Ultrasound Molecular Imaging With BR55 in Patients With Breast and Ovarian Lesions: First-in-Human Results

Purpose We performed a first-in-human clinical trial on ultrasound molecular imaging (USMI) in patients with breast and ovarian lesions using a clinical-grade contrast agent (kinase insert domain receptor [KDR] –targeted contrast microbubble [MBKDR]) that is targeted at the KDR, one of the key regulators of neoangiogenesis in cancer. The aim of this study was to assess whether USMI using MBKDR is safe and allows assessment of KDR expression using immunohistochemistry (IHC) as the gold standard. Methods Twenty-four women (age 48 to 79 years) with focal ovarian lesions and 21 women (age 34 to 66 years) with focal breast lesions were injected intravenously with MBKDR (0.03 to 0.08 mL/kg of body weight), and USMI of the lesions was performed starting 5 minutes after injection up to 29 minutes. Blood pressure, ECG, oxygen levels, heart rate, CBC, and metabolic panel were obtained before and after MBKDR administration. Persistent focal MBKDR binding on USMI was assessed. Patients underwent surgical resection of the target lesions, and tissues were stained for CD31 and KDR by IHC. Results USMI with MBKDR was well tolerated by all patients without safety concerns. Among the 40 patients included in the analysis, KDR expression on IHC matched well with imaging signal on USMI in 93% of breast and 85% of ovarian malignant lesions. Strong KDR-targeted USMI signal was present in 77% of malignant ovarian lesions, with no targeted signal seen in 78% of benign ovarian lesions. Similarly, strong targeted signal was seen in 93% of malignant breast lesions with no targeted signal present in 67% of benign breast lesions. Conclusion USMI with MBKDR is clinically feasible and safe, and KDR-targeted USMI signal matches well with KDR expression on IHC. This study lays the foundation for a new field of clinical USMI in cancer.

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201Tl Scintigraphy in the Evaluation of Palpable and Nonpalpable Breast Lesions: Correlation with Mammography and Ultrasonography

Nuklearmedizin ◽

10.1055/s-0038-1629848 ◽

1997 ◽

Vol 36 (08) ◽

pp. 282-288 ◽

Cited By ~ 8

Author(s):

T. Atasever ◽

A. Özdemir ◽

I. Öznur ◽

N. I. Karabacak ◽

N. Gökçora ◽

...

Keyword(s):

Final Diagnosis ◽

Lower Sensitivity ◽

Breast Lesions ◽

Breast Cancers ◽

Combined Use ◽

Malignant Breast ◽

Malignant Lesions ◽

Benign Breast Lesions ◽

Palpable Breast ◽

Metastatic Sites

Summary Aim: Our goal was to determine the clinical usefulness of TI-201 to identify breast cancer in patients with suspicious breast lesions on clinical examination, and/or abnormal radiologic (mammography and/or ultrasonography) findings. Methods: TI-201 scintigraphy were performed in sixty-eight patients with 70 breast abnormalities (51 palpable, 19 nonpalpable) and compared with mammography and ultrasonography (US). Early (15 min) and late (3 h) images of the breasts were obtained following the injection of 111 MBq (3 mCi) of TI-201. Visual and semiquantitative interpretation was performed. Results: Final diagnosis confirmed 52 malignant breast lesions and 18 benign conditions. TI-201 visualized 47 of 52 (90%) overall malignant lesions. Thirty-eight of 40 (95%) palpable and 9 of 12 (75%) nonpalpable breast cancers were detected by TI-201 scintigraphy. The smallest mass lesion detected by TI-201 measured 1.5x1.0 cm. Eleven breast lesions were interpreted as indeterminate by mammography and/or sonography. TI-201 scintigraphy excluded malignancy in 7 of 8 (88%) patients with benign breast lesions interpreted as indeterminate. Five of the 18 (28%) benign breast lesions showed TI-201 uptake. None of the fibroadenoma and fibrocystic changes accumulated TI-201. TI-201 scintigraphy, mammography and ultrasonography showed 90%, 92%, 85% overall sensitivity and 72%, 56%, 61% overall specificity respectively. Twenty-one of the 28 (75%) axillary nodal metastatic sites were also detected by TI-201. In malignant and benign lesions, early and late lesion/contralateral normal side (L/N) ratios were 1.58 ± 0.38 (mean ± SD) and 1.48 ± 0.32 (p >0.05), 1.87 ± 0.65 and 1.34 ± 0.20 (p<0.05) respectively. The mean early and late L/N ratios of malignant and benign groups did not show statistical difference (p>0.05). Conclusion: Overall, TI-201 scintigraphy was the most specific of the three methods and yielded favourable results in palpable breast cancers, while it showed lower sensitivity in nonpalpable cancers and axillary metastases. Combined use of TI-201 scintigraphy with mammography and US seems to be useful in difficult cases, such as dense breasts and indeterminate breast lesions.

