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Wang X, Jing L, Yan L, Wang P, Zhao C, Xu H, Xia H. A conditional inference tree model for predicting cancer risk of non-mass lesions detected on breast ultrasound. Eur Radiol 2024; 34:4776-4788. [PMID: 38133675 DOI: 10.1007/s00330-023-10504-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 10/12/2023] [Accepted: 11/01/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVES To generate and validate a prediction model based on imaging features for cancer risk of non-mass lesions (NMLs) detected on breast ultrasound (US). METHODS In this single-center study, consecutive women with 503 NMLs detected on breast US between 2012 and 2019 were retrospectively identified. The lesions were randomly assigned to the training or testing dataset with a 70/30 split. Age, symptoms, lesion size, and US features were collected. Multivariate analyses were employed to identify risk factors associated with malignancy. The predictive model was developed by using conditional inference trees (CTREE). RESULTS There were 498 patients (50.9 ± 13.29 years; range, 22-88 years) with 503 NMLs with histopathologic results or > 2-year follow-up, including 224 (44.5%) benign and 279 (55.5%) malignant lesions. At multivariate analysis, age (odds ratio (OR) = 1.08, 95% confidence interval (CI), 1.06-1.11, p < 0.001), NMLs with focal mass effect (OR = 3.03, 95% CI, 1.59-5.81, p = 0.001), indistinct glandular-fat interface (GFI) (OR = 4.23, 95% CI, 2.31-7.73, p < 0.001), geographic (OR = 3.47, 95% CI, 1.20-10.8, p = 0.022) and mottled (OR = 3.67, 95% CI, 1.32-10.21, p = 0.013) patterns, and calcifications (OR = 2.15, 95% CI, 1.16-4.01, p = 0.016) were associated with malignancy. The GFI status, architectural patterns, general morphology, and calcifications were consistently identified as the strongest US predictors of malignancy using CTREE analysis. Based on these factors, individuals were stratified into six risk groups. The predictive model showed an area under the curve of 0.797 in the testing dataset. CONCLUSION The CTREE model efficiently aids in interpreting and managing ultrasound-detected breast NMLs, overcoming BI-RADS limitations by refining cancer risk stratification. CLINICAL RELEVANCE STATEMENT The CTREE model allows for the reclassification of BI-RADS categories into subgroups with varying malignancy probabilities, thus providing a valuable enhancement to the BI-RADS assessment for the diagnosis of ultrasound-detected NMLs, with the potential to minimize unnecessary biopsies. KEY POINTS • The indistinct glandular-fat interface (GFI) status, NML with focal mass effect, geographic or mottled patterns, and calcifications are the strongest imaging predictors of malignant non-mass lesions (NMLs) detected on breast US. • A practical system has been created to categorize NMLs found in breast US; each classification is associated with a degree of diagnostic certainty. • The model may contribute to patient stratification by determining the relative likelihood of malignancy and thus support clinical decision-making and evidence-based management.
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Affiliation(s)
- Xi Wang
- Department of Ultrasound, Zhongshan Hospital Fudan University, 180 Feng-Lin Road, Shanghai, 200032, People's Republic of China
| | - Luxia Jing
- Department of Ultrasound, Zhongshan Hospital Fudan University, 180 Feng-Lin Road, Shanghai, 200032, People's Republic of China
| | - Lixia Yan
- Department of Ultrasound, Zhongshan Hospital Fudan University, 180 Feng-Lin Road, Shanghai, 200032, People's Republic of China
| | - Peilei Wang
- Department of Ultrasound, Zhongshan Hospital Fudan University, 180 Feng-Lin Road, Shanghai, 200032, People's Republic of China
| | - Chongke Zhao
- Department of Ultrasound, Zhongshan Hospital Fudan University, 180 Feng-Lin Road, Shanghai, 200032, People's Republic of China
| | - Huixiong Xu
- Department of Ultrasound, Zhongshan Hospital Fudan University, 180 Feng-Lin Road, Shanghai, 200032, People's Republic of China
| | - Hansheng Xia
- Department of Ultrasound, Zhongshan Hospital Fudan University, 180 Feng-Lin Road, Shanghai, 200032, People's Republic of China.
