ABSTRACT
A retrospective review of 133 patients who had undergone augmentation mammoplasty (n = 122), reconstructive mammoplasty (n = 10), and silicone injections (n = 1) was undertaken to establish the normal appearance of various types of implants, to establish a range of normal variations (wrinkles, valves, minor bulges), and to recognize true implant complications (collapse of a saline prosthesis, leakage of silicone gel, capsular contracture, capsular calcification, and deformities). The detection and evaluation of breast parenchymal abnormalities in the presence of a radiopaque implant are more difficult, and frequently ultrasound (US) or special mammographic views in conjunction with physical examination are required. Coned-down compression spot views are suggested for asymmetric opacities or ill-defined mammographic masses, and magnification views are recommended for microcalcifications: Both should be obtained with the Eklund implant displacement technique. Tangential or other special views combined with US are best for the evaluation of palpable abnormalities and suspected silicone implant rupture.
Subject(s)
Mammaplasty , Mammography , Prostheses and Implants , Ultrasonography, Mammary , Adult , Aged , Breast/pathology , Breast Diseases/diagnostic imaging , Calcinosis/diagnostic imaging , Connective Tissue/diagnostic imaging , Contracture/diagnostic imaging , Equipment Design , Equipment Failure , Female , Humans , Mammography/methods , Mastectomy/rehabilitation , Middle Aged , Prostheses and Implants/adverse effects , Retrospective Studies , Silicones/adverse effects , Sodium Chloride , Surface Properties , Ultrasonography, Mammary/methodsABSTRACT
The question of whether image processing affects a radiologist's diagnostic performance is becoming more important as the digital modalities proliferate. In the multi-observer study reported, the performance of radiologists who interpret a series of posteroanterior digitized chest images displayed on a high-resolution workstation, with and without a set of image processing options, is determined. These include brightness, contrast, reverse look-up tables (black-bone), and two edge enhancement options. Three hundred images were evaluated twice (once in each mode) by each of seven board-certified radiologists, who recorded their confidence ratings for the presence or absence of one or more of the following abnormalities: interstitial disease, nodule, and pneumothorax. The original, unprocessed digital image was available for reference for those sessions in which the processing options were available. With the exception of one reader, receiver operating characteristic (ROC) analysis showed no statistically significant difference between the two modes (with and without processing) for the detection of any of the different abnormalities by individual readers. Likewise, the group as a whole showed no significant difference (P less than .05) for detection of any of the three abnormalities between the two reading modes.
Subject(s)
Hospital Information Systems , Image Processing, Computer-Assisted , Observer Variation , ROC Curve , Radiography, Thoracic , Radiology Information Systems , Humans , Visual PerceptionABSTRACT
The differences among radiologists in interpreting conventional and digitized images obtained with different radiologic procedures is an important research issue in these times of implementation and growth of the digital modalities. The authors performed a multiobserver study to determine the performance of radiologists reading posteroanterior conventional radiographs, digitized radiographs laser printed onto film, and images displayed on a high-resolution workstation (video monitor). A total of 300 images were evaluated by seven radiologists who recorded their ordinal confidence rating of the presence or absence of one or more of the following abnormalities: interstitial disease, nodule, and pneumothorax. Receiver operating characteristic analysis showed statistically significant differences for the detection of different abnormalities by individual readers. The group as a whole showed a significant reduction in observer performance for the detection of interstitial disease and pneumothorax when the laser-printed radiographs or the workstation was used rather than conventional radiographs.
Subject(s)
Data Display , Hospital Information Systems , Image Processing, Computer-Assisted , ROC Curve , Radiography, Thoracic , Radiology Information Systems , Computer Systems , Humans , Pneumothorax/diagnostic imaging , Pulmonary Fibrosis/diagnostic imaging , Radiographic Image Enhancement , Solitary Pulmonary Nodule/diagnostic imaging , X-Ray FilmABSTRACT
A case of a 44-year-old woman with a solitary pulmonary coin lesion is presented. Histologic study of this nodule revealed a normal intraparenchymal pulmonary lymph node. A review of the literature discusses the incidence and characteristics of this entity.
Subject(s)
Lung/diagnostic imaging , Lymph Nodes/abnormalities , Adult , Diagnosis, Differential , Female , Humans , Lymph Nodes/diagnostic imaging , Radiography , Solitary Pulmonary Nodule/diagnostic imagingABSTRACT
Lumpectomy with radiation therapy is becoming widely accepted as an alternative treatment for breast carcinoma in place of radical mastectomy. This article illustrates the spectrum of mammographic changes seen at various intervals after lumpectomy with irradiation to help the mammographer distinguish postoperative scar from a recurrent carcinoma.
