238 research outputs found
Biopsja mammotomiczna w diagnostyce niepalpacyjnych zmian patologicznych piersi
Background: The aim of the study was to determine the effectiveness of mammotome biopsy (MB) in detecting preclinical breast pathologies. Material/Methods: The material consisted of 847 women, of whom, based on mammography and ultrasound, 349 patients were referred to have stereotactic mammotome biopsy (SMB) guided by digital mammography and 498 women were subjected to hand-held mammotome biopsy (HHMB) guided by US. Results: Ultimately, MB was done in 819 women. In all cases where breast carcinoma or atypical ductal hyperplasia (ADH) were detected, the patients were operated on and postoperative histopathology was treated as the reference for post-biopsy histopathology. Patients in whom post-MB histopathology detected benign lesions were subjected to a strict long-term follow-up using imaging studies. Ultimately, thanks to MB, 94 cases of breast cancer (12%) were detected as well as 725 (88%) cases of benign lesions, which corresponds to a sensitivity of 98.9% and 100% specificity. Conclusions: MB is an alternative to surgical biopsy in differentiating preclinical breast lesions. It is associated with a minimal risk of complications and may be successfully performed in an outpatient setting
Ultrasound Imaging
Ultrasound Imaging - Current Topics presents complex and current topics in ultrasound imaging in a simplified format. It is easy to read and exemplifies the range of experiences of each contributing author. Chapters address such topics as anatomy and dimensional variations, pediatric gastrointestinal emergencies, musculoskeletal and nerve imaging as well as molecular sonography. The book is a useful resource for researchers, students, clinicians, and sonographers looking for additional information on ultrasound imaging beyond the basics
Augmented reality-assisted ultrasound breast biopsy
Breast cancer is the most prevalent cancer in the world and the fifth-leading cause of cancer-related death. Treatment is effective in the early stages. Thus, a need to screen considerable portions of the population is crucial. When the screening procedure uncovers a suspect lesion, a biopsy is performed to assess its potential for malignancy. This procedure is usually performed using real-time Ultrasound (US) imaging. This work proposes a visualization system for US breast biopsy. It consists of an application running on AR glasses that interact with a computer application. The AR glasses track the position of QR codes mounted on an US probe and a biopsy needle. US images are shown in the user’s field of view with enhanced lesion visualization and needle trajectory. To validate the system, latency of the transmission of US images was evaluated. Usability assessment compared our proposed prototype with a traditional approach with different users. It showed that needle alignment was more precise, with 92.67 ± 2.32° in our prototype versus 89.99 ± 37.49° in a traditional system. The users also reached the lesion more accurately. Overall, the proposed solution presents promising results, and the use of AR glasses as a tracking and visualization device exhibited good performance.This work was funded by the projects “NORTE-01-0145-FEDER-000045” and “NORTE-01-
0145-FEDER-000059", supported by Northern Portugal Regional Operational Programme (NORTE
2020), under the Portugal 2020 Partnership Agreement, through the European Regional Development
Fund (FEDER). It was also funded by national funds, through the FCT (Fundação para a Ciência e
a Tecnologia) and FCT/MCTES in the scope of the project UIDB/05549/2020, UIDP/05549/2020
and LASI-LA/P/0104/2020. The authors also acknowledge FCT, Portugal and the European Social
Found, European Union, for funding support through the “Programa Operacional Capital Humano”
(POCH) in the scope of the PhD grants SFRH/BD/136721/2018 (Oliveira B.) and SFRH/BD/136670
(Torres H. R.)
