.I.B.); and Department of Radiology, Baptist Women's Health Center, Memphis, Tenn (M.I.A.)
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Hsu JC, Cruz ED, Lau KC, Bouché M, Kim J, Maidment ADA, Cormode DP. Renally Excretable and Size-Tunable Silver Sulfide Nanoparticles for Dual-Energy Mammography or Computed Tomography. CHEMISTRY OF MATERIALS : A PUBLICATION OF THE AMERICAN CHEMICAL SOCIETY 2019; 31:7845-7854. [PMID: 33005070 PMCID: PMC7523639 DOI: 10.1021/acs.chemmater.9b01750] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Significant effort has been focused on developing renally-clearable nanoparticle agents since efficient renal clearance is important for eventual clinical translation. Silver sulfide nanoparticles (Ag2S-NP) have recently been identified as contrast agents for dual energy mammography, computed tomography (CT) and fluorescence imaging and probes for drug delivery and photothermal therapy with good biocompatibility. However, most Ag2S-NP reported to date are not renally excretable and are observed in vivo to accumulate and remain in the reticuloendothelial system (RES) organs, i.e. liver and spleen, for a long time, which could negatively impact their likelihood for translation. Herein, we present renally-clearable, 3.1 nm Ag2S-NP with 85% of the injected dose (ID) being excreted within 24 hours of intravenous injection, which is amongst the best clearance of similarly sized nanoparticles reported thus far (mostly between 20-75% of ID). The urinary excretion and low RES accumulation of these nanoparticles in mice were indicated by in vivo CT imaging and biodistribution analysis. In summary, these ultrasmall Ag2S-NP can be effectively eliminated via urine and have high translational potential for various biomedical applications.
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Affiliation(s)
- Jessica C. Hsu
- Department of Radiology, University of Pennsylvania 3400 Spruce St, 1 Silverstein, Philadelphia, PA 19104, USA
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA
| | - Emma D. Cruz
- Department of Radiology, University of Pennsylvania 3400 Spruce St, 1 Silverstein, Philadelphia, PA 19104, USA
| | - Kristen C. Lau
- Department of Radiology, University of Pennsylvania 3400 Spruce St, 1 Silverstein, Philadelphia, PA 19104, USA
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA
| | - Mathilde Bouché
- Department of Radiology, University of Pennsylvania 3400 Spruce St, 1 Silverstein, Philadelphia, PA 19104, USA
| | - Johoon Kim
- Department of Radiology, University of Pennsylvania 3400 Spruce St, 1 Silverstein, Philadelphia, PA 19104, USA
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA
| | - Andrew D. A. Maidment
- Department of Radiology, University of Pennsylvania 3400 Spruce St, 1 Silverstein, Philadelphia, PA 19104, USA
| | - David P. Cormode
- Department of Radiology, University of Pennsylvania 3400 Spruce St, 1 Silverstein, Philadelphia, PA 19104, USA
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA
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Advanced approaches to imaging primary breast cancer: an update. Clin Transl Imaging 2019. [DOI: 10.1007/s40336-019-00346-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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58
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Yasin R, El Ghany EA. BIRADS 4 breast lesions: comparison of contrast-enhanced spectral mammography and contrast-enhanced MRI. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2019. [DOI: 10.1186/s43055-019-0043-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Breast cancer is the most common cancer in women worldwide. It is responsible for about 23% of cancer in females in both developed and developing countries [1]. We aimed to assess the accuracy of contrast-enhanced spectral mammography (CESM) versus contrast-enhanced breast MRI in the evaluation of BIRADS 4 breast lesions.
Results
Fifty patients were included in this study; there were 28 malignant cases and 22 benign cases; all cases were proved by histopathological result either by core biopsy or excision biopsy. CESM was found to have less sensitivity (94.1%) than MRI (100%) but CESM has higher specificity (100%) than MRI (95.5%). The accuracy of CESM was 96.4%, while the accuracy of MRI was 98.2% with no statistical significance (P value 0.827).
Conclusion
CESM can be used as a sensitive diagnostic tool in the detection and staging of breast cancer with higher specificity and less sensitivity as compared to contrast enhanced breast MRI.
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Zanardo M, Cozzi A, Trimboli RM, Labaj O, Monti CB, Schiaffino S, Carbonaro LA, Sardanelli F. Technique, protocols and adverse reactions for contrast-enhanced spectral mammography (CESM): a systematic review. Insights Imaging 2019; 10:76. [PMID: 31376021 PMCID: PMC6677840 DOI: 10.1186/s13244-019-0756-0] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 05/17/2019] [Indexed: 11/10/2022] Open
Abstract
We reviewed technical parameters, acquisition protocols and adverse reactions (ARs) for contrast-enhanced spectral mammography (CESM). A systematic search in databases, including MEDLINE/EMBASE, was performed to extract publication year, country of origin, study design; patients; mammography unit/vendor, radiation dose, low-/high-energy tube voltage; contrast molecule, concentration and dose; injection modality, ARs and acquisition delay; order of views; examination time. Of 120 retrieved articles, 84 were included from 22 countries (September 2003-January 2019), totalling 14012 patients. Design was prospective in 44/84 studies (52%); in 70/84 articles (83%), a General Electric unit with factory-set kVp was used. Per-view average glandular dose, reported in 12/84 studies (14%), ranged 0.43-2.65 mGy. Contrast type/concentration was reported in 79/84 studies (94%), with Iohexol 350 mgI/mL mostly used (25/79, 32%), dose and flow rate in 72/84 (86%), with 1.5 mL/kg dose at 3 mL/s in 62/72 studies (86%). Injection was described in 69/84 articles (82%), automated in 59/69 (85%), manual in 10/69 (15%) and flush in 35/84 (42%), with 10-30 mL dose in 19/35 (54%). An examination time < 10 min was reported in 65/84 studies (77%), 120 s acquisition delay in 65/84 (77%) and order of views in 42/84 (50%) studies, beginning with the craniocaudal view of the non-suspected breast in 7/42 (17%). Thirty ARs were reported by 14/84 (17%) studies (26 mild, 3 moderate, 1 severe non-fatal) with a pooled rate of 0.82% (fixed-effect model). Only half of CESM studies were prospective; factory-set kVp, contrast 1.5 mL/kg at 3 mL/s and 120 s acquisition delay were mostly used; only 1 severe AR was reported. CESM protocol standardisation is advisable.
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Affiliation(s)
- Moreno Zanardo
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy
| | - Andrea Cozzi
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy.
| | - Rubina Manuela Trimboli
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy
| | - Olgerta Labaj
- Department of Morphology, Surgery and Experimental Medicine, Section of Radiology, University of Ferrara, Via Ludovico Ariosto 35, 44121, Ferrara, Italy
| | - Caterina Beatrice Monti
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy
| | - Simone Schiaffino
- Unit of Radiology, IRCCS Policlinico San Donato, Via Morandi 30, 20097, San Donato Milanese, Italy
| | | | - Francesco Sardanelli
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy
- Unit of Radiology, IRCCS Policlinico San Donato, Via Morandi 30, 20097, San Donato Milanese, Italy
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Diagnostic performance of contrast-enhanced dual-energy spectral mammography (CESM): a retrospective study involving 644 breast lesions. Radiol Med 2019; 124:1006-1017. [PMID: 31250270 DOI: 10.1007/s11547-019-01056-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 06/18/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To evaluate the diagnostic performance of contrast-enhanced dual-energy spectral mammography (CESM) in comparison with that of full-field digital mammography (FFDM), either alone or accompanied with breast ultrasound (BUS) in a large series of patients/breast lesions (n = 644). PATIENTS AND METHODS In this retrospective study, five radiologists evaluated the lesions by three imaging modalities: FFDM, FFDM + BUS, and CESM and compared the imaging to the gold standard (histopathology or clinical follow-up). Diagnostic performance parameters and receiver operating characteristic (ROC) curves of CESM were calculated and compared to those of FFDM or FFDM + BUS (McNemar's test). Additionally, the reliability of tumor size measurement by CESM was compared with the histopathological measurement. RESULTS The study included 218 benign and 426 malignant lesions. 85% of benign and 93% of malignant lesions were adequately identified using CESM. With respect to FFDM and FFDM + BUS, CESM significantly increased sensitivity to 93.2% (+ 10.7% and + 3.4%, respectively); specificity to 84.4% (+ 15.8% and + 1.7%, respectively); PPV to 92.3% (+ 26.8% and + 3.6%, respectively); NPV to 86.0% (+ 1.6% and + 1.8%, respectively); and accuracy to 90.2% (+ 15.8% and + 3.2%, respectively). In the ROC curves analyses, the comparison among the three AUC values was also statistically significant (p < 0.001). Good agreement between tumor diameters measured using CESM and histopathology was observed (Spearman's rank correlation, r = 0.891, p < 0.0001), although this technique tended to produce an overestimation of the size (+ 7 mm). CONCLUSIONS CESM has high diagnostic accuracy and can be considered as a useful technique for the assessment of breast lesions.
