http://facweb.cs.depaul.edu/research/vc/medix/2011/papers/Source2.pdf

Texture analysis of medical images.

Magnetic resonance imaging of the breast: recommendations from the EUSOMA working group.

Purpose
To evaluate the value of diffusion-weighted imaging (DWI) in distinguishing between benign and malignant breast lesions.

Materials and Methods
Fifty-two female subjects (mean age = 58 years, age range = 25–75 years) with histopathologically proven breast lesions underwent DWI of the breasts with a single-shot echo-planar imaging (EPI) sequence using large b values. The computed mean apparent diffusion coefficients (ADCs) of the breast lesions and cell density were then correlated.

Results
The ADCs varied substantially between benign breast lesions ((1.57 ± 0.23) × 10−3 mm2/second) and malignant breast lesions ((0.97 ± 0.20) × 10−3 mm2/second). In addition, the mean ADCs of the breast lesions correlated well with tumor cellularity (P < 0.01, r = −0.542).

Conclusion
The ADC would be an effective parameter in distinguishing between malignant and benign breast lesions. Further, tumor cellularity has a significant influence on the ADCs obtained in both benign and malignant breast tumors. J. Magn. Reson. Imaging 2002;16:172–178. © 2002 Wiley-Liss, Inc.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/jmri.10140

Differentiation of clinically benign and malignant breast lesions using diffusion-weighted imaging.

System, method and apparatus for carrying out the recovery of an intact volume of tissue wherein a delivery cannula distal end is positioned in confronting adjacency with the volume of tissue to be recovered. An expandable metal capture component (116) is expressed from the distal end of the cannula (80) to expand while being electrically excited to electrosurgically cut around and circumscribe the tissue volume. Pursing cables (100, 101) are tensioned to complete the envelopment of the tissue volume, whereupon the volume is recovered by withdrawal of the instrument.

Minimally invasive intact recovery of tissue

Purpose: To determine, in a meta-analysis, the diagnostic performance of contrast material–enhanced magnetic resonance (MR) imaging in patients with breast lesions. Materials and Methods: Studies to assess the diagnostic performance of MR imaging in patients suspected of having breast cancer who underwent MR imaging and biopsy from January 1985 through March 2005 were reviewed for inclusion. A summary receiver operating characteristic curve was constructed, and pooled weighted estimates of sensitivity and specificity were calculated by using the recently developed bivariate approach for diagnostic meta-analysis. Results: Of 251 eligible studies, 44 were included in the meta-analysis (sample size range, 14–821; cancer prevalence, 23%–84%). Pooled weighted estimates of sensitivity and specificity were 0.90 (95% confidence interval: 0.88, 0.92) and 0.72 (95% confidence interval: 0.67, 0.77), respectively. The performance of breast MR imaging was influenced by the prevalence of cancer in the studied populatio...

Meta-Analysis of MR Imaging in the Diagnosis of Breast Lesions

The objective of this study was to determine whether linear discriminant analysis of different independent features of MR images of breast lesions can increase the sensitivity and specificity of this technique. For MR images of 23 benign and 20 malignant breast lesions, three independent classes of features, including characteristics of Gd-DTPA-uptake curve, boundary, and texture were evaluated. The three classes included five, four and eight features each, respectively. Discriminant analysis was applied both within and across the three classes, to find the best combination of features yielding the highest classification accuracy. The highest specificity and sensitivity of the different classes considered independently were as follows: Gd-up-take curves, 83% and 70%; boundary features, 86% and 70%; and texture, 70% and 75%, respectively. A combination of one feature each from the first two classes and age yielded a specificity of 79% and sensitivity of 90%, whereas highest figures of 93% and 95%, respectively, were obtained when a total of 10 features were combined across different classes. Statistical analysis of different independent classes of features in MR images of breast lesions can improve the classification accuracy of this technique significantly.

Multifeature analysis of Gd-enhanced MR images of breast lesions.

