scholarly journals Diagnostic accuracy of contrast-enhanced digital mammography in comparison with sonomammography for characterization of focal asymmetries

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Gelan Ali Mahmoud Soliman ◽  
Shaimaa Abdelsattar Mohammad ◽  
Mohamed El-Shinawi ◽  
Nermeen Nasry Keriakos
Keyword(s):  
Diagnostic Accuracy ◽  
Digital Mammography ◽  
Breast Imaging ◽  
Normal Tissue ◽  
Normal Breast ◽  
Ultrasound Evaluation ◽  
Contrast Enhanced ◽  
Malignant Lesions ◽  
Mass Enhancement

Abstract Background Mammographic focal asymmetry represents normal breast tissue, benign, or malignant lesions. Accurate characterization is important for better management. The study evaluates diagnostic accuracy of contrast-enhanced digital mammography (CEDM) for characterization of focal asymmetries seen in 2D mammography. Results The study was done prospectively on 38 females among 360 patients who underwent baseline sonomammographic assessment for diagnostic and screening purposes. Complementary ultrasound was performed only when a finding was detected in cases of screening mammograms. Focal asymmetries were evaluated according to Breast Imaging Reporting and Data System (BI-RADS) lexicon 2013. CEDM was performed and followed by ultrasound (US) guided core biopsy for solid lesions or aspiration for cystic lesions. CEDM processing resulted in recombined image showing enhancing abnormality. Low energy image and recombined image findings were analyzed blindly and classified into focus enhancement, mass enhancement, non-mass enhancement, and non-enhanced lesions. CEDM and sonomammography findings were compared regarding pathological probability and multiplicity. Histopathology was the reference standard. Mass enhancement showed strong correlation with malignant pathology. Non-mass enhancement showed no correlation with particular pathology. All non-enhanced focal asymmetries were benign in pathology or normal tissue. Rim enhancement needed second look ultrasound evaluation. CEDM was superior to sonomammography with higher sensitivity (77.8%, 65.7% respectively), NPV (0.8, 0.6), accuracy (0.6, 0.2) but lower specificity (81.8% vs. 100%). Multiplicity detection by CEDM was 26.3% and by sonomammography was 10.5%. Conclusion CEDM is more accurate than sonomammography in determination of normal tissue, benign, or malignant lesions in cases of mammographic focal asymmetry. CEDM is more accurate in detection of multiplicity. Undesired biopsies were avoidable with proper management of suspicious and malignant lesions.

scholarly journals Quantitative Analysis of the Time–Intensity Curve of Contrast-Enhanced Ultrasound of the Liver: Differentiation of Benign and Malignant Liver Lesions

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1244
Author(s):  
Sonja Schwarz ◽  
Dirk-André Clevert ◽  
Michael Ingrisch ◽  
Thomas Geyer ◽  
Vincent Schwarze ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Diagnostic Accuracy ◽  
Late Phase ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced ◽  
Malignant Lesions ◽  
Benign Liver ◽  
Benign Liver Lesions

Background: To evaluate the diagnostic accuracy of quantitative perfusion parameters in contrast-enhanced ultrasound to differentiate malignant from benign liver lesions. Methods: In this retrospective study 134 patients with a total of 139 focal liver lesions were included who underwent contrast enhanced ultrasound (CEUS) between 2008 and 2018. All examinations were performed by a single radiologist with more than 15 years of experience using a second-generation blood pool contrast agent. The standard of reference was histopathology (n = 60), MRI or CT (n = 75) or long-term CEUS follow up (n = 4). For post processing regions of interests were drawn both inside of target lesions and the liver background. Time–intensity curves were fitted to the CEUS DICOM dataset and the rise time (RT) of contrast enhancement until peak enhancement, and a late-phase ratio (LPR) of signal intensities within the lesion and the background tissue, were calculated and compared between malignant and benign liver lesion using Student’s t-test. Quantitative parameters were evaluated with respect to their diagnostic accuracy using receiver operator characteristic curves. Both features were then combined in a logistic regression model and the cumulated accuracy was assessed. Results: RT of benign lesions (14.8 ± 13.8 s, p = 0.005), and in a subgroup analysis, particular hemangiomas (23.4 ± 16.2 s, p < 0.001) differed significantly to malignant lesions (9.3 ± 3.8 s). The LPR was significantly different between benign (1.59 ± 1.59, p < 0.001) and malignant lesions (0.38 ± 0.23). Logistic regression analysis with RT and LPR combined showed a high diagnostic accuracy of quantitative CEUS parameters with areas under the curve of 0.923 (benign vs. malignant) and 0.929 (hemangioma vs. malignant. Conclusions: Quantified CEUS parameters are helpful to differentiate malignant from benign liver lesions, in particular in case of atypical hemangiomas.

