Diagnostic values of radiomics models in micro-calcifications in carotid plaques / 中华神经医学杂志

Objective:To construct radiomics models of micro-calcification in carotid plaques, and compare their diagnostic values.Methods:Fifty-two patients with large atherosclerotic cerebral infarction admitted to Department of Neurology, Third Affiliated Hospital of Soochow University from May 2017 to November 2019 were enrolled. All patients underwent conventional carotid artery Doppler ultrasound to detect carotid plaques and Micropure? ultrasound to detect micro-calcifications in the plaques. A cross-section image with maximum numbers of micro-calcifications was chosen when there were micro-calcifications in carotid plaques; otherwise, a cross-section image with the largest area of the plaque was chosen. After all images were normalized by Photoshop software, the plaques were delineated as regions of interest using MaZda 4.6 software and 283 texture features of the plaques were automatically extracted. The texture features with the strongest predictive value were selected through consistency analysis (intrclass correlation coefficient [ICC]>0.75), two-sample t-test, Least absolute shrinkage and selection operator (Lasso) regression. The predictive models were constructed by RandomForest (RF) and Support vector machine (SVM) classifiers. The training set and test set were divided by 7: 3 to analyze the classification accuracy. Receiver operating characteristic (ROC) curves were used to calculate the area under the curve (AUC) to evaluate the diagnostic values of the models. Delong test was used to compare the difference between the diagnostic values of the 2 classifiers in test set. Results:A total of 148 plaque images from 52 patients were enrolled, including 104 plaques with micro-calcification and 44 plaques without micro-calcification. Nine texture features were finally selected after ICC analysis, T test and Lasso regression: 5 image gray histogram features were mean, variance, skewness, kurtosis and 99 th percentile (Perc. 99%); 1 autoregressive model feature was Teta3, and 3 wavelet transform features were WavEnLH_s-3, WavEnLH_s-4, and WavEnLH_s-6. With RF classifier, accuracy of the diagnostic model was 0.93, enjoying AUC of 0.92; with SVM classifier, that was 0.91, enjoying AUC of 0.90; Delong test showed that the diagnostic values of the 2 classifiers in test set were significantly different ( Z=1.000, P=0.320). Conclusion:Radiomic models constructed by RF and SVM classifiers can identify micro-calcification in carotid plaques, and the 2 classifiers share equivalent diagnostic values.

Correlations of micro-calcification load in carotid plaques and plaque vulnerability scores with 18F-sodium fluoride uptake ratio in PET-CT / 中华神经医学杂志

Objective:To explore the correlations of micro-calcification load in carotid plaques and plaque vulnerability scores detected by Micropure? ultrasonic technology with 18F-sodium fluoride ( 18F-NaF) uptake ratio (tissue-background ratio [TBR]) in positron emission tomography-computed tomography (PET-CT). Methods:Baseline data of patients with carotid atherosclerotic plaques admitted to our hospital from March 2017 to November 2020 were collected. Carotid arteries of these patients simultaneously positive on Micropure? ultrasound examination and 18F-NaF PET-CT were included. The number of spots in carotid plaques detected by Micropure? ultrasonic technology was defined as load of micro-calcification: they were divided into large number of micro-calcifications group (≥5 spots) and small number of micro-calcifications group (1-4 spots). The scores of carotid plaque vulnerability were evaluated according to carotid atherosclerosis scores in Diagnostic Value of Carotid Atherosclerosis Score for Ischemic Stroke. Correlations of TBR with micro-calcification load and plaque vulnerability scores in these 39 carotid arteries were analyzed. Results:Thirty-nine carotid arteries from 28 patients were enrolled: 24 carotid arteries were classified into the large number of micro-calcifications group and 15 carotid arteries were classified into the small number of micro-calcifications group. TBR of the large number of micro-calcifications group (2.61±0.73) was significantly increased as cpmpared with that of the small number of micro-calcifications group (1.93±0.43, t=-3.657, P=0.001). In the 39 carotid arteries, micro-calcification load was 5(3, 5), while the carotid plaque vulnerability scores were 2 (2, 3); micro-calcification load was positively correlated with TBR (2.35±0.71, r s=0.519, P=0.001), but no correlation was noted between TBR and carotid plaque vulnerability scores ( r s=0.086, P=0.602). Conclusion:Carotid plaque micro-calcification load detected by Micropure? ultrasound examination is associated with 18F-NaF uptake ratio; the larger the micro-calcification load, the more obvious the uptake of 18F-NaF.

