scholarly journals Architecture distortion score (ADS) in malignancy risk stratification of architecture distortion on contrast-enhanced digital mammography

2020 ◽  
Author(s):  
Yonggeng Goh ◽  
Ching Wan Chan ◽  
Premilla Pillay ◽  
Herng-Sheng Lee ◽  
Huay-Ben Pan ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Digital Mammography ◽  
Statistical Significance ◽  
Screening Mammography ◽  
Brier Score ◽  
Architectural Distortion ◽  
Contrast Enhanced ◽  
Risk Of Malignancy ◽  
Risk Predictor ◽  
Parenchyma Enhancement

Abstract Objective To develop a risk predictor model in evaluation of tomosynthesis-detected architectural distortion (AD) based on characteristics of contrast-enhanced digital mammography (CEDM). Methods Ninety-four AD lesions on CEDM in combination with tomosynthesis were retrospectively reviewed from 92 consecutive women (mean age, 52.4 years ± 7.9) with abnormal diagnostic or screening mammography. CEDM results were correlated with histology of ADs using cross-tabulation for statistical analysis. Predictors for risk of malignancy from CEDM characteristics (background parenchyma enhancement, degree of AD enhancement, enhancing morphology, size of enhancement, and enhancing spiculations) and patient’s age were evaluated using logistic regression. We propose a sum score, termed AD score (ADS), for risk stratification and corresponding suggested BI-RADS category. Results Thirty-three of ninety-four (35.1%) of detected AD lesions were malignant. The sensitivity, specificity, PPV, and NPV of CEDM in evaluation of malignant AD are 100%, 42.6%, 48.5%, and 100%, respectively. Absence of AD enhancement on CEDM is highly indicative of no underlying malignancy. On multivariate analysis, the predictors on CEDM with statistical significance are (1) marked intensity of AD enhancement (OR, 22.6; 95%CI 3.1, 166.6; p = .002); and (2) presence of enhancing spiculations (OR, 9.1; 95%CI 2.2, 36.5; p = .002). A prediction model whose scores (ADS) given by ranking of OR of all predictors with AUC of 0.934 and Brier score of 0.0956 was developed. Conclusion ADS-based lesion characterization on CEDM enables risk assessment of tomosynthesis-detected AD lesions. Key Points • Architecture distortions presenting with marked enhancement intensity and presence of enhancing spiculations are highly associated with risk of malignancy. • Absence of architecture distortion enhancement in minimal or mild background parenchyma enhancement on CEDM indicates low risk of breast malignancy (NPV = 100%).

Can adding contrast-enhanced digital mammography (CEDM) as an adjunct to diagnostic mammography/US help decrease biopsy rates in women with suspicious (BIRADS 4) breast lesions?

2015 ◽  
Vol 33 (28_suppl) ◽  
pp. 6-6 ◽  
Author(s):  
Bhavika K Patel ◽  
Marina Giurescu ◽  
Sarah Eversman ◽  
Eversman William ◽  
Heidi Kosiorek ◽  
...  
Keyword(s):  
Digital Mammography ◽  
False Positive ◽  
Screening Mammography ◽  
Normal Mammary Gland ◽  
Contrast Enhanced ◽  
Diagnostic Mammography ◽  
Study Population ◽  
Increased Sensitivity ◽  
Angiographic Technique

6 Background: Traditional screening mammography (MG) enables early detection of breast cancer and therefore results in decreased mortality. Mammography, however, is an imperfect tool and limited by an overall sensitivity of 75-85%. Specificity is limited as well resulting in many false-positive examinations and unnecessary follow-up examinations. The recent development of contrast-enhanced digital mammography (CEDM) has made the usage of IV contrast enhancement with mammography a possibility. CEDM is an angiographic technique that uses digital subtraction, which removes the normal mammary gland on images in order to detect breast tumors and visualize their vascularity. The literature is promising with regard to CEDM as studies have found that CEDM achieves increased sensitivity without reductions in specificity in comparison to MG, US and/or MRI. Methods: In this multi-reader study we compared the diagnostic accuracy of CEDM as an adjunct to MG/US in patients with suspicious findings (BI-RADS 4). The study population included 31 patients who were imaged with CEDM prior to their scheduled US or stereotactic-guided biopsy. We compared the relative performance of MG/US alone versus MG/US/CEDM in determining the probability of malignancy. Histology served as the gold standard. Results: See table below. Conclusions: The addition of CEDM to the workup of suspected lesions on MG and/or US preliminarily decreases the number of false-positive MG thereby with potential to reduce cost and unnecessary patient harm. [Table: see text]

