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Ohno M, Ohno N, Miyati T, Kawashima H, Kozaka K, Matsuura Y, Gabata T, Kobayashi S. Triexponential Diffusion Analysis of Diffusion-weighted Imaging for Breast Ductal Carcinoma in Situ and Invasive Ductal Carcinoma. Magn Reson Med Sci 2021; 20:396-403. [PMID: 33563872 PMCID: PMC8922350 DOI: 10.2463/mrms.mp.2020-0103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose To obtain detailed information in breast ductal carcinoma in situ (DCIS) and invasive ductal carcinoma (IDC) using triexponential diffusion analysis. Methods Diffusion-weighted images (DWI) of the breast were obtained using single-shot diffusion echo-planar imaging with 15 b-values. Mean signal intensities at each b-value were measured in the DCIS and IDC lesions and fitted with the triexponential function based on a two-step approach: slow-restricted diffusion coefficient (Ds) was initially determined using a monoexponential function with b-values > 800 s/mm2. The diffusion coefficient of free water at 37°C was assigned to the fast-free diffusion coefficient (Df). Finally, the perfusion-related diffusion coefficient (Dp) was derived using all the b-values. Furthermore, biexponential analysis was performed to obtain the perfusion-related diffusion coefficient (D*) and the perfusion-independent diffusion coefficient (D). Monoexponential analysis was performed to obtain the apparent diffusion coefficient (ADC). The sensitivity and specificity of the aforementioned diffusion coefficients for distinguishing between DCIS and IDC were evaluated using the pathological results. Results The Ds, D, and ADC of DCIS were significantly higher than those of IDC (P < 0.01 for all). There was no significant correlation between Dp and Ds, but there was a weak correlation between D* and D. The combination of Dp and Ds showed higher sensitivity and specificity (85.9% and 71.4%, respectively), compared to the combination of D* and D (81.5% and 33.3%, respectively). Conclusion Triexponential analysis can provide detailed diffusion information for breast tumors that can be used to differentiate between DCIS and IDC.
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Affiliation(s)
- Masako Ohno
- Department of Radiological Technology, Kanazawa University Hospital
| | - Naoki Ohno
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University
| | - Tosiaki Miyati
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University
| | - Hiroko Kawashima
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University.,Department of Radiology, Kanazawa University Hospital
| | - Kazuto Kozaka
- Department of Radiology, Kanazawa University Hospital
| | | | | | - Satoshi Kobayashi
- Department of Radiological Technology, Kanazawa University Hospital.,Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University.,Department of Radiology, Kanazawa University Hospital
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2
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Durhan G, Poker A, Settarzade E, Karakaya J, Kösemehmetoğlu K, Akpınar MG, Demirkazık FB. Magnetic resonance imaging findings of invasive breast cancer in different histological grades and different histopathological types. Clin Imaging 2021; 76:98-103. [PMID: 33582618 DOI: 10.1016/j.clinimag.2021.01.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 01/10/2021] [Accepted: 01/29/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the magnetic resonance imaging (MRI) findings of invasive breast cancer in different histopathological types (invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC) and mixed ductal-lobular carcinoma (MDLC)) and different histological grades. METHODS A retrospective review was made of 1256 patients who underwent breast MRI at our hospital between January 2015 and December 2018. A total of 152 lesions (27 ILC, 102 IDC, 23 MDLC and 20 grade 1, 83 grade 2 and 49 grade 3) were included in the study. All the lesions were evaluated according to size, shape, margin, dynamic curve, ADC value and T2 signal intensity ratio (SIR). RESULTS Most of the lesions tended to show type 2 and type 3 dynamic curve, type 1 dynamic curve was more commonly seen in ILC and grade 1 groups. IDC showed higher T2 SIR than the other types and grade 3 showed higher T2 SIR than other grades (p< 0,05) There was no statistically significant difference between the groups according to morphological features and mean ADC values (p > 0,05). CONCLUSION T2 SIR and dynamic curve can help the radiologists predict histopathological findings while morphological features and ADC values were not helpful in distinguishing histological types and grades.
