Diagnostic Accuracy of Mammography and Contrast-Enhanced MR Imaging in 238 Histologically Verified Breast Lesions

1997 ◽  
Vol 38 (4) ◽  
pp. 489-496 ◽  
Author(s):  
B. Boné ◽  
Z. Péntek ◽  
L. Perbeck ◽  
B. Veress
Keyword(s):  
Mr Imaging ◽  
Breast Surgery ◽  
Histopathological Examination ◽  
High Sensitivity ◽  
Histopathological Diagnosis ◽  
Breast Lesions ◽  
Benign Lesions ◽  
Post Contrast ◽  
X Ray ◽  
Contrast Enhanced

Purpose: To determine the sensitivity and specificity of X-ray mammography and of MR imaging in 238 consecutively operated breasts, and to correlate the findings to histopathological diagnosis. Material and Methods: Over 15 months, 220 patients scheduled for breast surgery were examined consecutively, before surgery, by means of both mammography and MR imaging. of the 220 patients, 18 underwent bilateral breast surgery. The entire breast was examined by means of T1-weighted transversal images using a 3D fast low-angle shot (FLASH) sequence. One pre— and 2 post-contrast scans were performed. Each breast was examined by means of mammography and 3 views were applied as routine. All palpable and mammographically suspect lesions were examined on additional images as microfocus magnification or spot compression. The two methods were evaluated independently of each other. Results: In total, 145 malignant and 93 benign lesions were found at histopathological examination. The sensitivity of mammography was 89% and MR imaging 92%. The specificity was 72% in both methods. When the results of the 2 methods were combined, a sensitivity of 99% and a specificity of 55% was achieved. Conclusion: Mammography and MR imaging seemed to complement each other to produce a high sensitivity. Unfortunately it is impossible at present to supplement mammography with MR imaging in each patient as a routine owing to the current technical and financial limitations.

Association between lesion enhancement and breast cancer in contrast-enhanced spectral mammography

2021 ◽  
pp. 028418512110600
Author(s):  
Fatma Nur Soylu Boy ◽  
Kamber Goksu ◽  
Iksan Tasdelen
Keyword(s):  
Contrast Enhancement ◽  
Predictive Value ◽  
Histopathological Examination ◽  
Daily Practice ◽  
Histopathological Diagnosis ◽  
Point Scale ◽  
Contrast Enhanced ◽  
Marked Enhancement ◽  
Histopathological Results ◽  
Malignancy Potential

Background Contrast-enhanced spectral mammography (CESM) may help to determine the malignancy potential of lesions according to the degree of enhancement. Purpose To investigate the correlation between the degree of contrast enhancement of the lesions in contrast-enhanced spectral mammography (CESM) and the final histopathological diagnosis in patients with BI-RADS 4 and 5 lesions. Material and Methods CESM was performed in 128 patients who had BI-RADS 4 and 5 lesions on mammography and underwent histopathological examination. A total of 128 index lesions were scored using a 4-point scale regarding the degree of contrast enhancement (0 = no contrast enhancement, 1 = minimal, 2 = moderate, 3 = marked), a score of 2 and 3 was accepted as suggestive of malignancy. The study was approved in our institutional scientific committee. Results In total, 76 (59.4%) of the lesions had benign histopathological results, whereas 52 of them had malignant results. Contrast enhancement was not observed in 22.7% of the lesions while 24.2% had minimal enhancement, 18.8% had moderate enhancement, and 34.4% had marked enhancement in CESM. The sensitivity of the degree of contrast enhancement in CESM was 98.1%, when the specificity was 77.6%, positive predictive value was 75%, negative predictive value was 98.3%, and accuracy was 85.9%. Conclusion This study demonstrated that the degree of contrast enhancement of the lesions in CESM may be used in daily practice with easily performing a visual scale in predicting the malignancy potential of the lesions.

scholarly journals Frequency of Malignancy Seen in Probably Benign Lesions at Contrast-enhanced Breast MR Imaging: Findings from ACRIN 6667

Radiology ◽  
2010 ◽  
Vol 255 (3) ◽  
pp. 731-737 ◽  
Author(s):  
Susan P. Weinstein ◽  
Lucy G. Hanna ◽  
Constantine Gatsonis ◽  
Mitchell D. Schnall ◽  
Mark A. Rosen ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Imaging Findings ◽  
Benign Lesions ◽  
Contrast Enhanced ◽  
Breast Mr

