1
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Cömert D, van Gils CH, Veldhuis WB, Mann RM. Challenges and Changes of the Breast Cancer Screening Paradigm. J Magn Reson Imaging 2023; 57:706-726. [PMID: 36349728 DOI: 10.1002/jmri.28495] [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: 07/29/2022] [Revised: 10/07/2022] [Accepted: 10/07/2022] [Indexed: 11/11/2022] Open
Abstract
Since four decades mammography is used for early breast cancer detection in asymptomatic women and still remains the gold standard imaging modality. However, population screening programs can be personalized and women can be divided into different groups based on risk factors and personal preferences. The availability of new and evolving imaging modalities, for example, digital breast tomosynthesis, dynamic-contrast-enhanced magnetic resonance imaging (MRI), abbreviated MRI protocols, diffusion-weighted MRI, and contrast-enhanced mammography leads to new challenges and perspectives regarding the feasibility and potential harms of breast cancer screening. The aim of this review is to discuss the current guidelines for different risk groups, to analyze the recent published studies about the diagnostic performance of the imaging modalities and to discuss new developments and future perspectives. LEVEL OF EVIDENCE: 1 TECHNICAL EFFICACY: Stage 6.
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Affiliation(s)
- Didem Cömert
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Radiology and Nuclear Medicine, Utrecht University Medical Center, Utrecht, The Netherlands
| | - Carla H van Gils
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Wouter B Veldhuis
- Department of Radiology and Nuclear Medicine, Utrecht University Medical Center, Utrecht, The Netherlands
| | - Ritse M Mann
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Radiology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
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2
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Sherminie LPG, Jayatilake ML. Fractal Dimension Analysis of Pixel Dynamic Contrast Enhanced-Magnetic Resonance Imaging Pharmacokinetic Parameters for Discrimination of Benign and Malignant Breast Lesions. JCO Clin Cancer Inform 2023; 7:e2200101. [PMID: 36745858 DOI: 10.1200/cci.22.00101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
PURPOSE Breast cancer is the most frequent cancer in women worldwide. However, its diagnosis mostly depends on visual examination of radiologic images, leading to an overdiagnosis with substantial costs. Therefore, a quantitative approach such as dynamic contrast enhanced (DCE)-magnetic resonance imaging (MRI) through pharmacokinetic (PK) modeling is required for reliable analysis. As PK parameters lack information on parameter heterogeneity, texture-based analysis is required to quantify PK parameter heterogeneity. Therefore, this study focused on determining the usefulness of fractal dimension (FD) as a potential imaging biomarker of tumor heterogeneity for discriminating benign and malignant breast lesions. METHODS Parametric maps for PK parameters, extravasation rate of contrast agent from blood plasma to extravascular extracellular space (Ktrans) and volume fraction of extravascular extracellular space (ve), were generated for the regions of interest (ROIs) under the standard model using 18 lesions. Then, tumor ROI and pixel DCE-MRI time-course data were analyzed to extract pixel values of Ktrans and ve. For each ROI, FD values of Ktrans and ve were computed using the blanket method. RESULTS The FD values of Ktrans for benign and malignant lesions varied from 2.96 to 3.49 and from 2.37 to 3.16, respectively, whereas FD values of ve for benign and malignant lesions varied from 3.01 to 5.15 and 2.42 to 3.44, respectively. There were significant differences in FD values derived from Ktrans parametric maps (P = .0053) and ve parametric maps (P = .0271) between benign and malignant lesions according to the statistical analysis. CONCLUSION Incorporating texture heterogeneity changes in breast lesions captured by FD with quantitative DCE-MRI parameters generated under the standard model is a potential marker for prediction of malignant lesions.
