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1.
Medicine (Baltimore) ; 100(41): e27495, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34731130

RESUMO

ABSTRACT: Intravoxel incoherent motion (IVIM) diffusion-weighted magnetic resonance imaging (MRI) can be used to estimate perfusion-related parameters, but these parameters may differ, based on the curve-fitting algorithm used for IVIM. Microvessel density (MVD) and vascular endothelial growth factor (VEGF) status are used as angiogenic factors in breast cancer. We aimed to investigate the relationship between MVD, VEGF, and intravoxel incoherent motion (IVIM)-derived parameters, obtained by 4 curve-fitting algorithms, in patients with invasive breast cancers.This retrospective study investigated IVIM-derived parameters, D (ie, tissue diffusivity), D∗ (ie, pseudodiffusivity), and f (ie, perfusion fraction), of 55 breast cancers, using 10 b values (range, 0-800 s/mm2) and 4 curve-fitting algorithms: algorithm 1, linear fitting of D and f first, followed by D∗; algorithm 2, linear fitting of D and f and nonlinear fitting of D∗; algorithm 3, linear fitting of D and f, linear fitting of D∗, and ignoring D contribution for low b values; and algorithm 4, full nonlinear fitting of D, f, and D∗. We evaluated whole-tumor histograms of D, f, and D∗ for their association with MVD and VEGF.D∗10, D∗25, D∗50, D∗mean, D∗75, D∗90, f10, and f25, derived using algorithm 3, were associated with VEGF expression (P = .043, P = 0.012, P = .019, P = .024, P = .044, P = .041, P = .010, and P = .005, respectively). However, no correlation existed between MVD and IVIM-derived parameters.Perfusion-related IVIM parameters obtained by curve-fitting algorithm 3 may reflect VEGF expression.


Assuntos
Indutores da Angiogênese/metabolismo , Neoplasias da Mama/diagnóstico por imagem , Imagem de Difusão por Ressonância Magnética/métodos , Densidade Microvascular/fisiologia , Fator A de Crescimento do Endotélio Vascular/metabolismo , Adulto , Idoso , Algoritmos , Neoplasias da Mama/patologia , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Pessoa de Meia-Idade , Movimento (Física) , Invasividade Neoplásica/patologia , Imagem de Perfusão/métodos , Estudos Retrospectivos
2.
Sci Rep ; 11(1): 20205, 2021 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-34642389

RESUMO

The purpose of this study is to investigate imaging characteristics of young age breast cancer (YABC) focusing on correlation with pathologic factors and association with disease recurrence. From January 2017 to December 2019, patients under 40 years old who were diagnosed as breast cancer were enrolled in this study. Morphologic analysis of tumor and multiple quantitative parameters were obtained from pre-treatment dynamic contrast enhanced breast magnetic resonance imaging (DCE-MRI). Tumor-stroma ratio (TSR), microvessel density (MVD) and endothelial Notch 1 (EC Notch 1) were investigated for correlation with imaging parameters. In addition, recurrence associated factors were assessed using both clinico-pathologic factors and imaging parameters. A total of 53 patients were enrolled. Several imaging parameters derived from apparent diffusion coefficient (ADC) histogram showed negative correlation with TSR; and there was negative correlation between MVD and Ve in perfusion analysis. There were nine cases of recurrences with median interval of 16 months. Triple negative subtype and low CD34 MVD positivity in Notch 1 hotspots showed significant association with tumor recurrence. Texture parameters reflecting tumor sphericity and homogeneity were also associated with disease recurrence. In conclusion, several quantitative MRI parameters can be used as imaging biomarkers for tumor microenvironment and can predict disease recurrence in YABC.

3.
Opt Express ; 29(17): 27160-27170, 2021 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-34615137

RESUMO

Three-dimensional printing based on fused deposition modeling has been shown to provide a cost-efficient and time-saving tool for fabricating a variety of THz optics for a frequency range of <0.2 THz. By using a broadband THz source, with a useful spectral range from 0.08 THz to 1.5 THz, we show that 3D-printed waveplates operate well up to 0.6 THz and have bandwidths similar to commercial products. Specifically, we investigate quarter- and half-waveplates, q-plates, and spiral phaseplates. We demonstrate a route to achieve broadband performance, so that 3D-printed waveplates can also be used with broadband, few-cycle THz pulses, for instance, in nonlinear THz spectroscopy or other THz high field applications.

