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van Nijnatten TJA, Morscheid S, Baltzer PAT, Clauser P, Alcantara R, Kuhl CK, Wildberger JE. Contrast-enhanced breast imaging: Current status and future challenges. Eur J Radiol 2024; 171:111312. [PMID: 38237520 DOI: 10.1016/j.ejrad.2024.111312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/04/2024] [Accepted: 01/09/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Contrast-enhanced breast MRI and recently also contrast-enhanced mammography (CEM) are available for breast imaging. The aim of the current overview is to explore existing evidence and ongoing challenges of contrast-enhanced breast imaging. METHODS This narrative provides an introduction to the contrast-enhanced breast imaging modalities breast MRI and CEM. Underlying principle, techniques and BI-RADS reporting of both techniques are described and compared, and the following indications and ongoing challenges are discussed: problem-solving, high-risk screening, supplemental screening in women with extremely dense breast tissue, breast implants, neoadjuvant systemic therapy (NST) response monitoring, MRI-guided and CEM- guided biopsy. RESULTS Technique and reporting for breast MRI are standardised, for the newer CEM standardisation is in progress. Similarly, compared to other modalities, breast MRI is well established as superior for problem-solving, screening women at high risk, screening women with extremely dense breast tissue or with implants; and for monitoring response to NST. Furthermore, MRI-guided biopsy is a reliable technique with low long-term false negative rates. For CEM, data is as yet either absent or limited, but existing results in these settings are promising. CONCLUSION Contrast-enhanced breast imaging achieves highest diagnostic performance and should be considered essential. Of the two contrast-enhanced modalities, evidence of breast MRI superiority is ample, and preliminary results on CEM are promising, yet CEM warrants further study.
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Affiliation(s)
- T J A van Nijnatten
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; GROW - School for Oncology and Reproduction, Maastricht University Medical Center+, Maastricht, the Netherlands.
| | - S Morscheid
- Department of Diagnostic and Interventional Radiology, University Hospital Aachen, Aachen, Germany
| | - P A T Baltzer
- Department of Biomedical Imaging and Image-Guided Therapy, Division of General and Pediatric Radiology, Medical University of Vienna, Vienna, Austria
| | - P Clauser
- Department of Biomedical Imaging and Image-Guided Therapy, Division of General and Pediatric Radiology, Medical University of Vienna, Vienna, Austria
| | - R Alcantara
- Radiology and Nuclear Medicine Department, Hospital del Mar, Barcelona, Spain
| | - C K Kuhl
- Department of Diagnostic and Interventional Radiology, University Hospital Aachen, Aachen, Germany
| | - J E Wildberger
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center+, Maastricht, the Netherlands
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Hussain S, Lafarga-Osuna Y, Ali M, Naseem U, Ahmed M, Tamez-Peña JG. Deep learning, radiomics and radiogenomics applications in the digital breast tomosynthesis: a systematic review. BMC Bioinformatics 2023; 24:401. [PMID: 37884877 PMCID: PMC10605943 DOI: 10.1186/s12859-023-05515-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 10/02/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Recent advancements in computing power and state-of-the-art algorithms have helped in more accessible and accurate diagnosis of numerous diseases. In addition, the development of de novo areas in imaging science, such as radiomics and radiogenomics, have been adding more to personalize healthcare to stratify patients better. These techniques associate imaging phenotypes with the related disease genes. Various imaging modalities have been used for years to diagnose breast cancer. Nonetheless, digital breast tomosynthesis (DBT), a state-of-the-art technique, has produced promising results comparatively. DBT, a 3D mammography, is replacing conventional 2D mammography rapidly. This technological advancement is key to AI algorithms for accurately interpreting medical images. OBJECTIVE AND METHODS This paper presents a comprehensive review of deep learning (DL), radiomics and radiogenomics in breast image analysis. This review focuses on DBT, its extracted synthetic mammography (SM), and full-field digital mammography (FFDM). Furthermore, this survey provides systematic knowledge about DL, radiomics, and radiogenomics for beginners and advanced-level researchers. RESULTS A total of 500 articles were identified, with 30 studies included as the set criteria. Parallel benchmarking of radiomics, radiogenomics, and DL models applied to the DBT images could allow clinicians and researchers alike to have greater awareness as they consider clinical deployment or development of new models. This review provides a comprehensive guide to understanding the current state of early breast cancer detection using DBT images. CONCLUSION Using this survey, investigators with various backgrounds can easily seek interdisciplinary science and new DL, radiomics, and radiogenomics directions towards DBT.
