针对乳腺核磁共振成像的灰度不均匀现象,提出一种融合全局和局部信息的水平集图像分割方法(global and local combined C_V,GLCCV)。该方法将图像的局部信息融入基于全局信息的Chan-Vese(C_V)水平集方法;根据局部灰度拟合均值占全局灰...针对乳腺核磁共振成像的灰度不均匀现象,提出一种融合全局和局部信息的水平集图像分割方法(global and local combined C_V,GLCCV)。该方法将图像的局部信息融入基于全局信息的Chan-Vese(C_V)水平集方法;根据局部灰度拟合均值占全局灰度均值的比例,构造自适应平衡指示函数调节全局和局部效应之间的均衡;加入惩罚项以避免重新初始化。对比实验表明,该水平集分割模型能够有效分割多种灰度不均匀场景下的乳腺MR图像,在抗噪和精确性方面优于融合前的分割方法。展开更多
Objectives: MRI is the most sensitive modality for local staging of breast cancer. Herceptin receptor over-expression is seen in 15% - 30% of breast tumours, and is associated with increased aggression, poorer prognos...Objectives: MRI is the most sensitive modality for local staging of breast cancer. Herceptin receptor over-expression is seen in 15% - 30% of breast tumours, and is associated with increased aggression, poorer prognosis, higher grade at diagnosis and increased lymphatic dissemination. This study aimed at evaluating the role of MRI in Herceptin receptor positive vs negative tumours. Methods: 193 pre-operative MRIs were performed in 2021 for staging of 162 Her-2 negative and 37 Her-2 positive tumours. Recall rates and further biopsies (ipsilateral/contralateral) were assessed in both groups, and MRI largest size was compared to pathological size of invasive cancer and DCIS. Results: 36.4% of Her-2 negative tumours were recalled;further ipsilateral malignancy was identified in 13.6%. Contralateral malignancy was identified in 1.2%. 29.7% of Her-2 positive tumours were recalled;further ipsilateral malignancy was identified in 16.2%. No contralateral malignancy was seen in Her-2 positive tumours. The OR of Her-2 positive tumours having ipsilateral foci of malignancy on MRI is 0.83 (CI 0.3, 2.2). Pathological size concordance with MRI size was seen in 70.3% of Her-2 negative, and 48.6% of Her-2 positive tumours. Discordance in both groups was due to MRI size overestimation (70.8% of Her-2 negative discordance;89.4% of Her-2 positive discordance). Conclusions: Pre-operative MRI did not detect significant increased additional foci in Her-2 positive tumours. Significant concordance with pathological size was not seen in both groups;MRI overestimation was the most frequent cause for discordance in both groups. Advances in Knowledge: This study compares MRI features of Her-2 positive and Her-2 negative tumours. It demonstrates that there is no significant increased multifocality or multicentricity of Her-2 positive tumours, but MRI over-estimates size in 30% of Her-2 negative and 51% of Her-2 positive cancers.展开更多
目的探讨弥散加权成像(diffusion-weighted MR imaging,DWI)联合动态对比增强磁共振成像(dynamic contrast-enhanced M R imaging,DCE M RI)对表现为非肿块样强化(none-mass enhancement,NM LE)的乳腺良恶性病变的诊断价值。方法回顾性...目的探讨弥散加权成像(diffusion-weighted MR imaging,DWI)联合动态对比增强磁共振成像(dynamic contrast-enhanced M R imaging,DCE M RI)对表现为非肿块样强化(none-mass enhancement,NM LE)的乳腺良恶性病变的诊断价值。方法回顾性分析49个乳腺NMLE病灶,比较良恶性组间强化分布、内部强化特征、动态曲线模式及表观弥散系数(apparent diffusion coefficient,ADC)值的差异有无统计学意义。绘制接受者操作特征曲线(receiver operating characteristic curve,ROC)评估ADC值的诊断效能、确定最佳诊断分界点。应用多因素分析探讨表现为NMLE的乳腺恶性病变的磁共振影像特征。结果良恶性组间病灶的内部强化特征、动态曲线模式的差异无统计学意义(P>0.05)。段样分布(P=0.01)、病灶内ADC值<1.2×10-3mm2/s(P<0.001)提示其为乳腺癌。段样分布的诊断灵敏度(sensitivity,Se)、特异度(specificity,Sp)、阳性预测值(positive predictive value,PPV)、阴性预测值(negative predictive value,NPV)分别为73.1%、87.0%、86.4%、74.1%。以ADC阈值为诊断标准,其Se、Sp、PPV、NPV分别为:84.6%、91.3%、91.7%、84.0%。当NMLE表现为段样分布且病灶内ADC值小于1.2×10-3mm2/s时强烈提示其为乳腺癌,PPV为92.9%。结论 DWI联合DCE M RI对于表现为NM LE的乳腺癌具有较高的诊断准确性。展开更多
