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Mohan SL, Dhamija E, Gauba R. Approach to Nonmass Lesions on Breast Ultrasound. Indian J Radiol Imaging 2024; 34:677-687. [PMID: 39318554 PMCID: PMC11419763 DOI: 10.1055/s-0044-1779589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2024] Open
Abstract
Nonmass lesions in breast ultrasound (US) are areas of altered echogenicity without definite margins or mass effect. However, these lesions may show calcifications, associated architectural distortion, or shadowing just like masses. They vary in their echogenicity, distribution, ductal or nonductal appearance and the associated features that can be seen in variety of benign and malignant pathologies. With no uniform definition or classification system, there is no standardized approach in further risk categorization and management strategies of these lesions. Malignant nonmass lesions are not uncommon and few sonographic features can help in differentiating benign and malignant pathologies. US-guided tissue sampling or lesion localization can be preferred in the nonmass lesions identified on second look US after magnetic resonance imaging or mammography. This article aims to describe various imaging patterns and attempts to provide an algorithmic approach to nonmass findings on breast US.
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Affiliation(s)
- Supraja Laguduva Mohan
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Ekta Dhamija
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Richa Gauba
- Department of Radiodiagnosis, National Cancer Institute - All India Institute of Medical Sciences, Jhajjar, Haryana, India
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2
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Esmaeil NK, Salih AM. Investigation of multi-infections and breast disease comorbidities in granulomatous mastitis. Ann Med Surg (Lond) 2024; 86:1881-1886. [PMID: 38576970 PMCID: PMC10990350 DOI: 10.1097/ms9.0000000000001636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 12/08/2023] [Indexed: 04/06/2024] Open
Abstract
Introduction Granulomatous mastitis (GM) is an inflammatory breast disease typically caused by infection, posing diagnostic challenges. It can coexist with other breast disorders or multiple infections, which have been vaguely discussed. This study investigates the incidence of multi-infection and breast disease comorbidities in GM. Method The study enroled 63 females who had a confirmed diagnosis of GM. Laboratory investigations and bacterial cultures had been conducted for all the cases. The patients had undergone ultrasonography examination utilizing the LOGIQ E9 system. Core needle biopsy had been done to procure tissue samples for histopathological examination. Thorough scrutiny and assessment of patients' records were performed. The variables encompassed age at presentation, breastfeeding data, parity, smoking status, seasonal affliction, hair-washing agents, exposure to radiation, comorbidities, and clinical, ultrasound and histopathological findings. Results The patients' ages ranged from 24 to 50. Breastfeeding history was positive in nearly all cases (97%). The majority of cases exhibited multiparity (81%). In total, 63.5% were passive smokers. Multi-infections were detected in six cases (9.5%). Among them, B. cepacia complex and Toxoplasma gondii were identified in two cases (3.16%). Other multi-infections involved Staphylococcus epidermidis and Toxoplasma gondii, Burkholderia cepacia and S. kloosii and Toxoplasma gondii, Staphylococcus epidermis and Brucella spp., Candida spp. and Brucella spp. Histopathological analysis revealed GM comorbidities with other breast diseases in 35% of the cases. Conclusion Multi-infections and breast disease comorbidities may further complicate diagnosis and management of GM. The findings of this study may raise additional questions about the nature of the disease or potential complications associated with it.
