Journal articles on the topic 'Breast Tumors Tomography'
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Kelly, Catherine M., Clare Smith, Susan Conlon, Reem Salman, John McCaffrey, and Emmet Jordan. "Positron emission tomography/computed tomography (PET/CT) as a biomarker of pathologic response to neoadjuvant chemotherapy in breast carcinoma." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): e21147-e21147. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e21147.
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e21147 Background: Pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) in breast carcinoma is prognostic. Predictive biomarkers for pCR include early response to NAC, estrogen receptor (ER) negativity, HER2 positivity, and high Ki67. We assessed whether absence of fluoro-deoxy glucose (FDG) uptake measured by standardized uptake value (SUV) after NAC would predict pCR. Methods: We identified 23 patients (pts) who had PET/CT scanning pre and post NAC. We examined breast cancer subtype, chemotherapy (CT) regimen, number of cycles of CT given, clinical and pathological staging data and changes in SUV in the breasts and lymph nodes pre and post NAC. pCR was defined as no residual cancer in the breast or axillary lymph nodes. Results: Median age at diagnosis was 46 years (IQR; 37 to 56). Median tumor size at diagnosis was 30mm (IQR; 25 to 43) and 19 pts (83%) had node positive breast cancer. Most tumors were ductal (n=22) with 1 lobular cancer. Preoperatively 95% received all CT. All HER2+ pts received Trastuzumab. Anthracycline/taxane based regimens were most frequently given in 22 cases, 1 received lapatinib/trastuzumab. Five tumors (21.7%) were ER+/HER2+; 14 (60.9%) ER+/HER2-; 2 (8.7%) ER-/HER2+ and 2 (8.7%) were ER-/HER2-. All tumors were high (n=9, 39.1%) or intermediate grade (n=14, 61%). SUV was significantly lower post NAC (p=0.035). We observed no SUV uptake in breast or lymph nodes in 15 cases (65.2%) post NAC, these corresponded to; ER+HER2+ 4/5 (80%); ER+HER2- 7/15 (46.7%); ER-HER2- 2/2(100%), ER-HER2+ 2/2(100%). Absent SUV uptake post NAC was associated with a pCR (breast and lymph nodes) in 5/15 (33%) of pts (ER+HER2+ n=1, ER+HER2- n=1, ER-HER2- n=2, ER-HER2+ n=1). Ten of 15 tumors (67%) had no SUV uptake in the breast post NAC and 7 (47%) were associated with a pCR. There was a trend toward increased odds of pCR with no SUV uptake post NAC (OR 2.76; 95% CI 0.85 to 8.94: P= 0.09). Overall rate of pCR was 21.7% (n=5). Conclusions: A non-statistically significant trend toward increased odds of pCR with no SUV uptake post NAC was observed. Larger subtype-specific breast cancer cohorts will be required to determine the value of PET/CT as a predictive biomarker for pCR.
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Titskaya, Anna, Vladimir Chernov, Elena Slonimskaya, Ivan Sinilkin, and Roman Zelchan. "Radionuclide Diagnosis of Breast Cancers." Advanced Materials Research 1084 (January 2015): 460–63. http://dx.doi.org/10.4028/www.scientific.net/amr.1084.460.
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To study the diagnostic capabilities of planar breast scintigraphy and single photon emission computed tomography (SPECT) with 99mTc-MIBI in visualizing of breast tumors, 61 patients with a diagnosis of breast cancer were included in the study. The results showed that sensitivity of the planar mode in identifying primary breast tumors was 46%. The sensitivity of SPECT in detecting primary tumor was 93.4%. The sensitivity of the planar mode in visualization of nodal metastases was 44.8%, against 93.1% in SPECT. This study showed that SPECT has a high diagnostic efficiency in regard of visualization of small sized tumors, multicenter tumor growth, identifying space-occupying lesions on the background of modified breast tissue.
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Dose, J., N. Avril, H. Graeff, and F. Jänicke. "Positron Emission Tomography for Diagnosis of Breast Tumors." Oncology Research and Treatment 20, no. 3 (1997): 190–95. http://dx.doi.org/10.1159/000218937.
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Koolen, B. B., W. V. Vogel, M. J. T. F. D. Vrancken Peeters, C. E. Loo, E. J. Th Rutgers, and R. A. Valdés Olmos. "Molecular Imaging in Breast Cancer: From Whole-Body PET/CT to Dedicated Breast PET." Journal of Oncology 2012 (2012): 1–8. http://dx.doi.org/10.1155/2012/438647.
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Positron emission tomography (PET), with or without integrated computed tomography (CT), using 18F-fluorodeoxyglucose (FDG) is based on the principle of elevated glucose metabolism in malignant tumors, and its use in breast cancer patients is frequently being investigated. It has been shown useful for classification, staging, and response monitoring, both in primary and recurrent disease. However, because of the partial volume effect and limited resolution of most whole-body PET scanners, sensitivity for the visualization of small tumors is generally low. To improve the detection and quantification of primary breast tumors with FDG PET, several dedicated breast PET devices have been developed. In this nonsystematic review, we shortly summarize the value of whole-body PET/CT in breast cancer and provide an overview of currently available dedicated breast PETs.
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Hajibeigi, Asghar, Khaled Nasr, Durga Udayakumar, Kien Nham, and Robert E. Lenkinski. "Breast Tumor Microcalcification Induced by Bone Morphogenetic Protein-2: A New Murine Model for Human Breast Tumor Diagnosis." Contrast Media & Molecular Imaging 2018 (November 11, 2018): 1–9. http://dx.doi.org/10.1155/2018/2082154.
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Widespread use of screening mammography has recently increased the detection of breast microcalcifications. These nonpalpable microcalcifications with specific features in breast tissues are clinically considered an early indicator of breast carcinoma. Our goal in this study was to develop a murine breast microcalcification model for optimizing in vivo imaging. Recombinant human BMP-2 was expressed in E. coli, and the purified bioactive protein was used as inducing factor for the production of breast microcalcifications in a murine animal model. Syngeneic breast tumors were obtained by injection of MDA-MB-231 human breast cancer cells with Matrigel into the mammary fat pad of female nude mice. Different doses of bioactive rhBMP-2 were administered either as single or multiple intraperitoneal injections or directly into tumor on a weekly basis. Three weeks after the first injection of rhBMP-2, the microcalcification of breast tumor was detected by microcomputed tomography followed by intravenous injection of radiotracer [18F] Sodium fluoride for positron emission tomography imaging. Our findings indicate that rhBMP-2 induced microcalcifications of breast tumor by both systemic and direct injection of rhBMP-2 into tumors in a dose-dependent manner. Although little is known about the molecular mechanism of microcalcification, here we report a new murine model of human breast tumor induced microcalcification by rhBMP-2 to optimize in vivo imaging methods and to study the role of BMP-2 as a mediator of pathological mineralization and bone-like microcalcification formation in breast tumor. This BMP-2-induced microcalcification model may allow us to discriminate the type of microcalcification in tumors and to perform quantitative analysis on the calcification as a new detection strategy for early identification of pathological mineralization of breast tissues in women.