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Littrup PJ, Mehrmohammadi M, Duric N. Breast Tomographic Ultrasound: The Spectrum from Current Dense Breast Cancer Screenings to Future Theranostic Treatments. Tomography 2024; 10:554-573. [PMID: 38668401 PMCID: PMC11053617 DOI: 10.3390/tomography10040044] [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: 02/24/2024] [Revised: 04/03/2024] [Accepted: 04/11/2024] [Indexed: 04/29/2024] Open
Abstract
This review provides unique insights to the scientific scope and clinical visions of the inventors and pioneers of the SoftVue breast tomographic ultrasound (BTUS). Their >20-year collaboration produced extensive basic research and technology developments, culminating in SoftVue, which recently received the Food and Drug Administration's approval as an adjunct to breast cancer screening in women with dense breasts. SoftVue's multi-center trial confirmed the diagnostic goals of the tissue characterization and localization of quantitative acoustic tissue differences in 2D and 3D coronal image sequences. SoftVue mass characterizations are also reviewed within the standard cancer risk categories of the Breast Imaging Reporting and Data System. As a quantitative diagnostic modality, SoftVue can also function as a cost-effective platform for artificial intelligence-assisted breast cancer identification. Finally, SoftVue's quantitative acoustic maps facilitate noninvasive temperature monitoring and a unique form of time-reversed, focused US in a single theranostic device that actually focuses acoustic energy better within the highly scattering breast tissues, allowing for localized hyperthermia, drug delivery, and/or ablation. Women also prefer the comfort of SoftVue over mammograms and will continue to seek out less-invasive breast care, from diagnosis to treatment.
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Affiliation(s)
- Peter J. Littrup
- Department of Imaging Sciences, University of Rochester, Rochester, NY 14642, USA; (M.M.); (N.D.)
- Delphinus Medical Technologies, Inc., Novi, MI 48374, USA
| | - Mohammad Mehrmohammadi
- Department of Imaging Sciences, University of Rochester, Rochester, NY 14642, USA; (M.M.); (N.D.)
| | - Nebojsa Duric
- Department of Imaging Sciences, University of Rochester, Rochester, NY 14642, USA; (M.M.); (N.D.)
- Delphinus Medical Technologies, Inc., Novi, MI 48374, USA
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Jeon T, Kim YS, Son HM, Lee SE. Tips for finding magnetic resonance imaging-detected suspicious breast lesions using second-look ultrasonography: a pictorial essay. Ultrasonography 2022; 41:624-632. [PMID: 35487504 PMCID: PMC9262675 DOI: 10.14366/usg.21219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 02/28/2022] [Indexed: 11/04/2022] Open
Abstract
Second-look ultrasonography (US) is a targeted breast US examination that evaluates suspicious lesions detected on magnetic resonance imaging (MRI). It is a useful tool for determining the probability of malignancy and facilitating US-guided biopsy. Lesions detected on MRI and US should be correlated accurately, which is challenging in some cases. This article documents second-look US and MRI findings that are correlated with the pathology, and suggests helpful approaches for correlating between the two modalities.
