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Tidsskrift For Den Norske Laegeforening... Jan 2017
Topics: False Positive Reactions; Female; Humans; Mammography; Mass Screening
PubMed: 28127062
DOI: 10.4045/tidsskr.17.0051 -
Academic Radiology Oct 2019A linear array of carbon nanotube-enabled x-ray sources allows for stationary digital breast tomosynthesis (sDBT), during which projection views are collected without...
RATIONALE AND OBJECTIVES
A linear array of carbon nanotube-enabled x-ray sources allows for stationary digital breast tomosynthesis (sDBT), during which projection views are collected without the need to move the x-ray tube. This work presents our initial clinical experience with a first-generation sDBT device.
MATERIALS AND METHODS
Following informed consent, women with a "suspicious abnormality" (Breast Imaging Reporting and Data System 4), discovered by digital mammography and awaiting biopsy, were also imaged by the first generation sDBT. Four radiologists participated in this paired-image study, completing questionnaires while interpreting the mammograms and sDBT image stacks. Areas under the receiver operating characteristic curve were used to measure reader performance (likelihood of correctly identifying malignancy based on pathology as ground truth), while a multivariate analysis assessed preference, as readers compared one modality to the next when interpreting diagnostically important image features.
RESULTS
Findings from 43 women were available for analysis, in whom 12 cases of malignancy were identified by pathology. The mean areas under the receiver operating characteristic curve was significantly higher (p < 0.05) for sDBT than mammography for all breast density categories and breast thicknesses. Additionally, readers preferred sDBT over mammography when evaluating mass margins and shape, architectural distortion, and asymmetry, but preferred mammography when characterizing microcalcifications.
CONCLUSION
Readers preferred sDBT over mammography when interpreting soft-tissue breast features and were diagnostically more accurate using images generated by sDBT in a Breast Imaging Reporting and Data System 4 population. However, the findings also demonstrated the need to improve microcalcification conspicuity, which is guiding both technological and image-processing design changes in future sDBT devices.
Topics: Adult; Breast; Breast Neoplasms; Female; Humans; Image Processing, Computer-Assisted; Mammography; Middle Aged; Multimodal Imaging; Nanotubes, Carbon; Radiographic Image Enhancement
PubMed: 30660473
DOI: 10.1016/j.acra.2018.12.026 -
Cleveland Clinic Journal of Medicine Jul 2017Digital breast tomosynthesis (DBT) is a relatively new imaging technology that is being adopted widely for breast cancer screening. Initial evidence suggests that it may... (Review)
Review
Digital breast tomosynthesis (DBT) is a relatively new imaging technology that is being adopted widely for breast cancer screening. Initial evidence suggests that it may reduce recall rates and increase cancer detection rates when added to digital mammography screening. However, more rigorous, prospective studies are needed to determine whether it improves long-term clinical outcomes of breast cancer screening.
Topics: Breast; Breast Neoplasms; Early Detection of Cancer; Female; Humans; Mammography; Treatment Outcome
PubMed: 28696192
DOI: 10.3949/ccjm.84a.16057 -
Medical Physics Aug 2022Understanding the magnitude and variability of the radiation dose absorbed by the breast fibroglandular tissue during mammography and digital breast tomosynthesis (DBT)...
BACKGROUND
Understanding the magnitude and variability of the radiation dose absorbed by the breast fibroglandular tissue during mammography and digital breast tomosynthesis (DBT) is of paramount importance to assess risks versus benefits. Although homogeneous breast models have been proposed and used for decades for this purpose, they do not accurately reflect the actual heterogeneous distribution of the fibroglandular tissue in the breast, leading to biases in the estimation of dose from these modalities.
PURPOSE
To develop and validate a method to generate patient-derived, heterogeneous digital breast phantoms for breast dosimetry in mammography and DBT.
