In order to preprocess mammograms for diagnosing the early cases of breast cancer and improving the computational efficiency in the computer-aided detection of micro-calcifications in mammograms, we have advanced a novel processing technique for the extraction of micro-calcification region of interest (MROI). The proposed method is based on a three-step procedure: (1) the mammogram is divided into sub-images of the same size; (2) the wavelet multi-resolution method is conducted on the sub-images, and the parameters related to wavelet transform and threshold T are discussed according to rho; (3) the classification of sub-images is determined by T. It is tested with 20 mammograms and the results show that the method can achieve a true positive rate as high as 89.7% with a false positive rate as low as 2.1%.
Breast Diseases ; diagnostic imaging ; pathology ; Breast Neoplasms ; diagnostic imaging ; pathology ; Calcinosis ; diagnostic imaging ; Diagnosis, Computer-Assisted ; Humans ; Mammography

Adult ; Breast ; pathology ; Breast Neoplasms ; diagnostic imaging ; pathology ; Female ; Humans ; Lymphoma, Non-Hodgkin ; diagnostic imaging ; pathology ; Ultrasonography

Breast ; pathology ; Breast Neoplasms ; diagnostic imaging ; pathology ; Carcinoma, Medullary ; diagnostic imaging ; pathology ; Female ; Humans ; Middle Aged ; Stomach Neoplasms ; diagnostic imaging ; secondary ; Tomography, X-Ray Computed

OBJECTIVETo evaluate the impact of lesion size on the detection rate of non-palpable breast malignant lesions and determine whether lesion size should prompt biopsy of non-palpable breast lesions.

METHODSThe study included 816 ultrasonographically detected non-palpable breast lesions. We divided the lesions into five groups based on their largest diameters: ≤0.5cm, 0.6-1.0cm, 1.1-1.5cm, 1.6-2.0 cm, and >2.0 cm. The detection rate of malignancies of different sizes were compared among these lesions, Breast Imaging Reporting and Data System (BI-RADS) category 2-3 lesions, and BI-RADS grades 4-5 lesions. The feasibility of using lesion size as biopsy indicator for BI-RADS category 2-3 non-palpable breast lesion was analyzed using ROC curve.

RESULTSOf these 816 lesions, 100 (12.3%) were found to be malignant lesions. The detection rate of malignancy significantly increased along with the increase of lesion size (P<0.05). When the BI-RADS category was not considered, the frequency of malignancy in the >2.0 cm group was significantly higher than in other groups (P<0.05) The frequencies of malignancy in the 0.6-1.0 cm group, 1.1-1.5 cm group, and 1.6-2.0 cm group were higher than that in ≤0.5 cm group, but the difference was not significant (P>0.05) For BI RADS category 4 and 5 lesions, the frequency of malignancy in >2.0 cm group was higher than in other groups, but significant difference was only seen between >2.0 cm group and ≤0.5 cm group (P<0.05).

CONCLUSIONSLesion size may influence the detection rate of malignancy of non palpable breast lesions, and can be used as biopsy indicator of non palpable breast lesions in BI-RADS 2,3 category When we use 1.25cm as threshold,the sensitivity and specificity may be satisfying.

Breast ; pathology ; Breast Neoplasms ; diagnostic imaging ; pathology ; Female ; Humans ; Sensitivity and Specificity ; Ultrasonography, Mammary

OBJECTIVETo explore the correlation between pathological findings and mammographic features of microcalcification in calcified breast carcinoma without a mass.

METHODSThe morphology and distribution of the microcalcification lesions displayed by mammography were retrospectively analyzed in 108 cases of the calcified breast carcinoma without a mass in comparison with the pathological findings of the lesions.

RESULTSThe mammographic morphology or distribution of the microcalcification lesions did not differ significantly across different pathological types of calcified breast carcinoma without a mass (P>0.05). The microcalcification lesions showed no significant morphological difference between invasive and noninvasive breast carcinomas (P>0.05). Fine pleomorphic calcifications were frequently found in both invasive and noninvasive breast carcinomas, but fine linear and fine linear branching calcifications and mixed malignant calcifications were more common in invasive breast carcinoma. The distribution of the microcalcifications showed significantly different patterns between invasive and noninvasive breast carcinoma (P=0.006), characterized by segmental and cluttered distributions of the lesions, respectively.

CONCLUSIONThere is no specific mammographic features in correlation with the pathological types of microcalcification lesions in calcified breast carcinoma without a mass, but invasive and noninvasive calcified breast carcinomas have different mammographic features in the morphology and distribution of the microcalcifications to allow their preoperative differentiation.

Breast Neoplasms ; diagnostic imaging ; pathology ; Calcinosis ; diagnostic imaging ; pathology ; Carcinoma, Ductal, Breast ; diagnostic imaging ; pathology ; Female ; Humans ; Mammography ; methods ; Retrospective Studies

OBJECTIVETo assess the value of X-ray stereotactic core needle biopsy (SCNB) in diagnosis of mammographic minimal lesions.

METHODSThirty-one cases with suspicious malignant lesions detected by mammography underwent breast biopsy using computer-assisted stereotactic system with spring-loaded biopsy guns and 16G core needles. All specimens underwent histopathologic examination. Surgical operations were performed in 24 cases after SCNB, and pathological findings of SCNB specimens were compared with those of surgical biopsy.

RESULTAmong 24 cases with surgical excision, 8 cases (33.3%) were confirmed as breast carcinoma, and the other 16 cases (66.7%) was benign breast lesions. The consistency rate of diagnosis with two methods was 87.5%.

CONCLUSIONAs a safe and effective diagnostic method, SCNB is preferred approach to differentiate between malignant and benign diseases of minimal breast lesions before surgery.

