The Experts below are selected from a list of 1929 Experts worldwide ranked by ideXlab platform
Constance D Lehman - One of the best experts on this subject based on the ideXlab platform.
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Breast cancer screening with Digital Breast Tomosynthesis are initial benefits sustained
Radiology, 2020Co-Authors: Manisha Bahl, Anne Marie Mccarthy, Sarah F Mercaldo, Pragya A Dang, Kathryn P Lowry, Constance D LehmanAbstract:The benefits of reduced false-positive examinations and higher specificity with screening Digital Breast Tomosynthesis were sustained after the first screening round.
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comparison of upright Digital Breast Tomosynthesis guided versus prone stereotactic vacuum assisted Breast biopsy
Radiology, 2019Co-Authors: Manisha Bahl, Mary Maunglay, Helen Anne Dalessandro, Constance D LehmanAbstract:Purpose To compare the performance of upright Digital Breast Tomosynthesis (DBT)-guided vacuum-assisted Breast biopsy (VABB) with that of prone stereotactic (PS) VABB. Materials and Methods This retrospective review involved consecutive patients who underwent PS VABB from August 2014 to December 2015 and upright DBT-guided VABB from February 2016 to June 2017. Tissue sampling methods were the same for PS and DBT-guided biopsies. Wilcoxon and Pearson χ2 tests were used to compare the groups. Results During the study period, 439 PS VABBs in 408 patients (mean age, 56.5 years; age range, 32-84 years) and 706 DBT-guided VABBs in 682 patients (mean age, 57.9 years; age range, 23-90 years) were recommended. Technical success was achieved for more lesions with DBT-guided VABB versus PS VABB (99.3% [695 of 700] vs 95.1% [410 of 431], respectively; P < .001). Mean procedure time was shorter with DBT-guided VABB versus PS VABB (12 vs 27 minutes, respectively; P < .001), and fewer exposures were acquired with DBT-guided VABB versus PS VABB (three vs 12, respectively; P < .001). A higher percentage of lesions for which DBT-guided VABB was performed were noncalcified lesions (eg, architectural distortion, asymmetry, and mass) than for PS VABB (29.2% [203 of 695] vs 3.4% [14 of 410], respectively; P < .001). There were no differences in the distribution of histologic results (P = .42). No major complications were observed in either group. Conclusion Upright Digital Breast Tomosynthesis-guided vacuum-assisted Breast biopsy has a higher rate of technical success than does prone stereotactic vacuum-assisted biopsy and can be performed in less than half the time and with one-fourth of the exposures. In addition, more architectural distortions and asymmetries are amenable to biopsy with Digital Breast Tomosynthesis-guided vacuum-assisted Breast biopsy. © RSNA, 2018.
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the effect of Digital Breast Tomosynthesis adoption on facility level Breast cancer screening volume
American Journal of Roentgenology, 2018Co-Authors: Christoph I Lee, Constance D Lehman, Karla Kerlikowske, Louise M Henderson, Tracy Onega, Weiwei Zhu, Jessica C Germino, Ellen S Omeara, J Haas, Brian L SpragueAbstract:OBJECTIVE. The purpose of this study was to determine whether Digital Breast Tomosynthesis (DBT) adoption was associated with a decrease in screening mammography capacity across Breast Cancer Scree...
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Breast cancer characteristics associated with 2d Digital mammography versus Digital Breast Tomosynthesis for screening detected and interval cancers
Radiology, 2017Co-Authors: Manisha Bahl, Anne Marie Mccarthy, Pragya A Dang, Kathryn P Lowry, Shannon Gaffney, Constance D LehmanAbstract:The overall rates of screening-detected and interval cancers are similar with Digital mammography (DM) and Digital Breast Tomosynthesis (DBT), but a higher proportion of screening-detected cancers are invasive rather than in situ at DBT compared with DM.