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Fanizzi A, Losurdo L, Basile TMA, Bellotti R, Bottigli U, Delogu P, Diacono D, Didonna V, Fausto A, Lombardi A, Lorusso V, Massafra R, Tangaro S, La Forgia D. Fully Automated Support System for Diagnosis of Breast Cancer in Contrast-Enhanced Spectral Mammography Images. J Clin Med 2019; 8:jcm8060891. [PMID: 31234363 PMCID: PMC6616937 DOI: 10.3390/jcm8060891] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 06/08/2019] [Accepted: 06/17/2019] [Indexed: 12/24/2022] Open
Abstract
Contrast-Enhanced Spectral Mammography (CESM) is a novelty instrumentation for diagnosing of breast cancer, but it can still be considered operator dependent. In this paper, we proposed a fully automatic system as a diagnostic support tool for the clinicians. For each Region Of Interest (ROI), a features set was extracted from low-energy and recombined images by using different techniques. A Random Forest classifier was trained on a selected subset of significant features by a sequential feature selection algorithm. The proposed Computer-Automated Diagnosis system is tested on 48 ROIs extracted from 53 patients referred to Istituto Tumori “Giovanni Paolo II” of Bari (Italy) from the breast cancer screening phase between March 2017 and June 2018. The present method resulted highly performing in the prediction of benign/malignant ROIs with median values of sensitivity and specificity of 87.5% and 91.7%, respectively. The performance was high compared to the state-of-the-art, even with a moderate/marked level of parenchymal background. Our classification model outperformed the human reader, by increasing the specificity over 8%. Therefore, our system could represent a valid support tool for radiologists for interpreting CESM images, both reducing the false positive rate and limiting biopsies and surgeries.
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Affiliation(s)
- Annarita Fanizzi
- Dip. di Diagnosi e Terapia per Immagini, I.R.C.C.S. Istituto Tumori "Giovanni Paolo II" di Bari, 70124 Bari, Italy.
| | - Liliana Losurdo
- Dip. di Diagnosi e Terapia per Immagini, I.R.C.C.S. Istituto Tumori "Giovanni Paolo II" di Bari, 70124 Bari, Italy.
| | - Teresa Maria A Basile
- Dip. Interateneo di Fisica "M. Merlin", Università degli Studi di Bari "A. Moro", 70125 Bari, Italy.
| | - Roberto Bellotti
- Dip. Interateneo di Fisica "M. Merlin", Università degli Studi di Bari "A. Moro", 70125 Bari, Italy.
| | - Ubaldo Bottigli
- Dip. di Scienze Fisiche, della Terra e dell'Ambiente, Università degli Studi di Siena, 53100 Siena, Italy.
| | - Pasquale Delogu
- Dip. di Scienze Fisiche, della Terra e dell'Ambiente, Università degli Studi di Siena, 53100 Siena, Italy.
| | - Domenico Diacono
- INFN-Istituto Nazionale di Fisica Nucleare, Sezione di Bari, 70125 Bari, Italy.
| | - Vittorio Didonna
- Dip. di Diagnosi e Terapia per Immagini, I.R.C.C.S. Istituto Tumori "Giovanni Paolo II" di Bari, 70124 Bari, Italy.
| | - Alfonso Fausto
- Dip. di Diagnostica per Immagini, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy.
| | - Angela Lombardi
- INFN-Istituto Nazionale di Fisica Nucleare, Sezione di Bari, 70125 Bari, Italy.
| | - Vito Lorusso
- Dip. Area Medica, I.R.C.C.S. Istituto Tumori "Giovanni Paolo II" di Bari, 70124 Bari, Italy.
| | - Raffaella Massafra
- Dip. di Diagnosi e Terapia per Immagini, I.R.C.C.S. Istituto Tumori "Giovanni Paolo II" di Bari, 70124 Bari, Italy.
| | - Sabina Tangaro
- INFN-Istituto Nazionale di Fisica Nucleare, Sezione di Bari, 70125 Bari, Italy.
| | - Daniele La Forgia
- Dip. di Diagnosi e Terapia per Immagini, I.R.C.C.S. Istituto Tumori "Giovanni Paolo II" di Bari, 70124 Bari, Italy.
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Correlation between quantitative assessment of contrast enhancement in contrast-enhanced spectral mammography (CESM) and histopathology-preliminary results. Eur Radiol 2019; 29:6220-6226. [PMID: 31089850 PMCID: PMC6795639 DOI: 10.1007/s00330-019-06232-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 04/02/2019] [Accepted: 04/08/2019] [Indexed: 11/16/2022]
Abstract
Objectives Contrast-enhanced spectral mammography (CESM) is a novel method for breast cancer detection. The aim of this study is to check if there is a possibility of quantitative assessment of contrast enhancement in CESM and if there is any correlation between quantitative assessment of contrast enhancement in CESM and histopathology. Methods A total of 167 female patients underwent CESM. All subjects previously had suspicious lesions found on mammography, breast ultrasound, or both. After imaging, the following parameters were evaluated: number of enhancing lesions in each breast and size and degree of enhancement of each lesion. Based on the collected data, the percentage signal difference between enhancing lesion and background (%RS) and signal-difference-to-noise ratio (SDNR) were measured for each lesion. Results The number of lesions detected in the study population was 195. Among all diagnosed lesions, 120 (62%) were assessed to be infiltrating cancers, 16 (8%) non-infiltrating cancers, and 59 (30%) were benign. Thirteen (7%) lesions did not enhance in CESM; all non-enhancing lesions were confirmed to be benign under histopathological examination. Analysis of enhancement indices showed that signal values within lesions and signal values within background ROIs (regions of interest) were similar in CC (craniocaudal) and MLO (mediolateral) projections. Mean %RS values were correlated with the type of enhancing lesion, infiltrating cancers having the highest values, benign lesions the lowest. Conclusions This work has demonstrated a significant correlation between the degree of lesion enhancement in CESM and malignancy. Quantitative analysis of enhancement levels in CESM can distinguish between invasive cancers and benign or in situ lesions. Key Points • There is a possibility of quantitative assessment of contrast enhancement in CESM. • Correlation between quantitative assessment of contrast enhancement in CESM and histopathology was observed.
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Youn I, Choi S, Choi YJ, Moon JH, Park HJ, Ham SY, Park CH, Kim EY, Kook SH. Contrast enhanced digital mammography versus magnetic resonance imaging for accurate measurement of the size of breast cancer. Br J Radiol 2019; 92:20180929. [PMID: 31017460 DOI: 10.1259/bjr.20180929] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To compare the accuracy of contrast-enhanced digital mammography (CEDM) and MRI, including maximal intensity projection (MIP) images, for measuring the tumour size of breast cancer. METHODS We included 52 females (mean age, 50.9 years) with surgery due to breast cancer, and measured maximum diameter of main mass on mediolateral oblique (MLO) and craniocaudal (CC) views of mammography and CEDM; sagittal, axial MIP images, and early dynamic contrast-enhanced MRI (CEMRI) before surgery. Bland-Altman plot, intraclass correlation coefficient, and univariate linear regression analysis were used to evaluate the maximum size between imaging and pathology including only invasive component (OPinvasive) or with carcinoma in situ (OPmax). RESULTS Mean OPinvasive was 15.5 mm, and overestimation rate was similar or higher than underestimation rate on all images except CC view of mammography and axial MIP image of CEDM. Mean OPmax was 21.7 mm, and underestimation rate was higher than the overestimation rate. All parameters of CEDM and CEMRI showed good agreement ( k > 0.75) with OPinvasive, with the most favourable result being the CC view of CEDM and axial MIP image of CEMRI. CONCLUSION All views of CEDM and MRI provided accurate measurements of tumour size. Axial plane CEDM and MRI would be the first choice for image review and treatment planning, with the highest accuracy obtained by using CC view of CEDM. ADVANCES IN KNOWLEDGE Previous studies have not compared the measurement of the tumour size using detailed sequences; in our study, we discovered that CEDM can be an alternative modality to CEMRI.
