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Patel MM, Adrada BE, Fowler AM, Rauch GM. Molecular Breast Imaging and Positron Emission Mammography. PET Clin 2023; 18:487-501. [PMID: 37258343 DOI: 10.1016/j.cpet.2023.04.005] [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: 06/02/2023]
Abstract
There is growing interest in application of functional imaging modalities for adjunct breast imaging due to their unique ability to evaluate molecular/pathophysiologic changes, not visible by standard anatomic breast imaging. This has led to increased use of nuclear medicine dedicated breast-specific single photon and coincidence imaging systems for multiple indications, such as supplemental screening, staging of newly diagnosed breast cancer, evaluation of response to neoadjuvant treatment, diagnosis of local disease recurrence in the breast, and problem solving. Studies show that these systems maybe especially useful for specific subsets of patients, not well served by available anatomic breast imaging modalities.
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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
| | - Amy M Fowler
- Department of Radiology, Section of Breast Imaging and Intervention, University of Wisconsin - Madison, 600 Highland Avenue, Madison, WI 53792-3252, USA; Department of Medical Physics, University of Wisconsin Carbone Cancer Center, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792-3252, USA
| | - Gaiane M Rauch
- Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe, Unit 1473, Houston, TX 77030, USA; Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe, Unit 1473, Houston, TX 77030, USA
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2
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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: 60] [Impact Index Per Article: 60.0] [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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3
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van Loevezijn AA, Corion CL, Zeillemaker AM, Wijers LM, Smithuis RH, Valdés Olmos RA, van der Hage JA, de Geus-Oei LF, Benard M, Pereira Arias-Bouda LM. Clinical impact of molecular breast imaging as adjunct diagnostic modality in evaluation of indeterminate breast abnormalities and unresolved diagnostic concerns. Nucl Med Commun 2023; 44:417-426. [PMID: 36897051 PMCID: PMC10171295 DOI: 10.1097/mnm.0000000000001684] [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: 05/24/2022] [Accepted: 02/24/2023] [Indexed: 03/11/2023]
Abstract
PURPOSE Improvements in molecular breast imaging (MBI) have increased the use of MBI as adjunct diagnostic modality and alternative to MRI. We aimed to assess the value of MBI in patients with equivocal breast lesions on conventional imaging, especially in terms of its ability to rule out malignancy. METHODS We selected patients who underwent MBI in addition to conventional diagnostics due to equivocal breast lesions between 2012 and 2015. All patients underwent digital mammography, target ultrasound and MBI. MBI was performed using a single-head Dilon 6800 gamma camera after administration of 600 MBq 99m Tc-sestamibi. Imaging was reported according to BI-RADS classification and compared with pathology or follow-up of ≥6 months. RESULTS Of 226 women included, pathology was obtained in 106 (47%) and (pre)malignant lesions were found in 25 (11%). Median follow-up was 5.4 years (IQR 3.9-7.1). Sensitivity was higher for MBI compared to conventional diagnostics (84% vs. 32%; P = 0.002), identifying malignancy in 21 and 6 patients, respectively, but specificity did not differ (86% vs. 81%; P = 0.161). Positive and negative predictive value were 43% and 98% for MBI and 17% and 91% for conventional diagnostics. MBI was discordant with conventional diagnostics in 68 (30%) patients and correctly changed diagnosis in 46 (20%) patients, identifying 15 malignant lesions. In subgroups with nipple discharge ( N = 42) and BI-RADS 3 lesions ( N = 113) MBI detected 7 of 8 occult malignancies. CONCLUSION MBI correctly adjusted treatment in 20% of patients with diagnostic concerns after conventional work-up, and could rule out malignancy with a high negative predictive value of 98%.
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Affiliation(s)
- Ariane A. van Loevezijn
- Department of Surgical Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek, Amsterdam
| | | | | | | | | | | | | | - Lioe-Fee de Geus-Oei
- Department of Radiology, Section of Nuclear Medicine
- Biomedical Photonic Imaging Group, University of Twente, Enschede
| | - Menno Benard
- Department of Research and Education, Alrijne Hospital
| | - Lenka M. Pereira Arias-Bouda
- Department of Radiology, Section of Nuclear Medicine
- Department of Nuclear Medicine, Alrijne hospital, Leiderdorp, The Netherlands
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Maimone S, Morozov AP, Letter HP, Robinson KA, Wasserman MC, Li Z, Maxwell RW. Abbreviated Molecular Breast Imaging: Feasibility and Future Considerations. JOURNAL OF BREAST IMAGING 2022; 4:590-599. [PMID: 38416994 DOI: 10.1093/jbi/wbac060] [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: 05/20/2022] [Indexed: 03/01/2024]
Abstract
OBJECTIVE Molecular breast imaging (MBI) is a supplemental screening modality consistently demonstrating incremental cancer detection over mammography alone; however, its lengthy duration may limit widespread utilization. The study purpose was to assess feasibility of an abbreviated MBI protocol, providing readers with mediolateral oblique (MLO) projections only and assessing performance in lesion detection and localization. METHODS Retrospective IRB-exempt blinded reader study administered to 5 fellowship-trained breast imaging radiologists. Independent reads performed for 124 screening MBI cases, half abnormal and half negative/normal. Readers determined whether an abnormality was present, side of abnormality, and location of abnormality (medial/lateral). Abnormal cases had confirmatory biopsy or surgical pathology; normal cases had imaging follow-up ensuring true negative results. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated to assess performance. A false negative result indicated that a reader failed to detect abnormal uptake; a false positive result indicated a reader incorrectly called an abnormality for a negative case. Tests for association included chi-square, Fisher-exact, and analysis of variance. RESULTS Mean reader performance for detecting abnormal uptake: sensitivity 96.8%, specificity 98.7%, PPV 98.8%, and NPV 96.9%. Accuracy in localizing lesions to the medial or lateral breast was 100%. There were no associations in reader performance with reader experience, reader technique, lesion morphology, or lesion pathology. Median lesion size was 1.0 cm (range: 0.4-8.0 cm). All readers correctly identified 97.7% (42/43) of lesions with malignant or elevated risk pathology. CONCLUSION An abbreviated MBI protocol (MLO images only) maintained high accuracy in lesion detection and localization.
