Unenhanced breast magnetic resonance imaging: detection of breast cancer.

Abstract. – OBJECTIVE: To evaluate the diagnostic performance of unenhanced MRI (UEMRI) for malignant breast lesions and its reproducibility. PATIENTS AND METHODS: We retrospectively included 118 patients who had breast MRI. DWI and STIR images were read in combination and referred to as UE-MRI; the presence or absence of the malignant lesion was noted by two observers. Their results were compared with those of final histopathology or with a two-year negative follow-up for diagnostic performance assessment; ROC curves were built. Diagnostic performance was stratified according to lesion site and size. Interobserver agreement was evaluated through the Cohen’s k statistic. RESULTS: Specificity of STIR and DWI was 99.3% and 95.7% for Reader 1; 99.3% and 96.4% for Reader 2. Sensitivity was 76.5% and 76.5% for Reader 1; 77.5% and 77.6% for Reader 2. The ROC AUC (Reader 1) was 0.869 and 0.844 for STIR and DWI, respectively (p<0.001 both); for Reader 2, values were 0.874 and 0.853 respectively (p<0.001 both). Lesion dimension ≤10 mm was associated with lower AUC values. Lesion site didn’t influence the diagnostic performance. Interobserver agreement was very good for STIR and DWI (k=0.887, p <0.001, and k=0.867, p <0.001). DISCUSSION: UE-MRI has a good overall diagnostic performance in the detection of breast cancer and a very good specificity for both STIR and DWI sequences. We observed reduced diagnostic performance for lesions ≤10 mm in size. Lesion’s site isn’t associated with a significantly decreased diagnostic performance of UE-MRI. There’s a good interobserver agreement for both sequences (STIR and DWI). CONCLUSIONS: UE-MRI may be employed in patients with contraindication to gadolinium. It has considerable specificity and positive predictive value and good reproducibility

Sensitivity of breast MRI for ductal carcinoma in situ appearing as microcalcifications only on mammography

Purpose This study aims to investigate sensitivity of breast magnetic resonance imaging (MRI) for mammographic microcalcifications-only ductal carcinoma in situ (DCIS), based on its histopathology and mammographic extent of microcalcifications. Methods Mammograms were reviewed to measure the extent of microcalcifications. Sensitivity of MRI was calculated in the overall study population and in groups differing for DCIS nuclear grade, microinvasivity, and microcalcifications' extent. Results Overall sensitivity of MRI was 78.3% for dynamic contrast enhanced and 66.7% for diffusion-weighted imaging and did not vary with nuclear grade and microinvasivity, while it increased with larger extent of microcalcifications (ExpB=1.063\u20131.046, P=.037\u2013.013). Conclusions Mammographic extent of microcalcifications positively affects sensitivity of breast MRI

Can Breast Cancer Biopsy Influence Sentinel Lymph Node Status?

Micro-Abstract Breast cancer has a high risk of dissemination during biopsy. Tumor cell displacement rates to the needle tract and sentinel lymph node metastasis rates have previously been reported for different biopsy techniques. We evaluated the effect of preoperative ultrasound-guided core needle biopsy performed with different needle sizes on the rate of sentinel lymph node metastases in patients with breast cancer

Environmental factors influencing deposition and preservation of laminated sediments in Edisto Inlet, western Ross Sea (Antarctica)