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Affiliation(s)
- Inyoung Youn
- 1 Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of medicine , Seoul , Korea
| | - SeonHyeong Choi
- 1 Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of medicine , Seoul , Korea
| | - Yoon Jung Choi
- 1 Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of medicine , Seoul , Korea
| | - Ju Hee Moon
- 1 Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of medicine , Seoul , Korea
| | - Hee Jin Park
- 1 Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of medicine , Seoul , Korea
| | - Soo-Youn Ham
- 1 Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of medicine , Seoul , Korea
| | - Chan Heun Park
- 2 Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of medicine , Seoul , Korea
| | - Eun Young Kim
- 2 Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of medicine , Seoul , Korea
| | - Shin Ho Kook
- 1 Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of medicine , Seoul , Korea
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Dromain C, Vietti-Violi N, Meuwly JY. Angiomammography: A review of current evidences. Diagn Interv Imaging 2019; 100:593-605. [PMID: 30962168 DOI: 10.1016/j.diii.2019.01.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/16/2019] [Accepted: 01/19/2019] [Indexed: 12/26/2022]
Abstract
Although mammography is currently the imaging technique of choice for screening and diagnosis, it has some limitations, especially in patients with high-density breasts. The evolution from film screen to full-field digital mammography has recently led to the development of new imaging techniques, which are less expensive and widely available. Contrast-enhanced spectral mammography (CESM) is one of them, coupling X-ray breast imaging to the intravenous administration of an iodinated contrast material. CESM provides both morphological information, similar to mammography, and functional information of tumor perfusion. In this review, the imaging technique, the specificity of interpretation of CESM compared to MRI and the currently available data are presented. The clinical performances of CESM versus those of mammography and MRI and its additional value in preoperative local assessment and screening is discussed. The potential advantages and disadvantages are mentioned and we also discuss how CESM contributes to the detection of lesions and how it can be used in daily clinical workflow.
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Affiliation(s)
- C Dromain
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland.
| | - N Vietti-Violi
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland
| | - J Y Meuwly
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland
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Xing D, Lv Y, Sun B, Xie H, Dong J, Hao C, Chen Q, Chi X. Diagnostic Value of Contrast-Enhanced Spectral Mammography in Comparison to Magnetic Resonance Imaging in Breast Lesions. J Comput Assist Tomogr 2019; 43:245-251. [PMID: 30531546 PMCID: PMC6426358 DOI: 10.1097/rct.0000000000000832] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Objective The aim of this study was to evaluate the diagnostic value between contrast-enhanced spectral mammography (CESM) and breast magnetic resonance imaging (MRI) in breast disease. Methods Two hundred thirty-five patients who were suspected of having breast abnormalities by clinical examination or mammography underwent CESM and MRI examination. Using histopathologic results as the criterion standard, the diagnostic performance of CESM and MRI was investigated. The areas under receiver operating characteristic curves were applied to analyze diagnostic efficiency. The Pearson correlation coefficients between CESM versus pathology and MRI versus pathology were calculated. Results Two hundred sixty-three breast lesions were found in 235 patients, in which 177 were malignant and 86 were benign. By evaluating the diagnostic value, sensitivity, positive predictive value, negative predictive value, and false-negative rate from CESM examination were comparable to those from MRI (91.5%, 94.7%, 83.7%, and 8.5% vs 91.5%, 90.5%, 82.1%, and 8.5%). Importantly, the accuracy and the specificity were higher for CESM than those for MRI (81% and 89.5% vs 80.2% and 71.7%), whereas the false-positive rate was lower (10.5% vs 19.8%). The areas under receiver operating characteristic curves of CESM and MRI were 0.950 and 0.939, displaying the equivalent diagnostic efficiency (P = 0.48). For the agreement between measurements, mean tumor sizes were 3.1 cm for CESM and 3.4 cm for MRI compared with 3.2 cm on histopathologic results. The Pearson correlation coefficient of CESM versus histopathology (r = 0.774, P = 0.000) was consistent with MRI versus histopathology (r = 0.771, P = 0.000). Conclusions Our results show better accuracy, specificity, and false-positive rate of CESM in breast cancer detection than MRI. Contrast-enhanced spectral mammography displayed a good correlation with histopathology in assessing the lesion size of breast cancer, which is consistent with MRI.
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Affiliation(s)
- Dong Xing
- From the Department of Radiology and
| | | | - Bolin Sun
- Interventional Therapy Ward, Yantai Yuhuangding Hospital
| | | | | | | | - Qianqian Chen
- The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
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A COMPARISON OF THE DIAGNOSTIC VALUE OF MAGNETIC RESONANCE MAMMOGRAPHY VERSUS ULTRASOUND MAMMOGRAPHY IN MODERATE- AND HIGH-RISK BREAST CANCER PATIENTS. ACTA ACUST UNITED AC 2018. [DOI: 10.14260/jemds/2018/1245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Lancaster RB, Gulla S, De Los Santos J, Umphrey HR. Contrast-Enhanced Spectral Mammography in Breast Imaging. Semin Roentgenol 2018; 53:294-300. [PMID: 30449347 DOI: 10.1053/j.ro.2018.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Rachael B Lancaster
- Department of Surgery, University of Alabama at Birmingham Medical Center, Birmingham, AL 35233.
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Contrast-Enhanced Mammography (CEM) for Detecting Residual Disease after Neoadjuvant Chemotherapy: A Comparison with Breast Magnetic Resonance Imaging (MRI). BIOMED RESEARCH INTERNATIONAL 2018; 2018:8531916. [PMID: 30533440 PMCID: PMC6250019 DOI: 10.1155/2018/8531916] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 10/04/2018] [Accepted: 10/30/2018] [Indexed: 01/11/2023]
Abstract
Objective To evaluate the performance of contrast-enhanced mammography (CEM) compared to magnetic resonance imaging (MRI) for estimating residual tumor size after neoadjuvant chemotherapy (NAC) in women with newly diagnosed breast cancer. Methods The institutional review board approved this study. This prospective study included women with newly diagnosed breast cancer who underwent breast CEM and MRI at the end of the last cycle of NAC and before definitive surgery. Size of residual malignancy on post-NAC CEM and MRI was compared with surgical pathology. Agreements and correlations of CEM and MRI measurements with histological size were assessed. Results Thirty-three patients were included with a mean age of 45 years (range 22-76). The sensitivity, specificity, and positive and negative predictive value for detection of residual disease of CEM were 76%, 87.5%, 95%, and 86.4%, and those of MRI were 92%, 75%, 92%, and 75%. Comparing CEM to MRI, the mean difference was -0.8 cm, concordance coefficient was 0.7, and Pearson correlation was 0.7 (p = 0.0003). The concordance coefficient between measurements of each imaging modality and pathologic tumor size was 0.7 for CEM and 0.4 for MRI. Pearson correlation was 0.8 for CEM and 0.5 for MRI. Mean differences between CEM, MRI, and residual histopathological tumor size were 0.8 cm and 1.8 cm, respectively. Conclusions CEM has good correlation and agreement with histopathology for measuring residual disease after NAC. CEM was comparable to MRI, showing high positive predictive value and specificity for detecting residual disease.
