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Sample records for abnormal screening mammograms

  1. Improving work-up of the abnormal mammogram through organized assessment: results from the ontario breast screening program.

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    Quan, May Lynn; Shumak, Rene S; Majpruz, Vicky; Holloway, Claire M D; O'Malley, Frances P; Chiarelli, Anna M

    2012-03-01

    Women with an abnormal screening mammogram should ideally undergo an organized assessment to attain a timely diagnosis. This study evaluated outcomes of women undergoing work-up after abnormal mammogram through a formal breast assessment affiliate (BAA) program with explicit care pathways compared with usual care (UC) using developed quality indicators for screening mammography programs. Between January 1 and December 31, 2007, a total of 320,635 women underwent a screening mammogram through the Ontario Breast Screening Program (OBSP), of whom 25,543 had an abnormal result requiring further assessment. Established indicators assessing timeliness, appropriateness of follow-up, and biopsy rates were compared between women who were assessed through either a BAA or UC using χ(2) analysis. Work-up of the abnormal mammogram for patients screened through a BAA resulted in a greater proportion of women attaining a definitive diagnosis within the recommended time interval when a histologic diagnosis was required. In addition, use of other quality measures including specimen radiography for both core biopsies and surgical specimens and preoperative core needle biopsy was greater in BAA facilities. These findings support future efforts to increase the number of BAAs within the OBSP, because the pathways and reporting methods associated with them result in improvements in our ability to provide timely and appropriate care for women requiring work-up of an abnormal mammogram.

  2. Vessel segmentation in screening mammograms

    Science.gov (United States)

    Mordang, J. J.; Karssemeijer, N.

    2015-03-01

    Blood vessels are a major cause of false positives in computer aided detection systems for the detection of breast cancer. Therefore, the purpose of this study is to construct a framework for the segmentation of blood vessels in screening mammograms. The proposed framework is based on supervised learning using a cascade classifier. This cascade classifier consists of several stages where in each stage a GentleBoost classifier is trained on Haar-like features. A total of 30 cases were included in this study. In each image, vessel pixels were annotated by selecting pixels on the centerline of the vessel, control samples were taken by annotating a region without any visible vascular structures. This resulted in a total of 31,000 pixels marked as vascular and over 4 million control pixels. After training, the classifier assigns a vesselness likelihood to the pixels. The proposed framework was compared to three other vessel enhancing methods, i) a vesselness filter, ii) a gaussian derivative filter, and iii) a tubeness filter. The methods were compared in terms of area under the receiver operating characteristics curves, the Az values. The Az value of the cascade approach is 0:85. This is superior to the vesselness, Gaussian, and tubeness methods, with Az values of 0:77, 0:81, and 0:78, respectively. From these results, it can be concluded that our proposed framework is a promising method for the detection of vessels in screening mammograms.

  3. Automatic detection of abnormalities in mammograms

    International Nuclear Information System (INIS)

    Suhail, Zobia; Sarwar, Mansoor; Murtaza, Kashif

    2015-01-01

    In recent years, an increased interest has been seen in the area of medical image processing and, as a consequence, Computer Aided Diagnostic (CAD) systems. The basic purpose of CAD systems is to assist doctors in the process of diagnosis. CAD systems, however, are quite expensive, especially, in most of the developing countries. Our focus is on developing a low-cost CAD system. Today, most of the CAD systems regarding mammogram classification target automatic detection of calcification and abnormal mass. Calcification normally indicates an early symptom of breast cancer if it appears as a small size bright spot in a mammogram image. Based on the observation that calcification appears as small bright spots on a mammogram image, we propose a new scale-specific blob detection technique in which the scale is selected through supervised learning. By computing energy for each pixel at two different scales, a new feature “Ratio Energy” is introduced for efficient blob detection. Due to the imposed simplicity of the feature and post processing, the running time of our algorithm is linear with respect to image size. Two major types of calcification, microcalcification and macrocalcification have been identified and highlighted by drawing a circular boundary outside the area that contains calcification. Results are quite visible and satisfactory, and the radiologists can easily view results through the final detected boundary. CAD systems are designed to help radiologists in verifying their diagnostics. A new way of identifying calcification is proposed based on the property that microcalcification is small in size and appears in clusters. Results are quite visible and encouraging, and can assist radiologists in early detection of breast cancer

  4. Consequences of false-positive screening mammograms.

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    Tosteson, Anna N A; Fryback, Dennis G; Hammond, Cristina S; Hanna, Lucy G; Grove, Margaret R; Brown, Mary; Wang, Qianfei; Lindfors, Karen; Pisano, Etta D

    2014-06-01

    False-positive mammograms, a common occurrence in breast cancer screening programs, represent a potential screening harm that is currently being evaluated by the US Preventive Services Task Force. To measure the effect of false-positive mammograms on quality of life by measuring personal anxiety, health utility, and attitudes toward future screening. The Digital Mammographic Imaging Screening Trial (DMIST) quality-of-life substudy telephone survey was performed shortly after screening and 1 year later at 22 DMIST sites and included randomly selected DMIST participants with positive and negative mammograms. Mammogram requiring follow-up testing or referral without a cancer diagnosis. The 6-question short form of the Spielberger State-Trait Anxiety Inventory state scale (STAI-6) and the EuroQol EQ-5D instrument with US scoring. Attitudes toward future screening as measured by women's self-report of future intention to undergo mammographic screening and willingness to travel and stay overnight to undergo a hypothetical new type of mammography that would identify as many cancers with half the false-positive results. Among 1450 eligible women invited to participate, 1226 (84.6%) were enrolled, with follow-up interviews obtained in 1028 (83.8%). Anxiety was significantly higher for women with false-positive mammograms (STAI-6, 35.2 vs 32.7), but health utility scores did not differ and there were no significant differences between groups at 1 year. Future screening intentions differed by group (25.7% vs 14.2% more likely in false-positive vs negative groups); willingness to travel and stay overnight did not (9.9% vs 10.5% in false-positive vs negative groups). Future screening intention was significantly increased among women with false-positive mammograms (odds ratio, 2.12; 95% CI, 1.54-2.93), younger age (2.78; 1.5-5.0), and poorer health (1.63; 1.09-2.43). Women's anticipated high-level anxiety regarding future false-positive mammograms was associated with willingness

  5. Rapid point-of-care breath test for biomarkers of breast cancer and abnormal mammograms.

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    Michael Phillips

    Full Text Available BACKGROUND: Previous studies have reported volatile organic compounds (VOCs in breath as biomarkers of breast cancer and abnormal mammograms, apparently resulting from increased oxidative stress and cytochrome p450 induction. We evaluated a six-minute point-of-care breath test for VOC biomarkers in women screened for breast cancer at centers in the USA and the Netherlands. METHODS: 244 women had a screening mammogram (93/37 normal/abnormal or a breast biopsy (cancer/no cancer 35/79. A mobile point-of-care system collected and concentrated breath and air VOCs for analysis with gas chromatography and surface acoustic wave detection. Chromatograms were segmented into a time series of alveolar gradients (breath minus room air. Segmental alveolar gradients were ranked as candidate biomarkers by C-statistic value (area under curve [AUC] of receiver operating characteristic [ROC] curve. Multivariate predictive algorithms were constructed employing significant biomarkers identified with multiple Monte Carlo simulations and cross validated with a leave-one-out (LOO procedure. RESULTS: Performance of breath biomarker algorithms was determined in three groups: breast cancer on biopsy versus normal screening mammograms (81.8% sensitivity, 70.0% specificity, accuracy 79% (73% on LOO [C-statistic value], negative predictive value 99.9%; normal versus abnormal screening mammograms (86.5% sensitivity, 66.7% specificity, accuracy 83%, 62% on LOO; and cancer versus no cancer on breast biopsy (75.8% sensitivity, 74.0% specificity, accuracy 78%, 67% on LOO. CONCLUSIONS: A pilot study of a six-minute point-of-care breath test for volatile biomarkers accurately identified women with breast cancer and with abnormal mammograms. Breath testing could potentially reduce the number of needless mammograms without loss of diagnostic sensitivity.

  6. Malignancy and Abnormality Detection of Mammograms using Classifier Ensembling

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    Nawazish Naveed

    2011-07-01

    Full Text Available The breast cancer detection and diagnosis is a critical and complex procedure that demands high degree of accuracy. In computer aided diagnostic systems, the breast cancer detection is a two stage procedure. First, to classify the malignant and benign mammograms, while in second stage, the type of abnormality is detected. In this paper, we have developed a novel architecture to enhance the classification of malignant and benign mammograms using multi-classification of malignant mammograms into six abnormality classes. DWT (Discrete Wavelet Transformation features are extracted from preprocessed images and passed through different classifiers. To improve accuracy, results generated by various classifiers are ensembled. The genetic algorithm is used to find optimal weights rather than assigning weights to the results of classifiers on the basis of heuristics. The mammograms declared as malignant by ensemble classifiers are divided into six classes. The ensemble classifiers are further used for multiclassification using one-against-all technique for classification. The output of all ensemble classifiers is combined by product, median and mean rule. It has been observed that the accuracy of classification of abnormalities is more than 97% in case of mean rule. The Mammographic Image Analysis Society dataset is used for experimentation.

  7. Association between Radiologists' Experience and Accuracy in Interpreting Screening Mammograms

    Directory of Open Access Journals (Sweden)

    Maristany Maria-Teresa

    2008-04-01

    Full Text Available Abstract Background Radiologists have been observed to differ, sometimes substantially, both in their interpretations of mammograms and in their recommendations for follow-up. The aim of this study was to determine how factors related to radiologists' experience affect the accuracy of mammogram readings. Methods We selected a random sample of screening mammograms from a population-based breast cancer screening program. The sample was composed of 30 women with histopathologically-confirmed breast cancer and 170 women without breast cancer after a 2-year follow-up (the proportion of cancers was oversampled. These 200 mammograms were read by 21 radiologists routinely interpreting mammograms, with different amount of experience, and by seven readers who did not routinely interpret mammograms. All readers were blinded to the results of the screening. A positive assessment was considered when a BI-RADS III, 0, IV, V was reported (additional evaluation required. Diagnostic accuracy was calculated through sensitivity and specificity. Results Average specificity was higher in radiologists routinely interpreting mammograms with regard to radiologists who did not (66% vs 56%; p Conclusion Among radiologists who read routinely, volume is not associated with better performance when interpreting screening mammograms, although specificity decreased in radiologists not routinely reading mammograms. Follow-up of cases for which further workup is recommended might reduce variability in mammogram readings and improve the quality of breast cancer screening programs.

  8. Performance of computer-aided detection in false-negative screening mammograms of breast cancers

    International Nuclear Information System (INIS)

    Han, Boo Kyung; Kim, Ji Young; Shin, Jung Hee; Choe, Yeon Hyeon

    2004-01-01

    To analyze retrospectively the abnormalities visible on the false-negative screening mammograms of patients with breast cancer and to determine the performance of computer-aided detection (CAD) in the detection of cancers. Of 108 consecutive cases of breast cancer diagnosed over a period of 6 years, of which previous screening mammograms were available, 32 retrospectively visible abnormalities (at which locations cancer later developed) were found in the previous mammograms, and which were originally reported as negative. These 32 patients ranged in age from 38 to 72 years (mean 52 years). We analyzed their previous mammographic findings, and assessed the ability of CAD to mark cancers in previous mammograms, according to the clinical presentation, the type of abnormalities and the mammographic parenchymal density. In these 32 previous mammograms of breast cancers (20 asymptomatic, 12 symptomatic), the retrospectively visible abnormalities were identified as densities in 22, calcifications in 8, and densities with calcifications in 2. CAD marked abnormalities in 20 (63%) of the 32 cancers with false-negative screening mammograms; 14 (70%) of the 20 subsequent screening-detected cancers, 5 (50%) of the 10 interval cancers, and 1 (50%) of the 2 cancers palpable after the screening interval. CAD marked 12 (50%) of the 24 densities and 9 (90%) of the 10 calcifications. CAD marked abnormalities in 7 (50%) of the 14 predominantly fatty breasts, and 13 (72%) of the 18 dense breasts. CAD-assisted diagnosis could potentially decrease the number of false-negative mammograms caused by the failure to recognize the cancer in the screening program, although its usefulness in the prevention of interval cancers appears to be limited

  9. Computerized Analysis and Detection of Missed Cancer in Screening Mammogram

    National Research Council Canada - National Science Library

    Li, Lihua

    2004-01-01

    This project is to explore an innovative CAD strategy for improving early detection of breast cancer in screening mammograms by focusing on computerized analysis and detection of cancers missed by radiologists...

  10. Computer Analysis and Detection of Missed Cancer in Screening Mammogram

    National Research Council Canada - National Science Library

    Li, Lihua

    2006-01-01

    This project is to explore an innovative CAD strategy for improving early detection of breast cancer in screening mammograms by focusing on computerized analysis and detection of cancers missed by radiologists...

  11. Computerized Analysis and Detection of Missed Cancer in Screening Mammogram

    National Research Council Canada - National Science Library

    Li, Lihua

    2007-01-01

    This project is to explore an innovative CAD strategy for improving early detection of breast cancer in screening mammograms by focusing on computerized analysis and detection of cancers missed by radiologists...

  12. Computerized Analysis and Detection of Missed Cancer in Screening Mammogram

    National Research Council Canada - National Science Library

    Li, Lihua

    2005-01-01

    This project is to explore an innovative CAD strategy for improving early detection of breast cancer in screening mammograms by focusing on computerized analysis and detection of cancers missed by radiologists...

  13. Mammograms

    Science.gov (United States)

    ... exam may be used along with a mammogram. Magnetic resonance imaging (MRI) , which uses a powerful magnet ... as possible, the x-ray technician will gently lift the breast tissue slightly away from the implant ...

  14. Automated Labeling of Screening Mammograms with Arterial Calcifications

    NARCIS (Netherlands)

    Mordang, Jan-Jurre; Hauth, Jakob; den Heeten, Gerard J.; Karssemeijer, Nico

    2014-01-01

    For the automatic detection of malignant microcalcification clusters in screening mammograms a computer aided detection (CADe) system has been developed. The most frequent false positives of this system are breast arterial calcifications (BACs). The purpose of this study was to construct a method

  15. Prediction of incomplete screening mammograms based on age and race.

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    Justice, Tiffany D; Stiff, Jennifer H; Myers, John A; Milam, Michael R

    2012-01-01

    This study examined the age-associated rate of incomplete mammograms requiring additional testing based on Breast Imaging-Reporting and Data System (BIRADS) score. A retrospective, observational study design from a tertiary medical center was used to evaluate which explanatory variables significantly predicted whether a woman had an incomplete mammogram. An incomplete mammogram was defined as a BIRADS score of 0 (requiring further imaging), whereas a benign process was defined as a BIRADS score of 1 or 2. Explanatory variables included traditional clinical factors (age, race, and menopausal state). During the study period, 20,269 subjects were evaluated. The majority of the patients were white (n = 12,955; 64.6%) and had a BIRADS score consistent with a benign finding (n = 17,571; 86.6%). Premenopausal state (odds ratio [OR], 1.38; 95% CI, 1.27-1.50), white race (OR, 1.18; 95% CI, 1.08-1.29), and younger age (OR, 1.38; 95% CI, 1.27-1.50) significantly increased the odds a woman had an incomplete study. In this cross-sectional, single-institution analysis, premenopausal state and white race are associated with an increased rate for incomplete mammograms. Patients should be counseled appropriately before the initiation of screening.

  16. Medical Advocacy and Supportive Environments for African-Americans Following Abnormal Mammograms.

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    Molina, Yamile; Hempstead, Bridgette H; Thompson-Dodd, Jacci; Weatherby, Shauna Rae; Dunbar, Claire; Hohl, Sarah D; Malen, Rachel C; Ceballos, Rachel M

    2015-09-01

    African-American women experience disproportionately adverse outcomes relative to non-Latina White women after an abnormal mammogram result. Research has suggested medical advocacy and staff support may improve outcomes among this population. The purpose of the study was to understand reasons African-American women believe medical advocacy to be important and examine if and how staff can encourage and be supportive of medical advocacy. A convenience-based sample of 30-74-year-old women who self-identified as African-American/Black/of African descent and who had received an abnormal mammogram result was recruited from community-based organizations, mobile mammography services, and the local department of health. This qualitative study included semi-structured interviews. Patients perceived medical advocacy to be particularly important for African-Americans, given mistrust and discrimination present in medical settings and their own familiarity with their bodies and symptoms. Respondents emphasized that staff can encourage medical advocacy through offering information in general in a clear, informative, and empathic style. Cultural competency interventions that train staff how to foster medical advocacy may be a strategy to improve racial disparities following an abnormal mammogram.

  17. Ethnic differences in social support after initial receipt of an abnormal mammogram.

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    Molina, Yamile; Hohl, Sarah D; Nguyen, Michelle; Hempstead, Bridgette H; Weatherby, Shauna Rae; Dunbar, Claire; Beresford, Shirley A A; Ceballos, Rachel M

    2016-10-01

    We examine access to and type of social support after initial receipt of an abnormal mammogram across non-Latina White (NLW), African American, and Latina women. This cross-sectional study used a mixed method design, with quantitative and qualitative measures. Women were recruited through 2 community advocates and 3 breast-health-related care organizations. With regard to access, African American women were less likely to access social support relative to NLW counterparts. Similar nonsignificant differences were found for Latinas. Women did not discuss results with family and friends to avoid burdening social networks and negative reactions. Networks' geographic constraints and medical mistrust influenced Latina and African American women's decisions to discuss results. With regard to type of social support, women reported emotional support across ethnicity. Latina and African American women reported more instrumental support, whereas NLW women reported more informational support in the context of their well-being. There are shared and culturally unique aspects of women's experiences with social support after initially receiving an abnormal mammogram. Latina and African American women may particularly benefit from informational support from health care professionals. Communitywide efforts to mitigate mistrust and encourage active communication about cancer may improve ethnic disparities in emotional well-being and diagnostic resolution during initial receipt of an abnormal mammogram. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  18. Screen-detected breast cancer: Does presence of minimal signs on prior mammograms predict staging or grading of cancer?

    Energy Technology Data Exchange (ETDEWEB)

    Bansal, G.J., E-mail: gjbansal@gmail.com [Department of Radiology, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW (United Kingdom); Thomas, K.G. [Department of Radiology, Breast Test Wales, Cathedral Road, Cardiff (United Kingdom)

    2011-07-15

    Aim: To investigate whether the presence of minimal signs on prior mammograms predict staging or grading of cancer. Materials and methods: The previous mammograms of 148 consecutive patients with screen-detected breast cancer were examined. Women with an abnormality visible (minimal signs) on both current and prior mammograms formed the study group; the remaining patients formed the control group. Age, average size of tumour, tumour characteristic, histopathology, grade, and lymph node status were compared between the two groups, using Fisher's exact test. Cases in which earlier diagnosis would have made a significant prognostic difference were also evaluated. Results: Eighteen percent of patients showed an abnormality at the site of the tumour on previous mammograms. There was no statistically significant difference between the two groups with respect to age, average size of tumour, histopathology, grade or lymph node status with p-values being 0.609, 0.781, 0.938, and 0.444, respectively. The only statistically significant difference between the two groups was tumour characteristics with more microcalcifications associated with either mass or asymmetrical density seen in the study group (p = 0.003). Five patients in the study group showed lymph node positivity and were grade 3, and therefore, may have had possible gain from earlier diagnosis. Conclusion: The present study did not demonstrate a statistical difference in grading or staging between the group that showed 'minimal signs' on prior mammograms versus normal prior mammograms. Microcalcification seems to be the most common characteristic seen in the missed cancer and a more aggressive management approach is suggested for breast microcalcifications.

  19. Modeling sequential context effects in diagnostic interpretation of screening mammograms.

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    Alamudun, Folami; Paulus, Paige; Yoon, Hong-Jun; Tourassi, Georgia

    2018-07-01

    Prior research has shown that physicians' medical decisions can be influenced by sequential context, particularly in cases where successive stimuli exhibit similar characteristics when analyzing medical images. This type of systematic error is known to psychophysicists as sequential context effect as it indicates that judgments are influenced by features of and decisions about the preceding case in the sequence of examined cases, rather than being based solely on the peculiarities unique to the present case. We determine if radiologists experience some form of context bias, using screening mammography as the use case. To this end, we explore correlations between previous perceptual behavior and diagnostic decisions and current decisions. We hypothesize that a radiologist's visual search pattern and diagnostic decisions in previous cases are predictive of the radiologist's current diagnostic decisions. To test our hypothesis, we tasked 10 radiologists of varied experience to conduct blind reviews of 100 four-view screening mammograms. Eye-tracking data and diagnostic decisions were collected from each radiologist under conditions mimicking clinical practice. Perceptual behavior was quantified using the fractal dimension of gaze scanpath, which was computed using the Minkowski-Bouligand box-counting method. To test the effect of previous behavior and decisions, we conducted a multifactor fixed-effects ANOVA. Further, to examine the predictive value of previous perceptual behavior and decisions, we trained and evaluated a predictive model for radiologists' current diagnostic decisions. ANOVA tests showed that previous visual behavior, characterized by fractal analysis, previous diagnostic decisions, and image characteristics of previous cases are significant predictors of current diagnostic decisions. Additionally, predictive modeling of diagnostic decisions showed an overall improvement in prediction error when the model is trained on additional information about

  20. A retrospective study of the performance of radiographers in interpreting screening mammograms

    International Nuclear Information System (INIS)

    Moran, S.; Warren-Forward, H.

    2011-01-01

    Purpose: This paper provides data on the continued success of radiographers in reviewing mammograms with similar accuracy to screen readers. Method: The participants consisted of 7 radiographers and 2 current official screen readers. Two hundred and fifty sets of mammograms from 2003 were used in this study. Each participant reviewed each set of mammograms as a Rescreen or Recall. Patient outcomes were assessed by following up the results of any histology or pathology tests in 2003 or the 2005/2006 screening results. Results: The screen reader's sensitivities ranged from 79% to 93% and the specificities ranged from 82% to 84%. The radiographer values ranged from 57% to 97% and 63% to 80% respectively. Conclusion: The sensitivity and specificity values attained by some radiographers were equivalent to those of both the screen readers. Accuracy rates of the radiographers suggest that screen reading by selected and appropriately trained radiographers should be achievable in Australia.

  1. Language barriers, location of care, and delays in follow-up of abnormal mammograms.

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    Karliner, Leah S; Ma, Lin; Hofmann, Michael; Kerlikowske, Karla

    2012-02-01

    Breast cancer is frequently diagnosed after an abnormal mammography result. Language barriers can complicate communication of those results. We evaluated the association of non-English language with delay in follow-up. Retrospective cohort study of women at 3 mammography facilities participating in the San Francisco Mammography Registry with an abnormal mammogram result from 1997 to 2008. We measured median time from report of abnormal result to first follow-up test. Of 13,014 women with 16,109 abnormal mammograms, 4027 (31%) had a non-English patient language. Clinical facilities differed in proportion of non-English speakers and in time to first follow-up test: facility A (38%; 25 d), facility B (18%; 14 d), and facility C (51%; 41 d). Most mammography examinations (67%) had breast imaging and reporting data system 0 (incomplete) assessment, requiring radiographic follow-up. At 30 days of follow-up, 67% of all English speakers with incomplete assessments had a follow-up examination compared with 50% of all non-English speakers (Planguage; compared with English speakers and adjusting for education, non-English speakers had twice the odds ratio of >30-day delay in follow-up (odds ratio=2.3; 95% confidence interval, 1.4-3.9). There are considerable differences among facilities in delays in diagnostic follow-up of abnormal mammography results. More attention must be paid to understanding mammography facility factors, such as wait time to schedule diagnostic mammography and radiology workload, to improve rates of timely follow-up, particularly for those facilities disproportionately serving vulnerable non-English speaking patients.

  2. Language Barriers, Location of Care and Delays in Follow-up of Abnormal Mammograms

    Science.gov (United States)

    Karliner, LS; Ma, L; Hofmann, M; Kerlikowske, K

    2013-01-01

    Background Breast cancer is frequently diagnosed after an abnormal mammography result. Language barriers can complicate communication of those results. Objectives We evaluated the association of non-English language with delay in follow-up. Methods: Retrospective cohort study of women at three mammography facilities participating in the San Francisco Mammography Registry (SFMR) with an abnormal mammogram result from 1997-2008. We measured median time from report of abnormal result to first follow-up test. Results Of 13,014 women with 16,109 abnormal mammograms, 4,027 (31%) had a non-English patient language. Clinical facilities differed in proportion of non-English-speakers and in time to first follow-up test: facility A (38%; 25 days), facility B (18%; 14 days), facility C (51%; 41 days). Most (67%) mammography examinations had BIRADS 0 (incomplete) assessment, requiring radiographic follow-up. At 30 days of follow-up 67% of all English speakers with incomplete assessments had a follow-up exam compared with 50% of all non-English speakers (p30 day delay in follow-up (OR 2.3; 95 CI 1.4-3.9). Conclusions There are considerable differences among facilities in delays in diagnostic follow-up of abnormal mammography results. More attention must be paid to understanding mammography facility factors, such as wait time to schedule diagnostic mammography and radiology workload, in order to improve rates of timely follow-up, particularly for those facilities disproportionately serving vulnerable non-English speaking patients. PMID:21993060

  3. Improved Screening Mammogram Workflow by Maximizing PACS Streamlining Capabilities in an Academic Breast Center.

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    Pham, Ramya; Forsberg, Daniel; Plecha, Donna

    2017-04-01

    The aim of this study was to perform an operational improvement project targeted at the breast imaging reading workflow of mammography examinations at an academic medical center with its associated breast centers and satellite sites. Through careful analysis of the current workflow, two major issues were identified: stockpiling of paperwork and multiple worklists. Both issues were considered to cause significant delays to the start of interpreting screening mammograms. Four workflow changes were suggested (scanning of paperwork, worklist consolidation, use of chat functionality, and tracking of case distribution among trainees) and implemented in July 2015. Timestamp data was collected 2 months before (May-Jun) and after (Aug-Sep) the implemented changes. Generalized linear models were used to analyze the data. The results showed significant improvements for the interpretation of screening mammograms. The average time elapsed for time to open a case reduced from 70 to 28 min (60 % decrease, p workflow for diagnostic mammograms at large unaltered even with increased volume of mammography examinations (31 % increase of 4344 examinations for May-Jun to 5678 examinations for Aug-Sep). In conclusion, targeted efforts to improve the breast imaging reading workflow for screening mammograms in a teaching environment provided significant performance improvements without affecting the workflow of diagnostic mammograms.

  4. PS2-01: A Multimodal Reminder Program Improves Routine Mammogram Screening Rates

    Science.gov (United States)

    Feldstein, Adrianne C; Perrin, Nancy; Rosales, Gabriella; Schneider, Jennifer; Rix, Mary M; Morgan, Gail; Keels, Kara; Lassi, Michael; Schoap, Stephanie; Glasgow, Russell E.

    2010-01-01

    Background/Aims: This retrospective cohort study evaluated the effectiveness of implementation and maintenance phases of a multimodal reminder program to improve routine mammography screening. Methods: The program used automated reminder calls and was conducted at Kaiser Permanente Northwest, a nonprofit group-model HMO with an electronic medical record. Study participants were women HMO members aged 42 or older who were 20 months past their last mammogram (index date) during three time periods: pre-reminder (2004), post-reminder implementation phase (2006), and post-reminder maintenance phase (Jan 1–July 1, 2007) (Total n=35,104). The program targeted women aged 50–69 with a mammogram due followed by post card, followed by up to 2 automated phone calls and 1 live call for non-responders. Women aged 42–49 (for whom clinical guidelines also recommend mammography) receiving no reminders constituted the primary comparison group (CG 1). The primary outcome was time until mammogram in the 10 months following the index date. Results: Pre-reminder, 63.4% of targeted women completed a mammogram; this number increased to 75.4% in the post-reminder implementation; 80.6% completed a mammogram in the maintenance phases. After controlling for demographics and clinic visits, intervention women were 1.51 times more likely to complete a mammogram (CI 1.40–1.62) post-reminder implementation, compared to CG 1. The effect was maintained in 2007 (HR 1.81 [CI 1.65–1.99]). Women of other races (Asian, Pacific Island, or Native American) were less likely to complete a mammogram, as were those taking a greater number of medications. Women with a college education, who were married, or who had visited a primary care provider or gynecologist during follow-up were more likely to complete a mammogram. Conclusions: We found that a multimodal reminder system could be effectively implemented and maintained in a large health system. If widely implemented, this intervention could

  5. Patient understanding of the revised USPSTF screening mammogram guidelines: need for development of patient decision aids

    Directory of Open Access Journals (Sweden)

    Allen Summer V

    2012-10-01

    Full Text Available Abstract Background The purpose of the study was to examine patients’ understanding of the revised screening mammogram guidelines released by the United States Preventive Services Task Force (USPSTF in 2009 addressing age at initiation and frequency of screening mammography. Methods Patients from the Departments of Family Medicine, Internal Medicine, and Obstetrics and Gynecology (n = 150 at a tertiary care medical center in the United States completed a survey regarding their understanding of the revised USPSTF guidelines following their release, within four to six months of their scheduled mammogram (March 2010 to May 2010. Results Of the patients surveyed, 97/147 (67% indicated increased confusion regarding the age and frequency of screening mammography, 61/148 (41% reported increased anxiety about mammograms, and 58/146 (40% reported anxiety about their own health status following the release of the revised screening guidelines. Most of the patients surveyed, 111/148 (75%, did not expect to change their timing or frequency of screening mammograms in the future. Conclusion Results from this survey suggested increased confusion and possibly an increase in patients’ anxiety related to screening mammography and their own health status following the release of the revised USPSTF screening mammogram guidelines to the public and subsequent media portrayal of the revised guidelines. Although the study did not specifically address causality for these findings, the results highlight the need for improvements in the communication of guidelines to patients and the public. Development of shared decision-making tools and outcomes should be considered to address the communication challenge.

  6. Disparities in abnormal mammogram follow-up time for Asian women compared to non-Hispanic Whites and between Asian ethnic groups

    Science.gov (United States)

    Nguyen, KH; Pasick, RJ; Stewart, SL; Kerlikowske, K; Karliner, LS

    2017-01-01

    Background Delays in abnormal mammogram follow-up contribute to poor outcomes. We examined abnormal screening mammogram follow-up differences for non-Hispanic Whites (NHW) and Asian women. Methods Prospective cohort of NHW and Asian women with a Breast Imaging Reporting and Data System abnormal result of 0 or 3+ in the San Francisco Mammography Registry between 2000–2010. We performed Kaplan-Meier estimation for median-days to follow-up with a diagnostic radiologic test, and compared proportion with follow-up at 30, 60 and 90 days, and no follow-up at one-year for Asians overall (and Asian ethnic groups) and NHWs. We additionally assessed the relationship between race/ethnicity and time-to-follow-up with adjusted Cox proportional hazards models. Results Among Asian women, Vietnamese and Filipinas had the longest, and Japanese the shortest, median follow-up time (32, 28, 19 days, respectively) compared to NHWs (15 days). The proportion of women receiving follow-up at 30 days was lower for Asians vs NHWs (57% vs 77%, pAsian ethnic groups except Japanese. Asians had a reduced hazard of follow-up compared with NHWs (aHR 0.70, 95% CI 0.69–0.72). Asians also had a higher rate than NHWs of no follow-up (15% vs 10%; pAsian ethnic groups, Filipinas had the highest percentage of women with no follow-up (18.1%). Conclusion Asian, particularly Filipina and Vietnamese, women were less likely than NHWs to receive timely follow-up after an abnormal screening mammogram. Research should disaggregate Asian ethnicity to better understand and address barriers to effective cancer prevention. PMID:28603859

  7. Psychological distress, social withdrawal, and coping following receipt of an abnormal mammogram among different ethnicities: a mediation model.

    Science.gov (United States)

    Molina, Yamile; Beresford, Shirley A A; Espinoza, Noah; Thompson, Beti

    2014-09-01

    To explore ethnic differences in psychological distress and social withdrawal after receiving an abnormal mammogram result and to assess if coping strategies mediate ethnic differences. Descriptive correlational. Two urban mobile mammography units and a rural community hospital in the state of Washington. 41 Latina and 41 non-Latina Caucasian (NLC) women who had received an abnormal mammogram result. Women completed standard sociodemographic questions, Impact of Event Scale-Revised, the social dimension of the Psychological Consequences Questionnaire, and the Brief COPE. Ethnicity, psychological distress, social withdrawal, and coping. Latinas experienced greater psychological distress and social withdrawal compared to NLC counterparts. Denial as a coping strategy mediated ethnic differences in psychological distress. Religious coping mediated ethnic differences in social withdrawal. Larger population-based studies are necessary to understand how ethnic differences in coping strategies can influence psychological outcomes. This is an important finding that warrants additional study among women who are and are not diagnosed with breast cancer following an abnormal mammogram. Nurses may be able to work with Latina patients to diminish denial coping and consequent distress. Nurses may be particularly effective, given cultural values concerning strong interpersonal relationships and respect for authority figures.

  8. Reading screening mammograms – Attitudes among radiologists and radiographers about skill mix

    International Nuclear Information System (INIS)

    Johansen, Lena Westphal; Brodersen, John

    2011-01-01

    Introduction: Because of shortage of personnel for the Danish mammography screening programme, the aim of this study was to investigate the attitudes of radiologists and radiographers towards a future implementation of radiographers reading screening mammograms. Materials and methods: Seven combined phenomenological and hermeneutical interviews with radiographers and radiologists were performed. Stratified selection was used for sampling of informants. The interviews were analysed against theory about quality, organization and profession. Results: Quality related possibilities: radiographers do routinely measure the performance quality, radiographers obtain sufficient reading qualifications, and skill mix improves quality. Quality related obstacles: radiologists do not routinely measure performance quality. Organization related possibilities: shortage of radiologists, positive attitudes of managers, and improved working relations. Organization related obstacles: shortage of radiographers and negative attitudes of managers. Professional related possibilities: positive experience with skill mix. Professional related obstacles: worries about negative consequences for the training of radiologists, and resistance against handing over tasks to another profession. Conclusion: Attitudes towards radiographers reading screening mammograms are attached to either quality-, organisational or professional perspectives. Radiographers are capable of learning to read mammograms at sufficient performance level but routine measurement of performance quality is essential. Resistance against skill mix may be caused by an emotionally conditioned fear of losing demarcations. The main motive for skill mix is improvement of the utilization of resources. No evidence was found regarding the organisational and financial consequences of skill mix. Despite of this all radiologists and radiographers experienced with skill mix were strong advocates for reading radiographers.

  9. Computer aided monitoring of breast abnormalities in X-ray mammograms

    OpenAIRE

    Selvan, Arul; Saatchi, Reza; Ferris, Christine

    2011-01-01

    X­ray mammography is regarded as the most effective tool for the detection and diagnosis of breast cancer, but the interpretation of mammograms is a difficult and \\ud error­prone task. Computer­aided detection (CADe) systems address the problem that radiologists often miss signs of cancers that are retrospectively visible in mammograms. Furthermore, computer­aided diagnosis (CADx) systems assist the radiologist in the classification of mammographic lesions as benign or malignant[1].\\ud This p...

  10. Detection of microcalcifications in television-enhanced nonmagnified screen-film mammograms compared with matching magnification unenhanced mammograms

    International Nuclear Information System (INIS)

    Kimme-Smith, C.; Gormley, L.S.; Gold, R.H.; Bassett, L.W.

    1988-01-01

    The object of this investigation was to determine which imaging method was associated with greater accuracy in the interpretation of breast microcalcifications: 1.5X to 2.0X magnification with a microfocal spot or Damon DETECT-enhanced mammograms. The authors' test series consisted of matched pairs of images of 31 breasts, each containing a cluster of microcalcifications within a biopsy-proved benign (N = 21) or malignant (N =10) lesion. Three experienced mammographers and three senior radiology residents with 2 weeks of training in mammography interpreted the calcifications. On the basis of receiver operating characteristic analysis, the authors conclude that (1) inexperienced mammographers should not use television image enhancement alone to evaluate microcalcifications and (2) television-enhanced mammograms are not a substitute for microfocal spot magnification mammograms

  11. Annual Screening Mammogram and its Relation to Breast Density

    Directory of Open Access Journals (Sweden)

    Sabek EAS

    2017-11-01

    Full Text Available Background: Current national screening programs totally depend on mammographic evaluation. After increased incidence of breast cancer in women under the age of 35, mammography sensitivity in now a question. Several factors added to decrease sensitivity of mammography, such as increased density in older age groups and increased aggressiveness of tumour biology. All these factors will change the reliability of the screening program. The study is a retrospective study conducted at Ain Shams University. Method: 138 patients diagnosed with cancer breast underwent both mammography and sonography to determine percentage of patient with more than one focus, age and density distribution breast cancer in the affected patient and accuracy of both mammography and US. Results: By studying this population, we found that around 61,44% have areas of density ranging from dense breast, heterogenous density or scattered density. These areas of density render the mammography a less sensitive tool as its sensitivity fall to 34.09%, while that of US was 77.27%. Conclusion: As breast cancer is prevalent in younger population, also with increased density in older population who are relatively insensitive to mammography, we recommended the use of Automated Breast Ultrasound (ABUS in the national screening program.

  12. Reading screening mammograms - Attitudes among radiologists and radiographers about skill mix

    DEFF Research Database (Denmark)

    Johansen, Lena Westphal; Brodersen, John

    2011-01-01

    INTRODUCTION: Because of shortage of personnel for the Danish mammography screening programme, the aim of this study was to investigate the attitudes of radiologists and radiographers towards a future implementation of radiographers reading screening mammograms. MATERIALS AND METHODS: Seven...... do routinely measure the performance quality, radiographers obtain sufficient reading qualifications, and skill mix improves quality. Quality related obstacles: radiologists do not routinely measure performance quality. Organization related possibilities: shortage of radiologists, positive attitudes...... of managers, and improved working relations. Organization related obstacles: shortage of radiographers and negative attitudes of managers. Professional related possibilities: positive experience with skill mix. Professional related obstacles: worries about negative consequences for the training...

  13. Disparities in abnormal mammogram follow-up time for Asian women compared with non-Hispanic white women and between Asian ethnic groups.

    Science.gov (United States)

    Nguyen, Kim H; Pasick, Rena J; Stewart, Susan L; Kerlikowske, Karla; Karliner, Leah S

    2017-09-15

    Delays in abnormal mammogram follow-up contribute to poor outcomes. In the current study, the authors examined differences in abnormal screening mammogram follow-up between non-Hispanic white (NHW) and Asian women. The authors used a prospective cohort of NHW and Asian women with a Breast Imaging, Reporting and Data System (BI-RADS) abnormal result of category 0 or 3-plus in the San Francisco Mammography Registry between 2000 and 2010. Kaplan-Meier estimation for the median number of days to follow-up with a diagnostic radiologic test was performed, and the authors compared the percentage of women with follow-up at 30 days, 60 days, and 90 days and no follow-up at 1 year for Asian women overall (and Asian ethnic groups) and NHW women. In addition, the authors assessed the relationship between race/ethnicity and time to follow-up with adjusted Cox proportional hazards models. Among Asian women, Vietnamese and Filipina women had the longest, and Japanese women the shortest, median follow-up (32 days, 28 days, and 19 days, respectively) compared with NHW women (15 days). The percentage of women receiving follow-up at 30 days was lower for Asians versus NHWs (57% vs 77%; PAsian ethnic groups except Japanese. Asian women had a reduced hazard of follow-up compared with NHW women (adjusted hazard ratio, 0.70; 95% confidence interval, 0.69-0.72). Asian women also had a higher rate of receiving no follow-up compared with NHW women (15% vs 10%; PAsian ethnic groups, Filipinas were found to have the highest percentage of women with no follow-up (18.1%). Asian women, particularly Filipina and Vietnamese women, were less likely than NHW women to receive timely follow-up after an abnormal screening mammogram. Research should disaggregate Asian ethnicity to better understand and address barriers to effective cancer prevention. Cancer 2017;123:3468-75. © 2017 American Cancer Society. © 2017 American Cancer Society.

  14. Preoperative diagnosis of carcinoma within fibroadenoma on screening mammograms

    International Nuclear Information System (INIS)

    Borecky, N.; Rickard, M.

    2008-01-01

    Three cases of fibroadenoma associated with carcinoma are reported. These cases were diagnosed within a screening programme as a result of suspicious mammographic findings, and the diagnosis of malignancy was confirmed preoperatively by core biopsy in all cases. The mammographic findings suggestive of carcinoma within fibroadenoma were irregularity of margins in one case and associated new suspicious pleomorphic and linear calcifications in the two other cases. The preoperative diagnosis of carcinoma within fibroadenoma was provided by ultrasound-guided core biopsy in two cases and core biopsy under stereotactic guidance in one case. Whereas asymptomatic fibroadenoma with benign imaging appearances usually does not require further investigation, fibroadenoma with atypical imaging features requires a triple test investigation.

  15. First Trimester Ultrasound Screening for Congenital Abnormalities ...

    African Journals Online (AJOL)

    approach used, especially with the introduction of first trimester ultrasound as a reliable screening method. Objective: To give a comprehensive review of the basis for first trimester ultrasound screening for congenital abnormalities, it's utilization in the prenatal screening for chromosomal, structural and genetic abnormalities ...

  16. Abnormal Cervical Cancer Screening Test Results

    Science.gov (United States)

    ... lesion? • What are the different types of abnormal Pap test results? • What testing is needed after an abnormal ... that could lead to cancer. Screening includes the Pap test and, for some women, testing for a virus ...

  17. Can the NHS breast screening programme afford not to double read screening mammograms?

    International Nuclear Information System (INIS)

    Liston, J.C.; Dall, B.J.G.

    2003-01-01

    AIM: Rapid expansion of the National Health Service (UK) Breast Screening Programme (NHSBSP) to routinely invite women aged 50-70 years will result in many new readers undertaking screen reading. A timely method for assessing performance and preferably one that facilitates a steep learning curve will be required. MATERIALS AND METHODS: This unit screens a population of 88000 women aged 50-64 years and double reads >90% films. A record is kept of proven screen-detected cancers not recalled for assessment by either the first or second reader but correctly recalled following third-reader arbitration. Individual readers' workload and recall rates are obtained by running an annual co-writer report. The results of this 7 year prospective audit are presented. RESULTS: In total 177167 women were screened between 1/4/95 and 31/3/02 resulting in the detection of 1072 cancers. Eighty-seven cancers (8.1%) were detected after arbitration. Individual readers recall to assessment rates and percentage of cases incorrectly returned to routine recall varied. Prompt feedback of missed/misinterpreted cases allowed both experienced and inexperienced readers to modify their recall thresholds for particular mammographic abnormalities. CONCLUSION: It is recommended this audit method is adopted by all units in the NHSBSP and that the Advisory Committee for Breast Cancer Screening review the policy of single versus double reading

  18. Availability and accessibility of subsidized mammogram screening program in peninsular Malaysia: A preliminary study using travel impedance approach

    Science.gov (United States)

    Aljunid, Syed Mohamed

    2018-01-01

    Access to healthcare is essential in the pursuit of universal health coverage. Components of access are availability, accessibility (spatial and non-spatial), affordability and acceptability. Measuring spatial accessibility is common approach to evaluating access to health care. This study aimed to determine the availability and spatial accessibility of subsidised mammogram screening in Peninsular Malaysia. Availability was determined from the number and distribution of facilities. Spatial accessibility was determined using the travel impedance approach to represent the revealed access as opposed to potential access measured by other spatial measurement methods. The driving distance of return trips from the respondent’s residence to the facilities was determined using a mapping application. The travel expenditure was estimated by multiplying the total travel distance by a standardised travel allowance rate, plus parking fees. Respondents in this study were 344 breast cancer patients who received treatment at 4 referral hospitals between 2015 and 2016. In terms of availability, there were at least 6 major entities which provided subsidised mammogram programs. Facilities with mammogram involved with these programs were located more densely in the central and west coast region of the Peninsula. The ratio of mammogram facility to the target population of women aged 40–74 years ranged between 1: 10,000 and 1:80,000. In terms of accessibility, of the 3.6% of the respondents had undergone mammogram screening, their mean travel distance was 53.4 km (SD = 34.5, range 8–112 km) and the mean travel expenditure was RM 38.97 (SD = 24.00, range RM7.60–78.40). Among those who did not go for mammogram screening, the estimated travel distance and expenditure had a skewed distribution with median travel distance of 22.0 km (IQR 12.0, 42.0, range 2.0–340.0) and the median travel cost of RM 17.40 (IQR 10.40, 30.00, range 3.40–240.00). Higher travel impedance was noted

  19. Availability and accessibility of subsidized mammogram screening program in peninsular Malaysia: A preliminary study using travel impedance approach.

    Science.gov (United States)

    Mahmud, Aidalina; Aljunid, Syed Mohamed

    2018-01-01

    Access to healthcare is essential in the pursuit of universal health coverage. Components of access are availability, accessibility (spatial and non-spatial), affordability and acceptability. Measuring spatial accessibility is common approach to evaluating access to health care. This study aimed to determine the availability and spatial accessibility of subsidised mammogram screening in Peninsular Malaysia. Availability was determined from the number and distribution of facilities. Spatial accessibility was determined using the travel impedance approach to represent the revealed access as opposed to potential access measured by other spatial measurement methods. The driving distance of return trips from the respondent's residence to the facilities was determined using a mapping application. The travel expenditure was estimated by multiplying the total travel distance by a standardised travel allowance rate, plus parking fees. Respondents in this study were 344 breast cancer patients who received treatment at 4 referral hospitals between 2015 and 2016. In terms of availability, there were at least 6 major entities which provided subsidised mammogram programs. Facilities with mammogram involved with these programs were located more densely in the central and west coast region of the Peninsula. The ratio of mammogram facility to the target population of women aged 40-74 years ranged between 1: 10,000 and 1:80,000. In terms of accessibility, of the 3.6% of the respondents had undergone mammogram screening, their mean travel distance was 53.4 km (SD = 34.5, range 8-112 km) and the mean travel expenditure was RM 38.97 (SD = 24.00, range RM7.60-78.40). Among those who did not go for mammogram screening, the estimated travel distance and expenditure had a skewed distribution with median travel distance of 22.0 km (IQR 12.0, 42.0, range 2.0-340.0) and the median travel cost of RM 17.40 (IQR 10.40, 30.00, range 3.40-240.00). Higher travel impedance was noted among those who

  20. Closing the Gap in Mammogram Screening: An Experimental Intervention among Low-Income Hispanic Women in Community Health Clinics

    Science.gov (United States)

    Deavenport, Alexis; Modeste, Naomi; Marshak, Helen Hopp; Neish, Christine

    2011-01-01

    A low rate of mammogram screening exists among low-income Hispanic women. To address this disparity, an experimental intervention containing audiovisual and written media was conducted using the health belief model as a framework. The purpose of this study was to determine if low-income Hispanic women, more than 40 years of age, who received…

  1. Evaluating radiographers' diagnostic accuracy in screen-reading mammograms: what constitutes a quality study?

    International Nuclear Information System (INIS)

    Debono, Josephine C; Poulos, Ann E

    2015-01-01

    The aim of this study was to first evaluate the quality of studies investigating the diagnostic accuracy of radiographers as mammogram screen-readers and then to develop an adapted tool for determining the quality of screen-reading studies. A literature search was used to identify relevant studies and a quality evaluation tool constructed by combining the criteria for quality of Whiting, Rutjes, Dinnes et al. and Brealey and Westwood. This constructed tool was then applied to the studies and subsequently adapted specifically for use in evaluating quality in studies investigating diagnostic accuracy of screen-readers. Eleven studies were identified and the constructed tool applied to evaluate quality. This evaluation resulted in the identification of quality issues with the studies such as potential for bias, applicability of results, study conduct, reporting of the study and observer characteristics. An assessment of the applicability and relevance of the tool for this area of research resulted in adaptations to the criteria and the development of a tool specifically for evaluating diagnostic accuracy in screen-reading. This tool, with further refinement and rigorous validation can make a significant contribution to promoting well-designed studies in this important area of research and practice

  2. Detection of architectural distortion in prior screening mammograms using Gabor filters, phase portraits, fractal dimension, and texture analysis

    International Nuclear Information System (INIS)

    Rangayyan, Rangaraj M.; Prajna, Shormistha; Ayres, Fabio J.; Desautels, J.E.L.

    2008-01-01

    Mammography is a widely used screening tool for the early detection of breast cancer. One of the commonly missed signs of breast cancer is architectural distortion. The purpose of this study is to explore the application of fractal analysis and texture measures for the detection of architectural distortion in screening mammograms taken prior to the detection of breast cancer. A method based on Gabor filters and phase portrait analysis was used to detect initial candidates for sites of architectural distortion. A total of 386 regions of interest (ROIs) were automatically obtained from 14 ''prior mammograms'', including 21 ROIs related to architectural distortion. From the corresponding set of 14 ''detection mammograms'', 398 ROIs were obtained, including 18 related to breast cancer. For each ROI, the fractal dimension and Haralick's texture features were computed. The fractal dimension of the ROIs was calculated using the circular average power spectrum technique. The average fractal dimension of the normal (false-positive) ROIs was significantly higher than that of the ROIs with architectural distortion (p = 0.006). For the ''prior mammograms'', the best receiver operating characteristics (ROC) performance achieved, in terms of the area under the ROC curve, was 0.80 with a Bayesian classifier using four features including fractal dimension, entropy, sum entropy, and inverse difference moment. Analysis of the performance of the methods with free-response receiver operating characteristics indicated a sensitivity of 0.79 at 8.4 false positives per image in the detection of sites of architectural distortion in the ''prior mammograms''. Fractal dimension offers a promising way to detect the presence of architectural distortion in prior mammograms. (orig.)

  3. Women's Behaviors Toward Mammogram and Pap Test: Opportunities to Increase Cervical Cancer Screening Participation Rates among Older Women.

    Science.gov (United States)

    Tavasoli, Simon M; Kane, Eli; Chiarelli, Anna M; Kupets, Rachel

    Screening rates for cervical cancer remain moderate among women over 50 years of age. Because cervical and breast screening interventions can be linked, evaluating screening factors relating to both is important. This study evaluates factors associated with breast and cervical screening participation in women aged 52 to 69. A cross-sectional study was used to describe characteristics associated with screening behaviors of 1,173,456 eligible women in Ontario, Canada. Overdue for screening was defined as more than 2.5 years from last mammogram or more than 3.5 years from last Pap test. Factors that might influence uptake of mammogram or Pap test were included as covariates in a multivariable multinomial logistic regression model. Overall, 52.4% of eligible women were up-to-date for both, 21.3% were overdue for both, 14.4% were overdue for Pap test but were up-to-date with mammogram, and 11.9% were overdue for mammogram but were up-to-date with Pap test. There was an opposite effect of age on likelihood of being overdue for Pap test only versus mammogram only. Women aged 67 to 69 compared with those 52 to 54 were more likely to be overdue for Pap test only (adjusted odds ratio, 2.3; 95% confidence interval, 2.3-2.4) and less likely to be overdue for mammogram only (adjusted odds ratio, 0.5; 95% confidence interval, 0.5-0.6). A greater proportion of women rostered to a female physician versus a male physician were up-to-date for both (63.7% vs. 51.5%). Comparing screening patterns may provide physician- and patient-directed strategies to increase cervical screening participation by recruiting women who are overdue for Pap test but undergoing breast cancer screening. Copyright © 2017 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  4. Computer-aided detection system for clustered microcalcifications: comparison of performance on full-field digital mammograms and digitized screen-film mammograms

    International Nuclear Information System (INIS)

    Ge Jun; Hadjiiski, Lubomir M; Sahiner, Berkman; Wei Jun; Helvie, Mark A; Zhou Chuan; Chan Heangping

    2007-01-01

    We have developed a computer-aided detection (CAD) system to detect clustered microcalcifications automatically on full-field digital mammograms (FFDMs) and a CAD system for screen-film mammograms (SFMs). The two systems used the same computer vision algorithms but their false positive (FP) classifiers were trained separately with sample images of each modality. In this study, we compared the performance of the CAD systems for detection of clustered microcalcifications on pairs of FFDM and SFM obtained from the same patient. For case-based performance evaluation, the FFDM CAD system achieved detection sensitivities of 70%, 80% and 90% at an average FP cluster rate of 0.07, 0.16 and 0.63 per image, compared with an average FP cluster rate of 0.15, 0.38 and 2.02 per image for the SFM CAD system. The difference was statistically significant with the alternative free-response receiver operating characteristic (AFROC) analysis. When evaluated on data sets negative for microcalcification clusters, the average FP cluster rates of the FFDM CAD system were 0.04, 0.11 and 0.33 per image at detection sensitivity level of 70%, 80% and 90% compared with an average FP cluster rate of 0.08, 0.14 and 0.50 per image for the SFM CAD system. When evaluated for malignant cases only, the difference of the performance of the two CAD systems was not statistically significant with AFROC analysis

  5. Estimating screening-mammography receiver operating characteristic (ROC) curves from stratified random samples of screening mammograms: a simulation study.

    Science.gov (United States)

    Zur, Richard M; Pesce, Lorenzo L; Jiang, Yulei

    2015-05-01

    To evaluate stratified random sampling (SRS) of screening mammograms by (1) Breast Imaging Reporting and Data System (BI-RADS) assessment categories, and (2) the presence of breast cancer in mammograms, for estimation of screening-mammography receiver operating characteristic (ROC) curves in retrospective observer studies. We compared observer study case sets constructed by (1) random sampling (RS); (2) SRS with proportional allocation (SRS-P) with BI-RADS 1 and 2 noncancer cases accounting for 90.6% of all noncancer cases; (3) SRS with disproportional allocation (SRS-D) with BI-RADS 1 and 2 noncancer cases accounting for 10%-80%; and (4) SRS-D and multiple imputation (SRS-D + MI) with missing BI-RADS 1 and 2 noncancer cases imputed to recover the 90.6% proportion. Monte Carlo simulated case sets were drawn from a large case population modeled after published Digital Mammography Imaging Screening Trial data. We compared the bias, root-mean-square error, and coverage of 95% confidence intervals of area under the ROC curve (AUC) estimates from the sampling methods (200-2000 cases, of which 25% were cancer cases) versus from the large case population. AUC estimates were unbiased from RS, SRS-P, and SRS-D + MI, but biased from SRS-D. AUC estimates from SRS-P and SRS-D + MI had 10% smaller root-mean-square error than RS. Both SRS-P and SRS-D + MI can be used to obtain unbiased and 10% more efficient estimate of screening-mammography ROC curves. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

  6. Diagnostic imaging and biopsy pathways following abnormal screen-film and digital screening mammography

    Science.gov (United States)

    Hubbard, Rebecca A.; Zhu, Weiwei; Horblyuk, Ruslan; Karliner, Leah; Sprague, Brian L.; Henderson, Louise; Lee, David; Onega, Tracy; Buist, Diana SM.; Sweet, Alison

    2013-01-01

    Objective The transition from screen-film to digital mammography may have altered diagnostic evaluation of women following a positive screening examination. This study compared use and timeliness of diagnostic imaging and biopsy for women screened with screen-film or digital mammography. Materials and Methods Data were from 35,321 positive screening mammograms on 32,087 women aged 40–89 years, from 22 Breast Cancer Surveillance Consortium facilities in 2005–2008. Diagnostic pathways were classified by their inclusion of diagnostic mammography, ultrasound, magnetic resonance imaging (MRI), and biopsy. We compared time to resolution and frequency of diagnostic pathways by patient characteristics, screening exam modality, and radiology facility. Between-facility differences were evaluated by computing the proportion of mammograms receiving follow-up with a particular pathway for each facility and examining variation in these proportions across facilities. Multinomial logistic regression adjusting for age, calendar year, and facility compared odds of follow-up with each pathway. Results The median time to resolution of a positive screening mammogram was 10 days. Compared to screen-film mammograms, digital mammograms were more frequently followed by only a single diagnostic mammogram (46% vs. 36%). Pathways following digital screening mammography were also less likely to include biopsy (16% vs. 20%). However, in adjusted analyses most differences were not statistically significant (p = 0.857 for mammography only; p = 0.03 for biopsy). Substantial variability in diagnostic pathway frequency was seen across facilities. For instance, the frequency of evaluation with diagnostic mammography alone ranged from 23% to 55% across facilities. Conclusion Differences in evaluation of positive digital and screen-film screening mammograms were minor, and appeared to be largely attributable to substantial variation between radiology facilities. To guide health systems in their

  7. Occult Primary Neuroendocrine Tumor Metastasis to the Breast Detected on Screening Mammogram

    Directory of Open Access Journals (Sweden)

    Fabiana Policeni

    2016-01-01

    Full Text Available Metastatic tumors are rare in the breast. Well-differentiated neuroendocrine tumors (WDNETs are slow-growing neoplasms that arise from neuroendocrine cells, particularly in the gastrointestinal tract and bronchial tree. Metastatic WDNET to the breast is a rare entity. We present a case report of ileal WDNET metastatic to the breast which was initially identified as a small mass in the patient′s left breast on screening mammography. Targeted ultrasound identified a suspicious mass, and ultrasound-guided percutaneous core biopsy was performed. Pathology revealed metastatic WDNET. Breast magnetic resonance imaging (MRI was then performed and demonstrated left axillary Level 2 lymphadenopathy, and liver lesions were suspicious for metastasis. The patient underwent abdominal computed tomography (CT to evaluate for distant metastatic disease. A spiculated mass was found near the ileocecal valve, suggestive of primary ileal WDNET. In addition, CT identified multiple liver lesions, most compatible with metastasis. Indium 111 OctreoScan confirmed radiotracer uptake in the ileum consistent with primary neuroendocrine tumor. In this report, we review the imaging characteristics of metastatic WDNET to the breast by different imaging modalities including mammogram, ultrasound, and breast MRI.

  8. Relationship between arterial vascular calcifications seen on screening mammograms and biochemical markers of endothelial injury

    Energy Technology Data Exchange (ETDEWEB)

    Pidal, Diego [Unidad de Investigacion del, Hospital de Jove, Gijon (Spain)], E-mail: dpidal@hotmail.com; Sanchez Vidal, M Teresa [Servicio de Medicina Interna, Hospital de Jove (Spain)], E-mail: medicinainterna@hospitaldejove.com; Rodriguez, Juan Carlos [Unidad de Investigacion del, Hospital de Jove, Gijon (Spain); Servicio de Cirugia General, Hospital de Jove (Spain); Instituto Universitario de Oncologia del Principado de Asturias, Oviedo (Spain)], E-mail: investigacion@hospitaldejove.com; Corte, M Daniela [Unidad de Investigacion del, Hospital de Jove, Gijon (Spain); Instituto Universitario de Oncologia del Principado de Asturias, Oviedo (Spain)], E-mail: mdanielac@hotmail.com; Pravia, Paz [Servicio de Radiodiagnostico, Hospital de Jove (Spain)], E-mail: radiologia@hospitaldejove.com; Guinea, Oscar [Servicio de Radiodiagnostico, Hospital de Jove (Spain)], E-mail: oscarfguinea@seram.org; Pidal, Ivan [Unidad de Investigacion del, Hospital de Jove, Gijon (Spain)], E-mail: ivanpida@hotmail.com; Bongera, Miguel [Unidad de Investigacion del, Hospital de Jove, Gijon (Spain)], E-mail: mbchoppy@hotmail.com; Escribano, Damaso [Servicio de Medicina Interna, Hospital de Jove (Spain)], E-mail: medicinainterna@hospitaldejove.com; Gonzalez, Luis O. [Unidad de Investigacion del, Hospital de Jove, Gijon (Spain)], E-mail: lovidiog@telefonica.net; Diez, M Cruz [Servicio de Cirugia General, Hospital de Jove (Spain)], E-mail: cirugiageneral@hospitaldejove.com; Venta, Rafael [Servicio de Analisis Clinicos, Hospital de San Agustin, Aviles (Spain); Departamento de Bioquimica y Biologia Molecular, Universidad de Oviedo (Spain)], E-mail: rafael.venta@sespa.princast.es; Vizoso, Francisco J. [Unidad de Investigacion del, Hospital de Jove, Gijon (Spain); Servicio de Cirugia General, Hospital de Jove (Spain); Instituto Universitario de Oncologia del Principado de Asturias, Oviedo (Spain)], E-mail: fjvizoso@telefonica.net

    2009-01-15

    To assess whether breast arterial calcifications (BAC) are associated with altered serum markers of cardiovascular risk, mammograms and records from 1759 women (age range: 45-65 years) screened for breast cancer were revised. One hundred and forty seven (8.36%) women showed BAC. A total of 136 women with BAC and controls (mean age: 57 and 55 years, respectively) accepted entering the study. There were no significant differences in serum levels of urea, glucose, uric acid, creatinine, total cholesterol, HDL-C, LDL-C, folic acid, vitamin B{sub 12}, TSH or cysteine, between both groups of patients. However, women with BAC showed higher serum levels of triglycerides (p = 0.006), homocysteine (p = 0.002) and hs-CRP (p = 0.003) than women without BAC. Likewise, we found a significantly higher percentage of cases with an elevated LDL-C/HDL-C ratio (coronary risk index >2) amongst women with BAC than in women without BAC (56.7 and 38.2%, respectively; p = 0.04). Our results indicate that the finding of BAC identify women showing altered serum markers of cardiovascular risk.

  9. Relationship between arterial vascular calcifications seen on screening mammograms and biochemical markers of endothelial injury

    International Nuclear Information System (INIS)

    Pidal, Diego; Sanchez Vidal, M Teresa; Rodriguez, Juan Carlos; Corte, M Daniela; Pravia, Paz; Guinea, Oscar; Pidal, Ivan; Bongera, Miguel; Escribano, Damaso; Gonzalez, Luis O.; Diez, M Cruz; Venta, Rafael; Vizoso, Francisco J.

    2009-01-01

    To assess whether breast arterial calcifications (BAC) are associated with altered serum markers of cardiovascular risk, mammograms and records from 1759 women (age range: 45-65 years) screened for breast cancer were revised. One hundred and forty seven (8.36%) women showed BAC. A total of 136 women with BAC and controls (mean age: 57 and 55 years, respectively) accepted entering the study. There were no significant differences in serum levels of urea, glucose, uric acid, creatinine, total cholesterol, HDL-C, LDL-C, folic acid, vitamin B 12 , TSH or cysteine, between both groups of patients. However, women with BAC showed higher serum levels of triglycerides (p = 0.006), homocysteine (p = 0.002) and hs-CRP (p = 0.003) than women without BAC. Likewise, we found a significantly higher percentage of cases with an elevated LDL-C/HDL-C ratio (coronary risk index >2) amongst women with BAC than in women without BAC (56.7 and 38.2%, respectively; p = 0.04). Our results indicate that the finding of BAC identify women showing altered serum markers of cardiovascular risk

  10. Avoidable surgical consultations in women with a positive screening mammogram: Experience from a southern region of the Dutch breast screening programme

    Energy Technology Data Exchange (ETDEWEB)

    Schreutelkamp, J.L., E-mail: schreutelkamp@home.nl [Department of Radiology, Atrium Medical Center Parkstad, Henri Dunantstraat 5, 6419 PC Heerlen (Netherlands); Kwee, R.M., E-mail: rmkwee@gmail.com [Department of Radiology, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht (Netherlands); Booij, M. de, E-mail: machiel_de_booij@hotmail.com [Department of Radiology, Atrium Medical Center Parkstad, Henri Dunantstraat 5, 6419 PC Heerlen (Netherlands); Adriaensen, M.E.A.P.M., E-mail: miraude@gmail.com [Department of Radiology, Atrium Medical Center Parkstad, Henri Dunantstraat 5, 6419 PC Heerlen (Netherlands)

    2014-03-15

    Introduction: According to current Dutch guidelines, all women with a positive screening mammogram are referred for a full hospital assessment, which includes surgical consultation and radiological assessment. Surgical consultation may be unnecessary for many patients. Our objective was to determine how often surgical consultations can be avoided by radiological pre-assessment. Materials and methods: All women with a positive screening mammogram, referred to our radiology department between 2002 and 2007, were included (n = 1014). Percentage of women that was downstaged to BI-RADS category 1 or 2 by radiological pre-assessment was calculated. Negative predictive value (NPV) for malignancy was estimated from the in-hospital follow-up, which was available up to September 2012. Results: 423 of 1014 women (42%) were downstaged to BI-RADS category 1 or 2 by radiological pre-assessment. During follow-up, 8 of these 423 women (2%) developed a malignancy in the same breast. At least 6 of these malignancies were located at a different location as the original screening findings which led to the initial referral. The estimated NPV for malignancy was 99.5% (95%CI, 98.3–99.9). Conclusion: By referring women with a positive screening mammogram to the radiology department for pre-assessment, a surgical consultation was avoided in 42%, with an estimated NPV of 99.5% for malignancy.

  11. Mammogram - calcifications

    Science.gov (United States)

    Microcalcifications or macrocalcifications; Breast cancer - calcifications; Mammography - calcifications ... breast lumps or cysts Past injury to the breast tissue Powders, ... Microcalcifications are tiny calcium specks seen on a mammogram. ...

  12. Application of support vector machines to breast cancer screening using mammogram and history data

    Science.gov (United States)

    Land, Walker H., Jr.; Akanda, Anab; Lo, Joseph Y.; Anderson, Francis; Bryden, Margaret

    2002-05-01

    Support Vector Machines (SVMs) are a new and radically different type of classifiers and learning machines that use a hypothesis space of linear functions in a high dimensional feature space. This relatively new paradigm, based on Statistical Learning Theory (SLT) and Structural Risk Minimization (SRM), has many advantages when compared to traditional neural networks, which are based on Empirical Risk Minimization (ERM). Unlike neural networks, SVM training always finds a global minimum. Furthermore, SVMs have inherent ability to solve pattern classification without incorporating any problem-domain knowledge. In this study, the SVM was employed as a pattern classifier, operating on mammography data used for breast cancer detection. The main focus was to formulate the best learning machine configurations for optimum specificity and positive predictive value at very high sensitivities. Using a mammogram database of 500 biopsy-proven samples, the best performing SVM, on average, was able to achieve (under statistical 5-fold cross-validation) a specificity of 45.0% and a positive predictive value (PPV) of 50.1% at 100% sensitivity. At 97% sensitivity, a specificity of 55.8% and a PPV of 55.2% were obtained.

  13. Risks of mammograms

    International Nuclear Information System (INIS)

    Swartz, H.M.; Reichling, B.A.

    1977-01-01

    In summary, the following practical guidelines for mammography are offered: 1. Any woman, regardless of age, with signs or symptoms that indicate breast cancer should have a mammogram. 2. A woman who has a high risk for breast cancer (e.g., strong family history, no pregnancy before 30 years of age, or a previous breast cancer) should receive periodic screening examinations, including mammography. 3. Periodic screening for asymptomatic women over the age of 50 is indicated. 4. The value of periodic screening for asymptomatic women who are not considered to be at high risk and are under the age of 50 years is not established. Such screening should be carried out only when useful data can be collected on the benefits and risks of this procedure. 5. For any individual woman, the risk of inducing breast cancer by mammography is very low. 6. Mammograms should be made only with modern equipment and techniques designed to provide optimum information with minimal dose

  14. Adverse Pregnancy Outcomes after Abnormal First Trimester Screening for Aneuploidy

    OpenAIRE

    Goetzl, Laura

    2010-01-01

    Women with abnormal first trimester screening but with a normal karyotype are at risk for adverse pregnancy outcomes. A nuchal translucency >3.5mm is associated with an increased risk of subsequent pregnancy loss, fetal infection, fetal heart abnormalities and other structural abnormalities. Abnormal first trimester analytes are also associated with adverse pregnancy outcomes but the predictive value is less impressive. As a single marker, PAPP-A

  15. Adverse Pregnancy Outcomes after Abnormal First Trimester Screening for Aneuploidy

    Science.gov (United States)

    Goetzl, Laura

    2010-01-01

    Women with abnormal first trimester screening but with a normal karyotype are at risk for adverse pregnancy outcomes. A nuchal translucency >3.5mm is associated with an increased risk of subsequent pregnancy loss, fetal infection, fetal heart abnormalities and other structural abnormalities. Abnormal first trimester analytes are also associated with adverse pregnancy outcomes but the predictive value is less impressive. As a single marker, PAPP-A screening with the possible addition of uterine artery PI assessment in the midtrimester. PMID:20638576

  16. More than just a mammogram: breast cancer screening perspectives of relatives of women with intellectual disability.

    Science.gov (United States)

    Greenwood, Nechama W; Dreyfus, Deborah; Wilkinson, Joanne

    2014-12-01

    Women with intellectual disability (ID) have similar rates of breast cancer as the general public, but higher breast cancer mortality and lower rates of regular screening mammography. Screening rates are lowest among women who live with their families. Though women with ID often make decisions in partnership with their relatives, we lack research related to family member perspectives on mammography. We conducted a qualitative study of family members of women with ID, with an interview guide focused on health care decision making and experiences, and breast cancer screening barriers, facilitators, and beliefs as related to their loved ones. Sixteen family members underwent semistructured interviews. Important themes included mammography as a reference point for other social and cultural concerns, such as their loved one's sexuality or what it means to be an adult woman; fear of having to make hard decisions were cancer to be diagnosed acting as a barrier to screening; a focus on quality of life; and desire for quality health care for their loved one, though quality care did not always equate to regular cancer screening. Adults with ID are valued members of their families, and their relatives are invested in their well-being. However, families fear the potentially complicated decisions associated with a cancer diagnosis and may choose to forgo screening due to misinformation and a focus on quality of life. Effective interventions to address disparities in mammography should focus on adults with ID and their families together, and incorporate the family context.

  17. Classification of normal screening mammograms is strongly influenced by perceived mammographic breast density.

    Science.gov (United States)

    Ang, Zoey Zy; Rawashdeh, Mohammad A; Heard, Rob; Brennan, Patrick C; Lee, Warwick; Lewis, Sarah J

    2017-08-01

    To investigate how breast screen readers classify normal screening cases using descriptors of normal mammographic features and to assess test cases for suitability for a single reading strategy. Fifteen breast screen readers interpreted a test set of 29 normal screening cases and classified them by firstly rating their perceived difficulty to reach a 'normal' decision, secondly identifying the cases' salient normal mammographic features and thirdly assessing the cases' suitability for a single reading strategy. The relationship between the perceived difficulty in making 'normal' decisions and the normal mammographic features was investigated. Regular ductal pattern (T b  = -0.439, P = 0.001), uniform density (T b  = -0.527, P normal' decisions. Cases with regular ductal pattern (T b  = 0.447, P = 0.002), uniform density (T b  = 0.550, P normal and hence their suitability for single reading. © 2017 The Royal Australian and New Zealand College of Radiologists.

  18. Characteristics of breast cancers detected by ultrasound screening in women with negative mammograms

    International Nuclear Information System (INIS)

    Bae, Min-Sun; Han, Wonshik; Koo, Hye-Ryoung

    2011-01-01

    Screening ultrasound (US) can increase the detection of breast cancer. However, little is known about the clinicopathologic characteristics of breast cancers detected by screening US. A search of the database for patients with breast cancer yielded a dataset in 6837 women who underwent breast surgery at Seoul National University Hospital (Korea). Of 6837 women, 1047 were asymptomatic and had a non-palpable cancer. Two hundred fifty-four women with 256 cancers detected by US (US-detected cancer) and 793 women with 807 cancers detected by mammography (MG-detected cancer) were identified. The imaging, clinicopathologic, and molecular data were reviewed. Univariate and multivariate analyses were carried out. Women with US-detected cancer were younger and were more likely to undergo breast-conserving surgery and to have node-negative invasive cancer (P 2 cm in size, tumors that were ≤1 cm in size were 2.2-fold more likely to be US-detected cancers (P=0.02). Compared to the luminal A subtype tumors (estrogen receptor [ER]+, PR+, HER2-), luminal B subtype tumors (ER+, PR+, HER2+) were less likely to be in the US-detected cancer group (P<0.01). Women with dense breasts were more likely to have US-detected cancer (P<0.01) versus those with non-dense breasts. Screening US-detected cancers were less likely to be diagnosed as category 5 instead of category 4 (P<0.01). In conclusion, women with US-detected breast cancer are more likely to have small-sized invasive cancer and more likely associated with the luminal A subtype. (author)

  19. Computer-Aided Evaluation of Screening Mammograms Based on Local Texture Models

    Czech Academy of Sciences Publication Activity Database

    Grim, Jiří; Somol, Petr; Haindl, Michal; Daneš, J.

    2009-01-01

    Roč. 18, č. 4 (2009), s. 765-773 ISSN 1057-7149 R&D Projects: GA ČR GA102/07/1594; GA ČR GA102/08/0593; GA MŠk 1M0572 Grant - others:GA MŠk(CZ) 2C06019 Institutional research plan: CEZ:AV0Z10750506 Keywords : Screening mammography * texture information * local statistical model * Gaussian mixture Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 2.848, year: 2009

  20. Computer-aided diagnosis for screening of breast cancer on mammograms. Current status and future potential

    International Nuclear Information System (INIS)

    Doi, Kunio

    2007-01-01

    Described are the history, current status and future potential of computer-aided diagnosis (CAD) with particular emphasis on screening mammography for breast cancer. The systematic basic and clinical studies on CAD started around 20 years before and the significance of CAD has been well recognized to be evident because of human errors occurring in the visual check by doctors of so numerous screening images. Improvement of diagnostic accuracy by CAD has been demonstrated by statistical analysis of ROC (receiver operating characteristic) curves. In mammography, reviewed is detection of the early stage breast cancer like microcalcifications by computer alone, by CAD plus one or more doctors' reading, and by practical clinical CAD diagnosis. For differential diagnosis for malignancy, microcalcifications and masses are given their characteristic image properties and the results are that the Az-value (area under ROC curve) is higher in CAD than in doctor's (0.80 vs 0.61) in the former and, doctor's (0.93) is improved by CAD to 0.96 in the latter masses. In this diagnosis, similar images in the digital database are useful and the database can learn by repeated input of individual data by neural network. Detection of the lesion and especially, its differential diagnosis will be more important in parallel to database development and CAD will be also useful for doctor' carrier as an educational mean. (R.T.)