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Affiliation(s)
- Nawzad Kh. Esmaeil
- Community Health Department, College of Health and Medical Technology, Sulaimani Polytechnic University
- Department of Medical Laboratory Technology, Kalar Technical College, Kalar Polytechnic University
| | - Abdulwahid M. Salih
- Smart Health Tower
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan Region, Iraq
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Ma Q, Lu X, Qin X, Xu X, Fan M, Duan Y, Tu Z, Zhu J, Wang J, Zhang C. A sonogram radiomics model for differentiating granulomatous lobular mastitis from invasive breast cancer: a multicenter study. LA RADIOLOGIA MEDICA 2023; 128:1206-1216. [PMID: 37597127 DOI: 10.1007/s11547-023-01694-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/28/2023] [Indexed: 08/21/2023]
Abstract
PURPOSE To construct a nomogram based on sonogram features and radiomics features to differentiate granulomatous lobular mastitis (GLM) from invasive breast cancer (IBC). MATERIALS AND METHODS A retrospective collection of 213 GLMs and 472 IBCs from three centers was divided into a training set, an internal validation set, and an external validation set. A radiomics model was built based on radiomics features, and the RAD score of the lesion was calculated. The sonogram radiomics model was constructed using ultrasound features and RAD scores. Finally, the diagnostic efficacy of the three sonographers with different levels of experience before and after combining the RAD score was assessed in the external validation set. RESULTS The RAD score, lesion diameter, orientation, echogenicity, and tubular extension showed significant differences in GLM and IBC (p < 0.05). The sonogram radiomics model based on these factors achieved optimal performance, and its area under the curve (AUC) was 0.907, 0.872, and 0.888 in the training, internal, and external validation sets, respectively. The AUCs before and after combining the RAD scores were 0.714, 0.750, and 0.830 and 0.834, 0.853, and 0.878, respectively, for sonographers with different levels of experience. The diagnostic efficacy was comparable for all sonographers when combined with the RAD score (p > 0.05). CONCLUSION Radiomics features effectively enhance the ability of sonographers to discriminate between GLM and IBC and reduce interobserver variation. The nomogram combining ultrasound features and radiomics features show promising diagnostic efficacy and can be used to identify GLM and IBC in a noninvasive approach.
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Affiliation(s)
- Qianqing Ma
- Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, No.218 Jixi Road, Shushan District, Hefei, 230022, Anhui, China
| | - Xiaofeng Lu
- Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, No.218 Jixi Road, Shushan District, Hefei, 230022, Anhui, China
| | - Xiachuan Qin
- Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, No.218 Jixi Road, Shushan District, Hefei, 230022, Anhui, China
- Department of Ultrasound, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College (University Nan Chong), Sichuan, China
| | - Xiangyi Xu
- Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, No.218 Jixi Road, Shushan District, Hefei, 230022, Anhui, China
| | - Min Fan
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yayang Duan
- Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, No.218 Jixi Road, Shushan District, Hefei, 230022, Anhui, China
| | - Zhengzheng Tu
- Anhui Provincial Key Laboratory of Multimodal Cognitive Computation, School of Computer Science and Technology, Anhui University, Hefei, China
| | - Jianhui Zhu
- Anhui Provincial Key Laboratory of Multimodal Cognitive Computation, School of Computer Science and Technology, Anhui University, Hefei, China
| | - Junli Wang
- Department of Ultrasound, The Second People's Hospital of Wuhu, No.259 Jiuhuashan Road, Jinghu District, Wuhu, 241001, Anhui, China.
| | - Chaoxue Zhang
- Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, No.218 Jixi Road, Shushan District, Hefei, 230022, Anhui, China.
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4