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Affiliation(s)
- Taejun Jeon
- Department of Radiology, Yeungnam University College of Medicine, Daegu, Korea
| | - Young Seon Kim
- Department of Radiology, Yeungnam University College of Medicine, Daegu, Korea
| | - Hye Min Son
- Department of Radiology, Yeungnam University College of Medicine, Daegu, Korea
| | - Seung Eun Lee
- Department of Radiology, Yeungnam University College of Medicine, Daegu, Korea
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Duric N, Sak M, Littrup PJ. The Potential Role of the Fat-Glandular Interface (FGI) in Breast Carcinogenesis: Results from an Ultrasound Tomography (UST) Study. J Clin Med 2021; 10:5615. [PMID: 34884317 PMCID: PMC8658427 DOI: 10.3390/jcm10235615] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/18/2021] [Accepted: 11/23/2021] [Indexed: 11/29/2022] Open
Abstract
This study explored the relationship between the extent of the fat-glandular interface (FGI) and the presence of malignant vs. benign lesions. Two hundred and eight patients were scanned with ultrasound tomography (UST) as part of a Health Insurance Portability and Accountability Act (HIPAA)-compliant study. Segmentation of the sound speed images, employing the k-means clustering method, was used to help define the extent of the FGI for each patient. The metric, α, was defined as the surface area to volume ratio of the segmented fibroglandular volume and its mean value across patients was determined for cancers, fibroadenomas and cysts. ANOVA tests were used to assess significance. The means and standard deviations of α for cancers, fibroadenomas and cysts were found to be 4.0 ± 2.0 cm-1, 3.1 ± 1.7 cm-1 and 2.3 ± 0.9 cm-1, respectively. The differences were statistically significant (p < 0.001). The separation between the groups increased when α was measured on only the image slice where the finding was most prominent, with values for cancers, fibroadenomas and cysts of 5.4 ± 3.6 cm-1, 3.6 ± 2.3 cm-1 and 2.4 ± 1.5 cm-1, respectively. Of the three types of masses studied, cancer was associated with the most extensive FGIs, suggesting a potential role for the FGI in carcinogenesis, a subject for future studies.
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Affiliation(s)
- Nebojsa Duric
- Department of Imaging Sciences, University of Rochester, Rochester, NY 14642, USA
- Delphinus Medical Technologies Inc., Novi, MI 48374, USA;
| | - Mark Sak
- School of Medicine, Wayne State University, Detroit, MI 48202, USA;
| | - Peter J. Littrup
- Delphinus Medical Technologies Inc., Novi, MI 48374, USA;
- School of Medicine, Wayne State University, Detroit, MI 48202, USA;
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Littrup PJ, Duric N, Sak M, Li C, Roy O, Brem RF, Larsen LH, Yamashita M. Multicenter Study of Whole Breast Stiffness Imaging by Ultrasound Tomography (SoftVue) for Characterization of Breast Tissues and Masses. J Clin Med 2021; 10:5528. [PMID: 34884229 PMCID: PMC8658621 DOI: 10.3390/jcm10235528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/10/2021] [Accepted: 11/25/2021] [Indexed: 12/16/2022] Open
Abstract
We evaluated whole breast stiffness imaging by SoftVue ultrasound tomography (UST), extracted from the bulk modulus, to volumetrically map differences in breast tissues and masses. A total 206 women with either palpable or mammographically/sonographically visible masses underwent UST scanning prior to biopsy as part of a prospective, HIPAA-compliant multicenter cohort study. The volumetric data sets comprised 298 masses (78 cancers, 105 fibroadenomas, 91 cysts and 24 other benign) in 239 breasts. All breast tissues were segmented into six categories, using sound speed to separate fat from fibroglandular tissues, and then subgrouped by stiffness into soft, intermediate and hard components. Ninety percent of women had mammographically dense breasts but only 11.2% of their total breast volume showed hard components while 69% of fibroglandular tissues were softer. All smaller masses (<1.5 cm) showed a greater percentage of hard components than their corresponding larger masses (p < 0.001). Cancers had significantly greater mean stiffness indices and lower mean homogeneity of stiffness than benign masses (p < 0.05). SoftVue stiffness imaging demonstrated small stiff masses, mainly due to cancers, amongst predominantly soft breast tissues. Quantitative stiffness mapping of the whole breast and underlying masses may have implications for screening of women with dense breasts, cancer risk evaluations, chemoprevention and treatment monitoring.
