scholarly journals Three-dimensional tomosynthesis versus two-dimensional mammography in detection and characterization of different breast lesions

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Samia Aboelnour Abdeltwab Abdelattef ◽  
Suzan Farouk Ibrahim ◽  
Wafaa Raft Abdelhamid ◽  
Fatten Mohamed Mahmoud
Keyword(s):  
Breast Cancer ◽  
Three Dimensional ◽  
Digital Breast Tomosynthesis ◽  
Final Diagnosis ◽  
Recall Rate ◽  
Architectural Distortion ◽  
Breast Lesions ◽  
Predictive Values ◽  
Sensitivity Specificity

Abstract Background Breast cancer is considered the most serious lesion among different breast lesions. Mammography is the corner stone for screening for detection of breast cancer. It has been modified to digital mammography (DM) and then to digital breast tomosynthesis (DBT). Tomosynthesis is an emerging technique for diagnosis and screening of breast lesions. The aim of this study is to interrogate whether the addition of DBT to DM helps in better detection and characterization of different breast lesions. Methods This is a prospective study carried on 38 female patients according to our inclusion criteria. All patients were evaluated by using DM alone and thereafter with the addition of DBT to DM. Recall rate was calculated, and the imaging findings of each case were correlated with the final diagnosis and follow-up. Results DM identified 32 lesions while DBT with DM identified 37 lesions. On DM alone, 17 lesions were characterized as masses, 5 as focal asymmetry, 2 as architectural distortion, 7 as microcalcification and 1 as macrocalcification. With the addition of DBT, 27 lesions were characterized as masses, 1 as focal asymmetry, 1 as architectural distortion, 7 as microcalcification and 1 as macrocalcification. So, there were better detection and characterization of lesions with the addition of DBT than DM alone. The sensitivity, specificity, AUC, positive and negative predictive values were significantly higher with the addition of DBT to DM (100%, 90.5%, 0.952, 90% and 100%, respectively) than with DM (77.8%, 80.9%, 0.794, 77.8% and 80.9%, respectively) for all breast lesions. Conclusions The addition of DBT to DM helps in better detection and characterization of different breast lesions. This leads to early detection of breast cancer, improvement of the performance of radiologists and saving time by reduction of recall rate.

scholarly journals Diagnostic accuracy of digital breast tomosynthesis in combination with 2D mammography for the characterisation of mammographic abnormalities

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Vithya Visalatchi Sanmugasiva ◽  
Marlina Tanty Ramli Hamid ◽  
Farhana Fadzli ◽  
Faizatul Izza Rozalli ◽  
Chai Hong Yeong ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Breast Imaging ◽  
Digital Breast Tomosynthesis ◽  
Asian Population ◽  
Architectural Distortion ◽  
Breast Lesions ◽  
Cross Sectional ◽  
Breast Tomosynthesis ◽  
Full Field

AbstractThis study aims to assess the diagnostic accuracy of digital breast tomosynthesis in combination with full field digital mammography (DBT + FFDM) in the charaterisation of Breast Imaging-reporting and Data System (BI-RADS) category 3, 4 and 5 lesions. Retrospective cross-sectional study of 390 patients with BI-RADS 3, 4 and 5 mammography with available histopathology examination results were recruited from in a single center of a multi-ethnic Asian population. 2 readers independently reported the FFDM and DBT images and classified lesions detected (mass, calcifications, asymmetric density and architectural distortion) based on American College of Radiology-BI-RADS lexicon. Of the 390 patients recruited, 182 malignancies were reported. Positive predictive value (PPV) of cancer was 46.7%. The PPV in BI-RADS 4a, 4b, 4c and 5 were 6.0%, 38.3%, 68.9%, and 93.1%, respectively. Among all the cancers, 76% presented as masses, 4% as calcifications and 20% as asymmetry. An additional of 4% of cancers were detected on ultrasound. The sensitivity, specificity, PPV and NPV of mass lesions detected on DBT + FFDM were 93.8%, 85.1%, 88.8% and 91.5%, respectively. The PPV for calcification is 61.6% and asymmetry is 60.7%. 81.6% of cancer detected were invasive and 13.3% were in-situ type. Our study showed that DBT is proven to be an effective tool in the diagnosis and characterization of breast lesions and supports the current body of literature that states that integrating DBT to FFDM allows good characterization of breast lesions and accurate diagnosis of cancer.

