Comparative analysis of image-based phenotypes of mammographic density and parenchymal patterns in distinguishing between BRCA1/2 cases, unilateral cancer cases, and controls.

We statistically compare the contributions of parenchymal phenotypes to mammographic density in distinguishing between high-risk cases and low-risk controls. The age-matched evaluation included computerized mammographic assessment of breast percent density (PD) and parenchymal patterns (phenotypes of coarseness and contrast) from radiographic texture analysis (RTA) of the full-field digital mammograms from 456 cases: 53 women with BRCA1/2 gene mutations, 75 with unilateral cancer, and 328 at low risk of developing breast cancer. Image-based phenotypes of parenchymal pattern coarseness and contrast were each found to significantly discriminate between the groups; however, PD did not.

Segmentation of breast masses on dedicated breast computed tomography and three-dimensional breast ultrasound images.

We present and evaluate a method for the three-dimensional (3-D) segmentation of breast masses on dedicated breast computed tomography (bCT) and automated 3-D breast ultrasound images. The segmentation method, refined from our previous segmentation method for masses on contrast-enhanced bCT, includes two steps: (1) initial contour estimation and (2) active contour-based segmentation to further evolve and refine the initial contour by adding a local energy term to the level-set equation. Segmentation performance was assessed in terms of Dice coefficients (DICE) for 129 lesions on noncontrast bCT, 38 lesions on contrast-enhanced bCT, and 98 lesions on 3-D breast ultrasound (US) images.

Computerized detection of breast cancer on automated breast ultrasound imaging of women with dense breasts.

Purpose: Develop a computer-aided detection method and investigate its feasibility for detection of breast cancer in automated 3D ultrasound images of women with dense breasts.

Methods: The HIPAA compliant study involved a dataset of volumetric ultrasound image data, "views," acquired with an automated U-Systems Somo●V(®) ABUS system for 185 asymptomatic women with dense breasts (BI-RADS Composition/Density 3 or 4). For each patient, three whole-breast views (3D image volumes) per breast were acquired.

Accuracy of axillary lymph node staging in breast cancer patients: an observer-performance study comparison of MRI and ultrasound.

Purpose: To compare magnetic resonance imaging (MRI) and ultrasound (US) for axillary lymph node (LN) staging in breast cancer patients in an observer-performance study.

Materials And Methods: An observer-performance study was conducted with five breast radiologists reviewing 50 consecutive patients of newly diagnosed invasive breast cancer with the use of ipsilateral axillary MRI and US. LN status was pathologically proved in all patients.

Utility of preoperative ultrasound for predicting pN2 or higher stage axillary lymph node involvement in patients with newly diagnosed breast cancer.

Objective: The objective of our study was to report the positive predictive value (PPV) of ultrasound of the axilla to predict pN2 or higher disease in breast cancer patients.

Materials And Methods: A retrospective study of 559 patients with newly diagnosed invasive breast cancer from 2005 through 2009 was performed. All patients underwent ipsilateral axillary ultrasound for staging purposes.

Multimodality computer-aided breast cancer diagnosis with FFDM and DCE-MRI.

Rationale And Objectives: To investigate a multimodality computer-aided diagnosis (CAD) scheme that combines image information from full-field digital mammography (FFDM) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for computerized breast cancer classification.

Materials And Methods: From a retrospective FFDM database with 432 lesions (255 malignant, 177 benign) and a retrospective DCE-MRI database including 476 lesions (347 malignant, 129 benign), we constructed a multimodality dataset of 213 lesions (168 malignant, 45 benign). Each lesion was present on both FFDM and DCE-MRI images and deemed to be a difficult case given the necessity of having both clinical imaging exams.

MR-directed ("Second-Look") ultrasound examination for breast lesions detected initially on MRI: MR and sonographic findings.

Objective: The objective of our study was to assess the clinical utility of MR-directed ("second-look") ultrasound examination to search for breast lesions detected initially on MRI.

Materials And Methods: A retrospective review was performed of the records of 158 consecutive patients (202 lesions) with breast abnormalities initially detected on MRI between July 2003 and May 2006. All lesions were detected as enhancing findings on a dynamic contrast MR study and were subsequently evaluated with ultrasound.

Breast US computer-aided diagnosis system: robustness across urban populations in South Korea and the United States.

Purpose: To evaluate the robustness of a breast ultrasonographic (US) computer-aided diagnosis (CAD) system in terms of its performance across different patient populations.

Materials And Methods: Three US databases were analyzed for this study: one South Korean and two United States databases. All three databases were utilized in an institutional review board-approved and HIPAA-compliant manner.

Automated method for improving system performance of computer-aided diagnosis in breast ultrasound.

The purpose of this research was to demonstrate the feasibility of a computerized auto-assessment method in which a computer-aided diagnosis (CADx) system itself provides a level of confidence for its estimate for the probability of malignancy for each radiologist-identified lesion. The computer performance was assessed within a leave-one-case-out protocol using a database of sonographic images from 542 patients (19% cancer prevalence). We investigated the potential of computer-derived confidence levels both as 1) an output aid to radiologists and 2) as an automated method to improve the computer classification performance-in the task of differentiating between cancerous and benign lesions for the entire database.

Evaluation of computer-aided diagnosis on a large clinical full-field digital mammographic dataset.

Rationale And Objectives: To convert and optimize our previously developed computerized analysis methods for use with images from full-field digital mammography (FFDM) for breast mass classification to aid in the diagnosis of breast cancer.

Materials And Methods: An institutional review board approved protocol was obtained, with waiver of consent for retrospective use of mammograms and pathology data. Seven hundred thirty-nine FFDM images, which contained 287 biopsy-proven breast mass lesions, of which 148 lesions were malignant and 139 lesions were benign, were retrospectively collected.

Axillary lymph nodes suspicious for breast cancer metastasis: sampling with US-guided 14-gauge core-needle biopsy--clinical experience in 100 patients.

Purpose: To study the clinical usefulness of ultrasonography (US)-guided core-needle biopsy (CNB) of axillary lymph nodes and the US-depicted abnormalities that may be used to predict nodal metastases.

Materials And Methods: This retrospective study was HIPAA compliant and institutional review board approved; the requirement for informed patient consent was waived. US-guided 14-gauge CNB of abnormal axillary lymph nodes was performed in 100 of 144 patients with primary breast cancer who underwent US assessment of axillary lymph nodes.

Performance of breast ultrasound computer-aided diagnosis: dependence on image selection.

Rationale And Objectives: The automated classification of sonographic breast lesions is generally accomplished by extracting and quantifying various features from the lesions. The selection of images to be analyzed, however, is usually left to the radiologist. Here we present an analysis of the effect that image selection can have on the performance of a breast ultrasound computer-aided diagnosis system.

Breast US computer-aided diagnosis workstation: performance with a large clinical diagnostic population.

Purpose: To evaluate the performance of a computer-aided diagnosis (CAD) workstation in classifying cancer in a realistic data set representative of a clinical diagnostic breast ultrasonography (US) practice.

Materials And Methods: The database consisted of consecutive diagnostic breast US scans collected with informed consent with a protocol approved by the institutional review board and compliant with the HIPAA. Images from 508 patients with a total of 1046 distinct abnormalities were used.

US-guided core needle biopsy of axillary lymph nodes in patients with breast cancer: why and how to do it.

Axillary lymph node status is an extremely important prognostic factor in the assessment of new breast cancer patients. Sentinel lymph node biopsy is now often performed instead of axillary dissection for lymph node staging but raises numerous issues of practicality. Sentinel lymph node biopsy can be avoided if lymph node metastasis is documented presurgically, making an alternative staging method desirable.