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Affiliation(s)
- Gamze Durhan
- Hacettepe University Faculty of Medicine, Department of Radiology, Ankara, Turkey.
| | - Ahmet Poker
- Hacettepe University Faculty of Medicine, Department of Radiology, Ankara, Turkey
| | - Emil Settarzade
- Hacettepe University Faculty of Medicine, Department of Radiology, Ankara, Turkey
| | - Jale Karakaya
- Hacettepe University Faculty of Medicine, Department of Biostatistics, Ankara, Turkey
| | - Kemal Kösemehmetoğlu
- Hacettepe University Faculty of Medicine, Department of Pathology, Ankara, Turkey
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3
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Lee SY, Woo OH, Shin HS, Song SE, Cho KR, Seo BK, Hwang SY. Assessment of Additional MRI-Detected Breast Lesions Using the Quantitative Analysis of Contrast-Enhanced Ultrasound Scans and Its Comparability with Dynamic Contrast-Enhanced MRI Findings of the Breast. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2021; 82:889-902. [PMID: 36238077 PMCID: PMC9514400 DOI: 10.3348/jksr.2020.0115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/04/2020] [Accepted: 09/14/2020] [Indexed: 11/21/2022]
Abstract
Purpose To assess the diagnostic performance of contrast-enhanced ultrasound (CEUS) for additional MR-detected enhancing lesions and to determine whether or not kinetic pattern results comparable to dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of the breast can be obtained using the quantitative analysis of CEUS. Materials and Methods In this single-center prospective study, a total of 71 additional MR-detected breast lesions were included. CEUS examination was performed, and lesions were categorized according to the Breast Imaging-Reporting and Data System (BI-RADS). The sensitivity, specificity, and diagnostic accuracy of CEUS were calculated by comparing the BI-RADS category to the final pathology results. The degree of agreement between CEUS and DCE-MRI kinetic patterns was evaluated using weighted kappa. Results On CEUS, 46 lesions were assigned as BI-RADS category 4B, 4C, or 5, while 25 lesions category 3 or 4A. The diagnostic performance of CEUS for enhancing lesions on DCE-MRI was excellent, with 84.9% sensitivity, 94.4% specificity, and 97.8% positive predictive value. A total of 57/71 (80%) lesions had correlating kinetic patterns and showed good agreement (weighted kappa = 0.66) between CEUS and DCE-MRI. Benign lesions showed excellent agreement (weighted kappa = 0.84), and invasive ductal carcinoma (IDC) showed good agreement (weighted kappa = 0.69). Conclusion The diagnostic performance of CEUS for additional MR-detected breast lesions was excellent. Accurate kinetic pattern assessment, fairly comparable to DCE-MRI, can be obtained for benign and IDC lesions using CEUS.
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Affiliation(s)
- Sei Young Lee
- Department of Radiology, Korea University Guro Hospital, College of Medicine, Korea University, Seoul, Korea
| | - Ok Hee Woo
- Department of Radiology, Korea University Guro Hospital, College of Medicine, Korea University, Seoul, Korea
| | - Hye Seon Shin
- Department of Radiology, Korea University Guro Hospital, College of Medicine, Korea University, Seoul, Korea
| | - Sung Eun Song
- Department of Radiology, Korea University Anam Hospital, College of Medicine, Korea University, Seoul, Korea
| | - Kyu Ran Cho
- Department of Radiology, Korea University Anam Hospital, College of Medicine, Korea University, Seoul, Korea
| | - Bo Kyoung Seo
- Department of Radiology, Korea University Ansan Hospital, College of Medicine, Korea University, Seoul, Korea
| | - Soon Young Hwang
- Medical Science Research Support Center, Division of Medical Statistics, Korea University Guro Hospital, College of Medicine, Korea University, Seoul, Korea
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4
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Lyons D, Wahab RA, Vijapura C, Mahoney MC. The nipple-areolar complex: comprehensive imaging review. Clin Radiol 2020; 76:172-184. [PMID: 33077158 DOI: 10.1016/j.crad.2020.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 09/11/2020] [Indexed: 10/23/2022]
Abstract
The nipple-areolar complex can be affected by a variety of benign and malignant entities that can present with non-specific symptoms. Benign pathologies commonly affecting the nipple-areolar complex include nipple calcifications, nipple adenoma, abscess of Montgomery tubercles, ductal ectasia, periductal mastitis, and papilloma. Malignant pathologies that affect the nipple-areolar complex include Paget's disease of the breast, ductal carcinoma in-situ, and invasive ductal carcinoma. Clinical history and examination, imaging, and tissue sampling when appropriate are co-dependent factors that guide the assessment of nipple-areolar pathologies. This article provides a review of the normal anatomy, common anatomical variants, benign and malignant pathologies, and imaging techniques to guide the diagnostic assessment of the nipple-areolar complex.