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Role of quantitative analysis of T2 relaxation time in differentiating benign from malignant breast lesions

Journal of International Medical Research ◽

10.1177/0300060517721071 ◽

2018 ◽

Vol 46 (5) ◽

pp. 1928-1935 ◽

Cited By ~ 11

Author(s):

Li Liu ◽

Bo Yin ◽

Kawai Shek ◽

Daoying Geng ◽

Yiping Lu ◽

...

Keyword(s):

Breast Cancer ◽

Relaxation Time ◽

Quantitative Analysis ◽

Breast Lesions ◽

T2 Relaxation Time ◽

T2 Relaxation ◽

Malignant Breast ◽

Mri Diagnosis ◽

Malignant Lesions

Objective To investigate the role of quantitative analysis of T2 relaxation time in the magnetic resonance imaging (MRI) diagnosis of breast cancer. Methods The study enrolled patients with clinical breast masses who were examined using MRI at eight different echo times. The differences in T2 relaxation time of benign and malignant breast lesions were analysed. Results A total of 67 patients (67 breast lesions: 46 malignant, 21 benign) were examined. The mean ± SD T2 relaxation time was significantly lower in the 46 malignant lesions compared with the 21 benign lesions (82.69 ± 15.37 ms versus 95.48 ± 26.51 ms, respectively). The area under the curve was 0.731. Using 79.52 ms as the cut-off between benign and malignant breast lesions, a sensitivity of 85.7% and a specificity of 58.7% were obtained. Conclusions There was a significant difference in T2 relaxation time between benign and malignant breast lesions. The specificity of using T2 relaxation time alone for the differentiation of benign from malignant lesions was not high, but it could constitute a new adjunct in the MRI diagnosis of breast cancer.

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Efficacy of FNAC in Diagnosis of Breast Lumps - A Retrospective Study

International Journal of Research and Review ◽

10.52403/ijrr.20210903 ◽

2021 ◽

Vol 8 (9) ◽

pp. 13-17

Author(s):

Oankar Kumar Maurya ◽

Richa . ◽

Manohar Lal

Keyword(s):

Retrospective Study ◽

Diagnostic Accuracy ◽

False Negative ◽

Patient Acceptance ◽

Breast Lesions ◽

Main Role ◽

Study Results ◽

Malignant Lesions ◽

Benign Breast Lesions ◽

Breast Lumps

Background: FNAC is an established and highly accurate method for diagnosis of breast lesions. Its further advantage is to give rapid diagnosis, cost-effectiveness, excellent patient acceptance and minimal or no morbidity. The study aimed to diagnose various breast masses before operation by FNAC and to compare the result of FNAC with histopathological study to assess the efficacy of FNAC. Materials and Methods: The study entitled “Efficacy of FNAC in diagnosis of Breast Lumps” is a retrospective study conducted in department of surgery with collaboration of pathology department at Nalanda Medical College and Hospital, Patna during the period of July 2017 to December 2019. During this period, 150 FNAC cases were selected for study. Results: Fibroadenoma was the most commonly diagnosed entity in benign breast lesions, followed by fibrocystic disease. Among malignant lesions, infiltrating ductal carcinoma was the most common. The overall diagnostic accuracy of FNAC in benign breast lesions was 94.59%. The fibroadenomas were correctly diagnosed in 92.96% cases. There were 5.41% false negative results in our series. There was no false positive result giving specificity of 100%. Conclusion: FNAC is an inexpensive, simple, safe and readily acceptable procedure to the patient and plays main role to provide rapid and accurate diagnosis of breast lumps. FNAC enables us to differentiate benign from malignant lesions with high sensitivity, specificity and diagnostic accuracy. Keywords: Breast Lump, FNAC, HPE: Histopathological Examination.