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Affiliation(s)
- Lahanda Purage G Sherminie
- Department of Nuclear Science, Faculty of Science, University of Colombo, Colombo, Sri Lanka.,Department of Radiography/Radiotherapy, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Mohan L Jayatilake
- Department of Radiography/Radiotherapy, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka
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3
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Mahani M, Khakbaz F, Ju H. Hairpin oligosensor using SiQDs: Förster resonance energy transfer study and application for miRNA-21 detection. Anal Bioanal Chem 2022; 414:2505-2512. [PMID: 35099583 DOI: 10.1007/s00216-022-03891-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/27/2021] [Accepted: 01/10/2022] [Indexed: 11/28/2022]
Abstract
MicroRNAs are known to be tumor suppressors and promoters and can be used as cancer markers. In this work, a novel oligosensor was designed using Si quantum dots (SiQDs) for the detection of miRNAs. Five-nanometer SiQDs were synthesized, with a band gap of 2.8 eV, fluorescence lifetime of 4.56 μs (τ1/2 = 3.26 μs), quantum yield of 25%, fluorescence rate constant of 6.25 × 104, and non-radiative rate constant of 1.60 × 105 s-1. They showed excellent water dispersibility, good stability (with 95% confidence for 6-month storage) without photobleaching, and high biocompatibility, with an IC50 value of 292.2 μg/L. The SiQDs and Black Hole Quencher-1 (BHQ1) were conjugated to the 5' and 3' terminals of an oligomer, respectively. The resulting hairpin molecular beacon showed resonance energy transfer efficiency of 63%. A distance of 0.91 R (Förster distance) between SiQD and BHQ1 was obtained. In the presence of a stoichiometric amount of the complementary oligonucleotide (ΔGhybridization = -35.09 kcal mol-1), 98% of the fluorescence was recovered due to loop opening of the hairpin structure. The probe showed good selectivity toward miRNA-21, with a limit of detection of 14.9 fM. The oligosensor recoveries of miRNA-21 spiked in human serum and urine were 94-98% and 93-108%, respectively.
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Affiliation(s)
- Mohamad Mahani
- Department of Chemistry, Faculty of Chemistry and Chemical Engineering, Graduate University of Advanced Technology, Kerman, Iran.
| | - Faeze Khakbaz
- Department of Chemistry, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Huangxian Ju
- State Key Laboratory of Analytical Chemistry for Life Science, Department of Chemistry, Nanjing University, Nanjing, 210023, China
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4
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Comparison of the diagnostic performance of Magnetic Resonance Imaging (MRI), ultrasound and mammography for detection of breast cancer based on tumor type, breast density and patient's history: A review. Radiography (Lond) 2022; 28:848-856. [DOI: 10.1016/j.radi.2022.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 01/14/2022] [Accepted: 01/19/2022] [Indexed: 02/07/2023]
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5
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Bonelli LA, Calabrese M, Belli P, Corcione S, Losio C, Montemezzi S, Pediconi F, Petrillo A, Zuiani C, Camera L, Carbonaro LA, Cozzi A, De Falco Alfano D, Gristina L, Panzeri M, Poirè I, Schiaffino S, Tosto S, Trecate G, Trimboli RM, Valdora F, Viganò S, Sardanelli F. MRI versus Mammography plus Ultrasound in Women at Intermediate Breast Cancer Risk: Study Design and Protocol of the MRIB Multicenter, Randomized, Controlled Trial. Diagnostics (Basel) 2021; 11:diagnostics11091635. [PMID: 34573983 PMCID: PMC8469187 DOI: 10.3390/diagnostics11091635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 12/28/2022] Open
Abstract
In women at high/intermediate lifetime risk of breast cancer (BC-LTR), contrast-enhanced magnetic resonance imaging (MRI) added to mammography ± ultrasound (MX ± US) increases sensitivity but decreases specificity. Screening with MRI alone is an alternative and potentially more cost-effective strategy. Here, we describe the study protocol and the characteristics of enrolled patients for MRIB feasibility, multicenter, randomized, controlled trial, which aims to compare MRI alone versus MX+US in women at intermediate breast cancer risk (aged 40-59, with a 15-30% BC-LTR and/or extremely dense breasts). Two screening rounds per woman were planned in ten centers experienced in MRI screening, the primary endpoint being the rate of cancers detected in the 2 arms after 5 years of follow-up. From July 2013 to November 2015, 1254 women (mean age 47 years) were enrolled: 624 were assigned to MX+US and 630 to MRI. Most of them were aged below 50 (72%) and premenopausal (45%), and 52% used oral contraceptives. Among postmenopausal women, 15% had used hormone replacement therapy. Breast and/or ovarian cancer in mothers and/or sisters were reported by 37% of enrolled women, 79% had extremely dense breasts, and 41% had a 15-30% BC-LTR. The distribution of the major determinants of breast cancer risk profiles (breast density and family history of breast and ovarian cancer) of enrolled women varied across centers.
