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1.
Maha Helal Manal F. Abu Samra Mohammed A. Ibraheem Asmaa Salama Ebtesam Esmail Hassan Nour El-Huda Hassan 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(3):741-750
Aim
Assess accuracy of contrast enhanced spectral mammography (CESM) versus conventional mammography and ultrasound in evaluation of BI-RADS 3 and 4 breast lesions with pathological correlation.Patients and methods
Thirty female patients with 35 breast lesions diagnosed by conventional imaging as BI-RADS 3 and 4, presented to Women’s Imaging Unit of Radiology Department between January and December 2015, age ranged from 23 to 70 years. All patients underwent conventional mammography and ultrasound then CESM.Results
Patients divided into two groups, benign and malignant lesions group according to histological analysis. Mammography results that malignant lesions detected in 18/35 (51.4%) while benign lesions 17/35 (48.6%). Ultrasound revealed 27/35 (77.1%) lesions were malignant and 8/35 (22.9%) lesions benign. But CESM, revealed 25/35 (71.4%) lesions were malignant & 10/35 (28.6%) lesions benign. Among 7 patients with multifocal/ multi-centric histologically proven malignant lesions, all detected by CESM 7/7 cases (100%) versus 2/7 cases (28.6%) and 6/7 cases (85.7%) detected by mammography and ultrasound respectively. Based on, CESM had 95.2% sensitivity and 82.9% diagnostic accuracy.Conclusion
CESM has better diagnostic accuracy than mammography alone and mammography plus ultrasound. CESM has 82.9% diagnostic accuracy in comparison to 51.4% for mammography and 77.1% for ultrasound. 相似文献2.
Rehab Abdel Rahman El Bakry 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(2):529-535
Objectives
Comparison between digital mammography alone and with adding digital breast tomosynthesis in breast cancer screening.Patients & methods
143 females underwent digital mammography, digital breast tomosynthesis and breast ultrasound.Results
DBT+DM decreased recall rate by 38% in BI-RADS 0. From BI-RADS I till BI-RADS V DBT+DM showed more accuracy than DM. In BI-RADS IV DBT+DM decreased false positive results by 33%.Conclusion
Adding digital breast tomosynthesis to digital mammography improves the diagnostic accuracy in breast cancer screening. 相似文献3.
Ayman M.A.M. Nada Rashad Hamdi Ahmed Shokry 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):1179-1186
Purpose
To evaluate the value of dual energy contrast enhanced (DECE) soft tissue digital mammography and ultrasound elastography (UE) in the detection of breast lesions and discrimination between benign and malignant ones.Patients and methods
32 female patients with breast lesions were prospectively evaluated at the female imaging unit of Diagnostic and Interventional Radiology Department of the National Cancer Institute, Cairo University. Routine sono-mammography was done for each patient then these patients were submitted to DECE soft tissue digital mammography as well as UE.The DECE digital mammography scans were held via GE Senographe 2000D “GE Healthcare; Chalfont St-Giles, UK” FFDM system with some specific software and hardware adaptations.The UE exams were held on ultrasound scanner with elastography unit and 7.5?Mhz linear array electronic probe (Hitachi digital, EUB- 7500; Hitachi medical, Tokyo, Japan).Results
This study showed that sensitivity and specificity of DECE soft tissue digital mammography and UE were 86.3%, 60% and 80.9%, 40% respectively.Conclusion
DECE soft tissue digital mammography demonstrated significant increase in the sensitivity without a loss in specificity. DECE soft tissue digital mammography is fast-reproducible imaging tool without operator dependency. DECE soft tissue digital mammography and UE are valuable tools to evaluate equivocal lesions. 相似文献4.
