Characterisation of indeterminate focal breast lesions on grey-scale ultrasound: role of ultrasound elastography.

PURPOSE: This study was undertaken to evaluate the role of ultrasound (US) elastography in characterising focal breast lesions classified as indeterminate on B-mode US. MATERIALS AND METHODS: Eighty-four focal breast lesions, 64 benign and 20 malignant (mean diameter, 15.1 mm), detected but not characterised on B-mode US in 72 women, Breast Imaging Reporting and Data System (BI-RADS) US category 3 (n=56) or category 4 (n=28), were studied with US elastography and classified in consensus by two radiologists according to a five-point colour scale. Sensitivity, specificity and positive and negative predictive values (PPV and NPV) of US elastography compared with conventional US were calculated…

ADVANCEMENTS IN COMPUTER-AIDED BI-RADS US CHARACTERIZATION OF FOCAL BREAST LESIONS: CLINICAL ASSESSMENT OF A NEW SOFTWARE RELEASE OF S-DETECT

High-rate x-ray spectroscopy in mammography with a CdTe detector: A digital pulse processing approach

Purpose:Direct measurement of mammographic x-ray spectra under clinical conditions is a difficult task due to the high fluence rate of the x-ray beams as well as the limits in the development of high resolution detection systems in a high counting rate environment. In this work we present a detection system, based on a CdTe detector and an innovative digital pulse processing (DPP) system, for high-rate x-ray spectroscopy in mammography. Methods: The DPP system performs a digital pile-up inspection and a digital pulse height analysis of the detector signals, digitized through a 14-bit, 100 MHz digitizer, for x-ray spectroscopy even at high photon counting rates. We investigated on the respon…

BACKGROUND PARENCHYMAL ENHANCEMENT, MAMMOGRAPHIC DENSITY AND RISK OF BREAST CANCER

A method to reduce the FP/imm number through CC and MLO views comparison in mammographic images

In this paper we propose a method to reduce the FP/imm number through CC and MLO mammographic views comparison of the same patient. The proposed solution uses the symmetry properties of the breast to compute a geometric transformation that permits to represent the two images in comparable coordinates systems. Through this method, potential pathological ROIs of one of the projections are correlated with the ROIs in the second view. To show the effectiveness of the result we apply the method on a dataset composed of 112 couples of pathological images. Experiments shows that method enables a reduction by up to 700/0 of the FP/imm number detected after the classification step

Applicazione di un sistema CAD nella identificazione delle opacità mammografiche: esperienza personale

Computer assisted diagnosis (CAD) in mammography. Comparison of diagnostic accuracy of a new algorithm (Cyclopus(R), Medicad) with two commercial systems

The study compares the diagnostic accuracy (correct identification of cancer) of a new computer-assisted diagnosis (CAD) system (Cyclopus) with two other commercial systems (R2 and CADx). Cyclopus was tested on a set of 120 mammograms on which the two compared commercial systems had been previously tested. The set consisted of mammograms reported as negative, preceding 31 interval cancers reviewed as screening error or minimal sign, and of 89 verified negative controls randomly selected from the same screening database. Cyclopus sensitivity was 74.1% (R2=54.8%; CADx=41.9%) and was higher for interval cancers reviewed as screening error (90.9%; R2=54.5%; CADx=81.8%) compared with those revie…

S-Detect characterization of focal solid breast lesions: a prospective analysis of inter-reader agreement for US BI-RADS descriptors

Background: To assess inter-reader agreement for US BI-RADS descriptors using S-Detect: a computer-guided decision-making software assisting in US morphologic analysis. Methods: 73 solid focal breast lesions (FBLs) (mean size: 15.9 mm) in 73 consecutive women (mean age: 51 years) detected at US were randomly and independently assessed according to the BI-RADS US lexicon, without and with S-Detect, by five independent reviewers. US-guided core-biopsy and 24-month follow-up were considered as standard of reference. Kappa statistics were calculated to assess inter-operator agreement, between the baseline and after S-Detect evaluation. Agreement was graded as poor (≤ 0.20), moderate (0.21–0.40)…

MAGIC-5: an Italian mammographic database of digitised images for research

The implementation of a database of digitised mammograms is discussed. The digitised images were collected beginning in 1999 by a community of physicists in collaboration with radiologists in several Italian hospitals as a first step in developing and implementing a computer-aided detection (CAD) system. All 3,369 mammograms were collected from 967 patients and classified according to lesion type and morphology, breast tissue and pathology type. A dedicated graphical user interface was developed to visualise and process mammograms to support the medical diagnosis directly on a high-resolution screen. The database has been the starting point for developing other medical imaging applications,…

Ultrasonographic Detection of Vascularity of Focal Breast Lesions: Microvascular Imaging Versus Conventional Color and Power Doppler Imaging.

To compare microvascular flow imaging (MVFI) to conventional Color-Doppler (CDI) and Power-Doppler (PDI) imaging in the detection of vascularity of Focal Breast Lesions (FBLs). A total of 180 solid FBLs (size: 3.5–45.2 mm) detected in 180 women (age: 21–87 years) were evaluated by means of CDI, PDI, and MVFI. Two blinded reviewers categorized lesion vascularity in absent or present, and vascularity pattern as (a) internal; (b) vessels in rim; (c) combined. The presence of a “penetrating vessel” was assessed separately. Differences in vascularization patterns (chi2 test) and intra- and inter-observer agreement (Fleiss method) were calculated. ROC analysis was performed to assess performance…

COMPUTER ASSISTED DIAGNOSIS (CAD) IN MAMMOGRAPHY. COMPARISON OF DIAGNOSTIC ACCURACY OF A NEW ALGORITHM (CYCLOPUS®, MEDICAD) WITH TWO COMMERCIAL SYSTEMS