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1.
Kristina Lång Matilda Nergården Ingvar Andersson Aldana Rosso Sophia Zackrisson 《European radiology》2016,26(11):3899-3907
Objectives
To analyse false positives (FPs) in breast cancer screening with tomosynthesis (BT) vs. mammography (DM).Methods
The Malmö Breast Tomosynthesis Screening Trial (MBTST) is a prospective population-based study comparing one-view BT to DM in screening. This study is based on the first half of the MBTST population (n?=?7,500). Differences in FP recall rate, findings leading to recall, work-up and biopsy rate between cases recalled on BT alone, DM alone and BT+DM were analysed.Results
The FP recall rate was 1.7 % for BT alone (n?=?131), 0.9 % for DM alone (n?=?69) and 1.1 % for BT?+?DM (n?=?81). The FP recall rate for BT alone was halved after the initial phase of the trial, stabilising at 1.5 %. BT doubled the recall of stellate distortions compared to DM (n?=?64 vs. n?=?33). There were fewer fibroadenomas and cysts, and the biopsy rate was slightly lower for FP recalled on BT alone compared to DM alone (15.3 % vs. 27.6 %: p?=?0.037 and 33.8 % vs. 36.2 %; p?=?0.641, respectively).Conclusions
FPs increased with BT screening mainly due to the recall of stellate distortions. The FP recall rate was still well within the European guidelines and showed evidence of a learning curve. Characterisation of rounded lesions was improved with BT.Key Points
? Tomosynthesis screening gave a higher false-positive recall rate than mammography ? There was a decline in the false-positive recall rate for tomosynthesis ? The recall due to stellate distortions simulating malignancy was doubled with tomosynthesis ? Tomosynthesis found more radial and postoperative scar tissue than mammography ? Tomosynthesis is better at characterising rounded lesions2.
Objective
To compare the visibility of circumscribed masses on digital breast tomosynthesis (DBT) images and 2D mammograms and determine the usefulness of DBT for differentiation between benign and malignant circumscribed masses.Methods
Seventy-one (19 malignant and 52 benign) mammographic well-circumscribed masses were included. Visibility of the masses and halo signs on DBT images were retrospectively compared with 2D mammograms. The effects of mammographic breast density on mass visibility were also evaluated.Results
For DBT, 83% were superior and 17% were equivalent in visibility of the masses to that of 2D, and superiority of DBT was significantly enhanced in the high breast density group compared with the low breast density group (91% vs 68%, respectively, p = 0.016). Three lesions were only detected on DBT. There was no significant difference in the superiority of DBT for lesion visibility between malignant and benign masses. The halo sign was detected in 58% lesions on DBT and in 4% on 2D (p < 0.001).Conclusion
Circumscribed masses were better visualized on DBT than on 2D mammograms, particularly in high-density breasts. The halo sign often appeared on DBT and gave a clearer mass margin. However, circumscribed masses on DBT are not assured of being benign.Key Points
? Circumscribed masses were better visualized on breast tomosynthesis than on 2D mammography. ? Tomosynthesis visualized circumscribed masses better than 2D for all breast density categories. ? Halo signs often appeared on tomosynthesis and contributed to detect circumscribed margins. ? Circumscribed masses on tomosynthesis images are not assured of being benign lesions.3.
