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Rapley M, Freitas V, Weinberg IN, Baldassi B, Poladyan H, Waterston M, Ghai S, Taeb S, Bubon O, Reznik A, Mulligan AM. Case report: Possible role of low-dose PEM for avoiding unneeded procedures associated with false-positive or equivocal breast MRI results. Front Oncol 2024; 14:1405404. [PMID: 39091907 PMCID: PMC11291220 DOI: 10.3389/fonc.2024.1405404] [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: 03/22/2024] [Accepted: 07/05/2024] [Indexed: 08/04/2024] Open
Abstract
Contrast-enhanced breast magnetic resonance imaging (MRI) is currently recommended as a screening tool for high-risk women and has been advocated for women with radiologically dense breast tissue. While breast MRI is acknowledged for its high sensitivity (with an exception for lower-grade ductal carcinoma in situ (DCIS) where emerging techniques like diffusion-weighted imaging offer improvement), its limitations include sensitivity to hormonal changes and a relatively high false-positive rate, potentially leading to overdiagnosis, increased imaging uncertainty, and unnecessary biopsies. These factors can exacerbate patient anxiety and impose additional costs. Molecular imaging with breast-targeted Positron Emission Tomography (PET) has shown the capability to detect malignancy independent of breast density and hormonal changes. Furthermore, breast-targeted PET has shown higher specificity when compared with MRI. However, traditional PET technology is associated with high radiation dose, which can limit its widespread use particularly in repeated studies or for undiagnosed patients. In this case report, we present a clinical application of low-dose breast imaging utilizing a breast-targeted PET camera (Radialis PET imager, Radialis Inc). The case involves a 33-year-old female patient who had multiple enhanced lesions detected on breast MRI after surgical removal of a malignant phyllodes tumor from the right breast. A benign core biopsy was obtained from the largest lesion seen in the left breast. One month after the MRI, 18F-fluorodeoxyglucose (18F-FDG) PET imaging session was performed using the Radialis PET Imager. Although the Radialis PET Imager has proven high count sensitivity and the capability to detect breast lesions with low metabolic activity (at a dose similar to mammography), no areas of increased 18F-FDG uptake were visualized in this particular case. The patient underwent a right-sided nipple-sparing mastectomy and left-sided lumpectomy, with bilateral reconstruction. The excised left breast tissue was completely benign, as suggested by both core biopsy and the PET results. The case presented highlights a promising clinical application of low-dose breast-targeted PET imaging to mitigate the uncertainty associated with MRI while keeping radiation doses within the safe range typically used in X-ray mammography.
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Affiliation(s)
- Madeline Rapley
- Department of Physics, Lakehead University, Thunder Bay, ON, Canada
| | - Vivianne Freitas
- Temerty Faculty of Medicine, Joint Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | | | | | | | | | - Sandeep Ghai
- Temerty Faculty of Medicine, Joint Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Samira Taeb
- Department of Research, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Oleksandr Bubon
- Department of Physics, Lakehead University, Thunder Bay, ON, Canada
- Radialis Inc., Thunder Bay, ON, Canada
| | - Alla Reznik
- Department of Physics, Lakehead University, Thunder Bay, ON, Canada
- Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON, Canada
| | - Anna Marie Mulligan
- Laboratory Medicine Program, University Health Network – Toronto General Hospital Site, University of Toronto, Toronto, ON, Canada
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Ghammraoui B, Ghani MU, Glick SJ. Evaluating spectral performance for quantitative contrast-enhanced breast CT with a GaAs based photon counting detector: a simulation approach. Biomed Phys Eng Express 2024; 10:055011. [PMID: 38968931 DOI: 10.1088/2057-1976/ad5f96] [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: 12/20/2023] [Accepted: 07/05/2024] [Indexed: 07/07/2024]
Abstract
Quantitative contrast-enhanced breast computed tomography (CT) has the potential to improve the diagnosis and management of breast cancer. Traditional CT methods using energy-integrated detectors and dual-exposure images with different incident spectra for material discrimination can increase patient radiation dose and be susceptible to motion artifacts and spectral resolution loss. Photon Counting Detectors (PCDs) offer a promising alternative approach, enabling acquisition of multiple energy levels in a single exposure and potentially better energy resolution. Gallium arsenide (GaAs) is particularly promising for breast PCD-CT due to its high quantum efficiency and reduction of fluorescence x-rays escaping the pixel within the breast imaging energy range. In this study, the spectral performance of a GaAs PCD for quantitative iodine contrast-enhanced breast CT was evaluated. A GaAs detector with a pixel size of 100μm, a thickness of 500μm was simulated. Simulations were performed using cylindrical phantoms of varying diameters (10 cm, 12 cm, and 16 cm) with different concentrations and locations of iodine inserts, using incident spectra of 50, 55, and 60 kVp with 2 mm of added aluminum filtration and and a mean glandular dose of 10 mGy. We accounted for the effects of beam hardening and energy detector response using TIGRE CT open-source software and the publicly available Photon Counting Toolkit (PcTK). Material-specific images of the breast phantom were produced using both projection and image-based material decomposition methods, and iodine component images were used to estimate iodine intake. Accuracy and precision of the proposed methods for estimating iodine concentration in breast CT images were assessed for different material decomposition methods, incident spectra, and breast phantom thicknesses. The results showed that both the beam hardening effect and imperfection in the detector response had a significant impact on performance in terms of Root Mean Squared Error (RMSE), precision, and accuracy of estimating iodine intake in the breast. Furthermore, the study demonstrated the effectiveness of both material decomposition methods in making accurate and precise iodine concentration predictions using a GaAs-based photon counting breast CT system, with better performance when applying the projection-based material decomposition approach. The study highlights the potential of GaAs-based photon counting breast CT systems as viable alternatives to traditional imaging methods in terms of material decomposition and iodine concentration estimation, and proposes phantoms and figures of merit to assess their performance.