Occurrence and Positive Predictive Value of Additional Nonmass Findings for Risk Stratification of Breast Microcalcifications in Mammography

2013 ◽  
Vol 64 (4) ◽  
pp. 333-338 ◽  
Author(s):  
Marga B. Rominger ◽  
Eva V. Sax ◽  
Jens H. Figiel ◽  
Nina Timmesfeld
Keyword(s):  
Positive Predictive Value ◽  
Risk Stratification ◽  
Predictive Value ◽  
Invasive Carcinoma ◽  
Architectural Distortion ◽  
Odds Ratios ◽  
Predictive Values ◽  
Risk Of Malignancy ◽  
Additional Imaging ◽  
Hook Wire

Purpose To assess the occurrence and positive predictive value of additional nonmass findings to stratify the risk of breast microcalcifications. Methods This retrospective evaluation included 278 lesions with vacuum- or image-guided hook-wire biopsy for suspicious microcalcifications. The lesions were categorized into exclusive microcalcifications and microcalcifications with focal asymmetry, tubular density or architectural distortion (ie, nonmass findings). To evaluate the utility of additional nonmass findings for risk stratification, outcome variables were positive predictive values and odds ratios for malignancy and invasive carcinoma. Results Forty-five of 278 microcalcification lesions (16%) were associated with nonmass findings: 28 focal asymmetries, 2 tubular densities, and 15 focal asymmetries in conjunction with tubular densities. Architectural distortion was observed in 28 of these cases. The odds ratio for additional nonmass findings relative to exclusive microcalcifications was 5.9 and was statistically significant ( P < .00001). Architectural distortion was the most specific indicator for malignancy and invasiveness, with odds ratios of 6.5 ( P = .0072) and 5.6 ( P = .0214), respectively. Conclusions Microcalcifications with nonmass findings were less frequent than exclusive microcalcifications but were more predictive for malignancy. Architectural distortion demonstrated the highest risk of malignancy and invasiveness. Assessment of additional nonmass findings might be useful for further risk stratification of microcalcifications, indications for additional imaging, and pretreatment considerations.

Cancer Conspicuity on Low-energy Images of Contrast-enhanced Mammography Compared With 2D Mammography

2021 ◽  
Author(s):  
Christina Konstantopoulos ◽  
Tejas S Mehta ◽  
Alexander Brook ◽  
Vandana Dialani ◽  
Rashmi Mehta ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Analysis Of Variance ◽  
Digital Mammography ◽  
Regions Of Interest ◽  
Low Energy ◽  
Wilcoxon Test ◽  
Digital Mammogram ◽  
Contrast Enhanced ◽  
Improved Performance ◽  
2D Images

Abstract Objective Low-energy (LE) images of contrast-enhanced mammography (CEM) have been shown to be noninferior to digital mammography. However, our experience is that LE images are superior to 2D mammography. Our purpose was to compare cancer appearance on LE to 2D images. Methods In this IRB-approved retrospective study, seven breast radiologists evaluated 40 biopsy-proven cancer cases on craniocaudal (CC) and mediolateral oblique (MLO) LE images and recent 2D images for cancer visibility, confidence in margins, and conspicuity of findings using a Likert scale. Objective measurements were performed using contrast-to-noise ratio (CNR) estimated from regions of interest placed on tumor and background parenchyma. Reader agreement was evaluated using Fleiss kappa. Per-reader comparisons were performed using Wilcoxon test and overall comparisons used three-way analysis of variance. Results Low-energy images showed improved performance for visibility (CC LE 4.0 vs 2D 3.5, P &lt; 0.001 and MLO LE 3.7 vs 2D 3.5, P = 0.01), confidence in margins (CC LE 3.2 vs 2D 2.8, P &lt; 0.001 and MLO LE 3.1 vs 2D 2.9, P &lt; 0.008), and conspicuity compared to tissue density compared to 2D mammography (CC LE 3.6 vs 2D 3.2, P &lt; 0.001 and MLO LE 3.5 vs 2D 3.2, P &lt; 0.001). The average CNR was significantly higher for LE than for digital mammography (CC 2.1 vs 3.2, P &lt; 0.001 and MLO 2.1 vs 3.4, P &lt; 0.001). Conclusion Our results suggest that cancers may be better visualized on the LE CEM images compared with the 2D digital mammogram.

scholarly journals New technologies in breast cancer detection – contrast enhanced dual-energy spectral mammography

