The Impact of Data Management on the Achievable Dose and Efficiency of Mammography and Radiography During the COVID-19 Era: A Facility-Based Cohort Study.

Purpose: To evaluate the impact of using computational data management resources and analytical software on radiation doses in mammography and radiography during the COVID-19 pandemic, develop departmental diagnostic reference levels (DRLs), and describe achievable doses (ADs) for mammography and radiography based on measured dose parameters. Patients and Methods: This ambispective cohort study enrolled 795 and 12,115 patients who underwent mammography and radiography, respectively, at the King Fahd Hospital of the University, Al-Khobar City, Saudi Arabia between May 25 and November 4, 2021. Demographic data were acquired from patients' electronic medical charts. Data on mammographic and radiographic dose determinants were acquired from the data management software. Based on the time when the data management software was operational in the institute, the study was divided into the pre-implementation and post-implementation phases. Continuous and categorical variables were compared between the two phases using an unpaired t-test and the chi-square test. Results: The median accumulated average glandular dose (AGD; a mammographic dose determinant) in the post-implementation phase was three-fold higher than that in the pre-implementation phase. The average mammographic exposure time in the post-implementation phase was 16.3 ms shorter than that in the pre-implementation phase. Furthermore, the median values of the dose area product ([DAP], a radiographic dose determinant) were 9.72 and 19.4 cGycm2 in the pre-implementation and post-implementation phases, respectively. Conclusion: Although the data management software used in this study helped reduce the radiation exposure time by 16.3 ms in mammography, its impact on the mean accumulated AGD was unfavorable. Similarly, radiographic exposure indices, including DAP, tube voltage, tube current, and exposure time, were not significantly different after the data management software was implemented. Close monitoring of patient radiation doses in mammography and radiography, and dose reduction will become possible if imaging facilities use DRLs and ADs via automated systems.

Processing of Wisconsin Breast Cancer Data using Ebola Optimization Algorithm with Mixture Kernel SVM

Being a deadly disease, breast cancer is becoming the more progressive one in providing higher mortality for females around the world. Thereby, the need for an appropriate strategy is always required for earlier breast cancer diagnosis. The physicians utilize the Computer-Aided Diagnosis (CAD) tool for effective and tireless detection of such cancers. In this regard, the work is intended to design a CAD system for breast cancer diagnosis in a timely manner. The implementation starts with the use of Wisconsin Breast Cancer dataset. After performing preprocessing and visual analysis of the input dataset, feature selection is performed to improve the efficiency of the CAD system. This can be done by using the recently evolved Ebola Optimization Algorithm (EOA). This algorithm is based on an effective approach used in the propagation of the Ebola virus among individuals. After feature selection, the dominant features are then classified with the aid of a mixture Kernel Support Vector Machine (mK-SVM) algorithm. Additionally, the work utilized the Linear SVM, and KNN algorithms for the experimental analysis and comparison. As a result, the mK-SVM together with EOA provides maximum accuracy of 97.19% in classifying the input as either benign severity or malignant case. © 2022 IEEE.

Comparative Analysis of Medical Imaging Techniques Used for the Detection of Thyroid Gland with an Emphasis on Thermogram

In today's scenario, every human being in the world is scared of the COVID-19 pandemic, and everyone in the world want early medication for COVID-19. So in this paper, a study of numerous medical imaging techniques used for detection of thyroid gland in the human being in different stages of human life is presented. Early thyroid illness discovery is that the main necessary in growing the speed of diagnosing cure and survival of the affected creature. There are a various medical imaging techniques used to detect thyroid diseases in human being. Some techniques are used to diagnose stages of thyroid cancer in humans. This paper is used to explain the procedure for the diagnosis of images, investigation of images, pros, cons, and limitations of imaging techniques. A comparative study of various medical imaging techniques explains the Thermogram image is the noninvasive system that detects the relative temperature variations in patients form thyroid diseases. In this paper, survey of the various algorithm implemented is studied for thermography, MRI, ultrasound, and mammography from the literature review and it is observed that detection of thyroid abnormalities using different techniques not only decides many factors such as segmentation of the region of thyroid gland, image quality, and extraction features and classifiers. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Performance Analysis of Wiener filter in Restoration of Covid-19 Chest X-Ray Images, Ultrasound Images and Mammograms