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Affiliation(s)
- Sadam Hussain
- School of Engineering and Sciences, Tecnológico de Monterrey, Ave. Eugenio Garza Sada 2501, 64849, Monterrey, Mexico.
| | - Yareth Lafarga-Osuna
- School of Engineering and Sciences, Tecnológico de Monterrey, Ave. Eugenio Garza Sada 2501, 64849, Monterrey, Mexico
| | - Mansoor Ali
- School of Engineering and Sciences, Tecnológico de Monterrey, Ave. Eugenio Garza Sada 2501, 64849, Monterrey, Mexico
| | - Usman Naseem
- College of Science and Engineering, James Cook University, Cairns, Australia
| | - Masroor Ahmed
- School of Engineering and Sciences, Tecnológico de Monterrey, Ave. Eugenio Garza Sada 2501, 64849, Monterrey, Mexico
| | - Jose Gerardo Tamez-Peña
- School of Medicine and Health Sciences, Tecnológico de Monterrey, Ave. Eugenio Garza Sada 2501, 64849, Monterrey, Mexico
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Taneja AK, Chhabra A. Neuropathy Score Reporting and Data System (NS-RADS): A Practical Review of MRI-Based Peripheral Neuropathy Assessment. Semin Ultrasound CT MR 2023; 44:386-397. [PMID: 37437974 DOI: 10.1053/j.sult.2023.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
The Neuropathy Score Reporting and Data System (NS-RADS) is a newly developed MR imaging-based classification that standardizes reporting and multidisciplinary communication for MR imaging diagnosis and follow-up of peripheral neuropathies. NS-RADS classification has shown to be accurate and reliable across different centers, readers' experience levels, and degrees of peripheral neuropathies, which include nerve injury, entrapment, neoplasm, diffuse neuropathy, post-interventional status, and temporal changes in muscle denervation. This article brings a practical review of NS-RADS classification, representative MR cases, and a step-by-step tutorial on how to approach this staging system. Readers can gain knowledge and apply it in their practice, aiming to standardize the communications between specialties and improve patient management.
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Affiliation(s)
- Atul K Taneja
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX; Hospital Israelita Albert Einstein, Sao Paulo, SP, Brazil
| | - Avneesh Chhabra
- Department of Orthopedic Surgery, UT Southwestern Medical Center, Dallas, TX; Johns Hopkins University, Baltimore, MD; Walton Center of Neuroscience, Liverpool, UK; University of Dallas, Richardson, TX; Johns Hopkins University, Maryland, MD; Walton Centre for Neuroscience, Liverpool, UK.
