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1.
Br J Radiol ; 94(1120): 20200880, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33560894

RESUMO

OBJECTIVES: To assess the value of contrast-enhanced ultrasound (CEUS) for diagnosing malignant non-mass breast lesions (NMLs) and to explore the CEUS diagnostic criteria. METHODS: A total of 116 patients with 119 NMLs detected by conventional US were enrolled. Histopathological results were used as the reference standard. The enhancement characteristics of NMLs in CEUS were compared between malignant and benign NMLs. The CEUS diagnostic criteria for malignant NMLs were established using independent diagnostic indicators identified by binary logistic regression analysis. The diagnostic performance of Breast Imaging Reporting and Data System-US (BI-RADS-US), CEUS, and BI-RADS-US combined with CEUS was evaluated and compared. RESULTS: Histopathological results showed 63 and 56 benign and malignant NMLs. Enhancement degree (OR = 5.75, p = 0.003), enhancement area (OR = 4.25, p = 0.005), and radial or penetrating vessels (OR = 7.54, p = 0.003) were independent diagnostic indicators included to establish the CEUS diagnostic criteria. The sensitivity and specificity of BI-RADS-US, CEUS, and BI-RADS-US combined with CEUS were 100 and 30.2%, 80.4 and 74.6%, and 94.6 and 77.8%, respectively; the corresponding areas under the receiver operating characteristic curve (AUC) were 0.819, 0.775, and 0.885, respectively. CONCLUSIONS: CEUS has a high specificity in malignant NML diagnosis based on the diagnostic criteria including enhancement degree, enhancement area, and radial or penetrating vessels, but with lower sensitivity than BI-RADS-US. The combination of CEUS and BI-RADS-US is an effective diagnostic tool with both high sensitivity and specificity for the diagnosis of malignant NMLs. ADVANCES IN KNOWLEDGE: In this study, we assessed the diagnostic value of CEUS for malignant NMLs and constructed a feasible diagnostic criterion. We further revealed that the combination of CEUS and BI-RADS-US has a high diagnostic value for malignant NMLs.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Meios de Contraste , Aumento da Imagem/métodos , Ultrassonografia Mamária/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Mama/diagnóstico por imagem , Feminino , Humanos , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade , Adulto Jovem
2.
Radiol Med ; 126(4): 517-526, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33385300

RESUMO

OBJECTIVES: To investigate the role of automated breast volume scanner (ABVS) compared to handheld ultrasound (HHUS) and contrast-enhanced magnetic resonance imaging (CE-MRI) in the early detection of patients with locally advanced breast cancer who are more likely to reach a complete pathological response (pCR) during neoadjuvant chemotherapy (NAC). METHODS: A single-institution prospective study was performed in patients with histological diagnosis of invasive breast cancer, eligible for NAC, and who were to undergo surgery in our Hospital. Imaging examinations with ABVS, HHUS and CE-MRI were performed at diagnosis (basal time) and after 3 months of chemotherapy (middle time). The tumor size of each lesion was measured at the basal and middle times, and the dimensional variation was reported. Based on this, patients were divided dichotomously by the median value, obtaining "good responders" (goodR) versus "poor responders" (poorR). The results were correlated with the histological assessment (pCR versus No-pCR) with the use of the intergroup comparison of categorical data (Fisher's exact test). RESULT: A total of 21 patients were included; 5 obtained a pCR (23%). Both the ABVS and the CE-MRI found all 5 patients with pCR in the group of goodR (10 patients), while none of the poorR (11 patients) obtained a pCR [correlation was statistically significant (p 0.01)]. In the HHUS, goodR (10 patients) 1 obtained a pCR while in the poorR (11 patients) 4 obtained a pCR [correlation not statistically significant (p 0.31)]. CONCLUSIONS: ABVS could be a useful tool, appearing to be more reliable than HHUS, and as accurate as CE-MRI, in early detection of patients who could reach a pCR after NAC.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Mama/diagnóstico por imagem , Terapia Neoadjuvante , Reconhecimento Automatizado de Padrão , Ultrassonografia Mamária/métodos , Adulto , Mama/anatomia & histologia , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Meios de Contraste , Feminino , Humanos , Imageamento Tridimensional , Imagem por Ressonância Magnética/métodos , Tamanho do Órgão , Estudos Prospectivos
3.
Radiol Clin North Am ; 59(1): 67-83, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33223001