Contrast-enhanced spectral mammography in patients with MRI contraindications

2017 ◽  
Vol 59 (7) ◽  
pp. 798-805 ◽  
Author(s):  
Vivien Richter ◽  
Valerie Hatterman ◽  
Heike Preibsch ◽  
Sonja D Bahrs ◽  
Markus Hahn ◽  
...  
Keyword(s):  
Problem Solving ◽  
Diagnostic Accuracy ◽  
Breast Imaging ◽  
Diagnostic Yield ◽  
Therapy Response ◽  
Lesion Size ◽  
Size Estimation ◽  
Imaging Data ◽  
Technical Problems ◽  
Contrast Enhanced

Background Contrast-enhanced spectral mammography (CESM) is a novel breast imaging technique providing comparable diagnostic accuracy to breast magnetic resonance imaging (MRI). Purpose To show that CESM in patients with MRI contraindications is feasible, accurate, and useful as a problem-solving tool, and to highlight its limitations. Material and Methods A total of 118 patients with MRI contraindications were examined by CESM. Histology was obtained in 94 lesions and used as gold standard for diagnostic accuracy calculations. Imaging data were reviewed retrospectively for feasibility, accuracy, and technical problems. The diagnostic yield of CESM as a problem-solving tool and for therapy response evaluation was reviewed separately. Results CESM was more accurate than mammography (MG) for lesion categorization (r = 0.731, P < 0.0001 vs. r = 0.279, P = 0.006) and for lesion size estimation (r = 0.738 vs. r = 0.689, P < 0.0001). Negative predictive value of CESM was significantly higher than of MG (85.71% vs. 30.77%, P < 0.0001). When used for problem-solving, CESM changed patient management in 2/8 (25%) cases. Superposition artifacts and timing problems affected diagnostic utility in 3/118 (2.5%) patients. Conclusion CESM is a feasible and accurate alternative for patients with MRI contraindications, but it is necessary to be aware of the method’s technical limitations.

Role of contrast-enhanced spectral mammography in the post biopsy management of B3 lesions: Preliminary results

2018 ◽  
Vol 105 (5) ◽  
pp. 378-387 ◽  
Author(s):  
Giulia Bicchierai ◽  
Jacopo Nori ◽  
Diego De Benedetto ◽  
Cecilia Boeri ◽  
Ermanno Vanzi ◽  
...  
Keyword(s):  
Breast Imaging ◽  
Surgical Excision ◽  
Surgical Biopsy ◽  
Predictive Values ◽  
Contrast Enhanced ◽  
B3 Lesions ◽  
Malignant Lesions ◽  
Sensitivity Specificity

PurposeTo evaluate the role of contrast-enhanced spectral mammography (CESM) in the post biopsy management of breast lesions classified as lesions of uncertain malignant potential (B3) by core needle biopsy and vacuum-assisted biopsy (VAB).MethodsThe local ethics committee approved this retrospective study and for this type of study formal consent is not required. A total of 42 B3 lesions in 40 women aged 41–77 years were included in our study. All patients underwent CESM 2–3 weeks after the biopsy procedure and surgical excision was subsequently performed within 60 days of the CESM procedure. Three radiologists reviewed the images independently. The results were then compared with histologic findings.ResultsThe sensitivity, specificity, and positive and negative predictive values for confirmed demonstration of malignancy at CESM were 33.3%, 87.2%, 16.7%, and 94.4% for reader 1; 66.7%, 76.9%, 18.2%, and 96.7% for reader 2; 66.7%, 74.4%, 16.7%, and 96.7% for reader 3. Overall agreement on detection of malignant lesions using CESM among readers ranged from moderate to substantial (κ = .451–.696), for categorization of BPE from moderate to substantial (κ = .562–.711), and for evaluation of lesion intensity enhancement from fair to moderate (κ = .346–.459).ConclusionIn cases of Breast Imaging Reporting and Data System (BI-RADS) 1, BI-RADS 2, or BI-RADS 3 results at CESM, follow-up or VAB rather than surgical biopsy might be performed.

