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Patel MM, Adrada BE. Hereditary Breast Cancer: BRCA Mutations and Beyond. Radiol Clin North Am 2024; 62:627-642. [PMID: 38777539 DOI: 10.1016/j.rcl.2023.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Hereditary breast cancers are manifested by pathogenic and likely pathogenic genetic mutations. Penetrance expresses the breast cancer risk associated with these genetic mutations. Although BRCA1/2 are the most widely known genetic mutations associated with breast cancer, numerous additional genes demonstrate high and moderate penetrance for breast cancer. This review describes current genetic testing, details the specific high and moderate penetrance genes for breast cancer and reviews the current approach to screening for breast cancer in patients with these genetic mutations.
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Affiliation(s)
- Miral M Patel
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe, CPB5.3208, Houston, TX 77030, USA.
| | - Beatriz Elena Adrada
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe, CPB5.3208, Houston, TX 77030, USA
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2
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Udayakumar D, Madhuranthakam AJ, Doğan BE. Magnetic Resonance Perfusion Imaging for Breast Cancer. Magn Reson Imaging Clin N Am 2024; 32:135-150. [PMID: 38007276 DOI: 10.1016/j.mric.2023.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023]
Abstract
Breast cancer is the most frequently diagnosed cancer among women worldwide, carrying a significant socioeconomic burden. Breast cancer is a heterogeneous disease with 4 major subtypes identified. Each subtype has unique prognostic factors, risks, treatment responses, and survival rates. Advances in targeted therapies have considerably improved the 5-year survival rates for primary breast cancer patients largely due to widespread screening programs that enable early detection and timely treatment. Imaging techniques are indispensable in diagnosing and managing breast cancer. While mammography is the primary screening tool, MRI plays a significant role when mammography results are inconclusive or in patients with dense breast tissue. MRI has become standard in breast cancer imaging, providing detailed anatomic and functional data, including tumor perfusion and cellularity. A key characteristic of breast tumors is angiogenesis, a biological process that promotes tumor development and growth. Increased angiogenesis in tumors generally indicates poor prognosis and increased risk of metastasis. Dynamic contrast-enhanced (DCE) MRI measures tumor perfusion and serves as an in vivo metric for angiogenesis. DCE-MRI has become the cornerstone of breast MRI, boasting a high negative-predictive value of 89% to 99%, although its specificity can vary. This review presents a thorough overview of magnetic resonance (MR) perfusion imaging in breast cancer, focusing on the role of DCE-MRI in clinical applications and exploring emerging MR perfusion imaging techniques.
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Affiliation(s)
- Durga Udayakumar
- Department of Radiology, Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX 75390, USA.
| | - Ananth J Madhuranthakam
- Department of Radiology, Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX 75390, USA
| | - Başak E Doğan
- Department of Radiology, Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX 75390, USA
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3
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Greenwood HI, Dodelzon K. Screening in Women With BRCA Mutations Revisited. JOURNAL OF BREAST IMAGING 2024; 6:4-13. [PMID: 38166173 DOI: 10.1093/jbi/wbad093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Indexed: 01/04/2024]
Abstract
Patients with BRCA1 or BRCA2 gene mutations are at high risk for the development of breast cancer. This article reviews the current evidence for breast cancer screening of patients with BRCA1 or BRCA2 pathogenic gene mutations if they have not undergone prophylactic mastectomy. It will review the current evidence-based imaging recommendations for different modalities and ages of screening initiation in screening this patient population at high risk. Special considerations in transgender BRCA1 and BRCA2 mutation carriers are also discussed.
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Affiliation(s)
- Heather I Greenwood
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Katerina Dodelzon
- Department of Radiology, Weill Cornell Medical College, New York, NY, USA
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4
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Coffey K, Mango V. Revisiting Screening in Women With a Family History of Breast Cancer. JOURNAL OF BREAST IMAGING 2023; 5:635-645. [PMID: 38141237 DOI: 10.1093/jbi/wbad069] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Indexed: 12/25/2023]
Abstract
Women with a family history (FH) of breast cancer and without known genetic susceptibility represent a unique population whose lifetime probability of developing breast cancer varies widely depending on familial factors, breast density, and the risk assessment tool used. Recently updated guidelines from the American College of Radiology recommend supplemental annual screening with contrast-enhanced MRI or contrast-enhanced mammography for women with an FH who are high risk (≥20% lifetime risk) or have dense breasts. To date, most screening studies addressing outcomes in women with FH have largely included those also with confirmed or suspected gene mutations, in whom the lifetime risk is highest, with limited data for women at average to intermediate risk who are not known to be genetically susceptible and may not benefit as much from the same screening approaches. Further research focusing specifically on women with FH as the only breast cancer risk factor is warranted to refine risk assessment and optimize a multimodality personalized screening approach.
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Affiliation(s)
- Kristen Coffey
- Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY, USA
| | - Victoria Mango
- Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY, USA
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5
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Cheng K, Wang J, Liu J, Zhang X, Shen Y, Su H. Public health implications of computer-aided diagnosis and treatment technologies in breast cancer care. AIMS Public Health 2023; 10:867-895. [PMID: 38187901 PMCID: PMC10764974 DOI: 10.3934/publichealth.2023057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 10/10/2023] [Indexed: 01/09/2024] Open
Abstract
Breast cancer remains a significant public health issue, being a leading cause of cancer-related mortality among women globally. Timely diagnosis and efficient treatment are crucial for enhancing patient outcomes, reducing healthcare burdens and advancing community health. This systematic review, following the PRISMA guidelines, aims to comprehensively synthesize the recent advancements in computer-aided diagnosis and treatment for breast cancer. The study covers the latest developments in image analysis and processing, machine learning and deep learning algorithms, multimodal fusion techniques and radiation therapy planning and simulation. The results of the review suggest that machine learning, augmented and virtual reality and data mining are the three major research hotspots in breast cancer management. Moreover, this paper discusses the challenges and opportunities for future research in this field. The conclusion highlights the importance of computer-aided techniques in the management of breast cancer and summarizes the key findings of the review.
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Affiliation(s)
- Kai Cheng
- Yantai Affiliated Hospital of Binzhou Medical University, Yantai, 264100, China
| | - Jiangtao Wang
- Yantai Affiliated Hospital of Binzhou Medical University, Yantai, 264100, China
| | - Jian Liu
- Yantai Affiliated Hospital of Binzhou Medical University, Yantai, 264100, China
| | - Xiangsheng Zhang
- Yantai Affiliated Hospital of Binzhou Medical University, Yantai, 264100, China
| | - Yuanyuan Shen
- Yantai Affiliated Hospital of Binzhou Medical University, Yantai, 264100, China
| | - Hang Su
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
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Wilding M, Fleming J, Moore K, Crook A, Reddy R, Choi S, Schlub TE, Field M, Thiyagarajan L, Thompson J, Berman Y. Clinical and imaging modality factors impacting radiological interpretation of breast screening in young women with neurofibromatosis type 1. Fam Cancer 2023; 22:499-511. [PMID: 37335380 DOI: 10.1007/s10689-023-00340-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 05/28/2023] [Indexed: 06/21/2023]
Abstract
Young women with Neurofibromatosis type 1 (NF1) have a high risk of developing breast cancer and poorer survival following breast cancer diagnosis. International guidelines recommend commencing breast screening between 30 and 35 years; however, the optimal screening modality is unestablished, and previous reports suggest that breast imaging may be complicated by the presence of intramammary and cutaneous neurofibromas (cNFs). The aim of this study was to explore potential barriers to implementation of breast screening for young women with NF1.Twenty-seven women (30-47 years) with NF1 completed breast screening with breast MRI, mammogram and breast ultrasound. Nineteen probably benign/suspicious lesions were detected across 14 women. Despite the presence of breast cNFs, initial biopsy rate for participants with NF1 (37%), were comparable to a BRCA pathogenic variant (PV) cohort (25%) (P = 0.311). No cancers or intramammary neurofibromas were identified. Most participants (89%) returned for second round screening.The presence of cNF did not affect clinician confidence in 3D mammogram interpretation, although increasing breast density, frequently seen in young women, impeded confidence for 2D and 3D mammogram. Moderate or marked background parenchymal enhancement on MRI was higher in the NF1 cohort (70.4%) than BRCA PV carriers (47.3%), which is an independent risk factor for breast cancer.Breast MRI was the preferred mode of screening over mammogram, as the majority (85%) with NF1 demonstrated breast density (BI-RADS 3C/4D), which hinders mammogram interpretation. For those with high breast density and high cNF breast coverage, 3D rather than 2D mammogram is preferred, if MRI is unavailable.
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Affiliation(s)
- Mathilda Wilding
- NSLHD Familial Cancer Service, Department of Cancer Services, Royal North Shore Hospital, Sydney, NSW, Australia.
| | - Jane Fleming
- Department of Clinical Genetics, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Katrina Moore
- Department of Endocrine Surgery, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Ashley Crook
- NSLHD Familial Cancer Service, Department of Cancer Services, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Ranjani Reddy
- North Shore Radiology & Nuclear Medicine, Pacific Highway, Sydney, NSW, Australia
| | - Sarah Choi
- North Shore Radiology & Nuclear Medicine, Pacific Highway, Sydney, NSW, Australia
| | - Timothy E Schlub
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Michael Field
- NSLHD Familial Cancer Service, Department of Cancer Services, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Lavvina Thiyagarajan
- Department of Clinical Genetics, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Jeff Thompson
- Northern Clinical School, Faculty of Health and Medicine, University of Sydney, Sydney, NSW, Australia
| | - Yemima Berman
- Department of Clinical Genetics, Royal North Shore Hospital, Sydney, NSW, Australia
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Priyadarshani KN, Singh S. Ultra Sensitive Breast Cancer Cell Lines Detection Using Dual Nanocavities Engraved Junctionless FET. IEEE Trans Nanobioscience 2023; 22:889-896. [PMID: 37027544 DOI: 10.1109/tnb.2023.3246106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
This article reports breast cancer cell lines (Hs578T, MDA-MB-231, MCF-7, and T47D) and healthy breast cells (MCF-10A) detection based on the modulation of its electrical properties by deploying dual nanocavity engraved junctionless FET. The device has a dual gate to enhance gate control and has two nanocavities etched under both gates for breast cancer cell lines immobilization. As the cancer cells are immobilized in the engraved nanocavities, which were earlier filled with air, the dielectric constant of the nanocavities changes. This results in the modulation of the device's electrical parameters. This electrical parameters modulation is then calibrated to detect the breast cancer cell lines. The reported device demonstrates a higher sensitivity toward the detection of breast cancer cells. The JLFET device optimization is done for improving the performance by optimizing the nanocavity thickness and the SiO2 oxide length. The variation in the dielectric property of cell lines plays a key role in the detection technique of the reported biosensor. The sensitivity of the JLFET biosensor is analyzed in terms of ∆VTH, ∆ION, ∆gm , and ∆SS . The reported biosensor shows the maximum sensitivity for T47D ( κ = 32 ) breast cancer cell line with ∆VTH = 0.800 V, ∆ION = 0.165 mA/μm, ∆gm = 0.296 mA/V-μm , and ∆SS = 5.41 mV/decade. Moreover, the effect of variation in the occupancy of the cavity by the immobilized cell lines has also been studied and analyzed. With increased cavity occupancy the variation in the device performance parameter enhances Further, the sensitivity of the proposed biosensor is compared with the existing biosensors and it is reported to be highly sensitive as compared to the existing biosensors. Hence, the device can be utilized for array based screening of cell lines of breast cancer and diagnosis with the benefit of easier fabrication and cost effectiveness of the device.
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Kumar B, Chaujar R. Fin field-effect-transistor engineered sensor for detection of MDA-MB-231 breast cancer cells: A switching-ratio-based sensitivity analysis. Phys Rev E 2023; 108:034408. [PMID: 37849201 DOI: 10.1103/physreve.108.034408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 09/01/2023] [Indexed: 10/19/2023]
Abstract
The present study describes the utilization of a gallium-arsenide gate-stack gate-all-around (GaAs-GS-GAA) fin field-effect transistor (FinFET) to accomplish the electrical identification of the breast cancer cell MDA-MB-231 by monitoring the device switching ratio. The proposed sensor uses four nanocavities carved beneath the gate electrodes for enhanced detection sensitivity. MDA-MB-231 (cancerous) and MCF-10A (healthy) breast cells have a distinct dielectric constant, and it changes when exposed to microwave frequencies spanning across 200 MHz and 13.6 GHz, which modifies the electrical characteristics, allowing for early diagnosis. First, a percentage shift in the primary DC characteristics is presented to demonstrate the advantage of GS-GAA FinFET over conventional FinFET. The sensor measures the switching-ratio-based sensitivity, which comes out to be 99.72% for MDA-MB-231 and 47.78% for MCF-10A. The sensor was tested for stability and reproducibility and found to be repeatable and sufficiently stable with settling times of 55.51, 60.80, and 71.58 ps for MDA-MB-231 cells, MCF-10A cells, and air, respectively. It can distinguish between viable and nonviable cells based on electrical response alterations. The possibility of early detection of cancerous breast cells using Bruggeman's model is also discussed. Further, the impact of biomolecule occupancy and frequency variations on the device sensitivity is carried out. This study also explains how to maximize the sensing performance by adjusting the fin height, fin width, work function, channel doping, temperature, and drain voltage. Lastly, this article compared the proposed breast cancer cell detectors to existing literature to evaluate their performance and found considerable improvement. The findings of this research have the potential to establish GaAs-GS-GAA FinFET as a promising contender for MDA-MB-231 breast cancer cell detection.