4.
J Comput Assist Tomogr ; 45(6): 843-848, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34347708

RESUMO

OBJECTIVE: The aim of this study was to investigate whether texture analysis of contrast-enhanced T1 weighted images could predict risk of ductal carcinoma in situ (DCIS). METHODS: The study included 185 DCIS lesions that were classified as either low risk or non-low risk using surgical pathology records. All magnetic resonance imaging texture analyses were performed using postprocessing software, and texture-derived parameters were extracted. RESULTS: The sphericity, compactness, and spherical disproportion were significantly different in the low-risk and non-low risk groups using the Van Nuys Prognostic Index (mean ± SD, 0.479 ± 0.189 vs 0.414 ± 0.176, 0.161 ± 0.159 vs 0.112 ± 0.134, and 2.569 ± 1.434 vs 2.934 ± 1.374, respectively; P < 0.05). In the univariate analyses, sphericity (odds ratio, 7.091; 95% confidence interval, 1.236-40.666; P = 0.028) and compactness (odds ratio, 9.267; 95% confidence interval, 1.125-76.360; P = 0.039) were significantly associated with a high probability of being low risk according to the Van Nuys Prognostic Index. CONCLUSIONS: Whole-lesion texture analysis may be helpful in identifying patients classified as having low-risk DCIS before surgery.

5.
PLoS One ; 16(6): e0252476, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34115797

RESUMO

PURPOSE: To investigate the imaging characteristics of early and late recurrent breast cancer and the detectability of mammography, ultrasonography, and breast magnetic resonance imaging (MRI) in patients who underwent breast-conservation therapy (BCT). MATERIALS AND METHODS: Total of 1312 women with 2026 surveillance breast MRI after BCT between January 2014 and September 2018 were studied. Early recurrence was defined as newly diagnosed breast cancer and/or axillary metastasis within 12 months of surgery. Late recurrence was defined as recurrence after 12months of surgery. We assessed the detectability of recurrent lesions in each postoperative imaging modality and evaluated characteristics of recurrent lesions on postoperative MRI by comparing early and late recurrence groups. RESULT: Of the 2026 cases, 103 were confirmed as recurrent breast cancer by biopsy or surgery. Thirty-one cases were early recurrence, and 72 cases were late recurrence. MRI showed significantly higher detectability for recurrent lesions (102 cases, 99%) than mammography (59.4%, p < 0.001) or ultrasound (68.9%, p < 0.001), or both mammography and ultrasound (81.6%, p < 0.001). The recurrent lesions did not have typical malignant morphologic features, but variable features on MRI. However, early recurrent lesions showed fast enhancement in early dynamic phase regardless of the kinetic pattern of delayed dynamic phase; and late recurrence lesions showed early fast enhancement and delayed washout pattern. There were 19 cases which were not detected on mammography or ultrasound but could only be detected with MRI. CONCLUSION: Postoperative breast MRI showed significantly higher detectability for recurrent lesions than mammography and ultrasound. Early fast enhancement is the most important feature of recurrent lesions on postoperative breast MRI for both early and late recurrence groups. Due to its high possibility of recurrence, further work-up should be considered regardless of their morphologic features.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Mastectomia Segmentar/métodos , Neoplasias da Mama/cirurgia , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Ultrassonografia Mamária
6.
J Breast Cancer ; 24(2): 218-228, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33913277

RESUMO

PURPOSE: Interest in unenhanced magnetic resonance imaging (MRI) screening for breast cancer is growing due to concerns about gadolinium deposition in the brain and the high cost of contrast-enhanced MRI. The purpose of this report is to describe the protocol of the Diffusion-Weighted Magnetic Resonance Imaging Screening Trial (DWIST), which is a prospective, multicenter, intraindividual comparative cohort study designed to compare the performance of mammography, ultrasonography, dynamic contrast-enhanced (DCE) MRI, and diffusion-weighted (DW) MRI screening in women at high risk of developing breast cancer. METHODS: A total of 890 women with BRCA mutation or family history of breast cancer and lifetime risk ≥ 20% are enrolled. The participants undergo 2 annual breast screenings with digital mammography, ultrasonography, DCE MRI, and DW MRI at 3.0 T. Images are independently interpreted by trained radiologists. The reference standard is a combination of pathology and 12-month follow-up. Each image modality and their combination will be compared in terms of sensitivity, specificity, accuracy, positive predictive value, rate of invasive cancer detection, abnormal interpretation rate, and characteristics of detected cancers. The first participant was enrolled in April 2019. At the time of manuscript submission, 5 academic medical centers in South Korea are actively enrolling eligible women and a total of 235 women have undergone the first round of screening. Completion of enrollment is expected in 2022 and the results of the study are expected to be published in 2026. DISCUSSION: DWIST is the first prospective multicenter study to compare the performance of DW MRI and conventional imaging modalities for breast cancer screening in high-risk women. DWIST is currently in the patient enrollment phase. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03835897.

