• Title, Summary, Keyword: breast ultrasonography

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Comparison of Diagnostic Values of Ultrasonography and Computed Tomography for Detecting Lateral Lymph Node Metastasis in N1b Papillary Thyroid Carcinoma

  • Back, Kyorim;Kim, Min Jhi;Choe, Junhoo;Kim, Jung-Han;Kim, Jee Soo
    • Journal of Endocrine Surgery
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    • v.18 no.3
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    • pp.199-204
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    • 2018
  • Purpose: We focused on the comparison of the diagnostic accuracy of preoperative ultrasonography (US) with that of computed tomography (CT), especially for lateral lymph node metastasis (LLNM) in N1b papillary thyroid carcinoma (PTC). Methods: We conducted a retrospective cohort study at the Thyroid Cancer Center of Samsung Medical Center, a tertiary referral center in Korea, by analyzing data collected between January 1997 and June 2015. A total of 1,323 patients who met the following inclusion criteria were enrolled. Results: Diagnostic values were calculated on a "per level" basis by comparing the results of US, CT, and histopathology. Between US and CT, there was no significant difference in the sensitivity (59.3% vs. 61.0%, P=0.073), specificity (83.0% vs. 81.1%, P=0.051), or accuracy (68.6% vs. 68.9%, P=0.660). However, US+CT showed significantly higher sensitivity (74.6% vs. 59.3%, P<0.001) and accuracy (74.0% vs. 68.6%, P<0.001) compared to US alone. Conclusion: There was no significant difference in sensitivity, specificity, and diagnostic accuracy for LLNM between US and CT; however, a combination of CT and US had significantly higher sensitivity, specificity, and diagnostic accuracy in detection of LLNM compared to US or CT alone. We conclude that the strategy for the examination of the lateral neck in PTC patients can be effectively determined by the combination of CT and US rather than US or CT only.

Clinical and Ultrasonographic Changes of the Breast after Use of Soy Isoflavones

  • Alipour, Sadaf;Afshar, Somayeh;Moini, Ashraf;Dastjerdi, Marzieh Vahid;Saberi, Azin;Bayani, Leila;Eslami, Bita;Hosseini, Ladan
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.12
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    • pp.6093-6095
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    • 2012
  • Background: Phytoestrogens may be an alternative therapy in control of menopausal symptoms but their definite effects on breast tissue must be determined. Our study aimed to define the clinical and ultrasonographic changes of the breast after use of soy isoflavones in menopausal women. Materials and Methods: Menopausal women with hot flashes were randomly grouped as cases and controls and cases received soy isoflavones for 12 weeks. Breast examination (BE) and ultrasonography (US) were done at 0, 6 and 12 weeks. Tenderness and nodularity on BE were graded 1-4 by breast surgeons. Results: There were 30 women in the case and 26 in the control group. The mean age was 51.3 years and the mean age of menopause was 49.2 years. There was no change in the BE and US at 6 weeks in controls. In the case group, 10% had grade 1 tenderness and 13.3% grade 2 tenderness and grade 1 nodularity in BE accompanied with diffuse small cysts in US. At 12 weeks, there was no change in BE and US in the 2 groups. Conclusions: There was no statistically significant difference in the BE of the 2 groups at 6 and 12 weeks (p value=0.36 and 0.41 for nodularity and tenderness respectively) and in the US results. Although the literature contains many facts concerning PEs and the breast, further prospective studies are needed to identify structural breast changes produced by PEs in order to identify the appropriate dosage and indications of use.

Comparison of Shear Wave Elastography and Pathologic Results Using BI - RADS Category for Breast Mass (유방종괴에 대한 BI-RADS범주를 이용한 횡탄성 초음파와 병리결과 비교분석)