Medical images such as X-Ray images, Mammograms and Ultrasound images are very useful diagnostic techniques used for understanding the functions of different internal organs, bones, tissues, etc. Most of the times these medical images are degraded by some noises and different kinds of blur. Image blurring and degradation leads to loss of quality of images which in hand causes difficulty in proper diagnosis. This paper emphases on the efficacy of Wiener filter in image de blurring and denoising Chest X-Ray of Covid-19 patients, ultrasound images of fetal abdominal cyst, umbilical cord cyst and Common Carotid Artery, Mammogram of both pathological and non-pathological breasts. Performance of Wiener filter is analyzed using image restoration parameters like Structural Similarity (SSIM), Histogram, Peak Signal to Noise Ratio and Mean Square Error. © 2022 IEEE.

Uptake of screening mammogram in West Central Illinois during the COVID-19 pandemic: lessons learned

Objectives. The study aims to reveal the trend of mammogram uptake in seventeen rural counties in Illinois to understand how the COVID-19 pandemic influenced breast cancer screening in the area. Material and methods. Aggregated data on mammography screening for West Central Illinois was provided by the Illinois Hospital Association. Data for 2018 and 2019 was used to determine the typical monthly and an- nual screenings for the two years before the onset of COVID-19. Then, the two years' data was compared to the 2020 data. The monthly mean values for the aggregated 2018 and 2019 data were generated as the base "year" to compare with the monthly value for 2020. Paired t-test analysis was used to find if there were any statistically significant differences between the years and between the base year and 2020. Results. January 2020 revealed an uptick to 2921, which is more than the uptake for January 2018 (2700) and January 2019 (2488), and 13% greater than the mean value of 2594 for the previous two years. This was followed by a gradual decrease in uptake in February 2020 by 4% compared to previous years at a mean of 2518 and a further decline in March (44%), with a drastic fall (98%) by April 2020 at 56 screening mammograms in all 17 counties. The lowest uptake in any three months occurred from March through May 2020. Compared to previous years, an increase in uptake was noted across the region in 2020 June (8%) and July (4%) after the pandemic restrictions were relaxed. Overall, the total uptake in 2020 was 15% less than the average annual uptake for 2018-2019 with a deficit of 5537. There was no statistically significant difference in mammogram uptake across the three years. Conclusions. The findings reveal that there was a significant reduction in uptake during the pandemic restriction period. However, increased uptake during the rest of the year effectively mitigated this reduction to such an extent that there was no statistically significant downturn compared to each of the previous two years. A rising trend in total annual uptake noted in preceding years could have continued without the COVID-19 event.

Impacto de la vacunaci?n frente al SARS-CoV-2 en una unidad de cribado de c?ncer de mama

BACKGROUND // A common secondary effect after SARS-CoV-2 immunization is an increased in size of the axillary lymph nodes ipsilateral to the vaccinated site. Eventually, an increased in size of the axillary lymph nodes may lead to a misinterpretation of the breast screening mammogram, performed in asymptomatic women between the age 50 to 69 years old for early breast cancer diagnosis. The aim of our research was to evaluate the impact of the vaccination for SARS-CoV-2 in the breast screening programmes in terms of recall rates and number of false positive results. As a secondary purpose we would analysed the protocols adopted by different breast screening units around the world after SARS-CoV-2 vaccination. METHODS // Observational and retrospective study analysing breast screening mammograms from a single Breast Cancer Screening Unit in Madrid. The mammograms of previously vaccinated women were analysed, reviewing the axillary lymph nodes and the re-call rate secondary to axillary lymphadenopathies.RESULTS // Four hundred and twenty three screening mammograms were performed in May 2021 in the University Hospital Ramon y Cajal in Madrid, which is part of the Breast Screening Programme in Madrid, Spain. None of the women previously vaccinated for SARS-CoV-2 were recalled for complementary studies due to an increased in the axillary lymph nodes.CONCLUSIONS // The protocol stablished by the Spanish Society of Breast Image that stands up for a routine breast screening mammogram after SARS-CoV-2 immunization, has no increase in the recall rate or increase in number of false positives.

