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Radiologia 2019Breast tomosynthesis is a continually improving tool for diagnostic radiologists. This update about tomosynthesis reviews the advantages of the technique both in... (Review)
Review
Breast tomosynthesis is a continually improving tool for diagnostic radiologists. This update about tomosynthesis reviews the advantages of the technique both in patients with suspected or known disease and in screening, as well as its limitations, of which the dose of radiation is the most important. The more recent advent of synthesized mammography, computer-assisted detection, and tomosynthesis-guided biopsy have helped to reduce the dose of radiation used and have improved the diagnostic performance of tomosynthesis, so they are also discussed in this review.
Topics: Breast Neoplasms; Female; Humans; Mammography
PubMed: 30808510
DOI: 10.1016/j.rx.2019.01.002 -
Canadian Association of Radiologists... Feb 2022The purpose of this article is to provide a detailed and updated review of the physics, techniques, indications, limitations, reporting, implementation and management of... (Review)
Review
OBJECTIVES
The purpose of this article is to provide a detailed and updated review of the physics, techniques, indications, limitations, reporting, implementation and management of contrast enhanced mammography.
BACKGROUND
Contrast enhanced mammography (CEM), is an emerging iodine-based modified dual energy mammography technique. In addition to having the same advantages as standard full-field digital mammography (FFDM), CEM provides information regarding tumor enhancement, relying on tumor angiogenesis, similar to dynamic contrast enhanced magnetic resonance imaging (DCE-MRI). This article reviews current literature on CEM and highlights considerations that are critical to the successful use of this modality.
CONCLUSION
Multiple studies point to the advantage of using CEM in the diagnostic setting of breast imaging, which approaches that of DCE-MRI.
Topics: Breast; Breast Neoplasms; Contrast Media; Female; Humans; Mammography; Radiographic Image Enhancement; Sensitivity and Specificity
PubMed: 34492211
DOI: 10.1177/08465371211029047 -
Physica Medica : PM : An International... Jul 2022Dose management systems (DMS's) have been widely used for radiation dose data collection and analysis, and have been proven useful for optimization. Although DMS's are...
BACKGROUND AND AIM
Dose management systems (DMS's) have been widely used for radiation dose data collection and analysis, and have been proven useful for optimization. Although DMS's are used for patient dosimetry, a quality assurance (QA) program has not yet been developed. The aim of this work was to propose vendor neutral quality tests and discuss how QA can be established for DMS's to ensure robustness and quality of patient dose data.
MATERIALS & METHODS
Different DMS's functions were organized in three groups according to their complexity. As basic functions, we defined those that depend on simple data collection and require data verification. Intermediate functions provide calculations such as effective dose or higher dose alerts, while the advanced group aims to address complicated analyses, such as peak skin dose calculations.
RESULTS
An Excel file was developed that includes quality tests on basic and intermediate functions for different modalities (radiography, interventional radiology, CT and mammography) and is provided as Annex. For advanced functionalities, tests are discussed to guide medical physics experts to design their QA program as appropriate.
CONCLUSIONS
The QA program is intended to ensure the trustworthy functioning for applications in normal circumstances and patient outliers. As DMS's are systems with regular upgrades, the associated QA program should be a dynamic process that takes into account the functionalities of the DMS and its application in the clinics. Medical physics experts should ensure the safety and accuracy of DMS's, as an essential component in patient dosimetry - part of their mission.
Topics: Humans; Mammography; Quality Assurance, Health Care; Radiometry
PubMed: 35598480
DOI: 10.1016/j.ejmp.2022.05.002 -
International Journal of Occupational... Oct 2022Mammographic density (MD) refers to the percentage of dense tissue of an entire breast and was proposed to be used as a surrogate marker for breast cancer. High-dose...
OBJECTIVES
Mammographic density (MD) refers to the percentage of dense tissue of an entire breast and was proposed to be used as a surrogate marker for breast cancer. High-dose ionizing radiation (IR) has been recognized as a breast cancer risk factor. The aim of our study was to investigate association between lifetime low dose ionizing radiation (LDIR) and MD.