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Phillips J, Mihai G, Hassonjee SE, Raj SD, Palmer MR, Brook A, Zhang D. Comparative Dose of Contrast-Enhanced Spectral Mammography (CESM), Digital Mammography, and Digital Breast Tomosynthesis. AJR Am J Roentgenol 2018; 211:839-846. [DOI: 10.2214/ajr.17.19036] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- Jordana Phillips
- Department of Radiology, Harvard Medical School and Beth Israel Deaconess Medical Center, 330 Brookline Ave, 4th Fl, Boston, MA 02215
| | - Georgeta Mihai
- Department of Radiology, Harvard Medical School and Beth Israel Deaconess Medical Center, 330 Brookline Ave, 4th Fl, Boston, MA 02215
| | - Sarah Esaa Hassonjee
- Department of Radiology, Harvard Medical School and Beth Israel Deaconess Medical Center, 330 Brookline Ave, 4th Fl, Boston, MA 02215
| | - Sean D. Raj
- Department of Radiology, Harvard Medical School and Beth Israel Deaconess Medical Center, 330 Brookline Ave, 4th Fl, Boston, MA 02215
| | - Matthew R. Palmer
- Department of Radiology, Harvard Medical School and Beth Israel Deaconess Medical Center, 330 Brookline Ave, 4th Fl, Boston, MA 02215
| | - Alexander Brook
- Department of Radiology, Harvard Medical School and Beth Israel Deaconess Medical Center, 330 Brookline Ave, 4th Fl, Boston, MA 02215
| | - Da Zhang
- Department of Radiology, Harvard Medical School and Beth Israel Deaconess Medical Center, 330 Brookline Ave, 4th Fl, Boston, MA 02215
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Hsu JC, Naha PC, Lau KC, Chhour P, Hastings R, Moon BF, Stein JM, Witschey WRT, McDonald ES, Maidment ADA, Cormode DP. An all-in-one nanoparticle (AION) contrast agent for breast cancer screening with DEM-CT-MRI-NIRF imaging. NANOSCALE 2018; 10:17236-17248. [PMID: 30191237 PMCID: PMC6148383 DOI: 10.1039/c8nr03741h] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Conventional X-ray mammography has low diagnostic sensitivity for women with dense breasts. As a result, alternative contrast-enhanced screening tools such as dual energy mammography (DEM), computed tomography (CT), magnetic resonance imaging (MRI), and near-infrared fluorescence (NIRF) imaging are being used or investigated for these women. However, currently available contrast agents are non-ideal, have safety issues, and each imaging technique requires a different contrast agent. We therefore sought to develop a multimodal contrast agent that is functional for each breast imaging modality to simplify the diagnosis process and address the issues of existing contrast agents. Herein, we present a novel "all-in-one" nanoparticle (AION) multimodal imaging probe that has potent DEM, CT, MRI, and NIRF contrast properties and improved biocompatibility. AION were formed by co-encapsulation of a near-infrared fluorophore (DiR), silver sulfide nanoparticles (Ag2S-NP), and iron oxide nanoparticles (IO-NP) in PEGylated micelles. AION showed negligible cytotoxicity, which was in agreement with its minimal silver ion release profiles. AION generated strong contrast with all imaging modalities as demonstrated in phantom imaging. AION allowed in vivo tumor imaging as evidenced by the increase in contrast after injection. This study indicates the potential of AION as an effective multimodal contrast agent for breast cancer diagnosis with a range of imaging methods.
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Affiliation(s)
- Jessica C Hsu
- Department of Radiology, University of Pennsylvania, 3400 Spruce St, 1 Silverstein, Philadelphia, PA 19104, USA.
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Patel BK, Davis J, Ferraro C, Kosiorek H, Hasselbach K, Ocal T, Pockaj B. Value Added of Preoperative Contrast-Enhanced Digital Mammography in Patients With Invasive Lobular Carcinoma of the Breast. Clin Breast Cancer 2018; 18:e1339-e1345. [PMID: 30122347 DOI: 10.1016/j.clbc.2018.07.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 07/09/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Invasive lobular carcinoma (ILC) is the second most frequently diagnosed breast cancer, accounting for 5% to 15% of all invasive breast cancers, yet it remains radiologically elusive in many cases. The goal of this study was to compare the ability to accurately assess disease extent with contrast-enhanced digital mammography (CEDM) and full-field digital mammography (FFDM) in patients with biopsy-proven ILC. PATIENTS AND METHODS A single-institution retrospective review of patients diagnosed with ILC with preoperative CEDM was performed. One of 3 blinded radiologist readers rereviewed cases within 1 month of another. Final size diameter was based on the largest dimension on recombined CEDM or FFDM and compared to the reference standard histopathology. Bland-Altman plots were used to visualize the differences between tumor size on imaging and pathology. RESULTS Thirty women were included. Mean tumor diameter was 27.0 mm (range, 7.0-118 mm) on postoperative histology, 26.0 mm on CEDM, and 16.4 mm on standard mammogram. For CEDM versus FFDM, 5 (16.7%) of 30 versus 9 (30.0%) of 30 cases underestimated pathology by > 10 mm and 5 (16.7%) of 30 versus 3 (10.0%) of 30 overestimated histopathology by > 10 mm, respectively. Two (6.7%) of 30 cases required surgical reexcision. Both Lin (0.87 vs. 0.55) and Pearson (0.87 vs. 0.70) correlation coefficient measures were higher for CEDM versus FFDM. CONCLUSION CEDM outperforms standard digital mammography in ability to accurately assess disease extent in patients with biopsy-proven ILC, resulting in improved surgical outcomes. Future studies should compare surgical outcomes in patients with preoperative magnetic resonance imaging and CEDM in patients with ILC.
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Affiliation(s)
| | - John Davis
- Department of Surgery, Mayo Clinic, Phoenix, AZ
| | | | - Heidi Kosiorek
- Health Sciences Research, Department of Biostatistics, Mayo Clinic, Phoenix, AZ
| | | | - Tolgay Ocal
- Department of Pathology, Mayo Clinic, Phoenix, AZ
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Zhu X, Huang JM, Zhang K, Xia LJ, Feng L, Yang P, Zhang MY, Xiao W, Lin HX, Yu YH. Diagnostic Value of Contrast-Enhanced Spectral Mammography for Screening Breast Cancer: Systematic Review and Meta-analysis. Clin Breast Cancer 2018; 18:e985-e995. [PMID: 29983379 DOI: 10.1016/j.clbc.2018.06.003] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 05/09/2018] [Accepted: 06/08/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Contrast-enhanced spectral mammography (CESM) is a new image examination technology that has developed over the past few years. As CESM technology keeps improving, a current meta-analysis review is needed to systematically evaluate the potential diagnostic value of CESM. METHODS A total of 18 studies were included in the review. Sensitivity, specificity, and other important parameters of CESM accuracy for breast cancer diagnosis were pooled and analyzed using random-effects models. Summary receiver operating characteristic curves were calculated for overall accuracy estimation. RESULTS The summary estimates for CESM in the diagnosis of breast cancer were as follows: the pooled sensitivity and specificity were 0.89 (95% confidence interval [CI], 0.88-0.91) and 0.84 (95% CI, 0.82-0.85), respectively. Positive likelihood ratio was 3.73 (95% CI, 2.68-5.20), negative likelihood ratio was 0.10 (95% CI, 0.06-0.15), and diagnostic odds ratio was 71.36 (95% CI, 36.28-140.39). The area under the curve was 0.96 (standard error = 0.011). CONCLUSION CESM has a high diagnostic accuracy for evaluating breast cancer and can be considered as a useful test for initial assessment of breast lesions.
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Affiliation(s)
- Xiao Zhu
- Department of Breast Surgery of Affiliated Tumor Hospital of Guangxi Medical University, Guangxi, PR China
| | - Jun-Ming Huang
- Department of Oncology, Panyu Hospital of Chinese Medicine, Guangdong, PR China
| | - Kun Zhang
- Deparment of Breast Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Shandong, PR China
| | - Long-Jie Xia
- Department of Breast Surgery of Affiliated Tumor Hospital of Guangxi Medical University, Guangxi, PR China
| | - Lan Feng
- National Center for Protein Sciences, Beijing, PR China
| | - Ping Yang
- Department of Oncology, Panyu Hospital of Chinese Medicine, Guangdong, PR China
| | - Meng-Ya Zhang
- Graduate School of Guangxi Medical University, Guangxi, PR China
| | - Wei Xiao
- Graduate School of Guangxi Medical University, Guangxi, PR China
| | - Hui-Xia Lin
- Graduate School of Guangxi Medical University, Guangxi, PR China
| | - Ying-Hua Yu
- Department of Breast Surgery of Affiliated Tumor Hospital of Guangxi Medical University, Guangxi, PR China.