2019 ◽  
pp. 49-61
Author(s):  
A. V. Chernaya ◽  
S. N. Novikov ◽  
P. V. Krivorotko ◽  
R. Kh. Ulyanova ◽  
V. V. Danilov
Keyword(s):  
Breast Cancer ◽  
Digital Mammography ◽  
Predictive Value ◽  
New Technologies ◽  
Malignant Tumors ◽  
Dual Energy ◽  
Post Contrast ◽  
Morphological Studies ◽  
Contrast Enhanced ◽  
Sensitivity Specificity

Purpose: to study the possibilities of contrast enhanced dual-energy spectral mammography (CESM) in the diagnostics of malignant tumors in the breast.Material and methods. Forty-seven patients with suspicious for breast cancer (BC) lesions underwent CESM. Digital mammography (MMG) and post-contrast images were correlated with the results of path morphological studies after surgery or puncture biopsy was performed.Results. Sensitivity, specificity and overall accuracy in the diagnostics of breast cancer were 83.3%, 85.7%, 85.1% for digital mammography and 91.6%, 91.4%, 91.4% for CESM, respectively. The positive predictive value was 66.6% for digital MMG and 78.5% for CESM. The negative predictive value (NPV) was 96.9% for the CESM and exceeded NPV of the digital MMG, which was 93.7%.Conclusion. Thus, these findings suggest that CESM is an effective method for the diagnostics of malignant tumors in the breast.

scholarly journals Exploring the Value of Radiomics Features Based on B-Mode and Contrast-Enhanced Ultrasound in Discriminating the Nature of Thyroid Nodules

2021 ◽  
Vol 11 ◽  
Author(s):  
Shi Yan Guo ◽  
Ping Zhou ◽  
Yan Zhang ◽  
Li Qing Jiang ◽  
Yong Feng Zhao
Keyword(s):  
Diagnostic Performance ◽  
Thyroid Nodules ◽  
New Technologies ◽  
Statistical Significance ◽  
Characteristic Curve ◽  
Logistic Models ◽  
Contrast Enhanced Ultrasound ◽  
Clinical Value ◽  
Contrast Enhanced ◽  
Significant Difference

BackgroundWith the improvement of ultrasound imaging resolution and the application of various new technologies, the detection rate of thyroid nodules has increased greatly in recent years. However, there are still challenges in accurately diagnosing the nature of thyroid nodules. This study aimed to evaluate the clinical application value of the radiomics features extracted from B-mode ultrasound (B-US) images combined with contrast-enhanced ultrasound (CEUS) images in the differentiation of benign and malignant thyroid nodules by comparing the diagnostic performance of four logistic models.MethodsWe retrospectively collected and ultimately included B-US images and CEUS images of 123 nodules from 123 patients, and then extracted the corresponding radiomics features from these images respectively. Meanwhile, a senior radiologist combined the thyroid imaging reporting and data system (TI-RADS) and the enhancement pattern of the ultrasonography to make a graded diagnosis of the malignancy of these nodules. Next, based on these radiomics features and grades, logistic regression was used to help build the models (B-US radiomics model, CEUS radiomics model, B-US+CEUS radiomics model, and TI-RADS+CEUS model). Finally, the study assessed the diagnostic performance of these radiomics features with a comparison of the area under the curve (AUC) of the receiver operating characteristic curve of four logistic models for predicting the benignity or malignancy of thyroid nodules.ResultsThe AUC in the differential diagnosis of the nature of thyroid nodules was 0.791 for the B-US radiomics model, 0.766 for the CEUS radiomics model, 0.861 for the B-US+CEUS radiomics model, and 0.785 for the TI-RADS+CEUS model. Compared to the TI-RADS+CEUS model, there was no statistical significance observed in AUC between the B-US radiomics model, CEUS radiomics model, B-US+CEUS radiomics model, and TI-RADS+CEUS model (P&gt;0.05). However, a significant difference was observed between the single B-US radiomics model or CEUS radiomics model and B-US+CEUS radiomics model (P&lt;0.05).ConclusionIn our study, the B-US radiomics model, CEUS radiomics model, and B-US+CEUS radiomics model demonstrated similar performance with the TI-RADS+CEUS model of senior radiologists in diagnosing the benignity or malignancy of thyroid nodules, while the B-US+CEUS radiomics model showed better diagnostic performance than single B-US radiomics model or CEUS radiomics model. It was proved that B-US radiomics features and CEUS radiomics features are of high clinical value as the combination of the two had better diagnostic performance.

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