MATERIAL AND METHODS
A cross-sectional study included 467 women aged 40-60 years who underwent screening mammography in Łódź, Poland. The digital mammography examination of the breasts included both craniocaudal and mediolateral oblique views. The volumetric breast density (VBD) (%) and fibrograndular tissue volume (FG) (cm) were determined based on the analysis of mammographic image ("for processing") using Volpara Imaging Software. The exposure to IR was estimated for each individual, based on the data from interviews about diagnostic or therapeutic medical procedures performed in the area of the neck, chest, abdomen and spine, which involved X-rays and γ rays and the data about the doses derived from literature. Linear and logistic regression were fitted with VBD and FG as the outcomes and organ breast dose, effective dose and number of mammographies as the determinants, adjusted for major confounders.
RESULTS
The analyses showed no association between VBD or FG and the breast organ dose or the effective dose. The only significant finding observed concerned the association between the number of mammographies and the FG volume with β coefficient: 0.028 (95% CI: 0.012-0.043), and predicted mean FG volume >13.4 cm3 among the women with >3 mammographies when compared to those with none.
CONCLUSIONS
This study does not, in general, provide support for the positive association between LDIR and MD. The weak association of the FG volume with the number of mammographies warrants further verification in larger independent studies. Int J Occup Med Environ Health. 2022;35(5):635-49.
Topics: Breast Density; Breast Neoplasms; Cross-Sectional Studies; Early Detection of Cancer; Female; Humans; Mammography; Radiation, Ionizing
PubMed: 35913368
DOI: 10.13075/ijomeh.1896.01916 -
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; Mammary Glands, Human; Mammography; Radiation Dosage; Thyroid Gland
PubMed: 35428461
DOI: 10.1016/j.rxeng.2020.10.013 -
Journal of Ultrasound Jun 2023The purpose of this study was to assess the diagnostic performance of mammography (MMG) and ultrasound (US) imaging for detecting breast cancer. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The purpose of this study was to assess the diagnostic performance of mammography (MMG) and ultrasound (US) imaging for detecting breast cancer.
METHODS
Comprehensive searches of PubMed, Scopus and EMBASE from 2008 to 2021 were performed. A summary receiver operating characteristic curve (SROC) was constructed to summarize the overall test performance of MMG and US. Histopathologic analysis and/or close clinical and imaging follow-up for at least 6 months were used as golden reference.
RESULTS
Analysis of the studies revealed that the overall validity estimates of MMG and US in detecting breast cancer were as follows: pooled sensitivity per-patient were 0.82 (95% CI 0.76-0.87) and 0.83 (95% CI 0.71-0.91) respectively, The pooled specificities for detection of breast cancer using MMG, and US were 0.84 (95% CI 0.73-0.92) and 0.84 (95% CI 0.74-0.91) respectively. AUC of MMG, and US were 0.8933 and 0.8310 respectively. Pooled sensitivity and specificity per-lesion was 76% (95% CI 0.62-0.86) and 82% (95% CI 0.66-0.91) for MMG and 94% (95% CI 0.87-0.97) and 84% (95% CI 0.74-0.91) for US.
CONCLUSIONS
The meta-analysis found that, US and MMG has similar diagnostic performance in detecting breast cancer on per-patient basis after corrected threshold effect. However, on a per-lesion basis US was found to have a better diagnostic accuracy than MMG.
Topics: Female; Humans; Breast Neoplasms; Mammography; Ultrasonography, Mammary; Ultrasonography; Sensitivity and Specificity
PubMed: 36696046
DOI: 10.1007/s40477-022-00755-3 -
European Journal of Radiology Oct 2022In X-ray breast imaging, Digital Mammography (DM) and Digital Breast Tomosynthesis (DBT), are the standard and largely used techniques, both for diagnostic and screening... (Review)
Review
In X-ray breast imaging, Digital Mammography (DM) and Digital Breast Tomosynthesis (DBT), are the standard and largely used techniques, both for diagnostic and screening purposes. Other techniques, such as dedicated Breast Computed Tomography (BCT) and Contrast Enhanced Mammography (CEM) have been developed as an alternative or a complementary technique to the established ones. The performance of these imaging techniques is being continuously assessed to improve the image quality and to reduce the radiation dose. These imaging modalities are predominantly used in the diagnostic setting to resolve incomplete or indeterminate findings detected with conventional screening examinations and could potentially be used either as an adjunct or as a primary screening tool in select populations, such as for women with dense breasts. The aim of this review is to describe the radiation dosimetry for these imaging techniques, and to compare the mean glandular dose with standard breast imaging modalities, such as DM and DBT.
