scholarly journals Comparison of BSGI , MRI, mammography, and ultrasound for the diagnosis of breast lesions and their correlations with specific molecular subtypes in Chinese women

2020 ◽  
Author(s):  
Hongbiao Liu ◽  
Hongwei Zhan ◽  
Da Sun ◽  
Ying Zhang

Abstract Background: Breast cancer is a leading cause of cancer in females, and is the second leading cancer-related cause of death in this group. Early diagnosis is essential to breast cancer to be effectively treated, and ultrasound, mammography, and magnetic resonance imaging (MRI) represent three key technologies that are utilized for the diagnosis of breast lesions. Breast-specific gamma imaging (BSGI) is an approach to molecular breast imaging that allows for high-resolution radio-imaging that is not adversely impacted by breast tissue density. This study was therefore designed to assess the relative diagnostic efficacy of BSGI, MRI, mammography, and ultrasound in different molecular subtypes of breast cancer among Chinese women.Methods: Diagnostic findings from 390 patients that had undergone diagnosis and treatment in our breast surgery department were retrospectively reviewed. Patients had been diagnosed via BSGI, mammography, ultrasound, and MRI. The diagnostic efficacy of these different imaging modalities and their associated biological characteristics were compared in the present study.Results: A total of 229 of these 390 patients (58.7%) were diagnosed with malignant breast cancer, with the remaining 161 (41.3%) cases having been found to be benign. BSGI, MRI, mammography, and ultrasound yielded respective sensitivity values of 91.7%, 92.5%, 77.3%, and 82.1%, while the respective specificity values for these imaging modalities were 80.7%, 69.7%, 74.5%, and 70.8%. For lesions > 1 cm, BSGI offered a sensitivity of 92.5%. For mammographic breast density A, B, C, and D, BSGI offered a sensitivity of 93.3%, 94.0%, 91.5%, and 89.3%, respectively. BSGI also yielded a significantly higher lesion-to-normal lesion ratio (LNR) for malignant lesions relative to benign lesions (2.76±1.32 vs 1.46±0.49).Conclusions: These findings confirm that BSGI is highly sensitive and is superior to mammography in the detection and diagnosis of ductal carcinomas in situ (DCIS). Such diagnostic efficacy can be further improved by using BSGI as an auxiliary modality to mammography and ultrasound, potentially improving the reliability of breast lesion diagnosis, thereby ensuring that patients receive rapid and effective treatment without the risk of misdiagnosis or unnecessary surgical treatment.

2020 ◽  
Author(s):  
hongbiao liu ◽  
Hongwei Zhan ◽  
Da Sun ◽  
Ying Zhang

Abstract Background: Breast cancer is a leading cause of cancer in females, and is the second leading cancer-related cause of death in this group. Early diagnosis is essential to breast cancer to be effectively treated, and ultrasound, mammography, and magnetic resonance imaging (MRI) represent three key technologies that are utilized for the diagnosis of breast lesions. Breast-specific gamma imaging (BSGI) is an approach to molecular breast imaging that allows for high-resolution radio-imaging that is not adversely impacted by breast tissue density. This study was therefore designed to assess the relative diagnostic efficacy of BSGI, MRI, mammography, and ultrasound in different molecular subtypes of breast cancer among Chinese women. Methods: Diagnostic findings from 390 patients that had undergone diagnosis and treatment in our breast surgery department were retrospectively reviewed. Patients had been diagnosed via BSGI, mammography, ultrasound, and MRI. The diagnostic efficacy of these different imaging modalities and their associated biological characteristics were compared in the present study. Results: A total of 229 of these 390 patients (58.7%) were diagnosed with malignant breast cancer, with the remaining 161 (41.3%) cases having been found to be benign. BSGI, MRI, mammography, and ultrasound yielded respective sensitivity values of 91.7%, 92.5%, 77.3%, and 82.1%, while the respective specificity values for these imaging modalities were 80.7%, 69.7%, 74.5%, and 70.8%. For lesions > 1 cm, BSGI offered a sensitivity of 92.5%. For mammographic breast density A, B, C, and D, BSGI offered a sensitivity of 93.3%, 94.0%, 91.5%, and 89.3%, respectively. BSGI also yielded a significantly higher lesion-to-normal lesion ratio (LNR) for malignant lesions relative to benign lesions (2.76±1.32 vs 1.46±0.49). Conclusions: These findings confirm that BSGI is highly sensitive and is superior to mammography in the detection and diagnosis of ductal carcinomas in situ (DCIS). Such diagnostic efficacy can be further improved by using BSGI as an auxiliary modality to mammography and ultrasound, potentially improving the reliability of breast lesion diagnosis, thereby ensuring that patients receive rapid and effective treatment without the risk of misdiagnosis or unnecessary surgical treatment.