  • An, Hyun;Im, In-Chul
    • Journal of the Korean Society of Radiology
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    • v.12 no.2
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    • pp.217-223
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    • 2018
  • This study to search the diagnostic performance of shear wave elastography(SWE) in breast mass and to compare the biopsy result and stiffness obtained from shear wave elastography. Diagnostic breast ultrasonography and SWE were targeted for 157 patients who had breast ultrasonography was diagnosed mass from June 2017 to September 2017. Pathology results of 157 patients showed a benign 92 patients(Age, $44.54{\pm}11.84$) and a malignancy 65 patients(Age, $51.55{\pm}10.54$). Final evaluation, biopsy result, and quantitative SWE result were obtained and compared with each other according to Breast Imaging Reporting and Data System(BI-RADS) of diagnostic breast ultrasonography. Quantitative SWE value and pathologic result showed the highest diagnostic specificity of 83.70% in Emean and sensitivity of 89.23% in Emin. Quantitative SWE result and biopsy result is statistically significant.(p=0.000). The optimal cut-off value for malignant lesions was 66.3 kPa and 63.7 kPa, respectively, for the sensitivity, specificity, high maximum mean elasticity value(Emax) and mean elasticity value(Emean) and this showed the highest diagnostic area under the ROC curve(Az) value compared to other SWE measurement(p=0.000). The addition of SWE to conventional US in breast mass make a increase diagnostic specificity and reduce unnecessary biopsy. Therefore, it is expected that it will be helpful to analyze the breast mass using the above analysis and apparatus.

Computer-Aided Detection with Automated Breast Ultrasonography for Suspicious Lesions Detected on Breast MRI

  • Kim, Sanghee;Kang, Bong Joo;Kim, Sung Hun;Lee, Jeongmin;Park, Ga Eun
    • Investigative Magnetic Resonance Imaging
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    • v.23 no.1
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    • pp.46-54
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    • 2019
  • Purpose: The aim of this study was to evaluate the diagnostic performance of a computer-aided detection (CAD) system used with automated breast ultrasonography (ABUS) for suspicious lesions detected on breast MRI, and CAD-false lesions. Materials and Methods: We included a total of 40 patients diagnosed with breast cancer who underwent ABUS (ACUSON S2000) to evaluate multiple suspicious lesions found on MRI. We used CAD ($QVCAD^{TM}$) in all the ABUS examinations. We evaluated the diagnostic accuracy of CAD and analyzed the characteristics of CAD-detected lesions and the factors underlying false-positive and false-negative cases. We also analyzed false-positive lesions with CAD on ABUS. Results: Of a total of 122 suspicious lesions detected on MRI in 40 patients, we excluded 51 daughter nodules near the main breast cancer within the same quadrant and included 71 lesions. We also analyzed 23 false-positive lesions using CAD with ABUS. The sensitivity, specificity, positive predictive value, and negative predictive value of CAD (for 94 lesions) with ABUS were 75.5%, 44.4%, 59.7%, and 62.5%, respectively. CAD facilitated the detection of 81.4% (35/43) of the invasive ductal cancer and 84.9% (28/33) of the invasive ductal cancer that showed a mass (excluding non-mass). CAD also revealed 90.3% (28/31) of the invasive ductal cancers measuring larger than 1 cm (excluding non-mass and those less than 1 cm). The mean sizes of the true-positive versus false-negative mass lesions were $2.08{\pm}0.85cm$ versus $1.6{\pm}1.28cm$ (P < 0.05). False-positive lesions included sclerosing adenosis and usual ductal hyperplasia. In a total of 23 false cases of CAD, the most common (18/23) cause was marginal or subareolar shadowing, followed by three simple cysts, a hematoma, and a skin wart. Conclusion: CAD with ABUS showed promising sensitivity for the detection of invasive ductal cancer showing masses larger than 1 cm on MRI.

Sparganosis existed for more than three years that misdiagnosed as a breast cancer (3년이상 존재한 유방암으로 의심되었던 스파르가눔증)

  • Won, Tae Wan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.8
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    • pp.5508-5512
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    • 2015
  • Objective.: Sparganosis locations in humans are usually presented with a subcutaneous tissue of abdominal wall, chest, abdominal vicera and brain, but are rarely found in the breast. Methods. A case of sparganosis was confirmed by surgical excision of two parasites in a 76-year-old female patient present to a palpable mass in the right breast (presumed to have been sparganosis approximately 3 years ago). She had no history to direct ingestion of snakes or frogs, but had the history of drinking contaminated water. Mammography, ultrasonography, MRI, and FDG PET/CT imaging findings for patient were characteristic of sparganosis due to suspicion of breast cancer. Conclusions: The first route of infection in humans is drinking contaminated water. The second route is the ingestion of raw or partially cooked snakes or frogs. The third route is infected wound snake, frog muscle that attach to the case. However, only a few cases of drinking contaminated water have been reported in the country. Ultrasonography, MRI is known to be helpful for diagnosis of breast sparganosis. However, Mammography, ultrasonography, MRI, and FDG PET/CT for breast sparganosis is not reported present in the country. Reported the case and reviewed the related literature briefly.

