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JFIMBreast MRI can have both high sensitivity and specificity for cancer detection but also poses challenges. Specificity may be around 70-90% depending on the population and comparison to mammography. Sensitivity also varies based on the gold standard used, ranging from over 95% in many studies to around 75% for screening studies. Both false positives and false negatives can occur for reasons such as artifacts, normal breast tissue, benign lesions, tumor characteristics like size, and interpretation errors. The document provides guidance on analyzing lesions, potential pitfalls, and ways to improve accuracy such as recognizing pseudo-enhancement, accounting for clinical context, and recommending appropriate follow up.
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Mr Mammography New
MRI can detect breast lesions with high sensitivity but has variable specificity in differentiating benign from malignant lesions. MR spectroscopy provides additional metabolic information that can improve specificity by detecting elevated choline levels associated with malignant tumors. Response to chemotherapy can also be assessed non-invasively with MR spectroscopy by monitoring changes in choline levels within 24 hours of treatment. Limitations include difficulty with small lesions, dense breasts, and lactating breasts.
Sophie Taieb : Breast MRI indication 2014
Breast MRI has poor specificity but can provide useful information when used appropriately according to evidence-based guidelines. It has high sensitivity for detecting breast cancer but many benign lesions also enhance, leading to false positives. MRI is best used to further evaluate lesions already detected by other imaging when biopsy is not possible, to screen high-risk patients, and assess response to neoadjuvant chemotherapy or detect recurrence. Strict technical protocols and reporting standards help optimize MRI's clinical utility while minimizing unnecessary additional procedures due to false positives.
Breast imaging breast mri s taieb
The document discusses breast MRI techniques and findings. It begins by outlining appropriate protocols for breast MRI, including performing exams in specialized breast units with adequate case volume and availability of biopsy. Appropriate sequences and timing of exams within the menstrual cycle are also discussed. Examples are then provided of various breast lesions identified on MRI and their BI-RADS assessments, including masses, non-mass enhancements, and foci. The importance of comparing MRI findings to other imaging modalities and pathology is emphasized. Areas to improve specificity, such as 3T MRI, diffusion-weighted imaging, and contrast agents, are also evaluated.
Comparison between mammogram and mri in detecting breast cancer
MRI mammography is more accurate than mammography in detecting breast diseases. A study compared MRI and mammography on 15 patients and found MRI detected 12 cases of ductal carcinoma in situ (DCIS) in the right breast that mammography missed, as well as 10 cases of DCIS in the left breast. MRI mammography had a sensitivity of 100% while mammography's sensitivity was only 18% for detecting breast cancer. MRI is better able to detect cancers obscured by dense breast tissue and can provide additional information on tumor extent.
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Presentation on Evolving Trends in Breast MRI by Dr. Harriett B. Borofsky, Director of Breast Imaging, Mills-Peninsula Women's Center.
Breast Cancer not Detected on MRI
This study evaluated the sensitivity of breast MRI for detecting breast cancers. Of 222 cancers, MRI correctly identified 213 but missed 9 cancers (sensitivity of 96.8%). The 7 true false-negatives included 4 DCIS lesions and 3 invasive cancers. False-negative lesions were often small or obscured by surrounding enhancing breast tissue. While MRI is highly sensitive for breast cancer, a small percentage of cancers can be missed, particularly DCIS and cancers in a background of diffuse parenchymal enhancement.
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This document discusses the use of breast MRI in evaluating response to neoadjuvant chemotherapy. MRI can provide both morphological and functional information about tumors. Studies show DCE-MRI and DWI-MRI may help assess response after 1-2 cycles of chemotherapy, with changes in tumor size, kinetic parameters and ADC values predicting pathological complete or near-complete response. Larger prospective trials are still needed to standardize MRI methods and thresholds to determine if changes on MRI could guide modifications to chemotherapy regimens for non-responders. Overall, MRI shows potential as a predictive marker and non-invasive method for monitoring early response to neoadjuvant breast cancer treatment.Breast imaging birads irm t pousse
This document summarizes updates made to the BI-RADS MRI lexicon in its third edition. It describes new features for characterizing breast lesions on MRI, including background parenchymal enhancement categories, mass shape and margin descriptions, and distributions for non-mass enhancements. Kinetic enhancement curves are also discussed. The importance of the revised lexicon is to standardize MRI reporting and improve assessment of lesions, with certain characteristics like irregular masses or clustered ring non-mass enhancements having a higher positive predictive value for malignancy.
