Breast MRI during Neoadjuvant Chemotherapy: Lack of Background Parenchymal Enhancement Suppression and Inferior Treatment Response.

Background Suppression of background parenchymal enhancement (BPE) is commonly observed after neoadjuvant chemotherapy (NAC) at contrast-enhanced breast MRI. It was hypothesized that nonsuppressed BPE may be associated with inferior response to NAC. Purpose To investigate the relationship between lack of BPE suppression and pathologic response.

Predicting breast cancer response to neoadjuvant treatment using multi-feature MRI: results from the I-SPY 2 TRIAL.

Dynamic contrast-enhanced (DCE) MRI provides both morphological and functional information regarding breast tumor response to neoadjuvant chemotherapy (NAC). The purpose of this retrospective study is to test if prediction models combining multiple MRI features outperform models with single features. Four features were quantitatively calculated in each MRI exam: functional tumor volume, longest diameter, sphericity, and contralateral background parenchymal enhancement.

Effect of Arrival of Prior Mammograms on Recall Negation for Screening Mammograms Performed With Digital Breast Tomosynthesis in a Clinical Setting.

Purpose: This retrospective study evaluates the effect of comparison with prior mammograms on recall negation for screening mammography performed with digital breast tomosynthesis (DBT) in a clinical setting and compares it with that performed without DBT.

Methods: This is an Institutional Review Board-approved, HIPAA-compliant retrospective review of the electronic medical record for all nonbaseline screening mammograms performed in clinical practice over 13 months. For each mammogram, we recorded if DBT were used, the BI-RADS assigned at initial interpretation, and whether prior mammograms were available at initial interpretation.

Breast Cancers Found with Digital Breast Tomosynthesis: A Comparison of Pathology and Histologic Grade.

To compare the pathology and histologic grading of breast cancers detected with digital breast tomosynthesis to those found with conventional digital mammography. The institutional review board approved this study. A database search for all breast cancers diagnosed from June 2012 through December 2013 was performed.

Direct Interactive Public Education by Breast Radiologists About Screening Mammography: Impact on Anxiety and Empowerment.

Purpose: Anxiety has been called a "harm" of screening mammography. The authors provided direct, interactive education to lay audiences and measured these sessions' impact on anxiety and any increased understanding of breast cancer screening.

Methods: Academic breast radiologist provided seven 1-hour sessions of structured lectures and question-and-answer periods.

Digital Breast Tomosynthesis Utilization in the United States: A Survey of Physician Members of the Society of Breast Imaging.

Purpose: To assess utilization of digital breast tomosynthesis (DBT) and examine criteria for offering DBT to patients.

Methods: We created an online survey for physician members of the Society of Breast Imaging to assess their use of DBT. The questions covered availability of DBT at the participant's practice, whether DBT was used for clinical care or research, clinical decision rules guiding patient selection for DBT, costs associated with DBT, plans to obtain DBT, and breast imaging practice characteristics.

Compliance With Screening Mammography Guidelines After a False-Positive Mammogram.

Purpose: To assess whether women with a false-positive mammogram who do return for screening are less likely to be compliant with screening mammography guidelines than are women with a negative mammogram.

Methods: This institutional review board-approved, HIPAA-compliant retrospective cohort study includes women >40 years old who received 9,385 consecutive, nonbaseline screening mammograms between December 1, 2012 and December 31, 2013. Using linear regression, we evaluated differences in time between mammograms by prior recall status, after adjusting for location of current mammogram (outpatient office versus mobile unit) and age.

Direct Interactive Public Education by Breast Radiologists About Screening Mammography: Impact on Anxiety and Empowerment.

Purpose: Anxiety has been called a "harm" of screening mammography. The authors provided direct, interactive education to lay audiences and measured these sessions' impact on anxiety and any increased understanding of breast cancer screening.

Methods: Academic breast radiologist provided seven 1-hour sessions of structured lectures and question-and-answer periods.

