Common Current Procedural Terminology Codes in Breast Imaging

2019 ◽  
Vol 1 (4) ◽  
pp. 334-337
Author(s):  
Dana H Smetherman
Keyword(s):  
Breast Imaging ◽  
Digital Breast Tomosynthesis ◽  
Axillary Lymph Nodes ◽  
Computer Assisted ◽  
Axillary Lymph ◽  
Current Procedural Terminology ◽  
Imaging Procedures ◽  
Breast Tomosynthesis ◽  
Computer Assisted Detection ◽  
Magnetic Resonance Imaging Mri

Abstract This article reviews the common Current Procedural Terminology (CPT) codes for frequently performed breast imaging procedures. The CPT codes for breast radiology services, including the revised codes for mammography, computer-assisted detection (CAD), breast ultrasound, breast magnetic resonance imaging (MRI), and imaging-guided breast interventional procedures and the new codes for digital breast tomosynthesis (DBT) and marker placement in axillary lymph nodes are outlined. The application of basic CPT coding principles, such as the use of modifiers and the different structure of code families in breast radiology services, is also discussed. CPT codes are updated on an ongoing basis to reflect the evolution of medical practice, and the CPT codes for breast imaging procedures have changed significantly in the past 5 years. These modifications can affect the distribution of work and utilization of resources in radiology departments. A working knowledge of coding practices will facilitate compliance with billing regulations and help ensure breast radiologists are appropriately paid for their work.

Supplemental Screening for Women with Dense Breasts: What Do Practicing Radiologists Recommend?

2019 ◽  
Vol 1 (1) ◽  
pp. 32-36 ◽  
Author(s):  
Tisha Singer ◽  
Ana P Lourenco ◽  
Grayson L Baird ◽  
Martha B Mainiero
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Breast Imaging ◽  
Digital Breast Tomosynthesis ◽  
Risk Groups ◽  
High Rate ◽  
Breast Tomosynthesis ◽  
Dense Breasts ◽  
Additional Imaging ◽  
Magnetic Resonance Imaging Mri

Abstract Objective To evaluate radiologists’ supplemental screening recommendations for women with dense breasts, at average, intermediate, or high risk of breast cancer, and to determine if there are differences between their recommendations for their patients, their friends and family, and themselves. Methods This is an anonymous survey of Society of Breast Imaging (SBI) members. Demographics, knowledge of breast density as a risk factor, and recommendations for screening with digital breast tomosynthesis (DBT), ultrasound (US), and magnetic resonance imaging (MRI) in women with dense breasts, at average, intermediate, or high- risk of breast cancer were assessed. The likelihood of their recommending the screening test for their patients, their family and friends, and themselves was assessed on a Likert scale from 0 to 4 (0 = “not at all likely” to 4 = “extremely likely”). Results There were 295 responses: 67% were women, and breast imaging comprised 95% of their practice. Among participants, 53% correctly answered the question on relative risk of breast cancer when comparing extremely dense versus fatty breasts, and 57% when comparing heterogeneously dense versus scattered breasts. US is recommended at a relatively low rate (1.0–1.4 on the 0–4 scale), regardless of risk. DBT is recommended at a relatively high rate (2.5–3.0 on the 0–4 scale), regardless of risk status. MR is recommended mainly for those at high risk (3.6 on the 0–4 scale). Radiologists were more likely to recommend additional imaging for themselves than for their patients and their family and friends. Conclusion For women with dense breasts, radiologists are “somewhat likely” to recommend US and “likely” to “very likely” to recommend DBT regardless of risk group. They are “very likely” to recommend MRI for high-risk groups.

scholarly journals A Decision Support System Based on BI-RADS and Radiomic Classifiers to Reduce False Positive Breast Calcifications at Digital Breast Tomosynthesis: A Preliminary Study

2021 ◽  
Vol 11 (6) ◽  
pp. 2503
Author(s):  
Marco Alì ◽  
Natascha Claudia D’Amico ◽  
Matteo Interlenghi ◽  
Marina Maniglio ◽  
Deborah Fazzini ◽  
...  
Keyword(s):  
Decision Support ◽  
Decision Support System ◽  
Support System ◽  
Breast Imaging ◽  
Digital Breast Tomosynthesis ◽  
Breast Tomosynthesis ◽  
Preliminary Study ◽  
Personalized Risk ◽  
Fold Cross Validation ◽  
Malignant Diagnosis