7.
Eur Radiol ; 31(10): 7771-7782, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33779816

RESUMO

OBJECTIVES: To prospectively evaluate the diagnostic performance of screening ABUS as the primary screening test for breast cancer among Korean women aged 40-49 years. METHODS: This prospective, multicenter study included asymptomatic Korean women aged 40-49 years from three academic centers between February 2017 and October 2019. Each participant underwent ABUS without mammography, and the ABUS images were interpreted at each hospital with double-reading by two breast radiologists. Biopsy and at least 1 year of follow-up was considered the reference standard. Diagnostic performance of ABUS screening and subgroup analyses according to patient and tumor characteristics were evaluated. RESULTS: Reference standard data were available for 959 women. The recall rate was 9.8% (95% confidence interval [CI]: 7.9%, 11.7%; 94 of 959 women) and the cancer detection yield was 5.2 per 1000 women (95% CI: -0.6, 11.1; 5 of 959 women). There was only one interval cancer. The sensitivity was 83.3% (95% CI: 53.5%, 100%; 5 of 6 cancers) and the specificity was 90.7% (95% CI: 88.8%, 92.5%; 864 of 95. women). The positive predictive values of biopsies performed (PPV3) was 20.0% (95% CI: 4.3%, 35.7%; 5 of 25 women). Women with heterogeneous background echotexture had a higher recall rate (p = .009) and lower specificity (p = .036). Women with body mass index values < 25 kg/m2 had a higher mean recall rate (p = .046). CONCLUSION: In East Asia, screening automated breast US may be an alternative to screening mammography for detecting breast cancers in women aged 40-49 years. KEY POINTS: • Automated breast US screening for breast cancer in asymptomatic women aged 40-49 is effective with 5.2 per 1000 cancer detection yield. • Women with heterogeneous background echotexture had a higher recall rate and lower specificity. • Women with body mass index < 25 kg/m2 had a higher recall rate.


Assuntos
Neoplasias da Mama , Neoplasias da Mama/diagnóstico por imagem , Detecção Precoce de Câncer , Feminino , Humanos , Mamografia , Programas de Rastreamento , Estudos Prospectivos , Sensibilidade e Especificidade , Ultrassonografia Mamária
8.
Ultrasonography ; 40(3): 318-332, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33652513

RESUMO

PURPOSE: This study was undertaken to compare the diagnostic performance and biopsy reduction rate of combined shear-wave elastography (SWE) and B-mode ultrasonography (US) versus B-mode US alone for breast lesions and to determine the most discriminatory parameter in SWE. METHODS: A systematic review and meta-analysis were conducted. The resources for the study were obtained from MEDLINE, Embase, Cochrane Library, and KoreaMed on August 17, 2018. The quality of the articles was evaluated using the Scottish Intercollegiate Guidelines Network (SIGN) tool. RESULTS: Twenty-five articles with 5,147 breast lesions were selected. The meta-analysis showed pooled sensitivities of 0.94 and 0.97 (P=0.087), pooled specificities of 0.85 and 0.61 (P=0.009), and area under the receiver operating characteristic curve (AUC) of 0.96 and 0.96 (P=0.095) for combined SWE and B-mode US versus B-mode US alone. When SWE was combined with B-mode US, the Breast Imaging Reporting and Data System category changed from 4 to 3 in 71.3% of the tests, decreasing the frequency of unnecessary biopsies by 41.1%. All four parameters of SWE (the color grade of lesion stiffness, maximum elasticity, mean elasticity, and color grade of lesion stiffness/homogeneity of the lesion) improved the specificity when they were added to B-mode US. The AUC for each SWE parameter was 0.99, 0.96, 0.96, and 0.93, respectively. CONCLUSION: Adding SWE to B-mode US not only provides additional diagnostic information for differentiating between benign and malignant breast lesions, but also decreases the likelihood of unnecessary biopsies.