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73
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Liu D, Ba Z, Ni X, Wang L, Yu D, Ma X. Apparent Diffusion Coefficient to Subdivide Breast Imaging Reporting and Data System Magnetic Resonance Imaging (BI-RADS-MRI) Category 4 Lesions. Med Sci Monit 2018; 24:2180-2188. [PMID: 29644993 PMCID: PMC5914275 DOI: 10.12659/msm.907000] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND This study aims to subdivide BI-RADS-MRI (Breast Imaging Reporting and Data System Magnetic Resonance Imaging) Category 4 lesions and to evaluate the role of Fischer's scoring system, apparent diffusion coefficient (ADC), and Fischer's + ADC in differential diagnosis of breast lesions. MATERIAL AND METHODS This study retrospectively analyzed the data of 143 patients (150 breast lesions), who were diagnosed by biopsy, and received dynamic contrast enhancement and diffusion-weighted imaging. The diagnostic efficacies of ADC, Fischer's scoring system, and the Fischer's + ADC were analyzed by the receiver operating characteristics curve. The area under the curve (AUC) was calculated. Fischer's scoring system and the Fischer's + ADC were used to subdivide BI-RADS Category 4 breast lesions. RESULTS ADC value was negatively correlated with the tumor grade. The AUC of Fischer's + ADC (0.949) was significantly higher than that of ADC (0.855) and Fischer's (0.912) (P=0.0008 and 0.001, respectively). Scored by Fischer's scoring system, Category 4 and 5 indicated a likely malignant threshold with sensitivity and specificity of 98.70% and 65.75%, respectively. Scored by the Fischer's + ADC method, Category 4B and 4C indicated a likely malignant threshold with sensitivity of 97.40% and specificity of 82.19%. Kappa values were 0.63 (ADC), 0.65 (Fischer's), and 0.80 (Fischer's + ADC), respectively. The positive predictive value of BI-RADS 4A, 4B, and 4C were 7.69%, 52.38% and 89.29%, respectively. CONCLUSIONS Fischer's scoring system combined with ADC could reasonably subdivide Category 4 breast lesions with high specificity and sensitivity.
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Affiliation(s)
- Dandan Liu
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, Shandong, China (mainland).,Department of Radiology, Laigang Hospital Affiliated to Taishan Medical University, Laiwu, Shandong, China (mainland)
| | - Zhaogui Ba
- Department of Radiology, Laigang Hospital Affiliated to Taishan Medical University, Laiwu, Shandong, China (mainland)
| | - Xiaoli Ni
- Department of Radiology, Laigang Hospital Affiliated to Taishan Medical University, Laiwu, Shandong, China (mainland)
| | - Linhong Wang
- Department of Radiology, Laigang Hospital Affiliated to Taishan Medical University, Laiwu, Shandong, China (mainland)
| | - Dexin Yu
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, Shandong, China (mainland)
| | - Xiangxing Ma
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, Shandong, China (mainland)
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Travieso-Aja MDM, Naranjo-Santana P, Fernández-Ruiz C, Severino-Rondón W, Maldonado-Saluzzi D, Rodríguez Rodríguez M, Vega-Benítez V, Luzardo O. Factors affecting the precision of lesion sizing with contrast-enhanced spectral mammography. Clin Radiol 2018; 73:296-303. [DOI: 10.1016/j.crad.2017.10.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Accepted: 10/27/2017] [Indexed: 12/20/2022]
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Savaridas S, Taylor D, Gunawardana D, Phillips M. Could parenchymal enhancement on contrast-enhanced spectral mammography (CESM) represent a new breast cancer risk factor? Correlation with known radiology risk factors. Clin Radiol 2017; 72:1085.e1-1085.e9. [DOI: 10.1016/j.crad.2017.07.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 07/17/2017] [Accepted: 07/25/2017] [Indexed: 10/18/2022]
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Iotti V, Ravaioli S, Vacondio R, Coriani C, Caffarri S, Sghedoni R, Nitrosi A, Ragazzi M, Gasparini E, Masini C, Bisagni G, Falco G, Ferrari G, Braglia L, Del Prato A, Malavolti I, Ginocchi V, Pattacini P. Contrast-enhanced spectral mammography in neoadjuvant chemotherapy monitoring: a comparison with breast magnetic resonance imaging. Breast Cancer Res 2017; 19:106. [PMID: 28893303 PMCID: PMC5594558 DOI: 10.1186/s13058-017-0899-1] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Accepted: 08/25/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Neoadjuvant-chemotherapy (NAC) is considered the standard treatment for locally advanced breast carcinomas. Accurate assessment of disease response is fundamental to increase the chances of successful breast-conserving surgery and to avoid local recurrence. The purpose of this study was to compare contrast-enhanced spectral mammography (CESM) and contrast-enhanced-MRI (MRI) in the evaluation of tumor response to NAC. METHODS This prospective study was approved by the institutional review board and written informed consent was obtained. Fifty-four consenting women with breast cancer and indication of NAC were consecutively enrolled between October 2012 and December 2014. Patients underwent both CESM and MRI before, during and after NAC. MRI was performed first, followed by CESM within 3 days. Response to therapy was evaluated for each patient, comparing the size of the residual lesion measured on CESM and MRI performed after NAC to the pathological response on surgical specimens (gold standard), independently of and blinded to the results of the other test. The agreement between measurements was evaluated using Lin's coefficient. The agreement between measurements using CESM and MRI was tested at each step of the study, before, during and after NAC. And last of all, the variation in the largest dimension of the tumor on CESM and MRI was assessed according to the parameters set in RECIST 1.1 criteria, focusing on pathological complete response (pCR). RESULTS A total of 46 patients (85%) completed the study. CESM predicted pCR better than MRI (Lin's coefficient 0.81 and 0.59, respectively). Both methods tend to underestimate the real extent of residual tumor (mean 4.1mm in CESM, 7.5mm in MRI). The agreement between measurements using CESM and MRI was 0.96, 0.94 and 0.76 before, during and after NAC respectively. The distinction between responders and non-responders with CESM and MRI was identical for 45/46 patients. In the assessment of CR, sensitivity and specificity were 100% and 84%, respectively, for CESM, and 87% and 60% for MRI. CONCLUSION CESM and MRI lesion size measurements were highly correlated. CESM seems at least as reliable as MRI in assessing the response to NAC, and may be an alternative if MRI is contraindicated or its availability is limited.
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Affiliation(s)
- Valentina Iotti
- Radiology Unit, Department of Diagnostic Imaging and Laboratory Medicine, Arcispedale Santa Maria Nuova - IRCCS, Viale Umberto I, No. 50, 42123, Reggio Emilia, Italy.