RESUMO

The sensitivity of mammography is more limited in patients with dense breasts and some patients at higher risk for breast cancer. Patients with intermediate or high risk for breast cancer may begin screening earlier and benefit from supplemental screening techniques beyond standard 2-dimensional mammography. A patient's individual risk factors for developing breast cancer, their breast density, and the evidence supporting specific modalities for a given clinical scenario help to determine the need for supplemental screening and the modality chosen. Additional factors include the availability of supplemental screening techniques at an individual institution, cost, insurance coverage, and state-specific breast density legislation.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Meios de Contraste , Aumento da Imagem/métodos , Imagem por Ressonância Magnética/métodos , Mamografia/métodos , Ultrassonografia Mamária/métodos , Mama/diagnóstico por imagem , Detecção Precoce de Câncer , Feminino , Humanos , Risco
4.
Ultrasonics ; 110: 106271, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33166786

RESUMO

Accurate breast mass segmentation of automated breast ultrasound (ABUS) is a great help to breast cancer diagnosis and treatment. However, the lack of clear boundary and significant variation in mass shapes make the automatic segmentation very challenging. In this paper, a novel automatic tumor segmentation method SC-FCN-BLSTM is proposed by incorporating bi-directional long short-term memory (BLSTM) and spatial-channel attention (SC-attention) module into fully convolutional network (FCN). In order to decrease performance degradation caused by ambiguous boundaries and varying tumor sizes, an SC-attention module is designed to integrate both finer-grained spatial information and rich semantic information. Since ABUS is three-dimensional data, utilizing inter-slice context can improve segmentation performance. A BLSTM module with SC-attention is constructed to model the correlation between slices, which employs inter-slice context to assist segmentation for false positive elimination. The proposed method is verified on our private ABUS dataset of 124 patients with 170 volumes, including 3636 2D labeled slices. The Dice similarity coefficient (DSC), Recall, Precision and Hausdorff distance (HD) of the proposed method are 0.8178, 0.8067, 0.8292 and 11.1367. Experimental results demonstrate that the proposed method offered improved segmentation results compared with existing deep learning-based methods.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Interpretação de Imagem Assistida por Computador/métodos , Redes Neurais de Computação , Reconhecimento Automatizado de Padrão/métodos , Ultrassonografia Mamária/métodos , Algoritmos , Diagnóstico por Computador , Feminino , Humanos
5.
Medicine (Baltimore) ; 99(44): e22929, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33126355

