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Soo, Mary Scott Campbell

Overview:

I am currently studying alternative and adjunctive imaging modalities for detecting carcinoma in the breast. This includes PET imaging, MRI and techniques for improvements in sonographic imaging. I am also studying various modalities for imaging breast implants.

Positions:

Associate Professor of Radiology

Radiology, Breast Imaging
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 1987

M.D. — Wake Forest University

News:

Grants:

City of Hope / Contract to continue work on 1U01CA189283-01A1

Administered By
Biostatistics & Bioinformatics
AwardedBy
City of Hope
Role
Investigator
Start Date
October 01, 2015
End Date
July 31, 2020

Comfort Talk Study

Administered By
Radiology, Musculoskeletal Imaging
AwardedBy
Hypnalgesics, LLC
Role
Collaborator
Start Date
September 01, 2014
End Date
June 30, 2016

Pain, Distress and Mammography Use in Breast Cancer Patients

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
January 01, 2009
End Date
December 31, 2014

Reducing Benign Breast Biopsies with Computer Modeling

Administered By
Radiology, Breast Imaging
AwardedBy
National Institutes of Health
Role
Clinical Investigator
Start Date
June 01, 2003
End Date
May 31, 2008

Breast Cancer Imaging Using Non-Parallel Beam SPECT

Administered By
Radiology
AwardedBy
National Institutes of Health
Role
Consultant
Start Date
March 01, 1998
End Date
March 31, 2008

FDG-PEM Detection - Characterization of Breast Cancer

Administered By
Radiology, Breast Imaging
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
September 01, 2004
End Date
August 31, 2007

Computer-Aided Diagnosis Of Breast Cancer Invasion

Administered By
Radiology
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
July 01, 1998
End Date
June 30, 2003
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Publications:

Relationships Between MRI Breast Imaging-Reporting and Data System (BI-RADS) Lexicon Descriptors and Breast Cancer Molecular Subtypes: Internal Enhancement is Associated with Luminal B Subtype.

The aim of this study was to determine the associations between breast MRI findings using the Breast Imaging-Reporting and Data System (BI-RADS) lexicon descriptors and breast cancer molecular subtypes. In this retrospective, IRB-approved, single institution study MRIs from 278 women with breast cancer were reviewed by one of six fellowship-trained breast imagers. Readers reported BI-RADS descriptors for breast masses (shape, margin, internal enhancement) and non-mass enhancement (distribution, internal enhancement). Pathology reports were reviewed for estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2). Surrogates were used to categorize tumors by molecular subtype: ER/PR+, HER2- (luminal A); ER/PR+, HER2+ (luminal B); ER/PR-, HER2+ (HER2); ER/PR/HER2- (basal). A univariate logistic regression model was developed to identify associations between BI-RADS descriptors and molecular subtypes. Internal enhancement for mass and non-mass enhancement was combined for analysis. There was an association between mass shape and basal subtype (p = 0.039), which was more frequently round (17.1%) than other subtypes (range: 0-8.3%). In addition, there was an association between mass margin and HER2 subtype (p = 0.040), as HER2 cancers more frequently had a smooth margin (33.3%) than other subtypes (range: 4.2-17.1%). Finally, there was an association between internal enhancement and luminal B subtype (p = 0.003), with no cases of luminal B cancer demonstrating homogeneous internal enhancement versus a range of 10.9-23.5% for other subtypes. There are associations between breast cancer molecular subtypes and lesion appearance on MRI using the BI-RADS lexicon.

Authors
Grimm, LJ; Zhang, J; Baker, JA; Soo, MS; Johnson, KS; Mazurowski, MA
MLA Citation
Grimm, LJ, Zhang, J, Baker, JA, Soo, MS, Johnson, KS, and Mazurowski, MA. "Relationships Between MRI Breast Imaging-Reporting and Data System (BI-RADS) Lexicon Descriptors and Breast Cancer Molecular Subtypes: Internal Enhancement is Associated with Luminal B Subtype." The breast journal (March 13, 2017).
PMID
28295860
Source
epmc
Published In
The Breast Journal
Publish Date
2017
DOI
10.1111/tbj.12799

Persistent Breast Pain Among Women With Histories of Breast-conserving Surgery for Breast Cancer Compared With Women Without Histories of Breast Surgery or Cancer.

This study compared persistent breast pain among women who received breast-conserving surgery for breast cancer and women without a history of breast cancer.Breast cancer survivors (n=200) were recruited at their first postsurgical surveillance mammogram (6 to 15 mo postsurgery). Women without a breast cancer history (n=150) were recruited at the time of a routine screening mammogram. All women completed measures of breast pain, pain interference with daily activities and intimacy, worry about breast pain, anxiety symptoms, and depression symptoms. Demographic and medical information were also collected.Persistent breast pain (duration ≥6 mo) was reported by 46.5% of breast cancer survivors and 12.7% of women without a breast cancer history (P<0.05). Breast cancer survivors also had significantly higher rates of clinically significant persistent breast pain (pain intensity score ≥3/10), as well as higher average breast pain intensity and unpleasantness scores. Breast cancer survivors with persistent breast pain had significantly higher levels of depressive symptoms, as well as pain worry and interference, compared with survivors without persistent breast pain or women without a breast cancer history. Anxiety symptoms were significantly higher in breast cancer survivors with persistent breast pain compared with women without a breast cancer history.Results indicate that persistent breast pain negatively impacts women with a history of breast-conserving cancer surgery compared with women without that history. Strategies to ameliorate persistent breast pain and to improve adjustment among women with persistent breast pain should be explored for incorporation into standard care for breast cancer survivors.

Authors
Edmond, SN; Shelby, RA; Keefe, FJ; Fisher, HM; Schmidt, JE; Soo, MS; Skinner, CS; Ahrendt, GM; Manculich, J; Sumkin, JH; Zuley, ML; Bovbjerg, DH
MLA Citation
Edmond, SN, Shelby, RA, Keefe, FJ, Fisher, HM, Schmidt, JE, Soo, MS, Skinner, CS, Ahrendt, GM, Manculich, J, Sumkin, JH, Zuley, ML, and Bovbjerg, DH. "Persistent Breast Pain Among Women With Histories of Breast-conserving Surgery for Breast Cancer Compared With Women Without Histories of Breast Surgery or Cancer." The Clinical journal of pain 33.1 (January 2017): 51-56.
PMID
27922843
Source
epmc
Published In
Clinical Journal of Pain
Volume
33
Issue
1
Publish Date
2017
Start Page
51
End Page
56

Positive and negative mood following imaging-guided core needle breast biopsy and receipt of biopsy results.

Positive and negative mood are independent psychological responses to stressful events. Negative mood negatively impacts well-being and co-occurring positive mood leads to improved adjustment. Women undergoing core needle breast biopsies (CNB) experience distress during CNB and awaiting results; however, influences of mood are not well known. This longitudinal study examines psychosocial and biopsy- and spirituality-related factors associated with mood in patients day of CNB and one week after receiving results. Ninety women undergoing CNB completed questionnaires on psychosocial factors (chronic stress, social support), biopsy experiences (pain, radiologist communication), and spirituality (peace, meaning, faith) day of CNB. Measures of positive and negative mood were completed day of CNB and one week after receiving results (benign n = 50; abnormal n = 25). Multiple linear regression analyses were conducted. Greater positive mood correlated with greater peace (β = .25, p = .02) day of CNB. Lower negative mood correlated with greater peace (β = -.29, p = .004) and there was a trend for a relationship with less pain during CNB (β = .19, p = .07). For patients with benign results, day of CNB positive mood predicted positive mood post-results (β = .31, p = .03) and only chronic stress predicted negative mood (β = .33, p = .03). For women with abnormal results, greater meaning day of CNB predicted lower negative mood post-results (β = -.45, p = .03). Meaning and peace may be important for women undergoing CNB and receiving abnormal results.

Authors
Perlman, KL; Shelby, RA; Wren, AA; Kelleher, SA; Dorfman, CS; O'Connor, E; Kim, C; Johnson, KS; Soo, MS
MLA Citation
Perlman, KL, Shelby, RA, Wren, AA, Kelleher, SA, Dorfman, CS, O'Connor, E, Kim, C, Johnson, KS, and Soo, MS. "Positive and negative mood following imaging-guided core needle breast biopsy and receipt of biopsy results." Psychology, health & medicine (December 23, 2016): 1-14.
PMID
28007008
Source
epmc
Published In
Psychology, Health & Medicine
Publish Date
2016
Start Page
1
End Page
14
DOI
10.1080/13548506.2016.1271438

Patient Anxiety Before and Immediately After Imaging-Guided Breast Biopsy Procedures: Impact of Radiologist-Patient Communication.

The aim of this study was to evaluate patient anxiety and its association with perceived radiologist-patient communication in the setting of imaging-guided breast biopsy.After informed consent was obtained, 138 women recommended for imaging-guided breast procedures completed questionnaires immediately before and after biopsies, measuring state anxiety using the State-Trait Anxiety Inventory (range, 20-80). Before biopsies, women also completed questionnaires regarding their perceived communication with the radiologists recommending the procedures (modified Questionnaire on the Quality of Physician-Patient Interaction), demographic characteristics, and medical history; immediately after the biopsies, they completed a measure of perceived communication with the radiologists performing the biopsies. Experience levels (eg, attending radiologist, fellow) of the radiologists recommending and performing the biopsies were recorded. Data were analyzed using paired and independent t tests, one-way analysis of variance, Pearson's correlations, and multiple linear regression analyses.Average prebiopsy anxiety was 44.5 ± 12.4 (range, 20-77) on a scale ranging from 20 to 80 points. Perceived communication with radiologists recommending biopsies averaged 52.4 ± 11.5 (range, 18-65). Better communication with radiologists recommending biopsies was significantly associated with lower levels of prebiopsy anxiety (r = -0.22, P = .01). After the biopsies, women's anxiety significantly decreased (paired t = -7.32, P < .001). Better communication with radiologists performing biopsies (mean, 57.8 ± 8.4; range, 32-65) was associated with lower postbiopsy anxiety after accounting for patients' baseline anxiety levels (β = -0.17, P = .04). White women reported higher prebiopsy and postbiopsy anxiety; nonwhite women reported poorer communication with recommending radiologists.Patients' perceptions of better communication with radiologists were associated with lower levels of anxiety before and after biopsies. These results have implications for radiologist training and adherence to mammographic screening.

Authors
Miller, LS; Shelby, RA; Balmadrid, MH; Yoon, S; Baker, JA; Wildermann, L; Soo, MS
MLA Citation
Miller, LS, Shelby, RA, Balmadrid, MH, Yoon, S, Baker, JA, Wildermann, L, and Soo, MS. "Patient Anxiety Before and Immediately After Imaging-Guided Breast Biopsy Procedures: Impact of Radiologist-Patient Communication." Journal of the American College of Radiology : JACR 13.11S (November 2016): e62-e71.
PMID
27814826
Source
epmc
Published In
Journal of the American College of Radiology
Volume
13
Issue
11S
Publish Date
2016
Start Page
e62
End Page
e71
DOI
10.1016/j.jacr.2016.09.034

Suspicious breast calcifications undergoing stereotactic biopsy in women ages 70 and over: Breast cancer incidence by BI-RADS descriptors.

To determine the malignancy rate overall and for specific BI-RADS descriptors in women ≥70 years who undergo stereotactic biopsy for calcifications.We retrospectively reviewed 14,577 consecutive mammogram reports in 6839 women ≥70 years to collect 231 stereotactic biopsies of calcifications in 215 women. Cases with missing images or histopathology and calcifications associated with masses, distortion, or asymmetries were excluded. Three breast radiologists determined BI-RADS descriptors by majority. Histology, hormone receptor status, and lymph node status were correlated with BI-RADS descriptors.There were 131 (57 %) benign, 22 (10 %) atypia/lobular carcinomas in situ, 55 (24 %) ductal carcinomas in situ (DCIS), and 23 (10 %) invasive diagnoses. Twenty-seven (51 %) DCIS cases were high-grade. Five (22 %) invasive cases were high-grade, two (9 %) were triple-negative, and three (12 %) were node-positive. Malignancy was found in 49 % (50/103) of fine pleomorphic, 50 % (14/28) of fine linear, 25 % (10/40) of amorphous, 20 % (3/15) of round, 3 % (1/36) of coarse heterogeneous, and 0 % (0/9) of dystrophic calcifications.Among women ≥70 years that underwent stereotactic biopsy for calcifications only, we observed a high rate of malignancy. Additionally, coarse heterogeneous calcifications may warrant a probable benign designation.• Cancer rates of biopsied calcifications in women ≥70 years are high • Radiologists should not dismiss suspicious calcifications in older women • Coarse heterogeneous calcifications may warrant a probable benign designation.

Authors
Grimm, LJ; Johnson, DY; Johnson, KS; Baker, JA; Soo, MS; Hwang, ES; Ghate, SV
MLA Citation
Grimm, LJ, Johnson, DY, Johnson, KS, Baker, JA, Soo, MS, Hwang, ES, and Ghate, SV. "Suspicious breast calcifications undergoing stereotactic biopsy in women ages 70 and over: Breast cancer incidence by BI-RADS descriptors." European radiology (October 17, 2016).
PMID
27752832
Source
epmc
Published In
European Radiology
Publish Date
2016

Imaging-Guided Core-Needle Breast Biopsy: Impact of Meditation and Music Interventions on Patient Anxiety, Pain, and Fatigue.

To evaluate the impact of guided meditation and music interventions on patient anxiety, pain, and fatigue during imaging-guided breast biopsy.After giving informed consent, 121 women needing percutaneous imaging-guided breast biopsy were randomized into three groups: (1) guided meditation; (2) music; (3) standard-care control group. During biopsy, the meditation and music groups listened to an audio-recorded, guided, loving-kindness meditation and relaxing music, respectively; the standard-care control group received supportive dialogue from the biopsy team. Immediately before and after biopsy, participants completed questionnaires measuring anxiety (State-Trait Anxiety Inventory Scale), biopsy pain (Brief Pain Inventory), and fatigue (modified Functional Assessment of Chronic Illness Therapy-Fatigue). After biopsy, participants completed questionnaires assessing radiologist-patient communication (modified Questionnaire on the Quality of Physician-Patient Interaction), demographics, and medical history.The meditation and music groups reported significantly greater anxiety reduction (P values < .05) and reduced fatigue after biopsy than the standard-care control group; the standard-care control group reported increased fatigue after biopsy. The meditation group additionally showed significantly lower pain during biopsy, compared with the music group (P = .03). No significant difference in patient-perceived quality of radiologist-patient communication was noted among groups.Listening to guided meditation significantly lowered biopsy pain during imaging-guided breast biopsy; meditation and music reduced patient anxiety and fatigue without compromising radiologist-patient communication. These simple, inexpensive interventions could improve women's experiences during core-needle breast biopsy.

Authors
Soo, MS; Jarosz, JA; Wren, AA; Soo, AE; Mowery, YM; Johnson, KS; Yoon, SC; Kim, C; Hwang, ES; Keefe, FJ; Shelby, RA
MLA Citation
Soo, MS, Jarosz, JA, Wren, AA, Soo, AE, Mowery, YM, Johnson, KS, Yoon, SC, Kim, C, Hwang, ES, Keefe, FJ, and Shelby, RA. "Imaging-Guided Core-Needle Breast Biopsy: Impact of Meditation and Music Interventions on Patient Anxiety, Pain, and Fatigue." Journal of the American College of Radiology : JACR 13.5 (May 2016): 526-534.
PMID
26853501
Source
epmc
Published In
Journal of the American College of Radiology
Volume
13
Issue
5
Publish Date
2016
Start Page
526
End Page
534
DOI
10.1016/j.jacr.2015.12.004

Anxiety prior to breast biopsy: Relationships with length of time from breast biopsy recommendation to biopsy procedure and psychosocial factors.

This study investigated how time from breast biopsy recommendation to biopsy procedure affected pre-biopsy anxiety (N = 140 women), and whether the relationship between wait time and anxiety was affected by psychosocial factors (chronic life stress, traumatic events, social support). Analyses showed a significant interaction between wait time and chronic life stress. Increased time from biopsy recommendation was associated with greater anxiety in women with low levels of life stress. Women with high levels of life stress experienced increased anxiety regardless of wait time. These results suggest that women may benefit from shorter wait times and receiving strategies for managing anxiety.

Authors
Hayes Balmadrid, MA; Shelby, RA; Wren, AA; Miller, LS; Yoon, SC; Baker, JA; Wildermann, LA; Soo, MS
MLA Citation
Hayes Balmadrid, MA, Shelby, RA, Wren, AA, Miller, LS, Yoon, SC, Baker, JA, Wildermann, LA, and Soo, MS. "Anxiety prior to breast biopsy: Relationships with length of time from breast biopsy recommendation to biopsy procedure and psychosocial factors." Journal of health psychology (September 30, 2015).
PMID
26424811
Source
epmc
Published In
Journal of Health Psychology
Publish Date
2015

Abbreviated screening protocol for breast MRI: a feasibility study.

To compare the performance of two shortened breast magnetic resonance imaging (MRI) protocols to a standard MRI protocol for breast cancer screening.In this Health Insurance Portability and Accountability Act compliant, institutional review board-approved pilot study, three fellowship-trained breast imagers evaluated 48 breast MRIs (24 normal, 12 benign, and 12 malignant) selected from a high-risk screening population. MRIs were presented in three viewing protocols, and a final Breast Imaging-Reporting and Data System assessment was recorded for each case. The first shortened protocol (abbreviated 1) included only fat-saturated precontrast T2-weighted, precontrast T1-weighted, and first pass T1-weighted postcontrast sequences. The second shortened protocol (abbreviated 2) included the abbreviated 1 protocol plus the second pass T1-weighted postcontrast sequence. The third protocol (full), reviewed after a 1-month waiting period, included a nonfat-saturated T1-weighted sequence, fat-saturated T2-weighted, precontrast T1-weighted, and three or four dynamic postcontrast sequences. Interpretation times were recorded for the abbreviated 1 and full protocols. Sensitivity and specificity were compared via a chi-squared analysis. This pilot study was designed to detect a 10% difference in sensitivity with a power of 0.8.There was no significant difference in sensitivity between the abbreviated 1 (86%; P = .22) or abbreviated 2 (89%; P = .38) protocols and the full protocol (95%). There was no significant difference in specificity between the abbreviated 1 (52%; P = 1) or abbreviated 2 (45%; P = .34) protocols and the full protocol (52%). The abbreviated 1 and full protocol interpretation times were similar (2.98 vs. 3.56 minutes).In this pilot study, reader performance comparing two shortened breast MRI protocols to a standard protocol in a screening cohort were similar, suggesting that a shortened breast MRI protocol may be clinically useful, warranting further investigation.

Authors
Grimm, LJ; Soo, MS; Yoon, S; Kim, C; Ghate, SV; Johnson, KS
MLA Citation
Grimm, LJ, Soo, MS, Yoon, S, Kim, C, Ghate, SV, and Johnson, KS. "Abbreviated screening protocol for breast MRI: a feasibility study." Academic radiology 22.9 (September 2015): 1157-1162.
PMID
26152500
Source
epmc
Published In
Academic Radiology
Volume
22
Issue
9
Publish Date
2015
Start Page
1157
End Page
1162
DOI
10.1016/j.acra.2015.06.004

Can breast cancer molecular subtype help to select patients for preoperative MR imaging?

PURPOSE: To assess whether breast cancer molecular subtype classified by surrogate markers can be used to predict the extent of clinically relevant disease with preoperative breast magnetic resonance (MR) imaging. MATERIALS AND METHODS: In this HIPAA-compliant, institutional review board-approved study, informed consent was waived. Preoperative breast MR imaging reports from 441 patients were reviewed for multicentric and/or multifocal disease, lymph node involvement, skin and/or nipple invasion, chest wall and/or pectoralis muscle invasion, or contralateral disease. Pathologic reports were reviewed to confirm the MR imaging findings and for hormone receptors (estrogen and progesterone subtypes), human epidermal growth factor receptor type 2 (HER2 subtype), tumor size, and tumor grade. Surrogates were used to categorize tumors by molecular subtype: hormone receptor positive and HER2 negative (luminal A subtype); hormone receptor positive and HER2 positive (luminal B subtype); hormone receptor negative and HER2 positive (HER2 subtype); hormone receptor negative and HER2 negative (basal subtype). All patients included in the study had a histologic correlation with MR imaging findings or they were excluded. χ(2) analysis was used to compare differences between subtypes, with multivariate logistic regression analysis used to assess for variable independence. RESULTS: Identified were 289 (65.5%) luminal A, 45 (10.2%) luminal B, 26 (5.9%) HER2, and 81 (18.4%) basal subtypes. Among subtypes, significant differences were found in the frequency of multicentric and/or multifocal disease (luminal A, 27.3% [79 of 289]; luminal B, 53.3% [24 of 45]; HER2, 65.4% [17 of 26]; basal, 27.2% [22 of 81]; P < .001) and lymph node involvement (luminal A, 17.3% [50 of 289]; luminal B, 35.6% [26 of 45]; HER2, 34.6% [nine of 26]; basal 24.7% [20 of 81]; P = .014). Multivariate analysis showed that molecular subtype was independently predictive of multifocal and/or multicentric disease. CONCLUSION: Preoperative breast MR imaging is significantly more likely to help detect multifocal and/or multicentric disease and lymph node involvement in luminal B and HER2 molecular subtype breast cancers. Molecular subtype may help to select patients for preoperative breast MR imaging.

Authors
Grimm, LJ; Johnson, KS; Marcom, PK; Baker, JA; Soo, MS
MLA Citation
Grimm, LJ, Johnson, KS, Marcom, PK, Baker, JA, and Soo, MS. "Can breast cancer molecular subtype help to select patients for preoperative MR imaging?." Radiology 274.2 (February 2015): 352-358.
PMID
25325325
Source
epmc
Published In
Radiology
Volume
274
Issue
2
Publish Date
2015
Start Page
352
End Page
358
DOI
10.1148/radiol.14140594

Predictors of pain experienced by women during percutaneous imaging-guided breast biopsies.