Issues to consider before implementing digital breast tomosynthesis into a breast imaging practice.

OBJECTIVE. The purpose of this article is to discuss issues surrounding the implementation of digital breast tomosynthesis (DBT) into a clinical breast imaging practice and assist radiologists, technologists, and administrators who are considering the addition of this new technology to their practices. CONCLUSION.

Implications of CISNET modeling on number needed to screen and mortality reduction with digital mammography in women 40-49 years old.

Objective: In this article, we evaluate the implications of recent Cancer Intervention and Surveillance Modeling Network (CISNET) modeling of benefits and harms of screening to women 40-49 years old using annual digital mammography.

Conclusion: We show that adding annual digital mammography of women 40-49 years old to biennial screening of women 50-74 years old increases lives saved by 27% and life-years gained by 47%. Annual digital mammography in women 40-49 years old saves 42% more lives and life-years than biennial digital mammography.

Digital breast tomosynthesis utilization in the United States: a survey of physician members of the Society of Breast Imaging.

Purpose: To assess utilization of digital breast tomosynthesis (DBT) and examine criteria for offering DBT to patients.

Methods: We created an online survey for physician members of the Society of Breast Imaging to assess their use of DBT. The questions covered availability of DBT at the participant's practice, whether DBT was used for clinical care or research, clinical decision rules guiding patient selection for DBT, costs associated with DBT, plans to obtain DBT, and breast imaging practice characteristics.

Early-stage BRCA2-linked breast cancer diagnosed in the first trimester of pregnancy associated with a hypercoagulable state.

This patient was found to have a BRCA2 gene mutation. She underwent lumpectomy and axillary lymph node dissection without any evidence of lymph node metastasis. Systemic chemotherapy with doxorubicin and cyclophosphamide for four cycles was administered beginning in the second trimester.

Agreement of the order of overall performance levels under different reading paradigms.

Rationale And Objectives: To investigate consistency of the orders of performance levels when interpreting mammograms under three different reading paradigms.

Materials And Methods: We performed a retrospective observer study in which nine experienced radiologists rated an enriched set of mammography examinations that they personally had read in the clinic ("individualized") mixed with a set that none of them had read in the clinic ("common set"). Examinations were interpreted under three different reading paradigms: binary using screening Breast Imaging Reporting and Data System (BI-RADS), receiver-operating characteristic (ROC), and free-response ROC (FROC).

Binary and multi-category ratings in a laboratory observer performance study: a comparison.

The authors investigated radiologists, performances during retrospective interpretation of screening mammograms when using a binary decision whether to recall a woman for additional procedures or not and compared it with their receiver operating characteristic (ROC) type performance curves using a semi-continuous rating scale. Under an Institutional Review Board approved protocol nine experienced radiologists independently rated an enriched set of 155 examinations that they had not personally read in the clinic, mixed with other enriched sets of examinations that they had individually read in the clinic, using both a screening BI-RADS rating scale (recall/not recall) and a semi-continuous ROC type rating scale (0 to 100). The vertical distance, namely the difference in sensitivity levels at the same specificity levels, between the empirical ROC curve and the binary operating point were computed for each reader.

The "laboratory" effect: comparing radiologists' performance and variability during prospective clinical and laboratory mammography interpretations.

Purpose: To compare radiologists' performance during interpretation of screening mammograms in the clinic with their performance when reading the same mammograms in a retrospective laboratory study.

Materials And Methods: This study was conducted under an institutional review board-approved, HIPAA-compliant protocol; the need for informed consent was waived. Nine experienced radiologists rated an enriched set of mammograms that they had personally read in the clinic (the "reader-specific" set) mixed with an enriched "common" set of mammograms that none of the participants had previously read in the clinic by using a screening Breast Imaging Reporting and Data System (BI-RADS) rating scale.

A method to improve visual similarity of breast masses for an interactive computer-aided diagnosis environment.