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Affiliation(s)
- Bahaa Ghammraoui
- Division of Imaging, Diagnostics, and Software Reliability, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, MD 20993, United States of America
| | - Muhammad Usman Ghani
- Division of Imaging, Diagnostics, and Software Reliability, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, MD 20993, United States of America
| | - Stephen J Glick
- Division of Imaging, Diagnostics, and Software Reliability, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, MD 20993, United States of America
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Grubstein A, Friehmann T, Dahan M, Abitbol C, Gadiel I, Schejtman DM, Shochat T, Atar E, Tamir S. Digital Breast Tomosynthesis for Upgraded BIRADS Scoring towards the True Pathology of Lesions Detected by Contrast-Enhanced Mammography. Tomography 2024; 10:806-815. [PMID: 38787021 PMCID: PMC11125662 DOI: 10.3390/tomography10050061] [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: 04/23/2024] [Revised: 05/14/2024] [Accepted: 05/15/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE To determine the added value of digital breast tomosynthesis (DBT) in the assessment of lesions detected by contrast-enhanced mammography (CEM). MATERIAL AND METHODS A retrospective study was conducted in a tertiary university medical center. All CEM studies including DBT performed between January 2016 and December 2020 were included. Lesions were categorized and scored by four dedicated breast radiologists according to the recent CEM and DBT supplements to the Breast Imaging Reporting and Data System (BIRADS) lexicon. Changes in the BIRADS score of CEM-detected lesions with the addition of DBT were evaluated according to the pathology results and 1-year follow-up imaging study. RESULTS BIRADS scores of CEM-detected lesions were upgraded toward the lesion's pathology with the addition of DBT (p > 0.0001), overall and for each reader. The difference in BIRADS scores before and after the addition of DBT was more significant for readers who were less experienced. The reason for changes in the BIRADS score was better lesion margin visibility. The main BIRADS descriptors applied in the malignant lesions were spiculations, calcifications, architectural distortion, and sharp or obscured margins. CONCLUSIONS The addition of DBT to CEM provides valuable information on the enhancing lesion, leading to a more accurate BIRADS score.
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Affiliation(s)
- Ahuva Grubstein
- Radiology, Rabin Medical Center, Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo 49100, Israel; (T.F.); (M.D.); (C.A.); (I.G.); (D.M.S.); (E.A.); (S.T.)
| | - Tal Friehmann
- Radiology, Rabin Medical Center, Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo 49100, Israel; (T.F.); (M.D.); (C.A.); (I.G.); (D.M.S.); (E.A.); (S.T.)
| | - Marva Dahan
- Radiology, Rabin Medical Center, Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo 49100, Israel; (T.F.); (M.D.); (C.A.); (I.G.); (D.M.S.); (E.A.); (S.T.)
| | - Chen Abitbol
- Radiology, Rabin Medical Center, Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo 49100, Israel; (T.F.); (M.D.); (C.A.); (I.G.); (D.M.S.); (E.A.); (S.T.)
| | - Ithai Gadiel
- Radiology, Rabin Medical Center, Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo 49100, Israel; (T.F.); (M.D.); (C.A.); (I.G.); (D.M.S.); (E.A.); (S.T.)
| | - Dario M. Schejtman
- Radiology, Rabin Medical Center, Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo 49100, Israel; (T.F.); (M.D.); (C.A.); (I.G.); (D.M.S.); (E.A.); (S.T.)
| | - Tzippy Shochat
- Biostatistics, Rabin Medical Center, Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo 49100, Israel;
| | - Eli Atar
- Radiology, Rabin Medical Center, Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo 49100, Israel; (T.F.); (M.D.); (C.A.); (I.G.); (D.M.S.); (E.A.); (S.T.)
| | - Shlomit Tamir
- Radiology, Rabin Medical Center, Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo 49100, Israel; (T.F.); (M.D.); (C.A.); (I.G.); (D.M.S.); (E.A.); (S.T.)
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Massera RT, Tomal A, Thomson RM. Multiscale Monte Carlo simulations for dosimetry in x-ray breast imaging: Part I - Macroscopic scales. Med Phys 2024; 51:1105-1116. [PMID: 38156766 DOI: 10.1002/mp.16910] [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: 03/30/2023] [Revised: 11/07/2023] [Accepted: 12/10/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND X-ray breast imaging modalities are commonly employed for breast cancer detection, from screening programs to diagnosis. Thus, dosimetry studies are important for quality control and risk estimation since ionizing radiation is used. PURPOSE To perform multiscale dosimetry assessments for different breast imaging modalities and for a variety of breast sizes and compositions. The first part of our study is focused on macroscopic scales (down to millimeters). METHODS Nine anthropomorphic breast phantoms with a voxel resolution of 0.5 mm were computationally generated using the BreastPhantom software, representing three breast sizes with three distinct values of volume glandular fraction (VGF) for each size. Four breast imaging modalities were studied: digital mammography (DM), contrast-enhanced digital mammography (CEDM), digital breast tomosynthesis (DBT) and dedicated breast computed tomography (BCT). Additionally, the impact of tissue elemental compositions from two databases were compared. Monte Carlo (MC) simulations were performed with the MC-GPU code to obtain the 3D glandular dose distribution (GDD) for each case considered with the mean glandular dose (MGD) fixed at 4 mGy (to facilitate comparisons). RESULTS The GDD within the breast is more uniform for CEDM and BCT compared to DM and DBT. For large breasts and high VGF, the ratio between the minimum/maximum glandular dose to MGD is 0.12/4.02 for DM and 0.46/1.77 for BCT; the corresponding results for a small breast and low VGF are 0.35/1.98 (DM) and 0.63/1.42 (BCT). The elemental compositions of skin, adipose and glandular tissue have a considerable impact on the MGD, with variations up to 30% compared to the baseline. The inclusion of tissues other than glandular and adipose within the breast has a minor impact on MGD, with differences below 2%. Variations in the final compressed breast thickness alter the shape of the GDD, with a higher compression resulting in a more uniform GDD. CONCLUSIONS For a constant MGD, the GDD varies with imaging modality and breast compression. Elemental tissue compositions are an important factor for obtaining MGD values, being a source of systematic uncertainties in MC simulations and, consequently, in breast dosimetry.
