scholarly journals Radiologists Detect A Higher Frequency of Incidental Findings On Radiotherapy-Planning CT Scans of Breast Cancer Patients Than Oncologist

2022 ◽  
Author(s):  
Stine Nyby ◽  
Signe Hertz Hansen ◽  
Sophie Yammeni ◽  
Agnieszka Monika Delekta ◽  
Gintare Naujokaite ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Incidental Findings ◽  
Radiotherapy Planning ◽  
Ct Scans ◽  
Breast Cancer Patients ◽  
Cohen’S Kappa ◽  
Cohen's Kappa ◽  
Malignant Lesions ◽  
Planning Ct

Abstract Purpose: Breast cancer patients scheduled for postoperative radiotherapy undergo radiotherapy-planning computed tomography (CT), and incidental findings (IFs) may appear. This study investigated the interobserver variability between radiologists and oncologists when assessing IFs on radiotherapy-planning CT scans in breast cancer patients prior to adjuvant radiotherapy. Methods: We included 383 breast cancer patients who underwent planning CT at the Aalborg University Hospital between February 1, 2017 and February 28, 2018. IFs noted by the oncologists were identified from medical records. Two specialized radiologists reviewed the scans and described their IFs. IFs were classified as benign or potential malignant lesions. Cohen’s kappa statistic was used to measure interobserver agreement.Results: A total of 513 IFs were registered. The radiologists registered 433 findings, and the oncologists noted 80 (1.1 and 0.2 IFs per patient, respectively). Most potential malignant IFs were found in the liver, lungs, bones, and lymph nodes. The radiologists and oncologists detected potential malignant lesions in 94 (25%) and 34 (9%) patients, respectively. The oncologists’ sensitivity for detecting IFs in the liver and lungs were 29% and 20%, respectively. The agreements on IFs in the liver and lungs were fair (Cohen’s kappa values of 0.33 and 0.28, respectively).Conclusion: Radiologists reported a significantly higher frequency of IFs and potential malignant lesions than oncologists. Additionally, the oncologists had a low sensitivity when reporting IFs in both the liver and lungs. These results emphasize the need for specialized radiologists to scrutinize planning CT scans of breast cancer patients to ensure the intention to treat.

Natural progression and clinical significance of incidentally detected pulmonary nodules in radiotherapy planning CT scans of breast cancer patients: a retrospective cohort

2016 ◽  
Vol 15 (4) ◽  
pp. 359-363
Author(s):  
Sasidharan Balu Krishna ◽  
Sunitha Susan Varghese ◽  
Paul Gopu Gopurathingal ◽  
Venkata Krishna Reddy Pilaka ◽  
Selvamani Backianathan
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Clinical Significance ◽  
Pulmonary Nodules ◽  
Locoregional Therapy ◽  
Radiotherapy Planning ◽  
Lung Nodules ◽  
Breast Cancer Patients ◽  
Natural Progression

AbstractAimIndeterminate pulmonary nodules incidentally detected during radiological imaging completed for radiotherapy planning always creates dilemma for the oncologist. The purpose of this study is to evaluate the clinical significance of pulmonary nodules incidentally detected in patients undergoing locoregional radiotherapy for breast cancer and present a retrospective analysis of the natural progression of such nodules.MethodsA retrospective review of computed tomography scans of breast cancer patients who underwent radiotherapy over a period of 3 years to screen out patients with indeterminate lung nodules was undertaken. This was correlated with the patient and tumour characteristics and the status of the disease at last follow-up.ResultsOf the 132 patients reviewed 28 had indeterminate lung nodules. Of the 28 patients, four had progressive lung nodules on follow-up. Subgroup analyses did not show any significant correlation.Discussion and conclusionOne fifth of patients may present with incidentally detected lung nodules. Multiple nodules, ER negative status and locally advanced breast cancer may point to a higher risk of these nodules progressing to metastatic cancer. There is no indication to stop locoregional therapy in the presence of indeterminate nodules, but close follow-up of high-risk group is recommended.