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Affiliation(s)
- Santo Maimone
- Mayo Clinic Florida, Department of Radiology, Jacksonville, FL, USA
| | - Andrey P Morozov
- Mayo Clinic Florida, Department of Radiology, Jacksonville, FL, USA
| | - Haley P Letter
- Mayo Clinic Florida, Department of Radiology, Jacksonville, FL, USA
| | | | | | - Zhuo Li
- Mayo Clinic Florida, Department of Biostatistics, Jacksonville, FL, USA
| | - Robert W Maxwell
- Mayo Clinic Florida, Department of Radiology, Jacksonville, FL, USA
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Downstream imaging following abnormal molecular breast imaging, lessons learned and suggestions for success. Clin Imaging 2022; 92:44-51. [DOI: 10.1016/j.clinimag.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 09/16/2022] [Accepted: 09/21/2022] [Indexed: 11/23/2022]
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Breast-Specific Gamma Imaging: An Added Value in the Diagnosis of Breast Cancer, a Systematic Review. Cancers (Basel) 2022; 14:cancers14194619. [PMID: 36230540 PMCID: PMC9559460 DOI: 10.3390/cancers14194619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 11/23/2022] Open
Abstract
Simple Summary Breast-specific gamma imaging represents an emergent instrument for breast cancer detection. We selected on Medline articles published from 1995 to 2022 that compare various imaging modalities with breast-specific gamma imaging. The aim of this paper was to assess if this imaging method is a more valuable choice in detecting breast malignant lesions compared to morphological counterparts such mammography, ultrasound, and magnetic resonance imaging in terms of specificity, sensibility and positive and negative predictive value. At the cost of a major radiology burden, breast-specific gamma imaging is more specific, with a sensibility comparable to magnetic resonance imaging and higher than ultrasonography and mammography. Abstract Purpose: Breast cancer is the most common solid tumor and the second highest cause of death in the United States. Detection and diagnosis of breast tumors includes various imaging modalities, such as mammography (MMG), ultrasound (US), and contrast-enhancement MRI. Breast-specific gamma imaging (BSGI) is an emerging tool, whereas morphological imaging has the disadvantage of a higher absorbed dose. Our aim was to assess if this imaging method is a more valuable choice in detecting breast malignant lesions compared to morphological counterparts. Methods: research on Medline from 1995 to June 2022 was conducted. Studies that compared at least one anatomical imaging modality with BSGI were screened and assessed through QUADAS2 for risk of bias and applicability concerns assessment. Sensitivity, specificity, positive and negative predictive value (PPV and NPV) were reported. Results: A total of 15 studies compared BSGI with MMG, US, and MRI. BSGI sensitivity was similar to MRI, but specificity was higher. Specificity was always higher than MMG and US. BSGI had higher PPV and NPV. When used for the evaluation of a suspected breast lesion, the overall sensitivity was better than the examined overall sensitivity when BSGI was excluded. Risk of bias and applicability concerns domain showed mainly low risk of bias. Conclusion: BSGI is a valuable imaging modality with similar sensitivity to MRI but higher specificity, although at the cost of higher radiation burden.
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The Impact of Dense Breasts on the Stage of Breast Cancer at Diagnosis: A Review and Options for Supplemental Screening. Curr Oncol 2022; 29:3595-3636. [PMID: 35621681 PMCID: PMC9140155 DOI: 10.3390/curroncol29050291] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/23/2022] [Accepted: 04/25/2022] [Indexed: 11/16/2022] Open
Abstract
The purpose of breast cancer screening is to find cancers early to reduce mortality and to allow successful treatment with less aggressive therapy. Mammography is the gold standard for breast cancer screening. Its efficacy in reducing mortality from breast cancer was proven in randomized controlled trials (RCTs) conducted from the early 1960s to the mid 1990s. Panels that recommend breast cancer screening guidelines have traditionally relied on the old RCTs, which did not include considerations of breast density, race/ethnicity, current hormone therapy, and other risk factors. Women do not all benefit equally from mammography. Mortality reduction is significantly lower in women with dense breasts because normal dense tissue can mask cancers on mammograms. Moreover, women with dense breasts are known to be at increased risk. To provide equity, breast cancer screening guidelines should be created with the goal of maximizing mortality reduction and allowing less aggressive therapy, which may include decreasing the interval between screening mammograms and recommending consideration of supplemental screening for women with dense breasts. This review will address the issue of dense breasts and the impact on the stage of breast cancer at the time of diagnosis, and discuss options for supplemental screening.
