Journal of Medical Imaging and Radiation Oncology最新文献_第3页

Systematic Review of Intravenous Contrast-Induced Nephropathy and Prophylaxis With Hydration 静脉造影剂肾病及水合预防的系统综述。

IF 1.4 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Oncology

Pub Date : 2025-12-03 DOI: 10.1111/1754-9485.70051

Stephanie Yang Chen, Miriam Scadeng

Despite the extensive body of literature on post-contrast acute kidney injury and prophylaxis, there is ongoing disagreement on the appropriateness of intravenous contrast administration and prophylactic measures in patients with poor renal function. Existing reviews indiscriminately include data from both historical high-osmolar (HOCM) as well as modern low- (LOCM) and iso-osmolar contrast media (IOCM). This systematic review assesses existing literature on contrast-associated kidney injury in adults (defined as individuals over 15 years of age) from intravenous (IV) iodinated LOCM/IOCM for computed tomography (CT) and prophylactic hydration with saline. Studies were searched on PubMed, Medline/Ovid, Cochrane and the University of Auckland Library. Papers were separated into trials and non-trials, with the references of non-trial articles followed until the original trial was identified, and duplicate patient groups were removed. The quality of studies were assessed using the GRADE system. Of 1253 potentially relevant studies, no high quality studies were identified. There were 13 moderate to low quality studies relating to contrast-associated acute kidney injury (CA-AKI), with the remaining assessed as very low quality. Inferences based on the moderate to low quality studies suggest that although contrast-induced acute kidney (CI-AKI) is a real phenomenon, the effect is not of a magnitude that is clinically significant for stable patients irrespective of baseline renal function. There was only a single low quality study for prophylactic IV hydration with saline, with the remaining studies being of very low quality.

尽管有大量关于造影剂后急性肾损伤和预防的文献，但对于肾功能不佳患者静脉注射造影剂和预防措施的适宜性仍存在分歧。现有的综述不加区分地包括来自历史高渗透压造影剂（HOCM）以及现代低渗透压造影剂（LOCM）和等渗透压造影剂（IOCM）的数据。本系统综述评估了成人（定义为15岁以上的个体）通过静脉（IV）碘化LOCM/IOCM进行计算机断层扫描（CT）和预防性生理盐水水化治疗后造影剂相关肾损伤的现有文献。研究在PubMed、Medline/Ovid、Cochrane和奥克兰大学图书馆进行了检索。论文分为试验和非试验，非试验文章的参考文献跟随，直到确定原始试验，并删除重复的患者组。使用GRADE系统评估研究的质量。在1253项可能相关的研究中，没有发现高质量的研究。对比剂相关急性肾损伤（CA-AKI）有13项中等到低质量的研究，其余的被评估为非常低质量。基于中低质量研究的推断表明，尽管造影剂诱导的急性肾脏（CI-AKI）是一种真实的现象，但无论基线肾功能如何，对稳定患者的影响都没有达到临床显著的程度。只有一项低质量的关于预防性静脉注射生理盐水的研究，其余的研究质量都很低。

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引用次数: 0

Viewpoint: Optimising Cancer Treatment to Reduce Its Environmental Impact. 观点：优化癌症治疗以减少其对环境的影响。

IF 1.4 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Oncology

Pub Date : 2025-12-02 DOI: 10.1111/1754-9485.70052

Robert Chuter, Kari Tanderup

It is widely accepted that treatment and care for patients with cancer must and should happen, as it is what everyone would want for themselves and their loved ones. Everyone wants the best possible care, but climate change and the extreme weather that it causes are increasingly affecting everyone including patients in negative ways. To continue giving the best possible cancer care without harming our environment and therefore patients, there is a need to optimise care. Through improving efficiency, reducing travel, using renewable energy and other measures it is possible to limit our environmental impact whilst still giving the best care available. In many cases this creates a win-win-win scenario for patients and the environment and, in many cases, significant cost savings.

