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Giorgi Rossi P, Mancuso P, Pattacini P, Campari C, Nitrosi A, Iotti V, Ponti A, Frigerio A, Correale L, Riggi E, Giordano L, Segnan N, Di Leo G, Magni V, Sardanelli F, Fornasa F, Romanucci G, Montemezzi S, Falini P, Auzzi N, Zappa M, Ottone M, Mantellini P, Duffy SW, Armaroli P, Coriani C, Pescarolo M, Stefanelli G, Tondelli G, Beretti F, Caffarri S, Marchesi V, Canovi L, Colli M, Boschini M, Bertolini M, Ragazzi M, Pattacini P, Giorgi Rossi P, Iotti V, Ginocchi V, Ravaioli S, Vacondio R, Campari C, Caroli S, Nitrosi A, Braglia L, Cavuto S, Mancuso P, Djuric O, Venturelli F, Vicentini M, Braghiroli MB, Lonetti J, Davoli E, Bonelli E, Fornasa F, Montemezzi S, Romanucci G, Lucchi I, Martello G, Rossati C, Mantellini P, Ambrogetti D, Iossa A, Carnesciali E, Mazzalupo V, Falini P, Puliti D, Zappa M, Battisti F, Auzzi N, Verdi S, Degl'Innocenti C, Tramalloni D, Cavazza E, Busoni S, Betti E, Peruzzi F, Regini F, Sardanelli F, Di Leo G, Carbonaro LA, Magni V, Cozzi A, Spinelli D, Monaco CG, Schiaffino S, Benedek A, Menicagli L, Ferraris R, Favettini E, Dettori D, Falco P, Presti P, Segnan N, Ponti A, Frigerio A, Armaroli P, Correale L, Marra V, Milanesio L, Artuso F, Di Leo A, Castellano I, Riggi E, Casella D, Pitarella S, Vergini V, Giordano L, Duffy SW, Graewingholt A, Lang K, Falcini F. Comparing accuracy of tomosynthesis plus digital mammography or synthetic 2D mammography in breast cancer screening: baseline results of the MAITA RCT consortium. Eur J Cancer 2024; 199:113553. [PMID: 38262307 DOI: 10.1016/j.ejca.2024.113553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 01/01/2024] [Accepted: 01/06/2024] [Indexed: 01/25/2024]
Abstract
AIM The analyses here reported aim to compare the screening performance of digital tomosynthesis (DBT) versus mammography (DM). METHODS MAITA is a consortium of four Italian trials, REtomo, Proteus, Impeto, and MAITA trial. The trials adopted a two-arm randomised design comparing DBT plus DM (REtomo and Proteus) or synthetic-2D (Impeto and MAITA trial) versus DM; multiple vendors were included. Women aged 45 to 69 years were individually randomised to one round of DBT or DM. FINDINGS From March 2014 to February 2022, 50,856 and 63,295 women were randomised to the DBT and DM arm, respectively. In the DBT arm, 6656 women were screened with DBT plus synthetic-2D. Recall was higher in the DBT arm (5·84% versus 4·96%), with differences between centres. With DBT, 0·8/1000 (95% CI 0·3 to 1·3) more women received surgical treatment for a benign lesion. The detection rate was 51% higher with DBT, ie. 2·6/1000 (95% CI 1·7 to 3·6) more cancers detected, with a similar relative increase for invasive cancers and ductal carcinoma in situ. The results were similar below and over the age of 50, at first and subsequent rounds, and with DBT plus DM and DBT plus synthetic-2D. No learning curve was appreciable. Detection of cancers >= 20 mm, with 2 or more positive lymph nodes, grade III, HER2-positive, or triple-negative was similar in the two arms. INTERPRETATION Results from MAITA confirm that DBT is superior to DM for the detection of cancers, with a possible increase in recall rate. DBT performance in screening should be assessed locally while waiting for long-term follow-up results on the impact of advanced cancer incidence.
