Abstract:
RATIONALE AND OBJECTIVES:To determine the diagnostic accuracy of stereotactically and sonographically guided core biopsy (CB) for the diagnosis of nonpalpable breast lesions. MATERIALS AND METHODS:Twenty-two institutions enrolled 2,403 women who underwent imaging-guided fine needle aspiration followed by imaging-guided large-CB of nonpalpable breast abnormalities. All mammograms were reviewed for study eligibility by one of two breast imaging radiologists. The protocol for image-guided biopsy, using either ultrasound (USCB) or stereotactic (SCB) guidance, was standardized at all institutions and all biopsy specimens were over-read by one of three expert pathologists. Patients with atypical ductal hyperplasia (ADH), atypical lobular hyperplasia, or lobular neoplasia on CB underwent surgical excision. Those with negative CB but suspicious ("discordant") pre-biopsy mammography also underwent surgical excision. Patients having a negative CB that was concordant with the pre-biopsy mammography suspicion were assigned to follow-up mammography at 6, 12, and 24 months following CB. RESULTS:A gold standard diagnosis based on definitive histopathologic diagnosis, mammography follow-up, or an imputed gold standard diagnosis was established for 1,681 patients. Of 310 cases with a gold standard diagnosis of invasive breast carcinoma, 261 (84.2%) were invasive carcinoma, 31 (10%) were ductal carcinoma in situ (DCIS), four (1.3%) were ADH, one (0.3%) was a non-breast cancer, and 13 (4.2%) were benign on CB. For 138 cases with a gold standard diagnosis of DCIS, 113 (81.9%) were DCIS, 20 (14.5%) were ADH, and five (3.6%) were benign on CB. For 57 cases (13 masses, 44 calcifications) with an initial CB diagnosis of ADH, atypical lobular hyperplasia or lobular neoplasia, 20 (35.1%) had a gold standard diagnosis of DCIS (4 masses, 16 calcifications) and four (7.0%) had a gold standard diagnosis of invasive cancer (4 calcifications). Of 144 cases (22 masses, 122 calcifications) with an initial CB diagnosis of DCIS, 31 (21.5%) had a gold standard diagnosis of invasive cancer (10 masses, 21 calcifications). The sensitivity, specificity and accuracy for CB by either imaging guidance method in this trial were .91, 1.00, and .98, respectively. The sensitivity, predictive value negative, and accuracy of CB for diagnosing masses (.96, .99, and .99, respectively) were significantly greater (P < .001) than for calcifications (.84, .94, and .96, respectively). The sensitivity (.89) of SCB for diagnosing all lesions was significantly lower (P = 0.029) than that of USCB (.97) because of the preponderance of calcifications biopsied by SCB versus USCB. There was no difference between USCB and SCB in sensitivity, predictive value negative, or accuracy for the diagnosis of masses (97.3, 98.9, and 99.2, respectively for USCB; 95.6, 98.5, and 98.9 respectively for SCB). CONCLUSION:Percutaneous, imaged-guided core breast biopsy is an accurate diagnostic alternative to surgical biopsy in women with mammographically detected suspicious breast lesions.
journal_name
Acad Radioljournal_title
Academic radiologyauthors
Fajardo LL,Pisano ED,Caudry DJ,Gatsonis CA,Berg WA,Connolly J,Schnitt S,Page DL,McNeil BJ,Radiologist Investigators of the Radiologic Diagnostic Oncology Group V.doi
10.1016/s1076-6332(03)00510-5keywords:
subject
Has Abstractpub_date
2004-03-01 00:00:00pages
293-308issue
3eissn
1076-6332issn
1878-4046journal_volume
11pub_type
临床试验,杂志文章,多中心研究,随机对照试验abstract:RATIONALE AND OBJECTIVES:To describe the application of time maximum intensity projection CTA (t-MIP CTA) in acute ischemic stroke and compare t-MIP CTA and single-phase CTA (sCTA) in assessing collateral circulation and predicting prognosis. MATERIALS AND METHODS:Twenty-nine acute ischemic stroke patients who underwe...
