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Tomosynthesis-detected Architectural Distortion: Management Algorithm with Radiologic-Pathologic Correlation.
Durand, Melissa A; Wang, Steven; Hooley, Regina J; Raghu, Madhavi; Philpotts, Liane E.
Afiliação
  • Durand MA; From the Department of Radiology, Yale University School of Medicine, 333 Cedar St, PO Box 208042, New Haven, CT 06520-8042 (M.A.D., R.J.H., M.R., L.E.P.); and Department of Radiology, Kaiser Permanente, Bakersfield, Calif (S.W.).
  • Wang S; From the Department of Radiology, Yale University School of Medicine, 333 Cedar St, PO Box 208042, New Haven, CT 06520-8042 (M.A.D., R.J.H., M.R., L.E.P.); and Department of Radiology, Kaiser Permanente, Bakersfield, Calif (S.W.).
  • Hooley RJ; From the Department of Radiology, Yale University School of Medicine, 333 Cedar St, PO Box 208042, New Haven, CT 06520-8042 (M.A.D., R.J.H., M.R., L.E.P.); and Department of Radiology, Kaiser Permanente, Bakersfield, Calif (S.W.).
  • Raghu M; From the Department of Radiology, Yale University School of Medicine, 333 Cedar St, PO Box 208042, New Haven, CT 06520-8042 (M.A.D., R.J.H., M.R., L.E.P.); and Department of Radiology, Kaiser Permanente, Bakersfield, Calif (S.W.).
  • Philpotts LE; From the Department of Radiology, Yale University School of Medicine, 333 Cedar St, PO Box 208042, New Haven, CT 06520-8042 (M.A.D., R.J.H., M.R., L.E.P.); and Department of Radiology, Kaiser Permanente, Bakersfield, Calif (S.W.).
Radiographics ; 36(2): 311-21, 2016.
Article em En | MEDLINE | ID: mdl-26963448
ABSTRACT
As use of digital breast tomosynthesis becomes increasingly widespread, new management challenges are inevitable because tomosynthesis may reveal suspicious lesions not visible at conventional two-dimensional (2D) full-field digital mammography. Architectural distortion is a mammographic finding associated with a high positive predictive value for malignancy. It is detected more frequently at tomosynthesis than at 2D digital mammography and may even be occult at conventional 2D imaging. Few studies have focused on tomosynthesis-detected architectural distortions to date, and optimal management of these distortions has yet to be well defined. Since implementing tomosynthesis at our institution in 2011, we have learned some practical ways to assess architectural distortion. Because distortions may be subtle, tomosynthesis localization tools plus improved visualization of adjacent landmarks are crucial elements in guiding mammographic identification of elusive distortions. These same tools can guide more focused ultrasonography (US) of the breast, which facilitates detection and permits US-guided tissue sampling. Some distortions may be sonographically occult, in which case magnetic resonance imaging may be a reasonable option, both to increase diagnostic confidence and to provide a means for image-guided biopsy. As an alternative, tomosynthesis-guided biopsy, conventional stereotactic biopsy (when possible), or tomosynthesis-guided needle localization may be used to achieve tissue diagnosis. Practical uses for tomosynthesis in evaluation of architectural distortion are highlighted, potential complications are identified, and a working algorithm for management of tomosynthesis-detected architectural distortion is proposed.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Mama / Mamografia / Interpretação de Imagem Assistida por Computador / Intensificação de Imagem Radiográfica / Carcinoma Ductal de Mama Tipo de estudo: Prognostic_studies Limite: Female / Humans Idioma: En Ano de publicação: 2016 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Mama / Mamografia / Interpretação de Imagem Assistida por Computador / Intensificação de Imagem Radiográfica / Carcinoma Ductal de Mama Tipo de estudo: Prognostic_studies Limite: Female / Humans Idioma: En Ano de publicação: 2016 Tipo de documento: Article