Breast lesions: differential diagnosis using digital subtraction angiography.

Watt, A C; Ackerman, L V; Windham, Joe P.; Shetty, P.C.; Burke, Matthew; Flynn, Michael J.; Grodinsky, C; Fine, Gerald; Wilderman, S.J.

doi:10.1148/radiology.159.1.3513251

Cited by 57 publications

(27 citation statements)

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“…When it is indicated, angiography can frequently indicate malignancy by showing the neovascularity of a tumor. However, angiographic examination of breast cancer has gained little attention, although previous studies have shown that breast tumor vessels display characteristics that suggest malignancy [2,3]. Continuous-wave Doppler sonography is another technique to detect the blood flow in breast tumors [4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Breast cancer vascularity: Color Doppler sonography and histopathology study

Lee

Chu

Huang

et al. 1996

Breast Cancer Res Tr

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In this prospective study, the authors examined 50 patients with breast tumors (malignant, n = 32; benign, n = 18) to investigate the correlation between color Doppler flow mapping and histopathological findings and to evaluate the clinical significance of color Doppler mapping. Among the 32 patients with breast cancer, color Doppler signals were detected in 24 patients (75%). The maximum flow velocities varied from 5 to 34 cm/sec, with 16 (67%) of them above 15 cm/sec. Among the 18 patients with benign tumors, color Doppler signals could be detected in 7 (39%). The maximum flow velocity varied from 3 to 30 cm/sec but was over 15 cm/sec in only two patients (28%). Histological studies revealed that color Doppler signals detected by Doppler sonography correlated with disordered neovascularization penetrating the lesion from its periphery, consisting of thin-walled blood vessels and large arteriovenous shunts. Although large tumors tend to have high Doppler flow, there is no significant correlation between the maximum flow velocity and tumor size. There is also no significant correlation between the detection of high flow color Doppler signals and the age, receptor status, tumor size, lymph node metastases, or clinical stage of patients with breast cancer. However, there is a positive association (p < 0.05) between nodal metastases and higher tumor flow velocity in T1 (< or = 2 cm) breast tumors, but not in larger tumors. It is concluded that color Doppler is useful in the assessment of tumor vascularity but is of limited value in the differentiation of benign from malignant lesions. However, the presence of color Doppler signals in T1 breast cancer suggesting early dissemination of the cancer might be of important clinical significance in detecting those small, apparently early, but aggressive tumors with poor prognosis.

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Section: Introductionmentioning

confidence: 99%

Breast cancer vascularity: Color Doppler sonography and histopathology study

Lee

Chu

Huang

et al. 1996

Breast Cancer Res Tr

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“…Angiogenesis leads to a higher vascularization and to an increased blood flow. Pre vious work in angiography and digital subtraction angiography of breast carcinoma had demonstrated that vascular abnormal ities are associated with malignant breast lesions [12,13]. The first studies on flow detection with Doppler ultrasound using the continuous-wave Doppler (CW Doppler) were described by Wells et al [14] and White and Cledgett [15].…”

Section: Discussionmentioning

confidence: 99%

Angiogenesis as a Diagnostic Factor in Primary Breast Cancer: Microvessel Quantitation by Stereological Methods and Correlation with Color Doppler Sonography

et al. 1994

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Background: In contrast to benign lesions without signs of inflammation, malignant tumors have a capacity for angiogenesis. Therefore it was of interest to evaluate with color Doppler ultrasound if breast carcinomas showed higher vascularization than benign lesions. To enable a correlation with the pathoanatomic situation of vascularization, stereological methods were used to quantify microvessel volume, surface and length as indicators for angiogenesis. Patients and Methods: Two hundred and five patients with a palpable and/or mammographically seen breast tumor were investigated before they underwent surgery with color Doppler ultrasound for the detection of blood flow in the tumor or in an area around the tumor within a distance of 2 cm. In 101 cases microvessels of the tumor were identified by immunohistochemistry using the monoclonal mouse antibody (JC70) that detects the vascular endothelium-associated antigen CD31 and quantified by stereological methods. The quantified vessel volume, surface, and length were compared to color flow results and other prognostic factors in breast cancer. Results: The detection of blood flow by color Doppler sonography in the tumor and in the peritumoral region was significantly higher in malignant than in benign breast lesions (p = 0.003). By stereological quantitation of microvessels it could be shown that breast carcinoma had a significantly higher volume, surface and length of vessels than fibroadenoma (p < 0.00001 and p < 0.0001). In the group of breast cancers a significant correlation was found between high length of microvessels per mm3 tumor and tumor size (p = 0.04 – Jonckheere test), a negative estrogen receptor (p < .007) and a negative progesterone receptor (p = 0.005). No correlation was found between microvessel length and nodal status, tumor grade, ploidy status, and S-phase fraction. Conclusions: Microvessel count in breast tumors, using the JC70 antibody to CD31, and stereology for quantitation in a three-dimensional fashion, is an effective method to look for the extent of angiogenesis and to correlate Doppler flow results with pathoanatomic vascular data. With color Doppler sonography an effective clinical method is available for distinguishing between benign and malignant lesions.