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Xiao, Xuehua, Fengping Gan, and Haixia Yu. "Tomographic Ultrasound Imaging in the Diagnosis of Breast Tumors under the Guidance of Deep Learning Algorithms." Computational Intelligence and Neuroscience 2022 (February 28, 2022): 1–7. http://dx.doi.org/10.1155/2022/9227440.
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This study was aimed to discuss the feasibility of distinguishing benign and malignant breast tumors under the tomographic ultrasound imaging (TUI) of deep learning algorithm. The deep learning algorithm was used to segment the images, and 120 patients with breast tumor were included in this study, all of whom underwent routine ultrasound examinations. Subsequently, TUI was used to assist in guiding the positioning, and the light scattering tomography system was used to further measure the lesions. A deep learning model was established to process the imaging results, and the pathological test results were undertaken as the gold standard for the efficiency of different imaging methods to diagnose the breast tumors. The results showed that, among 120 patients with breast tumor, 56 were benign lesions and 64 were malignant lesions. The average total amount of hemoglobin (HBT) of malignant lesions was significantly higher than that of benign lesions (P < 0.05). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of TUI in the diagnosis of breast cancer were 90.4%, 75.6%, 81.4%, 84.7%, and 80.6%, respectively. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of ultrasound in the diagnosis of breast cancer were 81.7%, 64.9%, 70.5%, 75.9%, and 80.6%, respectively. In addition, for suspected breast malignant lesions, the combined application of ultrasound and tomography can increase the diagnostic specificity to 82.1% and the accuracy to 83.8%. Based on the above results, it was concluded that TUI combined with ultrasound had a significant effect on benign and malignant diagnosis of breast cancer and can significantly improve the specificity and accuracy of diagnosis. It also reflected that deep learning technology had a good auxiliary role in the examination of diseases and was worth the promotion of clinical application.
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Liu, S. Shawn, Krutika Patel, Donna Lynn Dyess, and Andrea Kahn. "Primary Smooth Muscle Tumor of Breast: An Unusual Case Presentation." American Journal of Clinical Pathology 152, Supplement_1 (September 11, 2019): S41. http://dx.doi.org/10.1093/ajcp/aqz113.011.
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Abstract Introduction Primary smooth muscle tumors (SMT) of the breast are rare with leiomyosarcomas representing less than 0.1% of all malignant breast tumors. Case Presentation A 58-year-old female with no significant past medical history noted on screening mammography to have a circumscribed 6-mm nodule in the right breast, upper outer quadrant. Core needle biopsy showed a spindle cell neoplasm with smooth muscle differentiation. The excisional biopsy showed a 6-mm lesion composed of atypical hyperchromatic spindle cells in fascicles, marked nuclear pleomorphism, and 5 mitoses per 10 high-power fields. By immunohistochemistry, the spindle cells were positive for smooth muscle actin, desmin, and negative for S-100 and cytokeratin AE1/AE3. Positron emission tomography/computed tomography of head/neck, chest, abdomen, and pelvis did not identify other neoplasms. Despite the lesion size, findings were supportive of a leiomyosarcoma. Discussion Breast SMTs have nonspecific clinical or imaging features. Histologically, these present as spindle cell tumors with smooth muscle differentiation. Initial workup starts with distinction between benign and malignant neoplasms. The malignant SMTs are usually large tumors with cytologic atypia and mitotic activity used as diagnostic criteria. In addition, the distinction between primary and metastasis is important and frequently relies on clinical history and exclusion of other primary origins by radiographic survey. In the current case, although the tumor size is unusually small, the histological features and absence of other primary malignancies support the diagnosis of a leiomyosarcoma. Conclusion Primary leiomyosarcoma of breast is extremely uncommon with less than 70 cases reported in the literature. Although they are usually large tumors, this diagnosis should be included in the differential diagnosis when smooth muscle differentiation, significant atypia, and mitoses are encountered in a spindle cell tumor of the breast.
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Khalil, Muhammad Hassan, Li Jie, and Jia Dong Xu. "Mathematical Analysis of Microwave Tomography: The Reconstruction Problem of Malignant Tumor." Applied Mechanics and Materials 332 (July 2013): 527–33. http://dx.doi.org/10.4028/www.scientific.net/amm.332.527.
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Early breast cancer detection is an emerging field of research as it can save many lives infected by malignant tumors. Microwave imaging is one of the main pillars in biomedical fields of comprehensive cancer care. The mathematical theory of microwave tomography involves solving an image reconstruction problem for Maxwell’s equations. In this research contribution, we analyze the potential of an image reconstruction model for the early detection of breast tumors from microwave tomography method. The detection of early-stage tumors within the breast by microwave tomography imaging is challenged by both the moderate endogenous dielectric contrast between healthy and malignant glandular tissues and the spatial resolution available from illumination at microwave frequencies. The formulation as a shape-reconstruction problem offers several advantages compared to more traditional pixel-based schemes, to mention, in particular, well defined boundaries and the incorporation of an intrinsic regularization that reduces the dimensionality of the inverse problem whereby at the same time stabilizing the reconstruction. We present in this paper a novel strategy that can detect very small tumors compared to the wavelength used for illuminating the breast. In addition, our algorithm can determine the sizes and the dielectric properties of the tumors with good accuracy.
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Popova, N. S., S. N. Novikov, P. I. Krzhivitskiy, L. A. Zhukova, P. V. Krivorotko, A. S. Artemyeva, A. E. Michnin, et al. "Diagnostic capabilities of breast scintigraphy and molecular imaging of the mammary glands in the detection of various biological subtypes of breast cancer." Tumors of female reproductive system 18, no. 3 (December 1, 2022): 14–23. http://dx.doi.org/10.17650/1994-4098-2022-18-3-14-23.
