A retrospective comparison of contrast enhanced spectral mammography (CESM) to breast MRI in breast cancer detection: An initial study for sensitivity analysis.

2014 ◽  
Vol 32 (26_suppl) ◽  
pp. 7-7
Author(s):  
Luna Li ◽  
Kristin Brill ◽  
Pauline Germaine ◽  
Elizabeth Tinney ◽  
Karen Hendershott ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Detection ◽  
Small Sample Size ◽  
Statistical Significance ◽  
Small Sample ◽  
Breast Cancer Detection ◽  
Contrast Enhanced ◽  
Significant Difference ◽  
Mean Size ◽  
Index Cancer

7 Background: CESM is a new study using contrast and dual energy digital mammographic technology to detect contrast enhanced cancer that may be invisible on conventional mammogram. Limited studies have shown that adding CESM to diagnostic workup adjunct with mammogram and breast ultrasound does increase sensitivity for breast cancer detection. More studies are needed to compare the sensitivity of CESM to BMRI to further define the role of CESM in breast cancer diagnosis. Methods: This study involved 50 malignant breasts in 48 women retrospectively chosen from of 960 patients in our institution during the period of October 2012 to March 2014. Both CESM and BMRI were done for each patient within 30 days. The cancer diagnoses were confirmed by tissue diagnoses. The size of lesions was classified into three categories based on standard of breast cancer stages: 1 (0.2cm - < = 2 cm), 2 (2 cm < lesion < = 5 cm), 3 (> 5 cm). The enhancement intensity of both lesions and background has been quantified based on a scale of 0-3. Statistical significance was analyzed using T test for mean size of index cancer and mean score of enhancement intensity of background and lesions on CESM and BMRI. Sensitivity and positive predictive value (PPV) were calculated for both CESM and BMRI. Morphology consistence was calculated on both studies. Results: Both CESM and BMRI have sensitivity of 100% for breast cancer detection. CESM has a PPV of 98% versus 93% for BMRI. No statistical significance was identified on mean size of index cancer. The enhancement intensity of background and lesions is significantly higher on CESM than on BMRI (p < 0.01). The smallest cancer can be detected by both CESM and BMRI is less than 0.5 cm. Morphology consistence was 46/50 (92%). Conclusions: Our study indicates that CESM and BMRI have comparable high sensitivity on breast cancer detection. CESM has a higher PPV than BMRI that may indicate a better specificity (no significant difference due to the small sample size). Significantly less background enhancement intensity on CESM than on BMRI reflect an increased specificity. More studies need to be conducted for further evaluation.

scholarly journals The Performance Comparison of a Dual-Ridge Horn Antenna and a Planar Monopole Antenna in the Microwave Breast Cancer Detection

2020 ◽  
Vol 9 (2) ◽  
pp. 84-92
Author(s):  
A. R. Celik ◽  
M. B. Kurt
Keyword(s):  
Breast Cancer ◽  
Dielectric Constant ◽  
Cancer Detection ◽  
Breast Cancer Detection ◽  
Monopole Antenna ◽  
Ultra Wideband ◽  
Microwave Measurement ◽  
Significant Difference ◽  
Planar Monopole Antenna ◽  
Microwave Breast Cancer Detection

Detection of the breast cancer tumors at an early stage is very crucial to be successful in the treatment. Microwave measurement systems have gained much attention for this aim over last decades. The main principle of these systems is based on the significant difference in the dielectric properties of the malignant tumor and normal breast tissue in the microwave frequencies. In this paper, firstly several breast cancer detection techniques are mentioned. Then the advantages of the using microwaves in the detection systems are given. After that, some simulation and experimental studies of the radar-based ultra-wideband microwave measurement system are presented to detect tumor. The main purposes of these measurements are comparing the performance of a previously designed planar monopole antenna (PMA) with a dual-ridge horn (DRH) antenna and demonstrating a simple microwave breast cancer detection system. In the system, a planar breast phantom which is consisted of low dielectric constant material to represent the healthy tissue and high dielectric constant material to represent the tumor is used. Firstly, the measurements are made without tumor in the phantom. Then, the tumor-mimicking object is located to the phantom. In the measurements, both the PMA and DRH antennas are used respectively. These antennas are ultra-wideband and directional. They have narrow beamwidth and stable directional pattern at the interval of 3-10 GHz. According to the return loss results, the reflected energy increases when the antenna gets close to the tumor. Therefore, it can be said that the scattering parameters give important information about the tumor. According to the obtained results in this study, it can be said that the performance of the compact-sized PMA is better than the DRH antenna having larger size.