COVID-19 Vaccine-Associated Lymphadenopathy in Breast Imaging Recipients: A Review of Literature.

The unpredictability of the coronavirus disease 2019 (COVID-19) pandemic has created an ongoing global healthcare crisis. Implementation of a mass vaccination program to accelerate disease control remains in progress. Although injection site soreness, fatigue, and fever are the most common adverse reactions reported after a COVID-19 vaccination, ipsilateral lymph node enlargement has increasingly been observed. In patients undergoing routine screening and surveillance for breast cancer, interpreting lymphadenopathy (LAP) is challenging in the setting of a recent COVID-19 vaccination. With a growing proportion of the population receiving the vaccine, a multifaceted approach is necessary to avoid unnecessary and costly workup. In this comprehensive review, we summarize the existing literature on COVID-19 vaccine-associated LAP in breast imaging patients.

The association between immigrant Muslim Arab women's health beliefs, knowledge, fatalism, modesty, perceived spousal support and their mammogram utilizations: A mixed- methods approach

Breast cancer (BC) is the most commonly diagnosed cancer among females in the United States. Substantial evidence has shown that regular mammogram screenings are effective for early BC detection and mortality reduction. Immigrant Muslim Arab women (IMAW), however, are less likely to be engaged in breast cancer screening (BCS), particularly mammogram screening. Few studies have explored factors associated with low mammogram utilization among IMAW. Additionally, all have overlooked an important factor-a husband's influence in adherence to mammography screenings. In Arab and Muslim cultures, a husbands' influence and responsibilities extends to their wives' healthcare-seeking behaviors, thus becoming an important factor in a woman's health status.Developing and implementing a qualitative and quantitative mixed-method study sought: 1) to investigate associations between levels of IMAW's health beliefs, BC knowledge, BC fatalism, modesty, perceived spousal support, and receiving physician recommendations and mammogram utilization;and 2) to better understand IMAW's experiences and perceptions of spousal influence on mammogram utilization within their sociocultural context. The quantitative portion of the study was guided by the health beliefs model utilizing online surveys in Arabic and English. Due to the COVID 19 pandemic, a convenience sample was recruited using social media methods. Independent variables measured five scales: 1) perceived spousal support, 2) modified Powe fatalism inventory, 3) modesty measure for Muslim women, 4) BC knowledge, and 5) Champion breast health beliefs. Questions regarding receiving a health care providers' (HCPs) recommendation for mammography was measured by self-report. Logistic regression explored relationships between independent variables and two outcomes: 1) ever had a mammogram, and 2) had a mammogram in the past two years.Guided by symbolic interactionism, the qualitative portion of the study was conducted on a purposive sample of IMAW. A semi-structured interview guide in Arabic and English was used during the one-on-one interviews. Arabic interviews were translated into English and then transcribed by professional employees. Interviews were analyzed utilizing thematic analysis (Braun and Clarke, 2008). ATLAS.ti was used for the data analysis.The 184 IMAW participants in the quantitative study had an average age of 50 years (SD = 3.5, range = 45-58 years);86.6% reported having at least one mammogram in their lifetime, and 32.6% within the past two years. In bivariate analyses, perceived self-confidence, BC knowledge, receiving HCP recommendation, and perceived spousal support were positively associated with both outcomes (having had a mammogram and having one in the past two years). Whereas, perceived mammogram barriers was negatively associated with both outcomes. Perceived mammogram benefits was positively associated with only having had a mammogram within the past two years. In the final multivariate model, level of knowledge and perceived mammogram barriers retained the significant prediction of both outcomes, and receiving HCP recommendation of having had a mammogram.The 20 qualitative interviews, 16 in Arabic and four in English, produced five themes: (1) types of husbands' support experienced by IMAW;(2) the impact of husbands' support on their wives' attitudes about mammograms;(3) the importance of husbands' support for mammogram use;(4) reasons behind inadequate husbands' support;and (5) notions of "individual and collective duty" of enhancing husbands' support.Implications.Investigating factors influencing IMAW's BC screening behaviors has resulted in important findings that can guide medical providers and nurses to a better understating of the factors influencing IMAW's health-seeking behaviors and thus assist in positive BC screening behaviors. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Factors Associated with Screening Mammogram Uptake among Women Attending an Urban University Primary Care Clinic in Malaysia.