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Affiliation(s)
- D Lyons
- Department of Radiology, University of Cincinnati Medical Center, 234 Goodman Street, ML 0772, Cincinnati, OH, 45219-0772, USA.
| | - R A Wahab
- Department of Radiology, University of Cincinnati Medical Center, 234 Goodman Street, ML 0772, Cincinnati, OH, 45219-0772, USA
| | - C Vijapura
- Department of Radiology, University of Cincinnati Medical Center, 234 Goodman Street, ML 0772, Cincinnati, OH, 45219-0772, USA
| | - M C Mahoney
- Department of Radiology, University of Cincinnati Medical Center, 234 Goodman Street, ML 0772, Cincinnati, OH, 45219-0772, USA
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5
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Onishi N, Sadinski M, Hughes MC, Ko ES, Gibbs P, Gallagher KM, Fung MM, Hunt TJ, Martinez DF, Shukla-Dave A, Morris EA, Sutton EJ. Ultrafast dynamic contrast-enhanced breast MRI may generate prognostic imaging markers of breast cancer. Breast Cancer Res 2020; 22:58. [PMID: 32466799 PMCID: PMC7254650 DOI: 10.1186/s13058-020-01292-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 05/10/2020] [Indexed: 01/17/2023] Open
Abstract
Background Ultrafast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI)-derived kinetic parameters have demonstrated at least equivalent accuracy to standard DCE-MRI in differentiating malignant from benign breast lesions. However, it is unclear if they have any efficacy as prognostic imaging markers. The aim of this study was to investigate the relationship between ultrafast DCE-MRI-derived kinetic parameters and breast cancer characteristics. Methods Consecutive breast MRI examinations between February 2017 and January 2018 were retrospectively reviewed to determine those examinations that meet the following inclusion criteria: (1) BI-RADS 4–6 MRI performed on a 3T scanner with a 16-channel breast coil and (2) a hybrid clinical protocol with 15 phases of ultrafast DCE-MRI (temporal resolution of 2.7–4.6 s) followed by early and delayed phases of standard DCE-MRI. The study included 125 examinations with 142 biopsy-proven breast cancer lesions. Ultrafast DCE-MRI-derived kinetic parameters (maximum slope [MS] and bolus arrival time [BAT]) were calculated for the entire volume of each lesion. Comparisons of these parameters between different cancer characteristics were made using generalized estimating equations, accounting for the presence of multiple lesions per patient. All comparisons were exploratory and adjustment for multiple comparisons was not performed; P values < 0.05 were considered statistically significant. Results Significantly larger MS and shorter BAT were observed for invasive carcinoma than ductal carcinoma in situ (DCIS) (P < 0.001 and P = 0.008, respectively). Significantly shorter BAT was observed for invasive carcinomas with more aggressive characteristics than those with less aggressive characteristics: grade 3 vs. grades 1–2 (P = 0.025), invasive ductal carcinoma vs. invasive lobular carcinoma (P = 0.002), and triple negative or HER2 type vs. luminal type (P < 0.001). Conclusions Ultrafast DCE-MRI-derived parameters showed a strong relationship with some breast cancer characteristics, especially histopathology and molecular subtype.
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Affiliation(s)
- Natsuko Onishi
- Breast Imaging Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Meredith Sadinski
- Breast Imaging Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mary C Hughes
- Breast Imaging Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Eun Sook Ko
- Breast Imaging Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Peter Gibbs
- Breast Imaging Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Katherine M Gallagher
- Breast Imaging Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Theodore J Hunt
- Breast Imaging Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Danny F Martinez
- Breast Imaging Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Amita Shukla-Dave
- Breast Imaging Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Elizabeth A Morris
- Breast Imaging Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Elizabeth J Sutton
- Breast Imaging Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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6
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van Nijnatten TJ, Jochelson MS, Pinker K, Keating DM, Sung JS, Morrow M, Smidt ML, Lobbes MB. Differences in degree of lesion enhancement on CEM between ILC and IDC. BJR Open 2019; 1:20180046. [PMID: 33178931 PMCID: PMC7592434 DOI: 10.1259/bjro.20180046] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 02/19/2019] [Accepted: 02/21/2019] [Indexed: 01/08/2023] Open
Abstract
Objective: To investigate differences in the degree of enhancement on contrast-enhanced mammography (CEM) between patients with invasive lobular (ILC) and infiltrating ductal carcinoma (IDC) not otherwise specified. Methods and materials: Between 2010 and 2017, all patients diagnosed with ILC and who underwent CEM were included for this dual center study. Twenty-two patients with IDC, matched by size, were identified for comparison. Three independent readers, blinded for histopathology results, re-evaluated all CEM exams to determine degree of lesion enhancement according to a previously defined scoring scale ranging from minimal to strong enhancement. Interobserver agreement among the three readers was calculated by quadratic weighted κ coefficient. Results: 44 patients were included: 22 patients with ILC and 22 patients with IDC. There were no significant differences in age, mean tumor size, tumor grade or receptor status between the two subgroups. Degree of lesion enhancement on CEM was more often considered weak in case of ILC compared to IDC according to two out of three readers (31.8% vs 4.5 %, p = 0.045 and 22.7 vs 4.5 %, p = 0.185). All other lesions showed moderate or strong enhancement. Interobserver agreement between the three independent readers was good (κ = 0.72). Conclusion: In patients with ILC, degree of lesion enhancement on CEM appears to be more often weak than in infiltrating ductal carcinoma not otherwise specified. Radiologists should be aware that weakly enhancing lesions may in fact be malignant and particularly invasive lobular cancers. Advances in knowledge: Three independent readers evaluated 44 CEM cases with ILC or IDC. Degree of lesion enhancement seems more often weak in case of ILC. Radiologists should be aware of ILC in case of weak CEM enhancement.