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Digital Breast Tomosynthesis and the challenges of implementing an emerging Breast cancer screening technology into clinical practice
Journal of The American College of Radiology, 2013Co-Authors: Constance D Lehman, Christoph I LeeAbstract:Emerging imaging technologies, including Digital Breast Tomosynthesis, have the potential to transform Breast cancer screening. However, the rapid adoption of these new technologies outpaces the evidence of their clinical and cost-effectiveness. The authors describe the forces driving the rapid diffusion of Tomosynthesis into clinical practice, comparing it with the rapid diffusion of Digital mammography shortly after its introduction. They outline the potential positive and negative effects that adoption can have on imaging workflow and describe the practice management challenges when incorporating Tomosynthesis. The authors also provide recommendations for collecting evidence supporting the development of policies and best practices.
Emily F. Conant - One of the best experts on this subject based on the ideXlab platform.
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five consecutive years of screening with Digital Breast Tomosynthesis outcomes by screening year and round
Radiology, 2020Co-Authors: Emily F. Conant, Elizabeth S Mcdonald, Susan P Weinstein, Katrina E Korhonen, Samantha P Zuckerman, J A Birnbaum, J D Tobey, Rebecca A HubbardAbstract:The sensitivity of Digital Breast Tomosynthesis (DBT) was higher than that of Digital mammography (DM) in each of the first 5 years after implementation of DBT. DBT also helped detect a higher prop...
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Digital Breast Tomosynthesis concepts and clinical practice
Radiology, 2019Co-Authors: Alice Chong, Elizabeth S Mcdonald, Susan P Weinstein, Emily F. ConantAbstract:Digital Breast Tomosynthesis (DBT) is emerging as the standard of care for Breast imaging based on improvements in both screening and diagnostic imaging outcomes. The additional information obtained from the Tomosynthesis acquisition decreases the confounding effect of overlapping tissue, allowing for improved lesion detection, characterization, and localization. In addition, the quasi three-dimensional information obtained from the reconstructed DBT data set allows a more efficient imaging work-up than imaging with two-dimensional full-field Digital mammography alone. Herein, the authors review the benefits of DBT imaging in screening and diagnostic Breast imaging.
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Breast cancer conspicuity on simultaneously acquired Digital mammographic images versus Digital Breast Tomosynthesis images
Radiology, 2019Co-Authors: Katrina E Korhonen, Emily F. Conant, Elizabeth S Mcdonald, Marie Synnestvedt, Eric A Cohen, Susan P WeinsteinAbstract:For cancers visible at only one mammographic view, they are more often seen at the craniocaudal view than the mediolateral oblique view for both Digital mammography and Digital Breast Tomosynthesis.
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strategies to increase cancer detection review of true positive and false negative results at Digital Breast Tomosynthesis screening
Radiographics, 2016Co-Authors: Katrina E Korhonen, Susan P Weinstein, Elizabeth S Mcdonald, Emily F. ConantAbstract:Although Digital Breast Tomosynthesis improves Breast cancer detection, it is critical for radiologists to be cognizant of differences in cancer conspicuity both within the modality itself and between mammographic views; understanding differences in lesion conspicuity and learning strategies to reduce diagnostic errors can help readers improve the clinical outcomes of imaging with DBT.
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baseline screening mammography performance of full field Digital mammography versus Digital Breast Tomosynthesis
American Journal of Roentgenology, 2015Co-Authors: Elizabeth S Mcdonald, Mitchell D. Schnall, Anne Marie Mccarthy, Amana L Akhtar, Marie Synnestvedt, Emily F. ConantAbstract:OBJECTIVE. Baseline mammography studies have significantly higher recall rates than mammography studies with available comparison examinations. Digital Breast Tomosynthesis reduces recalls when compared with Digital mammographic screening alone, but many sites operate in a hybrid environment. To maximize the effect of screening Digital Breast Tomosynthesis with limited resources, choosing which patient populations will benefit most is critical. This study evaluates Digital Breast Tomosynthesis in the baseline screening population. MATERIALS AND METHODS. Outcomes were compared for 10,728 women who underwent Digital mammography screening, including 1204 (11.2%) baseline studies, and 15,571 women who underwent Digital Breast Tomosynthesis screening, including 1859 (11.9%) baseline studies. Recall rates, cancer detection rates, and positive predictive values were calculated. Logistic regression estimated the odds ratios of recall for Digital mammography versus Digital Breast Tomosynthesis for patients undergo...