Ultrasonographic features of pure ductal carcinoma in situ of the breast: correlations with pathologic features and biological markers

  • Cha, Hwajin;Chang, Yun-Woo;Lee, Eun Ji;Hwang, Ji Young;Kim, Hyun Joo;Lee, Eun Hye;Ryu, Jung Kyu
    • Ultrasonography
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    • v.37 no.4
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    • pp.307-314
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    • 2018
  • Purpose: The purpose of this study was to evaluate the ultrasonographic features of pure ductal carcinoma in situ (DCIS) of the breast and to evaluate the correlations of ultrasonographic features with pathologic and biological features. Methods: A total of 141 lesions in 138 women with pure DCIS who underwent preoperative breast ultrasonography were retrospectively reviewed. Ultrasonographic features were analyzed using the American College of Radiology Breast Imaging Reporting and Data System (BIRADS) ultrasonography lexicon and the diagnostic criteria of the Japan Society of Ultrasonics in Medicine. Pathologic features including the nuclear grade and presence of comedonecrosis were evaluated. Biological markers including estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 (HER2) status, as well as the Ki-67 index, were recorded. Ultrasonographic features were compared with pathologic findings and biological markers using the chi-square test. P-values of <0.05 were considered to indicate statistical significance. Results: Of the 141 lesions, 75 (53.2%) were mass lesions, 56 (39.7%) were non-mass lesions, and 10 (7.1%) were not visible. The most common feature of the mass pattern was a mass with irregular shape (32.6%), an indistinct margin (27.7%), and hypoechogenicity (37.6%). Microcalcifications were observed in 48 cases (36.6%) as an associated feature. Calcifications outside of a mass were more common than calcifications within a mass. Ultrasonographic microcalcifications and ductal changes were frequently observed in non-mass lesions. Ultrasonographic non-mass lesions were associated with high-grade DCIS (P=0.004) and the presence of comedonecrosis (P=0.006). Microcalcifications were significantly associated with high-grade DCIS (P<0.001), the presence of comedonecrosis (P<0.001), an elevated Ki-67 (P<0.001), and HER2 positivity (P=0.003). Conclusion: The most common ultrasonographic feature of pure DCIS was an irregular, hypoechoic mass with an indistinct margin. Ultrasonographic microcalcifications and ductal changes were more frequent in non-mass lesions, which were correlated with poor prognostic factors, such as a high nuclear grade, comedonecrosis, HER2 positivity, and an elevated Ki-67 index.

Usefulness of pelvic ultrasonography for the diagnosis of central precocious puberty in girls

  • Yu, Jung;Shin, Ha Young;Lee, Sun Hee;Kim, You Sung;Kim, Jae Hyun
    • Clinical and Experimental Pediatrics
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    • v.58 no.8
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    • pp.294-300
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    • 2015
  • Purpose: It is difficult to differentiate between central precocious puberty (CPP) and premature thelarche (PT) in girls. The aim of this study was to investigate the diagnostic usefulness of pelvic ultrasonography to distinguish between CPP and PT in girls with early breast development. Methods: This study included girls with early breast development who visited the clinic between January 2012 and December 2013. Clinical, laboratory, and pelvic ultrasonographic data were evaluated. CPP and PT were confirmed using the gonadotropin-releasing hormone stimulation test. Results: A total of 248 girls aged 7-8 years were included, among whom 186 (75.0%) had CPP and 62 (25.0%) had PT. The uterine length, transverse diameter, fundus, volume, and cross-sectional area were significantly larger in the CPP group (uterine length, $2.45{\pm}0.50cm$ vs. $2.63{\pm}0.49cm$, P=0.015; uterine volume, $0.95{\pm}0.62cm^3$ vs. $1.35{\pm}0.76cm^3$, P<0.001). However, there were no differences in the fundus/cervix ratio and ovarian measurements. In receiver operating characteristic analysis, a uterine volume of at least $1.07cm^3$ was the most predictive parameter for CPP with an area under the curve of 0.670 (95% confidence interval, 0.593-0.747). Conclusion: Uterine measurements by pelvic ultrasonography in girls with early pubertal development were significantly larger in the CPP group. However, the diagnostic value of ultrasonographic parameters was not high because of a considerable overlap of values between the two groups. Therefore, pelvic ultrasonography in combination with clinical and laboratory tests may be useful to distinguish between CPP and PT in girls.