scholarly journals Role of Tomosynthesis with correlation to 2D Mammography in characterization of breast lesions in dense breast

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A M Elshibiny ◽  
M E Abdelrahman ◽  
L M Abdelrahman
Keyword(s):  
Digital Mammography ◽  
New Technology ◽  
Malignant Lesion ◽  
Three Dimensional ◽  
Digital Breast Tomosynthesis ◽  
Individual Performance ◽  
Dense Breast ◽  
P Value ◽  
Breast Lesions

Abstract Background Digital Breast Tomosythesis is a new technology of digital mammography that enables the acquisition of three dimensional volume of thin section data, and thus reduces or eliminates tissue overlap especially in dense breast, such ability allow visualization of cancers not apparent by digital mammography and differentiate between benign and malignant lesion. Objectives to compare the efficacy of digital breast Tomosynthesis (BDT) to digital Mammography (DM) in diagnosis of different breast lesions in dense breast. Patients and Method in this prospective study 30 patients with breast density ACR/C and ACR/D were assessed by Digital Mammography and Digital Breast Tomsynthesis. Each lesion was assigned a blinded category in an individual performance for each modality. The resultant BI-RADS categories were correlated with report of the pathology specimens or outcome follow up. Results Both modalities were compared regarding characterization, using Chi Square test (p value:0.035).The sensitivity, specificity and accuracy of digital mammography was 62.5%, 68.75% and 66% have significantly increase with tomosynthesis to be 100%,91% and 97% respectively. Conclusion Digital breast tomosythesis significantly enhanced characterization of breast lesions than digital mammography in dense breast parenchyma (ACR/C and ACR/D).

scholarly journals Evaluation of Cystic and Solid Renal Lesions with Contrast-Enhanced Ultrasound: A Retrospective Study

2021 ◽  
Vol 07 (01) ◽  
pp. E25-E34
Author(s):  
Arash Najafi ◽  
Michael Wildt ◽  
Nicolin Hainc ◽  
Joachim Hohmann
Keyword(s):  
Final Diagnosis ◽  
Cystic Lesions ◽  
Likelihood Ratios ◽  
Renal Lesions ◽  
Contrast Enhanced ◽  
Potentially Malignant ◽  
Sensitivity Specificity ◽  
Solid Lesions ◽  
Conclusive Diagnosis

Abstract Purpose Renal lesions are frequent random findings on CT, MRI, and conventional ultrasound. Since they are usually found accidentally, the respective examinations have not been performed optimally to provide a conclusive diagnosis, making additional multiphase contrast-enhanced examinations necessary. The aim of the study is to correlate CEUS findings with the final diagnosis and to determine whether it is a suitable method for the conclusive characterization of undetermined renal lesions. Materials and Methods All CEUS examinations of focal renal lesions performed at our institute between 2007 and 2014 were retrospectively examined. 437 patients with a total of 491 lesions and 543 examinations were included. 54 patients had bilateral lesions. One patient had three lesions in one kidney. Histology was available in 49 cases and follow-ups in 124 cases. The sensitivity, specificity, positive and negative predictive value as well as positive and negative likelihood ratios were calculated. Results There were 54 malignant and 437 benign lesions. The sensitivity and specificity were 0.981/0.954 overall, 1.000/0.956 for cystic lesions, 0.977/0.906 for solid lesions, and 0.971/0.071 for the histologically confirmed lesions. Bosniak classification was consistent in 289 of 301 lesions (96%). Only 12 lesions (3.9%) were falsely assessed as malignant. Conclusion CEUS is an appropriate method for the clarification of undetermined renal lesions. The characterization of cystic lesions according to Bosniak is adequately possible, especially for potentially malignant lesions (types III and IV).