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Affiliation(s)
| | | | | | - Cinzia Campari
- Screening coordinating centre, AUSL - IRCCS di Reggio Emilia, Italy
| | - Andrea Nitrosi
- Medical Physics unit, AUSL - IRCCS di Reggio Emilia, Italy
| | | | - Antonio Ponti
- SSD Epidemiologia e Screening. AOU Città della Salute e della Scienza, CPO Piemonte Torino, Italy
| | - Alfonso Frigerio
- SSD Senologia di Screening AOU Città della Salute e della Scienza, CPO Piemonte Torino, Italy
| | - Loredana Correale
- SSD Epidemiologia e Screening. AOU Città della Salute e della Scienza, CPO Piemonte Torino, Italy
| | - Emilia Riggi
- SSD Epidemiologia e Screening. AOU Città della Salute e della Scienza, CPO Piemonte Torino, Italy
| | - Livia Giordano
- SSD Epidemiologia e Screening. AOU Città della Salute e della Scienza, CPO Piemonte Torino, Italy
| | - Nereo Segnan
- SSD Epidemiologia e Screening. AOU Città della Salute e della Scienza, CPO Piemonte Torino, Italy
| | - Giovanni Di Leo
- IRCC Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy
| | - Veronica Magni
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milan, Italy
| | - Francesco Sardanelli
- IRCC Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy; Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milan, Italy
| | - Francesca Fornasa
- Breast Unit ULSS9 Scaligera, Ospedale Fracastoro, Via Circonvallazione, 1, 37047 San Bonifacio, VR, Italy
| | - Giovanna Romanucci
- Breast Unit ULSS9 Scaligera, Ospedale Fracastoro, Via Circonvallazione, 1, 37047 San Bonifacio, VR, Italy
| | | | - Patrizia Falini
- ISPRO - Istituto per lo Studio, la Prevenzione e la Rete Oncologica, Firenze, Italy
| | - Noemi Auzzi
- ISPRO - Istituto per lo Studio, la Prevenzione e la Rete Oncologica, Firenze, Italy
| | - Marco Zappa
- ISPRO - Istituto per lo Studio, la Prevenzione e la Rete Oncologica, Firenze, Italy
| | - Marta Ottone
- Epidemiology Unit, AUSL - IRCCS di Reggio Emilia, Italy
| | - Paola Mantellini
- ISPRO - Istituto per lo Studio, la Prevenzione e la Rete Oncologica, Firenze, Italy
| | - Stephen W Duffy
- Wolfson Institute of Population Health, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Paola Armaroli
- SSD Epidemiologia e Screening. AOU Città della Salute e della Scienza, CPO Piemonte Torino, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Francesca Fornasa
- Breast Unit ULSS9 Scaligera, Ospedale Fracastoro, Via Circonvallazione, 1, 37047 San Bonifacio, VR, Italy
| | | | - Giovanna Romanucci
- Breast Unit ULSS9 Scaligera, Ospedale Fracastoro, Via Circonvallazione, 1, 37047 San Bonifacio, VR, Italy
| | - Ilaria Lucchi
- Breast Unit ULSS9 Scaligera, Ospedale Fracastoro, Via Circonvallazione, 1, 37047 San Bonifacio, VR, Italy
| | - Gessica Martello
- Breast Unit ULSS9 Scaligera, Ospedale Fracastoro, Via Circonvallazione, 1, 37047 San Bonifacio, VR, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Giovanni Di Leo
- IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | | | - Veronica Magni
- IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Andrea Cozzi
- IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Diana Spinelli
- IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | | | | | - Adrienn Benedek
- IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Laura Menicagli
- IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Axel Graewingholt
- Mammographiescreening-Zentrum Paderborn, Breast Cancer Screening, Paderborn, NRW, Germany
| | - Kristina Lang
- Departement of Translational Medicine, Lund University, Unilabs Mammography Unit, Skåne University Hospital, Malmö, Sweden
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Tonni G, Grisolia G, Baldi M, Bonasoni M, Ginocchi V, Rolo LC, Araujo Júnior E. Early Prenatal Ultrasound and Molecular Diagnosis of Apert Syndrome: Case Report with Postmortem CT-Scan and Chondral Plate Histology. Fetal Pediatr Pathol 2022; 41:281-292. [PMID: 32538685 DOI: 10.1080/15513815.2020.1775732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background Apert syndrome is characterized by craniosynostosis, midface hypoplasia and symmetric syndactyly. Case report: A 36-year-old mother, G2P1 underwent an ultrasound scan at 19 week's gestation. There was craniosynostosis, brachi-turricephaly and bilateral hand syndactyly. Genomic DNA from amniocentesis revealed the mutation C758C>Gp. (Pro to Arg substitution) at 252 of the exon 8 of the FGFR2 encoding for Apert syndrome. The pregnancy was terminated. Femoral chondral plate histology showed an increased interstitial matrix between bony trabeculae. Compared with normal, the trabeculae were thinner, more irregular with numerous osteoclasts suggesting abnormal bone remodeling. Hands and feet had an abrupt transition between resting and proliferating cartilage. Conclusion: Apert syndrome has increased intertrabecular matrix, thin trabeculae, increased remodeling, and irregular transition between the maturing and mineralization zones in the femur, and abnormal abrupt transition between the resting and proliferating cartilage in the fingers and toes.