  1. Communication Practices of Mammography Facilities and Timely Follow-up of a Screening Mammogram with a BI-RADS 0 Assessment.

    Science.gov (United States)

    Schapira, Marilyn M; Barlow, William E; Conant, Emily F; Sprague, Brian L; Tosteson, Anna N A; Haas, Jennifer S; Onega, Tracy; Beaber, Elisabeth F; Goodrich, Martha; McCarthy, Anne Marie; Herschorn, Sally D; Skinner, Celette Sugg; Harrington, Tory O; Geller, Berta

    2018-02-09

    The objective of this study was to evaluate the association of communication practices with timely follow-up of screening mammograms read as Breast Imaging Reporting and Data Systems (BI-RADS) 0 in the Population-based Research Optimizing Screening through Personalized Regimens (PROSPR) consortium. A radiology facility survey was conducted in 2015 with responses linked to screening mammograms obtained in 2011-2014. We considered timely follow-up to be within 15 days of the screening mammogram. Generalized estimating equation models were used to evaluate the association between modes of communication with patients and providers and timely follow-up, adjusting for PROSPR site, patient age, and race and ethnicity. The analysis included 34,680 mammography examinations with a BI-RADS 0 assessment among 28 facilities. Across facilities, 85.6% of examinations had a follow-up within 15 days. Patients in a facility where routine practice was to contact the patient by phone if follow-up imaging was recommended were more likely to have timely follow-up (odds ratio [OR] 4.63, 95% confidence interval [CI] 2.76-7.76), whereas standard use of mail was associated with reduced timely follow-up (OR 0.47, 95% CI 0.30-0.75). Facilities that had standard use of electronic medical records to report the need for follow-up imaging to a provider had less timely follow-up (OR 0.56, 95% CI 0.35-0.90). Facilities that routinely contacted patients by mail if they missed a follow-up imaging visit were more likely to have timely follow-up (OR 1.65, 95% CI 1.02-2.69). Our findings support the value of telephone communication to patients in relation to timely follow-up. Future research is needed to evaluate the role of communication in completing the breast cancer screening episode. Copyright © 2018. Published by Elsevier Inc.

  2. Screening human populations for abnormal radiosensitivity

    International Nuclear Information System (INIS)

    Gentner, N.E.; Morrison, D.P.

    1990-07-01

    A relatively rapid and inexpensive in vitro growback assay was developed that uses the irradiated versus the unirradiated re-growth responses of lymphoblastoid cell lines developed from individual donors as an estimator of donor radioresponse. The purpose of this project was to furnish an estimate of the proportion of strains derived from various study populations that may be regarded as exhibiting abnormal radioresponse. The emphasis in this study was on hypersensitivity, because of the known radiation-hypersensitivity and cancer proneness associated with the genetic disorder ataxia-telangiectasia. Using methods developed especially for survival analyses, the percentage of significantly hypersensitive responses was 5.5% in a donor population composed of ostensibly normal individuals. We also examined lines derived from an unselected cancer patient population. These were not enriched, compared to the reference normal population, for hypersensitive responses. We thus conclude that hypersensitivity in vitro is not associated with increased risk for spontaneous development of cancer. However, the failure to observe an association between hypersensitivity and spontaneous cancer does not preclude a correlation between such sensitivity and radiogenic cancer. At the present stage, we would caution against the application of this assay or related in vitro tests to the situation of an individual, as opposed to a population. While we have clear indications that hypersensitivity in vitro is associated with abnormal radioresponse in vivo, this study has identified sources of variation that must be understood before attempts are made to unambiguously attribute a particular type of radioresponse to an individual

  3. Application of support vector machines to breast cancer screening using mammogram and clinical history data

    Science.gov (United States)

    Land, Walker H., Jr.; McKee, Dan; Velazquez, Roberto; Wong, Lut; Lo, Joseph Y.; Anderson, Francis R.

    2003-05-01

    The objectives of this paper are to discuss: (1) the development and testing of a new Evolutionary Programming (EP) method to optimally configure Support Vector Machine (SVM) parameters for facilitating the diagnosis of breast cancer; (2) evaluation of EP derived learning machines when the number of BI-RADS and clinical history discriminators are reduced from 16 to 7; (3) establishing system performance for several SVM kernels in addition to the EP/Adaptive Boosting (EP/AB) hybrid using the Digital Database for Screening Mammography, University of South Florida (DDSM USF) and Duke data sets; and (4) obtaining a preliminary evaluation of the measurement of SVM learning machine inter-institutional generalization capability using BI-RADS data. Measuring performance of the SVM designs and EP/AB hybrid against these objectives will provide quantative evidence that the software packages described can generalize to larger patient data sets from different institutions. Most iterative methods currently in use to optimize learning machine parameters are time consuming processes, which sometimes yield sub-optimal values resulting in performance degradation. SVMs are new machine intelligence paradigms, which use the Structural Risk Minimization (SRM) concept to develop learning machines. These learning machines can always be trained to provide global minima, given that the machine parameters are optimally computed. In addition, several system performance studies are described which include EP derived SVM performance as a function of: (a) population and generation size as well as a method for generating initial populations and (b) iteratively derived versus EP derived learning machine parameters. Finally, the authors describe a set of experiments providing preliminary evidence that both the EP/AB hybrid and SVM Computer Aided Diagnostic C++ software packages will work across a large population of patients, based on a data set of approximately 2,500 samples from five different

  4. "Thanks for Letting Us All Share Your Mammogram Experience Virtually": Developing a Web-Based Hub for Breast Cancer Screening.

    Science.gov (United States)

    Galpin, Adam; Meredith, Joanne; Ure, Cathy; Robinson, Leslie

    2017-10-27

    The decision around whether to attend breast cancer screening can often involve making sense of confusing and contradictory information on its risks and benefits. The Word of Mouth Mammogram e-Network (WoMMeN) project was established to create a Web-based resource to support decision making regarding breast cancer screening. This paper presents data from our user-centered approach in engaging stakeholders (both health professionals and service users) in the design of this Web-based resource. Our novel approach involved creating a user design group within Facebook to allow them access to ongoing discussion between researchers, radiographers, and existing and potential service users. This study had two objectives. The first was to examine the utility of an online user design group for generating insight for the creation of Web-based health resources. We sought to explore the advantages and limitations of this approach. The second objective was to analyze what women want from a Web-based resource for breast cancer screening. We recruited a user design group on Facebook and conducted a survey within the group, asking questions about design considerations for a Web-based breast cancer screening hub. Although the membership of the Facebook group varied over time, there were 71 members in the Facebook group at the end point of analysis. We next conducted a framework analysis on 70 threads from Facebook and a thematic analysis on the 23 survey responses. We focused additionally on how the themes were discussed by the different stakeholders within the context of the design group. Two major themes were found across both the Facebook discussion and the survey data: (1) the power of information and (2) the hub as a place for communication and support. Information was considered as empowering but also recognized as threatening. Communication and the sharing of experiences were deemed important, but there was also recognition of potential miscommunication within online

  5. Maternal attitude towards first trimester screening for fetal abnormalities.

    Science.gov (United States)

    Maiz, Nerea; Burgos, Jorge; Barbazán, Maria José; Recio, Virginia; Martínez-Astorquiza, Txanton

    2016-05-01

    To explore the maternal attitude towards the screening for structural abnormalities at the 11-13-week scan, according to the severity of the abnormality. A secondary aim was to analyse which maternal characteristics influence in the maternal response. This is a descriptive study based on the responses to 300 self-administrated questionnaires completed immediately before routine ultrasounds scan. A totally of 296 (98.7%) women participated in the study. If the baby had any abnormality 93.9% would prefer to know at 12 weeks, 96.6% if the abnormality was lethal, 95.3% if the abnormality involves severe handicap, 91.2% if the abnormality can only be suspected, but not confirmed until the pregnancy is more advanced (16 or 20 weeks), 77.0% if the abnormality was minor and 79.4% women would like to know at 12 weeks if the baby appeared normal. Maternal age, gestational age at the time of the questionnaire and maternal attitude towards termination of pregnancy were the only factors affecting maternal responses. Pregnant women prefer to be informed in the first trimester about any abnormality in their fetuses, even in cases of minor or only suspected abnormalities. © 2016 John Wiley & Sons, Ltd. © 2016 John Wiley & Sons, Ltd.

  6. Non‐invasive prenatal screening for chromosomal abnormalities ...

    African Journals Online (AJOL)

    Non‐invasive prenatal screening for chromosomal abnormalities using circulating cell-free fetal DNA in maternal plasma: Current applications, limitations and ... fetal DNAtesting is a matter of concern, because of the low positive predictive value for these changes, and the associated significant cumulative false-positive rate.

  7. Ant-cuckoo colony optimization for feature selection in digital mammogram.

    Science.gov (United States)

    Jona, J B; Nagaveni, N

    2014-01-15

    Digital mammogram is the only effective screening method to detect the breast cancer. Gray Level Co-occurrence Matrix (GLCM) textural features are extracted from the mammogram. All the features are not essential to detect the mammogram. Therefore identifying the relevant feature is the aim of this work. Feature selection improves the classification rate and accuracy of any classifier. In this study, a new hybrid metaheuristic named Ant-Cuckoo Colony Optimization a hybrid of Ant Colony Optimization (ACO) and Cuckoo Search (CS) is proposed for feature selection in Digital Mammogram. ACO is a good metaheuristic optimization technique but the drawback of this algorithm is that the ant will walk through the path where the pheromone density is high which makes the whole process slow hence CS is employed to carry out the local search of ACO. Support Vector Machine (SVM) classifier with Radial Basis Kernal Function (RBF) is done along with the ACO to classify the normal mammogram from the abnormal mammogram. Experiments are conducted in miniMIAS database. The performance of the new hybrid algorithm is compared with the ACO and PSO algorithm. The results show that the hybrid Ant-Cuckoo Colony Optimization algorithm is more accurate than the other techniques.

  8. Toward the breast screening balance sheet: cumulative risk of false positives for annual versus biennial mammograms commencing at age 40 or 50.

    Science.gov (United States)

    Winch, Caleb J; Sherman, Kerry A; Boyages, John

    2015-01-01

    This study aimed to: (1) Estimate cumulative risk of recall from breast screening where no cancer is detected (a harm) in Australia; (2) Compare women screened annually versus biennially, commencing age 40 versus 50; and (3) Compare with international findings. At the no-cost metropolitan program studied, women attended biennial screening, but were offered annual screening if regarded at elevated risk for breast cancer. The cumulative risk of at least one recall was estimated using discrete-time survival analysis. Cancer detection statistics were computed. In total, 801,636 mammograms were undertaken in 231,824 women. Over 10 years, cumulative risk of recall was 13.3 % (95 % CI 12.7-13.8) for those screened biennially, and 19.9 % (CI 16.6-23.2) for those screened annually from age 50-51. Cumulative risk of complex false positive involving a biopsy was 3.1 % (CI 2.9-3.4) and 5.0 % (CI 3.4-6.6), respectively. From age 40-41, the risk of recall was 15.1 % (CI 14.3-16.0) and 22.5 % (CI 17.9-27.1) for biennial and annual screening, respectively. Corresponding rates of complex false positive were 3.3 % (CI 2.9-3.8) and 6.3 % (CI 3.4-9.1). Over 10 mammograms, invasive cancer was detected in 3.4 % (CI 3.3-3.5) and ductal carcinoma in situ in 0.7 % (CI 0.6-0.7) of women, with a non-significant trend toward a larger proportion of Tis and T1N0 cancers in women screened annually (74.5 %) versus biennially (70.1 %), χ (2) = 2.77, p = 0.10. Cancer detection was comparable to international findings. Recall risk was equal to European estimates for women screening from 50 and lower for screening from 40. Recall risk was half of United States' rates across start age and rescreening interval categories. Future benefit/harm balance sheets may be useful for communicating these findings to women.

  9. Screening for fetal chromosome abnormalities during the second trimester

    International Nuclear Information System (INIS)

    Dong Hui; Li Ming; Li Ping

    2005-01-01

    Objective: To develop a pre -natal screening program for fetal chromosome abnormalities based on risk values calculated from maternal serum markers levels during the second trimester. Methods: Serum levels of AFP, β-HCG, uE 3 were determined with CLIA in 1048 pregnant women during 14-21w gestation period and the results were analyzed with a specific software (screening program for Down' s syndrome developed by Beckman) for the risk rate. In those women defined as being of high risk rate, cells from amniotic fluid or umbilical cord blood were studied for karyotype analysis. Results: Of these 1048 women, 77 were designated as being of high risk rate for several chromosome abnormalities i.e. Down's syndrome, open spina bifida and trisomy -18 syndrome (overall positive rate 7.3%). Further fetal chromosome study in 31 of them revealed three proven cases of abnormality. Another cord blood study was performed in a calculated low risk rate case but with abnormal sonographic finding at 31 w gestation and proved to be abnormal (software study false negative). The remaining 46 high risk rate cases either refused future study (n=35) or were lost for follow-up (n=11). Fortunately, all the 35 women refused further study gave birth to normal babies without any chromosome abnormalities discovered on peripheral blood study. Besides, in a trial study, five high risk rate women were again evaluated a few weeks later but with tremendous difference between the results. Conclusion: The present program proves to be clinically useful but needs further study and revision. Many factors may influence the result of the analysis and the duration of gestation period in weeks should be as accurate as possible. At present, in order to avoid getting false negatives, we don't advise a second check in 'high risk' cases. (authors)

  10. How reassuring is a normal breast ultrasound in assessment of a screen-detected mammographic abnormality? A review of interval cancers after assessment that included ultrasound evaluation

    International Nuclear Information System (INIS)

    Bennett, M.L.; Welman, C.J.; Celliers, L.M.

    2011-01-01

    Aim: To review factors resulting in a false-negative outcome or delayed cancer diagnosis in women recalled for further evaluation, including ultrasound, after an abnormal screening mammogram. Materials and methods: Of 646,692 screening mammograms performed between 1 January 1995 and 31 December 2004, 34,533 women were recalled for further assessment. Nine hundred and sixty-four interval cancers were reported in this period. Forty-six of these women had been recalled for further assessment, which specifically included ultrasound evaluation in the preceding 24 months, and therefore, met the inclusion criteria for this study. Screening mammograms, further mammographic views, ultrasound scans, clinical findings, and histopathology results were retrospectively reviewed by two consultant breast radiologists. Results: The interval cancer developed in the contralateral breast (n = 9), ipsilateral breast, but different site (n = 6), and ipsilateral breast at the same site (n = 31) as the abnormality for which they had recently been recalled. In the latter group, 10 were retrospectively classified as a false-negative outcome, nine had a delay in obtaining a biopsy, and 12 had a delay due to a non-diagnostic initial biopsy. Various factors relating to these outcomes are discussed. Conclusion: Out of 34,533 women who attended for an assessment visit and the 46 women who subsequently developed an interval breast cancer, 15 were true interval cancers, 10 had a false-negative assessment outcome, and 21 had a delay to cancer diagnosis on the basis of a number of factors. When there is discrepancy between the imaging and histopathology results, a repeat biopsy rather than early follow-up would have avoided a delay in some cases. A normal ultrasound examination should not deter the radiologist from proceeding to stereotactic biopsy, if the index mammographic lesion is suspicious of malignancy.

  11. Evaluation of Abnormal Mammographic Findings in Initial Screening of 1000 Patients during 2008-2009 in Radiology Department of Imam Reza Hospital

    Directory of Open Access Journals (Sweden)

    Leili Rahimi

    2015-04-01

    Full Text Available Introduction: The aim of this study was to categorize abnormal mammographic findings in 1000 patients according to Breast Imaging-Reporting and Data System (BI-RADS and to report most common age of abnormal mammographic findings, average age of incidence of malignancy and determination of suitable age to start the screening process in women. Materials and Methods:1000 patients attending Radiology department for mammographic screening during 2007-2008 were asked to participate in this study. One radiologist evaluated the mammograms and categorized patients based on the BI-RADS. Results: The average age of patients diagnosed with invasive ductal carcinoma and in situ ductal carcinoma was 48±6.51years. The average age of patients in category 5 (that translates into “probably malignant” was (53±7.87 years. The average age of patients in other categories except for category 0 and category 1 that translates into “negative” was (52.07±7.81 years. There was also a significant relationship between patient’s age and BI-RADS categories according to findings of this study. Conclusion: Based on early incidence of irregular mammographies (52.07 years and early incidence of malignant findings in such mammographies (48± 6.51 years, it is suggested to implement screening programs in a great scale for patients older than 35 years old. Based on high percentage of patients with increased breast density findings in mammograms (11.6% and diagnosis of two cases with invasive ductal carcinoma in this group, we recommend sonography of patients with such findings to rule out the presence or absence of malignancy with a higher accuracy for which mammograms lack a diagnostic value.

  12. Computer-aided detection of masses in full-field digital mammography using screen-film mammograms for training

    International Nuclear Information System (INIS)

    Kallenberg, Michiel; Karssemeijer, Nico

    2008-01-01

    It would be of great value when available databases of screen-film mammography (SFM) images can be used to train full-field digital mammography (FFDM) computer-aided detection (CAD) systems, as compilation of new databases is costly. In this paper, we investigate this possibility. Firstly, we develop a method that converts an FFDM image into an SFM-like representation. In this conversion method, we establish a relation between exposure and optical density by simulation of an automatic exposure control unit. Secondly, we investigate the effects of using the SFM images as training samples compared to training with FFDM images. Our FFDM database consisted of 266 cases, of which 102 were biopsy-proven malignant masses and 164 normals. The images were acquired with systems of two different manufacturers. We found that, when we trained our FFDM CAD system with a small number of images, training with FFDM images, using a five-fold crossvalidation procedure, outperformed training with SFM images. However, when the full SFM database, consisting of 348 abnormal cases (including 204 priors) and 810 normal cases, was used for training, SFM training outperformed FFDMA training. These results show that an existing CAD system for detection of masses in SFM can be used for FFDM images without retraining.

  13. US Navy Women's Experience of an Abnormal Cervical Cancer Screening.

    Science.gov (United States)

    Braun, Lisa A; Kennedy, Holly Powell; Sadler, Lois S; Dixon, Jane; Womack, Julie; Wilson, Candy

    2016-01-01

    Recent policy revisions allow greater inclusion of military women in operational and/or deployable positions (ie, shipboard, overseas, and war zone duty assignments), but these positions can create unique health care challenges. Military members are often transient due to deployments and change of duty stations, impacting timely follow-up care for treatable health conditions. There has been minimal research on challenges or strategies in preventive health screening and follow-up for US military women. The purpose of this qualitative research study was to describe US Navy women's experiences with abnormal cervical cancer screenings requiring colposcopic follow-up care. Ship- and shored-based women receiving care at a military colposcopy clinic completed interviews about their experience. Two forms of narrative analysis, Labov's sociolinguistic structural analysis and Braun and Clarke's thematic analysis, were employed to gain a more robust understanding of the women's experiences. The sample was comprised of 26 women (16 ship-based, 10 shore-based). Five themes were identified: 1) It's like this bombshell (initial abnormal results notification); 2) I didn't understand (self-discovery process); 3) Freaked (emotional toll); 4) It's kind of like this back and forth (scheduling and navigating care); and 5) It really opened my eyes (lessons learned). The women's stories highlighted some issues unique to military health care, such as operational demands and follow-up care; other issues are likely common for most women learning about an abnormal cervical cancer screening result. Areas important for practice and future research include improving notification practices, providing information, understanding women's fear, and continuity of care. Research exploring educational initiatives and self-management practices are critical within military populations. © 2016 by the American College of Nurse-Midwives.

  14. Trends in screening mammograms for women 50 years of age and older - behavioral risk factor surveillance system, 1987

    International Nuclear Information System (INIS)

    Anon.

    1989-01-01

    To assess whether the media attention to breast cancer screening and the promotional efforts in 1987 were paralleled by increases in screening of women greater than or equal to 50 years of age, CDC analyzed data from 33 states that participated in the 1987 Behavioral Risk Factor Surveillance System (BRFSS)

  15. Computer-aided detection of breast cancer on mammograms: a swarm intelligence optimized wavelet neural network approach.

    Science.gov (United States)

    Dheeba, J; Albert Singh, N; Tamil Selvi, S

    2014-06-01

    Breast cancer is the second leading cause of cancer death in women. Accurate early detection can effectively reduce the mortality rate caused by breast cancer. Masses and microcalcification clusters are an important early signs of breast cancer. However, it is often difficult to distinguish abnormalities from normal breast tissues because of their subtle appearance and ambiguous margins. Computer aided diagnosis (CAD) helps the radiologist in detecting the abnormalities in an efficient way. This paper investigates a new classification approach for detection of breast abnormalities in digital mammograms using Particle Swarm Optimized Wavelet Neural Network (PSOWNN). The proposed abnormality detection algorithm is based on extracting Laws Texture Energy Measures from the mammograms and classifying the suspicious regions by applying a pattern classifier. The method is applied to real clinical database of 216 mammograms collected from mammogram screening centers. The detection performance of the CAD system is analyzed using Receiver Operating Characteristic (ROC) curve. This curve indicates the trade-offs between sensitivity and specificity that is available from a diagnostic system, and thus describes the inherent discrimination capacity of the proposed system. The result shows that the area under the ROC curve of the proposed algorithm is 0.96853 with a sensitivity 94.167% of and specificity of 92.105%. Copyright © 2014. Published by Elsevier Inc.

  16. Computer-assisted reading of mammograms

    Energy Technology Data Exchange (ETDEWEB)

    Karssemeijer, N. [Department of Radiology, University Hospital Nijmegen, P. O. Box 9101, Nijmegen, NL-6500 HB (Netherlands); Hendriks, J.H.C.L. [Department of Radiology, University Hospital Nijmegen, P. O. Box 9101, Nijmegen, NL-6500 HB (Netherlands)

    1997-06-01

    Techniques developed in computer vision and automated pattern recognition can be applied to assist radiologists in reading mammograms. With the introduction of direct digital mammography this will become a feasible approach. A radiologist in breast cancer screening can use findings of the computer as a second opinion, or as a pointer to suspicious regions. This may increase the sensitivity and specificity of screening programs, and it may avoid the need for double reading. In this paper methods which have been developed for automated detection of mammographic abnormalities are reviewed. Programs for detecting microcalcification clusters and stellate lesions have reached a level of performance which makes application in practice viable. Current programs for recognition of masses and asymmetry perform less well. Large-scale studies still have to demonstrate if radiologists in a screening situation can deal with the relatively large number of false positives which are marked by computer programs, where the number of normal cases is much higher than in observer experiments conducted thus far. (orig.). With 4 figs.

  17. MAMMOGRAMS ANALYSIS USING SVM CLASSIFIER IN COMBINED TRANSFORMS DOMAIN

    Directory of Open Access Journals (Sweden)

    B.N. Prathibha

    2011-02-01

    Full Text Available Breast cancer is a primary cause of mortality and morbidity in women. Reports reveal that earlier the detection of abnormalities, better the improvement in survival. Digital mammograms are one of the most effective means for detecting possible breast anomalies at early stages. Digital mammograms supported with Computer Aided Diagnostic (CAD systems help the radiologists in taking reliable decisions. The proposed CAD system extracts wavelet features and spectral features for the better classification of mammograms. The Support Vector Machines classifier is used to analyze 206 mammogram images from Mias database pertaining to the severity of abnormality, i.e., benign and malign. The proposed system gives 93.14% accuracy for discrimination between normal-malign and 87.25% accuracy for normal-benign samples and 89.22% accuracy for benign-malign samples. The study reveals that features extracted in hybrid transform domain with SVM classifier proves to be a promising tool for analysis of mammograms.

  18. Screening for chromosomal abnormalities by first trimester combined screening and noninvasive prenatal testing.

    Science.gov (United States)

    Kagan, K O; Hoopmann, M; Hammer, R; Stressig, R; Kozlowski, P

    2015-02-01

    To examine combined first trimester screening (FTS), noninvasive prenatal testing (NIPT) and a two-step policy that combines FTS and NIPT in screening for aneuploidy. Retrospective study involving 21,052 pregnancies where FTS was performed at the Praxis Praenatal.de in Duesseldorf, Germany. In each case, the sum risk of trisomy 21, 18 and 13 was computed. We assumed that NIPT detects 99 %, 98 %, 90 % and 99 % of cases with trisomy 21, 18, 13 and sex chromosomal abnormalities and that the false-positive rate is 0.5 %. The following screening policies were examined: NIPT or FTS with sum risk cut-offs of 1 in 50 and 1 in 250 in all patients or a two-step-policy with FTS in all patients followed by NIPT in the intermediate sum risk group. For the intermediate risk group, sum risk cut-offs of 1 in 50 and 1 in 1000 and 1 in 150 and 1 in 500 were used. There were 127, 34, 13 and 15 pregnancies with trisomy 21, 18, 13 and sex chromosomal abnormalities. 23 fetuses had other chromosomal abnormalities with an increased risk for adverse outcome that are not detectable by NIPT. 20,840 pregnancies were classified as normal as ante- and postnatal examinations did not show any signs of clinically significant chromosomal abnormalities. FTS with a sum risk cut-off of 1 in 50 and 1 in 250 detects 81 % and 91 % for all aneuploidies. NIPT detects 88 % of the respective pregnancies. The 2-step approach with sum risk cut-offs of 1 in 50 and 1 in 1000 detects 94 % of all aneuploidies. With sum risk cut-offs of 1 in 150 and 1 in 500, the detection rate is 93 %. A 2-step policy with FTS for all patients and NIPT in the intermediate risk group results in the highest detection rate of all aneuploidies. © Georg Thieme Verlag KG Stuttgart · New York.

  19. Abnormal ovarian cancer screening test result: women's informational, psychological and practical needs.

    Science.gov (United States)

    Ryan, Patricia Y; Graves, Kristi D; Pavlik, Edward J; Andrykowski, Michael A

    2007-01-01

    Considerable effort has been devoted to the identification of cost-effective approaches to screening for ovarian cancer (OC). Transvaginal ultrasound (TVS) is one such screening approach. Approximately 5-7% of routine TVS screening tests yield abnormal results. Some women experience significant distress after receipt of an abnormal TVS screening test. Four focus groups provided in-depth, qualitative data regarding the informational, psychological, and practical needs of women after the receipt of an abnormal TVS result. Through question and content analytic procedures, we identified four themes: anticipation, emotional response, role of the screening technician, and impact of prior cancer experiences. Results provide initial guidance toward development of interventions to promote adaptive responses after receipt of an abnormal cancer screening test result.

  20. Health Beliefs and Breast Cancer Screening in Rural Appalachia: An Evaluation of the Health Belief Model.

    Science.gov (United States)

    VanDyke, Santana D; Shell, Madelynn D

    2017-09-01

    This study explored the role of the Health Belief Model in predicting breast cancer screening among women in rural Appalachia. Health beliefs (perceived susceptibility to breast cancer, severity of breast cancer, and benefits and barriers to screening) were used to predict health behavior (mammogram frequency). A total of 170 women aged 18-78 were recruited at a free health clinic in central Appalachia. Women completed surveys that assessed demographic characteristics, mammogram frequency, and perceived susceptibility, severity, and benefits and barriers to mammography. Consistent with expectations, women with objectively elevated risks for breast cancer (history of abnormal mammograms or family history of breast cancer) perceived themselves to be at higher risk for breast cancer, and those with a history of abnormal mammograms were more likely to receive mammograms regularly. In addition, older women expected their prognosis to be marginally poorer following a diagnosis, perceived greater benefits and fewer barriers to mammography, and were significantly more likely to receive mammograms regularly. Consistent with the Health Belief Model, fewer perceived barriers to mammography predicted greater mammogram frequency. However, the model was not fully supported because perceived susceptibility, severity, and benefits to mammography did not predict mammogram frequency. Results highlight the importance of reducing real and perceived barriers to screening in order to improve mammography rates among rural populations. © 2016 National Rural Health Association.

  1. Screening for ocular abnormalities and subnormal vision in school ...

    African Journals Online (AJOL)

    Background: As in most African countries there is no national preschool or school eye screening service in Ethiopia. The purpose of this study was to conduct school eye screening in Butajira town to identify the causes of ocular morbidity and subnormal vision in school children and suggest possible intervention strategies.

  2. Prevalence of Abnormal Cervical Smears from Sporadic Screening ...

    African Journals Online (AJOL)

    The aim of the study was to find the prevalence of abnormal smears in an unscreened population of sexually active women attending a gynaecological clinic. “Pap” smears were taken sporadically for cytological examination from sexually active women attending gynaecological clinics at the Federal Medical Centre Gombe.

  3. Computer aided detection system for micro calcifications in digital mammograms.

    Science.gov (United States)

    Mohamed, Hayat; Mabrouk, Mai S; Sharawy, Amr

    2014-10-01

    Breast cancer continues to be a significant public health problem in the world. Early detection is the key for improving breast cancer prognosis. Mammogram breast X-ray is considered the most reliable method in early detection of breast cancer. However, it is difficult for radiologists to provide both accurate and uniform evaluation for the enormous mammograms generated in widespread screening. Micro calcification clusters (MCCs) and masses are the two most important signs for the breast cancer, and their automated detection is very valuable for early breast cancer diagnosis. The main objective is to discuss the computer-aided detection system that has been proposed to assist the radiologists in detecting the specific abnormalities and improving the diagnostic accuracy in making the diagnostic decisions by applying techniques splits into three-steps procedure beginning with enhancement by using Histogram equalization (HE) and Morphological Enhancement, followed by segmentation based on Otsu's threshold the region of interest for the identification of micro calcifications and mass lesions, and at last classification stage, which classify between normal and micro calcifications 'patterns and then classify between benign and malignant micro calcifications. In classification stage; three methods were used, the voting K-Nearest Neighbor classifier (K-NN) with prediction accuracy of 73%, Support Vector Machine classifier (SVM) with prediction accuracy of 83%, and Artificial Neural Network classifier (ANN) with prediction accuracy of 77%. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. Difficulties in evaluating abnormal lead screening results in children.

    Science.gov (United States)

    Block, B; Szekely, K; Escobar, M

    1996-01-01

    This report chronicles efforts to provide follow-up care for children with abnormal whole blood lead concentrations using the 1991 Centers for Disease Control and Prevention (CDC) guidelines in the Family Health Center at Shadyside Hospital in Pittsburgh. An automated surveillance module found all children with abnormal lead concentrations obtained between January 1994 and July 1995 and singled out children who were overdue for follow-up. Automated physician reminders and nursing case management were used to improve care and documentation. Longitudinal case summaries were used to evaluate care. All 99 children with a lead concentration of 10 micrograms/dL or greater had a documented follow-up plan. Twenty-nine children (47 percent) who had a lead concentration of 10 to 14 micrograms/dL, 23 (100 percent) who had a lead concentration of 15 to 19 micrograms/dL, and 8 (100 percent) who had a lead concentration of 20 micrograms/dL or greater had at least one follow-up lead concentration measurement by the end of the data collection in July 1995. Follow-up was incomplete in more than 70 percent of children. Nineteen children (19 percent) with initially abnormal lead concentrations had follow-up testing with persistently normal results. The yearly cost of follow-up was $15,888, with only 7 children requiring county health environmental intervention. The nurse-centered, computer-aided system improved follow-up care of children with abnormal lead concentrations, but most patients still did not receive mandated follow-up testing because of logistic obstacles. The effort and cost associated with CDC-mandated follow-up of children with lead concentrations between 10 and 19 micrograms/dL provides no apparent benefit and might detract from the care of children at higher risk.

  5. PRENATAL DIAGNOSIS AND SCREENING OF GENETIC ABNORMALITIES IN EARLY PREGNANCY

    Directory of Open Access Journals (Sweden)

    Jyothi Kiran Kohli

    2016-11-01

    Full Text Available BACKGROUND Genetic diseases are one of the major causes of hospital admissions due to disability and mortality particularly among children (1:5 children of hospital admission either partially/completely as distribution of genetic diseases is not related to socioeconomic background, which implies that developing world has a large number of genetic diseases largely left uncared for, i.e. overall incidence of foetal/neonatal loss due to genetic/genetic environmental causes are as follows: 1:50 newborns have major congenital abnormality, 1:100 have a unifactorial disorder, 1:200 have a major chromosomal abnormality before birth. Diagnosis of chromosomal anomalies in foetus is one of the most important challenges in modern perinatology as invasive or noninvasive methods. The aim of the study is to review on cytogenetic evaluation of CVS obtained (transcervically during first trimester of pregnancy by direct karyotyping of tissue. MATERIALS AND METHODS This study was conducted in 2001 in Department of Anatomy along with Obstetrics and Gynaecology Department, LNJP Hospital. 37 healthy cases with 6-12 weeks of gestational age coming for medical termination of pregnancy were included in the study. After written informed consent for procedure, ultrasound-guided transcervical chorionic villus sampling was done (Brambati’s method. Tissue procured was then processed for direct karyotyping and studied. Metaphase spreads were photographed and karyotypes prepared and studied. RESULTS Out of 37 pregnant females, 30 samples were successfully prepared and processed by Direct method out of which 23 were normal female (46, XX and 7 were normal male (46, XY. No normal anomaly was detected. Best biopsies were obtained with 8-12 weeks gestation. G Banding could not be performed as chromosome obtained were found to be resistant to banding. CONCLUSIONS To summarise chromosome preparations obtained from CVS by Direct method has advantage of providing sufficient number

  6. Adverse pregnancy outcomes after abnormal first-trimester screening for aneuploidy.

    Science.gov (United States)

    Goetzl, Laura

    2010-09-01

    Women with abnormal results of first trimester screening but with a normal karyotype are at risk for adverse pregnancy outcomes. A nuchal translucency of greater than 3.5 mm is associated with an increased risk of subsequent pregnancy loss, fetal infection, fetal heart abnormalities, and other structural abnormalities. Abnormal levels of first trimester analytes are also associated with adverse pregnancy outcomes, but the predictive value is less impressive. As a single marker, pregnancy-associated plasma protein (PAPP)-A level less than 1st percentile has a good predictive value for subsequent fetal growth restriction. Women with PAPP-A level less than 5th percentile should undergo subsequent risk assessment with routine maternal serum afetoprotein screening with the possible addition of uterine artery pulsatility index assessment in the midtrimester. Copyright 2010 Elsevier Inc. All rights reserved.

  7. Having a mammogram: how does it feel?

    International Nuclear Information System (INIS)

    Poulos, Ann

    2004-01-01

    Understanding women's responses to having a mammogram is important for radiographers and other health professionals. These responses are also essential for determining descriptors in rating scales used in research studies. The purpose of this reported study was to determine whether discomfort or pain is an appropriate descriptor for the mammography experience. An appropriate descriptor is essential so that accurate information can be provided to women undergoing mammography as well as to health professionals who encourage women to attend for breast screening by mammography. The study also aimed to explore the components of this descriptor by asking the women to identify perceived differences between discomfort and pain as they related to having a mammogram. From these differences a precise description of how it feels to have a mammogram was constructed. Thirty women attending for routine breast screening at BreastScreen NSW Central and Eastern Sydney participated in the study and were given a questionnaire which focussed on their perceptions of the pain/discomfort of the mammography experience. The results suggested that discomfort is a more appropriate descriptor of the mammography experience. Categorisation of the perceived differences between discomfort and pain revealed important new information for mammographic practice. Copyright (2004) Australian Institute of Radiography

  8. Cervical cancer: developments in screening and evaluation of the abnormal Pap smear.

    OpenAIRE

    Walsh, J M

    1998-01-01

    Of the more than 50 million Pap smears performed annually in the United States, about 5% of them are abnormal. Although the need for treatment of high-grade lesions is clear, the appropriate management of low-grade lesions remains controversial. New methods of screening for cervical cancer have become available, including testing for the human papilloma virus and improved methods of administering and evaluating the Pap smear. This review addresses new developments in cervical cancer screening...

  9. New screen on the block: non-invasive prenatal testing for fetal chromosomal abnormalities.

    Science.gov (United States)

    Filoche, Sara; Lawton, Beverley; Beard, Angela; Dowell, Anthony; Stone, Peter

    2017-12-01

    Non-invasive prenatal testing (NIPT) is a new screen for fetal chromosomal abnormalities. It is a screening test based on technology that involves the analysis of feto-placental DNA that is present in maternal blood. This DNA is then analysed for abnormalities of specific chromosomes (eg 13, 18, 21, X, Y). NIPT has a much higher screening capability for chromosomal abnormalities than current combined first trimester screening, with ~99% sensitivity for trisomy 21 (Down syndrome) and at least a 10-fold higher positive predictive value. The low false-positive rate (1-3%) is one of the most advertised advantages of NIPT. In practice, this could lead to a significant reduction in the number of false-positive tests and the need for invasive diagnostic procedures. NIPT is now suitable for singleton and twin pregnancies and can be performed from ~10 weeks in a pregnancy. NIPT is not currently publicly funded in most countries. However, the increasing availability of NIPT commercially will likely lead to an increase in demand for this as a screening option. Given the high numbers of women who visit a general practitioner (GP) in their first trimester, GPs are well-placed to also offer NIPT as a screening option. A GP's role in facilitating access to this service will likely be crucial in ensuring equity in access to this technology, and it is important to ensure that they are well supported to do so.

  10. Age Specific Cytological Abnormalities in Women Screened for Cervical Cancer in the Emirate of Abu Dhabi.

    Science.gov (United States)

    Al Zaabi, Muna; Al Muqbali, Shaikha; Al Sayadi, Thekra; Al Ameeri, Suhaila; Coetsee, Karin; Balayah, Zuhur; Ortashi, Osman

    2015-01-01

    Cervical cancer is the second most common cancer in women worldwide, with about 500,000 new cases and 270,000 deaths each year. Globally, it is estimated that over one million women currently have cervical cancer, most of whom have not been diagnosed, or have no access to treatment that could cure them or prolong their lives. In the United Arab Emirates (UAE) cervical cancer is the third most common cancer in women. A population-based cross-sectional retrospective survey of cervical smear abnormalities was conducted in the Emirate of Abu Dhabi, UAE, from January 2013 to December 2013 by collecting consecutive liquid-based cytology samples from the Department of Pathology at the SKMC Hospital in Abu Dhabi city. The total number of women screened for cervical cancer for the year 2013 at SKMC was 4,593, with 225 (4.89%) abnormal smears. The majority of the abnormal smear results were atypical squamous cells of undetermined significance (ASCUS) 114 (2.48%). This study showed 60% increase in the rate of abnormal cervical smears in the UAE over the last 10 years. In this study the highest incidence of high grade abnormalities were seen in women above the age of 61 years (1.73%), this might be due to the fact that this group of women missed the chance of screening of cervical cancer earlier in their lives or could be explained by the well-known second peak of HPV infection seen in many prevalence studies. We conclude that the rate of abnormal cervical smear in the screened Abu Dhabi women is not different from the rate in developed countries. A notable increase in both low and high grade abnormalities has occurred within the last decade.

  11. Probability of an Abnormal Screening PSA Result Based on Age, Race, and PSA Threshold

    Science.gov (United States)

    Espaldon, Roxanne; Kirby, Katharine A.; Fung, Kathy Z.; Hoffman, Richard M.; Powell, Adam A.; Freedland, Stephen J.; Walter, Louise C.

    2014-01-01

    Objective To determine the distribution of screening PSA values in older men and how different PSA thresholds affect the proportion of white, black, and Latino men who would have an abnormal screening result across advancing age groups. Methods We used linked national VA and Medicare data to determine the value of the first screening PSA test (ng/mL) of 327,284 men age 65+ who underwent PSA screening in the VA healthcare system in 2003. We calculated the proportion of men with an abnormal PSA result based on age, race, and common PSA thresholds. Results Among men age 65+, 8.4% had a PSA >4.0ng/mL. The percentage of men with a PSA >4.0ng/mL increased with age and was highest in black men (13.8%) versus white (8.0%) or Latino men (10.0%) (PPSA >4.0ng/mL ranged from 5.1% of Latino men age 65–69 to 27.4% of black men age 85+. Raising the PSA threshold from >4.0ng/mL to >10.0ng/mL, reclassified the greatest percentage of black men age 85+ (18.3% absolute change) and the lowest percentage of Latino men age 65–69 (4.8% absolute change) as being under the biopsy threshold (PPSA threshold together affect the pre-test probability of an abnormal screening PSA result. Based on screening PSA distributions, stopping screening among men whose PSA 10ng/ml has the greatest effect on reducing the number of older black men who will face biopsy decisions after screening. PMID:24439009

  12. A fuzzy rule-based approach for characterization of mammogram masses into BI-RADS shape categories.

    Science.gov (United States)

    Vadivel, A; Surendiran, B

    2013-05-01

    We present new geometric shape and margin features for classifying mammogram mass lesions into BI-RADS shape categories: round, oval, lobular and irregular. According to Breast Imaging Reporting and Data System (BIRADS), masses can be differentiated using its shape, size and density, which is how radiologist visualizes the mammograms. Measuring regular and irregular shapes mathematically is found to be a difficult task, since there is no single measure available to differentiate various shapes. It is known that for mammograms, shape features are superior to Haralick and wavelet based features. Various geometrical shape and margin features have been introduced based on maximum and minimum radius of mass to classify the morphology of masses. These geometric features are found to be good in discriminating regular shapes from irregular shapes. In this paper, each mass is described by shape feature vector consists of 17 shape and margin properties. The masses are classified into 4 categories such as round, oval, lobular and irregular. Classifying masses into 4 categories is a very difficult task compared to classifying masses as benign, malignant or normal vs. abnormal. Only shape and margin characteristics can be used to discriminate these 4 categories effectively. Experiments have been conducted on mammogram images from the Digital Database for Screening Mammography (DDSM) and classified using C5.0 decision tree classifier. Total of 224 DDSM mammogram masses are considered for experiment. The C5.0 decision tree algorithm is used to generate simple rules, which can be easily implemented and used in fuzzy inference system as if…then…else statements. The rules are used to construct the generalized fuzzy membership function for classifying the masses as round, oval, lobular or irregular. Proposed approach is twice effective than existing Beamlet based features for classifying the mass as round, oval, lobular or irregular. Copyright © 2013 Elsevier Ltd. All rights

  13. Radiological findings of screen-detected cancers in a multi-centre randomized, controlled trial of mammographic screening in women from age 40 to 48 years

    Energy Technology Data Exchange (ETDEWEB)

    Evans, A.J. [Breast Institute, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB (United Kingdom)]. E-mail: aevans@ncht.trent.nhs.uk; Kutt, E. [Avon Breast Cancer Screening Unit, Central Health Clinic, Tower Hill, Bristol, Avon (United Kingdom); Record, C. [Buckinghamshire Hospitals NHS Trust, Breast Screening Service, Stoke Mandeville Hospital, Mandeville Road, Aylesbury (United Kingdom); Waller, M. [Cancer Screening Evaluation Unit, Institute of Cancer Research, London (United Kingdom); Moss, S. [Cancer Screening Evaluation Unit, Institute of Cancer Research, London (United Kingdom)

    2006-09-15

    Aim: To elucidate the mammographic findings of screen-detected cancers in women screened between 40-48 years, and to establish the frequency and nature of abnormal findings on previous mammograms in women with screen-detected cancers. Methods: A radiology review panel consisting of three experienced breast radiologists viewed the screening mammograms in chronological order, confirming that any abnormalities detected corresponded to the cancers detected at later screens. An analysis correlating mammographic features with median invasive size and the proportion measuring less than 10 and 15 mm was performed. Results: Two hundred and thirty-two women had screen-detected invasive cancers with mammograms available for review. The most frequent features seen at diagnosis were spiculate mass, ill-defined mass, granular calcification, deformity and comedo calcification. Thirty-four percent of mammograms showed calcification. The mammographic sign associated with smallest median size was calcification. Calcification was also the mammographic abnormality most frequently associated with cancers <10 mm in size. In total there were 147 abnormal previous screens of 87 women. The most commonly missed features were granular microcalcification, deformity and ill-defined mass. Of the missed abnormalities 20% were classified as malignant, 43% as subtle change and 32% as non-specific. Conclusion: Compared with older women, screen-detected cancer in younger women more commonly manifests as calcification and less frequently a spiculate mass. Calcification is the sign most frequently associated with invasive cancers <10 mm in size. Calcification and deformity are the signs most frequently seen on the previous mammograms of women with screen-detected cancer.

  14. Validation of the Healthy Foot Screen: A Novel Assessment Tool for Common Clinical Abnormalities.

    Science.gov (United States)

    Persaud, Reneeka; Coutts, Patricia M; Brandon, Alisa; Verma, Luvneet; Elliott, James A; Sibbald, R Gary

    2018-04-01

    The purpose of this learning activity is to provide information about the Healthy Foot Screen, a new tool for assessment of common foot abnormalities. This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. After completing this continuing education activity, you should be able to:1. Recognize prevalence, causes, risk factors, signs, and types of common foot problems.2. Identify the results of this study about the new foot screening tool and its implications in primary care. Foot health is a key component of general health and well-being. Nevertheless, feet are often overlooked by healthcare providers and patients. Common foot problems include infections or inflammatory conditions, abnormal nail disorders (eg, onychomycosis), structural bony abnormalities, circulation disorders, and other conditions. The development of an easy-to-use, rapid, clinical tool to assess foot health can facilitate primary care provider recognition and treatment of common foot problems. This study ascertained interrater item reliability and validity from the preliminary version of one such tool called the Healthy Foot Screen.A total of 18 patients from a community dermatology clinic were individually screened by 11 interprofessional healthcare assessors using the preliminary tool. The assessors included a dermatologist/internist, family physicians, nurses, and podiatrists. The initial draft of the Healthy Foot Screen was created through an extensive literature review, complemented by the clinical judgment of the study team. Cronbach α was calculated for each item to determine interrater reliability. A minimum value of 0.6 was set for an item to be included in the final tool. Where applicable, scores for each item on the screen were calculated for right and left lower limbs and then averaged. Assessors were asked to complete a short survey.Interrater reliability scores for items on the

  15. Principles of first trimester screening in the age of non-invasive prenatal diagnosis: screening for chromosomal abnormalities.

    Science.gov (United States)

    Kagan, Karl Oliver; Sonek, Jiri; Wagner, Philipp; Hoopmann, Markus

    2017-10-01

    First trimester risk assessment for chromosomal abnormalities plays a major role in the contemporary pregnancy care. It has evolved significantly since its introduction in the 1990s, when it essentially consisted of just the nuchal translucency measurement. Today, it involves the measurement of several biophysical and biochemical markers and it is often combined with a cell-free DNA (cfDNA) analysis as a secondary test. A search of the Medline and Embase databases was done looking for articles about first trimester aneuploidy screening. We performed a detailed review of the literature to evaluate the screening tests currently available and their respective test performance. Combined screening for trisomy 21 based on maternal age, fetal NT, and the serum markers free beta-hCG and PAPP-A results in a detection rate of about 90% for a false positive of 3-5%. With the addition of further ultrasound markers, the false positive rate can be roughly halved. Screening based on cfDNA identifies about 99% of the affected fetuses for a false positive rate of 0.1%. However, there is a test failure rate of about 2%. The ideal combination between combined and cfDNA screening is still under discussion. Currently, a contingent screening policy seems most favorable where combined screening is offered for everyone and cfDNA analysis only for those with a borderline risk result after combined screening. Significant advances in screening for trisomy 21 have been made over the past 2 decades. Contemporary screening policies can detect for more than 95% of affected fetuses for false positive rate of less than 3%.

  16. Should previous mammograms be digitised in the transition to digital mammography?

    International Nuclear Information System (INIS)

    Taylor-Phillips, S.; Gale, A.G.; Wallis, M.G.

    2009-01-01

    Breast screening specificity is improved if previous mammograms are available, which presents a challenge when converting to digital mammography. Two display options were investigated: mounting previous film mammograms on a multiviewer adjacent to the workstation, or digitising them for soft copy display. Eight qualified screen readers were videotaped undertaking routine screen reading for two 45-min sessions in each scenario. Analysis of gross eye and head movements showed that when digitised, previous mammograms were examined a greater number of times per case (p=0.03), due to a combination of being used in 19% more cases (p=0.04) and where used, looked at a greater number of times (28% increase, p=0.04). Digitising previous mammograms reduced both the average time taken per case by 18% (p=0.04) and the participants' perceptions of workload (p < 0.05). Digitising previous analogue mammograms may be advantageous, in particular in increasing their level of use. (orig.)

  17. Should previous mammograms be digitised in the transition to digital mammography?

    Energy Technology Data Exchange (ETDEWEB)

    Taylor-Phillips, S.; Gale, A.G. [Loughborough University, Applied Vision Research Centre, Leicestershire (United Kingdom); Wallis, M.G. [Addenbrooke' s Hospital, Cambridge Breast Unit, Cambridge (United Kingdom)

    2009-08-15

    Breast screening specificity is improved if previous mammograms are available, which presents a challenge when converting to digital mammography. Two display options were investigated: mounting previous film mammograms on a multiviewer adjacent to the workstation, or digitising them for soft copy display. Eight qualified screen readers were videotaped undertaking routine screen reading for two 45-min sessions in each scenario. Analysis of gross eye and head movements showed that when digitised, previous mammograms were examined a greater number of times per case (p=0.03), due to a combination of being used in 19% more cases (p=0.04) and where used, looked at a greater number of times (28% increase, p=0.04). Digitising previous mammograms reduced both the average time taken per case by 18% (p=0.04) and the participants' perceptions of workload (p < 0.05). Digitising previous analogue mammograms may be advantageous, in particular in increasing their level of use. (orig.)

  18. The frequent shift to intermediate flora in preterm delivery cases after abnormal vaginal flora screening

    Science.gov (United States)

    Honda, Hiroshi; Yokoyama, Takanori; Akimoto, Yumiko; Tanimoto, Hirotoshi; Teramoto, Mitsue; Teramoto, Hideki

    2014-01-01

    The effect of screening and treatment for abnormal vaginal flora on the reduction of preterm deliveries remains controversial. We evaluated whether this screening and treatment reduces the preterm delivery rate for general-population pregnant women. Pregnant women of the Intervention group (n = 574) underwent the screening test and the treatment of vaginal metronidazole during the early second trimester, and those of the Control group (n = 1,161) did not. We compared the preterm delivery rate between these two groups. We also compared the profiles of vaginal flora of the preterm delivery cases with those of the pregnant women with a normal course. There was no significant difference in the preterm delivery rate between these two groups. However, in the preterm delivery cases, a frequent shift to intermediate flora was observed not before but after the screening in the Intervention group. This shift may explain why most of the previous studies failed in regard to the prevention of preterm deliveries. PMID:24762852

  19. Cross-validation of a psychometric system for screening neuropsychological abnormality in older children.

    Science.gov (United States)

    Boyd, T A; Tramontana, M G; Hooper, S R

    1986-01-01

    The Discriminant Equation (DE) represents a recently developed system for screening neuropsychological abnormality in older children. The DE was subjected to cross-validation on a sample of 82 child and adolescent psychiatric patients referred for a comprehensive neuropsychological assessment. An overall hit rate of 79.3% correct classification was found which supported the validity of the DE in predicting neuropsychological impairment. The findings are discussed in relation to population characteristics and the nature of the criterion to be predicted as they may affect the application of neuropsychological screening procedures.

  20. Computerized detection of mass lesions in digital mammograms

    International Nuclear Information System (INIS)

    Yin, F.F.; Giger, M.L.; Doi, K.; Metz, C.E.; Vyborny, C.J.; Schmidt, R.A.

    1989-01-01

    Early detection of breast cancer from the periodic screening of asymptomatic women could reduce breast cancer mortality by at least 40%. The authors are developing a computerized scheme for the detection of mass lesions in digital mammograms as an aid to radiologists in such high volume screening programs. Based on left-right architectural symmetry and gray-level histogram analysis, bilateral subtraction of left and right breast images is performed. False-positive detections included in bilateral-difference images are reduced with various images feature-extraction techniques. The database involves clinical film mammograms digitized by a TV camera and analyzed on a Micro-VAX workstation. Among five different bilateral subtraction techniques investigated, a nonlinear approach provided superior lesion enhancement. Feature-extraction techniques reduced substantially the remaining false-positives. Preliminary results, for 32 pairs of clinical mammograms, yielded a true-positive rate of approximately 95% with a false-positive rate of about 2 per image

  1. Screening for urine abnormalities among preschool children in western Saudi Arabia

    Science.gov (United States)

    Alharthi, Abdulla A.; Taha, Azza A.; Edrees, Awatif E.; Elnawawy, Ali N.; Abdelrahman, Azza H.

    2014-01-01

    Objectives: To estimate the frequency of urinary problems among preschool children. Methods: In this cross-sectional study, 1000 preschool asymptomatic children attending the outpatient clinics of the Children’s Hospital, Taif, Kingdom of Saudi Arabia between August 2013 and December 2013 were subjected to dipstick urine analysis. Microscopic examination was performed for the abnormal dipstick samples, and children with hematuria were investigated for kidney function. Results: Dipstick urine analysis revealed abnormal findings in 25.1% of the screened children. The most common dipstick abnormalities were positive nitrite test in 18.1%, hematuria in 16.9%, and positive leukocyte esterase test in 14.3% of the cases. The most common abnormality in microscopic urine examination was crystals in 13% of the cases. Pyuria were evident in 5% of cases and hematuria in 2.5%. The most common bacteria in positive urine culture samples was Escherichia coli in 62.6%. Conclusion: In view of these important findings, dipstick screening should be implemented in preschool children. PMID:25491212

  2. Tandem mass spectrometry newborn screening for inborn errors of intermediary metabolism: abnormal profile interpretation.

    Science.gov (United States)

    Fernández-Lainez, C; Aguilar-Lemus, J J; Vela-Amieva, M; Ibarra-González, I

    2012-01-01

    Expanded newborn screening for inherited metabolic disorders using tandem mass spectrometry was introduced in 1990's and is widely used around the world. In contrast to conventional screening methods, tandem mass spectrometry does not measure single analytes but identifies and quantifies metabolite profiles; one single blood spot analyzed provides information of about 60 metabolites including amino acids, acylcarnitines and related ratios that enable the diagnosis of approximately 50 different diseases. However, the interpretation of these profiles can become quite complex. The aim of this work is to present in an easy and practical manner a comprehensive compilation of information needed for tandem mass neonatal screening profile interpretation, and basic actions for immediate follow up of abnormal results, including the tests that are required for confirmatory purposes. Other conditions not attributable to metabolic disorders which can lead to an abnormal profile of these markers are also described as well as a series of general recommendations which would be useful for health professionals who are beginning newborn screening for inborn errors of intermediary metabolism using tandem mass spectrometry.

  3. Follow-up of abnormal or inadequate test results in the Danish Cervical Cancer Screening Program

    DEFF Research Database (Denmark)

    Kristiansen, Bettina Kjær

    2014-01-01

    Denmark has a higher incidence of cervical cancer than other Nordic countries, although all Danish women (aged 23–65) are screened regularly to identify possible cervical dysplasia or asymptomatic invasive cancer. Annually 40 000 women receives an abnormal or inadequate test result and a follow......-up recommendation. However problems with delayed follow-up may threaten the effectiveness of the Danish Cervical Cancer Screening Program, as 20% of women are delayed and dysplasia potentially can progress into cancer. Delayed follow-up is found in situations where women either consciously or unconsciously postpone...... will be of great importance to the future organisation of cervical and colorectal cancer screening programmes in Denmark, but will also have international interest because of their similar challenges....

  4. Using Natural Language Processing to Extract Abnormal Results From Cancer Screening Reports.

    Science.gov (United States)

    Moore, Carlton R; Farrag, Ashraf; Ashkin, Evan

    2017-09-01

    Numerous studies show that follow-up of abnormal cancer screening results, such as mammography and Papanicolaou (Pap) smears, is frequently not performed in a timely manner. A contributing factor is that abnormal results may go unrecognized because they are buried in free-text documents in electronic medical records (EMRs), and, as a result, patients are lost to follow-up. By identifying abnormal results from free-text reports in EMRs and generating alerts to clinicians, natural language processing (NLP) technology has the potential for improving patient care. The goal of the current study was to evaluate the performance of NLP software for extracting abnormal results from free-text mammography and Pap smear reports stored in an EMR. A sample of 421 and 500 free-text mammography and Pap reports, respectively, were manually reviewed by a physician, and the results were categorized for each report. We tested the performance of NLP to extract results from the reports. The 2 assessments (criterion standard versus NLP) were compared to determine the precision, recall, and accuracy of NLP. When NLP was compared with manual review for mammography reports, the results were as follows: precision, 98% (96%-99%); recall, 100% (98%-100%); and accuracy, 98% (96%-99%). For Pap smear reports, the precision, recall, and accuracy of NLP were all 100%. Our study developed NLP models that accurately extract abnormal results from mammography and Pap smear reports. Plans include using NLP technology to generate real-time alerts and reminders for providers to facilitate timely follow-up of abnormal results.

  5. Automated System for Early Breast Cancer Detection in Mammograms

    Science.gov (United States)

    Bankman, Isaac N.; Kim, Dong W.; Christens-Barry, William A.; Weinberg, Irving N.; Gatewood, Olga B.; Brody, William R.

    1993-01-01

    The increasing demand on mammographic screening for early breast cancer detection, and the subtlety of early breast cancer signs on mammograms, suggest an automated image processing system that can serve as a diagnostic aid in radiology clinics. We present a fully automated algorithm for detecting clusters of microcalcifications that are the most common signs of early, potentially curable breast cancer. By using the contour map of the mammogram, the algorithm circumvents some of the difficulties encountered with standard image processing methods. The clinical implementation of an automated instrument based on this algorithm is also discussed.

  6. Current controversies in prenatal diagnosis 2: Cell-free DNA prenatal screening should be used to identify all chromosome abnormalities.

    Science.gov (United States)

    Chitty, Lyn S; Hudgins, Louanne; Norton, Mary E

    2018-02-01

    Noninvasive prenatal testing (NIPT) using cell-free DNA (cfDNA) from maternal serum has been clinically available since 2011. This technology has revolutionized our ability to screen for the common aneuploidies trisomy 21 (Down syndrome), trisomy 18, and trisomy 13. More recently, clinical laboratories have offered screening for other chromosome abnormalities including sex chromosome abnormalities and copy number variants (CNV) without little published data on the sensitivity, specificity, and positive predictive value. In this debate, the pros and cons of performing prenatal screening via cfDNA for all chromosome abnormalities is discussed. At the time of the debate in 2017, the general consensus was that the literature does not yet support using this technology to screen for all chromosome abnormalities and that education is key for both providers and the patients so that the decision-making process is as informed as possible. © 2018 John Wiley & Sons, Ltd.

  7. Early Detection of Breast Cancer on Mammograms Using: Perceptual Feedback, Computer Processed Images and Ultrasound

    National Research Council Canada - National Science Library

    Bloch, Peter

    1996-01-01

    ... (as predicted by the gaze duration), enhanced the detectability or masses. (2) Computer processing of screening mammograms for detection of clusters of microcalcifications and parenchyma patterns associated with developing lesions...

  8. Decision support system for breast cancer detection using mammograms.

    Science.gov (United States)

    Ganesan, Karthikeyan; Acharya, Rajendra U; Chua, Chua K; Min, Lim C; Mathew, Betty; Thomas, Abraham K

    2013-07-01

    Mammograms are by far one of the most preferred methods of screening for breast cancer. Early detection of breast cancer can improve survival rates to a greater extent. Although the analysis and diagnosis of breast cancer are done by experienced radiologists, there is always the possibility of human error. Interobserver and intraobserver errors occur frequently in the analysis of medical images, given the high variability between every patient. Also, the sensitivity of mammographic screening varies with image quality and expertise of the radiologist. So, there is no golden standard for the screening process. To offset this variability and to standardize the diagnostic procedures, efforts are being made to develop automated techniques for diagnosis and grading of breast cancer images. This article presents a classification pipeline to improve the accuracy of differentiation between normal, benign, and malignant mammograms. Several features based on higher-order spectra, local binary pattern, Laws' texture energy, and discrete wavelet transform were extracted from mammograms. Feature selection techniques based on sequential forward, backward, plus-l-takeaway-r, individual, and branch-and-bound selections using the Mahalanobis distance criterion were used to rank the features and find classification accuracies for combination of several features based on the ranking. Six classifiers were used, namely, decision tree classifier, fisher classifier, linear discriminant classifier, nearest mean classifier, Parzen classifier, and support vector machine classifier. We evaluated our proposed methodology with 300 mammograms obtained from the Digital Database for Screening Mammography and 300 mammograms from the Singapore Anti-Tuberculosis Association CommHealth database. Sensitivity, specificity, and accuracy values were used to compare the performances of the classifiers. Our results show that the decision tree classifier demonstrated an excellent performance compared to

  9. Cellphone based mobile colposcope for the evaluation of women with abnormal cervical cancer screening

    Science.gov (United States)

    Kahn, Bruce S.; Kass, Alex J.; Waalen, Jill; Levitz, David

    2015-03-01

    Objective: Compare an inexpensive cell-phone based Mobile Colposcope, with a standard colposcope in the evaluation of women with abnormal Pap smear screening. Methodology: The study was a prospective, parallel noninferiority trial. Thirty women underwent colposcopy for the evaluation of an abnormal Pap smear. After application of acetic acid, images of the cervix were obtained with both a standard colposcope and the Mobile Colposcope. An additional set of images using both devices were obtained using the red-free (green filter) mode. Eight experienced gynecologists then evaluated 100 paired images (plain and green filter) from two different sites in random order using a web based assessment program. After reviewing each set of paired images, the expert would make an assessment of: 1) normal (no biopsy/ random biopsy), or 2) abnormal. For abnormal images, the expert then electronically marked the site(s) on the image where a biopsy was recommended. In image analysis, the cervical image was divided into 12 radial sectors and the marked sites for biopsy on the matched pairs were compared. Matched pairs that were considered normal, or those where biopsy site recommendations were within +/- 30° were considered equivalent; unmatched biopsy sites were considered non-equivalent. Results were compared using Wilcoxon Matched Pairs Signed Ranks Test. Expert assessment of Mobile Colposcope images compared with assessment by standard colposcope is currently onging. Conclusions: if the Mobile Colposcope demonstrates non-inferiority to imaging obtained with a standard colposcope and due to its low cost, it has the potential help improve cervical cancer screening in low resource settings.

  10. Screening outcomes in older US women undergoing multiple mammograms in community practice: does interval, age, or comorbidity score affect tumor characteristics or false positive rates?

    Science.gov (United States)

    Braithwaite, Dejana; Zhu, Weiwei; Hubbard, Rebecca A; O'Meara, Ellen S; Miglioretti, Diana L; Geller, Berta; Dittus, Kim; Moore, Dan; Wernli, Karen J; Mandelblatt, Jeanne; Kerlikowske, Karla

    2013-03-06

    Background Uncertainty exists about the appropriate use of screening mammography among older women because comorbid illnesses may diminish the benefit of screening. We examined the risk of adverse tumor characteristics and false positive rates according to screening interval, age, and comorbidity. Methods From January 1999 to December 2006, data were collected prospectively on 2993 older women with breast cancer and 137 949 older women without breast cancer who underwent mammography at facilities that participated in a data linkage between the Breast Cancer Surveillance Consortium and Medicare claims. Women were aged 66 to 89 years at study entry to allow for measurement of 1 year of preexisting illnesses. We used logistic regression analyses to calculate the odds of advanced (IIb, III, IV) stage, large (>20 millimeters) tumors, and 10-year cumulative probability of false-positive mammography by screening frequency (1 vs 2 years), age, and comorbidity score. The comorbidity score was derived using the Klabunde approximation of the Charlson score. All statistical tests were two-sided. Results Adverse tumor characteristics did not differ statistically significantly by comorbidity, age, or interval. Cumulative probability of a false-positive mammography result was higher among annual screeners than biennial screeners irrespective of comorbidity: 48.0% (95% confidence interval [CI] = 46.1% to 49.9%) of annual screeners aged 66 to 74 years had a false-positive result compared with 29.0% (95% CI = 28.1% to 29.9%) of biennial screeners. Conclusion Women aged 66 to 89 years who undergo biennial screening mammography have similar risk of advanced-stage disease and lower cumulative risk of a false-positive recommendation than annual screeners, regardless of comorbidity.

  11. Breast cancer screening

    Science.gov (United States)

    Mammogram - breast cancer screening; Breast exam - breast cancer screening; MRI - breast cancer screening ... performed to screen women to detect early breast cancer when it is more likely to be cured. ...

  12. Evaluation of mammogram compression efficiency

    International Nuclear Information System (INIS)

    Przelaskowski, A.; Surowski, P.; Kukula, A.

    2005-01-01

    Lossy image coding significantly improves performance over lossless methods, but a reliable control of diagnostic accuracy regarding compressed images is necessary. The acceptable range of compression ratios must be safe with respect to as many objective criteria as possible. This study evaluates the compression efficiency of digital mammograms in both numerically lossless (reversible) and lossy (irreversible) manner. Effective compression methods and concepts were examined to increase archiving and telediagnosis performance. Lossless compression as a primary applicable tool for medical applications was verified on a set 131 mammograms. Moreover, nine radiologists participated in the evaluation of lossy compression of mammograms. Subjective rating of diagnostically important features brought a set of mean rates given for each test image. The lesion detection test resulted in binary decision data analyzed statistically. The radiologists rated and interpreted malignant and benign lesions, representative pathology symptoms, and other structures susceptible to compression distortions contained in 22 original and 62 reconstructed mammograms. Test mammograms were collected in two radiology centers for three years and then selected according to diagnostic content suitable for an evaluation of compression effects. Lossless compression efficiency of the tested coders varied, but CALIC, JPEG-LS, and SPIHT performed the best. The evaluation of lossy compression effects affecting detection ability was based on ROC-like analysis. Assuming a two-sided significance level of p=0.05, the null hypothesis that lower bit rate reconstructions are as useful for diagnosis as the originals was false in sensitivity tests with 0.04 bpp mammograms. However, verification of the same hypothesis with 0.1 bpp reconstructions suggested their acceptance. Moreover, the 1 bpp reconstructions were rated very similarly to the original mammograms in the diagnostic quality evaluation test, but the

  13. ELM BASED CAD SYSTEM TO CLASSIFY MAMMOGRAMS BY THE COMBINATION OF CLBP AND CONTOURLET

    Directory of Open Access Journals (Sweden)

    S Venkatalakshmi

    2017-05-01

    Full Text Available Breast cancer is a serious life threat to the womanhood, worldwide. Mammography is the promising screening tool, which can show the abnormality being detected. However, the physicians find it difficult to detect the affected regions, as the size of microcalcifications is very small. Hence it would be better, if a CAD system can accompany the physician in detecting the malicious regions. Taking this as a challenge, this paper presents a CAD system for mammogram classification which is proven to be accurate and reliable. The entire work is decomposed into four different stages and the outcome of a phase is passed as the input of the following phase. Initially, the mammogram is pre-processed by adaptive median filter and the segmentation is done by GHFCM. The features are extracted by combining the texture feature descriptors Completed Local Binary Pattern (CLBP and contourlet to frame the feature sets. In the training phase, Extreme Learning Machine (ELM is trained with the feature sets. During the testing phase, the ELM can classify between normal, malignant and benign type of cancer. The performance of the proposed approach is analysed by varying the classifier, feature extractors and parameters of the feature extractor. From the experimental analysis, it is evident that the proposed work outperforms the analogous techniques in terms of accuracy, sensitivity and specificity.

  14. What women want. Women's preferences for the management of low-grade abnormal cervical screening tests: a systematic review

    DEFF Research Database (Denmark)

    Frederiksen, Maria Eiholm; Lynge, E; Rebolj, M

    2012-01-01

    Pap smears. In all but two studies testing other situations, women more often expressed a preference for active follow-up than for observation; however, women appeared to be somewhat more willing to accept observation if reassured of the low risk of cervical cancer. Conclusions Even for low......Please cite this paper as: Frederiksen M, Lynge E, Rebolj M. What women want. Women's preferences for the management of low-grade abnormal cervical screening tests: a systematic review. BJOG 2011; DOI: 10.1111/j.1471-0528.2011.03130.x. Background If human papillomavirus (HPV) testing will replace...... cytology in primary cervical screening, the frequency of low-grade abnormal screening tests will double. Several available alternatives for the follow-up of low-grade abnormal screening tests have similar outcomes. In this situation, women's preferences have been proposed as a guide for management...

  15. Abnormal TREC-Based Newborn Screening Test in a Premature Neonate with Massive Perivillous Fibrin Deposition of the Placenta

    Directory of Open Access Journals (Sweden)

    Stefan Kostadinov

    2016-01-01

    Full Text Available Severe combined immunodeficiency (SCID, a primary immunodeficiency arising from variable defects in lymphocyte development and survival, is characterized by significant deficiency of thymus derived (T- lymphocytes and variable defects in the B-lymphocyte population. Newborn screening for SCID is based on detection of low numbers of T-cell receptor excision circles (TRECs by real time quantitative PCR (RT-qPCR. This screening allows for early identification of individuals with SCID and other disorders characterized by T-lymphopenia. Higher rates of abnormal screens are commonly seen in premature and critically ill neonates, often representing false positives. It is possible that many abnormal screens seen in these populations are result of conditions that are characterized by systemic inflammation or stress, possibly in the context of stress-induced thymic involution. We present a case of a male infant delivered at 27 weeks, 6 days of gestation, with severe intrauterine growth restriction who had an abnormal TREC screen and a massive perivillous fibrin deposition (MPFD of the placenta. This association has not been reported previously. We are raising the awareness to the fact that conditions, such as MPFD, that can create adverse intrauterine environment are capable of causing severe stress-induced thymic involution of the fetus which can present with abnormal TREC results on newborn screening.

  16. Comparison of transvagianl ultrasonography with hysterosonography as a screening method in patients with abnormal uterine bleeding

    International Nuclear Information System (INIS)

    Ryu, Jeong Ah; Kim, Bo Hyun; Lee, Jong Mee; Kim, Soo Ah; Lee, Sang Hoon

    2004-01-01

    To assess the utility of hysterosonography (HS) as a screening method in patients with abnormal uterine bleeding. We retrospectively reviewed transvaginal ultrasonography (TVS) and HS for 105 patients whose diagnosis was confirmed pathologically. All 105 patients were initially evaluated on the same day with both TVS and HS. On TVS and HS examination. endometrial cavitary lesions were classified as diffuse hyperplasis, endometrial polyp, endometrial cancer, uterine synechia and submucosal leiomyoma. Hysteroscopy with biopsy (n=35), curettage (n=60) or hysterectomy (n=10) was performed, and the results of TVS and HS examination were correlated with the pathological findings. The sensitivity and specificity were 79.0% and 45.8% for TVS, and 95.1% and 83.3% for HS, respectively. The positive and negative predictive values were 83.0% and 39.3% for TVS, and 95.1% and 83.3% for HS, respectively. Twenty-seven showed a discrepancy between the TVS and HS, and eight cases showed a discrepancy between HS and the pathologic diagnosis. TVS is a sensitive method to evaluate the endometrial cavitary lesions, but it often does not provide the physician with sufficient diagnostic information. With its higher sensitivities, specificities and positive and negative predictive values, HS can be better used than TVS in evaluating those patients with abnormal uterine bleeding

  17. Comparison of transvagianl ultrasonography with hysterosonography as a screening method in patients with abnormal uterine bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Jeong Ah; Kim, Bo Hyun; Lee, Jong Mee; Kim, Soo Ah [Sungkyunkwan University, Seoul (Korea, Republic of); Lee, Sang Hoon [University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2004-03-15

    To assess the utility of hysterosonography (HS) as a screening method in patients with abnormal uterine bleeding. We retrospectively reviewed transvaginal ultrasonography (TVS) and HS for 105 patients whose diagnosis was confirmed pathologically. All 105 patients were initially evaluated on the same day with both TVS and HS. On TVS and HS examination. endometrial cavitary lesions were classified as diffuse hyperplasis, endometrial polyp, endometrial cancer, uterine synechia and submucosal leiomyoma. Hysteroscopy with biopsy (n=35), curettage (n=60) or hysterectomy (n=10) was performed, and the results of TVS and HS examination were correlated with the pathological findings. The sensitivity and specificity were 79.0% and 45.8% for TVS, and 95.1% and 83.3% for HS, respectively. The positive and negative predictive values were 83.0% and 39.3% for TVS, and 95.1% and 83.3% for HS, respectively. Twenty-seven showed a discrepancy between the TVS and HS, and eight cases showed a discrepancy between HS and the pathologic diagnosis. TVS is a sensitive method to evaluate the endometrial cavitary lesions, but it often does not provide the physician with sufficient diagnostic information. With its higher sensitivities, specificities and positive and negative predictive values, HS can be better used than TVS in evaluating those patients with abnormal uterine bleeding.