Manisha Bahl - One of the best experts on this subject based on the ideXlab platform.
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impact of Digital Breast Tomosynthesis dbt on finding types leading to true positive and false positive examinations
Clinical Imaging, 2021Co-Authors: Geunwon Kim, Sarah F Mercaldo, Manisha BahlAbstract:Abstract Purpose To investigate the frequencies of finding types with combined Digital Breast Tomosynthesis (DBT) and Digital mammography (DM) leading to true-positive (TP) and false-positive (FP) examinations. Materials and methods Consecutive screening mammograms at an academic medical center from March 2008 to February 2011 (DM group) and from January 2013 to December 2017 (DBT/DM group) were retrospectively reviewed. Multivariable logistic regression models were used to compare the proportions of mammographic finding types leading to TP and FP examinations between the two groups. Results The DM group had 554 TP and 7278 FP examinations, and the DBT/DM group had 1271 TP and 14,544 FP examinations. The finding type of calcifications led to a lower proportion of TP examinations in the DBT/DM than DM group (34.3% versus 47.7%, p Conclusions Mammographic findings leading to TP and FP examinations have shifted with the addition of DBT to DM.
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ductal carcinoma in situ on Digital mammography versus Digital Breast Tomosynthesis rates and predictors of pathologic upgrade
European Radiology, 2020Co-Authors: Geunwon Kim, Peter G Mikhael, Tawakalitu O Oseni, Manisha BahlAbstract:To compare upgrade rates of ductal carcinoma in situ (DCIS) on Digital mammography (DM) versus Digital Breast Tomosynthesis (DBT) and identify patient, imaging, and pathological features associated with upgrade risk. A retrospective review was performed of 318 women (mean 59 years, range 37–89) with screening-detected DCIS from 2007 to 2011 (DM group) and from 2013 to 2016 (DBT group). Comparisons made between DM and DBT groups using the unpaired t test and chi-square test include detection rates of DCIS, upgrade rates to invasive cancer, and pathological features of DCIS and upgraded cases. Patient, imaging, and pathological features associated with upgrade were also determined. P values < 0.05 were considered significant. There was no significant difference in detection rates of DCIS between DM and DBT groups (0.9 versus 1.0 per 1000 examinations, p = 0.45). Upgrade rates of DCIS to invasive cancer in DM and DBT groups were similar (17.3% versus 16.8%, p = 0.90), despite significant differences in pathological features of DCIS between DM and DBT groups (including nuclear grade, comedonecrosis, and progesterone receptor status [p ≤ 0.01]). Among upgraded cases, a higher proportion were high-grade invasive cancers with DBT (36.7% versus 9.5%, p = 0.03). In both groups, ultrasound-guided (versus stereotactic) biopsy was associated with higher upgrade risk (p ≤ 0.03). There was no significant difference in detection rates or upgrade rates of DCIS on DM versus DBT; however, upgraded cases were more likely to be high grade with DBT, suggesting possible differences in tumor biology between cancers with DM and DBT. In both DM and DBT groups, biopsy modality was associated with upgrade risk. • Detection rates and upgrade rates of ductal carcinoma in situ (DCIS) on Digital mammography (DM) versus Digital Breast Tomosynthesis (DBT) are similar. • A higher proportion of upgraded cases were high-grade invasive cancers with DBT than DM, suggesting possible differences in tumor biology between cancers that are detected with DM and DBT. • With both DM and DBT, ultrasound-guided biopsy (versus stereotactic biopsy) was associated with a higher risk of upgrade.