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Affiliation(s)
- Peter J. Littrup
- Department of Radiology, Karmanos Cancer Institute, Detroit, MI 48201, USA
- Department of Radiology, Wayne State University, Detroit, MI 48201, USA
- Delphinus Medical Technologies Inc., Novi, MI 48374, USA; (N.D.); (M.S.); (C.L.); (O.R.)
| | - Nebojsa Duric
- Delphinus Medical Technologies Inc., Novi, MI 48374, USA; (N.D.); (M.S.); (C.L.); (O.R.)
- Department of Radiology, University of Rochester, Rochester, NY 14642, USA
| | - Mark Sak
- Delphinus Medical Technologies Inc., Novi, MI 48374, USA; (N.D.); (M.S.); (C.L.); (O.R.)
| | - Cuiping Li
- Delphinus Medical Technologies Inc., Novi, MI 48374, USA; (N.D.); (M.S.); (C.L.); (O.R.)
| | - Olivier Roy
- Delphinus Medical Technologies Inc., Novi, MI 48374, USA; (N.D.); (M.S.); (C.L.); (O.R.)
| | - Rachel F. Brem
- Department of Radiology, The George Washington Cancer Center, George Washington University, Washington, DC 20037, USA;
| | - Linda H. Larsen
- Department of Radiology, Norris Cancer Center and Hospital, University of Southern California, Los Angeles, CA 90033, USA; (L.H.L.); (M.Y.)
| | - Mary Yamashita
- Department of Radiology, Norris Cancer Center and Hospital, University of Southern California, Los Angeles, CA 90033, USA; (L.H.L.); (M.Y.)
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Littrup PJ, Duric N, Sak M, Li C, Roy O, Brem RF, Yamashita M. The Fat-glandular Interface and Breast Tumor Locations: Appearances on Ultrasound Tomography Are Supported by Quantitative Peritumoral Analyses. JOURNAL OF BREAST IMAGING 2021; 3:455-464. [PMID: 38424790 DOI: 10.1093/jbi/wbab032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Indexed: 03/02/2024]
Abstract
OBJECTIVE To analyze the preferred tissue locations of common breast masses in relation to anatomic quadrants and the fat-glandular interface (FGI) using ultrasound tomography (UST). METHODS Ultrasound tomography scanning was performed in 206 consecutive women with 298 mammographically and/or sonographically visible, benign and malignant breast masses following written informed consent to participate in an 8-site multicenter, Institutional Review Board-approved cohort study. Mass locations were categorized by their anatomic breast quadrant and the FGI, which was defined by UST as the high-contrast circumferential junction of fat and fibroglandular tissue on coronal sound speed imaging. Quantitative UST mass comparisons were done for each tumor and peritumoral region using mean sound speed and percentage of fibroglandular tissue. Chi-squared and analysis of variance tests were used to assess differences. RESULTS Cancers were noted at the FGI in 95% (74/78) compared to 51% (98/194) of fibroadenomas and cysts combined (P < 0.001). No intra-quadrant differences between cancer and benign masses were noted for tumor location by anatomic quadrants (P = 0.66). Quantitative peritumoral sound speed properties showed that cancers were surrounded by lower mean sound speeds (1477 m/s) and percent fibroglandular tissue (47%), compared to fibroadenomas (1496 m/s; 65.3%) and cysts (1518 m/s; 84%) (P < 0.001; P < 0.001, respectively). CONCLUSION Breast cancers form adjacent to fat and UST localized the vast majority to the FGI, while cysts were most often completely surrounded by dense tissue. These observations were supported by quantitative peritumoral analyses of sound speed values for fat and fibroglandular tissue.