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Affiliation(s)
- Bhavya Kumar
- Department of Applied Physics, Delhi Technological University, Delhi 110042, India
| | - Rishu Chaujar
- Department of Applied Physics, Delhi Technological University, Delhi 110042, India
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Monticciolo DL, Newell MS, Moy L, Lee CS, Destounis SV. Breast Cancer Screening for Women at Higher-Than-Average Risk: Updated Recommendations From the ACR. J Am Coll Radiol 2023; 20:902-914. [PMID: 37150275 DOI: 10.1016/j.jacr.2023.04.002] [Citation(s) in RCA: 50] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/26/2023] [Accepted: 04/06/2023] [Indexed: 05/09/2023]
Abstract
Early detection decreases breast cancer death. The ACR recommends annual screening beginning at age 40 for women of average risk and earlier and/or more intensive screening for women at higher-than-average risk. For most women at higher-than-average risk, the supplemental screening method of choice is breast MRI. Women with genetics-based increased risk, those with a calculated lifetime risk of 20% or more, and those exposed to chest radiation at young ages are recommended to undergo MRI surveillance starting at ages 25 to 30 and annual mammography (with a variable starting age between 25 and 40, depending on the type of risk). Mutation carriers can delay mammographic screening until age 40 if annual screening breast MRI is performed as recommended. Women diagnosed with breast cancer before age 50 or with personal histories of breast cancer and dense breasts should undergo annual supplemental breast MRI. Others with personal histories, and those with atypia at biopsy, should strongly consider MRI screening, especially if other risk factors are present. For women with dense breasts who desire supplemental screening, breast MRI is recommended. For those who qualify for but cannot undergo breast MRI, contrast-enhanced mammography or ultrasound could be considered. All women should undergo risk assessment by age 25, especially Black women and women of Ashkenazi Jewish heritage, so that those at higher-than-average risk can be identified and appropriate screening initiated.
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Affiliation(s)
- Debra L Monticciolo
- Division Chief, Breast Imaging, Massachusetts General Hospital, Boston, Massachusetts.
| | - Mary S Newell
- Interim Division Chief, Breast Imaging, Emory University, Atlanta, Georgia
| | - Linda Moy
- Associate Chair for Faculty Mentoring, New York University Grossman School of Medicine, New York, New York; Editor-in-Chief, Radiology
| | - Cindy S Lee
- New York University Grossman School of Medicine, New York, New York
| | - Stamatia V Destounis
- Elizabeth Wende Breast Care, Rochester, New York; Chair, ACR Commission on Breast Imaging
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Wang H, van der Velden BHM, Verburg E, Bakker MF, Pijnappel RM, Veldhuis WB, van Gils CH, Gilhuijs KGA. Assessing Quantitative Parenchymal Features at Baseline Dynamic Contrast-enhanced MRI and Cancer Occurrence in Women with Extremely Dense Breasts. Radiology 2023; 308:e222841. [PMID: 37552061 DOI: 10.1148/radiol.222841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
Background Automated identification of quantitative breast parenchymal enhancement features on dynamic contrast-enhanced (DCE) MRI scans could provide added value in assessment of breast cancer risk in women with extremely dense breasts. Purpose To automatically identify quantitative properties of the breast parenchyma on baseline DCE MRI scans and assess their association with breast cancer occurrence in women with extremely dense breasts. Materials and Methods This study represents a secondary analysis of the Dense Tissue and Early Breast Neoplasm Screening trial. MRI was performed in eight hospitals between December 2011 and January 2016. After segmentation of fibroglandular tissue, quantitative features (including volumetric density, volumetric morphology, and enhancement characteristics) of the parenchyma were extracted from baseline MRI scans. Principal component analysis was used to identify parenchymal measures with the greatest variance. Multivariable Cox proportional hazards regression was applied to assess the association between breast cancer occurrence and quantitative parenchymal features, followed by stratification of significant features into tertiles. Results A total of 4553 women (mean age, 55.7 years ± 6 [SD]) with extremely dense breasts were included; of these women, 122 (3%) were diagnosed with breast cancer. Five principal components representing 96% of the variance were identified, and the component explaining the greatest independent variance (42%) consisted of MRI features relating to volume of enhancing parenchyma. Multivariable analysis showed that volume of enhancing parenchyma was associated with breast cancer occurrence (hazard ratio [HR], 1.09; 95% CI: 1.01, 1.18; P = .02). Additionally, women in the high tertile of volume of enhancing parenchyma showed a breast cancer occurrence twice that of women in the low tertile (HR, 2.09; 95% CI: 1.25, 3.61; P = .005). Conclusion In women with extremely dense breasts, a high volume of enhancing parenchyma on baseline DCE MRI scans was associated with increased occurrence of breast cancer as compared with a low volume of enhancing parenchyma. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Grimm in this issue.
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Affiliation(s)
- Hui Wang
- From the Image Sciences Institute (H.W., B.H.M.v.d.V., E.V., K.G.A.G.), Julius Center for Health Sciences and Primary Care (M.F.B., C.H.v.G.), and Department of Radiology (R.M.P., W.B.V.), University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
| | - Bas H M van der Velden
- From the Image Sciences Institute (H.W., B.H.M.v.d.V., E.V., K.G.A.G.), Julius Center for Health Sciences and Primary Care (M.F.B., C.H.v.G.), and Department of Radiology (R.M.P., W.B.V.), University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
| | - Erik Verburg
- From the Image Sciences Institute (H.W., B.H.M.v.d.V., E.V., K.G.A.G.), Julius Center for Health Sciences and Primary Care (M.F.B., C.H.v.G.), and Department of Radiology (R.M.P., W.B.V.), University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
| | - Marije F Bakker
- From the Image Sciences Institute (H.W., B.H.M.v.d.V., E.V., K.G.A.G.), Julius Center for Health Sciences and Primary Care (M.F.B., C.H.v.G.), and Department of Radiology (R.M.P., W.B.V.), University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
| | - Ruud M Pijnappel
- From the Image Sciences Institute (H.W., B.H.M.v.d.V., E.V., K.G.A.G.), Julius Center for Health Sciences and Primary Care (M.F.B., C.H.v.G.), and Department of Radiology (R.M.P., W.B.V.), University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
| | - Wouter B Veldhuis
- From the Image Sciences Institute (H.W., B.H.M.v.d.V., E.V., K.G.A.G.), Julius Center for Health Sciences and Primary Care (M.F.B., C.H.v.G.), and Department of Radiology (R.M.P., W.B.V.), University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
| | - Carla H van Gils
- From the Image Sciences Institute (H.W., B.H.M.v.d.V., E.V., K.G.A.G.), Julius Center for Health Sciences and Primary Care (M.F.B., C.H.v.G.), and Department of Radiology (R.M.P., W.B.V.), University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
| | - Kenneth G A Gilhuijs
- From the Image Sciences Institute (H.W., B.H.M.v.d.V., E.V., K.G.A.G.), Julius Center for Health Sciences and Primary Care (M.F.B., C.H.v.G.), and Department of Radiology (R.M.P., W.B.V.), University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
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Wehbe A, Gonte MR, O'Neill SC, Amit‐Yousif A, Purrington K, Manning M, Simon MS. Predictors of nonadherence to breast cancer screening guidelines in a United States urban comprehensive cancer center. Cancer Med 2023; 12:15482-15491. [PMID: 37329206 PMCID: PMC10417068 DOI: 10.1002/cam4.6182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 05/08/2023] [Accepted: 05/20/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND This study aimed to identify predictors of nonadherence to breast cancer screening guidelines in an urban screening clinic among high- and average-risk women in the United States. METHODS We reviewed records of 6090 women who received ≥2 screening mammograms over 2 years at the Karmanos Cancer Institute to examine how breast cancer risk and breast density were associated with guideline-concordant screening. Incongruent screening was defined as receiving supplemental imaging between screening mammograms for average-risk women, and as not receiving recommended supplemental imaging for high-risk women. We used t-tests and chi-square tests to examine bivariate associations with guideline-congruent screening, and probit regression to regress guideline-congruence unto breast cancer risk, breast density, and their interaction, controlling for age and race. RESULTS Incongruent screening was more likely among high- versus average-risk women (97.7% vs. 0.9%, p < 0.01). Among average-risk women, incongruent screening was more likely among those with dense versus nondense breasts (2.0% vs. 0.1%, p < 0.01). Among high-risk women, incongruent screening was more likely among those with nondense versus dense breasts (99.5% vs. 95.2%, p < 0.01). The significant main effects of density and high-risk on increased incongruent screening were qualified by a density by high-risk interaction, showing a weaker association between risk and incongruent screening among women with dense breasts (simple slope = 3.71, p < 0.01) versus nondense breasts (simple slope = 5.79, p < 0.01). Age and race were not associated with incongruent screening. CONCLUSIONS Lack of adherence to evidence-based screening guidelines has led to underutilization of supplementary imaging for high-risk women and potential overutilization for women with dense breasts without other risk factors.
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Affiliation(s)
- Alexandra Wehbe
- Harvard T.H. Chan School of Public HealthBostonMassachusettsUSA
- Department of OncologyBarbara Ann Karmanos Cancer InstituteDetroitMichiganUSA
- Population Studies and Disparities Research ProgramBarbara Ann Karmanos Cancer InstituteDetroitMichiganUSA
- Wayne State University School of MedicineDetroitMichiganUSA
| | - Madeleine R. Gonte
- Harvard T.H. Chan School of Public HealthBostonMassachusettsUSA
- Wayne State University School of MedicineDetroitMichiganUSA
| | - Suzanne C. O'Neill
- Department of Oncology, Lombardi Cancer CenterGeorgetown UniversityWashingtonDCUSA
| | - Alit Amit‐Yousif
- Center for Breast HealthOakland Macomb Obstetrics and GynecologyRochester HillsMichiganUSA
| | - Kristen Purrington
- Population Studies and Disparities Research ProgramBarbara Ann Karmanos Cancer InstituteDetroitMichiganUSA
| | - Mark Manning
- Department of PsychologyOakland UniversityRochesterMichiganUSA
- Center for Molecular Medicine and GeneticsWayne State University School of MedicineDetroitMichiganUSA
| | - Michael S. Simon
- Department of OncologyBarbara Ann Karmanos Cancer InstituteDetroitMichiganUSA
- Population Studies and Disparities Research ProgramBarbara Ann Karmanos Cancer InstituteDetroitMichiganUSA
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12
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Fraker JL, Clune CG, Sahni SK, Yaganti A, Vegunta S. Prevalence, Impact, and Diagnostic Challenges of Benign Breast Disease: A Narrative Review. Int J Womens Health 2023; 15:765-778. [PMID: 37223067 PMCID: PMC10202205 DOI: 10.2147/ijwh.s351095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 05/05/2023] [Indexed: 05/25/2023] Open
Abstract
Benign breast diseases, which are commonly seen in clinical practice, have various clinical presentations and implications, as well as management strategies. This article describes common benign breast lesions, presentations of these lesions, and typical radiographic and histologic findings. Also included in this review are the most recent data and guideline-based recommendations for the management of benign breast diseases at diagnosis, including surgical referral, medical management, and ongoing surveillance.
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Affiliation(s)
- Jessica L Fraker
- Division of Women’s Health Internal Medicine, Mayo Clinic, Scottsdale, AZ, USA
| | - Caroline G Clune
- Center for Breast Care, Mayo Clinic Health System — Southwest Wisconsin Region, La Crosse, WI, USA
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Sabrina K Sahni
- Jacoby Center for Breast Health, Mayo Clinic, Jacksonville, FL, USA
| | - Avani Yaganti
- Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Suneela Vegunta
- Division of Women’s Health Internal Medicine, Mayo Clinic, Scottsdale, AZ, USA
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13
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Surgical Planning after Neoadjuvant Treatment in Breast Cancer: A Multimodality Imaging-Based Approach Focused on MRI. Cancers (Basel) 2023; 15:cancers15051439. [PMID: 36900231 PMCID: PMC10001061 DOI: 10.3390/cancers15051439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/19/2023] [Accepted: 02/21/2023] [Indexed: 03/12/2023] Open
Abstract
Neoadjuvant chemotherapy (NACT) today represents a cornerstone in the treatment of locally advanced breast cancer and highly chemo-sensitive tumors at early stages, increasing the possibilities of performing more conservative treatments and improving long term outcomes. Imaging has a fundamental role in the staging and prediction of the response to NACT, thus aiding surgical planning and avoiding overtreatment. In this review, we first examine and compare the role of conventional and advanced imaging techniques in preoperative T Staging after NACT and in the evaluation of lymph node involvement. In the second part, we analyze the different surgical approaches, discussing the role of axillary surgery, as well as the possibility of non-operative management after-NACT, which has been the subject of recent trials. Finally, we focus on emerging techniques that will change the diagnostic assessment of breast cancer in the near future.
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Shahbazi-Gahrouei D, Aminolroayaei F, Nematollahi H, Ghaderian M, Gahrouei SS. Advanced Magnetic Resonance Imaging Modalities for Breast Cancer Diagnosis: An Overview of Recent Findings and Perspectives. Diagnostics (Basel) 2022; 12:2741. [PMID: 36359584 PMCID: PMC9689118 DOI: 10.3390/diagnostics12112741] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 10/26/2022] [Accepted: 11/07/2022] [Indexed: 08/28/2023] Open
Abstract
Breast cancer is the most prevalent cancer among women and the leading cause of death. Diffusion-weighted imaging (DWI) and diffusion tensor imaging (DTI) are advanced magnetic resonance imaging (MRI) procedures that are widely used in the diagnostic and treatment evaluation of breast cancer. This review article describes the characteristics of new MRI methods and reviews recent findings on breast cancer diagnosis. This review study was performed on the literature sourced from scientific citation websites such as Google Scholar, PubMed, and Web of Science until July 2021. All relevant works published on the mentioned scientific citation websites were investigated. Because of the propensity of malignancies to limit diffusion, DWI can improve MRI diagnostic specificity. Diffusion tensor imaging gives additional information about diffusion directionality and anisotropy over traditional DWI. Recent findings showed that DWI and DTI and their characteristics may facilitate earlier and more accurate diagnosis, followed by better treatment. Overall, with the development of instruments and novel MRI modalities, it may be possible to diagnose breast cancer more effectively in the early stages.