RESUMO

RATIONALE: The incidence of pregnancy-associated breast cancer (PABC) is increasing nowadays, and its diagnosis and treatment remain complicated due to the consideration of the fetus. The available data on PABC are primarily derived from case reports since there are ethical restrictions on conducting randomized clinical trials. In the present work, we reported a case of the human epidermal growth factor receptor 2 (HER2)-positive PABC and described the diagnosis and treatment for such type of breast cancer. PATIENT CONCERNS: A 27-year-old patient was admitted to our hospital with the complaints of right breast mass for 3 days, and she was a first-time pregnant woman with a single live intrauterine fetus at 26 + 3 weeks of gestation. Physical examination of the right breast revealed a palpable and hard mass with obscure boundaries (5.0 cm × 4.0 cm) in the upper outer quadrant. Significant axillary lymph nodes (2.0 cm) were also present. DIAGNOSIS: PABC. INTERVENTION: To protect the fetus, breast ultrasonography was used to test her breast mass, a core needle biopsy was adopted to confirm the diagnosis, and abdominal ultrasound and chest X-ray were used to evaluate the metastasis. The patient was scheduled for neoadjuvant therapy using bi-weekly pirarubicin in combination with cyclophosphamide (AC) without anti-HER2 therapy for consideration of the fetus's safety. After 4 cycles of AC, the patient delivered a healthy male infant. After the delivery, all the treatments were carried out according to the standard recommendation for HER2 + breast cancer as non-pregnant patients. OUTCOMES: After the surgery, the disease-free survival for the patient was 12 months until brain metastasis was diagnosed. She was still undergoing second-line anti-HER2 therapy and currently in a stable situation. Besides, the child was also healthy so far. LESSONS: The methods for the diagnosis and treatment of PABC that result in teratogenesis should be avoided to protect the fetus. Mammogram and chest X-ray were safe approaches for the fetus. Moreover, chemotherapy-based on pirarubicin in combination with cyclophosphamide had no risk to the fetus.


Assuntos
Neoplasias da Mama , Ciclofosfamida/administração & dosagem , Doxorrubicina/análogos & derivados , Mastectomia Radical Extensa/métodos , Cuidado Pós-Natal/métodos , Complicações Neoplásicas na Gravidez , Receptor ErbB-2/antagonistas & inibidores , Trastuzumab/administração & dosagem , Adulto , Antineoplásicos/administração & dosagem , Biópsia com Agulha de Grande Calibre/métodos , Neoplasias da Mama/metabolismo , Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , Doxorrubicina/administração & dosagem , Feminino , Idade Gestacional , Humanos , Estadiamento de Neoplasias , Gravidez , Complicações Neoplásicas na Gravidez/metabolismo , Complicações Neoplásicas na Gravidez/patologia , Complicações Neoplásicas na Gravidez/terapia , Resultado da Gravidez , Ultrassonografia Mamária/métodos
6.
PLoS One ; 15(9): e0239271, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32941537

RESUMO

PURPOSE: To evaluate the kinetic patterns of benign and malignant breast lesions using contrast-enhanced digital mammogram (CEDM). METHODS: Women with suspicious breast lesions on mammography or ultrasound were enrolled. Single-view mediolateral oblique (MLO) CEDM of an affected breast was acquired at 2, 3, 4, 7, and 10 min after injection of contrast agent. Three readers visually and semi-quantitatively analyzed the enhancement of suspicious lesions. The kinetic pattern of each lesion was classified as persistent, plateau, or washout over two time intervals, 2-4 min and 2-10 min, by comparing the signal intensity at the first time interval with that at the second. RESULTS: There were 73 malignant and 75 benign lesions in 148 patients (mean age: 52 years). Benign and malignant breast lesions showed the highest signal intensity at 3 min and 2 min, respectively. Average areas under receiver operating characteristic (ROC) curve for diagnostic accuracy based on lesion enhancement at different time points were 0.73 at 2 min, 0.72 at 3 min, 0.69 at 4 min, 0.67 at 7 min, and 0.64 at 10 min. Diagnostic performance was significantly better at 2, 3, and 4 min than at 7 and 10 min (all p < 0.05). A washout kinetic pattern was significantly associated with malignant lesions at 2-4 min and 2-10 min frames according to two of the three readers' interpretations (all p ≤ 0.001). CONCLUSION: Applications of optimal time intervals and kinetic patterns show promise in differentiation of benign and malignant breast lesions on CEDM.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Mamografia/métodos , Ultrassonografia Mamária/métodos , Adulto , Neoplasias da Mama/epidemiologia , Meios de Contraste/farmacocinética , Feminino , Humanos , Mamografia/normas , Mamografia/estatística & dados numéricos , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Ultrassonografia Mamária/normas , Ultrassonografia Mamária/estatística & dados numéricos
7.
Rev. senol. patol. mamar. (Ed. impr.) ; 33(3): 116-120, jul.-sept. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-197296