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Background. The accurate and early diagnosis of breast cancer can improve efficacy of the treatment. The standard diagnostic methods such as mammography, ultrasound, and magnetic resonance tomography have a pivotal role in the detection of breast tumors, however, in some cases, they have low diagnostic accuracy. Mammoscintigraphy (MSG) / molecular breast imaging (MBI) with tumor-specific radiopharmacy 99mTc-Technetril in patients with breast cancer can considerably increase the accuracy of diagnosis. However, the diagnostic performance of MSG / MBI in the detection of different biological subtypes of breast cancer is still under investigation.Aim. To evaluate the accuracy of MSG / MBI with 99mTc-Technetril in diagnosis of different biological subtypes of breast cancer.Materials and methods. The analysis included the results of MSG / MBI of 1080 patients (2154 mammary glands), who were examined for suspected breast cancer. MSG / MBI were performed 5–15 min after intravenous injection into the vein of one of the feet of 370–740 MBq of tumor-specific radiopharmacy 99mTc-Technetril. Examinations performed from 2007–2020 was carried out on the emission computed tomography Forte (Philips); since 2020 the molecular visualization has been providing on the special gamma-camera Discovery NM750b (General Electric). The obtained data were evaluated by 2 experienced radiologists. Verification of changes in breasts was provided by morphological examination (1060 cases) or dynamic observation.Results. The sensitivity, specificity and overall accuracy of MSG / MBI were 90 %, 98 %, 95 % correspondingly. When diagnosing tumors with a diameter of up to 10 mm, the sensitivity of MSG / MBI was decreased to 83 %. In patients with various biological subtypes, the sensitivity of MSG / MBI was as follows: luminal A – 88 %; luminal B– – 91 %; luminal B+ – 92 %; triple negative – 93 %; HER2-positive – 96 %. The intensity of tumor uptake depended on the biological subtype of breast cancer. The average values of the 99mTc-Technetril uptake coefficient were as follows: luminal A – 1.59; luminal B– – 1.71; luminal B+ – 1.95; triple negative – 1.93; HER2-positive – 2.22.Conclusion. Retrospective analysis indicate high diagnostic performance of MSG / MBI: sensitivity – 90 %, specificity – 98 %, accuracy – 95 %. There are significant differences in the intensity of 99mTc-Technetril accumulation in tumors in patients with different biological subtypes of breast cancer (p = 0.01–0.004). MSG / MBI characterized by significant differences in the sensitivity in the diagnosis of luminal A and HER2+ breast cancer subtypes: 88 % and 96 %, respectively (p = 0.02).
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Gómez-Cortés, Juan Carlos, José Javier Díaz-Carmona, José Alfredo Padilla-Medina, Alejandro Espinosa Calderon, Alejandro Israel Barranco Gutiérrez, Marcos Gutiérrez-López, and Juan Prado-Olivarez. "Electrical Impedance Tomography Technical Contributions for Detection and 3D Geometric Localization of Breast Tumors: A Systematic Review." Micromachines 13, no. 4 (March 23, 2022): 496. http://dx.doi.org/10.3390/mi13040496.
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Impedance measuring acquisition systems focused on breast tumor detection, as well as image processing techniques for 3D imaging, are reviewed in this paper in order to define potential opportunity areas for future research. The description of reported works using electrical impedance tomography (EIT)-based techniques and methodologies for 3D bioimpedance imaging of breast tissues with tumors is presented. The review is based on searching and analyzing related works reported in the most important research databases and is structured according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) parameters and statements. Nineteen papers reporting breast tumor detection and location using EIT were systematically selected and analyzed in this review. Clinical trials in the experimental stage did not produce results in most of analyzed proposals (about 80%), wherein statistical criteria comparison was not possible, such as specificity, sensitivity and predictive values. A 3D representation of bioimpedance is a potential tool for medical applications in malignant breast tumors detection being capable to estimate an ap-proximate the tumor volume and geometric location, in contrast with a tumor area computing capacity, but not the tumor extension depth, in a 2D representation.
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Parnas, A. V., A. I. Pronin, V. S. Ilyakov, N. A. Meshcheryakova, Z. Kh Kamolova, and A. I. Mikhaylov. "[18F]-Fluoroestradiol PET/CT: a modern look at nuclear medicine applications." Tumors of female reproductive system 17, no. 1 (June 16, 2021): 20–26. http://dx.doi.org/10.17650/1994-4098-2021-17-1-20-26.
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Breast cancer is one of the most commonly diagnosed cancers and the leading cause of cancer mortality among women. Approximately 70–80 % of breast cancers are estrogen (ER) and/or progesterone receptor-positive, thus making endocrine therapy an important stage of treatment. Receptor expression in breast cancer cells is usually assessed by tissue immunohistochemistry. The method of positron emission tomography, combined with computed tomography (PET/CT), makes it possible to evaluate not only anatomical and structural, but also metabolic changes in tumor tissue. 18F-Fluoroestradiol (18F-FES) is a radiopharmaceutical drug, an estradiol analogue, which is used in the diagnostics of ER-expressing tumors and is utilized for detection and quantification of ER expression in vivo. Various studies show that 18F-FES accumulation indicates presence of ER-positive tumor tissue, which, in most cases, is confirmed by tissue immunohistochemistry. Although current guidelines recommend 18F-fluorodeoxyglucose PET/CT when routine examinations demonstrate ambiguous results, 18F-FES PET/CT can be the preferable imaging modality in the diagnostics of ER-positive breast cancer. It should be noted, that PET/CT with 18F-FES can also be effective for evaluation of tumors with a high level of ER expression, like ovarian cancer.
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Quiros-Gonzalez, Isabel, Michal R. Tomaszewski, Monika A. Golinska, Emma Brown, Laura Ansel-Bollepalli, Lina Hacker, Dominique-Laurent Couturier, Rosa M. Sainz, and Sarah E. Bohndiek. "Photoacoustic Tomography Detects Response and Resistance to Bevacizumab in Breast Cancer Mouse Models." Cancer Research 82, no. 8 (April 11, 2022): 1658–68. http://dx.doi.org/10.1158/0008-5472.can-21-0626.
