Pub Date : 2024-10-18DOI: 10.1016/j.clinimag.2024.110333
Muhammed Shabil , Ganesh Bushi , Sanjit Sah
{"title":"Comment on “Diagnostic performance of dual-energy CT in detecting bone marrow edema in lower limb joint injuries: A meta-analysis”","authors":"Muhammed Shabil , Ganesh Bushi , Sanjit Sah","doi":"10.1016/j.clinimag.2024.110333","DOIUrl":"10.1016/j.clinimag.2024.110333","url":null,"abstract":"","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"116 ","pages":"Article 110333"},"PeriodicalIF":1.8,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512343","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}
Pub Date : 2024-10-16DOI: 10.1016/j.clinimag.2024.110332
Adam Kinzel , Mark McArthur , Lori Mankowski Gettle , Ely Felker , Maitraya Patel
Perivascular epithelioid cell tumors (PEComas) are a group of rare mesenchymal tumors, which demonstrate varied imaging appearances and treatment options. These tumors may arise de novo or in the setting of systemic disorders, such as tuberous sclerosis. Some PEComas are benign and easily resected while others may represent systemic or metastatic disease with limited therapeutic options. The purpose of this review is to introduce the topic of perivascular epithelioid cell tumors and the most common tumors within the PEComa family as well as discuss the epidemiology, morphology, radiographic appearance, and treatment options of these rare tumors.
{"title":"PEComas: A review of imaging and clinical features","authors":"Adam Kinzel , Mark McArthur , Lori Mankowski Gettle , Ely Felker , Maitraya Patel","doi":"10.1016/j.clinimag.2024.110332","DOIUrl":"10.1016/j.clinimag.2024.110332","url":null,"abstract":"<div><div>Perivascular epithelioid cell tumors (PEComas) are a group of rare mesenchymal tumors, which demonstrate varied imaging appearances and treatment options. These tumors may arise de novo or in the setting of systemic disorders, such as tuberous sclerosis. Some PEComas are benign and easily resected while others may represent systemic or metastatic disease with limited therapeutic options. The purpose of this review is to introduce the topic of perivascular epithelioid cell tumors and the most common tumors within the PEComa family as well as discuss the epidemiology, morphology, radiographic appearance, and treatment options of these rare tumors.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"116 ","pages":"Article 110332"},"PeriodicalIF":1.8,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-16DOI: 10.1016/j.clinimag.2024.110326
Lauren D. Hagenstein , Joseph Jenkins , Colby Adamson , Jourdain Dong , John Moore , Jing Gao
Purpose
Increased prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) highlights a desire for screening with liver ultrasound normalized local variance (NLV). We aimed to assess variations in NLV values measured at different sampling depths and discuss common technical considerations in measuring liver NLV.
Methods
We retrospectively measured liver NLVs at variable depths on ultrasound images pre-recorded in 116 participants who underwent liver magnetic resonance imaging-proton density fat fraction (MRI-PDFF) and ultrasound to screen for MASLD. Liver NLVs were measured and differences at variable depths were tested using one-way analysis of variance (ANOVA) and multiple paired comparisons using post hoc Tukey honestly significant difference (HSD), Scheffé, Bonferroni, and Holm multiple comparisons. Diagnostic performance of NLV values were analyzed by area under the receiver operating characteristic (AUROC) curve.
Results
The NLV measured at a depth of 10 cm significantly differed from those measured near the liver capsule and at depths of 6 cm and 8 cm (p < 0.001) from the skin. There was no significant difference in NLV value in other paired groups (p > 0.05). The difference in the area under AUROCs for NLVs measured at variable depths was not significant (p > 0.05).
Conclusions
The best diagnostic performance of liver NLV was measured at depth of 8 cm from the skin, although NLV measured at variable depth showed similar diagnostic performance for assessing ≥ mild hepatic steatosis. The study results provide a reference that can be used in the development of standardized scanning protocols and technical considerations in measuring liver NLV.