Detection of microcalcification clusters regions in mammograms combining discriminative deep belief networks / 生物医学工程学杂志

In order to overcome the shortcomings of high false positive rate and poor generalization in the detection of microcalcification clusters regions, this paper proposes a method combining discriminative deep belief networks (DDBNs) to automatically and quickly locate the regions of microcalcification clusters in mammograms. Firstly, the breast region was extracted and enhanced, and the enhanced breast region was segmented to overlapped sub-blocks. Then the sub-block was subjected to wavelet filtering. After that, DDBNs model for breast sub-block feature extraction and classification was constructed, and the pre-trained DDBNs was converted to deep neural networks (DNN) using a softmax classifier, and the network is fine-tuned by back propagation. Finally, the undetected mammogram was inputted to complete the location of suspicious lesions. By experimentally verifying 105 mammograms with microcalcifications from the Digital Database for Screening Mammography (DDSM), the method obtained a true positive rate of 99.45% and a false positive rate of 1.89%, and it only took about 16 s to detect a 2 888 × 4 680 image. The experimental results showed that the algorithm of this paper effectively reduced the false positive rate while ensuring a high positive rate. The detection of calcification clusters was highly consistent with expert marks, which provides a new research idea for the automatic detection of microcalcification clusters area in mammograms.

Prediction of complete pathological response to neoadjuvant chemotherapy in patients with breast cancer with reduced microcalcification / 中国肿瘤临床

Objective: To investigate causes and factors affecting microcalcification (MC) changes after neoadjuvant chemotherapy (NAC) in patients with breast cancer and to assess the correlation between MC reduction and complete remission rate [pathological complete response (pCR)] of tumors. Methods: Clinical data of 215 patients with breast cancer who visited Tianjin Medical University Cancer Hospital from January 1, 2015 to December 31, 2018 were collected. The patients were grouped according to MC range and number of changes, and factors that affected MC changes were evaluated. According to whether MC decreased or not, the patient group was divided into the MC range and MC number reduction groups, and the correlation between the decrease in MC and pCR, assessed using different molecular typing methods, was analyzed . The sensitivity and specificity of the receiver operating characteristic curve analysis (ROC) were used to evaluate the accuracy of MC reduction in predicting pCR. Results: The patients with a distribution of diffuse, initial MC range of >2 cm and MC quantity of >20 were more likely to have an MC reduction. The pCR rate was higher in the group with reduced and non-reduced MC. No significant difference was found between the group with decreased MC and the control group. The decreases in MC according to the different molecular typing methods were independent of factors affecting pCR. Reduction in MC range predicts pCR with a sensitivity of 77.78 and specificity of 57.45 (P=0.0001). Conclusions: The change factors of MC in patients with breast cancer after neoadjuvant chemotherapy were the range, number, and distribution of calcification. The pCR rate of the patients with reduced MC was high, but the accuracy of pCR prediction based on reduced MG was low. Thus, mammography was not recommended for evaluating pCR after neoadjuvant chemotherapy.

Mammographyfeatures of breast cancer patients older than 60 years: correlation between microcalcification and age / 中国肿瘤临床

