Negative Predictive Value of Breast Imaging in Patients with Palpable Lesions
4
Citation
3
Reference
10
Related Paper
Citation Trend
Abstract:
Negative Predictive Value of Breast Imaging in Patients with Palpable LesionsFerris M. HallAudio Available | ShareKeywords:
Breast imaging
Value (mathematics)
Breast imaging
Breast ultrasound
Breast examination
Cite
Citations (11)
The American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS) defines four different types of asymmetric breast findings: asymmetric breast tissue, densities seen in one projection, architectural distortion, and focal asymmetric densities. These lesions are frequently encountered at screening and diagnostic mammography and are significant because they may indicate a neoplasm, especially if an associated palpable mass is present. Once these lesions are detected at standard mammography, supplementary breast imaging with additional mammographic views and ultrasonography (US) can be a key aspect of work-up. The role of US in this setting has not been clearly defined. However, a positive US finding such as a solid mass or an area of focal shadowing increases the level of suspicion for malignancy. A thorough knowledge of the patient's clinical history, along with a fundamental understanding of the ACR BI-RADS lexicon and the role and limitations of supplementary breast imaging, will allow more accurate interpretation of these potentially perplexing soft-tissue findings. © RSNA, 2002
Breast imaging
BI-RADS
Breast tissue
Cite
Citations (71)
Dipyridamole
Positive predicative value
Cite
Citations (9)
Background : Several new nuclear medicine‐based breast imaging techniques have emerged over the last few years. These include Positron Emission Mammography (PEM), Breast Specific Gamma Imaging (BSGI) and Molecular Breast Imaging (MBI). These techniques usually employ doses of ∼ 10 mCi F‐18 FDG in the case of PEM, or 20–30 mCi Tc‐99m sestamibi in the cases of BSGI or MBI. In addition to their potential value as adjunct diagnostic tools, these techniques hold promise as potential adjuncts to screening mammography particularly for women with dense breast tissue where the sensitivity of mammography is known to be reduced. A previous study has shown MBI to have 2–3 times the sensitivity and equivalent specificity to screening mammography in women with dense breasts. However, the current administered doses employed in these techniques deliver effective radiation doses that are ∼10 times higher than mammography. From the BEIR VII tables, the lifetime associated risks from PEM, BSGI and MBI can be calculated and compared to that of screening mammography. These estimates indicate that in order to achieve a comparable radiation burden to mammography, the administered doses of F‐ 18 FDG and Tc‐99m sestamibi need to be reduced to less than 2 mCi F‐18 FDG and 4 mCi Tc‐99m sestamibi. This presentation will briefly review the clinical literature demonstrating the value of these new techniques in both diagnostic and screening applications, and will review the dosimetry and estimated lifetime associated risks from these technologies. It will then focus on one of these technologies — MBI, and will illustrate how we can optimize the physics of the collimation and detector to achieve a 5‐fold reduction in the required dose of Tc‐99m sestamibi for clinical studies. We will also review possible post‐acquisition processing techniques that may enable further reduction in dose, along with alternative radiopharmaceuticals that deliver low doses due to their biodistribution. A total of 4 dose reduction schemes will be discussed — a) development of optimized collimation for single‐photon imaging, b) improved utilization of the energy spectral characteristics of the gamma cameras, c) implementation of noise reduction and resolution recovery algorithms, and d) use of adaptive geometric mean algorithms for combination of images from opposing detectors. In addition we will consider alternative radiopharmaceuticals, such as Tc‐99m MDP that deliver a lower radiation burden than Tc‐99m sestamibi. We will demonstrate that image quality obtained with low‐dose MBI performed with 4 mCi Tc‐99m sestamibi matches that of standard MBI performed with 20 mCi dose. Low‐dose MBI presents radiation risks to the patient comparable to that of digital screening mammography, allowing its safe implementation as a screening technique.
Scintimammography
Breast imaging
Cite
Citations (0)
Mammography is widely acknowledged to be the most cost-effective technique for population screening for breast cancer. Recently in Australia, imaging modalities other than mammography, including thermography, electrical impedance, and computerised breast imaging, have been increasingly promoted as alternative methods of breast cancer screening. This study assessed the impact of three commercial breast imaging companies' promotional material upon consumers' beliefs about the effectiveness of the companies' technology in detecting breast cancer, and consumers' intentions to seek more information or consider having their breasts imaged by these modalities. Results showed 90% of respondents agreed that the companies' promotional material promoted the message that the advertised breast imaging method was effective in detecting breast cancer, and 80% agreed that the material promoted the message that the imaging method was equally or more effective than a mammogram. These findings have implications for women's preference for and uptake of alternative breast imaging services over mammography.
Breast imaging
Modalities
Breast Cancer Screening
Cite
Citations (11)
The usefulness of diagnostic tests, that is their ability to detect a person with disease or exclude a person without disease, is usually described by terms such as sensitivity, specificity, positive predictive value and negative predictive value. In this article, the first of the series, a simple, practical explanation of these concepts is provided and their use and misuse discussed. It is explained that while sensitivity and specificity are important measures of the diagnostic accuracy of a test, they are of no practical use when it comes to helping the clinician estimate the probability of disease in individual patients. Predictive values may be used to estimate probability of disease but both positive predictive value and negative predictive value vary according to disease prevalence. It would therefore be wrong for predictive values determined for one population to be applied to another population with a different prevalence of disease.Sensitivity and specificity are important measures of the diagnostic accuracy of a test but cannot be used to estimate the probability of disease in an individual patient. Positive and negative predictive values provide estimates of probability of disease but both parameters vary according to disease prevalence.