{"title":"Ultrasound normalized local variance to assess metabolic dysfunction-associated steatotic liver disease","authors":"Lauren D. Hagenstein , Joseph Jenkins , Colby Adamson , Jourdain Dong , John Moore , Jing Gao","doi":"10.1016/j.clinimag.2024.110326","DOIUrl":"10.1016/j.clinimag.2024.110326","url":null,"abstract":"<div><h3>Purpose</h3><div>Increased prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) highlights a desire for screening with liver ultrasound normalized local variance (NLV). We aimed to assess variations in NLV values measured at different sampling depths and discuss common technical considerations in measuring liver NLV.</div></div><div><h3>Methods</h3><div>We retrospectively measured liver NLVs at variable depths on ultrasound images pre-recorded in 116 participants who underwent liver magnetic resonance imaging-proton density fat fraction (MRI-PDFF) and ultrasound to screen for MASLD. Liver NLVs were measured and differences at variable depths were tested using one-way analysis of variance (ANOVA) and multiple paired comparisons using post hoc Tukey honestly significant difference (HSD), Scheffé, Bonferroni, and Holm multiple comparisons. Diagnostic performance of NLV values were analyzed by area under the receiver operating characteristic (AUROC) curve.</div></div><div><h3>Results</h3><div>The NLV measured at a depth of 10 cm significantly differed from those measured near the liver capsule and at depths of 6 cm and 8 cm (<em>p</em> < 0.001) from the skin. There was no significant difference in NLV value in other paired groups (<em>p</em> > 0.05). The difference in the area under AUROCs for NLVs measured at variable depths was not significant (<em>p</em> > 0.05).</div></div><div><h3>Conclusions</h3><div>The best diagnostic performance of liver NLV was measured at depth of 8 cm from the skin, although NLV measured at variable depth showed similar diagnostic performance for assessing ≥ mild hepatic steatosis. The study results provide a reference that can be used in the development of standardized scanning protocols and technical considerations in measuring liver NLV.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"116 ","pages":"Article 110326"},"PeriodicalIF":1.8,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512348","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}
Pub Date : 2024-10-15DOI: 10.1016/j.clinimag.2024.110330
Laura E. Minton , Jordan Perchik , Cathy Chen , Renu Pandit , Desmin Milner , Rachel Bass , Elainea Smith , Jessica Zarzour
As the representation of women in medicine has grown and reached parity in some specialties over the past two decades, radiology has not only lagged behind, but has remained stagnant. To strengthen the pipeline, the field must institute policies and practices to retain women in radiology and must effectively recruit and mentor women in medical school to enter the field. Women in medical school who are pursuing radiology, however, often struggle to find women mentors, opportunities for research, leadership, and service, and critically, often struggle to find a community that speaks to their experience. WIRED (Women in Radiology Education) is a student-led group dedicated to community building and advancing radiology mentorship, research, and service opportunities for women in medical school. This step-by-step guide to founding a WIRED chapter with examples of successful chapter events can enable radiology programs to provide targeted mentorship to women in medical school, and ultimately, increase the representation of women in radiology.
在过去的二十年里，女性在医学界的代表人数不断增加，并在一些专业领域实现了平等，但放射学不仅落在后面，而且一直停滞不前。为了加强这一渠道，放射学领域必须制定政策和实践来留住放射学领域的女性，并且必须有效地招募和指导医学院的女性进入这一领域。然而，正在攻读放射学专业的医学院女生往往很难找到女性导师、研究机会、领导力和服务，更关键的是，她们往往很难找到一个能与她们的经历对话的社区。WIRED (Women in Radiology Education) 是一个由学生领导的团体，致力于为医学院的女生建立社区和促进放射学导师、研究和服务机会。这本关于创建 WIRED 分会的分步指南附有分会活动的成功范例，可帮助放射学课程为医学院女生提供有针对性的指导，并最终增加放射学专业的女生人数。