Objective: We aimed to compare mammography features between breast cancers patients older and younger than 60 years and to investigate the correlation between rate of microcalcification and age. Methods: A retrospective analysis was conducted on-mammography data of 1,959 patients with breast cancer diagnosed based on pathology findings from June 2012 to April 2013 at the Tianjin Medical University Cancer Institute and Hospital. Our study population was divided into 2 groups: older patient group (n=512) and younger patient group (n=1,447). Results: The proportions of cases involving high mass density were 73.0% (330/452) and 46.0% (464/1,008) in the older and younger patient groups, respectively. Furthermore, the proportions of cases involving equal or low mass density were 27.0% (122/ 452) and 54.0% (544/1,008) in the corresponding groups, respectively (P<0.05). The older and younger patient groups included 178 (34.8%) and 603 (41.7%) patients with microcalcification, respectively (P<0.05). We further divided our patient population (1,959 patients) into various age groups: <30, 30-39, 40-49, 50-59, 60-69, and ≥70 years. The proportions of cases involving microcalcification in the corresponding age groups were 58.8% (10/17), 42.8% (74/173), 41.0% (259/632), 41.6% (260/625), 38.2% (137/359), and 26.8% (41/153), respectively (P=0.008). Conclusions: Although the proportions of mass density and microcalcification were different between the older and younger patient groups, the fact that microcalcified foci decreased with age deserves further attention.

Expressions of runt-related transcription factor 2 and osteopontin in breast cancer tissues and their clinical significance / 肿瘤

Objective: To investigate the expressions of Runt-related transcription factor 2 (RUNX2) and osteopontin (OPN) proteins in breast cancer tissues, and to explore their clinical significance. Methods: The expression levels of RUNX2 and OPN proteins in tumor tissues of 220 patients with breast cancer were detected by immunohistochemical staining method. The relationships between the expression levels of RUNX2 and OPN proteins and the clinicopathological features, such as tumor microcalcification, TNM staging and pathological types of breast cancer were analyzed. The overall survival (OS) time and disease-free survival (DFS) time of patients with breast cancer were followed up. The effects of RUNX2 and OPN expression levels on the prognosis of breast cancer patients were also analyzed. Results: The positive rates of RUNX2 and OPN proteins in calcification group were higher than those in non-calcification group (90.9% vs 82.7%, 96.4% vs 83.6%, both P 0.05). Conclusion: RUNX2 and OPN are highly expressed in microcalcification of breast cancer, which suggests that they may participate in the process of microcalcification formation in breast cancer tissues. RUNX2 is an adverse prognostic factor for DFS and OS of breast cancer patients. However, OPN has no effect on the survival of breast cancer patients.

Understanding Vulnerable Plaques: Current Status and Future Directions

The main cause of acute myocardial infarction is plaque rupture accompanied by superimposed coronary thrombosis. Thin-cap fibroatheromas (TCFAs) have been suggested as a type of lesion with a vulnerability that can cause plaque rupture. However, not only the existence of a TCFA but also the fine and complex interactions of other anatomical and hemodynamic factors, such as microcalcification in the fibrous cap, cholesterol crystal-induced inflammasome activation, the apoptosis of intraplaque macrophages, and endothelial shear stress distribution should precede a clinical event caused by plaque rupture. Recent studies are being conducted to identify these mechanisms through molecular imaging and hemodynamic assessment using computational fluid dynamics, which will result in better clinical results through selective coronary interventions.

Clinical significance of microcalcification in patients with thyroid micropapillary carcinoma / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the clinical significance of microcalcification under high resolution ultrasonography in predicting thyroid micropapillary carcinoma(PTMC) and cervical lymph node metastasis. METHODS The clinical data of 388 patients with papi l lar y thyroid microcarcinoma were analyzed retrospectively in Beijing Tongren Hospital from Jan 2013 to Jun 2017, which included patients' clinical ultrasonographic features and pathological results in this study. Pearson correlation analysis and data fitting modeling were used to analyze the microcalcification, the maximum diameter of the tumor and the cervical lymph node metastasis in the central region. RESULTS The incidence of microcalcification in PTMC patients was closely related to the maximal diameter of the tumor. The tumor diameter of PTMC was related to the lymph node metastasis rate in the central region of the neck, and it was not found that microcalcification was associated with lymph node metastasis in the central region of the neck. CONCLUSION The weight of microcalcification in the diagnosis of PTMC is related to the maximum diameter of the nodule. Furthermore, patients with thyroid nodules having a tumor diameter of less than 1 cm, with the larger diameter of tumor nodules, the greater the risk of PTMC, the more recommended fine needle biopsy.