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MRI-Based Machine Learning in Differentiation Between Benign and Malignant Breast Lesions

Frontiers in Oncology ◽

10.3389/fonc.2021.552634 ◽

2021 ◽

Vol 11 ◽

Author(s):

Yanjie Zhao ◽

Rong Chen ◽

Ting Zhang ◽

Chaoyue Chen ◽

Muhetaer Muhelisa ◽

...

Keyword(s):

Machine Learning ◽

Random Forest ◽

Decision Tree ◽

Texture Analysis ◽

Training Group ◽

Gradient Boosting ◽

Breast Lesions ◽

Extreme Gradient Boosting ◽

Malignant Breast ◽

Benign Breast Lesions

BackgroundDifferential diagnosis between benign and malignant breast lesions is of crucial importance relating to follow-up treatment. Recent development in texture analysis and machine learning may lead to a new solution to this problem.MethodThis current study enrolled a total number of 265 patients (benign breast lesions:malignant breast lesions = 71:194) diagnosed in our hospital and received magnetic resonance imaging between January 2014 and August 2017. Patients were randomly divided into the training group and validation group (4:1), and two radiologists extracted their texture features from the contrast-enhanced T1-weighted images. We performed five different feature selection methods including Distance correlation, Gradient Boosting Decision Tree (GBDT), least absolute shrinkage and selection operator (LASSO), random forest (RF), eXtreme gradient boosting (Xgboost) and five independent classification models were built based on Linear discriminant analysis (LDA) algorithm.ResultsAll five models showed promising results to discriminate malignant breast lesions from benign breast lesions, and the areas under the curve (AUCs) of receiver operating characteristic (ROC) were all above 0.830 in both training and validation groups. The model with a better discriminating ability was the combination of LDA + gradient boosting decision tree (GBDT). The sensitivity, specificity, AUC, and accuracy in the training group were 0.814, 0.883, 0.922, and 0.868, respectively; LDA + random forest (RF) also suggests promising results with the AUC of 0.906 in the training group.ConclusionThe evidence of this study, while preliminary, suggested that a combination of MRI texture analysis and LDA algorithm could discriminate benign breast lesions from malignant breast lesions. Further multicenter researches in this field would be of great help in the validation of the result.

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Diagnostic Accuracy of Magnetic Resonance Spectroscopy (MRS) in Diagnosing Malignant Breast Lesions Taking Histopathology as Gold Standard

10.53350/pjmhs211571847 ◽

2021 ◽

Vol 15 (7) ◽

pp. 1847-1849

Author(s):

Adnan Ahmed ◽

Jawad Ali Memon ◽

Muhammad Sibtain Shah ◽

Hafeez ur Rehman ◽

Tahir Baig ◽

...

Keyword(s):