{"title":"Women in Radiology Education (WIRED): An actionable step towards closing the gender gap in radiology","authors":"Laura E. Minton , Jordan Perchik , Cathy Chen , Renu Pandit , Desmin Milner , Rachel Bass , Elainea Smith , Jessica Zarzour","doi":"10.1016/j.clinimag.2024.110330","DOIUrl":"10.1016/j.clinimag.2024.110330","url":null,"abstract":"<div><div>As the representation of women in medicine has grown and reached parity in some specialties over the past two decades, radiology has not only lagged behind, but has remained stagnant. To strengthen the pipeline, the field must institute policies and practices to retain women in radiology and must effectively recruit and mentor women in medical school to enter the field. Women in medical school who are pursuing radiology, however, often struggle to find women mentors, opportunities for research, leadership, and service, and critically, often struggle to find a community that speaks to their experience. WIRED (Women in Radiology Education) is a student-led group dedicated to community building and advancing radiology mentorship, research, and service opportunities for women in medical school. This step-by-step guide to founding a WIRED chapter with examples of successful chapter events can enable radiology programs to provide targeted mentorship to women in medical school, and ultimately, increase the representation of women in radiology.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"116 ","pages":"Article 110330"},"PeriodicalIF":1.8,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479853","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}
Pub Date : 2024-10-15DOI: 10.1016/j.clinimag.2024.110329
Muhammad Ansar , Muhammad Arsam Ali , Noraiz Ali , Zeshan Haider , Aruj Latif , Anjum Tazeen , Zareen Fatima , Muhammad Nawaz Anjum
Background
Sonographic placental elastography has recently been employed as a non-invasive tool to investigate the structural alterations associated with various conditions such as pre-eclampsia, gestational diabetes and fetal growth restriction (FGR). The study was conducted based on the hypothesis that the placental elasticity might differ with varying severity of FGR and with that of appropriate for gestational age (AGA) pregnancies.
Methods
This study involved 121 pregnant women, with 54 in the normal group and 67 in the FGR group, which was defined as the fetal weight below the 10th percentile for gestational age. The FGR pregnancies were sub grouped into different stages based on the presence and extent of Doppler abnormalities. Shear-wave elastography was carried out to investigate the placental elasticity values, which were compared using the Kruskal-Wallis test. A P value of ≤0.05 was considered significant.
Results
The placental elasticity differed significantly between pregnancies with and without FGR and among the different stages of FGR. There was a significant difference in PE (kPa) and SWV (m/s) among groups, with a p-value of 0.000001. PE and SWV in FGR pregnancies were significantly higher compared to AGA as a whole using t-test with p values of <0.0001. Doppler indices of umbilical, uterine and fetal middle cerebral arteries also correlated significantly with these.
Conclusion
The study suggests that placental elasticity values reflect structural alterations associated with FGR and could serve as a valuable tool in the early detection and staging of this condition.
背景：最近，胎盘超声弹性成像已被用作一种非侵入性工具，用于研究与子痫前期、妊娠糖尿病和胎儿生长受限（FGR）等各种疾病相关的结构改变。本研究的假设是，胎盘弹性可能随 FGR 严重程度的不同而不同，也可能与胎龄适宜（AGA）孕妇的胎盘弹性不同：这项研究涉及 121 名孕妇，其中正常组 54 名，FGR 组 67 名，FGR 的定义是胎儿体重低于胎龄第 10 百分位数。根据多普勒异常的存在和程度，FGR 孕妇被分为不同的阶段。通过剪切波弹性成像检查胎盘弹性值，并使用 Kruskal-Wallis 检验进行比较。P值≤0.05为差异显著：结果：胎盘弹性在有FGR和无FGR的孕妇之间以及FGR的不同阶段之间存在显著差异。各组间的PE（kPa）和SWV（m/s）差异显著，P值为0.000001。采用 t 检验，FGR 孕妇的 PE 和 SWV 明显高于 AGA 整体，p 值为 结论：该研究表明，胎盘弹性值反映了与 FGR 相关的结构改变，可作为早期检测和分期的重要工具。
{"title":"Ultrasound shear wave elastography of the placenta: a potential tool for early detection of fetal growth restriction","authors":"Muhammad Ansar , Muhammad Arsam Ali , Noraiz Ali , Zeshan Haider , Aruj Latif , Anjum Tazeen , Zareen Fatima , Muhammad Nawaz Anjum","doi":"10.1016/j.clinimag.2024.110329","DOIUrl":"10.1016/j.clinimag.2024.110329","url":null,"abstract":"<div><h3>Background</h3><div>Sonographic placental elastography has recently been employed as a non-invasive tool to investigate the structural alterations associated with various conditions such as pre-eclampsia, gestational diabetes and fetal growth restriction (FGR). The study was conducted based on the hypothesis that the placental elasticity might differ with varying severity of FGR and with that of appropriate for gestational age (AGA) pregnancies.</div></div><div><h3>Methods</h3><div>This study involved 121 pregnant women, with 54 in the normal group and 67 in the FGR group, which was defined as the fetal weight below the 10th percentile for gestational age. The FGR pregnancies were sub grouped into different stages based on the presence and extent of Doppler abnormalities. Shear-wave elastography was carried out to investigate the placental elasticity values, which were compared using the Kruskal-Wallis test. A <em>P</em> value of ≤0.05 was considered significant.