PURPOSE: The purpose of this study was to evaluate pain experienced during imaging-guided core-needle breast biopsies and to identify factors that predict increased pain perception during procedures. METHODS: In this institutional review board-approved, HIPAA-compliant protocol, 136 women undergoing stereotactically or ultrasound-guided breast biopsy or cyst aspiration were recruited and provided written informed consent. Participants filled out questionnaires assessing anticipated biopsy pain, ongoing breast pain, pain experienced during biopsy, catastrophic thoughts about pain during biopsy, anxiety, perceived communication with the radiologist, chronic life stress, and demographic and medical information. Procedure type, experience level of the radiologist performing the biopsy, number of biopsies, breast density, histology, and tumor size were recorded for each patient. Data were analyzed using Spearman's ρ correlations and a probit regression model. RESULTS: No pain (0 out of 10) was reported by 39.7% of women, mild pain (1-3 out of 10) by 48.5%, and moderate to severe pain (≥4 out of 10) by 11.8% (n = 16). Significant (P < .05) predictors of greater biopsy pain in the probit regression model included younger age, greater prebiopsy breast pain, higher anticipated biopsy pain, and undergoing a stereotactic procedure. Anticipated biopsy pain correlated most strongly with biopsy pain (β = .27, P = .004). CONCLUSIONS: Most patients report minimal pain during imaging-guided biopsy procedures. Women experiencing greater pain levels tended to report higher anticipated pain before the procedure. Communication with patients before biopsy regarding minimal average pain reported during biopsy and encouragement to make use of coping strategies may reduce patient anxiety and anticipated pain.

Authors
Soo, AE; Shelby, RA; Miller, LS; Balmadrid, MH; Johnson, KS; Wren, AA; Yoon, SC; Keefe, FJ; Soo, MS
MLA Citation
Soo, AE, Shelby, RA, Miller, LS, Balmadrid, MH, Johnson, KS, Wren, AA, Yoon, SC, Keefe, FJ, and Soo, MS. "Predictors of pain experienced by women during percutaneous imaging-guided breast biopsies." Journal of the American College of Radiology : JACR 11.7 (July 2014): 709-716.
PMID
24993536
Source
epmc
Published In
Journal of the American College of Radiology
Volume
11
Issue
7
Publish Date
2014
Start Page
709
End Page
716
DOI
10.1016/j.jacr.2014.01.013

Cancelation of MRI guided breast biopsies for suspicious breast lesions identified at 3.0 T MRI: reasons, rates, and outcomes.

RATIONALE AND OBJECTIVES: To determine the cancelation rate of magnetic resonance imaging (MRI)-guided procedures in suspicious breast lesions initially detected at 3.0 Tesla (T) MRI. MATERIALS AND METHODS: With institutional review board approval, a Health Insurance Portability and Accountability Act-compliant retrospective review of 117 suspicious 3.0 T MRI-detected lesions in 101 patients scheduled to undergo MRI-guided procedures was performed; informed consent was waived. Patient information, imaging features, and outcome data were collected and compared among completed and canceled procedures using Fisher's exact test. RESULTS: MRI-guided breast biopsies were canceled in 13% (15/117) because of lesion nonvisualization, including three (20%) masses, one (1%) focus, and 11 (73%) areas of nonmasslike enhancement. Median lesion size was 1.1 cm. Sixty percent (9/15) of nonvisualized lesions were associated with minimal or mild background parenchymal enhancement at MRI. The nonvisualization rate was not associated with patient age, menopausal status, lesion type, size, breast density, or background parenchymal enhancement (P > .7 for each). No cancers were detected at original lesion sites in 14 (93%) patients undergoing follow-up imaging (n = 11) or mastectomy (n = 3) for cancer elsewhere; one (7%) was lost to follow-up. CONCLUSION: The MRI-guided breast biopsy cancelation rate from nonvisualization of suspicious lesions originally detected with 3.0 T MRI scanning was 13%, similar to rates reported for lesions detected at 1.0 and 1.5 T MRI. No cancers were detected on follow-up imaging. Canceling MRI-guided biopsies because of lesion nonvisualization is a reasonable approach if measures are taken to ensure lesion resolution at the time of biopsy and at imaging follow-up.

Authors
Johnson, KS; Baker, JA; Lee, SS; Soo, MS
MLA Citation
Johnson, KS, Baker, JA, Lee, SS, and Soo, MS. "Cancelation of MRI guided breast biopsies for suspicious breast lesions identified at 3.0 T MRI: reasons, rates, and outcomes." Acad Radiol 20.5 (May 2013): 569-575.
PMID
23473719
Source
pubmed
Published In
Academic Radiology
Volume
20
Issue
5
Publish Date
2013
Start Page
569
End Page
575
DOI
10.1016/j.acra.2013.01.005

Mammographic appearance of calcium hydroxylapatite (RadiesseTM) injected into the breast for nipple reconstruction.

Authors
Holbrook, A; Lee, S; Soo, MS
MLA Citation
Holbrook, A, Lee, S, and Soo, MS. "Mammographic appearance of calcium hydroxylapatite (RadiesseTM) injected into the breast for nipple reconstruction." Breast J 19.1 (January 2013): 104-113.
PMID
23241079
Source
pubmed
Published In
The Breast Journal
Volume
19
Issue
1
Publish Date
2013
Start Page
104
End Page
113
DOI
10.1111/tbj.12068

Patient Anxiety Before and Immediately After Imaging-Guided Breast Biopsy Procedures: Impact of Radiologist-Patient Communication

Purpose: The aim of this study was to evaluate patient anxiety and its association with perceived radiologist-patient communication in the setting of imaging-guided breast biopsy. Methods: After informed consent was obtained, 138 women recommended for imaging-guided breast procedures completed questionnaires immediately before and after biopsies, measuring state anxiety using the State-Trait Anxiety Inventory (range, 20-80). Before biopsies, women also completed questionnaires regarding their perceived communication with the radiologists recommending the procedures (modified Questionnaire on the Quality of Physician-Patient Interaction), demographic characteristics, and medical history; immediately after the biopsies, they completed a measure of perceived communication with the radiologists performing the biopsies. Experience levels (eg, attending radiologist, fellow) of the radiologists recommending and performing the biopsies were recorded. Data were analyzed using paired and independent t tests, one-way analysis of variance, Pearson's correlations, and multiple linear regression analyses. Results: Average prebiopsy anxiety was 44.5 ± 12.4 (range, 20-77) on a scale ranging from 20 to 80 points. Perceived communication with radiologists recommending biopsies averaged 52.4 ± 11.5 (range, 18-65). Better communication with radiologists recommending biopsies was significantly associated with lower levels of prebiopsy anxiety (r = -0.22, P = .01). After the biopsies, women's anxiety significantly decreased (paired t = -7.32, P < .001). Better communication with radiologists performing biopsies (mean, 57.8 ± 8.4; range, 32-65) was associated with lower postbiopsy anxiety after accounting for patients' baseline anxiety levels (β = -0.17, P = .04). White women reported higher prebiopsy and postbiopsy anxiety; nonwhite women reported poorer communication with recommending radiologists. Conclusions: Patients' perceptions of better communication with radiologists were associated with lower levels of anxiety before and after biopsies. These results have implications for radiologist training and adherence to mammographic screening. © 2013 American College of Radiology.

Authors
Miller, LS; Shelby, RA; Balmadrid, MH; Yoon, S; Baker, JA; Wildermann, L; Soo, MS
MLA Citation
Miller, LS, Shelby, RA, Balmadrid, MH, Yoon, S, Baker, JA, Wildermann, L, and Soo, MS. "Patient Anxiety Before and Immediately After Imaging-Guided Breast Biopsy Procedures: Impact of Radiologist-Patient Communication." JACR Journal of the American College of Radiology (2013).
PMID
23499400
Source
scival
Published In
Journal of the American College of Radiology
Publish Date
2013
DOI
10.1016/j.jacr.2012.11.005

Mammographic appearance of calcium hydroxylapatite (radiesse™) injected into the breast for nipple reconstruction

Authors
Holbrook, A; Lee, S; Soo, MS
MLA Citation
Holbrook, A, Lee, S, and Soo, MS. "Mammographic appearance of calcium hydroxylapatite (radiesse™) injected into the breast for nipple reconstruction." Breast Journal 19.1 (2013): 104-105.
Source
scival
Published In
The Breast Journal
Volume
19
Issue
1
Publish Date
2013
Start Page
104
End Page
105
DOI
10.1111/tbj.12068

Cancelation of MRI Guided Breast Biopsies for Suspicious Breast Lesions Identified at 3.0 T MRI. Reasons, Rates, and Outcomes

Rationale and Objectives: To determine the cancelation rate of magnetic resonance imaging (MRI)-guided procedures in suspicious breast lesions initially detected at 3.0 Tesla (T) MRI. Materials and Methods: With institutional review board approval, a Health Insurance Portability and Accountability Act-compliant retrospective review of 117 suspicious 3.0 T MRI-detected lesions in 101 patients scheduled to undergo MRI-guided procedures was performed; informed consent was waived. Patient information, imaging features, and outcome data were collected and compared among completed and canceled procedures using Fisher's exact test. Results: MRI-guided breast biopsies were canceled in 13% (15/117) because of lesion nonvisualization, including three (20%) masses, one (1%) focus, and 11 (73%) areas of nonmasslike enhancement. Median lesion size was 1.1 cm. Sixty percent (9/15) of nonvisualized lesions were associated with minimal or mild background parenchymal enhancement at MRI. The nonvisualization rate was not associated with patient age, menopausal status, lesion type, size, breast density, or background parenchymal enhancement (P > .7 for each). No cancers were detected at original lesion sites in 14 (93%) patients undergoing follow-up imaging (n = 11) or mastectomy (n = 3) for cancer elsewhere; one (7%) was lost to follow-up. Conclusion: The MRI-guided breast biopsy cancelation rate from nonvisualization of suspicious lesions originally detected with 3.0 T MRI scanning was 13%, similar to rates reported for lesions detected at 1.0 and 1.5 T MRI. No cancers were detected on follow-up imaging. Canceling MRI-guided biopsies because of lesion nonvisualization is a reasonable approach if measures are taken to ensure lesion resolution at the time of biopsy and at imaging follow-up. © 2013 AUR.

Authors
Johnson, KS; Baker, JA; Lee, SS; Soo, MS
MLA Citation
Johnson, KS, Baker, JA, Lee, SS, and Soo, MS. "Cancelation of MRI Guided Breast Biopsies for Suspicious Breast Lesions Identified at 3.0 T MRI. Reasons, Rates, and Outcomes." Academic Radiology 20.5 (2013): 569-575.
Source
scival
Published In
Academic Radiology
Volume
20
Issue
5
Publish Date
2013
Start Page
569
End Page
575
DOI
10.1016/j.acra.2013.01.005

Patient anxiety before and immediately after imaging-guided breast biopsy procedures: Impact of radiologist-patient communication

Purpose: The aim of this study was to evaluate patient anxiety and its association with perceived radiologist-patient communication in the setting of imaging-guided breast biopsy. Methods: After informed consent was obtained, 138 women recommended for imaging-guided breast procedures completed questionnaires immediately before and after biopsies, measuring state anxiety using the State-Trait Anxiety Inventory (range, 20-80). Before biopsies, women also completed questionnaires regarding their perceived communication with the radiologists recommending the procedures (modified Questionnaire on the Quality of Physician-Patient Interaction), demographic characteristics, and medical history; immediately after the biopsies, they completed a measure of perceived communication with the radiologists performing the biopsies. Experience levels (eg, attending radiologist, fellow) of the radiologists recommending and performing the biopsies were recorded. Data were analyzed using paired and independent t tests, one-way analysis of variance, Pearson's correlations, and multiple linear regression analyses. Results: Average prebiopsy anxiety was 44.5 ± 12.4 (range, 20-77) on a scale ranging from 20 to 80 points. Perceived communication with radiologists recommending biopsies averaged 52.4 ± 11.5 (range, 18-65). Better communication with radiologists recommending biopsies was significantly associated with lower levels of prebiopsy anxiety (r = -0.22, P =.01). After the biopsies, women's anxiety significantly decreased (paired t = -7.32, P <.001). Better communication with radiologists performing biopsies (mean, 57.8 ± 8.4; range, 32-65) was associated with lower postbiopsy anxiety after accounting for patients' baseline anxiety levels (β = -0.17, P =.04). White women reported higher prebiopsy and postbiopsy anxiety; nonwhite women reported poorer communication with recommending radiologists. Conclusions: Patients' perceptions of better communication with radiologists were associated with lower levels of anxiety before and after biopsies. These results have implications for radiologist training and adherence to mammographic screening. © 2013 American College of Radiology.

Authors
Miller, LS; Shelby, RA; Balmadrid, MH; Yoon, S; Baker, JA; Wildermann, L; Soo, MS
MLA Citation
Miller, LS, Shelby, RA, Balmadrid, MH, Yoon, S, Baker, JA, Wildermann, L, and Soo, MS. "Patient anxiety before and immediately after imaging-guided breast biopsy procedures: Impact of radiologist-patient communication." Journal of the American College of Radiology 10.6 (2013): 423-431.
Source
scival
Published In
Journal of the American College of Radiology
Volume
10
Issue
6
Publish Date
2013
Start Page
423
End Page
431
DOI
10.1016/j.jacr.2012.11.005

Suspicious breast lesions detected at 3.0 T magnetic resonance imaging: clinical and histological outcomes.

RATIONALE AND OBJECTIVES: To evaluate the imaging features and histological and clinical outcomes of a series of suspicious, mammographically occult breast lesions detected at 3.0 T magnetic resonance imaging (MRI). MATERIALS AND METHODS: Approval was obtained from the institutional review board. A Health Insurance Portability and Accountability Act-compliant retrospective review was performed of 121 suspicious, mammographically occult lesions detected on 3.0 T contrast-enhanced breast MRI. All 121 lesions underwent histological sampling. Radiology and clinic reports were reviewed for patient demographics, MRI indication and findings, biopsy and localization details, histological results, and follow-up information. Positive predictive value (PPV) of biopsy recommendations were calculated and compared for screening versus diagnostic cases. Likelihood of malignancy was also compared with lesion size. Statistical analyses were performed using chi-square, Fisher's exact, and two-tail z-tests. RESULTS: Overall 43 malignancies were diagnosed from 121 suspicious, mammographically occult 3.0 T MRI-detected lesions. Seventy-eight (64%) of the 121 were benign. The overall PPV of 3.0 T MRI-detected lesions was 36% (43/121). The PPV for biopsy in the screening setting (22% [10/45]) was statistically significantly less (P = .018) compared to the PPV of a biopsy recommendation in the diagnostic setting (43% [33/76]). There was no correlation between lesion size and the likelihood of detecting malignancy. CONCLUSION: Our PPV of suspicious, mammographically occult, breast lesions detected at 3.0 T breast MRI is similar to the PPV reported previously for suspicious breast lesions detected at 1.5 T. This study supports the use of 3.0 T breast MRI for both screening and diagnostic breast imaging.

Authors
Johnson, KS; Baker, JA; Lee, SS; Soo, MS
MLA Citation
Johnson, KS, Baker, JA, Lee, SS, and Soo, MS. "Suspicious breast lesions detected at 3.0 T magnetic resonance imaging: clinical and histological outcomes." Acad Radiol 19.6 (June 2012): 667-674.
PMID
22459645
Source
pubmed
Published In
Academic Radiology
Volume
19
Issue
6
Publish Date
2012
Start Page
667
End Page
674
DOI
10.1016/j.acra.2012.02.016

Using the BI-RADS lexicon in a restrictive form of double reading as a strategy for minimizing screening mammography recall rates.

OBJECTIVE: The purpose of this article is to determine the potential reduction in screening recall rates by strictly following standardized BI-RADS lexicon for lesions seen on screening mammography. MATERIALS AND METHODS: Of 3084 consecutive mammograms performed at our screening facilities, 345 women with 437 lesions were recalled for additional imaging and constituted our study population. Three radiologists retrospectively classified lesions using the standard BI-RADS lexicon and assigned each to one of four groups: group A, the finding met criteria for recall by the BI-RADS lexicon; group B, the finding did not meet strict BI-RADS criteria for recall but was sufficiently indeterminate to warrant recall by the majority of the study panel; group C, the finding was classifiable by the BI-RADS lexicon but was not recalled because it was benign or stable; and group D, the questioned finding was not considered an abnormality by our study panel. Recall rates and the cancer detection rate were determined. The adjusted recall rate was calculated for lesions considered appropriate for recall (group A), and the reduction in the recall rate was determined. RESULTS: Nineteen malignancies were detected in our recalled population, for a cancer detection rate of 0.65%. All 19 malignancies were lesions considered appropriate for recall (group A). If only group A lesions had been recalled, the recall rate would have decreased from 11.4% to 6.2%, representing a 46% reduction in recalls without affecting the cancer detection rate. CONCLUSION: Using the BI-RADS lexicon as a decision-making aid may help adjust thresholds for recalling indeterminate or suspicious lesions and reduce recall rates from screening mammography.

Authors
Ghate, SV; Baker, JA; Kim, CE; Johnson, KS; Walsh, R; Soo, MSC
MLA Citation
Ghate, SV, Baker, JA, Kim, CE, Johnson, KS, Walsh, R, and Soo, MSC. "Using the BI-RADS lexicon in a restrictive form of double reading as a strategy for minimizing screening mammography recall rates." AJR Am J Roentgenol 198.4 (April 2012): 962-970.
PMID
22451567
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
198
Issue
4
Publish Date
2012
Start Page
962
End Page
970
DOI
10.2214/AJR.11.6648

Prospective study of factors predicting adherence to surveillance mammography in women treated for breast cancer.

PURPOSE: This prospective study examined the factors that predicted sustained adherence to surveillance mammography in women treated for breast cancer. METHODS: Breast cancer survivors (N = 204) who were undergoing surveillance mammography completed questionnaires assessing mammography-related anticipatory anxiety, persistent breast pain, mammography pain, and catastrophic thoughts about mammography pain. Adherence to mammography in the following year was assessed. RESULTS: In the year after study entry, 84.8% of women (n = 173) returned for a subsequent mammogram. Unadjusted associations showed that younger age, shorter period of time since surgery, and having upper extremity lymphedema were associated with lower mammography adherence. Forty percent of women reported moderate to high levels of mammography pain (score of ≥ 5 on a 0 to 10 scale). Although mammography pain was not associated with adherence, higher levels of mammography-related anxiety and pain catastrophizing were associated with not returning for a mammogram (P < .05). The impact of anxiety on mammography use was mediated by pain catastrophizing (indirect effect, P < .05). CONCLUSION: Findings suggest that women who are younger, closer to the time of surgery, or have upper extremity lymphedema may be less likely to undergo repeated mammograms. It may be important for health professionals to remind selected patients directly that some women avoid repeat mammography and to re-emphasize the value of mammography for women with a history of breast cancer. Teaching women behavioral techniques (eg, redirecting attention) or providing medication for reducing anxiety could be considered for women with high levels of anxiety or catastrophic thoughts related to mammography.

Authors
Shelby, RA; Scipio, CD; Somers, TJ; Soo, MS; Weinfurt, KP; Keefe, FJ
MLA Citation
Shelby, RA, Scipio, CD, Somers, TJ, Soo, MS, Weinfurt, KP, and Keefe, FJ. "Prospective study of factors predicting adherence to surveillance mammography in women treated for breast cancer." J Clin Oncol 30.8 (March 10, 2012): 813-819.
PMID
22331949
Source
pubmed
Published In
Journal of Clinical Oncology
Volume
30
Issue
8
Publish Date
2012
Start Page
813
End Page
819
DOI
10.1200/JCO.2010.34.4333

Breast imaging

Authors
Soo, MS; Williford, ME; Walsh, R; Kornguth, PJ; Wellman, DL; Braithwaite, AC; Whiteside, BE
MLA Citation
Soo, MS, Williford, ME, Walsh, R, Kornguth, PJ, Wellman, DL, Braithwaite, AC, and Whiteside, BE. "Breast imaging." Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition. January 19, 2012. 61-.
Source
scopus
Publish Date
2012
Start Page
61

Breast imaging: Case 9

Authors
Walsh, R; Soo, MS
MLA Citation
Walsh, R, and Soo, MS. "Breast imaging: Case 9." Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition. January 19, 2012. 78-79.
Source
scopus
Publish Date
2012
Start Page
78
End Page
79

Breast imaging: Case 2

Authors
Walsh, R; Soo, MS
MLA Citation
Walsh, R, and Soo, MS. "Breast imaging: Case 2." Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition. January 19, 2012. 64-65.
Source
scopus
Publish Date
2012
Start Page
64
End Page
65

Breast imaging: Case 12

Authors
Walsh, R; Soo, MS
MLA Citation
Walsh, R, and Soo, MS. "Breast imaging: Case 12." Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition. January 19, 2012. 84-85.
Source
scopus
Publish Date
2012
Start Page
84
End Page
85

Breast imaging: Case 6

Authors
Walsh, R; Soo, MS
MLA Citation
Walsh, R, and Soo, MS. "Breast imaging: Case 6." Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition. January 19, 2012. 72-73.
Source
scopus
Publish Date
2012
Start Page
72
End Page
73

Breast imaging: Case 3

Authors
Walsh, R; Soo, MS
MLA Citation
Walsh, R, and Soo, MS. "Breast imaging: Case 3." Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition. January 19, 2012. 66-67.
Source
scopus
Publish Date
2012
Start Page
66
End Page
67

Breast imaging: Case 1

Authors
Williford, ME; Soo, MS
MLA Citation
Williford, ME, and Soo, MS. "Breast imaging: Case 1." Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition. January 19, 2012. 62-63.
Source
scopus
Publish Date
2012
Start Page
62
End Page
63

Breast imaging: Case 4

Authors
Williford, ME; Soo, MS
MLA Citation
Williford, ME, and Soo, MS. "Breast imaging: Case 4." Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition. January 19, 2012. 68-69.
Source
scopus
Publish Date
2012
Start Page
68
End Page
69

Breast imaging: Case 8

Authors
Williford, ME; Soo, MS
MLA Citation
Williford, ME, and Soo, MS. "Breast imaging: Case 8." Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition. January 19, 2012. 76-77.
Source
scopus
Publish Date
2012
Start Page
76
End Page
77

Breast imaging: Case 13

Authors
Williford, ME; Soo, MS
MLA Citation
Williford, ME, and Soo, MS. "Breast imaging: Case 13." Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition. January 19, 2012. 86-87.
Source
scopus
Publish Date
2012
Start Page
86
End Page
87

Breast imaging: Case 16

Authors
Williford, ME; Soo, MS
MLA Citation
Williford, ME, and Soo, MS. "Breast imaging: Case 16." Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition. January 19, 2012. 92-93.
Source
scopus
Publish Date
2012
Start Page
92
End Page
93