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MRI can detect breast lesions with high sensitivity but has variable specificity in differentiating benign from malignant lesions. MR spectroscopy provides additional metabolic information that can improve specificity by detecting elevated choline levels associated with malignant tumors. Response to chemotherapy can also be assessed non-invasively with MR spectroscopy by monitoring changes in choline levels within 24 hours of treatment. Limitations include difficulty with small lesions, dense breasts, and lactating breasts.
Sophie Taieb : Breast MRI indication 2014
Breast MRI has poor specificity but can provide useful information when used appropriately according to evidence-based guidelines. It has high sensitivity for detecting breast cancer but many benign lesions also enhance, leading to false positives. MRI is best used to further evaluate lesions already detected by other imaging when biopsy is not possible, to screen high-risk patients, and assess response to neoadjuvant chemotherapy or detect recurrence. Strict technical protocols and reporting standards help optimize MRI's clinical utility while minimizing unnecessary additional procedures due to false positives.
Breast imaging breast mri s taieb
The document discusses breast MRI techniques and findings. It begins by outlining appropriate protocols for breast MRI, including performing exams in specialized breast units with adequate case volume and availability of biopsy. Appropriate sequences and timing of exams within the menstrual cycle are also discussed. Examples are then provided of various breast lesions identified on MRI and their BI-RADS assessments, including masses, non-mass enhancements, and foci. The importance of comparing MRI findings to other imaging modalities and pathology is emphasized. Areas to improve specificity, such as 3T MRI, diffusion-weighted imaging, and contrast agents, are also evaluated.
Comparison between mammogram and mri in detecting breast cancer
MRI mammography is more accurate than mammography in detecting breast diseases. A study compared MRI and mammography on 15 patients and found MRI detected 12 cases of ductal carcinoma in situ (DCIS) in the right breast that mammography missed, as well as 10 cases of DCIS in the left breast. MRI mammography had a sensitivity of 100% while mammography's sensitivity was only 18% for detecting breast cancer. MRI is better able to detect cancers obscured by dense breast tissue and can provide additional information on tumor extent.
Evolving Trends in Breast MRI
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This study evaluated the sensitivity of breast MRI for detecting breast cancers. Of 222 cancers, MRI correctly identified 213 but missed 9 cancers (sensitivity of 96.8%). The 7 true false-negatives included 4 DCIS lesions and 3 invasive cancers. False-negative lesions were often small or obscured by surrounding enhancing breast tissue. While MRI is highly sensitive for breast cancer, a small percentage of cancers can be missed, particularly DCIS and cancers in a background of diffuse parenchymal enhancement.
Sophie Taieb : Breast MRI in neoadjuvant chemotherapy : A predictive respons...
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This document discusses the use of breast MRI in evaluating response to neoadjuvant chemotherapy. MRI can provide both morphological and functional information about tumors. Studies show DCE-MRI and DWI-MRI may help assess response after 1-2 cycles of chemotherapy, with changes in tumor size, kinetic parameters and ADC values predicting pathological complete or near-complete response. Larger prospective trials are still needed to standardize MRI methods and thresholds to determine if changes on MRI could guide modifications to chemotherapy regimens for non-responders. Overall, MRI shows potential as a predictive marker and non-invasive method for monitoring early response to neoadjuvant breast cancer treatment.Breast imaging birads irm t pousse
This document summarizes updates made to the BI-RADS MRI lexicon in its third edition. It describes new features for characterizing breast lesions on MRI, including background parenchymal enhancement categories, mass shape and margin descriptions, and distributions for non-mass enhancements. Kinetic enhancement curves are also discussed. The importance of the revised lexicon is to standardize MRI reporting and improve assessment of lesions, with certain characteristics like irregular masses or clustered ring non-mass enhancements having a higher positive predictive value for malignancy.
