Outcomes of Return to Routine Screening for BI-RADS 3 Lesions Detected at Supplemental Automated Whole-Breast Ultrasound in Women with Dense Breasts: A Prospective Study.
Background: Supplemental screening breast ultrasound (US) detects additional cancers in women with dense breasts but identifies many BI-RADS 3 lesions that result in short-term follow-ups and biopsies. Objective: To evaluate outcomes in patients recommended for return to routine screening for lesions assessed as BI-RADS 3 on supplemental automated whole-breast US (ABUS). Methods: This prospective study invited patients with BI-RADS 1 or 2 on screening mammography and breast density C or D to undergo supplemental ABUS. ABUS was interpreted as BI-RADS 1, 2, 3, or 0. Return to routine screening was recommended for ABUS BI-RADS 1, 2, or 3. ABUS BI-RADS 0 lesions underwent targeted hand-held US. Remaining patients were followed for 2 years. Malignancy rates were compared using Fisher's exact tests. Results: A total of 2257 women (mean age, 58.0±11.2 years) were included. Supplemental ABUS was scored as BI-RADS 1 in 1186 (52.5%), BI-RADS 2 in 591 (26.2%), BI-RADS 3 in 395 (17.5%), and BI-RADS 0 in 85 (3.8%). A total of 394 patients with ABUS BI-RADS 3 had 2-year follow-up, during which no cancer (0%, 95% CI 0.0%-0.9%) was diagnosed in the quadrant of the lesion. Among patients with 2-year follow-up, breast cancer was diagnosed in 4/1117 (0.4%) with ABUS BI-RADS 1, 2/556 (0.4%) with ABUS BI-RADS 2, and 2/394 (0.5%) with ABUS BI-RADS 3 (cancer in other quadrant than the lesion). Malignancy rates were not different between ABUS BI-RADS 1, 2, and 3 (p=.28). ABUS recall rate was 3.8% (85/2257; 95% CI 3.6%-4.0%). If short-term follow-up had been recommended for ABUS BI-RADS 3, ABUS recall rate would have been 21.3% (480/2257, 95% CI 19.6%-23.0%). Biopsy rate was 0.4% (12/2257; 95% CI 0.3%-0.9%); positive biopsy rate was 58.3% (7/12). One of 7 patients diagnosed with cancer by initial supplemental ABUS, and none of 8 patients diagnosed with cancer during subsequent follow-up, had node-positive cancer. Conclusions: Return to routine screening for ABUS BI-RADS 3 lesions results in a substantial decrease in recall rate, while being unlikely to result in adverse outcome. Clinical Impact: This prospective study supports a recommendation for routine annual follow-up for BI-RADS 3 lesions at supplemental ABUS.
Barr RG; DeSivestri A; Golatta M
American Journal Of Roentgenology
2021
2021-07-14
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.2214/AJR.21.26180" target="_blank" rel="noreferrer noopener">10.2214/AJR.21.26180</a>
Quantification of Liver Steatosis: Is CT Equivalent to PDFF?
Ferraioli G; Barr RG
American Journal Of Roentgenology
2021
2021-04
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.2214/AJR.20.25069" target="_blank" rel="noreferrer noopener">10.2214/AJR.20.25069</a>
Trans-luminal Angioplasty In Patients With Bilateral Renal-artery Stenosis Or Renal-artery Stenosis In A Solitary Functioning Kidney
Nuclear Medicine & Medical Imaging; Radiology
Kim P K; Spriggs D W; Rutecki G W; Reaven R E; Blend D; Whittier F C
American Journal of Roentgenology
1989
1989-12
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.2214/ajr.153.6.1305" target="_blank" rel="noreferrer noopener">10.2214/ajr.153.6.1305</a>
Pelvimetry Independent Of External Measurements
Nuclear Medicine & Medical Imaging; Radiology
Howland W J; Topcuoglu H N; Sayoc A S; Hissong S L; Vernier E
American Journal of Roentgenology
1977
1977
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.2214/ajr.128.6.1061" target="_blank" rel="noreferrer noopener">10.2214/ajr.128.6.1061</a>
Lung Torsion After Percutaneous Needle-biopsy Of Lung
Nuclear Medicine & Medical Imaging; Radiology
Graham R J; Heyd R L; Raval V A; Barrett T F
American Journal of Roentgenology
1992
1992-07
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.2214/ajr.159.1.1609717" target="_blank" rel="noreferrer noopener">10.2214/ajr.159.1.1609717</a>
A Comparison Of Iohexol And Conray-60 In Peripheral Angiography
Nuclear Medicine & Medical Imaging; Radiology
Gordon I J; Skoblar R S; Chicatelli P D; Leon J
American Journal of Roentgenology
1984
1905-06
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.2214/ajr.142.3.563" target="_blank" rel="noreferrer noopener">10.2214/ajr.142.3.563</a>