Samira Saraya Lamia Adel Asmaa Mahmoud 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(2):547-552
Objective
To assess the efficiency of dual energy contrast enhanced mammography in the assessment of the indeterminate breast lesions (BIRADS 3 and BIRADS 4).Materials and methods
34 female having 39 indeterminate breast lesions (BIRADS 3 and BIRADS 4) by digital mammography were further examined by dual energy contrast enhanced mammography. Two images were acquired at low and high energy in MLO view after 2 min and in CC view at 4 min post iodinated contrast injection (1.5 ml/kg with flow of 4 ml/s). Images were processed to obtain subtracted images to enhance the areas of the contrast uptake.Results
Results from pathology were detected for all cases. Contrast enhanced digital mammography showed specificity, sensitivity, PPV, NPV, FDR, FPR and accuracy of 93.75%, 91.3%, 88.2%, 95.4%, 11.7%, 8.6% and 92.3% respectively compared to full field digital mammography which were 68.75%, 69.5%, 61.1%, 76.1%, 38.8%, 30% and 69.2% respectively.Conclusion
Contrast-enhanced digital mammography is a useful tool to be used for breast cancer detection especially in indeterminate lesions (BIRADS 3 and 4). 相似文献5.
Noha Mohamed Osman Enas Abdel Ghany Nivine Chalabi 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(4):1182-1186
Objectives
We aimed to compare the recall rate (RR) and the cancer detection rate (CDR) of combined full field digital mammography and digital breast tomosynthesis (FFDM?+?DBT) to those of full field digital mammography (FFDM) alone in breast cancer survivors.Methods
We enrolled 146 female breast cancer survivors schedule. All patients underwent FFDM and DBT in the same setting. Results of FFDM alone were compared to those of FFDM?+?DBT regarding patients' RR and CDR.Sensitivity, specificity, accuracy, positive and negative predictive values were also calculated for FFDM alone and for FFDM?+?DBT in detecting breast cancer lesions.Results
Our results showed that FFDM?+?DBT decreased patients' RR by 3.4% and increased the CDR by 4.1%. Reduction in RR was evident in higher breast densities. FFDM mammography had 18 false negative lesions and 29 false positives. Sensitivity, specificity, accuracy, NPV and PPV in detecting breast lesions were: 84.2%, 53.1%, 64.0%, 86.7% and 48.9% for FFDM compared to 100%, 92.1%, 95.3%, 100% and 89.7% for FFDM?+?DBT.Conclusion
Combined FFDM?+?DBT in the post breast cancer surveillance regimen has shown to reduce the patients' RR and to increase the CDR. FFDM?+?DBT had higher diagnostic accuracy than FFDM alone. FFDM?+?DBT ought to be a standard combination in the breast cancer surveillance in treated patients. 相似文献6.
Noha Abd ElShafy ElSaid Hebatallah G.M. Mahmoud Asmaa Salama Marwa Nabil Eman D. ElDesouky 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(2):519-527
Objective
To evaluate the accuracy of CESM technique in predicting the final pathological response and residual tumor size post NAC in LABC.Patients and methods
This study was prospectively carried on 21 female patients diagnosed with stage II and III breast cancer. CESM was done at the end of last cycle of chemotherapy and before definitive surgery.Results
The sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), false negative and false positive of the CESM were assessed by comparing the enhancement of the residual lesions and their size post neoadjuvant chemotherapy (NAC) with the final pathological response and residual tumor size in the MD Anderson system. The specificity of the CESM in predicting the tumor response to NAC in this initial study is 91%, sensitivity was 40% and the NPV and PPV were 80% and 62.5% respectively. The sensitivity of this technique for complete response detection was 100% with a specificity 83% and lowered sensitivity in detecting chemoresistant tumors (33.3%).Conclusion
CESM is an emerging easy technique that can predict the final pathologic tumor response after NAC especially complete response acting as a good negative technique. 相似文献7.
8.