METHODS
The proposed phantoms were developed starting from patient-based models of compressed breasts, generated for multiple thicknesses and representing the two standard views acquired in mammography and DBT, that is, cranio-caudal (CC) and medio-lateral-oblique (MLO). Internally, the breast phantoms were defined as consisting of an adipose/fibroglandular tissue mixture, with a nonspatially uniform relative concentration. The parenchyma distributions were obtained from a previously described model based on patient breast computed tomography data that underwent simulated compression. Following these distributions, phantoms with any glandular fraction (1%-100%) and breast thickness (12-125 mm) can be generated, for both views. The phantoms were validated, in terms of their accuracy for average normalized glandular dose (D N) estimation across samples of patient breasts, using 88 patient-specific phantoms involving actual patient distribution of the fibroglandular tissue in the breast, and compared to that obtained using a homogeneous model similar to those currently used for breast dosimetry.
RESULTS
The average D N estimated for the proposed phantoms was concordant with that absorbed by the patient-specific phantoms to within 5% (CC) and 4% (MLO). These D N estimates were over 30% lower than those estimated with the homogeneous models, which overestimated the average D N by 43% (CC), and 32% (MLO) compared to the patient-specific phantoms.
CONCLUSIONS
The developed phantoms can be used for dosimetry simulations to improve the accuracy of dose estimates in mammography and DBT.
Topics: Breast; Breast Neoplasms; Female; Humans; Mammography; Phantoms, Imaging; Radiometry; Tomography, X-Ray Computed
PubMed: 35635844
DOI: 10.1002/mp.15785 -
Asian Pacific Journal of Cancer... Jan 2022While the past decades have seen a rise in the number of cases diagnosed with cancer, breast cancer in particular has become the most frequently diagnosed cancer in...
Analysing the Insights and Assessing the Impact of a Digital Mammography and Tomosynthesis Based 2-year Long Prospective Breast Screening Programme Organised in Western India.
BACKGROUND
While the past decades have seen a rise in the number of cases diagnosed with cancer, breast cancer in particular has become the most frequently diagnosed cancer in women over the past decade. The figures for associated mortality are on a decline in most Western and developed nations, but in contrast they continue to remain high in transitional nations like India.
MATERIALS AND METHODS
After receiving approval by IEC and IRB, we set-up a prospective 2-year long screening programme combined with outreach camps to ensure representation of the larger population and include urban, rural and tribal population. Strict screening criteria were enforced and trained female paramedical staff were assigned to the camp for patient counselling and breast cancer awareness. Investigation was performed at the tertiary care institute utilising both full-field digital breast mammography and tomosynthesis. Biopsy was advised for highly suspicious lesions.
RESULTS
The study encompassed n=1017 Indian women and revealed that 39% (n=397) of them belonged to 41-50 years age group. BIRADS categorisation of the lesions revealed that while majority (57%; n=580) women had no detectable abnormality, nearly 22% (n=224) had lesions suspected to be benign while 10% (n=99) of them had lesions with a suspicion of high index of malignancy. 43% (n=437) of the populace had dense breasts (type-C). Most of the BIRADS-5 lesions (36/38) were confirmed as malignant on histopathology.
CONCLUSION
We propose a model for screening mammography and also presents the results of this programme which we implemented to screen populace from a large and densely populated geographic region. The model was successful in being self-sustainable and received a good turnout on the back of community outreach breast awareness camps and by incentivizing the women by performing mammograms completely free of cost and also providing them reports.
Topics: Adult; Breast Neoplasms; Early Detection of Cancer; Female; Humans; India; Mammography; Middle Aged; Program Evaluation; Prospective Studies
PubMed: 35092402
DOI: 10.31557/APJCP.2022.23.1.327 -
Journal of Digital Imaging Aug 2023This work aimed to investigate whether global radiomic features (GRFs) from mammograms can predict difficult-to-interpret normal cases (NCs). Assessments from 537...