人们普遍认为，对癌症患者的治疗和护理必须而且应该发生，因为这是每个人都希望自己和他们所爱的人得到的。每个人都希望尽可能得到最好的护理，但气候变化及其导致的极端天气正日益以负面方式影响包括患者在内的每个人。为了在不损害环境和患者的情况下继续提供最好的癌症治疗，我们需要优化治疗。通过提高效率、减少旅行、使用可再生能源和其他措施，我们有可能在提供最佳护理的同时限制我们对环境的影响。在许多情况下，这为患者和环境创造了一个三赢的局面，在许多情况下，还节省了大量成本。

引用次数: 0

Diagnostic Accuracy and Measurement Variability of Urinary Stones Across CT Window Settings: A Systematic Review and Meta-Analysis 尿路结石在CT窗口设置中的诊断准确性和测量变异性：一项系统回顾和荟萃分析。

IF 1.4 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Oncology

Pub Date : 2025-12-02 DOI: 10.1111/1754-9485.70053

Mamta Panda, Mehak Manzoor, Lalit Kumar Gupta

Objectives

The CT scan plays a vital role in diagnosing and managing urolithiasis. However, variability in CT windowing techniques may alter the measurement of stone dimensions, thus affecting decision-making. This study aims to analyse the diagnostic accuracy and variability of urinary stone measurements with different CT window settings.

Methods

An electronic search was performed in PubMed, Scopus, Web of Science, and the Cochrane Library until July 2025 for studies comparing stone size measurements between standard soft-tissue and bone window settings. Meta-analysis was conducted using a random-effects model.

Results

The findings suggest that stone measurement through bone window settings is more accurate and shows less inter-observer variability than soft-tissue window settings. Smaller slice thickness and multi-planar reformatting further improved accuracy. Bone window settings also showed better consistency in diagnostic judgement, especially for smaller stones relevant to treatment planning such as ureteroscopy or conservative management.

Conclusion

Bone window imaging should be applied when assessing urinary stones using CT as it improves measurement accuracy and reduces variability. However, standardisation of imaging protocols is still required. This review highlights the need for consensus guidelines on CT windowing in urinary stone evaluation to support accurate diagnosis and improved patient management.

目的：CT扫描在尿石症的诊断和治疗中起着重要的作用。然而，CT开窗技术的可变性可能会改变结石尺寸的测量，从而影响决策。本研究旨在分析不同CT窗口设置下尿路结石的诊断准确性和可变性。方法：在PubMed， Scopus， Web of Science和Cochrane Library中进行电子检索，直到2025年7月，以比较标准软组织和骨窗设置之间的结石尺寸测量。采用随机效应模型进行meta分析。结果：研究结果表明，通过骨窗设置测量结石比软组织窗设置更准确，观察者之间的差异更小。更小的切片厚度和多平面重新格式化进一步提高了精度。骨窗设置在诊断判断上也表现出更好的一致性，特别是对于与输尿管镜检查或保守治疗等治疗计划相关的较小结石。结论：CT评估尿路结石时应应用骨窗成像，因为它提高了测量精度并减少了变异。然而，成像方案的标准化仍然是必需的。这篇综述强调了在尿路结石评估中需要有共识的CT窗口指南，以支持准确的诊断和改善患者管理。

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引用次数: 0

Understanding Clinical Decision-Making in Medical Imaging Referrals: A Cross-Sectional Study of Public Health Practices in South Australia 理解医学影像学转诊中的临床决策：南澳大利亚州公共卫生实践的横断面研究。

IF 1.4 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Oncology

Pub Date : 2025-11-27 DOI: 10.1111/1754-9485.70047

Marina Kostopoulos, Marc Agzarian, Kevin James Hickson, Chris Boyd, Kristin Graham, Anson Chau, Saravana Kumar

Objectives

To assess what motivates medical imaging utilisation and to understand what referring clinicians, and those who operationalise these referrals, consider important when making decisions to refer to medical imaging in the South Australia Public Health System.

Design, Setting

Two cross-sectional surveys were purpose-built for online delivery. One was conducted from March–August 2023 for SA Health referring clinicians, and another was conducted from February–July 2023 for South Australia Medical Imaging (SAMI) clinical staff.

Participants

Two cohorts were surveyed: referring clinicians within SA Health (n = 138) and SAMI clinical staff (n = 251), from both metropolitan and regional locations.

Main Outcome Measures

Two customised survey instruments.