Screening mammograms have resulted in a reduction in breast cancer mortality, yet the uptake in Malaysia was low. This study aimed to determine the prevalence and factors associated with screening mammogram uptake among women attending a Malaysian primary care clinic. A cross-sectional study was conducted among 200 women aged 40 to 74 attending the clinic. The data was collected using questionnaires assessing sociodemographic, clinical characteristics, knowledge and health beliefs. Multiple logistic regression was used to identify factors associated with mammogram uptake. The prevalence of screening mammograms was 46.0%. About 45.5% of women with high breast cancer risk had never undergone a mammogram. Older participants, aged 50 to 74 (OR = 2.57, 95% CI: 1.05, 6.29, p-value = 0.039) and those who received a physician's recommendation (OR = 7.61, 95% CI: 3.81, 15.20, p-value < 0.001) were more likely to undergo screening mammography. Significant health beliefs associated with mammogram uptake were perceived barriers (OR = 0.81, 95% CI: 0.67, 0.97, p-value = 0.019) and cues to action (OR = 1.30, 95% CI: 1.06, 1.59, p-value = 0.012). Approximately half of the participants and those in the high-risk group had never undergone a mammogram. Older age, physician recommendation, perceived barriers and cues to action were significantly associated with mammogram uptake. Physicians need to play an active role in promoting breast cancer screening and addressing the barriers.

Perception, attitude and experience of women living in Jeddah with or without Breast lump towards BSE & mammography: Pre- Post study

Background: Breast cancer is the most common cancer among women in Saudi Arabia with a higher mortality rate in comparison to other more advanced countries. This study aims to judge the effectiveness of awareness campaigns by assessing the improvement in knowledge regarding breast cancer and attitude towards screening after attending breast cancer awareness campaign, in addition to exploring areas of defective knowledge. Materials and Methods: This cross-sectional study is a community-based pre-post study. A precampaign questionnaire was distributed among 119 females to assess their knowledge about cancer of breast and attitude towards its screening methods from September 2020 to September 2021. After which an online awareness campaign was conducted due to Covid-19 restriction to educate the participants on breast cancer and its screening methods. This was followed by the distribution of a post-campaign questionnaire to assess improvement in knowledge and attitude. The collected data was then analyzed using Microsoft Excel software and IBM SPSS. Results and Conclusion: A significant increase was observed in the total scores of all participants (p=0.00) along with number of correct answers for knowledge and misconception related questions (p=0.003, p=0.021) after attending the awareness programs. There was a smaller increase in participant percentage with an encouraging attitude towards mammograms than towards BSE after the awareness campaign was conducted. Recommendations: More effective awareness campaigns should be conducted across the Kingdom and females need to be reassured regarding their concerns about mammograms.

Reduction in Standard Cancer Screening in 2020 throughout the U.S.

Cancer screening is an important way to reduce the burden of cancer. The COVID-19 pandemic created delays in screening with the potential to increase cancer disparities in the United States (U.S.). Data from the 2014-2020 Behavioral Risk Factor Surveillance System (BRFSS) survey were analyzed to estimate the percentages of adults who reported cancer screening in the last 12 months consistent with the U.S. Preventive Services Task Force (USPSTF) recommendation for cervical (ages 21-65), breast (ages 50-74), and colorectal cancer (ages 50-75) prior to the pandemic. Cancer screening percentages for 2020 (April-December excluding January-March) were compared to screening percentages for 2014-2019 to begin to look at the impact of the COVID-19 pandemic. Screening percentages for 2020 were decreased from those for 2014-2019 including several underserved racial groups. Decreases in mammography and colonoscopy or sigmoidoscopy were higher among American Indian/Alaskan Natives, Hispanics, and multiracial participants, but decreases in pap test were also highest among Hispanics, Whites, Asians, and African-Americans/Blacks. Decreases in mammograms among women ages 40-49 were also seen. As the 2020 comparison is conservative, the 2021 decreases in cancer screening are expected to be much greater and are likely to increase cancer disparities substantially.