Breast imaging: Case 20

Authors
Soo, MS
MLA Citation
Soo, MS. "Breast imaging: Case 20." Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition. January 19, 2012. 100-101.
Source
scopus
Publish Date
2012
Start Page
100
End Page
101

Breast imaging: Case 24

Authors
Whiteside, B; Soo, MS
MLA Citation
Whiteside, B, and Soo, MS. "Breast imaging: Case 24." Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition. January 19, 2012. 108-109.
Source
scopus
Publish Date
2012
Start Page
108
End Page
109

Breast imaging: Case 23

Authors
Soo, MS
MLA Citation
Soo, MS. "Breast imaging: Case 23." Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition. January 19, 2012. 106-107.
Source
scopus
Publish Date
2012
Start Page
106
End Page
107

Breast imaging: Case 21

Authors
Braithwaite, AC; Soo, MS
MLA Citation
Braithwaite, AC, and Soo, MS. "Breast imaging: Case 21." Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition. January 19, 2012. 102-103.
Source
scopus
Publish Date
2012
Start Page
102
End Page
103

Breast imaging: Case 14

Authors
Kornguth, PJ; Soo, MS
MLA Citation
Kornguth, PJ, and Soo, MS. "Breast imaging: Case 14." Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition. January 19, 2012. 88-89.
Source
scopus
Publish Date
2012
Start Page
88
End Page
89

Breast imaging: Case 11

Authors
Soo, MS
MLA Citation
Soo, MS. "Breast imaging: Case 11." Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition. January 19, 2012. 82-83.
Source
scopus
Publish Date
2012
Start Page
82
End Page
83

Breast imaging: Case 5

Authors
Soo, MS
MLA Citation
Soo, MS. "Breast imaging: Case 5." Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition. January 19, 2012. 70-71.
Source
scopus
Publish Date
2012
Start Page
70
End Page
71

Breast imaging: Case 15

Authors
Kornguth, PJ; Soo, MS
MLA Citation
Kornguth, PJ, and Soo, MS. "Breast imaging: Case 15." Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition. January 19, 2012. 90-91.
Source
scopus
Publish Date
2012
Start Page
90
End Page
91

Breast imaging: Case 17

Authors
Soo, MS
MLA Citation
Soo, MS. "Breast imaging: Case 17." Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition. January 19, 2012. 94-95.
Source
scopus
Publish Date
2012
Start Page
94
End Page
95

Breast imaging: Case 19

Authors
Braithwaite, AC; Soo, MS
MLA Citation
Braithwaite, AC, and Soo, MS. "Breast imaging: Case 19." Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition. January 19, 2012. 98-99.
Source
scopus
Publish Date
2012
Start Page
98
End Page
99

Breast imaging: Case 7

Authors
Kornguth, PJ; Soo, MS
MLA Citation
Kornguth, PJ, and Soo, MS. "Breast imaging: Case 7." Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition. January 19, 2012. 74-75.
Source
scopus
Publish Date
2012
Start Page
74
End Page
75

Breast imaging: Case 10

Authors
Soo, MS
MLA Citation
Soo, MS. "Breast imaging: Case 10." Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition. January 19, 2012. 80-81.
Source
scopus
Publish Date
2012
Start Page
80
End Page
81

Breast imaging: Case 22

Authors
Whiteside, B; Soo, MS
MLA Citation
Whiteside, B, and Soo, MS. "Breast imaging: Case 22." Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition. January 19, 2012. 104-105.
Source
scopus
Publish Date
2012
Start Page
104
End Page
105

Comparative performance of multiview stereoscopic and mammographic display modalities for breast lesion detection.

PURPOSE: Mammography is known to be one of the most difficult radiographic exams to interpret. Mammography has important limitations, including the superposition of normal tissue that can obscure a mass, chance alignment of normal tissue to mimic a true lesion and the inability to derive volumetric information. It has been shown that stereomammography can overcome these deficiencies by showing that layers of normal tissue lay at different depths. If standard stereomammography (i.e., a single stereoscopic pair consisting of two projection images) can significantly improve lesion detection, how will multiview stereoscopy (MVS), where many projection images are used, compare to mammography? The aim of this study was to assess the relative performance of MVS compared to mammography for breast mass detection. METHODS: The MVS image sets consisted of the 25 raw projection images acquired over an arc of approximately 45 degrees using a Siemens prototype breast tomosynthesis system. The mammograms were acquired using a commercial Siemens FFDM system. The raw data were taken from both of these systems for 27 cases and realistic simulated mass lesions were added to duplicates of the 27 images at the same local contrast. The images with lesions (27 mammography and 27 MVS) and the images without lesions (27 mammography and 27 MVS) were then postprocessed to provide comparable and representative image appearance across the two modalities. All 108 image sets were shown to five full-time breast imaging radiologists in random order on a state-of-the-art stereoscopic display. The observers were asked to give a confidence rating for each image (0 for lesion definitely not present, 100 for lesion definitely present). The ratings were then compiled and processed using ROC and variance analysis. RESULTS: The mean AUC for the five observers was 0.614 +/- 0.055 for mammography and 0.778 +/- 0.052 for multiview stereoscopy. The difference of 0.164 +/- 0.065 was statistically significant with a p-value of 0.0148. CONCLUSIONS: The differences in the AUCs and the p-value suggest that multiview stereoscopy has a statistically significant advantage over mammography in the detection of simulated breast masses. This highlights the dominance of anatomical noise compared to quantum noise for breast mass detection. It also shows that significant lesion detection can be achieved with MVS without any of the artifacts associated with tomosynthesis.

Authors
Webb, LJ; Samei, E; Lo, JY; Baker, JA; Ghate, SV; Kim, C; Soo, MS; Walsh, R
MLA Citation
Webb, LJ, Samei, E, Lo, JY, Baker, JA, Ghate, SV, Kim, C, Soo, MS, and Walsh, R. "Comparative performance of multiview stereoscopic and mammographic display modalities for breast lesion detection." Med Phys 38.4 (April 2011): 1972-1980.
Website
http://hdl.handle.net/10161/2508
PMID
21626930
Source
pubmed
Published In
Medical physics
Volume
38
Issue
4
Publish Date
2011
Start Page
1972
End Page
1980
DOI
10.1118/1.3562901

Breast self-examination: defining a cohort still in need.

BACKGROUND: The value of breast self-examination (BSE) to detect early breast cancer is controversial. METHODS: Within an institutional review board-approved prospective study, 147 high-risk women were enrolled from 2004 to 2007. Yearly clinical examination, BSE teaching, and mammography were performed simultaneously followed by interval breast magnetic resonance imaging (MRI). Women underwent additional BSE teaching at 6 months. Women reporting a mass on BSE underwent clinical evaluation. RESULTS: Fourteen breast cancers were detected in 12 women. BSE detected 6/14 breast cancers versus 6/14 detected by MRI and 2/14 by mammography. Of 24 masses detected by BSE, 6/24 were malignant. The sensitivity, specificity, and predictive value of BSE to detect breast cancer were 58.3%, 87.4%, and 29.2%, respectively. The sensitivity, specificity, and predictive value of a Breast Image Reporting and Data System (BI-RADS) score of >or=4 on MRI were 66.7%, 88.9%, and 34.8%, respectively. CONCLUSIONS: BSE detects new breast cancers in high-risk women undergoing screening mammogram, CBE, and yearly breast MRI.

Authors
Wilke, LG; Broadwater, G; Rabiner, S; Owens, E; Yoon, S; Ghate, S; Scott, V; Walsh, R; Baker, J; Soo, MS; Ibarra-Drendall, C; Stouder, A; Robertson, S; Barron, A; Seewaldt, V
MLA Citation
Wilke, LG, Broadwater, G, Rabiner, S, Owens, E, Yoon, S, Ghate, S, Scott, V, Walsh, R, Baker, J, Soo, MS, Ibarra-Drendall, C, Stouder, A, Robertson, S, Barron, A, and Seewaldt, V. "Breast self-examination: defining a cohort still in need." Am J Surg 198.4 (October 2009): 575-579.
PMID
19800471
Source
pubmed
Published In
American Journal of Surgery
Volume
198
Issue
4
Publish Date
2009
Start Page
575
End Page
579
DOI
10.1016/j.amjsurg.2009.06.012

The influence of increased ambient lighting on mass detection in mammograms.

RATIONALE AND OBJECTIVES: Recent research has provided evidence that in reading rooms equipped with liquid crystal displays (LCDs), a measured increase of ambient lighting may improve clinicians' detection performance. In agreement with this research, the American College of Radiology (ACR) has recommended a moderate increase of ambient lighting in mammography reading rooms. This study was designed to examine the effect of a controlled increase of ambient lighting in mammography reading rooms on the diagnostic performance of breast imaging radiologists. MATERIALS AND METHODS: Four breast imaging radiologists read 86 mammograms (43 containing subtle cancerous masses and 43 normal) under low (E = 1 lux) and elevated (E = 50 lux) ambient lighting levels on a Digital Imaging and Communications in Medicine-calibrated, medical-grade LCD. Radiologists were asked to identify cancerous masses and to rate their detection confidence. Observer areas under the curve (AUCs) were calculated using a receiver-operating characteristic analysis of fully paired results. Additionally, average observer selection times under both ambient lighting levels were determined. RESULTS: Average radiologist AUCs decreased with elevated ambient lighting (0.78 +/- 0.03 to 0.72 +/- 0.04). Observer performance differences, however, were of the same order of magnitude as interobserver variability and were not statistically significant. Average selection times under increased ambient lighting remained constant or decreased, with the greatest decrease occurring for false-positive (20.4 +/- 18.9 to 14.4 +/- 9.6 seconds) and true-positive (18.0 +/- 13.8 to 12.9 +/- 9.4 seconds) selections. CONCLUSION: The results agree with those of previous studies in that observer performance differences under a controlled increase of ambient lighting are not statistically significant. On the basis of these findings and ACR guidelines, a moderate increase of ambient lighting in mammography reading rooms is still suggested, but further research with additional cases and observers should be considered.

Authors
Pollard, BJ; Samei, E; Chawla, AS; Baker, J; Ghate, S; Kim, C; Soo, MS; Hashimoto, N
MLA Citation
Pollard, BJ, Samei, E, Chawla, AS, Baker, J, Ghate, S, Kim, C, Soo, MS, and Hashimoto, N. "The influence of increased ambient lighting on mass detection in mammograms." Acad Radiol 16.3 (March 2009): 299-304.
PMID
19201358
Source
pubmed
Published In
Academic Radiology
Volume
16
Issue
3
Publish Date
2009
Start Page
299
End Page
304
DOI
10.1016/j.acra.2008.08.017

Comparison of LCD and CRT displays based on efficacy for digital mammography.

RATIONALE AND OBJECTIVES: To compare two display technologies, cathode ray tube (CRT) and liquid crystal display (LCD), in terms of diagnostic accuracy for several common clinical tasks in digital mammography. MATERIALS AND METHODS: Simulated masses and microcalcifications were inserted into normal digital mammograms to produce an image set of 400 images. Images were viewed on one CRT and one LCD medical-quality display device by five experienced breast-imaging radiologists who rated the images using a categorical rating paradigm. The observer data were analyzed to determine overall classification accuracy, overall lesion detection accuracy, and accuracy for four specific diagnostic tasks: detection of benign masses, malignant masses, and microcalcifications, and discrimination of benign and malignant masses. RESULTS: Radiologists had similar overall classification accuracy (LCD: 0.83 +/- 0.01, CRT: 0.82 +/- 0.01) and lesion detection accuracy (LCD: 0.87 +/- 0.01, CRT: 0.85 +/- 0.01) on both displays. The difference in accuracy between LCD and CRT for the detection of benign masses, malignant masses, and microcalcifications, and discrimination of benign and malignant masses was -0.019 +/- 0.009, 0.020 +/- 0.008, 0.012 +/- 0.013, and 0.0094 +/- 0.011, respectively. Overall, the two displays did not exhibit any statistically significant difference (P > .05). CONCLUSION: This study explored the suitability of two different soft-copy displays for the viewing of mammographic images. It found that LCD and CRT displays offer similar clinical utility for mammographic tasks.

Authors
Saunders, RS; Samei, E; Baker, J; Delong, D; Soo, MS; Walsh, R; Pisano, E; Kuzmiak, CM; Pavic, D
MLA Citation
Saunders, RS, Samei, E, Baker, J, Delong, D, Soo, MS, Walsh, R, Pisano, E, Kuzmiak, CM, and Pavic, D. "Comparison of LCD and CRT displays based on efficacy for digital mammography." Acad Radiol 13.11 (November 2006): 1317-1326.
PMID
17070449
Source
pubmed
Published In
Academic Radiology
Volume
13
Issue
11
Publish Date
2006
Start Page
1317
End Page
1326
DOI
10.1016/j.acra.2006.07.017

Adaptive imaging on a diagnostic ultrasound scanner at quasi real-time rates.

Constructing an ultrasonic imaging system capable of compensating for phase errors in real-time is a significant challenge in adaptive imaging. We present a versatile adaptive imaging system capable of updating arrival time profiles at frame rates of approximately 2 frames per second (fps) with 1-D arrays and up to 0.81 fps for 1.75-D arrays, depending on the desired near-field phase correction algorithm. A novel feature included in this system is the ability to update the aberration profile at multiple beam locations for 1-D arrays. The features of this real-time adaptive imaging system are illustrated in tissue-mimicking phantoms with physical near-field phase screens and evaluated in clinical breast tissue with a 1.75-D array. The contrast-to-noise ratio (CNR) of anechoic cysts was shown to improve dramatically in the tissue-mimicking phantoms. In breast tissue, the width of point-like targets showed significant improvement: a reduction of 26.2% on average. Brightness of these targets, however, marginally decreased by 3.9%. For larger structures such as cysts, little improvement in features and CNR were observed, which is likely a result of the system assuming an infinite isoplanatic patch size for the 1.75-D arrays. The necessary requirements for constructing a real-time adaptive imaging system are also discussed.

Authors
Dahl, JJ; McAleavey, SA; Pinton, GF; Soo, MS; Trahey, GE
MLA Citation
Dahl, JJ, McAleavey, SA, Pinton, GF, Soo, MS, and Trahey, GE. "Adaptive imaging on a diagnostic ultrasound scanner at quasi real-time rates." IEEE Trans Ultrason Ferroelectr Freq Control 53.10 (October 2006): 1832-1843.
PMID
17036791
Source
pubmed
Published In
IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control
Volume
53
Issue
10
Publish Date
2006
Start Page
1832
End Page
1843

Primary primitive neuroectodermal tumor of the breast.

Authors
Maxwell, RW; Ghate, SV; Bentley, RC; Soo, MS
MLA Citation
Maxwell, RW, Ghate, SV, Bentley, RC, and Soo, MS. "Primary primitive neuroectodermal tumor of the breast." J Ultrasound Med 25.10 (October 2006): 1331-1333.
PMID
16998107
Source
pubmed
Published In
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine
Volume
25
Issue
10
Publish Date
2006
Start Page
1331
End Page
1333

MRI-guided vacuum-assisted breast biopsy with a handheld portable biopsy system.

OBJECTIVE: The purpose of this study was to evaluate a compact portable 10-gauge handheld battery-operated vacuum-assisted biopsy system for MRI-guided breast biopsy. CONCLUSION: The compact portable battery-operated biopsy system can be used successfully for MRI-guided core breast biopsy and is an alternative to current systems.

Authors
Ghate, SV; Rosen, EL; Soo, MSC; Baker, JA
MLA Citation
Ghate, SV, Rosen, EL, Soo, MSC, and Baker, JA. "MRI-guided vacuum-assisted breast biopsy with a handheld portable biopsy system." AJR Am J Roentgenol 186.6 (June 2006): 1733-1736.
PMID
16714667
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
186
Issue
6
Publish Date
2006
Start Page
1733
End Page
1736
DOI
10.2214/AJR.05.0551

Streaming detection for evaluation of indeterminate sonographic breast masses: a pilot study.

OBJECTIVE: Streaming detection is a novel sonography technique that uses ultrasonic energy to induce movement in cyst fluid that is detected on Doppler sonography. This pilot study evaluates the utility of streaming detection for differentiating cysts from solid masses in breast lesions that are indeterminate on sonography. SUBJECTS AND METHODS: Thirty-nine lesions-11 simple cysts and seven solid masses (control group) and 21 masses with indeterminate findings for the diagnosis of a cyst versus a solid lesion (study group)-in 34 patients were evaluated using streaming detection. All lesions underwent cyst aspiration or biopsy (n = 35) or were diagnosed simple cysts (n = 4) on sonography. Lesion size and depth were recorded. Streaming detection software was placed on conventional sonography units. Acoustic pulses were focused on the lesion, and if fluid movement was generated, it was seen on the spectral Doppler display as velocity away from the transducer. Lesions were then aspirated or underwent biopsy, and the viscosity of the aspirated fluid was recorded. The sensitivity and specificity of the technique and the effect of cyst size, cyst depth, and fluid viscosity in diagnosing fluid-filled cysts were assessed. RESULTS: Overall, 31 cysts and eight solid masses (seven benign, one carcinoma) were diagnosed in the study and control groups. Aspiration of indeterminate lesions resulted in 20 cysts and one solid mass. Lesions ranged in size from 4 to 47 mm and in depth from 4 to 29 mm. In the control group, streaming detection correctly showed nine of the 11 simple cysts (sensitivity, 82%; positive predictive value, 100%), and acoustic streaming was absent in all seven solid masses (specificity, 100%; negative predictive value, 78%). Of the indeterminate lesions, streaming detection allowed correct identification of 10 of 20 cysts (sensitivity, 50%; positive predictive value, 100%). Acoustic streaming was not detected in the one solid study group lesion. Neither cyst size or depth nor fluid viscosity had a significant effect on the ability to detect fluid. CONCLUSION: The streaming detection technique improved differentiation of cysts from solid masses in indeterminate lesions and has potential for reducing the number of recommended cyst aspirations for the diagnosis of indeterminate breast masses.

Authors
Soo, MS; Ghate, SV; Baker, JA; Rosen, EL; Walsh, R; Warwick, BN; Ramachandran, AR; Nightingale, KR
MLA Citation
Soo, MS, Ghate, SV, Baker, JA, Rosen, EL, Walsh, R, Warwick, BN, Ramachandran, AR, and Nightingale, KR. "Streaming detection for evaluation of indeterminate sonographic breast masses: a pilot study." AJR Am J Roentgenol 186.5 (May 2006): 1335-1341.
PMID
16632728
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
186
Issue
5
Publish Date
2006
Start Page
1335
End Page
1341
DOI
10.2214/AJR.05.0005

Reply [2]

Authors
Soo, MS; Ghate, S; Baker, JA; Rosen, E
MLA Citation
Soo, MS, Ghate, S, Baker, JA, and Rosen, E. "Reply [2]." American Journal of Roentgenology 186.3 (2006): 902-903.
Source
scival
Published In
AJR. American journal of roentgenology
Volume
186
Issue
3
Publish Date
2006
Start Page
902
End Page
903
DOI
10.2214/AJR.06.5013-1

Spatial and temporal aberrator stability for real-time adaptive imaging.

Reported real-time adaptive imaging systems use near-field phase correction techniques, which are desired because of their simple implementation and their compatibility with current system architectures. Aberrator stability is important to adaptive imaging because it defines the spatial and temporal limits for which the near-field phase estimates are valid. Spatial aberrator stability determines the required spatial sampling of the aberrator, and temporal aberrator stability determines the length of time for which the aberration profile can be used. In this study, the spatial and temporal stability of clinically measured aberrations is reported for breast, liver, and thyroid tissue. Cross correlations between aberration estimates revealed aberrators to have azimuthal isoplanatic patch sizes of 0.44, 0.28, and 0.20 mm for breast, liver, and thyroid tissue, respectively, at 80% correlation. Axial isoplanatic patch sizes were 1.26, 0.76, and 1.80 mm for the same tissue, respectively, at 80% correlation. Temporal stability at 80% correlation was determined to be greater than 1.5 seconds for breast and thyroid tissue, and 0.65 seconds for the liver. The effects of noise, motion, and target nonuniformity on aberrator stability are characterized by simulations and experiments in tissue mimicking phantoms.

Authors
Dahl, JJ; Soo, MS; Trahey, GE
MLA Citation
Dahl, JJ, Soo, MS, and Trahey, GE. "Spatial and temporal aberrator stability for real-time adaptive imaging." IEEE Trans Ultrason Ferroelectr Freq Control 52.9 (September 2005): 1504-1517.
PMID
16285449
Source
pubmed
Published In
IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control
Volume
52
Issue
9
Publish Date
2005
Start Page
1504
End Page
1517

Comparison of recall and cancer detection rates for immediate versus batch interpretation of screening mammograms.

PURPOSE: To retrospectively compare recall and cancer detection rates between immediate and subsequent batch methods for interpretation of screening mammograms. MATERIALS AND METHODS: Institutional review board approval was obtained, and informed consent was waived. Retrospective analysis was performed for 8698 screening mammograms obtained between January 1 and October 31, 2001, which were interpreted either immediately (n = 4113) or subsequently with batch method (n = 4585). Data were collected from data reporting system and patient billing records. Patients with high risk factors were excluded; 3441 patients were in the immediate group, and 3932 were in the batch group. The two groups were compared with respect to age, breast density, and availability of comparison films with Wilcoxon rank sum test. Recall rates and cancer detection rates for each group were determined and compared with Pearson chi(2) test; false-negative rates were compared with Fischer exact test. RESULTS: A significant difference (P < .001) was noted in recall rates between immediate (18%) and batch (14%) groups; however, no significant difference (P = .7) was noted in cancer detection rates (immediate, 0.5%; batch, 0.4%). Mean age of patients was 56.8 years (age range, 21-96 years) in the immediate group and 56.2 years (age range 24-98 years) in the batch group (P = .02). Comparison of breast densities between groups indicates no statistically significant difference (P = .4). The batch group had significantly fewer comparison mammograms (3106 [79%]) available than the immediate group (2856 [83%]) (P < .001). There was no significant difference in false-negative rates between the immediate group (0.1%) and the batch group (0.1%) (P > .99). CONCLUSION: Immediate interpretation of screening mammograms resulted in a statistically significant increase in recalls and additional clinical work-ups of perceived abnormalities; however, no significant difference in cancer detection rate was detected between groups.