Serum HER-2: sensitivity, specificity, and predictive values for detecting metastatic recurrence in breast cancer patients

2013 ◽  
Vol 139 (6) ◽  
pp. 1005-1013 ◽  
Author(s):  
Patricia Diana Sørensen ◽  
Erik Hugger Jakobsen ◽  
Jonna Skov Madsen ◽  
Eva Brix Petersen ◽  
Rikke Fredslund Andersen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Predictive Values ◽  
Metastatic Recurrence ◽  
Her 2 ◽  
Sensitivity Specificity

scholarly journals The diagnosis of delirium in 80 emergency unit patients

1998 ◽  
Vol 56 (2) ◽  
pp. 176-183
Author(s):  
AFONSO CARLOS NEVES ◽  
RICARDO DE CASTRO CINTRA SESSO ◽  
HENRIQUE BALLALAI FERRAZ ◽  
SÍLVIO FRANCISCO ◽  
JOÃO BAPTISTA DOS REIS-FILHO
Keyword(s):  
Correct Diagnosis ◽  
Diagnostic Testing ◽  
Final Diagnosis ◽  
Initial Diagnosis ◽  
University Hospital ◽  
Emergency Unit ◽  
Predictive Values ◽  
Kappa Test ◽  
History Of ◽  
Sensitivity Specificity

We evaluated the initial and final diagnosis of 80 patients with delirium arriving at the emergence unit of a university hospital in a large Brazilian city over a period of 30 months up to December 1991. The diagnosis was based on the DSM-IIIR criteria. Patients with a known history of head trauma or epileptic seizure and patients younger than 13 years were excluded. Only patients with a disease of up to 7 days were included.The patients were subdivided into four etiologic groups: vascular; associated with the use of alcohol; infectious-parasitic; miscellaneous.The results showed a rate of correct diagnosis ranging from 65 to 80% with the use of kappa test (standard good to excelent). Sensitivity, specificity, positive predictive and negative predictive values had results showing different conditions for initial diagnosis in each group. This study can help the initial diagnosis of delirium and the choice for diagnostic testing.

scholarly journals Tecnica di Imaging tridimensionale (Digital Breast Tomosynthesis) per la diagnosi del tumore alla mammella

2019 ◽  
Author(s):  
Di Guida Lisa ◽  
De Rosa Salvatore
Keyword(s):  
Breast Cancer ◽  
Early Diagnosis ◽  
Imaging Techniques ◽  
Three Dimensional ◽  
Digital Breast Tomosynthesis ◽  
Recurrence Time ◽  
Digital Tomosynthesis ◽  
Breast Tomosynthesis ◽  
X Ray Imaging ◽  
Projective Image

Breast cancer affects one in eight women over a lifetime. It is the most common cancer in women and represents 29% of all cancers affecting women, with a mortality rate of 17% of all deaths due to cancer on women. Sooner the cancer is identified with an early diagnosis, higher are the possibilities to treat it completely and longer is the recurrence time. Mammography is the most common method for early diagnosis. is a two-dimensional X-ray imaging technique and this involves the overlapping of the tissues in the projective image inability to visualize cancer in the first stage. In recent years, three-dimensional imaging techniques have been introduced, including digital tomosynthesis for the diagnosis of breast cancer, this technique has the advantages to perform dozens of projections, and not just one, from various angular views around the compressed breast. The major benefits of tomosynthesis are a lower stratification of breast tissues, better visibility of tumor masses especially for small tumors, breast tomosynthesis provides the ability to visualize 3D images to obtain a more accurated evaluation of lesions allowing better differentiation between overlapping fabrics.

scholarly journals Strain Elastography: A Valuable Additional Method to BI-RADS?