This work aimed to investigate whether global radiomic features (GRFs) from mammograms can predict difficult-to-interpret normal cases (NCs). Assessments from 537 readers interpreting 239 normal mammograms were used to categorise cases as 120 difficult-to-interpret and 119 easy-to-interpret based on cases having the highest and lowest difficulty scores, respectively. Using lattice- and squared-based approaches, 34 handcrafted GRFs per image were extracted and normalised. Three classifiers were constructed: (i) CC and (ii) MLO using the GRFs from corresponding craniocaudal and mediolateral oblique images only, based on the random forest technique for distinguishing difficult- from easy-to-interpret NCs, and (iii) CC + MLO using the median predictive scores from both CC and MLO models. Useful GRFs for the CC and MLO models were recognised using a scree test. The CC and MLO models were trained and validated using the leave-one-out-cross-validation. The models' performances were assessed by the AUC and compared using the DeLong test. A Kruskal-Wallis test was used to examine if the 34 GRFs differed between difficult- and easy-to-interpret NCs and if difficulty level based on the traditional breast density (BD) categories differed among 115 low-BD and 124 high-BD NCs. The CC + MLO model achieved higher performance (0.71 AUC) than the individual CC and MLO model alone (0.66 each), but statistically non-significant difference was found (all p > 0.05). Six GRFs were identified to be valuable in describing difficult-to-interpret NCs. Twenty features, when compared between difficult- and easy-to-interpret NCs, differed significantly (p < 0.05). No statistically significant difference was observed in difficulty between low- and high-BD NCs (p = 0.709). GRF mammographic analysis can predict difficult-to-interpret NCs.
Topics: Humans; Female; Mammography; Breast Density; Random Forest; Breast Neoplasms
PubMed: 37253894
DOI: 10.1007/s10278-023-00836-7 -
PloS One 2017To investigate: (1) the variability of mammographic compression parameters amongst Asian women; and (2) the effects of reducing compression force on image quality and...
OBJECTIVES
To investigate: (1) the variability of mammographic compression parameters amongst Asian women; and (2) the effects of reducing compression force on image quality and mean glandular dose (MGD) in Asian women based on phantom study.
METHODS
We retrospectively collected 15818 raw digital mammograms from 3772 Asian women aged 35-80 years who underwent screening or diagnostic mammography between Jan 2012 and Dec 2014 at our center. The mammograms were processed using a volumetric breast density (VBD) measurement software (Volpara) to assess compression force, compression pressure, compressed breast thickness (CBT), breast volume, VBD and MGD against breast contact area. The effects of reducing compression force on image quality and MGD were also evaluated based on measurement obtained from 105 Asian women, as well as using the RMI156 Mammographic Accreditation Phantom and polymethyl methacrylate (PMMA) slabs.
RESULTS
Compression force, compression pressure, CBT, breast volume, VBD and MGD correlated significantly with breast contact area (p<0.0001). Compression parameters including compression force, compression pressure, CBT and breast contact area were widely variable between [relative standard deviation (RSD)≥21.0%] and within (p<0.0001) Asian women. The median compression force should be about 8.1 daN compared to the current 12.0 daN. Decreasing compression force from 12.0 daN to 9.0 daN increased CBT by 3.3±1.4 mm, MGD by 6.2-11.0%, and caused no significant effects on image quality (p>0.05).
CONCLUSIONS
Force-standardized protocol led to widely variable compression parameters in Asian women. Based on phantom study, it is feasible to reduce compression force up to 32.5% with minimal effects on image quality and MGD.
Topics: Adult; Aged; Aged, 80 and over; Asia; Asian People; Breast; Breast Density; Female; Humans; Mammography; Middle Aged; Phantoms, Imaging; Retrospective Studies; Software
PubMed: 28419125
DOI: 10.1371/journal.pone.0175781 -
Radiologia Mar 2022There have always been concerns about the secondary effects of diagnostic methods that use ionizing radiation. During mammography, the parameters to be concerned about...
Mean glandular dose in the mammary gland and dose of radiation in the thyroid gland and lens in women with and without breast implants during different modalities of mammography.
UNLABELLED
There have always been concerns about the secondary effects of diagnostic methods that use ionizing radiation. During mammography, the parameters to be concerned about are the mean glandular dose and the scatter dose. We evaluated the dose of radiation to the breast, thyroid gland, and lens in digital mammography in women with and without implants, in tomosynthesis in women with and without implants, and in contrast-enhanced mammography.
MATERIALS AND METHODS
The study included 212 women with and without disease who were attended at the Centro Clínico de Estereotaxia, CECLINES, in Caracas, Venezuela, between June 2017 and August 2017; the women were classified into five groups according to the mammographic modality used to evaluate them and whether or not they had implants. The statistical analysis included descriptive statistics for the study population. We used the Mann-Whitney U to compare the mean glandular dose and dose in the thyroid gland and lens between groups.