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Affiliation(s)
- Gabriele Tonni
- Azienda Unità Sanitaria Locale di Reggio Emilia, Obstetrics and Gynecology, Istituto di Ricerca a Carattere Clinico Scientifico (IRCCS), Reggio Emilia, Italy
| | - Gianpaolo Grisolia
- Obstetrics and Gynecology, Azienda Ospedaliera Carlo Poma, Mantova, Italy
| | - Maurizia Baldi
- Human Genetic Laboratory, Istituto Giannina Gaslini, Genova, Italy
| | | | - Vladimiro Ginocchi
- Radiology, Guastalla Civil Hospital, Azienda Unità Sanitaria Locale di Reggio Emilia, Istituto di Ricerca a Carattere Clinico Scientifico (IRCCS), Reggio Emilia, Italy
| | - Liliam Cristine Rolo
- Obstetrics and Gynecology, Universidade Federal de Sao Paulo Hospital Sao Paulo, Sao Paulo, Brazil
| | - Edward Araujo Júnior
- Obstetrics, Federal University of Sao Paulo Paulista Medical School, Sao Paulo, Brazil
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Pattacini P, Nitrosi A, Giorgi Rossi P, Duffy SW, Iotti V, Ginocchi V, Ravaioli S, Vacondio R, Mancuso P, Ragazzi M, Campari C. A Randomized Trial Comparing Breast Cancer Incidence and Interval Cancers after Tomosynthesis Plus Mammography versus Mammography Alone. Radiology 2022; 303:256-266. [PMID: 35103537 DOI: 10.1148/radiol.211132] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Adding digital breast tomosynthesis (DBT) to digital mammography (DM) improves breast cancer screening sensitivity, but how this impacts mortality and other end points is unknown. Purpose To compare interval and overall breast cancer incidence after screening with DBT plus DM versus DM alone. Materials and Methods In this prospective trial (RETomo), women attending screening were randomized to one round of DBT plus DM (experimental arm) or to DM (control arm). All were then rescreened with DM after 12 months (women aged 45-49 years) or after 24 months (50-69 years). The primary outcome was interval cancer incidence. Cumulative incidence up to the subsequent screening round plus 9 months (21- and 33-month follow-up for women aged 45-49 and 50-69, respectively) was also reported. Ductal carcinomas in situ are included. Subgroup analyses by age and breast density were conducted; 95% CIs computed according to binomial distribution are reported. Results Baseline cancer detection was higher in the DBT plu DM arm than DM arm (101 of 13 356 women vs 61 of 13 521 women; relative detection, 1.7 [95% CI: 1.2, 2.3]). The mean age ± standard deviation for the women in both arms was 55 years ± 7. Interval cancer incidence was similar in the two arms (21 vs 22 cancers; relative incidence, 0.97 [95% CI: 0.53, 1.8]). Cumulative incidence remained higher in the DBT plus DM arm in women over 50 (153 vs 124 cancers; relative incidence, 1.2 [95% CI: 0.99, 1.6]), while it was similar in the two arms in women aged 45-49 (36 vs 41 cancers; relative incidence, 0.89 [95% CI: 0.57, 1.4]). Conclusion In women younger than 50 years, the benefit of early diagnosis seemed to be appreciable, while for women over age 50, the higher sensitivity of tomosynthesis plus mammography was not matched by a subsequent reduction in cancers at the next screening examination or in the intervening interval. Clinical trial registration no. NCT02698202 © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Lee and Ray in this issue.