PREOPERATIVE CONTRAST-ENHANCED MR IMAGING OF BREAST LESIONS: EFFECT ON THERAPEUTIC APPROACH

2003 ◽  
Vol 13 (Suppl 1) ◽  
pp. 29.2-29
Author(s):  
K. Schelfout ◽  
M. Van Goethem ◽  
E. Kersschot ◽  
W. Tjalma ◽  
J. Van den Haute ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Therapeutic Approach ◽  
Breast Lesions ◽  
Contrast Enhanced

Breast Lesions: Evaluation with Dynamic Contrast-enhanced T1-weighted MR Imaging and with T2*-weighted First-Pass Perfusion MR Imaging

Radiology ◽  
2000 ◽  
Vol 216 (2) ◽  
pp. 545-553 ◽  
Author(s):  
Kjell A. Kvistad ◽  
Jana Rydland ◽  
Jari Vainio ◽  
Hanne B. Smethurst ◽  
Steinar Lundgren ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Breast Lesions ◽  
Dynamic Contrast Enhanced ◽  
Pass Perfusion ◽  
Contrast Enhanced ◽  
First Pass ◽  
Perfusion Mr ◽  
Perfusion Mr Imaging ◽  
First Pass Perfusion

scholarly journals Prospective evaluation of contrast-enhanced ultrasound of breast BI-RADS 3-5 lesions

2020 ◽  
Author(s):  
Janu Eva ◽  
Krikavova Lucie ◽  
Little Jirina ◽  
Dvorak Karel ◽  
Brancikova Dagmar ◽  
...  
Keyword(s):  
Quantitative Analysis ◽  
Qualitative Analysis ◽  
Malignant Tumors ◽  
Blood Perfusion ◽  
Benign Tumors ◽  
Breast Lesions ◽  
Contrast Enhanced Ultrasound ◽  
Benign Lesions ◽  
Time To Peak ◽  
Contrast Enhanced

Abstract Purpose: To determine the benefit of contrast-enhanced ultrasound (CEUS) in the assessment of breast lesions. Materials and Methods: A standardized contrast-enhanced ultrasound was performed in 230 breast lesions classified as BI-RADS category 3 to 5. All lesions were subjected to qualitative and quantitative analysis. MVI (MicroVascular Imaging) technique was used to derive qualitative analysis parameters; blood perfusion of the lesions was assessed (perfusion homogeneity, type of vascularization, enhancement degree). Quantitative analysis was conducted to estimate perfusion changes in the lesions within drawn regions of interest (ROI); parameters TTP (time to peak), PI (peak intensity), WIS (wash in slope), AUC (area under curve) were obtained from time intensity (TI) curves. Acquired data were statistically analyzed to assess the ability of each parameter to differentiate between malignant and benign lesions. The combination of parameters was also evaluated for the possibility of increasing the overall diagnostic accuracy. Biological nature of the lesions was verified by a pathologist. Benign lesions without histopathological verification (BI-RADS 3) were followed up for at least 24 months. Results: Out of 230 lesions, 146 (64%) were benign, 67 (29%) were malignant, 17 (7%) lesions were eliminated. Malignant tumors showed statistically significantly lower TTP parameters (sensitivity 77.6%, specificity 52.7%) and higher WIS values (sensitivity 74.6%, specificity 66.4%) than benign tumors. Enhancement degree also proved to be statistically well discriminating as 55.2% of malignant lesions had a rich vascularity (sensitivity 89.6% and specificity 48.6%). The combination of quantitative analysis parameters (TTP, WIS) with enhancement degree did not result in higher accuracy in distinguishing between malignant and benign breast lesions. Conclusion: We have demonstrated that contrast-enhanced breast ultrasound has the potential to distinguish between malignant and benign lesions. In particular, this method could help to differentiate lesions BI-RADS category 3 and 4 and thus reduce the number of core-cut biopsies performed in benign lesions. Qualitative analysis, despite its subjective element, appeared to be more beneficial. A combination of quantitative and qualitative analysis did not increase the predictive capability of CEUS.