9.
Ultrasonography ; 40(2): 265-273, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32660207

RESUMO

PURPOSE: This study aimed to identify useful shear wave elastography (SWE) parameters for differentiating breast cancer and predicting associated immunohistochemical factors and subtypes. METHODS: From November 2018 to February 2019, a total of 211 breast lesions from 190 patients who underwent conventional breast ultrasonography and SWE were included. The Breast Imaging Reporting and Data System categories and qualitative and quantitative SWE parameters for each lesion were obtained. Pathologic results including immunohistochemical factors were evaluated. The diagnostic performance of each parameter and its correlation with histological characteristics, immunohistochemical factors, and subtypes of breast cancer were analyzed using analysis of variance, the independent t test, the Fisher exact test, logistic regression analysis, and the DeLong method. RESULTS: Among 211 breast lesions, 82 were malignant, and 129 were benign. Of the SWE parameters, Emax showed the highest area under the curve (AUC) for differentiating malignant from benign lesions (AUC, 0.891; cut-off>50.85). Poor tumor differentiation and progesterone receptor-negativity were correlated with higher SDmean and Emax (P<0.05). Ki-67-positive breast cancer showed higher SDmean and a heterogeneous color distribution (P<0.05). Ki-67 and cytokeratin 5/6-positive breast cancers showed higher Emax/Efat ratios (P<0.05). Luminal B, human epidermal growth factor receptor 2-enriched, and triple-negative (non-basal) subtypes showed somewhat higher SDmean values than the luminal A and triple-negative (basal) subtypes (P=0.028). CONCLUSION: Emax is a reliable parameter for differentiating malignancies from benign breast lesions. In addition, high stiffness and SDmean values in tumors measured on SWE could be used to predict poorly differentiated, progesterone receptor-negative, or Ki-67-positive breast cancer.

10.
Sci Rep ; 10(1): 7598, 2020 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-32371907

RESUMO

The purpose of this study was to investigate prognostic factors predicting recurrence of breast cancer, focusing on imaging factors including morphologic features, quantitative MR parameters, and clinicopathologic factors. This retrospective study was approved by our institutional review board, and the requirement to obtain informed consent was waived. A total of 267 patients with breast cancer were enrolled in this study, who underwent dynamic contrast-enhanced magnetic resonance imaging (MRI) before surgery from February 2014 to June 2016. Imaging parameters of MRI, including morphologic features, perfusion parameters, and texture analysis, were retrospectively reviewed by two expert breast radiologists. Clinicopathologic information of enrolled patients was also reviewed using medical records. Univariable and multivariable Cox proportional hazards regression analyses were used to identify factors associated with cancer recurrence. C statistics was used to discriminate low and high risk patients for disease recurrence. Using Kaplan-Meier survival analysis, disease-free survival was compared between patients who experienced recurrence and those who did not. At a median follow up of 49 months, 32 patients (12%) showed disease: six cases of ipsilateral breast or axilla recurrence, one case of contralateral breast recurrence, 24 cases of distant metastasis, and one case of both ipsilateral breast recurrence and distant metastasis. Of multiple imaging features and parameters, increased ipsilateral vascularity and higher positive skewness of texture analysis showed significant association with disease recurrence in every multivariable model regardless of tumor subtype and pathologic stage. Pathologic stage, especially if higher than stage II, showed significant association with disease recurrence and its highest hazard ratio was 3.45 [95% confidence interval (CI): 1.37-8.67, p = 0.008]. Of the multivariable models, the model including clinico-pathologic factors and both qualitative and quantitative imaging parameters showed good discrimination with a high C index value of 0.825 (95% CI: 0.755-0.896). In addition, recurrence associated factors were associated with short interval time to disease recurrence by Kaplan-Meier survival analysis. Therefore, comprehensive analysis using both clinico-pathologic factors and qualitative and quantitative imaging parameters is more effective in predicting breast cancer recurrence. Among those factors, higher pathologic stage, increased ipsilateral vascularity and higher positive skewness of texture analysis could be good predictors of breast cancer recurrence. Moreover, when these three factors are applied comprehensively, they may also be the predictors for poor survival.