Identification of carotid plaque microcalcification by Micropure imaging / 中华神经医学杂志

Objective To explore the relationship between carotid plaque microcalcifcation and ischemic stroke (including transient ischemic attack) and the value of carotid microcalcification in predicting ischemic stroke.Methods Twenty-six patients in accordance with atherothrombosis models classified by Korean modified TOAST classification were enrolled in this study from November 2016 to March 2017.The microcalcification of the bilateral carotid was detected by Micropure imaging and the severity of intracranial ischemic focal lesions was evaluated by Alberta stroke programme early CT scale (ASPECT).The relation of ASPECT scores with microcalcification of the bilateral carotid was analyzed,and the value of carotid microcalcification in predicting ischemic stroke was analyzed by receiver operating characteristic curve method.Results Microcalcifition was detected in 27 of the total 52 carotids (51.92％) in 19 patients,which localized in the fibrous cap in 23 carotids (85.19％) and the basilar part of the plaque in 4 carotids (14.81％).The microcalcification surrounded the macrocalcifiation in 14 carotids (51.85％).The ASPECT scores were 10.85±1.43 in the microcalcifition side,which were significantly higher than those in the side without microcalcifition (11.80±1.19,t=2.584,P=0.013).The area under the curve was 0.673,with sensitivity of 0.667 and specificity of 0.680.Conclusion Micropure imaging maybe a new approach to detect the carotid microcalcification,and plaques with microcalcifition mav easilv cause ipsilateral ischemic stroke.

Diagnostic value of breast imaging reporting and data system combined with wire-guided localization biopsy for breast microcalcifications in impalpable breast cancer / 肿瘤研究与临床

Objective To explore the diagnosis value of X-ray breast imaging reporting and data system (BI-RADS) combined with wire-guided localization biopsy for breast microcalcifications in impalpable breast cancer.Methods 192 palpation negative patients with 205 microcalcification lesions were detected by mammography.All lesions were classified according to BI-RADS descriptors for calcification and were categorized by the BI-RADS.The patients with BI-RADS category 4a and above underwent X-ray positioning guide wire-guided biopsy and pathological diagnosis.Results In 205 microcalcification lesions,74 (36.1％) were malignant lesions,131 (63.9 ％) were less than benign lesions.The positive predictive value of malignant breast lesions in clustered,segmental,regional linear branching calcifications were higher [83.3 ％ (5/6),100.0 ％ (11/11),100.0 ％ (1/1)],followed by clustered,linear,segmental,regional pleomorphic calcifications [55.9 ％ (38/68),50.0 ％ (1/2),40.0 ％ (8/20) and 33.3 ％ (4/12),respectively].The positive predictive values of malignant in linear branching calcifications and pleomorphic calcifications were significantly higher than those of coarse heterogeneous calcifications,amorphous or indistinct calcifications (x2 values were 34.44,51.87,16.71,29.86,all P ＜ 0.05).The linear branching calcification had the highest possibility.The proportions of malignant lesions in four different types of glands were extremely dense 40.5 ％ (30/74),heterogeneously dense 39.2 ％ (29/74),scattered areas of fibroglandular density 10.8 ％ (8/74) and fat 9.5 ％ (7/74),respectively.Conclusions BI-RADS categorization for breast microcalcification lesions can improve the detection rate of impalpable breast cancer.Linear branching calcification has higher predictive value for malignant lesions.Dense breast is the risk factors of breast cancer,which should be attached great importance.

Relationship between micro-calcification and prognostic factors in breast cancer patients / 肿瘤

Objective: To investigate the correlation between the prognosis of breast cancer patients and mammographic calcification. Methods: A total of 1 035 breast cancer patients with complete clin ical information were in cluded in this study. According to mammographic calcification before operation, the patients were divided into calcification group and non-calcification group, and then the expressions of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER-2) were compared between two groups. The influence of calcification on the positive expression rates of ER, PR and HER-2 and the relationship between calcification and tumor size, axillary lymph node status, histological grade, molecular classification and prognosis were analyzed. Results: The rate of calcification in the patients with axillary node metastasis was significantly higher than that in the patients without lymphatic metastasis [53.6% (199/371) vs 47.1% (312/663)] (P 0.05). In survival analysis, there was no obvious difference between the calcification group and non-calcification group. Conclusion: The breast cancer with micro-calcification shown on mammographic X-ray images was associated with the expression of HER-2, molecular typing and axillary lymph node status. The calcification is likely to have no effect on the survival of patients.