| | - Sara Ravaioli
- Radiology Unit, Department of Diagnostic Imaging and Laboratory Medicine, Arcispedale Santa Maria Nuova - IRCCS, Viale Umberto I, No. 50, 42123, Reggio Emilia, Italy
| | - Rita Vacondio
- Radiology Unit, Department of Diagnostic Imaging and Laboratory Medicine, Arcispedale Santa Maria Nuova - IRCCS, Viale Umberto I, No. 50, 42123, Reggio Emilia, Italy
| | - Chiara Coriani
- Radiology Unit, Department of Diagnostic Imaging and Laboratory Medicine, Arcispedale Santa Maria Nuova - IRCCS, Viale Umberto I, No. 50, 42123, Reggio Emilia, Italy
| | - Sabrina Caffarri
- Radiology Unit, Department of Diagnostic Imaging and Laboratory Medicine, AUSL Reggio Emilia, via Amendola 2, Reggio Emilia, 42122, Italy
| | - Roberto Sghedoni
- Medical Physics Unit, Department of Oncology and Advanced Technologies, Arcispedale Santa Maria Nuova - IRCCS, Viale Umberto I, No. 50, 42123, Reggio Emilia, Italy
| | - Andrea Nitrosi
- Medical Physics Unit, Department of Oncology and Advanced Technologies, Arcispedale Santa Maria Nuova - IRCCS, Viale Umberto I, No. 50, 42123, Reggio Emilia, Italy
| | - Moira Ragazzi
- Pathology Unit, Department of Oncology and Advanced Technologies, Arcispedale Santa Maria Nuova - IRCCS, Viale Umberto I, No. 50, 42123, Reggio Emilia, Italy
| | - Elisa Gasparini
- Oncology Unit, Hospital C. Magati, AUSL Reggio Emilia, Via Martiri della Libertà, No. 8, Scandiano (RE), 42019, Italy
| | - Cristina Masini
- Oncology Unit, Department of Oncology and Advanced Technologies, Arcispedale Santa Maria Nuova - IRCCS, Viale Umberto I, No. 50, 42123, Reggio Emilia, Italy
| | - Giancarlo Bisagni
- Oncology Unit, Department of Oncology and Advanced Technologies, Arcispedale Santa Maria Nuova - IRCCS, Viale Umberto I, No. 50, 42123, Reggio Emilia, Italy
| | - Giuseppe Falco
- Breast Surgery Unit, Department of Surgery, Arcispedale Santa Maria Nuova - IRCCS, Viale Umberto I, No. 50, 42123, Reggio Emilia, Italy
| | - Guglielmo Ferrari
- Breast Surgery Unit, Department of Surgery, Arcispedale Santa Maria Nuova - IRCCS, Viale Umberto I, No. 50, 42123, Reggio Emilia, Italy
| | - Luca Braglia
- Scientific Directorate, Arcispedale Santa Maria Nuova - IRCCS, Viale Umberto I, No. 50, 42123, Reggio Emilia, Italy
| | - Alberto Del Prato
- Radiology Unit, Department of Diagnostic Imaging and Laboratory Medicine, Arcispedale Santa Maria Nuova - IRCCS, Viale Umberto I, No. 50, 42123, Reggio Emilia, Italy
| | - Ivana Malavolti
- Radiology Unit, Department of Diagnostic Imaging and Laboratory Medicine, AUSL Reggio Emilia, via Amendola 2, Reggio Emilia, 42122, Italy
| | - Vladimiro Ginocchi
- Radiology Unit, Department of Diagnostic Imaging and Laboratory Medicine, AUSL Reggio Emilia, via Amendola 2, Reggio Emilia, 42122, Italy
| | - Pierpaolo Pattacini
- Radiology Unit, Department of Diagnostic Imaging and Laboratory Medicine, Arcispedale Santa Maria Nuova - IRCCS, Viale Umberto I, No. 50, 42123, Reggio Emilia, Italy
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Zhang S, Ding Y, Zhou Q, Wang C, Wu P, Dong J. Correlation Factors Analysis of Breast Cancer Tumor Volume Doubling Time Measured by 3D-Ultrasound. Med Sci Monit 2017; 23:3147-3153. [PMID: 28652562 PMCID: PMC5498121 DOI: 10.12659/msm.901566] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Tumor volume doubling time (TVDT) is relatively important for breast cancer diagnosis and prognosis evaluation. This study aimed to analyze the related factors that may affect the TVDT of breast cancer by three-dimensional ultrasound (3D-US). MATERIAL AND METHODS A total of 69 breast cancer patients were selected. 3D-US was applied to measure the volume of breast lumps diagnosed as BI-RADS-US 4A by conventional ultrasound. TVDT was calculated according to the formula TVDT=DT×log2/log(V2/V1). Multiple linear regression analysis was performed to analyze the factors influencing breast cancer TVDT. RESULTS The mean and median TVDT were 185±126 (range 66-521) and 164 days, respectively. TVDT showed no statistical significance according to regular shape, coarse margin, spicule sign, peripheral hyperechoic halo, microcalcification, and different posterior echo characteristics (P>0.05). Patients grouped by age, axillary lymphatic metastasis, histological differentiation, and Nottingham prognostic index (NPI) score exhibited significantly different TVDT (P<0.05). On the contrary, patients with different menstrual conditions, breast cancer family history, or pathological types presented similar TVDT (P>0.05). TVDT was obviously different in breast cancer with different ER, PR, Ki-67, and molecular subtyping but not HER2 expression. Multivariate analysis revealed that NPI score, axillary lymphatic metastasis, Ki-67, and molecular subtyping were risk factors of TVDT in breast cancer (P<0.05). CONCLUSIONS Breast cancer TVDT was significantly correlated with NPI score, axillary lymphatic metastasis, Ki-67, and molecular subtyping. Triple-negative breast cancer exhibited the most rapid growth.
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Affiliation(s)
- Shuyin Zhang
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China (mainland)
| | - Yan Ding
- Department of Medical Ultrasound, Nanjing Medical University Affiliated Wuxi People's Hospital, Wuxi, Jiangsu, China (mainland)
| | - Qiaoying Zhou
- Department of Medical Ultrasound, Nanjing Medical University Affiliated Wuxi People's Hospital, Wuxi, Jiangsu, China (mainland)
| | - Cheng Wang
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China (mainland)
| | - Pengxi Wu
- Department of Medical Ultrasound, Nanjing Medical University Affiliated Wuxi People's Hospital, Wuxi, Jiangsu, China (mainland)
| | - Ji Dong
- Department of Medical Ultrasound, Nanjing Medical University Affiliated Wuxi People's Hospital, Wuxi, Jiangsu, China (mainland)
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Taylor D, O'Hanlon S, Latham B. False-negative contrast-enhanced spectral mammography: use of more than one imaging modality and application of the triple test avoids misdiagnosis. BMJ Case Rep 2017; 2017:bcr-2016-218556. [PMID: 28363948 DOI: 10.1136/bcr-2016-218556] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 50-year-old woman presented with chest tenderness. On examination, both breasts were lumpy. Bilateral mammography showed heterogeneously dense parenchyma, with possible stromal distortion laterally on the right at the 0900 position. On ultrasound (US), a corresponding 13×9×10 mm irregular hypoechoic mass with internal vascularity was noted and both breasts had a complex heterogeneous fibroglandular background pattern. US-guided core biopsy with marker clip insertion was performed with the diagnosis of a grade 2 invasive ductal carcinoma (IDC). In view of the parenchymal pattern on mammography and US, contrast-enhanced spectral mammography (CESM) was performed for local staging. Mild background enhancement was noted, but there was no enhancement at the lesion site. The patient elected to have bilateral mastectomies and sentinel node biopsies. Final histopathology showed a node negative 11 mm grade 2 oestrogen and progesterone receptor positive, IDC.
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Affiliation(s)
- Donna Taylor
- Department of Radiology, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Susan O'Hanlon
- Department of Radiology, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Bruce Latham
- Department of PathWest, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
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Contrast-enhanced spectral mammography (CESM) versus MRI in the high-risk screening setting: patient preferences and attitudes. Clin Imaging 2017; 42:193-197. [DOI: 10.1016/j.clinimag.2016.12.011] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 12/11/2016] [Accepted: 12/19/2016] [Indexed: 11/22/2022]
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Breast Radiation Dose With CESM Compared With 2D FFDM and 3D Tomosynthesis Mammography. AJR Am J Roentgenol 2017; 208:362-372. [DOI: 10.2214/ajr.16.16743] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Fallenberg EM, Schmitzberger FF, Amer H, Ingold-Heppner B, Balleyguier C, Diekmann F, Engelken F, Mann RM, Renz DM, Bick U, Hamm B, Dromain C. Contrast-enhanced spectral mammography vs. mammography and MRI - clinical performance in a multi-reader evaluation. Eur Radiol 2016; 27:2752-2764. [PMID: 27896471 DOI: 10.1007/s00330-016-4650-6] [Citation(s) in RCA: 140] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 10/17/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To compare the diagnostic performance of contrast-enhanced spectral mammography (CESM) to digital mammography (MG) and magnetic resonance imaging (MRI) in a prospective two-centre, multi-reader study. METHODS One hundred seventy-eight women (mean age 53 years) with invasive breast cancer and/or DCIS were included after ethics board approval. MG, CESM and CESM + MG were evaluated by three blinded radiologists based on amended ACR BI-RADS criteria. MRI was assessed by another group of three readers. Receiver-operating characteristic (ROC) curves were compared. Size measurements for the 70 lesions detected by all readers in each modality were correlated with pathology. RESULTS Reading results for 604 lesions were available (273 malignant, 4 high-risk, 327 benign). The area under the ROC curve was significantly larger for CESM alone (0.84) and CESM + MG (0.83) compared to MG (0.76) (largest advantage in dense breasts) while it was not significantly different from MRI (0.85). Pearson correlation coefficients for size comparison were 0.61 for MG, 0.69 for CESM, 0.70 for CESM + MG and 0.79 for MRI. CONCLUSIONS This study showed that CESM, alone and in combination with MG, is as accurate as MRI but is superior to MG for lesion detection. Patients with dense breasts benefitted most from CESM with the smallest additional dose compared to MG. KEY POINTS • CESM has comparable diagnostic performance (ROC-AUC) to MRI for breast cancer diagnostics. • CESM in combination with MG does not improve diagnostic performance. • CESM has lower sensitivity but higher specificity than MRI. • Sensitivity differences are more pronounced in dense and not significant in non-dense breasts. • CESM and MRI are significantly superior to MG, particularly in dense breasts.