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Fei X, Song R, Yu X, Zhang S, Zhang Y, Gao Y, Bi D, Yao S, Cui J. The clinical significance of complete process management for the quality control of horizontal rotational resection of a breast mass. Heliyon 2023; 9:e13537. [PMID: 36865481 PMCID: PMC9970895 DOI: 10.1016/j.heliyon.2023.e13537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 02/02/2023] [Accepted: 02/02/2023] [Indexed: 02/09/2023] Open
Abstract
Objective To explore the clinical outcomes of the complete process management of horizontal rotational resection of a breast mass. Methods A retrospective study was conducted involving 638 patients who underwent horizontal rotational resection of breast tissue in the Department of Thyroid and Breast Surgery of the People's Hospital of China Medical University from August 2018 to August 2020 using the ultrasound Breast Imaging-Reporting and Data System (BI-RADS) classification of 4A and below. These patients were divided into the experimental group and the control group based on whether the surgery had been performed following the order of the complete process management. The time cutoff point for the two groups was June 2019. The propensity score matching method was used to implement 1:1 ratio matching according to age, mass size, location, ultrasound BI-RADS classification, and breast size (measured by basal diameter), and the patients in the two groups were compared for the duration of surgery (the time needed to performed the three-step 3D positioning), postoperative skin hematoma and ecchymosis, postoperative pathological malignancy rate, residual rate of the mass, and satisfaction rate. Results After 278 pairs were matched, no statistically significant differences were found between the two groups in terms of demographics (P > 0.05). The duration of surgery in the experimental group was significantly shorter compared with the control group (7.90 ± 2.18 min vs. 10.20 ± 5.99 min, respectively; P < 0.05); the satisfaction score in the experimental group (8.33 ± 1.36) was higher compared with the control group (6.48 ± 1.22) (P < 0.05); the malignant and residual rates of mass in the experimental group were lower than those in the control group, i.e., 6 vs. 21 cases (P < 0.05), and 4 vs. 16 cases, respectively (P < 0.05); the incidence of skin hematoma and ecchymosis was lower in the experimental group, i.e., 3 vs. 21 cases (P < 0.05). Conclusion Complete process management for horizontal rotational resection of a breast mass can shorten the duration of surgery, reduce the residual mass, postoperative bleeding, and postoperative malignancy rates, and improve the breast preservation rate and patient satisfaction. Accordingly, its popularization represents research value.
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Affiliation(s)
- Xiang Fei
- Department of Thyroid and Breast Surgery, People’s Hospital of China Medical University (Liaoning Provincial People’s Hospital), Shenyang, 110016, China
| | - Renfeng Song
- Department of General Surgery, First People’s Hospital of Huangzhong District, Xining, Qinghai Province, Xining, 056400, China
| | - Xuewei Yu
- Department of General Surgery, First People’s Hospital of Huangzhong District, Xining, Qinghai Province, Xining, 056400, China
| | - Siyuan Zhang
- Department of Breast and Thyroid Surgery, Beitun General Hospital of Tenth Division, Xinjiang Production and Construction Corps, Beitun, 836000, China
| | - Ying Zhang
- Department of Thyroid and Breast Surgery, People’s Hospital of China Medical University (Liaoning Provincial People’s Hospital), Shenyang, 110016, China
| | - Yang Gao
- Department of Thyroid and Breast Surgery, People’s Hospital of China Medical University (Liaoning Provincial People’s Hospital), Shenyang, 110016, China
| | - Dongning Bi
- Department of Thyroid and Breast Surgery, People’s Hospital of China Medical University (Liaoning Provincial People’s Hospital), Shenyang, 110016, China
| | - Shengsheng Yao
- Department of Thyroid and Breast Surgery, People’s Hospital of China Medical University (Liaoning Provincial People’s Hospital), Shenyang, 110016, China
| | - Jianchun Cui
- Department of Thyroid and Breast Surgery, People’s Hospital of China Medical University (Liaoning Provincial People’s Hospital), Shenyang, 110016, China,Corresponding author.
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Bäcklund M, Eriksson M, Gabrielson M, Hammarström M, Quay S, Bergqvist J, Hellgren R, Czene K, Hall P. OUP accepted manuscript. Oncologist 2022; 27:e597-e600. [PMID: 35604960 PMCID: PMC9256025 DOI: 10.1093/oncolo/oyac102] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 09/29/2021] [Indexed: 11/13/2022] Open
Abstract
Although breast cancer incidence is increasing, there are few primary preventive initiatives. Tamoxifen can reduce breast cancer incidence but is rarely used for primary prevention due to adverse events and tolerance issues. We tested if endoxifen, a tamoxifen metabolite, applied directly to the skin of the breast, could reduce mammographic density, a proxy for therapy response. Ninety women were randomized to placebo, 10 and 20 mg of topical Z-endoxifen for 6 months. Mammographic density and symptoms were measured at baseline and study exit. Despite a high discontinuation rate, driven by skin rashes, we found a significant mammographic density decrease, a dose-dependent increase in the concentration of plasma Z-endoxifen but no systemic side effects. Topical application of tamoxifen metabolites has the potential to decrease breast cancer incidence without major systemic side effects. However, endoxifen may not be suitable for topical administration and is unlikely to be used for breast cancer prevention.