Evaluation of BreastLight as a Tool for Early Detection of Breast Lesions among Females Attending National Cancer Institute, Cairo University

  • Labib, Nargis Albert;Ghobashi, Maha Mohamed;Moneer, Manar Mohamed;Helal, Maha Hesien;Abdalgaleel, Shaimaa Abdalaleem
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4647-4650
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    • 2013
  • Background: Breast illumination was suggested as a simple method for breast cancer screening. BreastLight is a simple apparatus for this purpose. Objective: To evaluate the diagnostic performance of BreastLight as a screening tool of breast cancer in comparison to mammography and histopathology. Materials and Methods: This hospital-based cross sectional study was conducted in the mammography unit of the radiodiagnosis department at National Cancer Institute, Cairo University. All participants were subjected to breast examination with the BreastLight tool, mammography and ultrasonography. Suspicious cases were biopsied for histopathological examination which is considered as a gold standard. Results: The mean age of the participants was $46.3{\pm}12.4$ years. Breast illumination method had sensitivity, specificity, positive predictive value, negative predictive value and total accuracy of 93.0%, 73.7%, 91.4%, 77.8% and 88.2%, respectively in detection of breast cancer. Conclusions: Breast illumination method with BreastLight apparatus is a promising easy-to-use tool to screen for breast cancer suitable for primary health care physician or at-home use. It needs further evaluation especially in asymptomatic women.

Analysis of Malignant Tumor Using Texture Characteristics in Breast Ultrasonography (유방 초음파 영상에서 질감 특성을 이용한 악성종양 분석)

  • Cho, Jin-Young;Ye, Soo-Young
    • Journal of the Institute of Convergence Signal Processing
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    • v.20 no.2
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    • pp.70-77
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    • 2019
  • Breast ultrasound readings are very important to diagnose early breast cancer. In Ultrasonic inspection, it shows a significant difference in image quality depending on the ultrasonic equipment, and there is a large difference in diagnosis depending on the experience and skill of the inspector. Therefore, objective criteria are needed for accurate diagnosis and treatment. In this study, we analyzed texture characteristics by applying GLCM (Gray Level Co-occurrence Matrix) algorithm and extracted characteristic parameters and diagnosed breast cancer using neural network classifier. Breast ultrasound images were classified into normal, benign and malignant tumors and six texture parameters were extracted. Fourteen cases of normal, malignant and benign tumor diagnosed by mammography were studied by using the extracted six parameters and learning by multi - layer perceptron neural network back propagation learning method. As a result of classification using 51 normal images, 62 benign tumor images, and 74 malignant tumor images of the learned model, the classification rate was 95.2%.

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Screening women with a personal history of breast cancer: overview of the evidence on breast imaging surveillance

  • Houssami, Nehmat;Cho, Nariya
    • Ultrasonography
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    • v.37 no.4
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    • pp.277-287
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    • 2018
  • This work reviews the evidence on breast imaging for screening (surveillance) in women with a history of breast cancer (BC). Early detection of second BCs in these women improves their prognosis based on studies using mammography (usually with clinical examinations) for surveillance. Cohort studies have estimated that mammography surveillance has moderate sensitivity (65.4%) and good specificity (98.3%), and have shown that these women are at a higher risk of interval BC than age- and breast density-matched women without a history of BC. Studies of adjunct imaging (ultrasound, magnetic resonance imaging) for surveillance that have reported detection and accuracy measures have generally shown that adjunct imaging detected more second BCs than mammography and added substantially to the amount of false-positive results; however, little evidence exists regarding screening efficacy of adjunct imaging as part of routine surveillance.