journal_title:Academic radiology
pub_type: 杂志文章
doi:10.1016/j.acra.2019.06.013
更新日期:2020-05-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:The goal of this study is to demonstrate how the teaching of radiology physics can be enhanced with the use of interactive scientific notebook software. METHODS:We used the scientific notebook software known as Project Jupyter, which is free, open-source, and available for the Macintosh, Windo...
journal_title:Academic radiology
pub_type: 杂志文章
doi:10.1016/j.acra.2017.11.024
更新日期:2018-06-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:Because several factors are involved in cancer detection, a malignant lesion that is visible on a mammogram will not necessarily be reported by the radiologist reading the case. Indeed, a significant fraction of screening-detected cancers are visible in retrospect, and were perceived by the rad...
journal_title:Academic radiology
pub_type: 杂志文章
doi:10.1016/j.acra.2004.04.015
更新日期:2004-08-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:To assess the diagnostic performance of magnetic resonance imaging (MRI) for targeting prostate cancer in patients with previous negative biopsies and elevated prostate-specific antigen (PSA) levels. MATERIALS AND METHODS:Pubmed, Scopus, and Cochrane Library databases were searched to identify...
journal_title:Academic radiology
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.acra.2014.01.004
更新日期:2014-05-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:Although the spiculation levels of breast mass boundaries are a primary sign of malignancy for masses detected on mammography, developing an automated computerized method to detect spiculation levels and quantitatively evaluating the performance of such a method is a difficult task. The objecti...
journal_title:Academic radiology
pub_type: 杂志文章
doi:10.1016/j.acra.2008.07.015
更新日期:2008-12-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:The aim of this study was to compare the diagnostic accuracy of 64-slice computed tomographic coronary angiography (CTCA) in groups of patients with low, intermediate, and high risk for coronary artery disease (CAD) events. MATERIALS AND METHODS:The institutional review board approved this stu...
journal_title:Academic radiology
pub_type: 杂志文章
doi:10.1016/j.acra.2007.12.008
更新日期:2008-04-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:The purpose of this study was to evaluate the utility of CO2 versus iodinated contrast medium for wedge hepatic venography in identifying portal vein anatomy during transjugular intrahepatic portosystemic shunt (TIPS) procedures. MATERIALS AND METHODS:Wedge hepatic venograms obtained with CO2 ...
journal_title:Academic radiology
pub_type: 杂志文章
doi:10.1016/S1076-6332(99)80487-5
更新日期:1999-02-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:Chest radiographs are recommended for prevention and detection of pneumoconiosis. In 2011, the International Labour Office (ILO) released a revision of the International Classification of Radiographs of Pneumoconioses that included a digitized standard images set. The present study compared res...
journal_title:Academic radiology
pub_type: 杂志文章
doi:10.1016/j.acra.2013.11.019
更新日期:2014-03-01 00:00:00
abstract:RATIONALE AND OBJECTIVE:Today, the exchange of medical images and clinical information is well defined by the digital imaging and communications in medicine (DICOM) and Health Level Seven (ie, HL7) standards. The interoperability among information systems is specified by the integration profiles of IHE (Integrating the...
journal_title:Academic radiology
pub_type: 杂志文章
doi:10.1016/j.acra.2004.11.015
更新日期:2005-03-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:The objective of this study was to develop and quantitatively evaluate a radiology-pathology fusion method for spatially mapping tissue regions corresponding to different chemoradiation therapy-related effects from surgically excised whole-mount rectal cancer histopathology onto preoperative ma...