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Abstract Angiogenesis is an established prognostic factor in advanced breast cancer, yet response to antiangiogenic therapies in this disease remains highly variable. Noninvasive imaging biomarkers could help identify patients that will benefit from antiangiogenic therapy and provide an ideal tool for longitudinal monitoring, enabling dosing regimens to be altered with real-time feedback. Photoacoustic tomography (PAT) is an emerging imaging modality that provides a direct readout of tumor hemoglobin concentration and oxygenation. We hypothesized that PAT could be used in the longitudinal setting to provide an early indication of response or resistance to antiangiogenic therapy. To test this hypothesis, PAT was performed over time in estrogen receptor–positive and estrogen receptor–negative breast cancer xenograft mouse models undergoing treatment with the antiangiogenic bevacizumab as a single agent. The cohort of treated tumors, which were mostly resistant to the treatment, contained a subset that demonstrated a clear survival benefit. At endpoint, the PAT data from the responding subset showed significantly lower oxygenation and higher hemoglobin content compared with both resistant and control tumors. Longitudinal analysis revealed that tumor oxygenation diverged significantly in the responding subset, identifying early treatment response and the evolution of different vascular phenotypes between the subsets. Responding tumors were characterized by a more angiogenic phenotype when analyzed with IHC, displaying higher vessel density, yet poorer vascular maturity and elevated hypoxia. Taken together, our findings indicate that PAT shows promise in providing an early indication of response or resistance to antiangiogenic therapy. Significance: Photoacoustic assessment of tumor oxygenation is a noninvasive early indicator of response to bevacizumab therapy, clearly distinguishing between control, responding, and resistant tumors within just a few weeks of treatment.
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Lemrabott, E., N. Abdelkader, A. Cheikh, N. Mamouni, S. Errarhay, C. Bouchikhi, and A. Banani. "CASE REPORT: METASTATIC PHYLLODE TUMOR." International Journal of Advanced Research 8, no. 10 (October 31, 2020): 989–92. http://dx.doi.org/10.21474/ijar01/11925.
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Rationale: Malignant phyllodes tumors are rare breast neoplasms that are associated with a 6.2% to 25% incidence rate of distant metastasis the lung is the most common metastatic site. To date, there is no consensus regarding the treatment of metastatic malignant phyllodes breast tumors. Patient concern: A 34-year-old woman was admitted into the gynecology department for a rapidly growing left breast tumor that was first noticed month prior. Diagnosis: Core needle biopsy revealed a malignant phyllodes tumor. A chest computed tomography tomography/CT showed metastatic lymph nodes that appeared to have spread to the right axilla She was subsequently followed by course of radiotherapy, she consulted again 3 months later for a productive cough, X-ray thorax in comparison with that made preoperatively: presence of the left peri-hilar nodules which were not present on the first X-ray Interventions: A left mastectomy with axillary lymph node dissection was conducted and a thoracoabdominal flap and a split thickness skin graft were performed for the skin defect. And radiotherapie adjuvant. Lessons: As standard treatment guidelines for metastatic malignant phyllodes tumors are lacking, we opted for the aforementioned aggressive treatments that resulted in complete remission of the lung metastasis. Therefore, aggressive treatment, whenever possible, is warranted.
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Avril, N., J. Dose, F. Jänicke, S. Bense, S. Ziegler, C. Laubenbacher, W. Römer, et al. "Metabolic characterization of breast tumors with positron emission tomography using F-18 fluorodeoxyglucose." Journal of Clinical Oncology 14, no. 6 (June 1996): 1848–57. http://dx.doi.org/10.1200/jco.1996.14.6.1848.
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PURPOSE To evaluate the diagnostic value of position emission tomographic (PET) imaging with F-18 fluorodeoxyglucose (FDG) in differentiating between benign and malignant breast tumors. PATIENTS AND METHODS Fifty-one patients, with suspicious breast lesions newly discovered either by physical examination or by mammography, underwent PET imaging before exploratory surgery. FDG-PET images of the breast were analyzed visually and quantitatively for objective assessment of regional tracer uptake. RESULTS Primary breast cancer was identified visually with a sensitivity of 68% to 94% and a specificity of 84% to 97% depending on criteria used for image interpretation. Quantitative analysis of FDG uptake in tumors using standardized uptake values (SUV) showed a significant difference between benign (1.4 +/- 0.5) and malignant (3.3 +/- 1.8) breast tumors (P < .01). Receiver operating characteristic (ROC) curve analysis exhibited a sensitivity of 75% and a specificity of 100% at a threshold SUV value of 2.5. Sensitivity increased to 92% with a corresponding specificity of 97% when partial volume correction of FDG uptake was performed based on independent anatomic information. CONCLUSION PET imaging allowed accurate differentiation between benign and malignant breast tumors providing a high specificity. Sensitivity for detection of small breast cancer ( < 1 cm) was limited due to partial volume effects. Quantitative image analysis combined with partial volume correction may be necessary to exploit fully the diagnostic accuracy. PET imaging may be helpful as a complimentary method in a subgroup of patients with indeterminate results of conventional breast imaging.
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Mukhopadhyay, Keya De, Ting-Tung Chang, William Phillips, Lu-Zhe Sun, and Beth Goins. "64Cu-Bevacizumab as a better PET imaging agent in detecting breast cancer in MDA-MB-231 orthotopic and bone metastasis mice model compared to 18FDG." American Journal of Applied Bio-Technology Research 2, no. 2 (April 6, 2021): 61–90. http://dx.doi.org/10.15864/ajabtr.224.
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Developing new imaging agents help in the detection of breast cancer with better sensitivity and specificity and it improves the patient outcomes significantly. This provides the physicians with improved early detection of breast cancer during the routine screening process and has the potential to help the surgeons in identifying the tumor margins more accurately for surgical resection. In this study, we evaluate the efficiency of 64Cu-bevacizumab to successfully detect the small tumors (5mm), large tumors (15mm) and metastatic sites in MDA-MB-231 breast cancer mouse models compared to 18FDG and conclude that 64Cu-bevacizumab is a promising PET (positron emission tomography) imaging agent with high possibility to be applied to human breast cancer detection, and could significantly improve patient survival.
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Rostami, Ali, Ahmad SalmanOgli, Farshad Farhadnia, Mahbobeh Dolatyari, Ghassem Rostami, and Erhan Pişkin. "Design of a portable nanosensor for easy breast tomography." RSC Advances 5, no. 25 (2015): 19002–13. http://dx.doi.org/10.1039/c4ra15867a.
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Pratiwi, Dwirani Rosmala, Dyah Fauziah, Rizkie T. Trisnawaty, and Cindy Angelina Limantara. "A Case Report of Breast Fibromatosis Mimicking Breast Cancer." Indonesian Journal of Cancer 16, no. 4 (December 28, 2022): 255. http://dx.doi.org/10.33371/ijoc.v16i4.919.