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Affiliation(s)
- Rodrigo T Massera
- Universidade Estadual de Campinas (UNICAMP), Instituto de Física Gleb Wataghin, Campinas, São Paulo, Brazil
- Carleton Laboratory for Radiotherapy Physics, Department of Physics, Carleton University, Ottawa, Ontario, Canada
| | - Alessandra Tomal
- Universidade Estadual de Campinas (UNICAMP), Instituto de Física Gleb Wataghin, Campinas, São Paulo, Brazil
| | - Rowan M Thomson
- Carleton Laboratory for Radiotherapy Physics, Department of Physics, Carleton University, Ottawa, Ontario, Canada
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Chan HP, Helvie MA, Gao M, Hadjiiski L, Zhou C, Garver K, Klein KA, McLaughlin C, Oudsema R, Rahman WT, Roubidoux MA. Deep learning denoising of digital breast tomosynthesis: Observer performance study of the effect on detection of microcalcifications in breast phantom images. Med Phys 2023; 50:6177-6189. [PMID: 37145996 PMCID: PMC10592580 DOI: 10.1002/mp.16439] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 04/06/2023] [Accepted: 04/11/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND The noise in digital breast tomosynthesis (DBT) includes x-ray quantum noise and detector readout noise. The total radiation dose of a DBT scan is kept at about the level of a digital mammogram but the detector noise is increased due to acquisition of multiple projections. The high noise can degrade the detectability of subtle lesions, specifically microcalcifications (MCs). PURPOSE We previously developed a deep-learning-based denoiser to improve the image quality of DBT. In the current study, we conducted an observer performance study with breast radiologists to investigate the feasibility of using deep-learning-based denoising to improve the detection of MCs in DBT. METHODS We have a modular breast phantom set containing seven 1-cm-thick heterogeneous 50% adipose/50% fibroglandular slabs custom-made by CIRS, Inc. (Norfolk, VA). We made six 5-cm-thick breast phantoms embedded with 144 simulated MC clusters of four nominal speck sizes (0.125-0.150, 0.150-0.180, 0.180-0.212, 0.212-0.250 mm) at random locations. The phantoms were imaged with a GE Pristina DBT system using the automatic standard (STD) mode. The phantoms were also imaged with the STD+ mode that increased the average glandular dose by 54% to be used as a reference condition for comparison of radiologists' reading. Our previously trained and validated denoiser was deployed to the STD images to obtain a denoised DBT set (dnSTD). Seven breast radiologists participated as readers to detect the MCs in the DBT volumes of the six phantoms under the three conditions (STD, STD+, dnSTD), totaling 18 DBT volumes. Each radiologist read all the 18 DBT volumes sequentially, which were arranged in a different order for each reader in a counter-balanced manner to minimize any potential reading order effects. They marked the location of each detected MC cluster and provided a conspicuity rating and their confidence level for the perceived cluster. The visual grading characteristics (VGC) analysis was used to compare the conspicuity ratings and the confidence levels of the radiologists for the detection of MCs. RESULTS The average sensitivities over all MC speck sizes were 65.3%, 73.2%, and 72.3%, respectively, for the radiologists reading the STD, dnSTD, and STD+ volumes. The sensitivity for dnSTD was significantly higher than that for STD (p < 0.005, two-tailed Wilcoxon signed rank test) and comparable to that for STD+. The average false positive rates were 3.9 ± 4.6, 2.8 ± 3.7, and 2.7 ± 3.9 marks per DBT volume, respectively, for reading the STD, dnSTD, and STD+ images but the difference between dnSTD and STD or STD+ did not reach statistical significance. The overall conspicuity ratings and confidence levels by VGC analysis for dnSTD were significantly higher than those for both STD and STD+ (p ≤ 0.001). The critical alpha value for significance was adjusted to be 0.025 with Bonferroni correction. CONCLUSIONS This observer study using breast phantom images showed that deep-learning-based denoising has the potential to improve the detection of MCs in noisy DBT images and increase radiologists' confidence in differentiating noise from MCs without increasing radiation dose. Further studies are needed to evaluate the generalizability of these results to the wide range of DBTs from human subjects and patient populations in clinical settings.