Adult ; Aged ; Biopsy, Needle ; methods ; Breast ; pathology ; Breast Diseases ; diagnostic imaging ; pathology ; Breast Neoplasms ; diagnostic imaging ; pathology ; Female ; Humans ; Mammography ; Middle Aged

To investigate the magnetic resonance imaging (MRI) features for ductal carcinoma in situ (DCIS) and plasma cell mastitis (PCM) , and to improve diagnostic accuracy for DCIS and PCM. 
 Methods: The MRI morphology confirmed by surgical pathology and dynamic enhancement for 35 patients with DCIS and 45 patients with PCM were retrospectively analyzed, which included T1 pre-scan high signal, enhanced distribution characteristics, internal strengthening mode, whether centrifugation or centripetal diffusion, dynamic enhancement curve morphology, diffusion-weighted imaging (DWI) signal characteristics, and apparent diffusion coefficient (ADC) values. 
 Results: The segmental distribution, clustered ring, T1 pre-catheters diffusion and the dynamic delayed concentric diffusion were more common in DCIS than those in PCM (P<0.05). Regional distribution, internal heterogeneity enhancement, and enhanced delay period eccentric diffusion were more common in PCM than those in DCIS (P<0.05). In the PCM group, nipple repertoire, DWI center high signal, adjacent skin thickening, and sinus formation were significantly higher than those in the DCIS group (P<0.05).
 Conclusion: Both DCIS and PCM show a non-mass like enhancement on MRI. Images in DCIS mostly show duct-like, branch-like and segment-like distribution. The internal enhancement mode is centripetal diffusion. Images in PCM mostly show regional distribution, and the inside displays heterogeneity enhancement with the adjacent skin thickening and nipple subsided.
Breast Neoplasms ; diagnostic imaging ; Carcinoma, Ductal, Breast ; diagnostic imaging ; Contrast Media ; Diagnosis, Differential ; Female ; Humans ; Magnetic Resonance Imaging ; Mastitis ; diagnostic imaging ; Plasma Cells ; pathology ; Retrospective Studies

Breast Neoplasms ; diagnostic imaging ; Carcinoma, Non-Small-Cell Lung ; diagnostic imaging ; pathology ; therapy ; Fluorodeoxyglucose F18 ; Humans ; Lung Neoplasms ; diagnostic imaging ; pathology ; therapy ; Lymphoma ; diagnostic imaging ; Neoplasm Recurrence, Local ; diagnostic imaging ; Neoplasm Staging ; Neoplasm, Residual ; Positron-Emission Tomography ; Treatment Outcome

OBJECTIVETo compare the methods of delineating the whole breast target volume based on surface marks, palpation and glandular tissue on CT images, and to explore the contouring criteria after breast-conserving surgery.

METHODSIn 15 patients with breast cancer after breast-conserving surgery, the whole breast target was delineated in 3D CT simulation images each by three different methods. The target volume delineated according to anatomical marks were named CTVan, according to breast palpation named CTVpa, and according to glandular mammary tissue showing by CT images named CTVgl. The volumes of CTVan, CTVpa and CTVgl, and the degree of inclusion (DI) and conformal index (CI) between the targets were measured.

RESULTSThe mean volumes of CTVan, CTVpa and CTVgl were (792.23 ± 282.25) cm(3), (618.33 ± 295.90) cm(3) and (196.83 ± 117.62) cm(3), respectively. The differences among the three methods were statistically significant (P < 0.001). The difference between CTVan and CTVpa had no statistical significance (P = 0.08), and both the differences between CTVan and CTVgl, and between CTVpa and CTVgl had statistical significance (both P < 0.001). The CI between CTVan and CTVpa (0.644 ± 0.122) was significantly larger than the CI between CTVan and CTVgl (0.264 ± 0.108), and the CI between CTVpa and CTVgl (0.328 ± 0.115)(P < 0.001). The DI of CTVan to CTVpa was 0.709 ± 0.144,DI of CTVgl to CTVan was 0.994 ± 0.005 and DI of CTVgl to CTVpa was 0.989 ± 0.008. The differences of inner, outer, upper and lower boundaries of CTVpa and CTVan were (3.35 ± 7.23) mm, (5.57 ± 13.37) mm, (1.75 ± 11.62) mm, and (11.25 ± 4.07)mm, respectively. The cranial and medial boundaries had a negative correlation with CTVpa (P < 0.05 for all).

CONCLUSIONSThe differences among the three methods in the delineation of whole breast target volume are statistically significant. The target volume delineated according to the glandular mammary tissue displayed by CT scan is significantly smaller than that by the other two methods. Combination of breast palpation and anatomical marks may be helpful in delineating the whole breast target volume is relatively reasonable at present.

Breast ; pathology ; Breast Neoplasms ; diagnostic imaging ; Female ; Humans ; Imaging, Three-Dimensional ; Mastectomy, Segmental ; Palpation ; Tomography, X-Ray Computed

Breast cancer is one of the main cancers leading to women mortality in the world. Since the causes are still obscure, the microcalcification clusters are the primary indicators of breast cancer, and the detection is of importance to the prevention and treatment of the disease. Microcalcifications appear in the small clusters of a few pixels and as spots which are slightly brighter than their backgrounds. It becomes a challenge to detect all the microcalcifications. This paper presents an approach for detecting microcalcifications in digital mammograms employing a dual-threshold method developed from LoG edge detection. Two thresholds are proposed in our method based on two additional criterions. Experimental results show that the proposed method can locate the microcalcifications exactly in mammogram as well as restrain the contours produced by the noises.
Algorithms ; Breast Neoplasms ; diagnostic imaging ; pathology ; Calcinosis ; diagnostic imaging ; Female ; Humans ; Mammography ; methods ; Radiographic Image Interpretation, Computer-Assisted ; methods