scholarly journals Diagnostic accuracy of contrast-enhanced digital mammography in breast cancer detection in comparison to tomosynthesis, synthetic 2D mammography and tomosynthesis combined with ultrasound in women with dense breast

2020 ◽  
pp. 20201046
Author(s):  
Rashmi Sudhir ◽  
Kamala Sannapareddy ◽  
Alekya Potlapalli ◽  
Pooja Boggaram Krishnamurthy ◽  
Suryakala Buddha ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Detection ◽  
Digital Mammography ◽  
Characteristic Curve ◽  
Breast Cancer Detection ◽  
Dense Breast ◽  
Breast Clinic ◽  
Data Set ◽  
Iodinated Contrast ◽  
Contrast Enhanced

Objective: To assess the diagnostic efficacy of contrast-enhanced digital mammography (CEDM) in breast cancer detection in comparison to synthetic two-dimensional mammography (s2D MG), digital breast tomosynthesis (DBT) alone and DBT supplemented with ultrasound examination in females with dense breast with histopathology as the gold-standard. Methods: It was a prospective study, where consecutive females presenting to symptomatic breast clinic between April 2019 and June 2020 were evaluated with DBT. Females who were found to have heterogeneously dense (ACR type C) or extremely dense (ACR type D) breast composition detected on s2D MG were further evaluated with high-resolution breast ultrasound and thereafter with CEDM, but before the core biopsy or surgical excision, were included in the study. s2D MG was derived from post-processing reconstruction of DBT data set. Females with pregnancy, renal insufficiency or prior allergic reaction to iodinated contrast agent were excluded from the study. Image interpretation was done by two experienced breast radiologists and both were blinded to histological diagnosis. Results: This study included 166 breast lesions in130 patients with mean age of 45 ± 12 years (age range 24–72 years). There were 87 (52.4%) malignant and 79 (47.6%) benign lesions. The sensitivity of CEDM was 96.5%, significantly higher than synthetic 2D MG (75.6%, p < 0.0001), DBT alone (82.8%, p < 0.0001) and DBT + ultrasound (88.5%, p = 0.0057); specificity of CEDM was 81%, significantly higher than s2D MG (63.3%, p = 0.0002) and comparable to DBT alone (84.4%, p = 0.3586) and DBT + ultrasound (79.7%, p = 0.4135). In receiver operating characteristic curve analysis, the area under the curve was of 0.896 for CEDM, 0.841 for DBT + ultrasound, 0.769 for DBT alone and 0.729 for s2D MG. Conclusion: CEDM is an accurate diagnostic technique for cancer detection in dense breast. CEDM allowed a significantly higher number of breast cancer detection than the s2D MG, DBT alone and DBT supplemented with ultrasonography in females with dense breast. Advances in knowledge: CEDM is a promising novel technology with higher sensitivity and negative predictive value for breast cancer detection in females with dense breast in comparison to DBT alone or DBT supplemented with ultrasound.

Association of losartan use with outcomes in metastatic pancreatic cancer patients treated with chemotherapy.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16738-e16738
Author(s):  
Jessica Allen ◽  
Kathan Mehta ◽  
Shrikant Anant ◽  
Prasad Dandawate ◽  
Anwaar Saeed ◽  
...  
Keyword(s):  
Small Sample Size ◽  
Metastatic Cancer ◽  
Statistical Significance ◽  
Objective Response ◽  
Locally Advanced ◽  
Small Sample ◽  
Ductal Adenocarcinoma ◽  
Control Group ◽  
100Mg Dose ◽  
Significant Difference