The cone-beam breast computed tomography characteristics of breast non-mass enhancement lesions

2020 ◽  
pp. 028418512096392
Author(s):  
Wei Kang ◽  
Wuning Zhong ◽  
Danke Su
Keyword(s):  
Computed Tomography ◽  
Predictive Value ◽  
Diagnostic Yield ◽  
High Sensitivity ◽  
High Specificity ◽  
Cone Beam ◽  
Diagnostic Model ◽  
Benign Lesions ◽  
Post Contrast ◽  
Mass Enhancement

Background Cone-beam computed tomography (CBBCT) of the breast is emerging as a way of improving breast cancer diagnostic yield. Purpose To find characteristics of non-mass enhancement (NME) lesions on breast CBBCT and to identify the characteristics that distinguish malignant and benign lesions. Material and Methods Breast CBBCT images of 84 NME lesions were analyzed. Internal enhancement distribution and patterns, calcification distribution and suspicious morphology, and ΔHU enhancement values were compared between post-contrast and pre-contrast malignant and benign lesions. Univariate analyses were applied to find the strongest indicators of malignancy, and logistic regression analysis was used to develop a fitting equation for the combined diagnostic model. Results In the 84 NME lesions, the indicators of malignancy were as follows: segmental enhancement distribution ( P = 0.011, 53.62% sensitivity, 86.67% specificity, 94.87% positive predictive value [PPV], and 28.89% negative predictive value [NPV]), clumped internal enhancement patterns ( P = 0.017, 50.72% sensitivity, 86.67% specificity, 94.59% PPV, and 27.66% NPV), ΔHU ≥ 93.57 Hounsfield units (HU) ( P = 0.004, 66.67% sensitivity, 73.33% specificity, 92.00% PPV, and 32.35% NPV), and NME lesions with calcification ( P = 0.002, 36.23% sensitivity, 20.00% specificity, 82.14% PPV, and 67.57% NPV). The fitting equation for the combined diagnostic model was as follows: Logit (P) = –0.579 +1.318 × enhancement distribution + 1.000 × internal enhancement patterns + 1.539 × ΔHU value + 1.641 ×NME type. Conclusion Individual diagnostic criteria based on breast CBBCT characteristics (segmental enhancement distribution, clumped internal enhancement patterns, ΔHU values > 93.57 HU, and NME lesions with calcification) had high specificity and PPV; when combined, they had high sensitivity in predicting malignant NME lesions.

scholarly journals Quantification of dynamic contrast-enhanced ultrasound (CEUS) in non-cystic breast lesions using external perfusion software

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ernst Michael Jung ◽  
Friedrich Jung ◽  
Christian Stroszczynski ◽  
Isabel Wiesinger
Keyword(s):  
Breast Cancer ◽  
Mean Transit Time ◽  
Scar Tissue ◽  
Surrounding Tissue ◽  
Breast Lesions ◽  
Contrast Enhanced Ultrasound ◽  
Benign Lesions ◽  
Asymptomatic Patients ◽  
Contrast Enhanced ◽  
Malignant Lesions

AbstractThe aim of this present clinical pilot study is the display of typical perfusion results in patients with solid, non-cystic breast lesions. The lesions were characterized using contrast enhanced ultrasound (CEUS) with (i) time intensity curve analyses (TIC) and (ii) parametric color maps. The 24 asymptomatic patients included were genetically tested for having an elevated risk for breast cancer. At a center of early detection of familial ovary and breast cancer, those patients received annual MRI and grey-scale ultrasound. If lesions remained unclear or appeared even suspicious, those patients also received CEUS. CEUS was performed after intravenous application of sulfur hexafluoride microbubbles. Digital DICOM cine loops were continuously stored for one minute in PACS (picture archiving and communication system). Perfusion images and TIC analyses were calculated off-line with external perfusion software (VueBox). The lesion diameter ranged between 7 and 15 mm (mean 11 ± 3 mm). Five hypoechoic irregular lesions were scars, 6 lesions were benign and 12 lesions were highly suspicious for breast cancer with irregular enhancement at the margins and a partial wash out. In those 12 cases, histopathology confirmed breast cancer. All the suspicious lesions were correctly identified visually. For the perfusion analysis only Peak Enhancement (PE) and Area Under the Curve (AUC) added more information for correctly identifying the lesions. Typical for benign lesions is a prolonged contrast agent enhancement with lower PE and prolonged wash out, while scars are characterized typically by a reduced enhancement in the center. No differences (p = 0.428) were found in PE in the center of benign lesions (64.2 ± 28.9 dB), malignant lesions (88.1 ± 93.6 dB) and a scar (40.0 ± 17.0 dB). No significant differences (p = 0.174) were found for PE values at the margin of benign lesions (96.4 ± 144.9 dB), malignant lesions (54.3 ± 86.2 dB) or scar tissue (203.8 ± 218.9 dB). Significant differences (p < 0.001) were found in PE of the surrounding tissue when comparing benign lesions (33.6 ± 25.2 dB) to malignant lesions (15.7 ± 36.3 dB) and scars (277.2 ± 199.9 dB). No differences (p = 0.821) were found in AUC in the center of benign lesions (391.3 ± 213.7), malignant lesions (314.7 ± 643.9) and a scar (213.1 ± 124.5). No differences (p = 0.601) were found in AUC values of the margin of benign lesions (313.3 ± 372.8), malignant lesions (272.6 ± 566.4) or scar tissue (695.0 ± 360.6). Significant differences (p < 0.01) were found in AUC of the surrounding tissue for benign lesions (151.7 ± 127.8), malignant lesions (177.9 ± 1345.6) and scars (1091 ± 693.3). There were no differences in perfusion evaluation for mean transit time (mTT), rise time (RT) and time to peak (TTP) when comparing the center to the margins and the surrounding tissue. The CEUS perfusion parameters PE and AUC allow a very good assessment of the risk of malignant breast lesions and thus a downgrading of BI-RADS 4 lesions. The use of the external perfusion software (VueBox, Bracco, Milan, Italy) did not lead to any further improvement in the diagnosis of suspicious breast lesions and does appears not to have any additional diagnostic value in breast lesions.