Enas A. Azab Marwa E. Ibrahim 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(2):564-570
Introduction
Diffusion-weighted imaging (DWI) is a modality that depicts the diffusivity of water molecules. This technique has the potential to play an adjunct role to conventional and dynamic MRI in the assessment of breast tissue.Aim of work
To evaluate the role of DWI with absolute and normalized ADC value measurements in characterization of breast lesions.Patients and methods
Seventy patients with mass or non mass lesions on mammography or breast ultrasound were included in this study. DWI were added to routine MR study with calculation of ADC absolute value and normalized ratio for lesions before biopsy of their breast lesions and results were correlated with histopathology.Results
Thirty out of 70 detected lesions were malignant. Malignant lesions showed lower ADC values and lower ratio of normalized ADC than benign lesions. The ROC study revealed that a cutoff ADC value of 1.1?×?10?3?mm2/s and normalized ADC ratio of 0.9 had high sensitivity of 89.75%, and 92.2% with specificity of 94.4% and 94.4% respectively in the differentiation between benign and malignant breast lesions.Conclusion
DWI is a short unenhanced scan that can be potential adjunct to conventional breast MRI and can be used to accurately characterize breast lesions with high sensitivity and specificity Suggested. 相似文献9.
Mohamed H. Zahran Mohamed M. El-Shafei Doaa M. Emara Samar M. Eshiba 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(1):249-258
Introduction
Elastography is considered a non-invasive imaging modality which determines the tumors according to their stiffness. Strain images representing the stiffness of the lesions compared to that of the surrounding normal tissue.Purpose
To prospectively evaluate the sensitivity and specificity of the real-time sonoelastography together with B-mode US for distinguishing benign from malignant breast lesions.Methods
The study was conducted on 80 patients, each patient was subjected to complete history taking, thorough clinical examination. All patients had conventional US and elastography using Hitachi 7.5?MHz linear probe (Hitachi hi vision avirus ultrasound), while only in 68 patients mammography was done.Results
Among the 80 patients, sensitivity and specificity of the elastography test of breast lesions according to the elastography score were 80% and 80.95% respectively, while sensitivity and specificity of conventional B mode US were 80% and 76% respectively and the combined B mode US and US elastography showed higher sensitivity and specificity of 86.6% and 90.4% respectively.Conclusion
Elastography is a non-invasive imaging technique which is done in the same session of ultrasound in an attempt to increase and improve the accuracy of diagnostic efficiency of ultrasound. 相似文献10.
Marwa Abd El-hamied Romeih Ahmed Ebraheem Ebeed Islam M. Sabry 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(2):553-563
Purpose
To assess the additional diagnostic value of share wave elastography in combination with B-mode ultrasound versus B-mode ultrasound alone in characterization of solid breast lesions.Patients and methods
prospective study included women with a single undiagnosed solid breast lesion, between May 2016 and May 2017. All patients underwent B-mode ultrasound and (SWE), and histopathology was performed on all lesions.Results
150 women included in this study. 87 breast lesions were malignant & 63 were benign. B-mode ultrasound was performed and the lesions were categorized according to the (BI-RADS). With a sensitivity of 89.7%, specificity of 76.2%, overall accuracy of 84%. Using SWE alone based on elasticity, speed and color pattern, the cut-off values were ≥46?kPa and ≥3.25?m/s. These values demonstrated a sensitivity of 96.6%, specificity of 90.47%, and overall accuracy of 94%. The color pattern had a better sensitivity of 96.8%, specificity of 92%, and overall accuracy of 94.5%.The combination of SWE and B-mode ultrasound results using logistic regression modeling improved diagnostic performance, with an overall accuracy of 96%.Conclusion
Combined B-mode ultrasound with shear-wave elastography will improve the overall diagnostic performance for the differentiation of benign and malignant breast lesions. 相似文献11.