  18. Results of a pilot programme of mammographic breast cancer screening in the Western Cape.

    Science.gov (United States)

    Apffelstaedt, J P; Hattingh, R; Baatjes, K; Wessels, N

    2014-04-01

    Mammographic screening programmes are now established in developing countries. We present an analysis of the first screening programme in sub-Saharan Africa. Women aged > or = 40 years were identified at three primary healthcare centres in the Western Cape Province, South Africa, and after giving informed consent underwent mammography at a mobile unit. After a single reading, patients with American College of Radiology Breast Imaging Reporting and Data System (BIRADS) 3 - 5 lesions were referred to a tertiary centre for further management. Between 1 February 2011 and 31 August 2012, 2 712 screening mammograms were performed. A total of 261 screening mammograms were reported as BIRADS 3 - 5 (recall rate 9.6%). Upon review of the 250 available screening mammograms, 58 (23%) were rated benign or no abnormalities (BIRADS 1 and 2) and no further action was taken. In 32 women, tissue was acquired (biopsy rate for the series 1.2%); 10 cancers were diagnosed (biopsy malignancy rate 31%). For the entire series of 2 712 screening mammograms, the cancer diagnosis rate was 3.7/1 000 examinations. Of 10 cancers diagnosed at screening, 5 were TNM clinical stage 0, 2 stage I and 3 stage II. The low cancer detection rate achieved, and the technical and multiple administrative problems experienced do not justify installation of a screening programme using the model utilised in this series.

  19. Is screening for abnormal ECG patterns justified in long-term follow-up of childhood cancer survivors treated with anthracyclines?

    NARCIS (Netherlands)

    Pourier, M.S.; Mavinkurve-Groothuis, A.M.C.; Loonen, J.J.; Bokkerink, J.P.M.; Roeleveld, N.; Beer, G.; Bellersen, L.; Kapusta, L.

    2017-01-01

    BACKGROUND: ECG and echocardiography are noninvasive screening tools to detect subclinical cardiotoxicity in childhood cancer survivors (CCSs). Our aims were as follows: (1) assess the prevalence of abnormal ECG patterns, (2) determine the agreement between abnormal ECG patterns and

  20. Fibrocystic change of breast : relation with parenchymal pattern on mammogram and fibroadenoma

    International Nuclear Information System (INIS)

    Lee, Ki Yeol; Cha, In Ho; Kang, Eun Young; Kim, Jung Hyuk

    1996-01-01

    To determine the relationship between fibrocystic change and parenchymal pattern and fibroadenoma on mammogram. Mammograms of 135 patients with histologically- diagnosed fibrocystic disease after excisional biopsy were retrospectively analyzed and correlated with pathologic specimens. Classification of the parenchymal pattern was based on Wolfe's method. On mammogram, we observed abnormality in 88 out of the 135 cases;these latter consisted of 70 cases of DY, 30 of P2, 20 of P1, and 15 of Nl, following Wolfe's parenchymal patterns. Among the 88 abnormal cases we obseved 37 cases of mass with clear boundaries, five cases of mass with unclear boundaries, 22 with clustered microcalcifications, six with macrocalcifications and 18 with asymmetric dense breast. Histologic examination revealed a varying composition of stromal fibrosis, epithelial hyperplasia,cyst formation, apocrine metaplasia, etc. Histologically fibroadenomatoid change in 18 cases was appeared as a radiopaque mass on mammogram, especially in those cases where the change was well-defined, which were all except three. Fibrocystic disease was prevalent in Wolfe's P2 and DY patterns(about 80%). About 40% of fibrocystic change appearing as a well defined mass on mammogram showed fibroadenomatoid chage histologically and was difficult to differentiate from fibroadenoma. Fibrocystic disease should therefore be included in the differential diagnosis of a mass which on mammogram is well-defined

  1. Fibrocystic change of breast : relation with parenchymal pattern on mammogram and fibroadenoma

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ki Yeol; Cha, In Ho; Kang, Eun Young; Kim, Jung Hyuk [Korea Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-10-01

    To determine the relationship between fibrocystic change and parenchymal pattern and fibroadenoma on mammogram. Mammograms of 135 patients with histologically- diagnosed fibrocystic disease after excisional biopsy were retrospectively analyzed and correlated with pathologic specimens. Classification of the parenchymal pattern was based on Wolfe's method. On mammogram, we observed abnormality in 88 out of the 135 cases;these latter consisted of 70 cases of DY, 30 of P2, 20 of P1, and 15 of Nl, following Wolfe's parenchymal patterns. Among the 88 abnormal cases we obseved 37 cases of mass with clear boundaries, five cases of mass with unclear boundaries, 22 with clustered microcalcifications, six with macrocalcifications and 18 with asymmetric dense breast. Histologic examination revealed a varying composition of stromal fibrosis, epithelial hyperplasia,cyst formation, apocrine metaplasia, etc. Histologically fibroadenomatoid change in 18 cases was appeared as a radiopaque mass on mammogram, especially in those cases where the change was well-defined, which were all except three. Fibrocystic disease was prevalent in Wolfe's P2 and DY patterns(about 80%). About 40% of fibrocystic change appearing as a well defined mass on mammogram showed fibroadenomatoid chage histologically and was difficult to differentiate from fibroadenoma. Fibrocystic disease should therefore be included in the differential diagnosis of a mass which on mammogram is well-defined.

  2. Diagnostic accuracy of commercial system for computer-assisted detection (CADx) as an adjunct to interpretation of mammograms

    International Nuclear Information System (INIS)

    Menna, Sabatino; Di Virgilio, Maria Rosaria; Burke, Paolo; Frigerio, Alfonso; Boglione, Elisa; Ciccarelli, Grazia; Di Filippo, Sabato; Garretti, Licia

    2005-01-01

    Purpose. To evaluate the diagnostic accuracy of the commercial computer-aided detection CADx system for the reading of mammograms. Materials and methods. The study assessed the Second Look system developed and marketed by CADx Medical Systems, Montreal, Canada. The diagnostic sensitivity was evaluated by means of a retrospective study on 98 consecutive cancers detected at screening by double independent reading. The specificity and the positive predictive value (PPV) for cancer of the CADx system were prospectively evaluated on a second group of 560 consecutive mammograms of asymptomatic women not included in screening program. The radiologist who was present during the test assessed the abnormal mammographic findings by one or more of the following diagnostic procedures: physical examination, additional mammographic detail views with or without magnification,ultrasonography, ultrasound- or mammography guided fine needle aspiration cytology, and core-biopsy. The exams first underwent conventional reading and then a second reading carried out with the aid of the CADx system. Results.The overall diagnostic sensitivity of the CADx system on the 98 screening cancers was 81.6%; in particular it was 89.3% for calcifications, 83.9% for masses and only 37.5% for architectural distortion. The CADx markings for each mammography were 4.7 on average. Identification of invasive carcinoma was independent from tumour size. In the second group of 560 mammograms, the CADx system marked all cases identified as positive by conventional reading and confirmed by biopsy (7/7), but did not permit the detection of any additional cancer. The CADx markings per exam were 4.2 on average, the specificity was 13.7% and the PPV was 0.55% versus 13.7% recall rate of conventional reading. CADx reading led to a 1.96% (11/560) increase of the women necessitating further diagnostic investigation. Conclusions. The results of our study show that the diagnostic sensitivity of the CADx system is lower

  3. Pap smear screening, pap smear abnormalities and psychosocial risk factors among women in a residential alcohol and drug rehabilitation facility.

    Science.gov (United States)

    Soccio, Jacqui; Brown, Margaret; Comino, Elizabeth; Friesen, Emma

    2015-12-01

    To compare rates of late- screening, abnormal Pap smears and prevalence of psychosocial factors for cervical cancer between women in the community and women attending a residential drug and alcohol facility. Women with drug and alcohol addiction experience higher rates of abnormal Pap smears, late- or under- screening and psychosocial risk factors including domestic violence and sexual assault. A descriptive cross-sectional study of women attending publically funded women's health clinics in the community or in a live-in residential drug and alcohol rehabilitation facility. The study was approved in May 2012. Data were collected between October 2012-December 2013 using standardized women's health questionnaires, domestic violence screening tools and Pap smear tests. Women attending the rehabilitation facility had higher rates of abnormal Pap smears (16·7% vs. 1·6%) and self-reported history of abnormal Pap smears (44·4% vs. 20·6%). They also reported higher rates of smoking (72·2% vs. 29·2%), experience of sexual assault (44·1% vs. 16·9%), experience of domestic violence (65·7% vs. 10·9%) and other psychosocial risk factors, than women living in the general community. Unexpectedly, women in the rehabilitation facility reported similar levels of late screening as women in the community (52·8% vs. 55·4%). Women with drug and alcohol addiction have significantly higher incidence of risk factors for cervical cancer and abnormal Pap smears. Provision of opportunistic cervical cancer screening during residential treatment appears to reduce incidence of late-screening. Roles of Women's Health Nurses in providing services to vulnerable women should be explored further. © 2015 John Wiley & Sons Ltd.

  4. Effects of aspirin on adverse pregnancy outcome in patients with abnormal aneuploidy screening biochemistry tests: A randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Fatemeh Mirzaei

    2016-09-01

    Full Text Available Subject: The aim of this research is to study the effects of low dose aspirin on preventing any adverse pregnancy outcome in women with aneuploidy abnormal screening tests in second quarter and to compare the effects of aspirin on normal and abnormal Doppler.Method: This clinical trial study was performed on pregnant women with abnormal aneuploidy screening tests and normal Karyotype at the gestational age 15-18 week. It consists of 83 persons in aspirin receiving group and 84 persons in control group. Doppler ultrasound was simultaneously done on them to survey the Doppler results. Any adverse pregnancy outcome (APO was compared between two groups.Results: The frequency of APO was 32.8% in aspirin receiving group and 41.7% in control group (p=o.o14, RR=0.438. The frequency of preterm delivery before 37th week in the group receiving aspirin with normal Doppler was 8.07% and in the control group was 32.7% (P=0.025. The frequency of NICU reception with normal Doppler was 5.8% in aspirin group and 19.7% in control group (p=0.015. APO frequency in the group with many abnormal factors was 11.5% in the group receiving aspirin and 53.8% in control group (p=0.015. APO frequency in abnormal Doppler group was 46.7% in the group receiving aspirin and 50% in control group (p=0.849, RR=0.112.Conclusion: Low dose of aspirin reduces APO. It reduces preterm delivery and reference of pregnant women to NICU with abnormal aneuploidy screening tests.

  5. Efficacy of computer-aided detection system for screening mammography

    International Nuclear Information System (INIS)

    Saito, Mioko; Ohnuki, Koji; Yamada, Takayuki; Saito, Haruo; Ishibashi, Tadashi; Ohuchi, Noriaki; Takahashi, Shoki

    2002-01-01

    A study was conducted to evaluate the efficacy of a computer-aided detection (CAD) system for screening mammography (MMG). Screening mammograms of 2,231 women aged over 50 yr were examined. Medio-lateral oblique (MLO) images were obtained, and two expert observers interpreted the mammograms by consensus. First, each mammogram was interpreted without the assistance of CAD, followed immediately by a re-evaluation of areas marked by the CAD system. Data were recorded to measure the effect of CAD on the recall rate, cancer detection rate and detection rate of masses, microcalcifications and other findings. The CAD system increased the recall rate from 2.3% to 2.6%. Six recalled cases were diagnosed as breast cancer pathologically, and CAD detected all of these lesions. Seven additional cases in which CAD detected abnormal findings had no malignancy. The detection rate of CAD for microcalcifications was high (95.0%). However, the detection rate for mass lesions and other findings was low (29.2% and 25.0% respectively). The false positivity rate was 0.13/film for microcalcifications, and 0.25/film for mass lesions. The efficacy of the CAD system for detecting microcalcifications on screening mammograms was confirmed. However, the low detection rate of mass lesions and relatively high rate of false positivity need to be further improved. (author)

  6. Mammograms

    Science.gov (United States)

    ... Types Bladder Cancer Breast Cancer Colorectal Cancer Kidney (Renal Cell) Cancer Leukemia Liver Cancer Lung Cancer Lymphoma ... that breast changes can occur because of pregnancy, aging, or menopause ; during menstrual cycles; or when taking ...

  7. Investigation of newborns with abnormal results in a newborn screening program for four lysosomal storage diseases in Brazil

    Directory of Open Access Journals (Sweden)

    Heydy Bravo

    2017-09-01

    Full Text Available Lysosomal storage diseases (LSDs are genetic disorders, clinically heterogeneous, mainly caused by defects in genes encoding lysosomal enzymes that degrade macromolecules. Several LSDs already have specific therapies that may improve clinical outcomes, especially if introduced early in life. With this aim, screening methods have been established and newborn screening (NBS for some LSDs has been developed. Such programs should include additional procedures for the confirmation (or not of the cases that had an abnormal result in the initial screening. We present here the methods and results of the additional investigation performed in four babies with positive initial screening results in a program of NBS for LSDs performed by a private laboratory in over 10,000 newborns in Brazil. The suspicion in these cases was of Mucopolysaccharidosis I - MPS I (in two babies, Pompe disease and Gaucher disease (one baby each. One case of pseudodeficiency for MPS I, 1 carrier for MPS I, 1 case of pseudodeficiency for Pompe disease and 1 carrier for Gaucher disease were identified. This report illustrates the challenges that may be encountered by NBS programs for LSDs, and the need of a comprehensive protocol for the rapid and precise investigation of the babies who have an abnormal screening result.

  8. Only a minority of sex chromosome abnormalities are detected by a national prenatal screening program for Down syndrome

    DEFF Research Database (Denmark)

    Viuff, Mette Hansen; Krag, Kirstine Stochholm; Uldbjerg, Niels

    2015-01-01

    STUDY QUESTION: How does a national prenatal screening program for Down syndrome (DS) perform in detecting sex chromosome abnormalities (SCAs)-Turner syndrome (TS), Klinefelter syndrome, 47,XXX and 47,XYY syndromes. SUMMARY ANSWER: The SCA detection rate resulting from DS screening was below 50...... of accompanying conditions. There is limited information about pre- and perinatal status that distinguishes SCA embryogenesis from normal fetal development. STUDY DESIGN, SIZE, DURATION: A register-based case-control study from the Danish Central Cytogenetic Register (DCCR), cross-linked with the Danish Fetal...

  9. Normal mammogram detection based on local probability difference transforms and support vector machines

    International Nuclear Information System (INIS)

    Chiracharit, W.; Kumhom, P.; Chamnongthai, K.; Sun, Y.; Delp, E.J.; Babbs, C.F

    2007-01-01

    Automatic detection of normal mammograms, as a ''first look'' for breast cancer, is a new approach to computer-aided diagnosis. This approach may be limited, however, by two main causes. The first problem is the presence of poorly separable ''crossed-distributions'' in which the correct classification depends upon the value of each feature. The second problem is overlap of the feature distributions that are extracted from digitized mammograms of normal and abnormal patients. Here we introduce a new Support Vector Machine (SVM) based method utilizing with the proposed uncrossing mapping and Local Probability Difference (LPD). Crossed-distribution feature pairs are identified and mapped into a new features that can be separated by a zero-hyperplane of the new axis. The probability density functions of the features of normal and abnormal mammograms are then sampled and the local probability difference functions are estimated to enhance the features. From 1,000 ground-truth-known mammograms, 250 normal and 250 abnormal cases, including spiculated lesions, circumscribed masses or microcalcifications, are used for training a support vector machine. The classification results tested with another 250 normal and 250 abnormal sets show improved testing performances with 90% sensitivity and 89% specificity. (author)

  10. Using autoencoders for mammogram compression.

    Science.gov (United States)

    Tan, Chun Chet; Eswaran, Chikkannan

    2011-02-01

    This paper presents the results obtained for medical image compression using autoencoder neural networks. Since mammograms (medical images) are usually of big sizes, training of autoencoders becomes extremely tedious and difficult if the whole image is used for training. We show in this paper that the autoencoders can be trained successfully by using image patches instead of the whole image. The compression performances of different types of autoencoders are compared based on two parameters, namely mean square error and structural similarity index. It is found from the experimental results that the autoencoder which does not use Restricted Boltzmann Machine pre-training yields better results than those which use this pre-training method.

  11. Rate of Opportunistic Pap Smear Screening and Patterns of Epithelial Cell Abnormalities in Pap Smears in Ajman, United Arab Emirates

    Science.gov (United States)

    Al Eyd, Ghaith J.; Shaik, Rizwana B.

    2012-01-01

    Objectives: The aim of this study was to estimate the proportion of women undergoing Papanicolaou (Pap) smear examinations, and the frequency of epithelial cell abnormalities in a teaching hospital in one emirate of the United Arab Emirates (UAE) during a three-year period. Methods: A retrospective study of 602 patient records from July 2007 to July 2010 was done in a teaching hospital in Ajman, UAE. The variables studied were age, ethnicity, menopausal status, and abnormalities in the Pap smear. Data were analysed using the Statistical Package for the Social Sciences and presented mainly as percentages; to assess associations, the chi-square test was used. Results: The total number of outpatients who attended the Obstetrics & Gynaecology Department from July 2007 to July 2010 was 150,111 patients, of which 602 (0.4% of the total) had a Pap smear test. The sample was 50.1% Arabs and 49.9% other nationalities. While 73% of the outpatients had specific complaints, 27% came for a routine screening. Epithelial cell abnormalities were seen in 3.3% of the sample, with atypical squamous cells of undetermined significance (ASCUS) found in 1.8%, low-grade squamous intraepithelial lesions (LSILs) found in 1.2%, and high-grade squamous intraepithelial lesions (HSILs) found in 0.3%. There were no cases of squamous cell carcinoma. Conclusion: Voluntary routine Pap smear screening was remarkably low in the study group. ASCUS was the most common epithelial cell abnormality. Community health education and opportunistic screening for cervical cancer are recommended for both national and expatriate women in the region. PMID:23275844

  12. Factors associated with screening for glucose abnormalities after gestational diabetes mellitus: baseline cohort of the interventional IMPACT study.

    Science.gov (United States)

    Bihan, H; Cosson, E; Khiter, C; Vittaz, L; Faghfouri, F; Leboeuf, D; Carbillon, L; Dauphin, H; Reach, G; Valensi, P

    2014-04-01

    Although it is important to screen women who have had gestational diabetes mellitus (GDM) for abnormal post-partum glucose levels, such testing is rarely performed. The aim of this study was to use data from the first observational phase of the IMPACT study to determine rates of screening within 6 months of delivery in a multiethnic cohort, focusing in particular on the effects of social deprivation and the risk of future diabetes. To investigate the frequency of post-partum screening, charts were analyzed, and all women attending four centres located in a deprived area who had had GDM between January 2009 and December 2010 were contacted by phone. The Evaluation of Precarity and Inequalities in Health Examination Centres (EPICES) deprivation index and Finnish Diabetes Risk Score (FINDRISK) questionnaire were also evaluated. Data were evaluable for 589 of the 719 women contacted (mean age: 33.4 ± 5.2 years; mean body mass index: 27.6 ± 5.4 kg/m(2)), and 196 (33.3%) reported having been screened. On multivariate analysis, factors associated with a lack of screening were smoking [odds ratio (OR): 0.42 (0.20-0.90), P<0.05], low consumption of fruit and vegetables [OR: 0.58 (0.39-0.82), P<0.01] and heavier offspring birth weight (P<0.05), although there were no differences in FINDRISK and EPICES scores between screened and unscreened women. One-third of women who had had GDM reported having been screened for dysglycaemia at 6 months post-partum. However, it is expected that the interventional phase of the IMPACT study will increase screening rates, especially in women with the risk factors associated with lower screening rates during this observational phase. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  13. Exploring general practitioners' experience of informing women about prenatal screening tests for foetal abnormalities: A qualitative focus group study

    Directory of Open Access Journals (Sweden)

    Meiser Bettina

    2008-05-01

    Full Text Available Abstract Background Recent developments have made screening tests for foetal abnormalities available earlier in pregnancy and women have a range of testing options accessible to them. It is now recommended that all women, regardless of their age, are provided with information on prenatal screening tests. General Practitioners (GPs are often the first health professionals a woman consults in pregnancy. As such, GPs are well positioned to inform women of the increasing range of prenatal screening tests available. The aim of this study was to explore GPs experience of informing women of prenatal genetic screening tests for foetal abnormality. Methods A qualitative study consisting of four focus groups was conducted in metropolitan and rural Victoria, Australia. A discussion guide was used and the audio-taped transcripts were independently coded by two researchers using thematic analysis. Multiple coders and analysts and informant feedback were employed to reduce the potential for researcher bias and increase the validity of the findings. Results Six themes were identified and classified as 'intrinsic' if they occurred within the context of the consultation or 'extrinsic' if they consisted of elements that impacted on the GP beyond the scope of the consultation. The three intrinsic themes were the way GPs explained the limitations of screening, the extent to which GPs provided information selectively and the time pressures at play. The three extrinsic factors were GPs' attitudes and values towards screening, the conflict they experienced in offering screening information and the sense of powerlessness within the screening test process and the health care system generally. Extrinsic themes reveal GPs' attitudes and values to screening and to disability, as well as raising questions about the fundamental premise of testing. Conclusion The increasing availability and utilisation of screening tests, in particular first trimester tests, has expanded GPs

  14. Influence of false-positive mammography results on subsequent screening: do physician recommendations buffer negative effects?

    Science.gov (United States)

    DeFrank, Jessica T; Rimer, Barbara K; Bowling, J Michael; Earp, Jo Anne; Breslau, Erica S; Brewer, Noel T

    2012-03-01

    Cancer screening guidelines often include discussion about the unintended negative consequences of routine screening. This prospective study examined effects of false-positive mammography results on women's adherence to subsequent breast cancer screening and psychological well-being. We also assessed whether barriers to screening exacerbated the effects of false-positive results. We conducted secondary analyses of data from telephone interviews and medical claims records for 2406 insured women. The primary outcome was adherence to screening guidelines, defined as adherent (10-14 months), delayed (15-34 months), or no subsequent mammogram on record. About 8% of women reported that their most recent screening mammograms produced false-positive results. In the absence of self-reported advice from their physicians to be screened, women were more likely to have no subsequent mammograms on record if they received false-positive results than if they received normal results (18% vs. 7%, OR = 3.17, 95% CI = 1.30, 7.70). Receipt of false-positive results was not associated with this outcome for women who said their physicians had advised regular screening in the past year (7% vs. 10%, OR = 0.74, 95% CI = 0.38, 1.45). False-positive results were associated with greater breast cancer worry (P thinking more about the benefits of screening (P positive mammography results, coupled with reports that women's physicians did not advise regular screening, could lead to non-adherence to future screening. Abnormal mammograms that do not result in cancer diagnoses are opportunities for physicians to stress the importance of regular screening.

  15. Non―invasive prenatal screening for chromosomal abnormalities ...

    African Journals Online (AJOL)

    Cláudia Amorim Costa

    2016-08-27

    Aug 27, 2016 ... Abstract Background: Prenatal screening for chromosomal aneuploidies was initiated in the 1970s, based in ..... In Table 1 a summary of the performance of traditional prenatal screening tests is presented, with the comparison of their detection rates of trisomy 21 for a fixed false-positive rate of 5% [44]. 5.

  16. Pathological axillary lymph nodes detected at mammographic screening

    Energy Technology Data Exchange (ETDEWEB)

    Lim, E. T.; O' Doherty, A.; Hill, A. D.; Quinn, C. M. E-mail: c.quinn@st-vincents.ie

    2004-01-01

    AIM: To investigate the significance of abnormal axillary lymph nodes detected at mammographic screening in the absence of a concomitant breast lesion. METHODS: Twenty-three thousand, seven hundred and seven women were screened at the Merrion Unit as part of the Irish National Breast Screening Programme ('BreastCheck') in the period June 2000 to July 2002. Nine women (0.4 per 1000 women screened) were found to have an abnormal axillary lymph node(s) in the absence of a mammographic breast lesion and were recalled for assessment. The radiological criteria for recall included: size greater than or equal to 15 mm, round or irregular shape, increased node density and absence of hilar lucency. Each woman underwent further mammographic views, ultrasound examination of axilla and breast, clinical examination and lymph node biopsy either by 14 G needle core biopsy (NCB) or open excision. RESULTS: The final pathological diagnoses in the nine patients were oestrogen receptor (OR) positive metastatic breast carcinoma (two patients), metastatic malignant melanoma (one patient), malignant lymphoma (two patients), caseating granulomatous lymphadenitis suggestive of tuberculosis (one patient), and other benign conditions (three patients). CONCLUSION: Abnormal axillary lymph nodes, in the absence of an accompanying breast lesion, are rarely identified on screening mammogram, but may harbour significant pathology and their presence on screening mammogram merits further investigation including biopsy.

  17. PERBANDINGAN METODE UNTUK PERBAIKAN KUALITAS CITRA MAMMOGRAM

    Directory of Open Access Journals (Sweden)

    Hanifah Rahmi Fajrin

    2016-11-01

    Full Text Available Kanker payudara merupakan pembunuh nomor satu pada wanita di seluruh dunia. Sejauh ini, deteksi dari kanker payudara hanya menggunakan mata telanjang dan berdasarkan jam terbang (pengalaman dari dokter dan radiologis. Terdapat beberapa kelemahan dalam menganalisis mammogram payudara guna mendeteksi keberadaan kanker payudara. Hal ini bisa diakibatkan oleh sel kanker yang tertutup oleh noise, kontras citra yang rendah dan faktor manusiawi lainnya seperti : kelelahan, mood, dan lainnya. Untuk meminimalisir hal tersebut dibutuhkan suatu metode yang dapat membantu dokter dalam menganalisis citra mammogram payudara. Pada penelitian ini, dilakukan suatu proses yang bertujuan untuk meningkatkan kualitas mammogram agar lebih memudahkan dokter dalam mendiagnosis kelainan pada payudara. Citra yang diolah merupakan citra mammogram yang tidak dipangkas dan tidak disegmentasi pada bagian Region of Interest (ROI, melainkan keseluruhan citra payudara setelah dihilangkan background yang berlebihan. Tahapan pada proses peningkatan kuliatas citra mammogram ini (pra pengolahan terdiri dari : menghilangkan label atau artifak yang ditemukan pada mammogram, meng-crop citra pada bagian payudara saja (menghilangkan background, memperbaiki kontras citra dengan membandingkan beberapa metode yaitu: CLAHE, Non Subsampled Contourlet Transform (NSCT, Contras Stretching (CS dan selanjutnya dilakukan smoothing dengan menggunakan filter median. Kinerja dari setiap metode dihitung dengan mencari nilai Mean Square Error (MSE dan Peak Signal to Noise Ratio (PSNR citra. Dari nilai MSE dan PSNR yang didapatkan, ditemukan nilai MSE dan PSNR terbaik pada metode NSCT dengan nilai 50.20878 db 31.75332 db. Kata kunci: CLAHE, NSCT, CS, median filter.

  18. Value of Digital Breast Tomosynthesis versus Additional Views for the Assessment of Screen-Detected Abnormalities - a First Analysis.

    Science.gov (United States)

    Heywang-Köbrunner, Sylvia; Jaensch, Alexander; Hacker, Astrid; Wulz-Horber, Sabina; Mertelmeier, Thomas; Hölzel, Dieter

    2017-05-01

    The purpose of this study was to countercheck the equivalence of single-view digital breast tomosynthesis (DBT) or DBT with additional views (DBT+AV) compared to traditional standard assessment by additional views (AV) in patients with a screen-detected abnormality. Patients with a screen-detected abnormality were consecutively invited to obtain 1 single-view wide-angle DBT in addition to the indicated AV. The study was approved by the local ethics committee and by the Federal Office for Radiation Protection. This study is based on 311 lesions in 285 patients with a follow-up of > 2 years and/or biopsy. Counting BI-RADS 0 and 3 as positive calls, the sensitivity/specificity of DBT+AV versus DBT only versus AV only were 96.4/54.3%, 96.4/56.6%, and 90.9/42.2%, respectively. The specificities and BI-RADS classifications differed significantly (p < 0.01). AV appeared unnecessary in 88.8% of the cases. DBT appeared to be at least equivalent to AV for assessing indeterminate screen-detected lesions and could replace AV for most lesions. To obtain the extra information appears possible without increasing the overall radiation dose. Subsequent blinded reader studies are ongoing.

  19. The Determination of the Number of Suspicious Clustered Micro Calcifications on ROI of Mammogram Images

    Science.gov (United States)

    Siong, Ting Shyue; Mat Isa, Nor Ashidi; Nordin, Zailani Mohd.; Ngah, Umi Kalthum

    Micro calcifications (MCCs) appear as a small cluster of white spots on mammographic images. Numerous researches have been conducted on this abnormality. However, most of the methods focus on MCCs detection without further processing of the original mammogram image. The purpose of this paper is to detect and determine the number of suspicious MCCs on the mammogram image. In the MCCs detection, the system allows the manipulation of mammogram image by using digital image processing techniques. An automated segmentation cluster of suspicious MCCs is done based on the region of interest (ROI). For MCCs detection and determination, this paper proposes the use of Contrast-Limited Adaptive Histogram Equalization (CLAHE), Morphological Tophat filtering, Sobel edge detection and Morphological operation. The number of MCCs from the ROI mammogram image is determined by using the process of morphological structuring. As a result, the approach has been successfully tested on a number of samples and returns an accurate detection of MCCs on the ROIs of the mammogram image.

  20. The relationship of cancer characteristics and patient outcome with time to lung cancer diagnosis after an abnormal screening CT

    International Nuclear Information System (INIS)

    Sonavane, Sushilkumar K.; Watts, Jubal; Singh, Satinder P.; Nath, Hrudaya; Pinsky, Paul; Gierada, David S.; Munden, Reginald

    2017-01-01

    The National Lung Screening Trial (NLST) demonstrated a reduction in lung cancer and all-cause mortality with low-dose CT (LDCT) screening. The aim of our study was to examine the time to diagnosis (TTD) of lung cancer in the LDCT arm of the NLST and assess its relationship with cancer characteristics and survival. The subjects (N = 462) with a positive baseline screen and subsequent lung cancer diagnosis within 3 years were evaluated by data and image review to confirm the baseline abnormality. The cases were analysed for the relationship between TTD and imaging features, cancer type, stage and survival for 7 years from baseline screen. Cancer was judged to be present at baseline in 397/462 cases. The factors that showed significant association (p value trend less than 0.05) with longer TTD included smaller nodule size, pure ground glass nodules (GGNs), smooth/lobulated margins, stages I/II, adenocarcinoma, and decreasing lung cancer mortality. The logistic regression model for lung cancer death showed significant inverse relationships with size less than 20 mm (OR = 0.32), pure GGNs (OR = 0.24), adenocarcinoma (OR = 0.57) and direct relationship with age (OR = 1.4). TTD after a positive LDCT screen in the NLST showed a strong association with imaging features, stage and mortality. (orig.)

  1. The relationship of cancer characteristics and patient outcome with time to lung cancer diagnosis after an abnormal screening CT

    Energy Technology Data Exchange (ETDEWEB)

    Sonavane, Sushilkumar K.; Watts, Jubal; Singh, Satinder P.; Nath, Hrudaya [University of Alabama in Birmingham School of Medicine, Department of Radiology- Cardiopulmonary section, Birmingham, AL (United States); Pinsky, Paul [National Cancer Institute, Division of Cancer Prevention, Bethesda, MD (United States); Gierada, David S. [Washington University School of Medicine, Department of Radiology, St. Louis, MO (United States); Munden, Reginald [Wake Forest School of Medicine, Department of Radiology, Winston Salem, NC (United States)

    2017-12-15

    The National Lung Screening Trial (NLST) demonstrated a reduction in lung cancer and all-cause mortality with low-dose CT (LDCT) screening. The aim of our study was to examine the time to diagnosis (TTD) of lung cancer in the LDCT arm of the NLST and assess its relationship with cancer characteristics and survival. The subjects (N = 462) with a positive baseline screen and subsequent lung cancer diagnosis within 3 years were evaluated by data and image review to confirm the baseline abnormality. The cases were analysed for the relationship between TTD and imaging features, cancer type, stage and survival for 7 years from baseline screen. Cancer was judged to be present at baseline in 397/462 cases. The factors that showed significant association (p value trend less than 0.05) with longer TTD included smaller nodule size, pure ground glass nodules (GGNs), smooth/lobulated margins, stages I/II, adenocarcinoma, and decreasing lung cancer mortality. The logistic regression model for lung cancer death showed significant inverse relationships with size less than 20 mm (OR = 0.32), pure GGNs (OR = 0.24), adenocarcinoma (OR = 0.57) and direct relationship with age (OR = 1.4). TTD after a positive LDCT screen in the NLST showed a strong association with imaging features, stage and mortality. (orig.)

  2. Noise equalization for detection of microcalcification clusters in direct digital mammogram images.

    NARCIS (Netherlands)

    McLoughlin, K.J.; Bones, P.J.; Karssemeijer, N.

    2004-01-01

    Equalizing image noise is shown to be an important step in the automatic detection of microcalcifications in digital mammography. This study extends a well established film-screen noise equalization scheme developed by Veldkamp et al. for application to full-field digital mammogram (FFDM) images. A

  3. Evaluation of radiographers’ mammography screen-reading accuracy in Australia

    International Nuclear Information System (INIS)

    Debono, Josephine C; Poulos, Ann E; Houssami, Nehmat; Turner, Robin M; Boyages, John

    2015-01-01

    This study aimed to evaluate the accuracy of radiographers’ screen-reading mammograms. Currently, radiologist workforce shortages may be compromising the BreastScreen Australia screening program goal to detect early breast cancer. The solution to a similar problem in the United Kingdom has successfully encouraged radiographers to take on the role as one of two screen-readers. Prior to consideration of this strategy in Australia, educational and experiential differences between radiographers in the United Kingdom and Australia emphasise the need for an investigation of Australian radiographers’ screen-reading accuracy. Ten radiographers employed by the Westmead Breast Cancer Institute with a range of radiographic (median = 28 years), mammographic (median = 13 years) and BreastScreen (median = 8 years) experience were recruited to blindly and independently screen-read an image test set of 500 mammograms, without formal training. The radiographers indicated the presence of an abnormality using BI-RADS®. Accuracy was determined by comparison with the gold standard of known outcomes of pathology results, interval matching and client 6-year follow-up. Individual sensitivity and specificity levels ranged between 76.0% and 92.0%, and 74.8% and 96.2% respectively. Pooled screen-reader accuracy across the radiographers estimated sensitivity as 82.2% and specificity as 89.5%. Areas under the reading operating characteristic curve ranged between 0.842 and 0.923. This sample of radiographers in an Australian setting have adequate accuracy levels when screen-reading mammograms. It is expected that with formal screen-reading training, accuracy levels will improve, and with support, radiographers have the potential to be one of the two screen-readers in the BreastScreen Australia program, contributing to timeliness and improved program outcomes

  4. Evaluation of radiographers’ mammography screen-reading accuracy in Australia

    Energy Technology Data Exchange (ETDEWEB)

    Debono, Josephine C, E-mail: josephine.debono@bci.org.au [Westmead Breast Cancer Institute, Westmead, New South Wales (Australia); Poulos, Ann E [Discipline of Medical Radiation Sciences, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales (Australia); Houssami, Nehmat [Screening and Test Evaluation Program, School of Public Health (A27), Sydney Medical School, University of Sydney, Sydney, New South Wales (Australia); Turner, Robin M [School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales (Australia); Boyages, John [Macquarie University Cancer Institute, Macquarie University Hospital, Australian School of Advanced Medicine, Macquarie University, Sydney, New South Wales (Australia); Westmead Breast Cancer Institute, Westmead, New South Wales (Australia)

    2015-03-15

    This study aimed to evaluate the accuracy of radiographers’ screen-reading mammograms. Currently, radiologist workforce shortages may be compromising the BreastScreen Australia screening program goal to detect early breast cancer. The solution to a similar problem in the United Kingdom has successfully encouraged radiographers to take on the role as one of two screen-readers. Prior to consideration of this strategy in Australia, educational and experiential differences between radiographers in the United Kingdom and Australia emphasise the need for an investigation of Australian radiographers’ screen-reading accuracy. Ten radiographers employed by the Westmead Breast Cancer Institute with a range of radiographic (median = 28 years), mammographic (median = 13 years) and BreastScreen (median = 8 years) experience were recruited to blindly and independently screen-read an image test set of 500 mammograms, without formal training. The radiographers indicated the presence of an abnormality using BI-RADS®. Accuracy was determined by comparison with the gold standard of known outcomes of pathology results, interval matching and client 6-year follow-up. Individual sensitivity and specificity levels ranged between 76.0% and 92.0%, and 74.8% and 96.2% respectively. Pooled screen-reader accuracy across the radiographers estimated sensitivity as 82.2% and specificity as 89.5%. Areas under the reading operating characteristic curve ranged between 0.842 and 0.923. This sample of radiographers in an Australian setting have adequate accuracy levels when screen-reading mammograms. It is expected that with formal screen-reading training, accuracy levels will improve, and with support, radiographers have the potential to be one of the two screen-readers in the BreastScreen Australia program, contributing to timeliness and improved program outcomes.

  5. INTELLIGENT DETECTION AND CLASSIFICATION OF MICROCALCIFICATION IN COMPRESSED MAMMOGRAM IMAGE

    Directory of Open Access Journals (Sweden)

    Benjamin Joseph

    2015-08-01

    Full Text Available The main contribution of this article is introducing an intelligent classifier to distinguish between benign and malignant areas of micro-calcification in companded mammogram image which is not proved or addressed elsewhere. This method does not require any manual processing technique for classification, thus it can be assimilated for identifying benign and malignant areas in intelligent way. Moreover it gives good classification responses for compressed mammogram image. The goal of the proposed method is twofold: one is to preserve the details in Region of Interest (ROI at low bit rate without affecting the diagnostic related information and second is to classify and segment the micro-calcification area in reconstructed mammogram image with high accuracy. The prime contribution of this work is that details of ROI and Non-ROI regions extracted using multi-wavelet transform are coded at variable bit rate using proposed Region Based Set Partitioning in Hierarchical Trees (RBSPIHT before storing or transmitting the image. Image reconstructed during retrieval or at the receiving end is preprocessed to remove the channel noise and to enhance the diagnostic contrast information. Then the preprocessed image is classified as normal or abnormal (benign or malignant using Probabilistic neural network. Segmentation of cancerous region is done using Fuzzy C-means Clustering (FCC algorithm and the cancerous area is computed. The experimental result shows that the proposed model performance is good at achieving high sensitivity of 97.27%, specificity of 94.38% at an average compression rate and Peak Signal to Noise Ratio (PSNR of 0.5bpp and 58dB respectively.

  6. Automated analysis of image mammogram for breast cancer diagnosis

    Science.gov (United States)

    Nurhasanah, Sampurno, Joko; Faryuni, Irfana Diah; Ivansyah, Okto

    2016-03-01

    Medical imaging help doctors in diagnosing and detecting diseases that attack the inside of the body without surgery. Mammogram image is a medical image of the inner breast imaging. Diagnosis of breast cancer needs to be done in detail and as soon as possible for determination of next medical treatment. The aim of this work is to increase the objectivity of clinical diagnostic by using fractal analysis. This study applies fractal method based on 2D Fourier analysis to determine the density of normal and abnormal and applying the segmentation technique based on K-Means clustering algorithm to image abnormal for determine the boundary of the organ and calculate the area of organ segmentation results. The results show fractal method based on 2D Fourier analysis can be used to distinguish between the normal and abnormal breast and segmentation techniques with K-Means Clustering algorithm is able to generate the boundaries of normal and abnormal tissue organs, so area of the abnormal tissue can be determined.

  7. Predictive value of increased nuchal translucency as a screening test for the detection of fetal chromosomal abnormalities.

    Science.gov (United States)

    Alexioy, Eleni; Alexioy, Eleni; Trakakis, Eftihios; Kassanos, Demetrios; Farmakidis, George; Kondylios, Antonios; Laggas, Demetrios; Salamalekis, Emmanuel; Florentin, Lia; Kanavakis, Emmanuel; Basios, George; Trompoukis, Pantelis; Georgiadoy, Lina; Panagiotopoulos, Takis

    2009-10-01

    The study aimed to estimate the incidence of increased nuchal translucency in the first trimester ultrasound scan results (cut-off limit 2.5 mm) and to evaluate the predictive value of increased nuchal translucency as a screening test for the detection of fetal chromosomal abnormalities. We used the ultrasound scan results of nuchal translucency evaluation and the results of chromosomal analysis of the invasive prenatal control performed as a result of increased nuchal translucency. We collected 2183 nuchal translucency ultrasound scans in which we detected 21 embryos with a pathologic value (0.96%). We collected the data of 168 cases of invasive prenatal control due to increased nuchal translucency from which 122 cases were found. A total of 122 cases of pregnant women undergone an invasive prenatal diagnostic method due to increased nuchal translucency, of which 11 fetuses were found with trisomy 21 (Down syndrome) (9%), 3 fetuses with trisomy 13 (Patau syndrome) (2.45%), 3 fetuses with monosomy 45XO (Turner syndrome) (2.45%) and 1 fetus with translocation (0.8%). The positive predictive value of the increased fetal nuchal translucency as a screening test for the detection of fetal chromosomal abnormalities based on the results of the chromosomal-genetic analysis of the invasive prenatal diagnostic procedures is 14.8%.

  8. Is screening for abnormal ECG patterns justified in long-term follow-up of childhood cancer survivors treated with anthracyclines?

    Science.gov (United States)

    Pourier, Milanthy S; Mavinkurve-Groothuis, Annelies M C; Loonen, Jacqueline; Bökkerink, Jos P M; Roeleveld, Nel; Beer, Gil; Bellersen, Louise; Kapusta, Livia

    2017-03-01

    ECG and echocardiography are noninvasive screening tools to detect subclinical cardiotoxicity in childhood cancer survivors (CCSs). Our aims were as follows: (1) assess the prevalence of abnormal ECG patterns, (2) determine the agreement between abnormal ECG patterns and echocardiographic abnormalities; and (3) determine whether ECG screening for subclinical cardiotoxicity in CCSs is justified. We retrospectively studied ECG and echocardiography in asymptomatic CCSs more than 5 years after anthracycline treatment. Exclusion criteria were abnormal ECG and/or echocardiogram at the start of therapy, incomplete follow-up data, clinical heart failure, cardiac medication, and congenital heart disease. ECG abnormalities were classified using the Minnesota Code. Level of agreement between ECG and echocardiography was calculated with Cohen kappa. We included 340 survivors with a mean follow-up of 14.5 years (range 5-32). ECG was abnormal in 73 survivors (21.5%), with ventricular conduction disorders, sinus bradycardia, and high-amplitude R waves being most common. Prolonged QTc (>0.45 msec) was found in two survivors, both with a cumulative anthracycline dose of 300 mg/m 2 or higher. Echocardiography showed abnormalities in 44 survivors (12.9%), mostly mild valvular abnormalities. The level of agreement between ECG and echocardiography was low (kappa 0.09). Male survivors more often had an abnormal ECG (corrected odds ratio: 3.00, 95% confidence interval: 1.68-5.37). Abnormal ECG patterns were present in 21% of asymptomatic long-term CCSs. Lack of agreement between abnormal ECG patterns and echocardiographic abnormalities may suggest that ECG is valuable in long-term follow-up of CCSs. However, it is not clear whether these abnormal ECG patterns will be clinically relevant. © 2016 Wiley Periodicals, Inc.

  9. Automated detection of microcalcification clusters in mammograms

    Science.gov (United States)

    Karale, Vikrant A.; Mukhopadhyay, Sudipta; Singh, Tulika; Khandelwal, Niranjan; Sadhu, Anup

    2017-03-01

    Mammography is the most efficient modality for detection of breast cancer at early stage. Microcalcifications are tiny bright spots in mammograms and can often get missed by the radiologist during diagnosis. The presence of microcalcification clusters in mammograms can act as an early sign of breast cancer. This paper presents a completely automated computer-aided detection (CAD) system for detection of microcalcification clusters in mammograms. Unsharp masking is used as a preprocessing step which enhances the contrast between microcalcifications and the background. The preprocessed image is thresholded and various shape and intensity based features are extracted. Support vector machine (SVM) classifier is used to reduce the false positives while preserving the true microcalcification clusters. The proposed technique is applied on two different databases i.e DDSM and private database. The proposed technique shows good sensitivity with moderate false positives (FPs) per image on both databases.

  10. Breast composition measurements using retrospective standard mammogram form (SMF)

    International Nuclear Information System (INIS)

    Highnam, R; Pan, X; Warren, R; Jeffreys, M; Smith, G Davey; Brady, M

    2006-01-01

    The standard mammogram form (SMF) representation of an x-ray mammogram is a standardized, quantitative representation of the breast from which the volume of non-fat tissue and breast density can be easily estimated, both of which are of significant interest in determining breast cancer risk. Previous theoretical analysis of SMF had suggested that a complete and substantial set of calibration data (such as mAs and kVp) would be needed to generate realistic breast composition measures and yet there are many interesting trials that have retrospectively collected images with no calibration data. The main contribution of this paper is to revisit our previous theoretical analysis of SMF with respect to errors in the calibration data and to show how and why that theoretical analysis did not match the results from the practical implementations of SMF. In particular, we show how by estimating breast thickness for every image we are, effectively, compensating for any errors in the calibration data. To illustrate our findings, the current implementation of SMF (version 2.2β) was run over 4028 digitized film-screen mammograms taken from six sites over the years 1988-2002 with and without using the known calibration data. Results show that the SMF implementation running without any calibration data at all generates results which display a strong relationship with when running with a complete set of calibration data, and, most importantly, to an expert's visual assessment of breast composition using established techniques. SMF shows considerable promise in being of major use in large epidemiological studies related to breast cancer which require the automated analysis of large numbers of films from many years previously where little or no calibration data is available

  11. Scheduling mammograms for asymptomatic women

    International Nuclear Information System (INIS)

    Gohagan, J.K.; Darby, W.P.; Spitznagel, E.L.; Tome, A.E.

    1988-01-01

    A decision theoretic model was used to investigate the relative importance of risk level, radiation hazard, mammographic accuracy, and cost in mammographic screening decision. The model uses woman-specific medical and family history facts and clinic-specific information regarding mammographic accuracy and practice to profile both woman and clinic, and to formulate periodic screening recommendations. Model parameters were varied extensively to investigate the sensitivity of screening schedules to input values. Multivariate risk was estimated within the program using published data from the Breast Cancer Detection Demonstration Project 5-year follow-up study. Radiation hazard estimates were developed from published radiation physics and radioepidemiologic risk data. Benchmark values for mammographic sensitivity and specificity under screening conditions were calculated from Breast Cancer Detection Demonstration Project data. Procedural costs used in the analysis were varied around values reflecting conditions at the Washington University Medical Center. Mortality advantages of early versus late breast cancer detection were accounted for using Health Insurance Plan of New York case survival rates. Results are compared with published screening policies to provide insight into implicit assumptions behind those policies. This analysis emphasizes the importance of accounting for variations in clinical accuracy under screening circumstances, in costs, in radiation exposure, and in woman-specific risk when recommending mammographic screening

  12. Abnormal Biochemical Analytes Used for Aneuploidy Screening and Adverse Pregnancy Outcomes in Twin Gestations.

    Science.gov (United States)

    Rosner, Jonathan Y; Fox, Nathan S; Saltzman, Daniel; Klauser, Chad K; Rebarber, Andrei; Gupta, Simi

    2015-12-01

    The objective of this study was to determine if first- and second-trimester biochemical markers for aneuploidy have an association with adverse pregnancy outcomes in twin gestations. A retrospective cohort study of patients who presented with dichorionic diamniotic twin gestations was performed. Patients with first-trimester low pregnancy-associated plasma protein A (PAPP-A) or low free β human chorionic gonadotropin (β-hCG), or second-trimester elevated α-fetoprotein (AFP), elevated inhibin A, elevated hCG, or low unconjugated estradiol were identified. The rates of adverse pregnancy outcomes were compared between patients with or without abnormal analytes with p pregnancies were included. Patients with a low PAPP-A had an increased risk for delivery aneuploidy markers are associated with an increased risk of adverse pregnancy outcomes in twin gestations. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  13. Detecting and classifying lesions in mammograms with Deep Learning.

    Science.gov (United States)

    Ribli, Dezső; Horváth, Anna; Unger, Zsuzsa; Pollner, Péter; Csabai, István

    2018-03-15

    In the last two decades, Computer Aided Detection (CAD) systems were developed to help radiologists analyse screening mammograms, however benefits of current CAD technologies appear to be contradictory, therefore they should be improved to be ultimately considered useful. Since 2012, deep convolutional neural networks (CNN) have been a tremendous success in image recognition, reaching human performance. These methods have greatly surpassed the traditional approaches, which are similar to currently used CAD solutions. Deep CNN-s have the potential to revolutionize medical image analysis. We propose a CAD system based on one of the most successful object detection frameworks, Faster R-CNN. The system detects and classifies malignant or benign lesions on a mammogram without any human intervention. The proposed method sets the state of the art classification performance on the public INbreast database, AUC = 0.95. The approach described here has achieved 2nd place in the Digital Mammography DREAM Challenge with AUC = 0.85. When used as a detector, the system reaches high sensitivity with very few false positive marks per image on the INbreast dataset. Source code, the trained model and an OsiriX plugin are published online at https://github.com/riblidezso/frcnn_cad .

  14. Intelligent detection of microcalcification from digitized mammograms

    Indian Academy of Sciences (India)

    This paper reports the design and implementation of an intelligent system for detection of microcalcification from digital mammograms. A neuron based thresholding strategy has been developed to reduce the number of candidate pixels. A back propagation neural network (BPNN) classifier has been used to classify the ...

  15. Intelligent detection of microcalcification from digitized mammograms

    Indian Academy of Sciences (India)

    Keywords. Breast cancer; digital mammogram; artificial neural networks; microcalcification detection. ... tested for the available images and was found to be quite robust, consistent and fast in detection. The output image with prompts generated by the system can form an important input to a radiologist for the final diagnosis.

  16. Sampling probability distributions of lesions in mammograms

    Science.gov (United States)

    Looney, P.; Warren, L. M.; Dance, D. R.; Young, K. C.

    2015-03-01

    One approach to image perception studies in mammography using virtual clinical trials involves the insertion of simulated lesions into normal mammograms. To facilitate this, a method has been developed that allows for sampling of lesion positions across the cranio-caudal and medio-lateral radiographic projections in accordance with measured distributions of real lesion locations. 6825 mammograms from our mammography image database were segmented to find the breast outline. The outlines were averaged and smoothed to produce an average outline for each laterality and radiographic projection. Lesions in 3304 mammograms with malignant findings were mapped on to a standardised breast image corresponding to the average breast outline using piecewise affine transforms. A four dimensional probability distribution function was found from the lesion locations in the cranio-caudal and medio-lateral radiographic projections for calcification and noncalcification lesions. Lesion locations sampled from this probability distribution function were mapped on to individual mammograms using a piecewise affine transform which transforms the average outline to the outline of the breast in the mammogram. The four dimensional probability distribution function was validated by comparing it to the two dimensional distributions found by considering each radiographic projection and laterality independently. The correlation of the location of the lesions sampled from the four dimensional probability distribution function across radiographic projections was shown to match the correlation of the locations of the original mapped lesion locations. The current system has been implemented as a web-service on a server using the Python Django framework. The server performs the sampling, performs the mapping and returns the results in a javascript object notation format.

  17. Minimizing misclassification of hormone users at mammography screening

    DEFF Research Database (Denmark)

    Njor, Sisse Helle; Pedersen, Anette Tønnes; Schwartz, Walter

    2008-01-01

    The aim of the study was to retrospectively determine the impact of comparing current mammograms with prior mammograms on risk of misclassification especially for hormone users. Data on mammography screening were retrieved for 1993-2005 from Fyn, Denmark. At first screen, two projections were made...... of HT. The study indicated that misclassification at screening mammography in current users of HT can be reduced considerably, when the screening mammograms are viewed with the mammograms taken 4 years earlier. It should be stressed that these results come from a single clinic, and replication in other...

  18. Beyond screening for chromosomal abnormalities: Advances in non-invasive diagnosis of single gene disorders and fetal exome sequencing.

    Science.gov (United States)

    Hayward, Jane; Chitty, Lyn S

    2018-04-01

    Emerging genomic technologies, largely based around next generation sequencing (NGS), are offering new promise for safer prenatal genetic diagnosis. These innovative approaches will improve screening for fetal aneuploidy, allow definitive non-invasive prenatal diagnosis (NIPD) of single gene disorders at an early gestational stage without the need for invasive testing, and improve our ability to detect monogenic disorders as the aetiology of fetal abnormalities. This presents clinicians and scientists with novel challenges as well as opportunities. In addition, the transformation of prenatal genetic testing arising from the introduction of whole genome, exome and targeted NGS produces unprecedented volumes of data requiring complex analysis and interpretation. Now translating these technologies to the clinic has become the goal of clinical genomics, transforming modern healthcare and personalized medicine. The achievement of this goal requires the most progressive technological tools for rapid high-throughput data generation at an affordable cost. Furthermore, as larger proportions of patients with genetic disease are identified we must be ready to offer appropriate genetic counselling to families and potential parents. In addition, the identification of novel treatment targets will continue to be explored, which is likely to introduce ethical considerations, particularly if genome editing techniques are included in these targeted treatments and transferred into mainstream personalized healthcare. Here we review the impact of NGS technology to analyse cell-free DNA (cfDNA) in maternal plasma to deliver NIPD for monogenic disorders and allow more comprehensive investigation of the abnormal fetus through the use of exome sequencing. Copyright © 2017. Published by Elsevier Ltd.

  19. Clinical performance of Siemens digital breast tomosynthesis versus standard supplementary mammography for the assessment of screen-detected soft-tissue abnormalities: a multi-reader study.

    Science.gov (United States)

    Whelehan, P; Heywang-Köbrunner, S H; Vinnicombe, S J; Hacker, A; Jänsch, A; Hapca, A; Gray, R; Jenkin, M; Lowry, K; Oeppen, R; Reilly, M; Stahnke, M; Evans, A

    2017-01-01

    To compare the diagnostic accuracy of standard screening images plus single-view digital breast tomosynthesis (DBT), using Siemens DBT equipment, with standard screening images plus supplementary mammographic views in non-calcific, screen-detected mammographic abnormalities. Participants were unselected women aged 50-69 years recalled within a population-based European breast screening programme for assessment of soft-tissue mammographic abnormalities. Supplementary mammographic views (SMVs) and DBT were performed in all cases. A range of equipment was used for screening and supplementary mammography, but all DBT examinations were performed using the Siemens Mammomat Inspiration. A retrospective multi-reader study including 238 cases for whom either histology or at least 2 years' follow-up was available was performed with eight suitably accredited UK breast screening personnel reading all cases under both conditions, with temporal separation. Readers were blinded to case outcomes and findings from other examinations. Diagnostic accuracy using receiver operating characteristic (ROC) analysis was compared between screening plus SMV images and screening plus DBT images. The study was powered to detect a 3% inferiority margin in diagnostic accuracy between methods. The final sample with complete data available for analysis included 195 benign cases (1,560 reads) and 35 malignant cases (280 reads). The DBT method yielded a slightly higher area under the curve (AUC) value than the SMV method (0.870 versus 0.857), but the difference was not statistically significant (p=0.4890), indicating that the methods have equivalent accuracy. Siemens DBT demonstrates equivalent diagnostic accuracy according to ROC curve analysis when used in place of SMVs in screen-detected soft-tissue mammographic abnormalities. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  20. Anatomic breast coordinate system for mammogram analysis

    DEFF Research Database (Denmark)

    Karemore, Gopal; Brandt, S.; Karssemeijer, N.

    2011-01-01

    inside the breast. Most of the risk assessment and CAD modules use a breast region in a image centered Cartesian x,y coordinate system. Nevertheless, anatomical structure follows curve-linear trajectories. We examined an anatomical breast coordinate system that preserves the anatomical correspondence...... between the mammograms and allows extracting not only the aligned position but also the orientation aligned with the anatomy of the breast tissue structure. Materials and Methods The coordinate system used the nipple location as the point A and the border of the pectoral muscle as a line BC. The skin air...... interface was identified as a curve passing through A and intersecting the pectoral muscle line. The nipple was defined as the origin of the coordinate system. A family of second order curves were defined through the nipple and intersecting the pectoral line (AD). Every pixel location in mammogram...

  1. Cervical screening program and the psychological impact of an abnormal Pap smear: a self-assessment questionnaire study of 590 patients.

    Science.gov (United States)

    Thangarajah, Fabinshy; Einzmann, Thomas; Bergauer, Florian; Patzke, Jan; Schmidt-Petruschkat, Silke; Theune, Monika; Engel, Katja; Puppe, Julian; Richters, Lisa; Mallmann, Peter; Kirn, Verena

    2016-02-01

    Invasive cervical cancer is today the fourth most common cancer of women in western civilization. Screening programs have led to a continuously decrease. Nevertheless, both screening and a positive test result are known to be associated with a negative psychological impact. Screening programs in European countries differ and thus psychological impact might as well. The aim of this study was to evaluate the psychological impact of women with an abnormal Pap smear in a German cohort. Between July 2013 and May 2014, a self-assessment questionnaire was distributed to 595 patients that were referred to a special clinic for cervical dysplasia for further evaluation of an abnormal Pap smear. Patients were recruited in five different centers. Most patients (45.9 %) were informed about the test result via phone call by their doctor. 68.8 % of the patients felt anxious and 26.3 % even felt panic. After having talked to their physician, 51.4 % of our cohort still felt worried and only 24.4 % felt reassured. Concerning disease management, 48.4 % underwent a control Pap smear in 6 months. The preferred information source was the physician (63.9 %). Compared to the results in other European countries, our study cohort showed differences concerning age distribution, patients living in a partnership, number of children and especially disease management. Cancer screening itself and abnormal test results have an impact on patient's feelings. To reduce the psychological impact, patients need to be better informed about the risks and benefits of cancer screening programs and in case of cervical cancer screening about the meaning of an abnormal test result. Our results underline the importance of a trustful physician-patient relationship in that matter.

  2. Analysis and comparison of breast density according to age on mammogram between Korean and Western women

    International Nuclear Information System (INIS)

    Kim, Seung Hyung; Kim, Mi Hye; Oh, Ki Keun

    2000-01-01

    To compare changes in breast parenchymal density among diverse age groups in asymptomatic Korean women with those of Western women, and to evaluate the effect of different patterns of breast parenchymal density on the sensitivity of screening mammography in Korean women. We analyzed the distribution of breast parenchymal density among diverse age groups in 823 asymptomatic Korean women aged 30-64 who underwent screening mammography between January and December 1998. On the basis of ACR BI-RADS breast composition, four density patterns were designated: patterns 1 and 2 related to fatty mammograms, and patterns 3 and 4 to dense mammograms. We compared the results with those for western women. In Korean women, the frequency of dense mammogram was 88.1% (30-34 years old), 91.1% (35-39), 78.3% (40-44), 61.1% (45-49), 30.1% (50-54), 21.1% (55-59), and 7.0% (60-64). Korean women in their 40s thus showed a higher frequency of dense mammograms, but this frequency decreased abruptly between the ages of 40 and 54. In Western women, however, there was little difference between 40 and 54-year-olds: the figures were 47.2% (40-44 years), 44.8% (45-49), and 44.4% (50-54). Because the frequency of their dense mammograms shows little change between Western women in their forties and in their fifties, it is clear that between these two age groups, mammographic sensitivity is only slightly different. Because the frequency of dense mammograms is much greater among Korean women in their forties than among Western women of the same age, and among korean women this frequency decreases abruptly, it appears, however, that the mammographic sensitivity of korean women is less among those in their forties than among those in their fifties. It is therefore thought that mammography combined with ultrasonography may increase screening sensitivity among Korean women under 50, who have a relatively higher incidence of breast cancer in the younger age groups than do Western women. (author)

  3. Dynamic multiple thresholding breast boundary detection algorithm for mammograms

    International Nuclear Information System (INIS)

    Wu, Yi-Ta; Zhou Chuan; Chan, Heang-Ping; Paramagul, Chintana; Hadjiiski, Lubomir M.; Daly, Caroline Plowden; Douglas, Julie A.; Zhang Yiheng; Sahiner, Berkman; Shi Jiazheng; Wei Jun

    2010-01-01

    Purpose: Automated detection of breast boundary is one of the fundamental steps for computer-aided analysis of mammograms. In this study, the authors developed a new dynamic multiple thresholding based breast boundary (MTBB) detection method for digitized mammograms. Methods: A large data set of 716 screen-film mammograms (442 CC view and 274 MLO view) obtained from consecutive cases of an Institutional Review Board approved project were used. An experienced breast radiologist manually traced the breast boundary on each digitized image using a graphical interface to provide a reference standard. The initial breast boundary (MTBB-Initial) was obtained by dynamically adapting the threshold to the gray level range in local regions of the breast periphery. The initial breast boundary was then refined by using gradient information from horizontal and vertical Sobel filtering to obtain the final breast boundary (MTBB-Final). The accuracy of the breast boundary detection algorithm was evaluated by comparison with the reference standard using three performance metrics: The Hausdorff distance (HDist), the average minimum Euclidean distance (AMinDist), and the area overlap measure (AOM). Results: In comparison with the authors' previously developed gradient-based breast boundary (GBB) algorithm, it was found that 68%, 85%, and 94% of images had HDist errors less than 6 pixels (4.8 mm) for GBB, MTBB-Initial, and MTBB-Final, respectively. 89%, 90%, and 96% of images had AMinDist errors less than 1.5 pixels (1.2 mm) for GBB, MTBB-Initial, and MTBB-Final, respectively. 96%, 98%, and 99% of images had AOM values larger than 0.9 for GBB, MTBB-Initial, and MTBB-Final, respectively. The improvement by the MTBB-Final method was statistically significant for all the evaluation measures by the Wilcoxon signed rank test (p<0.0001). Conclusions: The MTBB approach that combined dynamic multiple thresholding and gradient information provided better performance than the breast boundary

  4. Review and analysis of mammograms of the Servicio de Radiologia, Hospital Calderon Guardia from January 2013 to May 2013

    International Nuclear Information System (INIS)

    Lawrence Villalobos, Andrea; Solis Vargas, Carlos

    2013-01-01

    An analysis of 400 mammograms of the Radiology Service of the Calderon Guardia Hospital is carried out, linking the statistical findings between BIRADS Categorization, family hereditary factors, age groups and pathological personalities, of the patients treated in the period from January 2013 to May 2013 Calcifications are identified as the most frequent pathological findings in mammograms analyzed. Ultrasound is identified as the complementary method to mammography the most frequently used. Mammography is still the screening study for the early detection of breast cancer. The support of specialists in radiology of medical images is recommended to implement early reports in the second level of attention [es

  5. Diagnostic image quality of mammograms in German outpatient medical care

    International Nuclear Information System (INIS)

    Pfandzelter, R.; Wuelfing, U.; Boedeker, B.

    2010-01-01

    Purpose: A total of 79 115 mammograms from statutory health insurance (SHI) physicians within German outpatient care were evaluated with respect to the diagnostic image quality. Materials and Methods: Mammograms were randomly selected between 2006 and 2008 by the regional Associations of Statutory Health Insurance Physicians and submitted to regional boards of experts for external evaluation. The mammogram quality was evaluated using a 3-point scale (adequate, borderline, failure) and documented using a nationally standardized protocol. Results: 87.6 % of the mammograms were classified as adequate, 11.0 % as borderline and 1.4 % as failure. Mediolateral oblique mammograms (mlo) had worse ratings than craniocaudal mammograms (cc). Main reasons for classifying the mammograms as borderline or failure were 'inframammary fold not adequately visualized' (mlo), 'pectoral muscle not in the correct angle or not to the level with the nipple' (mlo), 'the nipple not in profile' (mlo, cc) and 'breast not completely or not adequately visualized' (cc). Conclusion: The results show a good overall quality of mammograms in German outpatient medical care. Failures can be associated predominantly with incorrect positioning of the breast. More precisely defined quality criteria using objective measures are recommended, especially for craniocaudal mammograms (cc). (orig.)

  6. Screening for cognitive and behavioural impairment in amyotrophic lateral sclerosis: Frequency of abnormality and effect on survival.

    Science.gov (United States)

    Xu, Zhouwei; Alruwaili, Ashwag Rafea S; Henderson, Robert David; McCombe, Pamela Ann

    2017-05-15

    To screen for cognitive and behavioural impairment in people with amyotrophic lateral sclerosis (ALS) and controls with neuromuscular disease and to correlate these with clinical features. 108 people with ALS and 60 controls with other neuromuscular diseases were recruited and assessed with the Addenbrooke's cognitive examination-III (ACE-III), the frontal assessment battery (FAB), and the executive function component of the Edinburgh cognitive and behavioural ALS screen (ECAS). The Amyotrophic lateral sclerosis-Frontotemporal dementia questionnaire (ALS-FTD-Q) and the Motor Neuron Disease Behavioural instrument (MiND-B) were administered to the caregivers of people with ALS. The prevalence of abnormalities was determined and correlated with clinical features and survival. In 37 people with ALS, serial studies were performed. The frequencies of cognitive impairment based on the ACE-III and FAB were 30.0% and 14.0%, in ALS and 11.7% and 3.3% in controls, respectively. Age and years of education influence the results of the ACE-III and ECAS executive function. In ALS, the frequencies of behavioural impairment based on ALS-FTD-Q and MiND-B were 32.1% and 39.4%, respectively. There is significant correlation of ALS-FTD-Q and MiND-B with the ALSFRS-R score. ALS participants with cognitive impairment measured with ACE-III had significantly shorter survival time than those without. ALS participants with behavioural impairment measured with ALS-FTD-Q had worse prognosis than those without. No significant difference was found between the first two serial cognitive tests based on ACE-III and FAB by using generalized estimating equation. There is a greater frequency of cognitive impairment in people with ALS than in patients with other neuromuscular diseases. The cognitive and behavioural tests are potential biomarkers of the prognosis of ALS. The results of cognitive tests are stable over 6months and possibly longer. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Genome-Wide Screening of Cytogenetic Abnormalities in Multiple Myeloma Patients Using Array-CGH Technique: A Czech Multicenter Experience

    Directory of Open Access Journals (Sweden)

    Jan Smetana

    2014-01-01

    Full Text Available Characteristic recurrent copy number aberrations (CNAs play a key role in multiple myeloma (MM pathogenesis and have important prognostic significance for MM patients. Array-based comparative genomic hybridization (aCGH provides a powerful tool for genome-wide classification of CNAs and thus should be implemented into MM routine diagnostics. We demonstrate the possibility of effective utilization of oligonucleotide-based aCGH in 91 MM patients. Chromosomal aberrations associated with effect on the prognosis of MM were initially evaluated by I-FISH and were found in 93.4% (85/91. Incidence of hyperdiploidy was 49.5% (45/91; del(13(q14 was detected in 57.1% (52/91; gain(1(q21 occurred in 58.2% (53/91; del(17(p13 was observed in 15.4% (14/91; and t(4;14(p16;q32 was found in 18.6% (16/86. Genome-wide screening using Agilent 44K aCGH microarrays revealed copy number alterations in 100% (91/91. Most common deletions were found at 13q (58.9%, 1p (39.6%, and 8p (31.1%, whereas gain of whole 1q was the most often duplicated region (50.6%. Furthermore, frequent homozygous deletions of genes playing important role in myeloma biology such as TRAF3, BIRC1/BIRC2, RB1, or CDKN2C were observed. Taken together, we demonstrated the utilization of aCGH technique in clinical diagnostics as powerful tool for identification of unbalanced genomic abnormalities with prognostic significance for MM patients.

  8. A new near-term breast cancer risk prediction scheme based on the quantitative analysis of ipsilateral view mammograms.

    Science.gov (United States)

    Sun, Wenqing; Tseng, Tzu-Liang Bill; Qian, Wei; Saltzstein, Edward C; Zheng, Bin; Yu, Hui; Zhou, Shi

    2018-03-01

    To help improve efficacy of screening mammography and eventually establish an optimal personalized screening paradigm, this study aimed to develop and test a new near-term breast cancer risk prediction scheme based on the quantitative analysis of ipsilateral view of the negative screening mammograms. The dataset includes digital mammograms acquired from 392 women with two sequential full-field digital mammography examinations. All the first ("prior") sets of mammograms were interpreted as negative during the original reading. In the sequential ("current") screening, 202 were proved positive and 190 remained negative/benign. For each pair of the "prior" ipsilateral mammograms, we adaptively fused the image features computed from two views. Using four different types of image features, we built four elastic net support vector machine (EnSVM) based classifiers. Then, the initial prediction scores form the 4 EnSVMs were combined to build a final artificial neural network (ANN) classifier that produces the final risk prediction score. The performance of the new scheme was evaluated by using a 10-fold cross-validation method and an assessment index of the area under the receiver operating characteristic curve (AUC). A total number of 466 features were initially extracted from each pair of ipsilateral mammograms. Among them, 51 were selected to build the EnSVM based prediction scheme. The AUC = 0.737 ± 0.052 was yielded using the new scheme. Applying an optimal operating threshold, the prediction sensitivity was 60.4% (122 of 202) and the specificity was 79.0% (150 of 190). The study results showed moderately high positive association between computed risk scores using the "prior" negative mammograms and the actual outcome of the image-detectable breast cancers in the next subsequent screening examinations. The study also demonstrated that quantitative analysis of the ipsilateral views of the mammograms enabled to provide useful information in predicting near

  9. Can delayed time to referral to a tertiary level urologist with an abnormal PSA level affect subsequent Gleason grade in the opportunistically screened population?

    LENUS (Irish Health Repository)

    O'Kelly, Fardod

    2013-09-01

    There is growing conflict in the literature describing the effect of delayed treatment on outcomes following radical prostatectomy. There is also evidence to suggest progression of low-risk prostate cancer to develop higher grades and volumes of prostate cancer during active surveillance. It is unknown as to what affect a delay in referral of those men with abnormal screened-PSA levels have on subsequent Gleason grade.

  10. Mammograms restoration by using Wiener filter

    Energy Technology Data Exchange (ETDEWEB)

    Dakovic, M., E-mail: mdakovic@gmail.com; Mijovic, S. [University of Montenegro, Faculty of Natural Sciences and Mathematics, Dž. Vašingtona bb, 20000 Podgorica (Montenegro); Ivanović, S. [Clinical Center of Montenegro, 20000 Podgorica (Montenegro)

    2016-03-25

    Restoration of digital mammograms, as a pre-processing tool, using deconvolution procedures, is analysed. It implies, knowing Modulation Transfer Function (MTF) of the mammography device and the estimation of the mammogram’s noise. Wiener filter is used, as the most objective in mammograms restoration by deconvolution. Using MATLAB program the deconvolution procedures are conducted in two ways with different level of approximation. The first method approximates the noise/signal power ratio by a constant and the second method uses autocorrelation functions of the noise and signals. Abilities and limitations of the methods are analysed and checked by using the raw images of the bar-pattern due to better visualisation of the obtained results. The raw images are obtained at a Computed Radiography (CR) mammography device in Clinical Centre in Podgorica. It is found that quality of the restored image highly depends of knowledge of type and magnitude of noise. In the both methods spatial resolution of the restored images are improved, but much better in a case where autocorrelation functions of the noise and signal are used. This procedure is proposed as an objective pre-processing tool to put back imperfectness of mammography devices.

  11. Mammogram CAD, hybrid registration and iconic analysis

    Science.gov (United States)

    Boucher, A.; Cloppet, F.; Vincent, N.

    2013-03-01

    This paper aims to develop a computer aided diagnosis (CAD) based on a two-step methodology to register and analyze pairs of temporal mammograms. The concept of "medical file", including all the previous medical information on a patient, enables joint analysis of different acquisitions taken at different times, and the detection of significant modifications. The developed registration method aims to superimpose at best the different anatomical structures of the breast. The registration is designed in order to get rid of deformation undergone by the acquisition process while preserving those due to breast changes indicative of malignancy. In order to reach this goal, a referent image is computed from control points based on anatomical features that are extracted automatically. Then the second image of the couple is realigned on the referent image, using a coarse-to-fine approach according to expert knowledge that allows both rigid and non-rigid transforms. The joint analysis detects the evolution between two images representing the same scene. In order to achieve this, it is important to know the registration error limits in order to adapt the observation scale. The approach used in this paper is based on an image sparse representation. Decomposed in regular patterns, the images are analyzed under a new angle. The evolution detection problem has many practical applications, especially in medical images. The CAD is evaluated using recall and precision of differences in mammograms.

  12. Significant frequency of MSH2/MSH6 abnormality in ovarian endometrioid carcinoma supports histotype-specific Lynch syndrome screening in ovarian carcinomas.

    Science.gov (United States)

    Rambau, Peter F; Duggan, Máire A; Ghatage, Prafull; Warfa, Khadija; Steed, Helen; Perrier, Renee; Kelemen, Linda E; Köbel, Martin

    2016-08-01

    Lynch syndrome screening in ovarian carcinoma is controversial. The aim of this study was to assess the frequency of deficient mismatch repair (dMMR) protein in a retrospective cohort enriched for non-high-grade serous carcinomas and its association with outcome within histological types. Tissue microarrays representing 612 ovarian carcinomas were tested for mismatch repair proteins (MLH1, PMS2, MSH2, and MSH6) by immunohistochemistry. dMMR was detected in 13.8% of endometrioid and 2.4% of clear cell carcinomas, but not in other histological types. Within endometrioid carcinomas, 11 of 25 dMMR cases showed abnormal MLH1/PMS2, 10 cases showed abnormal MSH2/MSH6, and four cases showed only abnormal MSH6, indicating that at least 7.7% of endometrioid carcinomas have dMMR probably related to Lynch syndrome. The four dMMR clear cell carcinomas showed abnormal MSH2/MSH6 in three cases and only abnormal MSH6 in one case, all probably related to Lynch syndrome. Within endometrioid carcinomas, dMMR was significantly associated with age carcinoma, a higher CA125 level at diagnosis, higher FIGO grade, absence of ARID1A, and at least 20 CD8-positive intraepithelial lymphocytes per high-power field, but was not associated with cancer-specific death. Age ovarian carcinoma confined to endometrioid and clear cell carcinomas. © 2016 John Wiley & Sons Ltd.