Ji Soo Choi Boo-Kyung Han Eun Young Ko Eun Sook Ko Soo Yeon Hahn Jung Hee Shin Min Jung Kim 《European radiology》2016,26(8):2538-2546
Objective
To evaluate the interpretative performance of two-dimensional (2D) synthetic mammography (SM) reconstructed from digital breast tomosynthesis (DBT) in the detection of T1-stage invasive breast cancers, compared to 2D full-field digital mammography (FFDM).Methods
This retrospective study enrolled 214 patients. For each patient, FFDM and DBT were performed between January and June 2013, and SM was reconstructed from DBT data. Three radiologists interpreted images and recorded visibility scores and morphologies of cancers. Diagnostic performances of SM and FFDM were compared. Percentages of detected cancers and visibility scores were compared for tumour size, and presence of calcifications for each observer.Results
Observer sensitivity showed no difference for detection with SM and FFDM (P?>?0.05). One observer showed a higher specificity (P?=?0.02) and higher positive predictive value with SM (95 % CI 0.6–16.4), but the differences in the corresponding values between SM and FFDM for the other observers were not statistically significant. In subgroup analyses according to tumour size and presence of calcifications, percentages of detected cancers and visibility scores were not significantly different.Conclusions
Diagnostic performances of SM and FFDM are comparable for detecting T1-stage breast cancers. Therefore, our results indicate that SM may eliminate the need for additional FFDM during DBT-based imaging.Key Points
? DBT plus FFDM increases radiation dose compared to FFDM alone.? Detecting T1-stage cancers with only SM is comparable to detection with FFDM.? Two-dimensional SM may replace dose-requiring FFDM in DBT-based imaging.4.
Objectives
To compare radiation dose delivered by digital mammography (FFDM) and breast tomosynthesis (DBT) for a single view.Methods
4,780 FFDM and 4,798 DBT images from 1,208 women enrolled in a screening trial were used to ground dose comparison. Raw images were processed by an automatic software to determine volumetric breast density (VBD) and were used together with exposure data to compute the mean glandular dose (MGD) according to Dance’s model. DBT and FFDM were compared in terms of operation of the automatic exposure control (AEC) and MGD level.Results
Statistically significant differences were found between FFDM and DBT MGDs for all views (CC: MGDFFDM=1.366 mGy, MGDDBT=1.858 mGy; p<0.0001; MLO: MGDFFDM=1.374 mGy, MGDDBT=1.877 mGy; p<0.0001). Considering the 4,768 paired views, Bland-Altman analysis showed that the average increase of DBT dose compared to FFDM is 38 %, and a range between 0 % and 75 %.Conclusions
Our findings show a modest increase of radiation dose to the breast by tomosynthesis compared to FFDM. Given the emerging role of DBT, its use in conjunction with synthetic 2D images should not be deterred by concerns regarding radiation burden, and should draw on evidence of potential clinical benefit.Key Points
? Most studies compared tomosynthesis in combination with mammography vs. mammography alone. ? There is some concern about the dose increase with tomosynthesis. ? Clinical data show a small increase in radiation dose with tomosynthesis. ? Synthetic 2D images from tomosynthesis at zero dose reduce potential harm. ? The small dose increase should not be a barrier to use of tomosynthesis.5.
Objective
To demonstrate the non-inferiority of synthetic image (SI) mammography versus full-field digital mammography (FFDM) in breast tomosynthesis (DBT) examinations.Methods
An observational, retrospective, single-centre, multireader blinded study was performed, using 2384 images to directly compare SI and FFDM based on Breast Imaging Reporting and Data System (BIRADS) categorisation and visibility of radiological findings. Readers had no access to digital breast tomosynthesis slices. Multiple reader, multiple case (MRMC) receiver operating characteristic (ROC) methodology was used to compare the diagnostic performance of SI and FFDM images. The kappa statistic was used to estimate the inter-reader and intra-reader reliability.Results
The area under the ROC curves (AUC) reveals the non-inferiority of SI versus FFDM based on BIRADS categorisation [difference between AUC (ΔAUC), -0.014] and lesion visibility (ΔAUC, -0.001) but the differences were not statistically significant (p=0.282 for BIRADS; p=0.961 for lesion visibility). On average, 77.4% of malignant lesions were detected with SI versus 76.5% with FFDM. Sensitivity and specificity of SI are superior to FFDM for malignant lesions scored as BIRADS 5 and breasts categorised as BIRADS 1.Conclusions
SI is not inferior to FFDM when DBT slices are not available during image reading. SI can replace FFDM, reducing the dose by 45%.Key Points
? Stand-alone SI demonstrated performance not inferior for lesion visibility as compared to FFDM.? Stand-alone SI demonstrated performance not inferior for lesion BIRADS categorisation as compared to FFDM.? Synthetic images provide important dose savings in breast tomosynthesis examinations.6.
