Photoacoustic mammography: initial clinical results.

[Purpose]Photoacoustic tomography can image the hemoglobin distribution and oxygenation state inside tissue with high spatial resolution. The purpose of this study is to investigate its clinical usefulness for diagnosis of breast cancer and evaluation of therapeutic response in relation to other diagnostic modalities. [Materials and methods]Using a prototype machine for photoacoustic mammography (PAM), 27 breast tumor lesions, including 21 invasive breast cancer (IBC), five ductal carcinoma in situ (DCIS), and one phyllodes tumor, were measured. Nine out of twenty-one IBC patients had received primary systemic therapy (PST). [Results]Eight out of twelve IBC without PST were visible. Notably, detection was possible in all five cases with DCIS, whereas it was not in one case with phyllodes tumor. Seven out of nine IBC with PST were assigned as visible in spite of decreased size of tumor after PST. The mean value of hemoglobin saturation in the visible lesions was 78.6 %, and hemoglobin concentration was 207 μM. The tumor images of PAM were comparable to those of magnetic resonance imaging (MRI). [Conclusions]It is suggested that PAM can image tumor vascularity and oxygenation, which may be useful for diagnosis and characterization of breast cancer

良性および悪性炎症性乳房疾患の鑑別：T2強調、拡散強調MR画像の価値

京都大学0048新制・論文博士博士(医学)乙第13218号論医博第2165号新制||医||1033(附属図書館)京都大学大学院医学研究科内科系専攻(主査)教授 溝脇 尚志, 教授 黒田 知宏, 教授 鈴木 実学位規則第4条第2項該当Doctor of Medical ScienceKyoto UniversityDFA

The role of breast tomosynthesis in a predominantly dense breast population at a tertiary breast centre : breast density assessment and diagnostic performance in comparison with MRI

Objectives: To compare breast density measured on digital breast tomosynthesis (DBT) (BI-RADS-based breast composition and fully-automatic estimation) and magnetic resonance imaging (MRI) (BI-RADS amount of fibroglandular tissue), and to evaluate the diagnostic performance in terms of sensitivity and specificity of DBT and MRI in a predominantly dense breast population. Methods: Between 2015 and 2016, 152 women with 103 breast malignancies, who underwent 3-T breast MRI and DBT within 2 months’ time, were enrolled in this study. Breast composition/fibroglandular tissue and findings on DBT (two readers) and MRI were reported using BI-RADS 5th edition. Digital mammography images were analysed for breast percent density (PD) using the Libra software tool. Results: A majority of women had dense breasts as categorised by breast composition c (heterogeneously dense) (68%) and d (extremely dense) (15%). The mean PD was 44% (range, 18-89%) and the correlation between breast composition and PD was r = 0.6. The diagnostic performance of MRI was significantly higher compared to DBT for one reader as described by the area under the receiver operating characteristic (ROC) curve (p = 0.004) and of borderline significance for the other reader (p = 0.052). Conclusions: MRI had higher diagnostic performance than DBT in a dense breast population in the tertiary setting. Key Points: • MRI had higher diagnostic performance than DBT in a dense breast population• Diagnostic performance of DBT was comparable to MRI in women with fatty breasts• MRI was superior to DBT in preoperative breast cancer size assessmen