Focal Spot, Spring 1989
https://digitalcommons.wustl.edu/focal_spot_archives/1051/thumbnail.jp
Diagnostic value of fine-needle aspiration biopsy for breast mass: a systematic review and meta-analysis
<p>Abstract</p> <p>Background</p> <p>Fine-needle aspiration biopsy (FNAB) of the breast is a minimally invasive yet maximally diagnostic method. However, the clinical use of FNAB has been questioned. The purpose of our study was to establish the overall value of FNAC in the diagnosis of breast lesions.</p> <p>Methods</p> <p>After a review and quality assessment of 46 studies, sensitivity, specificity and other measures of accuracy of FNAB for evaluating breast lesions were pooled using random-effects models. Summary receiver operating characteristic curves were used to summarize overall accuracy. The sensitivity and specificity for the studies data (included unsatisfactory samples) and underestimation rate of unsatisfactory samples were also calculated.</p> <p>Results</p> <p>The summary estimates for FNAB in diagnosis of breast carcinoma were as follows (unsatisfactory samples was temporarily exluded): sensitivity, 0.927 (95% confidence interval [CI], 0.921 to 0.933); specificity, 0.948 (95% CI, 0.943 to 0.952); positive likelihood ratio, 25.72 (95% CI, 17.35 to 28.13); negative likelihood ratio, 0.08 (95% CI, 0.06 to 0.11); diagnostic odds ratio, 429.73 (95% CI, 241.75 to 763.87); The pooled sensitivity and specificity for 11 studies, which reported unsatisfactory samples (unsatisfactory samples was considered to be positive in this classification) were 0.920 (95% CI, 0.906 to 0.933) and 0.768 (95% CI, 0.751 to 0.784) respectively. The pooled proportion of unsatisfactory samples that were subsequently upgraded to various grade cancers was 27.5% (95% CI, 0.221 to 0.296).</p> <p>Conclusions</p> <p>FNAB is an accurate biopsy for evaluating breast malignancy if rigorous criteria are used. With regard to unsatisfactory samples, futher invasive procedures are required in order to minimize the chance of a missed diagnosis of breast cancer.</p
Modular framework for a breast biopsy smart navigation system
Dissertação de mestrado em Informatics EngineeringBreast cancer is currently one of the most commonly diagnosed cancers and the fifth leading cause of
cancer-related deaths. Its treatment has a higher survivorship rate when diagnosed in the disease’s early
stages. The screening procedure uses medical imaging techniques, such as mammography or ultrasound,
to discover possible lesions. When a physician finds a lesion that is likely to be malignant, a biopsy
is performed to obtain a sample and determine its characteristics. Currently, real-time ultrasound is the
preferred medical imaging modality to perform this procedure. The breast biopsy procedure is highly reliant
on the operator’s skill and experience, due to the difficulty in interpreting ultrasound images and correctly
aiming the needle. Robotic solutions, and the usage of automatic lesion segmentation in ultrasound
imaging along with advanced visualization techniques, such as augmented reality, can potentially make
this process simpler, safer, and faster.
The OncoNavigator project, in which this dissertation integrates, aims to improve the precision of
the current breast cancer interventions. To accomplish this objective various medical training and robotic
biopsy aid were developed. An augmented reality ultrasound training solution was created and the device’s
tracking capabilities were validated by comparing it with an electromagnetic tracking device. Another
solution for ultrasound-guided breast biopsy assisted with augmented reality was developed. This solution
displays real-time ultrasound video, automatic lesion segmentation, and biopsy needle trajectory display
in the user’s field of view. The validation of this solution was made by comparing its usability with the
traditional procedure. A modular software framework was also developed that focuses on the integration
of a collaborative medical robot with real-time ultrasound imaging and automatic lesion segmentation.
Overall, the developed solutions offered good results. The augmented reality glasses tracking capabilities
proved to be as capable as the electromagnetic system, and the augmented reality assisted breast biopsy
proved to make the procedure more accurate and precise than the traditional system.O cancro da mama é, atualmente, um dos tipos de cancro mais comuns a serem diagnosticados e a
quinta principal causa de mortes relacionadas ao cancro. O seu tratamento tem maior taxa de sobrevivência
quando é diagnosticado nas fases iniciais da doença. O procedimento de triagem utiliza técnicas
de imagem médica, como mamografia ou ultrassom, para descobrir possíveis lesões. Quando um médico
encontra uma lesão com probabilidade de ser maligna, é realizada uma biópsia para obter uma amostra
e determinar as suas características. O ultrassom em tempo real é a modalidade de imagem médica
preferida para realizar esse procedimento. A biópsia mamária depende da habilidade e experiência do
operador, devido à dificuldade de interpretação das imagens ultrassonográficas e ao direcionamento correto
da agulha. Soluções robóticas, com o uso de segmentação automática de lesões em imagens de
ultrassom, juntamente com técnicas avançadas de visualização, nomeadamente realidade aumentada,
podem tornar esse processo mais simples, seguro e rápido.