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Breast cancer screening with Digital Breast Tomosynthesis are initial benefits sustained
Radiology, 2020Co-Authors: Manisha Bahl, Anne Marie Mccarthy, Sarah F Mercaldo, Pragya A Dang, Kathryn P Lowry, Constance D LehmanAbstract:The benefits of reduced false-positive examinations and higher specificity with screening Digital Breast Tomosynthesis were sustained after the first screening round.
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comparison of upright Digital Breast Tomosynthesis guided versus prone stereotactic vacuum assisted Breast biopsy
Radiology, 2019Co-Authors: Manisha Bahl, Mary Maunglay, Helen Anne Dalessandro, Constance D LehmanAbstract:Purpose To compare the performance of upright Digital Breast Tomosynthesis (DBT)-guided vacuum-assisted Breast biopsy (VABB) with that of prone stereotactic (PS) VABB. Materials and Methods This retrospective review involved consecutive patients who underwent PS VABB from August 2014 to December 2015 and upright DBT-guided VABB from February 2016 to June 2017. Tissue sampling methods were the same for PS and DBT-guided biopsies. Wilcoxon and Pearson χ2 tests were used to compare the groups. Results During the study period, 439 PS VABBs in 408 patients (mean age, 56.5 years; age range, 32-84 years) and 706 DBT-guided VABBs in 682 patients (mean age, 57.9 years; age range, 23-90 years) were recommended. Technical success was achieved for more lesions with DBT-guided VABB versus PS VABB (99.3% [695 of 700] vs 95.1% [410 of 431], respectively; P < .001). Mean procedure time was shorter with DBT-guided VABB versus PS VABB (12 vs 27 minutes, respectively; P < .001), and fewer exposures were acquired with DBT-guided VABB versus PS VABB (three vs 12, respectively; P < .001). A higher percentage of lesions for which DBT-guided VABB was performed were noncalcified lesions (eg, architectural distortion, asymmetry, and mass) than for PS VABB (29.2% [203 of 695] vs 3.4% [14 of 410], respectively; P < .001). There were no differences in the distribution of histologic results (P = .42). No major complications were observed in either group. Conclusion Upright Digital Breast Tomosynthesis-guided vacuum-assisted Breast biopsy has a higher rate of technical success than does prone stereotactic vacuum-assisted biopsy and can be performed in less than half the time and with one-fourth of the exposures. In addition, more architectural distortions and asymmetries are amenable to biopsy with Digital Breast Tomosynthesis-guided vacuum-assisted Breast biopsy. © RSNA, 2018.
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Breast cancer characteristics associated with 2d Digital mammography versus Digital Breast Tomosynthesis for screening detected and interval cancers
Radiology, 2017Co-Authors: Manisha Bahl, Anne Marie Mccarthy, Pragya A Dang, Kathryn P Lowry, Shannon Gaffney, Constance D LehmanAbstract:The overall rates of screening-detected and interval cancers are similar with Digital mammography (DM) and Digital Breast Tomosynthesis (DBT), but a higher proportion of screening-detected cancers are invasive rather than in situ at DBT compared with DM.
Pragya A Dang - One of the best experts on this subject based on the ideXlab platform.
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Breast cancer screening with Digital Breast Tomosynthesis are initial benefits sustained
Radiology, 2020Co-Authors: Manisha Bahl, Anne Marie Mccarthy, Sarah F Mercaldo, Pragya A Dang, Kathryn P Lowry, Constance D LehmanAbstract:The benefits of reduced false-positive examinations and higher specificity with screening Digital Breast Tomosynthesis were sustained after the first screening round.