journal_title:Academic radiology
pub_type: 杂志文章
doi:10.1016/j.acra.2017.12.006
更新日期:2018-07-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:Assess whether staff training in advanced rapport skills and self-hypnotic relaxation techniques reduces noncompletion rates during magnetic resonance imaging (MRI). METHODS AND MATERIALS:All staff of a free-standing MRI facility was invited to 3 hours of preparatory communication lectures. Ha...
journal_title:Academic radiology
pub_type: 杂志文章
doi:10.1016/j.acra.2009.07.002
更新日期:2010-01-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:The objective of our study was to determine if the T1-weighted magnetic resonance imaging (MRI) features associated with diabetic pedal osteomyelitis are present in histopathologically proven cases of non-pedal osteomyelitis. MATERIALS AND METHODS:Seventy-five patients with a histopathological...
journal_title:Academic radiology
pub_type: 杂志文章
doi:10.1016/j.acra.2012.07.015
更新日期:2013-01-01 00:00:00
abstract::Continuous quality improvement methods provide a relatively new way to improve quality in healthcare by using a systems approach with key features of customer-mindedness, data collection, experimentation, and teamwork. CQI is not meant to solve simple problems but is increasingly applied in our complex healthcare orga...
journal_title:Academic radiology
pub_type: 杂志文章,评审
doi:10.1016/s1076-6332(03)00670-6
更新日期:2004-02-01 00:00:00
abstract::Long-term follow-up of randomized trials provide the most accurate estimates of overdiagnosis. Estimates from follow-up of service screening studies are almost as accurate if there is sufficient adjustment for lead time and risk status. When properly analyzed data from both of these types of trials indicate that the r...
journal_title:Academic radiology
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.acra.2015.01.020
更新日期:2015-08-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:I developed a volume estimation technique for the crescentic volume of the right ventricle (RV) of the heart. A geometric model was desired to avoid the lengthy data collection and reduction required by Simpson's rule. METHODS:An ellipsoidal shell model was developed that requires only simple ...
journal_title:Academic radiology
pub_type: 杂志文章
doi:10.1016/s1076-6332(12)80006-7
更新日期:1994-12-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:To assess the feasibility of 70-kVp high-pitch non-ECG-gated thoracic aortic computed tomography angiography (CTA) with 40-mL contrast agent compared to 100-kVp standard-pitch CTA with 60-mL contrast agent. MATERIALS AND METHODS:Sixty-seven patients (51 men and 16 women; mean age, 55 ± 14 year...
journal_title:Academic radiology
pub_type: 杂志文章
doi:10.1016/j.acra.2015.03.007
更新日期:2015-07-01 00:00:00
abstract:PURPOSE:Systemic lupus erythematosus (SLE) is a predominantly female autoimmune disease that can affect the central nervous system. Neuropsychiatric symptoms are found in 25-70% of SLE patients. Using diffusion tensor imaging, various studies have reported changes in white matter integrity in SLE patients with neuropsy...
journal_title:Academic radiology
pub_type: 杂志文章
doi:10.1016/j.acra.2016.03.019
更新日期:2016-11-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:With the introduction of new communication channels, such as encrypted messaging and online electronic medical record patient portals, there are ever-increasing ways for patients and their families to access their medical information. While patient preferences regarding how they receive the res...
journal_title:Academic radiology
pub_type: 杂志文章
doi:10.1016/j.acra.2019.07.010
更新日期:2020-05-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:To investigate the effect of a newly developed computer-aided diagnosis (CAD) system on reader interpretation of breast lesions in automated three-dimensional (3D) breast ultrasound. MATERIALS AND METHODS:A CAD system was developed to differentiate malignant lesions from benign lesions includi...
journal_title:Academic radiology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.acra.2013.07.013
更新日期:2013-11-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:We investigated the methodologic development of computed microtomography (CMT) for monitoring the development of osteoporosis in male Sprague-Dawley rats. METHODS:Eight rats were gastrectomized and eight rats were sham operated. Femurs, tibias, and tails were prepared, and CMT scans with spati...