Authors
Ghate, SV; Soo, MS; Baker, JA; Walsh, R; Gimenez, EI; Rosen, EL
MLA Citation
Ghate, SV, Soo, MS, Baker, JA, Walsh, R, Gimenez, EI, and Rosen, EL. "Comparison of recall and cancer detection rates for immediate versus batch interpretation of screening mammograms." Radiology 235.1 (April 2005): 31-35.
PMID
15798165
Source
pubmed
Published In
Radiology
Volume
235
Issue
1
Publish Date
2005
Start Page
31
End Page
35
DOI
10.1148/radiol.2351040699

BI-RADS for sonography: positive and negative predictive values of sonographic features.

OBJECTIVE: The purpose of this study was to assess the positive predictive value (PPV) and negative predictive value (NPV) of features described in the new sonographic BI-RADS lexicon for evaluating solid masses with known histologic diagnoses. MATERIALS AND METHODS: Sonograms of 403 solid lesions were analyzed by one of three dedicated breast radiologists. Each lesion was described using features from the sonographic BI-RADS lexicon. Lesion description and biopsy results were correlated. PPV and NPV were calculated. RESULTS: Histologic results showed that 141 (35%) of 403 masses were malignant. Sonographic BI-RADS descriptors showing high predictive value for malignancy include spiculated margin (86%, 19/22), irregular shape (62%, 102/164), and nonparallel orientation (69%, 75/109). Sonographic BI-RADS descriptors highly predictive of benign lesions include circumscribed margin (90%, 160/178), parallel orientation (78%, 228/294), and oval shape (84%, 200/237). For the sonographic BI-RADS features of mass margin, shape, orientation, lesion boundary, echo pattern, and posterior acoustic features, descriptors chosen were significantly (p < 0.001) different for malignant and benign masses. CONCLUSION: Descriptors from the new sonographic BI-RADS lexicon can be useful in differentiating benign from malignant solid masses.

Authors
Hong, AS; Rosen, EL; Soo, MS; Baker, JA
MLA Citation
Hong, AS, Rosen, EL, Soo, MS, and Baker, JA. "BI-RADS for sonography: positive and negative predictive values of sonographic features." AJR Am J Roentgenol 184.4 (April 2005): 1260-1265.
PMID
15788607
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
184
Issue
4
Publish Date
2005
Start Page
1260
End Page
1265
DOI
10.2214/ajr.184.4.01841260

Computer-aided detection of amorphous calcifications.

OBJECTIVE: Computer-aided detection (CAD) systems have been used successfully to detect malignant calcifications on mammography, with sensitivities ranging from 86% to 99%. Amorphous calcifications are a subset of small indistinct calcifications of intermediate concern that have a 20% likelihood of being malignant and that are frequently overlooked on mammography. The purpose of our study was to determine the sensitivity of one commercially available CAD system for detecting amorphous calcifications. MATERIALS AND METHODS: A commercially available CAD system evaluated mammograms of 82 patients with 85 mammographically detected and histologically sampled groups of amorphous calcifications (21 malignant, 14 high risk, and 50 benign). The sensitivity of the system for detecting the calcifications on at least one image of the two-view mammographic examination (case sensitivity) and on each individual mammographic image (image sensitivity) was determined. Findings were correlated with results from large core needle biopsy or surgical excision in each case. RESULTS: The CAD system detected amorphous calcifications in 43 of 85 cases (case sensitivity, 51%) and in 59 of 146 mammographic images (image sensitivity, 40%). The case sensitivities by histologic outcome were 57% for malignant calcifications, 29% for high-risk calcifications, and 54% for benign calcifications. An average of 2.0 false-positive marks were displayed per case. CONCLUSION: The CAD sensitivity for malignant amorphous calcifications is markedly lower than previously reported for all malignant calcifications. Breast imaging radiologists who use CAD systems should continue to search diligently for these difficult-to-detect lesions.

Authors
Soo, MS; Rosen, EL; Xia, JQ; Ghate, S; Baker, JA
MLA Citation
Soo, MS, Rosen, EL, Xia, JQ, Ghate, S, and Baker, JA. "Computer-aided detection of amorphous calcifications." AJR Am J Roentgenol 184.3 (March 2005): 887-892.
PMID
15728613
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
184
Issue
3
Publish Date
2005
Start Page
887
End Page
892
DOI
10.2214/ajr.184.3.01840887

Detection of primary breast carcinoma with a dedicated, large-field-of-view FDG PET mammography device: initial experience.

PURPOSE: To prospectively assess a dedicated, large field of view positron emission tomography (PET) mammographic device for imaging primary breast carcinoma. MATERIALS AND METHODS: Institutional review board approval was obtained for this study, and all patients provided written informed consent prior to participation. Subjects were recruited from a cohort of patients in whom diagnostic mammography and/or ultrasonography demonstrated lesions that were highly suggestive of malignancy. Twenty-three patients who met the inclusion criteria were subsequently imaged by using a dedicated PET mammography unit that was developed in conjunction with the Thomas Jefferson National Accelerator Facility (Newport News, Va). One hour after administration of 2.0-2.5 mCi (74.0-93.5 MBq) of fluorodeoxyglucose, 5-minute PET mammography of the affected breast was performed. Images were processed and reconstructed in the transverse craniocaudal and coronal planes. For each lesion, image-guided core-needle biopsy was performed immediately after PET mammography. Conventional mammography results and histologic findings were correlated with PET mammography images. The sensitivity, specificity, negative predictive value, and positive predictive value of PET mammography for demonstrating malignant lesions were calculated. RESULTS: PET mammography demonstrated 20 focal abnormalities, of which 18 were malignant and two were benign. Both benign lesions represented areas of fat necrosis. Three of 20 malignant lesions demonstrated at conventional mammography were not demonstrated at PET mammography. The overall sensitivity of PET mammography for malignancy was 86% (95% confidence interval: 65%, 95%), with a positive predictive value of 90% (95% confidence interval: 70%, 97%). The calculated specificity was 33% (95% confidence interval: 2%, 79%), and the negative predictive value was 25% (95% confidence interval: 1%, 70%). CONCLUSION: These pilot data suggest that PET mammography can demonstrate small primary breast malignancies.

Authors
Rosen, EL; Turkington, TG; Soo, MS; Baker, JA; Coleman, RE
MLA Citation
Rosen, EL, Turkington, TG, Soo, MS, Baker, JA, and Coleman, RE. "Detection of primary breast carcinoma with a dedicated, large-field-of-view FDG PET mammography device: initial experience." Radiology 234.2 (February 2005): 527-534.
PMID
15671006
Source
pubmed
Published In
Radiology
Volume
234
Issue
2
Publish Date
2005
Start Page
527
End Page
534
DOI
10.1148/radiol.2342040654

Stereotactic breast biopsy of noncalcified lesions: A cost-minimization analysis comparing 14-gauge multipass automated core biopsy to 14- and 11-gauge vacuum-assisted biopsy

A decision model was used to compare the relative costs of the 14-gauge automated gun technique to the 14-gauge and 11-gauge vacuum-assisted techniques for stereotactic biopsy of noncalcified breast lesions. Probability and cost variables were estimated from clinical experience with 76 automated gun biopsies, seventy-eight 14-gauge vacuum-assisted biopsies and thirty-nine 11-gauge vacuum-assisted biopsies. The 14-gauge automated gun was the preferred strategy from a cost standpoint: the 14-gauge vacuum technique was 1.19 times more expensive, and the 11-gauge was 1.22 times more expensive. © 2005 Elsevier Inc. All rights reserved.

Authors
Soo, MS; Kliewer, MA; Ghate, S; Helsper, RS; Rosen, EL
MLA Citation
Soo, MS, Kliewer, MA, Ghate, S, Helsper, RS, and Rosen, EL. "Stereotactic breast biopsy of noncalcified lesions: A cost-minimization analysis comparing 14-gauge multipass automated core biopsy to 14- and 11-gauge vacuum-assisted biopsy." Clinical Imaging 29.1 (2005): 26-33.
PMID
15859015
Source
scival
Published In
Clinical Imaging
Volume
29
Issue
1
Publish Date
2005
Start Page
26
End Page
33
DOI
10.1016/j.clinimag.2004.03.007

Image processing and data acquisition optimization for Acoustic Radiation Force Impulse imaging of in vivo breast masses

Acoustic Radiation Force Impulse (ARFI) imaging utilizes brief, high-energy acoustic pulses to excite tissue and ultrasonic correlation based tracking methods to monitor the resulting tissue displacement, which reflects the relative mechanical properties of tissue (i.e.. suffer tissue displaces less). ARFI image contrast is optimized utilizing tightly focused radiation force excitations at multiple axial and lateral locations throughout a 2D field of view. In an ongoing, IRB approved, clinical study, suspicious breast lesions are interrogated in vivo via multi-focal-zone ARFI prior to undergoing core biopsy. A Siemens SONOLINE Antares (TM) scanner and VF10-5 probe were configured to acquire ARFI data from multiple focal-zones and lateral locations. Data was acquired in real-time, and processed off-line. Processing included: filtering, parametric data analysis, normalization and combination of the multiple focal-zone data, and automatic edge detection. ARFI sequences were designed with varying pushing pulse frequencies and intensities. Contrast to noise ratio was evaluated in a tissue mimicking phantom for lesions at different depths using the different pushing pulse sequences. For shallower lesions (depth=10mm), CNR was higher than for deeper lesions, and did not vary appreciably for the different push sequences. For deeper lesions (depth=20mm), CNR increased with increasing push pulse intensity and decreasing push pulse frequency. With the pushing pulse transmit intensity calibrated (in a homogeneous phantom) to achieve uniform displacement at all axial depths, in vivo results yielded poor SNR at depth and did not achieve overall uniform displacement. In vivo, image quality improved with increasing push pulse intensity. To date, 27 masses have been interrogated using multi-focal-zone ARFI and overall good structural agreement exists between B-mode and ARFI images. Normalization and blending facilitate image generation from ARFI interrogation using different intensities at different focal depths.

Authors
Sharma, A; Trahey, G; Frinkley, K; Soo, MS; Palmeri, M; Nightingale, K
MLA Citation
Sharma, A, Trahey, G, Frinkley, K, Soo, MS, Palmeri, M, and Nightingale, K. "Image processing and data acquisition optimization for Acoustic Radiation Force Impulse imaging of in vivo breast masses." 2005.
Source
scival
Published In
Proceedings of SPIE
Volume
5750
Publish Date
2005
Start Page
205
End Page
215
DOI
10.1117/12.593473

Clinical evaluation of combined spatial compounding and adaptive imaging in breast tissue.

When spatial compounding is applied to targets with significant acoustic velocity inhomogeneities, the correlation between speckle patterns of the images to be averaged decreases, thereby increasing the speckle reduction nominally obtained. Phase correction applied to these targets improves the coherence of the wavefield and restores image spatial frequencies. Combining these two modes can be used to effectively increase the contrast-to-noise ratio (CNR) of imaging targets and improve the general image quality of these targets over spatial compounding alone. This paper presents a clinical evaluation of combined spatial compounding and adaptive imaging in breast tissue and compares this combined technique to conventional imaging and to adaptive imaging and spatial compounding operating independently. Experiments were performed on a 1.75-D, 8 x 96 array attached to a commercially-available scanner. Cysts, microcalcifications and other breast structures were targeted in order to assess the impact of the combined mode on CNR, target width, target brightness and target peak-to-background ratio (PBR). In general, phase correction improved cyst CNR by 7.7%, decreased target width by 18.7%, increased target brightness by 30.1% and increased PBR by 17.9%. Compounding alone, using three overlapping 9.71 mm subapertures, increased cyst CNR by 24.6%, but increased target width by 25.4% and decreased PBR by 13.2%. Combining both modes, however, increased cyst CNR by 32.6%, inappreciably increased target width by 1.1% and marginally decreased PBR by 2.8%. The increase in target brightness with this combined mode was 20.0%

Authors
Dahl, JJ; Soo, MS; Trahey, GE
MLA Citation
Dahl, JJ, Soo, MS, and Trahey, GE. "Clinical evaluation of combined spatial compounding and adaptive imaging in breast tissue." Ultrason Imaging 26.4 (October 2004): 203-216.
PMID
15864979
Source
pubmed
Published In
Ultrasonic Imaging
Volume
26
Issue
4
Publish Date
2004
Start Page
203
End Page
216
DOI
10.1177/016173460402600401

Resolution improvement of point targets by real-time phase aberration correction: In vivo results

Ten patients with suspected microcalcifications receiving treatment at the Duke University Medical Center were scanned with a 9MHz, 8x96 1.75D array transducer and Siemens Antares scanner. Aberration profiles were estimated by cross correlation of individual element echo signals using a least-squares algorithm over a 3×5 element neighborhood. Transmit and receive beamformer delays were modified to compensate for the estimated profile. Single video frames captured at times just before and just after application of aberration correction were compared. The apparent change in microcalcification width was estimated with sub-pixel precision by comparing upsampled image lines at a threshold of 80%. The average reduction in image width was 39.7%. The average brightness increase was only 1.9%. Offline processing of RF data captured on the same patients shows a pre-log compression increase in envelope amplitude of 39% after off-line aberration correction using the same algorithm. The relatively small improvement in brightness during online correction is due to logarithmic compression and video-saturation effects. © 2004 IEEE.

Authors
McAleavey, SA; Dahl, JJ; Soo, MS; Pinton, GF; Trahey, GE
MLA Citation
McAleavey, SA, Dahl, JJ, Soo, MS, Pinton, GF, and Trahey, GE. "Resolution improvement of point targets by real-time phase aberration correction: In vivo results." Proceedings - IEEE Ultrasonics Symposium 1 (2004): 235-238.
Source
scival
Published In
Proceedings - IEEE Ultrasonics Symposium
Volume
1
Publish Date
2004
Start Page
235
End Page
238

Spatial and temporal stability of tissue induced aberration

Real-time adaptive imaging systems employ near-field phase correction techniques, which are desired because of their computational simplicity and compatibility with current imaging system architectures. Aberrator stability is essential to adaptive imaging because it defines the spatial and temporal limits for which the near-field phase estimates are valid. In this study, the spatial and temporal stability of clinical aberrations is measured in breast, liver, and thyroid tissue and discussed in relation to real-time adpative imaging. Azimuthal isoplanatic patch sizes of 1.1, 0.44, and 1.0 mm were measured for breast, liver, and thyroid tissue, respectively, using a 70% correlation limit. Axial isoplanatic patch sizes were 2.0, 1.2, and 2.9 mm for the same tissue, respectively. Temporal stability was determined to be greater than 1.5 seconds for breast and thyroid tissue, and 1.2 seconds in the liver. The effects of noise, motion, and target non-uniformity on aberrator stability are characterized with simulations and experiments in tissue mimicking phantoms. © 2004 IEEE.

Authors
Dahl, JJ; Soo, MS; Trahey, GE
MLA Citation
Dahl, JJ, Soo, MS, and Trahey, GE. "Spatial and temporal stability of tissue induced aberration." Proceedings - IEEE Ultrasonics Symposium 1 (2004): 222-226.
Source
scival
Published In
Proceedings of the IEEE Ultrasonics Symposium
Volume
1
Publish Date
2004
Start Page
222
End Page
226
DOI
10.1109/ULTSYM.2004.1417707

Acoustic radiation force impulse imaging of in vivo breast masses

ARFI datasets were acquired in real time to identify differentiable features between benign and malignant breast masses in ARFI images. A modified Siemens SONOLINE Antares scanner and a VF10-5 probe were programmed to implement ARFI imaging in a multi-focal zone configuration. It was observed that the cysts and fibroadenomas, in general, exhibit less contrast IN ARFI images than in matched B-mode images. The results led to identification of some differentiating features between malingant and benign breast masses.

Authors
Sharma, AC; Soo, MS; Trahey, GE; Nightingale, KR
MLA Citation
Sharma, AC, Soo, MS, Trahey, GE, and Nightingale, KR. "Acoustic radiation force impulse imaging of in vivo breast masses." 2004.
Source
scival
Published In
Proceedings of the IEEE Ultrasonics Symposium
Volume
1
Publish Date
2004
Start Page
728
End Page
731

Imaging tissue mechanical properties using impulsive acoustic radiation force

Acoustic Radiation Force Impulse (ARFI) imaging utilizes brief, high energy, focused acoustic pulses to generate radiation force in tissue, and conventional diagnostic ultrasound methods to detect the resulting tissue displacements in order to image the relative mechanical properties of tissue. Parametric images of maximum displacement, the time the tissue takes to reach its peak displacement, and tissue recovery time provide information about tissue material properties and structure. FEM simulations have been developed and validated of tissue mechanical and thermal response to ARFI excitation. Potential clinical applications under investigation include: soft tissue lesion characterization, assessment of diffuse and focal atherosclerosis, and imaging of thermal lesion formation during tissue ablation procedures. In both in vivo and ex vivo data, structures shown in matched B-mode images are in good agreement with those shown in ARFI displacement images. In ex vivo tissue ablation studies (HIFU and RF-ablation), thermal lesion size correlates well with matched pathology images. In in vivo breast studies, palpable breast masses exhibit smaller displacements (i.e. they are stiffer) than surrounding tissues. Some malignant masses appear larger in ARFI displacement images than in matched B-mode images, consistent with a desmoplastic reaction; however, this is not the case for all malignant breast masses that have been studied. Benign fibroadenomas, in general, exhibit less contrast than malignant masses in ARFI displacement images. Results from ongoing studies will be presented. © 2004 IEEE.

Authors
Nightingale, K; Soo, MS; Palmeri, M; Congdon, A; Frinkley, K; Trahey, G
MLA Citation
Nightingale, K, Soo, MS, Palmeri, M, Congdon, A, Frinkley, K, and Trahey, G. "Imaging tissue mechanical properties using impulsive acoustic radiation force." 2004 2nd IEEE International Symposium on Biomedical Imaging: Macro to Nano 1 (2004): 41-44.
Source
scival
Published In
2004 2nd IEEE International Symposium on Biomedical Imaging: Macro to Nano
Volume
1
Publish Date
2004
Start Page
41
End Page
44

Accuracy of a collagen-plug biopsy site marking device deployed after stereotactic core needle breast biopsy.

OBJECTIVE: The goal of this study was to compare the accuracy of clip placement of a collagen-plug biopsy marking device with that of the more conventional, previously evaluated metallic tissue-marking clips. SUBJECTS AND METHODS. The placement accuracy of 31 collagen-plug marking devices was compared with the placement accuracy of 43 metallic marker clips deployed at biopsies performed between August 1, 2002, and November 20, 2002. The precision of marker placement was assessed by determining the position of the clip relative to the targeted mammographic lesion. Statistical analysis comparing the distance from the clip to the targeted lesion was performed. RESULTS: Using a two-group Wilcoxon's rank sum test, we found the clip-to-target distances for the collagen-plug central titanium marker were significantly different from the clip-to-target distances of the conventional metallic marker clips (p = 0.04). There were significantly fewer cases in which the clip-to-target distance was 1 cm or greater on at least one mammographic projection with the collagen-plug marker (5/31) than with the conventional metallic marker clip (19/43) (chi-square test, p = 0.02). CONCLUSION: The collagen-plug marking device is an effective alternative to existing marker clips, and use of this device may result in fewer cases in which the marker clip is substantially displaced (> or = 1 cm) away from the actual biopsy site.

Authors
Rosen, EL; Baker, JA; Soo, MS
MLA Citation
Rosen, EL, Baker, JA, and Soo, MS. "Accuracy of a collagen-plug biopsy site marking device deployed after stereotactic core needle breast biopsy." AJR Am J Roentgenol 181.5 (November 2003): 1295-1299.
PMID
14573422
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
181
Issue
5
Publish Date
2003
Start Page
1295
End Page
1299
DOI
10.2214/ajr.181.5.1811295

Accuracy of MRI in the detection of residual breast cancer after neoadjuvant chemotherapy.

OBJECTIVE: This study was undertaken to evaluate the ability of MRI to accurately show residual primary breast malignancy in women treated with neoadjuvant chemotherapy. MATERIALS AND METHODS: Twenty-one patients with locally advanced primary breast carcinoma underwent contrast-enhanced MRI before and after treatment with neoadjuvant anthracycline-based chemotherapy. For each patient, the maximum extent of the MRI abnormality was measured both before and after treatment. These measurements were subsequently compared with physical examination findings and histologic results to determine the ability of MRI to accurately reveal tumor extent after neoadjuvant chemotherapy. RESULTS: MRI after chemotherapy showed a correlation coefficient of 0.75 with histology, which was better than physical examination (r = 0.61). MRI underestimated the extent of residual tumor in two patients by more than 1 cm (including one false-negative examination), was within 1 cm in 12 of 21 patients, and overestimated tumor extent by more than 1 cm in seven of 21 patients. CONCLUSION: MRI can show residual malignancy after neoadjuvant chemotherapy better than physical examination, particularly in patients who have not had a complete clinical response to therapy.

Authors
Rosen, EL; Blackwell, KL; Baker, JA; Soo, MS; Bentley, RC; Yu, D; Samulski, TV; Dewhirst, MW
MLA Citation
Rosen, EL, Blackwell, KL, Baker, JA, Soo, MS, Bentley, RC, Yu, D, Samulski, TV, and Dewhirst, MW. "Accuracy of MRI in the detection of residual breast cancer after neoadjuvant chemotherapy." AJR Am J Roentgenol 181.5 (November 2003): 1275-1282.
PMID
14573420
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
181
Issue
5
Publish Date
2003
Start Page
1275
End Page
1282
DOI
10.2214/ajr.181.5.1811275

Computer-aided detection (CAD) in screening mammography: sensitivity of commercial CAD systems for detecting architectural distortion.