Brown fat in breast cancer patients: analysis of serial 18F-FDG PET/CT scans

2006 ◽  
Vol 33 (7) ◽  
pp. 785-791 ◽  
Author(s):  
C. Rousseau ◽  
E. Bourbouloux ◽  
L. Campion ◽  
N. Fleury ◽  
B. Bridji ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Fdg Pet ◽  
Brown Fat ◽  
Ct Scans ◽  
Breast Cancer Patients ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

scholarly journals The impact of inter-fraction set-up errors on the probability of pulmonary and cardiac complication in left-sided breast cancer patients

2014 ◽  
Vol 13 (4) ◽  
pp. 393-402
Author(s):  
Crispen Chamunyonga
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Radiotherapy Planning ◽  
Cardiac Complications ◽  
Cardiac Mortality ◽  
Breast Cancer Patients ◽  
Ipsilateral Lung ◽  
Radiation Induced ◽  
Set Up ◽  
The Impact

AbstractPurposeThis study evaluated the impact of patient set-up errors on the probability of pulmonary and cardiac complications in the irradiation of left-sided breast cancer.Methods and materialsUsing the CMS XiO Version 4·6 radiotherapy planning system's normal tissue complication probability (NTCP) algorithm and the Lyman–Kutcher–Burman model, we calculated the dose–volume histograms (DVH) indices for the ipsilateral lung and heart and the resultant NTCP for radiation-induced pneumonitis and excess cardiac mortality in 12 left-sided breast cancer patients.ResultsIsocentric shifts in the posterior direction had the greatest effect on the lung V20, heart V25, and mean and maximum doses to the lung and the heart. DVH results show that the ipsilateral lung V20 tolerance was exceeded in 58% of the patients after 1 cm posterior shifts. Similarly, the heart V25 tolerance was exceeded after 1 cm antero-posterior and left–right isocentric shifts in 70% of the patients. The baseline NTCPs for radiation-induced pneumonitis ranged from 0·73% to 3·4%, with a mean value of 1·7%. The maximum reported NTCP for radiation-induced pneumonitis was 5·8% (mean 2·6%) after 1 cm posterior isocentric shift. The NTCP for excess cardiac mortality were 0% in 100% of the patients (n = 12) before and after set-up error simulations.ConclusionsSet-up errors in left-sided breast cancer patients have a statistically significant impact on the Lung NTCPs and DVH indices. However, with a central lung distance of 3 cm or less (CLD < 3 cm), and a maximum heart distance of 1·5 cm or less (MHD < 1·5 cm), the treatment plans could tolerate set-up errors of up to 1 cm without any change in the NTCP to the heart.

Incidental breast lesions detected on diagnostic CT scans: A 3-year prospective study.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 69-69
Author(s):  
A. R. Ismail
Keyword(s):  
Breast Cancer ◽  
Prospective Study ◽  
Cancer Patients ◽  
Ct Scans ◽  
Breast Lesions ◽  
Breast Cancers ◽  
Breast Cancer Patients ◽  
Breast Clinic ◽  
Rapid Access ◽  
One Stop

69 Background: With increasing usage of diagnostic cross sectional radiology tests, patients are presenting to rapid access one-stop breast clinic with incidental breast lesions. Methods: A prospective study over a 3-year period, collecting details of all patients shown to have breast abnormalities detected by computed tomography (CT) scans done for various reasons. These patients were assessed by clinical breast examination coupled with mammography, ultrasonography and tissue biopsy if indicated. Results: An increasing trend has been seen in the total number of thoracic CT scans with 1,939 scans in 2005 and 5,215 scans in 2010 (169% increase). 26 patients were included in this study with CT scans showing incidental breast lesions in the last three years. They were all women with age range of 50-92 (median 82.5) years. The clinical indications of CT scans included evaluation of the abnormal chest radiograph (8, 31%), preoperative evaluation of non-breast malignancy (3, 11%), infectious diseases (3, 11%), weight loss (7, 27%) and miscellaneous (5, 20%). These 13 breast cancer patients constitute 1.36% of 956 breast cancers diagnosed over this three-year period. 8 out of 13 breast cancer patients in this group (62%) had metastases at the time of diagnosis. Conclusions: A significant number of breast lesions incidentally found on CT scans are shown to be breast cancers (50%). These patients need rapid access to one-stop breast clinic for full evaluation. [Table: see text]

scholarly journals Incidental Findings on Simulation CT Images for Adjuvant Radiotherapy in Breast Cancer Patients