journal_title:Academic radiology
pub_type: 杂志文章
doi:10.1016/s1076-6332(05)80487-8
更新日期:1995-09-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:Breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) scanning protocols vary widely. The purpose of this study was to determine the effects of postcontrast timing on delayed-phase lesion kinetics assessment and ability to discriminate malignant from benign lesions. MATERIALS A...
journal_title:Academic radiology
pub_type: 杂志文章
doi:10.1016/j.acra.2014.04.013
更新日期:2014-09-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:An atlas-based automated liver segmentation method from three-dimensional computed tomographic (3D CT) images has been developed. The method uses two types of atlases, a probabilistic atlas (PA) and a statistical shape model (SSM). MATERIALS AND METHODS:Voxel-based segmentation with a PA is fi...
journal_title:Academic radiology
pub_type: 杂志文章
doi:10.1016/j.acra.2008.07.008
更新日期:2008-11-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:Four-dimensional (4D) computed tomography (CT) can be used in radiation treatment planning to account for respiratory motion. Current 4D CT techniques have limitations in either spatial or temporal resolution. In addition, most of these techniques rely on auxiliary surrogates to relate the time...
journal_title:Academic radiology
pub_type: 杂志文章
doi:10.1016/j.acra.2006.05.004
更新日期:2006-09-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:Magnetic resonance (MR) imaging is used to assess brain tumor response to therapies, and a MR quality assurance (QA) program is necessary for multicenter clinical trials employing imaging. This study was performed to determine overall variability of quantitative imaging metrics measured with th...
journal_title:Academic radiology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.acra.2008.04.004
更新日期:2008-09-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:The American Cancer Society (ACS) and the United States Preventive Services Task Force (USPSTF) recommend colorectal cancer (CRC) screening to begin at age 50 in individuals at average risk for CRC. To estimate rate at which women eligible for CRC screening at the time of screening mammography ...
journal_title:Academic radiology
pub_type: 杂志文章
doi:10.1016/j.acra.2004.07.025
更新日期:2004-11-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:Presurgical assessment of fatty degeneration is important in the management of patients with rotator cuff tears. The Goutallier classification is widely accepted as a qualitative scoring system, although it is highly observer-dependent and has poor reproducibility. The objective of this study w...
journal_title:Academic radiology
pub_type: 杂志文章
doi:10.1016/j.acra.2017.03.026
更新日期:2017-11-01 00:00:00
abstract::At our institution, we have developed a remediation team of strong, focused experts who help us with struggling learners in making the diagnosis and then coaching on their milestone deficits. It is key for all program directors to recognize struggling residents because early recognition and intervention gives the resi...
journal_title:Academic radiology
pub_type: 杂志文章
doi:10.1016/j.acra.2016.12.022
更新日期:2017-06-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:Multireader imaging trials often use a factorial design, in which study patients undergo testing with all imaging modalities and readers interpret the results of all tests for all patients. A drawback of this design is the large number of interpretations required of each reader. Split-plot desi...
journal_title:Academic radiology
pub_type: 杂志文章
doi:10.1016/j.acra.2012.09.012
更新日期:2012-12-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:Describe new interactive digital teaching methods for medical student education in radiology and evaluate student responses. MATERIALS AND METHODS:Third- and fourth-year medical students on radiology clerkship were taught using either film-based "hot seat" format, digital "hot seat," or didact...
journal_title:Academic radiology
pub_type: 杂志文章
doi:10.1016/j.acra.2004.07.017
更新日期:2004-11-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:We investigated the influence of muscular activity and regional body temperature changes on the accumulation of intravenously (i.v.) administered, dextran-coated superparamagnetic iron oxide (SPIO) particles in the lymph nodes of rats. METHODS:Four groups of rats (N = 21) were used. Five rats ...
journal_title:Academic radiology
pub_type: 杂志文章
doi:10.1016/s1076-6332(96)80193-0
更新日期:1996-08-01 00:00:00