Stereotactic core biopsy of an impalpable screen-detected breast lesion using acupuncture-analgesia
R E English and J H Chen
Br J Radiol 2010;83:e208-e210
Link to Journal
Chinese acupuncture-analgesia is used for pain management during various surgical procedures. Over the past 40 years this approach has been introduced in many countries and has been particularly helpful in the investigation and treatment of patients who are unable to tolerate conventional analgesia.
We report here the case of a woman with a 17-year history of myalgic encephalitis who underwent a stereotactic core biopsy of the breast under acupuncture-analgesia. A planning session was needed to assess the patient’s existing condition and her response to acupuncture. During this session, a range of frequencies for electrical stimulation of the acupuncture needles using electro-acupuncture apparatus was determined. We describe the combined acupuncture and biopsy procedures and the patient’s impressions and outcomes are recorded
Stereotactic core biopsy of the breast under acupuncture-analgesia was well tolerated by the patient, allowing a satisfactory histological sample to be obtained. Overall the procedure was regarded as successful by the patient and all the staff involved. Given our positive experience with this patient we would be happy to offer the service to other patients who are unable to tolerate conventional local analgesia or who wish to exert patient choice
Sunday, 19 September 2010
Sunday, 18 July 2010
Zooming method (x 2.0) of digital mammography vs digital magnification view (x 1.8) in full-field digital mammography for the diagnosis of microcalcifications
Zooming method (x 2.0) of digital mammography vs digital magnification view (x 1.8) in full-field digital mammography for the diagnosis of microcalcifications
M J Kim, J H Youk, D R Kang, S H Choi, J Y Kwak, E J Son, and E-K Kim
Br J Radiol 2010;83 486-492
Link to Journal
The purpose of this study was to determine whether the interpretation of microcalcifications assessed on images zoomed (x 2.0) from digital mammograms is at least equivalent to that from digital magnification mammography (x 1.8) with respect to diagnostic accuracy and image quality.
Three radiologists with different levels of experience in mammography reviewed each full-field digital mammography reader set for 185 patients with pathologically proven microcalcification clusters, which consisted of digital magnification mammograms (MAGs) with a magnification factor of 1.8 and images zoomed from mammograms (ZOOM) with a zoom factor of 2.0. Each radiologist rated their suspicion of breast cancer in microcalcific lesions using a six-point scale and the image quality and their confidence in the decisions using a five-point scale. Results were analysed according to display methods using areas under the receiver operating characteristic curves (Az value) for ZOOM and MAGs to interpret microcalcifications, and the Wilcoxon matched pairs signed rank test for image quality and confidence levels.
There was no statistically significant difference in the level of suspicion of breast cancer between the ZOOM and MAG groups (Az = 0.8680 for ZOOM; Az = 0.8682 for MAG; p = 0.9897). However, MAG images were significantly better than ZOOM images in terms of visual imaging quality (p < 0.001), and the confidence level with MAG was better than with ZOOM (p < 0.001).
In conclusion, the performance of radiologists in the diagnosis of microcalcifications using ZOOM was similar to that using MAGs, although image quality and confidence levels were better using MAGs
M J Kim, J H Youk, D R Kang, S H Choi, J Y Kwak, E J Son, and E-K Kim
Br J Radiol 2010;83 486-492
Link to Journal
The purpose of this study was to determine whether the interpretation of microcalcifications assessed on images zoomed (x 2.0) from digital mammograms is at least equivalent to that from digital magnification mammography (x 1.8) with respect to diagnostic accuracy and image quality.
Three radiologists with different levels of experience in mammography reviewed each full-field digital mammography reader set for 185 patients with pathologically proven microcalcification clusters, which consisted of digital magnification mammograms (MAGs) with a magnification factor of 1.8 and images zoomed from mammograms (ZOOM) with a zoom factor of 2.0. Each radiologist rated their suspicion of breast cancer in microcalcific lesions using a six-point scale and the image quality and their confidence in the decisions using a five-point scale. Results were analysed according to display methods using areas under the receiver operating characteristic curves (Az value) for ZOOM and MAGs to interpret microcalcifications, and the Wilcoxon matched pairs signed rank test for image quality and confidence levels.