Youstina G.S. Ebrahim Mariam R. Louis Engy A. Ali 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(4):1175-1181
Objectives
Comparing the diagnostic accuracy of different MRI techniques in characterization of breast lesions.Methods
The study was performed using 1.5T MRI and included 35 females with detected 47 breast lesions. Lesions were analyzed regarding their morphology, kinetic curve pattern, DWI and tCho peak measurement. The results of each MRI parameter were correlated to histo-pathology.Results
The study included 35 females with 47 breast lesions. Sensitivity and specificity were 87.5% and 93.3% using morphology alone. By using curve pattern, they were 96.9% and 73.3%. DWI was 96.9% sensitive, 66.7% specific, and MRS was 74.2% sensitive and 71.4% specific. The cut-off ADC value was 1.063?×?10?3?mm2/s. Choline cut-off value was (0.36?mmol/l). Sensitivity and specificity were increased to 100% and 93.3% after combining either kinetic curve or DWI with morphology. Sensitivity was increased to 90.3%, after combining MRS with morphology, however this slightly reduced the specificity to 92.9%.Conclusion
MRI is very sensitive for detection of breast lesions, however it lacks specificity. Post-processing tools and functional MRI have improved the specificity. MRS has increased the sensitivity, however specificity has been slightly decreased.Advances in knowledge
Functional MRI is very helpful for characterization of different breast lesions, thus avoiding unnecessary intervention. 相似文献12.
Waleed M. Hetta Gamal Niazi 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(1):131-137
Purpose
To estimate the accuracy of ultrasonography in detection of tendinous and ligamentous injuries around the ankle in comparison to MRI.Materials and methods
60 patients referred with unilateral painful ankles are subjected to ankle ultrasonography and the results are compared with ankle MRI between December 2015 and September 2016.Results
132 pathologies including 62 tendon lesions, 46 ligamentous lesions, 10 bursitis and 14 joint effusion were diagnosed by MRI. Ultrasonography detected 59 tendinous lesions (missed 3 partial tears) with allover accuracy of 96%, 41 ligamentous lesions (missed 1 stretching lesion, 2 partial tears and 1complete tear) with allover accuracy of 94.3%, all bursal lesions detected and 2 cases with joint effusion were missed by ultrasonography.Conclusion
Ultrasonography is an accurate and sensitive modality in detecting tendinous and ligamentous lesions around the ankle and represent with MRI complementary tool for diagnosis and can be used alone is some conditions 相似文献13.
Hanan S. Gewefel 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(1):285-292
Background
Ultrasound and mammography alone may not always identify malignant breast lesions. Samsung Medison has added the Smart detect? (S-detect?) program to its ultrasound features, and this may improve the identification of benign and malignant breast lesions.Objective
To evaluate the accuracy of S-detect?, a new ultrasound added feature, and to identify benign and malignant breast lesions in women with symptoms or signs of focal breast disease.Methods
In a pilot study, the registered data of a selected 45 women is retrospectively audited and analyzed. These women, presenting with clinical symptoms of breast disease (diagnostic), were examined by mammography and ultrasound. The interpretation and Hand Held Ultrasound (HHUS) have been done with 2 radiologists determining the BIRADS® classification results for every woman (benign or malignant). In addition, S-detect? was applied during the ultrasound examination, and S-detect? findings (benign or malignant) were recorded in either concordance or discordance with radiologists’ findings. Biopsy was performed as a gold standard.Results
Among the enrolled 45 women in the study, 33 (73.3%) had concordant results with the radiologists while the remaining 12 (26.6%) were discordant, in 10 (22.2%) of the 12 discordant cases, S-detect? findings of benign contradicted radiologists’ findings and in 2 of the cases, S-detect? findings of malignant contradicted radiologists’ findings. In the 10 discordant cases where S-detect? recommended benign, only 2 were correct, but in the 2 discordant cases where S-detect? recommended malignant, both were correct. The overall accuracy of S-detect? was 82.22%, sensitivity 61.90%, but a specificity was 100%.Conclusion
The use of S-detect? in this study identified additional cases of malignancy, so this technology may be a useful tool in addition to mammography and US for the diagnosis of breast disease. The specificity of the S-detect? in this study is remarkably high; yet, the sensitivity is low. Despite a small number of cases, we suggest a larger scale study, to validate the clinical utility in using the B-mode plus S-detect? to enhance diagnosis in patients presenting with symptoms and signs of breast diseases. 相似文献14.
Mahmoud Abd Elaziz Dawood Noha Mohamed AbdelMaboud Ibrahim Haytham Haroun Elsaeed Nancy Gamal Hegazy 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(1):265-271
The aim of this prospective study was to evaluate the diagnostic performance of the use of strain index ratio by sonoelastography to differentiate between benign and malignant breast lesions.