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Affiliation(s)
- Luigina Ada Bonelli
- Unit of Clinical Epidemiology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy;
- Correspondence: ; Tel.: +39-010-5558502
| | - Massimo Calabrese
- Unit of Diagnostic Senology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (M.C.); (L.G.); (S.T.); (F.V.)
| | - Paolo Belli
- Department of Radiological, Radiotherapic and Hematological Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Roma, Italy;
| | - Stefano Corcione
- Breast Imaging Unit, Arcispedale Sant’Anna, Azienda Ospedaliero-Universitaria di Ferrara, 44124 Cona, Italy; (S.C.); (D.D.F.A.)
| | - Claudio Losio
- Unit of Senology, IRCCS Ospedale San Raffaele, 20132 Milano, Italy; (C.L.); (M.P.)
| | - Stefania Montemezzi
- Unit of Radiology BT, Azienda Ospedaliera Universitaria Integrata, 37126 Verona, Italy; (S.M.); (L.C.)
| | - Federica Pediconi
- Department of Radiological, Oncological and Pathological Sciences, Università degli Studi “La Sapienza”, 00161 Roma, Italy;
| | - Antonella Petrillo
- Radiology Unit, Istituto Nazionale dei Tumori IRCCS Fondazione G. Pascale, 80131 Napoli, Italy;
| | - Chiara Zuiani
- Institute of Radiology, Azienda Ospedaliera Universitaria “Santa Maria della Misericordia”, Università degli Studi di Udine, 33100 Udine, Italy;
| | - Lucia Camera
- Unit of Radiology BT, Azienda Ospedaliera Universitaria Integrata, 37126 Verona, Italy; (S.M.); (L.C.)
| | - Luca Alessandro Carbonaro
- Unit of Radiology, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy; (L.A.C.); (S.S.); (F.S.)
- Department of Radiology, Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, 20122 Milano, Italy
| | - Andrea Cozzi
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milano, Italy; (A.C.); (R.M.T.)
| | - Daniele De Falco Alfano
- Breast Imaging Unit, Arcispedale Sant’Anna, Azienda Ospedaliero-Universitaria di Ferrara, 44124 Cona, Italy; (S.C.); (D.D.F.A.)
- Mammography Center, Radiology Unit, Policlinico Sant’Orsola–Malpighi, 40138 Bologna, Italy
| | - Licia Gristina
- Unit of Diagnostic Senology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (M.C.); (L.G.); (S.T.); (F.V.)
| | - Marta Panzeri
- Unit of Senology, IRCCS Ospedale San Raffaele, 20132 Milano, Italy; (C.L.); (M.P.)
| | - Ilaria Poirè
- Unit of Clinical Epidemiology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy;
| | - Simone Schiaffino
- Unit of Radiology, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy; (L.A.C.); (S.S.); (F.S.)
| | - Simona Tosto
- Unit of Diagnostic Senology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (M.C.); (L.G.); (S.T.); (F.V.)
| | - Giovanna Trecate
- Department of Diagnostic Imaging, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milano, Italy; (G.T.); (S.V.)
| | - Rubina Manuela Trimboli
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milano, Italy; (A.C.); (R.M.T.)
- Breast Imaging and Screening Unit, Department of Radiology, Humanitas Clinical and Research Center—IRCCS, 20089 Rozzano, Italy
| | - Francesca Valdora
- Unit of Diagnostic Senology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (M.C.); (L.G.); (S.T.); (F.V.)
| | - Sara Viganò
- Department of Diagnostic Imaging, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milano, Italy; (G.T.); (S.V.)
| | - Francesco Sardanelli
- Unit of Radiology, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy; (L.A.C.); (S.S.); (F.S.)
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milano, Italy; (A.C.); (R.M.T.)