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Introduction: Breast Fibromatosis is a rare benign stromal tumor that accounts for 0.2% of all breast tumors. The clinical presentation and imaging features may mimic a malignant tumor. We reported a case of breast fibromatosis mimicking breast cancer.Case Presentation: A 22-years-old woman with a palpable breast lump was present and being examined. The ultrasound and mammography features suggested malignancy. Magnetic Resonance Imaging (MRI) and Multislice Computerized Tomography (MSCT) evaluation showed invasion of a tumor to muscle without intrathoracic involvement. A core biopsy was performed with the pathologic conclusion suspected as a phyllodes tumor with a differential diagnosis as mammary fibromatosis. The pathology result of intraoperative examination favor for fibromatosis. A wide excision procedure with a free margin could be achieved. The histopathological examination revealed spindle cells tumor infiltrating into muscle tissue. The result of immunohistochemistry examination excluded metaplastic carcinoma and Phyllodes tumor. Therefore, it confirmed a diagnosis of breast fibromatosis.Conclusions: Breast fibromatosis is a rare benign tumor of the breast that can mimic malignancy. This entity should be considered as one of the differential diagnoses in a patient with a breast lump. A pre-operative tissue diagnostic is mandatory to prevent radical treatment for this nonmalignant case.
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Fuster, David, Joan Duch, Pilar Paredes, Martín Velasco, Montserrat Muñoz, Gorane Santamaría, Montserrat Fontanillas, and Francesca Pons. "Preoperative Staging of Large Primary Breast Cancer With [18F]Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Compared With Conventional Imaging Procedures." Journal of Clinical Oncology 26, no. 29 (October 10, 2008): 4746–51. http://dx.doi.org/10.1200/jco.2008.17.1496.
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Purpose To evaluate the utility of positron emission tomography (PET) and [18F]fluorodeoxyglucose in the initial staging of large primary breast tumors. Patients and Methods This prospective study was approved by the ethics committee, and all patients gave their informed consent before enrollment. Sixty consecutive patients with large (> 3 cm) primary breast cancer diagnosed by clinical examination and breast magnetic resonance imaging (MRI) were entered onto the study. The mean age was 57 ± 13 years. Chest computed tomography (CT), liver ultrasonography, bone scan, and PET/CT were performed in all patients. All findings were histologically confirmed, and/or at least 1 year of follow-up was required. Correlation between parameters was calculated using Pearson's correlation coefficient. P < .05 was considered statistically significant. Results Primary tumor was identified by both PET/CT and MRI in all patients. Multifocal and/or multicentric tumors were found in 19 patients by MRI. Axillary lymph node metastases were found in 20 of 52 patients. Extra-axillary metastatic lymph nodes were also found in three patients. One patient showed an infiltrated lymph node in the contralateral axilla. The sensitivity and specificity for PET/CT to detect axillary lymph nodes metastases were 70% and 100%, respectively. PET/CT diagnosed all extra-axillary lymph nodes. The overall sensitivity and specificity of PET/CT in detecting distant metastases were 100% and 98%, respectively; whereas the sensitivity and specificity of conventional imaging were 60% and 83%, respectively. PET led to a change in the initial staging in 42% of patients. Conclusion PET/CT underestimates locoregional lymph node staging in large primary breast cancer patients. PET/CT is a valuable tool to discard unsuspected extra-axillary lymph nodes and distant metastases.
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Qin, Feng, Yapei Feng, Panpan Zhang, Yuemei Li, and Weiqiang Fan. "Diagnostic Value of Emission Computed Tomography Combined with Computed Tomography for Metastatic Malignant Tumor of Spine." Contrast Media & Molecular Imaging 2022 (May 26, 2022): 1–5. http://dx.doi.org/10.1155/2022/5847589.
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Objective. To explore the diagnostic value of emission computed tomography (ECT) combined with computed tomography (CT) for metastatic malignant tumor of spine. Methods. By means of retrospective study, a total of 102 patients with extraskeletal primary malignant tumor treated in our hospital from February 2019 to February 2021 were selected as the subjects. All patients had single lesion of the spine, of which 72 were malignant and 30 were benign according to the results of pathological examination. ECT and CT examinations were performed to all patients, and by taking the pathological findings as the gold standard, the sensitivity, specificity, positive predictive value and negative predictive value of ECT, CT, and their combination were calculated, and their efficacy in diagnosing metastatic malignant tumor of spine was analyzed. Results. A total of 68 (94.4%) metastatic malignant spinal tumors were detected by ECT combined with CT, with a detection rate of 100% in breast cancer and lung cancer, 94.1% in liver cancer, and 78.6% in prostate cancer, respectively; the combined diagnosis had a diagnostic sensitivity of 94.4%, specificity of 73.3%, positive predictive value of 89.5%, negative predictive value of 84.6%, and diagnostic accuracy rate of 88.2%, and AUC (95% CI) = 0.839 (0.739–0.939). Conclusion. Combining ECT with CT has a good diagnostic efficacy for metastatic malignant spinal tumors.
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Huang, Pei-Ching, Ren-Chin Wu, Yu-Hsiang Juan, Hui-Yu Ho, Yung-Chang Lin, Yi-Ting Huang, Shu-Hang Ng, Chyong-Huey Lai, Angel Chao, and Gigin Lin. "Diagnostic Accuracy of Whole-Body Computed Tomography for Incidental Ovarian Tumors in Patients with Prior Breast Cancer." Diagnostics 12, no. 2 (January 29, 2022): 347. http://dx.doi.org/10.3390/diagnostics12020347.
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Whole-body computed tomography (WBCT) serves as the first-line imaging modality for breast cancer follow-up. To investigate the imaging characteristics and diagnostic accuracy of WBCT for incidental ovarian tumors in patients with prior breast cancer, we retrospectively reviewed a consecutive cohort of 13,845 patients with breast cancer, of whom 149 had pathologically-proven ovarian lesions. We excluded patients with ovarian diagnosis before breast cancer, CT scan not including ovary, CT-pathology interval >30 days, and severe CT artifact. Among our 60 breast cancer patients (median age, 46 years) with pathologically proven ovarian lesions, 49 patients had benign diseases, seven had primary ovarian cancer and four had ovarian metastasis from breast cancer. The histologic types of breast cancer with ovarian metastases included invasive ductal carcinoma, lobular carcinoma and angiosarcoma. Cystic ovarian lesions identified on WBCT during the breast cancer follow-up are more likely to be benign, while solid-cystic lesions are likely to be primary ovarian cancers, and solid lesions may indicate ovarian metastasis. The diagnostic accuracy, sensitivity, specificity, and areas under the receiver operating characteristic curve of WBCT were 98.3%, 100.0%, 98.0%, and 0.99 (malignant vs. benign); 90.0%, 100.0%, 85.7%, and 0.93 (metastasis vs. primary ovarian cancer), respectively. The only false positive solid lesion was a Sertoli–Leydig tumor. In conclusion, WBCT may help diagnose incidental ovarian tumors in patients with prior breast cancers and guide disease management.