Assuntos
Neoplasias da Mama/diagnóstico , Imageamento por Ressonância Magnética , Adulto , Neoplasias da Mama/mortalidade , Gerenciamento Clínico , Feminino , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Imageamento por Ressonância Magnética/métodos , Imageamento por Ressonância Magnética/normas , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Prognóstico , Modelos de Riscos Proporcionais , Fatores de Risco
11.
Breast Cancer Res Treat ; 181(2): 403-409, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32328848

RESUMO

PURPOSE: The ACOSOG Z0011 trial demonstrated that axillary lymph node dissection (ALND) is unnecessary in select patients with cT1-2N0 tumors undergoing breast-conserving therapy with 1-2 positive sentinel lymph nodes (SLNs). However, patients with preoperatively confirmed ALN metastasis were not included and may be subjected to unnecessary ALND. The aim of this study is to identify patients who can be considered for ALND omission when the preoperative ALN biopsy results are positive. METHODS: Breast cancer patients who underwent preoperative ALN biopsy and primary surgery were retrospectively reviewed. Among patients with positive ALN biopsy results, clinicopathological and imaging characteristics were compared according to LN disease burden (1-2 positive LNs vs. ≥ 3 positive LNs). RESULTS: A total of 542 patients were included in the analysis. Among them, 225 (41.5%) patients had a preoperative positive ALN biopsy. More than 40% of the patients (n = 99, 44.0%) with a positive biopsy had only 1-2 positive ALNs. The association between nodal burden and imaging factors was strongest when ≥ 2 suspicious LNs were identified on PET/CT images (HR 8.795, 95% CI 4.756 to 13.262). More than one imaging modality showing ≥ 2 suspicious LNs was also strongly correlated with ≥ 3 positive ALNs (HR 5.148, 95% CI 2.881 to 9.200). CONCLUSIONS: Nearly half of patients with a preoperative biopsy-proven ALN metastasis had only 1-2 positive LNs on ALND. Patients meeting ACOSOG Z0011 criteria with only one suspicious LN on PET/CT or those presenting with few abnormal ALNs on only one imaging modality appear appropriate for SLNB and consideration of ALND omission.


Assuntos
Neoplasias da Mama/cirurgia , Carcinoma Ductal de Mama/cirurgia , Carcinoma Lobular/cirurgia , Linfonodos/cirurgia , Mastectomia Segmentar/métodos , Biópsia de Linfonodo Sentinela/métodos , Axila , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/diagnóstico por imagem , Carcinoma Ductal de Mama/secundário , Carcinoma Lobular/diagnóstico por imagem , Carcinoma Lobular/secundário , Feminino , Seguimentos , Humanos , Excisão de Linfonodo , Linfonodos/patologia , Metástase Linfática , Pessoa de Meia-Idade , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Prognóstico , Receptor ErbB-2/metabolismo , Receptores de Estrogênio/metabolismo , Receptores de Progesterona/metabolismo , Estudos Retrospectivos
12.
PLoS One ; 15(3): e0230347, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32163500

RESUMO

PURPOSE: To investigate the feasibility of abbreviated magnetic resonance imaging (AB-MRI) in women with a personal history (PH) of breast cancer as a screening tool. MATERIALS AND METHODS: We retrospectively reviewed 1880 screening AB-MRIs in 763 women with a PH of breast cancer (median age, 55 years; range, 23-89 years) between October 2015 and October 2016. The total acquisition times of AB-MRI were 8.3 min and 2.8 min with and without T2-weighted imaging, respectively. The tissue diagnosis or one-year follow-up status was used as the reference standard. The characteristics of tumor recurrences detected on AB-MRI screenings were analyzed. The cancer detection rates (CDRs) and additional CDRs for the 1st round and overall rounds of AB-MRI screening were calculated. The recall rate, sensitivity, specificity, positive predictive values for recall (PPV1) and biopsy (PPV3) for the 1st round of AB-MRI screening were calculated. The diagnostic performance of the combination of mammography and ultrasonography was compared with that of AB-MRI by receiver operating characteristic (ROC) curve analysis. RESULTS: Fifteen of a total of 21 recurrences were detected on the 1st round of AB-MRI screening: 93.3% were node-negative T1 tumors (median tumor size, 1.02 cm; range, 0.1-2 cm) or Tis; 66.7% were high-grade tumors; 8 of these 15 were mammographically and ultrasonographically occult. The CDR and additional CDR for the 1st round of AB-MRI screening were 0.019 and 0.010 per woman, respectively. The sensitivity, specificity, recall rate, PPV1 and PPV3 for the 1st round of AB-MRI screening were 100%, 96.0%, 14.3%, 13.8% and 58.3%, respectively. For detecting secondary cancer, AB-MRI showed a higher sensitivity and PPV than the combination of mammography and ultrasonography (95.2%, 57.1% vs 47.6%, 38.5%). The area under the ROC curve was higher for AB-MRI (0.966; 95% CI: 0.951-0.978) than the combination of mammography and ultrasonography (0.727; 95% CI: 0.694-0.759) (P<0.0001). CONCLUSION: AB-MRI improved cancer detection with a high specificity, sensitivity and PPV in women with a PH of breast cancer. AB-MRI could be a useful screening tool for detecting secondary cancer considering its high diagnostic performance and short examination time.


