Computer-Aided Diagnosis Parameters of Invasive Carcinoma of No Special Type on 3T MRI:Correlation with Pathologic Immunohistochemical Markers

Purpose@#To investigate the correlation between computer-aided diagnosis (CAD) parameters in 3-tesla (T) MRI and pathologic immunohistochemical (IHC) markers in invasive carcinoma of no special type (NST). @*Materials and Methods@#A total of 94 female who were diagnosed with NST carcinoma and underwent 3T MRI using CAD, from January 2018 to April 2019, were included. The relationship between angiovolume, curve peak, and early and late profiles of dynamic enhancement from CAD with pathologic IHC markers and molecular subtypes were retrospectively investigated using Dwass, Steel, Critchlow-Fligner multiple comparison analysis, and univariate binary logistic regression analysis. @*Results@#In NST carcinoma, a higher angiovolume was observed in tumors of higher nuclear and histologic grades and in lymph node (LN) (+), estrogen receptor (ER) (-), progesterone receptor (PR) (-), human epidermal growth factor 2 (HER2) (+), and Ki-67 (+) tumors. A high rate of delayed washout and a low rate of delayed persistence were observed in Ki-67 (+) tumors. In the binary logistic regression analysis of NST carcinoma, a high angiovolume was significantly associated with a high nuclear and histologic grade, LN (+), ER (-), PR (-), HER2 (+) status, and non-luminal subtypes. A high rate of washout and a low rate of persistence were also significantly correlated with the Ki-67 (+) status. @*Conclusion@#Angiovolume and delayed washout/persistent rate from CAD parameters in contrast enhanced breast MRI correlated with predictive IHC markers. These results suggest that CAD parameters could be used as clinical prognostic, predictive factors.

Correlation of the Strain Elastography-Derived Elasticity Scores with Prognostic Histologic Features, Immunohistochemical Markers, and Molecular Subtypes of Invasive Ductal Carcinoma

PURPOSE@#To investigate the correlation of the strain elasticity of breast cancer with histologic features, immunohistochemical markers and molecular subtypes that are known to be factors related to prognosis.@*MATERIALS AND METHODS@#B-mode ultrasound and strain elastography were performed in 123 patients (mean age, 53.4; range, 28–82) with invasive ductal carcinoma (IDC) (mean size, 1.54 cm; range, 0.4–7.0 cm). Histologic grade, lymph node (LN) status, lymphovascular invasion, immunohistochemical biomarkers [estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2 (HER2), CK5/6, epidermal growth factor receptor, and Ki-67] and molecular subtypes were determined from surgical pathology reports. The relationships between these factors and elasticity scores were evaluated.@*RESULTS@#LN involvement was associated with a higher elasticity score which was statistically significant (p = 0.042). The tumor size, lymphovascular invasion, histologic grades, immunohistochemical markers and molecular subtypes had no significant correlation with the elasticity score (p > 0.05 for all). However, the IDCs with larger size and a positive lymphovascular invasion tended to have higher elasticity scores. Furthermore, higher histologic grade cancers and the HER2 overexpression-type tended to have lower elasticity scores.@*CONCLUSION@#The elasticity score of IDC had a significant correlation with LN involvement but no statistically significant correlation with the histologic features, immunohistochemical markers or molecular subtypes.

Detection of Breast Cancer in Asymptomatic and Symptomatic Groups Using Computer-Aided Detection with Full-Field Digital Mammography / 한국유방암학회지

PURPOSE: We aimed to determine the sensitivity of computer-aided detection (CAD) applied to digital mammography in asymptomatic and symptomatic breast cancer patients. METHODS: We retrospectively analyzed digital mammography and CAD images from 210 patients diagnosed with breast cancer. The patients were divided into symptomatic and asymptomatic groups. The sensitivity of CAD in both groups was assessed in relation to breast tissue density, histopathological type of breast cancer, and tumor size. RESULTS: The detection rate of the CAD system was 87.8% in the asymptomatic group. The sensitivity in different tissue densities was 100% in fatty breasts (P1), 88.9% with scattered fibroglandular densities (P2), 94.4% in heterogeneously dense breasts (P3), and 66.7% in extremely dense breasts (P4). The detection rate of the CAD system in the symptomatic group was 87.2%, and the sensitivity was 90.5%, 90%, 86.6%, and 75% in P1-P4 breasts, respectively. In the asymptomatic group, the CAD system detected 90.3% of invasive ductal carcinomas, not otherwise specified (IDC-NOS) and 88.9% of ductal carcinomas in situ (DCIS), but did not detect other types of malignancy. In the symptomatic group, the CAD system detected 88.2% of IDC-NOS, 88.9% of DCIS and 75% of other types of malignancy. When analyzed according to tumor size, the sensitivity of CAD in the asymptomatic and symptomatic groups was 82.6% and 83.3% for tumors 2 cm. CONCLUSION: The sensitivity of CAD was low in P4 breasts and high for tumors larger than 2 cm, with no statistically significant differences between the asymptomatic and symptomatic groups for IDC-NOS and DCIS. CAD showed greater sensitivity for other neoplasms in symptomatic patients.

