Reproducibility of the Manchester Triage System: a multicentre vignette study.

Background: While several studies have evaluated the performance of the Manchester Triage System (MTS), none have specifically examined its accurate application by triage nurses and its association with clinical outcomes. This study focuses on the agreement between nurse-assigned MTS codes and those assigned by an expert group, as well as their ability to predict clinical outcomes.

Methods: This multicentre simulation study was conducted from January to March 2024 across four EDs in Italy employing MTS in clinical practice.

Preoperative breast MRI reduces reoperations for unilateral invasive lobular carcinoma: a patient-matched analysis from the MIPA study.

Objectives: To investigate the surgical impact of preoperative breast MRI in patients diagnosed with invasive lobular breast cancer (ILC) in a prospective observational study.

Methods: The prospective MIPA observational study database was queried for patients aged 18-80 with newly diagnosed unilateral ILC at needle biopsy referred for primary surgery. Patients who underwent preoperative MRI (MRI group) were matched (1:1) with those who did not (noMRI group) according to nine confounding covariates.

Supine breast MRI using a wearable coil facilitates the translation of MR imaging findings to clinical practice.

Purpose: The aim of this study is the evaluation of a wearable radiofrequency coil vest (BraCoil) for supine breast MRI, comparing lesion displacement and size with standard prone MRI and supine ultrasound, and assessing its potential impact on clinical workflows for targeted ultrasound and ultrasound-guided biopsy.

Material And Methods: MRI and ultrasound data were collected from 11 female patients with 18 breast lesions. Patients underwent two MRI exams: standard prone MRI using a commercial coil and supine MRI using the BraCoil.

The role of magnetic resonance imaging in the rare pathologies of the vulva.

Pathologies of the vulva encompass a wide range of mesenchymal and epithelial benign and malignant lesions. Suspicion is raised by non-specific symptoms or clinical findings detected during routine gynecological examinations, and histopathology is essential for the diagnosis. The role of imaging has often been limited, but it can be essential in guiding treatment and, in some cases, in helping differential diagnosis.

Background parenchymal enhancement in CEM and MRI: Is there always a high agreement?

Introduction: Background parenchymal enhancement (BPE) refers to the physiological enhancement of breast fibroglandular tissue. This study aimed to determine the agreement of BPE evaluation between contrast enhanced mammography (CEM) and magnetic resonance imaging (MRI) and investigate potential confounders.

Materials And Methods: This retrospective, IRB-approved study included women recalled from screening or with inconclusive findings on mammography and/or ultrasound, who underwent both CEM and MRI between 2018 and 2022.

A head-to-head comparison of breast lesion's conspicuity at contrast-enhanced mammography and contrast-enhanced MRI.

Purpose: Lesion conspicuity, the relative enhancement of a lesion compared to surrounding tissue, is a new descriptor in the ACR BI-RADS 2022 CEM supplement. We compared lesion conspicuity in contrast-enhanced mammography (CEM) and contrast-enhanced MRI (CE-MRI) in patients with suspicious breast lesions.

Materials And Methods: IRB-approved retrospective study; three blinded readers rated 462 indeterminate or suspicious breast lesions in 388 patients (54.

Contrast-Enhanced Digital Breast Tomosynthesis Compared With Contrast-Enhanced Mammography and Magnetic Resonance Imaging in the Assessment of Breast Lesions: A Pilot Study.

Objectives: Contrast-enhanced mammography (CEM) is an accurate competitor for contrast-enhanced breast magnetic resonance imaging (CE-MRI), but the examination is limited by the lack of 3D information. Digital breast tomosynthesis (DBT) allows better lesion detection and characterization compared with mammography. The availability of quasi-3D contrast imaging could further improve the performance of CEM.

Preparing radiology residents for breast MRI: A dual-site, resident-as-teacher feasibility project.

Purpose: To assess the impact of a faculty-mentored, resident-as-teacher theoretical-practical breast MRI (B-MRI) course on the reporting completeness and accuracy of "trainee" radiology residents (RRs) with basic or no experience in conventional breast imaging (CBI) and the personal skills and critical thinking of experienced, "teacher" RRs.

Methods: Six teacher-RRs from the Udine University residency program (URP) preliminarily selected and reported 55 B-MRI cases under faculty supervision. Twelve trainee-RRs (six from Udine URP and six from Vienna URP, with basic and no experience in CBI, respectively) underwent seven days of self-study on selected material, followed by a pre-training reporting test (pre-TRT) on 15 of the 55 B-MRI cases.

Association between mammographic breast density and outcome in patients with unilateral invasive breast cancer receiving neoadjuvant chemotherapy.

Purpose: To analyze the relationship between mammographic breast density and tumor response and outcome at follow-up, in terms of overall survival (OS) and disease-free survival (DFS), in patients with unilateral invasive breast cancer receiving neoadjuvant chemotherapy (NACT).

Methods: A total of 228 women (mean age, 47.6 years ± 10 [SD]; range: 24-74 years) with invasive breast cancer who underwent NACT were included in this observational retrospective study.

Inter-reader agreement of the BI-RADS CEM lexicon.

Purpose: The purpose of this study was to assess the inter-reader agreement of the breast imaging reporting and data system (BI-RADS) contrast-enhanced mammography (CEM) lexicon.