Recovery of Screening Mammogram Cancellations During COVID-19.

BACKGROUND: In response to the COVID-19 pandemic, the American Society of Breast Surgeons and American College of Radiology released a joint statement recommending that all breast screening studies be postponed effective March 26, 2020. STUDY DESIGN: A retrospective review of all canceled mammograms at a single tertiary care institution from January 1-August 31, 2020 was performed to evaluate the effect of this recommendation by quantifying both the number and reason for mammogram cancellations before and after March 26, 2020. Utilization of the electronic patient portal for appointment cancellation as a surrogate for telehealth uptake was noted. RESULTS: During the study period, 5340 mammogram appointments were kept and 2784 mammogram appointments were canceled. From a baseline of 30 (10.8%) canceled mammograms in January, cancellations peaked in March (576, 20.6%) and gradually decreased to a low in August (197, 7%). Reasons for cancellations varied significantly by month (P < .0001) and included COVID-19 related (236, 8.5%), unspecified patient reasons (1,210, 43.5%), administrative issues (147, 5.3%), provider requests (46, 1.7%), sooner appointments available (31, 1.1%), and reasons not given (486, 17.5%). In addition, compared to a baseline in January (51, 16.5%), electronic patient portal access peaked in August (67, 34.0%). CONCLUSION: Screening mammogram cancellations have gradually recovered after early COVID-19 restrictions were lifted and increasing use of electronic patient access appears to be sustained. Consequences for future staging at the time of diagnosis remain unknown. Understanding to what extent the pandemic affected screening may help surgeons plan for post-pandemic breast cancer care.

Patients characteristics related to screening mammography cancellation and rescheduling rates during the COVID-19 pandemic.

PURPOSE: To identify patient characteristics associated with screening mammography cancellations and rescheduling during the COVID-19 pandemic. METHODS: Scheduled screening mammograms during three time periods were retrospectively reviewed: state-mandated shutdown (3/17/2020-6/16/2020) during which screening mammography was cancelled, a period of 2 months immediately after screening mammography resumed (6/17/2020-8/16/2020), and a representative period prior to COVID-19 (6/17/2019-8/16/2019). Relative risk of cancellation before COVID-19 and after reopening was compared for age, race/ethnicity, insurance, history of chronic disease, and exam location, controlling for other collected variables. Risk of failure to reschedule was similarly compared between all 3 time periods. RESULTS: Overall cancellation rate after reopening was higher than before shutdown (7663/16595, 46% vs 5807/15792, 37%; p < 0.001). Relative risk of cancellation after reopening increased with age (1.20 vs 1.27 vs 1.36 for ages at 25th, 50th, and 75th quartile or 53, 61, and 70 years, respectively, p < 0.001). Relative risk of cancellation was also higher among Medicare patients (1.41) compared to Medicaid and those with other providers (1.26 and 1.21, respectively, p < 0.001) and non-whites compared to whites (1.34 vs 1.25, p = 0.03). Rescheduling rate during shutdown was higher than before COVID-19 and after reopening for all patients (10,658/13593, 78%, 3569/5807, 61%, and 4243/7663, respectively, 55%, p < 0.001). Relative risk of failure to reschedule missed mammogram was higher in hospitals compared to outpatient settings both during shutdown and after reopening (0.62 vs 0.54, p = 0.005 and 1.29 vs 1.03, p < 0.001, respectively). CONCLUSION: Minority race/ethnicity, Medicare insurance, and advanced age were associated with increased risk of screening mammogram cancellation during COVID-19.

Diagnostic interval for non-screening patients undergoing mammography during the COVID-19 pandemic.