Ultrasonographic and Mammographic Findings of Nodular Sclerosing Adenosis

PURPOSE: To evaluate the ultrasonographic and mammographic findings of cases of nodular adenosis. MATERIALS and METHODS: We evaluated 22 lesions with a pathologically proven nodular adenosis from five hospitals for three years. We excluded adenosis cases combined with other breast diseases. The findings of ultrasonography and mammography were retrospectively interpreted in consensus by two radiologists that were experienced in breast imaging according to the BI-RADS criteria. RESULTS: The age of the patients was 29-56 years with a mean age of 43.4 years. Ten lesions were biopsied with a 14-gauge core needle, seven lesions were biopsied with an 11-gauge vacuum-assisted mammotome and five lesions were removed by surgical excision. Mammography was performed in 15 patients and distinct abnormalities were seen in seven cases. These abnormalities consisted of an indistinct irregular mass, three circumscribed masses and three focal asymmetries. Calcifications were not seen in all of the masses. Ultrasonography was performed in 22 patients, revealing 13 irregular shaped lesions 8 oval shaped lesions and one round shape lesion. The margin was either circumscribed (n = 7) and not circumscribed (n = 15) in the lesions. The orientation of mass was parallel in 13 lesions and not parallel in 9 lesions. The boundary was an abrupt interface in all of the cases. The echogenecity of the mass was hypoechoic in 15 cases, isoechoic in 4 cases, hyperechoic in 2 cases and complex echogenic in one case. Nineteen of the cases showed no posterior feature and one case showed combined features. The final categories by the BI-RADS criteria were category 3 in three cases and category 4 in 19 cases (C4a 11, C4b 8). CONCLUSION: Nodular adenosis mostly presents as category 4 on ultrasonography. Therefore, a differential diagnosis with malignancy is difficult to determine. However, the findings of lesions highly suggestive of being malignant such as a spiculation or echogenic halo, are rare. On mammography, it is commonly obscured.

Thoracic CT Findings of Adult-Onset Still's Disease: A Case Report

Adult-onset of Still's disease is a rare systemic rheumatic disorder. It involves various organs including the lungs and pleura. We report here the CT findings of a patient with the thoracic manifestations of Still's disease, including axillary and mediastinal lymphadenopathies, pleural and pericardial effusions and infiltrations in both lung bases.

Extraskeletal Ewing Sarcoma of Cervical Epidural Region: Cases Report

Extraskeletal Ewing sarcoma is a rare malignant tumor found in children and young adults. It commonly occurs in deep soft tissue of the trunk, especially in the paravertebral region and extremities. We report two cases of extraskeletal Ewing sarcoma occurring as a cervical epidural tumor in elderly patients. The MRI and CT findings showed that paravertebral epidural tumors had invaded the spinal canal through the intervertebral foramen. At T1-weighted MR imaging, the masses were isointense to muscle, and at T2* and T2-weighted images were hyperintense, and heterogeneous contrast enhancement was observed. Extraskeletal Ewing sarcoma, though quite rare, should be borne in mind in the differential diagnosis of paraspinal epidural tumors.

A Case Report of Inflammatory Pseudotumor Involving the Clivus: CT and MR Findings

The authors describe a rare case of inflammatory pseudotumor involving the clivus, where a soft tissue mass lesion, with extension into the prevertebral retropharyngeal space and the cavernous sinuses, was detected by CT and MRI. The mass resembled a malignant tumor or aggressive infectious lesion, and the final diagnosis of inflammatory pseudotumor was a diagnosis of exclusion, decided after histopathological examination.