  13. Evaluation of hybrids algorithms for mass detection in digitalized mammograms

    International Nuclear Information System (INIS)

    Cordero, Jose; Garzon Reyes, Johnson

    2011-01-01

    The breast cancer remains being a significant public health problem, the early detection of the lesions can increase the success possibilities of the medical treatments. The mammography is an image modality effective to early diagnosis of abnormalities, where the medical image is obtained of the mammary gland with X-rays of low radiation, this allows detect a tumor or circumscribed mass between two to three years before that it was clinically palpable, and is the only method that until now achieved reducing the mortality by breast cancer. In this paper three hybrids algorithms for circumscribed mass detection on digitalized mammograms are evaluated. In the first stage correspond to a review of the enhancement and segmentation techniques used in the processing of the mammographic images. After a shape filtering was applied to the resulting regions. By mean of a Bayesian filter the survivors regions were processed, where the characteristics vector for the classifier was constructed with few measurements. Later, the implemented algorithms were evaluated by ROC curves, where 40 images were taken for the test, 20 normal images and 20 images with circumscribed lesions. Finally, the advantages and disadvantages in the correct detection of a lesion of every algorithm are discussed.

  14. Breast cancer risk prediction model: a nomogram based on common mammographic screening findings

    NARCIS (Netherlands)

    Timmers, J.M.H.; Verbeek, A.L.M.; Hout, J. in't; Pijnappel, R.M.; Broeders, M.J.M.; Heeten, G.J. den

    2013-01-01

    OBJECTIVES: To develop a prediction model for breast cancer based on common mammographic findings on screening mammograms aiming to reduce reader variability in assigning BI-RADS. METHODS: We retrospectively reviewed 352 positive screening mammograms of women participating in the Dutch screening

  15. Breast cancer risk prediction model: a nomogram based on common mammographic screening findings

    NARCIS (Netherlands)

    Timmers, J. M. H.; Verbeek, A. L. M.; Inthout, J.; Pijnappel, R. M.; Broeders, M. J. M.; den Heeten, G. J.

    2013-01-01

    To develop a prediction model for breast cancer based on common mammographic findings on screening mammograms aiming to reduce reader variability in assigning BI-RADS. We retrospectively reviewed 352 positive screening mammograms of women participating in the Dutch screening programme (Nijmegen

  16. A swarm optimized neural network system for classification of microcalcification in mammograms.

    Science.gov (United States)

    Dheeba, J; Selvi, S Tamil

    2012-10-01

    Early detection of microcalcification clusters in breast tissue will significantly increase the survival rate of the patients. Radiologists use mammography for breast cancer diagnosis at early stage. It is a very challenging and difficult task for radiologists to correctly classify the abnormal regions in the breast tissue, because mammograms are noisy images. To improve the accuracy rate of detection of breast cancer, a novel intelligent computer aided classifier is used, which detects the presence of microcalcification clusters. In this paper, an innovative approach for detection of microcalcification in digital mammograms using Swarm Optimization Neural Network (SONN) is used. Prior to classification Laws texture features are extracted from the image to capture descriptive texture information. These features are used to extract texture energy measures from the Region of Interest (ROI) containing microcalcification (MC). A feedforward neural network is used for detection of abnormal regions in breast tissue is optimally designed using Particle Swarm Optimization algorithm. The proposed intelligent classifier is evaluated based on the MIAS database where 51 malignant, 63 benign and 208 normal images are utilized. The approach has also been tested on 216 real time clinical images having abnormalities which showed that the results are statistically significant. With the proposed methodology, the area under the ROC curve (A ( z )) reached 0.9761 for MIAS database and 0.9138 for real clinical images. The classification results prove that the proposed swarm optimally tuned neural network highly contribute to computer-aided diagnosis of breast cancer.

  17. Improving eye care follow-up adherence in diabetic patients with ocular abnormalities: the effectiveness of patient contracts in a free, pharmacy-based eye screening.

    Science.gov (United States)

    Aleo, C L; Murchison, A P; Dai, Y; Hark, L A; Mayro, E L; Collymore, B; Haller, J A

    2015-07-01

    Patient contracts are increasingly utilized in medical practice and have the potential to improve health outcomes in high-risk populations. However, as a relatively new tool, there has been limited research regarding the efficacy of patient contracts. Diabetic retinopathy (DR) is one of the leading causes of vision impairment in adults in the US and only 50-60% of adults with diabetes adhere to annual dilated fundus exam recommendations. This study aimed to evaluate the impact of patient contracts on follow-up adherence in diabetic patients with ocular abnormalities after a free, pharmacy-based eye screening. This prospective study implemented a non-invasive, non-mydriatic fundus camera in an urban, community-based pharmacy setting to screen for ocular diseases in patients with diabetes. Patients were assigned to the contract or non-contract group. Patients who signed a contract agreed to: 1) review their results with their primary care doctor, 2) follow-up with an ophthalmologist if their results were abnormal, and 3) inform research staff if/when they completed an eye care appointment. All study participants and their primary care doctors were notified of their results via mail. Follow-up questionnaires were administered to all patients by telephone three months after the screening results. 500 patients were screened and 113 (22.6%) had abnormal results. Of the patients who had abnormal results, 83 (74.3%) were able to be contacted. Of the 83 patients who were able to be contacted, the majority of patients were African American (73.5%) and female (56.6%). The mean age was 54.7 years. Of those, 34 (41.0%) adhered to follow-up recommendations. There was no significant difference in follow-up adherence between the contract (38.1%) and non-contract group (43.9%) (P = 0.59). In addition, 70.4% of patients did not comply with at least one measure of the contract agreement. Contracts did not increase follow-up adherence to eye appointments in diabetic patients with

  18. Improved Classification of Mammograms Following Idealized Training

    Science.gov (United States)

    Hornsby, Adam N.; Love, Bradley C.

    2014-01-01

    People often make decisions by stochastically retrieving a small set of relevant memories. This limited retrieval implies that human performance can be improved by training on idealized category distributions (Giguère & Love, 2013). Here, we evaluate whether the benefits of idealized training extend to categorization of real-world stimuli, namely classifying mammograms as normal or tumorous. Participants in the idealized condition were trained exclusively on items that, according to a norming study, were relatively unambiguous. Participants in the actual condition were trained on a representative range of items. Despite being exclusively trained on easy items, idealized-condition participants were more accurate than those in the actual condition when tested on a range of item types. However, idealized participants experienced difficulties when test items were very dissimilar from training cases. The benefits of idealization, attributable to reducing noise arising from cognitive limitations in memory retrieval, suggest ways to improve real-world decision making. PMID:24955325

  19. Psychosocial predictors of mammography history among Chinese American women without a recent mammogram.

    Science.gov (United States)

    Miller, Brittany C; Sarma, Elizabeth A; Sun, Yiyuan; Messina, Catherine R; Moyer, Anne

    2018-03-05

    Chinese American women have lower rates of mammography screening compared with non-Hispanic White women. Although the extent of perceived barriers, as conceptualized by the Health Belief Model, have been shown to distinguish between currently non-adherent Chinese American women who have ever and never had a mammogram, it is less clear which types of perceived barriers differentiate them. One hundred twenty-eight Chinese American women in the New York metropolitan area who had not had a mammogram in the past year completed baseline assessments for a mammography framing intervention study. Demographics, medical access variables, and perceived barriers to mammography (lack of access, lack of need for screening, and modesty) were used to predict mammography history (ever versus never screened). Fifty-five women (43%) reported having been screened at least once. A sequential logistic regression showed that English speaking ability and having health insurance significantly predicted mammography history. However, these control variables became non-significant when the three barrier factors were included in the final model. Women who reported a greater lack of access (OR = 0.36, p American women should identify and target specific perceived barriers with consideration of previous adherence.

  20. A Simulation Screening Mammography Module Created for Instruction and Assessment: Radiology Residents vs National Benchmarks.

    Science.gov (United States)

    Poot, Jeffrey D; Chetlen, Alison L

    2016-11-01

    To improve mammographic screening training and breast cancer detection, radiology residents participated in a simulation screening mammography module in which they interpreted an enriched set of screening mammograms with known outcomes. This pilot research study evaluates the effectiveness of the simulation module while tracking the progress, efficiency, and accuracy of radiology resident interpretations and also compares their performance against national benchmarks. A simulation module was created with 266 digital screening mammograms enriched with high-risk breast lesions (seven cases) and breast malignancies (65 cases). Over a period of 27 months, 39 radiology residents participated in the simulation screening mammography module. Resident sensitivity and specificity were compared to Breast Cancer Surveillance Consortium (BCSC data through 2009) national benchmark and American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS) acceptable screening mammography audit ranges. The sensitivity, the percentage of cancers with an abnormal initial interpretation (BI-RADS 0), among residents was 84.5%, similar to the BCSC benchmark sensitivity of 84.9% (sensitivity for tissue diagnosis of cancer within 1 year following the initial examination) and within the acceptable ACR BI-RADS medical audit range of ≥75%. The specificity, the percentage of noncancers that had a negative image interpretation (BI-RADS 1 or 2), among residents was 83.2% compared to 90.3% reported in the BCSC benchmark data, but lower than the suggested ACR BI-RADS range of 88%-95%. Using simulation modules for interpretation of screening mammograms is a promising method for training radiology residents to detect breast cancer and to help them achieve competence toward national benchmarks. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  1. Prevalence of undiagnosed abnormal glucose tolerance in adult patients cared for by general practitioners in Hungary. Results of a risk-stratified screening based on FINDRISC questionnaire

    Science.gov (United States)

    Winkler, Gábor; Hidvégi, Tibor; Vándorfi, Győző; Balogh, Sándor; Jermendy, György

    2013-01-01

    Background The prevalence of type 2 diabetes mellitus is rapidly increasing, worldwide and also in Hungary. Timely diagnosis and early treatment could be aided by targeted screening. Recognizing this, the Hungarian Diabetes Association initiated a risk-stratified screening with the involvement of primary care physicians. Material/Methods In the first phase of screening, the FINDRISC questionnaire was completed, followed by an oral glucose tolerance test (OGTT) for those with a score of ≥12. Between September 1, 2010 and March 31, 2011, 70,432 non-diabetic adults, who visited their general practitioners for any reason, were involved in the screening. Of these, 68,476 questionnaires proved to be suitable for processing. Results From the questionnaires, 28,077 (41.0%) had a score of ≥12. A valid OGTT was performed in 22,846 cases; of this group 3,217 subjects (14.1%) had elevated fasting glucose levels, 5,663 (24.8%) had impaired glucose tolerance, and 1,750 (7.6%) had manifest, previously undiagnosed, diabetes mellitus. Overall, from the valid OGTT group, 46.5% subjects had some degree of glucose intolerance. Conclusions Based on the FINDRISC questionnaire, the risk-stratified screening for diabetes mellitus proved to be simple and cost-effective method for the early detection of carbohydrate metabolism disorders. Using this method, the prevalence rate of previously undiagnosed abnormal glucose tolerance was high in adult patients cared for by general practitioners in Hungary. PMID:23344680

  2. Reassessment and Follow-Up Results of BI-RADS Category 3 Lesions Detected on Screening Breast Ultrasound.

    Science.gov (United States)

    Chae, Eun Young; Cha, Joo Hee; Shin, Hee Jung; Choi, Woo Jung; Kim, Hak Hee

    2016-03-01

    The purpose of this study is to determine the frequency and the malignancy rate of BI-RADS category 3 lesions detected on screening breast ultrasound and to reassess whether they satisfied the requirements of the American College of Radiology Imaging Network (ACRIN) 6666 protocol. Of 28,796 asymptomatic women who underwent screening mammography during 2 years, 12,187 underwent additional ultrasound as part of the screening. Patients for whom BI-RADS category 3 lesions were seen on the ultrasound were selected. We reviewed the initial ultrasound showing BI-RADS category 3 lesions and mammograms. We also investigated the clinical outcome of these lesions using the reference standard of a combination of pathologic analysis and follow-up for at least 24 months. The frequency of BI-RADS category 3 lesions detected on screening ultrasound was 14.6% (1783/12,187). Of the 1164 patients with a follow-up duration of at least 24 months or whose lesions were biopsied, eight were eventually proven to have malignancy (0.7%). The malignancy rate was 2.2% (4/184) for patients with abnormal mammograms and 0.4% (4/980) for those with normal mammograms. When the ACRIN 6666 protocols were strictly applied, 225 (19.3%) lesions were retrospectively recategorized as BI-RADS category 4 (n = 12) or category 2 (n = 213). All detected malignancies were early breast cancers with no lymph node metastasis. Although the frequency of ultrasound BI-RADS category 3 lesions is considerably high (14.6%), the malignancy rate is very low (0.7%), especially in patients with a normal mammogram. Therefore, with BI-RADS category 3 assessment, careful evaluation is required to avoid unnecessary short-interval follow-up or biopsy.

  3. The relationship of psychosocial factors to mammograms, physical activity, and fruit and vegetable consumption among sisters of breast cancer patients

    Directory of Open Access Journals (Sweden)

    Hartman SJ

    2011-08-01

    Full Text Available Sheri J Hartman1, Shira I Dunsiger1, Paul B Jacobsen21Centers for Behavioral and Preventive Medicine, The Miriam Hospital and W Alpert Medical School of Brown University, Providence, RI; 2Department of Health Outcomes and Behavior, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USAAbstract: This study examined the relationship of psychosocial factors to health-promoting behaviors in sisters of breast cancer patients. One hundred and twenty sisters of breast cancer patients completed questionnaires assessing response efficacy of mammography screenings, physical activity, and fruit and vegetable consumption on decreasing breast cancer risk, breast cancer worry, involvement in their sister’s cancer care, mammography screenings, physical activity, and fruit and vegetable consumption. Results indicate that greater perceived effectiveness for mammograms was associated with a 67% increase in odds of yearly mammograms. Greater involvement in the patient’s care was associated with a 7% decrease in odds of yearly mammograms. Greater perceived effectiveness for physical activity was significantly related to greater physical activity. There was a trend for greater perceived effectiveness for fruits and vegetables to be associated with consuming more fruits and vegetables. Breast cancer worry was not significantly associated with the outcomes. While perceived effectiveness for a specific health behavior in reducing breast cancer risk was consistently related to engaging in that health behavior, women reported significantly lower perceived effectiveness for physical activity and fruits and vegetables than for mammograms. Making women aware of the health benefits of these behaviors may be important in promoting changes.Keywords: breast cancer risk, mammograms, physical activity, diet, perceived effectiveness

  4. A comparison of face to face and group education on informed choice and decisional conflict of pregnant women about screening tests of fetal abnormalities.

    Science.gov (United States)

    Kordi, Masoumeh; Riyazi, Sahar; Lotfalizade, Marziyeh; Shakeri, Mohammad Taghi; Suny, Hoseyn Jafari

    2018-01-01

    Screening of fetal anomalies is assumed as a necessary measurement in antenatal cares. The screening plans aim at empowerment of individuals to make the informed choice. This study was conducted in order to compare the effect of group and face-to-face education and decisional conflicts among the pregnant females regarding screening of fetal abnormalities. This study of the clinical trial was carried out on 240 pregnant women at education course were held in two weekly sessions for intervention groups during two consecutive weeks, and the usual care was conducted for the control group. The rate of informed choice and decisional conflict was measured in pregnant women before education and also at weeks 20-22 of pregnancy in three groups. The data analysis was executed using SPSS statistical software (version 16), and statistical tests were implemented including Chi-square test, Kruskal-Wallis test, Wilcoxon test, Mann-Whitney U-test, one-way analysis of variance test, and Tukey's range test. The P education group, 64 members (80%) in group education class, and 20 persons (25%) in control group had the informed choice regarding screening tests, but there was no statistically significant difference between two individual and group education classes. Similarly, during the postintervention phase, there was a statistically significant difference in mean score of decisional conflict scale among pregnant women regarding screening tests in three groups ( P = 0.001). With respect to effectiveness of group and face-to-face education methods in increasing the informed choice and reduced decisional conflict in pregnant women regarding screening tests, each of these education methods may be employed according to the clinical environment conditions and requirement to encourage the women for conducting the screening tests.

  5. Automated analysis for microcalcifications in high resolution digital mammograms

    Energy Technology Data Exchange (ETDEWEB)

    Mascio, L.N.; Hernandez, J.M.; Logan, C.M.

    1993-01-01

    Digital mammography offers the promise of significant advances in early detection of breast cancer. Our overall goal is to design a digital system which improves upon every aspect of current mammography technology: the x-ray source, detector, visual presentation of the mammogram and computer-aided diagnosis capabilities. This paper will discuss one part of our whole-system approach -- the development of a computer algorithm using gray-scale morphology to automatically analyze and flag microcalcifications in digital mammograms in hopes of reducing the current percentage of false-negative diagnoses, which is estimated at 20%. The mammograms used for developing this ``mammographers assistant`` are film mammograms which we have digitized at either 70 {mu}m or 35 {mu}m per pixel resolution with 4096 (12 bits) of gray level per pixel. For each potential microcalcification detected in these images, we compute a number of features in order to distinguish between the different kinds of objects detected.

  6. A new approach to microcalcification detection in digital mammograms

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, Heng-Da; Liu, Yui Man [Utah State Univ., Logan, UT (United States); Freimanis, R.I. [Bowman Gray School of Medicine, Winston-Salem, NC (United States)

    1996-12-31

    Computer-aided mammography is an important and challenging task in automated diagnosis. It has great potential over the traditional x-ray mammography in terms of efficiency and accuracy. Microcalcifications are the earliest sign of breast carcinomas and their accurate detection is one of the key issues for breast cancer control. In this study, a novel approach to detecting microcalcifications in digital mammograms is presented. The essential idea of the proposed approach is to apply a fuzzified image of a mammogram to locate the regions of interest and to interact the fuzzified image with the original image to preserve the fidelity. The major advantage of the proposed method is its ability to detect microcalcifications in very dense breast mammograms. A series of clinical mammograms are employed to test the proposed algorithm. The experiments aptly show that the microcalcifications are not only accurately detected but their features are also well preserved.

  7. Automated analysis for microcalcifications in high-resolution digital mammograms

    Science.gov (United States)

    Mascio, Laura N.; Hernandez, John A.; Logan, Clinton M.

    1993-09-01

    Digital mammography offers the promise of significant advances in early detection of breast cancer. Our overall goal is to design a digital system which improves upon every aspect of current mammography technology: the x-ray source, detector, visual presentation of the mammogram and computer-aided diagnosis capabilities. This paper will discuss one part of our whole-system approach--the development of a computer algorithm using gray-scale morphology to automatically analyze and flag microcalcifications in digital mammograms in hopes of reducing the current percentage of false-negative diagnoses, which is estimated at 20%. The mammograms used for developing this 'mammographers assistant' are film mammograms which we have digitized at either 70 micrometers or 35 micrometers per pixel resolution with 4096 (12 bits) of gray level per pixel. For each potential microcalcification detected in these images, we compute a number of features in order to distinguish between the different kinds of objects detected.

  8. Computer-Aided Detection in Digital Mammography: False-Positive Marks and Their Reproducibility in Negative Mammograms

    International Nuclear Information System (INIS)

    Kim, Seung Ja; Moon, Woo Kyung; Cho, Nariya; Chang, Jung Min; Seong, Min Hyun

    2009-01-01

    Background: There are relatively few studies reporting the frequency of false-positive computer-aided detection (CAD) marks and their reproducibility in normal cases. Purpose: To evaluate retrospectively the false-positive mark rate of a CAD system and the reproducibility of false-positive marks in two sets of negative digital mammograms. Material and Methods: Two sets of negative digital mammograms were obtained in 360 women (mean age 57 years, range 30-76 years) with an approximate interval of 1 year (mean time 343.7 days), and a CAD system was applied. False-positive CAD marks and the reproducibility were determined. Results: Of the 360 patients, 252 (70.0%) and 240 (66.7%) patients had 1-7 CAD marks on the initial and second mammograms, respectively. The false-positive CAD mark rate was 1.5 (1.1 for masses and 0.4 for calcifications) and 1.4 (1.0 for masses and 0.4 for calcifications) per examination in the initial and second mammograms, respectively. The reproducibility of the false-positive CAD marks was 12.0% for both mass (81/680) and microcalcification (33/278) marks. Conclusion: False-positive CAD marks were seen in approximately 70% of normal cases. However, the reproducibility was very low. Radiologists must be familiar with the findings of false-positive CAD marks, since they are very common and can increase the recall rate in screening

  9. Simultaneous detection and classification of breast masses in digital mammograms via a deep learning YOLO-based CAD system.

    Science.gov (United States)

    Al-Masni, Mohammed A; Al-Antari, Mugahed A; Park, Jeong-Min; Gi, Geon; Kim, Tae-Yeon; Rivera, Patricio; Valarezo, Edwin; Choi, Mun-Taek; Han, Seung-Moo; Kim, Tae-Seong

    2018-04-01

    Automatic detection and classification of the masses in mammograms are still a big challenge and play a crucial role to assist radiologists for accurate diagnosis. In this paper, we propose a novel Computer-Aided Diagnosis (CAD) system based on one of the regional deep learning techniques, a ROI-based Convolutional Neural Network (CNN) which is called You Only Look Once (YOLO). Although most previous studies only deal with classification of masses, our proposed YOLO-based CAD system can handle detection and classification simultaneously in one framework. The proposed CAD system contains four main stages: preprocessing of mammograms, feature extraction utilizing deep convolutional networks, mass detection with confidence, and finally mass classification using Fully Connected Neural Networks (FC-NNs). In this study, we utilized original 600 mammograms from Digital Database for Screening Mammography (DDSM) and their augmented mammograms of 2,400 with the information of the masses and their types in training and testing our CAD. The trained YOLO-based CAD system detects the masses and then classifies their types into benign or malignant. Our results with five-fold cross validation tests show that the proposed CAD system detects the mass location with an overall accuracy of 99.7%. The system also distinguishes between benign and malignant lesions with an overall accuracy of 97%. Our proposed system even works on some challenging breast cancer cases where the masses exist over the pectoral muscles or dense regions. Copyright © 2018 Elsevier B.V. All rights reserved.

  10. Performance of a subsidised mammographic screening programme in Malaysia, a middle-income Asian country

    Directory of Open Access Journals (Sweden)

    Marianne Lee

    2017-01-01

    Full Text Available Abstract Background The incidence of breast cancer in Asia is increasing because of urbanization and lifestyle changes. In the developing countries in Asia, women present at late stages, and mortality is high. Mammographic screening is the only evidence-based screening modality that reduces breast cancer mortality. To date, only opportunistic screening is offered in the majority of Asian countries because of the lack of justification and funding. Nevertheless, there have been few reports on the effectiveness of such programmes. In this study, we describe the cancer detection rate and challenges experienced in an opportunistic mammographic screening programme in Malaysia. Methods From October 2011 to June 2015, 1,778 asymptomatic women, aged 40–74 years, underwent subsidised mammographic screening. All patients had a clinical breast examination before mammographic screening, and women with mammographic abnormalities were referred to a surgeon. The cancer detection rate and variables associated with a recommendation for adjunct ultrasonography were determined. Results The mean age for screening was 50.8 years and seven cancers (0.39% were detected. The detection rate was 0.64% in women aged 50 years and above, and 0.12% in women below 50 years old. Adjunct ultrasonography was recommended in 30.7% of women, and was significantly associated with age, menopausal status, mammographic density and radiologist’s experience. The main reasons cited for recommendation of an adjunct ultrasound was dense breasts and mammographic abnormalities. Discussion The cancer detection rate is similar to population-based screening mammography programmes in high-income Asian countries. Unlike population-based screening programmes in Caucasian populations where the adjunct ultrasonography rate is 2–4%, we report that 3 out of 10 women attending screening mammography were recommended for adjunct ultrasonography. This could be because Asian women attending screening

  11. Assessing the Risk of Ovarian Malignancy in Asymptomatic Women With Abnormal CA 125 and Transvaginal Ultrasound in the Prostate, Lung, Colorectal, and Ovarian Screening Trial

    Science.gov (United States)

    Partridge, Edward E.; Greenlee, Robert T.; Riley, Thomas L.; Commins, John; Ragard, Lawrence; Xu, Jian-Lun; Buys, Saundra S.; Prorok, Philip C.; Fouad, Mona N.

    2012-01-01

    Objective To estimate the risk of ovarian malignancy among asymptomatic women with abnormal transvaginal ultrasound or CA 125 and to provide guidance to physicians managing these women. Methods A cohort of women from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial with abnormal ovarian results at the initial (T0) and subsequent (T1+) screens were analyzed to estimate which findings were associated with high risk of ovarian cancer. Risks of cancer of greater than 10% were designated as high and risks of 3% or less as low. Results For the T0 screen, two high-risk categories were identified: CA 125 of 70 or more with negative transvaginal ultrasound (positive predictive value [PPV] 15.9%, CI 14.7%–17.7%); and positive for both CA 125 and transvaginal ultrasound (PPV 25.0%, CI 23.3%–27.3%). For T1+ screens, three high-risk categories were identified: negative transvaginal ultrasound with change in CA 125 greater than 45 or more (PPV 29.0%, CI 28.3%–30.3%); increase in size of cyst 6 cm or greater with negative CA 125 (PPV 13.3%, CI 10.5%–18.0%); and positive for both tests (PPV 42.9%, CI 40.0%–46.0%). High-risk criteria for T0 provide a sensitivity of 60%, specificity 96.2%, PPV 19.7%, and a negative predictive value (NPV) of 99.3%. T1+ criteria yielded a sensitivity of 85.3%, specificity 95.6%, PPV 29.6% and NPV 99.7%. Conclusions High risk categories for predicting risk of cancer in women with abnormal CA 125, TVU or both at initial and subsequent screens have been identified. The large number of women in this study, the four year complete follow-up, and very small number of invasive cancers in the low risk categories provides guidance for clinical decisions regarding need for surgery in these women. PMID:23262924

  12. Current status of clinical image evaluation of mammograms: preliminary report

    International Nuclear Information System (INIS)

    Gwak, Yeon Joo; Kim, Hye Jung; Lee, Hui Joong; Ryeom, Hun Kyu

    2008-01-01

    To survey the current overall quality of mammograms and to improve Korean standards in comparison to the American College of Radiology (ACR) standards for clinical image evaluations. A total of 104 mammograms, collected from 63 hospitals and clinics, were examined following the revised new Korean standards and ACR standards for clinical image evaluation. The pass and failure rates of the mammogram were evaluated according to each of the standards compared. The pass threshold for the Korean standards was analyzed using the ROC (receiver operating characteristic) curve in associated with the ACR standards. The categories of the Korean standards were evaluated in association with failure of the ACR standards. Among the 104 mammograms, 99.0% passed the Korean standards, whereas 86.5% passed the ACR standards. A score of 75.5 was the pass threshold for the Korean standards. Moreover, the Korean standards categories associated with the failure of ACR standards included positioning, compression, and contrast/exposure (ρ < 0.05). The pass rate of the image evaluation for each mammogram following the Korean standards was 99%, compared to 86.5% for the ACR standards. Hence, the Korean standards were not as stringent. Consequently, stricter regulations are suggested for improvement in the quality of mammograms

  13. Microcalcifications Detected as an Abnormality on Screening Mammography: Outcomes and Followup over a Five-Year Period

    Directory of Open Access Journals (Sweden)

    Melissa Craft

    2013-01-01

    Full Text Available Objectives. This study reviewed the outcome of women attending a breast screening program recalled for assessment of microcalcifications and examined the incidence of a breast carcinoma detected during the following five years in any of the women who were given a benign diagnosis at assessment. Method. A retrospective study consisted of 235 clients attending an Australian BreastScreen program in 2003, who were recalled for investigation of microcalcifications detected on screening mammography. Records for the following five years were available for 168 women in the benign outcome group including those who did not require biopsy at initial assessment. Results. Malignant disease was detected in 26.0% (n=146 of the women who underwent biopsy. None of the women in the benign outcome group, with available five-year follow-up records, developed a subsequent breast cancer, arising from the calcifications initially recalled in 2003. Conclusions. This study highlights the effectiveness of an Australian screening program in diagnosing malignancy in women with screen detected microcalcification. This has been achieved by correctly determining 38% (n=235 of the women as benign without the need for biopsy or early recall. A low rate of open surgical biopsies was performed with no cancer diagnoses missed at the time of initial assessment.

  14. Study of the Effects of Total Modulation Transfer Function Changes on Observer Performance Using Clinical Mammograms.

    Science.gov (United States)

    Bencomo, Jose Antonio Fagundez

    The main goal of this study was to relate physical changes in image quality measured by Modulation Transfer Function (MTF) to diagnostic accuracy. One Hundred and Fifty Kodak Min-R screen/film combination conventional craniocaudal mammograms obtained with the Pfizer Microfocus Mammographic system were selected from the files of the Department of Radiology, at M.D. Anderson Hospital and Tumor Institute. The mammograms included 88 cases with a variety of benign diagnosis and 62 cases with a variety of malignant biopsy diagnosis. The average age of the patient population was 55 years old. 70 cases presented calcifications with 30 cases having calcifications smaller than 0.5mm. 46 cases presented irregular bordered masses larger than 1 cm. 30 cases presented smooth bordered masses with 20 larger than 1 cm. Four separated copies of the original images were made each having a different change in the MTF using a defocusing technique whereby copies of the original were obtained by light exposure through different thicknesses (spacing) of transparent film base. The mammograms were randomized, and evaluated by three experienced mammographers for the degree of visibility of various anatomical breast structures and pathological lesions (masses and calicifications), subjective image quality, and mammographic interpretation. 3,000 separate evaluations were anayzed by several statistical techniques including Receiver Operating Characteristic curve analysis, McNemar test for differences between proportions and the Landis et al. method of agreement weighted kappa for ordinal categorical data. Results from the statistical analysis show: (1) There were no statistical significant differences in the diagnostic accuracy of the observers when diagnosing from mammograms with the same MTF. (2) There were no statistically significant differences in diagnostic accuracy for each observer when diagnosing from mammograms with the different MTF's used in the study. (3) There statistical

  15. Morphological Enhancement of Microcalcifications in Digital Mammograms

    Science.gov (United States)

    Jagannath, H. S.; Virmani, J.; Kumar, V.

    2012-09-01

    Mammography is a commonly used technique for early detection of breast cancer. In mammograms, microcalcifications show low contrast margin with the background parenchymal tissue (specifically when the background tissue type is fibroglandular) as a result, subjective analysis of these calcifications with respect to their size, shape and morphology presents a daunting challenge even for experienced radiologists. Thus the present work investigates the potential of two morphological techniques i.e., top-hat morphological processing and h-dome morphological processing for enhancement of microcalcifications embedded in variety of background tissue types including fatty, glandular and fibroglandular tissues while restoring their shape and size. The enhancement results are also compared with standard contrast limited adaptive histogram equalization method. For subjective analysis, 25 synthetic images with simulated microcalcifications of various shapes and sizes are used. Objective analysis is carried out on 50 mammographic images taken from benchmark dataset (McGill University mammographic database) by computing quantitative indices like contrast improvement ratio and detail variance/background variance ratios. After rigorous experimentation on both synthetic and benchmark data set it was observed that h-dome morphological processing (with h = 60) is ideally suited for enhancement of microcalcifications while restoring their shape and size.

  16. Mobile Versus Fixed Facility: Latinas' Attitudes and Preferences for Obtaining a Mammogram.

    Science.gov (United States)

    Scheel, John R; Tillack, Allison A; Mercer, Lauren; Coronado, Gloria D; Beresford, Shirley A A; Molina, Yamile; Thompson, Beti

    2018-01-01

    Mobile mammographic services have been proposed as a way to reduce Latinas' disproportionate late-stage presentation compared with white women by increasing their access to mammography. The aims of this study were to assess why Latinas may not use mobile mammographic services and to explore their preferences after using these services. Using a mixed-methods approach, a secondary analysis was conducted of baseline survey data (n = 538) from a randomized controlled trial to improve screening mammography rates among Latinas in Washington. Descriptive statistics and bivariate regression were used to characterize mammography location preferences and to test for associations with sociodemographic indices, health care access, and perceived breast cancer risk and beliefs. On the basis of these findings, a qualitative study (n = 18) was used to explore changes in perceptions after using mobile mammographic services. More Latinas preferred obtaining a mammogram at a fixed facility (52.3% [n = 276]) compared with having no preference (46.3% [n = 249]) and preferring mobile mammographic services (1.7% [n = 9]). Concerns about privacy and comfort (15.6% [n = 84]) and about general quality (10.6% [n = 57]) were common reasons for preferring a fixed facility. Those with no history of mammography preferred a fixed facility (P mobile mammographic services after obtaining a mammogram. Although most Latinas preferred obtaining a mammogram at a fixed facility, positive experiences with mobile mammography services changed their attitudes toward them. These findings highlight the need to include community education when using mobile mammographic service to increase screening mammography rates in underserved communities. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  17. Towards an in-plane methodology to track breast lesions using mammograms and patient-specific finite-element simulations

    Science.gov (United States)

    Lapuebla-Ferri, Andrés; Cegoñino-Banzo, José; Jiménez-Mocholí, Antonio-José; Pérez del Palomar, Amaya

    2017-11-01

    In breast cancer screening or diagnosis, it is usual to combine different images in order to locate a lesion as accurately as possible. These images are generated using a single or several imaging techniques. As x-ray-based mammography is widely used, a breast lesion is located in the same plane of the image (mammogram), but tracking it across mammograms corresponding to different views is a challenging task for medical physicians. Accordingly, simulation tools and methodologies that use patient-specific numerical models can facilitate the task of fusing information from different images. Additionally, these tools need to be as straightforward as possible to facilitate their translation to the clinical area. This paper presents a patient-specific, finite-element-based and semi-automated simulation methodology to track breast lesions across mammograms. A realistic three-dimensional computer model of a patient’s breast was generated from magnetic resonance imaging to simulate mammographic compressions in cranio-caudal (CC, head-to-toe) and medio-lateral oblique (MLO, shoulder-to-opposite hip) directions. For each compression being simulated, a virtual mammogram was obtained and posteriorly superimposed to the corresponding real mammogram, by sharing the nipple as a common feature. Two-dimensional rigid-body transformations were applied, and the error distance measured between the centroids of the tumors previously located on each image was 3.84 mm and 2.41 mm for CC and MLO compression, respectively. Considering that the scope of this work is to conceive a methodology translatable to clinical practice, the results indicate that it could be helpful in supporting the tracking of breast lesions.

  18. A novel approach for classification of abnormalities in digitized ...

    Indian Academy of Sciences (India)

    Feature extraction is an important process for the overall system performance in classification. The objective of this article is to reveal the effectiveness of texture feature analysis for detecting the abnormalities in digitized mammograms using Self Adaptive Resource Allocation Network (SRAN) classifier. Thus, we proposed a ...

  19. Three-Class Mammogram Classification Based on Descriptive CNN Features

    Directory of Open Access Journals (Sweden)

    M. Mohsin Jadoon

    2017-01-01

    Full Text Available In this paper, a novel classification technique for large data set of mammograms using a deep learning method is proposed. The proposed model targets a three-class classification study (normal, malignant, and benign cases. In our model we have presented two methods, namely, convolutional neural network-discrete wavelet (CNN-DW and convolutional neural network-curvelet transform (CNN-CT. An augmented data set is generated by using mammogram patches. To enhance the contrast of mammogram images, the data set is filtered by contrast limited adaptive histogram equalization (CLAHE. In the CNN-DW method, enhanced mammogram images are decomposed as its four subbands by means of two-dimensional discrete wavelet transform (2D-DWT, while in the second method discrete curvelet transform (DCT is used. In both methods, dense scale invariant feature (DSIFT for all subbands is extracted. Input data matrix containing these subband features of all the mammogram patches is created that is processed as input to convolutional neural network (CNN. Softmax layer and support vector machine (SVM layer are used to train CNN for classification. Proposed methods have been compared with existing methods in terms of accuracy rate, error rate, and various validation assessment measures. CNN-DW and CNN-CT have achieved accuracy rate of 81.83% and 83.74%, respectively. Simulation results clearly validate the significance and impact of our proposed model as compared to other well-known existing techniques.

  20. Mammogram retrieval through machine learning within BI-RADS standards.

    Science.gov (United States)

    Wei, Chia-Hung; Li, Yue; Huang, Pai Jung

    2011-08-01

    A content-based mammogram retrieval system can support usual comparisons made on images by physicians, answering similarity queries over images stored in the database. The importance of searching for similar mammograms lies in the fact that physicians usually try to recall similar cases by seeking images that are pathologically similar to a given image. This paper presents a content-based mammogram retrieval system, which employs a query example to search for similar mammograms in the database. In this system the mammographic lesions are interpreted based on their medical characteristics specified in the Breast Imaging Reporting and Data System (BI-RADS) standards. A hierarchical similarity measurement scheme based on a distance weighting function is proposed to model user's perception and maximizes the effectiveness of each feature in a mammographic descriptor. A machine learning approach based on support vector machines and user's relevance feedback is also proposed to analyze the user's information need in order to retrieve target images more accurately. Experimental results demonstrate that the proposed machine learning approach with Radial Basis Function (RBF) kernel function achieves the best performance among all tested ones. Furthermore, the results also show that the proposed learning approach can improve retrieval performance when applied to retrieve mammograms with similar mass and calcification lesions, respectively. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. Three-Class Mammogram Classification Based on Descriptive CNN Features.

    Science.gov (United States)

    Jadoon, M Mohsin; Zhang, Qianni; Haq, Ihsan Ul; Butt, Sharjeel; Jadoon, Adeel

    2017-01-01

    In this paper, a novel classification technique for large data set of mammograms using a deep learning method is proposed. The proposed model targets a three-class classification study (normal, malignant, and benign cases). In our model we have presented two methods, namely, convolutional neural network-discrete wavelet (CNN-DW) and convolutional neural network-curvelet transform (CNN-CT). An augmented data set is generated by using mammogram patches. To enhance the contrast of mammogram images, the data set is filtered by contrast limited adaptive histogram equalization (CLAHE). In the CNN-DW method, enhanced mammogram images are decomposed as its four subbands by means of two-dimensional discrete wavelet transform (2D-DWT), while in the second method discrete curvelet transform (DCT) is used. In both methods, dense scale invariant feature (DSIFT) for all subbands is extracted. Input data matrix containing these subband features of all the mammogram patches is created that is processed as input to convolutional neural network (CNN). Softmax layer and support vector machine (SVM) layer are used to train CNN for classification. Proposed methods have been compared with existing methods in terms of accuracy rate, error rate, and various validation assessment measures. CNN-DW and CNN-CT have achieved accuracy rate of 81.83% and 83.74%, respectively. Simulation results clearly validate the significance and impact of our proposed model as compared to other well-known existing techniques.

  2. A comparison of face to face and group education on informed choice and decisional conflict of pregnant women about screening tests of fetal abnormalities

    Science.gov (United States)

    Kordi, Masoumeh; Riyazi, Sahar; Lotfalizade, Marziyeh; Shakeri, Mohammad Taghi; Suny, Hoseyn Jafari

    2018-01-01

    BACKGROUND AND GOAL: Screening of fetal anomalies is assumed as a necessary measurement in antenatal cares. The screening plans aim at empowerment of individuals to make the informed choice. This study was conducted in order to compare the effect of group and face-to-face education and decisional conflicts among the pregnant females regarding screening of fetal abnormalities. METHODS: This study of the clinical trial was carried out on 240 pregnant women at pregnancy age in health care medical centers in Mashhad city in 2014. The form of individual-midwifery information and informed choice questionnaire and decisional conflict scale were used as tools for data collection. The face-to-face and group education course were held in two weekly sessions for intervention groups during two consecutive weeks, and the usual care was conducted for the control group. The rate of informed choice and decisional conflict was measured in pregnant women before education and also at weeks 20–22 of pregnancy in three groups. The data analysis was executed using SPSS statistical software (version 16), and statistical tests were implemented including Chi-square test, Kruskal–Wallis test, Wilcoxon test, Mann–Whitney U-test, one-way analysis of variance test, and Tukey's range test. The P education group, 64 members (80%) in group education class, and 20 persons (25%) in control group had the informed choice regarding screening tests, but there was no statistically significant difference between two individual and group education classes. Similarly, during the postintervention phase, there was a statistically significant difference in mean score of decisional conflict scale among pregnant women regarding screening tests in three groups (P = 0.001). DISCUSSION AND CONCLUSION: With respect to effectiveness of group and face-to-face education methods in increasing the informed choice and reduced decisional conflict in pregnant women regarding screening tests, each of these education

  3. Attitudes of women in their forties toward the 2009 USPSTF mammogram guidelines: a randomized trial on the effects of media exposure.

    Science.gov (United States)

    Davidson, AuTumn S; Liao, Xun; Magee, B Dale

    2011-07-01

    The objective of the study was to assess women's attitudes toward 2009 US Preventive Services Task Force mammography screening guideline changes and evaluate the role of media in shaping opinions. Two hundred forty-nine women, aged 39-49 years, presenting for annual examinations randomized to read 1 of 2 articles, and survey completion comprised the design of the study. Eighty-eight percent overestimated the lifetime breast cancer (BrCa) risk. Eighty-nine percent want yearly mammograms in their 40s. Eighty-six percent felt the changes were unsafe, and even if the changes were doctor recommended, 84% would not delay screening until age 50 years. Those with a friend/relative with BrCa were more likely to want annual mammography in their forties (92% vs 77%, P = .001), and feel changes unsafe (91% vs 69%, P ≤ .0001). Participants with previous false-positive mammograms were less likely to accept doctor-recommended screening delay until age 50 years (8% vs 21%, P = .01). Women overestimate BrCa risk. Skepticism of new mammogram guidelines exists, and is increased by exposure to negative media. Those with prior false-positive mammograms are less likely to accept changes. Copyright © 2011 Mosby, Inc. All rights reserved.

  4. Diagnostic accuracy of fundal height and handheld ultrasound-measured abdominal circumference to screen for fetal growth abnormalities

    Science.gov (United States)

    Haragan, Adriane F.; Hulsey, Thomas C.; Hawk, Angela F.; Newman, Roger B.; Chang, Eugene Y.

    2015-01-01

    OBJECTIVE We sought to compare fundal height and handheld ultrasound–measured fetal abdominal circumference (HHAC) for the prediction of fetal growth restriction (FGR) or large for gestational age. STUDY DESIGN This was a diagnostic accuracy study in nonanomalous singleton pregnancies between 24 and 40 weeks’ gestation. Patients underwent HHAC and fundal height measurement prior to formal growth ultrasound. FGR was defined as estimated fetal weight less than 10%, whereas large for gestational age was defined as estimated fetal weight greater than 90%. Sensitivity and specificity were calculated and compared using methods described elsewhere. RESULTS There were 251 patients included in this study. HHAC had superior sensitivity and specificity for the detection of FGR (sensitivity, 100% vs 42.86%) and (specificity, 92.62% vs 85.24%). HHAC had higher specificity but lower sensitivity when screening for LGA (specificity, 85.66% vs 66.39%) and (sensitivity, 57.14% vs 71.43%). CONCLUSION HHAC could prove to be a valuable screening tool in the detection of FGR. Further studies are needed in a larger population. PMID:25818672

  5. Sperm shape abnormalities induced by energy-related hydrocarbons and industrial chemicals. Progress report, January 1-June 30, 1979. [Methods of screening for toxic agents

    Energy Technology Data Exchange (ETDEWEB)

    Wyrobek, A.J.

    1979-07-23

    Using existing and new biological screening and testing systems, the presence of carcinogenic, mutagenic, teratogenic and physiologic or metabolically toxic agents associated with coal and oil shale extraction, conversion or utilization was identified. The purpose of the study is to further develop and apply the detection of morphologically abnormal mammalian sperm as a rapid, simple, quantitative assay of the pathologic response of the male gonad to toxic agents associated with the recovery, process stream, and emission of nonnuclear sources of energy, with primary attention to substances from in situ coal gasification and in situ oil-shale extraction. Changes in mouse sperm head dimensions following low dose x-ray exposure have been compiled and analyzed.

  6. Regions of micro-calcifications clusters detection based on new features from imbalance data in mammograms

    Science.gov (United States)

    Wang, Keju; Dong, Min; Yang, Zhen; Guo, Yanan; Ma, Yide

    2017-02-01

    Breast cancer is the most common cancer among women. Micro-calcification cluster on X-ray mammogram is one of the most important abnormalities, and it is effective for early cancer detection. Surrounding Region Dependence Method (SRDM), a statistical texture analysis method is applied for detecting Regions of Interest (ROIs) containing microcalcifications. Inspired by the SRDM, we present a method that extract gray and other features which are effective to predict the positive and negative regions of micro-calcifications clusters in mammogram. By constructing a set of artificial images only containing micro-calcifications, we locate the suspicious pixels of calcifications of a SRDM matrix in original image map. Features are extracted based on these pixels for imbalance date and then the repeated random subsampling method and Random Forest (RF) classifier are used for classification. True Positive (TP) rate and False Positive (FP) can reflect how the result will be. The TP rate is 90% and FP rate is 88.8% when the threshold q is 10. We draw the Receiver Operating Characteristic (ROC) curve and the Area Under the ROC Curve (AUC) value reaches 0.9224. The experiment indicates that our method is effective. A novel regions of micro-calcifications clusters detection method is developed, which is based on new features for imbalance data in mammography, and it can be considered to help improving the accuracy of computer aided diagnosis breast cancer.

  7. Radiological and pathological findings of interval cancers in a multi-centre, randomized, controlled trial of mammographic screening in women from age 40-41 years

    Energy Technology Data Exchange (ETDEWEB)

    Evans, A.J. [Breast Institute, Nottingham City Hospital, Nottingham (United Kingdom)]. E-mail: andrew.evans@nuh.nhs.uk; Kutt, E. [Avon Breast Cancer Screening Unit, Central Health Clinic, Tower Hill, Bristol, Avon (United Kingdom); Record, C. [Breast Screening Service, Stoke Mandeville Hospital, Aylesbury (United Kingdom); Waller, M. [Cancer Screening Evaluation Unit, Institute of Cancer Research, London (United Kingdom); Bobrow, L. [Histopathology, Addenbrookes Hospital, Cambridge (United Kingdom); Moss, S. [Cancer Screening Evaluation Unit, Institute of Cancer Research, London (United Kingdom)

    2007-04-15

    Aim: The aim of this study was to analyse the radiographic findings of the screening mammograms of women with interval cancer who participated in a multi-centre, randomized, controlled trial of mammographic screening in women from age 40-48 years. Materials and methods: The screening and diagnostic mammograms of 208 women with interval cancers were reviewed. Abnormalities were classified as malignant, subtle and non-specific. Results: Eighty-seven (42%) of women had true, 66 (32%) occult and 55 (26%) false-negative interval cancers. The features most frequently missed or misinterpreted were granular microcalcification (38%), asymmetric density (27%) and distortion (22%). Thirty-seven percent of abnormal previous screens were classified as malignant, 39% subtle change and 21% as non-specific. Granular calcifications were significantly more common on the diagnostic mammograms of false-negative interval cancers than those of true interval cancers (28 versus 14%, p = 0.04). Occult interval cancers were more likely to be <10 mm and <15 mm in invasive pathological size than other interval cancers (p = 0.03 and 0.005, respectively). True interval cancers were more likely to be histologically grade 3 than other interval cancers (p = 0.04). Women who developed true and false-negative interval cancers had similar background patterns, but women with occult cancers had a higher proportion of dense patterns (p < 0.05). Conclusion: Interval cancers in a young screening population have a high proportion of occult lesions that are small and occur in dense background patterns. The proportion of interval cancers that are false negative is similar that seen in older populations and granular microcalcification is the commonest missed mammographic feature.

  8. Radiological and pathological findings of interval cancers in a multi-centre, randomized, controlled trial of mammographic screening in women from age 40-41 years

    International Nuclear Information System (INIS)

    Evans, A.J.; Kutt, E.; Record, C.; Waller, M.; Bobrow, L.; Moss, S.

    2007-01-01

    Aim: The aim of this study was to analyse the radiographic findings of the screening mammograms of women with interval cancer who participated in a multi-centre, randomized, controlled trial of mammographic screening in women from age 40-48 years. Materials and methods: The screening and diagnostic mammograms of 208 women with interval cancers were reviewed. Abnormalities were classified as malignant, subtle and non-specific. Results: Eighty-seven (42%) of women had true, 66 (32%) occult and 55 (26%) false-negative interval cancers. The features most frequently missed or misinterpreted were granular microcalcification (38%), asymmetric density (27%) and distortion (22%). Thirty-seven percent of abnormal previous screens were classified as malignant, 39% subtle change and 21% as non-specific. Granular calcifications were significantly more common on the diagnostic mammograms of false-negative interval cancers than those of true interval cancers (28 versus 14%, p = 0.04). Occult interval cancers were more likely to be <10 mm and <15 mm in invasive pathological size than other interval cancers (p = 0.03 and 0.005, respectively). True interval cancers were more likely to be histologically grade 3 than other interval cancers (p = 0.04). Women who developed true and false-negative interval cancers had similar background patterns, but women with occult cancers had a higher proportion of dense patterns (p < 0.05). Conclusion: Interval cancers in a young screening population have a high proportion of occult lesions that are small and occur in dense background patterns. The proportion of interval cancers that are false negative is similar that seen in older populations and granular microcalcification is the commonest missed mammographic feature

  9. Automated analysis for microcalcifications in high resolution digital mammograms

    Energy Technology Data Exchange (ETDEWEB)

    Mascio, L.N.; Hernandez, J.M.; Logan, C.M.

    1994-10-01

    Digital mammography offers the promise of significant advances in early detection of breast cancer. Our overall goal is to design a digital system which improves upon every aspect of current mammography technology: the x-ray source, detector, visual presentation of the mammogram and computer-aided diagnosis capabilities. This paper will discuss one part of our whole-system approach -- the development of a computer algorithm using gray-scale morphology to automatically analyze and flag microcalcifications in digital mammograms in hopes of reducing the current percentage of false-negative diagnoses, which is estimated at 20%. The mamrnograms used for developing this ``mammographers assistant`` are film mammograms which we have digitized at either 70{mu}m or 35{mu}m per pixel resolution with 4096(12 bits) of gray level per pixel. For each potential microcalcification detected. in these images, we compute a number of features in order to distinguish between the different kinds of objects detected.

  10. Increased mammogram-induced DNA damage in mammary epithelial cells aged in vitro.

    Directory of Open Access Journals (Sweden)

    Laia Hernández

    Full Text Available Concerned about the risks of mammography screening in the adult population, we analyzed the ability of human mammary epithelial cells to cope with mammogram-induced DNA damage. Our study shows that an X-ray dose of 20 mGy, which is the standard dose received by the breast surface per two-view mammogram X-ray exploration, induces increased frequencies of DNA double-strand breaks to in vitro aged-but not to young-human mammary epithelial cells. We provide evidence that aged epithelial breast cells are more radiosensitive than younger ones. Our studies point to an inefficient damage response of aged cells to low-dose radiation, this being due to both delayed and incomplete mobilization of repair proteins to DNA strand breaks. This inefficient damage response is translated into an important delay in double-strand break disappearance and consequent accumulation of unrepaired DNA breaks. The result of this is a significant increase in micronuclei frequency in the in vitro aged mammary epithelial cells exposed to doses equivalent to a single mammogram X-ray exploration. Since our experiments were carried out in primary epithelial cell cultures in which cells age at the same time as they undergo replication-dependent telomere shortening, we needed to determine the contribution of these two factors to their phenotype. In this paper, we report that the exogenous expression of human telomerase retrotranscriptase in late population doubling epithelial cells does not rescue its delayed repair phenotype. Therefore, retarded DNA break repair is a direct consequence of cellular aging itself, rather than a consequence of the presence of dysfunctional telomeres. Our findings of long-lasting double strand breaks and incomplete DNA break repair in the in vitro aged epithelial cells are in line with the increased carcinogenic risks of radiation exposures at older ages revealed by epidemiologic studies.

  11. Automatic correspondence detection in mammogram and breast tomosynthesis images

    Science.gov (United States)

    Ehrhardt, Jan; Krüger, Julia; Bischof, Arpad; Barkhausen, Jörg; Handels, Heinz

    2012-02-01

    Two-dimensional mammography is the major imaging modality in breast cancer detection. A disadvantage of mammography is the projective nature of this imaging technique. Tomosynthesis is an attractive modality with the potential to combine the high contrast and high resolution of digital mammography with the advantages of 3D imaging. In order to facilitate diagnostics and treatment in the current clinical work-flow, correspondences between tomosynthesis images and previous mammographic exams of the same women have to be determined. In this paper, we propose a method to detect correspondences in 2D mammograms and 3D tomosynthesis images automatically. In general, this 2D/3D correspondence problem is ill-posed, because a point in the 2D mammogram corresponds to a line in the 3D tomosynthesis image. The goal of our method is to detect the "most probable" 3D position in the tomosynthesis images corresponding to a selected point in the 2D mammogram. We present two alternative approaches to solve this 2D/3D correspondence problem: a 2D/3D registration method and a 2D/2D mapping between mammogram and tomosynthesis projection images with a following back projection. The advantages and limitations of both approaches are discussed and the performance of the methods is evaluated qualitatively and quantitatively using a software phantom and clinical breast image data. Although the proposed 2D/3D registration method can compensate for moderate breast deformations caused by different breast compressions, this approach is not suitable for clinical tomosynthesis data due to the limited resolution and blurring effects perpendicular to the direction of projection. The quantitative results show that the proposed 2D/2D mapping method is capable of detecting corresponding positions in mammograms and tomosynthesis images automatically for 61 out of 65 landmarks. The proposed method can facilitate diagnosis, visual inspection and comparison of 2D mammograms and 3D tomosynthesis images for

  12. The significance of screening for microvascular diseases in Chinese community-based subjects with various metabolic abnormalities.

    Directory of Open Access Journals (Sweden)

    Can Pang

    Full Text Available BACKGROUND: To assess the association of albuminuria and retinopathy with metabolic syndrome (MetS and the related metabolic components defined by various criteria in Chinese community-based subjects. METHODS: A total of 3240 Chinese subjects were recruited from urban communities and classified into subgroups with isolated or concomitant state of the two microvascular diseases. MetS was defined according to the standard of International Diabetes Federation, the National Cholesterol Education Program's Adult Treatment Panel III and Chinese Diabetes Society (CDS, separately. Albuminuria was defined as an elevated morning urine albumin-to-creatinine ratio. Retinopathy were identified with nonmydriatic retinal photographs according to the Diabetic Retinopathy Disease Severity Scale. Logistic regression was performed to analyze the contributive risk factors. RESULTS: The subgroup of isolated retinopathy was the oldest (P<0.05, with higher blood pressure (P<0.001 and larger waist circumference (P<0.05. After adjusting for age, sex and other metabolic components, individuals with blood pressure over 130/85 mmHg were prone to have isolated albuminuria (OR: 1.51, P = 0.0001; while individuals with fasting plasma glucose over 5.6 mmol/L were in high risk of retinopathy concomitant with albuminria (OR: 3.04, P = 0.006. Larger waist circumference was a potential risk factors for isolated albuminuria and isolated retinopathy, though not significant after further adjustment of other metabolic components. The risk for albuminuria and retinopathy increased with the aggregation of three or more metabolic components. However, the MetS per se did not have synergic effect and only the MetS defined by CDS remained as a risk factor. CONCLUSIONS: Albuminuria and retinopathy were highly associated with accumulated metabolic abnormalities including sub-clinical elevated blood pressure and elevated fasting plasma glucose.

  13. A new approach to develop computer-aided detection schemes of digital mammograms

    International Nuclear Information System (INIS)

    Tan, Maxine; Liu, Hong; Zheng, Bin; Qian, Wei; Pu, Jiantao

    2015-01-01

    The purpose of this study is to develop a new global mammographic image feature analysis based computer-aided detection (CAD) scheme and evaluate its performance in detecting positive screening mammography examinations. A dataset that includes images acquired from 1896 full-field digital mammography (FFDM) screening examinations was used in this study. Among them, 812 cases were positive for cancer and 1084 were negative or benign. After segmenting the breast area, a computerized scheme was applied to compute 92 global mammographic tissue density based features on each of four mammograms of the craniocaudal (CC) and mediolateral oblique (MLO) views. After adding three existing popular risk factors (woman’s age, subjectively rated mammographic density, and family breast cancer history) into the initial feature pool, we applied a sequential forward floating selection feature selection algorithm to select relevant features from the bilateral CC and MLO view images separately. The selected CC and MLO view image features were used to train two artificial neural networks (ANNs). The results were then fused by a third ANN to build a two-stage classifier to predict the likelihood of the FFDM screening examination being positive. CAD performance was tested using a ten-fold cross-validation method. The computed area under the receiver operating characteristic curve was AUC = 0.779   ±   0.025 and the odds ratio monotonically increased from 1 to 31.55 as CAD-generated detection scores increased. The study demonstrated that this new global image feature based CAD scheme had a relatively higher discriminatory power to cue the FFDM examinations with high risk of being positive, which may provide a new CAD-cueing method to assist radiologists in reading and interpreting screening mammograms. (paper)

  14. Rastreio para anomalias cromossômicas no primeiro trimestre da gestação First-trimester screening for chromosomal abnormalities

    Directory of Open Access Journals (Sweden)

    Kipros Herodotou Nicolaides

    2007-12-01

    Full Text Available Um efetivo rastreio para anomalias cromossômicas pode ser realizado no primeiro trimestre da gestação. A associação entre a transluscência nucal (TN e as concentrações séricas maternas da fração beta-livre da gonadotrofina coriônica humana e da proteína plasmática-A associada à gestação pode identificar 90% dos fetos com trissomia do cromossomo 21 e outras anomalias cromossômicas, com uma taxa de falso-positivo de 5%. Esses números são superiores aos obtidos pelo rastreio utilizando-se apenas a idade materna (30% ou o rastreio bioquímico materno, no segundo trimestre da gestação (65%. Um rastreio mais eficaz, no primeiro trimestre, pode ser atingido por meio de uma avaliação ecográfica em dois tempos, dividindo-se as pacientes em grupos de alto, intermediário e baixo risco. No grupo de alto risco, o diagnóstico invasivo estaria indicado, ao contrário do grupo de baixo risco, no qual a presença de uma anomalia seria pouco provável. No grupo de risco intermediário (risco de 1 em 101 a 1 em 1.000, seria oferecida uma segunda avaliação ecográfica, para posicionar a paciente no grupo de alto ou baixo risco (presença/ausência do osso nasal ou presença/ausência da regurgitação tricúspide ou presença/ausência de alteração do fluxo sangüíneo no ducto venoso. A biópsia de vilo corial estaria indicada quando, após a realização da segunda abordagem, o risco ajustado da paciente se tornasse maior ou igual a 1 em 100. Essa segunda abordagem ecográfica deveria ser realizada por pessoal treinado, e os seus resultados deveriam ser constantemente avaliados, como um controle de qualidade. Esse processo foi estabelecido pela Fetal Medicine Foudation e aceito internacionalmente.Screening for major chromosomal abnormalities can be provided in the first trimester of pregnancy. Screening by a combination of fetal nuchal translucency and maternal serum free human chorionic gonadotropin and pregnancy-associated plasma

  15. Improving follow-up of abnormal cancer screens using electronic health records: trust but verify test result communication

    Directory of Open Access Journals (Sweden)

    Reis Brian

    2009-12-01

    Full Text Available Abstract Background Early detection of colorectal cancer through timely follow-up of positive Fecal Occult Blood Tests (FOBTs remains a challenge. In our previous work, we found 40% of positive FOBT results eligible for colonoscopy had no documented response by a treating clinician at two weeks despite procedures for electronic result notification. We determined if technical and/or workflow-related aspects of automated communication in the electronic health record could lead to the lack of response. Methods Using both qualitative and quantitative methods, we evaluated positive FOBT communication in the electronic health record of a large, urban facility between May 2008 and March 2009. We identified the source of test result communication breakdown, and developed an intervention to fix the problem. Explicit medical record reviews measured timely follow-up (defined as response within 30 days of positive FOBT pre- and post-intervention. Results Data from 11 interviews and tracking information from 490 FOBT alerts revealed that the software intended to alert primary care practitioners (PCPs of positive FOBT results was not configured correctly and over a third of positive FOBTs were not transmitted to PCPs. Upon correction of the technical problem, lack of timely follow-up decreased immediately from 29.9% to 5.4% (p Conclusion Electronic communication of positive FOBT results should be monitored to avoid limiting colorectal cancer screening benefits. Robust quality assurance and oversight systems are needed to achieve this. Our methods may be useful for others seeking to improve follow-up of FOBTs in their systems.

  16. Task-Oriented and Bottle Feeding Adversely Affect the Quality of Mother-Infant Interactions Following Abnormal Newborn Screens

    Science.gov (United States)

    Tluczek, Audrey; Clark, Roseanne; McKechnie, Anne Chevalier; Orland, Kate Murphy; Brown, Roger L.

    2010-01-01

    Objective Examine effects of newborn screening (NBS) and neonatal diagnosis on the quality of mother-infant interactions in the context of feeding. Methods Study compared the quality of mother-infant feeding interactions among four groups of infants classified by severity of NBS and diagnostic results: cystic fibrosis (CF), congenital hypothyroidism, heterozygote CF carrier, and healthy with normal NBS. The Parent-Child Early Relational Assessment and a task-oriented item measured the quality of feeding interactions for 130 dyads, infant ages 3–19 weeks (M=9.19, SD=3.28). The Center for Epidemiologic Studies Depression Scale and State-Trait Anxiety Inventory measured maternal depression and anxiety. Results Composite Indicator Structure Equation Modeling showed that infant diagnostic status and, to a lesser extent, maternal education predicted feeding method. Mothers of infants with CF were most likely to bottle feed, which was associated with more task-oriented maternal behavior than breastfeeding. Mothers with low task-oriented behavior showed more sensitivity and responsiveness to infant cues, as well as less negative affect and behavior in their interactions with their infants than mothers with high task-oriented scores. Mothers of infants with CF were significantly more likely to have clinically significant anxiety and depression than the other groups. However, maternal psychological profile did not predict feeding method or interaction quality. Conclusions Mothers in the CF group were the least likely to breastfeed. Research is needed to explicate long-term effects of feeding methods on quality of mother-child relationship and ways to promote continued breastfeeding following a neonatal CF diagnosis. PMID:20495477

  17. Improvement of digital mammogram images using histogram equalization, histogram stretching and median filter.

    Science.gov (United States)

    Langarizadeh, M; Mahmud, R; Ramli, A R; Napis, S; Beikzadeh, M R; Rahman, W E Z W A

    2011-02-01

    Breast cancer is one of the most important diseases in females worldwide. According to the Malaysian Oncological Society, about 4% of women who are 40 years old and above are involved have breast cancer. Masses and microcalcifications are two important signs of breast cancer diagnosis on mammography. Enhancement techniques, i.e. histogram equalization, histogram stretching and median filters, were used to provide better visualization for radiologists in order to help early detection of breast abnormalities. In this research 60 digital mammogram images which includes 20 normal and 40 confirmed diagnosed cancerous cases were selected and manipulated using the mentioned techniques. The original and manipulated images were scored by three expert radiologists. Results showed that the selected methods have a positive significant effect on image quality.

  18. Women with physical disability and the mammogram: An observational study to identify barriers and facilitators

    International Nuclear Information System (INIS)

    Poulos, Ann; Balandin, Susan; Llewellyn, Gwynnyth; McCarthy, Louella; Dark, Leigha

    2011-01-01

    Purpose: To identify barriers and facilitators experienced by women with physical disability having a mammogram. Method: Direct observation of the mammography procedure for women with a range of physical disability at screening facilities of BreastScreen NSW Australia. Results: A volunteer sample of 13 women with varying degrees of physical disability participated in the study. The outcomes suggested that many barriers for women with physical disability can be ameliorated by environmental adaptations and guidelines for both radiographers and women. Some women however cannot be screened successfully, or can be screened only with a level of trauma and/or pain which militates against their continuation within the screening program. This study has identified physical limitations which preclude a successful outcome, those which increase the discomfort/pain of the procedure and aspects of the procedure which can be improved to minimise the experience of discomfort/pain. Conclusion: From the outcomes of the study the development of a decision tool is indicated as a method of providing information for women with physical disability and their doctors as to the likelihood of a successful outcome to participation in mammography screening.

  19. Volumetric breast density estimation from full-field digital mammograms.

    NARCIS (Netherlands)

    Engeland, S. van; Snoeren, P.R.; Huisman, H.J.; Boetes, C.; Karssemeijer, N.

    2006-01-01

    A method is presented for estimation of dense breast tissue volume from mammograms obtained with full-field digital mammography (FFDM). The thickness of dense tissue mapping to a pixel is determined by using a physical model of image acquisition. This model is based on the assumption that the breast

  20. Flu Shots, Mammogram, and the Perception of Probabilities

    NARCIS (Netherlands)

    Carman, K.G.; Kooreman, P.

    2010-01-01

    We study individuals’ decisions to decline or accept preventive health care interventions such as flu shots and mammograms. In particular, we analyze the role of perceptions of the effectiveness of the intervention, by eliciting individuals' subjective probabilities of sickness and survival, with

  1. Application of texture analysis method for mammogram density classification

    Science.gov (United States)

    Nithya, R.; Santhi, B.

    2017-07-01

    Mammographic density is considered a major risk factor for developing breast cancer. This paper proposes an automated approach to classify breast tissue types in digital mammogram. The main objective of the proposed Computer-Aided Diagnosis (CAD) system is to investigate various feature extraction methods and classifiers to improve the diagnostic accuracy in mammogram density classification. Texture analysis methods are used to extract the features from the mammogram. Texture features are extracted by using histogram, Gray Level Co-Occurrence Matrix (GLCM), Gray Level Run Length Matrix (GLRLM), Gray Level Difference Matrix (GLDM), Local Binary Pattern (LBP), Entropy, Discrete Wavelet Transform (DWT), Wavelet Packet Transform (WPT), Gabor transform and trace transform. These extracted features are selected using Analysis of Variance (ANOVA). The features selected by ANOVA are fed into the classifiers to characterize the mammogram into two-class (fatty/dense) and three-class (fatty/glandular/dense) breast density classification. This work has been carried out by using the mini-Mammographic Image Analysis Society (MIAS) database. Five classifiers are employed namely, Artificial Neural Network (ANN), Linear Discriminant Analysis (LDA), Naive Bayes (NB), K-Nearest Neighbor (KNN), and Support Vector Machine (SVM). Experimental results show that ANN provides better performance than LDA, NB, KNN and SVM classifiers. The proposed methodology has achieved 97.5% accuracy for three-class and 99.37% for two-class density classification.

  2. An anatomically oriented breast coordinate system for mammogram analysis

    NARCIS (Netherlands)

    Brandt, S.S.; Karemore, G.; Karssemeijer, N.; Nielsen, M.

    2011-01-01

    We have developed a breast coordinate system that is based on breast anatomy to register female breasts into a common coordinate frame in 2-D mediolateral (ML) or mediolateral oblique (MLO) view mammograms. The breasts are registered according to the location of the pectoral muscle and the nipple

  3. Evaluating wait times from screening to breast cancer diagnosis among women undergoing organised assessment vs usual care.

    Science.gov (United States)

    Chiarelli, Anna M; Muradali, Derek; Blackmore, Kristina M; Smith, Courtney R; Mirea, Lucia; Majpruz, Vicky; O'Malley, Frances P; Quan, May Lynn; Holloway, Claire Mb

    2017-05-09

    Timely coordinated diagnostic assessment following an abnormal screening mammogram reduces patient anxiety and may optimise breast cancer prognosis. Since 1998, the Ontario Breast Screening Program (OBSP) has offered organised assessment through Breast Assessment Centres (BACs). For OBSP women seen at a BAC, an abnormal mammogram is followed by coordinated referrals through the use of navigators for further imaging, biopsy, and surgical consultation as indicated. For OBSP women seen through usual care (UC), further diagnostic imaging is arranged directly from the screening centre and/or through their physician; results must be communicated to the physician who is then responsible for arranging any necessary biopsy and/or surgical consultation. This study aims to evaluate factors associated with diagnostic wait times for women undergoing assessment through BAC and UC. Of the 2 147 257 women aged 50-69 years screened in the OBSP between 1 January 2002 and 31 December 2009, 155 866 (7.3%) had an abnormal mammogram. A retrospective design identified two concurrent cohorts of women diagnosed with screen-detected breast cancer at a BAC (n=4217; 47%) and UC (n=4827; 53%). Multivariable logistic regression analyses examined associations between wait times and assessment and prognostic characteristics by pathway. A two-sided 5% significance level was used. Screened women with breast cancer were two times more likely to be diagnosed within 7 weeks when assessed through a BAC vs UC (OR=1.91, 95% CI=1.73-2.10). In addition, compared with UC, women assessed through a BAC were significantly more likely to have their first assessment procedure within 3 weeks of their abnormal mammogram (OR=1.25, 95% CI=1.12-1.39), ⩽3 assessment procedures (OR=1.54, 95% CI=1.41-1.69), ⩽2 assessment visits (OR=1.86, 95% CI=1.70-2.05), and ⩾2 procedures per visit (OR=1.41, 95% CI=1.28-1.55). Women diagnosed through a BAC were also more likely than those in UC to have imaging (OR=1.99, 95

  4. Automatic classification for mammogram backgrounds based on bi-rads complexity definition and on a multi content analysis framework

    Science.gov (United States)

    Wu, Jie; Besnehard, Quentin; Marchessoux, Cédric

    2011-03-01

    Clinical studies for the validation of new medical imaging devices require hundreds of images. An important step in creating and tuning the study protocol is the classification of images into "difficult" and "easy" cases. This consists of classifying the image based on features like the complexity of the background, the visibility of the disease (lesions). Therefore, an automatic medical background classification tool for mammograms would help for such clinical studies. This classification tool is based on a multi-content analysis framework (MCA) which was firstly developed to recognize image content of computer screen shots. With the implementation of new texture features and a defined breast density scale, the MCA framework is able to automatically classify digital mammograms with a satisfying accuracy. BI-RADS (Breast Imaging Reporting Data System) density scale is used for grouping the mammograms, which standardizes the mammography reporting terminology and assessment and recommendation categories. Selected features are input into a decision tree classification scheme in MCA framework, which is the so called "weak classifier" (any classifier with a global error rate below 50%). With the AdaBoost iteration algorithm, these "weak classifiers" are combined into a "strong classifier" (a classifier with a low global error rate) for classifying one category. The results of classification for one "strong classifier" show the good accuracy with the high true positive rates. For the four categories the results are: TP=90.38%, TN=67.88%, FP=32.12% and FN =9.62%.

  5. Contrast Enhancement of Mammograms for Rapid Detection of Microcalcification Clusters

    Directory of Open Access Journals (Sweden)

    Hajar Moradmand

    2014-08-01

    Full Text Available Introduction Breast cancer is one of the most common types of cancer among women.  Early detection of breast cancer is the key to reducing the associated mortality rate. The presence of microcalcifications clusters (MCCs is one of the earliest signs of breast cancer. Due to poor imaging contrast of mammograms and noise contamination, radiologists may overlook some diagnostic signs, specially the presence of MCCs. In order to improve cancer detection, image enhancement methods are often used to aid radiologists. In this paper, a new enhancement method was presented for the accurate and early detection of MCCs in mammograms. Materials and Methods The proposed system consisted of four main steps including: 1 image scaling;2 breast region segmentation;3 noise cancellation using a filter, which is sensitive to MCCs; and 4 contrast enhancement of mammograms using Contrast-Limited Adaptive Histogram Equalization (CLAHE and wavelet transform. To evaluate this method, 120 clinical mammograms were used. Results To evaluate the performance of the image enhancement algorithm, contrast improvement index (CII was used. The proposed enhancement method in this research achieved the highest CII in comparison with other methods applied in this study. The Validity of the results was confirmed by an expert radiologist through visual inspection. Conclusion Detection of MCCs significantly improved in contrast-enhanced mammograms. The proposed method could be helpful for radiologists to easily detect MCCs; it could also decrease the number of biopsies and reduce the frequency of clinical misdiagnosis. Moreover, it could be useful prior to segmentation or classification stages.

  6. Screen for abnormal mitochondrial phenotypes in mouse embryonic stem cells identifies a model for succinyl-CoA ligase deficiency and mtDNA depletion

    Directory of Open Access Journals (Sweden)

    Taraka R. Donti

    2014-02-01

    Full Text Available Mutations in subunits of succinyl-CoA synthetase/ligase (SCS, a component of the citric acid cycle, are associated with mitochondrial encephalomyopathy, elevation of methylmalonic acid (MMA, and mitochondrial DNA (mtDNA depletion. A FACS-based retroviral-mediated gene trap mutagenesis screen in mouse embryonic stem (ES cells for abnormal mitochondrial phenotypes identified a gene trap allele of Sucla2 (Sucla2SAβgeo, which was used to generate transgenic mice. Sucla2 encodes the ADP-specific β-subunit isoform of SCS. Sucla2SAβgeo homozygotes exhibited recessive lethality, with most mutants dying late in gestation (e18.5. Mutant placenta and embryonic (e17.5 brain, heart and muscle showed varying degrees of mtDNA depletion (20–60%. However, there was no mtDNA depletion in mutant liver, where the gene is not normally expressed. Elevated levels of MMA were observed in embryonic brain. SCS-deficient mouse embryonic fibroblasts (MEFs demonstrated a 50% reduction in mtDNA content compared with wild-type MEFs. The mtDNA depletion resulted in reduced steady state levels of mtDNA encoded proteins and multiple respiratory chain deficiencies. mtDNA content could be restored by reintroduction of Sucla2. This mouse model of SCS deficiency and mtDNA depletion promises to provide insights into the pathogenesis of mitochondrial diseases with mtDNA depletion and into the biology of mtDNA maintenance. In addition, this report demonstrates the power of a genetic screen that combines gene trap mutagenesis and FACS analysis in mouse ES cells to identify mitochondrial phenotypes and to develop animal models of mitochondrial dysfunction.

