Stereotactic large-core needle breast biopsy: analysis of pain and discomfort related to the biopsy procedure

The purpose of this study was to determine the significance of variables such as duration of the procedure, type of breast tissue, number of passes, depth of the biopsies, underlying pathology, the operator performing the procedure, and their effect on women’s perception of pain and discomfort during stereotactic large-core needle breast biopsy. One hundred and fifty consecutive patients with a non-palpable suspicious mammographic lesions were included. Between three and nine 14-gauge breast passes were taken using a prone stereotactic table. Following the biopsy procedure, patients were asked to complete a questionnaire. There was no discomfort in lying on the prone table. There is no relation between type of breast lesion and pain, underlying pathology and pain and performing operator and pain. The type of breast tissue is correlated with pain experienced from biopsy (P = 0.0001). We found out that patients with dense breast tissue complain of more pain from biopsy than patients with more involution of breast tissue. The depth of the biopsy correlates with pain from biopsy (P = 0.0028). Deep lesions are more painful than superficial ones. There is a correlation between the number of passes and pain in the neck (P = 0.0188) and shoulder (P = 0.0366). The duration of the procedure is correlated with pain experienced in the neck (P = 0.0116) but not with pain experienced from biopsy

A novel image enhancement methodology for full field digital mammography

During breast screening it is necessary and essential to compress the breast with a compression paddle, in order to obtain a clear mammographic image. The quality of the image has a direct correlation with the accuracy of mammogram reading, which in turn could affect radiologist’s interpretation. Clinical observation has indicated that breast compression may have a side effect on image quality during the image acquisition and can result in unexpected variations in texture and intensity appearances, between breast tissue near the skinline and the rest of the breast. Within computer aided mammography, such variations increase the difficulty in breast tissue modelling and can be detrimental to image analysis, leading to incorrect prompts which can have an impact on sensitivity and specificity of screening mammography. We present an automatic image enhancement approach, in which both Cranio Caudal and Medio-Lateral Oblique views are utilised. We estimate the relative breast thickness ratio at a given projection location in order to alter/correct an inconsistent intensity distribution as a means of improving mammographic image quality. Our dataset consists of 360 full field digital mammographic images was used in a quantitative and qualitative evaluation. Visual assessment indicated good and consistent intensity variation over the processed images, whilst texture information (breast parenchymal patterns) was preserved and/or enhanced. By improving the consistency of the intensity distribution on the mammographic images, the developed method has demonstrated a potential benefit in density based mammographic segmentation and risk assessment. This in turn can be found useful in computer aided mammography, and is beneficial in a clinical setting by aiding screening radiologists in the process of decision making

A Nonrigid Registration of MR Breast Images Using Complex-valued Wavelet Transform

In this paper, a fast, slice-by-slice, nonrigid registration algorithm of dynamic magnetic resonance breast images is presented. The method is based on a multiresolution motion estimation of the breast using complex discrete wavelet transform (CDWT): the pyramid of oriented complex subimages is used to implement a hierarchical phase-matching-based motion estimation algorithm. The resulting motion estimate is nonrigid and pixel-independent. To assess the method performance, we computed the correlation coefficient and the normalized mutual information between pre- and postcontrast images with and without realignment. The indices increased after using our approach and the improvement was superior to rigid or affine registration. A set of clinical scores was also evaluated. The clinical validation demonstrated an increased readability in the subtraction images. In particular, CDWT registration allowed a best definition of breast and lesion borders and greater detail detectability