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Affiliation(s)
- Magnus Bäcklund
- Corresponding author: Magnus Bäcklund, MD, PhD, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, SE-171 65 Stockholm, Sweden. Tel: +46-8-524-823-39;
| | | | - Marike Gabrielson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mattias Hammarström
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Steve Quay
- Atossa Therapeutics, Inc., Seattle, WA, USA
| | - Jenny Bergqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Surgery, Breast Centre, Capio S:t Görans Hospital, Stockholm, Sweden
| | | | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Oncology, Södersjukhuset, Stockholm, Sweden
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Bäcklund M, Eriksson M, Hammarström M, Thoren L, Bergqvist J, Margolin S, Hellgren R, Wengström Y, Gabrielson M, Czene K, Hall P. OUP accepted manuscript. Oncologist 2022; 27:e601-e603. [PMID: 35605013 PMCID: PMC9256030 DOI: 10.1093/oncolo/oyac104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 10/25/2021] [Indexed: 11/14/2022] Open
Abstract
Mammographic density change has proven to be a reliable proxy for tamoxifen therapy response. The primary aim of this study was to identify time to tamoxifen-induced mammographic density change. We also analyzed side effects and adherence to therapy. In all, 42 women were randomized to 10 or 20 mg of daily oral tamoxifen. Mammograms were taken at baseline, 3, 6, and 9 months. Mammographic density change was measured using the automated STRATUS tool. Adverse events were monitored through a web-based questionnaire based on the FACT-ES tool. Nine out of the 42 (21%) participants discontinued therapy due to adverse events leaving 33 women in the study. A significant decrease in density was seen after 3 months of therapy. Dose did not seem to affect density change, side effects or adherence. Given the size of the study, additional studies are needed to confirm our data.
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Affiliation(s)
- Magnus Bäcklund
- Corresponding author: Magnus Bäcklund, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, SE-171 77 Stockholm, Sweden. Tel: +46 8 524 823 39; Fax: +46-8 524 823 39;
| | | | - Mattias Hammarström
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Linda Thoren
- Department of Oncology, Södersjukhuset, Stockholm, Sweden
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Jenny Bergqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Breast Centre, Department of Surgery, Capio S:t Görans Hospital, Stockholm, Sweden
| | - Sara Margolin
- Department of Oncology, Södersjukhuset, Stockholm, Sweden
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | | | - Yvonne Wengström
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Marike Gabrielson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Oncology, Södersjukhuset, Stockholm, Sweden
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Müller-Schimpfle M, Herröder N, Hödl P. [Diagnosis of breast diseases in a certified breast center]. Radiologe 2021; 61:137-49. [PMID: 33404685 DOI: 10.1007/s00117-020-00791-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2020] [Indexed: 10/22/2022]
Abstract
The beginning of the 21st century has seen immense improvements in the quality of diagnosis and treatment of breast cancer due to several, simultaneous developments. In particular, the introduction of a certification program from the German Cancer Society based on level III guidelines has enhanced the transparency and quality of treatment of breast diseases for all actors. As a result, patients have benefited from intensified cooperation especially between core disciplines in breast disease, gynecology, pathology, and radiology. The standardized and synoptic reading of multiple diagnostic modalities has enabled precise sampling of histologic specimen, which has improved prognosis and the successful individualization of therapy. In this article the benefits of breast cancer diagnosis and therapy in a certified breast center are illustrated using four case examples.
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