Diagnostic Performance of MRI, Molecular Breast Imaging, and                    Contrast-enhanced Mammography in Women with Newly Diagnosed Breast                    Cancer

Sumkin, Jules H.; Berg, Wendie A.; Carter, Gloria J; Bandos, Andriy I.; Chough, Denise M.; Ganott, Marie A.; Hakim, Christiane M.; Kelly, Amy E.; Zuley, Margarita L.; Houshmand, Golbahar; Anello, Maria; Gur, David

doi:10.1148/radiol.2019190887

Cited by 70 publications

(43 citation statements)

References 45 publications

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“…Unlike reports in previous studies on both on MRI and CEDMs, in our study the BPE level did not show significant correlation with the TFN results and it cannot be considered an important factor that obscured abnormal enhancing lesions [ [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [21] , [22] , [23] , 32 ]. In our study this result is probably due to the very limited number of cases with a marked BPE level, only 17 cases compared to 131 with the minimal, 126 with the mild and 56 with the moderate level.…”

Section: Discussioncontrasting

confidence: 99%

“…Contrast Enhanced Digital Mammography (CEDM) is the most recent diagnostic breast imaging technique that has already demonstrated a sensitivity for detecting breast cancer (BC) which is higher than digital mammography (DM) and similar to that of contrast-enhanced MRI [ [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] ]. One of the indications of CEDM is the preoperative staging of patients with a recent diagnosis of BC, and also in this context it has demonstrated a high sensitivity (88%–100%) and specificity (82%–98%) with a diagnostic performance similar to MRI and superior to conventional imaging like DM, ultrasound (US), digital breast tomosynthesis (DBT) [ [9] , [10] , [11] , [12] , [13] , [14] ].…”

Section: Introductionmentioning

confidence: 99%

“…From the analysis of several studies published in literature that evaluate the diagnostic performance of CEDM in various subgroups of patients for different purposes, an FN rate emerged between 0% and 20%. Lack of enhancement has been reported for tumors of very different sizes and for all BC types, including both invasive carcinomas and DCIS [ [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , 32 ].…”

Section: Introductionmentioning

confidence: 99%

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Which clinical, radiological, histological, and molecular parameters are associated with the absence of enhancement of known breast cancers with Contrast Enhanced Digital Mammography (CEDM)?

et al. 2020

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Background CEDM has demonstrated a diagnostic performance similar to MRI and could have similar limitations in breast cancer (BC) detection. Purpose The aim of our study was to systematically analyze the characteristics of the lesions with the absence of enhancement with CEDMs, called false-negatives (FNs), in order to identify which clinical, radiological, histological and molecular parameters are associated with the absence of enhancement of known BCs with CEDMs, and which types of BC are most likely to cause FNs in CEDMs. We also tried to evaluate which parameters instead increased the probability of showing enhancement in the same context. Materials and methods Included in our study group were 348 women with 348 diagnosed BCs performing CEDM as preoperative staging. Two breast-imaging radiologists reviewed the CEDM exams. The absence of perceptible contrast enhancement at the index cancer site was indicative of an FN CEDM, whereas cases with appreciable enhancement were considered true positives (TPs). Dichotomic variables were analyzed with Fisher’s exact probability test or, when applicable, the chi-square test. Binary logistic regression was performed on variables shown to be significant by the univariate analysis in order to assess the relationship between predictors (independent variables) and TFNs (outcome). Results Enhancement was observed in 317 (91.1%) of the 348 BCs. From the 31 (8.9%) lesions which were FNs, we excluded 12 (38.7%) which showed an artifact generated by the post biopsy hematoma and 6 (19.4%) which were outside the CEDM field of vision. We thus obtained 13 (41.9%) BCs considered “True False Negatives” (TFNs), i.e. BCs which showed no enhancement despite being within the CEDM field of vision and failed to show post biopsy hematoma artifacts. We found that the TFNs frequently have a unifocal disease extension, diameter <10 mm, a lower number of luminal B HER2-subtypes, a higher number of DCIS, and an index lesion with microcalcifications. Conclusions The parameters we found to be associated with no enhancement of known BCs with CEDMs were: unifocal disease extension, DCIS histotype, lesion dimensions <10 mm, and index lesion with microcalcifications. The characteristics that instead increase the probability of showing enhancement were US mass, Luminal B HER2 negative molecular subtype, the presence of an invasive ductal component, and lesion dimensions ≥10 mm.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Which clinical, radiological, histological, and molecular parameters are associated with the absence of enhancement of known breast cancers with Contrast Enhanced Digital Mammography (CEDM)?

et al. 2020

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“…GLOBALLY, BREAST CANCER is the most common malignant tumor in women 1 . As a noninvasive, radiation‐free examination with high soft‐tissue contrast, magnetic resonance imaging (MRI) plays an important role in the diagnosis, 2 treatment, 3 and prognostic evaluation 4 of breast cancer. However, breast cancer is a highly heterogeneous lesion characterized by variant biological features, and its diagnosis, treatment, and prognosis are affected by multiple factors, including breast cancer lesion size, pathological grade, receptor expression (estrogen receptor [ER], progesterone receptor [PR], and human epidermal growth factor receptor‐2 [HER‐2]), the status of axillary lymph node metastasis, and the antigen KI‐67 (Ki‐67) index 5 .…”

mentioning

confidence: 99%

Comparative Study of Amide Proton Transfer‐Weighted Imaging and Intravoxel Incoherent Motion Imaging in Breast Cancer Diagnosis and Evaluation