Results

A range of factors was reported to influence how clinicians' decisions to request medical imaging, including patient-related, staff-related and system-related factors. Both clinicians and SAMI staff agreed that ‘improving overall patient health’ and ‘reassurance or confirmation of disease absence’ were key motivators for requesting medical imaging. However, notable differences emerged in how other motivations were rated, as well as factors clinicians consider important when referring patients for medical imaging. While a small number of clinicians acknowledged over-requesting, a much larger proportion of SAMI staff perceived over-requesting as a common issue among referring clinicians.

Conclusions

This study is the first to explore the perspectives of South Australian clinicians on the factors that motivate medical imaging requests. It highlights a complex array of drivers influencing referral practices and differing perceptions of overuse between those who refer and those who operationalise those referrals. The findings can inform the development of targeted, evidence-based strategies to optimise medical imaging referrals, improve resource use and enhance healthcare delivery for the South Australian community.

目的：评估医学成像利用的动机，并了解转诊临床医生和那些操作这些转诊的人在决定在南澳大利亚公共卫生系统中转诊医学成像时考虑的重要因素。设计、设置：两个横断面调查是专门为在线交付而设计的。其中一项研究于2023年3月至8月对南澳卫生部的转诊临床医生进行，另一项研究于2023年2月至7月对南澳医学成像（SAMI）临床工作人员进行。参与者：调查了两个队列：来自大都市和地区的SA Health的转诊临床医生（n = 138）和SAMI临床工作人员（n = 251）。主要结果测量：两个定制的调查工具。结果：报告了一系列影响临床医生如何决定要求医学成像的因素，包括与患者相关的、与工作人员相关的和与系统相关的因素。临床医生和SAMI工作人员都同意，“改善病人的整体健康”和“保证或确认疾病的消失”是要求医学成像的关键动机。然而，在评估其他动机方面，以及临床医生在推荐患者进行医学成像时认为重要的因素方面，出现了显著的差异。虽然少数临床医生承认请求过多，但更大比例的SAMI工作人员认为请求过多是转诊临床医生之间的常见问题。结论：本研究首次探讨了南澳大利亚临床医生对激发医学成像要求的因素的观点。它强调了影响转诊做法的一系列复杂驱动因素，以及转诊者和转诊者对过度使用的不同看法。研究结果可以告知有针对性的，以证据为基础的战略的发展，以优化医学影像转诊，改善资源利用和加强医疗保健服务，为南澳大利亚社区。

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引用次数: 0

Rural Urban Differences in Receipt of Radiation Oncology Services for Breast, Prostate and Lung Cancer by Ethnicity in Aotearoa New Zealand 新西兰奥特罗阿地区农村、城市接受乳腺癌、前列腺癌和肺癌放射肿瘤学服务的差异

IF 1.4 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Oncology

Pub Date : 2025-11-26 DOI: 10.1111/1754-9485.70049

Stephen Withington, Gabrielle Davie, Sue Crengle, Melissa James, Benjamin Booker, Brandon de Graaf, Rory Miller, Ross Lawrenson, Garry Nixon

Introduction

Accessing radiation therapy is a challenge for rural cancer patients. This study explored the rates of receiving radiation therapy for rural Māori and non-Māori New Zealanders with breast, prostate or lung cancer compared with their most urban counterparts.

Method

Rates of receipt of radiation therapy per 100,000 population were calculated using radiation treatment data from 2014 to 2020, obtained from the Radiation Oncology Collection and resident population estimates from StatsNZ. Rurality was assigned by the Geographical Classification for Health (GCH).

Results

For females with breast cancer, receipt of radiotherapy was lower for those over 75 living in smaller cities (U2) and for non-Māori aged 45–64 living rurally. For prostate cancer, there was higher receipt of radiotherapy by rurality in those under 65. For lung cancer, radiotherapy rates were higher in rural patients under 65, particularly females and non-Māori, but lower receipt of curative radiotherapy was observed for the most rural (R2/R3) Māori females and males over 75. Irrespective of rurality, Māori receipt of radiotherapy was lower than non-Māori in the youngest age groups for breast and prostate cancer, while Māori aged 45–74 with breast cancer, and Māori females and males with lung cancer in almost all age groups and GCH categories, had higher rates of radiotherapy than their non-Māori counterparts.

Conclusion

This study observed some rural–urban differences in receipt of radiation therapy for the three cancers studied, though with evidence of variability by age group and cancer type, and significant differences between Māori and non-Māori.