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“…Watt et al (16,17) and Ackerman et al (18) performed digital subtraction angiography of the breast, using an x-ray image intensifier in a conventional angiography system. They were able to demonstrate that benign and malignant lesions could be differentiated according to the strength of enhancement (referred to as "blush").…”

Section: Temporal Subtraction Angiographymentioning

confidence: 99%

“…Watt et al (16,17) and Ackerman et al (18) used temporal subtraction to depict the contrast enhancement. This technique, illustrated in Figure 1a, is analogous to the vast majority of digital subtraction angiography performed today.…”

Section: Temporal Subtraction Angiographymentioning

confidence: 99%

“…Subtracted images of benign lesions showed little or no enhancement, while those of malignant lesions showed rapid intense enhancement, followed by gradual washout. Watt et al (16,17) and Ackerman et al (18) used temporal subtraction to depict the contrast enhancement. This technique, illustrated in Figure 1a, is analogous to the vast majority of digital subtraction angiography performed today.…”

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confidence: 99%

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X-Ray Polarization Imaging

Maidment¹

2006

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Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing this collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. (From -To) REPORT DATE (DD-MM-YYYY) 01-06-2006 REPORT TYPE Final DATES COVERED PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT NUMBERUniversity of Pennsylvania Philadelphia, PA 19175 SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR'S ACRONYM(S) U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 SPONSOR/MONITOR'S REPORT NUMBER(S) DISTRIBUTION / AVAILABILITY STATEMENTApproved for Public Release; Distribution Unlimited SUPPLEMENTARY NOTES-original document contains color ABSTRACTConventional mammography evaluates the spatial arrangement of tissue in the breast; the recorded signal is determined by the x-ray attenuation of the materials in each projection. Due to the low x-ray energy, every x-ray attenuated by the breast is absorbed by the breast (i.e., all of the x-ray energy is deposited in the breast). We have investigated whether it is possible to produce breast images based on x-ray polarization. Polarization radiography appeared to have the potential to supplement mammographic images by imaging the ability of breast tissue to rotate the x-ray polarization vector. We had hoped that new information about the breast could be gleaned at a low dose to the breast; preference being given to x-rays which would pass through the breast and have altered polarization, rather than being absorbed by the breast). We performed fundamental experiments regarding x-ray polarization to determine whether the polarization effect was sufficiently large to allow it to be used to produce images. Two different x-ray polarimeters were developed and tested. We were able to demonstrate polarization of the incident x-ray beam. However, neither polarimeter allowed successful measurement of polarization alterations of any material. We did, however, develop an excellent model of x-ray spectra, which has already seen wide usage. SUBJECT TERMS Conclusions……………………………………………………………………………………………………………29 References………………………………………………………………………………………………………………30 Appendices………………………………………………………………………………………………………………32Page 4 IntroductionAt optical energies, the pol...

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Breast lesions: differential diagnosis using digital subtraction angiography.

Cited by 57 publications

References 0 publications

Breast cancer vascularity: Color Doppler sonography and histopathology study

Breast cancer vascularity: Color Doppler sonography and histopathology study

Angiogenesis as a Diagnostic Factor in Primary Breast Cancer: Microvessel Quantitation by Stereological Methods and Correlation with Color Doppler Sonography

X-Ray Polarization Imaging

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