There was no statistically significant difference in the level of suspicion of breast cancer between the ZOOM and MAG groups (Az = 0.8680 for ZOOM; Az = 0.8682 for MAG; p = 0.9897). However, MAG images were significantly better than ZOOM images in terms of visual imaging quality (p < 0.001), and the confidence level with MAG was better than with ZOOM (p < 0.001).
In conclusion, the performance of radiologists in the diagnosis of microcalcifications using ZOOM was similar to that using MAGs, although image quality and confidence levels were better using MAGs
Monday, 5 July 2010
Extraction of a foreign body from the breast parenchyma using radioguided occult lesion localisation (ROLL) technique: a new approach
Extraction of a foreign body from the breast parenchyma using radioguided occult lesion localisation (ROLL) technique: a new approach
F Aydogan, D Atasoy, D Cebi Olgun, A Suleyman Dikici, A Aliyev, and E
Gazioglu
Br J Radiol 2010;83 e147-e149
Link to Journal
The radioguided occult lesion localisation (ROLL) technique is used for the excision of non-palpable breast lesions. This technique has not been described previously for the extraction of foreign bodies from the breast parenchyma. We report here a female patient who was admitted to our hospital with a foreign body in her right breast. The ROLL technique was used for the extraction of the foreign body
F Aydogan, D Atasoy, D Cebi Olgun, A Suleyman Dikici, A Aliyev, and E
Gazioglu
Br J Radiol 2010;83 e147-e149
Link to Journal
The radioguided occult lesion localisation (ROLL) technique is used for the excision of non-palpable breast lesions. This technique has not been described previously for the extraction of foreign bodies from the breast parenchyma. We report here a female patient who was admitted to our hospital with a foreign body in her right breast. The ROLL technique was used for the extraction of the foreign body
Thursday, 25 March 2010
Assessing heterogeneity of lesion enhancement kinetics in dynamic contrast-enhanced MRI for breast cancer diagnosi
Assessing heterogeneity of lesion enhancement kinetics in dynamic contrast-enhanced MRI for breast cancer diagnosis
A Karahaliou, K Vassiou, N S Arikidis, S Skiadopoulos, T Kanavou, and L
Costaridou
Br J Radiol 2010;83 296-309
Link to Journal
The current study investigates the feasibility of using texture analysis to quantify the heterogeneity of lesion enhancement kinetics in order to discriminate malignant from benign breast lesions. A total of 82 biopsy-proven breast lesions (51 malignant, 31 benign), originating from 74 women subjected to dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) were analysed. Pixel-wise analysis of DCE-MRI lesion data was performed to generate initial enhancement, post-initial enhancement and signal enhancement ratio (SER) parametric maps; these maps were subsequently subjected to co-occurrence matrix texture analysis.
The discriminating ability of texture features extracted from each parametric map was investigated using a least-squares minimum distance classifier and further compared with the discriminating ability of the same texture features extracted from the first post-contrast frame.
Selected texture features extracted from the SER map achieved an area under receiver operating characteristic curve of 0.922 ± 0.029, a performance similar to post-initial enhancement map features (0.906 ± 0.032) and statistically significantly higher than for initial enhancement map (0.767 ± 0.053) and first post-contrast frame (0.756 ± 0.060) features.
Quantifying the heterogeneity of parametric maps that reflect lesion washout properties could contribute to the computer-aided diagnosis of breast lesions in DCE-MRI
A Karahaliou, K Vassiou, N S Arikidis, S Skiadopoulos, T Kanavou, and L
Costaridou
Br J Radiol 2010;83 296-309
Link to Journal
The current study investigates the feasibility of using texture analysis to quantify the heterogeneity of lesion enhancement kinetics in order to discriminate malignant from benign breast lesions. A total of 82 biopsy-proven breast lesions (51 malignant, 31 benign), originating from 74 women subjected to dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) were analysed. Pixel-wise analysis of DCE-MRI lesion data was performed to generate initial enhancement, post-initial enhancement and signal enhancement ratio (SER) parametric maps; these maps were subsequently subjected to co-occurrence matrix texture analysis.
The discriminating ability of texture features extracted from each parametric map was investigated using a least-squares minimum distance classifier and further compared with the discriminating ability of the same texture features extracted from the first post-contrast frame.
Selected texture features extracted from the SER map achieved an area under receiver operating characteristic curve of 0.922 ± 0.029, a performance similar to post-initial enhancement map features (0.906 ± 0.032) and statistically significantly higher than for initial enhancement map (0.767 ± 0.053) and first post-contrast frame (0.756 ± 0.060) features.