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Affiliation(s)
- Heang-Ping Chan
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Mark A Helvie
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Mingjie Gao
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Lubomir Hadjiiski
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Chuan Zhou
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Kim Garver
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Katherine A Klein
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Carol McLaughlin
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Rebecca Oudsema
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - W Tania Rahman
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
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Norsuddin NM, Mei Sin JG, Ravintaran R, Arasaratnam S, Abdul Karim MK. Impact of age and breast thickness on mean glandular dose of standard digital mammography and digital breast tomosynthesis. Appl Radiat Isot 2023; 192:110525. [PMID: 36436228 DOI: 10.1016/j.apradiso.2022.110525] [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: 02/20/2022] [Revised: 09/28/2022] [Accepted: 10/18/2022] [Indexed: 01/04/2023]
Abstract
This study compares the mean glandular dose (MGD) across 2D, 3D projection and Contrast-Enhanced Digital Mammography (CEDM) mammographic techniques. The important metadata were extracted from the digital mammography console. 650 subjects were clustered based on projections, age and CBT. The MGD of 2D, 3D, and CEDM was positively correlated with CBT but inversely correlated with the age factor. This study indicate MGD of CEDM was 16% and 22% lower compared to 2D and 3D techniques, respectively.
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Affiliation(s)
- Norhashimah Mohd Norsuddin
- Department of Diagnostic & Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, 56000, Malaysia
| | - Justine Go Mei Sin
- Department of Diagnostic & Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, 56000, Malaysia
| | - Rathieswari Ravintaran
- Department of Diagnostic & Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, 56000, Malaysia
| | - Shantini Arasaratnam
- Department of Radiology, Hospital Kuala Lumpur, Jalan Pahang, Kuala Lumpur, 50586, Malaysia
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Yang ML, Bhimani C, Roth R, Germaine P. Contrast enhanced mammography: focus on frequently encountered benign and malignant diagnoses. Cancer Imaging 2023; 23:10. [PMID: 36691077 PMCID: PMC9872331 DOI: 10.1186/s40644-023-00526-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/09/2023] [Indexed: 01/24/2023] Open
Abstract
Contrast-enhanced mammography (CEM) is becoming a widely adopted modality in breast imaging over the past few decades and exponentially so over the last few years, with strong evidence of high diagnostic performance in cancer detection. Evidence is also growing indicating comparative performance of CEM to MRI in sensitivity with fewer false positive rates. As application of CEM ranges from potential use in screening dense breast populations to staging of known breast malignancy, increased familiarity with the modality and its implementation, and disease processes encountered becomes of great clinical significance. This review emphasizes expected normal findings on CEM followed by a focus on examples of the commonly encountered benign and malignant pathologies on CEM.
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Affiliation(s)
- Mindy L. Yang
- grid.411896.30000 0004 0384 9827Department of Radiology, Cooper University Hospital, 1 Cooper Plaza, Camden, NJ 08103 USA ,Present address: SimonMed Imaging, 6900 E Camelback Road, Suite 700, Scottsdale, AZ 85251 USA
| | - Chandni Bhimani
- grid.411896.30000 0004 0384 9827Department of Radiology, Cooper University Hospital, 1 Cooper Plaza, Camden, NJ 08103 USA ,Present address: Atlantic Medical Imaging, Bayport One Office Building, 8025 Black Horse Pike, Suite 300, West Atlantic City, NJ 08232 USA
| | - Robyn Roth
- grid.411896.30000 0004 0384 9827Department of Radiology, Cooper University Hospital, 1 Cooper Plaza, Camden, NJ 08103 USA
| | - Pauline Germaine
- grid.411896.30000 0004 0384 9827Department of Radiology, Cooper University Hospital, 1 Cooper Plaza, Camden, NJ 08103 USA
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Magni V, Cozzi A, Schiaffino S, Colarieti A, Sardanelli F. Artificial intelligence for digital breast tomosynthesis: Impact on diagnostic performance, reading times, and workload in the era of personalized screening. Eur J Radiol 2023; 158:110631. [PMID: 36481480 DOI: 10.1016/j.ejrad.2022.110631] [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: 11/07/2022] [Accepted: 11/24/2022] [Indexed: 12/05/2022]
Abstract
The ultimate goals of the application of artificial intelligence (AI) to digital breast tomosynthesis (DBT) are the reduction of reading times, the increase of diagnostic performance, and the reduction of interval cancer rates. In this review, after outlining the journey from computer-aided detection/diagnosis systems to AI applied to digital mammography (DM), we summarize the results of studies where AI was applied to DBT, noting that long-term advantages of DBT screening and its crucial ability to decrease the interval cancer rate are still under scrutiny. AI has shown the capability to overcome some shortcomings of DBT in the screening setting by improving diagnostic performance and by reducing recall rates (from -2 % to -27 %) and reading times (up to -53 %, with an average 20 % reduction), but the ability of AI to reduce interval cancer rates has not yet been clearly investigated. Prospective validation is needed to assess the cost-effectiveness and real-world impact of AI models assisting DBT interpretation, especially in large-scale studies with low breast cancer prevalence. Finally, we focus on the incoming era of personalized and risk-stratified screening that will first see the application of contrast-enhanced breast imaging to screen women with extremely dense breasts. As the diagnostic advantage of DBT over DM was concentrated in this category, we try to understand if the application of AI to DM in the remaining cohorts of women with heterogeneously dense or non-dense breast could close the gap in diagnostic performance between DM and DBT, thus neutralizing the usefulness of AI application to DBT.
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Affiliation(s)
- Veronica Magni
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Luigi Mangiagalli 31, 20133 Milano, Italy.
| | - Andrea Cozzi
- Unit of Radiology, IRCCS Policlinico San Donato, Via Rodolfo Morandi 30, 20097 San Donato Milanese, Italy
| | - Simone Schiaffino
- Unit of Radiology, IRCCS Policlinico San Donato, Via Rodolfo Morandi 30, 20097 San Donato Milanese, Italy
| | - Anna Colarieti
- Unit of Radiology, IRCCS Policlinico San Donato, Via Rodolfo Morandi 30, 20097 San Donato Milanese, Italy
| | - Francesco Sardanelli
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Luigi Mangiagalli 31, 20133 Milano, Italy; Unit of Radiology, IRCCS Policlinico San Donato, Via Rodolfo Morandi 30, 20097 San Donato Milanese, Italy.