OBJECTIVE: Computer-aided detection (CAD) algorithms have successfully revealed breast masses and microcalcifications on screening mammography. The purpose of our study was to evaluate the sensitivity of commercially available CAD systems for revealing architectural distortion, the third most common appearance of breast cancer. MATERIALS AND METHODS: Two commercially available CAD systems were used to evaluate screening mammograms obtained in 43 patients with 45 mammographically detected regions of architectural distortion. For each CAD system, we determined the sensitivity for revealing architectural distortion on at least one image of the two-view mammographic examination (case sensitivity) and for each individual mammogram (image sensitivity). Surgical biopsy results were available for each case of architectural distortion. RESULTS: Architectural distortion was deemed present and actionable by a panel of expert breast imagers in 80 views of the 45 cases. One CAD system detected distortion in 22 of 45 cases of distortion (case sensitivity, 49%) and in 30 of 80 mammograms (image sensitivity, 38%); it displayed 0.7 false-positive marks per image. Another CAD system identified distortion in 15 of 45 cases (case sensitivity, 33%) and 17 of 80 mammograms (image sensitivity, 21%); it displayed 1.27 false-positive marks per image. Sensitivity for malignancy-caused distortion was similar to or lower than sensitivity for all causes of distortion. CONCLUSION: Fewer than one half of the cases of architectural distortion were detected by the two most widely available CAD systems used for interpretations of screening mammograms. Considerable improvement in the sensitivity of CAD systems is needed for detecting this type of lesion. Practicing breast imagers who use CAD systems should remain vigilant for architectural distortion.

Authors
Baker, JA; Rosen, EL; Lo, JY; Gimenez, EI; Walsh, R; Soo, MS
MLA Citation
Baker, JA, Rosen, EL, Lo, JY, Gimenez, EI, Walsh, R, and Soo, MS. "Computer-aided detection (CAD) in screening mammography: sensitivity of commercial CAD systems for detecting architectural distortion." AJR Am J Roentgenol 181.4 (October 2003): 1083-1088.
PMID
14500236
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
181
Issue
4
Publish Date
2003
Start Page
1083
End Page
1088
DOI
10.2214/ajr.181.4.1811083

Cortisol levels and responses to mammography screening in breast cancer survivors: a pilot study.

OBJECTIVE: The purpose of this study was to compare baseline levels of salivary cortisol, diurnal cortisol slopes, and cortisol reactivity to a mammogram in breast cancer survivors and women without a history of cancer. METHODS: Participants were 33 breast cancer survivors (3-5 years postdiagnosis) and 21 women with no history of cancer who were scheduled for a routine follow-up mammogram. The first assessment occurred for 3 consecutive days 1 month before the mammogram, and the second assessment occurred on the day before, the day of, and the day after the mammogram. On each of these days, women completed questionnaires and collected saliva samples 6 times/day. RESULTS: Results indicated that breast cancer survivors had higher levels of cortisol at baseline than controls. There were no group differences in diurnal slopes in cortisol concentration or cortisol responses to wakening. There were group differences in cortisol responses to the mammogram: In breast cancer survivors, cortisol levels decreased from the 3-day baseline period to the 3-day period around the mammogram, whereas in the control subjects mean daily cortisol levels increased around the mammogram. Among cancer survivors, there were no significant associations between cortisol measures and general stress ratings, although there were some associations with specific psychological responses to mammography. CONCLUSIONS: Results of this pilot study indicate that breast cancer survivors show elevated levels of basal cortisol and suppressed cortisol response to a cancer-related stressor several years after completing treatment. Future research is needed to understand whether these patterns of hypothalamic-pituitary-adrenal functioning are a result of physiologic stress associated with cancer treatment or disease process, psychological stress associated with fear of recurrence, or a combination of both.

Authors
Porter, LS; Mishel, M; Neelon, V; Belyea, M; Pisano, E; Soo, MS
MLA Citation
Porter, LS, Mishel, M, Neelon, V, Belyea, M, Pisano, E, and Soo, MS. "Cortisol levels and responses to mammography screening in breast cancer survivors: a pilot study." Psychosom Med 65.5 (September 2003): 842-848.
PMID
14508030
Source
pubmed
Published In
Psychosomatic Medicine
Volume
65
Issue
5
Publish Date
2003
Start Page
842
End Page
848

Sonographic detection and sonographically guided biopsy of breast microcalcifications.

OBJECTIVE: The purpose of this study was to evaluate the ability of sonography to depict and guide biopsies of mammographically suspicious microcalcifications and to reveal the mammographic features and histologic outcomes of lesions amenable to sonographically guided biopsy. SUBJECTS AND METHODS: . Suspicious clusters of microcalcifications without other mammographic abnormalities were evaluated on sonography before biopsy and divided into two groups: those with and those without microcalcifications seen on sonography. Sonographically detected lesions underwent sonographically guided biopsy; lesions not seen on sonography underwent mammographically guided biopsy. Imaging features and histologies were correlated, and the positive predictive value of sonography was determined. RESULTS: Of 111 lesions (105 patients), 26 lesions (23%) were identified and underwent sonographically guided biopsy; 85 lesions (77%) were not identified sonographically. The diameters of microcalcification clusters in the sonographically identified group were significantly larger (p = 0.0005) and contained larger numbers of microcalcification particles (p = 0.038) compared with clusters not identified sonographically. Sonographically identified lesions were seen as masses (77%) or dilated ducts (23%) with echogenic foci. Sonographically identified lesions were more likely to be malignant than those not seen on sonography (69% vs 21%, respectively; p < 0.00002). Of 38 malignant lesions, those visible on sonography were more likely to be invasive than those not seen on sonography (72% vs 28%, respectively; p = 0.018). In malignant lesions undergoing core biopsy and surgical excision, the extent of disease was underestimated less with sonographically guided biopsy (7%, 1/15) than with stereotactic biopsy (33%, 5/15). CONCLUSION: Suspicious microcalcifications are seen infrequently on sonography (23%) but, when detected, can be successfully biopsied with sonographic guidance and more frequently are malignant and represent invasive cancer than those seen on mammography alone.

Authors
Soo, MS; Baker, JA; Rosen, EL
MLA Citation
Soo, MS, Baker, JA, and Rosen, EL. "Sonographic detection and sonographically guided biopsy of breast microcalcifications." AJR Am J Roentgenol 180.4 (April 2003): 941-948.
PMID
12646433
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
180
Issue
4
Publish Date
2003
Start Page
941
End Page
948
DOI
10.2214/ajr.180.4.1800941

Imaging-guided core needle biopsy of papillary lesions of the breast.

OBJECTIVE: Our objective was to assess the incidence of papillary lesions of the breast diagnosed at imaging-guided core needle biopsy and the need for surgical excision after a benign diagnosis. MATERIALS AND METHODS: This retrospective study included 1374 patients with consecutive suspicious breast lesions that underwent either mammography or sonographically guided large-core needle breast biopsy. Fifty-seven lesions (4%) were classified as papillary lesions. Eleven of the 57 cases were lost to follow-up (n = 6) or had not yet shown 2 years of stability (n = 5) and were excluded from this study. The remaining 46 papillary lesions constitute our study population. RESULTS: Surgical excision was performed in 17 (37%) of 46 papillary lesions. In the group of patients whose lesions were recommended for excision because carcinoma was identified at core biopsy, surgical excision revealed one false-positive and two true-positive diagnoses. In four cases, histologic diagnoses of the excisional biopsy and the core needle biopsy were discordant. One false-positive finding at core needle biopsy initially was interpreted as invasive ductal carcinoma on the basis of core needle biopsy specimens. In three false-negative findings, the initial diagnosis at core needle biopsy was upgraded after surgical excision. Two cases of papilloma with adjacent atypical ductal hyperplasia and one of atypical papilloma were upgraded to ductal carcinoma in situ after surgical excision. Imaging follow-up was performed in the remaining 29 patients. All lesions were stable or had decreased in size during the 2-year follow-up period. The negative predictive value of core needle biopsy for excluding malignancy among the papillary lesions diagnosed in our study was 93%. CONCLUSION: When the histologic diagnosis is benign, our data suggest that papillary lesions may be safely managed with imaging follow-up rather than with surgical excision. However, atypical papillary lesions or those associated with atypia require surgical excision because histologic underestimation occurs at a frequency similar to that in other atypical lesions undergoing core needle biopsy.

Authors
Rosen, EL; Bentley, RC; Baker, JA; Soo, MS
MLA Citation
Rosen, EL, Bentley, RC, Baker, JA, and Soo, MS. "Imaging-guided core needle biopsy of papillary lesions of the breast." AJR Am J Roentgenol 179.5 (November 2002): 1185-1192.
PMID
12388496
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
179
Issue
5
Publish Date
2002
Start Page
1185
End Page
1192
DOI
10.2214/ajr.179.5.1791185

Interpretation of digital mammograms: comparison of speed and accuracy of soft-copy versus printed-film display.

PURPOSE: To compare the speed and accuracy of the interpretations of digital mammograms by radiologists by using printed-film versus soft-copy display. MATERIALS AND METHODS: After being trained in interpretation of digital mammograms, eight radiologists interpreted 63 digital mammograms, all with old studies for comparison. All studies were interpreted by all readers in soft-copy and printed-film display, with interpretations of images in the same cases at least 1 month apart. Mammograms were interpreted in cases that included six biopsy-proved cancers and 20 biopsy-proved benign lesions, 20 cases of probably benign findings in patients who underwent 6-month follow-up, and 17 cases without apparent findings. Area under the receiver operating characteristic curve (A(z)), sensitivity, and specificity were calculated for soft-copy and printed-film display. RESULTS: There was no significant difference in the speed of interpretation, but interpretations with soft-copy display were slightly faster. The differences in A(z), sensitivity, and specificity were not significantly different; A(z) and sensitivity were slightly better for interpretations with printed film, and specificity was slightly better for interpretations with soft copy. CONCLUSION: Interpretation with soft-copy display is likely to be useful with digital mammography and is unlikely to significantly change accuracy or speed.

Authors
Pisano, ED; Cole, EB; Kistner, EO; Muller, KE; Hemminger, BM; Brown, ML; Johnston, RE; Kuzmiak, CM; Braeuning, MP; Freimanis, RI; Soo, MS; Baker, JA; Walsh, R
MLA Citation
Pisano, ED, Cole, EB, Kistner, EO, Muller, KE, Hemminger, BM, Brown, ML, Johnston, RE, Kuzmiak, CM, Braeuning, MP, Freimanis, RI, Soo, MS, Baker, JA, and Walsh, R. "Interpretation of digital mammograms: comparison of speed and accuracy of soft-copy versus printed-film display." Radiology 223.2 (May 2002): 483-488.
PMID
11997557
Source
pubmed
Published In
Radiology
Volume
223
Issue
2
Publish Date
2002
Start Page
483
End Page
488
DOI
10.1148/radiol.2232010704

Malignant lesions initially subjected to short-term mammographic follow-up.

PURPOSE: To determine whether systematically evaluated criteria for probably benign lesions were actually applied to lesions placed into that category. MATERIALS AND METHODS: A search of the mammography database yielded 295 cases that were initially followed up with short-term interval mammography but eventually received a biopsy recommendation for the same breast. Of the 83 malignancies (81 patients) for which mammograms and pathology reports were available for review, 51 malignancies corresponded to the lesions for which short-term follow-up was recommended. Each case was retrospectively reviewed to determine whether the lesion followed up represented the subsequently diagnosed malignancy. Each lesion was characterized with appropriate Breast Imaging Reporting and Data System descriptors, based on the mammographic imaging available when short-term follow-up was first recommended. These characteristics were then used to determine if, in retrospect, the mammographic appearance met previously published criteria for probably benign lesions. RESULTS: Of the 51 malignancies, 23 (45%) appeared mammographically as microcalcifications, 12 (24%) as masses, four (8%) as architectural distortion, and 12 (24%) as developing densities. None fulfilled strict criteria for a probably benign lesion when reviewed in retrospect. Forty-seven (92%) of 51 lesions had already demonstrated progression at the time of follow-up recommendation. CONCLUSION: Short-term mammographic follow-up is often recommended for lesions that, in retrospect, do not fulfill established diagnostic criteria for probably benign lesions.

Authors
Rosen, EL; Baker, JA; Soo, MS
MLA Citation
Rosen, EL, Baker, JA, and Soo, MS. "Malignant lesions initially subjected to short-term mammographic follow-up." Radiology 223.1 (April 2002): 221-228.
PMID
11930070
Source
pubmed
Published In
Radiology
Volume
223
Issue
1
Publish Date
2002
Start Page
221
End Page
228
DOI
10.1148/radiol.2231011355

Sonographically guided biopsy of suspicious microcalcifications of the breast: a pilot study.

OBJECTIVE: The purpose of this study is to evaluate the use of sonographic guidance for biopsy of mammographically detected suspicious microcalcifications. SUBJECTS AND METHODS: Twenty-three patients with suspicious microcalcifications detected on mammography (15 associated with masses or distortion; eight with microcalcifications alone) underwent sonographically guided core biopsy (n = 18) or sonographically guided needle localization before excision (n = 5). Microcalcifications were targeted, and specimen radiographs were obtained for each lesion, with the success of the procedure based on identifying microcalcifications on the specimen radiograph. For core biopsies, the number of cores obtained was compared with that in 49 control patients who underwent sonographically guided core biopsy of noncalcified masses. RESULTS: All 23 lesions (100%) were successfully biopsied under sonographic guidance, with microcalcifications seen on specimen radiographs in each case. Of 18 core biopsies, a mean of 8.7 cores was obtained compared with a mean of 5.5 cores in the control group (p<0.0001). Of 13 lesions sampled with core biopsy that subsequently underwent surgical excision, three (23%) were upgraded from atypical ductal hyperplasia to ductal carcinoma in situ (n = 1) and from ductal carcinoma in situ to invasive carcinoma (n = 2). Mammographically, most lesions contained more than 15 pleomorphic microcalcifications. On sonography, echogenic foci corresponded to microcalcifications in all but two cases in which broader echogenic regions were seen. When no mass or distortion was visible on mammography, sonography showed a mass or dilated ducts with internal echogenic foci. CONCLUSION: Microcalcifications identifiable on sonography can be successfully biopsied under sonographic guidance. Further study is necessary to determine whether targeting microcalcifications seen sonographically in the mass or duct can improve the rate of underestimation of disease compared with stereotactic core biopsy.

Authors
Soo, MS; Baker, JA; Rosen, EL; Vo, TT
MLA Citation
Soo, MS, Baker, JA, Rosen, EL, and Vo, TT. "Sonographically guided biopsy of suspicious microcalcifications of the breast: a pilot study." AJR Am J Roentgenol 178.4 (April 2002): 1007-1015.
PMID
11906892
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
178
Issue
4
Publish Date
2002
Start Page
1007
End Page
1015
DOI
10.2214/ajr.178.4.1781007

Breast US: assessment of technical quality and image interpretation.

PURPOSE: To determine whether ultrasonography (US) of the breast performed at a wide range of clinical practices conforms to the American College of Radiology (ACR) standards for quality and to assess the interpretations of breast sonograms. MATERIALS AND METHODS: Static images from 152 breast US examinations performed at 86 institutions were evaluated for compliance with ACR guidelines for breast US hardware, technical factors, imaging protocol, and image annotation. Official interpretations submitted by the referring facilities were compared with static images submitted by the facility. Discrepancies were confirmed by two dedicated breast radiologists after repeat imaging, short-interval follow-up imaging, or biopsy. RESULTS: A total of 60.5% of cases did not comply with at least one ACR guideline on breast US and included 9.2% of cases with inadequate equipment, 14.7% of cases with inappropriate focal zone placement, at least 14% of cases with static images in only one imaging plane, and 25% of cases with incomplete patient identifiers. Clinically relevant interpretation errors and interpretation discrepancies were confirmed in 23 (15.1%) of 152 cases. CONCLUSION: The majority of breast US examinations did not comply with at least some of the standards for quality set forth by the ACR. Attention to these basic standards could substantially improve image quality.

Authors
Baker, JA; Soo, MS
MLA Citation
Baker, JA, and Soo, MS. "Breast US: assessment of technical quality and image interpretation." Radiology 223.1 (April 2002): 229-238.
PMID
11930071
Source
pubmed
Published In
Radiology
Volume
223
Issue
1
Publish Date
2002
Start Page
229
End Page
238
DOI
10.1148/radiol.2231011125

Negative predictivevalue of breast imaging in patients with palpable lesions [3] (multiple letters)

Authors
Hall, FM; Soo, MS; Rosen, EL; Baker, JA
MLA Citation
Hall, FM, Soo, MS, Rosen, EL, and Baker, JA. "Negative predictivevalue of breast imaging in patients with palpable lesions [3] (multiple letters)." American Journal of Roentgenology 179.4 (2002): 1073-1074.
PMID
12239070
Source
scival
Published In
American Journal of Roentgenology
Volume
179
Issue
4
Publish Date
2002
Start Page
1073
End Page
1074

Acoustic radiation force impulse imaging: Remote palpation of the mechanical properties of tissue

An overview is given of the Acoustic Radiation Force Impulse (ARFI) imaging. It discusses the derivation of radiation force, the response of tissue to radiation force, and the potential for this imaging method to evaluate the mechanical properties of tissue. It is found that In vivo ARFI images of breast, abdomen, and carotid vessels demonstrate no speckle, good contrast between tissue structures, and resolution comparable to B-mode images.

Authors
Nightingale, K; Soo, MS; Nightingale, R; Bentley, R; Stutz, D; Palmeri, M; Dahl, J; Trahey, G
MLA Citation
Nightingale, K, Soo, MS, Nightingale, R, Bentley, R, Stutz, D, Palmeri, M, Dahl, J, and Trahey, G. "Acoustic radiation force impulse imaging: Remote palpation of the mechanical properties of tissue." Proceedings of the IEEE Ultrasonics Symposium 2 (2002): 1821-1830.
Source
scival
Published In
Proceedings of the IEEE Ultrasonics Symposium
Volume
2
Publish Date
2002
Start Page
1821
End Page
1830

Acoustic radiation force impulse imaging: In vivo demonstration of clinical feasibility

The clinical viability of a method of acoustic remote palpation, capable of imaging local variations in the mechanical properties of soft tissue using acoustic radiation force impulse (ARFI) imaging, is investigated in vivo. In this method, focused ultrasound (US) is used to apply localized radiation force to small volumes of tissue (2 mm3) for short durations (less than 1 ms) and the resulting tissue displacements are mapped using ultrasonic correlation-based methods. The tissue displacements are inversely proportional to the stiffness of the tissue and, thus, a stiffer region of tissue exhibits smaller displacements than a more compliant region. Due to the short duration of the force application, this method provides information about the mechanical impulse response of the tissue, which reflects variations in tissue viscoelastic characteristics. In this paper, experimental results are presented demonstrating that displacements on the order of 10 μm can be generated and detected in soft tissues in vivo using a single transducer on a modified diagnostic US scanner. Differences in the magnitude of displacement and the transient response of tissue are correlated with tissue structures in matched B-mode images. The results comprise the first in vivo ARFI images, and support the clinical feasibility of a radiation force-based remote palpation imaging system. © 2002 World Federation for Ultrasound in Medicine & Biology.

Authors
Nightingale, K; Soo, MS; Nightingale, R; Trahey, G
MLA Citation
Nightingale, K, Soo, MS, Nightingale, R, and Trahey, G. "Acoustic radiation force impulse imaging: In vivo demonstration of clinical feasibility." Ultrasound in Medicine and Biology 28.2 (2002): 227-235.
PMID
11937286
Source
scival
Published In
Ultrasound in Medicine & Biology
Volume
28
Issue
2
Publish Date
2002
Start Page
227
End Page
235
DOI
10.1016/S0301-5629(01)00499-9

MR imaging of extracapsular silicone from breast implants: Diagnostic pitfalls

OBJECTIVE. We sought to identify pitfalls in recognition of extracapsular silicone on MR imaging. MATERIALS AND METHODS. Three experienced observers reviewed MR images from 359 women with current (n = 320), prior (n = 15), or both current and prior (n = 24) silicone gel implants. Axial and sagittal fast spin-echo T2-weighted images with water suppression, axial inversion-recovery T2-weighted images with water suppression, and axial T2-weighted images with silicone suppression were obtained in a dedicated phased array breast coil on a 1.5-T magnet. Images were reviewed again when only one observer saw extracapsular silicone, and reasons for disagreement were recorded. RESULTS. Rupture was identified in 265 women (77%) with current silicone implants and 378 (55%) of 687 implants. Observers agreed in describing extracapsular silicone in 85 (12%) of 687 breasts with current silicone gel implants, of which 81 (95%) showed definite evidence of rupture on MR imaging. One observer reported extracapsular silicone in another 79 breasts. Confusion over contour deformity due to weakening versus breach of the capsule accounted for 33 (42%) of 79 disagreements. Another 20 (25%) of the 79 disagreements were attributed to poor conspicuity of extracapsular silicone on fast spin-echo T2-weighted images combined with intermittent observer failure to review inversion-recovery images. Subtlety of findings (n = 17, 22%) and technical issues (n = 9, 11%) with failed water suppression of pleural effusion or cysts and ghosting artifacts accounted for remaining disagreements. CONCLUSION. Extracapsular rupture is usually manifest as local spread of silicone in the breast and is not well-depicted on fast spin-echo T2-weighted images. Water-suppressed inversion-recovery T2-weighted images are often needed to identify extracapsular silicone. Distinction of the bulge in the fibrous capsule from herniation through the capsule remains problematic.

Authors
Berg, WA; Nguyen, TK; Middleton, MS; Soo, MS; Pennello, G; Brown, SL
MLA Citation
Berg, WA, Nguyen, TK, Middleton, MS, Soo, MS, Pennello, G, and Brown, SL. "MR imaging of extracapsular silicone from breast implants: Diagnostic pitfalls." American Journal of Roentgenology 178.2 (2002): 465-472.
PMID
11804919
Source
scival
Published In
American Journal of Roentgenology
Volume
178
Issue
2
Publish Date
2002
Start Page
465
End Page
472

Negative predictive value of sonography with mammography in patients with palpable breast lesions.

OBJECTIVE: This study was performed to determine the negative predictive value of sonography with mammography in evaluating palpable breast lesions. MATERIALS AND METHODS: Four hundred twenty patients with 455 palpable breast lesions were retrospectively identified from our mammography database as having negative mammographic and sonographic results. For patients diagnosed with breast cancer, images and medical records were reviewed to determine whether the palpable lesion evaluated on sonography and mammography corresponded to the patient's breast cancer. On the basis of the number of breast cancers that correlated to the palpable areas imaged, the negative predictive value of sonography with mammography was determined. RESULTS: Sixty-two of the 420 patients in the study group were already diagnosed with breast carcinoma, and eight new carcinomas were diagnosed during the study period. Only one of six ipsilateral cancers corresponded to a palpable lesion that had a negative imaging evaluation. This lesion was diagnosed as an invasive lobular cancer, hard and fixed at physical examination. Imaging and clinical follow-up of the remaining patients showed no abnormality at the sites of previously investigated palpable abnormalities. The mean imaging follow-up was 25 months. The negative predictive value of sonography and mammography in the setting of a palpable lesion was 99.8%. CONCLUSION: The negative predictive value of sonography with mammography is high, and together these imaging modalities can be reassuring if follow-up is planned when the physical examination is not highly suspicious. However, if the physical examination is suspicious, biopsy should not be delayed.