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8
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Covington MF, Mrose HE, Brown M. At Which Mean Glandular Dose Does the Benefit of Breast Cancer Deaths Averted Equal the Risk of Lives Lost to Screening From Radiation-induced Malignancy for Mammography With and Without Tomosynthesis? JOURNAL OF BREAST IMAGING 2022; 4:25-30. [PMID: 38422413 DOI: 10.1093/jbi/wbab087] [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: 08/19/2021] [Indexed: 03/02/2024]
Abstract
OBJECTIVE To estimate benefit-to-radiation-risk mean glandular dose (MGD) equivalence values for screening mammography, defined as the yearly MGD (over a 10-year period) at which the estimated benefit of mammography in terms of deaths averted equals the estimated risk of lives lost to screening due to radiation exposure (a benefit-to-risk ratio of 1). METHODS Benefit-to-risk ratios were calculated as the ratio of breast cancer deaths averted and lives lost to screening over 10-year intervals starting at age 40 for mammography and tomosynthesis using previously published methodology. The MGD values at which estimated benefit equals risk were tabulated. RESULTS The MGD values at which benefit-to-risk equivalence points were met for digital screening mammography are 63 milligray (mGy) (ages 40-49), 88 mGy (ages 50-59), 176 mGy (ages 60-69), and 336 mGy (ages 70-79). The MGD values that met benefit-to-risk equivalence for screening tomosynthesis plus digital mammography or synthetic mammography are 80 mGy (ages 40-49), 111 mGy (ages 50-59), 224 mGy (ages 60-69), and 427 mGy (ages 70-79). CONCLUSION Cutoff MGD values at which the estimated benefit from screening equals the estimated risk are well above standard screening MGD exposures. Care is necessary to ensure that threshold values are not exceeded during a screening exam, particularly for women ages 40-49 years old when using digital mammography plus tomosynthesis (due to an approximate doubling of dose per exam that will more readily exceed cutoff MGD values) and when many additional views are obtained.
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Affiliation(s)
- Matthew F Covington
- University of Utah, Department of Radiology and Imaging Sciences, Salt Lake City, UT, USA
- Huntsman Cancer Institute Center for Quantitative Cancer Imaging, Salt Lake City, UT, USA
| | - Helen E Mrose
- University of Utah, Department of Radiology and Imaging Sciences, Salt Lake City, UT, USA
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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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10
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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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Saenboonruang K, Poltabtim W, Thumwong A, Pianpanit T, Rattanapongs C. Rare-Earth Oxides as Alternative High-Energy Photon Protective Fillers in HDPE Composites: Theoretical Aspects. Polymers (Basel) 2021; 13:polym13121930. [PMID: 34200711 PMCID: PMC8230413 DOI: 10.3390/polym13121930] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/06/2021] [Accepted: 06/09/2021] [Indexed: 11/21/2022] Open
Abstract
This work theoretically determined the high-energy photon shielding properties of high-density polyethylene (HDPE) composites containing rare-earth oxides, namely samarium oxide (Sm2O3), europium oxide (Eu2O3), and gadolinium oxide (Gd2O3), for potential use as lead-free X-ray-shielding and gamma-shielding materials using the XCOM software package. The considered properties were the mass attenuation coefficient (µm), linear attenuation coefficient (µ), half value layer (HVL), and lead equivalence (Pbeq) that were investigated at varying photon energies (0.001–5 MeV) and filler contents (0–60 wt.%). The results were in good agreement (less than 2% differences) with other available programs (Phy-X/PSD) and Monte Carlo particle transport simulation code, namely PHITS, which showed that the overall high-energy photon shielding abilities of the composites considerably increased with increasing rare-earth oxide contents but reduced with increasing photon energies. In particular, the Gd2O3/HDPE composites had the highest µm values at photon energies of 0.1, 0.5, and 5 MeV, due to having the highest atomic number (Z). Furthermore, the Pbeq determination of the composites within the X-ray energy ranges indicated that the 10 mm thick samples with filler contents of 40 wt.% and 50 wt.% had Pbeq values greater than the minimum requirements for shielding materials used in general diagnostic X-ray rooms and computerized tomography rooms, which required Pbeq values of at least 1.0 and 1.5 mmPb, respectively. In addition, the comparisons of µm, µ, and HVL among the rare-earth oxide/HDPE composites investigated in this work and other lead-free X-ray shielding composites revealed that the materials developed in this work exhibited comparable X-ray shielding properties in comparison with that of the latter, implying great potential to be used as effective X-ray shielding materials in actual applications.
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Affiliation(s)
- Kiadtisak Saenboonruang
- Department of Applied Radiation and Isotopes, Faculty of Science, Kasetsart University, Bangkok 10900, Thailand; (W.P.); (A.T.); (T.P.); (C.R.)