导读：获得放射治疗对农村癌症患者来说是一个挑战。这项研究探讨了农村Māori和non-Māori新西兰乳腺癌、前列腺癌或肺癌患者接受放射治疗的比率，并将其与大多数城市患者进行了比较。方法：利用2014年至2020年的放射治疗数据和StatsNZ的常住人口估计值，计算每10万人的放射治疗接受率。农村是根据卫生地理分类（GCH）划分的。结果：对于女性乳腺癌患者，年龄在75岁以上、居住在小城市（U2）和年龄在45-64岁、居住在农村（non-Māori）的女性乳腺癌患者，接受放疗的比例较低。对于前列腺癌，65岁以下的农村居民接受放射治疗的比例较高。对于肺癌，65岁以下农村患者的放疗率较高，尤其是女性和non-Māori，但大多数农村（R2/R3） Māori女性和75岁以上男性的治愈性放疗率较低。无论农村情况如何，Māori年龄最小的乳腺癌和前列腺癌患者的放疗率低于non-Māori，而Māori年龄在45-74岁之间的乳腺癌患者，以及Māori几乎所有年龄组和GCH类别的女性和男性肺癌患者的放疗率都高于non-Māori。结论：本研究观察到三种癌症接受放射治疗的城乡差异，尽管有证据表明不同年龄组和癌症类型存在差异，并且Māori和non-Māori之间存在显著差异。

{"title":"Rural Urban Differences in Receipt of Radiation Oncology Services for Breast, Prostate and Lung Cancer by Ethnicity in Aotearoa New Zealand","authors":"Stephen Withington, Gabrielle Davie, Sue Crengle, Melissa James, Benjamin Booker, Brandon de Graaf, Rory Miller, Ross Lawrenson, Garry Nixon","doi":"10.1111/1754-9485.70049","DOIUrl":"10.1111/1754-9485.70049","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Accessing radiation therapy is a challenge for rural cancer patients. This study explored the rates of receiving radiation therapy for rural Māori and non-Māori New Zealanders with breast, prostate or lung cancer compared with their most urban counterparts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Rates of receipt of radiation therapy per 100,000 population were calculated using radiation treatment data from 2014 to 2020, obtained from the Radiation Oncology Collection and resident population estimates from StatsNZ. Rurality was assigned by the Geographical Classification for Health (GCH).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For females with breast cancer, receipt of radiotherapy was lower for those over 75 living in smaller cities (U2) and for non-Māori aged 45–64 living rurally. For prostate cancer, there was higher receipt of radiotherapy by rurality in those under 65. For lung cancer, radiotherapy rates were higher in rural patients under 65, particularly females and non-Māori, but lower receipt of curative radiotherapy was observed for the most rural (R2/R3) Māori females and males over 75. Irrespective of rurality, Māori receipt of radiotherapy was lower than non-Māori in the youngest age groups for breast and prostate cancer, while Māori aged 45–74 with breast cancer, and Māori females and males with lung cancer in almost all age groups and GCH categories, had higher rates of radiotherapy than their non-Māori counterparts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study observed some rural–urban differences in receipt of radiation therapy for the three cancers studied, though with evidence of variability by age group and cancer type, and significant differences between Māori and non-Māori.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"70 1","pages":"101-112"},"PeriodicalIF":1.4,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145604441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Triple-Phase Dual-Energy CT for Predicting Molecular Subtype in Breast Cancer: An Innovative Approach That Should Be Interpreted With Caution 三期双能CT预测乳腺癌分子亚型：一种应谨慎解读的创新方法。

IF 1.4 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Oncology

Pub Date : 2025-11-25 DOI: 10.1111/1754-9485.70048

Deniz Esin Tekcan Sanli, Ahmet Necati Sanli

引用次数: 0

RANZCR Breast Imaging Group (BIG) General Meeting Abstracts RANZCR乳腺成像组（BIG）大会摘要。

IF 1.4 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Oncology

Pub Date : 2025-11-18 DOI: 10.1111/1754-9485.70041

引用次数: 0

The Ozempic Generation: What the Interventional Radiologist Needs to Know About GLP-1 Agonists 臭氧的一代：介入放射科医生需要了解GLP-1激动剂。