2020 ◽  
Author(s):  
Hongbiao Liu ◽  
Hongwei Zhan ◽  
Da Sun ◽  
Ying Zhang

Abstract Background : Breast cancer is a leading cause of cancer in females, and is the second leading cancer-related cause of death in this group. Early diagnosis is essential to breast cancer to be effectively treated, and ultrasound, mammography, and MRI represent three key technologies that are utilized for the diagnosis of breast lesions. BSGI is an approach to molecular breast imaging that allows for high-resolution radio-imaging that is not adversely impacted by breast tissue density. This study was therefore designed to assess the relative diagnostic efficacy of BSGI, MRI, mammography, and ultrasound in different molecular subtypes of breast cancer among Chinese women. Methods : Diagnostic findings from 390 breast cancer patients that had undergone diagnosis and treatment in our breast surgery department were retrospectively reviewed. Patients had been diagnosed via BSGI, mammography, ultrasound, and MRI. The diagnostic efficacy of these different imaging modalities and their associated biological characteristics were compared in the present study. Results: A total of 229 of these 390 patients (58.7%) were diagnosed with malignant breast cancer, with the remaining 161 (41.3%) cases having been found to be benign. BSGI, MRI, mammography, and ultrasound yielded respective sensitivity values of 91.7%, 92.5%, 77.3%, and 82.1%, while the respective specificity values for these imaging modalities were 80.7%, 69.7%, 74.5%, and 70.8%. For lesions > 1 cm, BSGI offered a sensitivity of 92.5%, while for dense C and dense D breast tissue it yielded 91.5% and 89.3% sensitivity values, respectively, with these being similar to those achieved for dense A and dense B breast tissue (93.3% and 94.0%, respectively). BSGI also yielded a significantly higher LNR for malignant lesions relative to benign lesions (2.76±1.32 vs 1.46±0.49). Conclusions : These findings confirm that BSGI is highly sensitive and is superior to mammography in the detection and diagnosis of DCIS. Such diagnostic efficacy can be further improved by using BSGI as an auxiliary modality to mammography and ultrasound, potentially improving the reliability of breast lesion diagnosis, thereby ensuring that patients receive rapid and effective treatment without the risk of misdiagnosis or unnecessary surgical treatment.


Author(s):  
Jia Lin ◽  
Wenqiang Lin ◽  
Liang Xu ◽  
Teng Lin

BACKGROUND: Tumor angiogenesis plays a critical role in the growth and metastasis of breast cancer and evaluating the added value of vascular features to Breast Imaging Reporting and Data System (BI-RADS) in differentiating malignant nodules from benign ones is essential. Micro-flow Imaging (MFI) is a promising noninvasive diagnostic method for the microvessels in breast tumors, but its precise value is still uncertain. OBJECTIVES: Understanding whether malignant tumor vascular characteristics by MFI are associated with breast cancer and whether the diagnostic efficiency varies by age. MATERIALS AND METHODS: We used B-mode Ultrasound and MFI to detect the characteristics of 153 solid breast lesions. Two investigators reviewed the vessels images by MFI and assessed the vascular features, respectively. Evaluating diagnostic efficacy of different vascular features combined with BI-RADS in different age groups. RESULTS: The mean size of lesions is 19.4 (range 18–78) mm. There were 94 breast masses in benign, while 59 breast masses in malignant by pathology. III Adler classification, penetrating vessels, and complex flow pattern showed a positive association with a high risk of malignant breast lesions (p <  0.05). BI-RADS combined with vessel characteristics show better improvement of diagnostic performance of breast lesions in the elderly group than in the young group. CONCLUSIONS: Vascular features by MFI contribute to malignant breast masses’ diagnosis, and the association might be modified by age.


Author(s):  
Katie N Hunt

Abstract Molecular breast imaging (MBI) is a nuclear medicine technique that has evolved considerably over the past two decades. Technical advances have allowed reductions in administered doses to the point that they are now acceptable for screening. The most common radiotracer used in MBI, 99mTc-sestamibi, has a long history of safe use. Biopsy capability has become available in recent years, with early clinical experience demonstrating technically successful biopsies of MBI-detected lesions. MBI has been shown to be an effective supplemental screening tool in women with dense breasts and is also utilized for breast cancer staging, assessment of response to neoadjuvant chemotherapy, problem solving, and as an alternative to breast MRI in women who have a contraindication to MRI. The degree of background parenchymal uptake on MBI shows promise as a tool for breast cancer risk stratification. Radiologist interpretation is guided by a validated MBI lexicon that mirrors the BI-RADS lexicon. With short interpretation times, a fast learning curve for radiologists, and a substantially lower cost than breast MRI, MBI provides many benefits in the practices in which it is utilized. This review will discuss the current state of MBI technology, clinical applications of MBI, MBI interpretation, radiation dose associated with MBI, and the future of MBI.


2012 ◽  
Vol 37 (4) ◽  
pp. 344-350 ◽  
Author(s):  
Dietlind L. Wahner-Roedler ◽  
Judy C. Boughey ◽  
Carrie B. Hruska ◽  
Beiyun Chen ◽  
Deborah J. Rhodes ◽  
...  