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Di Maria S, Vedantham S, Vaz P. Breast dosimetry in alternative X-ray-based imaging modalities used in current clinical practices. Eur J Radiol 2022; 155:110509. [PMID: 36087425 PMCID: PMC9851082 DOI: 10.1016/j.ejrad.2022.110509] [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: 06/30/2022] [Revised: 08/18/2022] [Accepted: 08/30/2022] [Indexed: 01/21/2023]
Abstract
In X-ray breast imaging, Digital Mammography (DM) and Digital Breast Tomosynthesis (DBT), are the standard and largely used techniques, both for diagnostic and screening purposes. Other techniques, such as dedicated Breast Computed Tomography (BCT) and Contrast Enhanced Mammography (CEM) have been developed as an alternative or a complementary technique to the established ones. The performance of these imaging techniques is being continuously assessed to improve the image quality and to reduce the radiation dose. These imaging modalities are predominantly used in the diagnostic setting to resolve incomplete or indeterminate findings detected with conventional screening examinations and could potentially be used either as an adjunct or as a primary screening tool in select populations, such as for women with dense breasts. The aim of this review is to describe the radiation dosimetry for these imaging techniques, and to compare the mean glandular dose with standard breast imaging modalities, such as DM and DBT.
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Affiliation(s)
- S Di Maria
- Centro de Ciências e Tecnologias Nucleares, Instituto Superior Técnico, Campus Tecnológico e Nuclear, Estrada Nacional 10, km 139,7, 2695-066 Bobadela LRS, Portugal.
| | - S Vedantham
- Department of Medical Imaging, The University of Arizona, Tucson, AZ, USA; Department of Biomedical Engineering, The University of Arizona, Tucson, AZ, USA
| | - P Vaz
- Centro de Ciências e Tecnologias Nucleares, Instituto Superior Técnico, Campus Tecnológico e Nuclear, Estrada Nacional 10, km 139,7, 2695-066 Bobadela LRS, Portugal
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10
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Radiation Dose of Contrast-Enhanced Mammography: A Two-Center Prospective Comparison. Cancers (Basel) 2022; 14:cancers14071774. [PMID: 35406546 PMCID: PMC8997084 DOI: 10.3390/cancers14071774] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 03/24/2022] [Accepted: 03/28/2022] [Indexed: 12/10/2022] Open
Abstract
The radiation dose associated with contrast-enhanced mammography (CEM) has been investigated only by single-center studies. In this retrospective study, we aimed to compare the radiation dose between two centers performing CEM within two prospective studies, using the same type of equipment. The CEM mean glandular dose (MGD) was computed for low energy (LE) and high energy (HE) images and their sum was calculated for each view. MGD and related parameters (entrance dose, breast thickness, compression, and density) were compared between the two centers using the Mann−Whitney test. Finally, per-patient MGD was calculated by pooling the two datasets and determining the contribution of LE and HE images. A total of 348 CEM examinations were analyzed (228 from Center 1 and 120 from Center 2). The median total MGD per view was 2.33 mGy (interquartile range 2.19−2.51 mGy) at Center 1 and 2.46 mGy (interquartile range 2.32−2.70 mGy) at Center 2, with a 0.15 mGy median difference (p < 0.001) equal to 6.2%. LE-images contributed between 64% and 77% to the total patient dose in CEM, with the remaining 23−36% being associated with HE images. The mean radiation dose for a two-view bilateral CEM exam was 4.90 mGy, about 30% higher than for digital mammography.
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11
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Mechanical response of polyacrylamide breast tissue phantoms: Formulation, characterization and modeling. J Mech Behav Biomed Mater 2022; 129:105125. [DOI: 10.1016/j.jmbbm.2022.105125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 02/02/2022] [Accepted: 02/06/2022] [Indexed: 11/17/2022]
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12
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Chan HP, Helvie MA, Klein KA, McLaughlin C, Neal CH, Oudsema R, Rahman WT, Roubidoux MA, Hadjiiski LM, Zhou C, Samala RK. Effect of Dose Level on Radiologists' Detection of Microcalcifications in Digital Breast Tomosynthesis: An Observer Study with Breast Phantoms. Acad Radiol 2022; 29 Suppl 1:S42-S49. [PMID: 32950384 DOI: 10.1016/j.acra.2020.07.038] [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: 05/19/2020] [Revised: 07/30/2020] [Accepted: 07/30/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To compare radiologists' sensitivity, confidence level, and reading efficiency of detecting microcalcifications in digital breast tomosynthesis (DBT) at two clinically relevant dose levels. MATERIALS AND METHODS Six 5-cm-thick heterogeneous breast phantoms embedded with a total of 144 simulated microcalcification clusters of four speck sizes were imaged at two dose modes by a clinical DBT system. The DBT volumes at the two dose levels were read independently by six MQSA radiologists and one fellow with 1-33 years (median 12 years) of experience in a fully-crossed counter-balanced manner. The radiologist located each potential cluster and rated its conspicuity and his/her confidence that the marked location contained a cluster. The differences in the results between the two dose modes were analyzed by two-tailed paired t-test. RESULTS Compared to the lower-dose mode, the average glandular dose in the higher-dose mode for the 5-cm phantoms increased from 1.34 to 2.07 mGy. The detection sensitivity increased for all speck sizes and significantly for the two smaller sizes (p <0.05). An average of 13.8% fewer false positive clusters was marked. The average conspicuity rating and the radiologists' confidence level were higher for all speck sizes and reached significance (p <0.05) for the three larger sizes. The average reading time per detected cluster reduced significantly (p <0.05) by an average of 13.2%. CONCLUSION For a 5-cm-thick breast, an increase in average glandular dose from 1.34 to 2.07 mGy for DBT imaging increased the conspicuity of microcalcifications, improved the detection sensitivity by radiologists, increased their confidence levels, reduced false positive detections, and increased the reading efficiency.