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Carp, S. A., C. Wanyo, M. C. Specht, L. Schapira, B. Moy, D. M. Finkelstein, D. Boas, and S. J. Isakoff. "Functional metabolic tomographic optical breast imaging (TOBI) to monitor response to neoadjuvant therapy in breast cancer." Journal of Clinical Oncology 29, no. 27_suppl (September 20, 2011): 60. http://dx.doi.org/10.1200/jco.2011.29.27_suppl.60.
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60 Background: Recent studies using near-infrared optical measurements in breast tumors have demonstrated the promise of early monitoring of neoadjuvant chemotherapy (NAC) to predict outcome. Technologies to date have focused primarily on static measurements. Dynamic optical imaging, in conjunction with fractional mammographic compression, offers access to multiple functional and metabolic tissue biomarkers that may be used to predict treatment response. We have developed a novel tomographic optical breast imaging (TOBI) device to evaluate the early (day 7) prediction performance of this advanced technology. Methods: We are conducting a pilot feasibility study in female patients with unilateral locally advanced breast cancer undergoing standard-of-care NAC. Pre-treatment and day 7 post-treatment TOBI scans are obtained, with additional scans on day 1 of each subsequent chemotherapy cycle. The affected and contralateral normal breasts are compressed to 6-8 lbs of force and optical images are acquired once every 2 seconds for two minutes. Time-resolved oxy-(HbO), deoxy-(HbR), and total-(HbT) hemoglobin concentration and hemoglobin oxygen saturation (SO2) are calculated. The compression-induced rate of change of HbT correlates with changes in tissue blood volume indicative of biomechanical properties and the evolution of tissue SO2 estimates tissue metabolism. Results: We report initial data from two patients. One patient had a near-pathologic complete response (responder) and showed 21% and 23% decreases in HbT and HbR, respectively. The second patient had no significant response (non-responder) and had 2% and 1% decreases in HbT and HbR, respectively. Interestingly, the responder showed a dynamic decrease in HbT during compression in the tumor region at day 0 that disappeared at day 7, while the non-responder had similar rates of HbT change at both scans. Conclusions: We demonstrate for the first time the feasibility of dynamic optical breast tomography and show that optically derived parameters may be sensitive to therapyinduced changes in breast cancer. These dynamic measurements may provide novel insight into the physiologic changes in breast tumors during treatment.
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Titskaya, Anna, Vladimir Chernov, Elena Slonimskaya, Ivan Sinilkin, and Roman Zelchan. "Breast Scintigraphy with 199Tl in Diagnosis of Breast Cancer." Advanced Materials Research 1084 (January 2015): 361–64. http://dx.doi.org/10.4028/www.scientific.net/amr.1084.361.
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To study the diagnostic capabilities of emission single photon computed tomography with 199Tl in imaging of breast cancer 90 women with breast diseases were included in the study. During the research high indications of specificity 96.7% were obtained in the detection of breast cancer. The sensitivity of breast cancer visualization was 95%, while in the detection of tumors smaller than 10mm, the sensitivity was 75%, in detecting tumors more than 10mm - 98%. Considering the high sensitivity and specificity of SPECT with 199Tl, we can recommend the use of this method as an additional diagnostic criterion in cases where other methods of radiation diagnosis and the results of morphological studies do not provide a clear answer.
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Oldan, Jorge D., Abiola D. Femi-Abodunde, Mitchel A. Muhleman, and Amir H. Khandani. "Rubidium Uptake in Chest Tumors on PET/CT." World Journal of Nuclear Medicine 21, no. 01 (February 24, 2022): 018–27. http://dx.doi.org/10.1055/s-0042-1744195.
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Abstract Background Chest tumors are often found incidentally on cardiac scans; we aimed to describe the findings of rubidium (Rb) in incidentally discovered extracardiac tumors. Materials and Methods We reviewed a database of cardiac Rb scans performed over a period of 11 years and identified those with a previously unsuspected malignancy seen on the plane of section. We then measured maximum standard uptake value for each of the tumors, as well as background lung, liver, mediastinum, and body wall. In cases where fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) was available, we compared Rb results with FDG PET/CT. Results We identified 63 patients meeting criteria including full visualization of a tumor of at least 1.0 cm with no prior treatment. Of these patients, 17 had breast, 36 had lung, and 10 had miscellaneous other tumors. We selected patients with either breast or lung tumors for further analysis. Overall uptake was relatively stable between rest and stress but lower than FDG PET/CT; it was generally low and similar to blood pool. There was a small but statistically significant correlation between estrogen receptor positivity and Rb uptake in breast tumors. There was a stable pattern of uptake in background tissues, with liver being greater than mediastinal blood pool, which in turn was more avid than lung, which was more avid than subcutaneous body wall tissues. Lung showed a noticeable tendency toward increased uptake in dependent regions, likely reflecting low-level atelectasis. Conclusion Uptake was stable between rest and stress but low relative to FDG PET/CT; some correlations with receptors suggest it may be useful in molecular imaging.
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Akhter, Afroza, Subin Jeon, Hee Seung Bom, Jung Joon Min, and Seong Young Kwon. "Appropriate Diagnostic Approach in Patients with Suspicious Bone Metastasis from Low FDG-Avid Primary site in Thyroid gland: Case report." Bangladesh Journal of Nuclear Medicine 23, no. 1-2 (May 4, 2022): 63–66. http://dx.doi.org/10.3329/bjnm.v23i1-2.57712.