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Affiliation(s)
- Daryoush Shahbazi-Gahrouei
- Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan 8174673461, Iran
| | - Fahimeh Aminolroayaei
- Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan 8174673461, Iran
| | - Hamide Nematollahi
- Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan 8174673461, Iran
| | - Mohammad Ghaderian
- Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan 8174673461, Iran
| | - Sogand Shahbazi Gahrouei
- Department of Management, School of Humanities, Najafabad Branch, Islamic Azad University, Najafabad 8514143131, Iran
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15
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Mgbejime GT, Hossin MA, Nneji GU, Monday HN, Ekong F. Parallelistic Convolution Neural Network Approach for Brain Tumor Diagnosis. Diagnostics (Basel) 2022; 12:diagnostics12102484. [PMID: 36292173 PMCID: PMC9600759 DOI: 10.3390/diagnostics12102484] [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: 09/14/2022] [Revised: 09/27/2022] [Accepted: 10/03/2022] [Indexed: 11/17/2022] Open
Abstract
Today, Magnetic Resonance Imaging (MRI) is a prominent technique used in medicine, produces a significant and varied range of tissue contrasts in each imaging modalities, and is frequently employed by medical professionals to identify brain malignancies. With brain tumor being a very deadly disease, early detection will help increase the likelihood that the patient will receive the appropriate medical care leading to either a full elimination of the tumor or the prolongation of the patient’s life. However, manually examining the enormous volume of magnetic resonance imaging (MRI) images and identifying a brain tumor or cancer is extremely time-consuming and requires the expertise of a trained medical expert or brain doctor to manually detect and diagnose brain cancer using multiple Magnetic Resonance images (MRI) with various modalities. Due to this underlying issue, there is a growing need for increased efforts to automate the detection and diagnosis process of brain tumor without human intervention. Another major concern most research articles do not consider is the low quality nature of MRI images which can be attributed to noise and artifacts. This article presents a Contrast Limited Adaptive Histogram Equalization (CLAHE) algorithm to precisely handle the problem of low quality MRI images by eliminating noisy elements and enhancing the visible trainable features of the image. The enhanced image is then fed to the proposed PCNN to learn the features and classify the tumor using sigmoid classifier. To properly train the model, a publicly available dataset is collected and utilized for this research. Additionally, different optimizers and different values of dropout and learning rates are used in the course of this study. The proposed PCNN with Contrast Limited Adaptive Histogram Equalization (CLAHE) algorithm achieved an accuracy of 98.7%, sensitivity of 99.7%, and specificity of 97.4%. In comparison with other state-of-the-art brain tumor methods and pre-trained deep transfer learning models, the proposed PCNN model obtained satisfactory performance.
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Affiliation(s)
- Goodness Temofe Mgbejime
- School of Computer Science and Engineering, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Md Altab Hossin
- School of Innovation and Entrepreneurship, Chengdu University, Chengdu 610106, China
| | - Grace Ugochi Nneji
- Department of Computing, Oxford Brookes College of Chengdu University of Technology, Chengdu 610059, China
- Deep Learning and Intelligent Computing Lab, HACE SOFTTECH, Lagos 102241, Nigeria
- Correspondence: (G.U.N.); (H.N.M.)
| | - Happy Nkanta Monday
- Department of Computing, Oxford Brookes College of Chengdu University of Technology, Chengdu 610059, China
- Deep Learning and Intelligent Computing Lab, HACE SOFTTECH, Lagos 102241, Nigeria
- Correspondence: (G.U.N.); (H.N.M.)
| | - Favour Ekong
- School of Information and Software Engineering, University of Electronic Science and Technology of China, Chengdu 611731, China
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Hong R, Xu B. Breast cancer: an up-to-date review and future perspectives. CANCER COMMUNICATIONS (LONDON, ENGLAND) 2022; 42:913-936. [PMID: 36074908 PMCID: PMC9558690 DOI: 10.1002/cac2.12358] [Citation(s) in RCA: 76] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/16/2022] [Accepted: 08/21/2022] [Indexed: 11/10/2022]
Abstract
Breast cancer is the most common cancer worldwide. The occurrence of breast cancer is associated with many risk factors, including genetic and hereditary predisposition. Breast cancers are highly heterogeneous. Treatment strategies for breast cancer vary by molecular features, including activation of human epidermal growth factor receptor 2 (HER2), hormonal receptors (estrogen receptor [ER] and progesterone receptor [PR]), gene mutations (e.g., mutations of breast cancer 1/2 [BRCA1/2] and phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha [PIK3CA]) and markers of the immune microenvironment (e.g., tumor-infiltrating lymphocyte [TIL] and programmed death-ligand 1 [PD-L1]). Early-stage breast cancer is considered curable, for which local-regional therapies (surgery and radiotherapy) are the cornerstone, with systemic therapy given before or after surgery when necessary. Preoperative or neoadjuvant therapy, including targeted drugs or immune checkpoint inhibitors, has become the standard of care for most early-stage HER2-positive and triple-negative breast cancer, followed by risk-adapted post-surgical strategies. For ER-positive early breast cancer, endocrine therapy for 5-10 years is essential. Advanced breast cancer with distant metastases is currently considered incurable. Systemic therapies in this setting include endocrine therapy with targeted agents, such as CDK4/6 inhibitors and phosphoinositide 3-kinase (PI3K) inhibitors for hormone receptor-positive disease, anti-HER2 targeted therapy for HER2-positive disease, poly(ADP-ribose) polymerase inhibitors for BRCA1/2 mutation carriers and immunotherapy currently for part of triple-negative disease. Innovation technologies of precision medicine may guide individualized treatment escalation or de-escalation in the future. In this review, we summarized the latest scientific information and discussed the future perspectives on breast cancer.
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Affiliation(s)
- Ruoxi Hong
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, P. R. China
| | - Binghe Xu
- State Key Laboratory of Molecular Oncology and Department of Medical Oncology, Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100006, P. R. China
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17
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Clinical utility of MRI in the neoadjuvant management of early-stage breast cancer. Breast Cancer Res Treat 2022; 194:587-595. [PMID: 35704226 DOI: 10.1007/s10549-022-06640-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 05/24/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND With the increasing use of neoadjuvant treatment (NAT) for patients with early-stage breast cancer (ESBC), adequate clinical staging is essential to inform treatment. While the use of MRI with NAT has been proposed to help with accuracy of pre-treatment clinical staging, its impact in clinical practice remains controversial. METHODS A prospective institutional database of patients with ESBC treated with NAT between May 2012 and December 2020 was analyzed in order to compare the management of patients who received an MRI prior to NAT to those who did not. The indications for MRI and correlation of MRI findings to conventional breast imaging were evaluated. The impact of MRI on management was compared between the MRI and non-MRI groups. RESULTS A total of 530 patients met inclusion criteria. Of these, 186 (35.1%) had an MRI and 344 (64.9%) did not. The most frequent indication for MRI was the determination of disease extent (54.5%). Patients who had an MRI prior to neoadjuvant treatment were significantly more likely to be younger (47 years versus 57 years; p < 0.001) and have multifocal disease (32.3% versus 22.1%; p < 0.05). When compared to conventional imaging, MRI reported a greater extent of disease in the breast (37.6%), more nodal involvement (18.8%), and multifocal disease (15.1%). Additional diagnostic interventions were advised in 52.2% of patients who underwent MRI. Rates of mastectomies were greater in the MRI group (80.0% versus 58.9%; p < 0.05) in addition to more axillary dissections (28.0% versus 17.4%; p < 0.01). Rates of locoregional recurrences were low in both groups, with similar disease-free survival outcomes at 5 years. CONCLUSION MRI identified significantly more disease in contrast to conventional imaging and lead to more aggressive surgical management. Prospective studies evaluating the role of MRI before NAT and its impact on long-term outcomes are needed.
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Latif G, Ben Brahim G, Iskandar DNFA, Bashar A, Alghazo J. Glioma Tumors' Classification Using Deep-Neural-Network-Based Features with SVM Classifier. Diagnostics (Basel) 2022; 12:diagnostics12041018. [PMID: 35454066 PMCID: PMC9032951 DOI: 10.3390/diagnostics12041018] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 04/08/2022] [Indexed: 11/16/2022] Open
Abstract
The complexity of brain tissue requires skillful technicians and expert medical doctors to manually analyze and diagnose Glioma brain tumors using multiple Magnetic Resonance (MR) images with multiple modalities. Unfortunately, manual diagnosis suffers from its lengthy process, as well as elevated cost. With this type of cancerous disease, early detection will increase the chances of suitable medical procedures leading to either a full recovery or the prolongation of the patient's life. This has increased the efforts to automate the detection and diagnosis process without human intervention, allowing the detection of multiple types of tumors from MR images. This research paper proposes a multi-class Glioma tumor classification technique using the proposed deep-learning-based features with the Support Vector Machine (SVM) classifier. A deep convolution neural network is used to extract features of the MR images, which are then fed to an SVM classifier. With the proposed technique, a 96.19% accuracy was achieved for the HGG Glioma type while considering the FLAIR modality and a 95.46% for the LGG Glioma tumor type while considering the T2 modality for the classification of four Glioma classes (Edema, Necrosis, Enhancing, and Non-enhancing). The accuracies achieved using the proposed method were higher than those reported by similar methods in the extant literature using the same BraTS dataset. In addition, the accuracy results obtained in this work are better than those achieved by the GoogleNet and LeNet pre-trained models on the same dataset.
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Affiliation(s)
- Ghazanfar Latif
- Faculty of Computer Science and Information Technology, Université du Québec à Chicoutimi, 555 Boulevard de l’Université, Chicoutimi, QC G7H2B1, Canada; or
- Department of Computer Science, Prince Mohammad bin Fahd University, Khobar 31952, Saudi Arabia
| | - Ghassen Ben Brahim
- Department of Computer Science, Prince Mohammad bin Fahd University, Khobar 31952, Saudi Arabia
- Correspondence:
| | - D. N. F. Awang Iskandar
- Faculty of Computer Science and Information Technology, Universiti Malaysia Sarawak, Kota Samarahan 94300, Malaysia;
| | - Abul Bashar
- Department of Computer Engineering, Prince Mohammad bin Fahd University, Khobar 31952, Saudi Arabia;
| | - Jaafar Alghazo
- Department of Electrical and Computer Engineering, Virginia Military Institute, Lexington, VA 24450, USA;
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Green VL. Breast Cancer Risk Assessment and Management of the High-Risk Patient. Obstet Gynecol Clin North Am 2022; 49:87-116. [DOI: 10.1016/j.ogc.2021.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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20
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Singh S, Singh S. Dopingless Negative Capacitance Ferroelectric TFET for Breast Cancer Cells Detection: Design and Sensitivity Analysis. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2022; 69:1120-1129. [PMID: 34910631 DOI: 10.1109/tuffc.2021.3136099] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The current research article reports the electrical detection of breast cancer cell lines (MDA-MB-231, Hs578T, T47D, and MCF-7) by deploying dopingless negative capacitance (NC) ferroelectric (FE) tunnel field-effect transistor (DL-FE-TFET). This device has a double dual metal gate and two nanocavities engraved underneath both gate electrodes for higher detection sensitivity. Our work reports the detection of nontumorigenic cell (MCF-10A) and breast cancer cell lines by combining the NC effect of FE material and dopingless technology synergistically. Here, FE material amplifies the applied gate bias intrinsically. The in-depth electrostatic analysis in terms of surface potential, carrier concentration, energy band diagram, drive current, and electric field has been depicted. Variation of the dielectric constant of these breast cancerous cell lines dictates the detection mechanism in our reported biosensor. The sensitivity has been analyzed in terms of drive current, ION/IOFF ratio, [Formula: see text], and transconductance. The optimized cavity structure demonstrates significantly high drain current sensitivity of the order of 2.88×109 and ION/IOFF ratio sensitivity of the order of 3.2×105 . In addition, the effect of device geometry variation, such as cavity length and FE layer thickness on the drain current sensitivity and ION/IOFF sensitivity, transconductance sensitivity ( Sgm ), and threshold voltage sensitivity ( [Formula: see text]) of the device, has also been investigated. This device structure may be deployed for the array-based screening and diagnosis of breast cancer cells lines, with additional benefits including a simpler mechanism of transduction, cost effectiveness, technology compatibility with CMOS process, adjustable electrical response, and reproducibility.