2018 ◽  
Vol 25 (12) ◽  
pp. 1568-1576 ◽  
Author(s):  
Jason G. Ching ◽  
Rachel F. Brem

2020 ◽  
Author(s):  
Xuan Shao ◽  
xiao yan jin ◽  
zhi gang chen ◽  
zhi gang zhang ◽  
ke wang ◽  
...  

Abstract Background: Previous study has reported that circulating tumor cells (CTCs) could be served as a diagnostic biomarker in breast cancer (BC) screening. However, the differential efficacy of routine examination including ultrasound (US), mammogram (MG), magnetic resonance imaging (MR), and breast-specific gamma imaging (BSGI) and CTCs is unknown. This study aimed to compare CTCs with common used BC screening imaging modalities and to evaluate whether their combination would enhance the diagnostic potency in non-metastatic BC patients.Methods: 102 treatment-naive non-metastatic BC patients, 177 patients with breast benign diseases (BBD) and 64 healthy females, who had CTC detection and at least one of the following medical imaging examinations, US, MG or MR between December 2017 and November 2018, were enrolled in this study.Correlations of CTC enumeration with patients’ clinicopathological characteristics and medical imaging examinations were evaluated. Results: CTC detection rates (average CTC counts) in stage I-III BC patients were 92.9% (2.1), 87.2% (2.4) and 100% (4.2), respectively. CTCs counts were positively associated with cancer stage (p = 0.0084) and tumor size (p = 0.0301). CTC counts were more correlated with US than MR or MG. CTC counts were not associated with molecular subtypes of BC nor breast-specific gamma imaging (BSGI) results, indicating that CTC enumeration cannot be used to predict molecular signatures of BC. CTCs and medical imaging examinations would have the best diagnostic performance for BC when CTC cut-off was set to 2 and imaging Breast Imaging-Reporting and Data System (BI-RADS) was set to 4b. Combination of CTC with US, MG or MR increased the sensitivity for BC diagnosis, especially for MG. Sensitivity of MG increased from 0.694 to 0.917, even more than in conjugation with US (0.901). Conclusion: CTCs counts can be used as a diagnostic aid in BC screening and early diagnosis. CTCs counts were more relevant to US than MR or MG. Conjugation of CTCs counts would improve the diagnostic potency of medical imaging examinations for diagnosing BC, especially for MG in Chinese women.


2018 ◽  
Vol 169 (3) ◽  
pp. 513-522 ◽  
Author(s):  
Angela Collarino ◽  
Renato A. Valdés Olmos ◽  
Lotta G. A. J. van Berkel ◽  
Peter A. Neijenhuis ◽  
Lidy M. H. Wijers ◽  
...  

2020 ◽  
Vol 93 (1112) ◽  
pp. 20200195
Author(s):  
Jiamin Pan ◽  
Wenjuan Tong ◽  
Jia Luo ◽  
Jinyu Liang ◽  
Fushun Pan ◽  
...  

Objective: To compare the efficacy of contrast-enhanced ultrasound enabled reclassification of Breast Imaging Reporting and Data System (CEUS-BI-RADS) with MRI in the diagnosis of breast lesions with calcification. Methods: A total of 52 breast lesions with calcification from 51 patients were detected by ultrasound as hyperechoic foci and categorized as BI-RADS 3–5. The 51 patients further underwent CEUS scan and MRI. The ultrasound-BI-RADS combined with CEUS 5-point score system redefined the classification of BI-RADS which was called CEUS-BI-RADS. The diagnostic efficacy of three methods was assessed by receiver operating characteristic (ROC) curve analysis. Histopathological assessment used as the gold-standard. Results: The sensitivities of Ultrasound-BI-RADS, MRI classification of BI-RADS (MRI-BI-RADS) and CEUS-BI-RADS were 85%, 90% and 95% without significant difference among the three modalities (p > 0.05). The diagnostic specificities of ultrasound-BI-RADS, MRI-BI-RADS and CEUS-BI-RADS were 78.1%, 78.1% and 96.8%, respectively (p < 0.05); and the accuracy were 80.7%, 82.6% and 96.1% for ultrasound-BI-RADS, MRI-BI-RADS and CEUS-BI-RADS, respectively (p < 0.05). The area under ROC (AUROC) in differentiation of breast lesions with calcification was 0.945 for CEUS-BI-RADS, 0.907 for MRI-BI-RADS and 0.853 for ultrasound-BI-RADS, with no significant difference among the three modalities (p > 0.05). Conclusion: The CEUS-BI-RADS has a better diagnostic efficiency than MRI-BI-RADS in the differentiation of the breast lesions with calcification. Advances in knowledge: •CEUS is a better method in differentiation of breast lesions with calcification. •CEUS-BI-RADS increases the efficiency of diagnosis compared to MRI.


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