Breast Cancer ◽

Magnetic Resonance ◽

Magnetic Resonance Spectroscopy ◽

Diagnostic Accuracy ◽

Predictive Value ◽

Gold Standard ◽

Resonance Spectroscopy ◽

Breast Lesions ◽

Female Patients ◽

Malignant Breast

Background and Aims: Breast cancer is the prime cause of mortality among women of both developing and developed world. Out of 34.6% of female cancer patients, malignant breast cancer being the most common cancer found in Pakistan. The current study aims to evaluate the diagnostic accuracy of magnetic resonance spectroscopy in diagnosing malignant breast lesions taking histopathology as a gold standard. Materials and Methods: This cross-sectional study was carried out on 135 female patients with suspicious palpable lesions for malignancy referred from surgical OPD of Liaquat University of Medical and Health Sciences, Jamshoro during the period from October 2020 to March 2021. Magnetic resonance spectroscopy (MRS) dynamic enhanced images taken with contrast on 1.5 Tesla MRI machines were assessed based on kinetic and morphology. Malignancy biomarker was assessed with choline peak (Cho) allowed by MRS. The Single-voxel technique was utilized in order to evaluate the diagnostic performance of MRS in breast lesions malignancy. A comparison was made between MRS and biopsy findings. Results: Out of 135 female patients, 118 (87.40%) were malignant lesions patients assessed by MRS while histopathologically proven patients were 104 (77.33%). The calculated mean age of all the malignant patients was 48.3 ± 14.5 years with a range of 40-79 years. The diagnostic parameters of MRS such as specificity, accuracy, sensitivity, negative predictive value (NPV), and positive predictive value (PPV) was 74%, 88.2%, 93%, 77.8%, and 93.1% respectively while taking histopathology as a gold standard. Conclusion: MRS must be utilized as a primary imaging technique for the diagnosis of breast lesions malignancy due to its higher specificity, sensitivity, and accuracy in breast lumps characterization. MRS was found to be specific 74%, sensitive 88.2%, and accurate 93% in malignant breast cancer diagnosis. Keywords: MRS, Malignant breast lesions, Histopathology

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Usefulness of Elastography for the Evaluation of Subcentimeter Solid Breast Nodules

Applied Sciences ◽

10.3390/app11041409 ◽

2021 ◽

Vol 11 (4) ◽

pp. 1409

Author(s):

Florentina Guzmán-Aroca ◽

Yésica Martínez-Paredes ◽

Juan de Dios Berná-Serna ◽

Ana Azahara García-Ortega ◽

Juan de Dios Berná-Mestre ◽

...

Keyword(s):

Shear Wave ◽

Correct Diagnosis ◽

Shear Wave Elastography ◽

Accurate Diagnosis ◽

Breast Lesions ◽

Diagnostic Strategy ◽

Benign Lesions ◽

Ultrasound Study ◽

Malignant Breast ◽

Malignant Lesions

The accurate diagnosis of subcentimeter lesions is controversial, and therefore a standardized diagnosis algorithm is needed. The objective of the present work was to study the value of the elastography patterns obtained through the use of the shear wave elastography (SWE) technique with respect to histopathology for the evaluation of nodular breast lesions ≤1 cm. A retrospective study was conducted which included 65 sub-centimeter lesions from 57 patients with an average age of 45.6 ± 11.9. For all the cases, a B-mode ultrasound study, shear wave elastography, and a posterior anatomopathological study were conducted. The lesions had a diameter greater than 7.5 ± 1.7 mm (range: 4–9 mm). Through elastography, the distribution of the patterns was: cyst artifact (n = 13), pattern 1 (n = 4), pattern 2 (n = 31), pattern 3 (n = 13), and pattern 4 (n = 4). Of the 65 lesions, 15 were cysts, 46 were solid benign lesions, and 3 were malignant lesions. The sensitivity of the elastography was 75%, with a specificity of 98.46% and a correct diagnosis in 96.92% of the cases (n = 63). The results from this study show the usefulness of SWE for the evaluation of sub-centimeter breast lesions. In addition, this diagnostic strategy helps with the differential diagnosis between benign and malignant lesions and contributes to the early detection of malignant breast lesions.

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Section Discrepancy and Diagnostic Performance of Breast Lesions in Two-dimensional Ultrasound by Dynamic Videos versus Static Images

BIO Integration ◽

10.15212/bioi-2021-0021 ◽

2021 ◽

Author(s):

Dinghong Yang ◽

Xiaoyun Xiao ◽

Haohu Wang ◽

Huan Wu ◽

Wei Qin ◽

...