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Affiliation(s)
- Pierpaolo Pattacini
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.)
| | - Andrea Nitrosi
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.)
| | - Paolo Giorgi Rossi
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.)
| | - Stephen W Duffy
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.)
| | - Valentina Iotti
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.)
| | - Vladimiro Ginocchi
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.)
| | - Sara Ravaioli
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.)
| | - Rita Vacondio
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.)
| | - Pamela Mancuso
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.)
| | - Moira Ragazzi
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.)
| | - Cinzia Campari
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.)
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- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.)
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Pattacini P, Nitrosi A, Giorgi Rossi P, Iotti V, Ginocchi V, Ravaioli S, Vacondio R, Braglia L, Cavuto S, Campari C. Digital Mammography versus Digital Mammography Plus Tomosynthesis for Breast Cancer Screening: The Reggio Emilia Tomosynthesis Randomized Trial. Radiology 2018; 288:375-385. [DOI: 10.1148/radiol.2018172119] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Pierpaolo Pattacini
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R.), Scientific Directorate (L.B., S.C.), and Screening Coordinating Centre (C.C.), AUSL Reggio Emilia, IRCCS, Via Amendola 2, Reggio Emilia 42122, Italy
| | - Andrea Nitrosi
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R.), Scientific Directorate (L.B., S.C.), and Screening Coordinating Centre (C.C.), AUSL Reggio Emilia, IRCCS, Via Amendola 2, Reggio Emilia 42122, Italy
| | - Paolo Giorgi Rossi
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R.), Scientific Directorate (L.B., S.C.), and Screening Coordinating Centre (C.C.), AUSL Reggio Emilia, IRCCS, Via Amendola 2, Reggio Emilia 42122, Italy
| | - Valentina Iotti
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R.), Scientific Directorate (L.B., S.C.), and Screening Coordinating Centre (C.C.), AUSL Reggio Emilia, IRCCS, Via Amendola 2, Reggio Emilia 42122, Italy
| | - Vladimiro Ginocchi
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R.), Scientific Directorate (L.B., S.C.), and Screening Coordinating Centre (C.C.), AUSL Reggio Emilia, IRCCS, Via Amendola 2, Reggio Emilia 42122, Italy
| | - Sara Ravaioli
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R.), Scientific Directorate (L.B., S.C.), and Screening Coordinating Centre (C.C.), AUSL Reggio Emilia, IRCCS, Via Amendola 2, Reggio Emilia 42122, Italy
| | - Rita Vacondio
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R.), Scientific Directorate (L.B., S.C.), and Screening Coordinating Centre (C.C.), AUSL Reggio Emilia, IRCCS, Via Amendola 2, Reggio Emilia 42122, Italy
| | - Luca Braglia
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R.), Scientific Directorate (L.B., S.C.), and Screening Coordinating Centre (C.C.), AUSL Reggio Emilia, IRCCS, Via Amendola 2, Reggio Emilia 42122, Italy
| | - Silvio Cavuto
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R.), Scientific Directorate (L.B., S.C.), and Screening Coordinating Centre (C.C.), AUSL Reggio Emilia, IRCCS, Via Amendola 2, Reggio Emilia 42122, Italy
| | - Cinzia Campari
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R.), Scientific Directorate (L.B., S.C.), and Screening Coordinating Centre (C.C.), AUSL Reggio Emilia, IRCCS, Via Amendola 2, Reggio Emilia 42122, Italy