目的:利用BI-RADS(Breast Imaging-Reporting and Data System,乳房图像和资料系统)MRI征象描述评估MRI在诊断病理性乳头溢液中的价值及其与病理诊断的关系。方法:应用3.0TMRI检查35例病理性乳头溢液病人,并结合其术后病理结果进行对比...目的:利用BI-RADS(Breast Imaging-Reporting and Data System,乳房图像和资料系统)MRI征象描述评估MRI在诊断病理性乳头溢液中的价值及其与病理诊断的关系。方法:应用3.0TMRI检查35例病理性乳头溢液病人,并结合其术后病理结果进行对比。根据BI-RADSMRI征象描述分析乳头溢液病人的MRI图像特征,探讨MRI征象与病理诊断的关系。结果:MRI对于病理性乳头溢液的总体诊断准确率达87.8%,恶性病灶的MRI征象中最常见的强化分布是沿导管分布(60.0%)、最常见的强化形态是不均匀强化(60.0%),最常见的时间-信号曲线是平台型(60.0%)。结论:乳腺MRI为临床诊断病理性乳头溢液提供了非常有用的信息,有助于提高临床诊断的准确率。展开更多
Background: Preoperative identification of patients with extensive lymph node metastasis (LNM) is important for safe omission of axillary lymph node dissection (ALND) in sentinel node (SN)-positive (SN+) breast cancer...Background: Preoperative identification of patients with extensive lymph node metastasis (LNM) is important for safe omission of axillary lymph node dissection (ALND) in sentinel node (SN)-positive (SN+) breast cancer patients. Methods: We evaluated retrospectively the collected data of 758 breast cancer patients who underwent axillary surgery between 2008 and 2017, excluding those who received neoadjuvant chemotherapy. Results: Of the 758 patients, 607 were not suspicious to have LNM by axillary ultrasound (AUS-), but 38 suspicious cases were found by breast magnetic resonance imaging (MRI). Of 15 patients undergoing axillary fine needle biopsy (AFNA) due to second-look axillary ultrasound (AUS), 9 underwent ALND because of a positive AFNA (AFNA+). Among 81 (10.9%) patients undergoing ALND due to SN+ findings, 6 (7.4%) had extensive LNM (LNM ≥ 4). If MRI was not performed, among the 90 of 673 patients undergoing ALND who had SN+ findings, 12 (13.3%) had LNM ≥ 4. Conclusions: The proportion of cases with LNM ≥ 4 was reduced from 13.3% to 7.4% among patients undergoing SN biopsies combined with breast MRI. ALND might be omitted safely in SN+ cases according to detailed preoperative evaluations using additional breast MRI to ultrasound.展开更多
MRI provides a highly sensitive technique for early detection of abnormal breast tissue. It is useful for identifying a status of proliferation, angiogenesis, and microvascular permeability, which may indicate early b...MRI provides a highly sensitive technique for early detection of abnormal breast tissue. It is useful for identifying a status of proliferation, angiogenesis, and microvascular permeability, which may indicate early breast neoplasm formation. We retrospectively studied 2005 breast MRI images from Taiwan Residents women and classified them as either healthy or unhealthy according to BI-RADS categories. A subgroup of our study patients had received estrogen supplements, containing estrogen components or phytoestrogen, for at least 3 months. These patients’ images were also classified into the healthy and unhealthy groups. These two groups were compared and a significant difference was found between them (P < 0.002). Comparison of the MRI images also identified certain cases that demonstrated a typical estrogen/phytoestrogen effect or a withdrawal effect. The overuse of estrogen or phytoestrogen supplements can increase breast glandular tissue proliferation, as reflected on MRI images. Such proliferation may increase the patient’s risk of future breast cancer.展开更多