Stereotactic vacuum-assisted breast biopsy under lateral decubitus position

PURPOSE: Stereotactic vacuum-assisted breast biopsy (VAB) has been established as a standard method for histological diagnosis of microcalcification or nonpalpable breast lesions on mammography. Generally, the procedure has been done under the prone position or upright sitting position. We herein attempt to evaluate clinical utility of Stereotactic VAB under lateral decubitus position. METHODS: One hundred six women (mean age, 51.2 years) with mammographically detected microcalcification underwent lateral decubitus positioning VAB using the 8G probe. In all cases, we obtained mammography specimens for identification of microcalcification and postprocedure mammography. We reviewed mean procedure time, pieces of specimen, pathology and follow-up mammography. RESULTS: The procedure took approximately 20 minutes (range, 15-24 minutes). Average number of obtained specimens was 8.5 pieces (range, 6-12 pieces). Microcalcifications were confirmed in both specimen mammography and microscopic slides. Of 106 cases, 10 cases were diagnosed as ductal carcinoma in situ. Additional surgical management was performed. Atypical ductal hyperplasias were found in 8 cases, and fibrocystic changes in 88 cases. CONCLUSION: Stereotactic VAB using the 8G probe under lateral decubitus position does not need a dedicated table, and is easier to maintain the position. Also, this procedure is accurate and safe. Thus, stereotactic VAB using the 8G probe under lateral decubitus position will be a useful method for diagnosis of microcalcification or nonpalpable breast lesions on mammography.

Diagnostic value of X-ray stereotactic vacuum-assisted biopsy for breast micro-calcification / 肿瘤研究与临床

Objective To compare the accuracy and clinical effect between X-ray stereotactic vacuum-assisted biopsy (SVAB) and metal wire guided lumpectony.Methods From January 2010 to June 2014,681 cases of breast micro-calcification biopsy were performed.Among them,78 cases were performed with SVAB and 603 eases were performed with the method of stereotaetic metal wire guided lumpectomy.All cases were non-palpable breast lesions (NPBLs) and breast imaging-reporting and data system (BI-RADS) assessment categories 4.The diagnostic accuracy and clinical effect were compared.Results The sensitivity of both methods was 100 ％ with no misdiagnosis.The underestimation rate of SVAB was 12.5 ％.Compared with the method of metal wire guided lumpectomy,SVAB had many advantages,such as easy to use,quickly performed,low rate of local deformation and lower rate of operative complications.77.5 ％ patients benefited from SVAB by avoiding open surgery of benign disease.Conclusions SVAB is an accurate,safe and convenient method of biopsy.It can be recommended as the preferred method of micro-calcification (BI-RADS 4).Additional operation should be performed on patients with the pathological diagnosis of middle and high grade of dysplasia and any kind of carcinoma.

Application of Micropure System on Calcifications Detection of Thyroid Nodules / 中国医科大学学报

Objective To evaluate the ability of micropure system on calcifications detection of thyroid nodules. Methods A total of 63 patients with thyroid nodules that prepared for surgery were detected by micropure system and gray?scale ultrasound imaging,respectively. Results Among the 87 lesions removed with surgery,there were 72 benign lesions and 15 malignant ones. For the coarse calcifications,3 calcifications in the benign lesions were found both by micropure system and gray?scale ultrasound imaging;while in these malignant lesions,11 and 9 calcifications were visual?ized by micropure system and gray?scale ultrasound imaging,respectively. There was no significant difference between the two methods(P>0.05). For the micro?calcifications,8 and 2 calcifications were found in the benign lesions by micropure system and gray?scale ultrasound imaging,respec?tively;while 12 and 5 calcifications were visualized in the malignant lesions by micropure system and gray?scale ultrasound imaging,respectively. The micropure system method is more sensitive in micro?calcification detection compare to the traditional gray?scale ultrasound imaging method(P<0.05). Conclusion Micropure system can detect micro?calcifications and has a better visibility for micro?calcifications within the thyroid lesions, which can be applied in early thyroid cancer diagnosis.

