Sonography can be used to accurately classify some solid lesions as benign, allowing imaging follow-up rather than biopsy.

Architectural and dynamic features are important in breast MR imaging interpretation. Multivariate models involving feature assessment have a diagnostic accuracy superior to that of qualitative characterization of the dynamic enhancement pattern.

BACKGROUNDThe authors compared the performance of screening mammography versus magnetic resonance imaging (MRI) in women at genetically high risk for breast cancer.METHODSThe authors conducted an international prospective study of screening mammography and MRI in asymptomatic, genetically high‐risk women age ≥ 25 years. Women with a history of breast cancer were eligible for a contralateral screening if they had been diagnosed within 5 years or a bilateral screening if they had been diagnosed > 5 years previously. All examinations (MRI, mammography, and clinical breast examination [CBE]) were performed within 90 days of each other.RESULTSIn total, 390 eligible women were enrolled by 13 sites, and 367 women completed all study examinations. Imaging evaluations recommended 38 biopsies, and 27 biopsies were performed, resulting in 4 cancers diagnosed for an overall 1.1% cancer yield (95% confidence interval [95%CI], 0.3–2.8%). MRI detected all four cancers, whereas mammography detected one cancer. The diagnostic yield of mammography was 0.3% (95%CI, 0.01–1.5%). The yield of cancer by MRI alone was 0.8% (95%CI, − 0.3–2.0%). The biopsy recommendation rates for MRI and mammography were 8.5% (95%CI, 5.8–11.8%) and 2.2% (95%CI, 0.1–4.3%).CONCLUSIONSScreening MRI in high‐risk women was capable of detecting mammographically and clinically occult breast cancer. Screening MRI resulted in 22 of 367 of women (6%) who had negative mammogram and negative CBE examinations undergoing biopsy, resulting in 3 additional cancers detected. MRI also resulted in 19 (5%) false‐positive outcomes, which resulted in benign biopsies. Cancer 2005. © 2005 American Cancer Society.

A description and explanation of an unexpected echographic appearance in a patient who had sustained an abdominal shotgun wound is presented. In the B-scans, a trail of dense continuous echoes, simulating a comet tail, is seen distal to each lead pellet. This comet tail appearance is shown to be a type of reverberation artifact. The effect of object size, shape, composition, and orientation on the appearance of this artifact is demonstrated.