O projeto OncoNavigator, que esta dissertação integra, visa melhorar a precisão das atuais intervenções
ao cancro da mama. Para atingir este objetivo, vários ajudas para treino médico e auxílio à biópsia
por meio robótico foram desenvolvidas. Uma solução de treino de ultrassom com realidade aumentada
foi criada e os recursos de rastreio do dispositivo foram validados comparando-os com um dispositivo
eletromagnético. Outra solução para biópsia de mama guiada por ultrassom assistida com realidade aumentada
foi desenvolvida. Esta solução exibe vídeo de ultrassom em tempo real, segmentação automática
de lesões e exibição da trajetória da agulha de biópsia no campo de visão do utilizador. A validação desta
solução foi feita comparando a sua usabilidade com o procedimento tradicional. Também foi desenvolvida
uma estrutura de software modular que se concentra na integração de um robô médico colaborativo com
imagens de ultrassom em tempo real e segmentação automática de lesões. Os recursos de rastreio dos
óculos de realidade aumentada mostraram-se tão capazes quanto o sistema eletromagnético, e a biópsia
de mama assistida por realidade aumentada provou tornar o procedimento mais exato e preciso do que
o sistema tradicional
Ultrasound-guided breast-sparing surgery to improve cosmetic outcomes and quality of life. A prospective multicentre randomised controlled clinical trial comparing ultrasound-guided surgery to traditional palpation-guided surgery (COBALT trial)
<p>Abstract</p> <p>Background</p> <p>Breast-conserving surgery for breast cancer was developed as a method to preserve healthy breast tissue, thereby improving cosmetic outcomes. Thus far, the primary aim of breast-conserving surgery has been the achievement of tumour-free resection margins and prevention of local recurrence, whereas the cosmetic outcome has been considered less important. Large studies have reported poor cosmetic outcomes in 20-40% of patients after breast-conserving surgery, with the volume of the resected breast tissue being the major determinant. There is clear evidence for the efficacy of ultrasonography in the resection of nonpalpable tumours. Surgical resection of palpable breast cancer is performed with guidance by intra-operative palpation. These palpation-guided excisions often result in an unnecessarily wide resection of adjacent healthy breast tissue, while the rate of tumour-involved resection margins is still high. It is hypothesised that the use of intra-operative ultrasonography in the excision of palpable breast cancer will improve the ability to spare healthy breast tissue while maintaining or even improving the oncological margin status. The aim of this study is to compare ultrasound-guided surgery for palpable tumours with the standard palpation-guided surgery in terms of the extent of healthy breast tissue resection, the percentage of tumour-free margins, cosmetic outcomes and quality of life.</p> <p>Methods/design</p> <p>In this prospective multicentre randomised controlled clinical trial, 120 women who have been diagnosed with palpable early-stage (T1-2N0-1) primary invasive breast cancer and deemed suitable for breast-conserving surgery will be randomised between ultrasound-guided surgery and palpation-guided surgery. With this sample size, an expected 20% reduction of resected breast tissue and an 18% difference in tumour-free margins can be detected with a power of 80%. Secondary endpoints include cosmetic outcomes and quality of life. The rationale, study design and planned analyses are described.</p> <p>Conclusion</p> <p>The COBALT trial is a prospective, multicentre, randomised controlled study to assess the efficacy of ultrasound-guided breast-conserving surgery in patients with palpable early-stage primary invasive breast cancer in terms of the sparing of breast tissue, oncological margin status, cosmetic outcomes and quality of life.</p> <p>Trial Registration Number</p> <p>Netherlands Trial Register (NTR): <a href="http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2579">NTR2579</a></p
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