The purpose of this study was to develop and test a method for selecting "visually similar" regions of interest depicting breast masses from a reference library to be used in an interactive computer-aided diagnosis (CAD) environment. A reference library including 1000 malignant mass regions and 2000 benign and CAD-generated false-positive regions was established. When a suspicious mass region is identified, the scheme segments the region and searches for similar regions from the reference library using a multifeature based k-nearest neighbor (KNN) algorithm.

Head-mounted versus remote eye tracking of radiologists searching for breast cancer: a comparison.

Purpose: We compared performance and visual search parameters of radiologists detecting masses on mammograms by using both a head-mounted (HDMT) and a remote (REM) eye tracker.

Materials And Methods: Five experienced radiologists read twice a case set of 20 one-view (medial-lateral oblique) mammograms, of which 12 contained a malignant mass and eight were lesion-free. For each observer, one trial used an HDMT eye-tracking system and the other used an REM system.

Effects of lesion conspicuity on visual search in mammogram reading.

Rationale And Objectives: The goal of mammography screening is to detect breast cancer at early stages, but because of the complexity of the breast parenchyma and the variability of signs of the disease, many cancers go unreported when initially visible on the mammogram. We compared the visual search strategy used by experienced mammographers in a case set where they examined both the mammogram in which a malignant mass was discovered at screening mammography and the most recent prior mammogram.

Materials And Methods: Four experienced mammographers participated in this experiment.

Is maximum positive predictive value a good indicator of an optimal screening mammography practice?

Objective: Positive predictive value (PPV1) has been used as one important indicator of the quality of screening mammography programs. We show how the relationship between sensitivity and recall rate may affect the operating point at which optimal (maximum) PPV1 occurs.

Conclusion: Optimal (maximum) PPV1 can occur at any sensitivity level and should not be used as the sole indicator for practice optimization because it does not take into account the number of cancers that would be missed at that sensitivity.

Trends in recall, biopsy, and positive biopsy rates for screening mammography in an academic practice.

Purpose: To retrospectively evaluate whether recall, biopsy, and positive biopsy rates for a group of radiologists who met requirements of Mammography Quality Standards Act of 1992 (MQSA) demonstrated any change over time during a 27-month period (nine consecutive calendar quarters).

Materials And Methods: Institutional review board approved study protocol, and informed consent was waived. All screening mammograms that had been interpreted by MQSA-qualified radiologists between January 1, 2001, and March 31, 2003, were reviewed.

"Memory effect" in observer performance studies of mammograms.

Rationale And Objective: To evaluate breast radiologists' recognition of mammograms showing cancers that they correctly detected or "missed" during clinical interpretations.

Materials And Methods: Two similar experiments were conducted. In the first, 33 bilateral screening mammograms were reviewed by four breast imagers.

A method to test the reproducibility and to improve performance of computer-aided detection schemes for digitized mammograms.

The purpose of this study is to develop a new method for assessment of the reproducibility of computer-aided detection (CAD) schemes for digitized mammograms and to evaluate the possibility of using the implemented approach for improving CAD performance. Two thousand digitized mammograms (representing 500 cases) with 300 depicted verified masses were selected in the study. Series of images were generated for each digitized image by resampling after a series of slight image rotations.

Computer-aided detection performance in mammographic examination of masses: assessment.

Purpose: To compare performance of two computer-aided detection (CAD) systems and an in-house scheme applied to five groups of sequentially acquired screening mammograms.

Materials And Methods: Two hundred nineteen film-based mammographic examinations, classified into five groups, were included in this study. Group 1 included 58 examinations in which verified malignant masses were detected during screening; group 2, 39 in which all available latest examinations were performed prior to diagnosis of these malignant masses (subset of 39 women from group 1); group 3, 22 in which findings were interpreted as negative but were verified as cancer within 1 year from the negative interpretation (missed cancers); group 4, 50 in which findings were negative and patients were not recalled for additional procedures; and group 5, 50 in which patients were recalled for additional procedures and findings were negative for cancer.