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Scar formation after stereotactic vacuum-assisted core biopsy of benign breast lesions
Clinical Imaging 30 (2006) 438 – 441
Abstracts
Scar formation after stereotactic vacuum-assisted core biopsy of benign breast lesions Yazici B, Sever AR, Mills P, Fish D, Jones SE, Jones PA (A.R.S.: Maidstone Hospital Breast Screening Unit, Hermitage Lane, Maidstone ME16 9QQ, UK). Clin Radiol 2006;61:619–624. Aim: To evaluate scar formation of impalpable breast lesions with benign histological outcome using stereotactic 11-gauge vacuum-assisted core biopsy (VACB). Materials and methods: Two hundred ten lesions with benign histology, for which follow-up mammograms were available, were assessed for scar formation at the biopsy site. All biopsies were performed by using stereotactic VACB with an 11-gauge needle. The incidence of postbiopsy scar formation and the number of specimens removed were determined. Results: In 4.3% (9/210) of the lesions for which a biopsy was performed with 11-gauge directional vacuum-assisted technique, the follow-up mammogram revealed a scar formation. Of these, six were minimal scars, two were moderate scars, and one was a marked scar. Minimal and moderate scars were diagnosed on imaging only. However, the case with marked scar formation required tissue diagnosis to rule out malignancy. Conclusion: Although uncommon, scar formation can be seen in the follow-up mammograms after percutaneous breast biopsies. It is important that the radiologist interpreting follow-up mammograms is aware of the features of this lesion and its relationship to the biopsy procedure. n 2006 The Royal College of Radiologists. Reprinted by permission.
The role of ultrasound in the surgical management of patients diagnosed with ductal carcinoma in situ of the breast Khalpour N, Zager JS, Yen T, Stephens T, Kuerer HM, Singletary ES, Ross ML, Hunt KK, Babiera GV (G.V.B.: University of Texas MD Anderson Cancer center, 1400 Holcombe Blvd., Unit #444, PO Box 301402, Houston, TX 77030-1402). Breast J 2006;12:212–215. The purpose of this study was to determine the usefulness of ultrasound (US) as an adjunct to mammography (MMG) in the surgical treatment planning for patients with ductal carcinoma in situ (DCIS) of the breast. A total of 119 patients diagnosed with DCIS, who were treated between 1999 and 2002, were identified from the institutional database. US and MMG size of suspicious abnormalities, pathologic tumor size, and findings of axillary US and surgical axillary evaluation were analyzed. The median size difference of US versus pathologic tumor size and MMG versus pathologic tumor size was 1.0 and 2.0 cm, respectively. Correlation coefficients for US versus pathologic tumor size and MMG versus pathologic tumor size were 0.53 and 0.09, respectively. The negative and positive predictive values of axillary US to predict nodal disease were 93% and 27%, respectively. US evaluation appears to be a useful tool in conjunction with MMG in determining the extent of disease in patients diagnosed with DCIS. However, the low positive predictive value of US for evaluating metastases to axillary lymph nodes does not justify the routine use of this modality for axillary evaluation in patients with DCIS. Therefore, the use of US for patients diagnosed with DCIS needs further investigation. 0899-7071/06/$ – see front matter doi:10.1016/j.clinimag.2006.08.004
Unusual benign breast lesions—pictorial review Porter GJR, Evans AJ, Hamilton LJ, James JJ (Nottingham Breast Institute, City Hospital, Hucknall Road, Nottingham NG5 1PB, UK). Clin Radiol 2006;61:562–569. The purpose of this article is to show examples of the radiological (mammography and/or ultrasound) and pathologic appearances of unusual benign breast lesions. The conditions covered are granular cell tumours, fibromatosis, nodular fasciitis, myofibroblastomas, haemangiomas, neurofibromas, and leiomyomas. The article includes the first published description of the ultrasound appearance of a myofibroblastoma. Knowledge of these appearances may help confirm or refute radiological–pathological concordance of percutaneous biopsy results during multidisciplinary assessment of these lesions and aid patient management. n 2006 The Royal College of Radiologists. Reprinted by permission