This study was designed to evaluate pulse sequences and patient positioning for MR imaging of silicone breast implants in patients. One hundred forty-three patients (281 silicone implants) underwent imaging over a 21-month period. The combination of a T2-weighted fast spin echo technique (SE), T2-weighted fast SE with water suppression, and T1-weighted SE with fat suppression is recommended to reliably differentiate silicone from other breast tissues and to identify intracapsular and extracapsular ruptures or leaks. Seventy of the 143 patients underwent removal of their silicone implants. The sensitivity for detection of silicone implant rupture was 76%, with a specificity of 97%. Positioning the patient prone improved image quality.

Silicone breast implants in vivo: MR imaging.

Magnetic resonance imaging of the breast in the diagnosis of silicone breast implant rupture is widely accepted to be the imaging study of choice for most women. Magnetic resonance imaging in the detection of silicone implant failure has been shown to have the highest sensitivity and specificity and has the ability to image the entire implant without the use of ionizing radiation. Unfortunately, some women are unable to have a magnetic resonance imaging examination of the breast because of contraindications such as cardiac pacemakers, aneurysm clips, and claustrophobia. Therefore, mammography, ultrasonography, and computed tomography will have roles in the diagnosis of silicone breast implant ruptures. This article illustrates the spectrum of imaging appearances of normal silicone gel implants and the appearances of silicone breast implant ruptures.

The Diagnosis of Silicone Breast Implant Rupture

PURPOSE: To determine the value of breast ultrasonography (US) in the assessment of silicone breast implants for rupture. MATERIALS AND METHODS: Seventy-four women with local or systemic symptoms related to silicone implants underwent breast US. Of these, 28 underwent surgical removal of the implants. RESULTS: Of 57 implants removed, 37 were intact. The most reliable sign of an intact implant was an anechoic interior, although reverberation artifact and radical folds could be seen. Of 20 ruptured implants, 16 were intracapsular and four were extracapsular ruptures. The most reliable US sign of rupture was echogenic, horizontal ("stepladder") lines (14 of 20 ruptures). Two of the four extracapsular ruptures were accurately identified as echogenic nodules outside the implant; two were false-negative findings. Three intracapsular ruptures identified at US were false-positive; six were false-negative. Overall sensitivity for rupture was 70%, specificity was 92%, positive predictive value was 82%, and negative...

Silicone breast implants: US evaluation.

With the current controversy regarding the safety of silicone implants, the detection and evaluation of implant rupture are causing concern for both plastic surgeons and patients. Our study obtained comparative value analysis of mammography, sonography, and magnetic resonance imaging (MRI) in the detection of silicone implant rupture. Twenty-nine symptomatic patients (total of 59 silicone implants) were entered into the study. Intraoperative findings revealed 21 ruptured implants (36 percent). During physical examination, a positive "squeeze test" was highly suggestive of implant rupture. Mammograms were obtained of 51 implants (sensitivity 11 percent, specificity 89 percent). Sonography was performed on 57 implants (sensitivity 70 percent, specificity 92 percent). MRI was performed on 55 implants (sensitivity 81 percent, specificity 92 percent). Sonographically, implant rupture is demonstrated by the "stepladder sign." Double-lumen implants may appear as false-positive results for rupture on sonography. On MRI, the "linguine sign" represents disrupted fragments of a ruptured implant. The most reliable imaging modality for implant rupture detection is MRI, followed by sonogram. Mammogram is the least reliable. Our study supports the clinical indication and diagnostic value of sonogram and MRI in the evaluation of symptomatic breast implant patients.

D P Gorczyca

Papers

Multifeature analysis of Gd-enhanced MR images of breast lesions.

Silicone breast implants in vivo: MR imaging.

The Diagnosis of Silicone Breast Implant Rupture

Silicone breast implants: US evaluation.

Comparative silicone breast implant evaluation using mammography, sonography, and magnetic resonance imaging: experience with 59 implants.