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21
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Comparison of the diagnostic performance of Magnetic Resonance Imaging (MRI), ultrasound and mammography for detection of breast cancer based on tumor type, breast density and patient's history: A review. Radiography (Lond) 2022; 28:848-856. [DOI: 10.1016/j.radi.2022.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 01/14/2022] [Accepted: 01/19/2022] [Indexed: 02/07/2023]
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22
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Simpson CE, Kolb TM, Hsu S, Zimmerman SL, Corona‐Villalobos CP, Mathai SC, Damico RL, Hassoun PM. Ventricular mass discriminates pulmonary arterial hypertension as redefined at the Sixth World Symposium on Pulmonary Hypertension. Pulm Circ 2022; 12:e12005. [PMID: 35506079 PMCID: PMC9052971 DOI: 10.1002/pul2.12005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 11/19/2021] [Accepted: 11/20/2021] [Indexed: 11/09/2022] Open
Abstract
Cardiac magnetic resonance (CMR) measures of right ventricular (RV) mass, volumes, and function have diagnostic and prognostic value in pulmonary arterial hypertension (PAH). We hypothesized that RV mass-based metrics would discriminate incident PAH as redefined by the lower mean pulmonary arterial pressure (mPAP) threshold of >20 mmHg at the Sixth World Symposium on Pulmonary Hypertension (6th WSPH). Eighty-nine subjects with suspected PAH underwent CMR imaging, including 64 subjects with systemic sclerosis (SSc). CMR metrics, including RV and left ventricular (LV) mass, were measured. All subjects underwent right heart catheterization (RHC) for assessment of hemodynamics within 48 h of CMR. Using generalized linear models, associations between CMR metrics and PAH were assessed, the best subset of CMR variables for predicting PAH were identified, and relationships between mass-based metrics, hemodynamics, and other predictive CMR metrics were examined. Fifty-nine subjects met 6th WSPH criteria for PAH. RV mass metrics, including ventricular mass index (VMI), demonstrated the greatest magnitude difference between subjects with versus without PAH. Overall and in SSc, VMI and RV mass measured by CMR were among the most predictive variables discriminating PAH at RHC, with areas under the receiver operating characteristic curve 0.86 and 0.83. respectively. VMI increased linearly with pulmonary vascular resistance and with mPAP in PAH, including in lower ranges of mPAP associated with mild PAH. VMI ≥ 0.37 yielded a positive predictive value of 90% for discriminating PAH. RV mass metrics measured by CMR, including VMI, discriminate incident, treatment-naïve PAH as defined by 6th WSPH criteria.
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Affiliation(s)
- Catherine E. Simpson
- Department of Medicine, Division of Pulmonary and Critical Care MedicineJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Todd M. Kolb
- Department of Medicine, Division of Pulmonary and Critical Care MedicineJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Steven Hsu
- Department of Medicine, Division of CardiologyJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Stefan L. Zimmerman
- Department of Radiology and Radiological ScienceJohns Hopkins UniversityBaltimoreMarylandUSA
| | | | - Stephen C. Mathai
- Department of Medicine, Division of Pulmonary and Critical Care MedicineJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Rachel L. Damico
- Department of Medicine, Division of Pulmonary and Critical Care MedicineJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Paul M. Hassoun
- Department of Medicine, Division of Pulmonary and Critical Care MedicineJohns Hopkins UniversityBaltimoreMarylandUSA
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Zheng A, Jin ZN, Cui MY, Chen B, Yao F, Jin F, Xu YY. Clinical practice guidelines for ductal carcinoma in situ: Chinese Society of Breast Surgery (CSBrS) practice guidelines 2021. Chin Med J (Engl) 2021; 134:1519-1521. [PMID: 34116527 PMCID: PMC8280070 DOI: 10.1097/cm9.0000000000001506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Indexed: 11/03/2022] Open
Affiliation(s)
- Ang Zheng
- Department of Breast Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
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Pathak V, Nolte T, Rama E, Rix A, Dadfar SM, Paefgen V, Banala S, Buhl EM, Weiler M, Schulz V, Lammers T, Kiessling F. Molecular magnetic resonance imaging of Alpha-v-Beta-3 integrin expression in tumors with ultrasound microbubbles. Biomaterials 2021; 275:120896. [PMID: 34090049 DOI: 10.1016/j.biomaterials.2021.120896] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/10/2021] [Accepted: 05/12/2021] [Indexed: 11/28/2022]
Abstract
Microbubbles (MB) are used as ultrasound (US) contrast agents and can be efficiently targeted against markers of angiogenesis and inflammation. Due to their gas core, MB locally alter susceptibilities in magnetic resonance imaging (MRI), but unfortunately, the resulting contrast is low and not sufficient to generate powerful molecular MRI probes. Therefore, we investigated whether a potent molecular MR agent can be generated by encapsulating superparamagnetic iron oxide nanoparticles (SPION) in the polymeric shell of poly (n-butylcyanoacrylate) (PBCA) MB and targeted them against αvβ3 integrins on the angiogenic vasculature of 4T1 murine breast carcinomas. SPION-MB consist of an air core and a multi-layered polymeric shell enabling efficient entrapment of SPION. The mean size of SPION-MB was 1.61 ± 0.32 μm. Biotin-streptavidin coupling was employed to functionalize the SPION-MB with cyclic RGDfK (Arg-Gly-Asp) and RADfK (Arg-Ala-Asp) peptides. Cells incubated with RGD-SPION-MB showed enhanced transverse relaxation rates compared with SPION-MB and blocking αvβ3 integrin receptors with excess free cRGDfK significantly reduced RGD-SPION-MB binding. Due to the fast binding of RGD-SPION-MB in vivo, dynamic susceptibility contrast MRI was employed to track their retention in tumors in real-time. Higher retention of RGD-SPION-MB was observed compared with SPION-MB and RAD-SPION-MB. To corroborate our MRI results, molecular US was performed the following day using the destruction-replenishment method. Both imaging modalities consistently indicated higher retention of RGD-SPION-MB in angiogenic vessels compared with SPION-MB and RAD-SPION-MB. Competitive blocking experiments in mice further confirmed that the binding of RGD-SPION-MB to αvβ3 integrin receptors is specific. Overall, this study demonstrates that RGD-SPION-MB can be employed as molecular MR/US contrast agents and are capable of assessing the αvβ3 integrin expression in the neovasculature of malignant tumors.
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Affiliation(s)
- Vertika Pathak
- Institute for Experimental Molecular Imaging, RWTH Aachen University, 52074, Aachen, Germany
| | - Teresa Nolte
- Institute for Experimental Molecular Imaging, RWTH Aachen University, 52074, Aachen, Germany
| | - Elena Rama
- Institute for Experimental Molecular Imaging, RWTH Aachen University, 52074, Aachen, Germany
| | - Anne Rix
- Institute for Experimental Molecular Imaging, RWTH Aachen University, 52074, Aachen, Germany
| | | | - Vera Paefgen
- Institute for Experimental Molecular Imaging, RWTH Aachen University, 52074, Aachen, Germany
| | - Srinivas Banala
- Institute for Experimental Molecular Imaging, RWTH Aachen University, 52074, Aachen, Germany
| | - Eva Miriam Buhl
- Electron Microscope Facility, University Hospital RWTH, RWTH Aachen University, 52074, Aachen, Germany
| | - Marek Weiler
- Institute for Experimental Molecular Imaging, RWTH Aachen University, 52074, Aachen, Germany
| | - Volkmar Schulz
- Institute for Experimental Molecular Imaging, RWTH Aachen University, 52074, Aachen, Germany
| | - Twan Lammers
- Institute for Experimental Molecular Imaging, RWTH Aachen University, 52074, Aachen, Germany
| | - Fabian Kiessling
- Institute for Experimental Molecular Imaging, RWTH Aachen University, 52074, Aachen, Germany.
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25
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Clinical practice guidelines for diagnosis and treatment of invasive breast cancer: Chinese Society of Breast Surgery (CSBrS) practice guidelines 2021. Chin Med J (Engl) 2021; 134:1009-1013. [PMID: 33942798 PMCID: PMC8116006 DOI: 10.1097/cm9.0000000000001498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Latif G, Iskandar DNFA, Alghazo J, Butt MM. Brain MR Image Classification for Glioma Tumor detection using Deep Convolutional Neural Network Features. Curr Med Imaging 2021; 17:56-63. [PMID: 32160848 DOI: 10.2174/1573405616666200311122429] [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] [Received: 09/13/2019] [Revised: 01/29/2020] [Accepted: 02/11/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Detection of brain tumor is a complicated task, which requires specialized skills and interpretation techniques. Accurate brain tumor classification and segmentation from MR images provide an essential choice for medical treatments. Different objects within an MR image have similar size, shape, and density, which makes the tumor classification and segmentation even more complex. OBJECTIVE Classification of the brain MR images into tumorous and non-tumorous using deep features and different classifiers to get higher accuracy. METHODS In this study, a novel four-step process is proposed; pre-processing for image enhancement and compression, feature extraction using convolutional neural networks (CNN), classification using the multilayer perceptron and finally, tumor segmentation using enhanced fuzzy cmeans method. RESULTS The system is tested on 65 cases in four modalities consisting of 40,300 MR Images obtained from the BRATS-2015 dataset. These include images of 26 Low-Grade Glioma (LGG) tumor cases and 39 High-Grade Glioma (HGG) tumor cases. The proposed CNN feature-based classification technique outperforms the existing methods by achieving an average accuracy of 98.77% and a noticeable improvement in the segmentation results are measured. CONCLUSION The proposed method for brain MR image classification to detect Glioma Tumor detection can be adopted as it gives better results with high accuracies.
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Affiliation(s)
- Ghazanfar Latif
- Faculty of Computer Science and Information Technology, Universiti Malaysia Sarawak, Kota Samarahan, Malaysia
| | - D N F Awang Iskandar
- Faculty of Computer Science and Information Technology, Universiti Malaysia Sarawak, Kota Samarahan, Malaysia
| | - Jaafar Alghazo
- College of Computer Engineering and Sciences, Prince Mohammad bin Fahd University, Khobar, Saudi Arabia
| | - M Mohsin Butt
- College of Applied and Supporting Studies, King Fahd University of Petroleum and Minerals, Dhahran, Saudi Arabia
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27
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Quantitative STAU2 measurement in lymphocytes for breast cancer risk assessment. Sci Rep 2021; 11:915. [PMID: 33441653 PMCID: PMC7806934 DOI: 10.1038/s41598-020-79622-2] [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] [Received: 08/14/2020] [Accepted: 12/08/2020] [Indexed: 01/29/2023] Open
Abstract
Although mammograms play a key role in early breast cancer detection, the test is not applicable to all women, for example, women under the age of 40. The development of a noninvasive blood test with high sensitivity and accessibility will improve the effectiveness of breast cancer screening programmes. Secretory factors released from cancer cells can induce the expression of certain genes in a large number of white blood cells (WBCs). Therefore, cancer-dependent proteins in WBCs can be used as tumour markers with high sensitivity. Five proteins (LMAN1, AZI2, STAU2, MMP9 and PLOD1) from a systemic analysis of a variety of array data of breast cancer patients were subjected to immunofluorescence staining to evaluate the presence of fixed WBCs on 96-well plates from 363 healthy females and 358 female breast cancer patients. The results revealed that the average fluorescence intensity of anti-STAU2 and the percentage of STAU2-positive T and B lymphocytes in breast cancer patients (110.50 ± 23.38 and 61.87 ± 12.44, respectively) were significantly increased compared with those in healthy females (56.47 ± 32.03 and 33.02 ± 18.10, respectively) (p = 3.56 × 10-71, odds ratio = 24.59, 95% CI = 16.64-36.34). The effect of secreted molecules from breast cancer cells was proven by the increase in STAU2 intensity in PBMCs cocultured with MCF-7 and T47D cells at 48 h (p = 0.0289). The test demonstrated 98.32%, 82.96%, and 48.32% sensitivity and 56.47%, 83.47%, and 98.62% specificity in correlation with the percentage of STAU2-positive cells at 40, 53.34 and 63.38, respectively. We also demonstrated how to use the STAU2 test for the assessment of risk in women under the age of 40. STAU2 is a novel breast cancer marker that can be assessed by quantitative immunofluorescence staining of fixed WBCs that are transportable at room temperature via mail, representing a useful risk assessment tool for women without access to mammograms.
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Mulder RL, Hudson MM, Bhatia S, Landier W, Levitt G, Constine LS, Wallace WH, van Leeuwen FE, Ronckers CM, Henderson TO, Moskowitz CS, Friedman DN, Ng AK, Jenkinson HC, Demoor-Goldschmidt C, Skinner R, Kremer LC, Oeffinger KC. Updated Breast Cancer Surveillance Recommendations for Female Survivors of Childhood, Adolescent, and Young Adult Cancer From the International Guideline Harmonization Group. J Clin Oncol 2020; 38:4194-4207. [PMID: 33078972 PMCID: PMC7723685 DOI: 10.1200/jco.20.00562] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2020] [Indexed: 01/02/2023] Open
Abstract
PURPOSE As new evidence is available, the International Late Effects of Childhood Cancer Guideline Harmonization Group has updated breast cancer surveillance recommendations for female survivors of childhood, adolescent, and young adult cancer. METHODS We used evidence-based methods to apply new knowledge in refining the international harmonized recommendations developed in 2013. The guideline panel updated the systematic literature review, developed evidence summaries, appraised the evidence, and updated recommendations on the basis of evidence, clinical judgement, and consideration of benefits versus the harms of the surveillance interventions while attaining flexibility in implementation across different health care systems. The GRADE Evidence-to-Decision framework was used to translate evidence to recommendations. A survivor information form was developed to counsel survivors about the potential harms and benefits of surveillance. RESULTS The literature update identified new study findings related to the effects of prescribed moderate-dose chest radiation (10 to 19 Gy), radiation dose-volume, anthracyclines and alkylating agents in non-chest irradiated survivors, and the effects of ovarian function on breast cancer risk. Moreover, new data from prospective investigations were available regarding the performance metrics of mammography and magnetic resonance imaging among survivors of Hodgkin lymphoma. Modified recommendations include the performance of mammography and breast magnetic resonance imaging for survivors treated with 10 Gy or greater chest radiation (strong recommendation) and upper abdominal radiation exposing breast tissue at a young age (moderate recommendation) at least annually up to age 60 years. As a result of inconsistent evidence, no recommendation could be formulated for routine breast cancer surveillance for survivors treated with any type of anthracyclines in the absence of chest radiation. CONCLUSION The newly identified evidence prompted significant change to the recommendations formulated in 2013 related to moderate-dose chest radiation and anthracycline exposure as well as breast cancer surveillance modality.