Liliane ollivier : Breast MR Imaging in Women with High Genetic Risk
1) Breast MRI is useful for screening and surveillance in women with high genetic risk of breast cancer, such as those with BRCA1/BRCA2 mutations. MRI can identify cancers earlier than mammography due to certain features of hereditary breast cancers.
2) For lesions found on MRI, further workup with targeted ultrasound and biopsy is recommended. If no lesion is found on ultrasound, short-term MRI follow up or MRI-guided biopsy may be needed given the increased risk in this patient population.
3) Annual breast MRI, ultrasound and mammography (when applicable) is important for surveillance in high risk women due to the possibility of interval cancers developing between screenings. Following standardized imaging protocols and recommendations
Role of mammography and MRI in Breast disorders
Mammography is an x-ray test used to aid in the early detection and diagnosis of breast diseases in women. It uses low-dose radiation to produce images of the breast tissue. Screening mammograms are used to look for signs of breast cancer in women without symptoms, while diagnostic mammograms are used when abnormalities are detected or a woman has breast symptoms. Mammograms produce images of the breast tissue and can detect abnormalities such as masses, calcifications, architectural distortions, and asymmetries that may indicate breast cancer. The images are analyzed according to the Breast Imaging Reporting and Data System (BI-RADS) to determine if follow-up is needed. Digital mammography provides enhanced image quality compared to traditional film
C Balleyguier, Birads MRI jfim hanoi 2015
1. The document outlines updates to the BI-RADS MRI classification system from 2013, including standardized terminology for describing findings like masses and non-mass enhancements.
2. It describes the steps for analyzing breast MRI findings, including assessing morphology, kinetics, diffusion imaging, and synthesizing the results. Characteristics like mass shape, margins, internal enhancement and time-signal intensity curves are evaluated.
3. New sections were added to BI-RADS 2013 for describing breast density, background parenchymal enhancement, associated features, non-enhancing lesions, and findings related to breast implants. The changes aim to make MRI interpretation and reporting more practical and consistent.
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MRI of the breast has certain contraindications including the presence of metallic implants, those unable to lie prone, or with large body habitus. Normal breast tissue may enhance asymmetrically, so scheduling during days 7-20 of the menstrual cycle can provide less enhancement. Dedicated breast coils are used with patients lying prone, and protocols involve unilateral or bilateral imaging with pre-and post-contrast sequences to analyze enhancement kinetics. Morphological features like irregular shapes and enhancement kinetics help identify lesions, with Type I curves associated with benign lesions and Type III with malignancy. MRI is useful for screening, determining tumor extent, assessing recurrence or residual disease, and providing information not available from other imaging methods.
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This document discusses breast MRI protocols, techniques, and the interpretation of findings. It provides details on coil and patient positioning, recommended MRI field strength, and standard breast MRI protocols. It discusses recognizing normal enhancing structures like vessels, nipples, and lymph nodes. Guidelines are presented for analyzing lesion enhancement and characterizing benign masses based on criteria like smooth margins, shape, homogeneous enhancement, fat content, T2 signal, and rim enhancement. Examples of benign findings like fibroadenomas and fat-containing lesions are also described.
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This document discusses breast imaging recommendations and tools. It recommends annual mammography screening starting at age 40 for average risk women, while high risk women may benefit from additional screening with MRI. Digital mammography is the gold standard but has limitations depending on breast density. New tools like tomosynthesis and ultrasound can help address these limitations and provide additional information. The document reviews various breast imaging tools and their uses, as well as risk factors, screening guidelines, and case examples.
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This document discusses various imaging modalities used for breast cancer screening and diagnosis, including mammography, ultrasound, MRI, CT, and PET scans. It provides details on mammography techniques for screening and diagnostic purposes. Key findings from studies on screening mammography for different age groups are summarized. Guidelines on screening from organizations like ACS, NCCN, and NCI are also outlined. The use of ultrasound and MRI as supplemental tools for diagnosis is discussed.
Mammography
Mammography is the cornerstone imaging modality for breast cancer screening and diagnosis. It involves two standard views - craniocaudal and mediolateral oblique. Additional spot views may be needed based on findings. Image quality is optimized through use of specific equipment like molybdenum targets, grids, and compression to reduce thickness. Mammography finds masses and suspicious calcifications and uses the BI-RADS assessment system to characterize findings and guide need for biopsy. Regular screening can detect cancers early and improve outcomes.