Image Quality, Contrast Enhancement, and Radiation Dose of ECG-Triggered High-Pitch CT Versus Non-ECG-Triggered Standard-Pitch CT of the Thoracoabdominal Aorta
diagnosis; Radiology; Nuclear Medicine & Medical Imaging; aorta; reconstruction; heart-rate-variability; angiography; acquisition; CT angiography; dissection; dual-source ct; high pitch; source cardiac ct
OBJECTIVE. We sought to compare image quality, contrast enhancement, and radiation dose in patients undergoing ECG-triggered high-pitch helical CT or non-ECG-synchronized helical CT of the thoracoabdominal aorta. MATERIALS AND METHODS. We retrospectively assessed data from 101 consecutive patients (81 men, 20 women; mean age, 71 +/- 11 [SD] years) undergoing clinically indicated CT angiography (CTA) of the thoracoabdominal aorta on a dual-source scanner using either the ECG-triggered high-pitch helical mode (group 1, n = 52) or non-ECG-synchronized standard-pitch helical mode (group 2, n = 49) during the arterial phase. Two independent readers assessed image quality, noise, and contrast enhancement throughout the thoracoabdominal aorta. Scanner-reported dose-length product values were used to estimate effective dose values. RESULTS. Image quality at the root-proximal ascending level was higher in group 1 (mean +/- SD, 2.81 +/- 0.40) than in group 2 (1.22 +/- 0.47; p < 0.0001), with similar quality for both groups noted at other levels. Group 1 scans displayed higher image noise at all levels. The groups received a similar volume of contrast material (p = 0.77), and similar percentages of cases with acceptable contrast enhancement (> 250 HU) were noted in the two groups. The estimated radiation burden was significantly lower in group 1 (mean +/- SD, 5.4 +/- 1.8 mSv) than in group 2 (14.4 +/- 5.1 mSv; p < 0.0001). CONCLUSION. Imaging of the thoracoabdominal aorta with ECG-triggered high-pitch CTA provides higher quality images of the aortic root and ascending aorta with sufficient contrast enhancement and decreased estimated radiation dose compared with non- ECG-synchronized standard-pitch helical CT.
Bolen M A; Popovic Z B; Tandon N; Flamm S D; Schoenhagen P; Halliburton S S
American Journal of Roentgenology
2012
2012-04
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.2214/ajr.11.6921" target="_blank" rel="noreferrer noopener">10.2214/ajr.11.6921</a>
Type IV choledochal cyst presenting with obstructive jaundice: Role of MR cholangiopancreatography in preoperative evaluation
complications; Radiology; Nuclear Medicine & Medical Imaging
Arshanskiy Y; Vyas P K
American Journal of Roentgenology
1998
1998-08
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.2214/ajr.171.2.9694475" target="_blank" rel="noreferrer noopener">10.2214/ajr.171.2.9694475</a>
MR IMAGING OF GROWTH RECOVERY LINES IN FOSSIL VERTEBRAE
Nuclear Medicine & Medical Imaging; Radiology
Sebes J I; Langston J W; Gavant M L; Rothschild B
American Journal of Roentgenology
1991
1991-08
Journal Article
<a href="http://doi.org/10.2214/ajr.157.2.1853837" target="_blank" rel="noreferrer noopener">10.2214/ajr.157.2.1853837</a>
Treponematoses and the New World
disease; Nuclear Medicine & Medical Imaging; Radiology; syphilis
Rothschild B M
American Journal of Roentgenology
1999
1999-10
Journal Article
<a href="http://doi.org/10.2214/ajr.173.4.10511198" target="_blank" rel="noreferrer noopener">10.2214/ajr.173.4.10511198</a>
SCLEROSING LOBULAR HYPERPLASIA OF THE BREAST - IMAGING FEATURES IN 15 CASES
Nuclear Medicine & Medical Imaging; Radiology
OBJECTIVE. Sclerosing lobular hyperplasia is an infrequent benign lesion of the breast, defined as prominent hyperplasia of the lobules with sclerosis of the interlobular stroma. It commonly presents as a tumorlike mass clinically. Sclerosing lobular hyperplasia has been identified at biopsy at our institution with rare but increasing frequency. We reviewed the imaging features of 15 patients with biopsy-proven sclerosing lobular hyperplasia to determine if a characteristic imaging pattern could suggest this diagnosis. MATERIALS AND METHODS. The mammograms and sonograms of all women with pathologically proved sclerosing lobular hyperplasia seen between January 1986 and June 1993 were retrospectively reviewed by two of the authors who were familiar with the pathologic diagnosis. Imaging findings that led to biopsy or were present on the preoperative studies were reviewed. The study included 15 patients ranging in age from 21 to 46 years old, with a mean age of 32 