Topics: Breast; Breast Density; Breast Neoplasms; Female; Humans; Mammography; Radiometry; X-Rays
PubMed: 36087425
DOI: 10.1016/j.ejrad.2022.110509 -
Journal of Medical Radiation Sciences Jun 2020Studies have shown that the use of artificial intelligence can reduce errors in medical image assessment. The diagnosis of breast cancer is an essential task; however,... (Review)
Review
Studies have shown that the use of artificial intelligence can reduce errors in medical image assessment. The diagnosis of breast cancer is an essential task; however, diagnosis can include 'detection' and 'interpretation' errors. Studies to reduce these errors have shown the feasibility of using convolution neural networks (CNNs). This narrative review presents recent studies in diagnosing mammographic malignancy investigating the accuracy and reliability of these CNNs. Databases including ScienceDirect, PubMed, MEDLINE, British Medical Journal and Medscape were searched using the terms 'convolutional neural network or artificial intelligence', 'breast neoplasms [MeSH] or breast cancer or breast carcinoma' and 'mammography [MeSH Terms]'. Articles collected were screened under the inclusion and exclusion criteria, accounting for the publication date and exclusive use of mammography images, and included only literature in English. After extracting data, results were compared and discussed. This review included 33 studies and identified four recurring categories of studies: the differentiation of benign and malignant masses, the localisation of masses, cancer-containing and cancer-free breast tissue differentiation and breast classification based on breast density. CNN's application in detecting malignancy in mammography appears promising but requires further standardised investigations before potentially becoming an integral part of the diagnostic routine in mammography.
Topics: Humans; Image Processing, Computer-Assisted; Mammography; Neural Networks, Computer
PubMed: 32134206
DOI: 10.1002/jmrs.385 -
Cancer Prevention Research... Sep 2023Mammographic percentage of volumetric density is an important risk factor for breast cancer. Epidemiology studies historically used film images often limited to...
UNLABELLED
Mammographic percentage of volumetric density is an important risk factor for breast cancer. Epidemiology studies historically used film images often limited to craniocaudal (CC) views to estimate area-based breast density. More recent studies using digital mammography images typically use the averaged density between craniocaudal (CC) and mediolateral oblique (MLO) view mammography for 5- and 10-year risk prediction. The performance in using either and both mammogram views has not been well-investigated. We use 3,804 full-field digital mammograms from the Joanne Knight Breast Health Cohort (294 incident cases and 657 controls), to quantity the association between volumetric percentage of density extracted from either and both mammography views and to assess the 5 and 10-year breast cancer risk prediction performance. Our results show that the association between percent volumetric density from CC, MLO, and the average between the two, retain essentially the same association with breast cancer risk. The 5- and 10-year risk prediction also shows similar prediction accuracy. Thus, one view is sufficient to assess association and predict future risk of breast cancer over a 5 or 10-year interval.
PREVENTION RELEVANCE
Expanding use of digital mammography and repeated screening provides opportunities for risk assessment. To use these images for risk estimates and guide risk management in real time requires efficient processing. Evaluating the contribution of different views to prediction performance can guide future applications for risk management in routine care.
Topics: Humans; Female; Breast Neoplasms; Mammography; Breast; Breast Density; Risk Factors
PubMed: 37428020
DOI: 10.1158/1940-6207.CAPR-22-0499 -
Seminars in Cancer Biology Jul 2021Many breast lesions are associated with microcalcifications that are detectable by mammography. In most cases, radiologists are able to distinguish calcifications... (Review)
Review
Many breast lesions are associated with microcalcifications that are detectable by mammography. In most cases, radiologists are able to distinguish calcifications usually associated with benign diseases from those associated with malignancy. In addition to their value in the early detection of breast carcinoma and accurate radiological diagnosis, the presence of microcalcifications often affects the extent of surgical intervention. Certain types of microcalcifications are associated with negative genetic and molecular characteristics of the tumor and unfavorable prognosis. Microcalcifications localized in the larger ducts (duct-centric, casting-type microcalcifications) represent an independent negative prognostic marker compared to lesions containing other types of microcalcifications and to non-calcified lesions. In this review, we summarize the theoretical and methodological background for understanding the clinical impact and discuss the diagnostic and prognostic value of microcalcifications detected in the breast by mammography.
Topics: Breast Neoplasms; Calcinosis; Female; Humans; Mammography; Prognosis
PubMed: 31733292
DOI: 10.1016/j.semcancer.2019.10.024