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Yuan QQ, Xiao SX, Farouk O, Du YT, Sheybani F, Tan QT, Akbulut S, Cetin K, Alikhassi A, Yaghan RJ, Durur-Subasi I, Altintoprak F, Eom TI, Alper F, Hasbahceci M, Martínez-Ramos D, Oztekin PS, Kwong A, Pluguez-Turull CW, Brownson KE, Chandanwale S, Habibi M, Lan LY, Zhou R, Zeng XT, Bai J, Bai JW, Chen QR, Chen X, Zha XM, Dai WJ, Dai ZJ, Feng QY, Gao QJ, Gao RF, Han BS, Hou JX, Hou W, Liao HY, Luo H, Liu ZR, Lu JH, Luo B, Ma XP, Qian J, Qin JY, Wei W, Wei G, Xu LY, Xue HC, Yang HW, Yang WG, Zhang CJ, Zhang F, Zhang GX, Zhang SK, Zhang SQ, Zhang YQ, Zhang YP, Zhang SC, Zhao DW, Zheng XM, Zheng LW, Xu GR, Zhou WB, Wu GS. Management of granulomatous lobular mastitis: an international multidisciplinary consensus (2021 edition). Mil Med Res 2022; 9:20. [PMID: 35473758 PMCID: PMC9040252 DOI: 10.1186/s40779-022-00380-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 04/07/2022] [Indexed: 02/07/2023] Open
Abstract
Granulomatous lobular mastitis (GLM) is a rare and chronic benign inflammatory disease of the breast. Difficulties exist in the management of GLM for many front-line surgeons and medical specialists who care for patients with inflammatory disorders of the breast. This consensus is summarized to establish evidence-based recommendations for the management of GLM. Literature was reviewed using PubMed from January 1, 1971 to July 31, 2020. Sixty-six international experienced multidisciplinary experts from 11 countries or regions were invited to review the evidence. Levels of evidence were determined using the American College of Physicians grading system, and recommendations were discussed until consensus. Experts discussed and concluded 30 recommendations on historical definitions, etiology and predisposing factors, diagnosis criteria, treatment, clinical stages, relapse and recurrence of GLM. GLM was recommended as a widely accepted definition. In addition, this consensus introduced a new clinical stages and management algorithm for GLM to provide individual treatment strategies. In conclusion, diagnosis of GLM depends on a combination of history, clinical manifestations, imaging examinations, laboratory examinations and pathology. The approach to treatment of GLM should be applied according to the different clinical stage of GLM. This evidence-based consensus would be valuable to assist front-line surgeons and medical specialists in the optimal management of GLM.
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Affiliation(s)
- Qian-Qian Yuan
- Department of Thyroid and Breast Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
| | - Shu-Xuan Xiao
- Department of Pathology, University of Chicago Pritzker School of Medicine, Chicago, IL 60637 USA
| | - Omar Farouk
- Department of Surgical Oncology and Breast Surgery, Oncology Center, Faculty of Medicine, Mansoura University, Mansoura, 35516 Egypt
| | - Yu-Tang Du
- Department of Breast Surgery, Beijing University of Chinese Medicine, Beijing, 100700 China
| | - Fereshte Sheybani
- Department of Infectious Diseases and Tropical Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, 9177899191 Iran
| | - Qing Ting Tan
- Breast Department, KK Women’s and Children’s Hospital, 100 Bukit Timah Road, Singapore, 229899 Singapore
| | - Sami Akbulut
- Department of Surgery, Department of Public Health, Department of Biostatistics, Bioinformatics and Medical Informatics, Inonu University Faculty of Medicine, 44280 Malatya, Turkey
| | - Kenan Cetin
- Department of General Surgery, Faculty of Medicine, Çanakkale Onsekiz Mart University, 17020 Çanakkale, Turkey
| | - Afsaneh Alikhassi
- Department of Radiology, Cancer Institute, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, 1419733141 Iran
| | - Rami Jalal Yaghan
- Department of Surgery, College of Medicine and Medical Sciences, Arabian Gulf University-Bahrain, Manama, 26671 Bahrain
| | - Irmak Durur-Subasi
- Department of Radiology, International Faculty of Medicine, Istanbul Medipol University, 34810 Istanbul, Turkey
| | - Fatih Altintoprak
- Department of General Surgery, Faculty of Medicine, Sakarya University, 54050 Sakarya, Turkey
| | - Tae Ik Eom
- Department of Surgery, HiU Clinic, 170, Gwongwang-ro, Paldal-gu, Suwon, 16488 Korea