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Affiliation(s)
- Peter J Littrup
- Departments of Radiology and Oncology, Karmanos Cancer Institute, Detroit, MI, USA
- Department of Oncology, Wayne State University, Detroit, Novi, MI, USA
- Delphinus Medical Technologies, Inc., Novi, MI, USA
| | - Nebojsa Duric
- Departments of Radiology and Oncology, Karmanos Cancer Institute, Detroit, MI, USA
- Department of Oncology, Wayne State University, Detroit, Novi, MI, USA
- Delphinus Medical Technologies, Inc., Novi, MI, USA
| | - Mark Sak
- Delphinus Medical Technologies, Inc., Novi, MI, USA
| | - Cuiping Li
- Delphinus Medical Technologies, Inc., Novi, MI, USA
| | - Olivier Roy
- Delphinus Medical Technologies, Inc., Novi, MI, USA
| | - Rachel F Brem
- The George Washington Cancer Center, George Washington University, Washington, DC, USA
| | - Mary Yamashita
- University of Southern California; Norris Cancer Center and Hospital, Los Angeles, CA, USA
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The Tumor-Fat Interface Volume of Breast Cancer on Pretreatment MRI Is Associated with a Pathologic Response to Neoadjuvant Chemotherapy. BIOLOGY 2020; 9:biology9110391. [PMID: 33182628 PMCID: PMC7697338 DOI: 10.3390/biology9110391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 11/07/2020] [Indexed: 12/31/2022]
Abstract
Simple Summary Contact between a tumor and the adjacent fat is a potential biomarker to predict the therapy response in breast cancer, but it has not been quantitatively explored. In this study, we measured the direct contact between the tumor and adjacent fat using breast magnetic resonance imaging with machine learning and found that patients with a greater volume of contact between tumor and fat were less likely to have a complete pathological response. Our results suggest that the volume of the tumor–fat interface is a potential prognostic imaging biomarker to predict the treatment response to neoadjuvant chemotherapy. Abstract Adipocytes are active sources of numerous adipokines that work in both a paracrine and endocrine manner. It is not known that the direct contact between tumor and neighboring fat measured by pretreatment breast magnetic resonance imaging (MRI) affects treatment outcomes to neoadjuvant chemotherapy (NAC) in breast cancer patients. A biomarker quantifying the tumor–fat interface volume from pretreatment MRI was proposed and used to predict pathologic complete response (pCR) in breast cancer patients treated with NAC. The tumor–fat interface volume was computed with data-driven clustering using multiphasic MRI. Our approach was developed and validated in two cohorts consisting of 1140 patients. A high tumor–fat interface volume was significantly associated with a non-pCR in both the development and validation cohorts (p = 0.030 and p = 0.037, respectively). Quantitative measurement of the tumor–fat interface volume based on pretreatment MRI may be useful for precision medicine and subsequently influence the treatment strategy of patients.
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Kang T, Yau C, Wong CK, Sanborn JZ, Newton Y, Vaske C, Benz SC, Krings G, Camarda R, Henry JE, Stuart J, Powell M, Benz CC. A risk-associated Active transcriptome phenotype expressed by histologically normal human breast tissue and linked to a pro-tumorigenic adipocyte population. Breast Cancer Res 2020; 22:81. [PMID: 32736587 PMCID: PMC7395362 DOI: 10.1186/s13058-020-01322-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 07/23/2020] [Indexed: 01/04/2023] Open
Abstract
Background Previous studies have identified and validated a risk-associated Active transcriptome phenotype commonly expressed in the cancer-adjacent and histologically normal epithelium, stroma, and adipose containing peritumor microenvironment of clinically established invasive breast cancers, conferring a 2.5- to 3-fold later risk of dying from recurrent breast cancer. Expression of this Active transcriptome phenotype has not yet been evaluated in normal breast tissue samples unassociated with any benign or malignant lesions; however, it has been associated with increased peritumor adipocyte composition. Methods Detailed histologic and transcriptomic (RNAseq) analyses were performed on normal breast biopsy samples from 151 healthy, parous, non-obese (mean BMI = 29.60 ± 7.92) women, ages 27–66 who donated core breast biopsy samples to the Komen Tissue Bank, and whose average breast cancer risk estimate (Gail score) at the