Objectives
To compare interobserver variability (IOV), reader confidence, and sensitivity/specificity in detecting architectural distortion (AD) on digital mammography (DM) versus digital breast tomosynthesis (DBT).Methods
This IRB-approved, HIPAA-compliant reader study used a counterbalanced experimental design. We searched radiology reports for AD on screening mammograms from 5 March 2012–27 November 2013. Cases were consensus-reviewed. Controls were selected from demographically matched non-AD examinations. Two radiologists and two fellows blinded to outcomes independently reviewed images from two patient groups in two sessions. Readers recorded presence/absence of AD and confidence level. Agreement and differences in confidence and sensitivity/specificity between DBT versus DM and attendings versus fellows were examined using weighted Kappa and generalised mixed modeling, respectively.Results
There were 59 AD patients and 59 controls for 1,888 observations (59?×?2 (cases and controls)?×?2 breasts?×?2 imaging techniques?×?4 readers). For all readers, agreement improved with DBT versus DM (0.61 vs. 0.37). Confidence was higher with DBT, p?=?.001. DBT achieved higher sensitivity (.59 vs. .32), p?<?.001; specificity remained high (>.90). DBT achieved higher positive likelihood ratio values, smaller negative likelihood ratio values, and larger ROC values.Conclusions
DBT decreases IOV, increases confidence, and improves sensitivity while maintaining high specificity in detecting AD.Key points
? Digital breast tomosynthesis decreases interobserver variability in the detection of architectural distortion.? Digital breast tomosynthesis increases reader confidence in the detection of architectural distortion.? Digital breast tomosynthesis improves sensitivity in the detection of architectural distortion.7.
Etienne Cavaignac Geoffroy Perroncel Mathias Thépaut Julie Vial Franck Accadbled Jérôme Sales De Gauzy 《Knee surgery, sports traumatology, arthroscopy》2017,25(8):2442-2446
Purpose
Pathophysiology of osteochondritis dissecans (OCD) of the medial femoral condyle remains uncertain. Specifically, the relationship between the size of the anterior tibial spine (ATS) and the presence of OCD has not been explored. The purpose of this study was to evaluate the relationship between ATS size and the occurrence of OCD.Methods
Seventy-nine children between 8 and 17 years of age were included in two groups: OCD (n = 37) and control (n = 42). The groups were matched in terms of age, gender, BMI and weight. Two independent observers performed an MRI analysis of the size of the tibial spine and intercondylar notch relative to the size of the respective epiphyses. For this study, the “S ratio” was calculated by dividing the height of the tibial spine by the height of the tibial epiphysis. The “N ratio” was calculated by dividing the height of the notch by the height of the femoral epiphysis. These two ratios for both groups were compared using Student’s t test.Results
The mean value of the S ratio in the OCD group was 0.39 ± 0.06; the mean value of the S ratio in the control group was 0.32 ± 0.03 (P = 0.004). The mean value of the N ratio in the OCD group was 0.70 ± 0.08; the mean value of the N ratio in the control group was 0.70 ± 0.07 (n.s.).Conclusion
This study’s findings confirm our hypothesis that patients with OCD have a more prominent tibial spine than in patients without OCD.Level of evidence
IV.8.
Objectives
To compare the diagnostic performance of digital breast tomosynthesis (DBT) and magnetic resonance imaging (MRI) added to mammography in women with known breast cancers.Methods
Three radiologists independently reviewed image sets of 172 patients with 184 cancers; mammography alone, DBT plus mammography and MRI plus mammography, and scored for cancer probability using the Breast Imaging Reporting and Data System (BI-RADS). Jack-knife alternative free-response receiver-operating characteristic (JAFROC), which allows diagnostic performance estimation using single lesion as a statistical unit in a cancer-only population, was used. Sensitivity and positive predictive value (PPV) were compared using the McNemar and Fisher-exact tests.Results
The JAFROC figures of merit (FOMs) was lower in DBT plus mammography (0.937) than MRI plus mammography (0.978, P?=?0.0006) but higher than mammography alone (0.900, P?=?0 .0013). The sensitivity was lower in DBT plus mammography (88.2 %) than MRI plus mammography (97.8 %) but higher than mammography alone (78.3 %, both P?<?0 .0001). The PPV was significantly higher in DBT plus mammography (93.3 %) than MRI plus mammography (89.6 %, P?=?0 .0282).Conclusions
DBT provided lower diagnostic performance than MRI as an adjunctive imaging to mammography. However, DBT had higher diagnostic performance than mammography and higher PPV than MRI.Key Points
? Digital breast tomosynthesis (DBT) plus mammography was compared with MRI plus mammography. ? DBT had lower sensitivity and higher PPV than MRI. ? DBT had higher diagnostic performance than mammography.9.