Objective: We investigated the correlations between background parenchymal enhancement (BPE) and MRI interpretations with respect to short-interval follow-ups and biopsy rates. Methods: All accessible MRI examinations...Objective: We investigated the correlations between background parenchymal enhancement (BPE) and MRI interpretations with respect to short-interval follow-ups and biopsy rates. Methods: All accessible MRI examinations from 128 women during a limited time period in 2016 were evaluated. A blinded radiologist visually categorized BPE as minimal, mild, moderate, or marked. A BI-RADS category was also assigned. We used descriptive statistics to report the findings and chi-square and Fisher’s exact tests to compare categories. Results: Prevalence of minimal, mild, moderate, and marked BPE was 14.1%, 43.0%, 32.0%, and 10.9%, respectively. The short-interval follow-up rates were 22.2%, 27.3%, 26.8%, and 7.1% in women with minimal, mild, moderate, and marked BPE, respectively. BPE was not associated with the short-interval follow-up rate (p-value = 0.477). Biopsy rates were 22.2%, 27.3%, 22.0%, and 57.1% in women with minimal, mild, moderate, and marked BPE, respectively. Although there was no significant relationship between biopsy rates and BPE levels (p-value = 0.095) in the total population, these two factors were significantly associated in premenopausal women (p-value = 0.023) and in women of 30 - 39 years (p-value = 0.001). Conclusion: Higher BPE does not correlate with short-interval follow-up rates, but appears to be related to biopsy rate, thus causing false-positives and unnecessary biopsy recommendations, particularly in younger, premenopausal women.展开更多
Motiva Implants®(Establishment Labs Holdings Inc., NY, USA) contains a RFID micro transponder RFID(RT) (RT = registered trademark) known as Q Inside Safety Technology which provides an added safety feature emb...Motiva Implants®(Establishment Labs Holdings Inc., NY, USA) contains a RFID micro transponder RFID(RT) (RT = registered trademark) known as Q Inside Safety Technology which provides an added safety feature embedded in the shell of the Motiva breast implant [1] [2]. Because this RFID micro transponder has Ferric components, a concern over breast MRI imaging susceptibility artifact has arisen. Among breast images, a single high risk breast cancer patient was imaged at our institution (January 2018). All breast imaging modalities were used to determine if this high risk patient had a recurrence of her cancer or any new breast cancer. The MRI showed a susceptibility artifact on the posterior margin of the implant but breast ultrasound showed no abnormalities in the area of the susceptibility artifact. By using high risk screening including Mammography, Tomosynthesis, Breast Ultrasound and Breast MRI, an adequate survey of the high risk patient was completed [3]. Our high risk clinic examined the patient and the imaging results and came to the following conclusion: This patient showed no evidence of recurrent cancer and no new masses were identified. The conclusion was BIRADS 2 benign: normal findings post-mastectomy and implants. Recommendation was for routine high risk screening at yearly interval.展开更多
文摘针对乳腺核磁共振成像的灰度不均匀现象,提出一种融合全局和局部信息的水平集图像分割方法(global and local combined C_V,GLCCV)。该方法将图像的局部信息融入基于全局信息的Chan-Vese(C_V)水平集方法;根据局部灰度拟合均值占全局灰度均值的比例,构造自适应平衡指示函数调节全局和局部效应之间的均衡;加入惩罚项以避免重新初始化。对比实验表明,该水平集分割模型能够有效分割多种灰度不均匀场景下的乳腺MR图像,在抗噪和精确性方面优于融合前的分割方法。