RESUMO

El carcinoma sebáceo de mama (CSM) es una neoplasia muy poco frecuente. De acuerdo con la clasificación actual de la OMS, el CSM se define como un carcinoma de la mama en el que sus células presentan diferenciación sebácea en al menos el 50% de las mismas y no existe ninguna relación con las glándulas sebáceas de los anejos de la piel. Acorde con esta definición tan solo encontramos 21 casos descritos en la literatura. Presentamos un nuevo caso de CSM junto a una revisión de características clínicas, anatomopatológicas y terapéuticas de esta rara estirpe tumoral de mama


Sebaceous gland carcinoma (SGC) is an exceedingly rare neoplasm. According to the WHO, SGC is defined as a breast carcinoma in which at least 50% of cells show sebaceous differentiation and there is no relationship with the sebaceous glands of the skin annexes. Only 21 reported cases in the literature fit this definition. We present a new case of this rare breast tumour, as well as a review of its clinical, histological and therapeutic features


Assuntos
Humanos , Feminino , Idoso , Adenocarcinoma Sebáceo/patologia , Neoplasias da Mama/patologia , Carcinoma Ductal/patologia , Imuno-Histoquímica/métodos , Mamografia/métodos , Ultrassonografia Mamária/métodos , Mastectomia/métodos , Diagnóstico Diferencial
8.
Croat Med J ; 61(3): 223-229, 2020 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-32643338

RESUMO

AIM: To determine the relationship between breast stiffness assessed with sonoelastography (elasticity) and breast tissue density assessed with mammography (MG) and ultrasound (US). METHODS: This cross-sectional study involved 100 women who underwent MG, gray-scale US, and shear-wave sonoelastography during 2013. Mammographic density was categorized into four groups and sonographic density into three groups according to Breast Imaging-Reporting and Data System criteria. The stiffness of breast parenchymal and adipose tissue in all breast quadrants was quantified by shear-wave sonoelastography. Mean elastographic estimates were compared with MG- and US-derived density estimates. RESULTS: Parenchymal and adipose tissue elasticity positively correlated with MG- and US-derived breast density (for parenchyma: for MG Kendall's tau b 0.522; Jonckheere-Terpstra test P<0.001 and for US Kendall's tau b 0.533; Jonckheere-Terpstra test P<0.001); the higher was the breast density on MG and US, the higher was the elastographic stiffness. CONCLUSION: Sonoelastographic breast stiffness strongly positively correlated with breast density. Thus, sonoelastography may have a potential for estimating the breast cancer risk, which allows a novel application of this technique in routine clinical practice.


Assuntos
Tecido Adiposo/fisiologia , Densidade da Mama/fisiologia , Mama/diagnóstico por imagem , Mama/fisiologia , Técnicas de Imagem por Elasticidade/métodos , Tecido Parenquimatoso/fisiologia , Ultrassonografia Mamária/métodos , Adulto , Idoso , Estudos Transversais , Elasticidade/fisiologia , Feminino , Humanos , Pessoa de Meia-Idade , Ultrassonografia
10.
Rev. senol. patol. mamar. (Ed. impr.) ; 33(2): 68-71, abr.-jun. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-197286

RESUMO

INTRODUCCIÓN: El carcinoma medular es diagnosticado en aproximadamente del 1 al 7% de todos los cánceres mamarios y existen pocos casos asociados a una lesión quística. CASO CLÍNICO: Femenino de 34 años con diagnóstico de quiste complejo de mama derecha; histopatológicamente se reporta carcinoma medular en una de las paredes del quiste. CONCLUSIONES: Los tumores malignos de mama en formas quísticas han sido descritos en un 0,3-7%, y pocas veces son carcinomas medulares