Breast cancer
Breast cancer is a common and serious form of cancer that affects millions of women globally each year. It starts in the breast tissue and can spread to other parts of the body if not detected early. Some key risk factors include gender, age, family history and lifestyle factors. Symptoms may include a breast lump, skin changes, nipple discharge or inversion. Diagnosis involves examinations, mammography, ultrasound and biopsy. Cancer is staged according to tumor size and spread. Treatment options include surgery to remove all or part of the breast, chemotherapy, radiation therapy, hormone therapy and targeted drug therapies. The goal is cure, remission or palliation depending on the stage and type of cancer.
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This document provides an overview of mammography presented by Sumanjali N. of Manipal Hospital in Whitefield, Bengaluru. It begins with an introduction to mammography and breast anatomy. It then discusses breast cancer and various imaging modalities used including mammogram, ultrasound, tomosynthesis, PET mammogram, MR mammogram, and thermography. The role of a mammography technologist is outlined. Standard mammographic views and the breast imaging reporting and data system (BI-RADS) for assessing findings are described. Common mammographic artifacts are also reviewed. The presentation concludes by emphasizing the importance of screening mammography in early breast cancer detection and reassurance of patients.
Breast Density Notification Law Information For Primary Care Providers
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Caren Stalburg, MD, MA presented to the 2016 annual Snow meeting of the Michigan Section of the American Congress of Obstetricians and Gynecologists (ACOG) about her program to train Michigan providers about the new Breast Density Notification Law (http://www.midensebreasts.org/).
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MRI breast imaging is used for screening, diagnosis, and evaluation of breast lesions. It has several indications including screening high risk patients, assessing multicentricity, evaluating postoperative or post-NACT lesions, and assessing Paget's disease. The technique involves sequences like T1, T2, DCE, and DWI. Lesions are characterized by morphological features, kinetic enhancement patterns, and additional findings. MRI is also useful for evaluating breast implants and capsular contracture. Potential pitfalls include pseudoenhancement and normal tissue enhancement.
Early Stage Breast Cancer and Radiation Therapy
These slides are intended as an educational overview for newly diagnosed early stage breast cancer patients. My hope is that it can complement and enhance the doctor-patient relationship and shared decision making. I welcome any feedback on how to improve it.
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This document provides an overview of various breast imaging modalities including mammography, galactography/ductography, stereotactic guided procedures, digital tomosynthesis, ultrasound elastography, and MRI of the breast. Key imaging techniques are described such as mammography positioning, ductography technique, stereotactic biopsy procedures, and interpretation of ultrasound elastography images. Evaluation of breast lesions and interpretation of different imaging findings are also discussed.
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This document provides information about various breast imaging techniques including mammography. It describes what a mammogram is, the history of mammography, how mammograms are performed, what they can detect like masses and microcalcifications, and how results are categorized using BI-RADS. Other modalities like ultrasound and MRI are also discussed. Limitations of mammography include false negatives, overdiagnosis, and difficulty in dense breasts. Mammogram plans vary depending on a woman's history and any breast surgery or implants. Newer techniques like tomosynthesis aim to improve cancer detection.
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Mammography involves x-ray imaging of the breasts to detect cancer. Digital mammography was introduced in 2001. Mammogram results are categorized from 0 to 5 based on likelihood of malignancy, with Category 5 being highly suggestive of cancer. Mammograms have a specificity of 50-70% and sensitivity of 80-90% but can miss 10-15% of cancers. Ultrasound found multiple cysts and nodules in both breasts of a patient, categorized as probably benign (BI-RADS 3) with less than 2% chance of cancer. Follow-up in 6 months was recommended.
Riga 2016TomoCESMcombo
- Kettering General Hospital Breast Unit went digital between 2010-2012 and implemented tomosynthesis and contrast-enhanced spectral mammography (CESM) to improve cancer detection for women with dense breasts.
- A review of 50 patients who received tomosynthesis found it aided diagnosis in 36 patients (69%), providing extra information in 22 patients and more detailed information in 7 patients.