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Affiliation(s)
- Renée L. Mulder
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Melissa M. Hudson
- Departments of Epidemiology and Cancer Control, and Oncology, St Jude Children’s Research Hospital, Memphis, TN
| | - Smita Bhatia
- Institute for Cancer Outcomes and Survivorship and Department of Pediatrics, School of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Wendy Landier
- Institute for Cancer Outcomes and Survivorship and Department of Pediatrics, School of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Gill Levitt
- Department of Oncology/Haematology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Louis S. Constine
- Departments of Radiation Oncology and Pediatrics, University of Rochester Medical Center, Rochester, NY
| | - W. Hamish Wallace
- Department of Paediatric Oncology, Royal Hospital for Sick Children, Edinburgh, United Kingdom
| | - Flora E. van Leeuwen
- Department of Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Cécile M. Ronckers
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Institute for Biostatistics and Registry Research, Medical University Brandenburg, Theodor Fontane, Neuruppin, Germany
| | - Tara O. Henderson
- Department of Pediatrics, University of Chicago Pritzker School of Medicine, Chicago, IL
| | - Chaya S. Moskowitz
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Danielle N. Friedman
- Departments of Pediatrics and Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Helen C. Jenkinson
- Department of Paediatric Oncology, Birmingham Children’s Hospital, NHS Foundation Trust, Birmingham, United Kingdom
| | - Charlotte Demoor-Goldschmidt
- Centre for Research in Epidemiology and Population Health, Cancer and Radiation team, University of Paris-Sud, Villejuif, France
- Department of Pediatric and Adolescent Hematology/Oncology, CHU Angers, Angers, France
| | - Roderick Skinner
- Department of Paediatric and Adolescent Haematology/Oncology, Great North Children’s Hospital and Newcastle University Centre for Cancer, Newcastle upon Tyne, United Kingdom
| | - Leontien C.M. Kremer
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Department of Pediatric Oncology, Emma Children’s Hospital, Amsterdam University Medical Center, University of Amsterdam, the Netherlands
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Patel BK, Samreen N, Zhou Y, Chen J, Brandt K, Ehman R, Pepin K. MR Elastography of the Breast: Evolution of Technique, Case Examples, and Future Directions. Clin Breast Cancer 2020; 21:e102-e111. [PMID: 32900617 DOI: 10.1016/j.clbc.2020.08.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/20/2020] [Accepted: 08/10/2020] [Indexed: 02/07/2023]
Abstract
Recognizing that breast cancers present as firm, stiff lesions, the foundation of breast magnetic resonance elastography (MRE) is to combine tissue stiffness parameters with sensitive breast MR contrast-enhanced imaging. Breast MRE is a non-ionizing, cross-sectional MR imaging technique that provides for quantitative viscoelastic properties, including tissue stiffness, elasticity, and viscosity, of breast tissues. Currently, the technique continues to evolve as research surrounding the use of MRE in breast tissue is still developing. In the setting of a newly diagnosed cancer, associated desmoplasia, stiffening of the surrounding stroma, and necrosis are known to be prognostic factors that can add diagnostic information to patient treatment algorithms. In fact, mechanical properties of the tissue might also influence breast cancer risk. For these reasons, exploration of breast MRE has great clinical value. In this review, we will: (1) address the evolution of the various MRE techniques; (2) provide a brief overview of the current clinical studies in breast MRE with interspersed case examples; and (3) suggest directions for future research.
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Affiliation(s)
| | | | - Yuxiang Zhou
- Department of Radiology, Mayo Clinic, Phoenix, AZ
| | - Jun Chen
- Department of Radiology, Mayo Clinic, Rochester, MN
| | - Kathy Brandt
- Department of Radiology, Mayo Clinic, Rochester, MN
| | | | - Kay Pepin
- Department of Radiology, Mayo Clinic, Rochester, MN
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Pal UM, Gk AV, Gogoi G, Rila S, Shroff S, Am G, Borah P, Varma M, Kurpad V, Baruah D, Vaidya JS, Pandya HJ. Towards a Portable Platform Integrated With Multispectral Noncontact Probes for Delineating Normal and Breast Cancer Tissue Based on Near-Infrared Spectroscopy. IEEE TRANSACTIONS ON BIOMEDICAL CIRCUITS AND SYSTEMS 2020; 14:879-888. [PMID: 32746350 DOI: 10.1109/tbcas.2020.3005971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Currently, the confirmation of diagnosis of breast cancer is made by microscopic examination of an ultra-thin slice of a needle biopsy specimen. This slice is conventionally formalin-fixed and stained with hematoxylin-eosin and visually examined under a light microscope. This process is labor-intensive and requires highly skilled doctors (pathologists). In this paper, we report a novel tool based on near-infrared spectroscopy (Spectral-IRDx) which is a portable, non-contact, and cost-effective system and could provide a rapid and accurate diagnosis of cancer. The Spectral-IRDx tool performs absorption spectroscopy at near-infrared (NIR) wavelengths of 850, 935, and 1060 nm. We measure normalized detected voltage (Vdn) with the tool in 10 deparaffinized breast biopsy tissue samples, 5 of which were cancer (C) and 5 were normal (N) tissues. The difference in Vdn at 935 nm and 1060 nm between cancer and normal tissues is statistically significant with p-values of 0.0038 and 0.0022 respectively. Absorption contrast factor (N/C) of 1.303, 1.551, and 1.45 are observed for 850, 935, and 1060 nm respectively. The volume fraction contrast (N/C) of lipids and collagens are reported as 1.28 and 1.10 respectively. Higher absorption contrast factor (N/C) and volume fraction contrast (N/C) signifies higher concentration of lipids in normal tissues as compared to cancerous tissues, a basis for delineation. These preliminary results support the envisioned concept for noninvasive and noncarcinogenic NIR-based breast cancer diagnostic platform, which will be tested using a larger number of samples.
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Aboughaleb IH, Aref MH, El-Sharkawy YH. Hyperspectral imaging for diagnosis and detection of ex-vivo breast cancer. Photodiagnosis Photodyn Ther 2020; 31:101922. [PMID: 32726640 DOI: 10.1016/j.pdpdt.2020.101922] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 06/09/2020] [Accepted: 07/10/2020] [Indexed: 01/28/2023]
Abstract
BACKGROUND AND PURPOSE Breast cancer is one of the most widely recognized tumors. .Diagnosis made in the early stage of disease may imporve outcomes. The discovery of malignant growth utilizing noninvasive light intrusive methods in lieu of conventional excisional biopsy may assist in achieving this goal. MATERIALS AND METHODS The change of the optical properties of ex-vivo breast tissues provides different responses to light transmission, absorption, and particularly the reflection over the spectrum range. We offer the use of Hyperspectral imaging (HSI) with advanced image processing and pattern recognition in order to analyze HSI data for breast cancer detection. The spectral signatures were mined and evaluated in both malignant and normal tissue. K-mean clustering was designed for classifying hyperspectral data in order to evaluate and detection of cancer tissue. This method was used to detect ex-vivo breast cancer. Spatial spectral images were created to high spot the differences in the reflectance properties of malignant versus normal tissue. RESULTS Trials showed that the superficial spectral reflection images within 500 nm wavelength showed high variance (214.65) between cancerous and normal breast tissues. On the other hand, image within 620 nm wavelength showed low variance (0.0020).However, the superimposed of spectral region 420-620 nm was proposed as the optimum bandwidth. Finally, the proposed HS imaging system was capable to discriminate the tumor region from normal tissue of the ex-vivo breast sample with sensitivity and a specificity of 95 % and 96 %. CONCLUSIONS High sensitivity and specificity were achieved, which proposes potential for HSI as an edge evaluation method to enhance the surgical outcome compared to the presently available techniques in the clinics.
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Affiliation(s)
- Ibrahim H Aboughaleb
- Military Technical College, Biomedical Engineering Department, El-Fangary Street, Cairo, Egypt.
| | - Mohamed Hisham Aref
- Military Technical College, Biomedical Engineering Department, El-Fangary Street, Cairo, Egypt.
| | - Yasser H El-Sharkawy
- Military Technical College, Biomedical Engineering Department, El-Fangary Street, Cairo, Egypt.
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Does Breast Cancer Increasingly Affect Younger Women? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134884. [PMID: 32645841 PMCID: PMC7370185 DOI: 10.3390/ijerph17134884] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/03/2020] [Accepted: 07/03/2020] [Indexed: 12/26/2022]
Abstract
Breast cancer is the most frequently diagnosed malignant neoplasm among females. The proportion of women diagnosed in the premenopausal period is relatively small. Nevertheless, this is the most commonly diagnosed cancer among young women. The aim of the study was to analyze the incidence rate of breast cancer in a group of young women based on data obtained in the Lower Silesian Voivodeship between 1984 and 2016. A total of 34,251 women with a diagnosis of invasive breast cancer were analyzed. The median age of diagnosis exhibited an upward trend from 57 to 63. The youngest age of breast cancer diagnosis did not decrease. Women up to the age of 24 were sporadically diagnosed. Given the total number of cases, the proportion of women under the age of 39 was approximately 5%, and it did not increase throughout the entire examination period. The major increase in the growth trend during the analyzed period was observed in a group of women aged of 50–69 (regression coefficient: +24.9) and above 70 (regression coefficient +21.2). In a group of women under 40 the regression coefficient was only +4. It seems that breast cancer does not increasingly affect younger women since the risk in this age group remains low. However, an increasing incidence rate of breast cancer is more commonly observed in premenopausal women.
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A smart switching system to enable automatic tuning and detuning of metamaterial resonators in MRI scans. Sci Rep 2020; 10:10042. [PMID: 32572087 PMCID: PMC7308377 DOI: 10.1038/s41598-020-66884-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 05/28/2020] [Indexed: 12/20/2022] Open
Abstract
We present a radio-frequency-activated switching system that can automatically detune a metamaterial resonator to enhance magnetic resonance imaging (MRI) performance. Local sensitivity-enhancing metamaterials typically consist of resonant components, which means that the transmitted radio frequency field is spatially inhomogeneous. The switching system shows for the first time that a metamaterial resonator can be detuned during transmission and tuned during reception using a digital circuit. This allows a resonating system to maintain homogeneous transmit field while maintaining an increased receive sensitivity. As a result, sensitivity can be enhanced without changing the system-provided specific absorption rate (SAR) models. The developed digital circuit consists of inductors sensitive to the transmit radio-frequency pulses, along with diodes acting as switches to control the resonance frequency of the resonator. We first test the automatic resonator detuning on-the-bench, and subsequently evaluate it in a 1.5 T MRI scanner using tissue-mimicking phantoms. The scan results demonstrate that the switching mechanism automatically detunes the resonator in transmit mode, while retaining its sensitivity-enhancing properties (tuned to the Larmor frequency) in receive mode. Since it does not require any connection to the MRI console, the switching system can have broad applications and could be adapted for use with other types of MRI scanners and field-enhancing resonators.
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Hudson L, Gower N, Lenarcic S, Trufan SJ, White RL. Radiographic Surveillance of Patients with Non-BRCA1/2 Pathogenic Variants. Ann Surg Oncol 2020; 27:2248-2254. [PMID: 31974710 DOI: 10.1245/s10434-019-08191-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The National Comprehensive Cancer Network (NCCN) developed clinical practice guidelines for germline pathogenic variants in highly penetrant genes, such as TP53 and PTEN, and in moderately penetrant genes, such as CHEK2, ATM and PALB2. Whether the practice of radiographic surveillance of patients with pathogenic variants in genes other than BRCA1/2 complies with current NCCN guidelines remains unclear. METHODS Retrospective review of patients identified with pathogenic variants in genes other than BRCA1/2 from 2007 through 2017 to determine if radiographic surveillance was in accordance with NCCN guidelines for mammography and consideration of magnetic resonance imaging (MRI). Exclusions included variants of unknown significance, pathogenic variants not associated with an increased risk of breast cancer, and previous breast cancer diagnosis. RESULTS After exclusions, 35 patients with pathogenic variants in ATM, CDH1, CHEK2, NBN, PALB2, PTEN, and STK11 genes were reviewed to assess whether radiographic surveillance was in accordance with NCCN guidelines. Guidelines for those with variants in ATM, CHEK2 and NBN includes annual mammography with tomosynthesis and consideration of breast MRI at age 40, variants in CDH1 and PALB2 at age 30, variants in PTEN at age 30-35 or 5-10 years before the earliest family breast cancer, and variants in STK11 at age 25. Of these 35 patients, 11 (31%) received mammography only; 11 (31%) received mammography and MRI, and 13 (37%) received no radiographic surveillance. Two of the 35 (6%) patients who received radiographic surveillance were diagnosed with ductal carcinoma in situ or invasive breast cancer. CONCLUSION Thirty-one percent of patients with pathogenic variants in genes other than BRCA1/2 received both mammography and MRI. Thirty-seven percent of patients with these highly penetrant and moderately penetrant genes received no radiographic follow-up, clearly demonstrating an opportunity for improvement.