Positive predicative value
Predictive testing
Cite
Citations (649)
To assess the usefulness of HELISAL in the diagnosis of Helicobacter pylori infection by comparing it with ELISA, JATROX and histopathologic findings.Randomized prospective study.Sixty-one patients, thirty-three males and twenty-eight females, 18-73 years old, submitted to esophagogastroduodenoscopy.The sensitivity of HELISAL when compared to ELISA test was 60.8%, the specificity 73.3%, the positive predictive value 87.5%, the negative predictive value 37.9%, and the kappa index 0.26. When compared to histopathologic test: sensitivity 60.9%, specificity 65%, positive predictive value 78.1%, negative predictive value 44.7%, kappa 0.28. When compared to JATROX, sensitivity 57.7%, specificity 62.5%, positive predictive value 81.2%, negative predictive value 34.4%, kappa 0.21.The sensitivity of HELISAL test is lower than that of other compared tests, and the negative predictive value is very low. The specificity and the positive predictive value are higher than the sensitivity. The kappa index shows a very low concordance.
Kappa
Concordance
Esophagogastroduodenoscopy
Positive predicative value
Cite
Citations (9)
To determine the predictive value of emergency, bedside ultrasound (EUS) signs in the detection of acute cholecystitis (AC). This was a secondary analysis of a previously reported prospective study of EUS for AC. Cases done by physicians who met the training guidelines of the American College of Emergency Physicians by performing 25 prior examinations were selected to determine the predictive value of specific EUS signs for AC. The gold standard was surgical pathology obtained within 2 weeks, if available. Otherwise, the discharge diagnosis of AC was used as the criterion standard. A total of 291 patients were studied to evaluate the predictive value of EUS signs in the detection of AC. Gallbladder wall thickening (GBWT) and pericholecystic free fluid (PCFF) were the two most predictive individual signs for AC. The combination of gallstones with GBWT, PCFF, or sludge was also predictive of AC. Biliary ductal dilation and gallstones were the only least predictive signs. The combination of gallstones and GBWT, PCFF, or sludge on emergency ultrasound is predictive of AC.
Gold standard (test)
Vital signs
Cite
Citations (5)
Evolution in breast imaging has dramatically changed and upgraded by wide variety of technologic advances from the early days of direct-exposure film mammography to xeromammography to screen-film mammography to the current era of full-field digital mammography and digital breast tomosynthesis. In early 1950 Mammography has been introduced along with the breast self examination. After two decades thermography and ultrasound examination has been added in the breast imaging . From year 1990 to 2000 drastic technological advances, organized screening, with BI-RAD classification introduced by American College of Radiology Breast Imaging Reporting and Data System have helped to shape the specialty of breast imaging. With the development of digital mammography and tomosynthesis in 2020, breast ultrasonography and breast magnetic resonance imaging, both complementary to mammography, has set new standard in diagnostic accuracy of breast lesions.This paper gives a quick insight to the development of breast imaging and reviews the evolution of breast imaging starting from a historical perspective and progressing to the present day.
Keywords: Mammography screening, tomosynthesis ,Digital mammography.
Breast imaging
Tomosynthesis
Breast ultrasound
Digital Mammography
Digital Breast Tomosynthesis
Cite
Citations (2)
Breast density is an important risk factor for breast cancer and has a substantial effect on the sensitivity of mammography screening. This study aimed to evaluate intra and inter reader variability of visual breast density assessment in Saudi Arabia, using the American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS) breast density categories (5th edition) and Visual Analogue Scales (VAS). A random sample of 102 screening mammograms from the Saudi National Breast Cancer Screening Programme (SNBCSP) was assessed twice by two breast screening consultant radiologists for intra reader variability. Inter reader variability was assessed using screening mammograms from 1132 women. Each mammogram was assessed by two readers from a pool of 11 radiologists. Inter reader variability for two mammography technologists using a sample of 75 mammograms is also reported. Intra reader variability showed radiologist A had excellent agreement for VAS [Intraclass Correlation Coefficient (ICC) = 0.95] and BI-RADS [weighted kappa (κ) = 0.88], radiologist B had lower but still excellent agreement for VAS [ICC= 0.88] and substantial agreement for BI-RADS [κ = 0.71]. Inter reader variability between radiologists showed overall moderate agreement for BI-RADS [κ =0.61] while VAS had excellent agreement [ICC=0.89]. Results of inter reader agreement between two mammography technologists was fair using BI-RADS [κ= 0.35] and moderate using VAS [ICC=0.41]. In conclusion, agreement in breast density assessment by radiologists in the Saudi breast screening programme is acceptable. Mammography technologists showed lower agreement for both methods. Training is essential to increase reader agreement, double reading is also important in such population based breast cancer screening programmes.
BI-RADS
Breast imaging
Breast density
Mammographic Density
Kappa
Breast Cancer Screening
Cohen's kappa
Cite
Citations (2)