ABSTRACT
Objective@#To assess the value of multi-parametric MRI in mammographically detected breast imaging reporting and data systems (BI-RADS) 3 to 4 exclusive microcalcifications.@*Methods@#A retrospective analysis was performed in 152 patients with mammographically detected BI-RADS 3 to 4 exclusive microcalcifications from January 2013 to December 2017. All patients underwent bilateral breast multi-parametric MRI before surgical biopsy. Microcalcifications were classified according to BI-RADS by two radiologists with more than 10 years′ experience in breast imaging. The area under the curve (AUC), sensitivity and specificity of BI-RADS 3 to 4 exclusive microcalcifications diagnosis by mammography and mammography plus MRI were calculated and compared using pathology as the gold standard.@*Results@#A total of 152 lesions (93 benign lesionsand 59 malignant lesions) were assessed in this study. The positive predictive value (PPV) of mammography for BI-RADS 3, 4A, 4B and 4C microcalcifications diagnosis were 22.2%(16/72), 5.0%(1/20), 48.5%(17/35) and 100.0%(25/25) respectively. The PPV of MRI for BI-RADS 2, 3, 4, 5 microcalcifications diagnosis were 1.6%(1/62), 7.1%(2/28), 72.2%(13/18) and 97.7%(43/44).The area under curve, sensitivity and specificity of mammography for BI-RADS 3 to 4 microcalcifications diagnosis were 0.676,72.9% and 60.2%. The area under curve, sensitivity and specificity of mammography plus MRI for BI-RADS 3 to 4 microcalcifications diagnosis were 0.982, 94.9% and 93.6%.@*Conclusions@#Multi-parametric MRI can improve the diagnostic accuracy in mammographically detected BI-RADS 3 to 4 exclusive microcalcifications, which is helpful to differentiate benign and malignant breast lesions with microcalcifications and avoid unnecessary biopsies.
ABSTRACT
Objective@#To investigate the application value of CTDIvol and size-specific dose estimate(SSDE) in evaluating the radiation dose of adult chest CT.@*Methods@#A retrospective analysis was made on the CTDIvoland SSDE of 128 patients who underwent chest CT scanning in the First Affiliated Hospital of Zhejiang Chinese Medical University from March to April 2017 and all images are adequate for diagnosis. The subjects were divided into three groups according to body mass index (BMI): Group A, 38 cases with 16≤BMI<21.1 kg/m2; Group B, 53 cases with 21.1≤BMI<23.9 kg/m2; Group C, 37 cases with 23.9≤BMI<34.1 kg/m2. The diameters of anterior-posterior (AP) and left-right (LAT) of each patient were measured in the slice of nipple level, and CTDIvol, effective diameter (ED), conversion factor (fsize) and SSDE of each patient were recorded and calculated. Meanwhile, the differences between CTDIvol and SSDE in different BMI groups were compared.@*Results@#SSDE of each group was higher than CTDIvol, and increased by 50.13%, 42.83% and 33.68% in group A, B and C, respectively. There were significant differences in radiation dose between CTDIvol and SSDE in the three groups (t=-48.873, -57.001, -32.651, P<0.05). There were significant differences in ED, fsize, CTDIvol and SSDE among the three groups (F=51.456, 47.749, 113.916, 106.449, P<0.05).@*Conclusions@#SSDE can evaluate the radiation dose absorbed by patients with different body types in chest CT, while CTDIvol underestimated the radiation dose.The lower BMI, the greater the underestimated dose value, the more radiation dose absorbed.
ABSTRACT
Objective To investigate the application value of CTDIvol and size-specific dose estimate( SSDE) in evaluating the radiation dose of adult chest CT. Methods A retrospective analysis was made on the CTDIvol and SSDE of 128 patients who underwent chest CT scanning in the First Affiliated Hospital of Zhejiang Chinese Medical University from March to April 2017 and all images are adequate for diagnosis. The subjects were divided into three groups according to body mass index ( BMI):Group A,38 cases with 16≤BMI<21. 1 kg/m2; Group B,53 cases with 21. 1≤BMI<23. 9 kg/m2; Group C,37 cases with 23. 9≤BMI<34. 1 kg/m2. The diameters of anterior-posterior (AP) and left-right (LAT) of each patient were measured in the slice of nipple level, and CTDIvol , effective diameter ( ED) , conversion factor ( fsize ) and SSDE of each patient were recorded and calculated. Meanwhile, the differences between CTDIvol and SSDE in different BMI groups were compared. Results SSDE of each group was higher than CTDIvol , and increased by 50. 13％, 42. 83％ and 33. 68％ in group A, B and C, respectively. There were significant differences in radiation dose between CTDIvol and SSDE in the three groups ( t=-48. 873,-57. 001, -32. 651, P<0. 05) . There were significant differences in ED, fsize , CTDIvol and SSDE among the three groups ( F=51. 456, 47. 749, 113. 916, 106. 449, P<0. 05) . Conclusions SSDE can evaluate the radiation dose absorbed by patients with different body types in chest CT, while CTDIvol underestimated the radiation dose. The lower BMI, the greater the underestimated dose value, the more radiation dose absorbed.
ABSTRACT
Objective To assess the value of multi-parametric MRI in mammographically detected breast imaging reporting and data systems (BI-RADS) 3 to 4 exclusive microcalcifications. Methods A retrospective analysis was performed in 152 patients with mammographically detected BI-RADS 3 to 4 exclusive microcalcifications from January 2013 to December 2017. All patients underwent bilateral breast multi-parametric MRI before surgical biopsy. Microcalcifications were classified according to BI-RADS by two radiologists with more than 10 years′ experience in breast imaging. The area under the curve (AUC), sensitivity and specificity of BI-RADS 3 to 4 exclusive microcalcifications diagnosis by mammography and mammography plus MRI were calculated and compared using pathology as the gold standard. Results A total of 152 lesions (93 benign lesionsand 59 malignant lesions) were assessed in this study. The positive predictive value (PPV) of mammography for BI-RADS 3, 4A, 4B and 4C microcalcifications diagnosis were 22.2%(16/72),5.0%(1/20),48.5%(17/35) and 100.0%(25/25) respectively. The PPV of MRI for BI-RADS 2, 3, 4, 5 microcalcifications diagnosis were 1.6%(1/62),7.1%(2/28),72.2%(13/18) and 97.7%(43/44).The area under curve, sensitivity and specificity of mammography for BI-RADS 3 to 4 microcalcifications diagnosis were 0.676,72.9% and 60.2%. The area under curve, sensitivity and specificity of mammography plus MRI for BI-RADS 3 to 4 microcalcifications diagnosis were 0.982, 94.9% and 93.6%. Conclusions Multi-parametric MRI can improve the diagnostic accuracy in mammographically detected BI-RADS 3 to 4 exclusive microcalcifications, which is helpful to differentiate benign and malignant breast lesions with microcalcifications and avoid unnecessary biopsies.