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6
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Renzulli M, Zanotti S, Clemente A, Mineo G, Tovoli F, Reginelli A, Barile A, Cappabianca S, Taffurelli M, Golfieri R. Hereditary breast cancer: screening and risk reducing surgery. Gland Surg 2019; 8:S142-S149. [PMID: 31559181 PMCID: PMC6755941 DOI: 10.21037/gs.2019.04.04] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The screening modalities for women at high risk for breast cancer has received an increasing role during the last years. The aim of this study was to evaluate the performance of our screening program comparing the diagnostic sensitivity of clinical breast examination, mammography, ultrasonography (US) and magnetic resonance imaging (MRI). METHODS Clinical Breast examination, mammography, US and MRI for each patient with BRCA1 and BRCA2 mutation who underwent breast surgery in our Institution from October 2008 to April 2016 were retrospectively evaluated. The diagnostic accuracy for MRI and for the other surveillance tests in identifying early breast cancer were assessed. RESULTS Twenty-six female patients with genetic mutation underwent breast surgery. Twenty-two out of 26 (85%) developed cancer during the dedicated screening protocol whereas 4 women who underwent surgery did not have cancer. Imaging was able to detect cancer in all 22 patients (per patient sensibility of 100%), identifying all 35 neoplastic lesions (per lesion sensibility of 100%). The combination of Clinical Breast Examination, US and mammography aided the cancer diagnosis in 14 (64%) of patients with a sensitivity of 64% and specificity of 100%. MRI identified all the cancers, with sensibility and specificity of 100%. Moreover, in 8 (36%) of the 22 patients who developed breast cancers, the cancers were detected only by MRI, revealing a significant superiority respect to the other surveillance modalities (P<0.05). CONCLUSIONS MRI demonstrated to be the best imaging modality in detection of breast cancer even for lesion <1 cm. Prophylactic mastectomy is the most effective risk reduction strategy in women at high risk, contributing to the reduction of anxiety related to the condition of a carrier.
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Affiliation(s)
- Matteo Renzulli
- Radiology Unit, Department of Experimental, Diagnostic and Speciality Medicine, Sant’Orsola Hospital, University of Bologna, Bologna, Italy
| | - Simone Zanotti
- Breast Unit, Department of Woman, Child and Urological Diseases, Sant’Orsola Hospital, University of Bologna, Bologna, Italy
| | - Alfredo Clemente
- Radiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Giangaspare Mineo
- Radiology Unit, Department of Diagnostic Medicine and Prevention, Sant’Orsola Hospital, University of Bologna, Bologna, Italy
| | - Francesco Tovoli
- Unit of Internal Medicine, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Alfonso Reginelli
- Radiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Antonio Barile
- Department of Biotechnology and Applied Clinical Sciences, University of L’Aquila, S. Salvatore Hospital, L’Aquila, Italy
| | - Salvatore Cappabianca
- Radiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Mario Taffurelli
- Breast Unit, Department of Woman, Child and Urological Diseases, Sant’Orsola Hospital, University of Bologna, Bologna, Italy
| | - Rita Golfieri
- Radiology Unit, Department of Experimental, Diagnostic and Speciality Medicine, Sant’Orsola Hospital, University of Bologna, Bologna, Italy
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7
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Mann RM, Kuhl CK, Moy L. Contrast-enhanced MRI for breast cancer screening. J Magn Reson Imaging 2019; 50:377-390. [PMID: 30659696 PMCID: PMC6767440 DOI: 10.1002/jmri.26654] [Citation(s) in RCA: 163] [Impact Index Per Article: 32.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 01/03/2019] [Accepted: 01/04/2019] [Indexed: 12/15/2022] Open
Abstract
Multiple studies in the first decade of the 21st century have established contrast-enhanced breast MRI as a screening modality for women with a hereditary or familial increased risk for the development of breast cancer. In recent studies, in women with various risk profiles, the sensitivity ranges between 81% and 100%, which is approximately twice as high as the sensitivity of mammography. The specificity increases in follow-up rounds to around 97%, with positive predictive values for biopsy in the same range as for mammography. MRI preferentially detects the more aggressive/invasive types of breast cancer, but has a higher sensitivity than mammography for any type of cancer. This performance implies that in women screened with breast MRI, all other examinations must be regarded as supplemental. Mammography may yield ~5% additional cancers, mostly ductal carcinoma in situ, while slightly decreasing specificity and increasing the costs. Ultrasound has no supplemental value when MRI is used. Evidence is mounting that in other groups of women the performance of MRI is likewise superior to more conventional screening techniques. Particularly in women with a personal history of breast cancer, the gain seems to be high, but also in women with a biopsy history of lobular carcinoma in situ and even women at average risk, similar results are reported. Initial outcome studies show that breast MRI detects cancer earlier, which induces a stage-shift increasing the survival benefit of screening. Cost-effectiveness is still an issue, particularly for women at lower risk. Since costs of the MRI scan itself are a driving factor, efforts to reduce these costs are essential. The use of abbreviated MRI protocols may enable more widespread use of breast MRI for screening. Level of Evidence: 1 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2019;50:377-390.
