Application of breast ultrasound in a mammography-based Chinese breast screening study.

We evaluated the clinical significance of the combined use of mammography + ultrasound as a new breast screening strategy. The inclusion criteria were: (1) females aged >40yrs; (2) breast cancer diagnosis by the breast image screening personnel at FUSCC; (3) screening by both ultrasound and mammography; (4) mammographic/sonographic images analyzed independently by different radiologists; and (5) follow-up for at least 1 year. Fifty-four women were enrolled. The analysis included diagnostic sensitivity of mammography, ultrasound, and mammography + ultrasound. The sensitivities of mammography and mammography + ultrasound were compared overall as well as among different age groups/breast densities. The screening sensitivity of mammography, ultrasound, and mammography + ultrasound was 79.6, 57.4, and 92.6 %, respectively. The difference between mammography and mammography + ultrasound was significant (P < 0.05). The benefit of including ultrasound with mammography as a new breast image screening strategy was found statistically significant in patients with dense breast on mammogram while it was non-significant in younger (<50 years) women. We, therefore, concluded that mammography + ultrasound increased the diagnostic sensitivity of breast screening; hence it was more desirable for women with dense breast on mammography.

Diagnostic value of full-field digital mammography for breast carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the diagnostic value of full-field digital mammography for breast cancer.</p><p><b>METHODS</b>The clinical data and mammograms of 230 patients with breast diseases between January 2008 and July 2008 were collected and reviewed. Craniocaudal (CC) and mediolateral oblique (MLO) view mammograms were performed in all patients before surgery. Three experienced radiologists in breast imaging assessment analyzed and classified all the mammograms according to breast imaging reporting and data system (BI-RADS). The sensitivity, specificity and accuracy were evaluated according to their pathological diagnosis. The reasons resulting in false-negative and false-positive diagnosis were also analyzed.</p><p><b>RESULTS</b>Of the 238 samples, 130 had a malignant breast tumors and 108 cases of benign breast lesions. One hundred and nine of the 130 malignant breast tumors were invasive ductal carcinoma. Fifty-seven of the 108 benign breast lesions were breast adenosis. Masses or masses with microcalcification were the most frequently seen signs of the malignant tumors, accounting for 40.8% and 20.8%, respectively. The sensitivity, specificity and accuracy of FFDM in detecting breast carcinoma were 90.8%, 87.0% and 89.1%, respectively. The false-negative signs including negative X-ray finding (5 cases) and focal asymmetric densities (4 cases). The false-positive signs were masses with spiculate, indistinctive or lobulated margin leading to misdiagnosing the lesions as malignant tumors.</p><p><b>CONCLUSION</b>Full-field digital mammography (FFDM) is helpful in detection of breast cancers in women, with a higher sensitivity, specificity and accuracy, and has an important clinical application value.</p>

Evaluation of MRI in nasopharyngeal carcinoma with cavernous sinus infiltration / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the incidence, MRI characteristics and invasion route of nasopharyngeal carcinoma (NPC) infiltrating the cavernous sinus.</p><p><b>METHODS</b>The data of 141 patients with histologically proven NPC collected from May 2003 to June 2004 were reviewed. All patients were examined by 1.5-tesla superconducting MR unit to evaluate the tumor extent. MR FSE technique was used for T1 WI and T2WI images in the axial plane, followed by FSPGR fat-suppressed gadolinium-enhancement for T1WI images in the axial and coronal sections. All MR images were interpreted and evaluated by two diagnostic radiologists, paying particular attention to the nasopharynx and cavernous sinus infiltration.</p><p><b>RESULTS</b>MR imaging showed infiltration of 49 cavernous sinuses in 39 patients (27.7%). The most common MRI features were enlargement of cavernous sinus with unconventional enhancement (22/49, 44.9%), even with formation of mass inside the sinus (9/49, 18.4%). The other MRI image features were local or diffuse dura mater thickening of cavernous sinus and presence of obscure structure as intra-sinus blurs and hazies inside. The most common infiltration route is through the foramen ovale (18/49, 36.7%), or through both the foramen ovale and foramen lacerum (6/49, 12.2%).</p><p><b>CONCLUSION</b>In NPC patients, MRI invasion is characteristically and clearly shown as changes in the cavernous sinus. Possession of this information is crucial for giving correct treatment. The main infiltrtion route is through foramen ovale.</p>