</div></div><div><h3>Results</h3><div>The placental elasticity differed significantly between pregnancies with and without FGR and among the different stages of FGR. There was a significant difference in PE (kPa) and SWV (m/s) among groups, with a p-value of 0.000001. PE and SWV in FGR pregnancies were significantly higher compared to AGA as a whole using <em>t-</em>test with <em>p</em> values of <0.0001. Doppler indices of umbilical, uterine and fetal middle cerebral arteries also correlated significantly with these.</div></div><div><h3>Conclusion</h3><div>The study suggests that placental elasticity values reflect structural alterations associated with FGR and could serve as a valuable tool in the early detection and staging of this condition.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"116 ","pages":"Article 110329"},"PeriodicalIF":1.8,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512349","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}
Pub Date : 2024-10-10DOI: 10.1016/j.clinimag.2024.110311
Renee S. Friedman , Linda B. Haramati , Timothy F. Christian , Seth I. Sokol , Jonathan Alis
Pulmonary embolism (PE) remains a significant cause of mortality requiring prompt diagnosis and risk stratification. This review focuses on the role of computed tomography (CT) in the risk stratification of acute PE, highlighting its impact on patient management. We will explore basic pathophysiology of pulmonary embolism (PE) and review current guidelines, which will help radiologists interpret images within a broader clinical context. This review covers key CT findings which can be used for risk stratification including indicators of right ventricular (RV) dysfunction, clot burden, clot location and left atrial volume. We will discuss the measurement of RV/LV diameter ratio as a key indicator of RV dysfunction and its limitations and challenges within various patient populations. While these parameters should be included in a radiologist's report, their predictive value for mortality depends on the patient's existing cardiopulmonary reserve and should not be interpreted in isolation.
{"title":"Heart lung axis in acute pulmonary embolism: Role of CT in risk stratification","authors":"Renee S. Friedman , Linda B. Haramati , Timothy F. Christian , Seth I. Sokol , Jonathan Alis","doi":"10.1016/j.clinimag.2024.110311","DOIUrl":"10.1016/j.clinimag.2024.110311","url":null,"abstract":"<div><div>Pulmonary embolism (PE) remains a significant cause of mortality requiring prompt diagnosis and risk stratification. This review focuses on the role of computed tomography (CT) in the risk stratification of acute PE, highlighting its impact on patient management. We will explore basic pathophysiology of pulmonary embolism (PE) and review current guidelines, which will help radiologists interpret images within a broader clinical context. This review covers key CT findings which can be used for risk stratification including indicators of right ventricular (RV) dysfunction, clot burden, clot location and left atrial volume. We will discuss the measurement of RV/LV diameter ratio as a key indicator of RV dysfunction and its limitations and challenges within various patient populations. While these parameters should be included in a radiologist's report, their predictive value for mortality depends on the patient's existing cardiopulmonary reserve and should not be interpreted in isolation.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"116 ","pages":"Article 110311"},"PeriodicalIF":1.8,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142442271","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}
Pub Date : 2024-10-05DOI: 10.1016/j.clinimag.2024.110308
Julie Liana Hamzah , Jasmine Kai Sing Phua , Wei Ting Chan , Sze Yiun Teo , Veronique Kiak-Mien Tan , Geok Hoon Lim , Benita Kiat Tee Tan , Swee Ho Lim , Puay Hoon Tan , John Carson Allen , Lester Chee Hao Leong
Aim
Mammography is the mainstay of imaging surveillance after breast cancer (BC) treatment, but false negatives can occur. The objective of the study was to determine the factors that can predict poorer second breast cancer (SBC) mammogram detection of the ipsilateral and contralateral breast separately.