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Iotti V, Ravaioli S, Vacondio R, Coriani C, Caffarri S, Sghedoni R, Nitrosi A, Ragazzi M, Gasparini E, Masini C, Bisagni G, Falco G, Ferrari G, Braglia L, Del Prato A, Malavolti I, Ginocchi V, Pattacini P. Contrast-enhanced spectral mammography in neoadjuvant chemotherapy monitoring: a comparison with breast magnetic resonance imaging. Breast Cancer Res 2017; 19:106. [PMID: 28893303 PMCID: PMC5594558 DOI: 10.1186/s13058-017-0899-1] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Accepted: 08/25/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Neoadjuvant-chemotherapy (NAC) is considered the standard treatment for locally advanced breast carcinomas. Accurate assessment of disease response is fundamental to increase the chances of successful breast-conserving surgery and to avoid local recurrence. The purpose of this study was to compare contrast-enhanced spectral mammography (CESM) and contrast-enhanced-MRI (MRI) in the evaluation of tumor response to NAC. METHODS This prospective study was approved by the institutional review board and written informed consent was obtained. Fifty-four consenting women with breast cancer and indication of NAC were consecutively enrolled between October 2012 and December 2014. Patients underwent both CESM and MRI before, during and after NAC. MRI was performed first, followed by CESM within 3 days. Response to therapy was evaluated for each patient, comparing the size of the residual lesion measured on CESM and MRI performed after NAC to the pathological response on surgical specimens (gold standard), independently of and blinded to the results of the other test. The agreement between measurements was evaluated using Lin's coefficient. The agreement between measurements using CESM and MRI was tested at each step of the study, before, during and after NAC. And last of all, the variation in the largest dimension of the tumor on CESM and MRI was assessed according to the parameters set in RECIST 1.1 criteria, focusing on pathological complete response (pCR). RESULTS A total of 46 patients (85%) completed the study. CESM predicted pCR better than MRI (Lin's coefficient 0.81 and 0.59, respectively). Both methods tend to underestimate the real extent of residual tumor (mean 4.1mm in CESM, 7.5mm in MRI). The agreement between measurements using CESM and MRI was 0.96, 0.94 and 0.76 before, during and after NAC respectively. The distinction between responders and non-responders with CESM and MRI was identical for 45/46 patients. In the assessment of CR, sensitivity and specificity were 100% and 84%, respectively, for CESM, and 87% and 60% for MRI. CONCLUSION CESM and MRI lesion size measurements were highly correlated. CESM seems at least as reliable as MRI in assessing the response to NAC, and may be an alternative if MRI is contraindicated or its availability is limited.
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Affiliation(s)
- Valentina Iotti
- Radiology Unit, Department of Diagnostic Imaging and Laboratory Medicine, Arcispedale Santa Maria Nuova - IRCCS, Viale Umberto I, No. 50, 42123, Reggio Emilia, Italy.
| | - Sara Ravaioli
- Radiology Unit, Department of Diagnostic Imaging and Laboratory Medicine, Arcispedale Santa Maria Nuova - IRCCS, Viale Umberto I, No. 50, 42123, Reggio Emilia, Italy
| | - Rita Vacondio
- Radiology Unit, Department of Diagnostic Imaging and Laboratory Medicine, Arcispedale Santa Maria Nuova - IRCCS, Viale Umberto I, No. 50, 42123, Reggio Emilia, Italy
| | - Chiara Coriani
- Radiology Unit, Department of Diagnostic Imaging and Laboratory Medicine, Arcispedale Santa Maria Nuova - IRCCS, Viale Umberto I, No. 50, 42123, Reggio Emilia, Italy
| | - Sabrina Caffarri
- Radiology Unit, Department of Diagnostic Imaging and Laboratory Medicine, AUSL Reggio Emilia, via Amendola 2, Reggio Emilia, 42122, Italy
| | - Roberto Sghedoni
- Medical Physics Unit, Department of Oncology and Advanced Technologies, Arcispedale Santa Maria Nuova - IRCCS, Viale Umberto I, No. 50, 42123, Reggio Emilia, Italy
| | - Andrea Nitrosi
- Medical Physics Unit, Department of Oncology and Advanced Technologies, Arcispedale Santa Maria Nuova - IRCCS, Viale Umberto I, No. 50, 42123, Reggio Emilia, Italy
| | - Moira Ragazzi
- Pathology Unit, Department of Oncology and Advanced Technologies, Arcispedale Santa Maria Nuova - IRCCS, Viale Umberto I, No. 50, 42123, Reggio Emilia, Italy
| | - Elisa Gasparini
- Oncology Unit, Hospital C. Magati, AUSL Reggio Emilia, Via Martiri della Libertà, No. 8, Scandiano (RE), 42019, Italy