Authors
Soo, MS; Rosen, EL; Baker, JA; Vo, TT; Boyd, BA
MLA Citation
Soo, MS, Rosen, EL, Baker, JA, Vo, TT, and Boyd, BA. "Negative predictive value of sonography with mammography in patients with palpable breast lesions." AJR Am J Roentgenol 177.5 (November 2001): 1167-1170.
PMID
11641195
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
177
Issue
5
Publish Date
2001
Start Page
1167
End Page
1170
DOI
10.2214/ajr.177.5.1771167

Impact of core-needle breast biopsy on the surgical management of mammographic abnormalities.

OBJECTIVE: To evaluate the accuracy of percutaneous, image-guided core-needle breast biopsy (CNBx) and to compare the surgical management of patients with breast cancer diagnosed by CNBx with patients diagnosed by surgical needle-localization biopsy (SNLBx). SUMMARY BACKGROUND DATA: Percutaneous, image-guided CNBx is a less invasive alternative to SNLBx for the diagnosis of nonpalpable mammographic abnormalities. CNBx potentially spares patients with benign lesions from unnecessary surgery, although false-negative results can occur. For patients with malignant lesions, preoperative diagnosis by CNBx allows definitive treatment decisions to be made before surgery and may affect surgical outcomes. METHODS: Between 1992 and 1999, 939 patients with 1,042 mammographically detected lesions underwent biopsy by stereotactic CNBx or ultrasound-guided CNBx. Results were categorized pathologically as benign or malignant and, further, as invasive or noninvasive malignancies. Only biopsy results confirmed by excision or 1-year-minimum mammographic follow-up were included in the analysis. Patients with breast cancer diagnosed by CNBx were compared with a matched control group of patients with breast cancer diagnosed by SNLBx. RESULTS: Benign results were obtained in 802 lesions (77%), 520 of which were in patients with adequate follow-up. Ninety-five of the 520 evaluable lesions (18%) were subsequently excised because of atypical hyperplasia, mammographic-histologic discordance, or other clinical indications. There were 17 false-negative CNBx results in this group; 15 of these lesions were correctly diagnosed by excisional biopsy within 4 months of CNBx. In two patients (0.9%), delayed diagnoses of ductal carcinoma in situ were made at 15 and 19 months after CNBx. Malignant results were obtained in 240 lesions (23%), 220 of which were surgically excised from 202 patients at our institution. Two lesions diagnosed as ductal carcinoma in situ were reclassified as atypical ductal hyperplasia and considered false-positive results (0.4%). For malignant lesions, the sensitivity and specificity of CNBx for the detection of invasion were 89% and 96%, respectively. During the first surgical procedure, 115 of 199 patients (58%) diagnosed by CNBx underwent local excision; 194 of 199 patients (97%) evaluated by SNLBx underwent local excision. For patients whose initial surgery was local excision, those diagnosed before surgery by CNBx had larger excision specimens and were more likely to have negative surgical margins than were patients initially evaluated by SNLBx. Overall, patients diagnosed by CNBx required fewer surgical procedures for definitive treatment than did patients diagnosed by SNLBx. CONCLUSIONS: Diagnosis by CNBx spares most patients with benign mammographic abnormalities from unnecessary surgery. With the selective use of SNLBx to confirm discordant results, missed diagnoses are rare. When compared with SNLBx, preoperative diagnosis of breast cancer by CNBx facilitates wider initial margins of excision, fewer positive margins, and fewer surgical procedures to accomplish definitive treatment than diagnosis by SNLBx.

Authors
White, RR; Halperin, TJ; Olson, JA; Soo, MS; Bentley, RC; Seigler, HF
MLA Citation
White, RR, Halperin, TJ, Olson, JA, Soo, MS, Bentley, RC, and Seigler, HF. "Impact of core-needle breast biopsy on the surgical management of mammographic abnormalities." Ann Surg 233.6 (June 2001): 769-777.
PMID
11371735
Source
pubmed
Published In
Annals of Surgery
Volume
233
Issue
6
Publish Date
2001
Start Page
769
End Page
777

Artifacts and pitfalls in sonographic imaging of the breast.

Authors
Baker, JA; Soo, MS; Rosen, EL
MLA Citation
Baker, JA, Soo, MS, and Rosen, EL. "Artifacts and pitfalls in sonographic imaging of the breast." AJR Am J Roentgenol 176.5 (May 2001): 1261-1266.
PMID
11312192
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
176
Issue
5
Publish Date
2001
Start Page
1261
End Page
1266
DOI
10.2214/ajr.176.5.1761261

In vivo breast tissue backscatter measurements with 7.5- and 10-MHz transducers.

Measurements of the ultrasound (US) backscatter coefficient (BSC) of fibroglandular and fatty breast tissues in vivo from 5.25 through 13 MHz, using the reference phantom method, are presented. Radiofrequency echo data were collected at a series of locations in the left breasts of 16 adults, age 46 to 84, and in a custom-built phantom calibrated for backscatter and attenuation. Matched regions of interest (ROIs) were then selected in these images, from which the backscatter coefficient and the backscatter frequency dependence were ratiometrically estimated, after compensation for attenuation. The mean results in fibroglandular tissues were 78.9 x 10(-3)/cm, sr at 7.2 MHz (n(ROI) = 43, n = 13) and 146 x 10(-3)/cm, sr at 10.3 MHz (n(ROI) = 19, n = 10) with frequency dependencies of f(2.28) and f(3.25). The corresponding results in subcutaneous fat were 2.59 x 10(-3)/cm, sr at 7.2 MHz (n(ROI) = 56, n = 16) and 7.08 x 10(-3)/cm, sr at 10.3 MHz (n(ROI) = 57, n = 16) with frequency dependencies of f(3.49) and f(3.43). These findings are discussed and compared to similar measurements in the literature.

Authors
Anderson, ME; Soo, MS; Trahey, GE
MLA Citation
Anderson, ME, Soo, MS, and Trahey, GE. "In vivo breast tissue backscatter measurements with 7.5- and 10-MHz transducers." Ultrasound Med Biol 27.1 (January 2001): 75-81.
PMID
11295273
Source
pubmed
Published In
Ultrasound in Medicine & Biology
Volume
27
Issue
1
Publish Date
2001
Start Page
75
End Page
81

Wavefront estimation in the human breast

We acquired conventional and harmonic channel r.f. ultrasound echo data using a 3×80 element, 8.5 MHz multirow array from the breasts of eight volunteers. The data acquisition was interleaved to allow direct comparison normal and harmonic echo wavefronts. Harmonic imaging data was acquired using the pulse inversion technique. Data was acquired from extended regions of interest (25 mm deep, 10 mm wide). Time shift estimates from pairs of elements were combined using a weighted least squares algorithm to obtain a wavefront arrival time error estimate. Low spatial frequencies dominated most of the wavefront estimates, and many had a curvature suggesting a gross sound speed error. Wavefront estimates were often stable over lateral translations of a few millimeters, although they often changed significantly with range, particularly at tissue boundaries observed in the B-mode image. Averaging wavefront estimates over range yielded phase aberration estimates that generally improved image quality. We measured relatively small wavefront arrival errors with both conventional (22.9 +/- 7.6 ns r.m.s.) and harmonic (22.8 +/- 7.8 ns r.m.s.) echoes. For any particular measurement, the difference between conventional and harmonic wavefront estimates was small (0 +/- 4.5 ns r.m.s). Our measurements suggest relatively mild phase aberrations in the breast, although they may be more significant for higher frequency transducers and deeper imaging depths.

Authors
Gauss, RC; Trahey, GE; Soo, MS
MLA Citation
Gauss, RC, Trahey, GE, and Soo, MS. "Wavefront estimation in the human breast." Proceedings of SPIE - The International Society for Optical Engineering 4325 (2001): 172-181.
Source
scival
Published In
Proceedings of SPIE - The International Society for Optical Engineering
Volume
4325
Publish Date
2001
Start Page
172
End Page
181
DOI
10.1117/12.428194

Investigation of real-time remote palpation imaging

We are investigating a novel ultrasonic method for remote palpation, which provides images of local variations in tissue stiffness. Acoustic radiation force is applied to small volumes of tissue, and the resulting displacement patterns are imaged using ultrasonic correlation based techniques. Tissue displacements are inversely proportional to tissue stiffness, thus a stiffer region of tissue exhibits smaller displacements than a more compliant region. This method also provides information about tissue recovery after force cessation. We will present in vivo experimental results demonstrating the feasibility of this method. Using intensities ranging from 120 to 300 W/cm2, peak displacements of up to 50 microns were observed after 1.4 milliseconds of force application. The tissue moved to its peak displacement within 3 milliseconds of force application, and the time constants for tissue recovery varied with tissue type. Tissue displacements appeared to be correlated with tissue structure in matched B-mode images. To our knowledge, these results represent the first in vivo soft tissue images generated using radiation force. These findings support the feasibility of Remote Palpation imaging. We will discuss the technical, safety, and clinical challenges of implementing a real-time Remote Palpation imaging system on a commercial diagnostic scanner.

Authors
Nightingale, KR; Soo, MS; Nightingale, RW; Trahey, GE
MLA Citation
Nightingale, KR, Soo, MS, Nightingale, RW, and Trahey, GE. "Investigation of real-time remote palpation imaging." Proceedings of SPIE - The International Society for Optical Engineering 4325 (2001): 113-119.
Source
scival
Published In
Proceedings of SPIE - The International Society for Optical Engineering
Volume
4325
Publish Date
2001
Start Page
113
End Page
119
DOI
10.1117/12.428187

In vivo demonstration of acoustic radiation force impulse (ARFI) imaging in the thyroid, abdomen, and breast

Acoustic Radiation Force Impulse (ARFI) imaging is proposed as a method for characterizing local variations in tissue mechanical response. In this method, a single ultrasonic transducer array is used to both apply localized radiation forces within tissue and to track the resulting displacements. Tissue displacement is inversely proportional to tissue stiffness, and the temporal response of tissue to radiation force varies with tissue type. We have previously presented results generated using radiation force applied in a single pushing location in vivo, and using multiple pushing locations in tissue phantoms where the data was acquired over several minutes. In this paper, data are presented that were acquired using multiple applications of radiation force to interrogate an extended region of interest in a real-time data acquisition implementation, using beam sequences similar to those used for Color Doppler. In vivo ARFI images of the thyroid, abdomen, and breast are presented. Peak displacements of 5, 10, and 8 microns were observed in the these tissues, respectively. In all cases, the ARFI images and matched B-mode images show highly correlated structural information, and comparable resolution. Images of the thyroid exhibit remarkable uniformity in displacement with no speckle. The results suggest considerable clinical potential for ARFI imaging.

Authors
Nightingale, K; Soo, MS; Nightingale, R; Bentley, R; Trahey, G
MLA Citation
Nightingale, K, Soo, MS, Nightingale, R, Bentley, R, and Trahey, G. "In vivo demonstration of acoustic radiation force impulse (ARFI) imaging in the thyroid, abdomen, and breast." Proceedings of the IEEE Ultrasonics Symposium 2 (2001): 1633-1638.
Source
scival
Published In
Proceedings of the IEEE Ultrasonics Symposium
Volume
2
Publish Date
2001
Start Page
1633
End Page
1638

Tissue harmonic imaging sonography of breast lesionsImproved margin analysis, conspicuity, and image quality compared to conventional ultrasound

The purpose of this preference study is to determine if tissue harmonic imaging (THI) is preferred over conventional sonography for imaging breast masses. A prospective evaluation of 73 identical image pairs (one obtained with conventional sonography, one with THI sonography) was performed, examining 25 cysts, 36 solid masses, and 12 indeterminate lesions. Each image was evaluated for lesion contrast, margins, and overall image quality using a graduated score. Statistical analysis was performed using a modified t test. For cystic and solid lesions, THI was preferred for lesion conspicuity, margin, and overall quality (P<.001). For indeterminate lesions, THI was significantly preferred for lesion conspicuity and overall quality (P<.05), but the preference for margins was not significant. Overall, THI of breast lesions was significantly preferred for lesion contrast and margin evaluation compared to conventional sonography. This modality deserves further evaluation and may improve detection and evaluation of breast lesions. Copyright © 2001 Elsevier Science. Inc.

Authors
Rosen, EL; Soo, MS
MLA Citation
Rosen, EL, and Soo, MS. "Tissue harmonic imaging sonography of breast lesionsImproved margin analysis, conspicuity, and image quality compared to conventional ultrasound." Clinical Imaging 25.6 (2001): 379-384.
PMID
11733148
Source
scival
Published In
Clinical Imaging
Volume
25
Issue
6
Publish Date
2001
Start Page
379
End Page
384
DOI
10.1016/S0899-7071(01)00335-7

Silicone gel breast implant rupture, extracapsular silicone, and health status in a population of women

Objective. To assess whether breast implant rupture or extracapsular silicone are associated with selected symptoms of self-reported physician-diagnosed connective tissue disease (CTD). Methods. Women with silicone gel breast implants responded to a questionnaire that included questions on health status, satisfaction with implants, symptoms of CTD, and physician-diagnosed disease. These women then had magnetic resonance imaging (MRI) of their breasts to determine the status of the implants with respect to rupture and extracapsular silicone. Results. Women with breast implant rupture diagnosed by MRI were no more likely to report a diagnosis of selected CTD than those with intact implants or those with implants of indeterminate status. Women with extracapsular silicone (silicone gel outside of the fibrous scar that forms around breast implants) were more likely to report having fibromyalgia (FM, p = 0.004) or other CTD, which included dermatomyositis, polymyositis, Hashimoto's thyroiditis, mixed CTD, pulmonary fibrosis, eosinophilic fasciitis, and polymyalgia (p = 0.008) than other women in the study. The association with FM remained statistically significant when adjusted for multiple comparisons (7 diagnoses) and implant age, implant location, or implant manufacturer (p < 0.05 in all cases), hut became of borderline statistical significance when adjusted for multiple comparisons and self-perceived health status (p = 0.094) or self-perceived rupture status (p = 0.051). The association with other CTD remained statistically significant when adjusted for multiple comparisons and implant location or implant manufacturer, but became borderline or insignificant when adjusted for multiple comparisons and for implant age (p = 0.051), self-perceived health status (p = 0.434), or self-perceived rupture status (p = 0.145). Logistic regression was used to compute odds ratios of self-reported diagnoses comparing women with and without extracapsular silicone. The odds ratios were 2.8 (95% CI 1.2 to 6.3) for FM, and 2.6 (95% CI 0.8 to 8.5) for other CTD after adjustment for implant age, implant location, implant manufacturer, implant type, self-perceived health, self-perceived rupture status, and site of surgery practice. Conclusion. These data suggest an association between extracapsular silicone from ruptured silicone breast implants and FM. If this association persists in other studies, women with silicone gel breast implants should he informed of the potential risk of developing fibromyalgia if their breast implants rupture and the silicone gel escapes the fibrous scar capsule.

Authors
Brown, SL; Pennello, G; Berg, WA; Soo, MS; Middleton, MS
MLA Citation
Brown, SL, Pennello, G, Berg, WA, Soo, MS, and Middleton, MS. "Silicone gel breast implant rupture, extracapsular silicone, and health status in a population of women." Journal of Rheumatology 28.5 (2001): 996-1003.
PMID
11361228
Source
scival
Published In
Journal of Rheumatology
Volume
28
Issue
5
Publish Date
2001
Start Page
996
End Page
1003

The evolving role of sonography in evaluating solid breast masses.

Many investigators have attempted to use ultrasound imaging to differentiate benign from malignant solid breast masses. Studies have evaluated several generations of gray-scale imaging, Doppler, color Doppler, and power Doppler imaging, and several unconventional ultrasound techniques. Although various individual studies have shown promise, ultrasound criteria for avoiding biopsy of solid lesions have not been widely adopted. Considerable observer variability also remains an important obstacle. This article reviews the results, strengths, and weaknesses of some of the key studies addressing this issue. Fundamental criteria for a successful ultrasound model are also specified.

Authors
Baker, JA; Soo, MS
MLA Citation
Baker, JA, and Soo, MS. "The evolving role of sonography in evaluating solid breast masses." Semin Ultrasound CT MR 21.4 (August 2000): 286-296. (Review)
PMID
11014251
Source
pubmed
Published In
Seminars in Ultrasound, CT and MRI
Volume
21
Issue
4
Publish Date
2000
Start Page
286
End Page
296

Tubular adenomas of the breast: imaging findings with histologic correlation.

OBJECTIVE: The purpose of this study is to describe the imaging features of tubular adenomas, which are rare benign breast tumors usually found in women younger than 35 years old. CONCLUSION: In young women, tubular adenomas can look like noncalcified fibroadenomas on mammography and sonography. In older women, tubular adenomas may resemble malignant masses with microcalcifications. Awareness of these findings may help in assessing concordance between imaging and histologic findings after percutaneous core biopsy of these rare lesions.

Authors
Soo, MS; Dash, N; Bentley, R; Lee, LH; Nathan, G
MLA Citation
Soo, MS, Dash, N, Bentley, R, Lee, LH, and Nathan, G. "Tubular adenomas of the breast: imaging findings with histologic correlation." AJR Am J Roentgenol 174.3 (March 2000): 757-761.
PMID
10701621
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
174
Issue
3
Publish Date
2000
Start Page
757
End Page
761
DOI
10.2214/ajr.174.3.1740757

Herpes simplex virus mastitis: Clinical and imaging findings

Authors
Soo, MS; Ghate, S
MLA Citation
Soo, MS, and Ghate, S. "Herpes simplex virus mastitis: Clinical and imaging findings." American Journal of Roentgenology 174.4 (2000): 1087-1088.
PMID
10749256
Source
scival
Published In
AJR. American journal of roentgenology
Volume
174
Issue
4
Publish Date
2000
Start Page
1087
End Page
1088

Optimizing visualization of breast microcalcifications

We combine our results from a series of clinical, experimental, and analytical studies to present comprehensive recommendations for the improved visualization of breast microcalcifications with ultrasound. Such improved visualization would extend the utility of breast ultrasound in guiding biopsy and in the differentiation of breast lesions, particularly in the mammographically dense breast. The in vivo clinical data used to inform our recommendations were collected with a Siemens Elegra scanner and 7.5 and 10 MHz probes, and include breast tissue backscatter measurements (N = 16), channel-by-channel RF echo data from microcalcifications (N = 7), and measurements of speckle statistics in breast tissues (N = 16). Our measurements of speckle statistics suggest that echoes from these tissues do not exhibit fully-developed speckle (SNR = 1.3-1.4 vs. 1.85 control, 1.91 theoretical). Imaging parameters considered include sound speed error, phase aberration, probe frequency, spatial resolution, and speckle reduction by compounding. We compare the relative impact of these parameters on visualization using, among other performance metrics, the area under the ROC curve AUC. We identify the overall performance trends so demonstrated in the interest of guiding improvements in breast imaging with ultrasound.

Authors
Anderson, ME; Soo, MSC; Trahey, GE
MLA Citation
Anderson, ME, Soo, MSC, and Trahey, GE. "Optimizing visualization of breast microcalcifications." Proceedings of the IEEE Ultrasonics Symposium 2 (2000): 1315-1320.
Source
scival
Published In
Proceedings of the IEEE Ultrasonics Symposium
Volume
2
Publish Date
2000
Start Page
1315
End Page
1320

Prevalence of rupture of silicone gel breast implants revealed on MR imaging in a population of women in Birmingham, Alabama

OBJECTIVE. Silicone gel breast implants have been reported to rupture, but the prevalence of implant rupture in an unreferred population of women is not known. The objective of this study was to assess the prevalence of implant rupture and the presence of extracapsular silicone gel in an unreferred population of women without regard to the absence or presence of any local or systemic symptoms. SUBJECTS AND METHODS. Women identified as part of a National Cancer Institute cohort study on breast implants, living in the Birmingham, AL, area were invited to undergo MR imaging of their current silicone gel breast implants at the Kirklin Clinic at the University of Alabama at Birmingham. Three radiologists independently examined and rated all MR images for signs of implant rupture and extracapsular silicone. RESULTS. A total of 344 women with silicone gel breast implants underwent MR imaging. Breast implant rupture was reported by at least two of three radiologists for 378 (55.0%) of the 687 implants in this study. Another 50 implants (7.2%) were rated as indeterminate (suspicious) for rupture. A majority of women in this study, 265 (77.0%) of 344, had at least one breast implant that was rated as ruptured or indeterminate. Radiologists also agreed that silicone gel could be seen outside the fibrous capsule that forms around the implant in 85 (12.4%) of the 687 implants affecting 73 women (21.2%). Factors that affected implant rupture were implant age and location (submuscular or subglandular). The median implant age at rupture was estimated to be 10.8 years with a 95% confidence interval of 8.4-13.9 years. CONCLUSION. The prevalence of silent or occult silicone gel breast implant rupture is higher than was previously suspected. Most women in this study had MR imaging evidence of at least one ruptured silicone gel breast implant.

Authors
Brown, SL; Middleton, MS; Berg, WA; Soo, MS; Pennello, G
MLA Citation
Brown, SL, Middleton, MS, Berg, WA, Soo, MS, and Pennello, G. "Prevalence of rupture of silicone gel breast implants revealed on MR imaging in a population of women in Birmingham, Alabama." American Journal of Roentgenology 175.4 (2000): 1057-1064.
PMID
11000165
Source
scival
Published In
American Journal of Roentgenology
Volume
175
Issue
4
Publish Date
2000
Start Page
1057
End Page
1064

Focal fibrosis: a common breast lesion diagnosed at imaging-guided core biopsy.