Primary Breast Amyloidosis Presenting as Microcalcifications Only

Amyloidosis is a rare disease characterized by the formation of pathological protein deposits in organs or tissues. It is typically a systemic disease which can occur in a localized form. Amyloidosis of the breast is uncommon. Common mammographic findings of breast amyloidosis are multiple nodules with or without calcifications. We report a case of primary localized breast amyloidosis presenting suspicious microcalcifications on mammography without associated masses. Mammography in a 72-year-old woman displayed multiple, linearly distributed, irregular and rod-like calcifications in the subareolar area of the left breast. The patient underwent surgical excision under mammo-guided needle localization and the pathology was confirmed to be breast amyloidosis.

An Unusual Case of Gastric Cancer Presenting with Breast Metastasis with Pleomorphic Microcalcifications / 한국유방암학회지

Breast metastasis from gastric carcinoma is rare. We present a case of right breast mass with microcalcification in which the diagnosis of poorly differentiated adenocarcinoma from the stomach was made after a biopsy. Pleomorphic microcalcification was noted in the ill-defined breast mass, which is a rare feature in breast metastasis. Since breast metastasis usually signifies advanced metastatic disease, differentiating primary breast cancer from metastasis is important for appropriate treatment.

Value of Steel Wire Implantation with Prone Table Stereotactic Digital Mammography in the Detection of Microcalcification of the Breast / 中国肿瘤临床

Objective:To explore the clinical value of stereotactic wire-localized biopsy(SWLB)in digital mammography in the detection of microcalcification of the breast.Methods:A total of 45 patients with nonpalpable breast lesions which were positive for microcalcification by mammography but could not be detected clinically underwent SWLB.Their mammography fndings were analyzed in detail with pathology.Results:Among the 45 cases,13 cases(28.9%)had malignant lesions including ductal carcinoma in situ in 3 cases (20.1%),ductal carcinoma in situ with microinvasion in 4 cases(30.8%),invasive ductal carcinoma in 5 cases (38.5%)and intraductal papillary carcinoma in 1 case(7.7%).Thirty-two cases(71.1%)had benign lesions,2 cases(6.3%)of which were severe atypical hyperplasia.Conclusion:SWLB can accurately guide the surgical excision of nonpalpable breast microcalcification lesions and diagnose microcalcifications exactly,which is helpful for increasing the detection rate of eady-stage breast cancer.

Biópsia excisional por agulhamento de lesões mamárias não palpáveis: indicações, técnica e resultados / Excisonal biopsy with wirw localization of non palpable breast lesions: indicators, technique and results

Com o aumento do rastreamento mamográfico, identificam-se cada vez mais lesões menores e não palpáveis, surgindo a necessidade de localiza-las tanto para diagnóstico como para tratamento. Neste trabalho, descreveram-se a técnica e suas indicações e apresentaram-se os resultados dos casos de agulhamento do Serviço de Mastologia e Radiologia do Hospital de Clínicas de Porto Alegre (HCPA). Métodos: Avaliaram-se, retrospectivamente, 586 casos de agulhamento operados no período de 1995 a 2004. As indicações para o procedimento foram as alterações mamográficas de lesões não palpáveis, classificadas de acordo o sistema BIRADS. Resultados: A principal indicação cirúrgica foram as microcalcificações, num total de 373 casos (63,7%), seguidas de nódulos em 37,2%. A idade média das pacientes foi de 53 anos (23 a 82). O valor preditivo positivo (VPP) geral para malignidade foi de 0,30 (177/586 casos). As alterações funcionais benignas da mama (AFBMs) corresponderam ao diagnóstico mais comum (34,1%). Noventa e quatro por cento dos casos de carcinoma ductal in situ (CDIS) foram diagnosticados mamograficamente como microcalcificações. Conclusões: Considerando os dados apresentados e a experiência do serviço, a biópsia por agulhamento continua sendo o principal procedimento para diagnóstico e tratamento de lesões não palpáveis. Trata-se de um método seguro, porém não isento de riscos.