- Specialized Center of Rubber and Polymer Materials in Agriculture and Industry (RPM), Faculty of Science, Kasetsart University, Bangkok 10900, Thailand
- Correspondence: ; Tel.: +66-25-625555 (ext. 646219)
| | - Worawat Poltabtim
- Department of Applied Radiation and Isotopes, Faculty of Science, Kasetsart University, Bangkok 10900, Thailand; (W.P.); (A.T.); (T.P.); (C.R.)
| | - Arkarapol Thumwong
- Department of Applied Radiation and Isotopes, Faculty of Science, Kasetsart University, Bangkok 10900, Thailand; (W.P.); (A.T.); (T.P.); (C.R.)
| | - Theerasarn Pianpanit
- Department of Applied Radiation and Isotopes, Faculty of Science, Kasetsart University, Bangkok 10900, Thailand; (W.P.); (A.T.); (T.P.); (C.R.)
| | - Chanis Rattanapongs
- Department of Applied Radiation and Isotopes, Faculty of Science, Kasetsart University, Bangkok 10900, Thailand; (W.P.); (A.T.); (T.P.); (C.R.)
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Molecular Breast Cancer Imaging in the Era of Precision Medicine. AJR Am J Roentgenol 2020; 215:1512-1519. [DOI: 10.2214/ajr.20.22883] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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13
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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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14
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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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15
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An Update on Screening and Prevention for Breast and Gynecological Cancers in Average and High Risk Individuals. Am J Med Sci 2020; 360:489-510. [DOI: 10.1016/j.amjms.2020.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 05/22/2020] [Accepted: 06/03/2020] [Indexed: 11/21/2022]
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16
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Jain R, Katz DR, Kapoor AD. The Clinical Utility of a Negative Result at Molecular Breast Imaging: Initial Proof of Concept. Radiol Imaging Cancer 2020; 2:e190096. [PMID: 33778735 PMCID: PMC7983715 DOI: 10.1148/rycan.2020190096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 04/28/2020] [Accepted: 05/27/2020] [Indexed: 11/11/2022]
Abstract
Purpose To calculate the negative predictive value (NPV) and false-negative rate (FNR) of molecular breast imaging (MBI) performed in patients who had low-suspicion index findings on mammograms and US images. Materials and Methods This retrospective study included patients who had undergone MBI between January 2015 and July 2017, who had index findings on screening mammograms and/or US images, and for whom either histopathologic results or a minimum of 1-year imaging follow-up results were available. A drawn dose of 8 mCi (296 MBq) of technetium 99m sestamibi was administered to all patients for MBI. The NPV and FNR of MBI was calculated for the cohort of 381 findings among 338 women (median age, 56 years; age range, 28-89 years) included in this study. Results Overall, 292 of the 381 (76.6%) MBI results were interpreted as negative. Of the 292, 27 patients underwent subsequent biopsies, results of which were negative for cancer; one patient underwent biopsy, and the result was positive for cancer; and 264 patients had true-negative findings based on follow-up imaging for a minimum of 1 year. Of the 89 MBI acquisitions interpreted as positive, there were 36 cancers. The NPV was calculated to be 99.7% (291 of 292, 95% confidence interval [CI]: 99.1%, 100%), and the FNR was 2.7% (one of 37, 95% CI: 0%, 7.9%). Interposing MBI reduced the number of biopsies by 67.5%. Conclusion The concept of the clinical utility of a negative MBI result may be valid but requires further testing.Keywords: Breast, Molecular Imaging-Cancer© RSNA, 2020.
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Affiliation(s)
- Ravi Jain
- From Middlesex Health, 28 Crescent St, Middletown, CT 06457
| | - Deanna R. Katz
- From Middlesex Health, 28 Crescent St, Middletown, CT 06457
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Molecular Breast Imaging at Ultra-Low Radiation Dose. AJR Am J Roentgenol 2020; 215:W30. [DOI: 10.2214/ajr.19.22746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Breast-specific gamma imaging or ultrasonography as adjunct imaging diagnostics in women with mammographically dense breasts. Eur Radiol 2020; 30:6062-6071. [PMID: 32524221 DOI: 10.1007/s00330-020-06950-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 03/28/2020] [Accepted: 05/08/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Mammography (MMG) shows decreased diagnostic accuracy in dense breast tissue, and thus, ultrasonography (US) and breast-specific gamma imaging (BSGI) have gradually been adopted for women with mammographically dense breasts. However, these two adjunct modalities have not been directly compared in previous studies. Hence, we investigated the adjunctive efficacy of US and BSGI in mammographically dense breasts. METHODS This retrospective, comparative study recruited women with mammographically dense breasts. All enrolled women underwent US and BSGI as adjunctive imaging, and the comparative sensitivity, specificity, and diagnostic accuracy of combined MMG plus BSGI versus MMG plus US were evaluated. McNemar's test was used for paired binary data in this comparative analysis. RESULTS From April 2013 to April 2016, 364 women with mammographically dense breasts and a final surgical or biopsy pathological diagnosis were recruited, comprising 218 cases of malignant disease (59.9%) and 146 cases of benign disease (40.1%). There was no difference between BSGI and US in enhancing the sensitivity of MMG diagnosis (Se-Difference 3.2%, p = 0.23), but the diagnostic specificity of MMG plus BSGI was superior to that of MMG plus US (Sp-Difference 10.3%, p = 0.003). The area under the ROC curve showed that MMG plus BSGI had better diagnostic accuracy than MMG plus US (0.90 vs. 0.83, p = 0.0019). CONCLUSIONS For women with mammographically dense breasts, MMG plus BSGI or US can improve the diagnostic accuracy. In addition, BSGI has high specificity and could reduce invasive biopsies and thus may represent a viable diagnostic imaging alternative for mammographically dense breasts. KEY POINTS • Both BSGI and US can be applied as adjunct imaging diagnostics in women with mammographically dense breasts. • The diagnostic accuracy of MMG plus BSGI was higher than that of MMG plus US. • BSGI has the potential to be used as an adjunct diagnostic modality in women with mammographically dense breasts.