- A prospective study of 117 CESM exams found it to be as sensitive as MRI in detecting cancer and impacted management for 30% of cancer patients. CESM provided accurate sizing for invasive cancers but was less accurate for lobular cancers and cancers with ductal carcinoma in situ.
1.breast cancer screening(backup slide-1)
This document discusses four breast imaging modalities: 1) Mammography uses low-energy x-rays to examine breast tissue for early cancer detection. 2) Breast MRI is useful for high-risk women and can find cancers not seen on mammogram. 3) Breast ultrasound uses sound waves to image the breast and shows dense tissue not visible via mammogram. 4) Digital breast tomosynthesis takes x-ray images from different angles to reconstruct 3D slices of the breast, improving detection over standard mammography.
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The document discusses various applications of MRI including MRI breast, MRI fistulogram, and MRI defecography. It provides details on the basic principles of MRI such as how hydrogen protons are aligned using magnetic fields and radiofrequency pulses. When describing MRI breast, it covers indications, technique, interpretation of findings, and comparisons to mammography. For MRI fistulogram, it discusses anal canal anatomy, classifications of fistulas, and MRI sequences and views used.
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1) Breast MRI is useful for screening and surveillance in women with high genetic risk of breast cancer, such as those with BRCA1/BRCA2 mutations. MRI can identify cancers earlier than mammography due to certain features of hereditary breast cancers.
2) For lesions found on MRI, further workup with targeted ultrasound and biopsy is recommended. If no lesion is found on ultrasound, short-term MRI follow up or MRI-guided biopsy may be needed given the increased risk in this patient population.
3) Annual breast MRI, ultrasound and mammography (when applicable) is important for surveillance in high risk women due to the possibility of interval cancers developing between screenings. Following standardized imaging protocols and recommendations
Role of mammography and MRI in Breast disorders
Mammography is an x-ray test used to aid in the early detection and diagnosis of breast diseases in women. It uses low-dose radiation to produce images of the breast tissue. Screening mammograms are used to look for signs of breast cancer in women without symptoms, while diagnostic mammograms are used when abnormalities are detected or a woman has breast symptoms. Mammograms produce images of the breast tissue and can detect abnormalities such as masses, calcifications, architectural distortions, and asymmetries that may indicate breast cancer. The images are analyzed according to the Breast Imaging Reporting and Data System (BI-RADS) to determine if follow-up is needed. Digital mammography provides enhanced image quality compared to traditional film
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1. The document outlines updates to the BI-RADS MRI classification system from 2013, including standardized terminology for describing findings like masses and non-mass enhancements.
2. It describes the steps for analyzing breast MRI findings, including assessing morphology, kinetics, diffusion imaging, and synthesizing the results. Characteristics like mass shape, margins, internal enhancement and time-signal intensity curves are evaluated.
3. New sections were added to BI-RADS 2013 for describing breast density, background parenchymal enhancement, associated features, non-enhancing lesions, and findings related to breast implants. The changes aim to make MRI interpretation and reporting more practical and consistent.
Mri breast,indication,contra,prtocol,techniq,curves
MRI of the breast has certain contraindications including the presence of metallic implants, those unable to lie prone, or with large body habitus. Normal breast tissue may enhance asymmetrically, so scheduling during days 7-20 of the menstrual cycle can provide less enhancement. Dedicated breast coils are used with patients lying prone, and protocols involve unilateral or bilateral imaging with pre-and post-contrast sequences to analyze enhancement kinetics. Morphological features like irregular shapes and enhancement kinetics help identify lesions, with Type I curves associated with benign lesions and Type III with malignancy. MRI is useful for screening, determining tumor extent, assessing recurrence or residual disease, and providing information not available from other imaging methods.
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This document discusses breast MRI protocols, techniques, and the interpretation of findings. It provides details on coil and patient positioning, recommended MRI field strength, and standard breast MRI protocols. It discusses recognizing normal enhancing structures like vessels, nipples, and lymph nodes. Guidelines are presented for analyzing lesion enhancement and characterizing benign masses based on criteria like smooth margins, shape, homogeneous enhancement, fat content, T2 signal, and rim enhancement. Examples of benign findings like fibroadenomas and fat-containing lesions are also described.
