Factors Affecting Breast Cancer Detectability on Digital Breast Tomosynthesis and Two-Dimensional Digital Mammography in Patients with Dense Breasts

OBJECTIVE: To compare digital breast tomosynthesis (DBT) and conventional full-field digital mammography (FFDM) in the detectability of breast cancers in patients with dense breast tissue, and to determine the influencing factors in the detection of breast cancers using the two techniques. MATERIALS AND METHODS: Three blinded radiologists independently graded cancer detectability of 300 breast cancers (288 women with dense breasts) on DBT and conventional FFDM images, retrospectively. Hormone status, histologic grade, T stage, and breast cancer subtype were recorded to identify factors affecting cancer detectability. The Wilcoxon signed-rank test was used to compare cancer detectability by DBT and conventional FFDM. Fisher's exact tests were used to determine differences in cancer characteristics between detectability groups. Kruskal-Wallis tests were used to determine whether the detectability score differed according to cancer characteristics. RESULTS: Forty breast cancers (13.3%) were detectable only with DBT; 191 (63.7%) breast cancers were detected with both FFDM and DBT, and 69 (23%) were not detected with either. Cancer detectability scores were significantly higher for DBT than for conventional FFDM (median score, 6; range, 0–6; p < 0.001). The DBT-only cancer group had more invasive lobular-type breast cancers (22.5%) than the other two groups (i.e., cancer detected on both types of image [both-detected group], 5.2%; cancer not detected on either type of image [both-non-detected group], 7.3%), and less detectability of ductal carcinoma in situ (5% vs. 16.8% [both-detected group] vs. 27.5% [both-non-detected group]). Low-grade cancers were more often detected in the DBT-only group than in the both-detected group (22.5% vs. 10%, p = 0.026). Human epidermal growth factor receptor-2 (HER-2)-negative cancers were more often detected in the DBT-only group than in the both-detected group (92.3% vs. 70.5%, p = 0.004). Cancers surrounded by mostly glandular tissue were detected less often in the DBT only group than in the both-non-detected group (10% vs. 31.9%, p = 0.016). DBT cancer detectability scores were significantly associated with cancer type (p = 0.012), histologic grade (p = 0.013), T and N stage (p = 0.001, p = 0.024), proportion of glandular tissue surrounding lesions (p = 0.013), and lesion type (p < 0.001). CONCLUSION: Invasive lobular, low-grade, or HER-2-negative cancer is more detectable with DBT than with conventional FFDM in patients with dense breasts, but cancers surrounded by mostly glandular tissue might be missed with both techniques.

Diagnosis of Iatrogenic Femoropopliteal bypass Graft Entrapment Syndrome by MDCT: A Case Report

Popliteal artery entrapment syndrome is a well-known congenital condition causing limb ischemia. A similar entity caused by entrapment of a femoropopliteal bypass graft by the muscle and tendons around the knee has also been described. Ultrasonography or MR imaging is considered as a choice of a noninvasive modality for this condition, but there are some limitations. We report a case of iatrogenic entrapment of femoropopliteal bypass graft that was confirmed by multidetector row computed tomography (MDCT).

Prevalence of Mycoplasma pneumoniae Antibodies in Healthy Residents of Jeonnam Province / 대한임상미생물학회지

BACKGROUND: Mycoplasma pneumoniae is the most frequent cause of respiratory tract infections in schoolaged children and adolescents. For appropriate use of antibiotics, diagnosis of M. pneumoniae infection in routine clinical practice has been based on serology using a single serum sample. We evaluated the seroprevalence of anti-M. pneumoniae-specific antibodies in 500 asymptomatic, healthy persons in Jeonnam Province. METHODS: Sera were collected from 500 healthy persons in Jeonnam Province. Anti-M. pneumoniae antibody titer was measured using a microparticle agglutination assay Serodia Myco II (Fujirebio, Japan) and VIRCELL IgM Mycoplasma ELISA kits (Vircell, Granada, Spain). RESULTS: Anti-M. pneumoniae antibody titers in 500 healthy individuals were 1:20 in 344 (68.8%), 1:40 in 16 (3.2%), 1:80 in 71 (14.2%), 1:160 in 45 (9.0%), 1:320 in 14 (2.8%), and 1:160) and positive IgM, and an assessment of current infection with single serum serology has its limitation for the diagnosis of M. pneumoniae infections.