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Affiliation(s)
- Laura Hudson
- Division of Surgical Oncology, Department of Surgery, Carolinas Medical Center, Levine Cancer Institute, Charlotte, NC, USA
| | - Nicole Gower
- Division of Surgical Oncology, Department of Surgery, Carolinas Medical Center, Levine Cancer Institute, Charlotte, NC, USA
| | - Stacy Lenarcic
- Department of Genetics, Levine Cancer Institute, Charlotte, NC, USA
| | - Sally J Trufan
- Department of Cancer Biostatistics, Levine Cancer Institute, Charlotte, NC, USA
| | - Richard L White
- Division of Surgical Oncology, Department of Surgery, Carolinas Medical Center, Levine Cancer Institute, Charlotte, NC, USA.
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Lobbes MBI, Hecker J, Houben IPL, Pluymakers R, Jeukens C, Laji UC, Gommers S, Wildberger JE, Nelemans PJ. Evaluation of single-view contrast-enhanced mammography as novel reading strategy: a non-inferiority feasibility study. Eur Radiol 2019; 29:6211-6219. [PMID: 31073859 PMCID: PMC6795610 DOI: 10.1007/s00330-019-06215-7] [Citation(s) in RCA: 4] [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: 01/10/2019] [Revised: 03/13/2019] [Accepted: 04/02/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Guidelines recommend screening of high-risk women using breast magnetic resonance imaging (MRI). Contrast-enhanced mammography (CEM) has matured, providing excellent diagnostic accuracy. To lower total radiation dose, evaluation of single-view (1 V) CEM exams might be considered instead of double-view (2 V) readings as an alternative reading strategy in women who cannot undergo MRI. METHODS This retrospective non-inferiority feasibility study evaluates whether the use of 1 V results in an acceptable sensitivity for detecting breast cancer (non-inferiority margin, - 10%). CEM images from May 2013 to December 2017 were included. 1 V readings were performed by consensus opinion of three radiologists, followed by 2 V readings being performed after 6 weeks. Cases were considered "malignant" if the final BI-RADS score was ≥ 4, enabling calculation of sensitivity, specificity, and area under the receiver operating characteristic curve (AUC). Histopathological results or follow-up served as a gold standard. RESULTS A total of 368 cases were evaluated. Mean follow-up for benign or negative cases was 20.9 months. Sensitivity decreased by 9.6% from 92.9 to 83.3% when only 1 V was used for evaluation (p < 0.001). The lower limit of the 90% confidence interval around the difference in sensitivity between 1 V and 2 V readings was - 15% and lies below the predefined non-inferiority margin of - 10%. Hence, non-inferiority of 1 V to 2 V reading cannot be concluded. AUC for 1 V was significantly lower, 0.861 versus 0.899 for 2 V (p = 0.0174). CONCLUSION Non-inferiority of 1 V evaluations as an alternative reading strategy to standard 2 V evaluations could not be concluded. 1 V evaluations had lower diagnostic performance compared with 2 V evaluations. KEY POINTS • To lower radiation exposure used in contrast-enhanced mammography, we studied a hypothetical alternative strategy: single-view readings (1 V) versus (standard) double-view readings (2 V). • Based on our predefined margin of - 10%, non-inferiority of 1 V could not be concluded. • 1 V evaluation is not recommended as an alternative reading strategy to lower CEM-related radiation exposure.
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Affiliation(s)
- M B I Lobbes
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.
- GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands.
| | - J Hecker
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - I P L Houben
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - R Pluymakers
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - C Jeukens
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - U C Laji
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - S Gommers
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - J E Wildberger
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - P J Nelemans
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
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Yalnız C, Rosenblat J, Spak D, Wei W, Scoggins M, Le-Petross C, Dryden MJ, Adrada B, Doğan BE. Association of Retrospective Peer Review and Positive Predictive Value of Magnetic Resonance Imaging-Guided Vacuum-Assisted Needle Biopsies of Breast. Eur J Breast Health 2019; 15:229-234. [PMID: 31620681 DOI: 10.5152/ejbh.2019.5002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 06/30/2019] [Indexed: 12/17/2022]
Abstract
Objective To evaluate the association between retrospective peer review of breast magnetic resonance imaging-guided vacuum-assisted needle biopsies and positive predictive value of subsequent magnetic resonance imaging-guided biopsies. Materials and Methods In January, 2015, a weekly conference was initiated in our institution to evaluate all breast magnetic resonance imaging-guided vacuum-assisted needle biopsies performed over January 1, 2014-December 31, 2015. During this weekly conferences, breast dynamic contrast-enhanced magnetic resonance imaging findings of 6 anonymized cases were discussed and then the faculty voted on whether they agree with the biopsy indication, accurate sampling and radiology-pathology correlation. We retrospectively reviewed and compared the magnetic resonance imaging indication, benign or malignant pathology rates, lesion types and the positive predictive value of magnetic resonance imaging-guided vacuum-assisted needle biopsy in the years before and after initiating this group peer review. Results The number of dynamic contrast-enhanced magnetic resonance imaging and magnetic resonance imaging-guided vacuum-assisted needle biopsies before and after initiating the review were 1447 vs 1596 (p=0.0002), and 253 (17.5%) vs 203 (12.7%) (p=0.04), respectively. There was a significant decrease in the number of benign biopsies in 2015 (n=104) compared to 2014 (n=154, p=0.04). The positive predictive value of magnetic resonance imaging-guided biopsy significantly increased after group review was implemented (Positive predictive value in 2014=%39.1 and positive predictive value in 2015=%48.8) (p=0.03), although the indications (p=0.49), history of breast cancer (p=0.14), biopsied magnetic resonance imaging lesion types (p=0.53) were not different. Less surgical excision was performed on magnetic resonance imaging-guided vacuum-assisted needle biopsy identified high-risk lesions in 2015 (p=0.25). Conclusion Our study showed an association between retrospective peer review of past biopsies and increased positive predictive value of magnetic resonance imaging-guided vacuum-assisted needle biopsies in our institution.
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Affiliation(s)
- Ceren Yalnız
- Department of Diagnostic Radiology, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Juliana Rosenblat
- Department of Diagnostic Radiology, Memorial Healthcare System, Hollywood, FL, USA
| | - David Spak
- Department of Diagnostic Radiology, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Wei Wei
- Taussig Cancer Institute Cleveland Clinic, Biostatistics, Cleveland, OH, USA
| | - Marion Scoggins
- Department of Diagnostic Radiology, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Carisa Le-Petross
- Department of Diagnostic Radiology, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Mark J Dryden
- Department of Diagnostic Radiology, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Beatriz Adrada
- Department of Diagnostic Radiology, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Başak E Doğan
- Department of Radiology, Division of Breast Imaging, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Why the Gold Standard Approach by Mammography Demands Extension by Multiomics? Application of Liquid Biopsy miRNA Profiles to Breast Cancer Disease Management. Int J Mol Sci 2019; 20:ijms20122878. [PMID: 31200461 PMCID: PMC6627787 DOI: 10.3390/ijms20122878] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 06/07/2019] [Accepted: 06/11/2019] [Indexed: 02/06/2023] Open
Abstract
In the global context, the epidemic of breast cancer (BC) is evident for the early 21st century. Evidence shows that national mammography screening programs have sufficiently reduced BC related mortality. Therefore, the great utility of the mammography-based screening is not an issue. However, both false positive and false negative BC diagnosis, excessive biopsies, and irradiation linked to mammography application, as well as sub-optimal mammography-based screening, such as in the case of high-dense breast tissue in young females, altogether increase awareness among the experts regarding the limitations of mammography-based screening. Severe concerns regarding the mammography as the “golden standard” approach demanding complementary tools to cover the evident deficits led the authors to present innovative strategies, which would sufficiently improve the quality of the BC management and services to the patient. Contextually, this article provides insights into mammography deficits and current clinical data demonstrating the great potential of non-invasive diagnostic tools utilizing circulating miRNA profiles as an adjunct to conventional mammography for the population screening and personalization of BC management.
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Steinberg I, Huland DM, Vermesh O, Frostig HE, Tummers WS, Gambhir SS. Photoacoustic clinical imaging. PHOTOACOUSTICS 2019; 14:77-98. [PMID: 31293884 PMCID: PMC6595011 DOI: 10.1016/j.pacs.2019.05.001] [Citation(s) in RCA: 277] [Impact Index Per Article: 55.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 04/09/2019] [Accepted: 05/30/2019] [Indexed: 05/18/2023]
Abstract
Photoacoustic is an emerging biomedical imaging modality, which allows imaging optical absorbers in the tissue by acoustic detectors (light in - sound out). Such a technique has an immense potential for clinical translation since it allows high resolution, sufficient imaging depth, with diverse endogenous and exogenous contrast, and is free from ionizing radiation. In recent years, tremendous developments in both the instrumentation and imaging agents have been achieved. These opened avenues for clinical imaging of various sites allowed applications such as brain functional imaging, breast cancer screening, diagnosis of psoriasis and skin lesions, biopsy and surgery guidance, the guidance of tumor therapies at the reproductive and urological systems, as well as imaging tumor metastases at the sentinel lymph nodes. Here we survey the various clinical and pre-clinical literature and discuss the potential applications and hurdles that still need to be overcome.
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Affiliation(s)
- Idan Steinberg
- Department of Radiology, At Stanford University, School of Medicine, Stanford, CA, United States
- Department of Bioengineering, At Stanford University, School of Medicine, Stanford, CA, United States
| | - David M. Huland
- Department of Radiology, At Stanford University, School of Medicine, Stanford, CA, United States
- Molecular Imaging Program at Stanford, Canary Center at Stanford for Cancer Early Detection, At Stanford University, School of Medicine, Stanford, CA, United States
| | - Ophir Vermesh
- Department of Radiology, At Stanford University, School of Medicine, Stanford, CA, United States
- Molecular Imaging Program at Stanford, Canary Center at Stanford for Cancer Early Detection, At Stanford University, School of Medicine, Stanford, CA, United States
| | - Hadas E. Frostig
- Department of Radiology, At Stanford University, School of Medicine, Stanford, CA, United States
- Molecular Imaging Program at Stanford, Canary Center at Stanford for Cancer Early Detection, At Stanford University, School of Medicine, Stanford, CA, United States
| | - Willemieke S. Tummers
- Department of Radiology, At Stanford University, School of Medicine, Stanford, CA, United States
- Molecular Imaging Program at Stanford, Canary Center at Stanford for Cancer Early Detection, At Stanford University, School of Medicine, Stanford, CA, United States
| | - Sanjiv S. Gambhir
- Department of Radiology, At Stanford University, School of Medicine, Stanford, CA, United States
- Department of Bioengineering, At Stanford University, School of Medicine, Stanford, CA, United States
- Department of Materials Science & Engineering, At Stanford University, School of Medicine, Stanford, CA, United States
- Molecular Imaging Program at Stanford, Canary Center at Stanford for Cancer Early Detection, At Stanford University, School of Medicine, Stanford, CA, United States
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Guindalini RSC, Zheng Y, Abe H, Whitaker K, Yoshimatsu TF, Walsh T, Schacht D, Kulkarni K, Sheth D, Verp MS, Bradbury AR, Churpek J, Obeid E, Mueller J, Khramtsova G, Liu F, Raoul A, Cao H, Romero IL, Hong S, Livingston R, Jaskowiak N, Wang X, Debiasi M, Pritchard CC, King MC, Karczmar G, Newstead GM, Huo D, Olopade OI. Intensive Surveillance with Biannual Dynamic Contrast-Enhanced Magnetic Resonance Imaging Downstages Breast Cancer in BRCA1 Mutation Carriers. Clin Cancer Res 2019; 25:1786-1794. [PMID: 30154229 PMCID: PMC6395536 DOI: 10.1158/1078-0432.ccr-18-0200] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 05/23/2018] [Accepted: 08/22/2018] [Indexed: 12/17/2022]
Abstract
PURPOSE To establish a cohort of high-risk women undergoing intensive surveillance for breast cancer.Experimental Design: We performed dynamic contrast-enhanced MRI every 6 months in conjunction with annual mammography (MG). Eligible participants had a cumulative lifetime breast cancer risk ≥20% and/or tested positive for a pathogenic mutation in a known breast cancer susceptibility gene. RESULTS Between 2004 and 2016, we prospectively enrolled 295 women, including 157 mutation carriers (75 BRCA1, 61 BRCA2); participants' mean age at entry was 43.3 years. Seventeen cancers were later diagnosed: 4 ductal carcinoma in situ (DCIS) and 13 early-stage invasive breast cancers. Fifteen cancers occurred in mutation carriers (11 BRCA1, 3 BRCA2, 1 CDH1). Median size of the invasive cancers was 0.61 cm. No patients had lymph node metastasis at time of diagnosis, and no interval invasive cancers occurred. The sensitivity of biannual MRI alone was 88.2% and annual MG plus biannual MRI was 94.1%. The cancer detection rate of biannual MRI alone was 0.7% per 100 screening episodes, which is similar to the cancer detection rate of 0.7% per 100 screening episodes for annual MG plus biannual MRI. The number of recalls and biopsies needed to detect one cancer by biannual MRI were 2.8 and 1.7 in BRCA1 carriers, 12.0 and 8.0 in BRCA2 carriers, and 11.7 and 5.0 in non-BRCA1/2 carriers, respectively. CONCLUSIONS Biannual MRI performed well for early detection of invasive breast cancer in genomically stratified high-risk women. No benefit was associated with annual MG screening plus biannual MRI screening.See related commentary by Kuhl and Schrading, p. 1693.