INTRODUCTION: Medullary carcinoma is diagnosed in approximately 1% to 7% of all breast cancers and has been rarely associated with a cystic lesion. CASE REPORT: A 34-year-old woman was diagnosed with a complex cyst of the right breast. Histopathological analysis identified medullary carcinoma in one of the walls of the cyst. CONCLUSIONS: Malignant tumours of the breast are rarely found in cystic forms. Only 0.3% to 7% of breast cancer cases have been reported as medullary carcinomas


Assuntos
Humanos , Feminino , Adulto , Neoplasias da Mama/patologia , Carcinoma Medular/patologia , Cisto Mamário/patologia , Carcinoma Adenoide Cístico/patologia , Mamografia/métodos , Ultrassonografia Mamária/métodos , Excisão de Linfonodo/métodos , Mastectomia/métodos , Imuno-Histoquímica/métodos
11.
Int J Comput Assist Radiol Surg ; 15(6): 981-988, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32350786

RESUMO

PURPOSE: Detecting breast lesions using ultrasound imaging is an important application of computer-aided diagnosis systems. Several automatic methods have been proposed for breast lesion detection and segmentation; however, due to the ultrasound artefacts, and to the complexity of lesion shapes and locations, lesion or tumor segmentation from ultrasound breast images is still an open problem. In this paper, we propose using a lesion detection stage prior to the segmentation stage in order to improve the accuracy of the segmentation. METHODS: We used a breast ultrasound imaging dataset which contained 163 images of the breast with either benign lesions or malignant tumors. First, we used a U-Net to detect the lesions and then used another U-Net to segment the detected region. We could show when the lesion is precisely detected, the segmentation performance substantially improves; however, if the detection stage is not precise enough, the segmentation stage also fails. Therefore, we developed a test-time augmentation technique to assess the detection stage performance. RESULTS: By using the proposed two-stage approach, we could improve the average Dice score by 1.8% overall. The improvement was substantially more for images wherein the original Dice score was less than 70%, where average Dice score was improved by 14.5%. CONCLUSIONS: The proposed two-stage technique shows promising results for segmentation of breast US images and has a much smaller chance of failure.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Mama/diagnóstico por imagem , Diagnóstico por Computador , Processamento de Imagem Assistida por Computador/métodos , Ultrassonografia Mamária/métodos , Artefatos , Bases de Dados Factuais , Feminino , Humanos
12.
Arch Gynecol Obstet ; 301(6): 1533-1541, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32363545

RESUMO

PURPOSE: To prospectively compare the diagnostic accuracy of radial breast ultrasound (r-US) to that of conventional meander-like breast ultrasound (m-US), patients of a consecutive, unselected, mixed collective were examined by both scanning methods. METHODS: Out of 1948 dual examinations, 150 revealed suspicious lesions resulting in 168 biopsies taken from 148 patients. Histology confirmed breast cancers in 36 cases. Sensitivity, specificity, accuracy, PPV, and NPV were calculated for r-US and m-US. The examination times were recorded. RESULTS: For m-US and r-US, sensitivity (both 88.9%), specificity (86.4% versus 89.4%), accuracy (86.9% versus 89.3%), PPV (64.0% versus 69.6%), NPV (both 98.3%), false-negative rate (both 5.6%), and rate of cancer missed by one method (both 5.6%) were similar. The mean examination time for r-US (14.8 min) was significantly (p < 0.01) shorter than for m-US (22.6 min). CONCLUSION: Because the diagnostic accuracy of r-US and m-US are comparable, r-US can be considered an alternative to m-US in routine breast US with the added benefit of a significantly shorter examination time.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Ultrassonografia Mamária/métodos , Neoplasias da Mama/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos
13.
Br J Radiol ; 93(1112): 20200195, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32463295

RESUMO

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.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Calcinose/diagnóstico por imagem , Meios de Contraste , Imagem por Ressonância Magnética , Ultrassonografia Mamária/métodos , Adolescente , Adulto , Idoso , Mama/diagnóstico por imagem , Mama/patologia , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/patologia , Calcinose/diagnóstico , Feminino , Humanos , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Adulto Jovem
14.
Clin Imaging ; 66: 111-120, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32470708

