Breast Density measurements using Spectral mammography and Philips MicroDose Mammography

English: no original description (Photo credit: Wikipedia)

NEW article regarding spectral mammography using Philips MicroDose and breast density measurements on mammography.
My colleague Sobhi Molloi from University of California, Irvine has been using dual energy mammography using the same system we use in Moffitt Cancer Center, Tampa FL.
This is unrelated to either the automated calibrated breast density measurements we have developed at Moffitt with John Heine PhD, or to the SXA method I have been working with John Shepherd PhD from The University of California, San Francisco.

Early results are promising, so we will have to collaborate to use the 3 separate tools to determine which type of method best represents personalized breast cancer risk from breast density.

Related articles

• Talking about LOW DOSE MAMMOGRAPHY with OncLive magazine
• Breast Density Variations and Breast Cancer Risk

Accuracy of Screening Mammography in Older Women

Accuracy of Screening Mammography in Older Women
Natalie Sinclair, Benjamin Littenberg, Berta Geller, and Hyman Muss
AJR 2011;197:1268-1273

Link to Journal

VERMONT data:
The objective of this study was to determine the operating characteristics of mammography screening— that is, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and cancer detection rate—in women as they age

Screening mammography is more accurate in older women than in younger women, suggesting that it may be of value in assessing women in all age groups. These data do not address the impact of mammography screening on mortality or breast cancer outcomes

MRI Findings of Pure Ductal Carcinoma in Situ: Kinetic Characteristics Compared According to Lesion Type and Histopathologic Factors

MRI Findings of Pure Ductal Carcinoma in Situ: Kinetic Characteristics Compared According to Lesion Type and Histopathologic Factors
Jeong-Ah Kim, Eun Ju Son, Ji Hyun Youk, Eun-Kyung Kim, Min Jung Kim, Jin Young Kwak, and Joon Jeong
AJR 2011;196:1450-1456

Link to Journal

RESULTS:
The dominant morphologic appearance was a non-mass lesion with segmental and clumped or heterogeneous enhancement. The pure ductal carcinoma in situ lesions exhibited variable enhancement patterns consisting of persistent (34.3%), plateau (52.2%), and washout (13.4%) curves. The mean initial enhancement slope (p < 0.005) and time to peak enhancement (p < 0.05) correlated with MRI lesion type, and time to peak enhancement (p < 0.05) correlated with the sonographic findings. No statistically significant correlations were observed between the kinetic characteristics and histopathologic factors or mammographic findings (p > 0.05).

CONCLUSION:
Non-mass lesions and plateau curve enhancement were the dominant MRI findings of pure ductal carcinoma in situ. The lesions with mass appearance at MRI had more suspicious kinetic characteristics than did non-mass lesions

Full-Field Digital Mammographic Interpretation With Prior Analog Versus Prior Digitized Analog Mammography: Time for Interpretation

Full-Field Digital Mammographic Interpretation With Prior Analog Versus Prior Digitized Analog Mammography: Time for Interpretation
Akshay S. Garg, Jocelyn A. Rapelyea, Lauren R. Rechtman, Jessica Torrente, Rebecca B. Bittner, Caitrin M. Coffey, and Rachel F. Brem
AJR 2011;196:1436-1438

Link to Journal

RESULTS:
For each radiologist, the mean reading time for FFDM with digitized priors was significantly shorter in length in comparison with the mean reading time calculated for interpreting FFDM using analog film priors. The differences in times recorded between digitized analog versus analog ranged from 11.31 to 74.18 seconds. The reading times for the four readers ranged from 17.32 to 185.94 seconds, with a mean of 58.56 seconds when using analog film prior mammograms. When using digitized analog prior mammograms, the reading times for the four readers ranged from 11.32 to 109.11 seconds with a mean of 39.76 seconds. The average difference in reading time was calculated to be 18.80 seconds, showing that there is a 32% increase in interpretation speed when using a digitized prior analog for comparison studies as opposed to an analog prior.

CONCLUSION:
There is a statistically significant 32.1% average improvement in interpretation time when FFDM screening mammograms use digitized analog comparison mammograms than if FFDM is interpreted with the original analog film mammograms. This should allow more FFDMs to be interpreted in the same amount of time if digitized prior analog mammograms are used

Mucocele-Like Tumors of the Breast as Cystic Lesions: Sonographic-Pathologic Correlation

Mucocele-Like Tumors of the Breast as Cystic Lesions: Sonographic-Pathologic Correlation
Sun Mi Kim, Hak Hee Kim, Doo Kyung Kang, Hee Jung Shin, Nariya Cho, Jeong Mi Park, and Joo Hee Cha
AJR 2011;196:1424-1430
   
Link to Journal

RESULTS:
Mammography showed 53 lesions had calcifications without (n = 39) or with (n = 14) a mass. Calcifications of intermediate concern or associated with higher probability of malignancy were found more frequently in mucocele-like tumors associated with ADH or malignancy than in pure mucocele-like tumors (92.3% vs 62.9%, p = 0.019). At ultrasound, 69 of the mucocele-like tumors (95.8%) were seen as a cystic mass. Cysts with thick septations, clustered cysts, and complex masses were more frequently seen in mucocele-like tumors associated with ADH or malignancy (89.7% vs 32.5%, p < 0.001). The positive predictive value for BI-RADS category 4 was 13.3% (95% CI, 6.9–24.2%) and was 50% for BI-RADS category 5 (95% CI, 15–85%).


CONCLUSION:
Mucocele-like tumors associated with ADH or malignancy were more frequently seen as clustered cysts, cysts with thick septations, and complex masses associated with calcifications of intermediate concern or higher probability of malignancy. BI-RADS can be used in the management of mucocele-like tumors.

Hyperechoic Lesions of the Breast: Not Always Benign

Hyperechoic Lesions of the Breast: Not Always Benign
Anna Linda, Chiara Zuiani, Michele Lorenzon, Alessandro Furlan, Rossano Girometti, Viviana Londero, and Massimo Bazzocchi
AJR 2011; 196:1219-1224

Link to Journal


Of all biopsied lesions, 25 (0.6%) were hyperechoic. Among the 1849 malignant lesions, nine (0.4%) were hyperechoic. The remaining 16 were benign. None of the hyperechoic malignancies was a "purely" sonographic lesion, because all were palpable, mammographically visible, or detectable on breast MRI. Malignant lesions were more likely than benign lesions to have noncircumscribed margins (9/9 vs 7/16; p = 0.008) and nonparallel orientation (6/9 vs 1/16; p = 0.003).

When encountering a hyperechoic nodule, malignant nature cannot be excluded. Suspicious sonographic signs and correlation with other imaging techniques may help avoid misdiagnosis.

Variation of Breast Vascular Maps on Dynamic Contrast-Enhanced MRI After Primary Chemotherapy of Locally Advanced Breast Cancer

Variation of Breast Vascular Maps on Dynamic Contrast-Enhanced MRI After Primary Chemotherapy of Locally Advanced Breast Cancer
Laura Martincich, Ilaria Bertotto, Filippo Montemurro, Riccardo Ponzone, Luca A. Carbonaro, Daniele Regge, and Francesco Sardanelli
AJR 2011; 196:1214-1218

Link to Journal

Before primary chemotherapy, DCE-MRI vascular maps were asymmetrically increased ipsilaterally to the LABC. After primary chemotherapy, vascular maps significantly changed only in the breast harboring the cancer, with significant differences between responders and nonresponders.