Breast imaging update
This document discusses breast imaging recommendations and tools. It recommends annual mammography screening starting at age 40 for average risk women, while high risk women may benefit from additional screening with MRI. Digital mammography is the gold standard but has limitations depending on breast density. New tools like tomosynthesis and ultrasound can help address these limitations and provide additional information. The document reviews various breast imaging tools and their uses, as well as risk factors, screening guidelines, and case examples.
Imaging in breast cancer
This document discusses various imaging modalities used for breast cancer screening and diagnosis, including mammography, ultrasound, MRI, CT, and PET scans. It provides details on mammography techniques for screening and diagnostic purposes. Key findings from studies on screening mammography for different age groups are summarized. Guidelines on screening from organizations like ACS, NCCN, and NCI are also outlined. The use of ultrasound and MRI as supplemental tools for diagnosis is discussed.
Mammography
Mammography is the cornerstone imaging modality for breast cancer screening and diagnosis. It involves two standard views - craniocaudal and mediolateral oblique. Additional spot views may be needed based on findings. Image quality is optimized through use of specific equipment like molybdenum targets, grids, and compression to reduce thickness. Mammography finds masses and suspicious calcifications and uses the BI-RADS assessment system to characterize findings and guide need for biopsy. Regular screening can detect cancers early and improve outcomes.
Breast cancer
Breast cancer is a common and serious form of cancer that affects millions of women globally each year. It starts in the breast tissue and can spread to other parts of the body if not detected early. Some key risk factors include gender, age, family history and lifestyle factors. Symptoms may include a breast lump, skin changes, nipple discharge or inversion. Diagnosis involves examinations, mammography, ultrasound and biopsy. Cancer is staged according to tumor size and spread. Treatment options include surgery to remove all or part of the breast, chemotherapy, radiation therapy, hormone therapy and targeted drug therapies. The goal is cure, remission or palliation depending on the stage and type of cancer.
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This document provides an overview of mammography presented by Sumanjali N. of Manipal Hospital in Whitefield, Bengaluru. It begins with an introduction to mammography and breast anatomy. It then discusses breast cancer and various imaging modalities used including mammogram, ultrasound, tomosynthesis, PET mammogram, MR mammogram, and thermography. The role of a mammography technologist is outlined. Standard mammographic views and the breast imaging reporting and data system (BI-RADS) for assessing findings are described. Common mammographic artifacts are also reviewed. The presentation concludes by emphasizing the importance of screening mammography in early breast cancer detection and reassurance of patients.
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Caren Stalburg, MD, MA presented to the 2016 annual Snow meeting of the Michigan Section of the American Congress of Obstetricians and Gynecologists (ACOG) about her program to train Michigan providers about the new Breast Density Notification Law (http://www.midensebreasts.org/).
Dr. Stalburg is Division Chief and Clinical Assistant Professor in the Division of Professional Education in the Department of Learning Health Sciences and Assistant Professor of Obstetrics and Gynecology in the University of Michigan Medical School. Mri breast (2)
MRI breast imaging is used for screening, diagnosis, and evaluation of breast lesions. It has several indications including screening high risk patients, assessing multicentricity, evaluating postoperative or post-NACT lesions, and assessing Paget's disease. The technique involves sequences like T1, T2, DCE, and DWI. Lesions are characterized by morphological features, kinetic enhancement patterns, and additional findings. MRI is also useful for evaluating breast implants and capsular contracture. Potential pitfalls include pseudoenhancement and normal tissue enhancement.
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These slides are intended as an educational overview for newly diagnosed early stage breast cancer patients. My hope is that it can complement and enhance the doctor-patient relationship and shared decision making. I welcome any feedback on how to improve it.
Breast imaging modalities
This document provides an overview of various breast imaging modalities including mammography, galactography/ductography, stereotactic guided procedures, digital tomosynthesis, ultrasound elastography, and MRI of the breast. Key imaging techniques are described such as mammography positioning, ductography technique, stereotactic biopsy procedures, and interpretation of ultrasound elastography images. Evaluation of breast lesions and interpretation of different imaging findings are also discussed.