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Affiliation(s)
- Heang-Ping Chan
- Department of Radiology, University of Michigan, 1500 E. Medical Center Dr., Med Inn Building C477, Ann Arbor, MI 48109-5842.
| | - Mark A Helvie
- Department of Radiology, University of Michigan, 1500 E. Medical Center Dr., Med Inn Building C477, Ann Arbor, MI 48109-5842
| | - Katherine A Klein
- Department of Radiology, University of Michigan, 1500 E. Medical Center Dr., Med Inn Building C477, Ann Arbor, MI 48109-5842
| | - Carol McLaughlin
- Department of Radiology, University of Michigan, 1500 E. Medical Center Dr., Med Inn Building C477, Ann Arbor, MI 48109-5842
| | - Colleen H Neal
- Department of Radiology, University of Michigan, 1500 E. Medical Center Dr., Med Inn Building C477, Ann Arbor, MI 48109-5842
| | - Rebecca Oudsema
- Department of Radiology, University of Michigan, 1500 E. Medical Center Dr., Med Inn Building C477, Ann Arbor, MI 48109-5842
| | - W Tania Rahman
- Department of Radiology, University of Michigan, 1500 E. Medical Center Dr., Med Inn Building C477, Ann Arbor, MI 48109-5842
| | - Marilyn A Roubidoux
- Department of Radiology, University of Michigan, 1500 E. Medical Center Dr., Med Inn Building C477, Ann Arbor, MI 48109-5842
| | - Lubomir M Hadjiiski
- Department of Radiology, University of Michigan, 1500 E. Medical Center Dr., Med Inn Building C477, Ann Arbor, MI 48109-5842
| | - Chuan Zhou
- Department of Radiology, University of Michigan, 1500 E. Medical Center Dr., Med Inn Building C477, Ann Arbor, MI 48109-5842
| | - Ravi K Samala
- Department of Radiology, University of Michigan, 1500 E. Medical Center Dr., Med Inn Building C477, Ann Arbor, MI 48109-5842
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13
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Mainprize JG. To Use Tomosynthesis or Not in the Augmented Breast? JOURNAL OF BREAST IMAGING 2021; 3:701-702. [PMID: 38424934 DOI: 10.1093/jbi/wbab078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Indexed: 03/02/2024]
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14
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Vu NQ, Bice C, Garrett J, Longhurst C, Belden D, Haerr C, Prue L, Woods RW. Screening Digital Breast Tomosynthesis: Radiation Dose Among Patients With Breast Implants. JOURNAL OF BREAST IMAGING 2021; 3:694-700. [PMID: 38424937 DOI: 10.1093/jbi/wbab073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Indexed: 03/02/2024]
Abstract
OBJECTIVE To compare the mean glandular dose (MGD), cancer detection rate (CDR), and recall rate (RR) among screening examinations of patients with breast implants utilizing various digital breast tomosynthesis (DBT)-based imaging protocols. METHODS This IRB-approved retrospective study included 1998 women with breast implants who presented for screening mammography between December 10, 2013, and May 29, 2020. Images were obtained using various protocol combinations of DBT and 2D digital mammography. Data collected included MGD, implant type and position, breast density, BI-RADS final assessment category, CDR, and RR. Statistical analysis utilized type II analysis of variance and the chi-square test. RESULTS The highest MGD was observed in the DBT only protocol, while the 2D only protocol had the lowest (10.29 mGy vs 5.88 mGy, respectively). Statistically significant difference in MGD was observed across protocols (P < 0.0001). The highest per-view MGD was among DBT full-field (FF) views in both craniocaudal and mediolateral oblique projections (P < 0.0001). No significant difference was observed in RR among protocols (P = 0.17). The combined 2D (FF only) + DBT implant-displaced (ID) views protocol detected the highest number of cancers (CDR, 7.2 per 1000), but this was not significantly different across protocols (P = 0.48). CONCLUSION The combination of 2D FF views and DBT ID views should be considered for women with breast implants in a DBT-based screening practice when aiming to minimize radiation exposure without compromising the sensitivity of cancer detection. Avoidance of DBT FF in this patient population is recommended to minimize radiation dose.
