The effect of individual radiographers on rates of attendance to breast screening: a 7-year retrospective study

Identification of histological features of endometrioid adenocarcinoma based on amide proton transfer-weighted imaging and multimodel diffusion-weighted imaging

BACKGROUND

Noninvasive identification of the histological features of endometrioid adenocarcinoma is necessary. This study aimed to investigate whether amide proton transfer-weighted imaging (APTWI) and multimodel (monoexponential, biexponential, and stretched exponential) diffusion-weighted imaging (DWI) could predict the histological grade of endometrial adenocarcinoma (EA). In addition, we analyzed the correlation between each parameter and the Ki-67 index.

METHODS

A total of 90 EA patients who received pelvic magnetic resonance imaging (MRI) were enrolled. The magnetization transfer ratio asymmetry [MTRasym (3.5 ppm)], apparent diffusion coefficient (ADC), diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), distributed diffusion coefficient (DDC), and water molecular diffusion heterogeneity index (α) were measured and compared. Correlation coefficients between each parameter and histological grade and the Ki-67 index were calculated. Statistical methods included the independent samples t test, Spearman's correlation, and logistic regression.

RESULTS

MTRasym (3.5 ppm) [(3.72%±0.31%) vs. (3.27%±0.48%)], f [(3.15%±0.36%) vs. (2.69%±0.83%)], and α [(0.89±0.05) vs. (0.81±0.09)] were higher and ADC [(0.82±0.08) vs. (0.89±0.10) ×10^-3 mm²/s], D [(0.67±0.09) vs. (0.81±0.11) ×10^-3 mm²/s], and DDC [(1.04±0.09) vs. (1.13±0.13) ×10^-3 mm²/s] were lower in high-grade EA than in low-grade EA (P<0.05). MTRasym (3.5 ppm) and D were independent predictors for the histological grade of EA. The combination of MTRasym (3.5 ppm) and D were better able to identify high- and low-grade EA than was each parameter. MTRasym (3.5 ppm) and α were moderately and weakly positively correlated, respectively, with histological grade and the Ki-67 index (r=0.528, r=0.514, r=0.395, and r=0.367; P<0.05). D was moderately negatively correlated with histological grade and the Ki-67 index (r=-0.540 and r=-0.529; P<0.05). DDC was weakly and moderately negatively correlated with histological grade and the Ki-67 index, respectively (r=-0.473 and r=-0.515; P<0.05). ADC was weakly negatively correlated with histological grade and the Ki-67 index (r=-0.417 and r=-0.427; P<0.05). f was weakly positively correlated with histological grade and the Ki-67 index (r=0.294 and r=0.355; P<0.05).

CONCLUSIONS

Our study found that both multimodel DWI and APTWI could be used to estimate the histological grade and Ki-67 index of EA, and the combination of high MTRasym (3.5 ppm) and low D may be an effective imaging marker for predicting the grade of EA.

Impact of the age expansion of breast screening on screening uptake and screening outcomes among older women in BreastScreen western

Objectives

To assess the impact of age expansion of screening (EOS) of the target age group from 50 to 69 to 50–74 in Australia, which began mid-2013, by examining screening uptake and outcomes of older women, and by identifying factors associated with continuing screening after reaching the age of 75 years.

Methods

Retrospective study using data from women aged 65+ who attended BreastScreen Western Australia between 2010 and 2017 for free mammograms. Screening uptake and screening outcomes were calculated for the periods before (2010–2012) and after (2015–2017) the age EOS to women aged 70–74. Logistic regression was used to identify variables associated with continuing screening after reaching age 75 years, while controlling for possible confounding variables.

Results

Age EOS increased screening uptake amongst women aged 70–74 b y 36% and amongst women ≥75 years by 3% while screening uptake in women aged 65-69 decreased by 3%. Rate of invasive screened-detected cancers significantly decreased among women aged 70–74 from 11.4/1000 screens before to 8.1/1000 screens after age EOS. Likelihood of continuing screening into age ≥75 years was higher in women who had a personal history or a family history of breast cancer, or used hormone replacement therapy within six months of screening. Women who were born outside Australia were less likely to continue screening after reaching age 75 years.

Conclusions

Our study found that age EOS to women aged 70–74 was effective in increasing screening uptake in this age-group but was accompanied by a moderate increase in screening uptake amongst women ≥75 years via self-referral for whom potential benefit of screening may be limited.

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In 2013 BreastScreen Australia extended the target age group from 50 to 69 to 50–74.

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Age expansion of screening (EOS) to women aged 70–74 increased screening uptake by 36%.

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Age EOS increased screening uptake for women aged ≥75 years by 3%.

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High risk women were more likely to continue screening after reaching age 75 years.

Characterization of radiographers' mammography practice in five European countries: a pilot study

Objectives

This pilot study aimed to characterize and compare radiographers’ mammography practice, including quality control and continuous professional development in five European countries.

Methods

Online survey was performed to collect data regarding participants’ profile, institution’s profile, mammography practice, quality control and continuous professional development. The questionnaire was sent to clinical radiographers working in Estonia, Finland, Norway, Portugal and Switzerland. Descriptive statistical and subgroup analyzes were performed.

Results

The amount of returned questionnaires was 140. Most respondents were female (92%), having radiography bachelor. The majority (89%) of radiographers was working with full-field digital mammography. The majority (97%) of mammography images were acquired using AEC, and half of the radiographers were using dose saving programmes suggested by the manufacturers. The most typical (50%) compression force ranged from 8 to 11 kg. Part of the radiographers (44%) did not know if their practice followed specific guidelines. The most challenging tasks in mammography identified by radiographers were patient positioning (86%), coping with pain (88%), managing anxiety (83%) and imaging breast implants (71%). The majority (88%) of the respondents undertook continuous professional development activities.

Conclusions

The mammography practice varies across the five countries. We found country-specific traits related to mammography image acquisition, patient-centered care and quality management procedures. The lack of evidence-based knowledge suggests the importance of well-designed studies on these topics. The variability found in this pilot study encourages radiographers to question their own practice and teachers to review and revise the training programmes. Validation in larger studies including more countries is needed.