Methods
A multicentre retrospective review was performed on female patients with a previous history of treated BC who developed a second breast cancer (SBC) in the ipsilateral (ISBC) or contralateral breast (CSBC) within 10 years from the first BC. SBC cases that occurred between January 2006 and October 2017 were included from the institutional database. The ISBC and CSBC mammogram-occult (MO) rates were correlated with mammographic breast density as well as various clinical, radiological and histological characteristics of the first BC.
Results
274 cases of SBC were evaluated. 39.4 % (108/274) of cases were ISBC and 60.6 % (166/274) were CSBC. 35 (32.4 %) of the ISBCs and 42 (25.3 %) of the CSBCs were MO (p = 0.218). On multivariate analysis, symptomatic first BC (p = 0.041), prevailing dense breast tissue at the time of SBC diagnosis (p = 0.003) and trabecular thickening on surveillance mammograms (p = 0.017) were associated with MO ISBC. MO first BC (p < 0.001) was the only factor found to correlate with MO CSBC.
Conclusion
The study found various clinical, radiological and pathological factors associated with mammogram surveillance failure for the ipsilateral and contralateral breast. This information can provide additional guidance in the planning of a personalised surveillance program using adjunct imaging screening.
目的乳腺X光检查是乳腺癌（BC）治疗后影像监测的主要手段，但也可能出现假阴性。本研究旨在确定哪些因素可分别预测同侧和对侧乳房的第二次乳腺癌（SBC）乳房X光检查检出率较低的情况。研究方法对曾接受过乳腺癌治疗，并在第一次乳腺癌治疗后10年内在同侧（ISBC）或对侧乳房（CSBC）发生第二次乳腺癌（SBC）的女性患者进行了多中心回顾性研究。2006年1月至2017年10月期间发生的SBC病例被纳入机构数据库。ISBC和CSBC的乳腺X光检查发现率（MO）与乳腺X光检查乳腺密度以及首次BC的各种临床、放射学和组织学特征相关。39.4%的病例（108/274）为 ISBC，60.6%的病例（166/274）为 CSBC。35例（32.4%）的ISBC和42例（25.3%）的CSBC为MO（P = 0.218）。在多变量分析中，无症状的首次 BC（p = 0.041）、诊断 SBC 时乳腺组织普遍致密（p = 0.003）和监测乳房 X 光片上的小梁增厚（p = 0.017）与 MO ISBC 相关。结论该研究发现了与同侧和对侧乳房乳腺 X 线造影监测失败相关的各种临床、放射学和病理学因素。这些信息可为规划使用辅助影像筛查的个性化监测计划提供更多指导。
{"title":"Factors affecting mammogram breast cancer surveillance effectiveness in the ipsilateral and contralateral breast","authors":"Julie Liana Hamzah , Jasmine Kai Sing Phua , Wei Ting Chan , Sze Yiun Teo , Veronique Kiak-Mien Tan , Geok Hoon Lim , Benita Kiat Tee Tan , Swee Ho Lim , Puay Hoon Tan , John Carson Allen , Lester Chee Hao Leong","doi":"10.1016/j.clinimag.2024.110308","DOIUrl":"10.1016/j.clinimag.2024.110308","url":null,"abstract":"<div><h3>Aim</h3><div>Mammography is the mainstay of imaging surveillance after breast cancer (BC) treatment, but false negatives can occur. The objective of the study was to determine the factors that can predict poorer second breast cancer (SBC) mammogram detection of the ipsilateral and contralateral breast separately.</div></div><div><h3>Methods</h3><div>A multicentre retrospective review was performed on female patients with a previous history of treated BC who developed a second breast cancer (SBC) in the ipsilateral (ISBC) or contralateral breast (CSBC) within 10 years from the first BC. SBC cases that occurred between January 2006 and October 2017 were included from the institutional database. The ISBC and CSBC mammogram-occult (MO) rates were correlated with mammographic breast density as well as various clinical, radiological and histological characteristics of the first BC.</div></div><div><h3>Results</h3><div>274 cases of SBC were evaluated. 