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Affiliation(s)
- Nhu Q Vu
- University of Wisconsin, School of Medicine and Public Health, Madison, WI, USA
| | - Curran Bice
- University of Wisconsin, School of Medicine and Public Health, Madison, WI, USA
| | - John Garrett
- UW Health, Department of Radiology, Madison, WI, USA
| | - Colin Longhurst
- University of Wisconsin, Department of Statistics, Madison, WI, USA
| | - Daryn Belden
- UW Health, Department of Radiology, Madison, WI, USA
| | - Carolyn Haerr
- UW Health, Department of Radiology, Madison, WI, USA
| | - Lucinda Prue
- UnityPoint Health-Meriter, Department of Radiology, Madison, WI, USA
| | - Ryan W Woods
- University of Wisconsin, School of Medicine and Public Health, Madison, WI, USA
- UW Health, Department of Radiology, Madison, WI, USA
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15
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Hunt KN. Molecular Breast Imaging: A Scientific Review. JOURNAL OF BREAST IMAGING 2021; 3:416-426. [PMID: 38424795 DOI: 10.1093/jbi/wbab039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Indexed: 03/02/2024]
Abstract
Molecular breast imaging (MBI) is a nuclear medicine technique that has evolved considerably over the past two decades. Technical advances have allowed reductions in administered doses to the point that they are now acceptable for screening. The most common radiotracer used in MBI, 99mTc-sestamibi, has a long history of safe use. Biopsy capability has become available in recent years, with early clinical experience demonstrating technically successful biopsies of MBI-detected lesions. MBI has been shown to be an effective supplemental screening tool in women with dense breasts and is also utilized for breast cancer staging, assessment of response to neoadjuvant chemotherapy, problem solving, and as an alternative to breast MRI in women who have a contraindication to MRI. The degree of background parenchymal uptake on MBI shows promise as a tool for breast cancer risk stratification. Radiologist interpretation is guided by a validated MBI lexicon that mirrors the BI-RADS lexicon. With short interpretation times, a fast learning curve for radiologists, and a substantially lower cost than breast MRI, MBI provides many benefits in the practices in which it is utilized. This review will discuss the current state of MBI technology, clinical applications of MBI, MBI interpretation, radiation dose associated with MBI, and the future of MBI.
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Affiliation(s)
- Katie N Hunt
- Mayo Clinic, Department of Radiology, Rochester, MN, USA
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16
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Monticciolo DL, Malak SF, Friedewald SM, Eby PR, Newell MS, Moy L, Destounis S, Leung JWT, Hendrick RE, Smetherman D. Breast Cancer Screening Recommendations Inclusive of All Women at Average Risk: Update from the ACR and Society of Breast Imaging. J Am Coll Radiol 2021; 18:1280-1288. [PMID: 34154984 DOI: 10.1016/j.jacr.2021.04.021] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 11/25/2022]
Abstract
Breast cancer remains the most common nonskin cancer, the second leading cause of cancer deaths, and the leading cause of premature death in US women. Mammography screening has been proven effective in reducing breast cancer deaths in women age 40 years and older. A mortality reduction of 40% is possible with regular screening. Treatment advances cannot overcome the disadvantage of being diagnosed with an advanced-stage tumor. The ACR and Society of Breast Imaging recommend annual mammography screening beginning at age 40, which provides the greatest mortality reduction, diagnosis at earlier stage, better surgical options, and more effective chemotherapy. Annual screening results in more screening-detected tumors, tumors of smaller sizes, and fewer interval cancers than longer screening intervals. Screened women in their 40s are more likely to have early-stage disease, negative lymph nodes, and smaller tumors than unscreened women. Delaying screening until age 45 or 50 will result in an unnecessary loss of life to breast cancer and adversely affects minority women in particular. Screening should continue past age 74 years, without an upper age limit unless severe comorbidities limit life expectancy. Benefits of screening should be considered along with the possibilities of recall for additional imaging and benign biopsy and the less tangible risks of anxiety and overdiagnosis. Although recall and biopsy recommendations are higher with more frequent screening, so are life-years gained and breast cancer deaths averted. Women who wish to maximize benefit will choose annual screening starting at age 40 years and will not stop screening prematurely.
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Affiliation(s)
- Debra L Monticciolo
- Vice-chair for Research, Department of Radiology, and Section Chief, Breast Imaging, Texas A&M University Health Sciences, Baylor Scott & White Healthcare-Central Texas, Temple, Texas.
| | | | - Sarah M Friedewald
- Chief of Breast and Women's Imaging; Vice Chair of Operations, Department of Radiology; Medical Director, Lynn Sage Comprehensive Breast Center, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Peter R Eby
- Chief of Breast Imaging, Radiology Representative to the Cancer Committee, Virginia Mason Medical Center, Seattle, Washington
| | - Mary S Newell
- Associate Division Director; Associate Director of Breast Center, Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia
| | - Linda Moy
- Laura and Isaac Perlutter Cancer Center, NYU School of Medicine, New York City, New York
| | - Stamatia Destounis
- Chair of Clinical Research and Medical Outcomes Department, Elizabeth Wende Breast Care, Rochester, New York
| | - Jessica W T Leung
- Deputy Chair of Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - R Edward Hendrick
- Department of Radiology, University of Colorado School of Medicine, Aurora, Colorado
| | - Dana Smetherman
- Department Chair and Associate Medical Director of the Medical Specialties, Department of Radiology, Ochsner Medical Center, New Orleans, Louisiana
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17
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Loving VA, Aminololama-Shakeri S, Leung JWT. Anxiety and Its Association With Screening Mammography. JOURNAL OF BREAST IMAGING 2021; 3:266-272. [PMID: 38424779 DOI: 10.1093/jbi/wbab024] [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: 01/26/2021] [Indexed: 03/02/2024]
Abstract
Anxiety is often cited as a risk of screening mammography, and organizations such as the U.S. Preventive Services Task Force list anxiety as a screening-associated "harm" that should be mitigated. However, the level of mammography-related anxiety risk is difficult to assign clearly for myriad reasons, including the variability of individuals' baseline susceptibility to anxiety, the self-reported nature of subjective anxiety states, and the multiple sources of breast cancer screening-related anxiety. In addition, anxiety measures differ between studies and psychological responses to screening mammography vary across racial and ethnic groups. Nonetheless, breast radiology practices should acknowledge the existence of mammography-associated anxiety and consider strategies to decrease it. These strategies include immediate screening interpretations, patient education efforts, and relaxation techniques.