  7. Impact of high resolution radiation doses of mammograms: Evaluation cost-benefit

    International Nuclear Information System (INIS)

    Ferreira, R.; Peixoto, J.; Yacovenco, A.

    1996-01-01

    The purpose of this study was to evaluate the impact of high resolution mammograms over a group of assimptomatic women submitted to the breast exam. The radiation doses to the skin surface and the average dose to the glandular tissue from the cranio caudal view were evaluated. The sample consisted of 407 women throughout Brazil. From these results, in the light of ICRP 60., using the absolute radiobiological risk model, it was possible to estimate the lifetime risk in two ways; firstly the lifetime risk expressed as the excess of radioinduced breast cancer, secondly the lifetime loss for the female population from the age bracket of 30 to 70. that results show that the benefits of high resolutions mammography outweigh the risk to at least, 40 % of efficacy in screening programmes It is therefore concluded that only women of 40 years old or above be included in such a programme

  8. The accuracy of digital breast tomosynthesis compared with coned compression magnification mammography in the assessment of abnormalities found on mammography

    International Nuclear Information System (INIS)

    Morel, J.C.; Iqbal, A.; Wasan, R.K.; Peacock, C.; Evans, D.R.; Rahim, R.; Goligher, J.; Michell, M.J.

    2014-01-01

    Aim: To compare the diagnostic accuracy of the digital breast tomosynthesis (DBT) with coned compression magnification mammography (CCMM). Materials and methods: The study design included two reading sessions completed by seven experienced radiologists. In the first session, all readers read bilateral standard two-view mammograms and a CCMM view of the lesion before giving a combined score for assessment. In the second session, readers read bilateral standard two-view mammograms plus one-view DBT. The two reading sessions of the experiment were separated by at least 2 weeks to reduce the chance of reader memory of the images read in the previous session from influencing the performance in the subsequent session. Results: Three hundred and fifty-four lesions were assessed and receiver-operative characteristic (ROC) analysis was used to evaluate the difference between the two modes. For standard two-view mammography plus CCMM, the area under the curve (AUC) was 0.87 [95% confidence interval (CI): 0.83–0.91] and for standard two-view mammography plus DBT the AUC was 0.93 (95% CI: 0.91–0.95). The difference between the AUCs was 0.06 with p-value of 0.0014. Conclusion: Two-view mammography with one-view DBT showed significantly improved accuracy compared to two-view mammography and CCMM in the assessment of mammographic abnormalities. These results show that DBT can be used effectively in the further evaluation of mammographic abnormalities found at screening and in symptomatic diagnostic practice. - Highlights: • Diagnostic accuracy of magnification mammography and digital breast tomosynthesis. • There is statistical difference between CCMM and DBT. • DBT has a role in evaluating mammographic abnormalities

  9. Congenital Abnormalities

    Science.gov (United States)

    ... Stages Ages and Stages Prenatal Baby (0-12 mos.) Toddler 1-3yrs. Preschool 3-5yrs Grade School ... Categories of Congenital Abnormalities Chromosome Abnormalities Chromosomes are structures that carry genetic material inherited from one generation ...

  10. Connective tissue representation for detection of microcalcifications in digital mammograms

    Science.gov (United States)

    McLoughlin, Kristin J.; Bones, Philip J.; Kovesi, Peter

    2002-05-01

    Microcalcification clusters appear as an early sign of breast cancer and play an important role in interpreting mammograms. Progress is reported towards an automated computer aided detection system for clustered microcalcifications utilizing two image feature parameters: local contrast and shape. The use of a shape parameter is necessary to distinguish thin patches of connective tissue from microcalcifications. Two shape parameter techniques are compared in the segmentation of 15 digital mammogram images. The first technique implements the linear Hough transform, while the second uses image phase information in the Fourier domain. In both cases labeling of the image is performed by a deterministic relaxation scheme, in which both image data dn prior beliefs are weighted simultaneously. Similar segmentation results are obtained for each shape parameter technique however the execution time for the phase method is approximately one quarter that for the Hough method. Both techniques offer an improvement over segmentation results obtained without the shape parameter.

  11. A method for detecting microcalcifications in Digital Mammograms

    OpenAIRE

    Wallet, Bradley C.; Solka, Jeffrey L.; Priebe, Carey E.

    1997-01-01

    Microcalcification clusters are often an important indicator for the detection of malignancy in mammograms. In many cases, microcalcifications are the only indication of a malignancy. However, the detection of microcalcifications can be a difficult process. They are small and can be embedded in dense tissue. This paper presents a method for automatically detecting microcalcifications. We utilize a high-boost filter to suppress background clutter enabling segmentation even in very dense breast...

  12. Comparison of mammogram images using different quantization methods

    Science.gov (United States)

    Chen, E. T. Y.; Lee, James; Nelson, Alan C.

    1993-07-01

    Special devices with higher quantization resolution are needed to display or process most medical images. In this paper, we compare three different quantization approaches for mammogram images in order to process them in 8 bits/pixel resolution. Since microcalcification is one of the most important indications of risk of breast cancer, a simple shift operation (uniform quantization) cannot retain this vital information. Quantization based on the local histogram will give better results but at the price of more computation.

  13. Monte Carlo Modelling of Mammograms : Development and Validation

    International Nuclear Information System (INIS)

    Spyrou, G.; Panayiotakis, G.; Bakas, A.; Tzanakos, G.

    1998-01-01

    A software package using Monte Carlo methods has been developed for the simulation of x-ray mammography. A simplified geometry of the mammographic apparatus has been considered along with the software phantom of compressed breast. This phantom may contain inhomogeneities of various compositions and sizes at any point. Using this model one can produce simulated mammograms. Results that demonstrate the validity of this simulation are presented. (authors)

  14. Automated recognition of microcalcification clusters in mammograms

    Science.gov (United States)

    Bankman, Isaac N.; Christens-Barry, William A.; Kim, Dong W.; Weinberg, Irving N.; Gatewood, Olga B.; Brody, William R.

    1993-07-01

    The widespread and increasing use of mammographic screening for early breast cancer detection is placing a significant strain on clinical radiologists. Large numbers of radiographic films have to be visually interpreted in fine detail to determine the subtle hallmarks of cancer that may be present. We developed an algorithm for detecting microcalcification clusters, the most common and useful signs of early, potentially curable breast cancer. We describe this algorithm, which utilizes contour map representations of digitized mammographic films, and discuss its benefits in overcoming difficulties often encountered in algorithmic approaches to radiographic image processing. We present experimental analyses of mammographic films employing this contour-based algorithm and discuss practical issues relevant to its use in an automated film interpretation instrument.

  15. PERBANDINGAN EKSTRAKSI CIRI PADA DATA MAMMOGRAM UNTUK IDENTIFIKASI MIKROKALSIFIKASI

    Directory of Open Access Journals (Sweden)

    Endang Supriyati

    2014-11-01

    Full Text Available ABSTRAK Salah satu cara untuk mendeteksi ada tidaknya kanker pada payudara adalah dengan mammografi. Pada penelitian ini, dilakukan pengenalan pola dengan klasifikasi massa, jinak, dan ganas pada data mammogram. Namun data mammogram memiliki noise dan struktur patologis yang tidak teratur sehingga perlu dilakukan pengolahan citra terlebih dahulu. Tahapan pengolahan citra yang dilakukan antara lain: preprocessing, segmentasi, dan ekstraksi ciri. Pada tahap preprocessing dilakukan perbaikan kualitas citra dengan operasi CLAHE (Contrast Limited Adaptive Histogram equalization dan tahap segmentasi dilakukan dengan metode OTSU. Sedangkan tahap ekstraksi ciri, ada 3 metode yang diperbandingkan yaitu Discreate Wavelet Transformation (DWT, Gray Level Co-occurance Matrix (GLCM, dan Gabor Wavelet (GW. Setelah pengolahan citra dilakukan, tahap selanjutnya adalah pengenalan pola dengan klasifikasi menggunakan metode Jaringan Syaraf Tiruan (JST-Lavenberg Marquard (LM. Dari uji coba yang telah dilakukan dengan klasifikasi JST, hasil terbaik dari testing dengan data training diperoleh pada data mammogram dengan ekstraksi ciri menggunakan Gabor Wavelet. Sedangkan testing dengan data testing menunjukkan hasil yang tidak stabil. Hal ini dikarenakan adanya diversifikasi data yang besar, baik pada ukuran mau pun struktur patologis dari mammary. Kata kunci: ekstraksi ciri, Discreate Wavelet Transformation, Gray Level Co-occurance Matrix, Gabor Wavelet, klasifikasi, jaringan syaraf tiruan-Lavenberg Marquard.

  16. Field nonuniformity correction for quantitative analysis of digitized mammograms

    International Nuclear Information System (INIS)

    Pawluczyk, Olga; Yaffe, Martin J.

    2001-01-01

    Several factors, including the heel effect, variation in distance from the x-ray source to points in the image and path obliquity contribute to the signal nonuniformity of mammograms. To best use digitized mammograms for quantitative image analysis, these field non-uniformities must be corrected. An empirically based correction method, which uses a bowl-shaped calibration phantom, has been developed. Due to the annular spherical shape of the phantom, its attenuation is constant over the entire image. Remaining nonuniformities are due only to the heel and inverse square effects as well as the variable path through the beam filter, compression plate and image receptor. In logarithmic space, a normalized image of the phantom can be added to mammograms to correct for these effects. Then, an analytical correction for path obliquity in the breast can be applied to the images. It was found that the correction causes the errors associated with field nonuniformity to be reduced from 14% to 2% for a 4 cm block of material corresponding to a combination of 50% fibroglandular and 50% fatty breast tissue. A repeatability study has been conducted to show that in regions as far as 20 cm away from the chest wall, variations due to imaging conditions and phantom alignment contribute to <2% of overall corrected signal

  17. Estimating average glandular dose by measuring glandular rate in mammograms

    International Nuclear Information System (INIS)

    Goto, Sachiko; Azuma, Yoshiharu; Sumimoto, Tetsuhiro; Eiho, Shigeru

    2003-01-01

    The glandular rate of the breast was objectively measured in order to calculate individual patient exposure dose (average glandular dose) in mammography. By employing image processing techniques and breast-equivalent phantoms with various glandular rate values, a conversion curve for pixel value to glandular rate can be determined by a neural network. Accordingly, the pixel values in clinical mammograms can be converted to the glandular rate value for each pixel. The individual average glandular dose can therefore be calculated using the individual glandular rates on the basis of the dosimetry method employed for quality control in mammography. In the present study, a data set of 100 craniocaudal mammograms from 50 patients was used to evaluate our method. The average glandular rate and average glandular dose of the data set were 41.2% and 1.79 mGy, respectively. The error in calculating the individual glandular rate can be estimated to be less than ±3%. When the calculation error of the glandular rate is taken into consideration, the error in the individual average glandular dose can be estimated to be 13% or less. We feel that our method for determining the glandular rate from mammograms is useful for minimizing subjectivity in the evaluation of patient breast composition. (author)

  18. Quantification and normalization of x-ray mammograms

    International Nuclear Information System (INIS)

    Tromans, Christopher E; Cocker, Mary R; Brady, Michael

    2012-01-01

    The analysis of (x-ray) mammograms remains qualitative, relying on the judgement of clinicians. We present a novel method to compute a quantitative, normalized measure of tissue radiodensity traversed by the primary beam incident on each pixel of a mammogram, a measure we term the standard attenuation rate (SAR). SAR enables: the estimation of breast density which is linked to cancer risk; direct comparison between images; the full potential of computer aided diagnosis to be utilized; and a basis for digital breast tomosynthesis reconstruction. It does this by removing the effects of the imaging conditions under which the mammogram is acquired. First, the x-ray spectrum incident upon the breast is calculated, and from this, the energy exiting the breast is calculated. The contribution of scattered radiation is calculated and subtracted. The SAR measure is the scaling factor that must be applied to the reference material in order to match the primary attenuation of the breast. Specifically, this is the scaled reference material attenuation which when traversed by an identical beam to that traversing the breast, and when subsequently detected, results in the primary component of the pixel intensity observed in the breast image. We present results using two tissue equivalent phantoms, as well as a sensitivity analysis to detector response changes over time and possible errors in compressed thickness measurement. (paper)

  19. Automatic detection of clustered microcalcifications in digitized mammogram films

    Science.gov (United States)

    Yu, Songyang; Guan, Ling; Brown, Stephen

    1999-01-01

    The existence of clustered microcalcifications is one of the important early signs of breast cancer. This paper presents an image processing procedure for the automatic detection of clustered microcalcifications in digitized mammograms. In particular, a sensitivity range of around one false positive per image is targeted. The proposed method consists of two main steps. First, possible microcalcification pixels in the mammograms are segmented out using wavelet features or both wavelet features and gray level statistical features, and labeled into potential individual microcalcification objects by their spatial connectivity. Second, individual microcalcifications are detected by using the structure features extracted from the potential microcalcification objects. The classifiers used in these two steps are feedforward neutral networks. The method is applied to a database of 40 mammograms (Nijmegen database) containing 105 clusters of microcalcifications. A free response operating characteristics curve is used to evaluate the performance. Results show that the proposed procedure gives quite satisfactory detection performance. In particular, a 93% mean true positive detection rate is achieved at the price of one false positive per image when both wavelet features and gray level statistical features are used in the first step.

  20. Automated registration of diagnostic to prediagnostic x-ray mammograms: Evaluation and comparison to radiologists' accuracy

    International Nuclear Information System (INIS)

    Pinto Pereira, Snehal M.; Hipwell, John H.; McCormack, Valerie A.; Tanner, Christine; Moss, Sue M.; Wilkinson, Louise S.; Khoo, Lisanne A. L.; Pagliari, Catriona; Skippage, Pippa L.; Kliger, Carole J.; Hawkes, David J.; Santos Silva, Isabel M. dos

    2010-01-01

    Purpose: To compare and evaluate intensity-based registration methods for computation of serial x-ray mammogram correspondence. Methods: X-ray mammograms were simulated from MRIs of 20 women using finite element methods for modeling breast compressions and employing a MRI/x-ray appearance change model. The parameter configurations of three registration methods, affine, fluid, and free-form deformation (FFD), were optimized for registering x-ray mammograms on these simulated images. Five mammography film readers independently identified landmarks (tumor, nipple, and usually two other normal features) on pairs of diagnostic and corresponding prediagnostic digitized images from 52 breast cancer cases. Landmarks were independently reidentified by each reader. Target registration errors were calculated to compare the three registration methods using the reader landmarks as a gold standard. Data were analyzed using multilevel methods. Results: Between-reader variability varied with landmark (p<0.01) and screen (p=0.03), with between-reader mean distance (mm) in point location on the diagnostic/prediagnostic images of 2.50 (95% CI 1.95, 3.15)/2.84 (2.24, 3.55) for nipples and 4.26 (3.43, 5.24)/4.76 (3.85, 5.84) for tumors. Registration accuracy was sensitive to the type of landmark and the amount of breast density. For dense breasts (≥40%), the affine and fluid methods outperformed FFD. For breasts with lower density, the affine registration surpassed both fluid and FFD. Mean accuracy (mm) of the affine registration varied between 3.16 (95% CI 2.56, 3.90) for nipple points in breasts with density 20%-39% and 5.73 (4.80, 6.84) for tumor points in breasts with density <20%. Conclusions: Affine registration accuracy was comparable to that between independent film readers. More advanced two-dimensional nonrigid registration algorithms were incapable of increasing the accuracy of image alignment when compared to affine registration.

  1. Access to cancer screening in people with learning disabilities in the UK: cohort study in the health improvement network, a primary care research database.

    Directory of Open Access Journals (Sweden)

    David P J Osborn

    Full Text Available To assess whether people with learning disability in the UK have poorer access to cancer screening.Four cohort studies comparing people with and without learning disability, within the recommended age ranges for cancer screening in the UK. We used Poisson regression to determine relative incidence rates of cancer screening.The Health Improvement Network, a UK primary care database with over 450 General practices.Individuals with a recorded diagnosis of learning disability including general diagnostic terms, specific syndromes, chromosomal abnormalities and autism in their General Practitioner computerised notes. For each type of cancer screening, a comparison cohort of up to six people without learning disability was selected for each person with a learning disability, using stratified sampling on age within GP practice.Incidence rate ratios for receiving 1 a cervical smear test, 2 a mammogram, 3 a faecal occult blood test and 4 a prostate specific antigen test.Relative rates of screening for all four cancers were significantly lower for people with learning disability. The adjusted incidence rate ratios (95% confidence intervals were Cervical smears: Number eligible with learning disability = 6,254; IRR = 0.54 (0.52-0.56. Mammograms: Number eligible with learning disability = 2,956; IRR = 0.76 (0.72-0.81; Prostate Specific Antigen: Number eligible = 3,520; IRR = 0.87 (0.80-0.96 and Faecal Occult Blood Number eligible = 6,566; 0.86 (0.78-0.94. Differences in screening rates were less pronounced in more socially deprived areas. Disparities in cervical screening rates narrowed over time, but were 45% lower in 2008/9, those for breast cancer screening appeared to widen and were 35% lower in 2009.Despite recent incentives, people with learning disability in the UK are significantly less likely to receive screening tests for cancer that those without learning disability. Other methods for reducing inequalities in access to cancer screening should be

  2. Hough transform for clustered microcalcifications detection in full-field digital mammograms

    Science.gov (United States)

    Fanizzi, A.; Basile, T. M. A.; Losurdo, L.; Amoroso, N.; Bellotti, R.; Bottigli, U.; Dentamaro, R.; Didonna, V.; Fausto, A.; Massafra, R.; Moschetta, M.; Tamborra, P.; Tangaro, S.; La Forgia, D.

    2017-09-01

    Many screening programs use mammography as principal diagnostic tool for detecting breast cancer at a very early stage. Despite the efficacy of the mammograms in highlighting breast diseases, the detection of some lesions is still doubtless for radiologists. In particular, the extremely minute and elongated salt-like particles of microcalcifications are sometimes no larger than 0.1 mm and represent approximately half of all cancer detected by means of mammograms. Hence the need for automatic tools able to support radiologists in their work. Here, we propose a computer assisted diagnostic tool to support radiologists in identifying microcalcifications in full (native) digital mammographic images. The proposed CAD system consists of a pre-processing step, that improves contrast and reduces noise by applying Sobel edge detection algorithm and Gaussian filter, followed by a microcalcification detection step performed by exploiting the circular Hough transform. The procedure performance was tested on 200 images coming from the Breast Cancer Digital Repository (BCDR), a publicly available database. The automatically detected clusters of microcalcifications were evaluated by skilled radiologists which asses the validity of the correctly identified regions of interest as well as the system error in case of missed clustered microcalcifications. The system performance was evaluated in terms of Sensitivity and False Positives per images (FPi) rate resulting comparable to the state-of-art approaches. The proposed model was able to accurately predict the microcalcification clusters obtaining performances (sensibility = 91.78% and FPi rate = 3.99) which favorably compare to other state-of-the-art approaches.

  3. Multi-task transfer learning deep convolutional neural network: application to computer-aided diagnosis of breast cancer on mammograms

    Science.gov (United States)

    Samala, Ravi K.; Chan, Heang-Ping; Hadjiiski, Lubomir M.; Helvie, Mark A.; Cha, Kenny H.; Richter, Caleb D.

    2017-12-01

    Transfer learning in deep convolutional neural networks (DCNNs) is an important step in its application to medical imaging tasks. We propose a multi-task transfer learning DCNN with the aim of translating the ‘knowledge’ learned from non-medical images to medical diagnostic tasks through supervised training and increasing the generalization capabilities of DCNNs by simultaneously learning auxiliary tasks. We studied this approach in an important application: classification of malignant and benign breast masses. With Institutional Review Board (IRB) approval, digitized screen-film mammograms (SFMs) and digital mammograms (DMs) were collected from our patient files and additional SFMs were obtained from the Digital Database for Screening Mammography. The data set consisted of 2242 views with 2454 masses (1057 malignant, 1397 benign). In single-task transfer learning, the DCNN was trained and tested on SFMs. In multi-task transfer learning, SFMs and DMs were used to train the DCNN, which was then tested on SFMs. N-fold cross-validation with the training set was used for training and parameter optimization. On the independent test set, the multi-task transfer learning DCNN was found to have significantly (p  =  0.007) higher performance compared to the single-task transfer learning DCNN. This study demonstrates that multi-task transfer learning may be an effective approach for training DCNN in medical imaging applications when training samples from a single modality are limited.

  4. Meiotic abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1993-12-31

    Chapter 19, describes meiotic abnormalities. These include nondisjunction of autosomes and sex chromosomes, genetic and environmental causes of nondisjunction, misdivision of the centromere, chromosomally abnormal human sperm, male infertility, parental age, and origin of diploid gametes. 57 refs., 2 figs., 1 tab.

  5. Two-view versus single-view mammography at subsequent screening in a region of the Dutch breast screening programme.

    NARCIS (Netherlands)

    Smallenburg, V.v.; Duijm, L.E.M.; Heeten, G.J. den; Groenewoud, J.H.; Jansen, F.H.M.; Fracheboud, J.; Plaisier, M.L.; Doorne-Nagtegaal, H.J. van; Broeders, M.J.M.

    2012-01-01

    We retrospectively determined the effect of analogue two-view mammography versus single-view mammography at subsequent screens on breast cancer detection and determined financial consequences for a current digital mammography setting. Two screening radiologists reviewed the mammograms of 536 screen

  6. Two-view versus single-view mammography at subsequent screening in a region of the Dutch breast screening programme

    NARCIS (Netherlands)

    Smallenburg, Vivian van Breest; Duijm, Lucien E. M.; den Heeten, Gerard J.; Groenewoud, Johanna H.; Jansen, Frits H.; Fracheboud, Jacques; Plaisier, Menno L.; van Doorne-Nagtegaal, Heidi J.; Broeders, Mireille J. M.

    2012-01-01

    We retrospectively determined the effect of analogue two-view mammography versus single-view mammography at subsequent screens on breast cancer detection and determined financial consequences for a current digital mammography setting. Two screening radiologists reviewed the mammograms of 536 screen

  7. Breast Cancer Detection with Gabor Features from Digital Mammograms

    Directory of Open Access Journals (Sweden)

    Yufeng Zheng

    2010-01-01

    Full Text Available A new breast cancer detection algorithm, named the “Gabor Cancer Detection” (GCD algorithm, utilizing Gabor features is proposed. Three major steps are involved in the GCD algorithm, preprocessing, segmentation (generating alarm segments, and classification (reducing false alarms. In preprocessing, a digital mammogram is down-sampled, quantized, denoised and enhanced. Nonlinear diffusion is used for noise suppression. In segmentation, a band-pass filter is formed by rotating a 1-D Gaussian filter (off center in frequency space, termed as “Circular Gaussian Filter” (CGF. A CGF can be uniquely characterized by specifying a central frequency and a frequency band. A mass or calcification is a space-occupying lesion and usually appears as a bright region on a mammogram. The alarm segments (suspicious to be masses/calcifications can be extracted out using a threshold that is adaptively decided upon the histogram analysis of the CGF-filtered mammogram. In classification, a Gabor filter bank is formed with five bands by four orientations (horizontal, vertical, 45 and 135 degree in Fourier frequency domain. For each mammographic image, twenty Gabor-filtered images are produced. A set of edge histogram descriptors (EHD are then extracted from 20 Gabor images for classification. An EHD signature is computed with four orientations of Gabor images along each band and five EHD signatures are then joined together to form an EHD feature vector of 20 dimensions. With the EHD features, the fuzzy C-means clustering technique and k-nearest neighbor (KNN classifier are used to reduce the number of false alarms. The experimental results tested on the DDSM database (University of South Florida show the promises of GCD algorithm in breast cancer detection, which achieved TP (true positive rate = 90% at FPI (false positives per image = 1.21 in mass detection; and TP = 93% at FPI = 1.19 in calcification detection.

  8. Factors Influencing Compliance with Mammography Screening Recommendations in an Air Force Population

    National Research Council Canada - National Science Library

    Link, Tamara

    1998-01-01

    .... Data was analyzed using SPSS for Windows version 6.1. This study found that over 80% of respondents indicated their last mammogram was for routine screening purposes as opposed to diagnostic purposes. Most respondents (82...

  9. Automatic breast cancer risk assessment from digital mammograms

    DEFF Research Database (Denmark)

    Karemore, Gopal Raghunath; Brandt, Sami; Karssemeijer, N

    pixel location is represented by geodesic distance from nipple and parametric angle, instead of x and y in traditional Cartesian coordinate system within a breast coordinate system, thus locale tissue orientation is compared more accurately (G. Karemore et al, 2010). For every pixel, a collection......Purpose: Textural characteristics of the breast tissue structure on mammogram have been shown to improve breast cancer risk assessment in several large studies. Currently, however, the texture is not used to assess risk in standard clinical procedures or involved in general breast cancer risk...... of 0.64, which is statistically significant and different than other methods (P

  10. Walking abnormalities

    Science.gov (United States)

    ... include: Arthritis of the leg or foot joints Conversion disorder (a mental disorder) Foot problems (such as a ... injuries. For an abnormal gait that occurs with conversion disorder, counseling and support from family members are strongly ...

  11. Opportunistic Breast Cancer Education and Screening in Rural Honduras.

    Science.gov (United States)

    Kennedy, Linda S; Bejarano, Suyapa A; Onega, Tracy L; Stenquist, Derek S; Chamberlin, Mary D

    2016-08-01

    In Honduras, the breast cancer burden is high, and access to women's health services is low. This project tested the connection of community-based breast cancer detection with clinical diagnosis and treatment in a tightly linked and quickly facilitated format. The Norris Cotton Cancer Center at Dartmouth College partnered with the Honduran cancer hospital La Liga Contra el Cancer to expand a cervical cancer screening program, which included self-breast exam (SBE) education and clinical breast exams (CBEs), to assess patient attitudes about and uptake of breast cancer education and screening services. The cervical cancer screening event was held in Honduras in 2013; 476 women from 31 villages attended. Half of the women attending elected to receive a CBE; most had concerns about lactation. Clinicians referred 12 women with abnormal CBEs to La Liga Contra el Cancer for additional evaluation at no cost. All referred patients were compliant with the recommendation and received follow-up care. One abnormal follow-up mammogram/ultrasound result was negative on biopsy. One woman with an aggressive phyllodes tumor had a mastectomy within 60 days. Multimodal education about breast cancer screening maximized delivery of women's health services in a low-tech rural setting. The addition of opportunistic breast cancer education and screening to a cervical cancer screening event resulted in high uptake of services at low additional cost to program sponsors. Such novel strategies to maximize delivery of women's health services in low-resource settings, where there is no access to mammography, may result in earlier detection of breast cancer. Close follow-up of positive results with referral to appropriate treatment is essential.

  12. Computerized detection of masses on mammograms by entropy maximization thresholding

    International Nuclear Information System (INIS)

    Kom, Guillaume; Tiedeu, Alain; Feudjio, Cyrille; Ngundam, J.

    2010-03-01

    In many cases, masses in X-ray mammograms are subtle and their detection can benefit from an automated system serving as a diagnostic aid. It is to this end that the authors propose in this paper, a new computer aided mass detection for breast cancer diagnosis. The first step focuses on wavelet filters enhancement which removes bright background due to dense breast tissues and some film artifacts while preserving features and patterns related to the masses. In the second step, enhanced image is computed by Entropy Maximization Thresholding (EMT) to obtain segmented masses. The efficiency of 98,181% is achieved by analyzing a database of 84 mammograms previously marked by radiologists and digitized at a pixel size of 343μmm x 343μ mm. The segmentation results, in terms of size of detected masses, give a relative error on mass area that is less than 8%. The performance of the proposed method has also been evaluated by means of the receiver operating-characteristics (ROC) analysis. This yielded respectively, an area (Az) of 0.9224 and 0.9295 under the ROC curve whether enhancement step is applied or not. Furthermore, we observe that the EMT yields excellent segmentation results compared to those found in literature. (author)

  13. Mammographer personality traits – elements of the optimal mammogram experience

    Directory of Open Access Journals (Sweden)

    Amanda Louw

    2014-11-01

    Doelstellings: Die doel van hierdie studie was om van die faktore wat pasiënte se persepsies beïnvloed, te ondersoek. Pasiënte se persepsies en voorkeure ten opsigte van mammograwe se persoonlikheidseienskappe word in hierdie artikel bespreek. Metode: In dié beskrywende, verkennende studie is ’n nie-waarskynlikheid-gerieflikheidsteekproef-metode gebruik om data van 274 mammogram-pasiënte in vier kliniese opleidingsentrums in Gauteng met behulp van ’n vraelys in te win. Die respondente moes die belangrikheid van 24 persoonlikheidseienskappe van mammograwe beoordeel. Geldigheid, betroubaarheid, geloofwaardigheid en etiese oorwegings is in ag geneem. Resultate: Van al die vraelyste is 91% ingehandig. Die data is met behulp van beskrywende statistiek en faktoranalise geïnterpreteer, en vier faktore is uit die persoonlikheidskaal geïdentifiseer. Gevolgtrekking: Dit blyk dat pasiënte mammograwe beoordeel volgens die vertroue wat hulle inboesem, die sorg wat hulle verleen, hoe veilig hulle pasiënte laat voel, asook hoe goed hulle kommunikeer. Aangesien die mammograaf-pasiënt-verhouding pasiënte se indrukke van mammogramme sterk beïnvloed, kan hierdie vier faktore as fundamentele elemente van ’n optimale mammogram-ondersoek beskou word.

  14. Bio Inspired Swarm Algorithm for Tumor Detection in Digital Mammogram

    Science.gov (United States)

    Dheeba, J.; Selvi, Tamil

    Microcalcification clusters in mammograms is the significant early sign of breast cancer. Individual clusters are difficult to detect and hence an automatic computer aided mechanism will help the radiologist in detecting the microcalcification clusters in an easy and efficient way. This paper presents a new classification approach for detection of microcalcification in digital mammogram using particle swarm optimization algorithm (PSO) based clustering technique. Fuzzy C-means clustering technique, well defined for clustering data sets are used in combination with the PSO. We adopt the particle swarm optimization to search the cluster center in the arbitrary data set automatically. PSO can search the best solution from the probability option of the Social-only model and Cognition-only model. This method is quite simple and valid, and it can avoid the minimum local value. The proposed classification approach is applied to a database of 322 dense mammographic images, originating from the MIAS database. Results shows that the proposed PSO-FCM approach gives better detection performance compared to conventional approaches.

  15. ANALISA PERBANDINGAN METODE SEGMENTASI CITRA PADA CITRA MAMMOGRAM

    Directory of Open Access Journals (Sweden)

    Toni Arifin

    2016-09-01

    Full Text Available Abstract Cancer is a desaeas with a high prevalence in the world. As many 8,2 million people died of cancer. The prevalence of cancer was happened in woman that is breast cancer. Breast cancer is a malignancy derived from grandular cells, gland duct and supporting the breast tissues. There are many ways of detecting the presence of breast cancer which one is mammography test that aims to examine the human breast using low-dose X-rays. Observation mammography results in the form of mammogram images can be done with image processing, in this way the process of observation is not take a long time and error in the observation can be reduced. One of the process image processing is image segmentation, the step of image segmentation is an important in image analysis there force is needed method in process of image sementation. This observation is aims to analyze comparison of two image segmentation methods of mammogram images that is using Watershed method and Otsu method after that it will see the quality of image by calculating the signal to noise ratio and timing run of each method. The result of this observation is showed that the signal to noise ratio on the Watershed method 7,475 dB and Otsu method 6.197 dB and the conclution is Watershed method is better than Otsu method, whereas if viewed the timing run Watershed method 0,016 seconds is more faster than Otsu method.

  16. Benign Lesions on Screening Mammography: Increasing Diagnostic Confidence in a Hitherto Unscreened Population.

    Science.gov (United States)

    Joshi, Piyush; Sharma, Rohit

    2017-09-01

    Screening mammography is used for detection of breast cancer and is interpreted using the Breast Image Reporting and Data System (BIRADS) convention. It is not routinely offered to women in countries which do not have a national screening programme resulting in a challenge for the radiologist who has to interpret these in the absence of previous mammograms. To analyse benign and probably benign lesions in screening mammograms in a hitherto unscreened population and suggest protocols to increase diagnostic confidence. Screening mammograms of 362 asymptomatic women in the age range of 40 to 60 years carried out over a two year period were retrospectively analysed. Patients of breast cancer and those who had palpable lumps were excluded from the study. All images were analysed in standard Mediolateral Oblique (MLO) and Craniocaudal (CC) projections with additional views wherever necessary. Corroborative ultrasound had been carried out wherever indicated in the opinion of the interpreting radiologist. The mammograms were finally classified according to the BIRADS convention. Of the total number of 362 women screened, most of whom did not have any previous mammogram, 162 were reported as BIRADS I, 179 as BIRADS II and 18 as BIRADS III. The mammograms reported as BIRADS II had various findings including dystrophic calcification/macrocalcification, vascular calcification, simple cysts and fibroadenomas. Only 26 (16.04%) of the BIRADS I mammograms had undergone further evaluation with Ultrasound (US) due to dense breasts or asymmetrical involution of breast tissue whereas 76 (42.5%) of the BIRADS II mammograms had undergone further evaluation with US to characterize lesions like cysts and fibroadenomas, but occasionally also for benign clustered calcification. Of BIRADS III mammograms, 12 (66.6%) had required US correlation to exclude a mass in cases with dense breasts. The increased likelihood of ultrasound corroboration in BIRADS II and BIRADS III was analysed using the

  17. Detection of breast cancer by soft-copy reading of digital mammograms: Comparison between a routine image-processing parameter and high-contrast parameters

    Energy Technology Data Exchange (ETDEWEB)

    Kamitani, Takeshi; Yabuuchi, Hidetake; Soeda, Hiroyasu; Matsuo, Yoshio; Okafuji, Takashi; Setoguchi, Taro; Hatakenaka, Masamitsu; Honda, Hiroshi (Dept. of Clinical Radiology, Graduate School of Medical Sciences, Kyushu Univ., Fukuoka (Japan)), e-mail: kamitani@radiol.med.kyushu-u.ac.jp; Sakai, Shuji (Dept. of Health Sciences, Graduate School of Medical Sciences, Kyushu Univ., Fukuoka (Japan)); Ishii, Nobuhide (Fuji Film Medical Co., Ltd., Fukuoka (Japan))

    2010-01-15

    Background: Recent studies have reported the clinical usefulness of the soft-copy reading of mammograms. However, image-processing parameters for soft-copy reading of digital mammograms have not been established. Purpose: To compare observer performance in detecting breast cancer by soft-copy reading of digital mammograms using a routine image-processing parameter versus each of several high-contrast parameters. Material and Methods: The mammograms of 154 breasts, including 48 abnormal breasts with breast cancer and 106 normal breasts, were examined. Cancers were classified into 34 mass-dominant cancers, 11 microcalcification-dominant cancers, two cancers showing only architectural distortion, and one cancer without abnormal findings. All mammograms were performed using a computed radiography (CR) system. Each image was processed using GA (1.2), which was the contrast parameter recommended by the manufacturer for hard-copy film, GA (1.4), GA (1.6), and GA (1.8). These images were displayed on 5-megapixel (M) liquid-crystal display monitors. Five experienced radiologists classified them into BI-RADS category 1-2 or 3-5, and were also asked to rate the images on a scale of 0 to 100 for the likelihood of the presence of masses and microcalcifications in each breast. Results: In mass-dominant cancers of dense breast tissue, the mean sensitivities of GA (1.2), GA (1.4), GA (1.6), and GA (1.8) were 32.7, 38.2, 36.4, and 40.0, and the AZ values were 0.67, 0.73, 0.71, and 0.73, respectively; in microcalcification-dominant cancers, the mean sensitivities were 80.0, 74.5, 80.0, and 78.2, respectively; however, there were no significant differences among them. Conclusion: High-contrast parameters tended to show relatively high sensitivity and AZ values in the detection of masses in dense breast tissue, but relatively low sensitivity for microcalcifications

  18. Automated microcalcification detection in mammograms using statistical variable-box-threshold filter method

    Science.gov (United States)

    Wilson, Mark; Mitra, Sunanda; Roberson, Glenn H.; Shieh, Yao-Yang

    1997-10-01

    Currently early detection of breast cancer is primarily accomplished by mammography and suspicious findings may lead to a decision for performing a biopsy. Digital enhancement and pattern recognition techniques may aid in early detection of some patterns such as microcalcification clusters indicating onset of DCIS (ductal carcinoma in situ) that accounts for 20% of all mammographically detected breast cancers and could be treated when detected early. These individual calcifications are hard to detect due to size and shape variability and inhomogeneous background texture. Our study addresses only early detection of microcalcifications that allows the radiologist to interpret the x-ray findings in computer-aided enhanced form easier than evaluating the x-ray film directly. We present an algorithm which locates microcalcifications based on local grayscale variability and of tissue structures and image statistics. Threshold filters with lower and upper bounds computed from the image statistics of the entire image and selected subimages were designed to enhance the entire image. This enhanced image was used as the initial image for identifying the micro-calcifications based on the variable box threshold filters at different resolutions. The test images came from the Texas Tech University Health Sciences Center and the MIAS mammographic database, which are classified into various categories including microcalcifications. Classification of other types of abnormalities in mammograms based on their characteristic features is addressed in later studies.

  19. The effect of feature selection methods on computer-aided detection of masses in mammograms.

    Science.gov (United States)

    Hupse, Rianne; Karssemeijer, Nico

    2010-05-21

    In computer-aided diagnosis (CAD) research, feature selection methods are often used to improve generalization performance of classifiers and shorten computation times. In an application that detects malignant masses in mammograms, we investigated the effect of using a selection criterion that is similar to the final performance measure we are optimizing, namely the mean sensitivity of the system in a predefined range of the free-response receiver operating characteristics (FROC). To obtain the generalization performance of the selected feature subsets, a cross validation procedure was performed on a dataset containing 351 abnormal and 7879 normal regions, each region providing a set of 71 mass features. The same number of noise features, not containing any information, were added to investigate the ability of the feature selection algorithms to distinguish between useful and non-useful features. It was found that significantly higher performances were obtained using feature sets selected by the general test statistic Wilks' lambda than using feature sets selected by the more specific FROC measure. Feature selection leads to better performance when compared to a system in which all features were used.

  20. Hidden costs of low-cost screening mammography

    International Nuclear Information System (INIS)

    Cyrlak, D.

    1987-01-01

    Twenty-two hundred women in Orange County, California, took part in a low-cost mammography screening project sponsored by the American Cancer Society and the KCBS-TV. Patients were followed up by telephone and questioned about actual costs incurred as a result of screening mammography, including costs of repeated and follow-up mammograms, US examinations and surgical consultations. The total number of biopsies, cancers found, and the costs involved were investigated. The authors' results suggest that particularly in centers with a high positive call rate, the cost of screening mammograms accounts for only a small proportion of the medical costs

  1. Exposure parameters of mammograms with and without mass lesions from a South African breast care centre

    International Nuclear Information System (INIS)

    Acho, Sussan N.; Boonzaier, Willem P. E.; Nel, Ina F.

    2017-01-01

    In South African breast care centres, full-field digital mammography units provide breast imaging services to symptomatic and asymptomatic women simultaneously. This study evaluated the technical exposure parameters of 800 mammograms of which 100 mammograms had obvious mass lesions in the fibro-glandular tissue. The average breast compression force of mammograms with mass lesions in the fibro-glandular tissue was 18.4% less than the average breast compression force of mammograms without mass lesions. The average mean glandular dose (MGD), tube potential (kV p ) and compressed breast thickness (CBT) values were 2.14 mGy, 30.5 kV p and 63.9 mm, respectively, for mammograms with mass lesions, and 1.45 mGy, 29.6 kV p and 56.9 mm, respectively, for mammograms without mass lesions. Overall, the average MGD and mean CBT of mammograms with mass lesion were significantly higher compared to those without mass lesions (p < 0.05), although there was no significant difference in their tube potentials (p > 0.05). (authors)

  2. Assessment of a novel mass detection algorithm in mammograms

    Directory of Open Access Journals (Sweden)

    Ehsan Kozegar

    2013-01-01

    Settings and Design: The proposed mass detector consists of two major steps. In the first step, several suspicious regions are extracted from the mammograms using an adaptive thresholding technique. In the second step, false positives originating by the previous stage are reduced by a machine learning approach. Materials and Methods: All modules of the mass detector were assessed on mini-MIAS database. In addition, the algorithm was tested on INBreast database for more validation. Results: According to FROC analysis, our mass detection algorithm outperforms other competing methods. Conclusions: We should not just insist on sensitivity in the segmentation phase because if we forgot FP rate, and our goal was just higher sensitivity, then the learning algorithm would be biased more toward false positives and the sensitivity would decrease dramatically in the false positive reduction phase. Therefore, we should consider the mass detection problem as a cost sensitive problem because misclassification costs are not the same in this type of problems.

  3. Non-negative Dimensionality Reduction for Mammogram Classification

    Directory of Open Access Journals (Sweden)

    I. Buciu

    2009-05-01

    Full Text Available Directly classifying high dimensional datamay exhibit the ``curse of dimensionality'' issue thatwould negatively influence the classificationperformance with an increase in the computationalload, depending also on the classifier structure. Whenworking with classifiers not affected by this issue (suchas Support Vector Machines, for instance, thecomputational load still exists due to the required timein computing the kernel matrix. Moreover, theperformance is affected when a few samples per classis available for the training procedure. One commonsolution is to carry out a feature extraction step forreducing the data dimension prior to classification.The paper describes the application of NonnegativeMatrix Factorization (NMF for extracting featuresfrom mammogram medical images with differentresolution, further used for recognizing breast tumors.For comparison, Principal Component Analysis (PCAand Independent Component Analysis (ICA wereexplored. Experiments show that NMF methodoutperforms PCA and ICA, leading to higherclassification accuracy.

  4. Locally adaptive decision in detection of clustered microcalcifications in mammograms

    Science.gov (United States)

    Sainz de Cea, María V.; Nishikawa, Robert M.; Yang, Yongyi

    2018-02-01

    In computer-aided detection or diagnosis of clustered microcalcifications (MCs) in mammograms, the performance often suffers from not only the presence of false positives (FPs) among the detected individual MCs but also large variability in detection accuracy among different cases. To address this issue, we investigate a locally adaptive decision scheme in MC detection by exploiting the noise characteristics in a lesion area. Instead of developing a new MC detector, we propose a decision scheme on how to best decide whether a detected object is an MC or not in the detector output. We formulate the individual MCs as statistical outliers compared to the many noisy detections in a lesion area so as to account for the local image characteristics. To identify the MCs, we first consider a parametric method for outlier detection, the Mahalanobis distance detector, which is based on a multi-dimensional Gaussian distribution on the noisy detections. We also consider a non-parametric method which is based on a stochastic neighbor graph model of the detected objects. We demonstrated the proposed decision approach with two existing MC detectors on a set of 188 full-field digital mammograms (95 cases). The results, evaluated using free response operating characteristic (FROC) analysis, showed a significant improvement in detection accuracy by the proposed outlier decision approach over traditional thresholding (the partial area under the FROC curve increased from 3.95 to 4.25, p-value  adaptive decision approach could not only reduce the number of FPs in detected MCs but also improve case-to-case consistency in detection.

  5. A novel statistical approach for detection of suspicious regions in digital mammogram

    Directory of Open Access Journals (Sweden)

    Z.A. Abo-Eleneen

    2013-07-01

    Full Text Available In this paper, we propose a novel algorithm to detect the suspicious regions on digital mammograms that based on the Fisher information measure. The proposed algorithm is tested different types and categories of mammograms (fatty, fatty-glandular and dense glandular within mini-MIAS database (Mammogram Image Analysis Society database (UK. The proposed method is compared with a different segmentation based information theoretical methods to demonstrate their effectiveness. The experimental results on mammography images showed the effectiveness in the detection of suspicious regions. This study can be a part of developing a computer-aided decision (CAD system for early detection of breast cancer.

  6. Breast Cancer Screening (PDQ®)—Patient Version

    Science.gov (United States)

    Breast cancer screening is performed using mammogram, clinical breast exam (CBE), and MRI (magnetic resonance imaging) tests. Learn about these and other tests that have been studied to detect or screen for breast cancer in this expert-reviewed and evidence-based summary.

  7. When ultrasound anomalies are present: An estimation of the frequency of chromosome abnormalities not detected by cell-free DNA aneuploidy screens.

    Science.gov (United States)

    Reimers, Rebecca M; Mason-Suares, Heather; Little, Sarah E; Bromley, Bryann; Reiff, Emily S; Dobson, Lori J; Wilkins-Haug, Louise

    2018-03-01

    This study characterizes cytogenetic abnormalities with ultrasound findings to refine counseling following negative cell-free DNA (cfDNA). A retrospective cohort of pregnancies with chromosome abnormalities and ultrasound findings was examined to determine the residual risk following negative cfDNA. Cytogenetic data was categorized as cfDNA detectable for aneuploidies of chromosomes 13, 18, 21, X, or Y or non-cfDNA detectable for other chromosome abnormalities. Ultrasound reports were categorized as structural anomaly, nuchal translucency (NT) ≥3.0 mm, or other "soft markers". Results were compared using chi squared and Fishers exact tests. Of the 498 fetuses with cytogenetic abnormalities and ultrasound findings, 16.3% (81/498) had non-cfDNA detectable results. In the first, second, and third trimesters, 12.4% (32/259), 19.5% (42/215), and 29.2% (7/24) had non-cfDNA detectable results respectively. The first trimester non-cfDNA detectable results reduced to 7.7% (19/246) if triploidy was detectable by cfDNA testing. For isolated first trimester NT of 3.0-3.49 mm, 15.8% (6/38) had non-cfDNA detectable results, while for NT ≥3.5 mm, it was 12.3% (20/162). For cystic hygroma, 4.3% (4/94) had non-cfDNA detectable results. Counseling for residual risk following cfDNA in the presence of an ultrasound finding is impacted by gestational age, ultrasound finding, and cfDNA detection of triploidy. © 2018 John Wiley & Sons, Ltd.

  8. Ensemble of convolutional neural networks for classification of breast microcalcification from mammograms.

    Science.gov (United States)

    Sert, Egemen; Ertekin, Seyda; Halici, Ugur

    2017-07-01

    Human level recall performance in detecting breast cancer considering microcalcifications from mammograms has a recall value between 74.5% and 92.3%. In this research, we approach to breast microcalcification classification problem using convolutional neural networks along with various preprocessing methods such as contrast scaling, dilation, cropping etc. and decision fusion using ensemble of networks. Various experiments on Digital Database for Screening Mammography dataset showed that preprocessing poses great importance on the classification performance. The stand-alone models using the dilation and cropping preprocessing techniques achieved the highest recall value of 91.3%. The ensembles of the stand-alone models surpass this recall value and a 97.3% value of recall is achieved. The ensemble having the highest F1 Score (harmonic mean of precision and recall), which is 94.5%, has a recall value of 94.0% and a precision value of 95.0%. This recall is still above human level performance and the models achieve competitive results in terms of accuracy, precision, recall and F1 score measures.

  9. Detection of microcalcifications in mammograms using error of prediction and statistical measures

    Science.gov (United States)

    Acha, Begoña; Serrano, Carmen; Rangayyan, Rangaraj M.; Leo Desautels, J. E.

    2009-01-01

    A two-stage method for detecting microcalcifications in mammograms is presented. In the first stage, the determination of the candidates for microcalcifications is performed. For this purpose, a 2-D linear prediction error filter is applied, and for those pixels where the prediction error is larger than a threshold, a statistical measure is calculated to determine whether they are candidates for microcalcifications or not. In the second stage, a feature vector is derived for each candidate, and after a classification step using a support vector machine, the final detection is performed. The algorithm is tested with 40 mammographic images, from Screen Test: The Alberta Program for the Early Detection of Breast Cancer with 50-μm resolution, and the results are evaluated using a free-response receiver operating characteristics curve. Two different analyses are performed: an individual microcalcification detection analysis and a cluster analysis. In the analysis of individual microcalcifications, detection sensitivity values of 0.75 and 0.81 are obtained at 2.6 and 6.2 false positives per image, on the average, respectively. The best performance is characterized by a sensitivity of 0.89, a specificity of 0.99, and a positive predictive value of 0.79. In cluster analysis, a sensitivity value of 0.97 is obtained at 1.77 false positives per image, and a value of 0.90 is achieved at 0.94 false positive per image.

  10. Clinical outcomes and a high prevalence of abnormalities on comprehensive arterial and venous thrombophilia screening in TIA or ischaemic stroke patients with a patent foramen ovale, an inter-atrial septal aneurysm or both.

    Science.gov (United States)

    Lim, Soon Tjin; Murphy, Stephen J X; Smith, Deirdre R; Williams, Jennifer; Navarro, Silvia Gil; McCabe, John; Moore, David P; McHugh, Johnny; McCabe, Dominick J H

    2017-06-15

    Data are limited on the optimal management of cryptogenic TIA/stroke patients with a patent foramen ovale (PFO)±inter-atrial septal aneurysm (IASA), especially with an inherited thrombophilia. Prospectively-collected data on TIA/ischaemic stroke patients with PFO, IASA or both who received 'goal-directed secondary-prevention medical treatment' were analysed. All patients had trans-oesophageal echocardiography, anti-nuclear, anti-cardiolipin, anti-beta 2 glycoprotein I antibodies, rheumatoid factor, lupus anticoagulant, protein C&S, anti-thrombin, factor VIII activity, activated protein C resistance, Factor V Leiden, prothrombin gene and MTHFR-c.677C>T mutation screening. ENA and homocysteine were assessed in the latter study period. Eighty-three patients were recruited. Mean follow-up: 48.1months. Forty-seven patients (56.6%) had an isolated PFO, 32 (38.6%) a PFO and an IASA, and 4 (4.8%) an IASA alone. Eighteen (21.7%) had ≥1 abnormality on thrombophilia screening. The most important abnormalities which lead to treatment changes in 11 patients (13.3%) were primary anti-phospholipid syndrome (N=3; 3.6%), protein S deficiency (N=2; 2.4%) hyper-homocysteinaemia (N=6/72 screened, 8.3%). Four patients (4.8%) opted for PFO closure: two with protein S deficiency, and two with no identified thrombophilia. Seven (8.4%) had recurrent TIA/ischaemic stroke during follow-up (overall annualised incidence: 2.1%), of whom five had a PFO alone and two a PFO and IASA. Comprehensive arterial and venous thrombophilia screening is warranted in TIA/ischaemic stroke patients with a PFO±IASA, is conclusively abnormal in over a fifth, and informed important decision-making regarding individualised therapy in 13.3% of patients. The incidence of recurrent vascular events in this population is low on optimal, personalised secondary-prevention treatment, even with an underlying thrombophilia. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Automated detection of microcalcification clusters in digital mammograms based on wavelet domain hidden Markov tree modeling

    International Nuclear Information System (INIS)

    Regentova, E.; Zhang, L.; Veni, G.; Zheng, J.

    2007-01-01

    A system is designed for detecting microcalcification clusters (MCC) in digital mammograms. The system is intended for computer-aided diagnostic prompting. Further discrimination of MCC as benign or malignant is assumed to be performed by radiologists. Processing of mammograms is based on the statistical modeling by means of wavelet domain hidden markov trees (WHMT). Segmentation is performed by the weighted likelihood evaluation followed by the classification based on spatial filters for a single microcalcification (MC) and a cluster of MC detection. The analysis is carried out on FROC curves for 40 mammograms from the mini-MIAS database and for 100 mammograms with 50 cancerous and 50 benign cases from DDSM database. The designed system is capable to detect 100% of true positive cases in these sets. The rate of false positives is 2.9 per case for mini-MIAS dataset; and 0.01 for the DDSM images. (orig.)

  12. Detection of Microcalcification in Mammograms Using Wavelet Transform and Fuzzy Shell Clustering

    OpenAIRE

    Balakumaran, T.; Vennila, I. L. A.; Shankar, C. Gowri

    2010-01-01

    Microcalcifications in mammogram have been mainly targeted as a reliable earliest sign of breast cancer and their early detection is vital to improve its prognosis. Since their size is very small and may be easily overlooked by the examining radiologist, computer-based detection output can assist the radiologist to improve the diagnostic accuracy. In this paper, we have proposed an algorithm for detecting microcalcification in mammogram. The proposed microcalcification detection algorithm inv...

  13. A Hybrid Image Filtering Method for Computer-Aided Detection of Microcalcification Clusters in Mammograms

    OpenAIRE

    Zhang, Xiaoyong; Homma, Noriyasu; Goto, Shotaro; Kawasumi, Yosuke; Ishibashi, Tadashi; Abe, Makoto; Sugita, Norihiro; Yoshizawa, Makoto

    2013-01-01

    The presence of microcalcification clusters (MCs) in mammogram is a major indicator of breast cancer. Detection of an MC is one of the key issues for breast cancer control. In this paper, we present a highly accurate method based on a morphological image processing and wavelet transform technique to detect the MCs in mammograms. The microcalcifications are firstly enhanced by using multistructure elements morphological processing. Then, the candidates of microcalcifications are refined by a m...

  14. Computer-aided detection system applied to full-field digital mammograms

    Energy Technology Data Exchange (ETDEWEB)

    Vega Bolivar, Alfonso; Sanchez Gomez, Sonia; Merino, Paula; Alonso-Bartolome, Pilar; Ortega Garcia, Estrella (Dept. of Radiology, Univ. Marques of Valdecilla Hospital, Santander (Spain)), e-mail: avegab@telefonica.net; Munoz Cacho, Pedro (Dept. of Statistics, Univ. Marques of Valdecilla Hospital, Santander (Spain)); Hoffmeister, Jeffrey W. (iCAD, Inc., Nashua, NH (United States))

    2010-12-15

    Background: Although mammography remains the mainstay for breast cancer screening, it is an imperfect examination with a sensitivity of 75-92% for breast cancer. Computer-aided detection (CAD) has been developed to improve mammographic detection of breast cancer. Purpose: To retrospectively estimate CAD sensitivity and false-positive rate with full-field digital mammograms (FFDMs). Material and Methods: CAD was used to evaluate 151 cases of ductal carcinoma in situ (DCIS) (n=48) and invasive breast cancer (n=103) detected with FFDM. Retrospectively, CAD sensitivity was estimated based on breast density, mammographic presentation, histopathology type, and lesion size. CAD false-positive rate was estimated with screening FFDMs from 200 women. Results: CAD detected 93% (141/151) of cancer cases: 97% (28/29) in fatty breasts, 94% (81/86) in breasts containing scattered fibroglandular densities, 90% (28/31) in heterogeneously dense breasts, and 80% (4/5) in extremely dense breasts. CAD detected 98% (54/55) of cancers manifesting as calcifications, 89% (74/83) as masses, and 100% (13/13) as mixed masses and calcifications. CAD detected 92% (73/79) of invasive ductal carcinomas, 89% (8/9) of invasive lobular carcinomas, 93% (14/15) of other invasive carcinomas, and 96% (46/48) of DCIS. CAD sensitivity for cancers 1-10 mm was 87% (47/54); 11-20 mm, 99% (70/71); 21-30 mm, 86% (12/14); and larger than 30 mm, 100% (12/12). The CAD false-positive rate was 2.5 marks per case. Conclusion: CAD with FFDM showed a high sensitivity in identifying cancers manifesting as calcifications or masses. CAD sensitivity was maintained in small lesions (1-20 mm) and invasive lobular carcinomas, which have lower mammographic sensitivity

  15. Computer-aided detection system applied to full-field digital mammograms

    International Nuclear Information System (INIS)

    Vega Bolivar, Alfonso; Sanchez Gomez, Sonia; Merino, Paula; Alonso-Bartolome, Pilar; Ortega Garcia, Estrella; Munoz Cacho, Pedro; Hoffmeister, Jeffrey W.

    2010-01-01

    Background: Although mammography remains the mainstay for breast cancer screening, it is an imperfect examination with a sensitivity of 75-92% for breast cancer. Computer-aided detection (CAD) has been developed to improve mammographic detection of breast cancer. Purpose: To retrospectively estimate CAD sensitivity and false-positive rate with full-field digital mammograms (FFDMs). Material and Methods: CAD was used to evaluate 151 cases of ductal carcinoma in situ (DCIS) (n=48) and invasive breast cancer (n=103) detected with FFDM. Retrospectively, CAD sensitivity was estimated based on breast density, mammographic presentation, histopathology type, and lesion size. CAD false-positive rate was estimated with screening FFDMs from 200 women. Results: CAD detected 93% (141/151) of cancer cases: 97% (28/29) in fatty breasts, 94% (81/86) in breasts containing scattered fibroglandular densities, 90% (28/31) in heterogeneously dense breasts, and 80% (4/5) in extremely dense breasts. CAD detected 98% (54/55) of cancers manifesting as calcifications, 89% (74/83) as masses, and 100% (13/13) as mixed masses and calcifications. CAD detected 92% (73/79) of invasive ductal carcinomas, 89% (8/9) of invasive lobular carcinomas, 93% (14/15) of other invasive carcinomas, and 96% (46/48) of DCIS. CAD sensitivity for cancers 1-10 mm was 87% (47/54); 11-20 mm, 99% (70/71); 21-30 mm, 86% (12/14); and larger than 30 mm, 100% (12/12). The CAD false-positive rate was 2.5 marks per case. Conclusion: CAD with FFDM showed a high sensitivity in identifying cancers manifesting as calcifications or masses. CAD sensitivity was maintained in small lesions (1-20 mm) and invasive lobular carcinomas, which have lower mammographic sensitivity

  16. Comparison Between Digital and Synthetic 2D Mammograms in Breast Density Interpretation.

    Science.gov (United States)

    Alshafeiy, Taghreed I; Wadih, Antoine; Nicholson, Brandi T; Rochman, Carrie M; Peppard, Heather R; Patrie, James T; Harvey, Jennifer A

    2017-07-01

    The purpose of this study was to compare assessments of breast density on synthetic 2D images as compared with digital 2D mammograms. This retrospective study included consecutive women undergoing screening with digital 2D mammography and tomosynthesis during May 2015 with a negative or benign outcome. In separate reading sessions, three radiologists with 5-25 years of clinical experience and 1 year of experience with synthetic 2D mammography read digital 2D and synthetic 2D images and assigned breast density categories according to the 5th edition of BI-RADS. Inter- and intrareader agreement was assessed for each BI-RADS density assessment and combined dense and nondense categories using percent agreement and Cohen kappa coefficient for consensus and all reads. A total of 309 patients met study inclusion criteria. Agreement between consensus BI-RADS density categories assigned for digital and synthetic 2D mammography was 80.3% (95% CI, 75.4-84.5%) with κ = 0.73 (95% CI, 0.66-0.79). For combined dense and nondense categories, agreement reached 91.9% (95% CI, 88.2-94.7%). For consensus readings, similar numbers of patients were shifted between nondense and dense categories (11 and 14, respectively) with the synthetic 2D compared with digital 2D mammography. Interreader differences were apparent; assignment to dense categories was greater with digital 2D mammography for reader 1 (odds ratio [OR], 1.26; p = 0.002), the same for reader 2 (OR, 0.91; p = 0.262), and greater with synthetic 2D mammography for reader 3 (OR, 0.86; p = 0.033). Overall, synthetic 2D mammography is comparable with digital 2D mammography in assessment of breast density, though there is some variability by reader. Practices can readily adopt synthetic 2D mammography without concern that it will affect density assessment and subsequent recommendations for supplemental screening.

  17. A combined approach for the enhancement and segmentation of mammograms using modified fuzzy C-means method in wavelet domain.

    Science.gov (United States)

    Srivastava, Subodh; Sharma, Neeraj; Singh, S K; Srivastava, R

    2014-07-01

    In this paper, a combined approach for enhancement and segmentation of mammograms is proposed. In preprocessing stage, a contrast limited adaptive histogram equalization (CLAHE) method is applied to obtain the better contrast mammograms. After this, the proposed combined methods are applied. In the first step of the proposed approach, a two dimensional (2D) discrete wavelet transform (DWT) is applied to all the input images. In the second step, a proposed nonlinear complex diffusion based unsharp masking and crispening method is applied on the approximation coefficients of the wavelet transformed images to further highlight the abnormalities such as micro-calcifications, tumours, etc., to reduce the false positives (FPs). Thirdly, a modified fuzzy c-means (FCM) segmentation method is applied on the output of the second step. In the modified FCM method, the mutual information is proposed as a similarity measure in place of conventional Euclidian distance based dissimilarity measure for FCM segmentation. Finally, the inverse 2D-DWT is applied. The efficacy of the proposed unsharp masking and crispening method for image enhancement is evaluated in terms of signal-to-noise ratio (SNR) and that of the proposed segmentation method is evaluated in terms of random index (RI), global consistency error (GCE), and variation of information (VoI). The performance of the proposed segmentation approach is compared with the other commonly used segmentation approaches such as Otsu's thresholding, texture based, k-means, and FCM clustering as well as thresholding. From the obtained results, it is observed that the proposed segmentation approach performs better and takes lesser processing time in comparison to the standard FCM and other segmentation methods in consideration.

  18. Volumetric breast density estimation from full-field digital mammograms.

    Science.gov (United States)

    van Engeland, Saskia; Snoeren, Peter R; Huisman, Henkjan; Boetes, Carla; Karssemeijer, Nico

    2006-03-01

    A method is presented for estimation of dense breast tissue volume from mammograms obtained with full-field digital mammography (FFDM). The thickness of dense tissue mapping to a pixel is determined by using a physical model of image acquisition. This model is based on the assumption that the breast is composed of two types of tissue, fat and parenchyma. Effective linear attenuation coefficients of these tissues are derived from empirical data as a function of tube voltage (kVp), anode material, filtration, and compressed breast thickness. By employing these, tissue composition at a given pixel is computed after performing breast thickness compensation, using a reference value for fatty tissue determined by the maximum pixel value in the breast tissue projection. Validation has been performed using 22 FFDM cases acquired with a GE Senographe 2000D by comparing the volume estimates with volumes obtained by semi-automatic segmentation of breast magnetic resonance imaging (MRI) data. The correlation between MRI and mammography volumes was 0.94 on a per image basis and 0.97 on a per patient basis. Using the dense tissue volumes from MRI data as the gold standard, the average relative error of the volume estimates was 13.6%.

  19. A Probabilistic Approach for Breast Boundary Extraction in Mammograms

    Directory of Open Access Journals (Sweden)

    Hamed Habibi Aghdam

    2013-01-01

    Full Text Available The extraction of the breast boundary is crucial to perform further analysis of mammogram. Methods to extract the breast boundary can be classified into two categories: methods based on image processing techniques and those based on models. The former use image transformation techniques such as thresholding, morphological operations, and region growing. In the second category, the boundary is extracted using more advanced techniques, such as the active contour model. The problem with thresholding methods is that it is a hard to automatically find the optimal threshold value by using histogram information. On the other hand, active contour models require defining a starting point close to the actual boundary to be able to successfully extract the boundary. In this paper, we propose a probabilistic approach to address the aforementioned problems. In our approach we use local binary patterns to describe the texture around each pixel. In addition, the smoothness of the boundary is handled by using a new probability model. Experimental results show that the proposed method reaches 38% and 50% improvement with respect to the results obtained by the active contour model and threshold-based methods respectively, and it increases the stability of the boundary extraction process up to 86%.

  20. Method of automatic detection of tumors in mammogram

    Science.gov (United States)

    Xie, Mei; Ma, Zheng

    2001-09-01

    Prevention and early diagnosis of tumors in mammogram are foremost. Unfortunately, these images are often corrupted by the noise due to the film noise and the background texture of the images, which did not allow isolation of the target information from the background noise, and often results in the suspicious area to be analyzed inaccurately. In order to achieve more accurate detection and segmentation tumors, the quality of the images need to improve, (including to suppressing noise and enhancing the contrast of the image). This paper presents a new adaptive histogram threshold method approach for segmentation of suspicious mass regions in digitized images. The method use multi-scale wavelet decomposition and a threshold selection criterion based on a transformed imageís histogram. This separation can help eliminate background noise and discriminates against objects of different size and shape. The tumors are extracted by used an adaptively bayesian classifier. We demonstrate that the method proposed can greatly improve the accuracy of detection in tumors.

  1. Multiple-instance learning for breast cancer detection in mammograms.

    Science.gov (United States)

    Sánchez de la Rosa, Rubén; Lamard, Mathieu; Cazuguel, Guy; Coatrieux, Gouenou; Cozic, Michel; Quellec, Gwenolé

    2015-01-01

    This paper describes an experimental computer-aided detection and diagnosis system for breast cancer, the most common form of cancer among women, using mammography. The system relies on the Multiple-Instance Learning (MIL) paradigm, which has proven useful for medical decision support in previous works from our team. In the proposed framework, the breasts are first partitioned adaptively into regions. Then, either textural features, or features derived from the detection of masses and microcalcifications, are extracted from each region. Finally, feature vectors extracted from each region are combined using an MIL algorithm (Citation k-NN or mi-Graph), in order to recognize "normal" mammography examinations or to categorize examinations as "normal", "benign" or "cancer". An accuracy of 91.1% (respectively 62.1%) was achieved for normality recognition (respectively three-class categorization) in a subset of 720 mammograms from the DDSM dataset. The paper also discusses future improvements, that will make the most of the MIL paradigm, in order to improve "benign" versus "cancer" discrimination in particular.

  2. National Performance Benchmarks for Modern Screening Digital Mammography: Update from the Breast Cancer Surveillance Consortium.

    Science.gov (United States)

    Lehman, Constance D; Arao, Robert F; Sprague, Brian L; Lee, Janie M; Buist, Diana S M; Kerlikowske, Karla; Henderson, Louise M; Onega, Tracy; Tosteson, Anna N A; Rauscher, Garth H; Miglioretti, Diana L

    2017-04-01

    Purpose To establish performance benchmarks for modern screening digital mammography and assess performance trends over time in U.S. community practice. Materials and Methods This HIPAA-compliant, institutional review board-approved study measured the performance of digital screening mammography interpreted by 359 radiologists across 95 facilities in six Breast Cancer Surveillance Consortium (BCSC) registries. The study included 1 682 504 digital screening mammograms performed between 2007 and 2013 in 792 808 women. Performance measures were calculated according to the American College of Radiology Breast Imaging Reporting and Data System, 5th edition, and were compared with published benchmarks by the BCSC, the National Mammography Database, and performance recommendations by expert opinion. Benchmarks were derived from the distribution of performance metrics across radiologists and were presented as 50th (median), 10th, 25th, 75th, and 90th percentiles, with graphic presentations using smoothed curves. Results Mean screening performance measures were as follows: abnormal interpretation rate (AIR), 11.6 (95% confidence interval [CI]: 11.5, 11.6); cancers detected per 1000 screens, or cancer detection rate (CDR), 5.1 (95% CI: 5.0, 5.2); sensitivity, 86.9% (95% CI: 86.3%, 87.6%); specificity, 88.9% (95% CI: 88.8%, 88.9%); false-negative rate per 1000 screens, 0.8 (95% CI: 0.7, 0.8); positive predictive value (PPV) 1, 4.4% (95% CI: 4.3%, 4.5%); PPV2, 25.6% (95% CI: 25.1%, 26.1%); PPV3, 28.6% (95% CI: 28.0%, 29.3%); cancers stage 0 or 1, 76.9%; minimal cancers, 57.7%; and node-negative invasive cancers, 79.4%. Recommended CDRs were achieved by 92.1% of radiologists in community practice, and 97.1% achieved recommended ranges for sensitivity. Only 59.0% of radiologists achieved recommended AIRs, and only 63.0% achieved recommended levels of specificity. Conclusion The majority of radiologists in the BCSC surpass cancer detection recommendations for screening

  3. Detection of cancerous masses in mammograms by template matching: optimization of template brightness distribution by means of evolutionary algorithm.

    Science.gov (United States)

    Bator, Marcin; Nieniewski, Mariusz

    2012-02-01

    Optimization of brightness distribution in the template used for detection of cancerous masses in mammograms by means of correlation coefficient is presented. This optimization is performed by the evolutionary algorithm using an auxiliary mass classifier. Brightness along the radius of the circularly symmetric template is coded indirectly by its second derivative. The fitness function is defined as the area under curve (AUC) of the receiver operating characteristic (ROC) for the mass classifier. The ROC and AUC are obtained for a teaching set of regions of interest (ROIs), for which it is known whether a ROI is true-positive (TP) or false-positive (F). The teaching set is obtained by running the mass detector using a template with a predetermined brightness. Subsequently, the evolutionary algorithm optimizes the template by classifying masses in the teaching set. The optimal template (OT) can be used for detection of masses in mammograms with unknown ROIs. The approach was tested on the training and testing sets of the Digital Database for Screening Mammography (DDSM). The free-response receiver operating characteristic (FROC) obtained with the new mass detector seems superior to the FROC for the hemispherical template (HT). Exemplary results are the following: in the case of the training set in the DDSM, the true-positive fraction (TPF) = 0.82 for the OT and 0.79 for the HT; in the case of the testing set, TPF = 0.79 for the OT and 0.72 for the HT. These values were obtained for disease cases, and the false-positive per image (FPI) = 2.

  4. Breast ultrasound diagnostic performance and outcomes for mass lesions using Breast Imaging Reporting and Data System category 0 mammogram

    Directory of Open Access Journals (Sweden)

    Paulo Almazy Zanello

    2011-01-01

    Full Text Available PURPOSE: To evaluate the outcomes and diagnostic performance of ultrasonography after a Breast Imaging Reporting and Data System (Bi-RADS category 0 mammogram. MATERIAL AND METHODS: This retrospective study reviewed 4,384 consecutive patients who underwent a screening mammography from January 2005 to July 2006; 391 of the 4,384 exams were classified as Bi-RADS category 0. After exclusions, 241 patients received subsequent sonogram. Ultrasonography was considered diagnostic when the Bi-RADS category was changed to 2, 4, or 5, and it was considered indeterminate (Bi-RADS 3 when the results indicated that the patients should return for a mammographic follow-up. The outcomes of these patients were assessed to evaluate the diagnostic performance of ultrasonography. RESULTS: The mean age of the patients was 53.3 years (ranging from 35 to 81. Of the 241 patients, ultrasonography was considered diagnostic in 146 (60.6% patients and indeterminate in 95 (39.4% patients. In the diagnostic group, 111 out of 146 patients (70.2% had a sonogram result of Bi-RADS category 2 after a 2-year follow-up without evidence of malignancy. Furthermore, 35 out of 146 patients (29.8% had a suspicious sonogram with a result of Bi-RADS category 4. After a tissue sampling procedure, 10 patients were confirmed to have breast cancer, and 25 had benign histopathological features without any evidence of malignancy after a 2-year follow-up. The sensitivity of ultrasonography was 100%, specificity was 89.1%, and overall accuracy was 89.6%. CONCLUSIONS: Based on the degree of resolution and its diagnostic performance, ultrasonography was determined to be an excellent method for the subsequent evaluation of Bi-RADS 0 mammograms.

  5. Geometry-Based Pectoral Muscle Segmentation From MLO Mammogram Views.

    Science.gov (United States)

    Taghanaki, Saeid Asgari; Liu, Yonghuai; Miles, Brandon; Hamarneh, Ghassan

    2017-11-01

    Computer-aided diagnosis systems (CADx) play a major role in the early diagnosis of breast cancer. Extracting the breast region precisely from a mammogram is an essential component of CADx for mammography. The appearance of the pectoral muscle on medio-lateral oblique (MLO) views increases the false positive rate in CADx. Therefore, the pectoral muscle should be identified and removed from the breast region in an MLO image before further analysis. None of the previous pectoral muscle segmentation methods address all breast types based on the breast imaging-reporting and data system tissue density classes. In this paper, we deal with this deficiency by introducing a new simple yet effective method that combines geometric rules with a region growing algorithm to support the segmentation of all types of pectoral muscles (normal, convex, concave, and combinatorial). Experimental segmentation accuracy results were reported for four tissue density classes on 872 MLO images from three publicly available datasets. An average Jaccard index and Dice similarity coefficient of 0.972 ± 0.003 and 0.985 ± 0.001 were obtained, respectively. The mean Hausdorff distance between the contours detected by our method and the ground truth is below 5 mm for all datasets. An average acceptable segmentation rate of ∼95% was achieved outperforming several state-of-the-art competing methods. Excellent results were obtained even for the most challenging class of extremely dense breasts.Computer-aided diagnosis systems (CADx) play a major role in the early diagnosis of breast cancer. Extracting the breast region precisely from a mammogram is an essential component of CADx for mammography. The appearance of the pectoral muscle on medio-lateral oblique (MLO) views increases the false positive rate in CADx. Therefore, the pectoral muscle should be identified and removed from the breast region in an MLO image before further analysis. None of the previous pectoral muscle segmentation

  6. Clinical images evaluation of mammograms: a national survey

    International Nuclear Information System (INIS)

    Moon, Woo Kyung; Kim, Tae Jung; Cha, Joo Hee

    2003-01-01

    The goal of this study was to survey the overall quality of mammographic images in Korea. A total of 598 mammographic images collected from 257 hospitals nationwide were reviewed in terms of eight images quality categories, namely positioning, compression, contrast, exposure, sharpness, noise, artifacts, and examination identification, and rated on a five-point scale: (1=severe deficiency, 2=major deficiency, 3=minor deficiency, 4=good, 5=best). Failure was defined as the occurrence of more than four major deficiencies or one severe deficiency (score of 1 or 2). The results were compared among hospitals of varying kinds, and common problems in clinical images quality were identified. Two hundred and seventeen mammographic images (36.3%) failed the evaluation. Poor images were found in descending order of frequency, at The Society for Medical Examination (33/69, 47.8%), non-radiologyclinics (42/88, 47.7%), general hospitals (92/216, 42.6%), radiology clinics (39/102, 38.2%), and university hospitals (11/123, 8.9%) (p<0.01, Chi-square test). Among the 598 images, serious problems which occurred were related to positioning in 23.7% of instances (n=142) (p<0.01, Chi-square test), examination identification in 5.7% (n=34), exposure in 5.4% (n=32), contrast in 4.2% (n=25), sharpness in 2.7% (n=16), compression in 2.5% (n=15), artifacts in 2.5% (n=15), and noise in 0.3% (n=2). This study showed that in Korea, 36.3% of the mammograms examined in this sampling had important image-related defects that might have led to serious errors in patient management. The failure rate was significantly higher in non-radiology clinics and at The Society for Medical Examination than at university hospitals

  7. Computerized image analysis: estimation of breast density on mammograms

    Science.gov (United States)

    Zhou, Chuan; Chan, Heang-Ping; Petrick, Nicholas; Sahiner, Berkman; Helvie, Mark A.; Roubidoux, Marilyn A.; Hadjiiski, Lubomir M.; Goodsitt, Mitchell M.