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Affiliation(s)
- Eva M Fallenberg
- Clinic of Radiology, Campus Virchow-Klinikum, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - Florian F Schmitzberger
- Clinic of Radiology, Campus Virchow-Klinikum, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Heba Amer
- Clinic of Radiology, Campus Virchow-Klinikum, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | | | | | - Felix Diekmann
- Department of Medical Imaging, St. Joseph-Stift Bremen, Bremen, Germany
| | - Florian Engelken
- Clinic of Radiology, Campus Virchow-Klinikum, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Ritse M Mann
- Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Diane M Renz
- Department of Radiology, Universitätsklinikum Jena, Jena, Germany
| | - Ulrich Bick
- Clinic of Radiology, Campus Virchow-Klinikum, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Bernd Hamm
- Clinic of Radiology, Campus Virchow-Klinikum, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Clarisse Dromain
- Department of Radiology, Gustave Roussy Cancer Campus, Villejuif, France
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Łuczyńska E, Niemiec J, Hendrick E, Heinze S, Jaszczyński J, Jakubowicz J, Sas-Korczyńska B, Rys J. Degree of Enhancement on Contrast Enhanced Spectral Mammography (CESM) and Lesion Type on Mammography (MG): Comparison Based on Histological Results. Med Sci Monit 2016; 22:3886-3893. [PMID: 27768681 PMCID: PMC5077289 DOI: 10.12659/msm.900371] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Contrast enhanced spectral mammography (CESM) is a new method of breast cancer diagnosis in which an iodinated contrast agent is injected and dual-energy mammography is obtained in multiple views of the breasts. The aim of this study was to compare the degree of enhancement on CESM with lesion characteristics on mammography (MG) and lesion histology in women with suspicious breast lesions. Material/Methods The degree of enhancement on CESM (absent, weak, medium, or strong) was compared to lesion characteristics on MG (mass, mass with microcalcifications, or microcalcifications alone) and histology (infiltrating carcinoma, intraductal carcinoma, or benign) to compare sensitivity of the two modalities and to establish correlations that might improve diagnostic accuracy. Results Among 225 lesions identified with CESM and MG, histological evaluation revealed 143 carcinomas (127 infiltrating, 16 intraductal) and 82 benign lesions. This is the largest cohort investigated with CESM to date. The sensitivity of CESM was higher than that of MG (100% and 90%, respectively, p=0.010). Medium or strong enhancement on CESM and the presence of a mass on MG was the most likely indictor of malignancy (55.1% p=0.002). Among benign lesions, 60% presented as enhancement on CESM (were false-positive), and most frequently as medium or weak enhancement, together with a mass on MG (53%, p=0.047). Unfortunately, the study did not find combinations of MG findings and CESM enhancement patterns that would be helpful in defining false-positive lesions. We observed systematic overestimation of maximum lesion diameter on CESM compared to histology (mean difference: 2.29 mm). Conclusions Strong or medium enhancement on CESM and mass or mass with microcalcifications on MG were strong indicators of malignant transformation. However, we found no combination of MG and CESM characteristics helpful in defining false-positive lesions.
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Affiliation(s)
- Elżbieta Łuczyńska
- Department of Radiology, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Cracow Branch, Cracow, Poland
| | - Joanna Niemiec
- Department of Applied Radiobiology, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Cracow Branch, Cracow, Poland
| | - Edward Hendrick
- Department of Radiology, School of Medicine, University of Colorado, Denver, Aurora, CO, USA
| | - Sylwia Heinze
- Department of Radiology, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Cracow Branch, Cracow, Poland
| | - Janusz Jaszczyński
- Department of Urology, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Cracow Branch, Cracow, Poland
| | - Jerzy Jakubowicz
- Oncology Clinic and Department of Radiotherapy, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Cracow Branch, Cracow, Poland
| | - Beata Sas-Korczyńska
- Oncology Clinic and Department of Radiotherapy, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Cracow Branch, Cracow, Poland
| | - Janusz Rys
- Department of Tumour Pathology, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Cracow Branch, Cracow, Poland
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Naha PC, Lau KC, Hsu JC, Hajfathalian M, Mian S, Chhour P, Uppuluri L, McDonald ES, Maidment ADA, Cormode DP. Gold silver alloy nanoparticles (GSAN): an imaging probe for breast cancer screening with dual-energy mammography or computed tomography. NANOSCALE 2016; 8:13740-54. [PMID: 27412458 PMCID: PMC4955565 DOI: 10.1039/c6nr02618d] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Earlier detection of breast cancer reduces mortality from this disease. As a result, the development of better screening techniques is a topic of intense interest. Contrast-enhanced dual-energy mammography (DEM) is a novel technique that has improved sensitivity for cancer detection. However, the development of contrast agents for this technique is in its infancy. We herein report gold-silver alloy nanoparticles (GSAN) that have potent DEM contrast properties and improved biocompatibility. GSAN formulations containing a range of gold : silver ratios and capped with m-PEG were synthesized and characterized using various analytical methods. DEM and computed tomography (CT) phantom imaging showed that GSAN produced robust contrast that was comparable to silver alone. Cell viability, reactive oxygen species generation and DNA damage results revealed that the formulations with 30% or higher gold content are cytocompatible to Hep G2 and J774A.1 cells. In vivo imaging was performed in mice with and without breast tumors. The results showed that GSAN produce strong DEM and CT contrast and accumulated in tumors. Furthermore, both in vivo imaging and ex vivo analysis indicated the excretion of GSAN via both urine and feces. In summary, GSAN produce strong DEM and CT contrast, and has potential for both blood pool imaging and for breast cancer screening.
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Affiliation(s)
- Pratap C Naha
- Department of Radiology, University of Pennsylvania 3400 Spruce St, 1 Silverstein, Philadelphia, PA 19104, USA.
| | - Kristen C Lau
- Department of Radiology, University of Pennsylvania 3400 Spruce St, 1 Silverstein, Philadelphia, PA 19104, USA.
| | - Jessica C Hsu
- Department of Radiology, University of Pennsylvania 3400 Spruce St, 1 Silverstein, Philadelphia, PA 19104, USA. and Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA
| | - Maryam Hajfathalian
- Department of Mechanical Engineering, Temple University, Philadelphia, PA, USA
| | - Shaameen Mian
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA
| | - Peter Chhour
- Department of Radiology, University of Pennsylvania 3400 Spruce St, 1 Silverstein, Philadelphia, PA 19104, USA. and Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA
| | - Lahari Uppuluri
- Department of Radiology, University of Pennsylvania 3400 Spruce St, 1 Silverstein, Philadelphia, PA 19104, USA.
| | - Elizabeth S McDonald
- Department of Radiology, University of Pennsylvania 3400 Spruce St, 1 Silverstein, Philadelphia, PA 19104, USA.
| | - Andrew D A Maidment
- Department of Radiology, University of Pennsylvania 3400 Spruce St, 1 Silverstein, Philadelphia, PA 19104, USA.