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Affiliation(s)
| | - Maxine S Jochelson
- Department of Radiology, Breast Imaging Service, Memorial Sloan-Kettering Cancer Center, New York, USA
| | | | - Delia M Keating
- Department of Radiology, Breast Imaging Service, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - Janice S Sung
- Department of Radiology, Breast Imaging Service, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - Monica Morrow
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, USA
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7
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Kousi E, Smith J, Ledger AE, Scurr E, Allen S, Wilson RM, O'Flynn E, Pope RJ, Leach MO, Schmidt MA. Quantitative evaluation of contrast agent uptake in standard fat-suppressed dynamic contrast-enhanced MRI examinations of the breast. Med Phys 2018; 45:287-296. [PMID: 29095484 PMCID: PMC5814859 DOI: 10.1002/mp.12652] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 10/24/2017] [Accepted: 10/24/2017] [Indexed: 12/24/2022] Open
Abstract
PURPOSE To propose a method to quantify T1 and contrast agent uptake in breast dynamic contrast-enhanced (DCE) examinations undertaken with standard clinical fat-suppressed MRI sequences and to demonstrate the proposed approach by comparing the enhancement characteristics of lobular and ductal carcinomas. METHODS A standard fat-suppressed DCE of the breast was performed at 1.5 T (Siemens Aera), followed by the acquisition of a proton density (PD)-weighted sequence, also fat suppressed. Both sequences were characterized with test objects (T1 ranging from 30 ms to 2,400 ms) and calibration curves were obtained to enable T1 calculation. The reproducibility and accuracy of the calibration curves were also investigated. Healthy volunteers and patients were scanned with Ethics Committee approval. The effect of B0 field inhomogeneity was assessed in test objects and healthy volunteers. The T1 of breast tumors was calculated at different time points (pre-, peak-, and post-contrast agent administration) for 20 patients, pre-treatment (10 lobular and 10 ductal carcinomas) and the two cancer types were compared (Wilcoxon rank-sum test). RESULTS The calibration curves proved to be highly reproducible (coefficient of variation under 10%). T1 measurements were affected by B0 field inhomogeneity, but frequency shifts below 50 Hz introduced only 3% change to fat-suppressed T1 measurements of breast parenchyma in volunteers. The values of T1 measured pre-, peak-, and post-contrast agent administration demonstrated that the dynamic range of the DCE sequence was correct, that is, image intensity is approximately directly proportional to 1/T1 for that range. Significant differences were identified in the width of the distributions of the post-contrast T1 values between lobular and ductal carcinomas (P < 0.05); lobular carcinomas demonstrated a wider range of post-contrast T1 values, potentially related to their infiltrative growth pattern. CONCLUSIONS This work has demonstrated the feasibility of fat-suppressed T1 measurements as a tool for clinical studies. The proposed quantitative approach is practical, enabled the detection of differences between lobular and invasive ductal carcinomas, and further enables the optimization of DCE protocols by tailoring the dynamic range of the sequence to the values of T1 measured.