years. Seven were black, and eight were white. All women had mammograms, three patients had prior mammograms for comparison, and sonography was done in all but one case. Presenting symptoms included a recently discovered breast lump in eight patients, breast tenderness in one patient, and a dear nipple discharge in one patient. The other five were asymptomatic and had screening mammograms. RESULTS. Eight patients (53%) had a well-defined mass on mammography, varying in size from 1.0 cm to 8.0 cm (mean, 3.7 cm). In one of these patients, the nodule was proved to be a fibroadenoma; sclerosing lobular hyperplasia was found only microscopically. Microcalcifications were present within the mass on mammography in one patient. Mammograms in two women showed asymmetric increased density compared with the opposite breast, and in five cases, the mammographic findings were interpreted as normal. Sonograms showed a solid, well defined mass with either homogeneous or mixed echoes in 10 of 14 patients (71%). In only one of these nodules was acoustic enhancement present. In the other four women, sonograms were normal. No characteristic findings were identified that would suggest sclerosing lobular hyperplasia as a likely diagnosis preoperatively, and, in fact, in many cases a diagnosis of fibroadenoma was considered most probable. CONCLUSION. The imaging findings of sclerosing lobular hyperplasia are not sufficiently characteristic to distinguish the lesion from fibroadenomas and well-circumscribed carcinomas.
Poulton T B; Deparedes E S; Baldwin M
American Journal of Roentgenology
1995
1995-08
Journal Article
<a href="http://doi.org/10.2214/ajr.165.2.7618542" target="_blank" rel="noreferrer noopener">10.2214/ajr.165.2.7618542</a>
BONE-MARROW RECONVERSION IN ADULTS WHO ARE SMOKERS - MR-IMAGING FINDINGS
hyperplasia; knee; Nuclear Medicine & Medical Imaging; Radiology; red; yellow marrow
OBJECTIVE. Conversion of bone marrow in the extremities from red to yellow is a normal maturation process. Marrow reconversion is present when expected yellow marrow is replaced with active red marrow, and it tends to occur at times of physiologic stress. The significance of this finding on MR imaging is not always clear. Accordingly, we studied the prevalence of bone marrow reconversion in adults undergoing MR imaging of the knee for reasons other than marrow disorders. Possible relationships between marrow reconversion and age, sex, weight, and smoking were sought. MATERIALS AND METHODS. Fifty-nine outpatients over 24 years of age who had no evidence of hematopoietic disorders and for whom MR images of the knee were available for review were selected for study. Patients younger than 25 years old were eliminated to ensure that all patients in the study were old enough to have achieved normal adult marrow conversion. The 59 subjects were classified according to their smoking histories. Twenty-eight were nonsmokers, 10 were intermediate smokers, and 21 were heavy smokers. The MR images were classified as showing either red marrow (reconverted from yellow to red) or yellow marrow (converted) by two independent observers who had no knowledge of the patients' smoking histories. RESULTS. MR images of six heavy smokers, two intermediate smokers, and one nonsmoker showed evidence of reconversion. A statistically significant association between marrow reconversion and heavy smoking (p = .02) was found. Reconversion also was found to be more prevalent in patients less than 39 years old and in obese women who smoked. No association was found between weight, sex, or obese male smokers and reconversion. CONCLUSION. Our results show marrow reconversion at the knee is most prevalent in heavy smokers, younger patients, and especially obese women who smoke heavily. In these patients, marrow reconversion can be a normal finding on MR imaging. In other patients, other causes should be considered.
Poulton T B; Murphy W D; Duerk J L; Chapek C C; Feiglin D H
American Journal of Roentgenology
1993
1993-12
Journal Article
<a href="http://doi.org/10.2214/ajr.161.6.8249729" target="_blank" rel="noreferrer noopener">10.2214/ajr.161.6.8249729</a>
Condyloma acuminatum of the bladder
Nuclear Medicine & Medical Imaging; Radiology
Murphy W D
American Journal of Roentgenology
1996
1996-09
Journal Article
<a href="http://doi.org/10.2214/ajr.167.3.8751705" target="_blank" rel="noreferrer noopener">10.2214/ajr.167.3.8751705</a>