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comparing tumor characteristics and rates of Breast cancers detected by screening Digital Breast Tomosynthesis and full field Digital mammography
American Journal of Roentgenology, 2020Co-Authors: Pragya A Dang, Aijia Wang, Gunjan M Senapati, Ronilda Lacson, Ramin Khorasani, Catherine S GiessAbstract:OBJECTIVE. The purpose of this study was to compare the cancer detection rates (CDRs), tumor types, and characteristics between screening Digital Breast Tomosynthesis (DBT) and screening full-field...
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utility of Breast mri for further evaluation of equivocal findings on Digital Breast Tomosynthesis
American Journal of Roentgenology, 2018Co-Authors: Bethany L Niell, Pragya A Dang, Kandarp Bhatt, Kathryn L HumphreyAbstract:OBJECTIVE. The purpose of this study is to evaluate the utility of MRI as a problem-solving tool for equivocal findings on diagnostic Digital mammography (DM) and Digital Breast Tomosynthesis (DBT)...
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Breast cancer characteristics associated with 2d Digital mammography versus Digital Breast Tomosynthesis for screening detected and interval cancers
Radiology, 2017Co-Authors: Manisha Bahl, Anne Marie Mccarthy, Pragya A Dang, Kathryn P Lowry, Shannon Gaffney, Constance D LehmanAbstract:The overall rates of screening-detected and interval cancers are similar with Digital mammography (DM) and Digital Breast Tomosynthesis (DBT), but a higher proportion of screening-detected cancers are invasive rather than in situ at DBT compared with DM.
Daniel B. Kopans - One of the best experts on this subject based on the ideXlab platform.
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Multimodal Breast cancer imaging using coregistered dynamic diffuse optical tomography and Digital Breast Tomosynthesis.
Journal of Biomedical Optics, 2017Co-Authors: Bernhard B. Zimmermann, Richard H. Moore, Bin Deng, Bhawana Singh, Mark Martino, Juliette Selb, Qianqian Fang, Amir Y. Sajjadi, Jayne Cormier, Daniel B. KopansAbstract:Diffuse optical tomography (DOT) is emerging as a noninvasive functional imaging method for Breast cancer diagnosis and neoadjuvant chemotherapy monitoring. In particular, the multimodal approach of combining DOT with x-ray Digital Breast Tomosynthesis (DBT) is especially synergistic as DBT prior information can be used to enhance the DOT reconstruction. DOT, in turn, provides a functional information overlay onto the mammographic images, increasing sensitivity and specificity to cancer pathology. We describe a dynamic DOT apparatus designed for tight integration with commercial DBT scanners and providing a fast (up to 1 Hz) image acquisition rate to enable tracking hemodynamic changes induced by the mammographic Breast compression. The system integrates 96 continuous-wave and 24 frequency-domain source locations as well as 32 continuous wave and 20 frequency-domain detection locations into low-profile plastic plates that can easily mate to the DBT compression paddle and x-ray detector cover, respectively. We demonstrate system performance using static and dynamic tissue-like phantoms as well as in vivo images acquired from the pool of patients recalled for Breast biopsies at the Massachusetts General Hospital Breast Imaging Division.
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Digital Breast Tomosynthesis state of the art
Radiology, 2015Co-Authors: Srinivasan Vedantham, Andrew Karellas, Gopal R Vijayaraghavan, Daniel B. KopansAbstract:This topical review on Digital Breast Tomosynthesis (DBT) is provided with the intent of describing the state of the art in terms of technology, results from recent clinical studies, advanced applications, and ongoing efforts to develop multimodality imaging systems that include DBT. Particular emphasis is placed on clinical studies. The observations of increase in cancer detection rates, particularly for invasive cancers, and the reduction in false-positive rates with DBT in prospective trials indicate its benefit for Breast cancer screening. Retrospective multireader multicase studies show either noninferiority or superiority of DBT compared with mammography. Methods to curtail radiation dose are of importance. (©) RSNA, 2015.