Assuntos
Neoplasias da Mama/diagnóstico , Detecção Precoce de Câncer/métodos , Imageamento por Ressonância Magnética/métodos , Recidiva Local de Neoplasia/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Mama/ultraestrutura , Estudos de Viabilidade , Feminino , Humanos , Programas de Rastreamento , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
13.
Med Ultrason ; 22(1): 58-64, 2020 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-32096789

RESUMO

AIM: The objective of this study was to evaluate the diagnostic performance of second-look breast ultrasound (US) immediately after galactography in patients with nipple discharge. MATERIALS AND METHODS: Between January 2010 and November 2018, 89 patients with nipple discharge were retrospectively analyzed. All patients were examined by galactography and US. US was performed twice, before and after galactography. Galactography, mammography and US findings were categorized according to the Breast Imaging Reporting and Data System (BI-RADS). The final diagnosis was established by histopathological examination. RESULTS: Out of 89 patients, 25 (28.1%) patients had positive findings as evident by US before galactography. Forty-eight (53.9%) patients had positive findings as demonstrated by galactography. Fifty-nine (66.3%) patients had positive findings as evident by second-look US after galactography (13 patients with benign, 37 with borderline and 9 with malignant lesions). Second-look US after galactography showed the highest diagnostic accuracy (83.2%), sensitivity (95.8%) and negative predictive value (93.3%) for borderline and malignant lesions. For the detection of malignant lesions, secondlook US after galactography showed the highest sensitivity (90%) and negative predictive value (96.7%). Agreement between imaging and histological result using Bland-Altman analysis exhibited no significant difference between the size establishedby ultrasound and galactography. CONCLUSION: The second-look US after galactography is a powerful diagnostic tool for the detection of lesions in patients with nipple discharge and demonstrates high diagnostic accuracy, sensitivity and negative predictive value.


Assuntos
Mamografia , Derrame Papilar/diagnóstico por imagem , Mamilos/diagnóstico por imagem , Ultrassonografia Mamária , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos
14.
Magn Reson Imaging ; 66: 36-41, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31785544

RESUMO

PURPOSE: We aimed to investigate the magnetic resonance imaging (MRI) features and clinicopathologic factors with recurrence of triple-negative breast cancer (TNBC). PATIENTS AND METHODS: We identified 281 patients with 288 surgically confirmed TNBC lesions who underwent pretreatment MRI between 2009 and 2015. The presence of intratumoral high signal on T2-weighted images, high-signal rim on diffusion-weighted images (DWI), and rim enhancement on the dynamic contrast-enhanced MRI and clinicopathological data were collected. Cox proportional analysis was performed. RESULTS: Of the 288 lesions, 36 (12.5%) recurred after a median follow-up of 18 months (range, 3.6-68.3 months). Rim enhancement (hazard ratio [HR] = 3.15; 95% confidence interval [CI] = 1.01, 9.88; p = .048), and lymphovascular invasion (HR = 2.73, 95% CI = 1.20, 6.23; p = .016) were independently associated with disease recurrence. While fibroglandular volume, background parenchymal enhancement, intratumoral T2 high signal, and high-signal rim on DWI, were not found to be risk factors for recurrence. CONCLUSION: Pretreatment MRI features may help predict a high risk of recurrence in patients with TNBC.