Diagnosis of pulmonary emboli and image quality at CT pulmonary angiography: influence of imaging direction with multidetector CT Hargaden GC, Kavanagh EC, Fitzpatrick P, Murray JG (Department of Radiology, The Mater Misericordiae University Hospital, Eccles St., Dublin 7, Ireland). Clin Radiol 2006;61:600–603. Aim: To determine whether there was a significant difference in the prevalence of emboli detected when patients underwent computed tomography pulmonary angiography (CTPA) in a craniocaudal direction versus a caudocranial direction. Materials and methods: This was a prospective study of 203 consecutive patients attending for CTPA for suspected pulmonary embolus. Imaging was performed on a multisection Siemens Volume Zoom CT machine, with bolus tracking centred on the main pulmonary artery after intravenous administration of contrast at 3 ml/s. Patients were examined in a single breath-hold, from the top of the aortic arch to the highest point of the diaphragm, in a randomly assigned craniocaudal (group A), or caudocranial (group B) direction. Images were reviewed on a workstation in craniocaudal direction jointly by two radiologists unaware of the original imaging direction. The presence, number, and position of arterial emboli were noted, and a subjective assessment of overall image quality and opacification of upper and lower lobe vessels (grade 1, 2, 3, or 4) was made. Results: Emboli were detected in 46 patients. There was no significant difference in the prevalence of emboli detected in the two groups [group A: craniocaudal direction, n=22; group B: caudocranial direction, n=24 ( P=.76)]. Imaging direction did not significantly influence overall image quality ( P=.07); however, there was a significantly greater proportion of patients in group A with grade 1 opacification of the upper lobe arteries ( P=.02). Conclusion: Imaging direction does not significantly influence the diagnosis of pulmonary emboli, but craniocaudal direction significantly improves upper lobe pulmonary arterial enhancement with fewer nondiagnostic images, and on that basis we recommend that craniocaudal direction be used for CTPA studies. n 2006 The Royal College of Radiologists. Reprinted by permission.
Abstracts
Scar formation after stereotactic vacuum-assisted core biopsy of benign breast lesions Yazici B, Sever AR, Mills P, Fish D, Jones SE, Jones PA (A.R.S.: Maidstone Hospital Breast Screening Unit, Hermitage Lane, Maidstone ME16 9QQ, UK). Clin Radiol 2006;61:619–624. Aim: To evaluate scar formation of impalpable breast lesions with benign histological outcome using stereotactic 11-gauge vacuum-assisted core biopsy (VACB). Materials and methods: Two hundred ten lesions with benign histology, for which follow-up mammograms were available, were assessed for scar formation at the biopsy site. All biopsies were performed by using stereotactic VACB with an 11-gauge needle. The incidence of postbiopsy scar formation and the number of specimens removed were determined. Results: In 4.3% (9/210) of the lesions for which a biopsy was performed with 11-gauge directional vacuum-assisted technique, the follow-up mammogram revealed a scar formation. Of these, six were minimal scars, two were moderate scars, and one was a marked scar. Minimal and moderate scars were diagnosed on imaging only. However, the case with marked scar formation required tissue diagnosis to rule out malignancy. Conclusion: Although uncommon, scar formation can be seen in the follow-up mammograms after percutaneous breast biopsies. It is important that the radiologist interpreting follow-up mammograms is aware of the features of this lesion and its relationship to the biopsy procedure. n 2006 The Royal College of Radiologists. Reprinted by permission.
