Monitoring of verotoxigenic Escherichia coli (VTEC) and identification of human pathogenic VTEC types 1 Scientific Opinion of the Panel on Biological Hazards

OBJECTIVE. The purpose of our study was to investigate whether adding diffusion-weighted imaging (DWI) to dynamic contrast-enhanced MRI (DCE-MRI) could improve the positive predictive value (PPV) o...

https://www.ajronline.org/doi/pdf/10.2214/AJR.08.2139

Quantitative Diffusion-Weighted Imaging as an Adjunct to Conventional Breast MRI for Improved Positive Predictive Value

Standardization of b values allows improved interstudy comparisons on the diagnostic accuracy of diffusion-weighted MR breast examinations.

Diffusion-weighted MR for Differentiation of Breast Lesions at 3.0 T: How Does Selection of Diffusion Protocols Affect Diagnosis?

BACKGROUND

Breast carcinoma during pregnancy (BCP) is a difficult clinical situation, as it appears to put the health of the mother in conflict with that of the fetus.



METHODS

An international expert meeting was conducted to form guidelines on how to diagnose and treat women with BCP.



RESULTS

The goal for treatment of the pregnant woman with breast carcinoma is the same as that of the nonpregnant breast carcinoma patient: local control of disease and prevention of systemic metastases. However, certain treatment modalities need to be modified because of the potential for adverse effects on the fetus. There is evidence to support the safety of anthracycline-based chemotherapy during the second and third trimesters of pregnancy (Oxford Level of Evidence [LOE] 2b). Because of the lack of evidence, the expert opinion was not to recommend the routine use of newer cytotoxic drugs like the taxanes during pregnancy (LOE 5).



CONCLUSION

The recommendations provided should help to reach informed decision making by the patient. The ongoing prospective collection of data on BCP, such as that at the University of Texas M.D. Anderson Cancer Center (UTMDACC) and that of the German Breast Group/Breast International Group (GBG/BIG), is necessary to further our knowledge regarding the treatment of this unique group of breast carcinoma patients. Cancer 2006. © 2005 American Cancer Society.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/cncr.21610

Breast carcinoma during pregnancy. International recommendations from an expert meeting.

Adding quantitative diffusion-weighted imaging to the conventional MR imaging protocol resulted in significant diagnostic improvement.

Diffusion-weighted imaging improves the diagnostic accuracy of conventional 3.0-T breast MR imaging

OBJECTIVE We wanted to evaluate the role of diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC) for detecting breast tumors, as compared with the T1- and T2-weighted images. MATERIALS AND METHODS Forty-one female patients underwent breast MRI, and this included the T1-, T2-, DWI and dynamic contrast-enhanced images. Sixty-five enhancing lesions were detected on the dynamic contrast-enhanced images and we used this as a reference image for detecting tumor. Fifty-six breast lesions were detected on DWI and the histological diagnoses were as follows: 43 invasive ductal carcinomas, one mucinous carcinoma, one mixed infiltrative and mucinous carcinoma, seven ductal carcinomas in situ (DCIS), and four benign tumors. First, we compared the detectability of breast lesions on DWI with that of the T1- and T2-weighted images. We then compared the ADCs of the malignant and benign breast lesions to the ADCs of the normal fibroglandular tissue. RESULTS Fifty-six lesions were detected via DWI (detectability of 86.2%). The detectabilities of breast lesions on the T1- and T2-weighted imaging were 61.5% (40/65) and 75.4% (49/65), respectively. The mean ADCs of the invasive ductal carcinoma (0.89+/-0.18 x 10(-3)mm(2)/second) and DCIS (1.17+/-0.18 x 10(-3)mm(2)/ second) are significantly lower than those of the benign lesions (1.41+/-0.56 x 10(-3)mm(2)/second) and the normal fibroglandular tissue (1.51+/-0.29 x 10(-3)mm(2)/ second). CONCLUSION DWI has a high sensitivity for detecting breast tumors, and especially for detecting malignant breast tumors. DWI was an effective imaging technique for detecting breast lesions, as compared to using the T1- and T2-weighted images.

/pdf/the-role-of-diffusion-weighted-imaging-and-the-apparent-3czzqif5di.pdf

The role of diffusion-weighted imaging and the apparent diffusion coefficient (ADC) values for breast tumors.