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Metastatic bone tumors are the most common malignant tumor involving bone. Bone metastases from primary tumors of unknown origin are commonly attributed to prostate, breast, lung, and thyroid. 18F-fluorodeoxyglucose (FDG) Positron Emission Tomography- Computed Tomography (PET-CT) has a very useful imaging modality to identify primary site in patients with suspicious bone metastasis. However, it remained unclear whether PET-CT have clinical value to identify primary site because some cancer types have low FDG-avidity. We report a case of 84-year-old female patient presenting with metastatic bone tumor in skull without showing any metabolic activity in primary site of her thyroid gland on FDG PET-CT and we discussed how to use other clinical information in this patient. Bangladesh J. Nuclear Med. 23(1&2): 63-66, 2020
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Policeni, Fabiana, Brittany Pakalniskis, and Limin Yang. "Occult Primary Neuroendocrine Tumor Metastasis to the Breast Detected on Screening Mammogram." Journal of Clinical Imaging Science 6 (September 29, 2016): 41. http://dx.doi.org/10.4103/2156-7514.191439.
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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.
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Kang, Minwoo, Jong Il Shin, Sangjin Han, Jung Young Kim, Jeonghoon Park, Kwang Il Kim, Joo Hyun Kang, and Tae Sup Lee. "Therapeutic Response Monitoring with 89Zr-DFO-Pertuzumab in HER2-Positive and Trastuzumab-Resistant Breast Cancer Models." Pharmaceutics 14, no. 7 (June 24, 2022): 1338. http://dx.doi.org/10.3390/pharmaceutics14071338.
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Immuno-positron emission tomography (PET) has great potential to evaluate the target expression level and therapeutic response for targeted cancer therapy. Immuno-PET imaging with pertuzumab, due to specific recognition in different binding sites of HER2, could be useful for the determination of the therapeutic efficacy of HER2-targeted therapy, trastuzumab, and heat shock protein 90 (HSP90) inhibitor, in HER2-expressing breast cancer. The aim of this study is to evaluate the feasibility of monitoring therapeutic response with 89Zr-DFO-pertuzumab for the treatment of HER2-targeted therapeutics, trastuzumab, or the HSP90 inhibitor 17-DMAG, in trastuzumab-resistant JIMT-1 breast cancer models. We prepared an immuno-PET imaging agent using desferoxamine (DFO)-pertuzumab labeled with 89Zr and performed the biodistribution and PET imaging in breast cancer xenograft models for monitoring therapeutic response to HER2-targeted therapy. 89Zr-DFO-pertuzumab was successfully prepared and showed specific binding to HER2 in vitro and clearly visualized HER2 expressing JIMT-1 tumors. 89Zr-DFO-pertuzumab had prominent tumor uptake in HER2 expressing JIMT-1 tumors. JIMT-1 tumors showed trastuzumab-resistant and HSP90 inhibitor sensitive characterization. In immuno-PET imaging, isotype antibody-treated JIMT-1 tumors had similar uptake in trastuzumab-treated JIMT-1 tumors, but 17-DMAG-treated JIMT-1 tumors showed greatly reduced uptake compared to vehicle-treated tumors. Additionally, HER2 downregulation evaluated by immuno-PET imaging was verified by western blot analysis and immunofluorescence staining which resulted in a significant reduction in the tumor’s HER2 level in 17-DMAG-treated JIMT-1 tumors. 89Zr-DFO-pertuzumab immuno-PET may be clinically translated to select pertinent patients for HER2-targeted therapy and to monitor the therapeutic response in HER2-positive cancer patients under various HER2-targeted therapeutics treatments.
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Kratkiewicz, Karl, Alexander Pattyn, Naser Alijabbari, and Mohammad Mehrmohammadi. "Ultrasound and Photoacoustic Imaging of Breast Cancer: Clinical Systems, Challenges, and Future Outlook." Journal of Clinical Medicine 11, no. 5 (February 22, 2022): 1165. http://dx.doi.org/10.3390/jcm11051165.
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Presently, breast cancer diagnostic methods are dominated by mammography. Although drawbacks of mammography are present including ionizing radiation and patient discomfort, not many alternatives are available. Ultrasound (US) is another method used in the diagnosis of breast cancer, commonly performed on women with dense breasts or in differentiating cysts from solid tumors. Handheld ultrasound (HHUS) and automated breast ultrasound (ABUS) are presently used to generate reflection images which do not contain quantitative information about the tissue. This limitation leads to a subjective interpretation from the sonographer. To rectify the subjective nature of ultrasound, ultrasound tomography (UST) systems have been developed to acquire both reflection and transmission UST (TUST) images. This allows for quantitative assessment of tissue sound speed (SS) and acoustic attenuation which can be used to evaluate the stiffness of the lesions. Another imaging modality being used to detect breast cancer is photoacoustic tomography (PAT). Utilizing much of the same hardware as ultrasound tomography, PAT receives acoustic waves generated from tissue chromophores that are optically excited by a high energy pulsed laser. This allows the user to ideally produce chromophore concentration maps or extract other tissue parameters through spectroscopic PAT. Here, several systems in the area of TUST and PAT are discussed along with their advantages and disadvantages in breast cancer diagnosis. This overview of available systems can provide a landscape of possible intersections and future refinements in cancer diagnosis.
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Gantsev, Sh Kh, G. Schaller, K. Sh Gantsev, A. N. Plikhta, Sh R. Kzyrgalin, and R. A. Rustamkhanov. "Neuroendocrine Breast Cancer. Clinical Observation. Personalized Approach." Creative surgery and oncology 11, no. 2 (May 22, 2021): 144–48. http://dx.doi.org/10.24060/2076-3093-2021-11-2-144-148.
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Introduction. Neuroendocrine breast tumors represent a rare subtype of breast cancer, accounting for less than 1 % of all neuroendocrine neoplasms. Starting from their pathology definition, and going through their prevalence, prognosis and treatment, our knowledge is still really uncertain.Materials and methods. The article presents a rare clinical observation of a neuroendocrine breast tumor. A breast fibroadenoma was diagnosed at the initial diagnosis stage in a private clinic; after a surgical treatment and further morphological study, it was estimated: a diagnosis of Cancer in situ of the left breast T1N0M0, stage I. Next, 3D-conformal remote radiation therapy was performed on the area of the left breast.Results and discussion. After conducting positron emission tomography, multiple metastases were detected in the lymph nodes, bones, and liver. Additionally, micropreparations were consulted at the Federal Reference Center in St. Petersburg and at an independent third-party molecular biological laboratory in Germany (Munich). Given all the instrumental, molecular biological, histological and immunohistochemical studies of the patient, an individual regimen of drug therapy was selected.Conclusion. After 18 months of personalized drug therapy, we observed a positive trend and a significant decrease in metabolic activity according to positron emission tomography.
