Breast tomosynthesis in clinical practice: initial results

Breast tomosynthesis in clinical practice: initial results
Hendrik J. Teertstra, Claudette E. Loo, Maurice A. A. J. van den Bosch, Harm van Tinteren, Emiel J. T. Rutgers, Sara H. Muller & Kenneth G. A. Gilhuijs
Eur Radiol (2010) 20: 16–24

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The purpose of this study was to assess the potential value of tomosynthesis in women with an abnormal screening mammogram or with clinical symptoms. Mammography and tomosynthesis investigations of 513 woman with an abnormal screening mammogram or with clinical symptoms were prospectively classified according to the ACR BI-RADS criteria. Sensitivity and specificity of both techniques for the detection of cancer were calculated.

In 112 newly detected cancers, tomosynthesis and mammography were each false- negative in 8 cases (7%). In the false- negative mammography cases, the tumor was detected with ultrasound (n = 4),    MRI (n = 2), by recall after breast tomosynthesis interpretation (n = 1), and after prophylactic mastectomy (n = 1). Combining the results of mammography and tomosynthesis detected 109 cancers. Therefore in three patients, both mammography and tomosynthesis missed the carcinoma.

The sensitivity of both techniques for the detection of breast cancer was 92.9%, and the specificity of mammography and tomosynthesis was 86.1 and 84.4%, respectively.

Tomosynthesis can be used as an additional technique to mammography in patients referred with an abnormal screening mammo- gram or with clinical symptoms. Additional lesions detected by tomosynthesis, however, are also likely to be detected by other techniques used in the clinical work-up of these patients

Diagnostic value of MR elastography in addition to contrast-enhanced MR imaging of the breast—initial clinical results

Diagnostic value of MR elastography in addition to contrast-enhanced MR imaging of the breast—initial clinical results
Katja C. Siegmann, Tanja Xydeas, Ralph Sinkus, Bernhard Kraemer, Ulrich Vogel & Claus D. Claussen
Eur Radiol (2010) 20: 318–325

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In this study, the com-bination of MRE and CE-MRI could increase the diagnostic performance of breast MRI.

Further investigations of larger cohorts and smaller lesions (in particular those only visible on MRI) are necessary to validate these results.

US-guided diffused optical tomography: a promising functional imaging technique in breast lesions

US-guided diffused optical tomography: a promising functional imaging technique in breast lesions
Shan-Shan You, Yu-Xin Jiang, Qing-Li Zhu, Ji-Bin Liu, Jing Zhang, Qing Dai, He Liu & Qiang Sun
Eur Radiol 2010 20;2:293-302

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Results:  There were 96 benign lesions and 118 malignant lesions. The total haemoglobin concentration (THC) of all 214 lesions was calculated from DOT. The average THC in benign lesions was 125.5 ± 83.4 µmol/L, and in malignant lesions 222.2 ± 87.2 µmol/L. The THC of malignant lesions was significantly higher than that of benign lesions (p < 0.05). 

When a THC of 140 µmol/L was used as the cutoff value for differentiating breast cancer from benign lesions, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of DOT were 83.9%, 66.7%, 76.2%, 75.6% and 77.1%, respectively. 

Our study demonstrated that THC was significantly higher in malignant lesions than in benign lesions.
 
Conclusion:  US-guided diffused optical tomography, a noninvasive functional imaging technique, has potential utility in differentiating breast cancer from benign lesions

The role of mean diffusivity (MD) as a predictive index of the response to chemotherapy in locally advanced breast cancer: a preliminary study

The role of mean diffusivity (MD) as a predictive index of the response to chemotherapy in locally advanced breast cancer: a preliminary study
Chiara Iacconi, Marco Giannelli, Carolina Marini, Anna Cilotti, Monica Moretti, Paolo Viacava, Eugenia Picano, Andrea Michelotti & Davide Caramella
Eur Radiol (2010) 20: 303–308

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This preliminary study seems to indicate that low values of pre- chemotherapy MD may identify, before starting treatment, the patients with higher probability of response in terms of percentage of volume reduction of the lesion.

MD may represent a complementary parameter useful to select patients for neoadjuvant chemotherapy

Ultrasonographic alterations associated with the dilatation of mammary ducts: feature analysis and BI-RADS assessment

Ultrasonographic alterations associated with the dilatation of mammary ducts: feature analysis and BI-RADS assessment
Hsian-He Hsu, Jyh-Cherng Yu, Giu-Cheng Hsu, Wei-Chou Chang, Cheng-Ping Yu, Ho-Jui Tung, Ching Tzao & Guo-Shu HuangEur Radiol 2010 20;2:293-302

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Abnormalities that were away from the nipple and were not circumscribed had a higher risk of malignancy

Analysis of false-negative results after US-guided 14-gauge core needle breast biopsy

Analysis of false-negative results after US-guided 14-gauge core needle breast biopsy
Ji Hyun Youk, Eun-Kyung Kim, Min Jung Kim, Jin Young Kwak & Eun Ju Son
Eur Radiol (2010) 20: 782–789

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Most false negatives were found immediately and imaging-histological discordance was the most important clue. Careful correlation of clinical, radiological and histological results as well as appropriate follow-up is essential

Selection of diagnostic features on breast MRI to differentiate between malignant and benign lesions using computer-aided diagnosis: differences in le

Selection of diagnostic features on breast MRI to differentiate between malignant and benign lesions using computer-aided diagnosis: differences in lesions presenting as mass and non-mass-like enhancement
Dustin Newell, Ke Nie, Jeon-Hor Chen, Chieh-Chih Hsu, Hon J. Yu, Orhan Nalcioglu & Min-Ying Su
Eur Radiol (2010) 20: 771–781

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This study demonstrated that it is possible to build a quantitative diagnostic model for diagnosing mass- type lesions with a high sensitivity (0.97) and a reasonable specificity (0.80). However, further improvement is needed for diagnosis of lesions that present as non-mass-like enhancement