    2000-06-01

    An automated image analysis tool is being developed for estimation of mammographic breast density, which may be useful for risk estimation or for monitoring breast density change in a prevention or intervention program. A mammogram is digitized using a laser scanner and the resolution is reduced to a pixel size of 0.8 mm X 0.8 mm. Breast density analysis is performed in three stages. First, the breast region is segmented from the surrounding background by an automated breast boundary-tracking algorithm. Second, an adaptive dynamic range compression technique is applied to the breast image to reduce the range of the gray level distribution in the low frequency background and to enhance the differences in the characteristic features of the gray level histogram for breasts of different densities. Third, rule-based classification is used to classify the breast images into several classes according to the characteristic features of their gray level histogram. For each image, a gray level threshold is automatically determined to segment the dense tissue from the breast region. The area of segmented dense tissue as a percentage of the breast area is then estimated. In this preliminary study, we analyzed the interobserver variation of breast density estimation by two experienced radiologists using BI-RADS lexicon. The radiologists' visually estimated percent breast densities were compared with the computer's calculation. The results demonstrate the feasibility of estimating mammographic breast density using computer vision techniques and its potential to improve the accuracy and reproducibility in comparison with the subjective visual assessment by radiologists.

  8. DETECTION OF MICROCALCIFICATION IN DIGITAL MAMMOGRAMS USING ONE DIMENSIONAL WAVELET TRANSFORM

    Directory of Open Access Journals (Sweden)

    T. Balakumaran

    2010-11-01

    Full Text Available Mammography is the most efficient method for breast cancer early detection. Clusters of microcalcifications are the early sign of breast cancer and their detection is the key to improve prognosis of breast cancer. Microcalcifications appear in mammogram image as tiny localized granular points, which is often difficult to detect by naked eye because of their small size. Automatic and accurately detection of microcalcifications has received much more attention from radiologists and physician. An efficient method for automatic detection of clustered microcalcifications in digitized mammograms is the use of Computer Aided Diagnosis (CAD systems. This paper presents a one dimensional wavelet-based multiscale products scheme for microcalcification detection in mammogram images. The detection of microcalcifications were achieved by decomposing the each line of mammograms by 1D wavelet transform into different frequency sub-bands, suppressing the low-frequency subband, and finally reconstructing the mammogram from the subbands containing only significant high frequencies features. The significant features are obtained by multiscale products. Preliminary results indicate that the proposed scheme is better in suppressing the background and detecting the microcalcification clusters than any other wavelet decomposition methods.

  9. Mass screening in breast cancer

    International Nuclear Information System (INIS)

    Strax, P.

    1977-01-01

    Some questions about mass screening in breast cancer are answered it being concluded that: 1. mass screening for the detection of early breast cancer is the only means with proven potential for lowering the death rate of the disease; 2. mammography is an importante - if not the most important modality in mass screening; 3. new film - screen combinations generally available are capable of producing mammograms of excelent quality with radiation doses down to .1 rad into the body of breast. The risk of malignant changes from such dosage - even when given periodically is negligeable. New equipment, to be available, shortly, will use the new film - screen combinations in an automated manner with must reduce cost in time, filme, personnel and processing - of more than 50%. This would make mass screening more practical. (M.A.) [pt

  10. Factors influencing time to diagnosis after abnormal mammography in diverse women.

    Science.gov (United States)

    Pérez-Stable, Eliseo J; Afable-Munsuz, Aimee; Kaplan, Celia Patricia; Pace, Lydia; Samayoa, Cathy; Somkin, Carol; Nickleach, Dana; Lee, Marion; Márquez-Magaña, Leticia; Juarbe, Teresa; Pasick, Rena J

    2013-02-01

    Abnormal mammograms are common, and the risk of false positives is high. We surveyed women in order to understand the factors influencing the efficiency of the evaluation of an abnormal mammogram. Women aged 40-80 years, identified from lists with Breast Imaging Reporting and Data System (BIRADS) classifications of 0, 3, 4, or 5, were surveyed. Telephone surveys asked about the process of evaluation, and medical records were reviewed for tests and timing of evaluation. In this study, 970 women were surveyed, and 951 had chart reviews. Overall, 36% were college graduates, 68% were members of a group model health plan, 18% were Latinas, 25% were African Americans, 15% were Asian, and 43% were white. Of the 352 women who underwent biopsies, 151 were diagnosed with cancer (93 invasive). Median time to diagnosis was 183 days for BIRADS 3 compared to 29 days for BIRADS 4/5 and 27 days for BIRADS 0. At 60 days, 84% of BIRADS 4/5 women had a diagnosis. Being African American (hazard ratio [HR] 0.69, 95% confidence interval [CI] 0.49-0.97, p=0.03), income BIRADS 0, 4, or 5 abnormal mammograms was completed in most women within the recommended 60 days. Even within effective systems, correctible communication factors may adversely affect time to diagnosis.

  11. Computer aided system for segmentation and visualization of microcalcifications in digital mammograms

    International Nuclear Information System (INIS)

    Reljin, B.; Reljin, I.; Milosevic, Z.; Stojic, T.

    2009-01-01

    Two methods for segmentation and visualization of microcalcifications in digital or digitized mammograms are described. First method is based on modern mathematical morphology, while the second one uses the multifractal approach. In the first method, by using an appropriate combination of some morphological operations, high local contrast enhancement, followed by significant suppression of background tissue, irrespective of its radiology density, is obtained. By iterative procedure, this method highly emphasizes only small bright details, possible microcalcifications. In a multifractal approach, from initial mammogram image, a corresponding multifractal 'images' are created, from which a radiologist has a freedom to change the level of segmentation. An appropriate user friendly computer aided visualization (CAV) system with embedded two methods is realized. The interactive approach enables the physician to control the level and the quality of segmentation. Suggested methods were tested through mammograms from MIAS database as a gold standard, and from clinical praxis, using digitized films and digital images from full field digital mammograph. (authors)

  12. A Hybrid Image Filtering Method for Computer-Aided Detection of Microcalcification Clusters in Mammograms

    Directory of Open Access Journals (Sweden)

    Xiaoyong Zhang

    2013-01-01

    Full Text Available The presence of microcalcification clusters (MCs in mammogram is a major indicator of breast cancer. Detection of an MC is one of the key issues for breast cancer control. In this paper, we present a highly accurate method based on a morphological image processing and wavelet transform technique to detect the MCs in mammograms. The microcalcifications are firstly enhanced by using multistructure elements morphological processing. Then, the candidates of microcalcifications are refined by a multilevel wavelet reconstruction approach. Finally, MCs are detected based on their distributions feature. Experiments are performed on 138 clinical mammograms. The proposed method is capable of detecting 92.9% of true microcalcification clusters with an average of 0.08 false microcalcification clusters detected per image.

  13. Fuzzy technique for microcalcifications clustering in digital mammograms.

    Science.gov (United States)

    Vivona, Letizia; Cascio, Donato; Fauci, Francesco; Raso, Giuseppe

    2014-06-24

    Mammography has established itself as the most efficient technique for the identification of the pathological breast lesions. Among the various types of lesions, microcalcifications are the most difficult to identify since they are quite small (0.1-1.0 mm) and often poorly contrasted against an images background. Within this context, the Computer Aided Detection (CAD) systems could turn out to be very useful in breast cancer control. In this paper we present a potentially powerful microcalcifications cluster enhancement method applicable to digital mammograms. The segmentation phase employs a form filter, obtained from LoG filter, to overcome the dependence from target dimensions and to optimize the recognition efficiency. A clustering method, based on a Fuzzy C-means (FCM), has been developed. The described method, Fuzzy C-means with Features (FCM-WF), was tested on simulated clusters of microcalcifications, implying that the location of the cluster within the breast and the exact number of microcalcifications are known.The proposed method has been also tested on a set of images from the mini-Mammographic database provided by Mammographic Image Analysis Society (MIAS) publicly available. The comparison between FCM-WF and standard FCM algorithms, applied on both databases, shows that the former produces better microcalcifications associations for clustering than the latter: with respect to the private and the public database we had a performance improvement of 10% and 5% with regard to the Merit Figure and a 22% and a 10% of reduction of false positives potentially identified in the images, both to the benefit of the FCM-WF. The method was also evaluated in terms of Sensitivity (93% and 82%), Accuracy (95% and 94%), FP/image (4% for both database) and Precision (62% and 65%). Thanks to the private database and to the informations contained in it regarding every single microcalcification, we tested the developed clustering method with great accuracy. In particular

  14. Mammographic screening for breast cancer in a resource-restricted ...

    African Journals Online (AJOL)

    All mammograms performed between 2003 and 2012 at TBAH were analysed regarding patient demographics, clinical data, indication and outcome according to the American College of Radiology Breast Imaging Reporting and Data System (BIRADS). Screening mammography was offered to patients >40 years of age ...

  15. The Association of Social Support and Education with Breast and Cervical Cancer Screening

    Science.gov (United States)

    Documet, Patricia; Bear, Todd M.; Flatt, Jason D.; Macia, Laura; Trauth, Jeanette; Ricci, Edmund M.

    2015-01-01

    Background: Disparities in breast and cervical cancer screening by socioeconomic status persist in the United States. It has been suggested that social support may facilitate screening, especially among women of low socioeconomic status. However, at present, it is unclear whether social support enables mammogram and Pap test compliance. Purpose:…

  16. Experiences with a self-test for Dutch breast screening radiologists: lessons learnt

    NARCIS (Netherlands)

    Timmers, J. M. H.; Verbeek, A. L. M.; Pijnappel, R. M.; Broeders, M. J. M.; den Heeten, G. J.

    2014-01-01

    To evaluate a self-test for Dutch breast screening radiologists introduced as part of the national quality assurance programme. A total of 144 radiologists were invited to complete a test-set of 60 screening mammograms (20 malignancies). Participants assigned findings such as location, lesion type

  17. Experiences with a self-test for Dutch breast screening radiologists: lessons learnt

    NARCIS (Netherlands)

    Timmers, J.M.H.; Verbeek, A.L.M.; Pijnappel, R.M.; Broeders, M.J.M.; Heeten, GJ. den

    2014-01-01

    PURPOSE: To evaluate a self-test for Dutch breast screening radiologists introduced as part of the national quality assurance programme. METHODS AND MATERIALS: A total of 144 radiologists were invited to complete a test-set of 60 screening mammograms (20 malignancies). Participants assigned findings

  18. Rastreamento anterior para câncer de colo uterino em mulheres com alterações citológicas ou histológicas Previous screening for cervical cancer among women with cytological and histological abnormalities

    Directory of Open Access Journals (Sweden)

    C Rama

    2008-06-01

    do último exame citológico anterior.OBJECTIVE: To examine previous Pap smear history in women screened for cervical cancer with cytological or histological abnormalities. METHODS: Cross-sectional study in a sample of 5,485 women (15-65 years old who self-referred to cervical cancer screening in Sao Paulo and Campinas, Southeastern Brazil, between February 2002 and March 2003. A behavioral questionnaire was applied and cervical specimens were obtained for testing by Pap smears or liquid-based cytology. Women who had abnormal cytology were referred for colposcopic examination and, if abnormal, for cervical punch biopsy. To explore factors associated to cervical abnormalities Pearson's chi-was conduted square test at a 5% significance level. RESULTS: Cytological abnormalities were found in 354 women (6.4% and included 41 high-grade squamous intra-epithelial lesions and 3 carcinomas; 92.7% were normal results. Colposcopy was performed in 289 women, and 145 (50.2% showed abnormal results. Punch biopsies showed 14 cervical intraepithelial neoplasias grade 3 and 4 carcinomas. Previous Pap smears were reported in all women who had cytology suspected of carcinoma, 97.6% of those with high-grade squamous intra-epithelial lesions, all women with histological diagnosis of carcinoma and 92.9% of those who had cervical intraepithelial neoplasias grade 3 histologically. Previous Pap smear in the last tree years was reported by 86.5% and 92.8% of women with abnormal cytology and biopsy, respectively. CONCLUSIONS: There was no statistically significant difference regarding the number of Pap tests and time since their last test between women with histologically diagnosed carcinoma and cervical intraepithelial neoplasia grade 3 compared with those with normal cytology.

  19. Breast cancer screening behaviors among Korean American immigrant women: findings from the Health Belief Model.

    Science.gov (United States)

    Lee, Hee Yun; Stange, Mia Ju; Ahluwalia, Jasjit S

    2015-11-01

    This study examined the utilization of clinical breast examinations (CBEs) and mammograms among Korean American immigrant women and investigated how the six constructs of Health Belief Model (HBM) are associated with the receipt of breast cancer screening. Using a quota sampling strategy, 202 Korean American immigrant women were recruited in metropolitan areas in the northeastern United States. Approximately 64% of the participants reported having had at least one CBE in their lifetime, and about 81% of the sample had undergone at least one mammogram in their lifetime. Women who perceived themselves to be susceptible to breast cancer were more likely to have undergone a CBE, and women who had lower barriers to screening or demonstrated a higher level of confidence were more likely than their counterparts to undergo a mammogram. Findings suggest that HBM constructs such as susceptibility, barriers, and confidence should be considered when designing interventions aimed at promoting breast cancer screening. © The Author(s) 2014.

  20. Bayesian Classifier with Simplified Learning Phase for Detecting Microcalcifications in Digital Mammograms

    Directory of Open Access Journals (Sweden)

    Imad Zyout

    2009-01-01

    Full Text Available Detection of clustered microcalcifications (MCs in mammograms represents a significant step towards successful detection of breast cancer since their existence is one of the early signs of cancer. In this paper, a new framework that integrates Bayesian classifier and a pattern synthesizing scheme for detecting microcalcification clusters is proposed. This proposed work extracts textural, spectral, and statistical features of each input mammogram and generates models of real MCs to be used as training samples through a simplified learning phase of the Bayesian classifier. Followed by an estimation of the classifier's decision function parameters, a mammogram is segmented into the identified targets (MCs against background (healthy tissue. The proposed algorithm has been tested using 23 mammograms from the mini-MIAS database. Experimental results achieved MCs detection with average true positive (sensitivity and false positive (specificity of 91.3% and 98.6%, respectively. Results also indicate that the modeling of the real MCs plays a significant role in the performance of the classifier and thus should be given further investigation.

  1. Entropy based unsupervised Feature Selection in digital mammogram image using rough set theory.

    Science.gov (United States)

    Velayutham, C; Thangavel, K

    2012-01-01

    Feature Selection (FS) is a process, which attempts to select features, which are more informative. In the supervised FS methods various feature subsets are evaluated using an evaluation function or metric to select only those features, which are related to the decision classes of the data under consideration. However, for many data mining applications, decision class labels are often unknown or incomplete, thus indicating the significance of unsupervised FS. However, in unsupervised learning, decision class labels are not provided. The problem is that not all features are important. Some of the features may be redundant, and others may be irrelevant and noisy. In this paper, a novel unsupervised FS in mammogram image, using rough set-based entropy measures, is proposed. A typical mammogram image processing system generally consists of mammogram image acquisition, pre-processing of image, segmentation, features extracted from the segmented mammogram image. The proposed method is used to select features from data set, the method is compared with the existing rough set-based supervised FS methods and classification performance of both methods are recorded and demonstrates the efficiency of the method.

  2. Breast density measurement: 3D cone beam computed tomography (CBCT) images versus 2D digital mammograms

    Science.gov (United States)

    Han, Tao; Lai, Chao-Jen; Chen, Lingyun; Liu, Xinming; Shen, Youtao; Zhong, Yuncheng; Ge, Shuaiping; Yi, Ying; Wang, Tianpeng; Yang, Wei T.; Shaw, Chris C.

    2009-02-01

    Breast density has been recognized as one of the major risk factors for breast cancer. However, breast density is currently estimated using mammograms which are intrinsically 2D in nature and cannot accurately represent the real breast anatomy. In this study, a novel technique for measuring breast density based on the segmentation of 3D cone beam CT (CBCT) images was developed and the results were compared to those obtained from 2D digital mammograms. 16 mastectomy breast specimens were imaged with a bench top flat-panel based CBCT system. The reconstructed 3D CT images were corrected for the cupping artifacts and then filtered to reduce the noise level, followed by using threshold-based segmentation to separate the dense tissue from the adipose tissue. For each breast specimen, volumes of the dense tissue structures and the entire breast were computed and used to calculate the volumetric breast density. BI-RADS categories were derived from the measured breast densities and compared with those estimated from conventional digital mammograms. The results show that in 10 of 16 cases the BI-RADS categories derived from the CBCT images were lower than those derived from the mammograms by one category. Thus, breasts considered as dense in mammographic examinations may not be considered as dense with the CBCT images. This result indicates that the relation between breast cancer risk and true (volumetric) breast density needs to be further investigated.

  3. Abnormal Head Position

    Science.gov (United States)

    ... Frequently Asked Questions Español Condiciones Chinese Conditions Abnormal Head Position En Español Read in Chinese What is an abnormal head posture? An abnormal or compensatory head posture occurs ...

  4. Effects of Perceived Discrimination and Trust on Breast Cancer Screening among Korean American Women.

    Science.gov (United States)

    Hong, Hye Chong; Ferrans, Carol Estwing; Park, Chang; Lee, Hyeonkyeong; Quinn, Lauretta; Collins, Eileen G

    Korean American (KA) women continue to have lower breast cancer screening rates than other racial groups. Perceived discrimination and trust have been associated with breast cancer screening adherence, but little is known about the associations in KA women. Surveys were completed by 196 KA women in the Chicago metropolitan area. Multiple and Firth logistic regression analyses were performed to identify factors (perceived discrimination, trust, acculturation, cultural beliefs, health care access) influencing breast cancer screening adherence (mammogram). In addition, SPSS macro PROCESS was used to examine the mediating role of trust between perceived discrimination and breast cancer screening adherence. Ninety-three percent of the women surveyed had health insurance and 54% reported having a mammogram in the past 2 years. Predictors of having a mammogram were knowing where to go for a mammogram, having a regular doctor or usual place for health care, greater trust in health care providers, and lower distrust in the health care system. Perceived discrimination had an indirect effect on breast cancer screening through trust. The breast cancer screening rate among KA women is low. Perceived discrimination in health care, trust in health care providers, and distrust in the health care system directly or indirectly influenced breast cancer screening adherence in KA women. Trust is a factor that can be strengthened with educational interventions. Copyright © 2017 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  5. Evaluation of the population dose to the UK population from the National Health Service breast screening programme

    International Nuclear Information System (INIS)

    Faulkner, K.; Wallis, M. G.; Neilson, F.; Whitaker, C. J.

    2008-01-01

    In the United Kingdom National Health Service Breast Screening Programme (NHSBSP), women aged between 50 and 70 y are invited for mammography every 3 y. Screening histories for each woman, over four screening rounds, were analysed. Data from five screening programmes were used to select 57 425 women into the study. Cases were selected on the basis of being between the ages of 50 and 53 at the start of the NHSBSP (i.e. between 1989 and 1992). Assessment of the outcome for each screening round for each woman involved assigning a simple outcome code. Each of the possible pathways through the four screening rounds was analysed. This comprises of 500 possible pathways. This data enabled the following information to be determined: (i) The number of times a woman attended the screening programme. (ii) The number of women referred for assessment at each screening round. This information may be used to deduce the population dose to this group of women averaged over four screening rounds. Patient doses have been monitored since the programme's inception and are typically 4.5 mGy for two-view screening. It is possible to determine the mean glandular dose received by this cohort of women over four screening rounds by multiplying the number of examinations by the mean glandular dose for a typical woman. Allowance has to be made for the number of projections taken at each screening round. Once a woman has been screened, she may be invited back for further assessment if an abnormality is found on her mammogram. A stereotactic attachment is used to determine where to place the biopsy device. Although the dose received during a normal screening mammogram is well known, the dose for a stereotactic procedure and other assessment procedures is less well known, partly because only a small part of the breast is directly irradiated during stereo-taxis. However, the woman may have multiple exposures during this stage. A prospective survey of doses was completed to deduce the mean

  6. Cancer on a mammogram is not memorable: readers remember their recalls and not cancers

    International Nuclear Information System (INIS)

    Pitman, Alexander G.; Kok, Phebe; Zentner, Lucila

    2012-01-01

    To determine if presence of cancer on a mammogram makes that mammogram more memorable. A total of 100 mammograms (25 cancers) were grouped into 5 sets of 20 cases. Set pairs were presented in five reads to eight radiologist readers. Readers were asked to 'clear' or 'call back' cases, and at post-baseline reads to indicate whether each case was 'new' or 'old ' (remembered from prior read). Two sets were presented only at baseline, to calculate each reader's false recollection rate. For cases presented more than once ('old' cases, 100 presentations) readers could have 'correct memory' or 'memory loss'. Memory performance was defined as odds ratio of correct memory to memory loss. Multivariate logistic data regression analysis identified predictors of memory performance from: reader, set, time since last read, presence of cancer, and whether the case was called back at the last read. Memory performance differed markedly between readers and reader identity was a highly significant predictor of memory performance. Presence of cancer was not a significant predictor of memory performance (odds ratio 0.77, 95% CI: 0.49–1.21). Whether the case was called back at the last read was a highly significant predictor (odds ratio 4.22, 95% CI: 2.70–6.61) for the model incorporating reader variability, and also the model without reader variability (odds ratio 2.67, 95% CI: 1.74–4.08). The only statistically significant predictor of radiologist memory for a mammogram was whether the radiologist 'called it back' at a prior reading round. Presence of cancer on a mammogram did not make it memorable.

  7. Socioeconomic Disparities in Breast Cancer Screening in Hawaii

    OpenAIRE

    Timothy Halliday, PhD; Deborah A. Taira, ScD; James Davis, PhD; Henry Chan

    2007-01-01

    Introduction Despite evidence that breast cancer screening reduces morbidity and mortality, many women do not obtain mammograms. Our objective was to analyze the relationship between income and mammography screening for members enrolled in a large health plan in Hawaii. Methods We analyzed claims data for women (N = 46,328) aged 50 to 70 years during 2003 and 2004. We used parametric and nonparametric regression techniques. We used probit estimation to conduct multivariate analysis. Results A...

  8. Rastreamento Pré-natal de Anormalidades Cardíacas: Papel da Ultra–sonografia Obstétrica de Rotina renatal Screening of Cardiac Abnormalities: The Role of Routine Obstetrical Ultrasound

    Directory of Open Access Journals (Sweden)

    Tzvi Bacaltchuk

    2001-10-01

    was accessible by the four-chamber view alone. Arrhythmias during obstetrical scan were observed in 26.3 of the babies with prenatal suspicion of a heart abnormality, while only 3.4% of the patients without prenatal suspicion showed a rhythm alteration (p=0.009. Significant differences between the groups with and without prenatal suspicion of cardiac abnormalities were observed in relation to parity (p=0.029, delivery by cesarean section (p=0.006, need for intensive care (p=0.046 and school education level of the father (p=0.014. At multivariate analysis, only the presence of a rhythm alteration during ultrasound scan was shown to be an independent variable associated with prenatal suspicion of cardiac abnormalities. Conclusions: routine obstetrical ultrasound has been underused in prenatal screening of congenital heart diseases. Adequate training and making obstetricians and the population a ware of the problem may be instruments for increasing the efficacy of routine obstetrical ultrasound in rising the suspicion of fetal cardiac abnormalities.

  9. Prevalence and predictors of Pap smear cervical epithelial cell abnormality among HIV-positive and negative women attending gynecological examination in cervical cancer screening center at Debre Markos referral hospital, East Gojjam, Northwest Ethiopia.

    Science.gov (United States)

    Getinet, Melkamu; Gelaw, Baye; Sisay, Abinet; Mahmoud, Eiman A; Assefa, Abate

    2015-01-01

    Cervical cancer is the leading cause of cancer related death among women in developing countries. Cervical cancer is preceded by cervical surface epithelial cell abnormalities (ECA) which can be detected by Pap smear test. Simultaneous human papillomavirus and human immunodeficiency virus (HIV) infection increases cervical cancer. Data on the prevalence and predictors of ECA among women in Ethiopia is limited. Hence, we aimed to determine the prevalence and associated factors of ECA among women. A comparative cross-sectional study was conducted among HIV+ and HIV- women attending gynecological examination in cervical cancer screening center at the Debre Markos referral hospital. The study subjects were stratified by HIV status and systematic random sampling method was used to recruit study participants. Cervical smears were collected for Pap smear examination. Logistic regression analysis was employed to examine the possible risk factors of cervical ECA. A total of 197 HIV+ and 194 HIV- women were enrolled in the study. The overall prevalence of cervical ECA was 14.1 % of which the prevalence of atypical squamous cells undetermined significance (ASCUS), low grade squamous intraepithelial lesion (SIL), high grade SIL, squamous cell carcinoma and ASC, cannot exclude high grade SIL (ASCH) were 5.1, 3.8, 4.1 and 1.0 %, 0.0 % respectively. Significantly higher prevalence of ECA (17.8 %) was observed among HIV+ women (COR 1.9, 95 % CI: 1.1 - 3.4, p = 0.036) as compared to HIV-women (10.3 %). Multiple sexual partnership (AOR 3.2, 95 % CI: 1.1 - 10.0, p = 0.04), early ages of first sexual contact (Cervical ECA is a major problem among HIV-infected women. Lower CD4+ T-cell counts of below 350 cells/μl, HIV infection, multiple sexual partnership, early age at first sexual contact, parity greater than three and long term OCP use were significant predictors of prevalence of ECA. Strengthening screening program in HIV+ women should be considered.

  10. Inequalities in socioeconomic status and race and the odds of undergoing a mammogram in Brazil.

    Science.gov (United States)

    Melo, Enirtes Caetano Prates; de Oliveira, Evangelina Xavier Gouveia; Chor, Dóra; Carvalho, Marilia Sá; Pinheiro, Rejane Sobrino

    2016-09-15

    Access to mammograms, in common with other diagnostic procedures, is strongly conditioned by socioeconomic disparities. Which aspects of inequality affect the odds of undergoing a mammogram, and whether they are the same in different localities, are relevant issues related to the success of health policies. This study analyzed data from the 2008 PNAD - Brazilian National Household Sample Survey (11.607 million women 40 years of age or older), on having had at least one mammogram over life for women 40 years of age or older in each of Brazil's nine Metropolitan Regions (MR), according to socioeconomic position. The effects of income, schooling, health insurance and race in the different regions were investigated using multivariate logistical regression for each region individually, and for all MRs combined. The age-adjusted odds of a woman having had a mammogram according to race and stratified by two income strata (and two schooling strata) were also analyzed. Having a higher income increases four to seven times a woman's odds of having had at least one mammogram in all MRs except Curitiba. For schooling, the gradient, though less steep, is favorable to women with more years of study. Having health insurance increases two to three times the odds in all MRs. Multivariate analysis did not show differences due to race (except for the Fortaleza MR), but the stratified analysis by income and schooling shows effects of race in most MRs, with greater differences for women with higher socioeconomic status. This study confirms that income and schooling, as well as having health insurance, are still important determinants of inequality in health service use in Brazil. Additionally, race also contributes to the odds of having had a mammogram. The point is not to isolate the effect of each factor, but to evaluate how their interrelations may exacerbate differences, generating patterns of cumulative adversity, a theme that is still little explored in Brazil. This is much more

  11. Reader practice in mammography screen reporting in Australia

    International Nuclear Information System (INIS)

    Reed, W.; Poulos, A.; Brennan, P.

    2009-01-01

    Full text: Reader variability is a problem in mammography image reporting and compromises the efficacy of screening programmes. The purpose of this exploratory study was to survey reader practice in reporting screening mammograms in Australia to identify aspects of practice that warrant further investigation. Mammography reporting practice and influences on concentration and attention were investigated by using an original questionnaire distributed to screen readers in Australia. A response rate of 71% (83 out of 117) was achieved. Demographic data indicated that the majority of readers were over 46 years of age (73%), have been reporting on screening mammograms for over 10 years (61%), take less than 1 min to report upon a screening mammogram examination (66%), report up to 200 examinations in a single session (83%) and take up to 2 h to report one session (61%). A majority report on more than 5000 examinations annually (66%); 93% of participants regard their search strategy as systematic, 87% agreed that their concentration can vary throughout a session, 64% agreed that the relatively low number of positives can lead to lapses in concentration and attention and almost all (94%) participants agreed that methods to maximise concentration should be explored. Participants identified a range of influences on concentration within their working environment including volume of images reported in one session, image types and aspects of the physical environment. This study has provided important evidence of the need to investigate adverse influences on concentration during mammography screen reporting

  12. Development of a Computer-Aided Diagnosis System for Early Detection of Masses Using Retrospectively Detected Cancers on Prior Mammograms

    National Research Council Canada - National Science Library

    Wei, Jun

    2006-01-01

    The goal of this project is to develop a computer-aided diagnosis (CAD) system for mass detection using advanced computer vision techniques that will be trained with retrospectively detected cancers on prior mammograms...

  13. Development of a Computer-Aided Diagnosis System for Early Detection of Masses Using Retrospectively Detected Cancers on Prior Mammograms

    National Research Council Canada - National Science Library

    Wei, Jun

    2007-01-01

    The goal of this project is to develop a computer-aided diagnosis (CAD) system for mass detection using advanced computer vision techniques that will be trained with retrospectively detected cancers on prior mammograms...

  14. A combined approach for the enhancement and segmentation of mammograms using modified fuzzy C-means method in wavelet domain

    OpenAIRE

    Srivastava, Subodh; Sharma, Neeraj; Singh, S. K.; Srivastava, R.

    2014-01-01

    In this paper, a combined approach for enhancement and segmentation of mammograms is proposed. In preprocessing stage, a contrast limited adaptive histogram equalization (CLAHE) method is applied to obtain the better contrast mammograms. After this, the proposed combined methods are applied. In the first step of the proposed approach, a two dimensional (2D) discrete wavelet transform (DWT) is applied to all the input images. In the second step, a proposed nonlinear complex diffusion based uns...

  15. Differential Use of Screening Mammography in Older Women Initiating Metformin versus Sulfonylurea.

    Science.gov (United States)

    Hong, Jin-Liern; Henderson, Louise M; Jonsson Funk, Michele; Lund, Jennifer L; Buse, John B; Pate, Virginia; Stürmer, Til

    2017-06-01

    Differential use of screening mammography may lead to biased detection of breast cancer. This study aimed to compare receipt of screening mammography and the incidence of screen-detected breast cancer between metformin and sulfonylurea initiators. We used 2006-2014 US Medicare claims to identify initiators of metformin or sulfonylurea aged 65+ years continuously enrolled in Parts A/B for ≥2 years pre-initiation and ≥2 years post-initiation. We reported frequencies of screening mammograms and screen-detected breast cancer in 1 year pre-initiation among all cohort members and in 1 year post-initiation among cancer-free cohort members. Weighted screening risk differences (RDs) were estimated comparing metformin to sulfonylurea group. We identified 41,436 and 13,367 initiators of metformin and sulfonylurea, 35% and 24% of which had ≥1 screening mammogram in 1 year pre-initiation (weighted RD: 6 percentage points; 95% CI: 5 to 7), respectively. The weighted RD for screen-detected breast cancer associated with metformin was 0.00 percentage points (95% CI: -0.09 to 0.09). Among cancer-free cohort members, metformin initiators had 5 percentage points (95% CI: 4 to 6) and 0.11 percentage points (95% CI: -0.02 to 0.23) absolute risk excess of screening mammography and screen-detected breast cancer in 1 year post-initiation, compared with sulfonylurea initiators, respectively. Metformin initiators were more likely to receive screening mammograms than sulfonylurea initiators pre- and post-initiation, indicating possible detection bias due to differential screening mammography. Researchers should be aware of the potential for more screening mammograms pre- and post-initiation when interpreting the findings of metformin on breast cancer incidence. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  16. Detection of masses in mammograms by analysis of gradient vector convergence using sector filter

    International Nuclear Information System (INIS)

    Fakhari, Y.; Karimian, A.; Mohammadbeigi, M.

    2012-01-01

    Although mammography is the main diagnostic method for breast cancer, but the interpretation of mammograms is a difficult task and depends on the experience and skill of the radiologists. Computer Aided Detection (CADe) systems have been proposed to help radiologist in interpretation of mammograms. In this paper a novel filter called Sector filter is proposed to detect masses. This filter works based on the analysis of convergence of gradient vectors toward the center of filter. Using this filter, rounded convex regions, which are more likely to be pertained to a mass, could be detected in a gray scale image. After applying this filter on the images with two scales and their linear combination suspicious points were selected by a specific process. After implementation of the proposed method, promising results were achieved. The performance of the proposed method in this research was competitive or in some cases even better than that of other suggested methods in the literature. (authors)

  17. Detecting microcalcifications in mammograms by using SVM method for the diagnostics of breast cancer

    Science.gov (United States)

    Wan, Baikun; Wang, Ruiping; Qi, Hongzhi; Cao, Xuchen

    2005-01-01

    Support vector machine (SVM) is a new statistical learning method. Compared with the classical machine learning methods, SVM learning discipline is to minimize the structural risk instead of the empirical risk of the classical methods, and it gives better generative performance. Because SVM algorithm is a convex quadratic optimization problem, the local optimal solution is certainly the global optimal one. In this paper a SVM algorithm is applied to detect the micro-calcifications (MCCs) in mammograms for the diagnostics of breast cancer that has not been reported yet. It had been tested with 10 mammograms and the results show that the algorithm can achieve a higher true positive in comparison with artificial neural network (ANN) based on the empirical risk minimization, and is valuable for further study and application in the clinical engineering.

  18. Bayesian Maximum Entropy Based Algorithm for Digital X-ray Mammogram Processing

    Directory of Open Access Journals (Sweden)

    Radu Mutihac

    2009-06-01

    Full Text Available Basics of Bayesian statistics in inverse problems using the maximum entropy principle are summarized in connection with the restoration of positive, additive images from various types of data like X-ray digital mammograms. An efficient iterative algorithm for image restoration from large data sets based on the conjugate gradient method and Lagrange multipliers in nonlinear optimization of a specific potential function was developed. The point spread function of the imaging system was determined by numerical simulations of inhomogeneous breast-like tissue with microcalcification inclusions of various opacities. The processed digital and digitized mammograms resulted superior in comparison with their raw counterparts in terms of contrast, resolution, noise, and visibility of details.

  19. Clinical Image Evaluation of Film Mammograms in Korea: Comparison with the ACR Standard

    International Nuclear Information System (INIS)

    Gwak, Yeon Joo; Kim, Hye Jung; Kwak, Jin Young; Son, Eun Ju; Ko, Kyung Hee; Lee, Jin Hwa; Lim, Hyo Soon; Lee, You Jin; Park, Ji Won; Shin, Kyung Min; Jang, Yun-Jin

    2013-01-01

    The goal of this study is to compare the overall quality of film mammograms taken according to the Korean standards with the American College of Radiology (ACR) standard for clinical image evaluation and to identify means of improving mammography quality in Korea. Four hundred and sixty eight sets of film mammograms were evaluated with respect to the Korean and ACR standards for clinical image evaluation. The pass and failure rates of mammograms were compared by medical facility types. Average scores in each category of the two standards were evaluated. Receiver operating characteristic curve analysis was used to identify an optimal Korean standard pass mark by taking the ACR standard as the reference standard. 93.6% (438/468) of mammograms passed the Korean standard, whereas only 80.1% (375/468) passed the ACR standard (p < 0.001). Non-radiologic private clinics had the lowest pass rate (88.1%: Korean standard, 71.8%: ACR standard) and the lowest total score (76.0) by the Korean standard. Average scores of positioning were lowest (19.3/29 by the Korean standard and 3.7/5 by the ACR standard). A cutoff score of 77.0 for the Korean standard was found to correspond to a pass level when the ACR standard was applied. We suggest that tighter regulations, such as, raising the Korean pass mark, subtracting more for severe deficiencies, or considering a very low scores in even a single category as failure, are needed to improve the quality of mammography in Korea

  20. Early Detection of Breast Cancer on Mammograms Using: Perceptual Feedback, Computer Processed Images and Ultrasound

    Science.gov (United States)

    1994-01-01

    amDlitude distortions in ultrasound mammography.. 14. SUBJECT TERMS 15. NUMBER OF PAGES Breast Cancer Detection, Biofeedback , Ultrasound , Image Processing 16...PROCESSED IMAGES AND ULTRASOUND PRINCIPAL INVESTIGATOR: Peter Bloch, Ph.D. D,.L~kiX2D 3 CONTRACTING ORGANIZATION: University of Pennsylvania Office of...Cancer on Mammograms Using. Perceptual Feedback, Computer Processed Images and Ultrasound Peter Bloch, Ph.D., Principal Investigator Page Numbers Front

  1. Computerized detection of masses on mammograms: A comparative study of two algorithms

    International Nuclear Information System (INIS)

    Tiedeu, A.; Kom, G.; Kom, M.

    2007-02-01

    In this paper, we implement and carry out the comparison of two methods of computer-aided-detection of masses on mammograms. The two algorithms basically consist of 3 steps each: segmentation, binarization and noise suppression but using different techniques for each step. A database of 60 images was used to compare the performance of the two algorithms in terms of general detection efficiency, conservation of size and shape of detected masses. (author)

  2. Screening for Cervical Cancer

    Science.gov (United States)

    ... cervical cancer: • Cytology: This test, also called a Pap test or Pap smear, looks for abnormal changes in ... women ages 21 to 65, screening with a Pap test every 3 years has the highest benefits with ...

  3. Comparison of cumulative false-positive risk of screening mammography in the United States and Denmark

    DEFF Research Database (Denmark)

    Kemp Jacobsen, Katja; Abraham, Linn; Buist, Diana S M

    2015-01-01

    INTRODUCTION: In the United States (US), about one-half of women screened with annual mammography have at least one false-positive test after ten screens. The estimate for European women screened ten times biennially is much lower. We evaluate to what extent screening interval, mammogram type......, and statistical methods, can explain the reported differences. METHODS: We included all screens from women first screened at age 50-69 years in the US Breast Cancer Surveillance Consortium (BCSC) (n=99,455) between 1996-2010, and from two population-based mammography screening programs in Denmark (n=230,452 and n...

  4. Is postexcision, preradiation mammogram necessary in patients after breast-conserving surgery with negative margins.

    Science.gov (United States)

    Adkisson, Cameron D; McLaughlin, Sarah A; Vallow, Laura A; Heckman, Michael G; Diehl, Nancy N; Bagaria, Sanjay P; Howe, Nicholas; Gibson, Tammeza; Pockaj, Barbara

    2013-10-01

    In women with breast cancer and calcifications, controversy exists over the need for postexcision/lumpectomy, preradiation mammogram (PEM) after breast-conserving surgery (BCS). Further, the need for excision of remaining or suspicious calcifications after PEM when surgical margins are negative is unclear. We sought to characterize the utility of PEM hypothesizing that its value in directing the need for additional surgery is minimized after achieving negative surgical margins. We identified 524 women with breast cancer and calcifications treated with BCS with negative margins between 1996 and 2011. PEM was performed in 112 of 524 (21 %) women, with residual calcifications identified in 10 of 112 (9 %); of these, 2 of 112 (1.8 %) had residual disease. Local recurrence occurred in 4 of 112 (4 %) patients, none of whom had residual calcifications identified on PEM. The remaining 412 of 524 (79 %) women did not have PEM but had a postradiation mammogram 6 to 12 months after treatment identifying calcifications in 19 (5 %) women. Tissue diagnosis was benign in 14 women and was not pursued in the remaining 5. Local recurrence occurred in 13 (3 %) patients, none of whom had calcifications on the new post radiation baseline mammogram. Mammographically apparent calcifications representing residual disease occur infrequently after BCS with negative margins. The value of PEM may be to document the new radiographic baseline but should not be required to ensure adequate surgery. Radiation plays an integral role in sterilization of the remaining breast tissue after BCS.

  5. Quantitative assessment of breast density from digitized mammograms into Tabar's patterns

    International Nuclear Information System (INIS)

    Jamal, N; Ng, K-H; Looi, L-M; McLean, D; Zulfiqar, A; Tan, S-P; Liew, W-F; Shantini, A; Ranganathan, S

    2006-01-01

    We describe a semi-automated technique for the quantitative assessment of breast density from digitized mammograms in comparison with patterns suggested by Tabar. It was developed using the MATLAB-based graphical user interface applications. It is based on an interactive thresholding method, after a short automated method that shows the fibroglandular tissue area, breast area and breast density each time new thresholds are placed on the image. The breast density is taken as a percentage of the fibroglandular tissue to the breast tissue areas. It was tested in four different ways, namely by examining: (i) correlation of the quantitative assessment results with subjective classification, (ii) classification performance using the quantitative assessment technique, (iii) interobserver agreement and (iv) intraobserver agreement. The results of the quantitative assessment correlated well (r 2 = 0.92) with the subjective Tabar patterns classified by the radiologist (correctly classified 83% of digitized mammograms). The average kappa coefficient for the agreement between the readers was 0.63. This indicated moderate agreement between the three observers in classifying breast density using the quantitative assessment technique. The kappa coefficient of 0.75 for intraobserver agreement reflected good agreement between two sets of readings. The technique may be useful as a supplement to the radiologist's assessment in classifying mammograms into Tabar's pattern associated with breast cancer risk

  6. Understanding barriers to organized breast cancer screening in France: women's perceptions, attitudes, and knowledge.

    Science.gov (United States)

    Ferrat, Emilie; Le Breton, Julien; Djassibel, Memtolom; Veerabudun, Kalaivani; Brixi, Zahida; Attali, Claude; Renard, Vincent

    2013-08-01

    The participation rate in organized breast cancer screening in France is lower than recommended. Non-participants either use opportunistic screening or do not use either screening modality. To assess any differences in perceptions, attitudes and knowledge related to breast cancer screening between users of opportunistic screening and non-users of any screening mammograms and to identify potential barriers to participation in organized screening. Six focus groups were conducted in May 2010 with 34 French non-participants in organized screening, 15 who used opportunistic screening (OpS group) and 19 who used no screening (NoS group). The guide used for both groups explored perceptions and attitudes related to health, cancer and screening; perceptions of femininity; and knowledge about breast cancer screening. Thematic content analysis was performed. Perceptions, attitudes and knowledge differed between the two groups. Women in the OpS group perceived a high susceptibility to breast cancer, visited their gynaecologist regularly, were unfamiliar with organized screening modalities and had doubts about its quality. NoS women had very high- or low-perceived susceptibility to breast cancer, knew about screening modalities, had doubts about its usefulness and expressed negative opinions of mammograms. Differences in perceptions and attitudes related to breast cancer screening partially explain why some women choose opportunistic screening or no screening. General practitioners and gynaecologists are in a unique position to provide individually tailored preventative messages to improve participation in organized screening.

  7. Tooth - abnormal colors

    Science.gov (United States)

    ... medlineplus.gov/ency/article/003065.htm Tooth - abnormal colors To use the sharing features on this page, please enable JavaScript. Abnormal tooth color is any color other than white to yellowish- ...

  8. Urine - abnormal color

    Science.gov (United States)

    ... medlineplus.gov/ency/article/003139.htm Urine - abnormal color To use the sharing features on this page, please enable JavaScript. The usual color of urine is straw-yellow. Abnormally colored urine ...

  9. Abnormal uterine bleeding

    Science.gov (United States)

    Anovulatory bleeding; Abnormal uterine bleeding - hormonal; Polymenorrhea - dysfunctional uterine bleeding ... ACOG committee opinion no. 557: Management of acute abnormal uterine bleeding in nonpregnant reproductive-aged women. Reaffirmed 2015. ACOG. ...

  10. Does computer-aided detection have a role in the arbitration of discordant double-reading opinions in a breast-screening programme?

    Science.gov (United States)

    James, J J; Cornford, E J

    2009-01-01

    To investigate whether a computer-aided detection (CAD) system could act as an arbitrator of discordant double-reading opinions, replacing the need for an independent third film reader. The mammograms of the 240 women that underwent arbitration by an independent third reader were identified from the 16,629 women attending our screening centre between July 2003 and April 2004. Mammograms of the arbitration cases were digitized and analysed by a CAD system. To assess the ability of CAD to act as the arbitrator, the site of the CAD prompts was retrospectively compared to the site of any abnormality noted by the original film readers. If a CAD prompt was placed on a region marked by one of the film readers then the decision of CAD as the arbitrator was that the women should be recalled for further assessment. If no mark was placed then the region was considered low risk and the decision was not to recall. The decision of CAD as the arbitrator was retrospectively compared with the original recall decision of the independent third reader. There were 21 cancer cases in the group of women undergoing arbitration, diagnosed both at the original screening episode and subsequently. The independent third reader recalled 15/18 (83%) of the cancers that corresponded with the arbitrated lesion. CAD as the arbitrator would have recalled 16/18 (89%) of the cancers that corresponded to the arbitrated lesion. CAD acting as the arbitrator would have resulted in a significant increase in normal women being recalled to assessment in the arbitration group (Parbitrator of discordant double-reading opinions is to increase the recall rate, significantly above what is found when arbitration is performed by an independent third reader. Using CAD as an arbitrator may be an option to deal with discordant double-reading opinions when no other method of consensus or arbitration is available.

  11. American Indian Women and Screening Mammography: Findings from a Qualitative Study in Oklahoma

    Science.gov (United States)

    Tolma, Eleni; Batterton, Chasity; Hamm, Robert M.; Thompson, David; Engelman, Kimberly K.

    2012-01-01

    Background: Breast cancer is an important public health issue within the American Indian (AI) community in Oklahoma; however, there is limited information to explain the low screening mammography rates among AI women. Purpose: To identify the motivational factors affecting an AI woman's decision to obtain a mammogram. Methods: Through the use of…

  12. Quantification of masking risk in screening mammography with volumetric breast density maps

    NARCIS (Netherlands)

    Holland, Katharina; van Gils, Carla H; Mann, Ritse M; Karssemeijer, Nico

    PURPOSE: Fibroglandular tissue may mask breast cancers, thereby reducing the sensitivity of mammography. Here, we investigate methods for identification of women at high risk of a masked tumor, who could benefit from additional imaging. METHODS: The last negative screening mammograms of 111 women

  13. Quantification of masking risk in screening mammography with volumetric breast density maps

    NARCIS (Netherlands)

    Holland, K.; Gils, C.H. van; Mann, R.M.; Karssemeijer, N.

    2017-01-01

    PURPOSE: Fibroglandular tissue may mask breast cancers, thereby reducing the sensitivity of mammography. Here, we investigate methods for identification of women at high risk of a masked tumor, who could benefit from additional imaging. METHODS: The last negative screening mammograms of 111 women

  14. Mammographic screening for breast cancer in a resource-restricted environment.

    Science.gov (United States)

    Apffelstaedt, S P; Dalmayer, L; Baatjes, K

    2014-04-01

    Mammographic screening is carried out at public sector hospitals as part of clinical practice. We report the experience of such screening at Tygerberg Academic Hospital (TBAH), a tertiary referral hospital in the Western Cape Province, South Africa. All mammograms performed between 2003 and 2012 at TBAH were analysed regarding patient demographics, clinical data, indication and outcome according to the American College of Radiology Breast Imaging Reporting and Data System (BIRADS). Screening mammography was offered to patients > 40 years of age and mammograms were read by experienced breast surgeons. Patients with BIRADS 3 and 4 lesions were recalled for short-term follow-up, further imaging or tissue acquisition. Patients with BIRADS 5 lesions were recalled for tissue acquisition. Further imaging, method of tissue acquisition, histology results and use of neo-adjuvant therapy were also recorded. Of 16 105 mammograms, 3 774 (23.4%) were carried out for screening purposes. The median age of patients undergoing screening was 54 years. Of 407 women with mammograms that were reported as BIRADS 3 - 5 (10.8% of screening mammograms), 187 (46% of recalled women) went on to have further imaging only. Tissue was acquired in 175 patients (43% of recalled women), comprising a biopsy rate of 4.6% of the total series. The malignancy rate in cases in which tissue acquisition was done was 25%. Forty-three breast cancers were diagnosed (11.4/1 000 examinations). Of the cancers, nine (31%) were ductal carcinomas in situ. Of 20 invasive cancers, nine (45%) were < 10 mm in size. Of the invasive cancers, 40% were node-positive. The cancer diagnosis rate indicates a high breast cancer load in an urbanised population.

  15. Prevalence of asymptomatic urinary abnormalities among adolescents

    Directory of Open Access Journals (Sweden)

    Mohamed Fouad

    2016-01-01

    Full Text Available To determine the prevalence of asymptomatic urinary abnormalities in adolescents, first morning clean mid-stream urine specimens were obtained from 2500 individuals and examined by dipstick and light microscopy. Adolescents with abnormal screening results were reexamined after two weeks and those who had abnormal results twice were subjected to systemic clinical examination and further clinical and laboratory investigations. Eight hundred and three (32.1% individuals had urinary abnormalities at the first screening, which significantly decreased to 345 (13.8% at the second screening, (P <0.001. Hematuria was the most common urinary abnormalities detected in 245 (9.8% adolescents who had persistent urine abnormalities; 228 (9.1% individuals had non glomerular hematuria. The hematuria was isolated in 150 (6% individuals, combined with leukocyturia in 83 (3.3% individuals, and combined with proteinuria in 12 (0.5% individuals. Leukocyturia was detected in 150 (6% of all studied adolescents; it was isolated in 39 (1.6% individuals and combined with proteinuria in 28 (1.1% of them. Asymp- tomatic bacteriuria was detected in 23 (0.9% of all studied adolescents; all the cases were females. Proteinuria was detected in 65 (2.6% of all the studied adolescents; 45 (1.8% indivi- duals had <0.5 g/day and twenty (0.8% individuals had 0.5-3 g/day. Asymptomatic urinary abnormalities were more common in males than females and adolescents from rural than urban areas (P <0.01 and (P <0.001, respectively. The present study found a high prevalence of asymptomatic urinary abnormalities among adolescents in our population.

  16. Breast cancer screening of pregnant and breastfeeding women with BRCA mutations.

    Science.gov (United States)

    Carmichael, Harris; Matsen, Cindy; Freer, Phoebe; Kohlmann, Wendy; Stein, Matthew; Buys, Saundra S; Colonna, Sarah

    2017-04-01

    Screening recommendations for women with BRCA mutations include annual breast MRI starting at age 25, with annual mammogram added at age 30. The median age of childbearing in the US is age 28, therefore many BRCA mutation carriers will be pregnant or breastfeeding during the time when intensive screening is most important to manage their increased breast cancer risk. Despite this critical overlap, there is little evidence to guide clinicians on the appropriate screening for women with BRCA mutations during pregnancy or breastfeeding. Hormonal shifts that occur during pregnancy, the postpartum period, and breastfeeding result in changes to the breasts that may further complicate the sensitivity and specificity of screening modalities. We explore the safety and efficacy of available breast cancer screening modalities, including clinical breast exam, mammogram, breast MRI, and ultrasound among women with BRCA mutations who are pregnant or breastfeeding, providing recommendations from the most current published literature and expert opinion.

  17. Evaluating geodesic active contours in microcalcifications segmentation on mammograms.

    Science.gov (United States)

    Duarte, Marcelo A; Alvarenga, Andre V; Azevedo, Carolina M; Calas, Maria Julia G; Infantosi, Antonio F C; Pereira, Wagner C A

    2015-12-01

    Breast cancer is the most commonly occurring type of cancer among women, and it is the major cause of female cancer-related deaths worldwide. Its incidence is increasing in developed as well as developing countries. Efficient strategies to reduce the high death rates due to breast cancer include early detection and tumor removal in the initial stages of the disease. Clinical and mammographic examinations are considered the best methods for detecting the early signs of breast cancer; however, these techniques are highly dependent on breast characteristics, equipment quality, and physician experience. Computer-aided diagnosis (CADx) systems have been developed to improve the accuracy of mammographic diagnosis; usually such systems may involve three steps: (i) segmentation; (ii) parameter extraction and selection of the segmented lesions and (iii) lesions classification. Literature considers the first step as the most important of them, as it has a direct impact on the lesions characteristics that will be used in the further steps. In this study, the original contribution is a microcalcification segmentation method based on the geodesic active contours (GAC) technique associated with anisotropic texture filtering as well as the radiologists' knowledge. Radiologists actively participate on the final step of the method, selecting the final segmentation that allows elaborating an adequate diagnosis hypothesis with the segmented microcalcifications presented in a region of interest (ROI). The proposed method was assessed by employing 1000 ROIs extracted from images of the Digital Database for Screening Mammography (DDSM). For the selected ROIs, the rate of adequately segmented microcalcifications to establish a diagnosis hypothesis was at least 86.9%, according to the radiologists. The quantitative test, based on the area overlap measure (AOM), yielded a mean of 0.52±0.20 for the segmented images, when all 2136 segmented microcalcifications were considered. Moreover, a

  18. Mammography screening credit card and compliance.

    Science.gov (United States)

    Schapira, D V; Kumar, N B; Clark, R A; Yag, C

    1992-07-15

    Screening for breast cancer using mammography has been shown to be effective in reducing mortality from breast cancer. The authors attempted to determine if use of a wallet-size plastic screening "credit" card would increase participants' compliance for subsequent mammograms when compared with traditional methods of increasing compliance. Two hundred and twenty consecutive women, ages 40-70 years, undergoing their first screening mammography were recruited and assigned randomly to four groups receiving (1) a reminder plastic credit card (2) reminder credit card with written reminder; (3) appointment card; and (4) verbal recommendation. Return rates of the four groups were determined after 15 months. The return rate for subsequent mammograms was significantly higher for participants (72.4%) using the credit card than for participants (39.8%) exposed to traditional encouragement/reminders (P less than 0.0001). The credit card was designed to show the participant's screening anniversary, and the durability of the card may have been a factor in increasing the return rate. The use of reminder credit cards may increase compliance for periodic screening examinations for other cancers and other chronic diseases.

  19. Comparative multifractal analysis of dynamic infrared thermograms and X-ray mammograms enlightens changes in the environment of malignant tumors

    Directory of Open Access Journals (Sweden)

    Evgeniya Gerasimova-Chechkina

    2016-08-01

    Full Text Available There is growing evidence that the microenvironment surrounding a tumor plays a special role in cancer development and cancer therapeutic resistance. Tumors arise from the dysregulation and alteration of both the malignant cells and their environment. By providing tumor-repressing signals, the microenvironment can impose and sustain normal tissue architecture. Once tissue homeostasis is lost, the altered microenvironment can itself become a promoter of the tumorigenic transformation process. A major challenge in early breast cancer diagnosis is thus to show that these physiological and architectural alterations can be detected with currently used screening techniques. In a recent study, we used a 1D wavelet-based multi-scale method to analyze the temporal fluctuations of breast skin temperature collected with an IR thermography camera in patients with breast cancer. This study reveals that the multifractal complexity of temperature fluctuations about the cardiogenic and vasomotor perfusion oscillations observed in healthy breasts is lost in malignant tumor foci in cancerous breasts. Here we use a 2D wavelet-based multifractal method to analyze the spatial fluctuations of breast density in the X-ray mammograms of the same panel of patients. As compared to the long-range correlations and anti-correlations in roughness fluctuations, respectively observed in dense and fatty breast areas, some significant change in the nature of breast density fluctuations with some clear loss of correlations is detected in the neighborhood of malignant tumors. This attests to some architectural disorganization that may deeply affect heat transfer and related thermomechanics in breast tissues, corroborating the change to homogeneous monofractal temperature fluctuations recorded in cancerous breasts with the IR camera. These results open new perspectives in computer-aided methods to assist in early breast cancer diagnosis.

  20. Characteristics and screening outcome of women referred twice at screening mammography

    International Nuclear Information System (INIS)

    Setz-Pels, Wikke; Duijm, Lucien E.M.; Jansen, Frits H.; Louwman, Marieke W.J.; Roumen, Rudi M.H.; Voogd, Adri C.

    2012-01-01

    To determine the characteristics and screening outcome of women referred twice at screening mammography. We included 424,703 consecutive screening mammograms and collected imaging, biopsy and surgery reports of women with screen-detected breast cancer. Review of screening mammograms was performed to determine whether or not an initial and second referral comprised the same lesion. The overall positive predictive value of referral for cancer was 38.6% (95% CI 37.3-39.8%). Of 147 (2.6%) women referred twice, 86 had been referred for a different lesion at second referral and 32 of these proved malignant (37.2%, 95% CI 27.0-47.4%). Sixty-one women had been referred twice for the same lesion, of which 22 proved malignant (36.1%, 95% CI 24.1-48.0%). Characteristics of these women were comparable to women with cancer diagnosed after first referral. Compared with women without cancer at second referral for the same lesion, women with cancer more frequently showed suspicious densities at screening mammography (86.4% vs 53.8%, P = 0.02) and work-up at first referral had less frequently included biopsy (22.7% vs 61.5%, P = 0.004). Cancer risk in women referred twice for the same lesion is similar to that observed in women referred once, or referred for a second time but for a different lesion. (orig.)

  1. Validation of a method for measuring the volumetric breast density from digital mammograms

    International Nuclear Information System (INIS)

    Alonzo-Proulx, O; Shen, S Z; Yaffe, M J; Packard, N; Boone, J M; Al-Mayah, A; Brock, K K

    2010-01-01

    The purpose of this study was to evaluate the performance of an algorithm used to measure the volumetric breast density (VBD) from digital mammograms. The algorithm is based on the calibration of the detector signal versus the thickness and composition of breast-equivalent phantoms. The baseline error in the density from the algorithm was found to be 1.25 ± 2.3% VBD units (PVBD) when tested against a set of calibration phantoms, of thicknesses 3-8 cm, with compositions equivalent to fibroglandular content (breast density) between 0% and 100% and under x-ray beams between 26 kVp and 32 kVp with a Rh/Rh anode/filter. The algorithm was also tested against images from a dedicated breast computed tomography (CT) scanner acquired on 26 volunteers. The CT images were segmented into regions representing adipose, fibroglandular and skin tissues, and then deformed using a finite-element algorithm to simulate the effects of compression in mammography. The mean volume, VBD and thickness of the compressed breast for these deformed images were respectively 558 cm 3 , 23.6% and 62 mm. The displaced CT images were then used to generate simulated digital mammograms, considering the effects of the polychromatic x-ray spectrum, the primary and scattered energy transmitted through the breast, the anti-scatter grid and the detector efficiency. The simulated mammograms were analyzed with the VBD algorithm and compared with the deformed CT volumes. With the Rh/Rh anode filter, the root mean square difference between the VBD from CT and from the algorithm was 2.6 PVBD, and a linear regression between the two gave a slope of 0.992 with an intercept of -1.4 PVBD and a correlation with R 2 = 0.963. The results with the Mo/Mo and Mo/Rh anode/filter were similar.

  2. Validation of a method for measuring the volumetric breast density from digital mammograms

    Energy Technology Data Exchange (ETDEWEB)

    Alonzo-Proulx, O; Shen, S Z; Yaffe, M J [Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario M4N 3M5 (Canada); Packard, N; Boone, J M [UC Davis Medical Center, University of California-Davis, Sacramento, CA 95817 (United States); Al-Mayah, A; Brock, K K, E-mail: oliviera@sri.utoronto.c [University Health Network, University of Toronto, Toronto, Ontario M5G 2M9 (Canada)

    2010-06-07

    The purpose of this study was to evaluate the performance of an algorithm used to measure the volumetric breast density (VBD) from digital mammograms. The algorithm is based on the calibration of the detector signal versus the thickness and composition of breast-equivalent phantoms. The baseline error in the density from the algorithm was found to be 1.25 {+-} 2.3% VBD units (PVBD) when tested against a set of calibration phantoms, of thicknesses 3-8 cm, with compositions equivalent to fibroglandular content (breast density) between 0% and 100% and under x-ray beams between 26 kVp and 32 kVp with a Rh/Rh anode/filter. The algorithm was also tested against images from a dedicated breast computed tomography (CT) scanner acquired on 26 volunteers. The CT images were segmented into regions representing adipose, fibroglandular and skin tissues, and then deformed using a finite-element algorithm to simulate the effects of compression in mammography. The mean volume, VBD and thickness of the compressed breast for these deformed images were respectively 558 cm{sup 3}, 23.6% and 62 mm. The displaced CT images were then used to generate simulated digital mammograms, considering the effects of the polychromatic x-ray spectrum, the primary and scattered energy transmitted through the breast, the anti-scatter grid and the detector efficiency. The simulated mammograms were analyzed with the VBD algorithm and compared with the deformed CT volumes. With the Rh/Rh anode filter, the root mean square difference between the VBD from CT and from the algorithm was 2.6 PVBD, and a linear regression between the two gave a slope of 0.992 with an intercept of -1.4 PVBD and a correlation with R{sup 2} = 0.963. The results with the Mo/Mo and Mo/Rh anode/filter were similar.

  3. AN INTELLIGENT CONTENT BASED IMAGE RETRIEVAL SYSTEM FOR MAMMOGRAM IMAGE ANALYSIS

    Directory of Open Access Journals (Sweden)

    K. VAIDEHI

    2015-11-01

    Full Text Available An automated segmentation method which dynamically selects the parenchymal region of interest (ROI based on the patients breast size is proposed from which, statistical features are derived. SVM classifier is used to model the derived features to classify the breast tissue as dense, glandular and fatty. Then K-nn with different distance metrics namely city-block, Euclidean and Chebchev is used to retrieve the first k similar images closest to the given query image. The proposed method was tested with MIAS database and achieves an average precision of 86.15%. The results reveals that the proposed method could be employed for effective content based mammograms retrieval.

  4. Automated Feature Set Selection and Its Application to MCC Identification in Digital Mammograms for Breast Cancer Detection

    Directory of Open Access Journals (Sweden)

    Wu-Chung Shen

    2013-04-01

    Full Text Available We propose a fully automated algorithm that is able to select a discriminative feature set from a training database via sequential forward selection (SFS, sequential backward selection (SBS, and F-score methods. We applied this scheme to microcalcifications cluster (MCC detection in digital mammograms for early breast cancer detection. The system was able to select features fully automatically, regardless of the input training mammograms used. We tested the proposed scheme using a database of 111 clinical mammograms containing 1,050 microcalcifications (MCs. The accuracy of the system was examined via a free response receiver operating characteristic (fROC curve of the test dataset. The system performance for MC identifications was Az = 0.9897, the sensitivity was 92%, and 0.65 false positives (FPs were generated per image for MCC detection.

  5. Contribution of the Unified Health Care System to mammography screening in Brazil, 2013.

    Science.gov (United States)

    Freitas-Junior, Ruffo; Rodrigues, Danielle Cristina Netto; Corrêa, Rosangela da Silveira; Peixoto, João Emílio; de Oliveira, Humberto Vinícius Carrijo Guimarães; Rahal, Rosemar Macedo Sousa

    2016-01-01

    To estimate the coverage of opportunistic mammography screening performed via the Brazilian Sistema Único de Saúde (SUS, Unified Health Care System), at the state and regional level, in 2013. This was an ecological study in which coverage was estimated by determining the ratio between the number of mammograms performed and the expected number of mammograms among the population of females between 50 and 69 years of age. The number of mammograms performed in the target population was obtained from the Outpatient Database of the Information Technology Department of the SUS. To calculate the expected number of mammograms, we considered 58.9% of the target population, the proportion that would be expected on the basis of the recommendations of the Brazilian National Cancer Institute. In 2013, the estimated national coverage of mammography screening via the SUS was 24.8%. The mammography rate ranged from 12.0% in the northern region to 31.3% in the southern region. When stratified by state, coverage was lowest in the state of Pará and highest in the state of Santa Catarina (7.5% and 35.7%, respectively). The coverage of mammography screening performed via the SUS is low. There is a significant disparity among the Brazilian states (including the Federal District of Brasília) and among regions, being higher in the south/southeast and lower in the north/northeast.

  6. Defining Abnormally Low Tenders

    DEFF Research Database (Denmark)

    Ølykke, Grith Skovgaard; Nyström, Johan

    2017-01-01

    The concept of an abnormally low tender is not defined in EU public procurement law. This article takes an interdisciplinary law and economics approach to examine a dataset consisting of Swedish and Danish judgments and verdicts concerning the concept of an abnormally low tender. The purpose...

  7. Incidence of fetal chromosome abnormalities in insulin dependent diabetic women

    DEFF Research Database (Denmark)

    Henriques, C U; Damm, P; Tabor, A

    1991-01-01

    In order to screen for fetal neural tube defects and chromosome abnormalities, amniocentesis was carried out in 334 women with insulin-dependent diabetes mellitus (IDDM) between 1979 and 1987. Two cases (0.6%; 95% confidence limits 0.1-2.2%) of fetal chromosome abnormality were found: one case...... of Klinefelter's syndrome and one case of de novo translocation. This is comparable to the overall incidence of chromosome abnormality found at birth and is also comparable to the incidence of fetal chromosome abnormality (1.0%) found by amniocentesis at our Department in a group of 2,264 young non......-diabetic women with little risk of contracting genetic disorders. The results suggest that maternal IDDM does not increase the risk of fetal chromosome abnormality and consequently screening by amniocentesis for chromosome abnormalities among diabetic women does not seem to be indicated....

  8. Computer-aided detection and diagnosis of masses and clustered microcalcifications from digital mammograms

    Science.gov (United States)

    Nishikawa, Robert M.; Giger, Maryellen L.; Doi, Kunio; Vyborny, Carl J.; Schmidt, Robert A.; Metz, Charles E.; Wu, Chris Y.; Yin, Fang-Fang; Jiang, Yulei; Huo, Zhimin; Lu, Ping; Zhang, Wei; Ema, Takahiro; Bick, Ulrich; Papaioannou, John; Nagel, Rufus H.

    1993-07-01

    We are developing an 'intelligent' workstation to assist radiologists in diagnosing breast cancer from mammograms. The hardware for the workstation will consist of a film digitizer, a high speed computer, a large volume storage device, a film printer, and 4 high resolution CRT monitors. The software for the workstation is a comprehensive package of automated detection and classification schemes. Two rule-based detection schemes have been developed, one for breast masses and the other for clustered microcalcifications. The sensitivity of both schemes is 85% with a false-positive rate of approximately 3.0 and 1.5 false detections per image, for the mass and cluster detection schemes, respectively. Computerized classification is performed by an artificial neural network (ANN). The ANN has a sensitivity of 100% with a specificity of 60%. Currently, the ANN, which is a three-layer, feed-forward network, requires as input ratings of 14 different radiographic features of the mammogram that were determined subjectively by a radiologist. We are in the process of developing automated techniques to objectively determine these 14 features. The workstation will be placed in the clinical reading area of the radiology department in the near future, where controlled clinical tests will be performed to measure its efficacy.

  9. Acceleration of Image Segmentation Algorithm for (Breast) Mammogram Images Using High-Performance Reconfigurable Dataflow Computers.

    Science.gov (United States)

    Milankovic, Ivan L; Mijailovic, Nikola V; Filipovic, Nenad D; Peulic, Aleksandar S

    2017-01-01

    Image segmentation is one of the most common procedures in medical imaging applications. It is also a very important task in breast cancer detection. Breast cancer detection procedure based on mammography can be divided into several stages. The first stage is the extraction of the region of interest from a breast image, followed by the identification of suspicious mass regions, their classification, and comparison with the existing image database. It is often the case that already existing image databases have large sets of data whose processing requires a lot of time, and thus the acceleration of each of the processing stages in breast cancer detection is a very important issue. In this paper, the implementation of the already existing algorithm for region-of-interest based image segmentation for mammogram images on High-Performance Reconfigurable Dataflow Computers (HPRDCs) is proposed. As a dataflow engine (DFE) of such HPRDC, Maxeler's acceleration card is used. The experiments for examining the acceleration of that algorithm on the Reconfigurable Dataflow Computers (RDCs) are performed with two types of mammogram images with different resolutions. There were, also, several DFE configurations and each of them gave a different acceleration value of algorithm execution. Those acceleration values are presented and experimental results showed good acceleration.

  10. Klasifikasi Massa pada Citra Mammogram Berdasarkan Gray Level Cooccurence Matrix (GLCM

    Directory of Open Access Journals (Sweden)

    Refta Listia

    2014-01-01

    Breast cancer is the most common disease in women in many countries. Breast cancer can be performed using mammography. In this work, an approach is proposed to classify mammogram based on three classes such as normal, benign, and malignant. The proposed system consist of four major steps : preprocessing, segmentation, feature extraction and classification. In preprocessing grayscale, interpolation, amoeba mean filter and segmentation are applicated. Feature extraction using Gray level Cooccurence Matrix (GLCM and the features will be calculated in 4 angles (d=1 and d= 2,  GLCM 8 angles and GLCM 16 angles.  The 5 features are contrast, energy, entropy, correlation and homogeneity. The final step is classification using Backpropagation. Some of important parameters will be variated in this process such as learning rate and the number of node in  hidden layer. The research result suggest that extraction feature in 4 angles ( and d=1 is the best accuracy for classifying mammogram based on classes 81,1% and especially in accuracy is 100%.

  11. Plant abnormality diagnosis device

    International Nuclear Information System (INIS)

    Saeki, Akira.

    1992-01-01

    The device of the present invention diagnose an abnormal event occurred in a large-scaled plant, such as a nuclear power plant. The device comprises the following four functions. (1) Abnormality candidates are estimated based on an intelligence base storing characteristics established between the characteristics/functions and physical amounts of the plant components, and detected abnormality and measured values. Among the candidates, one which coincidents with the measured value such as an actual process amount is judged as a first cause. (2) In addition, a real time plant behavior is estimated based on parameters determining a plant operation mode. The candidate for the abnormality cause is estimated by the comparison between the result of the estimation and the measured value such as a process amount. (3) Characteristics established between the characteristics/functions and the physical amount of the plant components are structured stepwise thereby identifying the first abnormality cause. (4) Inactuated or failed portions of the components for restoring the abnormality to normal state are identified based on the intelligence base simultaneously with the estimation for the first abnormality cause. (I.S.)

  12. Arbitration of discrepant BI-RADS 0 recalls by a third reader at screening mammography lowers recall rate but not the cancer detection rate and sensitivity at blinded and non-blinded double reading

    NARCIS (Netherlands)

    Klompenhouwer, E. G.; Weber, R. J. P.; Voogd, A. C.; den Heeten, G. J.; Strobbe, L. J. A.; Broeders, M. J. M.; Tjan-Heijnen, V. C. G.; Duijm, L. E. M.

    2015-01-01

    To evaluate the characteristics of low suspicion lesions (BI-RADS 0) at blinded and non-blinded double reading of screening mammograms and to determine the potential effect of arbitration of discrepant BI-RADS 0 recalls by a third reader on screening outcome. We included a series of 84,927

  13. Chromosomal Abnormalities in ADHD

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2002-07-01

    Full Text Available The prevalence of fragile X syndrome, velocardiofacial syndrome (VCFS, and other cytogenetic abnormalities among 100 children (64 boys with combined type ADHD and normal intelligence was assessed at the NIMH and Georgetown University Medical Center.

  14. "Jeopardy" in Abnormal Psychology.

    Science.gov (United States)

    Keutzer, Carolin S.

    1993-01-01

    Describes the use of the board game, Jeopardy, in a college level abnormal psychology course. Finds increased student interaction and improved application of information. Reports generally favorable student evaluation of the technique. (CFR)

  15. Chromosomal abnormalities and autism

    Directory of Open Access Journals (Sweden)

    Farida El-Baz

    2016-01-01

    Conclusion: Chromosomal abnormalities were not detected in the studied autistic children, and so the relation between the genetics and autism still needs further work up with different study methods and techniques.

  16. Diagnostic performance of detecting breast cancer on computed radiographic (CR) mammograms: comparison of hard copy film, 3-megapixel liquid-crystal-display (LCD) monitor and 5-megapixel LCD monitor.

    Science.gov (United States)

    Yamada, Takayuki; Suzuki, Akihiko; Uchiyama, Nachiko; Ohuchi, Noriaki; Takahashi, Shoki

    2008-11-01

    The purpose was to compare observer performance in the detection of breast cancer using hard-copy film, and 3-megapixel (3-MP) and 5-megapixel (5-MP) liquid crystal display (LCD) monitors in a simulated screening setting. We amassed 100 sample sets, including 32 patients with surgically proven breast cancer (masses present, N = 12; microcalcifications, N = 10; other types, N = 10) and 68 normal controls. All the mammograms were obtained using computed radiography (CR; sampling pitch of 50 mum). Twelve mammographers independently assessed CR mammograms presented in random order for hard-copy and soft-copy reading at minimal 4-week intervals. Observers rated the images on seven-point (1 to 7) and continuous (0 to 100) malignancy scales. Receiver-operating-characteristics analysis was performed, and the average area under the curve (AUC) was calculated for each modality. The jackknife method with the Bonferroni correction was applied to multireader/multicase analysis. The average AUC values for the 3-MP LCD, 5-MP LCD, and hard-copy film were 0.954, 0.947, and 0.956 on the seven-point scale and 0.943, 0.923, and 0.944 on the continuous scale, respectively. There were no significant differences among the three modalities on either scale. Soft-copy reading using 3-MP and 5-MP LCDs is comparable to hard-copy reading for detecting breast cancer.

