Publications (5)14.47 Total impact
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Article: Differentiating benign from malignant solid breast masses with US strain imaging.
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ABSTRACT: To prospectively evaluate the sensitivity and specificity of ultrasonographic (US) strain imaging for distinguishing between benign and malignant solid breast masses, with biopsy results as the reference standard. The study was institutional review board approved and HIPAA compliant. Informed consent was obtained from all participating patients. US strain imaging of 403 breast masses was performed. The 50 malignant and 48 benign lesions (in patients aged 19-83 years; mean age, 49 years +/- 17 [standard deviation]) with the highest quality were selected for the reader study. Three observers blinded to the pathologic outcomes first described the B-mode image findings by using US Breast Imaging Reporting and Data System descriptors and derived a probability of malignancy. They then updated the probability by assessing strain images. Receiver operating characteristic (ROC) curves were constructed by using these probabilities. Areas under the ROC curve, sensitivities, and specificities were calculated and compared. Interobserver variability and the correlation between automated and subjective image quality assessment were analyzed. The average area under the ROC curve for all three readers after US strain imaging (0.903) was greater than that after B-mode US alone (0.876, P = .014). With use of a 2% probability of malignancy threshold, strain imaging-as compared with B-mode US alone-had improved average specificity (0.257 vs 0.132, P < .001) and high sensitivity (0.993 vs 0.987, P > .99). Significant interobserver variability was observed (P < .001). The ability to assess strain image quality appeared to correlate with the highest observer performance. US strain imaging can facilitate improved classification of benign and malignant breast masses. However, interobserver variability and image quality influence observer performance.Radiology 12/2007; 245(2):401-10. · 5.73 Impact Factor -
Article: Acrometastasis to the foot: an unusual presentation of transitional cell carcinoma of the bladder.
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ABSTRACT: Metastases from bladder cancer to the bones of the hands or feet are rare and usually present after the diagnosis of the primary lesion has been made. This case report describes a 76-year-old man presenting with initial signs of infection of the right foot. Subsequent bone scan revealed multiple bony metastases and hydronephrosis raising the possibility of a primary bladder tumour that was later confirmed by urine cytology and fine needle aspiration of the foot.Nuclear medicine review. Central & Eastern Europe: journal of Bulgarian, Czech, Macedonian, Polish, Romanian, Russian, Slovak, Yugoslav societies of nuclear medicine and Ukrainian Society of Radiology 02/2007; 10(1):26-8. -
Article: A quantitative lymphoscintigraphic evaluation of lymphatic function in the swollen hands of women with lymphoedema following breast cancer treatment.
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ABSTRACT: In BCRL (breast cancer-related lymphoedema), arm swelling is unevenly distributed and some regions are partly or entirely spared. In particular, the hand may or not be swollen, but when involved functional impairment can be substantial. We have found previously that, when the ipsilateral hand is spared of swelling (in a limb with swelling proximal to the hand), the local lymph drainage rate constant (k) is at least as high as in the contralateral hand, contrary to the traditional 'stopcock' concept of reduced lymph drainage from the whole limb. In the light of this finding, we have investigated lymph drainage in the hands of eight women with BCRL and moderate-to-severe hand swelling, using gamma-camera quantitative lymphoscintigraphy. Images showed pronounced superficial activity in the ipsilateral swollen arms of most patients, indicating dermal backflow. k for 99mTc-labelled hIgG (human IgG) measured over 5 h in the subcutis of the ipsilateral swollen hand was 34+/-24% less than in the contralateral hand (P=0.013). Activity measured in the ipsilateral swollen forearm increased progressively, but there was very little increase in the contralateral forearm, indicating retention of 99mTc-labelled hIgG in the swollen forearm. It is concluded that lymphatic function in the swollen hand is impaired, and that there appears to be two populations of women with BCRL, i.e. spared-hand and swollen-hand, irrespective of the cancer treatment received.Clinical Science 06/2006; 110(5):553-61. · 4.61 Impact Factor -
Article: Invasive ductal carcinoma of the breast with large central acellular zones (ring carcinoma): imaging and clinical findings in eight cases.
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ABSTRACT: To review the mammographic and ultrasound appearances in patients who have invasive ductal carcinoma with a central acellular zone (ring carcinoma), as this feature has been reported to be associated with a poorer outcome. Eight patients were identified with ring carcinomas. Two breast radiologists reviewed their mammograms and ultrasound images. Patient records were reviewed to assess outcome. All patients had lesions deep within the breast, adjacent to the chest wall, five lesions were incompletely visualised on mammography. The appearance was of a circumscribed or obscured mass, without microcalcification. Five patients had ultrasound demonstrating a solid well-circumscribed hypoechoic microlobulated lesion. In our series of patients who have a ring carcinoma of the breast, mammographic and ultrasound appearances were similar in all cases and lacked the typical features of malignancy.The Breast 11/2005; 14(5):419-24. · 2.49 Impact Factor -
Article: Idiopathic benign breast calcification.
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ABSTRACT: A 56-year-old woman who came in for screening mammography was found to have extensive unilateral calcification of her left breast which had developed since her previous screening mammogram. The calcification had a ductal and lobular appearance. Possible known etiologies are discussed, but these do not explain the appearance in this case, implying that the cause is idiopathic.The Breast Journal 10(4):355-8. · 1.64 Impact Factor