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Affiliation(s)
- Rodrigo Santa Cruz Guindalini
- Center for Clinical Cancer Genetics and Global Health, Department of Medicine, The University of Chicago, Chicago, Illinois
- CLION, CAM Group, Salvador, Bahia, Brazil
- Department of Radiology and Oncology, The State of Sao Paulo Cancer Institute, University of Sao Paulo Medical School, Sao Paulo, São Paulo, Brazil
| | - Yonglan Zheng
- Center for Clinical Cancer Genetics and Global Health, Department of Medicine, The University of Chicago, Chicago, Illinois
| | - Hiroyuki Abe
- Department of Radiology, The University of Chicago, Chicago, Illinois
| | - Kristen Whitaker
- Center for Clinical Cancer Genetics and Global Health, Department of Medicine, The University of Chicago, Chicago, Illinois
| | - Toshio F Yoshimatsu
- Center for Clinical Cancer Genetics and Global Health, Department of Medicine, The University of Chicago, Chicago, Illinois
| | - Tom Walsh
- Division of Medical Genetics, Department of Medicine, University of Washington, Seattle, Washington
| | - David Schacht
- Department of Radiology, The University of Chicago, Chicago, Illinois
| | - Kirti Kulkarni
- Department of Radiology, The University of Chicago, Chicago, Illinois
| | - Deepa Sheth
- Department of Radiology, The University of Chicago, Chicago, Illinois
| | - Marion S Verp
- Center for Clinical Cancer Genetics and Global Health, Department of Medicine, The University of Chicago, Chicago, Illinois
| | - Angela R Bradbury
- Department of Medicine, Division of Hematology-Oncology, and Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jane Churpek
- Center for Clinical Cancer Genetics and Global Health, Department of Medicine, The University of Chicago, Chicago, Illinois
| | - Elias Obeid
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Jeffrey Mueller
- Department of Pathology, The University of Chicago, Chicago, Illinois
| | - Galina Khramtsova
- Center for Clinical Cancer Genetics and Global Health, Department of Medicine, The University of Chicago, Chicago, Illinois
| | - Fang Liu
- Center for Clinical Cancer Genetics and Global Health, Department of Medicine, The University of Chicago, Chicago, Illinois
| | - Akila Raoul
- Center for Clinical Cancer Genetics and Global Health, Department of Medicine, The University of Chicago, Chicago, Illinois
| | - Hongyuan Cao
- Department of Public Health Sciences, The University of Chicago, Chicago, Illinois
| | - Iris L Romero
- Center for Clinical Cancer Genetics and Global Health, Department of Medicine, The University of Chicago, Chicago, Illinois
- Department of Obstetrics and Gynecology, The University of Chicago, Chicago, Illinois
| | - Susan Hong
- Center for Clinical Cancer Genetics and Global Health, Department of Medicine, The University of Chicago, Chicago, Illinois
- University of Illinois Cancer Center, University of Illinois - Chicago, Chicago, Illinois
| | - Robert Livingston
- Department of Laboratory Medicine, University of Washington, Seattle, Washington
| | - Nora Jaskowiak
- Department of Surgery, The University of Chicago, Chicago, Illinois
| | - Xiaoming Wang
- Computation Institute, The University of Chicago, Chicago, Illinois
| | - Marcio Debiasi
- PUCRS School of Medicine, Porto Alegre, Rio Grande do Sul, Brazil
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Rio Grande do Sul, Brazil
| | - Colin C Pritchard
- Department of Laboratory Medicine, University of Washington, Seattle, Washington
| | - Mary-Claire King
- Division of Medical Genetics, Department of Medicine, University of Washington, Seattle, Washington
| | - Gregory Karczmar
- Department of Radiology, The University of Chicago, Chicago, Illinois.
| | | | - Dezheng Huo
- Department of Public Health Sciences, The University of Chicago, Chicago, Illinois.
| | - Olufunmilayo I Olopade
- Center for Clinical Cancer Genetics and Global Health, Department of Medicine, The University of Chicago, Chicago, Illinois.
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Multi-Perspective Ultrasound Imaging Technology of the Breast with Cylindrical Motion of Linear Arrays. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9030419] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In this paper, we propose a multi-perspective ultrasound imaging technology with the cylindrical motion of four piezoelectric micromachined ultrasonic transducer (PMUT) rotatable linear arrays. The transducer is configured in a cross shape vertically on the circle with the length of the arrays parallel to the z axis, roughly perpendicular to the chest wall. The transducers surrounded the breast, which achieves non-invasive detection. The electric rotary table drives the PMUT to perform cylindrical scanning. A breast model with a 2 cm mass in the center and six 1-cm superficial masses were used for the experimental analysis. The detection was carried out in a water tank and the working temperature was constant at 32 °C. The breast volume data were acquired by rotating the probe 90° with a 2° interval, which were 256 × 180 A-scan lines. The optimized segmented dynamic focusing technology was used to improve the image quality and data reconstruction was performed. A total of 256 A-scan lines at a constant angle were recombined and 180 A-scan lines were recombined according to the nth element as a dataset, respectively. Combined with ultrasound imaging algorithms, multi-perspective ultrasound imaging was realized including vertical slices, horizontal slices and 3D imaging. The seven masses were detected and the absolute error of the size was approximately 1 mm where even the image of the injection pinhole could be seen. Furthermore, the breast boundary could be seen clearly from the chest wall to the nipple, so the location of the masses was easier to confirm. Therefore, the validity and feasibility of the data reconstruction method and imaging algorithm were verified. It will be beneficial for doctors to be able to comprehensively observe the pathological tissue.
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Ismail HM, Pretty CG, Signal MK, Haggers M, Chase JG. Attributes, Performance, and Gaps in Current & Emerging Breast Cancer Screening Technologies. Curr Med Imaging 2019; 15:122-131. [DOI: 10.2174/1573405613666170825115032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 08/15/2017] [Accepted: 08/22/2017] [Indexed: 01/29/2023]
Abstract
Background:Early detection of breast cancer, combined with effective treatment, can reduce mortality. Millions of women are diagnosed with breast cancer and many die every year globally. Numerous early detection screening tests have been employed. A wide range of current breast cancer screening methods are reviewed based on a series of searchers focused on clinical testing and performance. </P><P> Discussion: The key factors evaluated centre around the trade-offs between accuracy (sensitivity and specificity), operator dependence of results, invasiveness, comfort, time required, and cost. All of these factors affect the quality of the screen, access/eligibility, and/or compliance to screening programs by eligible women. This survey article provides an overview of the working principles, benefits, limitations, performance, and cost of current breast cancer detection techniques. It is based on an extensive literature review focusing on published works reporting the main performance, cost, and comfort/compliance metrics considered.Conclusion:Due to limitations and drawbacks of existing breast cancer screening methods there is a need for better screening methods. Emerging, non-invasive methods offer promise to mitigate the issues particularly around comfort/pain and radiation dose, which would improve compliance and enable all ages to be screened regularly. However, these methods must still undergo significant validation testing to prove they can provide realistic screening alternatives to the current accepted standards.
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Affiliation(s)
- Hina M. Ismail
- University of Canterbury, Christchurch, Canterbury, New Zealand
| | | | | | - Marcus Haggers
- Tiro Medical Limited, Christchurch, Canterbury, New Zealand
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Warnack E, Dhage S, Johnson E, Horowitz E, Joseph KA. The Use of Breast MRI for Patients With Preoperative Breast Cancer in an Underserved Population. J Surg Res 2018; 234:155-160. [PMID: 30527468 DOI: 10.1016/j.jss.2018.09.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 08/15/2018] [Accepted: 09/11/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Use of MRI for preoperative evaluation of newly diagnosed breast cancer has become more common, despite questionable impact on outcomes. We sought to determine how often and in what manner preoperative breast MRI changed surgical management in an underserved patient population. MATERIALS AND METHODS We examined the use of preoperative MRI at Bellevue Hospital Center (BHC), a public, tertiary hospital in lower Manhattan with a large underserved population. The BHC breast clinic database was used to identify patients who received preoperative MRI for breast cancer between January 2015 and December 2016. MRI was defined as changing surgical management in a positive manner if an MRI-detected abnormality had verification of malignancy in the final surgical specimen, confirming the MRI indication for wider excision or mastectomy, while MRI was defined to change surgical management in a negative manner if final pathology was discordant with MRI. Chi-square test was used to analyze characteristics of those who received MRI versus those who did not. RESULTS A total of 208 patients underwent breast surgery at BHC, and 62 patients underwent MRI for preoperative planning purposes. There were significant differences between the MRI and no MRI group in terms of ethnicity (P = 0.05), age (P < 0.01), and type of surgery (P = 0.03). 50% of the biopsies performed as a result of MRI were benign. MRI changed surgical management in 35 % of patients, most commonly by converting lumpectomy to mastectomy. Of cases in which MRI changed surgical management, most were positive changes. However, 4 patients underwent surgery and 11 patients underwent biopsy for benign pathology as a result of MRI findings. CONCLUSIONS MRI requires significant hospital and patient resource utilization. Especially in an underserved population, decision for MRI must be individualized, taking into account the risks and benefits of ordering this test.
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Affiliation(s)
| | - Shubhada Dhage
- NYU School of Medicine, Department of Surgery, New York, New York
| | - Elaheh Johnson
- NYU School of Medicine, Department of Surgery, New York, New York
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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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44
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Lancaster RB, Gulla S, De Los Santos J, Umphrey H. Breast Cancer Screening and Optimizing Recommendations. Semin Roentgenol 2018; 53:280-293. [DOI: 10.1053/j.ro.2018.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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45
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Pinnamaneni N, Moy L, Gao Y, Melsaether AN, Babb JS, Toth HK, Heller SL. Canceled MRI-guided Breast Biopsies Due to Nonvisualization: Follow-up and Outcomes. Acad Radiol 2018; 25:1101-1110. [PMID: 29478921 DOI: 10.1016/j.acra.2018.01.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 12/02/2017] [Accepted: 01/13/2018] [Indexed: 10/17/2022]
Abstract
RATIONALE AND OBJECTIVE The objective of this study was to evaluate breast lesion outcomes in patients after canceled MRI-guided breast biopsy due to lesion nonvisualization. MATERIALS AND METHODS Electronic medical records (January 2007-December 2014) were searched for patients with canceled magnetic resonance imaging (MRI)-guided breast biopsies due to lesion nonvisualization. A total of 1403 MRI-detected lesions were scheduled for MRI-guided biopsy and 89 were canceled because of nonvisualization. Imaging studies and medical records were reviewed for patient demographics, lesion characteristics, and subsequent malignancy. Patients without adequate MRI follow-up imaging were excluded. Statistical analysis was employed to determine if patient demographics or lesion characteristics were predictive of lesion resolution or lesion biopsy after subsequent follow-up. RESULTS Eighty-nine (6.3% [89/1403]; 95% confidence interval, 5.2%-7.7%) biopsies in 89 women were canceled because of nonvisualization. Follow-up MRIs greater than 5.5 months were available for 60.7% (54/89) of women. In 74.1% (40/54) of these patients, the lesions completely resolved on follow-up. In 25.9% (14/54) of the patients, the lesion persisted on follow-up; 42.9% (6/14) of these patients underwent biopsy. One case (1.9% [1/54]) yielded ductal carcinoma in situ with microinvasion at the 6-month follow-up. No patient demographics or lesion features were associated with lesion resolution or lesion biopsy. CONCLUSIONS The majority of canceled MRI-guided biopsy lesions resolved on later follow-up; however, because of the small possibility of a missed malignancy, follow-up MRI imaging at 6 months is recommended.
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46
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Vreemann S, van Zelst JCM, Schlooz-Vries M, Bult P, Hoogerbrugge N, Karssemeijer N, Gubern-Mérida A, Mann RM. The added value of mammography in different age-groups of women with and without BRCA mutation screened with breast MRI. Breast Cancer Res 2018; 20:84. [PMID: 30075794 PMCID: PMC6091096 DOI: 10.1186/s13058-018-1019-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 07/10/2018] [Indexed: 12/22/2022] Open
Abstract
Background Breast magnetic resonance imaging (MRI) is the most sensitive imaging method for breast cancer detection and is therefore offered as a screening technique to women at increased risk of developing breast cancer. However, mammography is currently added from the age of 30 without proven benefits. The purpose of this study is to investigate the added cancer detection of mammography when breast MRI is available, focusing on the value in women with and without BRCA mutation, and in the age groups above and below 50 years. Methods This retrospective single-center study evaluated 6553 screening rounds in 2026 women at increased risk of breast cancer (1 January 2003 to 1 January 2014). Risk category (BRCA mutation versus others at increased risk of breast cancer), age at examination, recall, biopsy, and histopathological diagnosis were recorded. Cancer yield, false positive recall rate (FPR), and false positive biopsy rate (FPB) were calculated using generalized estimating equations for separate age categories (< 40, 40–50, 50–60, ≥ 60 years). Numbers of screens needed to detect an additional breast cancer with mammography (NSN) were calculated for the subgroups. Results Of a total of 125 screen-detected breast cancers, 112 were detected by MRI and 66 by mammography: 13 cancers were solely detected by mammography, including 8 cases of ductal carcinoma in situ. In BRCA mutation carriers, 3 of 61 cancers were detected only on mammography, while in other women 10 of 64 cases were detected with mammography alone. While 77% of mammography-detected-only cancers were detected in women ≥ 50 years of age, mammography also added more to the FPR in these women. Below 50 years the number of mammographic examinations needed to find an MRI-occult cancer was 1427. Conclusions Mammography is of limited added value in terms of cancer detection when breast MRI is available for women of all ages who are at increased risk. While the benefit appears slightly larger in women over 50 years of age without BRCA mutation, there is also a substantial increase in false positive findings in these women.