Quantifying the heterogeneity of parametric maps that reflect lesion washout properties could contribute to the computer-aided diagnosis of breast lesions in DCE-MRI
Investigation of the effect of anode/filter materials on the dose and image quality of a digital mammography system based on an amorphous selenium fla
Investigation of the effect of anode/filter materials on the dose and image quality of a digital mammography system based on an amorphous selenium flat panel detector
P Baldelli, N Phelan, and G Egan
Br J Radiol 2010;83 290-295
Link to Journal
A comparison, in terms of image quality and glandular breast dose, was carried out between two similar digital mammography systems using amorphous selenium flat panel detectors.
The two digital mammography systems currently available from Lorad-Hologic were compared. The original system utilises Mo/Mo and Mo/Rh as target/filter combinations, while the new system uses W/Rh and W/Ag. Images of multiple mammography phantoms with simulated compressed breast thicknesses of 4 cm, 5 cm and 6 cm and various glandular tissue equivalency were acquired under different spectral conditions. The contrast of five details, corresponding to five glandular compositions, was calculated and the ratio of the square of the contrast-to-noise ratio to the average glandular dose was used as a figure-of-merit (FOM) to compare results. For each phantom thickness and target/filter combination, there is an optimum voltage that maximises the FOM.
Results show that the W/Rh combination is the best choice for all the detection tasks studied, but for thicknesses greater than 6 cm the W/Ag combination would probably be the best choice. In addition, the new system with W filter presents a better optimisation of the automatic exposure control in comparison with the original system with Mo filter
P Baldelli, N Phelan, and G Egan
Br J Radiol 2010;83 290-295
Link to Journal
A comparison, in terms of image quality and glandular breast dose, was carried out between two similar digital mammography systems using amorphous selenium flat panel detectors.
The two digital mammography systems currently available from Lorad-Hologic were compared. The original system utilises Mo/Mo and Mo/Rh as target/filter combinations, while the new system uses W/Rh and W/Ag. Images of multiple mammography phantoms with simulated compressed breast thicknesses of 4 cm, 5 cm and 6 cm and various glandular tissue equivalency were acquired under different spectral conditions. The contrast of five details, corresponding to five glandular compositions, was calculated and the ratio of the square of the contrast-to-noise ratio to the average glandular dose was used as a figure-of-merit (FOM) to compare results. For each phantom thickness and target/filter combination, there is an optimum voltage that maximises the FOM.
Results show that the W/Rh combination is the best choice for all the detection tasks studied, but for thicknesses greater than 6 cm the W/Ag combination would probably be the best choice. In addition, the new system with W filter presents a better optimisation of the automatic exposure control in comparison with the original system with Mo filter
Advances in mammographic imaging
Advances in mammographic imaging
K J Robson
Br J Radiol 2010;83 273-275
Link to Journal
Breast imaging in the UK is currently undergoing a major change, with the widespread implementation of full-field digital mammography (FFDM) equipment. This article looks at some of the advanced imaging techniques that have become possible following the development of FFDM units. These techniques may prove to be useful additions to standard mammography for some groups of women
K J Robson
Br J Radiol 2010;83 273-275
Link to Journal
Breast imaging in the UK is currently undergoing a major change, with the widespread implementation of full-field digital mammography (FFDM) equipment. This article looks at some of the advanced imaging techniques that have become possible following the development of FFDM units. These techniques may prove to be useful additions to standard mammography for some groups of women
Friday, 5 February 2010
The effect of Premium View post-processing software on digital mammographic reporting
The effect of Premium View post-processing software on digital mammographic reporting
E J Goldstraw, I Castellano, S Ashley, and S Allen
Br J Radiol 2010;83 122-128
Link to Journal
The use of Premium View may lead to higher cancer detection rates, at the expense of an initial increase in recall rate. Although prospective studies are suggested, this result is of interest in light of the proposed installation of digital mammography across the NHS Breast Screening Programme
E J Goldstraw, I Castellano, S Ashley, and S Allen
Br J Radiol 2010;83 122-128
Link to Journal
The use of Premium View may lead to higher cancer detection rates, at the expense of an initial increase in recall rate. Although prospective studies are suggested, this result is of interest in light of the proposed installation of digital mammography across the NHS Breast Screening Programme
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