39.4 % (108/274) of cases were ISBC and 60.6 % (166/274) were CSBC. 35 (32.4 %) of the ISBCs and 42 (25.3 %) of the CSBCs were MO (<em>p</em> = 0.218). On multivariate analysis, symptomatic first BC (<em>p</em> = 0.041), prevailing dense breast tissue at the time of SBC diagnosis (<em>p</em> = 0.003) and trabecular thickening on surveillance mammograms (<em>p</em> = 0.017) were associated with MO ISBC. MO first BC (<em>p</em> < 0.001) was the only factor found to correlate with MO CSBC.</div></div><div><h3>Conclusion</h3><div>The study found various clinical, radiological and pathological factors associated with mammogram surveillance failure for the ipsilateral and contralateral breast. This information can provide additional guidance in the planning of a personalised surveillance program using adjunct imaging screening.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"116 ","pages":"Article 110308"},"PeriodicalIF":1.8,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142445526","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}
In BRCA germline pathogenic sequence variants (PSV) carriers aged 30–39 years imaging is recommended at six-month intervals. The European society for medical oncology recommendation of the use of 6-monthly MRI six-monthly MRI screening is being considered at our institution, particularly for younger carriers under the age of 35, although it is not mandatory. If 6-monthly MRI is unavailable, annual MRI may be supplemented by ultrasound (with or without mammography). The aim of this study was to evaluate the utility of ultrasound screening added to mammography, as a 6-month supplement to annual MRI in BRCA PSV carriers aged 30–39 years.
Materials and methods
This IRB approved retrospective study included BRCA PSV carriers aged 30–39 years, who underwent breast cancer screening at our institution between January 2015 and March 2023. Participants were divided into two groups, those who had supplemental whole-breast US and mammography at six months and underwent screening before March 2019, and those who had only mammography without supplemental US and enrolled in screening after March 2019. Patient characteristics, cancer detection rates and cancer characteristics were compared between the two groups.
Results
Overall, 200 asymptomatic BRCA1/2 PSV carriers undergoing screening in our institution were included in the study. Mean age was 35.7 ± 3.5 years, and mean follow-up time was 37.4 ± 38.0 months. There were 118 (59 %) women screened with supplemental US, and 82 (41 %) women without. Eight cancers were diagnosed during the study period, four in women with supplemental US and four in women without. The sensitivity of whole-breast screening US was 25 % (1/4), specificity 85.7 % (222/259), PPV 2.6 % (1/38), and NPV 98.7 % (222/225). Of the four cancers detected in women screened with supplemental US, one was diagnosed by whole-breast US, two by MRI, and one by mammography. Of eight cancers included in this study, two were not detectable by targeted second-look US. All eight cancers were detectable by MRI.
Conclusion
The addition of whole-breast ultrasound to mammography and MRI screening in BRCA PSV carriers aged 30–39 years offered limited incremental benefit. MRI with 6 months supplemental mammography without US detected all cancer cases.