| | - David P Cormode
- Department of Radiology, University of Pennsylvania 3400 Spruce St, 1 Silverstein, Philadelphia, PA 19104, USA. and Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA and Department of Cardiology, University of Pennsylvania, Philadelphia, PA, USA
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86
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Kamal RM, Helal MH, Mansour SM, Haggag MA, Nada OM, Farahat IG, Alieldin NH. Can we apply the MRI BI-RADS lexicon morphology descriptors on contrast-enhanced spectral mammography? Br J Radiol 2016; 89:20160157. [PMID: 27327403 DOI: 10.1259/bjr.20160157] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE: To assess the feasibility of using the MRI breast imaging reporting and data system (BI-RADS) lexicon morphology descriptors to characterize enhancing breast lesions identified on contrast-enhanced spectral mammography (CESM). METHODS: The study is a retrospective analysis of the morphology descriptors of 261 enhancing breast lesions identified on CESM in 239 patients. We presented the morphological categorization of the included lesions into focus, mass and non-mass. Further classifications included (1) the multiplicity for "focus" category, (2) the shape, margin and internal enhancement for "mass" category and (3) the distribution and internal enhancement for "non-mass" category. Each morphology descriptor was evaluated individually (irrespective of all other descriptors) by calculating its sensitivity, specificity, positive-predictive value (PPV) and negative-predictive value (NPV) and likelihood ratios (LRs). RESULTS: The study included 68/261 (26.1%) benign lesions and 193/261 (73.9%) malignant lesions. Intensely enhancing foci, whether single (7/12, 58.3%) or multiple (2/12, 16.7%), were malignant. Descriptors of "irregular"-shape (PPV: 92.4%) and "non-circumscribed" margin (odds ratio: 55.2, LR positive: 4.77; p-value: <0.001) were more compatible with malignancy. Internal mass enhancement patterns showed a very low specificity (58.0%) and NPV (40.0%). Non-mass enhancement (NME) was detected in 81/261 lesions. Asymmetrical NME in 81% (n = 52/81) lesions was malignant lesions and internal enhancement patterns indicative of malignancy were the heterogeneous and clumped ones. CONCLUSION: We can apply the MRI morphology descriptors to characterize lesions on CESM, but with few expectations. In many situations, irregular-shaped, non-circumscribed masses and NME with focal, ductal or segmental distribution and heterogeneous or clumped enhancement are the most suggestive descriptors of malignant pathologies. ADVANCES IN KNOWLEDGE: (1) The MRI BI-RADS lexicon morphology descriptors can be applied in the characterization of enhancing lesions on CESM with a few exceptions. (2) Multiple bilateral intensely enhancing foci should not be included under the normal background parenchymal enhancement unless they are proved to be benign by biopsy. (3) Mass lesion features that indicated malignancy were irregular-shaped, spiculated and irregular margins and heterogeneous internal enhancement patterns. The rim enhancement pattern should not be considered as a descriptor of malignant lesions unless CESM is coupled with an ultrasound examination.
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Affiliation(s)
- Rasha M Kamal
- 1 Women's Imaging Unit, Department of Radiology, Kasr ElAiny Hospital, Cairo University, Egypt
| | - Maha H Helal
- 2 Women's Imaging Unit, Department of Radiology, National Cancer Institute, Cairo University, Egypt
| | - Sahar M Mansour
- 1 Women's Imaging Unit, Department of Radiology, Kasr ElAiny Hospital, Cairo University, Egypt
| | - Marwa A Haggag
- 2 Women's Imaging Unit, Department of Radiology, National Cancer Institute, Cairo University, Egypt
| | - Omniya M Nada
- 2 Women's Imaging Unit, Department of Radiology, National Cancer Institute, Cairo University, Egypt
| | - Iman G Farahat
- 3 Department of Pathology, National Cancer Institute, Cairo University, Egypt
| | - Nelly H Alieldin
- 4 Department of Biostatistics and Cancer Epidemiology, National Cancer Institute, Cairo University, Egypt
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Contrast-enhanced spectral mammography in recalls from the Dutch breast cancer screening program: validation of results in a large multireader, multicase study. Eur Radiol 2016; 26:4371-4379. [PMID: 27097789 PMCID: PMC5101272 DOI: 10.1007/s00330-016-4336-0] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 03/09/2016] [Accepted: 03/14/2016] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Contrast-enhanced spectral mammography (CESM) is a promising problem-solving tool in women referred from a breast cancer screening program. We aimed to study the validity of preliminary results of CESM using a larger panel of radiologists with different levels of CESM experience. METHODS All women referred from the Dutch breast cancer screening program were eligible for CESM. 199 consecutive cases were viewed by ten radiologists. Four had extensive CESM experience, three had no CESM experience but were experienced breast radiologists, and three were residents. All readers provided a BI-RADS score for the low-energy CESM images first, after which the score could be adjusted when viewing the entire CESM exam. BI-RADS 1-3 were considered benign and BI-RADS 4-5 malignant. With this cutoff, we calculated sensitivity, specificity and area under the ROC curve. RESULTS CESM increased diagnostic accuracy in all readers. The performance for all readers using CESM was: sensitivity 96.9 % (+3.9 %), specificity 69.7 % (+33.8 %) and area under the ROC curve 0.833 (+0.188). CONCLUSION CESM is superior to conventional mammography, with excellent problem-solving capabilities in women referred from the breast cancer screening program. Previous results were confirmed even in a larger panel of readers with varying CESM experience. KEY POINTS • CESM is consistently superior to conventional mammography • CESM increases diagnostic accuracy regardless of a reader's experience • CESM is an excellent problem-solving tool in recalls from screening programs.
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88
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Wang Q, Sun T, Cao Y, Gao P, Dong J, Fang Y, Fang Z, Sun X, Zhu Z. A dried blood spot mass spectrometry metabolomic approach for rapid breast cancer detection. Onco Targets Ther 2016; 9:1389-98. [PMID: 27042107 PMCID: PMC4795570 DOI: 10.2147/ott.s95862] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Objective Breast cancer (BC) is still a lethal threat to women worldwide. An accurate screening and diagnosis strategy performed in an easy-to-operate manner is highly warranted in clinical perspective. Besides the routinely focused protein markers, blood is full of small molecular metabolites with diverse structures and properties. This study aimed to screen metabolite markers with BC diagnosis potentials. Methods A dried blood spot-based direct infusion mass spectrometry (MS) metabolomic analysis was conducted for BC and non-BC differentiation. The targeted analytes included 23 amino acids and 26 acylcarnitines. Results Multivariate analysis screened out 21 BC-related metabolites in the blood. Regression analysis generated a diagnosis model consisting of parameters Pip, Asn, Pro, C14:1/C16, Phe/Tyr, and Gly/Ala. Tested with another set of BC and non-BC samples, this model showed a sensitivity of 92.2% and a specificity of 84.4%. Compared to the routinely used protein markers, this model exhibited distinct advantage with its higher sensitivity. Conclusion Blood metabolites screening is a more plausible approach for BC detection. Furthermore, this direct MS analysis could be finished within few minutes, which means that its throughput is higher than the currently used imaging techniques.
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Affiliation(s)
- Qingjun Wang
- Oncology Department 2, The First Affiliated Hospital of Liaoning Medical University, Jinzhou, People's Republic of China; Personalized Treatment and Diagnosis Research Center, The First Affiliated Hospital of Liaoning Medical University and Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Jinzhou, People's Republic of China
| | - Tao Sun
- Department of Internal Medicine 1, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Insititute, Shenyang, People's Republic of China
| | - Yunfeng Cao
- Oncology Department 2, The First Affiliated Hospital of Liaoning Medical University, Jinzhou, People's Republic of China; Personalized Treatment and Diagnosis Research Center, The First Affiliated Hospital of Liaoning Medical University and Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Jinzhou, People's Republic of China; CAS Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, People's Republic of China; Key Laboratory of Contraceptives and Devices Research (NPFPC), Shanghai Engineer and Technology Research Center of Reproductive Health Drug and Devices, Shanghai Institute of Planned Parenthood Research, Shanghai, People's Republic of China
| | - Peng Gao
- Personalized Treatment and Diagnosis Research Center, The First Affiliated Hospital of Liaoning Medical University and Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Jinzhou, People's Republic of China; CAS Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, People's Republic of China; Clinical Laboratory, Dalian Sixth People's Hospital, Dalian, People's Republic of China
| | - Jun Dong
- Personalized Treatment and Diagnosis Research Center, The First Affiliated Hospital of Liaoning Medical University and Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Jinzhou, People's Republic of China; CAS Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, People's Republic of China
| | - Yanhua Fang
- Personalized Treatment and Diagnosis Research Center, The First Affiliated Hospital of Liaoning Medical University and Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Jinzhou, People's Republic of China
| | - Zhongze Fang
- Personalized Treatment and Diagnosis Research Center, The First Affiliated Hospital of Liaoning Medical University and Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Jinzhou, People's Republic of China
| | - Xiaoyu Sun
- Personalized Treatment and Diagnosis Research Center, The First Affiliated Hospital of Liaoning Medical University and Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Jinzhou, People's Republic of China
| | - Zhitu Zhu
- Oncology Department 2, The First Affiliated Hospital of Liaoning Medical University, Jinzhou, People's Republic of China; Personalized Treatment and Diagnosis Research Center, The First Affiliated Hospital of Liaoning Medical University and Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Jinzhou, People's Republic of China
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