With the increasing use of mammography, more and smaller non- palpable lesions are found, bringing the need of localize them for diagnostic and even therapeutic purposes. We describe the surgical technique, indications and results with the well-known standard procedure of excision after wire localization. Method: We retrospectively evaluated the result of 586 wire localizations between 1995 and 2004. The indications for the procedure were non-palpable mammographic abnormalities classified according to BIRADS system. Results: The main indication for this procedure were microcalcifications in 63.7% of the cases (n=373), followed by lumps 37.2%. The mean age of these patients was 53 years (range 23- 82 years). We observed an overall positive predictive value (PPV) for malignancy of 0.30 (177/586 cases). Benign fybrocistic changes was found as the most common pathological diagnosis (34.1%). Ninety-four per cent of the ductal carcinoma in situ were detected mammographically as microcalcifications. Conclusions: The authors call attention for the use of a very careful and delicate surgical technique in order to achieve the best results. Our experience confirm that the wire-guided excision of non-palpable breast lesions is a safe and reliable diagnostic/therapeutic procedure.

Detection of Microcalcifications in Digital Mammograms Using Foveal Method / 대한의료정보학회지

OBJECTIVE: Breast cancer represents themost frequently diagnosed cancer in women. In order to reduce mortality, early detection of breast cancer is important, because diagnosis is more likely to be successful in the early stages of the disease. On the average, the reader's sensitivity can be increased by 10%with the assistance of computer-aided diagnosis (CAD) system. This paper presents a CAD system for the automatic detection of clustered micro-calcifications in digitized mammograms. METHODS: The proposed system consists of three main steps. First, breast region is segmented from original mammogram using contrast property of grey level co-occurrence matrix(GLCM). Second, potential micro-calcification pixels in the mammograms are detected by foveal method. Third, in order to reduce false-positive rate, individual micro-calcifications are detected by a set of 8 features extracted from the potential individual micro-calcification objects. RESULTS: In the result, Specificity and sensitivity are used to evaluate the detection performance of micro-calcifications.(sensitivity : 93.1%, specificity : 87.5%). CONCLUSION: This study could be a useful method for diagnosis of breast cancer as a CAD system.

US-guided Vacuum-assisted Breast Biopsy with Air Localization for Patients with Microcalcifications

PURPOSE: Stereotactic vacuum-assisted breast biopsy (SV AB) has recently been introduced as an alternative to the traditional surgical excisional biopsy with needle localization (NLBB). Although SVAB has excellent sensitivity and specificity with very low false negative results, patients might complain about the uncomfortable table and the painful breast compression that is done during SVAB. Furthermore, the cost of SVAB is too expensive to be widely adopted in Korea. So we developed a new technique of vacuum-assisted breast biopsy with air localization (VAB-AL) for the patients suffering with microcalcifications. METHODS: From April 2005 to Oct 2005, 10 microcalcification patients, whose lesions were difficult to be seen on breast ultrasonography, underwent vacuum-assisted breast biopsies with air localization (VAB-AL). First, classical NL was done to localize the mammographic abnormalities. Instead of insertion of the wire, 1 cc amounts of air were injected through a needle. The injected air could be easily visualized as a hyperechogenic density on breast sonography. Vacuum-assisted breast biopsy for the air-induced hyperechogenic densities was then done under sonographic guidance. The specimen radiography was performed to confirm that the lesion was removed. RESULTS: The mean age of the patients was 46 (range: 37~55). The upper-outer quadrant of the breast was the most common site of the lesions (6/10, 60%); the upper-inner quadrant (2/10, 20%), and then the lower-inner quadrant (1/10, 10%) followed. The specimen radiology for all 10 patients showed that the mammographic abnormalities were successfully removed. The most common pathologic type was fibrocystic disease (6/10, 70%); intraductal carcinoma (3/10, 30%), and then atypical ductal hyperplasia (1/10, 10%) followed. There were no major complications. CONCLUSION: Vacuum-assisted breast biopsy with air localization is a new technique that can minimize the complaints of patients with microcalcifications about the uncomfortable table, the painful breast compression and the economic burden of SVAB. This new procedure was successfully performed in our 10 patients, and we believe this procedure shows a lot of promise as one of alternatives to classical NLBB and SVAB.