scholarly journals The Use of Contrast-Enhanced Ultrasonography for the Characterization of Focal Liver Lesions

2017 ◽  
Vol 33 (6) ◽  
pp. 500-511
Author(s):  
Jennifer E. Bagley ◽  
Dennis E. Paul ◽  
Sutton Halferty ◽  
Dora DiGiacinto
Keyword(s):  
High Sensitivity ◽  
Diagnostic Process ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Benign Lesions ◽  
Underlying Liver Disease ◽  
Contrast Enhanced ◽  
Contrast Enhanced Ultrasonography ◽  
Malignant Lesions

Focal liver lesions often occur with or without an underlying liver disease. Contrast-enhanced ultrasonography can aid in characterizing liver lesions, potentially avoiding biopsy and computed tomography procedures. Contrast-enhanced ultrasonography has a high sensitivity and specificity for differentiating characteristics of liver lesions compared with noncontrast sonography. The different contrast characteristics aid in differentiating benign and malignant lesions. Malignant lesions tend to have washout of contrast in the venous phases, whereas benign lesions have hyperenhancement during the venous phases. Therefore, contrast-enhanced ultrasonography should be considered an essential component of the diagnostic process for diagnosing and following focal liver lesions.

scholarly journals Splenic Leiomyoma in Dog

2018 ◽  
Vol 6 (1) ◽  
pp. 8-12 ◽  
Author(s):  
Magdalena Magas ◽  
Katarzyna Szczepańska ◽  
Maurycy Jankowski ◽  
Dorota Bukowska ◽  
Paweł Antosik
Keyword(s):  
Clinical Case ◽  
Benign Tumor ◽  
Histopathological Examination ◽  
Smooth Muscles ◽  
Clinical Signs ◽  
Clinical Findings ◽  
Surgical Removal ◽  
Benign Lesions ◽  
X Ray ◽  
Tumor Lesion

AbstractLeiomyoma is a benign tumour, originating from smooth muscles cells. This tumor commonly involves the uterus, vagina, stomach, intestine, urinary bladder and other organs. Only a few cases of splenic leiomyoma in dogs have been reported in the available literature. Much more frequently malignant leiomyosarcoma was found. The aim of this study was to compile rare clinical case of splenic leiomyoma in dog, which developed with no clinical signs and no abnormalities in blood findings. A 14-year-old, spayed bitch was examined with ultrasonography, where lesions on the spleen were identified. Based on the clinical findings (blood test in norm, no metastases in X-ray examination) surgical removal of spleen was recommended. Two fragments of tumors were prepare for histopathological examination. The lesion was described as smooth muscle benign tumor, therefore a diagnosis of leiomyoma was made. About a year after splenectomy no signs of metastases were present in a ultrasound and X-ray examinations. This report indicates the necessity of taking the occurrence of benign lesions in the spleen into account. Splenectomy based on the presence of tumor lesion should be associated with histopathological examination to identify the nature of change. This clinical case, despite a marked morphological lesion shown during intraoperative examination, was benign with successful prognosis.

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