Dual-energy contrast-enhanced digital mammography: initial clinical results of a multireader, multicase study.

Introduction: The purpose of this study was to compare the diagnostic accuracy of dual-energy contrast-enhanced digital mammography (CEDM) as an adjunct to mammography (MX) ± ultrasonography (US) with the diagnostic accuracy of MX ± US alone.

Methods: One hundred ten consenting women with 148 breast lesions (84 malignant, 64 benign) underwent two-view dual-energy CEDM in addition to MX and US using a specially modified digital mammography system (Senographe DS, GE Healthcare). Reference standard was histology for 138 lesions and follow-up for 12 lesions.

Comparison of image acquisition and radiologist interpretation times in a diagnostic mammography center.

Rationale And Objectives: The purpose of this study was to determine the acquisition and interpretation times of screen-film mammography and soft-copy digital mammography in a diagnostic mammography center.

Materials And Methods: The study was conducted in three phases for patients presenting for clinical diagnostic workup to a mammography clinic. In the first phase, technologist acquisition and processing times and radiologist interpretation time were measured for patients imaged with a screen-film mammographic system.

Cancer cases from ACRIN digital mammographic imaging screening trial: radiologist analysis with use of a logistic regression model.

Purpose: To determine which factors contributed to the Digital Mammographic Imaging Screening Trial (DMIST) cancer detection results.

Materials And Methods: This project was HIPAA compliant and institutional review board approved. Seven radiologist readers reviewed the film hard-copy (screen-film) and digital mammograms in DMIST cancer cases and assessed the factors that contributed to lesion visibility on both types of images.

Radiologist evaluation of an X-ray tube-based diffraction-enhanced imaging prototype using full-thickness breast specimens.

Rationale And Objectives: Conventional mammographic image contrast is derived from x-ray absorption, resulting in breast structure visualization due to density gradients that attenuate radiation without distinction between transmitted, scattered, or refracted x-rays. Diffraction-enhanced imaging (DEI) allows for increased contrast with decreased radiation dose compared to conventional mammographic imaging because of monochromatic x-rays, its unique refraction-based contrast mechanism, and excellent scatter rejection. However, a lingering drawback to the clinical translation of DEI has been the requirement for synchrotron radiation.

The positive predictive value for diagnosis of breast cancer full-field digital mammography versus film-screen mammography in the diagnostic mammographic population.

Rationale And Objectives: Diagnostic mammography is performed on women with clinical symptoms that suggest breast cancer or women for whom further mammographic evaluation has been requested because of an abnormal screening mammography. We assessed whether the use of full-field digital mammography would improve the positive predictive value (PPV) for the diagnosis of breast cancer in a diagnostic population compared with film-screen mammography.

Materials And Methods: From January 2002 to December 2003, 11,621 patients underwent diagnostic mammography at the University of North Carolina Hospital, Chapel Hill.

Correlation of HER-2/neu overexpression with mammography and age distribution in primary breast carcinomas.

Rationale And Objectives: HER-2/neu is a valuable prognostic and therapeutic marker in primary breast carcinoma. The objective of this study was to determine the mammographic and patient characteristics (age) that correlate with HER-2/neu overexpression in primary breast carcinoma.

Materials And Methods: HER-2/neu characteristics and preoperative mammograms were available in 498 patients with 543 primary breast carcinomas (526 invasive carcinomas and 17 ductal carcinoma in situ).

Comparison of calcification specificity in digital mammography using soft-copy display versus screen-film mammography.

Objective: The purpose of this study was to compare specificity in the interpretation of calcifications in soft-copy reviewing of digital mammograms versus hard-copy reviewing of screen-film mammograms.

Materials And Methods: A total of 130 consecutive cases with calcifications (44 malignant and 86 benign) that had been evaluated with needle or surgical biopsy were collected. Both screen-film mammography and soft-copy digital mammography were obtained in the same patients under existing research protocols using Fischer Imaging's SenoScan (n = 71), Lorad's digital mammography system (n = 35), and GE Healthcare's Senographe 2000D (n = 24).

Consensus review: A method of assessment of calcifications that appropriately undergo a six-month follow-up.

Rationale And Objectives: Breast calcifications seen on mammography may be associated with benign conditions or malignancies. Accurate characterization of these calcifications is crucial to providing optimal care that may spare women unnecessary biopsies and appropriately allow interval mammography. The purpose of this study is to determine if consensus characterization of calcifications by two breast imaging experts using standardized criteria can establish that follow-up is a safe option.

A comparative study of mobile electronic data entry systems for clinical trials data collection.

Purpose: To determine the speed, accuracy, ease of use, and user satisfaction of various electronic data entry platforms for use in the collection of mammography clinical trials data.

Method And Materials: Four electronic data entry platforms were tested: standalone personal digital assistant (PDA), Tablet PC, digitizer Tablet/PDA Hybrid (DTP Hybrid), and digital pen (d-pen). Standard paper data entry was used as control.

Comparison of full-field digital mammography to screen-film mammography with respect to contrast and spatial resolution in tissue equivalent breast phantoms.

To determine if the improved contrast resolution of full-field digital mammography (FFDM) with reduced spatial resolution allows for superior or equal phantom object detection compared with screen-film mammography (SFM). Tissue equivalent breast phantoms simulating an adipose to glandular ratio of 50/50,30/70, and 20/80 were imaged according to each manufacturers' recommendation with four full-field digital mammography units (Fuji, Sectra, Fischer, and General Electric) and a screen-film mammography unit (MammoMatII 2000, Siemens, Munich, Germany). A total of 20 images were obtained in both hard- and soft-copy formats.

The effects of gray scale image processing on digital mammography interpretation performance.

Rationale And Objectives: To determine the effects of three image-processing algorithms on diagnostic accuracy of digital mammography in comparison with conventional screen-film mammography.

Materials And Methods: A total of 201 cases consisting of nonprocessed soft copy versions of the digital mammograms acquired from GE, Fischer, and Trex digital mammography systems (1997-1999) and conventional screen-film mammograms of the same patients were interpreted by nine radiologists. The raw digital data were processed with each of three different image-processing algorithms creating three presentations-manufacturer's default (applied and laser printed to film by each of the manufacturers), MUSICA, and PLAHE-were presented in soft copy display.

The role of magnetic resonance imaging in diagnosis and management of breast cancer.

A review of the literature on the current applications of breast magnetic resonance imaging (MRI) indications, their rationale and their place in diagnosis and management of breast cancer was given. Contrast-enhanced breast MRI is developing as a valuable adjunct to mammography and sonography. Its high sensitivity for invasive breast cancer establishes its superiority in evaluation of multifocality/multicentricity, tumor response to neoadjuvant chemotherapy, detection of recurrence, and staging.

Factors affecting increasing radiation dose for mammography in North Carolina from 1997 through 2001: an analysis of Food and Drug Administration annual surveys.

Rationale And Objectives: To determine which factors affected the increase in average glandular dose recorded at the annual US Food and Drug Administration Mammography Quality Standards Act inspections of mammography equipment in North Carolina from 1997 to 2001.

Materials And Methods: Average glandular dose, HVL, kVp, ambient light, luminance, equipment age, processing speed, and system speed for every mammography unit at all facilities in the state were collected by state inspectors. A mixed-effect model was used to assess the average changes of glandular dose over time and to identify the factors associated with these changes.

Ultrasound in the management of breast disease.

Since its introduction in the 1960s, ultrasound (US) has never been more important in breast disease management as it is today. Its historical role as an adjunct modality to mammography in differentiating cystic from solid lesions has been widely expanded. US-guided sampling procedures represent widely accepted modalities in lesion evaluation.