Objectives
Acromioclavicular joint injuries are typically diagnosed by clinical and radiographic assessment with the Rockwood classification, which is crucial for treatment planning. The purpose of this study was to describe how the ultrasound findings of acromioclavicular joint injury compare with radiography and MRI findings.Methods
Forty-seven patients with suspected unilateral acromioclavicular joint injury after acute trauma were enrolled in this prospective study. All patients underwent digital radiography, ultrasound and 3T MRI. A modified Rockwood classification was used to evaluate the coracoclavicular ligaments. The classifications of acromioclavicular joint injuries diagnosed with radiography, ultrasound and MRI were compared. MRI was used as the gold standard.Results
The agreement between the ultrasound and MRI findings was very good, with a correlation coefficient of 0.83 (95 % CI: 0.72–0.90; p < 0.0001). Ultrasound detected coracoclavicular ligament injuries with a sensitivity of 88.9 %, specificity of 90.0 %, positive predictive value of 92.3 % and negative predictive value of 85.7 %. The agreement between the ultrasound and radiography findings was poor, with a correlation coefficient of 0.69 (95 % CI: 0.51–0.82; p < 0.0001).Conclusion
Ultrasound is an effective examination for the diagnostic work-up of lesions of the coracoclavicular ligaments in the acute phase of an acromioclavicular injury.Key Points
? Ultrasound is appropriate for acute acromioclavicular trauma due to its accessibility.? Ultrasound contributes to the diagnostic work-up of acute lesions of the coracoclavicular ligaments. ? Ultrasound is appropriate in patients likely to benefit from surgical treatment. ? Ultrasound could be a supplement to standard radiography in acute acromioclavicular trauma.10.
Objective
To determine the added value of capsule, septum, and T2 hyperintense foci for differentiating large hepatocellular carcinoma (HCC; ≥ 5 cm) from intrahepatic cholangiocarcinoma (ICC) using gadoxetic acid MRI.Methods
The study included 116 patients (94 men, 22 women; mean age, 56.8 years) with surgically confirmed HCCs (n?=?87, 5.0–18.0 cm) or ICCs (n?=?29, 5.0–14.0 cm) who underwent gadoxetic acid MRI. Three observers independently reviewed MRIs in two sessions, examining enhancement patterns only and then adding capsule, septum, and T2 hyperintense foci. Reviewers used a five-point scale to score accuracy, sensitivity, and specificity.Results
A significant increase was observed in accuracy when ancillary features (96.1–98.3%) were added compared to enhancement pattern only (83.6–88.4%; p?≤?0.02). Sensitivity was significantly increased with combined reading (97.1–98.3%) compared to enhancement features only (81.6–88.5%; p?≤?0.006) for two observers, with no difference in specificity (84.5–89.7% vs. 86.2–98.3%; p?>?0.05). We found substantial to excellent interobserver agreement for ancillary features (0.598–0.976).Conclusion
Adding capsule, septum, and T2 hyperintense foci to enhancement patterns for gadoxetic acid MRI increased diagnostic performance for characterizing large HCC by differentiating it from ICC.Key Points
? Capsule, septum, and T2 hyperintense foci were useful for characterizing large HCC.? Adding ancillary features to enhancement pattern increased accuracy for diagnosing large HCC.? Interobserver agreement was substantial to excellent for ancillary features.11.