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Affiliation(s)
- Ritse M Mann
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.,Department of Radiology, the Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Christiane K Kuhl
- Department of Diagnostic and Interventional Radiology, University of Aachen, Aachen, Germany
| | - Linda Moy
- Center for Advanced Imaging Innovation and Research / Department of Radiology, Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine, New York, New York, USA
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8
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Shen L, Zhou G, Tong T, Tang F, Lin Y, Zhou J, Wang Y, Zong G, Zhang L. ADC at 3.0 T as a noninvasive biomarker for preoperative prediction of Ki67 expression in invasive ductal carcinoma of breast. Clin Imaging 2018; 52:16-22. [PMID: 29501957 DOI: 10.1016/j.clinimag.2018.02.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Revised: 01/24/2018] [Accepted: 02/12/2018] [Indexed: 11/17/2022]
Abstract
PURPOSE To investigate the role of apparent diffusion coefficient (ADC) as an imaging biomarker for invasive ductal carcinoma (IDC) in the breast. METHODS Seventy-one patients undergoing 3.0 Tesla DWI were retrospectively enrolled. Correlations between the ADC values and prognostic factors were evaluated. RESULTS Multivariate regression analyses showed that Ki67 expression and molecular subtype were independently associated with the ADC. Discriminant analysis excluded the ADC as a good biomarker for subtype, but the mean ADC significantly distinguished Ki67-positive (low ADC) from Ki67-negative (high ADC) lesions, as observed in the in ROC curves, with a diagnostic sensitivity of 1.00 and a cut-off value of 0.97 × 10-3 mm2/s. CONCLUSION The ADC may be helpful for predicting Ki67 expression in IDC preoperatively.
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Affiliation(s)
- Lu Shen
- Department of Radiology, East Hospital, School of Medicine, Tongji University, Shanghai, 200120, China
| | - Guoxing Zhou
- Department of Radiology, East Hospital, School of Medicine, Tongji University, Shanghai, 200120, China
| | - Tong Tong
- Department of Radiology, Shanghai Cancer Center, School of Medicine, Fudan University, Shanghai, 200032, China
| | - Fei Tang
- Department of Radiology, East Hospital, School of Medicine, Tongji University, Shanghai, 200120, China
| | - Yi Lin
- Department of Radiology, East Hospital, School of Medicine, Tongji University, Shanghai, 200120, China
| | - Jie Zhou
- Department of Radiology, East Hospital, School of Medicine, Tongji University, Shanghai, 200120, China
| | - Yibin Wang
- Department of Radiology, East Hospital, School of Medicine, Tongji University, Shanghai, 200120, China
| | - Genlin Zong
- Department of Radiology, East Hospital, School of Medicine, Tongji University, Shanghai, 200120, China
| | - Lei Zhang
- Department of Radiology, East Hospital, School of Medicine, Tongji University, Shanghai, 200120, China.