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Imaging breast mammogram
This document provides information about various breast imaging techniques including mammography. It describes what a mammogram is, the history of mammography, how mammograms are performed, what they can detect like masses and microcalcifications, and how results are categorized using BI-RADS. Other modalities like ultrasound and MRI are also discussed. Limitations of mammography include false negatives, overdiagnosis, and difficulty in dense breasts. Mammogram plans vary depending on a woman's history and any breast surgery or implants. Newer techniques like tomosynthesis aim to improve cancer detection.
Mammogram
Mammography involves x-ray imaging of the breasts to detect cancer. Digital mammography was introduced in 2001. Mammogram results are categorized from 0 to 5 based on likelihood of malignancy, with Category 5 being highly suggestive of cancer. Mammograms have a specificity of 50-70% and sensitivity of 80-90% but can miss 10-15% of cancers. Ultrasound found multiple cysts and nodules in both breasts of a patient, categorized as probably benign (BI-RADS 3) with less than 2% chance of cancer. Follow-up in 6 months was recommended.
Riga 2016TomoCESMcombo
- Kettering General Hospital Breast Unit went digital between 2010-2012 and implemented tomosynthesis and contrast-enhanced spectral mammography (CESM) to improve cancer detection for women with dense breasts.
- A review of 50 patients who received tomosynthesis found it aided diagnosis in 36 patients (69%), providing extra information in 22 patients and more detailed information in 7 patients.
- A prospective study of 117 CESM exams found it to be as sensitive as MRI in detecting cancer and impacted management for 30% of cancer patients. CESM provided accurate sizing for invasive cancers but was less accurate for lobular cancers and cancers with ductal carcinoma in situ.
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This document discusses four breast imaging modalities: 1) Mammography uses low-energy x-rays to examine breast tissue for early cancer detection. 2) Breast MRI is useful for high-risk women and can find cancers not seen on mammogram. 3) Breast ultrasound uses sound waves to image the breast and shows dense tissue not visible via mammogram. 4) Digital breast tomosynthesis takes x-ray images from different angles to reconstruct 3D slices of the breast, improving detection over standard mammography.
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The document discusses various applications of MRI including MRI breast, MRI fistulogram, and MRI defecography. It provides details on the basic principles of MRI such as how hydrogen protons are aligned using magnetic fields and radiofrequency pulses. When describing MRI breast, it covers indications, technique, interpretation of findings, and comparisons to mammography. For MRI fistulogram, it discusses anal canal anatomy, classifications of fistulas, and MRI sequences and views used.
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MRI has an important role in breast imaging in situations where clinical examination, mammography, and ultrasound have limitations, as it is sensitive to small abnormalities and effective in dense breasts. It can characterize breast lesions, stage malignant neoplasms, and follow patients after treatment. While it cannot image calcifications and is more expensive than other modalities, MRI can provide additional diagnostic information for patients with dense breasts or inconclusive ultrasound results. Both qualitative and quantitative analysis of enhancement kinetics are used to differentiate benign and malignant lesions on MRI.
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MRI is useful in the diagnosis, treatment, and follow-up of prostate cancer. It can visualize the prostate gland and detect tumors, assess extracapsular spread and seminal vesicle invasion, and detect bone metastases. The standard MRI protocol includes T2-weighted, diffusion-weighted, and dynamic contrast-enhanced sequences. Prostate cancer appears as a low T2 signal, exhibits restricted diffusion, and shows early contrast enhancement and washout. While other conditions like BPH, inflammation, and radiation effects can mimic cancer, MRI findings along with PSA, biopsy and clinical data are used to evaluate patients. MRI also helps plan and guide radiation therapy and assess treatment response or recurrence.
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Breast cancer is the most common cancer in women, with a lifetime risk of around 1 in 8. While the median age of diagnosis is 61, 5% of cases are diagnosed in women in their 30s. Understanding the basic breast anatomy, imaging studies like mammograms, and pathology reports which detail cancer stage and biology is important for deciding on treatment. Stage is based on tumor size and lymph node involvement. Higher grade or larger tumors have a greater chance of lymph node spread. Genetic testing can help determine prognosis and optimal treatment for early-stage cancers.