scholarly journals Contrast-enhanced ultrasonography features of hepatobiliary neoplasms in cats

2019 ◽  
Vol 186 (10) ◽  
pp. 320-320 ◽  
Author(s):  
Tommaso Banzato ◽  
Silvia Burti ◽  
Giuseppe Rubini ◽  
Riccardo Orlandi ◽  
Paolo Bargellini ◽  
...  
Keyword(s):  
Bile Duct ◽  
Diagnostic Accuracy ◽  
Large Range ◽  
Liver Parenchyma ◽  
Qualitative And Quantitative ◽  
Hepatocellular Carcinomas ◽  
Contrast Enhanced ◽  
Contrast Enhanced Ultrasonography ◽  
Malignant Lesions

BackgroundContrast-enhanced ultrasonography (CEUS) features of primary hepatobiliary neoplasms have been reported in dogs but no information is available in cats.MethodsQualitative and quantitative features of bile duct adenomas (BDAs, n=20), bile duct carcinomas (BDCs, n=16), and hepatocellular carcinomas (HCCs, n=8) are described in 44 cats.ResultsThere was an overlap in CEUS qualitative features between different histotypes, both in wash-in and wash-out phases. Distinction between different neoplasms based only on the CEUS qualitative features was not possible. At peak of enhancement, the BDAs, BDCs and HCCs showed a large range of echogenicities, from hypoenhancement to hyperenhancement, in comparison to the liver parenchyma. Eight of 20 BDAs showed inhomogeneous hyperenhancement during wash-in, which is a feature reported as typical of malignant lesions in dogs. BDC had a significantly faster wash-in compared with both BDA and HCC but the diagnostic accuracy of all the included quantitative variables was only moderate. No significant differences in the wash-out quantitative features of BDA and BDC were evident.ConclusionThere is poor evidence that CEUS may be used to distinguish between different primary hepatobiliary neoplasms in cats.

scholarly journals 3–5 BI-RADs Microcalcifications: Correlation between MRI and Histological Findings

ISRN Oncology ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Valeria Fiaschetti ◽  
Chiara Adriana Pistolese ◽  
Tommaso Perretta ◽  
Elsa Cossu ◽  
Chiara Arganini ◽  
...  
Keyword(s):  
Predictive Value ◽  
Breast Imaging ◽  
Breast Mri ◽  
Data Systems ◽  
Mri Findings ◽  
Day Range ◽  
Contrast Enhanced ◽  
Malignant Lesions ◽  
Stereotactic Vacuum Assisted Biopsy ◽  
Sensitivity Specificity

Purpose. To evaluate the correlation between MRI and histopathological findings in patients with mammographically detected 3–5 BI-RAD (Breast Imaging Reporting And Data Systems) microcalcifications and to allow a better surgical planning. Materials and Method. 62 female Patients (age ) with screening detected 3–5 BI-RAD microcalcifications underwent dynamic 3 T contrast-enhanced breast MRI. After 30-day (range 24–36 days) period, 55 Patients underwent biopsy using stereotactic vacuum-assisted biopsy (VAB), 5 Patients underwent stereotactic mammographically guided biopsy, and 2 Patients underwent MRI-guided VAB. Results. Microhistology examination demonstrated 36 malignant lesions and 26 benign lesions. The analysis of MRI findings identified 8 cases of MRI BI-RADS 5, 23 cases of MRI BI-RADS 4, 11 cases of MRI BI-RADS 3, 4 cases type A and 7 cases type B, and 20 cases of MRI BI-RADS 1-2. MRI sensitivity, specificity, positive predictive value, and negative predictive value were 88.8%, 76.9%, 84.2%, and 83.3%, respectively.

scholarly journals Role of Dynamic Contrast Enhanced MRI in Characterization of Breast Lesions

2014 ◽  
Vol 4 (1) ◽  
pp. 23-33
Author(s):  
P Issar ◽  
SK Issar
Keyword(s):  
Benign Lesion ◽  
Breast Lesions ◽  
Type I ◽  
Type Ii ◽  
Type Iii ◽  
Dynamic Contrast Enhanced ◽  
Contrast Enhanced ◽  
Malignant Lesions