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Affiliation(s)
- Evanthia Kousi
- CR‐UK and EPSRC Cancer Imaging CentreRoyal Marsden NHS Foundation TrustInstitute of Cancer ResearchSuttonSurreySM2 5PTUK
| | - Joely Smith
- Brighton and Sussex University Hospitals NHS TrustBrightonBN2 5BEUK
| | - Araminta E. Ledger
- CR‐UK and EPSRC Cancer Imaging CentreRoyal Marsden NHS Foundation TrustInstitute of Cancer ResearchSuttonSurreySM2 5PTUK
| | - Erica Scurr
- CR‐UK and EPSRC Cancer Imaging CentreRoyal Marsden NHS Foundation TrustInstitute of Cancer ResearchSuttonSurreySM2 5PTUK
| | - Steven Allen
- Department of RadiologyRoyal Marsden NHS Foundation TrustChelsea, LondonSW3 6JJUK
| | - Robin M. Wilson
- Department of RadiologyRoyal Marsden NHS Foundation TrustChelsea, LondonSW3 6JJUK
| | - Elizabeth O'Flynn
- CR‐UK and EPSRC Cancer Imaging CentreRoyal Marsden NHS Foundation TrustInstitute of Cancer ResearchSuttonSurreySM2 5PTUK
| | - Romney J.E. Pope
- Department of RadiologyRoyal Marsden NHS Foundation TrustChelsea, LondonSW3 6JJUK
| | - Martin O. Leach
- CR‐UK and EPSRC Cancer Imaging CentreRoyal Marsden NHS Foundation TrustInstitute of Cancer ResearchSuttonSurreySM2 5PTUK
| | - Maria A. Schmidt
- CR‐UK and EPSRC Cancer Imaging CentreRoyal Marsden NHS Foundation TrustInstitute of Cancer ResearchSuttonSurreySM2 5PTUK
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Dratwa C, Sebbag-Sfez D, Thibault F. IRM du sein dans le carcinome lobulaire infiltrant : aspects diagnostiques, bilan préthérapeutique, évaluation sous hormono- ou chimio-néo-adjuvante. IMAGERIE DE LA FEMME 2017. [DOI: 10.1016/j.femme.2017.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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9
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Pinker K, Baltzer P, Bogner W, Leithner D, Trattnig S, Zaric O, Dubsky P, Bago-Horvath Z, Rudas M, Gruber S, Weber M, Helbich TH. Multiparametric MR Imaging with High-Resolution Dynamic Contrast-enhanced and Diffusion-weighted Imaging at 7 T Improves the Assessment of Breast Tumors: A Feasibility Study. Radiology 2015; 276:360-70. [DOI: 10.1148/radiol.15141905] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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10
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Gubern-Mérida A, Martí R, Melendez J, Hauth JL, Mann RM, Karssemeijer N, Platel B. Automated localization of breast cancer in DCE-MRI. Med Image Anal 2015; 20:265-74. [DOI: 10.1016/j.media.2014.12.001] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 10/24/2014] [Accepted: 12/01/2014] [Indexed: 11/26/2022]
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A Novel Approach to Contrast-Enhanced Breast Magnetic Resonance Imaging for Screening. Invest Radiol 2014; 49:579-85. [DOI: 10.1097/rli.0000000000000057] [Citation(s) in RCA: 135] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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12
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Yamaguchi K, Abe H, Newstead GM, Egashira R, Nakazono T, Imaizumi T, Irie H. Intratumoral heterogeneity of the distribution of kinetic parameters in breast cancer: comparison based on the molecular subtypes of invasive breast cancer. Breast Cancer 2014; 22:496-502. [PMID: 24402638 DOI: 10.1007/s12282-013-0512-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 12/18/2013] [Indexed: 12/14/2022]
Abstract
PURPOSE To evaluate the distribution pattern of kinetic parameters in breast cancers with various molecular subtypes. MATERIALS AND METHODS This study was approved by institutional review board and was compliant with HIPAA. We classified 192 invasive breast cancers of 186 patients into four molecular subtypes using hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) results and evaluated the distribution pattern of kinetic parameters (percent volume of kinetic types relative to the tumor volume) in the molecular subtypes. RESULTS In the delayed phase, all three types of kinetic parameter (persistent, plateau, and washout pattern) were observed in each molecular subtype without any dominant type of kinetic parameter. The percentages of washout pattern in the HR+ and HER2- type and triple negative (TN) cancers tended to be lower than those in the other molecular subtype cancers. CONCLUSION Each molecular subtype of invasive breast cancer showed a heterogeneous kinetic pattern in dynamic-contrast magnetic resonance imaging (MRI). The HR+/HER2- cancers and the TN cancers had relatively lower percentages of washout pattern. When a manual assessment of the kinetic parameters is performed, close attention should be paid in order to identify the malignant washout kinetic pattern, particularly in HR+/HER2- cancer and TN cancer.