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E.Darai
Spain :
J.Alcazar
Germany :
M.Forsting
Netherlands :
J.Barentsz
Poland :
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Breast imaging pitffals mri p taourel
- 1. Pitfalls in breast MRI : How to deal between Sensitivity and Specifcity ? P. Taourel, E. Pages
- 2. Breast MRI : a weak specificity • Studies comparing MRI and MG – Staging of brast cancer : Spe = 70% close to Spe of MG – High risk women : Spe = 90 % • Why this feeling of low specificity – enhancement ≠ cancer – Lack of experience – Difficulty of biopsy C Kuhl Radiology 2007
- 3. Breast MRI : is it perfectly sensitive ? • The sensitivity of an exam depends of the gold standard > 95 % in most of the studies ≈ 75 % in screening studies = 85 % in the stidy with gold standard = pathologic analysis of mastectomy • MRI Sensitivity > Sensitivity of other imaging modalities
- 4. Causes of avoidable F+ • Artefacts • Normal structures • Benign tumors
- 7. Causes of avoidable F+ • Artefacts • Normal structures • Benign tumors
- 10. Backround enhancement • Bilateral and symmetric • Hormonal and therapeutic context • Age of the patient • The backround enhancement must be graded
- 11. Genetic risks, BRCA 1 40 years old
- 12. Genetic risks 40 years old Right mass : fibroadenoma ovariectomy
- 14. To analyze / classification BIRADS • Mass – 3D – Cancer, FA, papilloma, fat necrosis, sclerosing adenosis, lymph node, some atypical form of benign lesions – Key features for Benign: • • • • • • Smooth outline Regular form Homogeneous enhancement (value if big) Hyper T2 Fat content Weak enhancement and no wash-out
- 17. 2009 2010
- 19. Value of hyper T2 if homogeneous
- 20. Rim must be analyzed according to the content and the regular pattern
- 21. To analyze / BIRADS classification • Non mass enhancement – Neither mass nor focus – Benign mass, young patient, inflammation, DCIS, ILC – Key features for enhancement : • Bilateral and symmetric • Cysts ++ • Negative findings
- 23. To analyze / classification BIRADS • Focus – < 5 mm – Very low rate of malignancy – Key features for benign (no F.U = BIRADS 2) • Multiple • No wash-out • Clinical context
- 24. F• Lack of enhancement • Not seen – Backround enhancement, artefact – small – Tricky area • Misinterpretation • Mismanagement
- 25. Causes of False negative • Retrospective review of 60 pairs of breast cancer • 47% of « errors » – 10% = misdiagnosis – 25% = misinterpretation – 12% = mismanagement Pages Radiology 2012
- 26. Lack of enhancement • DCIS • Small invasive cancer • Some pathologic pattern: – Inflammatory cancer – Invasive lobular carcinoma
- 153. F• Lack of enhancement • Not seen – Backround enhancement, artefact – small – Tricky area • Misinterpretation • Mismanagement
- 156. Oct 2004 Mai 2005
- 175. 1an plus tard
- 192. F• Lack of enhancement • Not seen – Backround enhancement, artefact – small – Tricky area • Misinterpretation • Mismanagement
- 195. 2007 2008 Benign morphology’’ : oval form, smooth outlines, non enhanced septas
- 205. 1 year later
- 211. 2003 2005 2006
- 212. Be careful with kinetic, particularly in menopausal patients 2 3 OR not to have malignant curve in menopausal 2 patients : 2.94 : initial rise 2.38 : washout 1 I Millet Radiology dec 2013 Progressive Plateau ROI > 3 pixels Région la plus suspecte Lavage Temps (min)
- 213. F• Lack of enhancement • Not seen – Backround enhancement, artefact – small – Tricky area • Misinterpretation • Mismanagement
- 218. Importance du clip
- 219. How to avoid F+ and F- ? 1. 2. 3. 4. To recognize the pseudo-enhancement To negative normal structure : bilateral foci, punctuate enhancement, lymph nodes 6 month FU Interpretation according to clinical context and personal status - focus/BIRADS - enhancement/menopausal status 5. 6. Be careful with stability (morphology +++) Be careful with autosatisfaction : FU of benign results in biopsy performed on 2d look US