Automated Breast Volumetric Sonography Compared with Magnetic Resonance Imaging in Jewish BRCA 1/2 Mutation Carriers.

BACKGROUND: Automated breast volumetric sonography (ABVS) is a new technology with various possible applications. OBJECTIVES: To compare ABVS and breast magnetic resonance imaging (MRI) in the surveillance of women with BRCA1/2 gene mutation carriers. METHODS: We conducted a prospective study in Jewish female BRCA1/2 mutation carriers who underwent breast MRI and ABVS. The results of both exams performed 6 months apart or less, and relevant clinical data, were reviewed. The BIRADS results were divided into three subgroups according to subsequent expected management: BIRADS 1-2 (normal study), BIRADS 3 (probably benign finding), and BIRADS 4 and 5 (suspicious findings). BIRADS 0 and 6 scores were excluded from the study. Distribution of ABVS and MRI BIRADS scores were compared using McNemar's test, and concordance was calculated using the Cohen kappa test. RESULTS: Overall, 68 women, 40 BRCA1 and 28 BRCA2 mutation carriers, age range 26-69 (mean 44.55 ± 12.1 years), underwent 79 paired ABVS and MRI examinations. McNemar's test calculations showed no significant difference between MRI and ABVS BIRADS score distribution. Cohen's kappa test resulted in k = 0.158, an agreement that can be described as only "slight agreement" between both modalities. Of 14 discordant cases there was one cancer, revealed by MRI and not by ABVS performed 6 months prior to MRI. CONCLUSIONS: ABVS showed slight agreement with MRI in BRCA1/2 mutation carriers. These preliminary results on a small group of healthy high risk patients suggest that the diagnostic abilities of ABVS are inferior to MRI. Further studies encompassing larger groups are needed.

Use of Automated Breast Volumetric Sonography as a Second-Look Tool for Findings in Breast Magnetic Resonance Imaging.

Breast magnetic resonance imaging (MRI) has an important role in the detection and diagnosis of breast cancer. Suspicious findings on MRI are further evaluated with ultrasound. This case series illustrates the use of automated breast volumetric ultrasound (ABVS) as a tool for second-look ultrasound (SLUS) following MRI. Seven women underwent breast MRI with findings necessitating SLUS. ABVS was used for second look and all MRI lesions were detected. Four cancers, one fibroadenoma and two benign lesions, were diagnosed. This case series shows that ABVS can be used as a tool for SLUS following MRI and in some cases is superior to hand-held ultrasound.

Magnetic resonance imaging (MRI) evaluation of residual breast tissue following mastectomy and reconstruction with silicone implants.

PURPOSE: We present our use of magnetic resonance (MR) measurement to determine the amount of residual breast tissue (RBT) following total mastectomy with reconstruction. METHODS: Breast MR images of 45 women who underwent surgery between January and November 2011 were reviewed. The cohort included therapeutic and prophylactic mastectomies. RBT was evaluated at four points with a digital caliper assessing T2-weighted and T1-weighted images. RESULTS: Patients undergoing mastectomy for carcinoma tended to have less RBT than in prophylactic surgery. Greater age and recent surgery both correlated with larger RBT. CONCLUSIONS: Variable thickness of RBT is demonstrable following mastectomy and implant reconstruction using MR imaging.

Freehand elastography for determination of breast cancer size: comparison with B-mode sonography and histopathologic measurement.

OBJECTIVES: Elastography assesses the strain of soft tissues and is used to enhance diagnostic accuracy in evaluating breast tumors, but minimal data exist on its ability to accurately assess tumor size. This study was performed to assess the preoperative accuracy of measuring the size of biopsyproven breast cancer lesions with elastography and conventional B-mode sonography compared with the reference standard size measured by histopathologic examination. METHODS: Elastography and conventional B-mode sonography were performed on 69 women with histologically proven breast cancer, and tumor sizes on both modalities were recorded. These measurements were compared with the final pathologic size, which was used as the reference standard. The sizes and differences between sonographic, elastographic, and pathologic measurements were statistically tested, and an analysis of equivalence to the reference standard was performed using Bland-Altman plots. RESULTS: There was a significant difference between sizes on elastography and pathologic examination, with elastography overestimating the tumor size (P = .0187). Sonography slightly underestimated the tumor size, but this finding was not significant (P = .36). Bland-Altman plots confirmed that sonography but not elastography was an acceptable standard compared with the pathologic size. CONCLUSIONS: Breast elastography but not B-mode sonography overestimates the size of breast tumors compared with the final pathologic size.

Biologically derived companding algorithm for high dynamic range mammography images.

The screening mammography is currently the best procedure available for early detection of the breast cancer. The acquired mammograms are high dynamic range (HDR) images having a 12 bit grayscale resolution. When viewed by a radiologist, a single image must be examined several times, each time focusing on a different intensity range. We have developed a biologically derived mammography companding (BDMC) algorithm for compression, expansion, and enhancement of mammograms, in a fully automatic way. The BDMC is comprised of two main processing stages: 1) preliminary processing operations which include standardization of the intensity range and expansion of the intensities which belong to the low intensity range. 2) Adaptively companding the HDR range by integrating multiscale contrast measures. The algorithm's performance has been preliminarily clinically tested on dozens of mammograms in collaboration with experienced radiologists. It appears that the suggested method succeeds in presenting all of the clinical information, including all the abnormalities, in a single low dynamic range companded image. This companded and enhanced image is not degraded more than the HDR image and can be analyzed without the need for professional workstation and its specific enhancement software.