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Hendrick RE. Radiation Doses and Risks in Breast Screening. JOURNAL OF BREAST IMAGING 2020; 2:188-200. [PMID: 38424982 DOI: 10.1093/jbi/wbaa016] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Indexed: 03/02/2024]
Abstract
This article describes radiation doses and cancer risks of digital breast imaging technologies used for breast cancer detection. These include digital mammography (DM), digital breast tomosynthesis (DBT), and newer technologies such as contrast-enhanced digital or spectral mammography (CEM), whole-breast computed tomography, breast-specific gamma imaging (BSGI), molecular breast imaging (MBI), and positron emission mammography (PEM). This article describes the basis for radiation risk estimates, compares radiation doses and risks, and provides benefit-to-radiation-risk ratios for different breast imaging modalities that use ionizing radiation. Current x-ray-based screening modalities such as DM and DBT have small to negligible risks of causing radiation-induced cancers in women of normal screening age. Possible new screening modalities such as CEM have similar small cancer risks. Potential screening modalities that involve radionuclide injection such as BSGI, MBI, and PEM have significantly higher cancer risks unless efficient detection systems and reduced administered doses are used. Benefit-to-radiation-risk estimates are highly favorable for screening with DM and other modalities having comparable (or higher) cancer detection rates and comparably low radiation doses.
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Affiliation(s)
- R Edward Hendrick
- University of Colorado School of Medicine, Department of Radiology, Aurora, CO
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Urbano N, Scimeca M, Tancredi V, Bonanno E, Schillaci O. 99mTC-sestamibi breast imaging: Current status, new ideas and future perspectives. Semin Cancer Biol 2020; 84:302-309. [PMID: 31982511 DOI: 10.1016/j.semcancer.2020.01.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 01/14/2020] [Accepted: 01/15/2020] [Indexed: 02/06/2023]
Abstract
Here we proposed the most recent innovations in the use of Breast Specific Gamma Imaging with 99mTc-sestamibi for the management of breast cancer patients. To this end, we reported the recent discoveries concerning: a) the implementation of both instrumental devices and software, b) the biological mechanisms involved in the 99mTc-sestamibi uptake in breast cancer cells, c) the evaluation of Breast Specific Gamma Imaging with 99mTc-sestamibi as predictive markers of metastatic diseases. In this last case, we also reported preliminary data about the capability of Breast Specific Gamma Imaging with 99mTc-sestamibi to identify breast cancer lesions with high propensity to form bone metastatic lesions due to the presence of Breast Osteoblast-Like Cells.
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Affiliation(s)
- Nicoletta Urbano
- Nuclear Medicine, Policlinico "Tor Vergata", Viale Oxford, 81, 00133, Rome, Italy
| | - Manuel Scimeca
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy; University of San Raffaele, Via di Val Cannuta 247, 00166, Rome, Italy; Fondazione Umberto Veronesi (FUV), Piazza Velasca 5, 20122, Milano (Mi), Italy; UniCamillus, Saint Camillus International University of Health Sciences, Rome, Italy
| | - Virginia Tancredi
- Department of Systems Medicine, School of Sport and Exercise Sciences, University of Rome Tor Vergata, Rome, Italy; Centre of Space Biomedicine, University of Rome Tor Vergata, Rome, Italy
| | - Elena Bonanno
- Department of Experimental Medicine, University of Rome "Tor Vergata", Via Montpellier, 1, 00133, Rome, Italy; Diagnostica Medica' & 'Villa dei Platani', Neuromed Group, Avellino, 83100, Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy; IRCCS Neuromed, Pozzilli (Is), 86077, Italy.
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Dose Reduction in Molecular Breast Imaging With a New Image-Processing Algorithm. AJR Am J Roentgenol 2019; 214:185-193. [PMID: 31593516 DOI: 10.2214/ajr.19.21582] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE. The purpose of this study was to determine whether application of a proprietary image-processing algorithm would allow a reduction in the necessary administered activity for molecular breast imaging (MBI) examinations. MATERIALS AND METHODS. Images from standard-dose MBI examinations (300 MBq 99mTc-sestamibi) of 50 subjects were analyzed. The images were acquired in dynamic mode and showed at least one breast lesion. Half-dose MBI examinations were simulated by summing one-half of the dynamic frames and were processed with the algorithm under study in both a default and a preferred filter mode. Two breast radiologists independently completed a set of two-alternative forced-choice tasks to compare lesion conspicuity on standard-dose images, half-dose images, and the algorithm-processed half-dose images in both modes. RESULTS. Relative to the standard-dose images, the half-dose images were preferred in 4, the default-filtered half-dose images in 50, and preferred-filtered half-dose images in 76 of 100 readings. Compared with standard-dose images, in terms of lesion conspicuity, the half-dose images were rated better in 2, equivalent in 6, and poorer in 92 of 100 readings. The default-filtered half-dose images were rated better, equivalent, or poorer in 13, 73, and 14 of 100 readings. The preferred-filtered half-dose images were rated as better, equivalent, or poorer in 55, 34, and 11 of 100 readings. CONCLUSION. Compared with that on standard-dose images, lesion conspicuity on images obtained with the algorithm and acquired at one-half the standard dose was equivalent or better without compromise of image quality. The algorithm can also be used to decrease imaging time with a resulting increase in patient comfort and throughput.