Purpose

To evaluate the role of diffusion-weighted imaging (DWI) in the detection of breast cancers, and to correlate the apparent diffusion coefficient (ADC) value with prognostic factors.



Materials and Methods

Sixty-seven women with invasive cancer underwent breast MRI. Histological specimens were analyzed for tumor size and grade, and expression of estrogen receptors (ER), progesterone receptors, c-erbB-2, p53, Ki-67, and epidermal growth factor receptors. The computed mean ADC values of breast cancer and normal breast parenchyma were compared. Relationships between the ADC values and prognostic factors were determined using Wilcoxon signed rank test and Kruskal-Wallis test.



Results

DWI detected breast cancer as a hyperintense area in 62 patients (92.5 %). A statistically significant difference in the mean ADC values of breast cancer (1.09 ± 0.27 × 10−5 mm2/s) and normal parenchyma (1.59 ± 0.27 × 10−5 mm2/s) was detected (P < 0.0001). There were no correlations between the ADC value and prognostic factors. However, the median ADC value was lower in the ER-positive group than the ER negative group, and this difference was marginally significant (1.09 × 10−5 mm2/s versus 1.15 × 10−5 mm2/s, P = 0.053).



Conclusion

The ADC value was a helpful parameter in detecting malignant breast tumors, but ADC value could not predict patient prognosis. J. Magn. Reson. Imaging 2009;30:615–620. © 2009 Wiley-Liss, Inc.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/jmri.21884

Diffusion‐weighted imaging of breast cancer: Correlation of the apparent diffusion coefficient value with prognostic factors

Objective. To evaluate the mammographic and sonographic findings of pregnancy-associated breast cancer. Methods. A total of 22 consecutive patients with breast cancer pathologically diagnosed during pregnancy (n = 10) or lactation (n = 12) were included in this study. The ages of the patients ranged from 26 to 49 years. Both mammography and sonography were performed on 12 patients; sonography only was performed on 7 patients; and mammography only was performed on 3 patients. Mammographic and sonographic findings were evaluated retrospectively. Results. Mammography revealed positive findings in 13 (86.7%) of 15 patients, even though all 15 patients had dense breasts.

Pregnancy- and lactation-associated breast cancer: mammographic and sonographic findings.

Objective The purpose of this presentation is to show the sonographic findings of breast masses, which can occur in subcutaneous fat or in the cutaneous layer of the breast. Methods We reviewed the sonographic findings of superficial breast masses, including the epidermal inclusion cyst, steatocystoma multiplex, fat necrosis, accessory breast, Mondor disease, sparganosis, neurofibroma, tuberculosis, mastitis, and breast malignancy. Results Specific sonographic features of superficial breast masses have been illustrated. Conclusions Radiologists must be familiar with the sonographic findings of various diseases involving the superficial layer of the breast to avoid further patient workup.

Spectrum of sonographic findings in superficial breast masses

OBJECTIVE. The purpose of this study was to evaluate the imaging features—including the mammographic, sonographic, MRI, and bone scintigraphic findings—in 12 patients with metaplastic carcinoma with chondroid differentiation of the breast and to correlate the imaging findings with the pathologic features.CONCLUSION. Metaplastic carcinoma with chondroid differentiation of the breast manifests as a palpable mass and should be included in the differential diagnosis of a large indistinct highdensity mass with amorphous or coarse calcifications on mammography and a relatively circumscribed complex echoic mass with posterior enhancement on sonography. A relatively circumscribed mass with a nonenhancing T2 intermediate- to high-signal-intensity internal component on MRI and an area of intense uptake of 99mTc methylene diphosphonate (MDP) on bone scintigraphy might be useful in suggesting the diagnosis of metaplastic carcinoma with chondroid differentiation.

https://www.ajronline.org/doi/pdf/10.2214/AJR.05.0831

Eun Suk Cha

Papers

The role of diffusion-weighted imaging and the apparent diffusion coefficient (ADC) values for breast tumors.

Diffusion‐weighted imaging of breast cancer: Correlation of the apparent diffusion coefficient value with prognostic factors

Pregnancy- and lactation-associated breast cancer: mammographic and sonographic findings.

Spectrum of sonographic findings in superficial breast masses

Imaging Features of Metaplastic Carcinoma with Chondroid Differentiation of the Breast