文摘Objectives: MRI is the most sensitive modality for local staging of breast cancer. Herceptin receptor over-expression is seen in 15% - 30% of breast tumours, and is associated with increased aggression, poorer prognosis, higher grade at diagnosis and increased lymphatic dissemination. This study aimed at evaluating the role of MRI in Herceptin receptor positive vs negative tumours. Methods: 193 pre-operative MRIs were performed in 2021 for staging of 162 Her-2 negative and 37 Her-2 positive tumours. Recall rates and further biopsies (ipsilateral/contralateral) were assessed in both groups, and MRI largest size was compared to pathological size of invasive cancer and DCIS. Results: 36.4% of Her-2 negative tumours were recalled;further ipsilateral malignancy was identified in 13.6%. Contralateral malignancy was identified in 1.2%. 29.7% of Her-2 positive tumours were recalled;further ipsilateral malignancy was identified in 16.2%. No contralateral malignancy was seen in Her-2 positive tumours. The OR of Her-2 positive tumours having ipsilateral foci of malignancy on MRI is 0.83 (CI 0.3, 2.2). Pathological size concordance with MRI size was seen in 70.3% of Her-2 negative, and 48.6% of Her-2 positive tumours. Discordance in both groups was due to MRI size overestimation (70.8% of Her-2 negative discordance;89.4% of Her-2 positive discordance). Conclusions: Pre-operative MRI did not detect significant increased additional foci in Her-2 positive tumours. Significant concordance with pathological size was not seen in both groups;MRI overestimation was the most frequent cause for discordance in both groups. Advances in Knowledge: This study compares MRI features of Her-2 positive and Her-2 negative tumours. It demonstrates that there is no significant increased multifocality or multicentricity of Her-2 positive tumours, but MRI over-estimates size in 30% of Her-2 negative and 51% of Her-2 positive cancers.
文摘目的:利用BI-RADS(Breast Imaging-Reporting and Data System,乳房图像和资料系统)MRI征象描述评估MRI在诊断病理性乳头溢液中的价值及其与病理诊断的关系。方法:应用3.0TMRI检查35例病理性乳头溢液病人,并结合其术后病理结果进行对比。根据BI-RADSMRI征象描述分析乳头溢液病人的MRI图像特征,探讨MRI征象与病理诊断的关系。结果:MRI对于病理性乳头溢液的总体诊断准确率达87.8%,恶性病灶的MRI征象中最常见的强化分布是沿导管分布(60.0%)、最常见的强化形态是不均匀强化(60.0%),最常见的时间-信号曲线是平台型(60.0%)。结论:乳腺MRI为临床诊断病理性乳头溢液提供了非常有用的信息,有助于提高临床诊断的准确率。
文摘Background: Preoperative identification of patients with extensive lymph node metastasis (LNM) is important for safe omission of axillary lymph node dissection (ALND) in sentinel node (SN)-positive (SN+) breast cancer patients. Methods: We evaluated retrospectively the collected data of 758 breast cancer patients who underwent axillary surgery between 2008 and 2017, excluding those who received neoadjuvant chemotherapy. Results: Of the 758 patients, 607 were not suspicious to have LNM by axillary ultrasound (AUS-), but 38 suspicious cases were found by breast magnetic resonance imaging (MRI). Of 15 patients undergoing axillary fine needle biopsy (AFNA) due to second-look axillary ultrasound (AUS), 9 underwent ALND because of a positive AFNA (AFNA+). Among 81 (10.9%) patients undergoing ALND due to SN+ findings, 6 (7.4%) had extensive LNM (LNM ≥ 4). If MRI was not performed, among the 90 of 673 patients undergoing ALND who had SN+ findings, 12 (13.3%) had LNM ≥ 4. Conclusions: The proportion of cases with LNM ≥ 4 was reduced from 13.3% to 7.4% among patients undergoing SN biopsies combined with breast MRI. ALND might be omitted safely in SN+ cases according to detailed preoperative evaluations using additional breast MRI to ultrasound.