time of biopsy (1.27 ± 1.34) would not qualify them for endocrine prevention therapy. Results Full genome RNA sequencing (RNAseq) identified 52% (78/151) of these normal breast samples as expressing the Active breast phenotype. While Active signature genes were found to be most variably expressed in mammary adipocytes, donors with the Active phenotype had no difference in BMI but significantly higher Gail scores (1.46 vs. 1.18; p = 0.007). Active breast samples possessed 1.6-fold more (~ 80%) adipocyte nuclei, larger cross-sectional adipocyte areas (p < 0.01), and 0.5-fold fewer stromal and epithelial cell nuclei (p < 1e−6). Infrequent low-level expression of cancer gene hotspot mutations was detected but not enriched in the Active breast samples. Active samples were enriched in gene sets associated with adipogenesis and fat metabolism (FDR q ≤ 10%), higher signature scores for cAMP-dependent lipolysis known to drive breast cancer progression, white adipose tissue browning (Wilcoxon p < 0.01), and genes associated with adipocyte activation (leptin, adiponectin) and remodeling (CAV1, BNIP3), adipokine growth factors (IGF-1, FGF2), and pro-inflammatory fat signaling (IKBKG, CCL13). Conclusions The risk-associated Active transcriptome phenotype first identified in cancer-adjacent breast tissues also occurs commonly in healthy women without breast disease who do not qualify for breast cancer chemoprevention, and independently of breast expressed cancer-associated mutations. The risk-associated Active phenotype appears driven by a pro-tumorigenic adipocyte microenvironment that can predate breast cancer development.
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Affiliation(s)
- Taekyu Kang
- Buck Institute for Research on Aging, 8001 Redwood Blvd., Novato, CA, 94945, USA
| | - Christina Yau
- Buck Institute for Research on Aging, 8001 Redwood Blvd., Novato, CA, 94945, USA
| | | | | | | | | | | | | | - Roman Camarda
- Buck Institute for Research on Aging, 8001 Redwood Blvd., Novato, CA, 94945, USA
| | - Jill E Henry
- Susan G. Komen Tissue Bank at the Indiana University Simon Cancer Center, Indianapolis, IN, USA
| | - Josh Stuart
- University of California, Genomics Institute, Santa Cruz, CA, USA
| | - Mark Powell
- Buck Institute for Research on Aging, 8001 Redwood Blvd., Novato, CA, 94945, USA
| | - Christopher C Benz
- Buck Institute for Research on Aging, 8001 Redwood Blvd., Novato, CA, 94945, USA.
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van Rijssel MJ, Zijlstra F, Seevinck PR, Luijten PR, Gilhuijs KGA, Klomp DWJ, Pluim JPW. Reducing distortions in echo-planar breast imaging at ultrahigh field with high-resolution off-resonance maps. Magn Reson Med 2019; 82:425-435. [PMID: 30825245 PMCID: PMC6593992 DOI: 10.1002/mrm.27701] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 01/30/2019] [Indexed: 11/11/2022]
Abstract
PURPOSE DWI is a promising modality in breast MRI, but its clinical acceptance is slow. Analysis of DWI is hampered by geometric distortion artifacts, which are caused by off-resonant spins in combination with the low phase-encoding bandwidth of the EPI sequence used. Existing correction methods assume smooth off-resonance fields, which we show to be invalid in the human breast, where high discontinuities arise at tissue interfaces. METHODS We developed a distortion correction method that incorporates high-resolution off-resonance maps to better solve for severe distortions at tissue interfaces. The method was evaluated quantitatively both ex vivo in a porcine tissue phantom and in vivo in 5 healthy volunteers. The added value of high-resolution off-resonance maps was tested using a Wilcoxon signed rank test comparing the quantitative results obtained with a low-resolution off-resonance map with those obtained with a high-resolution map. RESULTS Distortion correction using low-resolution off-resonance maps corrected most of the distortions, as expected. Still, all quantitative comparison metrics showed increased conformity between the corrected EPI images and a high-bandwidth reference scan for both the ex vivo and in vivo experiments. All metrics showed a significant improvement when a high-resolution off-resonance map was used (P < 0.05), in particular at tissue boundaries. CONCLUSION The use of off-resonance maps of a resolution higher than EPI scans significantly improves upon existing distortion correction techniques, specifically by superior correction at glandular tissue boundaries.