OBJECTIVE: Focal fibrosis is a benign breast lesion commonly diagnosed by imaging-guided core biopsy. The goal of this study is to determine the frequency of focal fibrosis diagnosed at core biopsy and to describe its imaging features. MATERIALS AND METHODS: A consecutive series of 894 imaging-guided breast core biopsies were reviewed, and all cases of focal fibrosis were selected. The imaging features of each lesion were characterized. All lesions had been reviewed during radiologic-histologic review sessions to assess for accurate needle positioning and concordant results. Follow-up imaging and histologic data were reviewed to document lesion stability. RESULTS: Focal fibrosis was diagnosed in 80 (8.9%) of 894 imaging-guided core biopsies: 20 (8.7%) of 229 sonographically guided biopsies and 60 (9.0%) of 665 mammographically guided biopsies. Of 75 mammographically visible lesions, 39 (52%) were masses, 29 (39%) were densities, and seven (9.3%) were clusters of calcifications. Thirty-five hypoechoic lesions were visualized on sonography: 29 (80%) were oval, and six (17%) were irregularly shaped. Six (21%) of the 28 oval masses showed posterior enhancement, four (14%) posterior shadowing, and 19 (68%) neither feature. Fifty-two (65%) of 80 patients with focal fibrosis had routine imaging follow-up; all had stable findings (mean follow-up period, 27 months). No false-negative cases were identified. CONCLUSION: Focal fibrosis most commonly appears as an enlarging solid mass or developing density on mammography or as an oval mass on sonography. Our data suggest that focal fibrosis accounts for 9% of lesions that undergo imaging-guided core biopsy and that the diagnosis can be accurately reached using imaging-guided biopsy.

Authors
Rosen, EL; Soo, MS; Bentley, RC
MLA Citation
Rosen, EL, Soo, MS, and Bentley, RC. "Focal fibrosis: a common breast lesion diagnosed at imaging-guided core biopsy." AJR Am J Roentgenol 173.6 (December 1999): 1657-1662.
PMID
10584816
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
173
Issue
6
Publish Date
1999
Start Page
1657
End Page
1662
DOI
10.2214/ajr.173.6.10584816

Extended field-of-view two-dimensional ultrasonography of the breast: improvement in lesion documentation.

The purpose of this study was to evaluate the use of extended field-of-view two-dimensional ultrasonographic imaging for improvement in overall breast lesion documentation. Sonographic images of 59 patients with breast lesions or silicone implants were evaluated by three radiologists retrospectively to compare traditional static linear array images alone with images obtained with the addition of an extended field of view to determine if documentation of lesions was improved. The addition of extended field-of-view imaging improved lesion conspicuity by 21% over traditional images. It provided overall improvement in lesion documentation by including a reference point (nipple) or by more completely imaging large masses in 79% and implants in 69%. The larger field of view of this technique is promising as an adjunct to traditional sonography for breast lesion documentation.

Authors
Ghate, SV; Soo, MS; Mengoni, PM
MLA Citation
Ghate, SV, Soo, MS, and Mengoni, PM. "Extended field-of-view two-dimensional ultrasonography of the breast: improvement in lesion documentation." J Ultrasound Med 18.9 (September 1999): 597-601.
PMID
10478968
Source
pubmed
Published In
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine
Volume
18
Issue
9
Publish Date
1999
Start Page
597
End Page
601

Sonography of solid breast lesions: observer variability of lesion description and assessment.

OBJECTIVE: The purpose of this study was to measure the level of inter- and intraobserver agreement and to evaluate the causes of variability in radiologists' descriptions and assessments of sonograms of solid breast masses. MATERIALS AND METHODS: Sixty sonograms of solid masses were evaluated independently by five radiologists. Observers used the lexicon of a recently published benchmark report on sonographic appearances of breast masses to determine mass shape, margin, echogenicity, echo texture, presence of echogenic pseudocapsule, and acoustic transmission. Final diagnostic assessments were determined by applying the rule-based model of the same benchmark report to the radiologists' descriptions. In addition, one observer interpreted each case twice to evaluate intraobserver variability. Inter- and intraobserver variability were measured using Cohen's kappa statistic. We also investigated causes of variability in radiologists' descriptions. RESULTS: Interobserver agreement ranged from lowest for determining the presence of an echogenic pseudocapsule (kappa = .09) to highest for determining mass shape (kappa = .8). Intraobserver agreement was lowest for mass echo texture (kappa = .24) and greatest for mass shape (kappa = .79). Variability in descriptions of lesions contributed to interobserver (kappa = .51) and some intraobserver (kappa = .66) inconsistency in assessing the likelihood of malignancy. CONCLUSION: Lack of uniformity among observers' use of descriptive terms for solid breast masses resulted in inconsistent diagnoses. The need for improved definitions and additional illustrative examples could be addressed by developing a standardized lexicon similar to that of the Breast Imaging Reporting and Data System.

Authors
Baker, JA; Kornguth, PJ; Soo, MS; Walsh, R; Mengoni, P
MLA Citation
Baker, JA, Kornguth, PJ, Soo, MS, Walsh, R, and Mengoni, P. "Sonography of solid breast lesions: observer variability of lesion description and assessment." AJR Am J Roentgenol 172.6 (June 1999): 1621-1625.
PMID
10350302
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
172
Issue
6
Publish Date
1999
Start Page
1621
End Page
1625
DOI
10.2214/ajr.172.6.10350302

Sonographically guided percutaneous interventions of the breast using a steerable ultrasound beam.

Authors
Baker, JA; Soo, MS; Mengoni, P
MLA Citation
Baker, JA, Soo, MS, and Mengoni, P. "Sonographically guided percutaneous interventions of the breast using a steerable ultrasound beam." AJR Am J Roentgenol 172.1 (January 1999): 157-159.
PMID
9888759
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
172
Issue
1
Publish Date
1999
Start Page
157
End Page
159
DOI
10.2214/ajr.172.1.9888759

Stereotactic biopsy of noncalcified breast lesions: Utility of vacuum-assisted technique compared to multipass automated gun technique

The purpose of this study was to evaluate the stereotactic 14-gauge, vacuum-assisted biopsy technique in diagnosing noncalcified breast lesions. Stereotactic biopsy of 116 noncalcified breast lesions was performed with either 14-gauge, vacuum-assisted technique or multipass, automated large-core technique. The number of core samples and time required for each biopsy were compared. Outcome for each technique was compared based on recommendations after the mammographic-histologic review process. Results from surgical excision and mammographic follow-up were reviewed. The vacuum-assisted technique obtained more tissue cores (mean = 15.8) per lesion than the automated gun technique (mean = 5.8), showed marginal decrease in number of repeat biopsies for discordant results, and required fewer short-term follow-up mammograms, although the difference did not achieve statistical significance. The vacuum-assisted technique can be used successfully to sample noncalcified breast masses, with marginal improvement over the automated gun technique. Copyright (C) 2000 Elsevier Science Inc.

Authors
Soo, MS; Ghate, S; Delong, D
MLA Citation
Soo, MS, Ghate, S, and Delong, D. "Stereotactic biopsy of noncalcified breast lesions: Utility of vacuum-assisted technique compared to multipass automated gun technique." Clinical Imaging 23.6 (1999): 347-352.
PMID
10899415
Source
scival
Published In
Clinical Imaging
Volume
23
Issue
6
Publish Date
1999
Start Page
347
End Page
352
DOI
10.1016/S0899-7071(00)00164-9

Adaptive imaging in the breast

Various adaptive imaging methods have been proposed to compensate for the image degradation caused by the non-uniform acoustic velocity in soft tissues. Most adaptive imaging methods employ measurements of echo arrival times at the receive array to modify the timing of signals transmitted and received and form the 'corrected' image. In breast ultrasound imaging, improved image contrast and resolution would improve differential diagnosis of solid lesions and cyst, of benign and malignant lesions, and in the detection of microcalcifications. We report clinical measurements of arrival time profiles over large tissue regions in the breast using a 1.75D array. We used microcalcifications as targets of opportunity for these measurements. Arrival time profiles were measured using both fundamental and harmonic echoes and were employed to form 'corrected' B-mode images. We report large artifacts in arrival time profiles measured from regions of soft tissue containing specular interfaces, bright off-axis targets, or off-axis clutter. The effects of the artifacts were often reduced in harmonic echoes obtained from matched locations. Arrival time profiles apparently uncorrupted by target scattering artifacts were generally low magnitude and yielded improved image brightness.

Authors
Gauss, RC; Trahey, GE; Soo, MS
MLA Citation
Gauss, RC, Trahey, GE, and Soo, MS. "Adaptive imaging in the breast." Proceedings of the IEEE Ultrasonics Symposium 2 (1999): 1563-1569.
Source
scival
Published In
Proceedings of the IEEE Ultrasonics Symposium
Volume
2
Publish Date
1999
Start Page
1563
End Page
1569

In vivo breast tissue backscatter study with 7.5 MHz and 10 MHz probes

An on-going study of the backscatter coefficient (BSC) of fibroglandular breast tissue in vivo from 5-13 MHz is discussed. Initial results of the study are compared to published values for this tissue. The implications of these findings for the ultrasound visualization of microcalcifications are discussed.

Authors
Anderson, ME; Soo, MSC; Trahey, GE
MLA Citation
Anderson, ME, Soo, MSC, and Trahey, GE. "In vivo breast tissue backscatter study with 7.5 MHz and 10 MHz probes." Proceedings of the IEEE Ultrasonics Symposium 2 (1999): 1311-1314.
Source
scival
Published In
Proceedings of the IEEE Ultrasonics Symposium
Volume
2
Publish Date
1999
Start Page
1311
End Page
1314

Prone table stereotactic breast biopsy: facilitating biopsy of posterior lesions using the arm-through-the-hole technique.

Authors
Soo, MS; Walsh, R; Patton, J
MLA Citation
Soo, MS, Walsh, R, and Patton, J. "Prone table stereotactic breast biopsy: facilitating biopsy of posterior lesions using the arm-through-the-hole technique." AJR Am J Roentgenol 171.3 (September 1998): 615-617.
PMID
9725284
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
171
Issue
3
Publish Date
1998
Start Page
615
End Page
617
DOI
10.2214/ajr.171.3.9725284

Fat necrosis in the breast: sonographic features.

PURPOSE: To evaluate the ultrasonographic (US) features and evolution of fat necrosis in the breast. MATERIALS AND METHODS: The US features of 31 breast masses in 23 patients were reviewed. Fat necrosis was diagnosed on the basis of histologic (n = 20) and initial or follow-up (minimum follow-up, 15 months) mammographic (n = 11) findings. RESULTS: Sonograms demonstrated discrete masses in all but one patient. On the basis of the predominant US finding, masses were categorized as solid (n = 15), complex with mural nodules (n = 7), complex with echogenic bands (n = 4), anechoic with posterior acoustic enhancement (n = 2), anechoic with shadowing (n = 2), or no mass visible (n = 1). Distortion of the normal parenchymal architecture was seen in 21 masses. In four six masses, 1-26-month follow-up sonograms showed evolution of the US appearance. One solid mass remained solid appearing. Complex masses tended to evolve: Three became more solid appearing, and one became more cystic. No mass enlarged; two remained stable, and four decreased in size. CONCLUSION: A spectrum of US findings is associated with fat necrosis. If fat necrosis is suspected and mammographic findings are suspicious, knowledge of the US appearance and evolution of these patterns may enable imaging follow-up of these lesions rather than needless biopsy.

Authors
Soo, MS; Kornguth, PJ; Hertzberg, BS
MLA Citation
Soo, MS, Kornguth, PJ, and Hertzberg, BS. "Fat necrosis in the breast: sonographic features." Radiology 206.1 (January 1998): 261-269.
PMID
9423681
Source
pubmed
Published In
Radiology
Volume
206
Issue
1
Publish Date
1998
Start Page
261
End Page
269
DOI
10.1148/radiology.206.1.9423681

Microcalcifications as elastic scatterers under ultrasound.

One of the fundamental limitations of medical ultrasound in the imaging of the breast is the inability of current practice to reliably visualize microcalcifications in the size range of clinical interest. Microcalcifications (MCs) are small crystals of calcium phosphates that form in human tissue through a number of mechanisms. The size, morphology, and distribution of MCs are important indicators in the mammographic screening for and diagnosis of various carcinomas in the breast. The authors are investigating the imaging of MCs under ultrasound in the interest of extending the utility of medical ultrasound in the breast clinic. They present an analysis of the acoustic properties of MCs modeled as elastic spheres based on the Faran model that considers the predicted complex spectra and spatial coherence of echoes from MCs. They have found the predictions of the model to be similar to ultrasound echoes from suspected MCs in vivo. They also present breast phase aberration estimates and spatial and frequency compounding results based on the echoes from these targets.

Authors
Anderson, ME; Soo, MC; Trahey, GE
MLA Citation
Anderson, ME, Soo, MC, and Trahey, GE. "Microcalcifications as elastic scatterers under ultrasound." IEEE Trans Ultrason Ferroelectr Freq Control 45.4 (1998): 925-934.
PMID
18244247
Source
pubmed
Published In
IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control
Volume
45
Issue
4
Publish Date
1998
Start Page
925
End Page
934
DOI
10.1109/58.710559

Application of sound speed estimation and mapping to multi-layer media and in vivo data

The application of a pulse-echo sound speed estimation technique to multi-layered and biological media is discussed and demonstrated in simulation, phantom, and clinical experiments. We have recently described and demonstrated a technique which estimates the mean sound speed in a homogeneous medium. Given a homogeneous medium, the arrival times across a transducer array of ultrasound echoes from a target or region of interest, calculated to include the one-way transit time, are a unique function of sound speed. The sound speed estimator we describe analyzes the arrival time information in the RF data recorded on individual elements of an array following a single conventional transmittal. This method uses a single transducer array and has been shown to have accuracy on the order of 0.4% for wire targets in a variety of fluids and 0.5% in an attenuating, speckle-generating phantom medium. This method has potential applications in the correction of beam-forming errors caused by sound speed errors and in the mapping of tissue velocity over range and/or throughout a region of interest. We present simulation and phantom experiments demonstrating the ability of this technique to map mean tissue sound speed for simple geometries of multi-layered media. We also present in vivo sound speed estimates in the breast and compare these to published values for breast tissues.

Authors
Anderson, ME; McKeag, MS; Gauss, RC; Soo, MSC; Trahey, GE
MLA Citation
Anderson, ME, McKeag, MS, Gauss, RC, Soo, MSC, and Trahey, GE. "Application of sound speed estimation and mapping to multi-layer media and in vivo data." Proceedings of the IEEE Ultrasonics Symposium 2 (1998): 1393-1396.
Source
scival
Published In
Proceedings of the IEEE Ultrasonics Symposium
Volume
2
Publish Date
1998
Start Page
1393
End Page
1396

Imaging-guided core biopsies in the breast

Screening mammography programs have contributed to an overall decline in breast cancer mortality. The screening process, however, also results in detection and biopsy of many nonpalpable lesions that eventually prove to be benign, contributing to the burden of costs to our health care system. Percutaneous imaging-guided core biopsy has proven to be a safe and accurate technique for obtaining a histologic diagnosis in most patients who have screening-detected lesions; it is done at lower cost with lower resultant morbidity to the patient compared with traditional surgical excisional biopsy. I review the indications, techniques, method of correlating the histology with mammographic findings, and accreditation requirements for imaging-guided core biopsies of the breast done under mammographic (ie, stereotactic) or sonographic guidance.

Authors
Soo, MS
MLA Citation
Soo, MS. "Imaging-guided core biopsies in the breast." Southern Medical Journal 91.11 (1998): 994-1000.
PMID
9824178
Source
scival
Published In
Southern Medical Journal
Volume
91
Issue
11
Publish Date
1998
Start Page
994
End Page
1000

Breast tumour imaging using incomplete circular orbit pinhole SPET: a phantom study.

Improvements in 99Tcm-sestamibi breast lesion visualization using single photon emission tomography (SPET) may help define the clinical role of this technique alongside X-ray mammography in the diagnosis and management of breast cancer. Pinhole SPET offers the advantages of high resolution and sensitivity when compared to conventional parallel-beam collimation for sources located near the pinhole aperture. In this work, the potential of incomplete (180 degrees) circular orbit (ICO) SPET with pinhole collimation is investigated as a means to visualize small (6.4 and 9.6 mm diameter) spherical simulated tumours, at clinical count densities and tumour-to-background ratios, in a breast phantom. ICO pinhole SPET is compared to complete circular orbit (CCO) pinhole SPET for reference, and planar breast imaging (scintimammography) using parallel-beam and pinhole collimators. A prototype box-shaped pinhole collimator with a 4 mm diameter circular aperture was used to acquire projections of an 890 ml breast phantom both in isolation and mounted on a cylinder filled with a mixture of 99Tcm-pertechnetate and water. A heart phantom containing 99Tcm activity in the myocardium was placed in the cylinder. Simulated tumours containing 99Tcm were placed in the breast phantom and scanned at clinically relevant count densities and scan times with tumour-to-normal tissue concentration ratios of 5.0:1 (9.6 mm sphere) and 7.7:1 (6.4 mm sphere). Phantom data were reconstructed using pinhole filtered backprojection (FBP) and maximum likelihood-expectation maximization (ML-EM). The tumours were not visualized with scintimammography, in which lesion contrast and signal-to-noise were estimated from region of interest analysis to be < 2% and 0.01, respectively. Average (over lesion size and scan time) contrast and signal-to-noise in the ICO (CCO) SPET images were 33% and 1.72 (34% and 1.3), respectively. These values indicate that ICO pinhole SPET has the potential to improve visualization of small (< 10 mm) breast tumours when compared with scintimammography, which may be beneficial for the early classification of cancers of the breast.

Authors
Scarfone, C; Jaszczak, RJ; Li, J; Soo, MS; Smith, MF; Greer, KL; Coleman, RE
MLA Citation
Scarfone, C, Jaszczak, RJ, Li, J, Soo, MS, Smith, MF, Greer, KL, and Coleman, RE. "Breast tumour imaging using incomplete circular orbit pinhole SPET: a phantom study." Nucl Med Commun 18.11 (November 1997): 1077-1086.
PMID
9423209
Source
pubmed
Published In
Nuclear Medicine Communications
Volume
18
Issue
11
Publish Date
1997
Start Page
1077
End Page
1086

Intracapsular implant rupture: MR findings of incomplete shell collapse.

The objective of this study was to determine the frequency and significance of the MR findings of incomplete shell collapse for detecting implant rupture in a series of surgically removed breast prostheses. MR images of 86 breast implants in 44 patients were studied retrospectively and correlated with surgical findings at explantation. MR findings included (a) complete shell collapse (linguine sign), 21 implants; (b) incomplete shell collapse (subcapsular line sign, teardrop sign, and keyhole sign), 33 implants; (c) radial folds, 31 implants; and (d) normal, 1 implant. The subcapsular line sign was seen in 26 implants, the teardrop sign was seen in 27 implants, and the keyhole sign was seen in 23 implants. At surgery, 48 implants were found to be ruptured and 38 were intact. The MR findings of ruptured implants showed signs of incomplete collapse in 52% (n = 25), linguine sign in 44% (n = 21), and radial folds in 4% (n = 2). The linguine sign perfectly predicted implant rupture, but sensitivity was low. Findings of incomplete shell collapse improved sensitivity and negative predictive values, and the subcapsular line sign produced a significant incremental increase in predictive ability. MRI signs of incomplete shell collapse were more common than the linguine sign in ruptured implants and are significant contributors to the high sensitivity and negative predictive values of MRI for evaluating implant integrity.

Authors
Soo, MS; Kornguth, PJ; Walsh, R; Elenberger, C; Georgiade, GS; DeLong, D; Spritzer, CE
MLA Citation
Soo, MS, Kornguth, PJ, Walsh, R, Elenberger, C, Georgiade, GS, DeLong, D, and Spritzer, CE. "Intracapsular implant rupture: MR findings of incomplete shell collapse." J Magn Reson Imaging 7.4 (July 1997): 724-730.
PMID
9243394
Source
pubmed
Published In
Journal of Magnetic Resonance Imaging
Volume
7
Issue
4
Publish Date
1997
Start Page
724
End Page
730

The detection of breast microcalcifications with medical ultrasound.

Microcalcifications are small crystals of calcium apatites which form in human tissue through a number of mechanisms. The size, morphology, and distribution of microcalcifications are important indicators in the mammographic screening for and diagnosis of various carcinomas in the breast. Although x-ray mammography is currently the only accepted method for detecting microcalcifications, its efficacy in this regard can be reduced in the presence of dense parenchyma. Current ultrasound scanners do not reliably detect microcalcifications in the size range of clinical interest. The results of theoretical, simulation, and experimental studies focused on the improvement of the ultrasonic visualization of microcalcifications are presented. Methods for estimating the changes in microcalcification detection performance which result from changes in aperture geometry or the presence of an aberrator are presented. An analysis of the relative efficacy of spatial compounding and synthetic receive aperture geometries in the detection of microcalcifications is described. The impact of log compression of the detected image on visualization is discussed. Registered high resolution ultrasound and digital spot mammography images of microcalcifications in excised breast carcinoma tissue and results from the imaging of suspected microcalcifications in vivo are presented.

Authors
Anderson, ME; Soo, MS; Bentley, RC; Trahey, GE
MLA Citation
Anderson, ME, Soo, MS, Bentley, RC, and Trahey, GE. "The detection of breast microcalcifications with medical ultrasound." J Acoust Soc Am 101.1 (January 1997): 29-39.
PMID
9000730
Source
pubmed
Published In
The Journal of the Acoustical Society of America
Volume
101
Issue
1
Publish Date
1997
Start Page
29
End Page
39

Axillary lymph nodes: mammographic, pathologic, and clinical correlation.

OBJECTIVE: The purpose of this study was to determine the cause and frequency of axillary abnormalities seen mammographically and to evaluate the imaging characteristics of lymphadenopathy that are associated with malignancy. MATERIALS AND METHODS: Ninety-six axillary abnormalities seen mammographically in 94 patients were retrospectively reviewed and correlated with the clinical diagnoses and pathologic results found in the medical records. For each abnormality, the length, margins, and presence of microcalcifications were noted. Logistic regression was used to determine an association between these findings and status (benign or malignant). RESULTS: Seventy-six of 94 patients had lymphadenopathy. Eighteen of 94 patients had an abnormality other than lymphadenopathy. Because two of these 94 patients had more than one abnormality, a total of 96 abnormalities occurred, 20 of which were due to an abnormality other than lymphadenopathy. Regarding the 76 cases of lymphadenopathy, the most frequent diagnosis was nonspecific benign lymphadenopathy in 29% (n = 22) of cases, followed by metastatic breast cancer in 26% (n = 20) and chronic lymphocytic leukemia or well-differentiated lymphocytic lymphoma in 17% (n = 13). Other causes (n = 21) included collagen vascular disease, lymphomas other than well-differentiated lymphocytic lymphoma, metastatic disease from nonbreast primary site, metastatic disease from unknown primary site, sarcoidosis. HIV-related lymphadenopathy, and reactive lymphadenopathy associated with a breast abscess. An association between length of nonfatty lymph nodes and malignant status was statistically significant at the .001 level. When a length greater than 33 mm was used as a predictor of malignancy, the specificity and sensitivity were 97% and 31%, respectively. We found an association between malignancy and nonfatty lymph nodes with ill-defined or spiculated margins (p = .053). Regarding the 20 abnormalities other than lymphadenopathy, epidermal cysts (n = 7) were most prevalent. CONCLUSION: The most common axillary abnormality revealed on mammography was abnormal lymph nodes. Homogeneously dense (nonfatty) axillary lymph nodes were strongly associated with malignancy when the lymph nodes were longer than 33 mm, had ill-defined or spiculated margins, or contained intranodal microcalcifications. However, our study confirmed that in most cases benign and malignant lymph nodes cannot be distinguished from each other mammographically.