2015 ◽  
Vol 14 (5) ◽  
pp. 525-529 ◽  
Author(s):  
Jun Su Park ◽  
Doo Ho Choi ◽  
Seung Jae Huh ◽  
Won Park ◽  
Seok Jin Nam ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Incidental Findings ◽  
Adjuvant Radiotherapy ◽  
Ct Images ◽  
Breast Cancer Patients

scholarly journals Bragatston study protocol: a multicentre cohort study on automated quantification of cardiovascular calcifications on radiotherapy planning CT scans for cardiovascular risk prediction in patients with breast cancer

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e028752 ◽  
Author(s):  
Marleen J Emaus ◽  
Ivana Išgum ◽  
Sanne G M van Velzen ◽  
H J G Desirée van den Bongard ◽  
Sofie A M Gernaat ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Radiotherapy Planning ◽  
Ct Scans ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Multicentre Cohort Study ◽  
Automated Quantification ◽  
Cardiovascular Calcifications ◽  
Planning Ct

IntroductionCardiovascular disease (CVD) is an important cause of death in breast cancer survivors. Some breast cancer treatments including anthracyclines, trastuzumab and radiotherapy can increase the risk of CVD, especially for patients with pre-existing CVD risk factors. Early identification of patients at increased CVD risk may allow switching to less cardiotoxic treatments, active surveillance or treatment of CVD risk factors. One of the strongest independent CVD risk factors is the presence and extent of coronary artery calcifications (CAC). In clinical practice, CAC are generally quantified on ECG-triggered cardiac CT scans. Patients with breast cancer treated with radiotherapy routinely undergo radiotherapy planning CT scans of the chest, and those scans could provide the opportunity to routinely assess CAC before a potentially cardiotoxic treatment. The Bragatston study aims to investigate the association between calcifications in the coronary arteries, aorta and heart valves (hereinafter called ‘cardiovascular calcifications’) measured automatically on planning CT scans of patients with breast cancer and CVD risk.Methods and analysisIn a first step, we will optimise and validate a deep learning algorithm for automated quantification of cardiovascular calcifications on planning CT scans of patients with breast cancer. Then, in a multicentre cohort study (University Medical Center Utrecht, Utrecht, Erasmus MC Cancer Institute, Rotterdam and Radboudumc, Nijmegen, The Netherlands), the association between cardiovascular calcifications measured on planning CT scans of patients with breast cancer (n≈16 000) and incident (non-)fatal CVD events will be evaluated. To assess the added predictive value of these calcifications over traditional CVD risk factors and treatment characteristics, a case-cohort analysis will be performed among all cohort members diagnosed with a CVD event during follow-up (n≈200) and a random sample of the baseline cohort (n≈600).Ethics and disseminationThe Institutional Review Boards of the participating hospitals decided that the Medical Research Involving Human Subjects Act does not apply. Findings will be published in peer-reviewed journals and presented at conferences.Trial registration numberNCT03206333.

Steroid receptor quantities in different malignant lesions of breast cancer patients

1991 ◽  
Vol 27 ◽  
pp. S29
Author(s):  
M. Branković-Magić ◽  
D. Nikolić-Vukosavljević ◽  
Z. Nešković-Konstantinović ◽  
K. Kanjer ◽  
I. Spuẑić
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Steroid Receptor ◽  
Breast Cancer Patients ◽  
Malignant Lesions
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