OBJECTIVE: During the COVID-19 pandemic, there was a temporary cessation of mammography screening. However, in some facilities, diagnostic breast imaging services continued for patients with a high clinical suspicion of breast cancer. The objective of this study was to evaluate changes in the diagnostic interval (DI) of non-screening patients presenting for diagnostic mammography during the first wave of the COVID-19 pandemic. METHODS: Retrospective chart review was performed on patients presenting for non-screening diagnostic mammography from April 1 to June 30, 2020 (pandemic group) and April 1 to June 30, 2019 (pre-pandemic group). Age, reason for referral, number and type of imaging studies/biopsies necessary for a final diagnosis were recorded. Diagnostic interval (DI) was defined as the number of days from the date of the diagnostic mammogram to the date of the final diagnosis. RESULTS: Compared to the pre-pandemic group (n = 64), the pandemic group (n = 77) showed a reduction in DI of the entire cohort (pandemic: 1 day; pre-pandemic: 15 days, p < 0.0001) for patients not requiring tissue sampling (pandemic: 1 day; pre-pandemic: 11 days, .p < 0.0001) and those requiring tissue sampling with benign pathology (pandemic 9 days; pre-pandemic, 33 days, p = 0.0002). A higher percentage of patients in the pandemic group had their assessment completed during the initial visit (pandemic: 50.6%; pre-pandemic: 23.4%, p = 0.0009). CONCLUSION: During the first wave of the COVID-19 pandemic, the DI for patients with non-screening-related diagnostic mammography was significantly shorter, with a higher percentage of patients completing their assessments on the initial visit, compared to one year prior. KEY POINTS: • Despite reductions in manpower and clinical services, during pandemic times, it is possible to maintain a diagnostic breast imaging service for women at high clinical suspicion for breast cancer. • During pandemic times, breast imaging departments should consider restructuring to a Rapid Diagnostic Unit model with a navigation team that follows patients through the assessment process to a final diagnosis. • Departmental restructuring and patient navigation during pandemic times could either maintain or shorten the diagnostic interval for patients presenting for diagnostic mammography.

Unilateral axillary lymphadenopathy following COVID-19 vaccination: A case report and imaging findings.

As more people receive coronavirus disease 2019 (COVID-19) vaccinations, the side effects of the vaccines will become more apparent. One reported side effect that has come to light is unilateral axillary lymphadenopathy ipsilateral to the vaccination site. In general, unilateral axillary lymphadenopathy has a broad differential including malignancy, infection, autoimmune disorder, and iatrogenic etiologies. We present a case of a previously healthy 38-year-old woman who received her first dose of Pfizer COVID-19 vaccination 3 days prior to presenting to the emergency department complaining of 2 weeks of abdominal pain and 20-pound unintentional weight loss. Unilateral axillary lymphadenopathy, ipsilateral to the vaccination site, was found on a contrast-enhanced computed tomography examination of the chest, abdomen, and pelvis. Subsequent diagnostic mammograms did not demonstrate evidence of malignancy; however, axillary ultrasound again revealed nonspecific lymphadenopathy. A short-term follow-up axillary ultrasound was recommended, rather than a lymph node biopsy, given the history of recent vaccination. At clinical follow-up, the patient's abdominal pain resolved and no further weight loss was noted. This case report discusses the key components and workup recommendation of unilateral axillary lymphadenopathy in the setting of COVID-19 vaccination.

Current Available Computer-Aided Detection Catches Cancer but Requires a Human Operator.

INTRODUCTION: This study intends to show that the current widely used computer-aided detection (CAD) may be helpful, but it is not an adequate replacement for the human input required to interpret mammograms accurately. However, this is not to discredit CAD's ability but to further encourage the adoption of artificial intelligence-based algorithms into the toolset of radiologists. METHODS: This study will use Hologic (Marlborough, MA, USA) and General Electric (Boston, MA, USA) CAD read images provided by patients found to be Breast Imaging Reporting and Data System (BI-RADS) 6 from 2019 to 2020. In addition, patient information will be pulled from our institution's emergency medical record to confirm the findings seen in the pathologist report and the radiology read. RESULTS: Data from a total of 24 female breast cancer patients from January 31st 2019 to April 31st 2020, was gathered from our institution's emergency medical record with restrictions in patient numbers due to coronavirus disease 2019 (COVID-19). Within our patient population, CAD imaging was shown to be statistically significant in misidentifying breast cancer, while radiologist interpretation still proves to be the most effective tool. CONCLUSION: Despite a low sample size due to COVID-19, this study found that CAD did have significant difficulty in differentiating benign vs. malignant lesions. CAD should not be ignored, but it is not specific enough. Although CAD often marks cancer, it also marks several areas that are not cancer. CAD is currently best used as an additional tool for the radiologist.