The role of ultrasound in the surgical management of patients diagnosed with ductal carcinoma in situ of the breast Khalpour N, Zager JS, Yen T, Stephens T, Kuerer HM, Singletary ES, Ross ML, Hunt KK, Babiera GV (G.V.B.: University of Texas MD Anderson Cancer center, 1400 Holcombe Blvd., Unit #444, PO Box 301402, Houston, TX 77030-1402). Breast J 2006;12:212–215. The purpose of this study was to determine the usefulness of ultrasound (US) as an adjunct to mammography (MMG) in the surgical treatment planning for patients with ductal carcinoma in situ (DCIS) of the breast. A total of 119 patients diagnosed with DCIS, who were treated between 1999 and 2002, were identified from the institutional database. US and MMG size of suspicious abnormalities, pathologic tumor size, and findings of axillary US and surgical axillary evaluation were analyzed. The median size difference of US versus pathologic tumor size and MMG versus pathologic tumor size was 1.0 and 2.0 cm, respectively. Correlation coefficients for US versus pathologic tumor size and MMG versus pathologic tumor size were 0.53 and 0.09, respectively. The negative and positive predictive values of axillary US to predict nodal disease were 93% and 27%, respectively. US evaluation appears to be a useful tool in conjunction with MMG in determining the extent of disease in patients diagnosed with DCIS. However, the low positive predictive value of US for evaluating metastases to axillary lymph nodes does not justify the routine use of this modality for axillary evaluation in patients with DCIS. Therefore, the use of US for patients diagnosed with DCIS needs further investigation. 0899-7071/06/$ – see front matter doi:10.1016/j.clinimag.2006.08.004
Unusual benign breast lesions—pictorial review Porter GJR, Evans AJ, Hamilton LJ, James JJ (Nottingham Breast Institute, City Hospital, Hucknall Road, Nottingham NG5 1PB, UK). Clin Radiol 2006;61:562–569. The purpose of this article is to show examples of the radiological (mammography and/or ultrasound) and pathologic appearances of unusual benign breast lesions. The conditions covered are granular cell tumours, fibromatosis, nodular fasciitis, myofibroblastomas, haemangiomas, neurofibromas, and leiomyomas. The article includes the first published description of the ultrasound appearance of a myofibroblastoma. Knowledge of these appearances may help confirm or refute radiological–pathological concordance of percutaneous biopsy results during multidisciplinary assessment of these lesions and aid patient management. n 2006 The Royal College of Radiologists. Reprinted by permission
Diagnosis of pulmonary emboli and image quality at CT pulmonary angiography: influence of imaging direction with multidetector CT Hargaden GC, Kavanagh EC, Fitzpatrick P, Murray JG (Department of Radiology, The Mater Misericordiae University Hospital, Eccles St., Dublin 7, Ireland). Clin Radiol 2006;61:600–603. Aim: To determine whether there was a significant difference in the prevalence of emboli detected when patients underwent computed tomography pulmonary angiography (CTPA) in a craniocaudal direction versus a caudocranial direction. Materials and methods: This was a prospective study of 203 consecutive patients attending for CTPA for suspected pulmonary embolus. Imaging was performed on a multisection Siemens Volume Zoom CT machine, with bolus tracking centred on the main pulmonary artery after intravenous administration of contrast at 3 ml/s. Patients were examined in a single breath-hold, from the top of the aortic arch to the highest point of the diaphragm, in a randomly assigned craniocaudal (group A), or caudocranial (group B) direction. Images were reviewed on a workstation in craniocaudal direction jointly by two radiologists unaware of the original imaging direction. The presence, number, and position of arterial emboli were noted, and a subjective assessment of overall image quality and opacification of upper and lower lobe vessels (grade 1, 2, 3, or 4) was made. Results: Emboli were detected in 46 patients. There was no significant difference in the prevalence of emboli detected in the two groups [group A: craniocaudal direction, n=22; group B: caudocranial direction, n=24 ( P=.76)]. Imaging direction did not significantly influence overall image quality ( P=.07); however, there was a significantly greater proportion of patients in group A with grade 1 opacification of the upper lobe arteries ( P=.02). Conclusion: Imaging direction does not significantly influence the diagnosis of pulmonary emboli, but craniocaudal direction significantly improves upper lobe pulmonary arterial enhancement with fewer nondiagnostic images, and on that basis we recommend that craniocaudal direction be used for CTPA studies. n 2006 The Royal College of Radiologists. Reprinted by permission.