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Aydin H, Guner B, Esen Bostanci I, Bulut ZM, Aribas BK, Dogan L, Gulcelik MA. Is there any relationship between adc values of diffusion-weighted imaging and the histopathological prognostic factors of invasive ductal carcinoma? Br J Radiol 2018; 91:20170705. [PMID: 29299933 DOI: 10.1259/bjr.20170705] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE MRI is being used increasingly as a modality that can provide important information about breast cancer. Diffusion-weighted imaging (DWI) is an imaging technique from which apparent diffusion coefficient (ADC) values can be calculated in addition to obtaining important structural information which cannot be obtained from other imaging studies. We did not find any significant relationships between ADC values and prognostic factors, but did provide some explanations for conflicting results in the literature. METHODS The ADC results of 61 females with invasive ductal carcinomas were evaluated. DWI was performed and ADC values were calculated from the area in which restriction of diffusion was the highest in ADC mapping. B value was 500 and region of interest (ROI) was designated between 49 and 100 mm2. Calculations were performed automatically by the device. Tissue samples were obtained for prognostic factor evaluation. The relationships between ADC and prognostic factors were investigated. Comparisons between groups were made with one-way ANOVA and Kruskal Wallis test. Pairwise comparisons were made with Dunn's test. Analyses of categorical variables were made with Chi-square test. RESULTS We found a weak negative correlation between ADC and Ki-67 values (r = -0.279; p = 0.029). When we compared ADC values in regard to tumour type, we found no significant differences for tumour grade, Ki-67 positivity, estrogen receptor positivity, progesterone receptor positivity, C-erb B2, lymphovascular invasion and ductal carcinoma in situ or lobular carcinoma in situ component. On a side note, we found that mean ADC values decreased as tumour grade increased; however, this was not statistically significant. CONCLUSION The literature contains studies that report conflicting results which may be caused by differences in B values, ROI area and magnetic field strength. Multicentre studies and systematic reviews of these findings may produce crucial data for the use of DWI in breast cancer. Advances in knowledge: To determine if any significant relationship exists between DWI findings and prognostic factors of breast cancer.
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Affiliation(s)
- Hale Aydin
- 1 Department of Radiology, Dr AY Ankara Oncology Research and Training Hospital , Ankara , Turkey
| | - Bahar Guner
- 1 Department of Radiology, Dr AY Ankara Oncology Research and Training Hospital , Ankara , Turkey
| | - Isil Esen Bostanci
- 1 Department of Radiology, Dr AY Ankara Oncology Research and Training Hospital , Ankara , Turkey
| | - Zarife Melda Bulut
- 2 Department of Pathology, Dr AY Ankara Oncology Research and Training Hospital , Ankara , Turkey
| | - Bilgin Kadri Aribas
- 1 Department of Radiology, Dr AY Ankara Oncology Research and Training Hospital , Ankara , Turkey
| | - Lutfi Dogan
- 3 Department of General Surgery, Dr AY Ankara Oncology Research and Training Hospital , Ankara , Turkey
| | - Mehmet Ali Gulcelik
- 3 Department of General Surgery, Dr AY Ankara Oncology Research and Training Hospital , Ankara , Turkey.,Department of General Surgery, Gulhane Research and Training Hospital, Ankara , Turkey
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10
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Sivasubramanian K, Periyasamy V, Pramanik M. Hand-held Clinical Photoacoustic Imaging System for Real-time Non-invasive Small Animal Imaging. J Vis Exp 2017:56649. [PMID: 29155745 PMCID: PMC5752415 DOI: 10.3791/56649] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Translation of photoacoustic imaging into the clinic is a major challenge. Handheld real-time clinical photoacoustic imaging systems are very rare. Here, we report a combined photoacoustic and clinical ultrasound imaging system by integrating an ultrasound probe with light delivery for small animal imaging. We demonstrate this by showing sentinel lymph node imaging in small animals along with minimally invasive real-time needle guidance. A clinical ultrasound platform with access to raw channel data allows the integration of photoacoustic imaging leading to a handheld real-time clinical photoacoustic imaging system. Methylene blue was used for sentinel lymph node imaging at 675 nm wavelength. Additionally, needle guidance with dual modal ultrasound and photoacoustic imaging was shown using the imaging system. Depth imaging of up to 1.5 cm was demonstrated with a 10 Hz laser at a photoacoustic imaging frame rate of 5 frames per second.
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Affiliation(s)
| | - Vijitha Periyasamy
- School of Chemical and Biomedical Engineering, Nanyang Technological University
| | - Manojit Pramanik
- School of Chemical and Biomedical Engineering, Nanyang Technological University;
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