Digital breast tomosynthesis (DBT) studies were introduced as a successful help for the detection of calcification, which can be a primary sign of cancer. Expert radiologists are able to detect suspicious calcifications in DBT, but a high number of calcifications with non-malignant diagnosis at biopsy have been reported (false positives, FP). In this study, a radiomic approach was developed and applied on DBT images with the aim to reduce the number of benign calcifications addressed to biopsy and to give the radiologists a helpful decision support system during their diagnostic activity. This allows personalizing patient management on the basis of personalized risk. For this purpose, 49 patients showing microcalcifications on DBT images were retrospectively included, classified by BI-RADS (Breast Imaging-Reporting and Data System) and analyzed. After segmentation of microcalcifications from DBT images, radiomic features were extracted. Features were then selected with respect to their stability within different segmentations and their repeatability in test–retest studies. Stable radiomic features were used to train, validate and test (nested 10-fold cross-validation) a preliminary machine learning radiomic classifier that, combined with BI-RADS classification, allowed a reduction in FP of a factor of 2 and an improvement in positive predictive value of 50%.

scholarly journals Nonconventional Options for Tumor Localization in Breast and Axillary Lymph Nodes: A Pictorial How-To

2018 ◽  
Vol 8 ◽  
pp. 54 ◽  
Author(s):  
Naziya Samreen ◽  
Christine U Lee ◽  
Asha A Bhatt
Keyword(s):  
Breast Lesion ◽  
Preoperative Localization ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Resonance Imaging ◽  
Node Localization ◽  
Magnetic Resonance Imaging Mri ◽  
Lesion Localization ◽  
Ct And Mri ◽  
Breast Malignancies

Preoperative localization of breast malignancies using traditional ultrasound and digital techniques can be challenging, particularly after neoadjuvant chemotherapy when the target is not conspicuous. The purpose of this paper is to pictorially present nontraditional techniques that have been helpful in preoperative localization before surgery. We will discuss techniques for breast lesion localization using computed tomography (CT) and magnetic resonance imaging (MRI) as well as axillary lymph node localization using tomosynthesis, CT, and MRI.

scholarly journals Comparative Study of Digital Breast Tomosynthesis (DBT) with and without Ultrasound versus Breast Magnetic Resonance Imaging (MRI) in Detecting Breast Lesion

2022 ◽  
Vol 19 (2) ◽  
pp. 759
Author(s):  
Janice Hui Ling Goh ◽  
Toh Leong Tan ◽  
Suraya Aziz ◽  
Iqbal Hussain Rizuana
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Diagnostic Performance ◽  
Breast Lesion ◽  
Breast Magnetic Resonance Imaging ◽  
Digital Breast Tomosynthesis ◽  
Resonance Imaging ◽  
Breast Tomosynthesis ◽  
Breast Magnetic Resonance ◽  
Magnetic Resonance Imaging Mri

Digital breast tomosynthesis (DBT) is a fairly recent breast imaging technique invented to overcome the challenges of overlapping breast tissue. Ultrasonography (USG) was used as a complementary tool to DBT for the purpose of this study. Nonetheless, breast magnetic resonance imaging (MRI) remains the most sensitive tool to detect breast lesion. The purpose of this study was to evaluate diagnostic performance of DBT, with and without USG, versus breast MRI in correlation to histopathological examination (HPE). This was a retrospective study in a university hospital over a duration of 24 months. Findings were acquired from a formal report and were correlated with HPE. The sensitivity of DBT with or without USG was lower than MRI. However, the accuracy, specificity and PPV were raised with the aid of USG to equivalent or better than MRI. These three modalities showed statistically significant in correlation with HPE (p < 0.005, chi-squared). Generally, DBT alone has lower sensitivity as compared to MRI. However, it is reassuring that DBT + USG could significantly improve diagnostic performance to that comparable to MRI. In conclusion, results of this study are vital to centers which do not have MRI, as complementary ultrasound can accentuate diagnostic performance of DBT.

scholarly journals Systemic Sarcoidosis Presenting with Headache and Stroke-Like Episodes

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
J. Campbell ◽  
R. Kee ◽  
D. Bhattacharya ◽  
P. Flynn ◽  
M. McCarron ◽  
...  
Keyword(s):  
White Matter Lesions ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Computerised Tomography ◽  
Opening Pressure ◽  
Serum Angiotensin Converting Enzyme ◽  
History Of ◽  
Systemic Sarcoidosis ◽  
Granulomatous Disorder ◽  
Magnetic Resonance Imaging Mri

Sarcoidosis is a multisystem granulomatous disorder. Neurological manifestations as a presenting symptom are relatively rare. A 26-year-old male presented with a five-week history of headache suggestive of raised intracranial pressure. He subsequently developed transient episodes of mild right-sided hemiparesis and numbness. Magnetic resonance imaging (MRI) of brain revealed widespread inflammatory white matter lesions, an ischaemic focus in the left corona radiata, and widespread microhaemorrhages consistent with a more diffuse vasculopathy. Serum angiotensin-converting enzyme (ACE) level was normal. Lumbar puncture revealed an elevated opening pressure (36 cmH2O) and inflammatory cerebrospinal fluid (CSF). Computerised tomography (CT) of chest, abdomen, and pelvis revealed widespread lymphadenopathy and biopsy of axillary lymph nodes revealed the presence of noncaseating granulomata in keeping with systemic sarcoidosis. The patient responded well to corticosteroids. This case highlights the importance of considering sarcoidosis to be a rare but potentially treatable cause of stroke in younger patients.