Laminated diatomaceous deposits have been documented in some regions of Antarctica, including the Antarctic Peninsula and the Ross Sea. In general, very high sedimentation rates can overwhelm limited bioturbation, thus favoring the varve preservation, for example, in certain glacio-marine environments. The laminated sediments collected in the Edisto Inlet, western Ross Sea, exhibited well-defined dark and light laminae on a mm- to cm-scale. Dark laminae contained relatively high concentrations of a biomarker for fast ice, IPSO25, while low IPSO25 concentrations characterized the light laminae, and the diatom Corethron pennatum became the dominant species. Based on these assumptions, the dynamics of fast ice was reconstructed over the last 2.6 ka for the western Ross Sea. However, the absence of direct observations leaves the paleoclimatic and paleoceanographic interpretation of these laminated sediments with a certain degree of uncertainty. The project LASAGNE (Laminated Sediments in the Magnificent Edisto Inlet, Victoria Land: What processes control their deposition and preservation?), funded by the Italian Program of Antarctic Research (PNRA), proposes a multidisciplinary study that integrates the characteristics of fast ice, water column, and surface sediment, aiming to obtain information on the factors influencing both formation and preservation of laminated sediment in Edisto Inlet. The project integrates also biological data (phytoplankton, microzooplankton and foraminifera) collected in situ, and time series of satellite images of sea ice. The main goal is to provide new insights into the sub-seasonal formation of laminated sediments, offering a backbone for the interpretation of paleoclimatic sedimentary archives. Here, we present the results obtained from a comprehensive dataset collected in Edisto Inlet during the XXXVIII Italian PNRA expedition conducted on board the I/B Laura Bassi in February 2023. Collected data include CTD (Conductivity-Temperature-Depth) profiles with additional parameters (Dissolved Oxygen, fluorescence, turbidity) spatially distributed within and at the entrance of the bay, which was still partially covered by seasonal sea ice at the time of the cruise. Additionally, vessel-mounted and lowered ADCPs (Acoustic Doppler Current Profilers) were collected along transects and at each CTD station, respectively. The synoptic survey conducted during the austral Antarctic summer is used to describe the distribution of water masses and current dynamics in the bay, primarily driven by sea ice formation and melting, as well as atmospheric and tidal forcing. Time series obtained from a mooring deployed 1-year before the cruise (data covers the period February 2022 - February 2024) provide thermohaline variability of the water column even during the winter season, and fluxes and composition of organic debris sinking in the water column through time-series sediment trap samples. Sea ice cores, short sediment cores, and water samples are used to gain insight into the phytoplankton and microzooplankton living in platelet ice in spring and in open water in summer, respectively. Early diagenesis has also been taken into account to define how the original signal is preserved in the sedimentary record

Mammographic and Ultrasonographic Findings of Oxidized Regenerated Cellulose in Breast Cancer Surgery: A 5-Year Experience

The purpose of this study was to describe the ultrasonographic (US) and mammographic (MX) findings in patients who underwent breast-conserving surgery followed by oxidized regenerated cellulose (ORC) implantation in the surgical cavity and their size variations in follow-up

Magnetic resonance imaging appearance of oxidized regenerated cellulose in breast cancer surgery

Purpose: To describe magnetic resonance imaging (MRI) findings in patients who underwent breast-conserving surgery followed by oxidized regenerated cellulose (ORC) implantation in surgical cavity. Materials and methods: We retrospectively reviewed 51 MRI examinations performed between January 2009 and January 2014 in 51 patients who underwent BCS with ORC implantation. Results: In 29/51 (57 %) cases, MRIs showed abnormal findings with three main MRI patterns: (1) complex masses: hyperintense collections on T2-weighted (w) images with internal round hypointense nodules without contrast enhancement (55 %); (2) completely hyperintense collections (17 %); and (3) completely hypointense lesions (28 %). All lesions showed rim enhancement on T1w images obtained in the late phase of the dynamic study with a type 1 curve. Diffusion-weighted imaging was negative in all MRIs and, in particular, 22/29 (76 %) lesions were hyperintense but showing ADC values >1.4 × 10−3mm2/s, while the remaining 7/29 (24 %) lesions were hypointense. In four cases, linear non-mass-like enhancement was detected at the periphery of surgical cavity; these patients were addressed to a short-term follow-up, and the subsequent examinations showed the resolution of these findings. Conclusion: When applied to surgical residual cavity, ORC can lead alterations in surgical scar. This could induce radiologists to misinterpret ultrasonographic and mammographic findings, addressing patients to MRI or biopsy; so knowledge of MRI specific features of ORC, it is essential to avoid misdiagnosis of recurrence