Keyword(s):

Breast Imaging ◽

Diagnostic Performance ◽

Architectural Distortion ◽

Breast Lesions ◽

Two Dimensional ◽

Benign Lesions ◽

Static Image ◽

Malignant Breast ◽

Static Images ◽

Malignant Lesions

Background: Benign or malignant breast lesions with typical ultrasonic characteristics could be easily and correctly diagnosed with two-dimensional ultrasound (2D US). However, diagnosis of atypical lesions remains a challenge. Most atypical lesions have different ultrasonographic features with probe direction variation. Thus, the interpretation of ultrasonographic features based on static images empirically collected by sonographers might be inaccurate. We aimed to investigate the section discrepancy and diagnostic performance of breast lesions in 2D US by dynamic videos versus static images.Methods: Static images and dynamic videos based on two perpendicular planes of 468 breast lesions were collected and evaluated. The Breast Imaging and Reporting Data System (BI-RADS®) US lexicon was used. Category 3 was used as the cut-off point, and section discrepancy was defined as two perpendicular planes showing different BI-RADS categories (3 versus 4A, 4B, 4C, and 5).Results: This retrospective study included 315 benign and 153 malignant lesions. There were 53 and 50 lesions with section discrepancy during static and dynamic observations, respectively. The proportion of benign lesions with section discrepancy was significantly higher than that of malignant lesions (P < 0.05) either in dynamic or static observation, and the contingency coefficient was 0.2 between section discrepancy and histopathology. Duct changes were more clearly depicted in dynamic videos than in static images (P < 0.05) both in malignant and benign lesions. Calcification and architectural distortion were more sensitively detected by dynamic videos than with static images (P < 0.05) in malignant lesions. The interpretation of “margin” significantly differed in benign lesions between static images and dynamic videos (P < 0.05). The areas under the curve of static image-horizontal, static image-sagittal, dynamic video-horizontal, and dynamic video-sagittal were 0.807, 0.820, 0.837, and 0.846, respectively. The specificities of dynamic videos were higher than those of static images (P < 0.05).Conclusion: Breast lesions have section discrepancy in 2D US. Observations based on dynamic videos could more accurately reflect lesion features and increase the specificity of US in the differentiation of atypical breast lesions.

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Immunohistochemical Expression of p63 in Benign and Malignant Breast Lesions

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/48358.15526 ◽

2021 ◽

Author(s):

Abhishek Saini ◽

Swaran Kaur Saluja ◽

MK Garg ◽

Deepti Agarwal ◽

Amrita Kulhria ◽

...

Keyword(s):

Breast Cancer ◽

Myoepithelial Cells ◽

Normal Breast ◽

High Morbidity ◽

Breast Lesions ◽

Benign Lesions ◽

Medical College ◽

Malignant Breast ◽

Malignant Lesions

Introduction: Breast carcinoma demands attention as it causes high morbidity and mortality. It is important to recognise benign lesions to distinguish them from in situ and invasive breast cancer and to assess a patient’s risk of developing breast cancer, so that the most appropriate treatment modality for each case can be established. The p63 has been characterised as a reliable marker of myoepithelial cells of lactiferous duct. It is exclusively expressed in myoepithelial cells of normal breast tissue. Hence, p63 can be of great help in the differential diagnosis involving benign lesions. Also, p63 may aid in distinguishing benign from malignant lesions. Aim: To study the Immunohistochemistry (IHC) expression of p63 in benign and malignant breast lesions. Materials and Methods: The prospective study was conducted on 76 breast specimens for a period of one year, from 1st December 2018 to 30th November 2019 in the Department of Pathology, Bhagat Phool Singh, Government Medical College for Women, Khanpur Kalan, Sonepat, Haryana, India. IHC assessment for p63 nuclear protein was performed. The intensity of p63 expression was evaluated as continuous positive, discontinuous positive and negative. The extent was scored on the basis of percentage of positive cells and assigned a score of negative (0%), 1 (<25%), 2 (26-90%) and 3 (91-100%). Results: Out of 76 cases, 38 cases were diagnosed as benign and 38 cases as malignant. IHC staining with p63 showed nuclear positivity in all benign lesions. Among malignant lesions, four were positive and 34 were negative. Conclusion: According to the above results, p63 is a very useful IHC marker in diagnosing difficult cases, cases of carcinoma in situ, borderline cases and cases with inconclusive histomorphological diagnosis.

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