Authors
Walsh, R; Kornguth, PJ; Soo, MS; Bentley, R; DeLong, DM
MLA Citation
Walsh, R, Kornguth, PJ, Soo, MS, Bentley, R, and DeLong, DM. "Axillary lymph nodes: mammographic, pathologic, and clinical correlation." AJR Am J Roentgenol 168.1 (January 1997): 33-38.
PMID
8976915
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
168
Issue
1
Publish Date
1997
Start Page
33
End Page
38
DOI
10.2214/ajr.168.1.8976915

Wavefront distortion measurements in the human breast

Published wavefront distortion (phase aberration) measurements for the human breast ranged from mild phase aberrations (8 ns r.m.s) to severe phase aberrations (67 ns r.m.s.). These measurements are required to specify arrays and assess the potentials of adaptive imaging. They require high inter-element uniformity so that receive signal variations between elements can be attributed to wave propagation effects. Array elements must be small to minimize the integration of the arriving wavefront across the face of the element. We have developed an apparatus to make concurrent pulse-echo and pitch-catch measurements in a clinical setting. The breast is stabilized between opposing transducers with light compression. After fixing the position of the transducers, pulse-echo and pitch-catch snapshots are captured sequentially with tissue and reference phantom targets. Data was collected from the left breast in twelve volunteers. Phase errors were significantly smaller for pulse-echo measurements (mean 25 ns r.m.s.) than for pitch-catch measurements (mean 55 ns r.m.s.).

Authors
Gauss, RC; Scott, M; Trahey, GE
MLA Citation
Gauss, RC, Scott, M, and Trahey, GE. "Wavefront distortion measurements in the human breast." Proceedings of the IEEE Ultrasonics Symposium 2 (1997): 1547-1551.
Source
scival
Published In
Proceedings of the IEEE Ultrasonics Symposium
Volume
2
Publish Date
1997
Start Page
1547
End Page
1551

Complex radial folds versus subtle signs of intracapsular rupture of breast implants: MR findings with surgical correlation.

Detection of intracapsular rupture of silicone breast prostheses using MR imaging is often performed by identifying the "linguine sign" [1]. The linguine sign is easily differentiated from simple radial folds that are seen in intact implants. However, more subtle signs of intracapsular rupture, including undulating subcapsular lines and the "teardrop sign," are less often recognized [2-5] and may prove difficult for the less experienced radiologist to differentiate from complex radial folds of intact implants. In this essay, we illustrate the MR imaging findings of complex radial folds in intact implants and compare them with findings of incomplete shell collapse in ruptured implants in a surgically confirmed series of explanted silicone breast prostheses.

Authors
Soo, MS; Kornguth, PJ; Walsh, R; Elenberger, CD; Georgiade, GS
MLA Citation
Soo, MS, Kornguth, PJ, Walsh, R, Elenberger, CD, and Georgiade, GS. "Complex radial folds versus subtle signs of intracapsular rupture of breast implants: MR findings with surgical correlation." AJR Am J Roentgenol 166.6 (June 1996): 1421-1427.
PMID
8633456
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
166
Issue
6
Publish Date
1996
Start Page
1421
End Page
1427
DOI
10.2214/ajr.166.6.8633456

Microcalcifications as elastic scatterers under ultrasound: implications for medical imaging

Microcalcifications are small crystals of calcium phosphates which form in human tissue through a number of mechanisms. The size, morphology, and distribution of microcalcifications (MCs) are important indicators in the mammographic screening for and diagnosis of various carcinomas in the breast. Current ultrasound methodology is not considered reliable at detecting MCs in the size range of clinical interest. The authors are investigating the imaging of MCs under ultrasound in the interest of extending the capabilities of ultrasound. We present an analysis of the acoustic properties of MCs modeled as elastic spheres which considers the predicted complex spectra and spatial coherence of echoes from MCs. We compare the findings of the model to actual echoes from suspected MCs in vivo, and discuss the implications of these findings for medical imaging. We also present preliminary in vivo measurements of phase aberration and the backscatter coefficient of breast tissue, and discuss the ramifications of these results for MC visualization.

Authors
Anderson, ME; Trahey, GE; Soo, MS; Bentley, RC
MLA Citation
Anderson, ME, Trahey, GE, Soo, MS, and Bentley, RC. "Microcalcifications as elastic scatterers under ultrasound: implications for medical imaging." Proceedings of the IEEE Ultrasonics Symposium 2 (1996): 1463-1467.
Source
scival
Published In
Proceedings of the IEEE Ultrasonics Symposium
Volume
2
Publish Date
1996
Start Page
1463
End Page
1467

Film screen mammography and sonography in the evaluation of breast prosthesis integrity

The purpose of this study was to determine the sensitivity and specificity of film screen mammography and sonography in detecting implant rupture and identify findings significantly associated with rupture, The sensitivity and specificity of preoperative mammograms and sonograms performed on 139 consecutively removed implants were determined retrospectively from preoperative imaging reports. Mammograms and sonograms were then reviewed to identify findings associated with implant rupture. Multivariate and univariate analyses were performed with adjustments made for date of implant placement. The prevalence of rupture was 62%. Sensitivity and specificity from preoperative reports were 68% and 72% (individually, mammography 51% and 96%, respectively; sonography 85% and 57%, respectively). Protrusions (smooth and irregular) were highly associated with rupture (p < 0.05), Extracapsular silicone was also associated with rupture (p < 0.1). The sonographic 'snowstorm' pattern was significant in the univariate analysis, It was concluded that, although not as sensitive as MRI, mammography and sonography can demonstrate specific findings associated with ruptured implants. For patients with implants undergoing routine breast cancer screening, mammography and adjunctive sonography are still useful and readily available for detecting rupture.

Authors
Soo, MS; Sullivan, DC; Hooper, D; Conaway, MR; Georgiade, GS; Kornguth, PJ
MLA Citation
Soo, MS, Sullivan, DC, Hooper, D, Conaway, MR, Georgiade, GS, and Kornguth, PJ. "Film screen mammography and sonography in the evaluation of breast prosthesis integrity." Breast Disease 9.2 (1996): 81-92.
Source
scival
Published In
Breast Disease
Volume
9
Issue
2
Publish Date
1996
Start Page
81
End Page
92

MR imaging of the breast

Authors
Soo, MS; Spritzer, C
MLA Citation
Soo, MS, and Spritzer, C. "MR imaging of the breast." Applied Radiology 25.9 (1996): 18-24.
Source
scival
Published In
Applied Radiology
Volume
25
Issue
9
Publish Date
1996
Start Page
18
End Page
24

Periprosthetic mycobacterial infection. CT and mammographic findings.

Organisms of the Mycobacterium fortuitum complex are an uncommon but important cause of periprosthetic infection following augmentation mammoplasty or other breast surgery. This etiological agent must be considered in the particular case of periprosthetic infection, because special handling of the fluid is crucial to enhance recovery of the organism. We describe the computed tomography (CT) and mammographic findings in such an abscess with respect to the clinical context and subsequent management. To our knowledge, CT findings associated with any periprosthetic breast infection have not been described.

Authors
Walsh, R; Kliewer, MA; Sullivan, DC; Hertzberg, B; Paulson, EK; Soo, MS; Saksouk, FA; Kornguth, PJ
MLA Citation
Walsh, R, Kliewer, MA, Sullivan, DC, Hertzberg, B, Paulson, EK, Soo, MS, Saksouk, FA, and Kornguth, PJ. "Periprosthetic mycobacterial infection. CT and mammographic findings." Clin Imaging 19.3 (July 1995): 193-196.
PMID
7553436
Source
pubmed
Published In
Clinical Imaging
Volume
19
Issue
3
Publish Date
1995
Start Page
193
End Page
196

Medullary thyroid carcinoma metastatic to the breast: mammographic appearance.

Authors
Soo, MS; Williford, ME; Elenberger, CD
MLA Citation
Soo, MS, Williford, ME, and Elenberger, CD. "Medullary thyroid carcinoma metastatic to the breast: mammographic appearance." AJR Am J Roentgenol 165.1 (July 1995): 65-66.
PMID
7785635
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
165
Issue
1
Publish Date
1995
Start Page
65
End Page
66
DOI
10.2214/ajr.165.1.7785635

Seromas in residual fibrous capsules after explantation: mammographic and sonographic appearances.

PURPOSE: To evaluate the mammographic and sonographic findings associated with seromas that develop in residual fibrous capsules after explantation of breast prostheses. MATERIALS AND METHODS: Preoperative and postoperative mammograms were reviewed in 86 patients (mean age, 51 years; age range, 24-71 years) who had undergone surgical explantation of breast prostheses. Six seromas were found in four patients 46-68 years of age. Imaging findings were correlated with surgical and laboratory results for three seromas. A presumptive diagnosis was made of the other three lesions. RESULTS: Mammograms demonstrated all seromas as large, elliptic, water-opacity masses, some with well-circumscribed and some with irregular borders. Sonograms showed thin, compressible masses, two of which were flat and anechoic and one of which was hypoechoic. Three patients' images were initially misinterpreted, leading to excision of two seromas and aspiration of one. Seromas were not identified in patients whose implants were removed by means of complete capsulectomy. CONCLUSION: Radiologists must be aware of the imaging findings associated with seromas and of a patient's surgical history to avoid biopsy of benign lesions.

Authors
Soo, MS; Kornguth, PJ; Georgiade, GS; Sullivan, DC
MLA Citation
Soo, MS, Kornguth, PJ, Georgiade, GS, and Sullivan, DC. "Seromas in residual fibrous capsules after explantation: mammographic and sonographic appearances." Radiology 194.3 (March 1995): 863-866.
PMID
7862992
Source
pubmed
Published In
Radiology
Volume
194
Issue
3
Publish Date
1995
Start Page
863
End Page
866
DOI
10.1148/radiology.194.3.7862992

Papillary carcinoma of the breast: imaging findings.

Papillary carcinoma is a rare malignant tumor of the breast for which the survival rate is better than for most breast carcinomas. Histologically, invasive and in situ forms occur; the in situ form can extend throughout a ductal system (intraductal) or can be confined within a cystic structure (intracystic). Invasive papillary carcinoma can spread from either of the in situ forms but spreads more commonly from the intracystic type. Many reports in the literature have failed to differentiate invasive from in situ papillary carcinomas; similarly, the different mammographic patterns of the two in situ forms of these lesions have not been delineated clearly. Our review of 16 new cases of papillary carcinoma showed a frequent correlation between the histologic types and the mammographic appearance. The intraductal in situ form usually was characterized by clustered microcalcifications. The intracystic in situ type was associated with well-circumscribed masses on mammograms; these masses often were complex on sonograms. The purpose of this essay is to illustrate the mammographic and sonographic features of the histologic varieties of papillary carcinoma. Color Doppler sonograms and MR images of intracystic and invasive tumors also are included.

Authors
Soo, MS; Williford, ME; Walsh, R; Bentley, RC; Kornguth, PJ
MLA Citation
Soo, MS, Williford, ME, Walsh, R, Bentley, RC, and Kornguth, PJ. "Papillary carcinoma of the breast: imaging findings." AJR Am J Roentgenol 164.2 (February 1995): 321-326.
PMID
7839962
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
164
Issue
2
Publish Date
1995
Start Page
321
End Page
326
DOI
10.2214/ajr.164.2.7839962

Evaluation of the ultrasonic detectability of microcalcifications

Microcalcifications are small crystals of calcium apatites which form in human tissue through a number of mechanisms. The size, morphology, and distribution of microcalcifications are important indicators in the mammographic screening for and diagnosis of various carcinomas in the breast. Though x-ray mammography is currently the only accepted method for detecting microcalcifications, its efficacy in this regard can be reduced in the presence of dense parenchyma. Current ultrasound scanners are not capable of detecting microcalcifications in the size range of clinical interest. We present methods for estimating the changes in microcalcification detection performance which result from changes in aperture geometry or the presence of an aberrator. We present an analysis of the relative efficacy of spatial compounding and synthetic receive aperture geometries in the detection of microcalcifications. We present a preliminary analysis estimating the impact of phase aberration on detection. We present registered high resolution ultrasound and digital spot mammography images of microcalcifications in excised breast carcinoma tissue.

Authors
Anderson, M; Soo, MS; Bentley, R; Trahey, G
MLA Citation
Anderson, M, Soo, MS, Bentley, R, and Trahey, G. "Evaluation of the ultrasonic detectability of microcalcifications." Proceedings of the IEEE Ultrasonics Symposium 2 (1995): 1161-1166.
Source
scival
Published In
Proceedings of the IEEE Ultrasonics Symposium
Volume
2
Publish Date
1995
Start Page
1161
End Page
1166

Seromas in the breast: imaging findings.

Breast seromas are tumor-like collections of serosanguineous fluid in breast tissue that occur following excisional biopsy, lumpectomy, mastectomy, and plastic surgery procedures such as augmentation, prosthesis explantation, breast reduction, and breast reconstruction. Mammographically seromas are water-density masses located at the surgical site. They exhibit features characteristic of fluid collections on sonographic evaluation. This article reviews the spectrum of imaging findings associated with breast seromas.

Authors
Soo, MS; Williford, ME
MLA Citation
Soo, MS, and Williford, ME. "Seromas in the breast: imaging findings." Crit Rev Diagn Imaging 36.5 (1995): 385-440. (Review)
PMID
8540992
Source
pubmed
Published In
Critical Reviews in Computed Tomography (Informa)
Volume
36
Issue
5
Publish Date
1995
Start Page
385
End Page
440

Management of pineal non-germinoma germ cell tumor with residual teratoma and normal alpha-fetoprotein.

A 16-year-old white male presented with multiple abnormal extraocular movements secondary to an enhancing pineal tumor. Subtotal resection of the lesion revealed a mixed malignant germ cell tumor. The preoperative serum alpha-fetoprotein (AFP) was markedly elevated at 155 IU/L. The patient subsequently received radiotherapy and adjuvant chemotherapy consisting of cisplatin rotating monthly with vincristine and cyclophosphamide, with dramatic tumor regression and return of AFP to normal. Eighteen months later the persistence of a substantial tumor mass despite a normal AFP raised concern for residual active tumor. Histological examination of the resected lesion revealed benign teratoma and fibrous tissue. Repeat management of mixed malignant germ cell tumors, which demonstrate a persistent mass following an initial response to treatment.

Authors
Nashold, JR; Oakes, WJ; Friedman, HS; Halperin, EC; Soo, M; Hockenberger, B; Fuller, GN; Tien, R
MLA Citation
Nashold, JR, Oakes, WJ, Friedman, HS, Halperin, EC, Soo, M, Hockenberger, B, Fuller, GN, and Tien, R. "Management of pineal non-germinoma germ cell tumor with residual teratoma and normal alpha-fetoprotein." Med Pediatr Oncol 22.2 (1994): 137-139.
PMID
7505047
Source
pubmed
Published In
Pediatric Blood and Cancer
Volume
22
Issue
2
Publish Date
1994
Start Page
137
End Page
139

Mesenrhombencephalitis: MR findings in nine patients

OBJECTIVE. Mesenrhombencephalitis is a serious form of brainstem inflammation predominantly involving the deep and vital portions of the brain, that is, the mesencephalon (midbrain) and rhombencephalon (pons, medulla). Mesenrhombencephalitis is difficult to diagnose on the basis of clinical and laboratory findings alone, and access to this portion of the brain for surgical biopsy carries high morbidity. We describe the MR appearance of mesenrhombencephalitis and correlate the imaging findings with clinical information. MATERIALS AND METHODS. Unenhanced and contrast-enhanced MR images of nine patients with mesenrhombencephalitis were reviewed retrospectively and correlated with clinical, laboratory, and pathologic data. The patients were categorized according to the cause of the disease: three had herpes simplex, one had Listeria monocytogenes, and five had mesenrhombencephalitis of undetermined cause. The three patients with clinical and MR evidence of herpes simplex mesenrhombencephalitis (one confirmed by brain biopsy) were comatose at presentation, with cranial nerve abnormalities in two and seizures in one. One patient with L. monocytogenes (established by blood culture) had cranial nerve palsies, fever, and pain in the ear. Five additional patients had headache (three), fever (three), nausea and vomiting (four), cranial nerve palsies (three), coma (two), and hyporeflexia (one) or hyperreflexia (four). Brain biopsy performed in two patients revealed chronic inflammation of unspecified cause; in one, it was compatible with viral encephalitis. RESULTS. MR images in three patients with herpes simplex mesenrhombencephalitis showed T2 signal hyperintensity in the midbrain (two), pons (one), medulla (one), and temporal lobes (three). Parenchymal foci of hemorrhage (methemoglobin, one patient) and leptomeningeal enhancement (one patient) were identified in the temporal lobes. T2-weighted MR images in one patient with L. monocytogenes showed signal hyperintensity in the brainstem, vermis, midbrain, and internal capsules. On T1-weighted images, low signal was present in these areas, which enhanced with paramagnetic contrast agents. In the remaining five patients, T2-weighted MR images showed patchy signal hyperintensity in the pons, medulla, and thalamus in three each and in the midbrain and temporal lobes in one each. T1-weighted MR images showed normal findings (two) or signal hypointensity in the thalamus and pons in one patient each. Areas of leptomeningeal and parenchymal enhancement were identified in one patient each. Brainstem swelling was seen in three patients, one of whom had petechial hemorrhage in the pons and hydrocephalus. CONCLUSION. Mesenrhombencephalitis is a serious illness that is diagnosed by a combination of imaging, clinical, laboratory, and pathologic studies. MR imaging may be crucial to the early diagnosis of this illness, and radiologists must be familiar with this uncommon entity and its MR findings in order to make timely diagnoses and facilitate treatment.

Authors
Soo, MS; Tien, RD; Gray, L; Andrews, PI; Friedman, H
MLA Citation
Soo, MS, Tien, RD, Gray, L, Andrews, PI, and Friedman, H. "Mesenrhombencephalitis: MR findings in nine patients." American Journal of Roentgenology 160.5 (1993): 1089-1093.
PMID
8470582
Source
scival
Published In
American Journal of Roentgenology
Volume
160
Issue
5
Publish Date
1993
Start Page
1089
End Page
1093

Splenic vein aneurysm: MR appearance - A case report

A presumed pancreatic head mass by non-contrast CT examination, was proven to be a splenic vein aneurysm by enhanced CT, MRI, sonography and arteriography. Dangerous percutaneous aspiration was avoided.

Authors
Soo, MSC; Khoury, MB; Lupetin, AR
MLA Citation
Soo, MSC, Khoury, MB, and Lupetin, AR. "Splenic vein aneurysm: MR appearance - A case report." Angiology 42.7 (1991): 590-593.
PMID
1863019
Source
scival
Published In
Angiology
Volume
42
Issue
7
Publish Date
1991
Start Page
590
End Page
593

Degenerative disease of the lumbar spine role of CT-myelography in the MR era

One hundred patients with degenerative disease of the lumbar spine on whom both magnetic resonance (MR) and computed tomography (CT)-myelography were performed were reviewed. In one-third of the cases, the CT-myelogram provided additional useful information. This included definition of the extent of large disc herniations, demonstration of focal neural compression by small herniations, and clarifying abnormalities of the facets, including synovial cysts. These results should help to refine the indications for CT-myelography, which continues to be requested extensively. © 1991.

Authors
Goldberg, AL; Soo, MSC; Deeb, ZL; Rothfus, WE
MLA Citation
Goldberg, AL, Soo, MSC, Deeb, ZL, and Rothfus, WE. "Degenerative disease of the lumbar spine role of CT-myelography in the MR era." Clinical Imaging 15.1 (1991): 47-55.
PMID
2059889
Source
scival
Published In
Clinical Imaging
Volume
15
Issue
1
Publish Date
1991
Start Page
47
End Page
55

Metastatic lesions arising in a Riedel's lobe: Findings from a sulfur colloid liver-spleen scan

Clinically significant lesions originating within a Riedel's lobe are extremely rare. Characteristic findings from a Tc-99m SC liver-spleen scan of metastatic breast carcinoma arising in a Riedel's lobe are described.

Authors
Soo, MSC; Adatepe, MH
MLA Citation
Soo, MSC, and Adatepe, MH. "Metastatic lesions arising in a Riedel's lobe: Findings from a sulfur colloid liver-spleen scan." Clinical Nuclear Medicine 15.11 (1990): 814-815.
PMID
1963389
Source
scival
Published In
Clinical Nuclear Medicine
Volume
15
Issue
11
Publish Date
1990
Start Page
814
End Page
815

Intra-aortic counterpulsation balloon pumps: CT appearance

Intra-aortic counterpulsation balloon pumps (ICBP) used in the setting of cardiogenic shock or high risk cardiac surgery, have been identified on chest films in the inflated state during diastole (1). We report characteristic computed tomography (CT) findings of an inflated ICBP, discuss its radiographically identified complications, and suggest that the presence of this device should be excluded before suspecting other etiologies for intra-aortic gas. © 1990.

Authors
Soo, MSC; Dash, N; Lupetin, AR; Beckman, I
MLA Citation
Soo, MSC, Dash, N, Lupetin, AR, and Beckman, I. "Intra-aortic counterpulsation balloon pumps: CT appearance." Clinical Imaging 14.3 (1990): 225-227.
PMID
2224626
Source
scival
Published In
Clinical Imaging
Volume
14
Issue
3
Publish Date
1990
Start Page
225
End Page
227
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