  17. Abnormal sound detection device

    International Nuclear Information System (INIS)

    Yamada, Izumi; Matsui, Yuji.

    1995-01-01

    Only components synchronized with rotation of pumps are sampled from detected acoustic sounds, to judge the presence or absence of abnormality based on the magnitude of the synchronized components. A synchronized component sampling means can remove resonance sounds and other acoustic sounds generated at a synchronously with the rotation based on the knowledge that generated acoustic components in a normal state are a sort of resonance sounds and are not precisely synchronized with the number of rotation. On the other hand, abnormal sounds of a rotating body are often caused by compulsory force accompanying the rotation as a generation source, and the abnormal sounds can be detected by extracting only the rotation-synchronized components. Since components of normal acoustic sounds generated at present are discriminated from the detected sounds, reduction of the abnormal sounds due to a signal processing can be avoided and, as a result, abnormal sound detection sensitivity can be improved. Further, since it is adapted to discriminate the occurrence of the abnormal sound from the actually detected sounds, the other frequency components which are forecast but not generated actually are not removed, so that it is further effective for the improvement of detection sensitivity. (N.H.)

  18. Computer aided detection of clusters of microcalcifications on full field digital mammograms

    International Nuclear Information System (INIS)

    Ge Jun; Sahiner, Berkman; Hadjiiski, Lubomir M.; Chan, H.-P.; Wei Jun; Helvie, Mark A.; Zhou Chuan

    2006-01-01

    We are developing a computer-aided detection (CAD) system to identify microcalcification clusters (MCCs) automatically on full field digital mammograms (FFDMs). The CAD system includes six stages: preprocessing; image enhancement; segmentation of microcalcification candidates; false positive (FP) reduction for individual microcalcifications; regional clustering; and FP reduction for clustered microcalcifications. At the stage of FP reduction for individual microcalcifications, a truncated sum-of-squares error function was used to improve the efficiency and robustness of the training of an artificial neural network in our CAD system for FFDMs. At the stage of FP reduction for clustered microcalcifications, morphological features and features derived from the artificial neural network outputs were extracted from each cluster. Stepwise linear discriminant analysis (LDA) was used to select the features. An LDA classifier was then used to differentiate clustered microcalcifications from FPs. A data set of 96 cases with 192 images was collected at the University of Michigan. This data set contained 96 MCCs, of which 28 clusters were proven by biopsy to be malignant and 68 were proven to be benign. The data set was separated into two independent data sets for training and testing of the CAD system in a cross-validation scheme. When one data set was used to train and validate the convolution neural network (CNN) in our CAD system, the other data set was used to evaluate the detection performance. With the use of a truncated error metric, the training of CNN could be accelerated and the classification performance was improved. The CNN in combination with an LDA classifier could substantially reduce FPs with a small tradeoff in sensitivity. By using the free-response receiver operating characteristic methodology, it was found that our CAD system can achieve a cluster-based sensitivity of 70, 80, and 90 % at 0.21, 0.61, and 1.49 FPs/image, respectively. For case

  19. Computer aided detection of clusters of microcalcifications on full field digital mammograms.

    Science.gov (United States)

    Ge, Jun; Sahiner, Berkman; Hadjiiski, Lubomir M; Chan, Heang-Ping; Wei, Jun; Helvie, Mark A; Zhou, Chuan

    2006-08-01

    We are developing a computer-aided detection (CAD) system to identify microcalcification clusters (MCCs) automatically on full field digital mammograms (FFDMs). The CAD system includes six stages: preprocessing; image enhancement; segmentation of microcalcification candidates; false positive (FP) reduction for individual microcalcifications; regional clustering; and FP reduction for clustered microcalcifications. At the stage of FP reduction for individual microcalcifications, a truncated sum-of-squares error function was used to improve the efficiency and robustness of the training of an artificial neural network in our CAD system for FFDMs. At the stage of FP reduction for clustered microcalcifications, morphological features and features derived from the artificial neural network outputs were extracted from each cluster. Stepwise linear discriminant analysis (LDA) was used to select the features. An LDA classifier was then used to differentiate clustered microcalcifications from FPs. A data set of 96 cases with 192 images was collected at the University of Michigan. This data set contained 96 MCCs, of which 28 clusters were proven by biopsy to be malignant and 68 were proven to be benign. The data set was separated into two independent data sets for training and testing of the CAD system in a cross-validation scheme. When one data set was used to train and validate the convolution neural network (CNN) in our CAD system, the other data set was used to evaluate the detection performance. With the use of a truncated error metric, the training of CNN could be accelerated and the classification performance was improved. The CNN in combination with an LDA classifier could substantially reduce FPs with a small tradeoff in sensitivity. By using the free-response receiver operating characteristic methodology, it was found that our CAD system can achieve a cluster-based sensitivity of 70, 80, and 90 % at 0.21, 0.61, and 1.49 FPs/image, respectively. For case

  20. Breast cancer screening in older women.

    Science.gov (United States)

    Caplan, L S; Haynes, S G

    1996-01-01

    There is currently an epidemic of breast cancer in women 65 years of age and older. The purposes of this paper are to explore the breast cancer screening behaviors of older women and to identify some of the determinants of screening in these women. Data were analyzed from the 1987 National Health Interview Survey, a continuous nationwide household interview survey of the U.S. civilian, noninstitutionalized population. As in other studies, the utilization of breast cancer screening by older women was less in older women than in younger women. This was true for both mammography and clinical breast examination. A number of determinants of screening in older women were identified here. Women with a usual source of care and/or no activity limitation, as well as high school graduates, were the ones most likely to have received a screening mammogram and/or a screening clinical breast exam during the past year. The failure of older women to receive adequate breast cancer screening is an important concern which should be reevaluated, given the breast cancer epidemic in this population. This study identified a number of determinants of breast cancer screening in older women. For the most part, these determinants point to the primary care physician as the key to breast cancer screening in these women. Therefore, the primary care physician must be informed of, and encouraged to follow, the recommendations for periodic breast cancer screening in older women.

  1. Classification of micro-calcification in mammograms using scalable linear Fisher discriminant analysis.

    Science.gov (United States)

    Suhail, Zobia; Denton, Erika R E; Zwiggelaar, Reyer

    2018-01-25

    Breast cancer is one of the major causes of death in women. Computer Aided Diagnosis (CAD) systems are being developed to assist radiologists in early diagnosis. Micro-calcifications can be an early symptom of breast cancer. Besides detection, classification of micro-calcification as benign or malignant is essential in a complete CAD system. We have developed a novel method for the classification of benign and malignant micro-calcification using an improved Fisher Linear Discriminant Analysis (LDA) approach for the linear transformation of segmented micro-calcification data in combination with a Support Vector Machine (SVM) variant to classify between the two classes. The results indicate an average accuracy equal to 96% which is comparable to state-of-the art methods in the literature. Graphical Abstract Classification of Micro-calcification in Mammograms using Scalable Linear Fisher Discriminant Analysis.

  2. Block-based wavelet transform coding of mammograms with region-adaptive quantization

    Science.gov (United States)

    Moon, Nam Su; Song, Jun S.; Kwon, Musik; Kim, JongHyo; Lee, ChoongWoong

    1998-06-01

    To achieve both high compression ratio and information preserving, it is an efficient way to combine segmentation and lossy compression scheme. Microcalcification in mammogram is one of the most significant sign of early stage of breast cancer. Therefore in coding, detection and segmentation of microcalcification enable us to preserve it well by allocating more bits to it than to other regions. Segmentation of microcalcification is performed both in spatial domain and in wavelet transform domain. Peak error controllable quantization step, which is off-line designed, is suitable for medical image compression. For region-adaptive quantization, block- based wavelet transform coding is adopted and different peak- error-constrained quantizers are applied to blocks according to the segmentation result. In view of preservation of microcalcification, the proposed coding scheme shows better performance than JPEG.

  3. Case base classification on digital mammograms: improving the performance of case base classifier

    Science.gov (United States)

    Raman, Valliappan; Then, H. H.; Sumari, Putra; Venkatesa Mohan, N.

    2011-10-01

    Breast cancer continues to be a significant public health problem in the world. Early detection is the key for improving breast cancer prognosis. The aim of the research presented here is in twofold. First stage of research involves machine learning techniques, which segments and extracts features from the mass of digital mammograms. Second level is on problem solving approach which includes classification of mass by performance based case base classifier. In this paper we build a case-based Classifier in order to diagnose mammographic images. We explain different methods and behaviors that have been added to the classifier to improve the performance of the classifier. Currently the initial Performance base Classifier with Bagging is proposed in the paper and it's been implemented and it shows an improvement in specificity and sensitivity.

  4. Incidence of fetal chromosome abnormalities in insulin dependent diabetic women

    DEFF Research Database (Denmark)

    Henriques, C U; Damm, P; Tabor, A

    1991-01-01

    In order to screen for fetal neural tube defects and chromosome abnormalities, amniocentesis was carried out in 334 women with insulin-dependent diabetes mellitus (IDDM) between 1979 and 1987. Two cases (0.6%; 95% confidence limits 0.1-2.2%) of fetal chromosome abnormality were found: one case...... of Klinefelter's syndrome and one case of de novo translocation. This is comparable to the overall incidence of chromosome abnormality found at birth and is also comparable to the incidence of fetal chromosome abnormality (1.0%) found by amniocentesis at our Department in a group of 2,264 young non...

  5. Automated selection of BI-RADS lesion descriptors for reporting calcifications in mammograms

    Science.gov (United States)

    Paquerault, Sophie; Jiang, Yulei; Nishikawa, Robert M.; Schmidt, Robert A.; D'Orsi, Carl J.; Vyborny, Carl J.; Newstead, Gillian M.

    2003-05-01

    We are developing an automated computer technique to describe calcifications in mammograms according to the BI-RADS lexicon. We evaluated this technique by its agreement with radiologists' description of the same lesions. Three expert mammographers reviewed our database of 90 cases of digitized mammograms containing clustered microcalcifications and described the calcifications according to BI-RADS. In our study, the radiologists used only 4 of the 5 calcification distribution descriptors and 5 of the 14 calcification morphology descriptors contained in BI-RADS. Our computer technique was therefore designed specifically for these 4 calcification distribution descriptors and 5 calcification morphology descriptors. For calcification distribution, 4 linear discriminant analysis (LDA) classifiers were developed using 5 computer-extracted features to produce scores of how well each descriptor describes a cluster. Similarly, for calcification morphology, 5 LDAs were designed using 10 computer-extracted features. We trained the LDAs using only the BI-RADS data reported by the first radiologist and compared the computer output to the descriptor data reported by all 3 radiologists (for the first radiologist, the leave-one-out method was used). The computer output consisted of the best calcification distribution descriptor and the best 2 calcification morphology descriptors. The results of the comparison with the data from each radiologist, respectively, were: for calcification distribution, percent agreement, 74%, 66%, and 73%, kappa value, 0.44, 0.36, and 0.46; for calcification morphology, percent agreement, 83%, 77%, and 57%, kappa value, 0.78, 0.70, and 0.44. These results indicate that the proposed computer technique can select BI-RADS descriptors in good agreement with radiologists.

  6. Abnormal cervical cytology and health care use

    DEFF Research Database (Denmark)

    Frederiksen, Maria Eiholm; Baillet, Miguel Vázquez-Prada; Dugué, Pierre-Antoine

    2015-01-01

    OBJECTIVE: This study aimed to assess the long-term use of health care services in women with abnormal cytology results compared to women with normal cytology results. METHODS: We did a nationwide population-based study, using women aged 23 to 59years participating in the national organized...... cervical cancer screening program. We included a study population of 40,153 women with abnormal cytology (exposed) and 752,627 women with normal cytology (non-exposed). We retrieved data from the Danish Civil Registration System, the Danish Pathology Data Bank, the National Health Service, the National...... the "before" to the "after" period. This increase was significantly higher for exposed than non-exposed women regarding contacts to GP, admissions to hospitals, and drug use. CONCLUSION: Women with abnormal cytology results constitute a selected group with a higher health care use than other women even before...

  7. Interval breast cancer characteristics before, during and after the transition from screen-film to full-field digital screening mammography.

    Science.gov (United States)

    van Bommel, Rob M G; Weber, Roy; Voogd, Adri C; Nederend, Joost; Louwman, Marieke W J; Venderink, Dick; Strobbe, Luc J A; Rutten, Matthieu J C; Plaisier, Menno L; Lohle, Paul N; Hooijen, Marianne J H; Tjan-Heijnen, Vivianne C G; Duijm, Lucien E M

    2017-05-05

    To determine the proportion of "true" interval cancers and tumor characteristics of interval breast cancers prior to, during and after the transition from screen-film mammography screening (SFM) to full-field digital mammography screening (FFDM). We included all women with interval cancers detected between January 2006 and January 2014. Breast imaging reports, biopsy results and breast surgery reports of all women recalled at screening mammography and of all women with interval breast cancers were collected. Two experienced screening radiologists reviewed the diagnostic mammograms, on which the interval cancers were diagnosed, as well as the prior screening mammograms and determined whether or not the interval cancer had been missed on the most recent screening mammogram. If not missed, the cancer was considered an occult ("true") interval cancer. A total of 442 interval cancers had been diagnosed, of which 144 at SFM with a prior SFM (SFM-SFM), 159 at FFDM with a prior SFM (FFDM-SFM) and 139 at FFDM with a prior FFDM (FFDM-FFDM). The transition from SFM to FFDM screening resulted in the diagnosis of more occult ("true") interval cancers at FFDM-SFM than at SFM-SFM (65.4% (104/159) versus 49.3% (71/144), P mammography. However, this increase seems temporary and is no longer detectable after the second round of digital screening. Tumor characteristics and type of surgery are comparable for interval cancers detected prior to, during and after the transition from SFM to FFDM screening mammography, except of a lower proportion of invasive ductal cancers after the transition.

  8. Benefits of the quality assured double and arbitration reading of mammograms in the early diagnosis of breast cancer in symptomatic women

    International Nuclear Information System (INIS)

    Waldmann, Annika; Katalinic, Alexander; Kapsimalakou, Smaragda; Grande-Nagel, Isabell; Barkhausen, Joerg; Vogt, Florian M.; Stoeckelhuber, Beate M.; Fischer, Dorothea

    2012-01-01

    To address the benefits of double and arbitration reading regarding tumour detection rates, percentage of in situ tumours, and number (of patients) needed to send for expert reading (number needed to treat; NNT) for one additional tumour finding. QuaMaDi is a quality assured breast cancer diagnosis programme; with two-view mammography (craniocaudal, mediolateral oblique) and, in case of breast density ACR 3 or 4, routine ultrasound imaging; and with independent double reading of all images. A consecutive sample of symptomatic women, i.e. women at risk for breast cancer, women aged 70 and above, and/or women with preceding BI-RADS III findings, was analysed. 28,558 mammograms were performed (mean age of women: 57.3 [standard deviation: 12.3] years). Discordant findings were present in 3,837 double readings and were sent for arbitration reading. After histopathological assessment, 52 carcinomas were found (thereof 32% in situ). These carcinomas accounted for 1.8 tumours per 1,000 examinations in the total cohort and increased the tumour detection rate up to 16.4/1,000. The NNT in discordant cases was 74. Double and arbitration reading appears to be a useful tool to ensure the quality of early detection of breast lesions in symptomatic women during indication-based, standardised mammography. circle Quality assured breast cancer diagnosis is feasible outside organised screening structures. (orig.)

  9. Benefits of the quality assured double and arbitration reading of mammograms in the early diagnosis of breast cancer in symptomatic women

    Energy Technology Data Exchange (ETDEWEB)

    Waldmann, Annika; Katalinic, Alexander [University Hospital Schleswig-Holstein, Institute of Clinical Epidemiology, Luebeck (Germany); Kapsimalakou, Smaragda; Grande-Nagel, Isabell; Barkhausen, Joerg; Vogt, Florian M. [University Hospital Schleswig-Holstein, Clinic of Radiology and Nuclear Medicine, Luebeck (Germany); Stoeckelhuber, Beate M. [Hospital of Kiel, Department of Radiology, Kiel (Germany); Fischer, Dorothea [University of Luebeck, Department of Obstetrics and Gynecology, Luebeck (Germany)

    2012-05-15

    To address the benefits of double and arbitration reading regarding tumour detection rates, percentage of in situ tumours, and number (of patients) needed to send for expert reading (number needed to treat; NNT) for one additional tumour finding. QuaMaDi is a quality assured breast cancer diagnosis programme; with two-view mammography (craniocaudal, mediolateral oblique) and, in case of breast density ACR 3 or 4, routine ultrasound imaging; and with independent double reading of all images. A consecutive sample of symptomatic women, i.e. women at risk for breast cancer, women aged 70 and above, and/or women with preceding BI-RADS III findings, was analysed. 28,558 mammograms were performed (mean age of women: 57.3 [standard deviation: 12.3] years). Discordant findings were present in 3,837 double readings and were sent for arbitration reading. After histopathological assessment, 52 carcinomas were found (thereof 32% in situ). These carcinomas accounted for 1.8 tumours per 1,000 examinations in the total cohort and increased the tumour detection rate up to 16.4/1,000. The NNT in discordant cases was 74. Double and arbitration reading appears to be a useful tool to ensure the quality of early detection of breast lesions in symptomatic women during indication-based, standardised mammography. circle Quality assured breast cancer diagnosis is feasible outside organised screening structures. (orig.)

  10. Computer-aided detection of microcalcification clusters on full-field digital mammograms: multiscale pyramid enhancement and false positive reduction using an artificial neural network

    Science.gov (United States)

    Ge, Jun; Wei, Jun; Hadjiiski, Lubomir M.; Sahiner, Berkman; Chan, Heang-Ping; Helvie, Mark A.; Zhou, Chuan

    2005-04-01

    We are developing a computer-aided detection (CAD) system to detect microcalcification clusters automatically on full field digital mammograms (FFDMs). The CAD system includes five stages: preprocessing, image enhancement and/or box-rim filtering, segmentation of microcalcification candidates, false positive (FP) reduction, and clustering. In this study, we investigated the performance of a nonlinear multiscale Laplacian pyramid enhancement method in comparison with a box-rim filter at the image enhancement stage and the use of a new error metric to improve the efficiency and robustness of the training of a convolution neural network (CNN) at the FP reduction stage of our CAD system. A data set of 96 cases with 200 images was collected at the University of Michigan. This data set contained 215 microcalcification clusters, of which 64 clusters were proven by biopsy to be malignant and 151 were proven to be benign. The data set was separated into two independent data sets. One data set was used to train and validate the CNN in our CAD system. The other data set was used to evaluate the detection performance. For this data set, Laplacian pyramid multiscale enhancement did not improve the performance of the microcalcification detection system in comparison with our box-rim filter previously optimized for digitized screen-film mammograms. With the new error metric, the training of CNN could be accelerated and the classification performance in validation was improved from an Az value of 0.94 to 0.97 on average. The CNN in combination with rule-based classifiers could reduce FPs with a small tradeoff in sensitivity. By using the free-response receiver operating characteristic (FROC) methodology, it was found that our CAD system can achieve a cluster-based sensitivity of 70%, 80%, and 88% at 0.23, 0.39, and 0.71 FP marks/image, respectively. For case-based performance evaluation, a sensitivity of 80%, 90%, and 98% can be achieved at 0.17, 0.27, and 0.51 FP marks

  11. Breast cancer screening: Evidence of the effect of adjunct ultrasound screening in women with unilateral mammography-negative dense breasts

    Science.gov (United States)

    Adibi, Atoosa; Golshahi, Maryam; Sirus, Mehri; Kazemi, Kimia

    2015-01-01

    Background: Patients with the previous history of breast cancer are in risk of contralateral breast cancer. On the other hand, increased breast density is a risk factor for breast cancer and the sensitivity of detecting nonpalpable cancers in screening mammography in radiographically dense breasts is low. The use of ultrasonography in dense breast remains a controversial topic. The purpose of this study was to assess the usefulness of routine ultrasonography in follow-up of women with the previous history of breast cancer and negative mammography but dense breasts. Materials and Methods: In a cross-sectional study, a total of 267 individuals with unilateral postmastectomy mammogram screened and 153 subjects assigned to study. There were 28 subjects with American College of Radiology (ACR) breast density 2 and 125 with ACR breast density 3-4, which there was no new finding in their mammogram in comparison to previous studies. We assumed subjects with ACR breast density 3-4 as mammographic Breast Imaging Reporting and Data System (BI-RADS) category 0 for malignancy. Standard two-view mammogram was performed for all participants, and breast ultrasound (US) examinations were performed by an expert radiologist in radial and anti-radial planes. The data were analyzed using SPSS version 20.0 (SPSS Inc., Chicago, Illinois, USA). Results: The results showed that in subjects with ACR breast density 3-4, when there was no new density in two consecutive mammograms in comparison to previous studies, US also showed no possibility for malignancy (BI-RADS 1-2). And also in subjects with ACR breast density 2, when the mammographic results were BI-RADS 1-2, the US results was the same. Conclusion: Our data indicate that for the detection of breast cancer, sensitivity of US was not greater than mammography in patients with postmastectomy unilateral dense breast if there is not any new density. PMID:26109967

  12. Breast cancer screening: Evidence of the effect of adjunct ultrasound screening in women with unilateral mammography-negative dense breasts

    Directory of Open Access Journals (Sweden)

    Atoosa Adibi

    2015-01-01

    Full Text Available Background: Patients with the previous history of breast cancer are in risk of contralateral breast cancer. On the other hand, increased breast density is a risk factor for breast cancer and the sensitivity of detecting nonpalpable cancers in screening mammography in radiographically dense breasts is low. The use of ultrasonography in dense breast remains a controversial topic. The purpose of this study was to assess the usefulness of routine ultrasonography in follow-up of women with the previous history of breast cancer and negative mammography but dense breasts. Materials and Methods: In a cross-sectional study, a total of 267 individuals with unilateral postmastectomy mammogram screened and 153 subjects assigned to study. There were 28 subjects with American College of Radiology (ACR breast density 2 and 125 with ACR breast density 3-4, which there was no new finding in their mammogram in comparison to previous studies. We assumed subjects with ACR breast density 3-4 as mammographic Breast Imaging Reporting and Data System (BI-RADS category 0 for malignancy. Standard two-view mammogram was performed for all participants, and breast ultrasound (US examinations were performed by an expert radiologist in radial and anti-radial planes. The data were analyzed using SPSS version 20.0 (SPSS Inc., Chicago, Illinois, USA. Results: The results showed that in subjects with ACR breast density 3-4, when there was no new density in two consecutive mammograms in comparison to previous studies, US also showed no possibility for malignancy (BI-RADS 1-2. And also in subjects with ACR breast density 2, when the mammographic results were BI-RADS 1-2, the US results was the same. Conclusion: Our data indicate that for the detection of breast cancer, sensitivity of US was not greater than mammography in patients with postmastectomy unilateral dense breast if there is not any new density.

  13. Nitrofurantoin and congenital abnormalities

    DEFF Research Database (Denmark)

    Czeizel, A.E.; Rockenbauer, M.; Sørensen, Henrik Toft

    2001-01-01

    Objective: To study human teratogenic potential of oral nitrofurantoin treatment during pregnancy. Materials and Methods: Pair analysis of cases with congenital abnormalities and matched population controls in the population-based dataset of the Hungarian Case-Control Surveillance of Congenital...

  14. CT of pleural abnormalities

    International Nuclear Information System (INIS)

    Webb, W.R.

    1995-01-01

    Briefly discussed were CT diagnosis of pleural thickening, CT technique for examining the pleura or pleuro-pulmonary disease, diagnosis of pleural collections, diagnosis of pleural fluid abnormalities in patients with pneumonia, pleural neoplasms, malignant (diffuse) mesothelioma, metastases, local fibrous tumor of the pleura (benign mesothelioma) (21 refs.)

  15. Chromosomal abnormalities and autism

    African Journals Online (AJOL)

    Farida El-Baz

    2015-06-19

    Jun 19, 2015 ... ORIGINAL ARTICLE. Chromosomal abnormalities and autism. Farida El-Baz a. , Mohamed Saad Zaghloul a. , Ezzat El Sobky a. ,. Reham M Elhossiny a,. *, Heba Salah a. , Neveen Ezy Abdelaziz b a Pediatric Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt b Children with Special ...

  16. Analysis of utilization patterns and associated costs of the breast imaging and diagnostic procedures after screening mammography

    Directory of Open Access Journals (Sweden)

    Vlahiotis A

    2018-03-01

    Full Text Available Anna Vlahiotis,1 Brian Griffin,2 A Thomas Stavros,3 Jay Margolis1 1Value Based Care, Outcomes Research, Truven Health Analytics, an IBM Company, Bethesda, MD USA; 2Value Based Care, Outcomes Research, Truven Health Analytics, an IBM Company, Newark, NJ, USA; 3Seno Medical Instruments, Inc., San Antonio, TX, USA Background: Little data exist on real-world patterns and associated costs of downstream breast diagnostic procedures following an abnormal screening mammography or clinical exam.Objectives: To analyze the utilization patterns in real-world clinical settings for breast imaging and diagnostic procedures, including the frequency and volume of patients and procedures, procedure sequencing, and associated health care expenditures.Materials and methods: Using medical claims from 2011 to 2015 MarketScan Commercial and Medicare Databases, adult females with breast imaging/diagnostic procedures (diagnostic mammography, ultrasound, molecular breast imaging, tomosynthesis, magnetic resonance imaging, or biopsy other than screening mammography were selected. Continuous health plan coverage without breast diagnostic procedures was required for ≥13 months before the first found breast diagnostic procedure (index event, with a 13-month post-index follow-up period. Key outcomes included diagnostic procedure volumes, sequences, and payments. Results reported descriptively were projected to provide US national patient and procedure volumes.Results: The final sample of 875,526 patients was nationally projected to 12,394,432 patients annually receiving 8,732,909 diagnostic mammograms (53.3% of patients, 6,987,399 breast ultrasounds (42.4% of patients, and 1,585,856 biopsies (10.3% of patients. Following initial diagnostic procedures, 49.4% had second procedures, 20.1% followed with third procedures, and 10.0% had a fourth procedure. Mean (SD costs for diagnostic mammograms of US$349 ($493, ultrasounds US$132 ($134, and biopsies US$1,938 ($2,343 contributed

  17. Depression Screening

    Science.gov (United States)

    ... Depression Screening Substance Abuse Screening Alcohol Use Screening Depression Screening (PHQ-9) - Instructions The following questions are ... this tool, there is also text-only version . Depression Screening - Manual Instructions The following questions are a ...

  18. Mammography screening among Arab American women in metropolitan Detroit.

    Science.gov (United States)

    Schwartz, Kendra; Fakhouri, Monty; Bartoces, Monina; Monsur, Joseph; Younis, Amani

    2008-12-01

    Mammography screening behavior has not been well studied among Middle Eastern immigrant women. We conducted a telephone survey of 365 Arab American women residing in metropolitan Detroit, home to one of the largest populations of Middle Eastern immigrants in the US, to determine prevalence of factors associated with mammography, and attitudes and beliefs regarding mammography screening. Of 365 participants, only five were born in the US. Mean age was 53.2 years (SD 10.8). Two hundred twelve (58.1%) reported having mammogram every 1-2 years; 70% ever had mammogram. Age 50-64 years, having health insurance, married status, being in the US over 10 years, and being Lebanese were associated with mammography every 1-2 years. After adjusting for demographic factors, perceived seriousness of disease, general health motivation, and having fewer barriers were associated with more frequent screening. Appropriate mammography screening is decreased in this group. Targeted outreach regarding screening is appropriate for this population; however, lack of insurance may prevent adequate follow-up.

  19. Abnormal uterine artery Doppler velocimetry predicts adverse outcomes in patients with abnormal analytes.

    Science.gov (United States)

    Roeder, Hilary A; Dejbakhsh, Sheila Z; Parast, Mana M; Laurent, Louise C; Woelkers, Douglas A

    2014-10-01

    Our aim was to determine if uterine artery (UtA) Doppler studies would risk-stratify women with abnormal serum analytes on prenatal genetic screening into those at baseline and increased risk for preeclampsia and small-for-gestational age (SGA). This retrospective cohort study examined outcomes of patients with ⩾one abnormal analyte (PAPP-A3.0, AFP>2.5, inhibin>2.0, or unconjugated estriolUtA pulsatility index (PI). Preeclampsia, preterm preeclampsia, SGA (birthweight (BW) one abnormal analyte, UtA Doppler screening, and delivery outcomes. Twenty-four (18%) had an elevated UtA PI (PI>1.6); preeclampsia occurred in 16 (12%) and 26 (20%) delivered a SGA neonate. Abnormal UtA Doppler PI increased the likelihood of a composite outcome of preeclampsia or SGA from 27% to 71% (LR 6.48 (2.93, 14.30)); a negative UtA Doppler PI reduced the likelihood to 18% (LR 0.57 (0.42, 0.78)). Abnormal UtA Doppler PI increased the likelihood of a more severe composite outcome of preterm preeclampsia or IUGR from 11% to 39% (LR 5.49 (3.03, 9.97)); a negative UtA Doppler study reduced the likelihood to 4% (LR 0.35 (0.16, 0.80)). In patients with abnormal serum analytes, abnormal UtA Doppler PI is significantly associated with preeclampsia or SGA and improves the prediction of these adverse outcomes by 9-15-fold. Providers can incorporate UtA Doppler PI into an abbreviated surveillance regimen; they can be reassured that a normal study markedly decreases the risk of a severe early adverse outcome. Copyright © 2014 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.

  20. Benefits of the quality assured double and arbitration reading of mammograms in the early diagnosis of breast cancer in symptomatic women.

    Science.gov (United States)

    Waldmann, Annika; Kapsimalakou, Smaragda; Katalinic, Alexander; Grande-Nagel, Isabell; Stoeckelhuber, Beate M; Fischer, Dorothea; Barkhausen, Joerg; Vogt, Florian M

    2012-05-01

    To address the benefits of double and arbitration reading regarding tumour detection rates, percentage of in situ tumours, and number (of patients) needed to send for expert reading (number needed to treat; NNT) for one additional tumour finding. QuaMaDi is a quality assured breast cancer diagnosis programme; with two-view mammography (craniocaudal, mediolateral oblique) and, in case of breast density ACR 3 or 4, routine ultrasound imaging; and with independent double reading of all images. A consecutive sample of symptomatic women, i.e. women at risk for breast cancer, women aged 70 and above, and/or women with preceding BI-RADS III findings, was analysed. 28,558 mammograms were performed (mean age of women: 57.3 [standard deviation: 12.3] years). Discordant findings were present in 3,837 double readings and were sent for arbitration reading. After histopathological assessment, 52 carcinomas were found (thereof 32% in situ). These carcinomas accounted for 1.8 tumours per 1,000 examinations in the total cohort and increased the tumour detection rate up to 16.4/1,000. The NNT in discordant cases was 74. Double and arbitration reading appears to be a useful tool to ensure the quality of early detection of breast lesions in symptomatic women during indication-based, standardised mammography. • Quality assured breast cancer diagnosis is feasible outside organised screening structures. • Double and arbitration reading is beneficial for populations ineligible for screening. • Double and arbitration reading increases the tumour detection rate. • Double and arbitration reading increases the percentage of in situ cancers.

  1. Hemostatic Abnormalities in Multiple Myeloma Patients

    Science.gov (United States)

    Gogia, Aarti; Sikka, Meera; Sharma, Satender; Rusia, Usha

    2018-01-27

    Background: Multiple myeloma (MM) is a neoplastic plasma cell disorder characterized by clonal proliferation of plasma cells in the bone marrow. Diverse hemostatic abnormalities have been reported in patients with myeloma which predispose to bleeding and also thrombosis. Methods: Complete blood count, biochemical parameters and parameters of hemostasis i.e. platelet count, prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), factor VIII assay results, plasma fibrinogen, D-dimer and lupus anticoagulant, were assessed in 29 MM patients and 30 age matched controls. Results: The most frequent abnormal screening parameter was APTT. Of the six indicative of a bleeding tendency i.e. thrombocytopenia, prolonged PT, APTT, TT, reduced plasma fibrinogen and factor VIII, at least one was abnormal in 8 (27.6%) patients. Of the four prothrombotic markers, lupus anticoagulant, D-dimer, elevated factor VIII and plasma fibrinogen, one or more marker was present in 24 (82.7%). D-dimer was the most common prothrombotic marker, being elevated in 22 (75.9%) patients. One or more laboratory parameter of hemostasis was abnormal in all 29 (100%) patients. Though thrombotic complications are reported to be less frequent as compared to hemorrhagic manifestations, one or more marker of thrombosis was present in 24 (82.7%) patients. Conclusion: This study provided laboratory evidence of hemostatic dysfunction which may be associated with thrombotic or bleeding complications at diagnosis in all MM patients. Hence, screening for these abnormalities at the time of diagnosis should help improved prognosis in such cases. Creative Commons Attribution License

  2. Comparison of three tissue composition measurement techniques using digital mammograms — A signal-to-noise study

    OpenAIRE

    Breitenstein, Darryl S.; Shaw, Chris C.

    1998-01-01

    Tissue composition measurement may provide a quantitatively and physically meaningful method to objectively determine the “mammographic density” linked to breast cancer risk. A single energy hybrid (SEH) technique is described for measuring the tissue composition on a pixel-by-pixel basis with a single digital mammogram. Theoretical models were derived and used to compute signal-to-noise ratios (SNRs) in tissue composition measurement using the SEH method. The results were compared with those...

  3. Is there a correlation between the presence of a spiculated mass on mammogram and luminal a subtype breast cancer?

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Song; Wu, Xiao Dong; Xu, Wen Jian; Lin, Qing; Liu, Xue Jun; Li, Ying [The Affiliated Hospital of Qingdao University, Qingdao (China)

    2016-11-15

    To determine whether the appearance of a spiculated mass on a mammogram is associated with luminal A subtype breast cancer and the factors that may influence the presence or absence of the spiculated mass. Three hundred seventeen (317) patients who underwent image-guided or surgical biopsy between December 2014 and April 2015 were included in the study. Radiologists conducted retrospective assessments of the presence of spiculated masses according to the criteria of Breast Imaging Reporting and Data System. We used combinations of estrogen receptor (ER), progesterone receptor (PR), human epithelial growth factor receptor 2 (HER2), and Ki67 as surrogate markers to identify molecular subtypes of breast cancer. Pearson chi-square test was employed to measure statistical significance of correlations. Furthermore, we built a bi-variate logistic regression model to quantify the relative contribution of the factors that may influence the presence or absence of the spiculated mass. Seventy-one percent (71%) of the spiculated masses were classified as luminal A. Masses classified as luminal A were 10.3 times more likely to be presented as spiculated mass on a mammogram than all other subtypes. Patients with low Ki67 index (< 14%) and HER2 negative were most likely to present with a spiculated mass on their mammograms (p <0.001) than others. The hormone receptor status (ER and PR), pathology grade, overall breast composition, were all associated with the presence of a spiculated mass, but with less weight in contribution than Ki67 and HER2. We observed an association between the luminal A subtype of invasive breast cancer and the presence of a spiculated mass on a mammogram. It is hypothesized that lower Ki67 index and HER2 negativity may be the most significant factors in the presence of a spiculated mass.

  4. Volumetric quantification of the effect of aging and hormone replacement therapy on breast composition from digital mammograms

    Energy Technology Data Exchange (ETDEWEB)

    Hammann-Kloss, J.S., E-mail: sophie.hammann-kloss@egzb.de [Department of Radiology, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin (Germany); Ärztlicher Dienst, Evangelisches Geriatriezentrum Berlin gGmbH, Reinickendorfer Straße 61, 13347 Berlin (Germany); Bick, U., E-mail: ulrich.bick@charite.de [Department of Radiology, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin (Germany); Fallenberg, E., E-mail: eva.fallenberg@charite.de [Department of Radiology, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin (Germany); Engelken, F., E-mail: florian.engelken@charite.de [Department of Radiology, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin (Germany)

    2014-07-15

    Objective: To assess the physiological changes in breast composition with aging using volumetric breast composition measurement from digital mammograms and to assess the effect of hormone replacement therapy (HRT). Methods: A total of 764 consecutive mammograms of 208 non-HRT using women and 508 mammograms of 134 HRT-using women were analyzed using a volumetric breast composition assessment software (Quantra™, Hologic Inc.). Fibroglandular tissue volume (FTV), breast volume (BV), and percent density (PD) were measured. For statistical analysis, women were divided into a premenopausal (<46 years), a perimenopausal (46–55 years), and a postmenopausal (>55 years) age group. More detailed graphical analysis was performed using smaller age brackets. Women using HRT were compared to age-matched controls not using HRT. Results: Women in the postmenopausal age group had a significantly lower FTV and PD and a significantly higher BV than women in the premenopausal age group (FTV: 77 vs. 120 cm{sup 3}, respectively; PD: 16% vs. 28%, respectively; BV 478 vs. 406 cm{sup 3}, respectively; p < 0.01 for all). Median FTV was nearly stable in consecutive mammograms in the premenopausal and postmenopausal age groups, but declined at a rate of 3.9% per year in the perimenopausal period. Median PD was constant in the premenopausal and postmenopausal age groups and declined at a rate of 0.57% per year in the perimenopausal age group. BV continuously increased with age. Women using HRT throughout the study had a 5% higher PD than women not using HRT (22% vs. 17%, respectively; p < 0.001). Conclusions: Accurate knowledge of normal changes in breast composition are of particular interest nowadays due to the importance of breast density for breast cancer risk evaluation. FTV and PD change significantly during the perimenopausal period but remain relatively constant before and thereafter. Median total breast volume consistently increases with age and further contributes to changes in

  5. Detection of Cancerous Masses in Mammograms by Template Matching: Optimization of Template Brightness Distribution by Means of Evolutionary Algorithm

    OpenAIRE

    Bator, Marcin; Nieniewski, Mariusz

    2011-01-01

    Optimization of brightness distribution in the template used for detection of cancerous masses in mammograms by means of correlation coefficient is presented. This optimization is performed by the evolutionary algorithm using an auxiliary mass classifier. Brightness along the radius of the circularly symmetric template is coded indirectly by its second derivative. The fitness function is defined as the area under curve (AUC) of the receiver operating characteristic (ROC) for the mass classifi...

  6. Neurological abnormalities predict disability

    DEFF Research Database (Denmark)

    Poggesi, Anna; Gouw, Alida; van der Flier, Wiesje

    2014-01-01

    To investigate the role of neurological abnormalities and magnetic resonance imaging (MRI) lesions in predicting global functional decline in a cohort of initially independent-living elderly subjects. The Leukoaraiosis And DISability (LADIS) Study, involving 11 European centres, was primarily aimed...... at evaluating age-related white matter changes (ARWMC) as an independent predictor of the transition to disability (according to Instrumental Activities of Daily Living scale) or death in independent elderly subjects that were followed up for 3 years. At baseline, a standardized neurological examination.......0 years, 45 % males), 327 (51.7 %) presented at the initial visit with ≥1 neurological abnormality and 242 (38 %) reached the main study outcome. Cox regression analyses, adjusting for MRI features and other determinants of functional decline, showed that the baseline presence of any neurological...

  7. Abnormal CA-125 levels in menopausal women without ovarian cancer.

    Science.gov (United States)

    Terada, Keith Y; Elia, Jennifer; Kim, Robert; Carney, Michael; Ahn, Hyeong Jun

    2014-10-01

    To determine if an abnormal CA-125 level in a menopausal female without ovarian cancer is associated with an increase in mortality. The Prostate, Lung, Colorectal, and Ovarian Cancer Screening Randomized Controlled (PLCO) Trial is a large multicenter prospective trial conducted by the National Cancer Institute (NCI). Over 78,000 healthy women aged 55-74 were randomized to a screening arm versus a usual medical care arm to evaluate the efficacy of screening in reducing mortality due to ovarian cancer. Women in the screening arm underwent annual screening for ovarian cancer with transvaginal ultrasound and CA-125 levels. There were 38,818 patients without ovarian cancer that had at least one CA-125 level drawn; 1201 (3.09%) had at least one abnormal level. The current study compares mortality in patients that had one or more abnormal CA-125 levels without ovarian cancer versus those with all normal levels. Patients with one or more abnormal CA-125 levels, without ovarian cancer, had a significantly higher mortality than patients with all normal CA-125 levels in the PLCO screening trial (pCA-125 and without ovarian cancer are exposed to an increased risk of premature mortality. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Equipment abnormality monitoring device

    International Nuclear Information System (INIS)

    Ando, Yasumasa

    1991-01-01

    When an operator hears sounds in a plantsite, the operator compares normal sounds of equipment which he previously heard and remembered with sounds he actually hears, to judge if they are normal or abnormal. According to the method, there is a worry that abnormal conditions can not be appropriately judged in a case where the number of objective equipments is increased and in a case that the sounds are changed gradually slightly. Then, the device of the present invention comprises a plurality of monitors for monitoring the operation sound of equipments, a recording/reproducing device for recording and reproducing the signals, a selection device for selecting the reproducing signals among the recorded signals, an acoustic device for converting the signals to sounds, a switching device for switching the signals to be transmitted to the acoustic device between to signals of the monitor and the recording/reproducing signals. The abnormality of the equipments can be determined easily by comparing the sounds representing the operation conditions of equipments for controlling the plant operation and the sounds recorded in their normal conditions. (N.H.)

  9. Contrast limited adaptive histogram equalization image processing to improve the detection of simulated spiculations in dense mammograms.

    Science.gov (United States)

    Pisano, E D; Zong, S; Hemminger, B M; DeLuca, M; Johnston, R E; Muller, K; Braeuning, M P; Pizer, S M

    1998-11-01

    The purpose of this project was to determine whether Contrast Limited Adaptive Histogram Equalization (CLAHE) improves detection of simulated spiculations in dense mammograms. Lines simulating the appearance of spiculations, a common marker of malignancy when visualized with masses, were embedded in dense mammograms digitized at 50 micron pixels, 12 bits deep. Film images with no CLAHE applied were compared to film images with nine different combinations of clip levels and region sizes applied. A simulated spiculation was embedded in a background of dense breast tissue, with the orientation of the spiculation varied. The key variables involved in each trial included the orientation of the spiculation, contrast level of the spiculation and the CLAHE settings applied to the image. Combining the 10 CLAHE conditions, 4 contrast levels and 4 orientations gave 160 combinations. The trials were constructed by pairing 160 combinations of key variables with 40 backgrounds. Twenty student observers were asked to detect the orientation of the spiculation in the image. There was a statistically significant improvement in detection performance for spiculations with CLAHE over unenhanced images when the region size was set at 32 with a clip level of 2, and when the region size was set at 32 with a clip level of 4. The selected CLAHE settings should be tested in the clinic with digital mammograms to determine whether detection of spiculations associated with masses detected at mammography can be improved.

  10. False Negative Mammogram of Breast Cancer : Analysis of Mammographic and Sonographic Findings and Correlation with Clinical Findings

    International Nuclear Information System (INIS)

    Lee, Kil Jun; Lee, Ji Yeon; Han, Sung Nim; Jeong, Seong Ki; Tae, Seok; Shin, Kyoung Ja; Lee, Sang Chun

    1995-01-01

    Recent mammographic equipment have been of good quality and yielded high diagnostic accuracy for the detection of breast cancer. However, negative mammogram does not necessarily rule out breast cancer. Therefore were viewed cause of false negative mammography in confirmed breast cancer to improve diagnostic accuracy and for adequate clinical approach. We reviewed 19 cases of confirmed breast cancer, which showed false negative mammography with positive sonographic findings. Retrospective analysis was done by correlating the patient's age, sonographic finding and mass size, mammographic breast pattern and cause of false negative mammogram, and clinical symptoms. Among the 5 patients below 35 years in age, mass was not visible due to dense breast in 4 and due to small size in 1 case. In 14 patients over 35 years in age, 11 had normal mammographic findings, 4 had dense breast, and 7 had small sized mass. Remaining 3 cases showed asymmetric density in 2 and architecture distortion in 1 case. All showed mass lesion in sonography : ill defined malignant appearance in 14,well defined malignant appearance in 2, and well defined benign in 3 cases. Negative mammogram should be correlated with sonography in case of dense breast, below 35 years in age with palpable mass and under risk for breast cancer

  11. Automated detection of breast masses on digital mammograms using adaptive density-weighted contrast-enhancement filtering

    Science.gov (United States)

    Petrick, Nicholas; Chan, Heang-Ping; Sahiner, Berkman; Wei, Datong; Helvie, Mark A.; Goodsitt, Mitchell M.; Adler, Dorit D.

    1995-05-01

    This paper presents a novel approach for segmentation of suspicious mass regions in digitized mammograms using a new adaptive density-weighted contrast enhancement (DWCE) filter in conjunction with Laplacian-Gaussian (LG) edge detection. The new algorithm processes a mammogram in two stages. In the first stage the entire mammogram is filtered globally using a DWCE adaptive filter which enhances the local contrast of the image based on its local mean pixel values. The enhanced image is then segmented with an LG edge detector into isolated objects. In the second stage of processing, the DWCE adaptive filter and the edge detector are applied locally to each of the segmented object regions detected in the first stage. The number of objects is then reduced based on morphological features. ROIs are selected from the remaining object set based on the centroid locations of the individual objects. The selected ROIs are then input to either a linear discriminant analysis (LDA) classifier or a convolution neural network (CNN) to further differentiate true-positives and false-positives. In this study ROIs obtained from a set of 84 images were used to train the LDA and CNN classifiers. The DWCE algorithm was then,used to extract ROIs from a set of 84 test images. The trained LDA and CNN classifiers were subsequently applied to the extracted ROIs, and the dependence of the detection system's accuracy on the feature extraction and classification techniques was analyzed.

  12. Experience with breast cancer, pre-screening perceived susceptibility and the psychological impact of screening

    DEFF Research Database (Denmark)

    Absetz, Pilvikki; Aro, Arja R; Sutton, Stephen R

    2003-01-01

    This prospective study examined whether the psychological impact of organized mammography screening is influenced by women's pre-existing experience with breast cancer and perceived susceptibility (PS) to the disease. From a target population of 16,886, a random sample of women with a normal...... responded to the follow-ups. Psychological impact was measured as anxiety (STAI-S), depression (BDI), health-related concerns (IAS), and breast cancer-specific beliefs and concerns. Data was analyzed with repeated measures analyses of variance, with estimates of effect size based on Eta-squared. Women...... normal mammograms. Experience and PS did not influence responses to different screening findings. Of the finding groups, false positives experienced most adverse effects: their risk perception increased and they reported most post-screening breast cancer-specific concerns. Furthermore, they became more...

  13. Primary Care Providers' Beliefs and Recommendations and Use of Screening Mammography by their Patients.

    Science.gov (United States)

    Haas, Jennifer S; Barlow, William E; Schapira, Marilyn M; MacLean, Charles D; Klabunde, Carrie N; Sprague, Brian L; Beaber, Elisabeth F; Chen, Jane S; Bitton, Asaf; Onega, Tracy; Harris, Kimberly; Tosteson, Anna N A

    2017-04-01

    Revised breast cancer screening guidelines have fueled debate about the effectiveness and frequency of screening mammography, encouraging discussion between women and their providers. To examine whether primary care providers' (PCPs') beliefs about the effectiveness and frequency of screening mammography are associated with utilization by their patients. Cross-sectional survey data from PCPs (2014) from three primary care networks affiliated with the Population-based Research Optimizing Screening through Personalized Regimens (PROSPR) consortium, linked with data about their patients' mammography use (2011-2014). PCPs (n = 209) and their female patients age 40-89 years without breast cancer (n = 30,233). Outcomes included whether (1) women received a screening mammogram during a 2-year period; and (2) screened women had >1 mammogram during that period, reflecting annual screening. Principal independent variables were PCP beliefs about the effectiveness of mammography and their recommendations for screening frequency. Overall 65.2% of women received >1 screening mammogram. For women 40-48 years, mammography use was modestly lower for those cared for by PCPs who believed that screening was ineffective compared with those who believed it was somewhat or very effective (59.1%, 62.3%, and 64.7%; p = 0.019 after controlling for patient characteristics). Of women with PCPs who reported they did not recommend screening before age 50, 48.1% were nonetheless screened. For women age 49-74 years, the vast majority were cared for by providers who believed that screening was effective. Provider recommendations were not associated with screening frequency. For women ≥75 years, those cared for by providers who were uncertain about effectiveness had higher screening use (50.7%) than those cared for by providers who believed it was somewhat effective (42.8%). Patients of providers who did not recommend screening were less likely to be screened than were those whose

  14. Repolarization abnormalities in the newborn.

    Science.gov (United States)

    Schwartz, Peter J; Stramba-Badiale, Marco

    2010-06-01

    The recognition of ventricular repolarization abnormalities in the newborn carries several and significant implications, because it calls attention to the possibility of dealing with an infant affected by the long QT syndrome (LQTS). This article provides key elements for the correct measurement of the QT interval in newborns and succinctly reviews some aspects of the disease. It gives normative values on the QT interval distribution in the first month of life based on a prospective study in more than 44,000 infants. It shows the probability, based on the QTc observed in two recordings, to find disease-causing mutations. The data indicate clearly that widespread electrocardiographic screening in the newborn allows early identification of most, if not all, the infants affected by LQTS with marked QT prolongation and thus of those at higher risk for life-threatening arrhythmias and sudden death. Through the affected infants, it becomes possible to identify the family members affected by LQTS, including the "silent mutation carriers"; our study shows that disease-causing mutations are found in 51% of the family members. Because early recognition leads to the implementation of effective preventive strategies, it follows that electrocardiographic screening will avoid preventable deaths either in the first year of life when they are usually labeled as "sudden infant death syndrome" or later in life. The case is made for medicolegal implications whenever neonatologists and pediatricians fail to inform the parents of a newborn child of the prevalence of LQTS (one in 2000), of the effectiveness of existing therapies, and of the diagnosis with a simple electrocardiogram.

  15. Modeling the impact of population screening on breast cancer mortality in the United States.

    Science.gov (United States)

    Mandelblatt, Jeanne S; Cronin, Kathleen A; Berry, Donald A; Chang, Yaojen; de Koning, Harry J; Lee, Sandra J; Plevritis, Sylvia K; Schechter, Clyde B; Stout, Natasha K; van Ravesteyn, Nicolien T; Zelen, Marvin; Feuer, Eric J

    2011-10-01

    Optimal US screening strategies remain controversial. We use six simulation models to evaluate screening outcomes under varying strategies. The models incorporate common data on incidence, mammography characteristics, and treatment effects. We evaluate varying initiation and cessation ages applied annually or biennially and calculate mammograms, mortality reduction (vs. no screening), false-positives, unnecessary biopsies and over-diagnosis. The lifetime risk of breast cancer death starting at age 40 is 3% and is reduced by screening. Screening biennially maintains 81% (range 67% to 99%) of annual screening benefits with fewer false-positives. Biennial screening from 50-74 reduces the probability of breast cancer death from 3% to 2.3%. Screening annually from 40 to 84 only lowers mortality an additional one-half of one percent to 1.8% but requires substantially more mammograms and yields more false-positives and over-diagnosed cases. Decisions about screening strategy depend on preferences for benefits vs. potential harms and resource considerations. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. The connecticut experiment: the role of ultrasound in the screening of women with dense breasts.

    Science.gov (United States)

    Weigert, Jean; Steenbergen, Sarah

    2012-01-01

    The aim of this study was to determine the potential of screening breast ultrasound to improve breast cancer detection in women with mammographically normal, but dense breasts. Six Connecticut radiology practices with 12 total sites participated in a retrospective chart review. The total number of screening mammograms, screening ultrasounds broken down by BIRADS (Breast Imaging Reporting and Data System) codes, and the number of positive and negative biopsies were collected from November 2009 through November 2010. Demographic data on the patients with positive biopsies as well as cancer staging were also collected. Sensitivity, Specificity, Positive Predictive Value, and Negative Predictive Value were calculated. A total of 72,030 screening mammograms and 8,647 screening ultrasounds were performed at the research sites during the study period. Relevant research indicates that 41% of the female population has dense breasts. In this study, 12% (8,647/72,030) underwent follow-up breast ultrasound screening. A total of 86% (7,451/8,647) of the ultrasounds were BIRADS 1 or 2, 9% (767/8,647) were BIRADS 3, 5% (429/8,647) were BIRADS 4 or 5. Of those 429 recommended to undergo biopsy 418 were performed and 28 cancers were found. There was one false negative. Screening breast ultrasound in women with mammographically normal, but dense breasts has a Positive Predictive Value (PPV) of 6.7% (28/418), Negative Predictive Value (NPV) of 99.9% (7,450/7,451), sensitivity of 96.6% (28/29), and a specificity of 94.9% (7,450/7,851). Screening ultrasound had an additional yield of 3.25 per 1,000 cancers in women with dense breasts and normal mammograms and no additional risk factors. As with all screening tests, time, cost, and false positive risk must be considered. © 2012 Wiley Periodicals, Inc.

  17. Study on Compression Induced Contrast in X-ray Mammograms Using Breast Mimicking Phantoms

    Directory of Open Access Journals (Sweden)

    A. B. M. Aowlad Hossain

    2015-09-01

    Full Text Available X-ray mammography is commonly used to scan cancer or tumors in breast using low dose x-rays. But mammograms suffer from low contrast problem. The breast is compressed in mammography to reduce x-ray scattering effects. As tumors are stiffer than normal tissues, they undergo smaller deformation under compression. Therefore, image intensity at tumor region may change less than the background tissues. In this study, we try to find out compression induced contrast from multiple mammographic images of tumorous breast phantoms taken with different compressions. This is an extended work of our previous simulation study with experiment and more analysis. We have used FEM models for synthetic phantom and constructed a phantom using agar and n-propanol for simulation and experiment. The x-ray images of deformed phantoms have been obtained under three compression steps and a non-rigid registration technique has been applied to register these images. It is noticeably observed that the image intensity changes at tumor are less than those at surrounding which induce a detectable contrast. Addition of this compression induced contrast to the simulated and experimental images has improved their original contrast by a factor of about 1.4

  18. Automated detection method for architectural distortion areas on mammograms based on morphological processing and surface analysis

    Science.gov (United States)

    Ichikawa, Tetsuko; Matsubara, Tomoko; Hara, Takeshi; Fujita, Hiroshi; Endo, Tokiko; Iwase, Takuji

    2004-05-01

    As well as mass and microcalcification, architectural distortion is a very important finding for the early detection of breast cancer via mammograms, and such distortions can be classified into three typical types: spiculation, retraction, and distortion. The purpose of this work is to develop an automatic method for detecting areas of architectural distortion with spiculation. The suspect areas are detected by concentration indexes of line-structures extracted by using mean curvature. After that, discrimination analysis of nine features is employed for the classifications of true and false positives. The employed features are the size, the mean pixel value, the mean concentration index, the mean isotropic index, the contrast, and four other features based on the power spectrum. As a result of this work, the accuracy of the classification was 76% and the sensitivity was 80% with 0.9 false positives per image in our database in regard to spiculation. It was concluded that our method was effective in detectiong the area of architectural distortion; however, some architectural distortions were not detected accurately because of the size, the density, or the different appearance of the distorted areas.

  19. Front-End Data Reduction in Computer-Aided Diagnosis of Mammograms: A Pilot Study

    Energy Technology Data Exchange (ETDEWEB)

    Gleason, S.S.; Nishikawa, R.M.; Sari-Sarraf, H.

    1999-02-20

    This paper presents the results of a pilot study whose primary objective was to further substantiate the efficacy of front-end data reduction in computer-aided diagnosis (CAD) of mammograms. This concept is realized by a preprocessing module that can be utilized at the front-end of most mammographic CAD systems. Based on fractal encoding, this module takes a mammo-graphic image as its input and generates, as its output, a collection of subregions called focus-of-attention regions (FARs). These FARs contain all structures in the input image that appear to be different from the normal background tissue. Subsequently, the CAD systems need only to process the presented FARs, rather than the entire input image. This accomplishes two objectives simultaneously: (1) an increase in throughput via a reduction in the input data, and (2) a reduction in false detections by limiting the scope of the detection algorithms to FARs only. The pilot study consisted of using the preprocessing module to analyze 80 mammographic images. The results were an average data reduction of 83% over all 80 images and an average false detection reduction of 86%. Furthermore, out of a total of 507 marked microcalcifications, 467 fell within FW, representing a coverage rate of 92%.

  20. A deep learning approach for the analysis of masses in mammograms with minimal user intervention.

    Science.gov (United States)

    Dhungel, Neeraj; Carneiro, Gustavo; Bradley, Andrew P

    2017-04-01

    We present an integrated methodology for detecting, segmenting and classifying breast masses from mammograms with minimal user intervention. This is a long standing problem due to low signal-to-noise ratio in the visualisation of breast masses, combined with their large variability in terms of shape, size, appearance and location. We break the problem down into three stages: mass detection, mass segmentation, and mass classification. For the detection, we propose a cascade of deep learning methods to select hypotheses that are refined based on Bayesian optimisation. For the segmentation, we propose the use of deep structured output learning that is subsequently refined by a level set method. Finally, for the classification, we propose the use of a deep learning classifier, which is pre-trained with a regression to hand-crafted feature values and fine-tuned based on the annotations of the breast mass classification dataset. We test our proposed system on the publicly available INbreast dataset and compare the results with the current state-of-the-art methodologies. This evaluation shows that our system detects 90% of masses at 1 false positive per image, has a segmentation accuracy of around 0.85 (Dice index) on the correctly detected masses, and overall classifies masses as malignant or benign with sensitivity (Se) of 0.98 and specificity (Sp) of 0.7. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Iso-precision scaling of digitized mammograms to facilitate image analysis

    International Nuclear Information System (INIS)

    Karssmeijer, N.; van Erning, L.

    1991-01-01

    This paper reports on a 12 bit CCD camera equipped with a linear sensor of 4096 photodiodes which is used to digitize conventional mammographic films. An iso-precision conversion of the pixel values is preformed to transform the image data to a scale on which the image noise is equal at each level. For this purpose film noise and digitization noise have been determined as a function of optical density and pixel size. It appears that only at high optical densities digitization noise is comparable to or larger than film noise. The quantization error caused by compression of images recorded with 12 bits per pixel to 8 bit images by an iso-precision conversion has been calculated as a function of the number of quantization levels. For mammograms digitized in a 4096 2 matrix the additional error caused by such a scale transform is only about 1.5 percent. An iso-precision scale transform can be advantageous when automated procedures for quantitative image analysis are developed. Especially when detection of signals in noise is aimed at, a constant noise level over the whole pixel value range is very convenient. This is demonstrated by applying local thresholding to detect small microcalcifications. Results are compared to those obtained by using logarithmic or linearized scales

  2. Feeling Abnormal: Simulation of Deviancy in Abnormal and Exceptionality Courses.

    Science.gov (United States)

    Fernald, Charles D.

    1980-01-01

    Describes activity in which student in abnormal psychology and psychology of exceptional children classes personally experience being judged abnormal. The experience allows the students to remember relevant research, become sensitized to the feelings of individuals classified as deviant, and use caution in classifying individuals as abnormal.…

  3. Abnormal glucose tolerance and lipid abnormalities in Indian ...

    African Journals Online (AJOL)

    Discussion. Regardless of varying diagnostic classification, abnormal glucose tolerance is a well-documented risk factor. 16 Abnormalities in. Because ofthe small number offemale MI survivors, the effect of obesity and abnormal glucose tolerance on lipid levels was studied in the male patients only. There was no significant.

  4. [Socioeconomic inequalities in mammography screening in Spanish women aged 45 to 69].

    Science.gov (United States)

    Serral, Gemma; Borrell, Carme; Puigpinós I Riera, Rosa

    To analyse mammography screening in Spanish women aged 45 to 69 according sociodemographic variables and to describe the role of population-based breast cancer screening programmes in terms of variability of said screening. Cross-sectional study of the 2011 National Health Survey. The study population includes women living in Spain between late 2011 and early 2012. The weighted sample analysed corresponds to 3,086 women aged 45 to 69. The dependent variables were mammograms and when the last mammogram was performed and why. Independent variables were age, social class, occupational status, country of origin, area of origin (rural/urban), health cover and years the programme had been in place. Logistic regression models were performed, with odds ratio (OR) adjusted according to age and 95% confidence intervals (95% CI). Approximately 91.9% indicated that they had had a mammogram before. The women who had had their last mammography screening in the previous 1 to 2 years were associated with the highest social class (OR: 1.69; 95% CI: 1.03-2.75). The reason for performing the last periodic mammogram via a population-based programme was associated with women aged between 60 and 69 years (OR: 1.51; 95% CI: 1.04-2.19). The results show that there are still inequalities in preventive practices. Possible risk groups need to be identified in order to promote the implementation of specific actions. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Exercises to Improve Gait Abnormalities

    Science.gov (United States)

    ... Articles Directories Videos Resources Contact Exercises to Improve Gait Abnormalities Home » Article Categories » Exercise and Fitness Font Size: A A A A Exercises to Improve Gait Abnormalities Next Page The manner of how a ...

  6. Possible logistic and sociodemographyc factors on breast cancer screening in Turkey: lessons from a women’s health project in Mersin province.

    Science.gov (United States)

    Abali, Huseyin; Ata, Alper; Gokçe, Gozde; Gokçe, Huseyin

    2012-06-01

    Mortality from breast cancer is decreasing partly owing to early detection. In Mersin province in our country, local health authorities launched an education program on sexual diseases and breast cancer early detection for women over 15 years of age. After the educational session, clinical breast examination was offered by a nurse or physician, and if suspicious they were recommended to apply a specialist for further examination. Here, we report the results on those women with abnormal clinical breast examination. In this second project, socio-demographic variables were investigated such as educational level and place of living,parameters to measure the success of previous project, whether they followed the recommendation themselves, whether mammograms were reported in accordance with Breast Imaging Reporting and Data System (BIRADS). Of 3,793 women recruited, mean age was 42.2 years, 42.3%were younger than 40.0 years. Majority (88.5%) were married, graduate of primary school (60.6%), without a job(91.2%), and inhabiting in the province (38.7%). Of the population, 98.1% believe in the importance of screening in the treatment of breast cancer. According to 70.3%,monthly breast self-examination enables early detection, 33.5% believe that clinical breast examination detects cancer early, and 35.5% think that annual mammography can detect it early. Among 2,183 women 40 years of age or over, 41.5% had mammography at once before participating in the first project. Breast self-examination was being carried out by 56.6% on a monthly basis. After an abnormal breast examination, 86.4% applied to hospitals for specialist examination. Reasons for declining to seek for further examination among 410 women answering were as follows:42.0% did not accept, 27.0% did not know it was important, 16.6% because of economical reasons, and 5.0% were too shy to be examined. Being older, being married, being the graduate of primary and secondary school, residing in rural areas, having a

  7. Impact of intermediate mammography assessment on the likelihood of false-positive results in breast cancer screening programmes

    Energy Technology Data Exchange (ETDEWEB)

    Ascunce, Nieves [Public Health Institute, CIBERESP, Navarra Breast Cancer Screening Programme, Pamplona (Spain); Instituto de Salud Publica, Navarra Breast Cancer Screening Programme, Pamplona (Spain); Ederra, Maria; Delfrade, Josu; Erdozain, Nieves [Public Health Institute, CIBERESP, Navarra Breast Cancer Screening Programme, Pamplona (Spain); Baroja, Araceli [Fundacion Rioja Salud, Logrono (Spain); Zubizarreta, Raquel [Public Health and Planning Directorate, Health Office, Galician Breast Cancer Screening Programme, Galicia (Spain); Salas, Dolores [General Directorate Public Health and Centre for Public Health Research (CSISP), Valencia (Spain); Castells, Xavier [Mar Teaching Hospital, CIBERESP, Department of Clinical Epidemiology, Barcelona (Spain)

    2012-02-15

    Breast cancer screening is offered to 100% of the target population in Spain and intermediate mammograms (IMs) are sometimes indicated. This study was aimed at analysing the frequency of IMs, the factors determining their recommendation, and their impact on the risk of false-positive results and the detection rate. Data from 3,471,307 mammograms from Spanish breast cancer screening programmes were included. 3.36% of the mammograms were IMs. The factors associated with the use of IMs were age, initial screening, previous invasive tests, a familial history of breast cancer and use of hormone replacement therapy. In screening episodes with an IM, the probability of a false-positive result was 13.74% (95% CI: 13.43-14.05), almost double that in episodes without IMs (6.02%, 95% CI 5.99-6.05). In young women with previous invasive procedures, a familial history of breast cancer or hormone replacement therapy use who were undergoing their initial screen, this probability was lower when IMs were performed. IMs always increased the detection rate. The factors prompting IMs should be characterised so that radiologists can systematise their recommendations according to the presence of the factors maximising the benefits and minimising the adverse effects of this procedure. (orig.)

  8. "5 mins of uncomfyness is better than dealing with cancer 4 a lifetime": an exploratory qualitative analysis of cervical and breast cancer screening dialogue on Twitter.

    Science.gov (United States)

    Lyles, Courtney R; López, Andrea; Pasick, Rena; Sarkar, Urmimala

    2013-03-01

    Twitter.com is a "micro-blogging" website. Although Twitter use is growing rapidly, little is known about health behavior discussions on this site, even though a majority of messages are publicly available. We retrieved publicly available Twitter messages during a 5-week period in early 2012, searching separately for the terms "Pap smear" and "mammogram." We used content analysis to code each 140-character message, generating a separate coding framework for each cancer screening term and calculating the frequencies of comments. Using the brief account description, we also coded the author as individual, organization, or news media outlet. There were 203 Pap smear and 271 mammogram messages coded, over three fourths of which were from individual accounts. Overall, 22 % of Pap smear messages and 25 % of mammogram messages discussed personal experiences, including attending appointments, negative sentiment about the procedure, and results. Other messages from both individuals and organizations (8 % Pap smear, 18 % mammogram) promoted screening. About one quarter of the messages expressed personal experiences with cancer screening. This demonstrates that Twitter can be a rich source of information and could be used to design new health-related interventions.

  9. Why mammography screening has not lived up to expectations from the randomised trials

    DEFF Research Database (Denmark)

    Gøtzsche, Peter C; Jørgensen, Karsten Juhl; Zahl, Per-Henrik

    2012-01-01

    We analysed the relation between tumour sizes and stages and the reported effects on breast cancer mortality with and without screening in trials and observational studies. The average tumour sizes in all the trials suggest only a 12% reduction in breast cancer mortality, which agrees with the 10...... adjuvant therapy and breast cancer awareness, not screening. We also believe it is more important to reduce the incidence of cancer than to detect it 'early.' Avoiding getting screening mammograms reduces the risk of becoming a breast cancer patient by one-third....

  10. [Penile congenital abnormalities].

    Science.gov (United States)

    Boillot, B; Teklali, Y; Moog, R; Droupy, S

    2013-07-01

    Congenital abnormalities of the penis are usually diagnosed at birth and pose aesthetic and functional problems sometimes requiring surgical management. A literature review was conducted on Medline considering the articles listed until January 2012. Hypospadias is the most common malformation (1 in 250 boys. Familial forms: 7%). The causes remain hypothetical but the doubling of the incidence in 30 years could be linked to fetal exposure to endocrine disruptors "estrogen-like" used in the food industry in particular. Surgical treatment is usually intended to improve the aesthetic appearance but sometimes, in case of significant curvature or posterior meatus, necessary for normal sexual life and fertility. Other malformations (epispades, buried penis, transpositions, twists and preputial abnormalities) as well as management for functional or aesthetic consequences of these malformations in adulthood require complex surgical care in a specialized environment. The improvement of surgical techniques and pediatric anesthesia allows an early and effective specialized surgical approach of penile malformations. Management of sequelae in adulthood must be discussed and requires experience of surgical techniques on pediatric and adult penis. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  11. Travel Times for Screening Mammography: Impact of Geographic Expansion by a Large Academic Health System.

    Science.gov (United States)

    Rosenkrantz, Andrew B; Liang, Yu; Duszak, Richard; Recht, Michael P

    2017-09-01

    This study aims to assess the impact of off-campus facility expansion by a large academic health system on patient travel times for screening mammography. Screening mammograms performed from 2013 to 2015 and associated patient demographics were identified using the NYU Langone Medical Center Enterprise Data Warehouse. During this time, the system's number of mammography facilities increased from 6 to 19, reflecting expansion beyond Manhattan throughout the New York metropolitan region. Geocoding software was used to estimate driving times from patients' homes to imaging facilities. For 147,566 screening mammograms, the mean estimated patient travel time was 19.9 ± 15.2 minutes. With facility expansion, travel times declined significantly (P travel times between such subgroups. However, travel times to pre-expansion facilities remained stable (initial: 26.8 ± 18.9 minutes, final: 26.7 ± 18.6 minutes). Among women undergoing mammography before and after expansion, travel times were shorter for the postexpansion mammogram in only 6.3%, but this rate varied significantly (all P travel burden and reduce travel time variation among sociodemographic populations. Nonetheless, existing patients strongly tend to return to established facilities despite potentially shorter travel time locations, suggesting strong site loyalty. Variation in travel times likely relates to various factors other than facility proximity. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  12. Breast cancer screening and health behaviors among African American and Caribbean Women in New York City.

    Science.gov (United States)

    Garbers, Samantha; Chiasson, Mary Ann

    2006-02-01

    A telephone-based survey regarding breast cancer screening practices among 300 African American and Caribbean women age 40 and over in New York City revealed that while U.S.-born women had significantly different sociodemographic profiles (in terms of insurance status, marital status, educational attainment), they were no more likely to have had a mammogram than the foreign-born women. Adjusting for insurance status and source of care, women with a provider recommendation were 8 times more likely ever to have had a mammogram (AOR 8.01, 95%CI: 3.74-17.14). Among foreign-born Caribbean women in the U.S. for less than half their lives, only 52% ever had a provider recommend a mammogram, compared with 77% of U.S.-born women. The findings confirm previous reports of the importance of physician recommendation in increasing mammography screening among urban Black women, and suggest that efforts to reach Caribbean-born women with breast cancer screening messages should emphasize the important role of providers.

  13. Newborn Screening

    Science.gov (United States)

    ... Laboratory Sciences Office of Public Health Genomics Publications & Articles Newborn Screening Lab Bulletin Laboratory Partners Multimedia Tools Newborn Screening Program – Role of Laboratories Meet the Scientist Newborn Screening: Family Stories Newborn Screening: Public Health ...

  14. Does computer-aided detection have a role in the arbitration of discordant double-reading opinions in a breast-screening programme?

    International Nuclear Information System (INIS)

    James, J.J.; Cornford, E.J.

    2009-01-01

    Aims: To investigate whether a computer-aided detection (CAD) system could act as an arbitrator of discordant double-reading opinions, replacing the need for an independent third film reader. Methods: The mammograms of the 240 women that underwent arbitration by an independent third reader were identified from the 16,629 women attending our screening centre between July 2003 and April 2004. Mammograms of the arbitration cases were digitized and analysed by a CAD system. To assess the ability of CAD to act as the arbitrator, the site of the CAD prompts was retrospectively compared to the site of any abnormality noted by the original film readers. If a CAD prompt was placed on a region marked by one of the film readers then the decision of CAD as the arbitrator was that the women should be recalled for further assessment. If no mark was placed then the region was considered low risk and the decision was not to recall. The decision of CAD as the arbitrator was retrospectively compared with the original recall decision of the independent third reader. Results: There were 21 cancer cases in the group of women undergoing arbitration, diagnosed both at the original screening episode and subsequently. The independent third reader recalled 15/18 (83%) of the cancers that corresponded with the arbitrated lesion. CAD as the arbitrator would have recalled 16/18 (89%) of the cancers that corresponded to the arbitrated lesion. CAD acting as the arbitrator would have resulted in a significant increase in normal women being recalled to assessment in the arbitration group (P < 0.001). The extra 50 recalls would have potentially increased the overall recall rate to assessment from 3.1 to 3.4%; a relative increase of 10%. Conclusions: The main effect of CAD acting as an arbitrator of discordant double-reading opinions is to increase the recall rate, significantly above what is found when arbitration is performed by an independent third reader. Using CAD as an arbitrator may be an

  15. Utility of supplemental screening with breast ultrasound in asymptomatic women with dense breast tissue who are not at high risk for breast cancer

    OpenAIRE

    Klevos, Geetika A; Collado-Mesa, Fernando; Net, Jose M; Yepes, Monica M

    2017-01-01

    Objective: To assess the results of an initial round of supplemental screening with hand-held bilateral breast ultrasound following a negative screening mammogram in asymptomatic women with dense breast tissue who are not at high risk for breast cancer. Materials and Methods: A retrospective, Health Insurance Portability and Accountability Act compliant, Institutional Research Board approved study was performed at a single academic tertiary breast center. Informed consent was waived. A system...