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Brown M, Covington MF. Comparative Benefit-to-Radiation Risk Ratio of Molecular Breast Imaging, Two-Dimensional Full-Field Digital Mammography with and without Tomosynthesis, and Synthetic Mammography with Tomosynthesis. Radiol Imaging Cancer 2019; 1:e190005. [PMID: 33778669 DOI: 10.1148/rycan.2019190005] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 04/25/2019] [Accepted: 04/30/2019] [Indexed: 02/02/2023]
Abstract
Purpose To apply previously published benefit-to-risk ratio methods for mammography and molecular breast imaging (MBI) risk estimates to an expanded range of mammographic screening techniques, compressed breast thicknesses, and screening views. Materials and Methods Only previously published estimates were used; therefore, this study was exempt from the requirement to obtain institutional review board approval. Benefit-to-risk ratios were calculated as the ratio of breast cancer deaths averted and lives lost to screening over 10-year intervals starting at age 40 years for MBI, two-dimensional (2D) full-field digital mammography (FFDM) alone, 2D FFDM with synthetic mammography, and 2D FFDM with tomosynthesis for two-, four-, and five-view screening mammography and compressed breast thicknesses of 20-29 mm, 50-59 mm, and 80-89 mm. Results Central estimates of the benefit-to-risk ratios ranged from 3 to 179 for screening mammography and from 5 to 9 for MBI. Benefit-to-risk ratios for MBI were inferior to those for mammography for most scenarios, but MBI may be performed at an equal or superior benefit-to-risk ratio for women aged 40-59 years with a compressed breast thickness of at least 80 mm and for those undergoing mammographic screening examinations with four or five views per breast. The benefit-to-risk ratios across all ages with use of tomosynthesis plus 2D FFDM as a screening examination were 45% lower than those for tomosynthesis plus synthetic mammography. Conclusion Benefit-to-risk ratios for MBI are within the lower range of those for mammography when accounting for variation in mammography technique, compressed breast thickness, and age. Benefit-to-risk ratios of synthetic mammography plus tomosynthesis are superior to those of tomosynthesis plus 2D FFDM.Keywords: Breast, Mammography, Molecular Imaging, Molecular Imaging-Cancer, Radiation Safety, Radionuclide Studies, Screening, Tomosynthesis© RSNA, 2019See also the commentary by Hruska in this issue.
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Affiliation(s)
- Matthew Brown
- Sections of Nuclear Medicine (M.B., M.F.C.) and Breast Imaging (M.F.C.), Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110
| | - Matthew F Covington
- Sections of Nuclear Medicine (M.B., M.F.C.) and Breast Imaging (M.F.C.), Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110
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Advanced approaches to imaging primary breast cancer: an update. Clin Transl Imaging 2019. [DOI: 10.1007/s40336-019-00346-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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24
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Hruska CB. Let's Get Real about Molecular Breast Imaging and Radiation Risk. Radiol Imaging Cancer 2019; 1:e190070. [PMID: 33779637 PMCID: PMC7983654 DOI: 10.1148/rycan.2019190070] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 08/16/2019] [Indexed: 11/11/2022]
Affiliation(s)
- Carrie B. Hruska
- From the Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905
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Narayanan D, Berg WA. Dedicated Breast Gamma Camera Imaging and Breast PET: Current Status and Future Directions. PET Clin 2018; 13:363-381. [PMID: 30100076 DOI: 10.1016/j.cpet.2018.02.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Recent advances in nuclear medicine instrumentation have led to the emergence of improved molecular imaging techniques to image breast cancer: dedicated gamma cameras using γ-emitting 99mTc-sestamibi and breast-specific PET cameras using 18F-fluorodeoxyglucose. This article focuses on the current role of such approaches in the clinical setting including diagnosis, assessing local extent of disease, monitoring response to therapy, and, for gamma camera imaging, possible supplemental screening in women with dense breasts. Barriers to clinical adoption and technologies and radiotracers under development are also discussed.
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Affiliation(s)
- Deepa Narayanan
- National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20850, USA.
| | - Wendie A Berg
- Department of Radiology, University of Pittsburgh School of Medicine, Magee-Womens Hospital of UPMC, 300 Halket Street, Pittsburgh, PA 15213
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Abstract
Screening mammography saves lives. The mainstay of screening has been mammography. Multiple alternative options, however, for supplemental imaging are now available. Some are just improved anatomic delineation whereas others include physiology added to anatomy. A third group (molecular imaging) is purely physiologic. This article describes and compares the available options and for which patient populations they should be used.