Computer-Aided Detection and Diagnosis for 3D X-Ray Based Breast Imaging

2012 ◽  
pp. 66-85
Author(s):  
Gautam S. Muralidhar ◽  
Alan C. Bovik ◽  
Mia K. Markey
Keyword(s):  
Breast Imaging ◽  
Digital Breast Tomosynthesis ◽  
Future Research ◽  
Computer Aided Detection ◽  
Breast Tomosynthesis ◽  
X Ray ◽  
Computer Aided ◽  
Recent Developments ◽  
Initial Work ◽  
Detection And Diagnosis

The last 15 years has seen the advent of a variety of powerful 3D x-ray based breast imaging modalities such as digital breast tomosynthesis, digital breast computed tomography, and stereo mammography. These modalities promise to herald a new and exciting future for early detection and diagnosis of breast cancer. In this chapter, the authors review some of the recent developments in 3D x-ray based breast imaging. They also review some of the initial work in the area of computer-aided detection and diagnosis for 3D x-ray based breast imaging. The chapter concludes by discussing future research directions in 3D computer-aided detection.

scholarly journals The value of mammography in women with focal breast complaints in addition to initial targeted ultrasound

2020 ◽  
Author(s):  
L. Appelman ◽  
P. T. M. Appelman ◽  
C. C. N. Siebers ◽  
P. Bult ◽  
H. L. S. Go ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Imaging ◽  
Digital Breast Tomosynthesis ◽  
Breast Disease ◽  
Added Value ◽  
Breast Tomosynthesis ◽  
Targeted Ultrasound ◽  
Symptomatic Breast Cancer ◽  
Symptomatic Breast

Abstract Purpose To determine the added value of mammography in women with focal breast complaints and the utility of initial targeted ultrasound in this setting. Methods Women with symptomatic breast disease who were evaluated by breast imaging (mammography/digital breast tomosynthesis and ultrasound) between January 2016 and December 2016 in the Radboud University Medical Centre were included. We retrospectively collected the following data: date of birth, indication of imaging, visibility on mammography/ultrasound, whether biopsy was taken, additional findings, BI-RADS-classification, pathology and follow-up results. Results A total of 494 women were included (mean age 46.5, range 30 to 93). In 49 women (9.9%), symptomatic breast cancer was diagnosed, all visible during targeted ultrasound. The negative predictive value of targeted ultrasound was very high (99.8%). Additional findings on mammography were significantly more often malignant when the symptomatic lesion was also malignant (3.8% vs 70%, P < 0.05). In only one patient with symptoms caused by a benign finding, an incidental malignancy was detected on mammography outside the area of complaint (detection rate 2.2/1000 examinations). Conclusions The contribution of mammography for cancer detection in women with focal breast complaints is very low when targeted ultrasound is performed. Additional findings are most common in patients with symptomatic breast cancer. Our results suggest that initial targeted ultrasound is a more appropriate initial tool for the evaluation of focal breast complaints. Mammography could be performed on indication only.

Current Status of Breast Ultrasound

2011 ◽  
Vol 62 (1) ◽  
pp. 31-40 ◽  
Author(s):  
Anat Kornecki
Keyword(s):  
High Risk ◽  
Breast Imaging ◽  
Breast Ultrasound ◽  
Current Status ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Tumour Extension ◽  
The Status ◽  
High Risk Populations

Ultrasound (US) has a significant role in diagnostic breast imaging. It is most commonly used as an adjunctive test in characterizing lesions detected by other imaging modalities or by clinical examination. US is recognized as the modality of choice in the evaluation of women who are symptomatic and younger than 30 years of age, pregnant, or lactating. Combined mammography and US appear to have a role in screening high-risk populations. The use of standard Breast Imaging Reporting and Data System US lexicon is helpful in guiding the differentiation between benign and malignant sonographic signs. Biopsy is warranted when benign features are absent or for any feature consistent with malignancy, despite other benign findings. Whole breast and axillary US are useful in assessing tumour extension, multifocality, and the status of axillary lymph nodes. US is the modality of choice for guiding interventional breast procedures. The role of US as a guidance tool for nonoperative breast treatment is being investigated.

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