RESUMO

Breast malignancy is the second most common cause of cancer death in women. However, less common breast masses can mimic carcinoma and can pose diagnostic challenges. This case-based review describes a spectrum of rare breast neoplastic and non-neoplastic masses ranging from malignant to benign entities. Malignant masses in this review include adenoid cystic carcinoma, spindle cell lipoma, granular cell tumor, angiosarcoma, glomus tumor, adenosquamous carcinoma, and myofibroblastoma. Benign masses include sarcoidosis, diabetic mastopathy, and cat scratch disease. Demographics and, when relevant, clinical presentation are summarized. Breast imaging appearance on mammography and ultrasound are highlighted along with radiology-pathology correlation with the appearance and characteristics of the histopathological specimen of these rare masses.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Mama/diagnóstico por imagem , Adulto , Mama/patologia , Neoplasias da Mama/patologia , Diagnóstico Diferencial , Feminino , Tumor Glômico , Humanos , Lipoma/diagnóstico , Mamografia/métodos , Mastite/diagnóstico , Pessoa de Meia-Idade , Ultrassonografia , Ultrassonografia Mamária/métodos
15.
Radiol Med ; 125(12): 1243-1248, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32367322

RESUMO

BACKGROUND: Breast density is an independent risk factor for breast cancer. Mammography is supplemented with handheld ultrasound (HHUS) to increase sensitivity. Automatic breast ultrasound (ABUS) is an alternative to HHUS. Our study wanted to assess the difference in execution and reading time between ABUS and HHUS. METHODS AND MATERIALS: N = 221 women were evaluated consecutively between January 2019 and June 2019 (average age 53 years; range 24-89). The execution and reading time of ABUS and HHUS was calculated with an available stopwatch. Time started for both procedures when the patient was ready on the examination table to be examined to the end of image acquisition and interpretation. RESULTS: No patients interrupted the exam due to pain or discomfort. N = 221 women underwent ABUS and HHUS; N = 11 patients refused to undergo both procedures due to time constraints and refused ABUS; therefore, 210 patients were enrolled with both ABUS and HHUS available. The average time to perform and read the exam was 5 min for HHUS (DS ± 1.5) with a maximum time of 11 min and a minimum of 2 min. The average time with ABUS was 17 min (DS ± 3.8, with a maximum time of 31 min and a minimum time of 9 min). The ABUS technique took longer to be performed in all patients, with an average difference of 11 min (range 3-23 min) per patient, P < 0,001. Separating ABUS execution from reading time we highlighted as ABUS execution is more time-consuming respect HHUS. In addition, we can underline that time required by radiologists is longer for ABUS even only considering the interpretation time of the exam. CONCLUSION: A significant difference was observed in the execution and reading time of the two exams, where the HHUS method was more rapid and tolerated.


Assuntos
Densidade da Mama , Ultrassonografia Mamária/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Fatores de Risco , Sensibilidade e Especificidade , Fatores de Tempo , Ultrassonografia Mamária/estatística & dados numéricos , Adulto Jovem
16.
Ann R Coll Surg Engl ; 102(7): e167-e169, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32347740

RESUMO

Lymphadenopathy is a common presentation in surgical assessment units and has numerous differential diagnoses. In one-stop breast clinics, its discovery often raises concerns of malignancy. This case report focuses on the case of a 33-year-old pregnant woman presenting to the breast clinic with a right axillary lump, which was found to be the result of toxoplasmosis.