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Affiliation(s)
- Lizza Lebron-Zapata
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
| | - Maxine S Jochelson
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
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Smilg JS. Are you dense? The implications and imaging of the dense breast. SA J Radiol 2018; 22:1356. [PMID: 31754514 PMCID: PMC6837771 DOI: 10.4102/sajr.v22i2.1356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 06/18/2018] [Indexed: 11/21/2022] Open
Abstract
Mammography relies on a visual interpretation of imaging results that is often confounded by dense breast tissue. Dense tissue affects the ability and accuracy with which the radiologist is able to detect cancer. Dense tissue may mask the presence of a breast cancer, and breast density is well recognised as an independent risk factor for the development of breast cancer. In the dense breast, detected cancers tend to be larger, more often lymph node positive and of a higher stage than those diagnosed in fatty tissue. The incidence of tumour multifocality and multicentricity is higher, decreasing the chances for breast conserving treatment. The literature convincingly supports the use of supplemental imaging modalities in women who present with increased breast density. There are clear advantages and disadvantages to each set of diagnostic imaging tests. However, there is no simple, cost-effective solution for women with dense breasts to obtain a definitive detection status through imaging. Suggestions are put forward as to what supplemental imaging choices should be included for the imaging of the dense breast with reference to the current South African setting. Use of supplemental screening modalities should be tailored to individual risk assessment. In a resource-constrained environment, international recommendations may need to be adjusted.
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Affiliation(s)
- Jacqueline S Smilg
- Evolutionary Studies Institute, University of the Witwatersrand, South Africa.,Department of Radiation Sciences, University of the Witwatersrand, South Africa.,Department of Diagnostic Radiology, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
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28
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Lin L, Hu P, Shi J, Appleton CM, Maslov K, Li L, Zhang R, Wang LV. Single-breath-hold photoacoustic computed tomography of the breast. Nat Commun 2018; 9:2352. [PMID: 29907740 PMCID: PMC6003984 DOI: 10.1038/s41467-018-04576-z] [Citation(s) in RCA: 231] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 04/19/2018] [Indexed: 12/22/2022] Open
Abstract
We have developed a single-breath-hold photoacoustic computed tomography (SBH-PACT) system to reveal detailed angiographic structures in human breasts. SBH-PACT features a deep penetration depth (4 cm in vivo) with high spatial and temporal resolutions (255 µm in-plane resolution and a 10 Hz 2D frame rate). By scanning the entire breast within a single breath hold (~15 s), a volumetric image can be acquired and subsequently reconstructed utilizing 3D back-projection with negligible breathing-induced motion artifacts. SBH-PACT clearly reveals tumors by observing higher blood vessel densities associated with tumors at high spatial resolution, showing early promise for high sensitivity in radiographically dense breasts. In addition to blood vessel imaging, the high imaging speed enables dynamic studies, such as photoacoustic elastography, which identifies tumors by showing less compliance. We imaged breast cancer patients with breast sizes ranging from B cup to DD cup, and skin pigmentations ranging from light to dark. SBH-PACT identified all the tumors without resorting to ionizing radiation or exogenous contrast, posing no health risks.
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Affiliation(s)
- Li Lin
- Caltech Optical Imaging Laboratory, Andrew and Peggy Cherng Department of Medical Engineering, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA, 91125, USA.,Department of Biomedical Engineering, Washington University in St. Louis, One Brookings Dr., St. Louis, MO, 63130, USA
| | - Peng Hu
- Department of Biomedical Engineering, Washington University in St. Louis, One Brookings Dr., St. Louis, MO, 63130, USA
| | - Junhui Shi
- Caltech Optical Imaging Laboratory, Andrew and Peggy Cherng Department of Medical Engineering, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA, 91125, USA
| | - Catherine M Appleton
- Breast Imaging Section, Washington University School of Medicine in St. Louis, 510 South Kingshighway Blvd, St. Louis, MO, 63108, USA
| | - Konstantin Maslov
- Caltech Optical Imaging Laboratory, Andrew and Peggy Cherng Department of Medical Engineering, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA, 91125, USA
| | - Lei Li
- Caltech Optical Imaging Laboratory, Andrew and Peggy Cherng Department of Medical Engineering, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA, 91125, USA.,Caltech Optical Imaging Laboratory, Department of Electrical Engineering, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA, 91125, USA
| | - Ruiying Zhang
- Department of Biomedical Engineering, Washington University in St. Louis, One Brookings Dr., St. Louis, MO, 63130, USA
| | - Lihong V Wang
- Caltech Optical Imaging Laboratory, Andrew and Peggy Cherng Department of Medical Engineering, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA, 91125, USA. .,Caltech Optical Imaging Laboratory, Department of Electrical Engineering, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA, 91125, USA.
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29
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Radiation Risk Associated With X-Ray Mammography Screening: Communication and Exchange of Information via Tweets. J Am Coll Radiol 2018; 15:1033-1039. [PMID: 29661518 DOI: 10.1016/j.jacr.2018.02.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 02/13/2018] [Accepted: 02/22/2018] [Indexed: 11/22/2022]
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Heller SL, Heacock L, Moy L. Developments in Breast Imaging: Update on New and Evolving MR Imaging and Molecular Imaging Techniques. Magn Reson Imaging Clin N Am 2018; 26:247-258. [PMID: 29622129 DOI: 10.1016/j.mric.2017.12.003] [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] [Indexed: 12/14/2022]
Abstract
This article reviews new developments in breast imaging. There is growing interest in creating a shorter, less expensive MR protocol with broader applicability. There is an increasing focus on and consideration for the additive impact that functional analysis of breast pathology have on identifying and characterizing lesions. These developments apply to MR imaging and molecular imaging. This article reviews evolving breast imaging techniques with attention to strengths, weaknesses, and applications of these approaches. We aim to give the reader familiarity with the state of current developments in the field and to increase awareness of what to expect in breast imaging.