Purpose: To assess the role of Dynamic contrast enhanced magnetic resonance imaging in characterization of breast lesions and to differentiate benign from malignant lesions on the basis of their morphology and enhancement kinetics. Material and Methods: Sixty patients referred to the department of Radiodiagnosis for breast MRI over a period of twenty months were included. Dynamic contrast enhanced (DCE) Magnetic Resonance Imaging (MRI) was performed to differentiate breast lesions on the basis of morphology and enhancement kinetics. The lesions were classified accordingly into type I (progressive enhancement) Type II (plateau) and Type III (washout) kinetics. Morphology and curves of benign and malignant lesions were compared. Result: fifty one benign lesions were detected in 32 patients and 29 malignant lesions were seen in 22 patients, whereas six patients showed normal MRI. It was found that benign lesion were round or oval in shape with well circumscribed margin and showed homogenous contrast enhancement whereas malignant lesions were irregular with spiculated margin and showed heterogenous contrast enhancement. The distribution curve types of benign lesion were Type I (81.25%-26cases), Type II (18.25%-6cases). For malignant lesions Type I (4.54%-1case), Type II (22.72%-5cases) and Type III (72.72%-16cases). Conclusion: The shape of the time- signal intensity curve were an important criteria in differentiating benign from malignant lesions in dynamic breast MR imaging. A type III time curve is a strong indicator of malignancy and is independent of other criteria. DOI: http://dx.doi.org/10.3126/njr.v4i1.11366 Nepalese Journal of Radiology, Vol.4(1) 2014: 23-33

scholarly journals Limited role of DWI with apparent diffusion coefficient mapping in breast lesions presenting as non-mass enhancement on dynamic contrast-enhanced MRI

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Daly Avendano ◽  
Maria Adele Marino ◽  
Doris Leithner ◽  
Sunitha Thakur ◽  
Blanca Bernard-Davila ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Roc Curves ◽  
Breast Cancer Diagnosis ◽  
Breast Lesions ◽  
Mri Findings ◽  
Adc Value ◽  
Dce Mri ◽  
Dynamic Contrast Enhanced ◽  
Contrast Enhanced ◽  
Mass Enhancement

Abstract Background Available data proving the value of DWI for breast cancer diagnosis is mainly for enhancing masses; DWI may be less sensitive and specific in non-mass enhancement (NME) lesions. The objective of this study was to assess the diagnostic accuracy of DWI using different ROI measurement approaches and ADC metrics in breast lesions presenting as NME lesions on dynamic contrast-enhanced (DCE) MRI. Methods In this retrospective study, 95 patients who underwent multiparametric MRI with DCE and DWI from September 2007 to July 2013 and who were diagnosed with a suspicious NME (BI-RADS 4/5) were included. Twenty-nine patients were excluded for lesion non-visibility on DWI (n = 24: 12 benign and 12 malignant) and poor DWI quality (n = 5: 1 benign and 4 malignant). Two readers independently assessed DWI and DCE-MRI findings in two separate randomized readings using different ADC metrics and ROI approaches. NME lesions were classified as either benign (> 1.3 × 10−3 mm2/s) or malignant (≤ 1.3 × 10−3 mm2/s). Histopathology was the standard of reference. ROC curves were plotted, and AUCs were determined. Concordance correlation coefficient (CCC) was measured. Results There were 39 malignant (59%) and 27 benign (41%) lesions in 66 (65 women, 1 man) patients (mean age, 51.8 years). The mean ADC value of the darkest part of the tumor (Dptu) achieved the highest diagnostic accuracy, with AUCs of up to 0.71. Inter-reader agreement was highest with Dptu ADC max (CCC 0.42) and lowest with the point tumor (Ptu) ADC min (CCC = − 0.01). Intra-reader agreement was highest with Wtu ADC mean (CCC = 0.44 for reader 1, 0.41 for reader 2), but this was not associated with the highest diagnostic accuracy. Conclusions Diagnostic accuracy of DWI with ADC mapping is limited in NME lesions. Thirty-one percent of lesions presenting as NME on DCE-MRI could not be evaluated with DWI, and therefore, DCE-MRI remains indispensable. Best results were achieved using Dptu 2D ROI measurement and ADC mean.

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