| | - Fatih Alper
- Department of Radiology, Faculty of Medicine, Ataturk University, 25240 Erzurum, Turkey
| | - Mustafa Hasbahceci
- Academic Support and Education Center, Hırkai Serif District, Kececi Cesmesi Str, Doktorlar Building, B/7, 34091 Istanbul, Turkey
| | - David Martínez-Ramos
- Department of General and Digestive Surgery, Hospital General Castellon, Avda Benicassim S/N, 12812004 Castellón, Spain
| | - Pelin Seher Oztekin
- Radiology Department, Ankara Training and Research Hospital, 305018 Ankara, Turkey
| | - Ava Kwong
- Department of Surgery, The University of Hong Kong, China; The University of Hong Kong-Shenzhen Hospital, Shenzhen, 518053 China
| | - Cedric W. Pluguez-Turull
- University of Miami Health System and Miller School of Medicine, 1475 NW 12th Avenue, Miami, FL 33136 USA
| | - Kirstyn E. Brownson
- Department of Surgery, University of Utah, Huntsman Cancer Institute, Salt Lake City, UT 84112 USA
| | - Shirish Chandanwale
- Department of Pathology, Dr D Y Patil Medical College Hospital and Research Centre, Pimpri, Pune, 603203 India
| | - Mehran Habibi
- Department of Surgery, Johns Hopkins Breast Center at Bayview Campus, 4940 Eastern Avenue, Rm. A-562, Baltimore, MD 21224 USA
| | - Liu-Yi Lan
- Department of Thyroid and Breast Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
| | - Rui Zhou
- Department of Thyroid and Breast Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
| | - Xian-Tao Zeng
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
| | - Jiao Bai
- Department of Diagnostic Ultrasound, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
| | - Jun-Wen Bai
- Department of Surgery, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010110 China
| | - Qiong-Rong Chen
- Center for Pathology and Molecular Diagnostics, Wuhan University, Wuhan, 430071 China
| | - Xing Chen
- Department of General Surgery, Fujian Provincial Hospital, Fuzhou, 350001 China
| | - Xiao-Ming Zha
- The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029 China
| | - Wen-Jie Dai
- Key Laboratory of Hepatosplenic Surgery and the First Department of General Surgery, First Affiliated Hospital of Harbin Medical University, Harbin, 150007 China
| | - Zhi-Jun Dai
- Department of Breast Surgery, Zhejiang University School of Medicine First Affiliated Hospital, Hangzhou, 310003 China
| | - Qin-Yu Feng
- Department of Thyroid and Breast Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
| | - Qing-Jun Gao
- Department of General Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550004 China
| | - Run-Fang Gao
- Department of General Surgery, Shanxi Provincial People’s Hospital, Taiyuan, 030012 China
| | - Bao-San Han
- Department of Breast Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200092 China
| | - Jin-Xuan Hou
- Department of Thyroid and Breast Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
| | - Wei Hou
- Department of Cardiothoracic Surgery, Zaoyang People’s Hospital, Zaoyang, 441299 Hubei China
| | - Hai-Ying Liao
- Department of Thyroid and Breast Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, 050004 China
| | - Hong Luo
- Department of General Surgery, Guangshan County People’s Hospital, Guangshan County, Xinxiang, 465499 Henan China
| | - Zheng-Ren Liu
- Department of Breast Surgery, First Affiliated Hospital of Nanchang University, Nanchang, 330006 China
| | - Jing-Hua Lu
- Chinese Academy of Sciences, Beijing, 100045 China
| | - Bin Luo
- Department of General Surgery, School of Clinical Medicine, Tsinghua University, Beijing Tsinghua Changgung Hospital, Beijing, 102218 China
| | - Xiao-Peng Ma
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Hospital, Hefei, 230001 China
| | - Jun Qian
- Department of Thyroid Surgery, First Affiliated Hospital of Kunming Medical University, Kunming, 650032 China
| | - Jian-Yong Qin
- Department of Oncology, Liwan Central Hospital of Guangzhou, Guangzhou, 510150 China
| | - Wei Wei
- Department of Breast Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036 Guangdong China
| | - Gang Wei
- Department of Thyroid and Breast Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
| | - Li-Ying Xu