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Affiliation(s)
- Vilert A Loving
- Banner MD Anderson Cancer Center, Division of Diagnostic Imaging, Gilbert, AZ, USA
| | | | - Jessica W T Leung
- The University of Texas MD Anderson Cancer Center, Department of Breast Imaging, Houston, TX, USA
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18
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Hendrick RE. Response to Two Letters Concerning Radiation Doses and Risks in Breast Screening. JOURNAL OF BREAST IMAGING 2020; 2:520-521. [PMID: 38424852 DOI: 10.1093/jbi/wbaa075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Indexed: 03/02/2024]
Affiliation(s)
- R Edward Hendrick
- University of Colorado School of Medicine, Department of Radiology, Aurora, CO
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19
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Covington MF. Molecular Breast Imaging Deserves Fair and Balanced Consideration. JOURNAL OF BREAST IMAGING 2020; 2:519. [PMID: 38424853 DOI: 10.1093/jbi/wbaa073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Indexed: 03/02/2024]
Affiliation(s)
- Matthew F Covington
- University of Utah, Department of Radiology and Imaging Sciences, Salt Lake City, UT
- Huntsman Cancer Institute, Center for Quantitative Cancer Imaging, Salt Lake City, UT
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20
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Conners AL, Ellis R, Fazzio RT, Hruska CB, Hunt KN, O'Connor MK, Rhodes DJ, Shermis R. Comment on "Radiation Doses and Risks in Breast Screening". JOURNAL OF BREAST IMAGING 2020; 2:519-520. [PMID: 38424854 DOI: 10.1093/jbi/wbaa074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Indexed: 03/02/2024]
Affiliation(s)
| | - Richard Ellis
- Mayo Clinic Health System Franciscan Healthcare, Department of Radiology, La Crosse, WI
| | | | | | - Katie N Hunt
- Mayo Clinic, Department of Radiology, Rochester, MN
| | | | - Deborah J Rhodes
- Yale New Haven Health, Department of Internal Medicine, New Haven, CT
| | - Robin Shermis
- ProMedica Health System Inc, Breast Care, Toledo, OH
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21
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Wang L, Strigel RM. Supplemental Screening for Patients at Intermediate and High Risk for Breast Cancer. Radiol Clin North Am 2020; 59:67-83. [PMID: 33223001 DOI: 10.1016/j.rcl.2020.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The sensitivity of mammography is more limited in patients with dense breasts and some patients at higher risk for breast cancer. Patients with intermediate or high risk for breast cancer may begin screening earlier and benefit from supplemental screening techniques beyond standard 2-dimensional mammography. A patient's individual risk factors for developing breast cancer, their breast density, and the evidence supporting specific modalities for a given clinical scenario help to determine the need for supplemental screening and the modality chosen. Additional factors include the availability of supplemental screening techniques at an individual institution, cost, insurance coverage, and state-specific breast density legislation.
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Affiliation(s)
- Lilian Wang
- Northwestern Medicine, Chicago, IL, USA; Prentice Women's Hospital, 250 East Superior Street, 4th Floor, Room 04-2304, Chicago, IL 60611, USA
| | - Roberta M Strigel
- Breast Imaging and Intervention, University of Wisconsin, 600 Highland Avenue, Madison, WI 53792-3252, USA.
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22
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Yousefi B, Akbari H, Maldague XP. Detecting Vasodilation as Potential Diagnostic Biomarker in Breast Cancer Using Deep Learning-Driven Thermomics. BIOSENSORS 2020; 10:E164. [PMID: 33142939 PMCID: PMC7693609 DOI: 10.3390/bios10110164] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/29/2020] [Accepted: 10/30/2020] [Indexed: 12/11/2022]
Abstract
Breast cancer is the most common cancer in women. Early diagnosis improves outcome and survival, which is the cornerstone of breast cancer treatment. Thermography has been utilized as a complementary diagnostic technique in breast cancer detection. Artificial intelligence (AI) has the capacity to capture and analyze the entire concealed information in thermography. In this study, we propose a method to potentially detect the immunohistochemical response to breast cancer by finding thermal heterogeneous patterns in the targeted area. In this study for breast cancer screening 208 subjects participated and normal and abnormal (diagnosed by mammography or clinical diagnosis) conditions were analyzed. High-dimensional deep thermomic features were extracted from the ResNet-50 pre-trained model from low-rank thermal matrix approximation using sparse principal component analysis. Then, a sparse deep autoencoder designed and trained for such data decreases the dimensionality to 16 latent space thermomic features. A random forest model was used to classify the participants. The proposed method preserves thermal heterogeneity, which leads to successful classification between normal and abnormal subjects with an accuracy of 78.16% (73.3-81.07%). By non-invasively capturing a thermal map of the entire tumor, the proposed method can assist in screening and diagnosing this malignancy. These thermal signatures may preoperatively stratify the patients for personalized treatment planning and potentially monitor the patients during treatment.
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Affiliation(s)
- Bardia Yousefi
- Department of Electrical and Computer Engineering, Laval University, Quebec City, QC G1V 0A6, Canada
| | - Hamed Akbari
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Xavier P.V. Maldague
- Department of Electrical and Computer Engineering, Laval University, Quebec City, QC G1V 0A6, Canada
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23
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Harvey JA. Screening: Looking into the Crystal Ball. JOURNAL OF BREAST IMAGING 2020; 2:177-178. [PMID: 38424983 DOI: 10.1093/jbi/wbaa019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Indexed: 03/02/2024]
Affiliation(s)
- Jennifer A Harvey
- University of Rochester Medical Center, Department of Imaging Sciences, Rochester, NY
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