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Affiliation(s)
| | - Frank Zijlstra
- Center for Image Sciences, UMC Utrecht, Utrecht, The Netherlands
| | - Peter R Seevinck
- Center for Image Sciences, UMC Utrecht, Utrecht, The Netherlands
| | - Peter R Luijten
- Center for Image Sciences, UMC Utrecht, Utrecht, The Netherlands
| | | | - Dennis W J Klomp
- Center for Image Sciences, UMC Utrecht, Utrecht, The Netherlands
| | - Josien P W Pluim
- Center for Image Sciences, UMC Utrecht, Utrecht, The Netherlands.,Department of Biomedical Engineering, Technische Universiteit Eindhoven, Eindhoven, The Netherlands
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Chen JH, Zhang Y, Chan S, Chang RF, Su MY. Quantitative analysis of peri-tumor fat in different molecular subtypes of breast cancer. Magn Reson Imaging 2018; 53:34-39. [PMID: 29969646 DOI: 10.1016/j.mri.2018.06.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 06/13/2018] [Accepted: 06/28/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSES The aim of this study was to develop morphological analytic methods to analyze the tumor-fat interface and in different peritumoral shells away from the tumor, and to compare the results among three molecular subtypes of breast cancer. MATERIALS AND METHODS A total of 102 women (mean age 48.5 y/o) with solitary well-defined breast cancers were analyzed, including 46 human epidermal growth factor receptor 2 (HER2) (+), 46 HER2(-) hormonal receptor (HR) (+), and 10 triple negative (TN) breast cancers. The tumor lesion, the breast, the fibroglandular and fatty tissue were segmented using well-established methods. The whole breast fat percentage and the peri-tumor interface fat percentage were measured. Three shells (SH1, SH2, SH3) surrounding the convex hall of the three dimensional (3D) tumor were defined and in each shell the volumetric percentage of fat was calculated. The peri-tumor interface fat percentage and the volumetric percentage of fat in the three peri-tumoral shells were compared among different subtypes. RESULTS In the TN group, the fat percentage on the tumor boundary was 43 ± 20% and 78 ± 12% for two dimensional (2D) and 3D measurement, respectively, which were the highest among the three subtypes but not significantly different. The fat percentage in SH2 and SH3 in the TN group was 82 ± 7% and 85 ± 7%, which was significantly higher compared to the two other two subtypes. The results remained after controlling for the whole breast fat percentage. CONCLUSIONS This study provided a feasible method for quantitative analysis of peri-tumoral tissue characteristics. Because of small patient number, the finding that TN tumors had the highest peri-tumor fat content among the three subtypes needs to be further verified with a large cohort study.
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Affiliation(s)
- Jeon-Hor Chen
- Center For Functional Onco-Imaging of Department of Radiological Sciences, University of California, Irvine, CA, USA; Department of Radiology, E-Da Hospital and I-Shou University, Kaohsiung, Taiwan.
| | - Yang Zhang
- Center For Functional Onco-Imaging of Department of Radiological Sciences, University of California, Irvine, CA, USA
| | - Siwa Chan
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan; Department of Medical Imaging, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan; Department of Radiology, School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Ruey-Feng Chang
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Min-Ying Su
- Center For Functional Onco-Imaging of Department of Radiological Sciences, University of California, Irvine, CA, USA
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Magee AL, Dashevsky BZ, Jahangir K, Kulkarni K. Incidental focal uptake in the breast and axilla on FDG PET: Clinical considerations and differential diagnosis. Clin Imaging 2017. [DOI: 10.1016/j.clinimag.2017.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
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