IF 1.4 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Oncology

Pub Date : 2025-11-15 DOI: 10.1111/1754-9485.70045

Suhail Wani, Salam Findakly, Tuan Phan, Matthew W. Lukies, Gerard S. Goh, Georgina Venn, Tim Joseph, Jim Koukounaras, Warren Clements

Glucagon-like peptide 1 receptor (GLP-1) agonists have been traditionally used in the treatment of type II diabetes. However, in recent times they have become a cornerstone in the pharmacological management of weight loss, and their use is increasing rapidly. Interventional Radiologists (IRs) need to understand GLP-1 agonists as they will increasingly encounter patients taking these medications in their daily practice, with implications for quality of care. These drugs have the potential to impact fasting glucose levels and gastric emptying, with implications for peri-procedural management when giving conscious sedation for an IR procedure. There is a need for IRs to adapt to the modern landscape. This review discusses the pharmacological effects, peri-procedural implications, and the need for IR-specific guidance in managing patients taking GLP-1 agonists.

胰高血糖素样肽1受体（GLP-1）激动剂传统上用于治疗II型糖尿病。然而，近年来，它们已成为减肥药理学管理的基石，其使用正在迅速增加。介入放射科医生（IRs）需要了解GLP-1激动剂，因为他们在日常实践中会越来越多地遇到服用这些药物的患者，这对护理质量有影响。这些药物有可能影响空腹血糖水平和胃排空，这对IR手术中给予有意识镇静的围手术期管理有影响。有必要让室内建筑适应现代景观。这篇综述讨论了GLP-1激动剂的药理学作用、围手术期影响，以及在管理服用GLP-1激动剂的患者时需要ir特异性指导。

引用次数: 0

CyberKnife Robotic Radiosurgery System for Treating Large Brain Metastases: A Single-Center Cohort Study 射波刀机器人放射外科系统治疗大面积脑转移：一项单中心队列研究。

IF 1.4 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Oncology

Pub Date : 2025-11-13 DOI: 10.1111/1754-9485.70046

Wen-Sa Peng, Xin Wang, Chao Li, Yun Guan, En-Min Wang, Li Pan, Zhi-Yong Qin, Hua-Guang Zhu

Introduction

This study evaluated local control and overall survival following hypofractionated stereotactic radiosurgery (HF-SRS) using the CyberKnife system for brain metastases ≥ 10 cm³, addressing the challenges of balancing efficacy and toxicity in larger lesions.

Methods

We enrolled patients with 1–4 newly diagnosed brain metastases from lung or breast cancer. The primary endpoint was local control of the treated metastases. The secondary endpoints were overall survival and incidence of radiation necrosis. Survival endpoints were evaluated using the Kaplan–Meier method. A Cox proportional hazards regression model was used to test for significant associations between clinical factors and outcomes.

Results

Between December 2016 and December 2018, 63 patients with 65 large brain metastases were included in this study. Of all the 63 cases, 55 cases were initially treated with HF-SRS; eight had tumour recurrence after gamma knife treatment. The radiosurgical margin dose (median, 30 Gy; range, 25–34 Gy) was prescribed at an isodose curve of 60%–75% (median, 67%) with multiple fractions (median, three fractions; range, 2–4), targeting a median tumour volume of 18.1 cm³ (range, 10.1–39.6 cm³). The median follow-up was 19 months. The local tumour control rates were 100%, 100%, and 92.58% at 6, 12, and 18 months, respectively. The 6-, 12-, and 18-month survival rates were 95.24%, 82.51%, and 68.61%, respectively. The cumulative incidence of radiation necrosis in patients who underwent primary HF-SRS was 7.02% and 14.04% at 1 year and 18 months, respectively.

Conclusion

We report our experience treating large brain metastases with HF-SRS. HF-SRS showed favourable local control with low incidence of complications.