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Affiliation(s)
- Samantha Lynn Heller
- NYU School of Medicine, NYU Laura and Isaac Perlmutter Cancer Center, 3rd Floor, New York, NY 10016, USA
| | - Laura Heacock
- NYU School of Medicine, NYU Laura and Isaac Perlmutter Cancer Center, 3rd Floor, New York, NY 10016, USA
| | - Linda Moy
- NYU School of Medicine, NYU Laura and Isaac Perlmutter Cancer Center, 3rd Floor, New York, NY 10016, USA.
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31
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Kopans DB. Breast cancer screening: Where have we been and where are we going? A personal perspective based on history, data and experience. Clin Imaging 2018; 48:vii-xi. [DOI: 10.1016/j.clinimag.2017.12.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 12/21/2017] [Indexed: 11/27/2022]
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Huppe AI, Mehta AK, Brem RF. Molecular Breast Imaging: A Comprehensive Review. Semin Ultrasound CT MR 2018; 39:60-69. [DOI: 10.1053/j.sult.2017.10.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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33
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Kopans DB. Breast cancer screening: Where have we been and where are we going? A personal perspective based on history, data and experience. Clin Imaging 2017; 50:91-95. [PMID: 29331672 DOI: 10.1016/j.clinimag.2017.12.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 12/21/2017] [Indexed: 01/22/2023]
Abstract
It is important to understand the history of breast cancer screening to better understand the continuing effort to reduce access to screening. Since the randomized, controlled trials have shown a statistically significant mortality reduction for women ages 40-74, the appropriate threshold for initiating screening is age 40 with no data to support the use of the age of 50 as a threshold for screening. All women are at risk for developing breast cancer and all women should have access to screening.
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Affiliation(s)
- Daniel B Kopans
- Radiology Harvard Medical School, Founder Bresat Imagning Division Massachusetts General Hospital, 20 Manitoba Road, Waban, MA 02468, United States.
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Shermis RB, Redfern RE, Burns J, Kudrolli H. Molecular Breast Imaging in Breast Cancer Screening and Problem Solving. Radiographics 2017; 37:1309-1606. [PMID: 28898193 DOI: 10.1148/rg.2017160204] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In the United States, legislative actions in over 28 states require radiologists to notify women who undergo breast screening mammography of their breast density. This has led to increased public interest in supplemental screening, but radiologists have not come to a consensus on a supplemental screening modality. In choosing between the most common options, whole-breast ultrasonography (US) and magnetic resonance (MR) imaging, one must weigh the benefits and drawbacks of each modality, as increased cancer detection may be accompanied by increased examination costs and biopsy rates. There has been recent interest in molecular breast imaging (MBI) for supplemental screening because of its high sensitivity, as well as its high specificity. This article describes how MBI fits into clinical practice alongside digital breast tomosynthesis (DBT), targeted US, and MR imaging. The authors describe their approach to breast cancer screening, which uses DBT as the primary imaging modality. DBT is complemented by automated density calculations and supplemented with functional imaging techniques, including MR imaging or MBI, for women with dense breasts. An algorithm based on the patient's breast cancer risk is used to determine if either MR imaging or MBI for supplemental screening is appropriate. MBI is also used as a problem-solving tool for the evaluation of clinical indications following complex mammography or US, or for unexplained physical findings. This article describes aspects related to implementing MBI in clinical practice, including the clinical workflow, patient management, radioactive tracer administration, and procedure reimbursement. © RSNA, 2017.
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Affiliation(s)
- Robin B Shermis
- From ProMedica Breast Care Center, ProMedica Toledo Hospital, 2121 Hughes Dr, 1st Floor, Toledo, OH 43606 (R.B.S.); ProMedica Research, ProMedica Health System, Toledo, Ohio (R.E.R.); Department of Surgery, University of Toledo Medical Center, Toledo, Ohio (J.B.); and Gamma Medica, Salem, NH (H.K.)
| | - Roberta E Redfern
- From ProMedica Breast Care Center, ProMedica Toledo Hospital, 2121 Hughes Dr, 1st Floor, Toledo, OH 43606 (R.B.S.); ProMedica Research, ProMedica Health System, Toledo, Ohio (R.E.R.); Department of Surgery, University of Toledo Medical Center, Toledo, Ohio (J.B.); and Gamma Medica, Salem, NH (H.K.)
| | - Jessica Burns
- From ProMedica Breast Care Center, ProMedica Toledo Hospital, 2121 Hughes Dr, 1st Floor, Toledo, OH 43606 (R.B.S.); ProMedica Research, ProMedica Health System, Toledo, Ohio (R.E.R.); Department of Surgery, University of Toledo Medical Center, Toledo, Ohio (J.B.); and Gamma Medica, Salem, NH (H.K.)
| | - Haris Kudrolli
- From ProMedica Breast Care Center, ProMedica Toledo Hospital, 2121 Hughes Dr, 1st Floor, Toledo, OH 43606 (R.B.S.); ProMedica Research, ProMedica Health System, Toledo, Ohio (R.E.R.); Department of Surgery, University of Toledo Medical Center, Toledo, Ohio (J.B.); and Gamma Medica, Salem, NH (H.K.)
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35
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Niell BL, Freer PE, Weinfurtner RJ, Arleo EK, Drukteinis JS. Screening for Breast Cancer. Radiol Clin North Am 2017; 55:1145-1162. [DOI: 10.1016/j.rcl.2017.06.004] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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