Misun Hwang Giulio Zuccoli Ashok Panigrahy David Rodriguez Michele D. Poe Maria L. Escolar 《European radiology》2016,26(10):3377-3382
Objectives
Evaluation of Krabbe disease burden and eligibility for hematopoietic stem cell transplantation are often based on neuroimaging findings using the modified Loes scoring system, which encompasses central but not peripheral nervous system changes. We show that quantitative evaluation of thickened cauda equina nerve roots may improve the evaluation of Krabbe disease and therapeutic guidance.Methods
Lumbar spine MRI scans of patients obtained between March 2013 and September 2013 were retrospectively evaluated and compared to those of controls. Quantitative evaluation of cauda equina roots was performed on the axial plane obtained approximately 5 mm below the conus medullaris. The largest nerves in the right and left anterior quadrants of the spinal canal were acquired.Results
Fifteen symptomatic patients with Krabbe disease (5–44 months old) and eleven age-matched controls were evaluated. The average areas (mm2) of anterior right and left nerves were 1.40 and 1.23, respectively, for patients and 0.61 and 0.60 for controls (differences: 0.79 and 0.63; p?<?0.001).Conclusions
Cauda equina nerve root thickening is associated with Krabbe disease in both treated and untreated patients. Adding lumbar spine MRI to the current neurodiagnostic protocols, which fails to account for peripheral nerve abnormalities, will likely facilitate the diagnosis of Krabbe disease.Key Points
? Neuroimaging is valuable for evaluating cauda equina nerve abnormality in Krabbe disease ? MRI can be used to quantitatively evaluate cauda equina nerve thickening ? Lumbar MRI could be useful for diagnosis and treatment monitoring of Krabbe disease12.
Background
Computed tomography (CT) for evaluation of occult and suspect hip fractures has been proposed as a good second-line investigation. The diagnostic precision compared to magnetic resonance imaging (MRI) is unclear.Purpose
To compare the diagnostic performance of CT and MRI in a retrospective study on patients with suspect and occult hip fractures.Material and methods
Forty-four elderly consecutive patients with low-energy trauma to the hip were identified where negative or suspect CT was followed by MRI. Primary reporting and review by two observers as well as the diagnostic performance of the two modalities were compared. Surgical treatment and clinical course were used as outcomes.Results
Compared to the primary reports, the CT reviewers found fewer normal and no suspect cases. MRI changed the primary diagnoses in 27 cases, and in 14 and 15 cases, respectively, at review. There was no disagreement on MRI diagnoses.Conclusion
In our patient population, MRI was deemed a more reliable modality for hip fracture diagnosis in comparison to CT. For clinical decision making, MRI seems to have a higher accuracy than CT. A negative CT finding cannot completely rule out a hip fracture in patients where clinical findings of hip fracture persevere.Key Points
? Experience is highly influential in diagnosing occult or suspect hip fractures at CT ? Inconclusive hip CT shows high inter-rater reliability at experienced review ? There was low diagnostic accuracy via CT compared to MRI for all interpreters ? Hip fractures can readily be diagnosed at MRI regardless of radiological experience13.
S.?Mojdeh?Mirmomen Arlene?Sirajuddin Moozhan?Nikpanah Rolf?Symons Anna?K.?Paschall Ioannis?Papageorgiou William?A.?Gahl Kevin?O’Brien Juvianee?I.?Estrada-Veras Ashkan?A.?Malayeri
Objectives
To investigate the computed tomography (CT) thoracic findings in Erdheim-Chester disease (ECD) and evaluate the association of these findings with the BRAFV600E mutation.Methods
This was a prospective study of patients with ECD (n=61, men=46) who underwent thoracic CT imaging. CT examinations were independently interpreted by two experienced radiologists. Association of imaging findings with BRAFV600E was achieved via the Chi-square or Fisher’s exact test and odds ratios (OR) with 95% confidence intervals (CI), as appropriate.Results
Fifty-five ECD patients (90%) showed pulmonary findings, which included interlobular septal thickening (69%), pulmonary nodules (62%), airway thickening (13%) and ground glass opacities (36%). Pulmonary nodules were classified by the pattern of distribution: subpleural regions (36%), lung parenchyma (13%) and both regions (13%). Pleural and mediastinal involvement were present in 15% and 62% of cases, respectively. The most common mediastinal finding was sheathing of the right coronary artery (34%), followed by sheathing of the thoracic aorta (30%). The BRAFV600E mutation, positive in 31 patients, was associated with the frequency of sheathing of the coronary arteries (p = 0.01).Conclusions
Of the thoracic findings reported in this study, we found a statistically significant positive association between the BRAFV600E mutation and presence of coronary artery sheathing.Key Points
? To assess the degree of thoracic involvement in ECD with CT. ? BRAF V600E mutation has a high association with right coronary artery sheathing. ? BRAF V600E genetic testing detects patients at high risk of developing RCA sheathing.14.