目的：对于 30-39 岁的 BRCA 基因致病序列变异（PSV）携带者，建议每隔 6 个月进行一次成像检查。欧洲肿瘤内科学会（European Society for Medical Oncology）建议每 6 个月进行一次核磁共振成像（MRI）筛查，本机构正在考虑每 6 个月进行一次核磁共振成像筛查，尤其是针对 35 岁以下的年轻携带者，尽管这并非强制性规定。如果无法进行每 6 个月一次的磁共振成像筛查，则可以每年进行一次磁共振成像筛查，并辅以超声波检查（可进行或不进行乳腺 X 射线检查）。本研究的目的是评估在乳腺 X 光检查的基础上进行超声波筛查的效用，作为对 30-39 岁 BRCA PSV 携带者每年进行一次核磁共振成像检查的 6 个月补充：这项经 IRB 批准的回顾性研究纳入了 2015 年 1 月至 2023 年 3 月期间在我院接受乳腺癌筛查的 30-39 岁 BRCA PSV 携带者。参与者被分为两组，一组是在 6 个月时补充全乳房 US 和乳房 X 光检查并在 2019 年 3 月前接受筛查的患者，另一组是仅接受乳房 X 光检查而未补充 US 并在 2019 年 3 月后参加筛查的患者。对两组患者的特征、癌症检出率和癌症特征进行了比较：共有 200 名无症状的 BRCA1/2 PSV 携带者在我院接受筛查。平均年龄为（35.7 ± 3.5）岁，平均随访时间为（37.4 ± 38.0）个月。118名（59%）妇女接受了补充US筛查，82名（41%）妇女未接受筛查。研究期间确诊了 8 例癌症，其中 4 例接受了辅助 US 检查，4 例未接受辅助 US 检查。全乳腺 US 筛选的灵敏度为 25%（1/4），特异性为 85.7%（222/259），PPV 为 2.6%（1/38），NPV 为 98.7%（222/225）。在通过补充性 US 筛查的妇女中发现的四种癌症中，一种是通过全乳腺 US 诊断的，两种是通过 MRI 诊断的，一种是通过乳腺 X 光检查诊断的。在这项研究中发现的八种癌症中，有两种无法通过有针对性的二次乳腺 US 检测出来。结论：结论：对于 30-39 岁的 BRCA PSV 携带者，在乳房 X 光检查和核磁共振成像筛查的基础上增加全乳房超声检查，其增量效益有限。核磁共振成像与6个月的乳腺X光补充检查（无 US）可检测出所有癌症病例。
{"title":"Clinical experience on the limited role of ultrasound for breast cancer screening in BRCA1 and BRCA2 mutations carriers aged 30–39 years","authors":"Hila Bufman , Vera Sorin , Renata Faermann , Rinat Bernstein-Molho , Eitan Friedman , Yiftach Barash , Nora Balint Lahat , Miri Sklair-Levy","doi":"10.1016/j.clinimag.2024.110310","DOIUrl":"10.1016/j.clinimag.2024.110310","url":null,"abstract":"<div><h3>Purpose</h3><div>In BRCA germline pathogenic sequence variants (PSV) carriers aged 30–39 years imaging is recommended at six-month intervals. The European society for medical oncology recommendation of the use of 6-monthly MRI six-monthly MRI screening is being considered at our institution, particularly for younger carriers under the age of 35, although it is not mandatory. If 6-monthly MRI is unavailable, annual MRI may be supplemented by ultrasound (with or without mammography). The aim of this study was to evaluate the utility of ultrasound screening added to mammography, as a 6-month supplement to annual MRI in BRCA PSV carriers aged 30–39 years.</div></div><div><h3>Materials and methods</h3><div>This IRB approved retrospective study included BRCA PSV carriers aged 30–39 years, who underwent breast cancer screening at our institution between January 2015 and March 2023. Participants were divided into two groups, those who had supplemental whole-breast US and mammography at six months and underwent screening before March 2019, and those who had only mammography without supplemental US and enrolled in screening after March 2019. Patient characteristics, cancer detection rates and cancer characteristics were compared between the two groups.</div></div><div><h3>Results</h3><div>Overall, 200 asymptomatic BRCA1/2 PSV carriers undergoing screening in our institution were included in the study. Mean age was 35.7 ± 3.5 years, and mean follow-up time was 37.4 ± 38.0 months. There were 118 (59 %) women screened with supplemental US, and 82 (41 %) women without. Eight cancers were diagnosed during the study period, four in women with supplemental US and four in women without. The sensitivity of whole-breast screening US was 25 % (1/4), specificity 85.7 % (222/259), PPV 2.6 % (1/38), and NPV 98.7 % (222/225). Of the four cancers detected in women screened with supplemental US, one was diagnosed by whole-breast US, two by MRI, and one by mammography. Of eight cancers included in this study, two were not detectable by targeted second-look US. All eight cancers were detectable by MRI.</div></div><div><h3>Conclusion</h3><div>The addition of whole-breast ultrasound to mammography and MRI screening in BRCA PSV carriers aged 30–39 years offered limited incremental benefit. MRI with 6 months supplemental mammography without US detected all cancer cases.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"116 ","pages":"Article 110310"},"PeriodicalIF":1.8,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407170","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}
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