Assuntos
Imageamento por Ressonância Magnética/métodos , Recidiva Local de Neoplasia/patologia , Neoplasias de Mama Triplo Negativas/diagnóstico por imagem , Neoplasias de Mama Triplo Negativas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Mama/diagnóstico por imagem , Mama/patologia , Meios de Contraste , Imagem de Difusão por Ressonância Magnética/métodos , Feminino , Seguimentos , Humanos , Aumento da Imagem/métodos , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Medição de Risco , Adulto Jovem
15.
Med Ultrason ; 21(3): 239-245, 2019 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-31476202

RESUMO

AIM: To investigate the effect of a computer-aided diagnosis (CAD) system on breast ultrasound (US) for inexperienced radiologists in describing and determining breast lesions. MATERIALS AND METHODS: Between October 2015 to January 2017, 500 suspicious or probable benign lesions in 413 patients were reviewed. Five experienced readers retrospectively reviewed for each of 100 lesions according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon and category, with CAD system (S-detectTM). The readers then made final decisions by combining CAD results to their US results. Using the nested experiment design, five inexperienced readers were asked to select the appropriate BI-RADS lexicons, categories, CAD results, and combination results for each of the 100 lesions, retrospectively. Diagnostic performance of experienced and inexperienced radiologists and CAD were assessed. For each case, agreements in the lexicons and categories were analyzed among the experienced reader, inexperienced reader and CAD. RESULTS: Indicators of the diagnostic performance for breast malignancy of the experienced group (AUC=0.83, 95%CI [0.80, 0.86]) were similar or higher than those of CAD (AUC = 0.79, 95%CI[0.74, 0.83], p=0.101), except for specificity. Conversely, indicators of diagnostic performance of inexperienced group (AUC=0.65, 95%CI[0.58, 0.71]) did not differ from or were lower than those of CAD(AUC=0.73, 95%CI[0.67, 0.78], p=0.013). Also, the diagnostic performance of the inexperienced group after combination with the CAD result was significantly improved (0.71, 95% CI [0.65, 0.77], p=0.001), whereas that of the experienced group did not change after combination with the CAD result, except for specificity and positive predictive value (PPV). Kappa values for the agreement of the categorization between CAD and each radiologist group were increased after applying the CAD result to their result of general US. Especially, the increase of the Kappa value was higher in the inexperienced group than in the experienced group. Also, for all the lexicons, the Kappa values between the experienced group and CAD were higher than those between the inexperienced group and CAD. CONCLUSION: By using the CAD system for classification of breast lesions, diagnostic performance of the inexperienced radiologists for malignancy was significantly improved, and better agreement was observed in lexicons between the experienced group and CAD than between the inexperienced group and CAD. CAD may be beneficial and educational for the inexperienced group.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Competência Clínica , Diagnóstico por Computador/métodos , Ultrassonografia Mamária/métodos , Mama/diagnóstico por imagem , Feminino , Humanos , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade
16.
AJR Am J Roentgenol ; 213(3): 710-715, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31063419

RESUMO

OBJECTIVE. The objective of this study was to evaluate changes in the positive predictive value (PPV) of categorization of suspicious calcification for malignancy with the 4th versus the 5th edition of BI-RADS. MATERIALS AND METHODS. A total of 469 cases from 444 women (mean age, 50.1 years; age range, 23-82 years) with pathologically confirmed suspicious calcifications from January 2012 to June 2016 were enrolled in this retrospective study. Two radiologists determined morphology and distribution by consensus and categorized suspicious calcifications using the categorization systems in the 4th and 5th editions of BI-RADS. The PPVs for morphology, distribution, and categorization of calcifications were analyzed. The Pearson chi-square test was used to compare PPVs for morphology and distribution of suspicious calcification. RESULTS. The PPVs of categorization using the 5th edition matched better with BI-RADS category assessment than did categorization using the 4th edition. The PPVs of morphology were as follows: amorphous, 15.9%; coarse heterogeneous, 31.7%; fine pleomorphic, 58.2%; and fine linear or branching, 90.6% (p < 0.001). The PPVs of distribution were as follows: regional, 31.5%; grouped, 31.3%; linear, 50%; and segmental, 77.9% (p < 0.001). When distribution was divided into two types (grouped or regional vs segmental or linear) and analyzed in combination with suspicious morphology, distribution affected the PPVs and categorization of coarse heterogeneous, fine pleomorphic, and fine linear or branching calcifications. CONCLUSION. Categorization using both morphology and distribution according to the BI-RADS 5th edition was helpful to stratify risk levels of areas of suspicious calcification.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Calcinose/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/patologia , Calcinose/patologia , Feminino , Humanos , Mamografia , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos
17.
Opt Express ; 27(9): 12762-12773, 2019 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-31052812

RESUMO

We investigate the electrical control of frequency conversion from a time-varying interdigitated photo-conductive antenna (IPCA) and time-varying metasurface in the terahertz (THz) frequency range. Ultrafast near-infrared (NIR) optical pulses rapidly modify the conductivities of the IPCA and metasurface; however, external voltages can retard this conductivity transition. Thus, external voltages can be used to control the frequency conversion process based on the interaction between the THz waves and the time-varying surfaces. In the IPCA, both frequency up- and down-conversion processes are suppressed by external voltages. However, in the metasurface, the down-conversion is dramatically suppressed by external voltages, whereas the suppression on the up-conversion is less effective.