RESULTS
The mean glandular dose and the dose of radiation received in the thyroid and lens were within the acceptable range. In a few exceptions, the mean glandular dose per view was slightly higher than 3 mGy. The scatter dose to the thyroid gland and the lens during mammography has a very small contribution to the annual dose equivalent.
CONCLUSION
The mean glandular dose and the scatter dose to the thyroid gland and lens delivered during tomosynthesis and 2D mammography in women with implants were higher than those delivered during other mammographic techniques in women without implants.
Topics: Breast Implants; Female; Humans; Male; Mammary Glands, Human; Mammography; Radiation Dosage; Thyroid Gland
PubMed: 35428461
DOI: 10.1016/j.rxeng.2020.10.013 -
Biomedica : Revista Del Instituto... Mar 2021Introduction: Mammography quality is directly related to the ability to detect an abnormality and, therefore, quality control is necessary for diagnostic imaging...
Introduction: Mammography quality is directly related to the ability to detect an abnormality and, therefore, quality control is necessary for diagnostic imaging centers. Objective: To evaluate image quality, reading, and mammography service in some diagnostic imaging centers in Manizales, Colombia. Materials and methods: Four diagnostic imaging centers participated voluntarily in the study under confidentiality agreements. Out of 520 women attending the centers, 318 had a mammography. The infrastructure, technology, and human resources of each unit were evaluated based on visual inspections. A radiologist expert in reading and clinical interpretation of mammary images evaluated the quality of the image and the reading. We made the statistical analysis using anova, the kappa index, and the percentage of disagreement. Results: We found images of diminished quality mainly due to the presence of artifacts in 75 % of those evaluated, as well as non-compliance with identification criteria and image labeling. There were difficulties in taking the lateral median oblique projection given the absence of the inframammary. The level of agreement in the BI-RADS reporting was low in the four centers with important differences in the report and description of findings. Conclusion: The city’s diagnostic centers under evaluation are authorized for their operation. However, there are important deficiencies in image quality and reading, which highlights the need to seek quality standards starting from those aspects that can be improved upon.
Topics: Breast Neoplasms; Colombia; Female; Humans; Mammography; Prospective Studies; Quality Control
PubMed: 33761189
DOI: 10.7705/biomedica.5135 -
Radiography (London, England : 1995) Jan 2024A positive experience in mammography is essential for increasing patient attendance and reattendance at these examinations, whether conducted for diagnostic or screening... (Review)
Review
INTRODUCTION
A positive experience in mammography is essential for increasing patient attendance and reattendance at these examinations, whether conducted for diagnostic or screening purposes. Mammograms indeed facilitate early disease detection, enhance the potential for cure, and consequently reduce breast cancer mortality. The main objective of this review was to identify and map the strategies aiming to improve the patient experience in diagnostic and screening mammography.
METHODS
This scoping review was performed following the JBI methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Searches were performed through databases of MEDLINE, Embase.com, CINAHL, APA PsycINFO, Cochrane Central Register of Controlled Trials, Web of Science, ProQuest Dissertation and Theses, and three clinical trial registries. This review considered studies evaluating the effect of interventions, occurring within the mammography department, on the patient experience.
RESULTS
The literature search yielded 8113 citations of which 60, matching the inclusion criteria, were included. The strategies were classified into eight categories. The most represented one was breast compression and positioning, followed by relaxation techniques and analgesic care, communication and information, screening equipment, examination procedures, patient-related factors, physical environment, and finally staff characteristics. The studied outcomes related to patient experience were mainly pain, anxiety, comfort, and satisfaction. Other types of outcomes were also considered in the studies such as image quality, technical parameters, or radiation dose. Most studies were conducted by radiographers, on female patients, and none mentioned the inclusion of male or transgender patients.
CONCLUSION
This review outlined a diversity of strategies to improve patient experience, although technique-based interventions were predominant. Further research is warranted, notably on psychological strategies, and on men and transgender people.
IMPLICATIONS FOR PRACTICE
This scoping review provides guidance to healthcare providers and services for better patient/client-centered care.
Topics: Female; Humans; Breast Neoplasms; Early Detection of Cancer; Mammography; Pain; Patient Satisfaction
PubMed: 38141428
DOI: 10.1016/j.radi.2023.11.016