2018 ◽  
Vol 39 (05) ◽  
pp. 526-534 ◽  
Author(s):  
Xin-Bao Zhao ◽  
Ji-Yi Yao ◽  
Xin Zhou ◽  
Shao-Yun Hao ◽  
Wen Mu ◽  
...  
Keyword(s):  
Classification System ◽  
Diagnostic Performance ◽  
Final Analysis ◽  
Daily Practice ◽  
Strain Ratio ◽  
Final Diagnosis ◽  
Ratio Method ◽  
Breast Lesions ◽  
Sensitivity Specificity ◽  
Histological Results

Abstract Background Breast lesions classified as BI-RADS-US 3 are probably benign and observation was recommended, while a considerable number of BI-RADS-US 4 lesions were benign, resulting in excessive biopsies. We focus exclusively on BI-RADS-US 3 and 4 lesions and hypothesize that improved diagnostic performance can be achieved by integrating real-time elastography (strain ratio) into the BI-RADS-US classification system. Method From April 2010 to September 2015, 1071 lesions were included in the final analysis. After the conventional ultrasound examination, the BI-RADS-US (2013) classification was used to evaluate the lesions. Then the strain ratios were calculated, and the final diagnosis was made on the basis of histological results. The sensitivity, specificity, accuracy, PPV and NPV were calculated and the AUCs were compared. Additionally, an analysis of the diagnostic performance expressed by the pretest and posttest probability of disease (POD) was performed in BI-RADS-US 3 and 4A lesions. Results With the cutoff point of 2.98, the sensitivity, specificity and accuracy of the strain ratio method were 86.9 %, 86.6 % and 82.6 %, respectively. In BI-RADS-US 3 lesions, a suspicious strain ratio significantly modified the POD from 1.3 % to a posttest POD of 29.8 %. In BI-RADS-US 4A lesions, a suspicious strain ratio significantly modified the POD from 8.5 % to a posttest POD of 48.7 %. Conclusion Ultrasonographic elastography (strain ratio) yields additional diagnostic information in the evaluation of BI-RADS-US 3 and 4 breast lesions. The strain ratios should be integrated into the BI-RADS-US classification system and into daily practice.

Sacroiliac joint injections with the guidance of three-dimensional cone beam computerized tomography (3D-CBCT) and fluoroscopy fusion

2020 ◽  
pp. neurintsurg-2020-016212
Author(s):  
Nisa Cem Oren ◽  
Saad Ali ◽  
James Mok ◽  
Zheng Feng Lu ◽  
Seon-Kyu Lee
Keyword(s):  
Real Time ◽  
Sacroiliac Joint ◽  
False Positive Rate ◽  
Three Dimensional ◽  
Final Diagnosis ◽  
Symptomatic Improvement ◽  
Cone Beam ◽  
Injection Technique ◽  
Dimensional Cone ◽  
Sensitivity Specificity

BackgroundWe describe our diagnostic sacroiliac joint (SIJ) injection technique under the guidance of three-dimensional cone beam computed tomography (3D-CBCT) fused with real-time fluoroscopy.MethodsA retrospective review of 17 patients (mean age 55.4 (range 40–74) years) who received a total of 23 diagnostic SIJ injections between March 2016 and November 2017 were performed. Pre- and post-procedure pain scores were reviewed from the medical records and then these findings were correlated with which patients were and were not diagnosed with SIJ pain by clinical management. The final diagnosis of SIJ-related pain was made in cases with at least 50% symptomatic improvement following SIJ-specific pain treatments.ResultsSome 87% (n=20/23) of injections achieved more than 50% pain relief after the diagnostic SIJ injection. The final diagnosis of the target SIJ-related pain after follow-up and management was found in 90% (n=18/20) of cases. There were two cases with positive tests diagnosed as non-SIJ pain including one with the diagnosis of femuroacetabular impingement and one with pain related to loosening of knee hardware. The sensitivity, specificity, positive predictive value, and negative predicative value of diagnostic SIJ injections were 100%, 60%, 89%, and 100%, respectively, with a 40% false-positive rate. There were no procedure-related complications.Conclusion3D-CBCT fused with real-time fluoroscopy for SIJ injection is accurate and safe.

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