Patients & Methods
This prospective study including 40 females, complaining of breast masses which were suspicious to be malignant on clinical examination. All patients were submitted to B-mode Ultrasound and sonoelastography. Biopsy as a gold standard and pathological study were done for all breast lesions.Results
US examination of every mass was done and categorized according to BI-RADS categories according to ACR2013, according to US lexicon. Sonoelastography examination with Lesions classification was performed on the basis of a 5-point scoring method proposed by Tsukuba elasticity score. Then measurements of strain ratio were done. Statistical analysis of combination of the three methods was sensitivity of 96.7%, specificity of 100% when we use cut off value of 3–4 in elastography score and ≤3 cut off value of strain ratio.Conclusion
The combined use of strain ratio with Tsukuba score and BI-RADS categorization increased the diagnostic performance in differentiation between benign and malignant breast lesions. 相似文献15.
Rania E. Mohamed Hossam A. Zytoon Mohamed A. Amin 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(2):536-552
Aim of the work
To study the diagnostic performance of combined single voxel 1H-MRS and DW-MRI with ADC values as a non-contrast diagnostic tool, compared to the DCE-MRI, in suspicious breast lesions.Materials and methods
113 female patients (mean age 45.8?years) with suspicious breast lesions, categorized as BI-RADS 3 or 4 by sono-mammographic examinations, were subjected to bilateral breast imaging with non-contrast MRI including conventional MRI, DW-MRI with quantitative ADC values, and single voxel 1H-MRS, in addition to DCE-MRI. They had 132 pathologically proved lesions (74 benign and 58 malignant).Results
DW-MRI with ADC values was 96.97% accurate with 94.92% sensitivity and 98.63% specificity, while DCE-MRI was 97.73% accurate with 98.29% sensitivity but with 97.29% specificity, and 1H-MRS was 98.48% accurate with the highest sensitivity (100%) and 97.33% specificity. Furthermore, the combined use of DW-MRI with ADC values and 1H-MRS improved the diagnostic capability than utilization of each sequence alone with the highest accuracy of 99.24%, 100% sensitivity and 98.65% specificity.Conclusion
The combined use of DW-MRI with quantitative ADC data and single-voxel 1H-MRS is a reliable non-contrast tool that provides higher accuracy in characterizing suspicious breast, and can efficiently be used in the absence of DCE-MRI. 相似文献16.
Enass M. Khattab Mai E.M. Khamis Ayman F. Ahmed 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(2):519-528
Objective
This study aimed to assess the diagnostic value of a combined imaging protocol of diffusion-weighted MRI, apparent diffusion coefficient (ADC) values, and MR spectroscopy(MRS) in discriminating benign and malignant breast lesions.Patients and methods
twenty-six female patients complaining from breast lesions were included in this study. Diffusion weighted images, apparent diffusion coefficients value, and magnetic resonance spectroscopy were obtained to all patients.Results
Combined ADC value and MRS in discriminating benign breast lesions from malignant tumors were false-positive in 3 patients , true-positive in 14 patients, false-negative in 1 patient and true-negative in 8 patients with specificity of 72.7%, sensitivity of 93.3%, NPV of 88.9%, PPV of 82.4% and accuracy of 84.6%.Conclusion
A great advantage of ADC value is the significant difference between benign and malignant lesions, because of this it plays an important role in characterization of breast lesions. MRS is the only in vivo technique which can detect tissue metabolites. In our study combined MRS with ADC value increased sensitivity in detecting lesions, while the specificity remained at lower level than that of the ADC value alone. 相似文献17.