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Affiliation(s)
- Ken Yamaguchi
- Department of Radiology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan,
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13
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Clinical application of bilateral high temporal and spatial resolution dynamic contrast-enhanced magnetic resonance imaging of the breast at 7 T. Eur Radiol 2013; 24:913-20. [DOI: 10.1007/s00330-013-3075-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 10/11/2013] [Accepted: 11/03/2013] [Indexed: 12/18/2022]
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14
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Menezes GL, van den Bosch MA, Postma EL, El Sharouni MA, Verkooijen HM, van Diest PJ, Pijnappel RM. Invasive ductolobular carcinoma of the breast: spectrum of mammographic, ultrasound and magnetic resonance imaging findings correlated with proportion of the lobular component. SPRINGERPLUS 2013; 2:621. [PMID: 24340243 PMCID: PMC3858590 DOI: 10.1186/2193-1801-2-621] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Accepted: 10/21/2013] [Indexed: 12/24/2022]
Abstract
Purpose The aim of this study was to describe the imaging features of patients with invasive ductolobular carcinoma of the breast in comparison with the proportion of the lobular component. Materials and methods We retrospectively reviewed mammographic, sonographic and MRI records of 113 patients with proven ductolobular carcinoma diagnosed between January 2008 and October 2012 according to the BI-RADS ® lexicon, and correlated these to the proportion of the lobular component. Results At mammography the most common finding (62.9%) for invasive ductolobular carcinoma was an irregular, spiculated and isodense mass. On ultrasound an irregular and hypoechoic mass, with spiculated margins and posterior acoustic shadowing was observed in 46.8% of cases. Isolated mass and mass associated with non-mass like enhancement (NMLE) were the most common findings by MRI (89.4%). Washout pattern in delayed phase was seen in 61.2% and plateau curve was more frequently observed in patients with larger lobular component. Additional malignant findings (multifocality, multicentricity and contralateral disease) did not correlate significantly with the proportion of the lobular component. Conclusion Invasive ductolobular carcinoma mainly presents as an irregular, spiculated mass, isodense on mammography and hypoechoic with posterior acoustic shadowing. On MRI it is usually seen as an isolated mass or as a dominant mass surrounded by smaller masses or NMLE. Washout is the most ordinary kinetic pattern of these tumors. In general, the imaging characteristics did not vary significantly with the proportion of the lobular component.
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Affiliation(s)
- Gisela Lg Menezes
- Department of Imaging, University Medical Centre Utrecht, E01.132, P.O. Box 85500, 3508, GA Utrecht, The Netherlands
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15
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Jung HN, Shin JH, Han BK, Ko EY, Cho EY. Are the imaging features of the pleomorphic variant of invasive lobular carcinoma different from classic ILC of the breast? Breast 2012; 22:324-9. [PMID: 22901443 DOI: 10.1016/j.breast.2012.07.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Revised: 07/13/2012] [Accepted: 07/30/2012] [Indexed: 12/16/2022] Open
Abstract
The aim of this study was to evaluate whether pleomorphic invasive lobular carcinoma (PILC) is different from classic invasive lobular carcinoma (CILC) in terms of radiologic and clinicopathologic features. We compared the radiologic and clinicopathologic features of 22 surgically confirmed PILCs in 21 patients from 2004 to 2009 and 47 CILCs from 47 consecutive patients. For all cases, we reviewed the imaging findings, medical records and pathological results. PILC had a higher T stage, N stage, nuclear and histologic grade compared to CILC. PILC was more commonly negative for estrogen receptors and positive for HER2 than CILC (all p < 0.05). However, there were no significant differences in age, symptoms, tumor size, extensive intraductal component, lymphovascular invasion, triple negative profile, or multiplicity between the two groups. PILC was not detected on mammography in 1 (4.5%) of 22 cases, whereas CILC was not detected on mammography in 7 (14.9%) of 47 cases and on MRI in 2 (5.0%) of 40 (p = 0.42 and p = 1.000, respectively). MRI identified more frequent multiplicity than mammography for both PILC and CILC (p < 0.001), but was similar to US (p = 0.066). Most lesions showed a spiculated mass or architectural distortion with or without calcifications on mammography and ultrasound. No differences in mass and/or non-mass lesions or kinetics on MRI were observed between the two groups. PILC shows more pathologically aggressive features, but cannot be differentiated from CILC based on imaging findings.
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Affiliation(s)
- Hye Na Jung
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, Republic of Korea
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