Correlation between mammographic density and volumetric fibroglandular tissue estimated on breast MR images

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/134976/1/mp8512.pd

Can high-frequency ultrasound predict metastatic lymph nodes in patients with invasive breast cancer?

Aim To determine whether high-frequency ultrasound can predict the presence of metastatic axillary lymph nodes, with a high specificity and positive predictive value, in patients with invasive breast cancer. The clinical aim is to identify patients with axillary disease requiring surgery who would not normally, on clinical grounds, have an axillary dissection, so potentially improving outcome and survival rates. Materials and methods The ipsilateral and contralateral axillae of 42 consecutive patients with invasive breast cancer were scanned prior to treatment using a B-mode frequency of 13 MHz and a Power Doppler frequency of 7 MHz. The presence or absence of an echogenic centre for each lymph node detected was recorded, and measurements were also taken to determine the L/S ratio and the widest and narrowest part of the cortex. Power Doppler was also used to determine vascularity. The contralateral axilla was used as a control for each patient. Results In this study of patients with invasive breast cancer, ipsilateral lymph nodes with a cortical bulge ≥3 mm and/or at least two lymph nodes with absent echogenic centres indicated the presence of metastatic axillary lymph nodes (10 patients). The sensitivity and specificity were 52.6% and 100%, respectively, positive and negative predictive values were 100% and 71.9%, respectively, the P value was 0.001 and the Kappa score was 0.55.\ud Conclusion This would indicate that high-frequency ultrasound can be used to accurately predict metastatic lymph nodes in a proportion of patients with invasive breast cancer, which may alter patient management

Automated registration of breast lesions in temporal pairs of mammograms for interval change analysisâ local affine transformation for improved localization

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/134991/1/mp6134.pd

Computerized image analysis: Estimation of breast density on mammograms

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/134888/1/mp6640.pd

Development of an automated detection algorithm for patient motion blur in digital mammograms

The purpose is to develop and validate an automated method for detecting image unsharpness caused by patient motion blur in digital mammograms. The goal is that such a tool would facilitate immediate re-taking of blurred images, which has the potential to reduce the number of recalled examinations, and to ensure that sharp, high-quality mammograms are presented for reading. To meet this goal, an automated method was developed based on interpretation of the normalized image Wiener Spectrum. A preliminary algorithm was developed using 25 cases acquired using a single vendor system, read by two expert readers identifying the presence of blur, location, and severity. A predictive blur severity score was established using multivariate modeling, which had an adjusted coefficient of determination, R2 =0.63±0.02, for linear regression against the average reader-scored blur severity. A heatmap of the relative blur magnitude showed good correspondence with reader sketches of blur location, with a Spearman rank correlation of 0.70 between the algorithmestimated area fraction with blur and the maximum of the blur area fraction categories of the two readers. Given these promising results, the algorithm-estimated blur severity score and heatmap are proposed to be used to aid observer interpretation. The use of this automated blur analysis approach, ideally with feedback during an exam, could lead to a reduction in repeat appointments for technical reasons, saving time, cost, potential anxiety, and improving image quality for accurate diagnosis.</p

Design and Characterization of a High-resolution Cardiovascular Imager

Fluoroscopic imaging devices for interventional radiology and cardiovascular applications have traditionally used image-intensifiers optically coupled to either charge-coupled devices (CCDs) or video pick-up tubes. While such devices provide image quality sufficient for most clinical applications, there are several limitations, such as loss of resolution in the fringes of the image-intensifier, veiling glare and associated contrast loss, distortion, size, and degradation with time. This work is aimed at overcoming these limitations posed by image-intensifiers, while improving on the image quality. System design parameters related to the development of a high-resolution CCD-based imager are presented. The proposed system uses four 8 x 8-cm three-side buttable CCDs tiled in a seamless fashion to achieve a field of view (FOV) of 16 x 16-cm. Larger FOVs can be achieved by tiling more CCDs in a similar manner. The system employs a thallium-doped cesium iodide (CsI:Tl) scintillator coupled to the CCDs by straight (non-tapering) fiberoptics and can be operated in 78, 156 or 234-microns pixel pitch modes. Design parameters such as quantum efficiency and scintillation yield of CsI:Tl, optical coupling efficiency and estimation of the thickness of fiberoptics to provide reasonable protection to the CCD, linearity, sensitivity, dynamic range, noise characteristics of the CCD, techniques for tiling the CCDs in a seamless fashion, and extending the field of view are addressed. The signal and noise propagation in the imager was modeled as a cascade of linear-systems and used to predict objective image quality parameters such as the spatial frequency-dependent modulation transfer function (MTF), noise power spectrum (NPS) and detective quantum efficiency (DQE). The theoretical predictions were compared with experimental measurements of the MTF, NPS and DQE of a single 8 x 8-cm module coupled to a 450-microns thick CsI:Tl at x-ray beam quality appropriate for cardiovascular fluoroscopy. The measured limiting spatial resolution (10% MTF) was 3.9 cy/mm and 3.6 cy/mm along the two orthogonal axes. The measured DQE(0) was ~0.62 and showed no dependence with incident exposure rate over the range of measurement. The experimental DQE measurements demonstrated good agreement with the theoretical estimate obtained using the parallel-cascaded linear-systems model. The temporal imaging properties were characterized in terms of image lag and showed a first frame image lag of 0.9%. The imager demonstrated the ability to provide images of high and uniform spatial resolution, while preserving and potentially improving on DQE performance at dose levels lower than that currently used in clinical practice. These results provide strong support for potential adaptation of this type of imager for cardiovascular and pediatric angiography

Evaluation of the current knowledge limitations in breast cancer research: a gap analysis

BACKGROUND A gap analysis was conducted to determine which areas of breast cancer research, if targeted by researchers and funding bodies, could produce the greatest impact on patients. METHODS Fifty-six Breast Cancer Campaign grant holders and prominent UK breast cancer researchers participated in a gap analysis of current breast cancer research. Before, during and following the meeting, groups in seven key research areas participated in cycles of presentation, literature review and discussion. Summary papers were prepared by each group and collated into this position paper highlighting the research gaps, with recommendations for action. RESULTS Gaps were identified in all seven themes. General barriers to progress were lack of financial and practical resources, and poor collaboration between disciplines. Critical gaps in each theme included: (1) genetics (knowledge of genetic changes, their effects and interactions); (2) initiation of breast cancer (how developmental signalling pathways cause ductal elongation and branching at the cellular level and influence stem cell dynamics, and how their disruption initiates tumour formation); (3) progression of breast cancer (deciphering the intracellular and extracellular regulators of early progression, tumour growth, angiogenesis and metastasis); (4) therapies and targets (understanding who develops advanced disease); (5) disease markers (incorporating intelligent trial design into all studies to ensure new treatments are tested in patient groups stratified using biomarkers); (6) prevention (strategies to prevent oestrogen-receptor negative tumours and the long-term effects of chemoprevention for oestrogen-receptor positive tumours); (7) psychosocial aspects of cancer (the use of appropriate psychosocial interventions, and the personal impact of all stages of the disease among patients from a range of ethnic and demographic backgrounds). CONCLUSION Through recommendations to address these gaps with future research, the long-term benefits to patients will include: better estimation of risk in families with breast cancer and strategies to reduce risk; better prediction of drug response and patient prognosis; improved tailoring of treatments to patient subgroups and development of new therapeutic approaches; earlier initiation of treatment; more effective use of resources for screening populations; and an enhanced experience for people with or at risk of breast cancer and their families. The challenge to funding bodies and researchers in all disciplines is to focus on these gaps and to drive advances in knowledge into improvements in patient care