Objective: Percutaneous breast and axillary core biopsy followed by marker placement are integral parts of a breast imager's practice benefiting both patients and clinicians. Marker placement is the standard to facilitate future care. The purpose of this study is to characterize the safety and performance of MammoMARK, CorMARK, and HydroMARK biopsy markers by evaluating device-related adverse events, device deficiencies, and long-term safety. Methods: A retrospective review of three radiology practices identified patients who underwent imageguided breast or axillary biopsies followed by marker placement between 1 January 2012 and 1 January 2017. Medical records were reviewed with adverse events related to marker placement and use recorded. Results: 768 markers were placed with three (0.4%) events recorded. Two device deficiencies and one non-serious adverse event occurred in three patients. Device deficiency events involved user errors deploying the markers, one to inability to locate the marker on post-biopsy imaging, and the second to misplacement relative to biopsy target. One non-serious adverse event involved inability to locate/ retain the marker in a surgically resected specimen. No serious adverse events were reported. Conclusion: Placement of breast biopsy markers is safe with minimal associated risks. Issues related to device malfunction, durability, reliability, safety, or performance were not reported.

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Attempts to use computers to aid in the detection of breast malignancies date back more than 20 years. Despite significant interest and investment, this has historically led to minimal or no significant improvement in performance and outcomes with traditional computer-aided detection. However, recent advances in artificial intelligence and machine learning are now starting to deliver on the promise of improved performance. There are at present more than 20 FDA-approved AI applications for breast imaging, but adoption and utilization are widely variable and low overall. Breast imaging is unique and has aspects that create both opportunities and challenges for AI development and implementation. Breast cancer screening programs worldwide rely on screening mammography to reduce the morbidity and mortality of breast cancer, and many of the most exciting research projects and available AI applications focus on cancer detection for mammography. There are, however, multiple additional potential applications for AI in breast imaging, including decision support, risk assessment, breast density quantitation, workflow and triage, quality evaluation, response to neoadjuvant chemotherapy assessment, and image enhancement. In this review the current status, availability, and future directions of investigation of these applications are discussed, as well as the opportunities and barriers to more widespread utilization.

Metabolic G-protein Coupled Receptors (GPCRs). (A) Intramembrane access to the binding pocket of GPR40 (also known as free fatty acid receptor 1; PDB code: 4PHU). The binding pocket of GPR40 (grey) is covered by extracellular loop 2 (ECL2; cyan) preventing entry from the extracellular space. Instead the allosteric regulator, TAK-875 (pink), accesses the binding pocket through the plasma membrane. (B) Structural determination of the lysophosphatidic acid receptor (LPA 1 ; PDB code: 4Z34). LPA 1 was crystallized with a stabilizing Cytochrome b 562 RIL subunit (circled in orange) inserted into the third intracellular loop and with membrane lipids bound to help orient LPA 1 in the plasma membrane. (C) Pharmacological regulation of metabotropic glutamate receptor 5 (mGlu5; PDB code: 4OO9). Slab view of the allosteric binding site (allosteric regulator mavoglurant (red)) within the 7-transmembrane helices of mGlu5 (green).

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