| | - Cristina Masini
- Oncology Unit, Department of Oncology and Advanced Technologies, Arcispedale Santa Maria Nuova - IRCCS, Viale Umberto I, No. 50, 42123, Reggio Emilia, Italy
| | - Giancarlo Bisagni
- Oncology Unit, Department of Oncology and Advanced Technologies, Arcispedale Santa Maria Nuova - IRCCS, Viale Umberto I, No. 50, 42123, Reggio Emilia, Italy
| | - Giuseppe Falco
- Breast Surgery Unit, Department of Surgery, Arcispedale Santa Maria Nuova - IRCCS, Viale Umberto I, No. 50, 42123, Reggio Emilia, Italy
| | - Guglielmo Ferrari
- Breast Surgery Unit, Department of Surgery, Arcispedale Santa Maria Nuova - IRCCS, Viale Umberto I, No. 50, 42123, Reggio Emilia, Italy
| | - Luca Braglia
- Scientific Directorate, Arcispedale Santa Maria Nuova - IRCCS, Viale Umberto I, No. 50, 42123, Reggio Emilia, Italy
| | - Alberto Del Prato
- Radiology Unit, Department of Diagnostic Imaging and Laboratory Medicine, Arcispedale Santa Maria Nuova - IRCCS, Viale Umberto I, No. 50, 42123, Reggio Emilia, Italy
| | - Ivana Malavolti
- Radiology Unit, Department of Diagnostic Imaging and Laboratory Medicine, AUSL Reggio Emilia, via Amendola 2, Reggio Emilia, 42122, Italy
| | - Vladimiro Ginocchi
- Radiology Unit, Department of Diagnostic Imaging and Laboratory Medicine, AUSL Reggio Emilia, via Amendola 2, Reggio Emilia, 42122, Italy
| | - Pierpaolo Pattacini
- Radiology Unit, Department of Diagnostic Imaging and Laboratory Medicine, Arcispedale Santa Maria Nuova - IRCCS, Viale Umberto I, No. 50, 42123, Reggio Emilia, Italy
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Tonni G, Palmisano M, Ginocchi V, Ventura A, Baldi M, Baffico AM. Dysmorphic choroid plexuses and hydrocephalus associated with increased nuchal translucency: early ultrasound markers of de novo thanatophoric dysplasia type II with cloverleaf skull (Kleeblattschaedel). Congenit Anom (Kyoto) 2014; 54:228-32. [PMID: 24517215 DOI: 10.1111/cga.12056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Accepted: 01/24/2014] [Indexed: 11/28/2022]
Abstract
Prenatal diagnosis of thanatophoric dysplasia (TD) type II presenting in the first trimester with increased nuchal translucency (NT) and cloverleaf skull (Kleeblattschaedel) have been scantly reported in the medical record. Abnormal choroid plexus has been seen in association with fetal anomalies. Here we described a case of increased NT associated with indented choroid plexuses, early onset hydrocephalus and cloverleaf skull in a fetus subsequently diagnosed at early second trimester to carry a de novo mutation encoding for TD type II. The findings of dysmorphic choroid plexus, early onset hydrocephalus and cloverleaf skull at first trimester scan may be early, useful ultrasound markers of TD type II. Molecular analysis to control for possible overlapping syndromes were performed and resulted negative. Postmortem X-ray and 3D-CT scan confirmed the cloverleaf skull, narrow thorax, straight femur with rhizomelic shortening of the limbs and the presence of a communicating hydrocephalus.
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Affiliation(s)
- Gabriele Tonni
- Department of Obstetrics & Gynecology, AUSL Reggio Emilia, Guastalla, Italy
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7
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Bertolini M, Nitrosi A, Rivetti S, Lanconelli N, Pattacini P, Ginocchi V, Iori M. A comparison of digital radiography systems in terms of effective detective quantum efficiency. Med Phys 2012; 39:2617-27. [DOI: 10.1118/1.4704500] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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8
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Sodano A, Noviello A, Petrosino T, Ginocchi V. [An instrumental senological study of 2 cases of intracystic breast carcinoma]. Radiol Med 1991; 82:685-7. [PMID: 1780472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- A Sodano
- Istituto di Scienze Radiologiche, II Facoltà di Medicina e Chirurgia, Università degli Studi Federico II, Napoli
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