- Department of Computed Tomography, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
| | - Hui-Chao Xue
- Department of General Surgery, Xinxiang Medical University First Affiliated Hospital, Xinxiang, 453100 Henan China
| | - Hua-Wei Yang
- Department of Breast Surgery, Guangxi Medical University Cancer Hospital, Nanning, 530021 China
| | - Wei-Ge Yang
- Department of General Surgery, Zhongshan Hospital Fudan University, Shanghai, 200032 China
| | - Chao-Jie Zhang
- Department of Breast and Thyroid Surgery, Hunan Provincial People’s Hospital/The First Affiliated Hospital of Hunan Normal University, Changsha, 410005 China
| | - Fan Zhang
- Department of Breast and Thyroid Surgery, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing, 400013 China
| | - Guan-Xin Zhang
- Department of General Surgery, Qinghai Province People’s Hospital, Xining, 810007 China
| | - Shao-Kun Zhang
- Department of Thyroid and Breast Surgery, Qingdao Women and Children’s Hospital, Qingdao, 266000 Shandong China
| | - Shu-Qun Zhang
- Department of Oncology, Xi’an Jiaotong University Second Affiliated Hospital, Xi’an, 710004 China
| | - Ye-Qiang Zhang
- Department of Cardiothoracic Surgery, Zaoyang First People’s Hospital, Zaoyang, 441299 Hubei China
| | - Yue-Peng Zhang
- Department of Diagnostic Ultrasound, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
| | - Sheng-Chu Zhang
- Department of Thyroid and Breast Surgery, Yichang Central People’s Hospital, Yichang, 443003 Hubei China
| | - Dai-Wei Zhao
- Department of Thyroid Surgery, The Second Affiliated Hospital, Guizhou Medical University, Kaili, 556000 Guizhou China
| | - Xiang-Min Zheng
- Department of General Surgery, Shanghai Changzheng Hospital, Shanghai, 200003 China
| | - Le-Wei Zheng
- Department of Thyroid and Breast Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
| | - Gao-Ran Xu
- Department of Thyroid and Breast Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
| | - Wen-Bo Zhou
- Department of Surgery, Dongfeng General Hospital Affiliated with Hubei Medical College, Shiyan, 442001 Hubei China
| | - Gao-Song Wu
- Department of Thyroid and Breast Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
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5
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Toprak N, Toktas O, Ince S, Gunduz AM, Yokus A, Akdeniz H, Ozkacmaz S. Does ARFI elastography complement B-mode ultrasonography in the radiological diagnosis of idiopathic granulomatous mastitis and invasive ductal carcinoma? Acta Radiol 2022; 63:28-34. [PMID: 33377394 DOI: 10.1177/0284185120983568] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Idiopathic granulomatous mastitis (IGM) is a chronic, unpleasant autoimmune inflammatory condition and is clinically and radiologically often confused with breast malignancy. PURPOSE To investigate the contributions of qualitative and quantitative aspects of acoustic radiation force impulse (ARFI) elastography to the differential diagnosis between IGM and invasive ductal carcinoma (IDC) in the breast. MATERIAL AND METHODS Ninety-four women with IDC and 39 with IGM were included in the study. Shear wave velocity (SWV) was calculated for all lesions using quantitative elastography. Next, each lesion's correspondence on qualitative elastographic images to those on the B-mode images was evaluated: pattern 1, no findings on elastography images; pattern 2, lesions that were bright inside; pattern 3, lesions that contained both bright and dark areas; and pattern 4, lesions that were dark inside. Pattern 4 was subdivided into 4a (dark area same size as lesion) and 4b (dark area larger than lesion size). Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were calculated. RESULTS The mean SWV based on ARFI elastography was 3.78 ± 1.26 m/s for IGM and 5.34 ± 1.43 m/s for IDC lesions (P < 0.05). Based on qualitative ARFI elastography, IDC lesions were mostly classified as pattern 4b, while IGM lesions were mostly classified as pattern 1 or 2 (P = 0.01). Evaluation of both the qualitative and quantitative aspects of ARFI elastography yielded a sensitivity of 89% and specificity of 84%. CONCLUSION ARFI elastography may facilitate the differential diagnosis between IGM and IDC.