Purpose
To determine the utility of cervical spine MRI in blunt trauma evaluation for instability after a negative non-contrast cervical spine CT.Methods
A review of medical records identified all adult patients with blunt trauma who underwent CT cervical spine followed by MRI within 48 h over a 33-month period. Utility of subsequent MRI was assessed in terms of findings and impact on outcome.Results
A total of 1,271 patients with blunt cervical spine trauma underwent both cervical spine CT and MRI within 48 h; 1,080 patients were included in the study analysis. Sixty-six percent of patients with a CT cervical spine study had a negative study. Of these, the subsequent cervical spine MRI had positive findings in 20.9%; 92.6% had stable ligamentous or osseous injuries, 6.0% had unstable injuries and 1.3% had potentially unstable injuries. For unstable injury, the NPV for CT was 98.5%. In all 712 patients undergoing both CT and MRI, only 1.5% had unstable injuries, and only 0.42% had significant change in management.Conclusions
MRI for blunt trauma evaluation remains not infrequent at our institution. MRI may have utility only in certain patients with persistent abnormal neurological examination.Key Points
? MRI has limited utility after negative cervical CT in blunt trauma.? MRI is frequently positive for non-specific soft-tissue injury.? Unstable injury missed on CT is infrequent.15.
Objectives
The purpose of this study was to assess the diagnostic image quality of ultra-low-dose chest computed tomography (ULD-CT) obtained with a radiation dose comparable to chest radiography and reconstructed with filtered back projection (FBP), adaptive statistical iterative reconstruction (ASIR) and model-based iterative reconstruction (MBIR) in comparison with standard dose diagnostic CT (SDD-CT) or low-dose diagnostic CT (LDD-CT) reconstructed with FBP alone.Methods
Unenhanced chest CT images of 42 patients acquired with ULD-CT were compared with images obtained with SDD-CT or LDD-CT in the same examination. Noise measurements and image quality, based on conspicuity of chest lesions on all CT data sets were assessed on a five-point scale.Results
The radiation dose of ULD-CT was 0.16?±?0.006 mSv compared with 11.2?±?2.7 mSv for SDD-CT (P?<?0.0001) and 2.7?±?0.9 mSv for LDD-CT. Image quality of ULD-CT increased significantly when using MBIR compared with FBP or ASIR (P?<?0.001). ULD-CT reconstructed with MBIR enabled to detect as many non-calcified pulmonary nodules as seen on SDD-CT or LDD-CT. However, image quality of ULD-CT was clearly inferior for characterisation of ground glass opacities or emphysema.Conclusion
Model-based iterative reconstruction allows detection of pulmonary nodules with ULD-CT with radiation exposure in the range of a posterior to anterior (PA) and lateral chest X-ray.Key Points
? Radiation dose is a key concern with the increased use of thoracic CT ? Ultra-low-dose chest CT approximates the radiation dose of conventional chest radiography ? Ultra-low-dose chest CT can be of diagnostic quality ? Solid pulmonary nodules are clearly depicted on ultra-low-dose chest CT16.