Assuntos
Linfadenopatia/etiologia , Complicações Parasitárias na Gravidez , Toxoplasmose/complicações , Adulto , Axila , Biópsia , Diagnóstico Diferencial , Feminino , Humanos , Linfonodos/patologia , Linfadenopatia/diagnóstico , Gravidez , Toxoplasmose/diagnóstico , Ultrassonografia Mamária/métodos
17.
Korean J Radiol ; 21(5): 550-560, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32323500

RESUMO

OBJECTIVE: To evaluate the interobserver agreement, diagnostic value, and associated clinical factors of automated breast ultrasound (ABUS) coronal features in differentiating breast lesions. MATERIALS AND METHODS: This study enrolled 457 pathologically confirmed lesions in 387 female (age, 46.4 ± 10.3 years), including 377 masses and 80 non-mass lesions (NMLs). The unique coronal features, including retraction phenomenon, hyper- or hypoechoic rim (continuous or discontinuous), skipping sign, and white wall sign, were defined and recorded. The interobserver agreement on image type and coronal features was evaluated. Furthermore, clinical factors, including the lesion size, distance to the nipple or skin, palpability, and the histological grade were analyzed. RESULTS: Among the 457 lesions, 296 were malignant and 161 were benign. The overall interobserver agreement for image type and all coronal features was moderate to good. For masses, the retraction phenomenon was significantly associated with malignancies (p < 0.001) and more frequently presented in small and superficial invasive carcinomas with a low histological grade (p = 0.027, 0.002, and < 0.001, respectively). Furthermore, continuous hyper- or hypoechoic rims were predictive of benign masses (p < 0.001), whereas discontinuous rims were predictive of malignancies (p < 0.001). A hyperechoic rim was more commonly detected in masses more distant from the nipple (p = 0.027), and a hypoechoic rim was more frequently found in large superficial masses (p < 0.001 for both). For NMLs, the skipping sign was a predictor of malignancies (p = 0.040). CONCLUSION: The coronal plane of ABUS may provide useful diagnostic value for breast lesions.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Mama/diagnóstico por imagem , Carcinoma Ductal de Mama/diagnóstico por imagem , Ultrassonografia Mamária/métodos , Adulto , Idoso , Mama/patologia , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/diagnóstico , Feminino , Humanos , Pessoa de Meia-Idade , Variações Dependentes do Observador , Sensibilidade e Especificidade
18.
Br J Radiol ; 93(1110): 20190932, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32216631

RESUMO

OBJECTIVE: This study aimed to compare the diagnostic performance of contrast-enhanced ultrasound (CEUS), MRI, and the combined use of the two modalities for differentiating breast lesions of different sizes. METHODS: A total of 406 patients with 406 solid breast masses detected by conventional ultrasound underwent both CEUS and MRI scans. Histological results were used as reference standards. The lesions were categorized into three groups according to size (Group 1, ≤ 20 mm; Group 2, > 20 mm, Group 3: total lesions). Sensitivity, specificity, accuracy, and receiver operating characteristic (ROC) curve analysis were used to assess the diagnostic performance of these imaging methods for breast lesions. RESULTS: There were 194 benign and 212 malignant breast lesions according to the histological diagnosis. Compared with MRI, CEUS demonstrated similar sensitivity in detecting breast cancer (p = 1.0000 for all) in all the three groups. With regard to specificity, accuracy, and the area under the ROC curve (Az) values, MRI showed a better performance than that shown by CEUS (p <0.05 for all), and the combination of the two modalities improved the diagnostic performance of CEUS alone significantly (p <0.05 for all) in all the three groups. However, the diagnostic specificity and accuracy of the combined method was not superior to that of MRI alone except for Group 2. CONCLUSION: CEUS demonstrated good sensitivity in detecting breast cancer, and the combined use with MRI can optimize the diagnostic specificity and accuracy in breast cancer prediction. ADVANCES IN KNOWLEDGE: Few studies have compared the diagnostic efficacy of CEUS and MRI, and this study is the first attempt to seek out the diagnostic values for breast lesions of variable sizes (lesions with ≤20 mm and >20 mm).