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Affiliation(s)
- Nurşen Toprak
- Department of Radiology, Medical Faculty of Yüzüncü Yıl University, Van, Turkey
| | - Osman Toktas
- Department of General Surgery, Medical Faculty of Yüzüncü Yıl University, Van, Turkey
| | - Suat Ince
- Department of Radiology, Medical Faculty of Yüzüncü Yıl University, Van, Turkey
| | - Ali Mahir Gunduz
- Department of Radiology, Medical Faculty of Yüzüncü Yıl University, Van, Turkey
| | - Adem Yokus
- Department of Radiology, Medical Faculty of Yüzüncü Yıl University, Van, Turkey
| | - Hüseyin Akdeniz
- Department of Radiology, Medical Faculty of Yüzüncü Yıl University, Van, Turkey
| | - Sercan Ozkacmaz
- Department of Radiology, Medical Faculty of Yüzüncü Yıl University, Van, Turkey
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Meraj T, Alosaimi W, Alouffi B, Rauf HT, Kumar SA, Damaševičius R, Alyami H. A quantization assisted U-Net study with ICA and deep features fusion for breast cancer identification using ultrasonic data. PeerJ Comput Sci 2021; 7:e805. [PMID: 35036531 PMCID: PMC8725669 DOI: 10.7717/peerj-cs.805] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/12/2021] [Indexed: 06/14/2023]
Abstract
Breast cancer is one of the leading causes of death in women worldwide-the rapid increase in breast cancer has brought about more accessible diagnosis resources. The ultrasonic breast cancer modality for diagnosis is relatively cost-effective and valuable. Lesion isolation in ultrasonic images is a challenging task due to its robustness and intensity similarity. Accurate detection of breast lesions using ultrasonic breast cancer images can reduce death rates. In this research, a quantization-assisted U-Net approach for segmentation of breast lesions is proposed. It contains two step for segmentation: (1) U-Net and (2) quantization. The quantization assists to U-Net-based segmentation in order to isolate exact lesion areas from sonography images. The Independent Component Analysis (ICA) method then uses the isolated lesions to extract features and are then fused with deep automatic features. Public ultrasonic-modality-based datasets such as the Breast Ultrasound Images Dataset (BUSI) and the Open Access Database of Raw Ultrasonic Signals (OASBUD) are used for evaluation comparison. The OASBUD data extracted the same features. However, classification was done after feature regularization using the lasso method. The obtained results allow us to propose a computer-aided design (CAD) system for breast cancer identification using ultrasonic modalities.
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Affiliation(s)
- Talha Meraj
- Department of Computer Science, COMSATS University Islamabad-Wah Campus, Wah Cantt, Pakistan
| | - Wael Alosaimi
- Department of Information Technology, College of Computers and Information Technology, Taif University, Taif, Saudi Arabia
| | - Bader Alouffi
- Department of Computer Science, College of Computers and Information Technology, Taif University, Taif, Saudi Arabia
| | - Hafiz Tayyab Rauf
- Department of Computer Science, Faculty of Engineering & Informatics, University of Bradford, Bradford, United Kingdom
| | - Swarn Avinash Kumar
- Department of Information Technology, Indian Institute of Information Technology, Uttar Pradesh, Jhalwa, Prayagraj, India
| | | | - Hashem Alyami
- Department of Computer Science, College of Computers and Information Technology, Taif University, Taif, Saudi Arabia
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7
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Ilesanmi AE, Chaumrattanakul U, Makhanov SS. Methods for the segmentation and classification of breast ultrasound images: a review. J Ultrasound 2021; 24:367-382. [PMID: 33428123 PMCID: PMC8572242 DOI: 10.1007/s40477-020-00557-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 12/21/2020] [Indexed: 02/07/2023] Open
Abstract
PURPOSE Breast ultrasound (BUS) is one of the imaging modalities for the diagnosis and treatment of breast cancer. However, the segmentation and classification of BUS images is a challenging task. In recent years, several methods for segmenting and classifying BUS images have been studied. These methods use BUS datasets for evaluation. In addition, semantic segmentation algorithms have gained prominence for segmenting medical images. METHODS In this paper, we examined different methods for segmenting and classifying BUS images. Popular datasets used to evaluate BUS images and semantic segmentation algorithms were examined. Several segmentation and classification papers were selected for analysis and review. Both conventional and semantic methods for BUS segmentation were reviewed. RESULTS Commonly used methods for BUS segmentation were depicted in a graphical representation, while other conventional methods for segmentation were equally elucidated. CONCLUSIONS We presented a review of the segmentation and classification methods for tumours detected in BUS images. This review paper selected old and recent studies on segmenting and classifying tumours in BUS images.