本研究评估了使用射波刀系统进行低分割立体定向放射手术（HF-SRS）治疗≥10 cm3脑转移瘤后的局部控制和总体生存，解决了在较大病灶中平衡疗效和毒性的挑战。方法：我们招募了1-4例新诊断的肺癌或乳腺癌脑转移患者。主要终点是治疗转移的局部控制。次要终点是总生存率和放射性坏死发生率。使用Kaplan-Meier法评估生存终点。采用Cox比例风险回归模型检验临床因素与预后之间的显著相关性。结果：2016年12月至2018年12月，63例65例脑转移患者纳入本研究。在所有63例病例中，55例最初使用HF-SRS治疗；8例经伽玛刀治疗后肿瘤复发。放射外科边缘剂量（中位数，30 Gy；范围，25-34 Gy）以60%-75%（中位数，67%）的等剂量曲线与多个分数（中位数，三个分数；范围，2-4）规定，目标肿瘤体积中位数为18.1 cm3（范围，10.1-39.6 cm3）。中位随访时间为19个月。6个月、12个月和18个月的局部肿瘤控制率分别为100%、100%和92.58%。6、12、18个月生存率分别为95.24%、82.51%、68.61%。原发性HF-SRS患者的累积放射坏死发生率在1年和18个月分别为7.02%和14.04%。结论：我们报告了用HF-SRS治疗大面积脑转移瘤的经验。HF-SRS显示良好的局部控制，并发症发生率低。

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引用次数: 0

Breast Microcalcification in Women Under 40 Years of Age 40岁以下女性乳房微钙化。

IF 1.4 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Oncology

Pub Date : 2025-11-11 DOI: 10.1111/1754-9485.70042

Alan J. Porter, Elizabeth B. Evans

Introduction

This study examines the results of vacuum-assisted biopsy (VAB) for suspicious microcalcification as the only significant mammographic finding, with particular reference to women under age 40 years.

Methods

The study cohort comprised symptomatic or asymptomatic women who had full-field digital mammography at the Wesley Breast Clinic over a 9-year period (2013– 2021). Suspicious microcalcification was subjected to vacuum-assisted biopsy (VAB). The histological results were classified as: (a) invasive cancer, (b) ductal carcinoma-in situ (DCIS), (c) atypia, (d) papillary lesions or (e) benign tissue.

Results

Of the 139,911 women examined by mammography, 5967 were under 40 and had mammography because of symptoms or significant risk factors for breast cancer. Overall, 1748 (1.2% of mammograms) revealed a suspicious cluster of microcalcification as the only abnormality. 68 of these were in women under 40 (1.1% of mammograms in these women). A positive result for malignancy, (DCIS or invasive cancer) was obtained in 20.8% of VABs overall, including 16.1% of women under 40 (2 invasive, 9 DCIS). Women under 50 had about half the risk of a malignant result on VAB compared with women aged 50 and over. B3 lesions (of uncertain malignant potential) were uncommon in women under 40.

Conclusions

The small number of women under 40 who had suspicious microcalcification requiring VAB, and of cancers thus found, suggests that, unless significant risk factors are present, it is difficult to justify mammography in women prior to age 35 with the sole aim of detecting microcalcification which could be, for example, DCIS.

简介：本研究检查了可疑微钙化的真空辅助活检（VAB）结果，作为唯一重要的乳房x线摄影发现，特别涉及40岁以下的女性。方法：研究队列包括有症状或无症状的妇女，她们在Wesley乳腺诊所接受了9年（2013- 2021）的全场数字乳房x光检查。可疑的微钙化进行了真空辅助活检（VAB）。组织学结果分为：(a)浸润性癌，(b)导管原位癌（DCIS）， (c)异型性癌，(d)乳头状病变或(e)良性组织。结果：在139,911名接受乳房x光检查的女性中，有5967名年龄在40岁以下，由于乳腺癌的症状或重大危险因素而接受乳房x光检查。总的来说，1748例（1.2%）的乳房x光片显示可疑的微钙化簇是唯一的异常。其中68例是40岁以下的女性（占这些女性乳房x光检查的1.1%）。恶性肿瘤（DCIS或浸润性癌）的阳性结果在20.8%的vab中获得，其中包括16.1%的40岁以下女性（2例浸润性，9例DCIS）。与50岁及以上的女性相比，50岁以下的女性患VAB恶性结果的风险约为一半。B3型病变（不确定恶性潜能）在40岁以下女性中少见。结论：少数40岁以下的女性有可疑的微钙化，需要进行VAB检查，并因此发现癌症，这表明，除非存在显著的危险因素，否则很难证明35岁之前的女性进行乳房x光检查的唯一目的是检测微钙化，例如DCIS。

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引用次数: 0