e16738 Background: A phase II trial has shown improved efficacy of neoadjuvant therapy when combined with losartan (by remodeling desmoplasia) in locally advanced pancreatic ductal adenocarcinoma (PDA). However, role of losartan is unknown in metastatic PDA. We examined the relationship between the use of the angiotensin II receptor antagonist, losartan, at time of diagnosis with clinical outcomes in metastatic PDA pts that received chemo. Methods: We retrospectively evaluated 114 metastatic PDA pts treated at our center between Jan 2000 and Nov 2019. We compared OS, PFS, objective response rate (ORR), and disease control rate (DCR) between pts using losartan at time of cancer diagnosis and a control group of pts not on losartan. A subanalysis was performed based on losartan dose: 100mg dose versus control pts. and based on chemo: FOLFIRINOX or gemcitabine+abraxane. Results: Table shows baseline demographics. No significant difference was found in OS [p = 0.455] or PFS [p = 0.919] in pts on losartan (median 274d, 83d) vs control (median 279d, 111d) [p = 0.466]. No significant difference was found in ORR [p = 0.621] or in DCR [p = 0.497]. No significant difference was found in OS [p = 0.771] or PFS [p = 0.064] in losartan pts (median 347d, 350d) vs control (median 333d, 101d) treated with FOLFIRINOX. No significant difference was found in OS [p = 0.916] or PFS [p = 0.341] in losartan (median 312d, 69d) vs control (median 221d, 136d) [p = 0.916] treated with gemcitabine+abraxane. No significant difference was found in OS [p = 0.727] or PFS [p = 0.790] in 100mg losartan pts (median 261d, 84d) vs control (median 279d, 111d). Conclusions: Pts on losartan at time of diagnosis had no significant difference in OS, PFS, ORR, DCR than control pts. However, a subanalysis of pts treated with FOLFIRINOX revealed a longer PFS with losartan than control but did not meet statistical significance, likely due to small sample size. To confirm if the benefit of losartan + FOLFIRINOX seen in neoadjuvant setting for locally advanced cancer also applies to metastatic cancer, our findings need to be validated in a larger cohort. [Table: see text]

Outcomes of metastatic synovial sarcoma with doxorubicin, pazopanib, and ifosfamide therapy.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e23552-e23552
Author(s):  
Priscila Barreto Coelho ◽  
Philippos Apolinario Costa ◽  
Andrea P. Espejo Freire ◽  
Deukwoo Kwon ◽  
Emily Jonczak ◽  
...  
Keyword(s):  
Synovial Sarcoma ◽  
Metastatic Disease ◽  
Small Sample Size ◽  
Statistical Significance ◽  
Small Sample ◽  
Rank Test ◽  
High Dose ◽  
Entire Cohort ◽  
Significant Difference ◽  
Localized Disease

e23552 Background: Synovial sarcoma (SS) accounts for 5-10% of all soft tissue sarcoma. SS are aggressive tumors with a median 5-year survival of 60-70% when localized disease but also a propensity for metastatic spread with 40-45% of patients developing metastasis within 5 years. It is considered a chemotherapy-sensitive sarcoma and treatment options are increasing. Herein, we present the outcomes of SS patients by systemic regimen and multimodality approach. Methods: This is a single institution, retrospective cohort of 79 patients with histopathologically confirmed SS treated at from 2004 to 2019. Clinical characteristics, treatment, response and survival were analyzed. We estimated medians of progression-free survival (PFS) and overall survival (OS) using the method of Kaplan-Meier along with the Log-Rank test. All tests were two-sided and statistical significance was considered when p<0.05. Results: Median follow-up was 3.7 years (range 3.13 to 4.33), 59.5% were women and median age at diagnosis was 41 (range 5-77). At presentation, 60 patients (75.9%) had localized disease and 19 (24.1%) presented with metastatic disease. Among the entire cohort the three-year OS rate was 78.9% (95%CI = 66.3-87.3) and five-year OS rate 68.7% (95%CI = 53.5-79.9). OS between localized disease (N = 45) and metastatic (N = 12) was not statistically significant (log-rank p = 0.098). When comparing different regimens, doxorubicin-based regimens (DBR) showed longest median PFS of 10.1 months (95%CI = 3.97-21.16), while pazopanib had a median PFS of 7.45 (95%CI = 2.63-12.3), high dose ifosfamide (HDI) 6.4 months (95%CI = 2.79-15.5) and trabectedin 3.12 months (95%CI = 0.99-6.97). Conversely, patients with metastatic disease treated with pazopanib experienced a median PFS of 11.47 months (95%CI = 2.63-32.9) while those treated with a DBR 8.15 months (95%CI = 1.08-35.8). Conclusions: SS is highly aggressive and, in our cohort, patients with local presentation had non-significant difference in OS to the metastatic disease, this could be due to a small sample size or the high probability for relapse this tumor has. Chemotherapy with DBRs showed superiority to other regimens and pazopanib showed to be slightly superior when evaluating only metastatic disease. Addition of pazopanib maintenance therapy may improve PFS and OS. Continuous evaluation of these patients with further inclusion of SS on immunotherapy is warranted.

scholarly journals CONTRAST ENHANCED BEAMFORMING FOR BREAST CANCER DETECTION

2011 ◽  
Vol 28 ◽  
pp. 219-234 ◽  
Author(s):  
Dallan Byrne ◽  
Martin O'Halloran ◽  
Martin Glavin ◽  
Edward Jones
Keyword(s):  
Breast Cancer ◽  
Cancer Detection ◽  
Breast Cancer Detection ◽  
Contrast Enhanced
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