  16. Classifying region of interests from mammograms with breast cancer into BIRADS using Artificial Neural Networks

    Directory of Open Access Journals (Sweden)

    Estefanía D. Avalos-Rivera

    2017-05-01

    Full Text Available Breast cancer is one of the most common cancers among female diseases all over the world. Early diagnosis and treatment is particularly important in reducing the mortality rate. This research is focused on the prevention of breast cancer, therefore it is important to detect micro-calcifications (MCs which are a sign of early stage breast cancer. Micro-calcifications are tiny deposits of calcium which are visible on mammograms as they present as tiny white spots. A computer-aided diagnosis system (CAD is created with the development of computer technology that way radiologists are aided improving their diagnostics while using CAD as a second reader. We are aiming to classify into BIRADS 2, 3 and 4 which are the stages when the cancer can be prevented and a fourth category called No lesion which are veins and tissue that our high pass Gaussian filter detects. This research focuses on classification using ANN (Artificial Neural Network. Experimenting with the categories to classify into using ANN, the results were the following: into the four mentioned before an overall accuracy of 71% was obtained, then joining categories BIRADS 2 and 3 into one and classifying into 3 categories gave an 80% of accuracy. Joining this two categories was the result of analizing the ROC curve and observation of the ROI images of the MCs as the regions measured are very alike in this two categories and variation is that MCs are more present in BIRADS 3 than in BIRADS 2. Data matrix was reduced using PCA (Principal Component Analysis but it did not gave better results so it was discarded as the ANN accuracy to classify was reduced to a 69.8%.

  17. Volumetric Mammogram Assessment: A Helpful Tool in the Treatment of Breast Asymmetries.

    Science.gov (United States)

    Zimman, Oscar A; Butto, Carlos D; Rostagno, Román; Rostagno, Camila

    2017-12-01

    The surgical approach to breast asymmetry depends on several factors, including the surgeon's experience, the anatomy of the patient, and several methods that may help to choose a technique and define the size of the implant or the amount of breast tissue to be excised. The aim of this study is to assist in evaluation of breast volumes with the Quantra™ software application, intended for use with Hologic™ digital mammography systems. Twenty-eight women were studied with full-field digital mammography (FFDM) with the Quantra™ software application, for use with Hologic™ digital mammography systems preoperatively. The case diagnoses were as follows: breast hypertrophy, ptosis, hypoplasia, and reconstruction, and the surgeries included breast reduction, mastopexy, mastopexy and breast reduction, mastoplasty and breast augmentation, breast augmentation, and immediate or delayed breast reconstruction. Patients were evaluated from 6 to 18 months after surgery. Volumetric mammogram studies help to decide the amount of tissue to be excised, the size of the implants, and the combination of both. The results of this study were evaluated by surgeons and patients and found to be highly satisfactory. The use of full-field digital mammography with adequate software should be considered as another tool to assist in making decisions regarding the correction of breast asymmetries. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  18. A Rare Stapes Abnormality

    Directory of Open Access Journals (Sweden)

    Hala Kanona

    2015-01-01

    Full Text Available The aim of this study is to increase awareness of rare presentations, diagnostic difficulties alongside management of conductive hearing loss and ossicular abnormalities. We report the case of a 13-year-old female reporting progressive left-sided hearing loss and high resolution computed tomography was initially reported as normal. Exploratory tympanotomy revealed an absent stapedius tendon and lack of connection between the stapes superstructure and footplate. The footplate was fixed. Stapedotomy and stapes prosthesis insertion resulted in closure of the air-bone gap by 50 dB. A review of world literature was performed using MedLine. Middle ear ossicular discontinuity can result in significant conductive hearing loss. This can be managed effectively with surgery to help restore hearing. However, some patients may not be suitable or decline surgical intervention and can be managed safely conservatively.

  19. Corpus callosum abnormalities: neuroradiological and clinical correlations.

    Science.gov (United States)

    Al-Hashim, Aqeela H; Blaser, Susan; Raybaud, Charles; MacGregor, Daune

    2016-05-01

    To study neuroradiological features in pediatric patients with corpus callosum abnormalities, using new functional subtyping for the corpus callosum, and to correlate the features with the clinical presentation. We performed a retrospective review of 125 patients with radiologically identified abnormalities of the corpus callosum seen between 1999 and 2012. The study reviewed clinical features, genetic etiology, and chromosomal microarray (CMA) results. We used a new functional classification for callosal abnormalities based on embryological and anatomical correlations with four classes: complete agenesis, anterior agenesis (rostrum, genu, body), posterior agenesis (isthmus, splenium), and complete hypoplasia (thinning). We also studied the presence of extracallosal abnormalities. The new functional callosal subtyping did not reveal significant differences between the various subtypes in association with neurological outcome; however, the presence of cardiac disease was found more frequently in the group with complete agenesis. Thirty-seven per cent (46/125) had identifiable causes: of these, 48% (22/46) had a monogenic disorder, 30% (14/46) had a pathogenic chromosomal copy-number variant detected by CMA or karyotype, and 22% (10/46) had a recognizable clinical syndrome for which no confirmatory genetic test was available (namely Aicardi syndrome/septo-optic dysplasia and Goldenhar syndrome). The diagnostic yield for a significant CMA change was 19%. The presence of Probst bundles was found to be associated with a better neurodevelopmental outcome. The functional classification system alone 'without clinical data' cannot predict the functional outcome. The presence of extracallosal brain abnormalities and an underlying genetic diagnosis predicted a worse neurodevelopmental outcome. This study highlights the importance of CMA testing and cardiac evaluation as part of a routine screen. © 2015 Mac Keith Press.

  20. What next for preimplantation genetic screening? A polar body approach!

    NARCIS (Netherlands)

    Geraedts, Joep; Collins, John; Gianaroli, Luca; Goossens, Veerle; Handyside, Alan; Harper, Joyce; Montag, Markus; Repping, Sjoerd; Schmutzler, Andreas

    2010-01-01

    Screening of human preimplantation embryos for numerical chromosome abnormalities has been conducted mostly at the preimplantation stage using fluorescence in situ hybridization. However, it is clear that preimplantation genetic screening (PGS) as it is currently practiced does not improve live

  1. Aneuploidy Screening in Pregnancy.

    Science.gov (United States)

    Dashe, Jodi S

    2016-07-01

    Prenatal aneuploidy screening has changed dramatically in recent years with increases in the types of chromosomal abnormalities reliably identified and in the proportion of aneuploid fetuses detected. Initially, screening was available only for trisomies 21 and 18 and was offered only to low-risk pregnancies. Improved detection with the quadruple- and first-trimester multiple marker screens led to the option of aneuploidy screening for women 35 years of age and older. Cell-free DNA tests now screen for common autosomal trisomies and sex chromosome aneuploidies. Cell-free DNA screening is particularly effective in older women because of higher positive predictive values and lower false-positive rates. Integrated first- and second-trimester multiple marker tests provide specific risks for trisomies 21, 18, and possibly 13, and may detect an even wider range of aneuploidies. Given current precision in risk assessment, based on maternal age and preferences for screening or diagnostic tests, counseling has become more complex. This review addresses the benefits and limitations of available aneuploidy screening methods along with counseling considerations when offering them.

  2. Mammography Screening Uptake among Female Health Care Workers in Primary Health Care Centers in Palestine - Motivators and Barriers.

    Science.gov (United States)

    Nazzal, Zaher; Sholi, Hisham; Sholi, Suha; Sholi, Mohammad; Lahaseh, Rawya

    2016-01-01

    Early detection remains the cornerstone of breast cancer control in terms of outcome and survival. Thus far the only breast cancer screening method proven effective is mammography. The awareness of female health care workers (HCW) about breast cancer prevention is of vital importance, as their beliefs and behavior may have a major impact on other women. This study was designed to assess mammography screening uptake among female healthcare workers at primary healthcare centers, and to identify the primary motivators and barriers that affect uptake results. A cross sectional study design was used to assess mammography screening by 299 female healthcare workers who completed a self-administered questionnaire that assessed demographics, screening uptake, motivators and barriers. The mean age was 46 years (within age of risk). The majority (95.1%) demonstrated adequate knowledge about breast cancer and mammography screening and 50% of the participants reported having at least one mammogram; however only 21% of them had regularly scheduled mammograms. The most frequent reported motivator was the perceived benefit that early detection of breast cancer is important for its management (89.6%), followed by the belief that mammography can detect breast cancer before its symptoms appear (84.4%). On the other hand, the most frequent barrier reported was being busy (46.7%), followed by the lack of perceived susceptibility (41.5%). Mammography screening was found to be sub-optimal in a population of HCW's with 50 % stating that they received a mammogram at least once, and a minority reported regular screening. There is a pressing need for educational programs aimed at removing the barriers that limit compliance with recommendations for mammography screening, and to emphasize the importance of early detection in breast cancer treatment. Ensuring the availability and accessibility of screening services, particularly for healthcare workers within their work settings are other

  3. Microcalcification detection in full-field digital mammograms with PFCM clustering and weighted SVM-based method

    Science.gov (United States)

    Liu, Xiaoming; Mei, Ming; Liu, Jun; Hu, Wei

    2015-12-01

    Clustered microcalcifications (MCs) in mammograms are an important early sign of breast cancer in women. Their accurate detection is important in computer-aided detection (CADe). In this paper, we integrated the possibilistic fuzzy c-means (PFCM) clustering algorithm and weighted support vector machine (WSVM) for the detection of MC clusters in full-field digital mammograms (FFDM). For each image, suspicious MC regions are extracted with region growing and active contour segmentation. Then geometry and texture features are extracted for each suspicious MC, a mutual information-based supervised criterion is used to select important features, and PFCM is applied to cluster the samples into two clusters. Weights of the samples are calculated based on possibilities and typicality values from the PFCM, and the ground truth labels. A weighted nonlinear SVM is trained. During the test process, when an unknown image is presented, suspicious regions are located with the segmentation step, selected features are extracted, and the suspicious MC regions are classified as containing MC or not by the trained weighted nonlinear SVM. Finally, the MC regions are analyzed with spatial information to locate MC clusters. The proposed method is evaluated using a database of 410 clinical mammograms and compared with a standard unweighted support vector machine (SVM) classifier. The detection performance is evaluated using response receiver operating (ROC) curves and free-response receiver operating characteristic (FROC) curves. The proposed method obtained an area under the ROC curve of 0.8676, while the standard SVM obtained an area of 0.8268 for MC detection. For MC cluster detection, the proposed method obtained a high sensitivity of 92 % with a false-positive rate of 2.3 clusters/image, and it is also better than standard SVM with 4.7 false-positive clusters/image at the same sensitivity.

  4. Factors associated with abnormal spirometry among HIV-infected individuals.

    Science.gov (United States)

    Drummond, M Bradley; Huang, Laurence; Diaz, Philip T; Kirk, Gregory D; Kleerup, Eric C; Morris, Alison; Rom, William; Weiden, Michael D; Zhao, Enxu; Thompson, Bruce; Crothers, Kristina

    2015-08-24

    HIV-infected individuals are susceptible to development of chronic lung diseases, but little is known regarding the prevalence and risk factors associated with different spirometric abnormalities in this population. We sought to determine the prevalence, risk factors and performance characteristics of risk factors for spirometric abnormalities among HIV-infected individuals. Cross-sectional cohort study. We analyzed cross-sectional US data from the NHLBI-funded Lung-HIV consortium - a multicenter observational study of heterogeneous groups of HIV-infected participants in diverse geographic sites. Logistic regression analysis was performed to determine factors statistically significantly associated with spirometry patterns. A total of 908 HIV-infected individuals were included. The median age of the cohort was 50 years, 78% were men and 68% current smokers. An abnormal spirometry pattern was present in 37% of the cohort: 27% had obstructed and 10% had restricted spirometry patterns. Overall, age, smoking status and intensity, history of Pneumocystis infection, asthma diagnosis and presence of respiratory symptoms were independently associated with an abnormal spirometry pattern. Regardless of the presence of respiratory symptoms, five HIV-infected participants would need to be screened with spirometry to diagnose two individuals with any abnormal spirometry pattern. Nearly 40% of a diverse US cohort of HIV-infected individuals had an abnormal spirometry pattern. Specific characteristics including age, smoking status, respiratory infection history and respiratory symptoms can identify those at risk for abnormal spirometry. The high prevalence of abnormal spirometry and the poor predictive capability of respiratory symptoms to identify abnormal spirometry should prompt clinicians to consider screening spirometry in HIV-infected populations.

  5. Screening for breast cancer post reduction mammoplasty

    International Nuclear Information System (INIS)

    Muir, T.M.; Tresham, J.; Fritschi, L.; Wylie, E.

    2010-01-01

    Aim: To investigate whether remodelling of the breast after breast reduction surgery has an effect on mammographic cancer detection. Methods and materials: For women who attended population-based screening between January 1998 to December 2007, data were extracted on their age, history of previous breast reduction, and the result of screening (recall for further assessment, cancer, or no cancer). The number of cancers detected, recalls per 1000 screens and the characteristics of the cancers detected in the two groups was compared. Results: In total 244,147 women with 736,219 screening episodes were reviewed. In the 4743 women who had a breast reduction, 51 breast cancers were detected [age standardized rate (ASR) of 4.28 per 1000 screening episodes; 95% CI 3.11-5.46], compared with 4342 breast cancers in 239 404 women screened in the non-reduction group (ASR of 5.99 per 1000 screening episodes; 95% CI 5.81-6.16). There were fewer cancers in the breast reduction group with a relative risk of 0.71. There was no significant difference in the rate of recall between the two groups, with a crude recall rate of 46.1 per 1000 screening episodes post-breast reduction compared with 50.7 per 1000 screening episodes for women without breast reduction. There was no significant difference in the pathological type or location of the cancer between the two groups of women. Conclusion: Postoperative breast changes following reduction mammoplasty do not significantly hinder analysis of the screening mammogram.

  6. Influences of Radiology Trainees on Screening Mammography Interpretation.

    Science.gov (United States)

    Hawley, Jeffrey R; Taylor, Clayton R; Cubbison, Alyssa M; Erdal, B Selnur; Yildiz, Vedat O; Carkaci, Selin

    2016-05-01

    Participation of radiology trainees in screening mammographic interpretation is a critical component of radiology residency and fellowship training. The aim of this study was to investigate and quantify the effects of trainee involvement on screening mammographic interpretation and diagnostic outcomes. Screening mammograms interpreted at an academic medical center by six dedicated breast imagers over a three-year period were identified, with cases interpreted by an attending radiologist alone or in conjunction with a trainee. Trainees included radiology residents, breast imaging fellows, and fellows from other radiology subspecialties during breast imaging rotations. Trainee participation, patient variables, results of diagnostic evaluations, and pathology were recorded. A total of 47,914 mammograms from 34,867 patients were included, with an overall recall rate for attending radiologists reading alone of 14.7% compared with 18.0% when involving a trainee (P radiology trainees, with no change in cancer detection rate. Radiology faculty members should be aware of this potentiality and mitigate tendencies toward greater false positives. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  7. Admissions screening: clinical benefits.

    Science.gov (United States)

    Korvin, C C; Pearce, R H; Stanley, J

    1975-08-01

    One thousand patients admitted to a 575-bed general hospital during a 6-month period each underwent 20 chemical and hematologic tests. The potential clinical benefit was assessed. There were 2223 abnormal results found; 675 were predicted on clinical assessment, 1325 did not yield new diagnoses, and the remaining 223 led to 83 new diagnoses in 77 patients. On critical evaluation of the new diagnoses, none were unequivocally beneficial to the patient. Up to 30 patients might have benefited had these abnormal findings been followed up diligently, 39 others had findings or diagnoses of no lasting significance, and in 14 patients asymptomatic mild biochemical diabetes was discovered. Although screening may reveal many abnormal test results, the clinical benefits are not impressive.

  8. Hypertrophic cardiomyopathy screening in young athletes

    Energy Technology Data Exchange (ETDEWEB)

    Rappoport, W.J. [Arizona Heart Inst., Phoenix, AZ (United States); Steingard, P.M. [Phoenix Suns, Phoenix, AZ (United States)

    2006-07-01

    Hypertrophic cardiomyopathy is the leading cause of sudden death during vigorous exercise. Early identification of this abnormality by ECG screening of high-school athletes before they participate in competitive sports helps save lives. (orig.)

  9. Ultrassonografia obstétrica entre a 11ª e a 14ª semanas: além do rastreamento de anomalias cromossômicas Obstetric ultrasound between the 11th and 14th weeks: beyond the screening for chromosomal abnormalities

    Directory of Open Access Journals (Sweden)

    Cleisson Fábio Andrioli Peralta

    2011-01-01

    Full Text Available Esta é uma revisão tradicional (narrativa que teve como objetivo salientar a contribuição da ultrassonografia (USG obstétrica entre a 11ª e a 14ª semana de gravidez, comumente denominada ultrassonografia morfológica de primeiro trimestre. Além do rastreamento de anomalias cromossômicas, a USG pode ser empregada neste período para: confirmação ou determinação da idade gestacional; avaliação da anatomia fetal; diagnóstico de malformações; rastreamento de anormalidades estruturais maiores e de síndromes gênicas; definição do prognóstico da gravidez; diagnóstico e caracterização das gestações múltiplas; e rastreamento da pré-eclampsia e da restrição de crescimento intrauterino. Foram incluídos os principais estudos sobre o tema publicados entre 1990 e 2010, pesquisados nas bibliotecas eletrônicas Cochrane e PubMed, e que podem ser incorporados nos níveis de evidência científica I a III.This is a traditional (narrative review with the objective of highlighting the contribution of obstetric ultrasonography (US between the 11th and 14th week of pregnancy, commonly called first trimester anomaly scan. In addition to being used for the screening of chromosomal anomalies, US can be employed during this period to confirm or determine gestational age, evaluate fetal anatomy, diagnose malformations, screen major structural abnormalities and genetic syndromes, define the prognosis of pregnancy, diagnose and characterize multiple pregnancies, and screen preeclampsia and intrauterine growth restriction. The most important studies about this subject published between 1990 and 2010 in the Cochrane and PubMed libraries were included. The selected studies can be classified with scientific levels I to III.

  10. Computerized decision support system for mass identification in breast using digital mammogram: a study on GA-based neuro-fuzzy approaches.

    Science.gov (United States)

    Das, Arpita; Bhattacharya, Mahua

    2011-01-01

    In the present work, authors have developed a treatment planning system implementing genetic based neuro-fuzzy approaches for accurate analysis of shape and margin of tumor masses appearing in breast using digital mammogram. It is obvious that a complicated structure invites the problem of over learning and misclassification. In proposed methodology, genetic algorithm (GA) has been used for searching of effective input feature vectors combined with adaptive neuro-fuzzy model for final classification of different boundaries of tumor masses. The study involves 200 digitized mammograms from MIAS and other databases and has shown 86% correct classification rate.

  11. Abnormal vaginal microbiota may be associated with poor reproductive outcomes

    DEFF Research Database (Denmark)

    Haahr, T.

    2016-01-01

    primers were specific for four common Lactobacillus spp., G. vaginalis and A. vaginae. Results: The prevalence of BV defined by Nugent score was 21% (27/130), whereas the prevalence of an abnormal vaginal microbiota was 28% (36/130) defined by qPCR with high concentrations of G. vaginalis and/or A....... vaginae. The qPCR diagnostic approach had a sensitivity and specificity of 93% and 93% for Nugent-defined BV. Eighty-four patients completed IVF treatment. The overall clinical pregnancy rate was 35% (29/84). Interestingly, only 9% (2/22) with qPCR defined abnormal vaginal microbiota obtained a clinical...... pregnancy (P = 0.004). Wider implications: If a negative correlation between abnormal vaginal microbiota and the clinical pregnancy rate is corroborated, patients could be screened and subsequently treated for abnormal vaginal microbiota prior to fertility treatment....

  12. iPixel: a visual content-based and semantic search engine for retrieving digitized mammograms by using collective intelligence.

    Science.gov (United States)

    Alor-Hernández, Giner; Pérez-Gallardo, Yuliana; Posada-Gómez, Rubén; Cortes-Robles, Guillermo; Rodríguez-González, Alejandro; Aguilar-Laserre, Alberto A

    2012-09-01

    Nowadays, traditional search engines such as Google, Yahoo and Bing facilitate the retrieval of information in the format of images, but the results are not always useful for the users. This is mainly due to two problems: (1) the semantic keywords are not taken into consideration and (2) it is not always possible to establish a query using the image features. This issue has been covered in different domains in order to develop content-based image retrieval (CBIR) systems. The expert community has focussed their attention on the healthcare domain, where a lot of visual information for medical analysis is available. This paper provides a solution called iPixel Visual Search Engine, which involves semantics and content issues in order to search for digitized mammograms. iPixel offers the possibility of retrieving mammogram features using collective intelligence and implementing a CBIR algorithm. Our proposal compares not only features with similar semantic meaning, but also visual features. In this sense, the comparisons are made in different ways: by the number of regions per image, by maximum and minimum size of regions per image and by average intensity level of each region. iPixel Visual Search Engine supports the medical community in differential diagnoses related to the diseases of the breast. The iPixel Visual Search Engine has been validated by experts in the healthcare domain, such as radiologists, in addition to experts in digital image analysis.

  13. Detection of microcalcification clusters using Hessian matrix and foveal segmentation method on multiscale analysis in digital mammograms.

    Science.gov (United States)

    Thangaraju, Balakumaran; Vennila, Ila; Chinnasamy, Gowrishankar

    2012-10-01

    Mammography is the most efficient technique for detecting and diagnosing breast cancer. Clusters of microcalcifications have been mainly targeted as a reliable early sign of breast cancer and their earliest detection is essential to reduce the probability of mortality rate. Since the size of microcalcifications is very tiny and may be overlooked by the observing radiologist, we have developed a Computer Aided Diagnosis system for automatic and accurate cluster detection. A three-phased novel approach is presented in this paper. Firstly, regions of interest that corresponds to microcalcifications are identified. This can be achieved by analyzing the bandpass coefficients of the mammogram image. The suspicious regions are passed to the second phase, in which the nodular structured microcalcifications are detected based on eigenvalues of second order partial derivatives of the image and microcalcification pixels are segmented out by exploiting the foveal segmentation in multiscale analysis. Finally, by combining the responses coming out from the second order partial derivatives and the foveal method, potential microcalcifications are detected. The detection performance of the proposed method has been evaluated by using 370 mammograms. The detection method has a TP ratio of 97.76 % with 0.68 false positives per image. We have examined the performance of our computerized scheme using free-response operating characteristics curve.

  14. Reduction of false positives in the detection of architectural distortion in mammograms by using a geometrically constrained phase portrait model

    International Nuclear Information System (INIS)

    Ayres, Fabio J.; Rangayyan, Rangaraj M.

    2007-01-01

    Objective One of the commonly missed signs of breast cancer is architectural distortion. We have developed techniques for the detection of architectural distortion in mammograms, based on the analysis of oriented texture through the application of Gabor filters and a linear phase portrait model. In this paper, we propose constraining the shape of the general phase portrait model as a means to reduce the false-positive rate in the detection of architectural distortion. Material and methods The methods were tested with one set of 19 cases of architectural distortion and 41 normal mammograms, and with another set of 37 cases of architectural distortion. Results Sensitivity rates of 84% with 4.5 false positives per image and 81% with 10 false positives per image were obtained for the two sets of images. Conclusion The adoption of a constrained phase portrait model with a symmetric matrix and the incorporation of its condition number in the analysis resulted in a reduction in the false-positive rate in the detection of architectural distortion. The proposed techniques, dedicated for the detection and localization of architectural distortion, should lead to efficient detection of early signs of breast cancer. (orig.)

  15. Turnaround times in breast cancer: From screening to diagnosis to treatment

    Directory of Open Access Journals (Sweden)

    Kaylene J Logan

    2013-01-01

    Discussion: The CCBCC ranks at the 75%ile in overall turnaround times; however, this turnaround time included an interval of MRI, not previously measured in NQMBC benchmark. Rate-limiting steps were identified as the time from screening mammogram to diagnostic mammogram, and biopsy to surgery-specifically, the sub-interval MRI to surgery. Since 2009, the CCBCC has already improved the process for obtaining insurance approval and preauthorization for MRIs; and has added an additional breast surgeon to share the burden of benign cases, and a nurse practitioner to see post-op and follow up patients, improving the accessibility to the primary breast surgeon specialist. Consideration should be given to future time interval studies that evaluate breast cancer turnaround time including MRI to help establish benchmarks.

  16. Psychosocial predictors of first attendance for organised mammography screening

    DEFF Research Database (Denmark)

    Aro, A R; de Koning, H J; Absetz, P

    1999-01-01

    OBJECTIVE: To study psychosocial predictors of attendance at an organised breast cancer screening programme. SETTING: Finnish screening programme based on personal first round invitations in 1992-94, and with 90% attendance rate. METHODS: Attenders (n = 946) belonged to a 10% random sample (n...... Scale, Illness Attitude Scale, Health Locus of Control Scale, Anxiety Inventory, and Depression Inventory. Univariate and multivariate logistic regression analyses were used to predict attendance. RESULTS: Those most likely to attend were working, middle income, and averagely educated women, who had...... of breast cancer risk as moderate were also predictive of attendance. Expectation of pain at mammography was predictive of non-attendance. CONCLUSION: Mammography screening organised as a public health service was well accepted. A recent mammogram, high reliance on self control of breast cancer...

  17. Decision trees and integrated features for computer aided mammographic screening

    Energy Technology Data Exchange (ETDEWEB)

    Kegelmeyer, W.P. Jr.; Groshong, B.; Allmen, M.; Woods, K.

    1997-02-01

    Breast cancer is a serious problem, which in the United States causes 43,000 deaths a year, eventually striking 1 in 9 women. Early detection is the only effective countermeasure, and mass mammography screening is the only reliable means for early detection. Mass screening has many shortcomings which could be addressed by a computer-aided mammographic screening system. Accordingly, we have applied the pattern recognition methods developed in earlier investigations of speculated lesions in mammograms to the detection of microcalcifications and circumscribed masses, generating new, more rigorous and uniform methods for the detection of both those signs. We have also improved the pattern recognition methods themselves, through the development of a new approach to combinations of multiple classifiers.

  18. Abnormal pressure in hydrocarbon environments

    Science.gov (United States)

    Law, B.E.; Spencer, C.W.

    1998-01-01

    Abnormal pressures, pressures above or below hydrostatic pressures, occur on all continents in a wide range of geological conditions. According to a survey of published literature on abnormal pressures, compaction disequilibrium and hydrocarbon generation are the two most commonly cited causes of abnormally high pressure in petroleum provinces. In young (Tertiary) deltaic sequences, compaction disequilibrium is the dominant cause of abnormal pressure. In older (pre-Tertiary) lithified rocks, hydrocarbon generation, aquathermal expansion, and tectonics are most often cited as the causes of abnormal pressure. The association of abnormal pressures with hydrocarbon accumulations is statistically significant. Within abnormally pressured reservoirs, empirical evidence indicates that the bulk of economically recoverable oil and gas occurs in reservoirs with pressure gradients less than 0.75 psi/ft (17.4 kPa/m) and there is very little production potential from reservoirs that exceed 0.85 psi/ft (19.6 kPa/m). Abnormally pressured rocks are also commonly associated with unconventional gas accumulations where the pressuring phase is gas of either a thermal or microbial origin. In underpressured, thermally mature rocks, the affected reservoirs have most often experienced a significant cooling history and probably evolved from an originally overpressured system.

  19. Breast and cervical cancer screening among South Asian immigrants in the United States.

    Science.gov (United States)

    Menon, Usha; Szalacha, Laura A; Prabhughate, Abhijit

    2012-01-01

    South Asian (SA) immigrants (from Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, and Sri Lanka) constitute the fastest growing of all Asian American immigrants to the United States, with a growth rate of 106% from 1990 to 2001. Data are lacking on health behaviors of this population subgroup, including cancer-related information. : The purpose of this study was to assess rates and correlates of breast and cervical cancer screening in a community sample of SAs. Participants were recruited from among attendees of 3 community-based agency programs. Data were collected in English, Hindi, and Gujarati from a convenience sample of 198 participants. Two-thirds of the sample (n = 127, 65.5%) had ever had a mammogram, whereas only a third (n = 65, 32.8%) had ever had a Papanicolaou smear or vaginal examination. Several predisposing factors (eg, country of birth, years in the United States, acculturation, age, and acknowledged barriers to screening) were significant predictors of breast and cervical screening, whereas the only enabling factor was past screening behavior. Additional study is warranted on cultural aspects of cancer screening behaviors. These data are formative on facilitators and barriers to mammogram and Papanicolaou test completion among these understudied minority women. Nurses who practice in primary care may begin to target health education based on sociodemographics of SA women and emphasize discussion of barriers to screening.

  20. Opt-Out Patient Navigation to Improve Breast and Cervical Cancer Screening Among Homeless Women.

    Science.gov (United States)

    Asgary, Ramin; Naderi, Ramesh; Wisnivesky, Juan

    2017-09-01

    A patient navigation model was implemented to improve breast and cervical cancer screening among women who were homeless in five shelters and shelter clinics in New York City in 2014. Navigation consisted of opt-out screening to eligible women; cancer health and screening education; scheduling and following up for screening completion, obtaining, and communicating results to patients and providers; and care coordination with social services organizations. Women (n = 162, aged 21-74, 58% black) completed mammogram (88%) and Pap testing (83%) from baselines of 59% and 50%, respectively. There was no association between mental health or substance abuse and screening completion. Adjusted analysis showed a significant association between refusing/missing Pap testing and older age (odds ratio [OR] 1.12, 95% confidence interval [CI] 1.04-1.20); independent predictors of mammogram included more pregnancies (OR 0.57, 95% CI 0.37-0.88) and older age (OR 0.84, 95% CI 0.79-0.90). Opt-out patient navigation is feasible and effective and may mitigate multilevel barriers to cancer screening among women with unstable housing.

  1. Screening of diseases associated with abnormal metabolites for ...

    African Journals Online (AJOL)

    Background: Organic acid disorders are a heterogeneous group of inborn errors of metabolism, in which organic acids accumulate in the body. They have high prevalence in Egypt because of a high rate of consanguineous marriages. Here we report our experience with the diagnostic evaluation of patients with organic ...

  2. Screening of diseases associated with abnormal metabolites for ...

    African Journals Online (AJOL)

    Dina A. Ghoraba

    2013-12-09

    Dec 9, 2013 ... Abstract Background: Organic acid disorders are a heterogeneous group of inborn errors of metabolism, in which organic acids accumulate in the body. They have high prevalence in Egypt because of a high rate of consanguineous marriages. Here we report our experience with the diagnostic evaluation of ...

  3. Breast cancer screening practices of African migrant women in Australia: a descriptive cross-sectional study.

    Science.gov (United States)

    Ogunsiji, Olayide Oluyemisi; Kwok, Cannas; Fan, Lee Chun

    2017-04-17

    Breast cancer is the most diagnosed cancer among women and a leading cause of mortality and morbidity, globally. Breast cancer mortality can be improved through routine cancer screening, yet migrant populations have lower participation rates. While African migrants are among the fastest growing migrant population in Australia, their breast cancer screening behaviour is under-studied. The aims of this study were to report breast cancer screening status of African migrant women and factors associated with their breast cancer screening behaviour in Australia. A descriptive, cross-sectional approach was utilised for this study. Two hundred and sixty four African migrant women aged 18-69 years and recruited from a number of organisations responded to a self-reported African version of the Breast Cancer Screening Beliefs Questionnaire (BCSBQ). Main research variables are breast cancer screening practices and demographic characteristics and total scores on each of the BCSBQ subscales. Multivariable logistic regression analyses were performed to investigate the impact of the demographic variables on the likelihood of women in the target age range 50-74 years having screening practices as recommended. While most of the participants heard of breast awareness (76.1%) and mammogram (85.2%), only 11.4% practised monthly breast awareness, whereas 65.9% had ever had a mammogram as frequently as recommended. Age and employment were determining factors for participating in mammogram. Significant different scores were found in the "Practical barriers" between women at the target age who had and had not performed breast awareness (80.4 versus 77.5, p-value = 0.002) and mammogram (77.1 versus 70.3, p-value = 0.009) regularly as recommended. Moreover, attitudes towards general health check-ups subscale scores were significantly higher in women who had performed clinical breast examination as frequently as recommended than those who had not. The research reveals that practical

  4. Observer variability in screen-film mammography versus full-field digital mammography with soft-copy reading

    Energy Technology Data Exchange (ETDEWEB)

    Skaane, Per; Young, Kari [Ullevaal University Hospital, Department of Radiology, Breast Imaging Center, Oslo (Norway); Diekmann, Felix; Diekmann, Susanne [University Charite, Department of Diagnostic Radiology, Berlin (Germany); Balleyguier, Corinne [Institut Gustave Roussy, Villejuif (France); Piguet, Jean-Charles [Institut Imagerive, Geneva (Switzerland); Abdelnoor, Michael [Ullevaal University Hospital, Center for Clinical Research, Section of Epidemiology and Biostatistics, Oslo (Norway); Niklason, Loren [Hologic Inc., Hillsborough, NC (United States)

    2008-06-15

    Full-field digital mammography (FFDM) with soft-copy reading is more complex than screen-film mammography (SFM) with hard-copy reading. The aim of this study was to compare inter- and intraobserver variability in SFM versus FFDM of paired mammograms from a breast cancer screening program. Six radiologists interpreted mammograms of 232 cases obtained with both techniques, including 46 cancers, 88 benign lesions, and 98 normals. Image interpretation included BI-RADS categories. A case consisted of standard two-view mammograms of one breast. Images were scored in two sessions separated by 5 weeks. Observer variability was substantial for SFM as well as for FFDM, but overall there was no significant difference between the observer variability at SFM and FFDM. Mean kappa values were lower, indicating less agreement, for microcalcifications compared with masses. The lower observer agreement for microcalcifications, and especially the low intraobserver concordance between the two imaging techniques for three readers, was noticeable. The level of observer agreement might be an indicator of radiologist performance and could confound studies designed to separate diagnostic differences between the two imaging techniques. The results of our study confirm the need for proper training for radiologists starting FFDM with soft-copy reading in breast cancer screening. (orig.)

  5. Effect of radiologist experience on the risk of false-positive results in breast cancer screening programs

    International Nuclear Information System (INIS)

    Zubizarreta Alberdi, Raquel; Llanes, Ana B.F.; Ortega, Raquel Almazan; Exposito, Ruben Roman; Collado, Jose M.V.; Oliveres, Xavier Castells; Queiro Verdes, Teresa; Natal Ramos, Carmen; Sanz, Maria Ederra; Salas Trejo, Dolores

    2011-01-01

    To evaluate the effect of radiologist experience on the risk of false-positive results in population-based breast cancer screening programmes. We evaluated 1,440,384 single-read screening mammograms, corresponding to 471,112 women aged 45-69 years participating in four Spanish programmes between 1990 and 2006. The mammograms were interpreted by 72 radiologists. The overall percentage of false-positive results was 5.85% and that for false-positives resulting in an invasive procedure was 0.38%. Both the risk of false-positives overall and of false-positives leading to an invasive procedure significantly decreased (p 14,999 mammograms with respect to the reference category (<500). The risk of both categories of false-positives was also significantly reduced (p < 0.001) as radiologists' years of experience increased: OR 0.96 and OR 0.84, respectively, for 1 year's experience and OR 0.72 and OR 0.73, respectively, for more than 4 years' experience with regard to the category of <1 year's experience. Radiologist experience is a determining factor in the risk of a false-positive result in breast cancer screening. (orig.)

  6. Age distribution of abnormal pap smear in a secondary hospital in ...

    African Journals Online (AJOL)

    Age distribution of abnormal pap smear in a secondary hospital in south-west Nigeria. ... Objective: To determine the age distribution pattern of abnormal Paps smear in women in our environment in order to have a basis for the points of entry and exit for cervical cancer screening protocol. Materials and Method: In this ...

  7. Phantom experiments and early clinical experience with a mammogram apparatus using a grid

    International Nuclear Information System (INIS)

    Schreer, I.; Demelt, M.; Wuerthner, K.

    1978-01-01

    The effect of a grid on film quality and dose was investigated in a mewly developed mammographic apparatus (Mammo Diagnost U - C.H.F. Mueller). It was shown that available film-screen combinations used with a grid produced practically the same picture quality as Definix Medical used without screen or grid. Although the dose required is almost doubled by the use of the grid, the latter, nevertheless, produces a reduction of surface dose to about a quarter (4 cm, plexiglass phantom). Using a film-screen combination not at present commercially available, there was some improvement in the demonstration of microcalcification, but the improvement resulted in an increase in the required radiation dose. (orig.) [de

  8. The performance of computer-aided detection when analyzing prior mammograms of newly detected breast cancers with special focus on the time interval from initial imaging to detection

    Energy Technology Data Exchange (ETDEWEB)

    Malich, Ansgar [Institute of Diagnostic Radiology, Suedharz-Hospital Nordhausen, Dr.-R.-Koch-Street 38, 99734 Nordhausen (Germany)], E-mail: ansgar.malich@gmx.de; Schmidt, Sabine [Institute of Diagnostic and Interventional Radiology, Friedrich-Schiller-University Jena, Bachstrasse 18, 07740 Jena (Germany); Fischer, Dorothee R. [Institute of diagnostic, interventional and pediatric Radiology, CH-3010 Bern (Switzerland); Facius, Mirjam; Kaiser, Werner A. [Institute of Diagnostic and Interventional Radiology, Friedrich-Schiller-University Jena, Bachstrasse 18, 07740 Jena (Germany)

    2009-03-15

    Purpose: The clinical role of CAD systems to detect breast cancer, which have not been on cancer containing mammograms not detected by the radiologist was proven retrospectively. Methods: All patients from 1992 to 2005 with a histologically verified malignant breast lesion and a mammogram at our department, were analyzed in retrospect focussing on the time of detection of the malignant lesion. All prior mammograms were analyzed by CAD (CADx, USA). The resulting CAD printout was matched with the cancer containing images yielding to the radiological diagnosis of breast cancer. CAD performance, sensitivity as well as the association of CAD and radiological features were analyzed. Results: 278 mammograms fulfilled the inclusion criteria. 111 cases showed a retrospectively visible lesion (71 masses, 23 single microcalcification clusters, 16 masses with microcalcifications, in one case two microcalcification clusters). 54/87 masses and 34/41 microcalcifications were detected by CAD. Detection rates varied from 9/20 (ACR 1) to 5/7 (ACR 4) (45% vs. 71%). The detection of microcalcifications was not influenced by breast tissue density. Conclusion: CAD might be useful in an earlier detection of subtle breast cancer cases, which might remain otherwise undetected.

  9. Time to definitive diagnosis of breast cancer in Latina and non-Hispanic white women: the six cities study

    OpenAIRE

    Ramirez, Amelie G; P?rez-Stable, Eliseo J; Talavera, Gregory A; Penedo, Frank J; Carrillo, J Emilio; Fernandez, Maria E; Mu?oz, Edgar; Long Parma, Dorothy; Holden, Alan EC; San Miguel de Majors, Sandra; N?poles, Anna; Casta?eda, Sheila F; Gallion, Kipling J

    2013-01-01

    Time delay after an abnormal screening mammogram may have a critical impact on tumor size, stage at diagnosis, treatment, prognosis, and survival of subsequent breast cancer. This study was undertaken to evaluate disparities between Latina and non-Hispanic white (NHW) women in time to definitive diagnosis of breast cancer after an abnormal screening mammogram, as well as factors contributing to such disparities. As part of the activities of the National Cancer Institute (NCI)-funded Redes En ...

  10. Triagem de hemoglobinopatias e avaliação da degeneração oxidativa da hemoglobina em trabalhadores portadores do traço falciforme (HbAS, expostos a riscos ocupacionais Screening of abnormal hemoglobin and the evaluation of oxidative degeneration of hemoglobin among workers with the sickle cell trait (HbAS, exposed to occupational hazards

    Directory of Open Access Journals (Sweden)

    Isaac L. Silva Filho

    2005-09-01

    Full Text Available Desde os anos 40, quando foram realizados os primeiros trabalhos de triagem para hemoglobinas anormais na população brasileira, tem sido descrita uma elevada prevalência destas em nosso meio, especialmente a hemoglobina S que, a despeito da heterogeneidade de sua distribuição geográfica, quase sempre é a mais freqüente nas diversas regiões estudadas. Aliado a este fato, estudos recentes têm demonstrado uma maior susceptibilidade desta a oxidação, tornando-a mais sensível ao estresse oxidativo que a hemoglobina normal (HbAA, mesmo em se tratando de portadores heterozigotos (HbAS. Tendo em vista que algumas substâncias químicas são comprovadamente meta-hemoglobinizantes, que alguns fatores ambientais podem influenciar na morbidade da anemia falciforme e também o pouco e controverso conhecimento de que se dispõe a respeito de portadores do traço falciforme, este estudo, além da pesquisa de hemo-globinas anormais, avaliou também a degeneração oxidativa da hemoglobina, através da pesquisa de corpos de Heinz e dosagem de meta-hemoglobina em uma população de trabalhadores portadores do traço falciforme, expostos a riscos ocupacionais. Foram triadas 2.190 amostras sangüíneas entre Outubro de 1999 e Dezembro de 2001. A população estudada foi constituída de trabalhadores de ambos os sexos com idades variando entre 18 e 76 anos. Os resultados evidenciaram 4,7% portadores de hemoglobinas anormais na população analisada, sendo que a hemoglobina S foi a mais freqüente - 3,2% (71. Trabalhadores portadores do traço falciforme apresentaram uma chance 14 vezes maior de possuírem valores aumentados de meta-hemoglobina em relação aos trabalhadores com genótipo AA, porém, esta diferença não foi estatisticamente significativa.Hemoglobinopathies are frequent hereditary diseases in Brazilian population and have been a public health problem. This study reports the screening of abnormal hemoglobin among Fiocruz`s employees, as

  11. Prenatal Diagnosis of Chromosome Abnormalities: A 13-Year Institution Experience

    Directory of Open Access Journals (Sweden)

    Carmen Comas

    2012-11-01

    Full Text Available Objective: To analyze trends in screening and invasive prenatal diagnosis of chromosome abnormalities (CA over a 13-year period and correlate them to changes in the national prenatal screening policy. Methods: We retrospectively reviewed Down syndrome (DS screening tests and fetal karyotypes obtained by prenatal invasive testing (IT in our fetal medicine unit between January 1999 and December 2011. Results: A total of 24,226 prenatal screening tests for DS and 11,045 invasive procedures have been analyzed. Over a 13-year period, utilization of non-invasive screening methods has significantly increased from 57% to 89%. The percentage of invasive procedures has declined from 49% to 12%, although the percentage of IT performed for maternal anxiety has increased from 22% to 55%. The percentage of detected CA increased from 2.5% to 5.9%. Overall, 31 invasive procedures are needed to diagnose 1 abnormal case, being 23 procedures in medical indications and 241 procedures in non-medical indications. Conclusions: Our experience on screening and invasive prenatal diagnostic practice shows a decrease of the number of IT, with a parallel decline in medical indications. There is an increasing efficiency of prenatal screening program to detect CA. Despite the increasing screening policies, our population shows a growing request for prenatal IT. The a priori low risk population shows a not negligible residual risk for relevant CA. This observation challenges the current prenatal screening strategy focused on DS; showing that the residual risk is higher than the current cut-off used to indicate an invasive technique.

  12. Effect of radiologist experience on the risk of false-positive results in breast cancer screening programs

    Energy Technology Data Exchange (ETDEWEB)

    Zubizarreta Alberdi, Raquel [Galician Breast Cancer Screening Programme, Public Health and Planning Directorate, Health Office, Galicia (Spain); Edificio Administrativo da Conselleria de Sanidade, Servicio de Programas Poboacionais de Cribado, Direccion Xeral de Saude Publica e Planificacion, Santiago de Compostela, Galicia (Spain); Llanes, Ana B.F.; Ortega, Raquel Almazan [Galician Breast Cancer Screening Programme, Public Health and Planning Directorate, Health Office, Galicia (Spain); Exposito, Ruben Roman; Collado, Jose M.V.; Oliveres, Xavier Castells [Department of Epidemiology and Evaluation, Institut Municipal d' Investigacio Medica-Parc de Salut Mar. CIBERESP, Barcelona (Spain); Queiro Verdes, Teresa [Galician Agency for Health Technology Assessment, Public Health and Planning Directorate, Health Office, Galicia (Spain); Natal Ramos, Carmen [Principality of Asturias Breast Cancer Screening Programme, Principality of Asturias (Spain); Sanz, Maria Ederra [Public Health Institute, Navarra Breast Cancer Screening Programme, Pamplona (Spain); Salas Trejo, Dolores [General Directorate Public Health and Centre for Public Health Research (CSISP), Valencia Breast Cancer Screening Programme, Valencia (Spain)

    2011-10-15

    To evaluate the effect of radiologist experience on the risk of false-positive results in population-based breast cancer screening programmes. We evaluated 1,440,384 single-read screening mammograms, corresponding to 471,112 women aged 45-69 years participating in four Spanish programmes between 1990 and 2006. The mammograms were interpreted by 72 radiologists. The overall percentage of false-positive results was 5.85% and that for false-positives resulting in an invasive procedure was 0.38%. Both the risk of false-positives overall and of false-positives leading to an invasive procedure significantly decreased (p < 0.001) with greater reading volume in the previous year: OR 0.77 and OR 0.78, respectively, for a reading volume 500-1,999 mammograms and OR 0.59 and OR 0.60 for a reading volume of >14,999 mammograms with respect to the reference category (<500). The risk of both categories of false-positives was also significantly reduced (p < 0.001) as radiologists' years of experience increased: OR 0.96 and OR 0.84, respectively, for 1 year's experience and OR 0.72 and OR 0.73, respectively, for more than 4 years' experience with regard to the category of <1 year's experience. Radiologist experience is a determining factor in the risk of a false-positive result in breast cancer screening. (orig.)

  13. Does gender discrimination impact regular mammography screening? Findings from the race differences in screening mammography study.

    Science.gov (United States)

    Dailey, Amy B; Kasl, Stanislav V; Jones, Beth A

    2008-03-01

    ABSTRACT Objective: To determine if gender discrimination, conceptualized as a negative life stressor, is a deterrent to adherence to mammography screening guidelines. African American and white women (1451) aged 40-79 years who obtained an index screening mammogram at one of five urban hospitals in Connecticut between October 1996 and January 1998 were enrolled in this study. This logistic regression analysis includes the 1229 women who completed telephone interviews at baseline and follow-up (average 29.4 months later) and for whom the study outcome, nonadherence to age-specific mammography screening guidelines, was determined. Gender discrimination was measured as lifetime experience in seven possible situations. Gender discrimination, reported by nearly 38% of the study population, was significantly associated with nonadherence to mammography guidelines in women with annual family incomes of > or =$50,000 (OR 1.99, 95% CI 1.33, 2.98) and did not differ across racial/ethnic group. Our findings suggest that gender discrimination can adversely influence regular mammography screening in some women. With nearly half of women nonadherent to screening mammography guidelines in this study and with decreasing mammography rates nationwide, it is important to address the complexity of nonadherence across subgroups of women. Life stressors, such as experiences of gender discrimination, may have considerable consequences, potentially influencing health prevention prioritization in women.

  14. Association Between Individual and Geographic Factors and Nonadherence to Mammography Screening Guidelines

    Science.gov (United States)

    McDonald, Kaila; Sherman, Recinda; Kinney, Anita Y; Stroup, Antoinette M

    2014-01-01

    Abstract Background: This study investigates factors that are associated with nonadherence to mammography screening guidelines in Utah, a state where mammography screening rates have remained consistently lower than national averages. Methods: We examined data on reported mammography use among women aged 40–74 years from the 2008 and 2010 Utah Behavioral Risk Factor Surveillance System (n=5,197, weighted n=417,064). Logistic regression models were used to estimate the effects of individual-level and geographic (travel time to nearest mammography facility, geographic accessibility, and rural/urban residence) factors on the odds of a woman not reporting receiving a mammogram in the last 2 years. Results: In 2008 and 2010, a disproportionate number of women aged 40–49 (43.1%, 95% confidence interval [CI] 39.9%–46.3%) reported not receiving a mammogram within the last 2 years compared to women 50–74 (26.8%, 95% CI 24.9%–28.7%). None of the geographic factors were significant predictors of screening adherence. Based on covariate adjusted models, statistically significant (pMammography screening efforts in Utah should focus on improving access to insurance or a regular source of health care. Future research should also consider how best to address extreme time demands and competing priorities that present potential barriers for women with large families, resulting in lower screening levels among these women. PMID:24865409

  15. SU-E-I-59: Investigation of the Usefulness of a Standard Deviation and Mammary Gland Density as Indexes for Mammogram Classification.

    Science.gov (United States)

    Takarabe, S; Yabuuchi, H; Morishita, J

    2012-06-01

    To investigate the usefulness of the standard deviation of pixel values in a whole mammary glands region and the percentage of a high- density mammary glands region to a whole mammary glands region as features for classification of mammograms into four categories based on the ACR BI-RADS breast composition. We used 36 digital mediolateral oblique view mammograms (18 patients) approved by our IRB. These images were classified into the four categories of breast compositions by an experienced breast radiologist and the results of the classification were regarded as a gold standard. First, a whole mammary region in a breast was divided into two regions such as a high-density mammary glands region and a low/iso-density mammary glands region by using a threshold value that was obtained from the pixel values corresponding to a pectoral muscle region. Then the percentage of a high-density mammary glands region to a whole mammary glands region was calculated. In addition, as a new method, the standard deviation of pixel values in a whole mammary glands region was calculated as an index based on the intermingling of mammary glands and fats. Finally, all mammograms were classified by using the combination of the percentage of a high-density mammary glands region and the standard deviation of each image. The agreement rates of the classification between our proposed method and gold standard was 86% (31/36). This result signified that our method has the potential to classify mammograms. The combination of the standard deviation of pixel values in a whole mammary glands region and the percentage of a high-density mammary glands region to a whole mammary glands region was available as features to classify mammograms based on the ACR BI- RADS breast composition. © 2012 American Association of Physicists in Medicine.

  16. Breast and cervical cancer screening disparities associated with disability severity.

    Science.gov (United States)

    Horner-Johnson, Willi; Dobbertin, Konrad; Andresen, Elena M; Iezzoni, Lisa I

    2014-01-01

    Prior research has noted disparities between women with and without disabilities in receipt of timely screening for breast and cervical cancer. Some studies suggest greater disparities for women with more severe disabilities, but the research to date has yielded inconsistent findings. Our purpose was to further examine differences in receipt of breast and cervical cancer screening in relation to severity of disability. We analyzed Medical Expenditure Panel Survey annual data files from 2002 to 2008. Logistic regression analyses examined whether Pap smears and mammograms had been received within the recommended timeframe according to U.S. Preventive Services Task Force Guidelines. We compared four groups of women aged 18 to 64 years, categorized by presence and complexity of disability: 1) No limitations, 2) basic action difficulties only, 3) complex activity limitations only, and 4) both basic and complex activity limitations. Women both with and without disabilities fell short of Healthy People 2020 goals for breast and cervical cancer screening. Overall, women with disabilities were less likely to be up to date with both mammograms and Pap tests. The magnitude of disparities was greater for women with complex limitations. Disparities in Pap testing, but not mammography, remained significant when controlling for demographic, geographic, and socioeconomic factors. Women with more complex or severe disability were less likely to be up to date with breast and cervical cancer screenings. Targeted efforts are needed to reduce barriers to breast and cervical cancer screening for women with significant disabilities, especially those who also experience other socioecological disadvantages. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  17. Utilisation of cancer screening services by disabled women in Chile.

    Science.gov (United States)

    Sakellariou, Dikaios; Rotarou, Elena S

    2017-01-01

    Research has shown that women with disabilities face additional challenges in accessing and using healthcare services compared to non-disabled women. However, relatively little is known about the utilisation of cancer screening services for women with disabilities. This study addresses this gap by examining the utilisation of the Papanicolaou test and mammography for disabled women in Chile. We used cross-sectional data, taken from a 2015 nationally-representative survey. Initially, we employed logistic regressions to test for differences in utilisation rates for the Papanicolaou test (66,281 observations) and the mammogram (35,294 observations) between disabled and non-disabled women. Next, logistic regressions were used to investigate the demographic, socioeconomic, and health-related factors affecting utilisation rates for cancer screening services for disabled women (sample sizes: 5,823 observations for the Papanicolaou test and 5,731 observations for the mammogram). Disabled women were less likely to undergo screening tests than non-disabled women. For the Papanicolaou test and mammography, the multivariable regression models showed that living in rural areas, having higher education, being affiliated with a private health insurance company, giving a good health self-assessment score, and being under medical treatment for other illnesses were associated with higher utilisation rates. On the other hand, being single, inactive with regard to employment, and having a better income were linked with lower utilisation. While utilisation rates for both disabled and non-disabled women have increased since 2006, the utilisation disparity has slightly increased. This study shows the influence of various factors in the utilisation rates of preventive cancer screening services for disabled women. To develop effective initiatives targeting inequalities in the utilisation of cancer screening tests, it is important to move beyond an exclusively single-disease approach and

  18. Somatosensory abnormalities in knee OA.

    Science.gov (United States)

    Wylde, Vikki; Palmer, Shea; Learmonth, Ian D; Dieppe, Paul

    2012-03-01

    The aim of this study was to use quantitative sensory testing (QST) to explore the range and prevalence of somatosensory abnormalities demonstrated by patients with advanced knee OA. One hundred and seven knee OA patients and 50 age- and sex-matched healthy participants attended a 1-h QST session. Testing was performed on the medial side of the knee and the pain-free forearm. Light-touch thresholds were assessed using von Frey filaments, pressure pain thresholds using a digital pressure algometer, and thermal sensation and pain thresholds using a Thermotest MSA. Significant differences in median threshold values from knee OA patients and healthy participants were identified using Mann-Whitney U-tests. The z-score transformations were used to determine the prevalence of the different somatosensory abnormalities in knee OA patients. Testing identified 70% of knee OA patients as having at least one somatosensory abnormality. Comparison of median threshold values between knee OA patients and healthy participants revealed that patients had localized thermal and tactile hypoaesthesia and pressure hyperalgesia at the osteoarthritic knee. Tactile hypoaesthesia and pressure hyperalgesia were also present at the pain-free forearm. The most prevalent somatosensory abnormalities were tactile hypoaesthesia and pressure hyperalgesia, evident in between 20 and 34% of patients. This study found that OA patients demonstrate an array of somatosensory abnormalities, of which the most prevalent were tactile hypoaesthesia and pressure hyperalgesia. Further research is now needed to establish the clinical implications of these somatosensory abnormalities.

  19. CANCER SCREENING AWARENESS AMONG NURSING STAFF IN GOVERNMENT MEDICAL COLLEGE: A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Mukesh Shanthilal

    2016-07-01

    Full Text Available BACKGROUND Cervical and breast cancers are the common malignancies among female population in India. Though there are approved screening methods available to prevent and detect these cancers at an early stage, there is a lack of awareness about cancer screening among general public as well as the health care professionals. This study is aimed to identify the knowledge, attitude and practice (KAP among the nursing staff regarding cancer screening in these two diseases. METHOD A cross-sectional interview based survey was conducted among 303 female nursing staff working in a government medical college hospital from November 2015 to December 2015. Ethical committee approval was taken. Verbal informed consent was sought from the study subjects. Nursing staff who gave consent to participate in the study were enrolled. There were no specific inclusion or exclusion criteria for the study subjects. A structured pretested questionnaire regarding knowledge, attitude and practice (KAP was used to collect the data. The questions were open-ended. Recall and recognition type of questions were used. The data was entered into MS Excel worksheet and analysed using descriptive statistics. RESULTS Total of 303 nurses included in the study. The age ranged from 21 to 64 years. Median age is 38 years. Only 24.4% (74/303 of Nurses were aware of cancer screening and many of them were aware of Pap smear (55.1%, 167/303 and mammogram (66.3%, 201/303 as investigational tools in diagnosing cancer. Only 17 out of 303 (5.6% nurses had Pap smear test done with an average of 1.23% Pap smear per individual. Mammogram screening was done in 13% (15/115 of the eligible nurses with an average of 1.2% mammogram per individual. The most common reason for not undergoing screening as expressed was they did not feel the need to be screened unless they were symptomatic (55%, they are too young for screening (14.8%, shyness (11.1%, fear (11.1% and lack of time (7.4%. However, 90% of them

  20. ECG abnormalities in patients with chronic kidney disease

    International Nuclear Information System (INIS)

    Shafi, S.; Saleem, M.; Anjum, R.; Abdullah, W.; Shafi, T.

    2017-01-01

    Chronic kidney disease (CKD) is associated with increased risk of cardiovascular disease. Electrocardiographic (ECG) abnormalities are common in CKD patients. However, there is variation in literature regarding frequency of ECG abnormalities in CKD patients and limited information in local population. Methods: The study design was cross-sectional in nature. All patients between ages of 20-80 years with CKD not previously on renal replacement therapy who were admitted to nephrology ward at a tertiary care facility over a 6-month period were included. All patients underwent 12 lead electrocardiograms (ECG). ECG abnormalities were defined based on accepted standard criteria. Results: Total number of patients included in the study was 124. Mean age of all patients was 49.9+-13.8 years, 106 (84.8%) had hypertension, 84 (70%) had diabetes mellitus, and 35 (29.9%) had known cardiovascular disease. Mean serum creatinine was 7.2+-3.4 mg/dl, mean eGFR was 10.6+-9.2 ml/min/1.73 m/sup 2/. Overall 78.4% of all CKD patients have one or more ECG abnormality. Left ventricular hypertrophy (40%), Q waves (27.2%), ST segment elevation or depression (23.4%), prolonged QRS duration (19.2%), tachycardia (17.6%) and left and right atrial enlargement (17.6%) were the most common abnormalities. Conclusion: ECG abnormalities are common in hospitalized CKD patients in local population. All hospitalized CKD patients should undergo ECG to screen for cardiovascular disease. (author)

  1. Mapping 3D breast lesions from full-field digital mammograms using subject-specific finite element models

    Science.gov (United States)

    García, E.; Oliver, A.; Diaz, O.; Diez, Y.; Gubern-Mérida, A.; Martí, R.; Martí, J.

    2017-03-01

    Patient-specific finite element (FE) models of the breast have received increasing attention due to the potential capability of fusing images from different modalities. During the Magnetic Resonance Imaging (MRI) to X-ray mammography registration procedure, the FE model is compressed mimicking the mammographic acquisition. Subsequently, suspicious lesions in the MRI volume can be projected into the 2D mammographic space. However, most registration algorithms do not provide the reverse information, avoiding to obtain the 3D geometrical information from the lesions localized in the mammograms. In this work we introduce a fast method to localize the 3D position of the lesion within the MRI, using both cranio-caudal (CC) and medio-lateral oblique (MLO) mammographic projections, indexing the tetrahedral elements of the biomechanical model by means of an uniform grid. For each marked lesion in the Full-Field Digital Mammogram (FFDM), the X-ray path from source to the marker is calculated. Barycentric coordinates are computed in the tetrahedrons traversed by the ray. The list of elements and coordinates allows to localize two curves within the MRI and the closest point between both curves is taken as the 3D position of the lesion. The registration errors obtained in the mammographic space are 9.89 +/- 3.72 mm in CC- and 8.04 +/- 4.68 mm in MLO-projection and the error in the 3D MRI space is equal to 10.29 +/- 3.99 mm. Regarding the uniform grid, it is computed spending between 0.1 and 0.7 seconds. The average time spent to compute the 3D location of a lesion is about 8 ms.

  2. Inter-Rater Reliability for Speech-Language Therapists' Judgement of Oesophageal Abnormality during Oesophageal Visualization

    Science.gov (United States)

    Miles, Anna

    2017-01-01

    Background: Oesophageal abnormalities are common findings in a speech-language therapy videofluoroscopy clinic. Fluoroscopic screening involving oropharynx alone fails to identify these patients. Oesophageal screening as an adjunct to videofluoroscopy is gaining popularity. Yet currently, little is known about the reliability of speech and…

  3. Cancer Screening: How Do Screening Tests Become Standard Tests?

    Science.gov (United States)

    ... Colonoscopy for colorectal cancer . Mammograms for breast cancer . Pap tests (Pap smears) for cervical cancer . Different types of ... follow a group of women who have regular Pap tests, and divide them into those who test positive ...

  4. Predictors of Participation in Mammography Screening among non-Hispanic Black, non-Hispanic White, and Hispanic Women

    Directory of Open Access Journals (Sweden)

    Cathy Melvin

    2016-09-01

    Full Text Available Introduction: Many factors influence women’s decisions to participate in guideline recommended screening mammography. We evaluated the influence of women’s socioeconomic characteristics, healthcare access, and cultural and psychological healthcare preferences on timely mammography screening participation.Materials and methods: A random digit dial survey of United States non-Hispanic Black, non-Hispanic White, and Hispanic women ages 40-75, from January-August 2009 determined self- reported time of most recent mammogram. Screening rates were assessed based on receipt of a screening mammogram within the prior 12 months, the interval recommended at the time by the American Cancer Society.Results: Thirty-nine percent of women reported not having a mammogram within the last 12 months. The odds of not having had a screening mammography was higher for non-Hispanic White women than for non-Hispanic Black (OR=2.16, 95% CI=0.26, 0.82, p=0.009 or Hispanic (OR=4.17, 95% CI=0.12, 0.48, p=0.01 women. Lack of health insurance (OR=3.22, 95% CI=1.54, 6.73, p=0.002 and lack of usual source of medical care (OR=3.37, 95% CI=1.43, 7.94, p=0.01 were associated with not being screened as were lower self-efficacy to obtain screening (OR=2.43, 95% CI=1.26, 4.73, p=0.01 and greater levels of religiosity and spirituality (OR=1.42, 95% CI=1.00, 2.00, p=0.05. Neither perceived risk nor present temporal orientation was significant.Discussion: Odds of not having a mammogram increased if women were uninsured, without medical care, non-Hispanic white, older in age, not confident in their ability to obtain screening, or held passive or external religious/spiritual values. Results are encouraging given racial disparities in healthcare participation and suggest that efforts to increase screening among minority women may be working.

  5. Associations Between Religion-Related Factors and Breast Cancer Screening Among American Muslims

    Science.gov (United States)

    Padela, Aasim I.; Murrar, Sohad; Adviento, Brigid; Liao, Chuanhong; Hosseinian, Zahra; Peek, Monica; Curlin, Farr

    2015-01-01

    American Muslims have low rates of mammography utilization, and research suggests that religious values influence their health-seeking behaviors. We assessed associations between religion-related factors and breast cancer screening in this population. A diverse group of Muslim women were recruited from mosques and Muslim organization sites in Greater Chicago to self-administer a survey incorporating measures of fatalism, religiosity, discrimination, and Islamic modesty. 254 surveys were collected of which 240 met age inclusion criteria (40 years of age or older). Of the 240, 72 respondents were Arab, 71 South Asian, 59 African American, and 38 identified with another ethnicity. 77 % of respondents had at least one mammogram in their lifetime, yet 37 % had not obtained mammography within the past 2 years. In multivariate models, positive religious coping, and perceived religious discrimination in healthcare were negatively associated with having a mammogram in the past 2 years, while having a PCP was positively associated. Ever having a mammogram was positively associated with increasing age and years of US residency, and knowing someone with breast cancer. Promoting biennial mammography among American Muslims may require addressing ideas about religious coping and combating perceived religious discrimination through tailored interventions. PMID:24700026

  6. Breast cancer screening among homeless women of New York City shelter-based clinics.

    Science.gov (United States)

    Asgary, Ramin; Garland, Victoria; Sckell, Blanca

    2014-01-01

    Millions of Americans experience homelessness annually. Data on breast cancer screening among homeless women is extremely limited. We performed a retrospective study evaluating 100 female patients 50 to 74 years old with at least three visits to two major New York City shelter-based clinics between 2010 and 2012 to evaluate and compare rates and predictors of mammograms in homeless and low-income domicile patients. Of those we included, 44% were homeless with majority Black and Hispanic. Mean age was 59.28 (±5.84) years. The majority were insured, with 44% smokers and 87% with chronic illnesses. Rates of mammogram within past 2 years were 59% in homeless and 57.1% in low-income domicile patients; 53% did not know the results of their mammogram. Homeless and domicile patients received equal provider counseling. Homeless women were more likely to be uninsured (p homelessness. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  7. An opportunity to address modifiable breast cancer risks: Mammography screening and physical activity readiness to change

    Directory of Open Access Journals (Sweden)

    Maria D. Thomson, PhD

    2017-03-01

    Full Text Available Breast cancer risk is significantly reduced by improvements in lifestyle factors such as physical activity. Previous work suggests personal experiences such as false positive mammography or family history of breast cancer may influence these health behaviors. Surveys were distributed to women aged 40–75 who had received a negative mammogram from an academic hospital in Virginia in 2015. Measures assessed breast cancer worry and perceived risk, awareness of cancer risk factors, family history of breast cancer, false positive mammography experience, and readiness to change physical activity. Surveys were collected from 106 women. The regression for readiness to change physical activity was significant, F(7, 91 = 3.7, p = 0.001, R2 = 0.22. Physical activity readiness to change was positively associated with income (p = 0.034 and receipt of a false positive mammogram (p = 0.045. African American women (p = 0.031 and women with family history of breast cancer (p = 0.027 reported lower readiness to change physical activity. Results support previous qualitative work suggesting the receipt of a false positive mammogram may stimulate motivation to increase physical activity. Mammography screening may serve as a strategic opportunity to target modifiable breast cancer risk factors at a time when women are highly receptive to a lifestyle change intervention.

  8. Thermography is not a feasible method for breast cancer screening.

    Science.gov (United States)

    Brkljacić, Boris; Miletić, Damir; Sardanelli, Francesco

    2013-06-01

    Breast cancer is a common malignancy causing high mortality in women especially in developed countries. Due to the contribution of mammographic screening and improvements in therapy, the mortality rate from breast cancer has decreased considerably. An imaging-based early detection of breast cancer improves the treatment outcome. Mammography is generally established not only as diagnostic but also as screening tool, while breast ultrasound plays a major role in the diagnostic setting in distinguishing solid lesions from cysts and in guiding tissue sampling. Several indications are established for contrast-enhanced magnetic resonance imaging. Thermography was not validated as a screening tool and the only study performed long ago for evaluating this technology in the screening setting demonstrated very poor results. The conclusion that thermography might be feasible for screening cannot be derived from studies with small sample size, unclear selection of patients, and in which mammography and thermography were not blindly compared as screening modalities. Thermography can not be used to aspirate, biopsy or localize lesions preoperatively since no method so far was described to accurately transpose the thermographic location of the lesion to the mammogram or ultrasound and to surgical specimen. Thermography cannot be proclaimed as a screening method, without any evidence whatsoever.

  9. Cancer Screening

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    Krishna Prasad

    2004-10-01

    Full Text Available Cancer screening is a means to detect cancer early with the goal of decreasing morbidity and mortality. At present, there is a reasonable consensus regarding screening for breast, cervical and colorectal cances and the role of screening is under trial in case of cancers of the lung,  ovaries and prostate. On the other hand, good screening tests are not available for some of the commonest cancers in India like the oral, pharyngeal, esophageal and stomach cancers.

  10. Prevalence and characteristics of abnormal Papanicolaou smear in Central Saudi Arabia.

    Science.gov (United States)

    Al-Kadri, Hanan M; Kamal, Mehak; Bamuhair, Samira S; Omair, Aamir A; Bamefleh, Hana S

    2015-01-01

    To assess the prevalence and characteristics of abnormal pap smear in the central region of Saudi Arabia. In this retrospective case control study conducted in the Departments of Obstetrics and Gynecology, and Histopathology at King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia, all pap smears screened for Saudi women between 2008 and 2011 were reviewed. Approximately 5000 pap smears are screened annually at King Abdulaziz Medical City utilizing the Bethesda III System (2001). All abnormal smears patients' data were collected and compared to the data of randomly selected 200 normal smears' patients. Abnormal pap smear prevalence was found to be 4.3% (841/19,650 Saudi patients were found with atypical epithelial cells abnormalities). Its prevalence in the years 2008 was 5.7%, 2009 was 4.9%, 2010 was 4.2%, and 2011 was 2.5%. Abnormal smear patients have lower parity (p=0.001), and were less likely to use intra-uterine devices (p=0.03) compared with normal smear patients. Presence of abnormal cervical appearance was associated with increased epithelial cell abnormalities (p=0.045). The only positive history that has characterized patients with epithelial cell abnormalities was their previous history of abnormal pap smear (p=0.001). Squamous cell abnormalities were identified in 91% of the patients (767/841), and glandular cell abnormalities were identified in 9% of the patients (74/841). Prevalence of abnormal pap smears in central Saudi Arabia is relatively low, while advanced glandular abnormalities prevalence was observed to be high. 

  11. Neuroimaging abnormalities in Griscelli's disease

    International Nuclear Information System (INIS)

    Sarper, Nazan; Akansel, Guer; Aydogan, Metin; Gedikbasi, Demet; Babaoglu, Kadir; Goekalp, Ayse Sevim

    2002-01-01

    Griscelli's disease is a rare autosomal recessive immunodeficiency syndrome. We report a 7-1/2-month-old white girl who presented with this syndrome, but initially without neurological abnormalities. Initial CT of the brain was normal. Despite haematological remission with chemotherapy, she developed neurological symptoms, progressing to coma. At this time, CT showed areas of coarse calcification in the globi pallidi, left parietal white matter and left brachium pontis. Hypodense areas were present in the genu and posterior limb of the internal capsule on the right side, as well as posterior aspects of both thalami, together with minimal generalised atrophy. MRI revealed areas of increased T2 signal and a focal area of abnormal enhancement in the subcortical white matter. Griscelli's disease should be added to the list of acquired neuroimaging abnormalities in infants. (orig.)

  12. Caregiving associated with selected cancer risk behaviors and screening utilization among women: cross-sectional results of the 2009 BRFSS

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    Reeves Katherine W

    2012-08-01

    Full Text Available Abstract Background Informal caregiving is increasingly common as the U.S. population ages, and there is concern that caregivers are less likely than non-caregivers to practice health-promoting behaviors, including cancer screening. We examined caregiving effects on cancer risk behaviors and breast and cervical cancer screening in the 2009 Behavioral Risk Factor Surveillance System. Methods Women age ≥41 with data on breast and cervical cancer screening were included (weighted frequency 3,478,000 women. Cancer screening was classified according to American Cancer Society guidelines. We evaluated the association of caregiving with cancer risk behaviors (obesity, physical activity, alcohol intake, smoking status, and fruit/vegetable consumption and cancer screening (mammography, clinical breast exam [CBE], and Pap test using logistic regression overall and with stratification on age ( Results Caregivers had greater odds of being obese, physically active, and current smokers. Subgroup analyses revealed that caregiving was associated with obesity in younger women and whites, and with less obesity in older women. Also, caregiving was associated with smoking only among younger women and non-whites. Caregivers had greater odds of ever having had a mammogram or CBE, yet there was no association with mammogram, CBE, or Pap test within guidelines. Conclusions Caregiving was associated with some health behaviors that increase cancer risk, yet not with cancer screening within guidelines. Effects of caregiving by age and race require confirmation by additional studies.

  13. Prevalence and distribution of congenital abnormalities in Turkey: differences between the prenatal and postnatal periods.

    Science.gov (United States)

    Oztarhan, Kazim; Gedikbasi, Ali; Yildirim, Dogukan; Arslan, Oguz; Adal, Erdal; Kavuncuoglu, Sultan; Ozbek, Sibel; Ceylan, Yavuz

    2010-12-01

    The aim of this study was to determine the distribution of cases associated with congenital abnormalities during the following three periods: pregnancy, birth, and the neonatal period. This was a retrospective study of cases between 2002 and 2006. All abnormal pregnancies, elective terminations of pregnancies, stillbirths, and births with congenital abnormalities managed in the Neonatology Unit were classified based on the above distribution scheme. During the 5-year study period, 1906 cases with congenital abnormalities were recruited, as follows: 640 prenatally detected and terminated cases, with most abnormalities related to the central nervous system, chromosomes, and urogenital system (56.7%, 12.7%, and 8.9%, respectively); 712 neonates with congenital abnormalities (congenital heart disease [49.2%], central nervous system abnormalities [14.7%], and urogenital system abnormalities [12.9%]); and hospital stillbirths, of which 34.2% had malformations (220 prenatal cases [34.4%] had multiple abnormalities, whereas 188 liveborn cases [26.4%] had multiple abnormalities). The congenital abnormalities rate between 2002 and 2006 was 2.07%. Systematic screening for fetal anomalies is the primary means for identification of affected pregnancies. © 2010 The Authors. Congenital Anomalies © 2010 Japanese Teratology Society.

  14. Increase in perceived case suspiciousness due to local contrast optimisation in digital screening mammography

    International Nuclear Information System (INIS)

    Visser, Roelant; Schuur, Klaas H.; Veldkamp, Wouter J.H.; Bun, Petra A.M.; Beijerinck, David; Deurenberg, Jan J.M.; Imhof-Tas, Mechli W.; Snoeren, Miranda M.; Karssemeijer, Nico; Heeten, Gerard J. den; Broeders, Mireille J.M.

    2012-01-01

    To determine the influence of local contrast optimisation on diagnostic accuracy and perceived suspiciousness of digital screening mammograms. Data were collected from a screening region in the Netherlands and consisted of 263 digital screening cases (153 recalled,110 normal). Each case was available twice, once processed with a tissue equalisation (TE) algorithm and once with local contrast optimisation (PV). All cases had digitised previous mammograms. For both algorithms, the probability of malignancy of each finding was scored independently by six screening radiologists. Perceived case suspiciousness was defined as the highest probability of malignancy of all findings of a radiologist within a case. Differences in diagnostic accuracy of the processing algorithms were analysed by comparing the areas under the receiver operating characteristic curves (A z ). Differences in perceived case suspiciousness were analysed using sign tests. There was no significant difference in A z (TE: 0.909, PV 0.917, P = 0.46). For all radiologists, perceived case suspiciousness using PV was higher than using TE more often than vice versa (ratio: 1.14-2.12). This was significant (P <0.0083) for four radiologists. Optimisation of local c