18.
ACS Appl Mater Interfaces ; 11(8): 7655-7660, 2019 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-30757895

RESUMO

We propose a single-layer terahertz metasurface that acts as an efficient terahertz waveplate, providing phase retardation of up to 180° with a tunable operation frequency. Designed with the tight coupling of elementary resonators, our metasurface provides extraordinarily strong hyperbolicity that is closely associated with the distance between resonators, enabling both significant phase retardation and spectral tunability through mechanical deformation. The proposed concept of terahertz waveplates based on relatively simple metastructures fabricated on stretchable polydimethylsiloxane is experimentally confirmed using terahertz spectroscopy. It is believed that the proposed design will pave the way for a diverse range of terahertz applications.

19.
Cancer Res Treat ; 51(4): 1295-1301, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30699499

RESUMO

PURPOSE: Women with dense breast are known to be at high risk for breast cancer, but their prevalence and number of Korean women are unknown. The current study was to investigate the distribution of mammographic breast density by age of women undergoing screening mammography, and to estimate the prevalence of Korean women with dense breasts, quantitatively. Materials and Methods: For obtaining a nationwide representative sample, 6,481 mammograms were collected from 86 screening units participated in the National Cancer Screening Program for breast cancer. Based on the American College of Radiology Breast Imaging Reporting and Data System classification, breast density was evaluated by six breast radiologists, qualitatively. We applied these breast density distributions to age-specific counts of the Korean women population derived to mid-year 2017 to estimate the number of Korean women with dense breasts. RESULTS: Overall, 54.4% (95% confidence interval [CI], 52.9% to 55.8%) of women 40 to 69 years of age had heterogeneously or extremely dense breasts, and this proportion was inversely associated with age. Based on the age distribution of Korean women, we estimated that 6,083,000 women (95% CI, 5,919,600 to 6,245,600) age 40-69 years in Korean have dense breasts. Women aged 40-49 years (n=3,450,000) accounted for 56.7% of this group. CONCLUSION: More than half of Korean women aged 40 and over have dense breasts. To prevent breast cancer effectively and efficiently, it is necessary to develop a new personalized prevention strategy considering her status of breast density.


Assuntos
Densidade da Mama , Neoplasias da Mama/prevenção & controle , Mama/diagnóstico por imagem , Detecção Precoce de Câncer/métodos , Adulto , Distribuição por Idade , Idoso , Mama/patologia , Neoplasias da Mama/patologia , Estudos Transversais , Feminino , Humanos , Mamografia , Pessoa de Meia-Idade , Variações Dependentes do Observador , Medicina de Precisão , Prevalência , República da Coreia/epidemiologia
20.
Int J Clin Exp Pathol ; 12(2): 664-668, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31933872

RESUMO

BACKGROUND: Primary angiosarcoma of the breast is extremely rare, accounting for less than 0.05% of all primary malignancies of the breast. Here, we report here a case of primary angiosarcoma with full description of radiology and histology, including electron microscopic findings. CASE PRESENTATION: A 39-year-old woman complained of a diffuse hard mass in her right breast. She did not have any history of radiation exposure. Ultrasonography revealed a 7 cm sized mass with an irregular anechoic cystic portion replacing the entire right breast. Modified radical mastectomy was performed. The diagnosis of intermediate grade angiosarcoma was made by microscopic examination, immunohistochemical staining, and electron microscopic examination. The patient underwent four cycles of adriamycin-ifosfamide chemotherapy and received radiation therapy. Multiple bone metastases occurred 9 months after surgery and palliative treatment was given. Follow up was lost at post-operative 22 months. CONCLUSIONS: We report a rare case of intermediate grade primary angiosarcoma with detailed radiological and histological findings. Despite postoperative chemoradiation therapy, multiple metastases suggest that intermediate grade may have a more aggressive behavior.

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