Meng

Wang

Sun

et al. 2020

Magnetic Resonance Imaging

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Background Amide proton transfer‐weighted imaging (APTWI) and intravoxel incoherent motion imaging (IVIM) are valuable MRI techniques applied to cancer. Purpose To compare APTWI and IVIM in the diagnosis of benign and malignant breast lesions and to evaluate the correlations between different parameters (MTRasym [3.5 ppm], D, D*, and f) and prognostic factors for breast cancer. Study Type Retrospective. Population In all, 123 breast lesions were studied before treatment, including 58 benign lesions and 65 malignant lesions. Field Strength/Sequence Conventional MRI (T1WI, T2WI, and diffusion‐weighted imaging [DWI]), APTWI, and IVIM MRI at 3T. Assessment The magnetization transfer ratio asymmetry at 3.5 ppm (MTRasym [3.5 ppm]), diffusion coefficient (D), pseudo diffusion coefficient (D*), and perfusion fraction (f) values were compared between the benign and malignant groups and between groups with different expression levels of prognostic factors. Statistical Tests Individual sample t‐test, χ2 test, Spearman correlation, logistic regression, and the Delong test. Results The D and MTRasym (3.5 ppm) values of the malignant group were lower than those of the benign group; however, D* and f values were higher than those of the benign group (all P < 0.05). The areas under the curve (AUCs) of D, MTRasym (3.5 ppm), D*, and f were 0.809, 0.778, 0.670, and 0.766, respectively; however, only the difference between AUC (D) and AUC (D*) was significant (Z = 2.374, P < 0.05). The D value showed a low correlation with the pathological grade and Ki‐67 expression (| r | = 0.294, 0.367); the f value showed a low correlation with estrogen receptor (ER) expression (| r | = 0.382); and the MTRasym (3.5 ppm) value showed a low correlation with pathological grade (| r | = 0.371). Data Conclusion This analysis revealed that both IVIM and APTWI could be used for the differential diagnosis of benign and malignant breast lesions, and APTWI‐derived MTRasym (3.5 ppm), IVIM‐derived D, D*, and f values showed correlations with some prognostic factors for breast cancer. Level of Evidence 2 Technical Efficacy Stage 2 J. Magn. Reson. Imaging 2020;52:1175–1186.

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“…The capability of sestamibi to identify malignant lesions by SPECT analysis has been shown for several human diseases such as hearth injury, breast cancer renal carcinomas, and PHP [ 29 , 30 , 31 , 32 , 33 ]. Indeed, numerous investigations demonstrated a close association between positive [ 99 mTc]Sestamibi analysis and the severity of disease [ 29 , 30 , 31 , 32 , 33 ]. However, few studies correlated the sestamibi uptake with the histopathological characteristics of human lesions [ 34 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

[99mTc]Sestamibi SPECT Can Predict Proliferation Index, Angiogenesis, and Vascular Invasion in Parathyroid Patients: A Retrospective Study

Urbano

Scimeca

Russo

et al. 2020

JCM

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The aim of this study was to evaluate the possible association among sestamibi uptake and the main histopathological characteristics of parathyroid lesions related to aggressiveness such as the proliferation index (Ki67 expression and mitosis), angiogenesis (number of vessels), and vascular invasion in hyperparathyroidism patients. To this end, 26 patients affected by primary hyperparathyroidism subjected to both scintigraphy with [99mTc]Sestamibi and surgery/bioptic procedure were retrospectively enrolled. Hyperfunctioning of the parathyroid was detected in 19 patients. Our data showed a significant positive association among the sestamibi uptake and the proliferation index histologically evaluated both in terms of the number of Ki67 positive cells and mitosis. According to these data, lesions with a higher valuer of L/N (lesion to nonlesion ratio) frequently showed several vessels in tumor areas and histological evidence of vascular invasion. It is noteworthy that among patients with negative scintigraphy, 2 patients showed a neoplastic lesion after surgery (histological analysis). However, it is important to highlight that these lesions displayed very low proliferation indexes, which was evaluated in terms of number of both mitosis and Ki67-positive cells, some/rare vessels in the main lesion, and no evidence of vascular invasion. In conclusion, data obtained on patients with positive or negative scintigraphy support the hypothesis that sestamibi can be a tracer that is capable of predicting some biological characteristics of parathyroid tumors such as angiogenesis, proliferation indexes, and the invasion of surrounding tissues or vessels.

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Diagnostic Performance of MRI, Molecular Breast Imaging, and Contrast-enhanced Mammography in Women with Newly Diagnosed Breast Cancer

Cited by 70 publications

References 45 publications

Which clinical, radiological, histological, and molecular parameters are associated with the absence of enhancement of known breast cancers with Contrast Enhanced Digital Mammography (CEDM)?

Which clinical, radiological, histological, and molecular parameters are associated with the absence of enhancement of known breast cancers with Contrast Enhanced Digital Mammography (CEDM)?

Comparative Study of Amide Proton Transfer‐Weighted Imaging and Intravoxel Incoherent Motion Imaging in Breast Cancer Diagnosis and Evaluation

[99mTc]Sestamibi SPECT Can Predict Proliferation Index, Angiogenesis, and Vascular Invasion in Parathyroid Patients: A Retrospective Study

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