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Meios de Contraste , Imagem por Ressonância Magnética/métodos , Ultrassonografia Mamária/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Mamárias/diagnóstico por imagem , Doenças Mamárias/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Imagem Multimodal/métodos , Curva ROC , Estudos Retrospectivos , Sensibilidade e Especificidade , Carga Tumoral , Adulto Jovem
19.
Anticancer Res ; 40(3): 1719-1729, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32132080

RESUMO

AIM: To assess the ability of ultrasound (US)-guided vacuum-assisted breast excision (VAE) to remove Breast Imaging Reporting and Data System (BI-RADS) ≥3 breast lesions in order to analyze US features most frequently associated with complete excision. MATERIALS AND METHODS: A total of 266 BI-RADS ≥3 lesions without microcalcifications underwent US-VAE. US-VAE and gold standard pathological results were compared. US features of lesions were analyzed. RESULTS: The complete excision rate was 93.61%; the VAE agreement rate was 99.62%. Circumscribed margins, regular shape, parallel orientation, and the absence of posterior features were favorable US features associated with complete excision. Lesions completely excised were: BI-RADS 3 ≤21.10 mm and BI-RADS 4 ≤18.70 mm with one unfavorable US characteristic, and BI-RADS 4 lesions ≤13.5 mm with two unfavorable US features hindered complete removal. Two atypical ductal hyperplasias (<10 mm, one unfavorable feature) and eight ductal carcinomas in situ (≤8.7 mm, one/two unfavorable features) were completely removed. CONCLUSION: US-VAE is highly accurate for diagnostic purpose and, in some cases, highly successful for complete lesion excision. This success also depends on the US characteristics and size of the lesion.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Mama/patologia , Ultrassonografia Mamária/métodos , Adulto , Idoso , Neoplasias da Mama/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
20.
Arch Gynecol Obstet ; 301(5): 1257-1265, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32215718

RESUMO

PURPOSE: To compare automated breast volumetric scanning (ABVS) with hand-held bilateral whole breast ultrasound (HHUS) prospectively in regards to patient workflow, woman preference, efficacy in lesion detection, and characterization. MATERIALS AND METHODS: Supplemental screening was performed with both ABVS and HHUS to 345 women with dense breasts and negative mammograms. Acquisition and evaluation times were recorded. Lesions were classified according to BIRADS US criteria and compared one to one. Women were recalled for a secondary HHUS examination if ABVS showed any additional lesions. Findings were compared based on biopsy results and/or 36-48 months of follow-up. RESULTS: Findings could be compared for 340 women. There were two carcinomas which were detected by both methods, with no interval cancers in the follow-up period. Recall rate was 46/340 (13.05%) for ABVS and 4/340 (1.18%) for HHUS. ABVS recalls decreased with experience. HHUS had more true negative (BIRADS 1-2) results, while ABVS had more false positive ones (p < 0.001). Positive predictive value was 4.17% for ABVS and 50% for HHUS. ABVS overdiagnosed shadowings (p < 0.01), distortions (p < 0.034), and irregular nodules (p < 0.001) in comparison to HHUS. At ABVS, 10.6% of women experienced severe pain. 59.7% stated that they would choose HHUS if they had the chance. CONCLUSION: ABVS is as good as HHUS in lesion detection. However, the recall rate is higher and positive predictive value is lower with ABVS, which could result in more follow-ups, and more anxiety for the women. More than 50% women stated they would prefer HHUS if they were given the chance.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Mama/diagnóstico por imagem , Interpretação de Imagem Assistida por Computador/métodos , Mamografia/métodos , Reconhecimento Automatizado de Padrão/métodos , Ultrassonografia Mamária/métodos , Adulto , Idoso , Biópsia , Mama/patologia , Densidade da Mama , Neoplasias da Mama/patologia , Feminino , Humanos , Aumento da Imagem/métodos , Masculino , Mamografia/instrumentação , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Sensibilidade e Especificidade , Ultrassonografia Mamária/instrumentação
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