Materials And Methods: In this IRB-approved, single-center, retrospective study, three breast radiologists, each with different levels of experience, reviewed 462 lesions in 421 routine clinical CEM according to the fifth edition of the BI-RADS lexicon for mammography and to the first version of the BI-RADS lexicon for CEM. Readers were blinded to patient outcomes and evaluated breast and lesion features on low-energy (LE) images (breast density, type of lesion, associated architectural distortion), lesion features on recombined (RC) images (type of enhancement, characteristic of mass enhancement, non-mass enhancement or enhancing asymmetry), and provided a final BI-RADS assessment.

MRI-only breast cancers are less aggressive than cancers identifiable on conventional imaging.

Background: Magnetic resonance imaging (MRI) has a superior sensitivity for the diagnosis of breast cancer, leading to lesions primarily detected by MRI. Some of these lesions cannot be identified by targeted second-look ultrasound (SLUS) examinations and are thus referred to as MRI-only lesions. We hypothesize that biologically more aggressive cancers lead to more distinct tissue damage improving visibility on SLUS.

Evaluation of apparent diffusion coefficient (ADC) with regards to reproducibility and diagnostic accuracy as well as possible significance of pre - and post - contrast acquisition and employment of different b values.

Purpose: Ongoing efforts are focusing on optimizing diffusion-weighted imaging (DWI) as an essential part of breast MRI protocol. Our study aimed to evaluate the effect of contrast media (CM) on the apparent diffusion coefficients (ADC) acquired following current recommendations.

Patient And Methods: Patients who underwent 3 T breast MRI with a histologically verified suspicious lesion were included in this IRB-approved, single-center, cross-sectional retrospective study.

A model combining BI-RADS® descriptors from pre-treatment B-mode breast ultrasound with clinicopathological tumor features shows promise in the prediction of residual disease after neoadjuvant chemotherapy.

Purpose: To create a simple model using standard BI-RADS® descriptors from pre-treatment B-mode ultrasound (US) combined with clinicopathological tumor features, and to assess the potential of the model to predict the presence of residual tumor after neoadjuvant chemotherapy (NAC) in breast cancer (BC) patients.

Method: 245 female BC patients receiving NAC between January 2017 and December 2019 were included in this retrospective study. Two breast imaging fellows independently evaluated representative B-mode tumor images from baseline US.

Influence of Gadolinium-based Contrast Media and Inter-reader Variation on the Estimation of Intravoxel Incoherent Motion (IVIM) Parameters in Breast MR Imaging.

Purpose: Gadolinium-based contrast media (GBCM) may affect apparent diffusion coefficient measurements on diffusion-weighted imaging. We aimed at investigating the effect of GBCM and inter-reader variation on intravoxel incoherent motion (IVIM) parameters in breast lesions.

Methods: A total of 89 patients referred to 3T breast MRI with at least one histologically verified lesion were included.

Enhancing the Kaiser score for lesion characterization in unenhanced breast MRI.

Purpose: To adapt the methodology of the Kaiser score, a clinical decision rule for lesion characterization in breast MRI, for unenhanced protocols.

Method: In this retrospective IRB-approved cross-sectional study, we included 93 consecutive patients who underwent breast MRI between 2021 and 2023 for further work-up of BI-RADS 0, 3-5 in conventional imaging or for staging purposes (BI-RADS 6). All patients underwent biopsy for histologic verification or were followed for a minimum of 12 months.

ESR Essentials: screening for breast cancer - general recommendations by EUSOBI.

Breast cancer is the most frequently diagnosed cancer in women accounting for about 30% of all new cancer cases and the incidence is constantly increasing. Implementation of mammographic screening has contributed to a reduction in breast cancer mortality of at least 20% over the last 30 years. Screening programs usually include all women irrespective of their risk of developing breast cancer and with age being the only determining factor.

How young radiologists use contrast media and manage adverse reactions: an international survey.

Objectives: To collect real-world data about the knowledge and self-perception of young radiologists concerning the use of contrast media (CM) and the management of adverse drug reactions (ADR).

Methods: A survey (29 questions) was distributed to residents and board-certified radiologists younger than 40 years to investigate the current international situation in young radiology community regarding CM and ADRs. Descriptive statistics analysis was performed.

Pilot study: A simple CAD-based tool to detect breast cancer on MRI of the breast.

Purpose: This pilot-study aims to assess, whether quantitatively assessed enhancing breast tissue as a percentage of the entire breast volume can serve as an indicator of breast cancer at breast MRI and whether the contrast-agent employed affects diagnostic efficacy.

Materials: This retrospective IRB-approved study, included 39 consecutive patients, that underwent two subsequent breast MRI exams for suspicious findings at conventional imaging with 0.1 mmol/kg gadobenic and gadoteric acid.

MRI Insights in Breast Imaging.

In the world, breast cancer is the most commonly diagnosed cancer among women. Currently, MRI is the most sensitive breast imaging method for detecting breast cancer, although false positive rates are still an issue. To date, the accuracy of breast MRI is widely recognized across various clinical scenarios, in particular, staging of known cancer, screening for breast cancer in high-risk women, and evaluation of response to neoadjuvant chemotherapy.