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Affiliation(s)
- Ademola E. Ilesanmi
- School of ICT, Sirindhorn International Institute of Technology, Thammasat University, Pathum Thani, 12000 Thailand
| | | | - Stanislav S. Makhanov
- School of ICT, Sirindhorn International Institute of Technology, Thammasat University, Pathum Thani, 12000 Thailand
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8
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Radiologic Features of Idiopathic Granulomatous Mastitis and Emphasis on Analysis of Socioeconomic Status: Over 5 Years of Experience. Indian J Surg 2021. [DOI: 10.1007/s12262-021-03138-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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9
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Smith E, Moore DA, Jordan SG. You'll see it when you know it: granulomatous mastitis. Emerg Radiol 2021; 28:1213-1223. [PMID: 34292441 DOI: 10.1007/s10140-021-01931-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 04/07/2021] [Indexed: 01/24/2023]
Abstract
Granulomatous mastitis (GM) is an under-recognized and under-diagnosed disease. Patients with GM often present to the emergency room with a painful breast mass, nipple retraction, and skin changes. This pictorial essay will review the clinical presentation and imaging appearance of GM, BI-RADS reporting parameters, differential diagnoses, and diagnostic challenges posed by this disease. Early and accurate diagnosis is essential, as misdiagnosis can result in repeated core biopsies, leading to fistulae and sinus tract formation. A classic history and typical sonographic appearance allow the emergency radiologist to confidently make this diagnosis.
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Affiliation(s)
- Elana Smith
- Department of Radiology, University of Maryland Medical Center, 22 S. Greene St., Baltimore, MD, 21201, USA.
| | - Dan A Moore
- University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Sheryl G Jordan
- Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
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De Cataldo C, Bruno F, Palumbo P, Di Sibio A, Arrigoni F, Clemente A, Bafile A, Gravina GL, Cappabianca S, Barile A, Splendiani A, Masciocchi C, Di Cesare E. Apparent diffusion coefficient magnetic resonance imaging (ADC-MRI) in the axillary breast cancer lymph node metastasis detection: a narrative review. Gland Surg 2021; 9:2225-2234. [PMID: 33447575 DOI: 10.21037/gs-20-546] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The presence of axillary lymph nodes metastases in breast cancer is the most significant prognostic factor, with a great impact on morbidity, disease-related survival and management of oncological therapies; for this reason, adequate imaging evaluation is strictly necessary. Physical examination is not enough sensitive to assess breast cancer nodal status; axillary ultrasonography (US) is commonly used to detect suspected or occult nodal metastasis, providing exclusively morphological evaluation, with low sensitivity and positive predictive value. Currently, sentinel lymph node biopsy (SLNB) and/or axillary dissection are the milestone for the diagnostic assessment of axillary lymph node metastases, although its related morbidity. The impact of magnetic resonance imaging (MRI) in the detection of nodal metastases has been widely investigated, as it continues to represent the most promising imaging modality in the breast cancer management. In particular, diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) values represent additional reliable non-contrast sequences, able to improve the diagnostic accuracy of breast cancer MRI evaluation. Several studies largely demonstrated the usefulness of implementing DWI/ADC MRI in the characterization of breast lesions. Herein, in the light of our clinical experience, we perform a review of the literature regarding the diagnostic performance and accuracy of ADC value as potential pre-operative tool to define metastatic involvement of nodal structures in breast cancer patients. For the purpose of this review, PubMed, Web of Science, and SCOPUS electronic databases were searched with different combinations of "axillary lymph node", "breast cancer", "MRI/ADC", "breast MRI" keywords. All original articles, reviews and metanalyses were included.