Purpose
To compare the diagnostic accuracy of DWI and STIR sequences in Whole body (WB) MRI of SpA patients.Materials and methods
Twenty consecutive patients with confirmed active SpA and 20 controls were investigated with identical WB MRI protocols, including DWI and STIR images. Two observers recorded ‘lesions’ (high signal intensity foci on STIR and high b-value DWI) in 17 anatomical areas, making a 17-point ‘area score’ and a 40-point ‘lesion score’. ROC performance, inter-observer agreement, correlation with clinical parameters and spine and sacro-iliac joints (SIJ) MRI scores were assessed.Results
SpA patients had significantly higher lesion scores on DWI than on STIR (p<0.025). The lesion score area under the curve was significantly higher with DWI (99.9) than with STIR (95.8, p=0.02). DWI lesion score ≥5 had both sensitivity and specificity ≥85 %. With STIR the best threshold ≥3 yielded sensitivity ≥85 % and specificity ≥60 %. DWI area score ≥3 yielded sensitivity ≥85 % and specificity ≥80 %. With STIR the best threshold ≥4 yielded sensitivity ≥70 % and specificity ≥80 %. Inter-observer agreement was strong for both sequences. In patients, the lesion score was positively correlated with ASDAS-CRP, log(CRP), and local MRI scores.Conclusions
DWI is a promising alternative to STIR in WB MRI to detect active SpA lesions.Key Points
? DWI is a robust alternative to STIR in WBMRI in SpA.? DWI might be superior in discriminating relevant inflammatory and degenerative changes.? Positive correlations exist between WB MRI, clinical, biological, local MRI data.? Distribution and frequency of abnormal MRI findings in SpA are highlighted.17.
18.
Objectives
To compare breast density measured on digital breast tomosynthesis (DBT) (BI-RADS-based breast composition and fully-automatic estimation) and magnetic resonance imaging (MRI) (BI-RADS amount of fibroglandular tissue), and to evaluate the diagnostic performance in terms of sensitivity and specificity of DBT and MRI in a predominantly dense breast population.Methods
Between 2015 and 2016, 152 women with 103 breast malignancies, who underwent 3-T breast MRI and DBT within 2 months’ time, were enrolled in this study. Breast composition/fibroglandular tissue and findings on DBT (two readers) and MRI were reported using BI-RADS 5th edition. Digital mammography images were analysed for breast percent density (PD) using the Libra software tool.Results
A majority of women had dense breasts as categorised by breast composition c (heterogeneously dense) (68%) and d (extremely dense) (15%). The mean PD was 44% (range, 18-89%) and the correlation between breast composition and PD was r = 0.6. The diagnostic performance of MRI was significantly higher compared to DBT for one reader as described by the area under the receiver operating characteristic (ROC) curve (p = 0.004) and of borderline significance for the other reader (p = 0.052).Conclusions
MRI had higher diagnostic performance than DBT in a dense breast population in the tertiary setting.Key Points
? MRI had higher diagnostic performance than DBT in a dense breast population ? Diagnostic performance of DBT was comparable to MRI in women with fatty breasts ? MRI was superior to DBT in preoperative breast cancer size assessment19.
Purpose
To evaluate the lifetime prevalence of back pain (BP) in adolescent pupils depending on their activity level.Methods
372 Austrian pupils, 155 Bavarian soccer club members and 150 youth athletes who participated in summer camps of the Munich Soccer School 2013 took part in this cross-sectional retrospective cohort study. An iPad-compatible survey was used to measure several information on occurrence, cause, type, localization and risk factors of BP as well as the activities in sports.Results
Prevalence of BP showed to be highest in the inactive group (63 %), while soccer athletes (33 %, p < 0.001) and club members of other sports (29 %, p < 0.001) differed significantly. Also, higher body mass indexes (BMI) accounted to be more likely connected to BP than lower ones. Conflicting other studies, the thoracic pain turned out to be the most concerned spine complaint.Conclusion
A u-shaped curve best describes the connection between activity and the risk for developing BP, while five to six training hours per week seem to be the optimal activity level. These findings moot a closer look at school sport activities as a preventive factor for BP, especially for complaints of the thoracic spine.20.