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Affiliation(s)
- Suzan Vreemann
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA, Nijmegen, the Netherlands.
| | - Jan C M van Zelst
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA, Nijmegen, the Netherlands
| | | | - Peter Bult
- Department of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Nicoline Hoogerbrugge
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Nico Karssemeijer
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA, Nijmegen, the Netherlands
| | - Albert Gubern-Mérida
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA, Nijmegen, the Netherlands
| | - Ritse M Mann
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA, Nijmegen, the Netherlands
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Sun H, Li H, Si S, Qi S, Zhang W, Ma H, Liu S, Yingxue L, Qian W. Performance evaluation of breast cancer diagnosis with mammography, ultrasonography and magnetic resonance imaging. JOURNAL OF X-RAY SCIENCE AND TECHNOLOGY 2018; 26:805-813. [PMID: 30103371 DOI: 10.3233/xst-18388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Various imaging modalities have been used to diagnose suspicious breast lesions. Purpose of this study is to compare the diagnostic accuracy for breast cancer using mammography, ultrasonography and magnetic resonance imaging (MRI). METHODS Total 107 patients aged from 19 to 62 years are included in this retrospective study. Mammography, ultrasonography and MRI scans were performed for each patient detected with suspected breast tumor within a month. In addition, the tumor diversity (10 types of benign and 5 types of malignant) was confirmed by pathological findings of tumor biopsy. To compare the diagnosis performance of the three imaging modalities, the overall fraction correct (accuracy), positive predict value (PPV), negative predict value (NPV), sensitivity and specificity were calculated. Meanwhile, the receiver operating characteristic (ROC) analysis was also performed. RESULTS The diagnostic accuracy ranged from 78.5% to 86.9% among three imaging modalities. All modalities yielded a PPV lower than 77.8% and a NPV higher than 90.0% in identifying the presence of malignant tumors. MRI presented a diagnostic accuracy of 86.9%, as well as a sensitivity of 95.5% and an area under curve (AUC) of 0.948, which are higher than mammography and ultrasonography. CONCLUSION By using a diverse dataset and comparing the diagnostic accuracy of three imaging modalities commonly used in breast cancer detection and diagnosis, this study also demonstrated that mammography, ultrasonography and MRI had different diagnostic performance in breast tumor identification. Among them, MRI yielded the highest performance even though the unexpected specificity may lead to over-diagnosis, and ultrosonography is slightly better than mammography.
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Affiliation(s)
- Hang Sun
- Sino-Dutch Biomedical and Information Engineering School, Northeastern University, Shenyang, Liaoning, China
| | - Hong Li
- Sino-Dutch Biomedical and Information Engineering School, Northeastern University, Shenyang, Liaoning, China
| | - Shuang Si
- Department of Radiology, Shengjing hospital of China Medical University, Shenyang, Liaoning, China
| | - Shouliang Qi
- Sino-Dutch Biomedical and Information Engineering School, Northeastern University, Shenyang, Liaoning, China
| | - Wei Zhang
- Department of Radiology, Shengjing hospital of China Medical University, Shenyang, Liaoning, China
| | - He Ma
- Sino-Dutch Biomedical and Information Engineering School, Northeastern University, Shenyang, Liaoning, China
| | - Siqi Liu
- Sino-Dutch Biomedical and Information Engineering School, Northeastern University, Shenyang, Liaoning, China
| | - Li Yingxue
- Department of Radiology, Shengjing hospital of China Medical University, Shenyang, Liaoning, China
| | - Wei Qian
- Sino-Dutch Biomedical and Information Engineering School, Northeastern University, Shenyang, Liaoning, China
- Department of Electrical and Computer Engineering, University of Texas, El Paso, TX, USA
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Feng J, Xu J, Jiang S, Yin H, Zhao Y, Gui J, Wang K, Lv X, Ren F, Pogue BW, Paulsen KD. Addition of T2-guided optical tomography improves noncontrast breast magnetic resonance imaging diagnosis. Breast Cancer Res 2017; 19:117. [PMID: 29065920 PMCID: PMC5655871 DOI: 10.1186/s13058-017-0902-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 09/18/2017] [Indexed: 11/10/2022] Open
Abstract
Background While dynamic contrast-enhanced magnetic resonance imaging (DCE MRI) is recognized as the most sensitive examination for breast cancer detection, it has a substantial false positive rate and gadolinium (Gd) contrast agents are not universally well tolerated. As a result, alternatives to diagnosing breast cancer based on endogenous contrast are of growing interest. In this study, endogenous near-infrared spectral tomography (NIRST) guided by T2 MRI was evaluated to explore whether the combined imaging modality, which does not require contrast injection or involve ionizing radiation, can achieve acceptable diagnostic performance. Methods Twenty-four subjects—16 with pathologically confirmed malignancy and 8 with benign abnormalities—were simultaneously imaged with MRI and NIRST prior to definitive pathological diagnosis. MRIs were evaluated independently by three breast radiologists blinded to the pathological results. Optical image reconstructions were constrained by grayscale values in the T2 MRI. MRI and NIRST images were used, alone and in combination, to estimate the diagnostic performance of the data. Outcomes were compared to DCE results. Results Sensitivity, specificity, accuracy, and area under the curve (AUC) of noncontrast MRI when combined with T2-guided NIRST were 94%, 100%, 96%, and 0.95, respectively, whereas these values were 94%, 63%, 88%, and 0.81 for DCE MRI alone, and 88%, 88%, 88%, and 0.94 when DCE-guided NIRST was added. Conclusion In this study, the overall accuracy of imaging diagnosis improved to 96% when T2-guided NIRST was added to noncontrast MRI alone, relative to 88% for DCE MRI, suggesting that similar or better diagnostic accuracy can be achieved without requiring a contrast agent. Electronic supplementary material The online version of this article (doi:10.1186/s13058-017-0902-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jinchao Feng
- Thayer School of Engineering, Dartmouth College, 14 Engineering Drive, Hanover, NH, 03755, USA.,Information Technology of Faculty, Beijing University of Technology, Beijing, 100124, China
| | - Junqing Xu
- Department of Radiology, Xijing Hospital, Xi'an, 710032, China
| | - Shudong Jiang
- Thayer School of Engineering, Dartmouth College, 14 Engineering Drive, Hanover, NH, 03755, USA
| | - Hong Yin
- Department of Radiology, Xijing Hospital, Xi'an, 710032, China.
| | - Yan Zhao
- Thayer School of Engineering, Dartmouth College, 14 Engineering Drive, Hanover, NH, 03755, USA
| | - Jiang Gui
- Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, 03755, USA
| | - Ke Wang
- Department of Radiology, Xijing Hospital, Xi'an, 710032, China
| | - Xiuhua Lv
- Department of Radiology, Xijing Hospital, Xi'an, 710032, China
| | - Fang Ren
- Department of Radiology, Xijing Hospital, Xi'an, 710032, China
| | - Brian W Pogue
- Thayer School of Engineering, Dartmouth College, 14 Engineering Drive, Hanover, NH, 03755, USA
| | - Keith D Paulsen
- Thayer School of Engineering, Dartmouth College, 14 Engineering Drive, Hanover, NH, 03755, USA.
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Jabbar SB, Lynch B, Seiler S, Hwang H, Sahoo S. Pathologic Findings of Breast Lesions Detected on Magnetic Resonance Imaging. Arch Pathol Lab Med 2017; 141:1513-1522. [PMID: 28782985 DOI: 10.5858/arpa.2016-0552-oa] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT - Breast magnetic resonance imaging (MRI) is now used routinely for high-risk screening and in the evaluation of the extent of disease in newly diagnosed breast cancer patients. Morphologic characteristics and the kinetic pattern largely determine how suspicious a breast lesion is on MRI. Because of its high sensitivity, MRI identifies a large number of suspicious lesions. However, the low to moderate specificity and the additional cost have raised questions regarding its frequent use. OBJECTIVES - To identify the pathologic entities that frequently present as suspicious enhancing lesions and to identify specific MRI characteristics that may be predictive of malignancy. DESIGN - One hundred seventy-seven MRI-guided biopsies from 152 patients were included in the study. The indication for MRI, MRI features, pathologic findings, and patient demographics were recorded. The MRI findings and the pathology slides were reviewed by a dedicated breast radiologist and breast pathologists. RESULTS - Seventy-one percent (126 of 177) of MRI-guided breast biopsies were benign, 11% (20 of 177) showed epithelial atypia, and 18% (31 of 177) showed malignancy. The vast majority (84%; 62 of 74) of MRI lesions with persistent kinetics were benign. However, 57% (17 of 30) of lesions with washout kinetics and 65% (62 of 95) of mass lesions were also benign. CONCLUSIONS - Magnetic resonance imaging detects malignancies undetected by other imaging modalities but also detects a wide variety of benign lesions. Benign and malignant lesions identified by MRI share similar morphologic and kinetic features, necessitating biopsy for histologic confirmation.
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Affiliation(s)
- Seema B Jabbar
- From the Departments of Pathology and Laboratory Medicine (Drs Jabbar, Lynch, Hwang, and Sahoo), and Radiology (Dr Seiler), University of Texas Southwestern Medical Center, Dallas. Dr Jabbar and Dr Lynch contributed equally to the study
| | - Beverly Lynch
- From the Departments of Pathology and Laboratory Medicine (Drs Jabbar, Lynch, Hwang, and Sahoo), and Radiology (Dr Seiler), University of Texas Southwestern Medical Center, Dallas. Dr Jabbar and Dr Lynch contributed equally to the study
| | - Stephen Seiler
- From the Departments of Pathology and Laboratory Medicine (Drs Jabbar, Lynch, Hwang, and Sahoo), and Radiology (Dr Seiler), University of Texas Southwestern Medical Center, Dallas. Dr Jabbar and Dr Lynch contributed equally to the study
| | - Helena Hwang
- From the Departments of Pathology and Laboratory Medicine (Drs Jabbar, Lynch, Hwang, and Sahoo), and Radiology (Dr Seiler), University of Texas Southwestern Medical Center, Dallas. Dr Jabbar and Dr Lynch contributed equally to the study
| | - Sunati Sahoo
- From the Departments of Pathology and Laboratory Medicine (Drs Jabbar, Lynch, Hwang, and Sahoo), and Radiology (Dr Seiler), University of Texas Southwestern Medical Center, Dallas. Dr Jabbar and Dr Lynch contributed equally to the study
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50
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Urban LABD, Chala LF, Bauab SDP, Schaefer MB, Dos Santos RP, Maranhão NMDA, Kefalas AL, Kalaf JM, Ferreira CAP, Canella EDO, Peixoto JE, de Amorim HLE, de Camargo Junior HSA. Breast cancer screening: updated recommendations of the Brazilian College of Radiology and Diagnostic Imaging, Brazilian Breast Disease Society, and Brazilian Federation of Gynecological and Obstetrical Associations. Radiol Bras 2017; 50:244-249. [PMID: 28894332 PMCID: PMC5586515 DOI: 10.1590/0100-3984.2017-0069] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Objective To present the current recommendations for breast cancer screening in Brazil,
as devised by the Brazilian College of Radiology and Diagnostic Imaging, the
Brazilian Breast Disease Society, and the Brazilian Federation of
Gynecological and Obstetrical Associations. Materials and methods We analyzed scientific studies available in the Medline and Lilacs databases.
In the absence of evidence, the recommendations reflected the consensus of a
panel of experts. Recommendations Annual mammography screening is recommended for women 40-74 years of age.
Among women ≥ 75 years of age, annual mammography screening should be
reserved for those with an expected survival > 7 years. Complementary
ultrasound should be considered for women with dense breasts. Complementary
magnetic resonance imaging is recommended for women at high risk. When
available, an advanced form of mammography known as tomosynthesis can be
considered as a means of screening for breast cancer.
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Affiliation(s)
- Linei Augusta Brolini Dellê Urban
- Coordinator of the National Mammography Commission, Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), São Paulo, SP, Brazil
| | - Luciano Fernandes Chala
- Member of the National Mammography Commission, Representative of the Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), São Paulo, SP, Brazil
| | - Selma di Pace Bauab
- Member of the National Mammography Commission, Representative of the Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), São Paulo, SP, Brazil
| | - Marcela Brisighelli Schaefer
- Member of the National Mammography Commission, Representative of the Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), São Paulo, SP, Brazil
| | - Radiá Pereira Dos Santos
- Member of the National Mammography Commission, Representative of the Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), São Paulo, SP, Brazil
| | - Norma Medicis de Albuquerque Maranhão
- Member of the National Mammography Commission, Representative of the Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), São Paulo, SP, Brazil
| | - Ana Lucia Kefalas
- Member of the National Mammography Commission, Representative of the Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), São Paulo, SP, Brazil
| | - José Michel Kalaf
- Member of the National Mammography Commission, Representative of the Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), São Paulo, SP, Brazil
| | - Carlos Alberto Pecci Ferreira
- Member of the National Mammography Commission, Representative of the Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), São Paulo, SP, Brazil
| | - Ellyete de Oliveira Canella
- Member of the National Mammography Commission, Representative of the Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), São Paulo, SP, Brazil
| | - João Emílio Peixoto
- Member of the National Mammography Commission, Representative of the Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), São Paulo, SP, Brazil
| | - Heverton Leal Ernesto de Amorim
- Member of the National Mammography Commission, Representative of the Sociedade Brasileira de Mastologia (SBM), São Paulo, SP, Brazil
| | - Helio Sebastião Amâncio de Camargo Junior
- Member of the National Mammography Commission, Representative of the Federação Brasileira das Associações de Ginecologia e Obstetrícia (Febrasgo), Rio de Janeiro, RJ, Brazil
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