文摘MRI provides a highly sensitive technique for early detection of abnormal breast tissue. It is useful for identifying a status of proliferation, angiogenesis, and microvascular permeability, which may indicate early breast neoplasm formation. We retrospectively studied 2005 breast MRI images from Taiwan Residents women and classified them as either healthy or unhealthy according to BI-RADS categories. A subgroup of our study patients had received estrogen supplements, containing estrogen components or phytoestrogen, for at least 3 months. These patients’ images were also classified into the healthy and unhealthy groups. These two groups were compared and a significant difference was found between them (P < 0.002). Comparison of the MRI images also identified certain cases that demonstrated a typical estrogen/phytoestrogen effect or a withdrawal effect. The overuse of estrogen or phytoestrogen supplements can increase breast glandular tissue proliferation, as reflected on MRI images. Such proliferation may increase the patient’s risk of future breast cancer.
文摘Objective: We investigated the correlations between background parenchymal enhancement (BPE) and MRI interpretations with respect to short-interval follow-ups and biopsy rates. Methods: All accessible MRI examinations from 128 women during a limited time period in 2016 were evaluated. A blinded radiologist visually categorized BPE as minimal, mild, moderate, or marked. A BI-RADS category was also assigned. We used descriptive statistics to report the findings and chi-square and Fisher’s exact tests to compare categories. Results: Prevalence of minimal, mild, moderate, and marked BPE was 14.1%, 43.0%, 32.0%, and 10.9%, respectively. The short-interval follow-up rates were 22.2%, 27.3%, 26.8%, and 7.1% in women with minimal, mild, moderate, and marked BPE, respectively. BPE was not associated with the short-interval follow-up rate (p-value = 0.477). Biopsy rates were 22.2%, 27.3%, 22.0%, and 57.1% in women with minimal, mild, moderate, and marked BPE, respectively. Although there was no significant relationship between biopsy rates and BPE levels (p-value = 0.095) in the total population, these two factors were significantly associated in premenopausal women (p-value = 0.023) and in women of 30 - 39 years (p-value = 0.001). Conclusion: Higher BPE does not correlate with short-interval follow-up rates, but appears to be related to biopsy rate, thus causing false-positives and unnecessary biopsy recommendations, particularly in younger, premenopausal women.
文摘Motiva Implants®(Establishment Labs Holdings Inc., NY, USA) contains a RFID micro transponder RFID(RT) (RT = registered trademark) known as Q Inside Safety Technology which provides an added safety feature embedded in the shell of the Motiva breast implant [1] [2]. Because this RFID micro transponder has Ferric components, a concern over breast MRI imaging susceptibility artifact has arisen. Among breast images, a single high risk breast cancer patient was imaged at our institution (January 2018). All breast imaging modalities were used to determine if this high risk patient had a recurrence of her cancer or any new breast cancer. The MRI showed a susceptibility artifact on the posterior margin of the implant but breast ultrasound showed no abnormalities in the area of the susceptibility artifact. By using high risk screening including Mammography, Tomosynthesis, Breast Ultrasound and Breast MRI, an adequate survey of the high risk patient was completed [3]. Our high risk clinic examined the patient and the imaging results and came to the following conclusion: This patient showed no evidence of recurrent cancer and no new masses were identified. The conclusion was BIRADS 2 benign: normal findings post-mastectomy and implants. Recommendation was for routine high risk screening at yearly interval.