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Digital Breast Tomosynthesis from concept to clinical care
American Journal of Roentgenology, 2014Co-Authors: Daniel B. KopansAbstract:OBJECTIVE. The purpose of this article is to describe the development of Digital Breast Tomosynthesis (DBT) and to describe its advantages over 2D mammography for Breast cancer screening. CONCLUSION. Mammographic screening has dramatically reduced Breast cancer deaths, but it does not depict all cancer early enough to result in a cure. In addition, because of the recall rates associated with mammography, efforts are underway to reduce access to screening. Use of DBT improves sensitivity and specificity, and there is no longer a need to obtain full-exposure 2D mammograms. DBT will replace standard 2D mammography for Breast cancer screening.
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calcifications in the Breast and Digital Breast Tomosynthesis
Breast Journal, 2011Co-Authors: Daniel B. Kopans, Sara Gavenonis, Elkan F Halpern, Richard D MooreAbstract:Our study was to compare the clarity with which calcifications are seen on conventional mammography (CM) with the same calcifications on Digital Breast Tomosynthesis (DBT). We define clarity as the sharpness, contrast, and diagnostic quality by which the calcifications were depicted. In a HIPPA compliant Institutional Review Board approved study, 3,000 women volunteered to have both a screening mammogram and a DBT study. A total of 119 sequential cases with relevant calcifications (not clearly benign) were reviewed. Two board certified, dedicated, Breast imaging radiologists reviewed the CM and DBT images in an unblinded paired comparison. Only the mediolateral oblique (MLO) projection was available for the DBT studies. The MLO and craniocaudal projections were reviewed using the 2D images. Window and leveling, and electronic zoom were permitted. Unlimited time was allowed to provide a subjective assessment as too how well the calcifications were seen, from a diagnostic perspective, when the two studies were evaluated side-by-side. In 41.6% of the cases, the readers felt that calcifications were seen with superior clarity on DBT. In 50.4% of the cases, the visibility of calcifications was the same for DBT and CM, and in 8% of the cases, calcifications were seen with greater clarity on CM than DBT. In 92% of the cases, the clarity with which calcifications were seen on DBT was equal to or better than for CM and in almost half, the clarity on DBT was judged to be better than for CM. Our analysis shows that calcifications can be demonstrated with equal or greater clarity on DBT as on CM, thus allowing for comparable, and, perhaps, improved interpretive analysis of detected calcifications.
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enhanced imaging of microcalcifications in Digital Breast Tomosynthesis through improved image reconstruction algorithms
arXiv: Medical Physics, 2009Co-Authors: Emil Y Sidky, Ingrid Reiser, Richard H. Moore, Robert M. Nishikawa, Xiaochuan Pan, Daniel B. KopansAbstract:PURPOSE: We develop a practical, iterative algorithm for image-reconstruction in under-sampled tomographic systems, such as Digital Breast Tomosynthesis (DBT). METHOD: The algorithm controls image regularity by minimizing the image total $p$-variation (TpV), a function that reduces to the total variation when $p=1.0$ or the image roughness when $p=2.0$. Constraints on the image, such as image positivity and estimated projection-data tolerance, are enforced by projection onto convex sets (POCS). The fact that the tomographic system is under-sampled translates to the mathematical property that many widely varied resultant volumes may correspond to a given data tolerance. Thus the application of image regularity serves two purposes: (1) reduction of the number of resultant volumes out of those allowed by fixing the data tolerance, finding the minimum image TpV for fixed data tolerance, and (2) traditional regularization, sacrificing data fidelity for higher image regularity. The present algorithm allows for this dual role of image regularity in under-sampled tomography. RESULTS: The proposed image-reconstruction algorithm is applied to three clinical DBT data sets. The DBT cases include one with microcalcifications and two with masses. CONCLUSION: Results indicate that there may be a substantial advantage in using the present image-reconstruction algorithm for microcalcification imaging.