Mai E.M. Khamis Ahmed M. Alaa El-deen Ahmad Abdel Azim Ismail 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):1149-1157
Objective
To detect the diagnostic efficiency of sono elastographic strain ratio in discriminating malignant from benign solid breast masses and compare it with the sono elastographic elasticity score method.Patients and methods
This study included 120 histopathologically diagnosed solid breast masses from 120 females (mean age 38.2?years). Elastography score and strain ratio (SR) were performed for each mass. Receiver operating characteristic (ROC) curve was plotted for both methods.Results
The benign lesions had significant lower SR (mean 2.12?±?1.72) than that of malignant lesions (mean 6.91?±?3.96). The AUC from ROC curve was 0.98 for elasticity score and 0.99 for SR. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the elasticity score in the diagnosis of solid breast masses were 100%, 88%, 83.3%, 100% and 92.5% respectively, and of the strain ratio were 93.3%, 97.3%, 95.5%, 96.1% and 95.8% respectively (when cutoff value 3.77 was used). There is no statistically significant difference found between both methods.Conclusion
SR has high diagnostic performance in differentiating malignant from benign solid breast masses, however there is no statistically significant difference between SR and elasticity score. 相似文献18.
Yasmin Mounir Tohamey Omar Sherif Omar 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(4):1190-1197
Objective
Assess the efficacy of using different imaging modalities aiming at proper characterization of benign and malignant inflammatory breast disorders.Methods
A prospective study included 34 patients presenting with clinical signs of mastitis. The patients underwent imaging according to clinical status (mammography, ultrasound and Magnetic resonance imaging) and the signs encountered in each modality were tested for their efficiency to discriminate benign from malignant inflammatory breast disorders.Results
Benign mastitis was finally diagnosed in 23 cases (67.4%) while 11 patients as malignant including inflammatory breast carcinoma.Mammogram was done in 22/34 cases (64.7%). The final diagnostic indices of mammography showed sensitivity 33.3%, specificity 61.54%, PPV 37.5%, NPV 57.14% and efficacy 50%.Ultrasound was done for all cases (34/34, 100%) with sensitivity 58.33%, specificity 72.73%, PPV 53.85%, NPV 76.19% and efficacy 67.6%.MRI was done for all cases (34/34, 100%) with sensitivity 91.67%, specificity 100%, PPV 100%, NPV of 95.65% and efficacy 97.1%.Conclusion
Diagnostic approach to inflammatory disorders includes multi-imaging modalities. Each modality plays a specific role in diagnosis with the highest specificity encountered on MRI evaluation followed by ultrasound and limited specificity on mammographic evaluation. It is essential to discriminate benign from malignant etiologies as there are major differences in their prognosis, and treatment options. 相似文献19.
Dalia Monir Fahmy Germeen Albair Ashamallah 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(1):176-180
Purpose
To evaluate the diagnostic reliability of PSIR sequence as compared to STIR in detection & counting of MS plaques in cervical cord and assess inter and intra-observer agreement.Patient and methods
A retrospective analysis of cervical MRI of 39 patients with Multiple sclerosis; Phase sensitive inversion recovery (PSIR) & short time inversion recovery (STIR) sequences were analyzed by 2 readers twice with 2?weeks interval for plaque detection, number and lesion conspicuity.Results
Mean conspicuity of lesions in PSIR and STIR was (3.4, 3.1 and 3.1, 2.8) for R1 and R2 without significant statistical difference (p?=?0.18, 0.11). There was substantial inter-observer agreement between R1 and R2 regarding number of lesions in STIR and PSIR (K?=?0.7, 0.72), almost perfect intra-reader observer agreement for STIR and PSIR (K?=?0.85, 0.87 for R1, 0.8, 0.85 for R2). No statistical difference between number of lesions detected in STIR and PSIR by 2 readers (P?=?0.5, 0.4). PSIR had higher sensitivity, specificity and accuracy compared to STIR (88.4/81.2, 98/96.1, 95/91.4) yet no statistical difference in accuracy (p value?=?0.13).Conclusion
PSIR sequence is accurate and reproducible in detection of MS lesions; it has higher sensitivity, specificity and accuracy than STIR sequence. 相似文献20.
Youssriah Y. Sabri Mona A.F. Hafez Khaled M. Kamel Dina A. Abbas 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(4):986-992