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Affiliation(s)
- Camilla De Cataldo
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Federico Bruno
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Pierpaolo Palumbo
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | | | - Francesco Arrigoni
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Alfredo Clemente
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | | | - Giovanni Luca Gravina
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Salvatore Cappabianca
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Antonio Barile
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Alessandra Splendiani
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Carlo Masciocchi
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Ernesto Di Cesare
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
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Diagnostic performance of shear wave elastography in discriminating malignant and benign breast lesions : Our experience with QelaXtoTM software. J Ultrasound 2020; 23:575-583. [PMID: 32529557 DOI: 10.1007/s40477-020-00481-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 05/14/2020] [Indexed: 12/17/2022] Open
Abstract
STUDY AIMS We sought to evaluate the diagnostic performance of quantitative elastography (shear wave elastography) and to establish the optimal cutoff value to differentiate malignant and benign breast lesions using QelaXtoTM software. METHODS We conducted a retrospective observational study of adult women with suspicious breast lesions (BIRADS 3, 4 or 5) who underwent programmed ultrasound-guided core biopsies. Breast lesions were assessed using quantitative elastography combined with B-mode ultrasound. Histopathology was used as reference standard. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were estimated, and a ROC curve analysis was conducted. Three elastography cutoff values were considered: 36, 50 and 80 kPa. RESULTS We included 143 women (mean age of 56 years) with a total of 145 breast lesions: 68 benign tumors (47.26%) and 77 malignancies (52.74%). Mean elasticity measurements of benign and malignant lesions were significantly different (24.6 kPa, SD 28.47, vs. 101.49 kPa, SD 47.38, [Formula: see text]). Using the 50 kPa cutoff, elastography showed a global sensitivity of 87% to discriminate malignant lesions (AUC = 0.897). Moreover, sensitivity was 90.7% when lesions were located 5-40 mm below the skin surface (optimal elastographic field of view). Our false positive rate was 17.65%, comprised mainly of fibroepithelial neoplasms, fibroadenomas and fibrosis. CONCLUSIONS Quantitative elastography can differentiate malignant and benign breast lesions with acceptable to excellent performance. In our sample, the QelaXtoTM software showed a lower optimal cutoff than other ultrasound systems.
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Bartolotta TV, Orlando AAM, Spatafora L, Dimarco M, Gagliardo C, Taibbi A. S-Detect characterization of focal breast lesions according to the US BI RADS lexicon: a pictorial essay. J Ultrasound 2020; 23:207-215. [PMID: 32185702 DOI: 10.1007/s40477-020-00447-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 02/29/2020] [Indexed: 02/06/2023] Open
Abstract
High-resolution ultrasonography (US) is a valuable tool in breast imaging. Nevertheless, US is an operator-dependent technique: to overcome this issue, the American College of Radiology (ACR) has developed the breast imaging-reporting and data system (BI-RADS) US lexicon. Despite this effort, the variability in the assessment of focal breast lesions (FBLs) with the use of BI-RADS US lexicon is still an issue. Within this framework, evidence shows that computer-aided image analysis may be effective in improving the radiologist's assessment of FBLs. In particular, S-Detect is a newly developed image-analytic computer program that provides assistance in morphologic analysis of FBLs seen on US according to the BI-RADS US lexicon. This pictorial essay describes state-of-the-art of sonographic characterization of FBLs by using S-Detect.
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Affiliation(s)
- Tommaso Vincenzo Bartolotta
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (Bi.N.D.), University Hospital "Policlinico P. Giaccone", Via Del Vespro 129, 90127, Palermo, Italy
- Fondazione Istituto G.Giglio di Cefalù Contrada Pietrapollastra-Pisciotto, 90015, Cefalù, PA, Italy
| | - Alessia Angela Maria Orlando
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (Bi.N.D.), University Hospital "Policlinico P. Giaccone", Via Del Vespro 129, 90127, Palermo, Italy.
| | - Luigi Spatafora
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (Bi.N.D.), University Hospital "Policlinico P. Giaccone", Via Del Vespro 129, 90127, Palermo, Italy
| | - Mariangela Dimarco
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (Bi.N.D.), University Hospital "Policlinico P. Giaccone", Via Del Vespro 129, 90127, Palermo, Italy
| | - Cesare Gagliardo
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (Bi.N.D.), University Hospital "Policlinico P. Giaccone", Via Del Vespro 129, 90127, Palermo, Italy
| | - Adele Taibbi
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (Bi.N.D.), University Hospital "Policlinico P. Giaccone", Via Del Vespro 129, 90127, Palermo, Italy
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