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Yang, Hao, Weipin Qian, Lily Yang, Huikai Xie, and Huabei Jiang. "In Vivo Evaluation of a Miniaturized Fluorescence Molecular Tomography (FMT) Endoscope for Breast Cancer Detection Using Targeted Nanoprobes." International Journal of Molecular Sciences 21, no. 24 (December 9, 2020): 9389. http://dx.doi.org/10.3390/ijms21249389.
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In this study, in vivo animal experiments with 12 nude mice bearing breast-cancer-patient-tissue-derived xenograft (PDX) tumors were performed aiming to verify the imaging capability of a novel miniaturized fluorescence molecular tomography (FMT) endoscope, in combination with targeted nanoparticle–near-infrared (NIR) dye conjugates. Tumor-bearing mice were divided into two groups by systematic injection with urokinase plasminogen activator receptor-targeted (n = 7) and nontargeted (n = 5) imaging nanoprobes as a contrast agent, respectively. Each mouse was imaged at 6, 24, and 48 h following the injection of nanoprobes using the FMT endoscope. The results show that systemic delivery of targeted nanoprobes produced a 4-fold enhancement in fluorescence signals from tumors, compared with tumors that received nontargeted nanoprobes. This study indicates that our miniaturized FMT endoscope, coupled with the targeted nanoparticle–NIR dye conjugates as a contrast agent, has high sensitivity and specificity, and thus great potential to be used for image-guided detection and removal of a primary tumor and local metastatic tumors during surgery.
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Kenny, L. M., E. Aboagye, P. S. Cohen, M. Miller, F. Turkheimer, A. Al-Nahhas, D. Blunt, and R. C. Coombes. "Imaging of angiogenesis in metastatic breast cancer by positron emission tomography (PET) using [18F]AH11585, an [18F]- labeled alphaVbeta3 (αvβ3) peptide." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 14067. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.14067.
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14067 Background: In vivo imaging of avβ3 expression in tumors and tumor endothelial cells may be a useful biomarker of angiogenesis. [18F]AH11585 is a novel peptide containing an Arginine-Glycine-Aspartic Acid (RGD) motif that binds to avβ3 with high affinity designed for use in PET studies. Methods: 7 patients with metastatic breast cancer (aged 37–68 years) received intravenous injections of [18F]AH11585 and were scanned dynamically by PET over 61.5 mins. Radioactivity concentrations, derived from regions of interest placed on tumour and normal tissues, were analysed mathematically to determine the net irreversible uptake (Ki), fractional retention (FRT) and standardized uptake at 56.5min (SUV) of the radiotracer. Computed tomography (CT) was performed within 4 weeks of the scan. Results: Tumor lesions were clearly visible on PET images in 6/7 patients. In one patient with a palpable supraclavicular lymph node not visible on CT, we were unsure if a hyperintense region visible by PET was tumor. In total 18/19 tumor lesions were identified on both PET and corresponding CT images. Tumors in areas of low background were hyperintense (lung, bone, breast) whereas those in areas of high background were hypointense regions (liver). Tumors with central necrosis showed high uptake of [18F]AH11585 around the periphery only. Mathematical analysis demonstrated irreversible retention of [18F]AH11585 in tumors. [18F]AH11585-PET discriminated between non-liver lesions (n=10) and normal tissues: Ki (p=0.002), FRT (p=0.0039), SUV (p=0.002). Corresponding comparisons for liver lesions (n=8) were significant for FRT (p=0.0078) and SUV (p=0.0078) only. Conclusions: [18F]AH11585 PET is a promisng method for in vivo imaging of avβ3 integrin expression in metastatic breast cancer. No significant financial relationships to disclose.
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Shin, Soo Hyun, Sang Hyun Park, Se Hun Kang, Seung Won Kim, Minsun Kim, and Daehong Kim. "Fluorine-19 Magnetic Resonance Imaging and Positron Emission Tomography of Tumor-Associated Macrophages and Tumor Metabolism." Contrast Media & Molecular Imaging 2017 (2017): 1–8. http://dx.doi.org/10.1155/2017/4896310.
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The presence of tumor-associated macrophages (TAMs) is significantly associated with poor prognosis of tumors. Currently, magnetic resonance imaging- (MRI-) based TAM imaging methods that use nanoparticles such as superparamagnetic iron oxide and perfluorocarbon nanoemulsions are available for quantitative monitoring of TAM burden in tumors. However, whether MRI-based measurements of TAMs can be used as prognostic markers has not been evaluated yet. In this study, we used positron emission tomography (PET) with 18F-2-fluoro-2-deoxy-D-glucose (18F-FDG) as a radioactive tracer and fluorine-19- (19F-) MRI for imaging mouse breast cancer models to determine any association between TAM infiltration and tumor metabolism. Perfluorocarbon nanoemulsions were intravenously administered to track and quantify TAM infiltration using a 7T MR scanner. To analyze glucose uptake in tumors, 18F-FDG-PET images were acquired immediately after 19F-MRI. Coregistered 18F-FDG-PET and 19F-MR images enabled comparison of spatial patterns of glucose uptake and TAM distribution in tumors. 19F-MR signal intensities from tumors exhibited a strong inverse correlation with 18F-FDG uptake while having a significant positive correlation with tumor growth from days 2 to 7. These results show that combination of 19F-MRI and 18F-FDG-PET can improve our understanding of the relationship between TAM and tumor microenvironment.
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Ahmad, Anis, Tulasigeri M. Totiger, Ana Paula Benaduce, Brian Marples, and Ivaylo Bodganov Mihaylov. "Establishing Correlations between Breast Tumor Response to Radio-Immunotherapy and Radiomics from Multi-Parametric Imaging: An Animal Study." Applied Sciences 10, no. 18 (September 17, 2020): 6493. http://dx.doi.org/10.3390/app10186493.
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Triple-negative breast cancer (TNBC), which is a type of invasive breast cancer, is characterized by severe disease progression, poor prognosis, high recurrence rate, and short survival. We sought to gain new insight into TNBC by applying computed tomography (CT) and magnetic resonance (MR) quantitative imaging (radiomics) approaches to predict the outcome of radio-immunotherapy treatments in a syngeneic subcutaneous murine breast tumor model. Five Athymic Nude mice were implanted with breast cancer cell lines (4T1) tumors on the right flank. The animals were CT- and MRI-imaged, tumors were contoured, and radiomics features were extracted. All animals were treated with radiotherapy (RT), followed by the administration of PD1 inhibitor. Approximately 10 days later, the animals were sacrificed, tumor volumes were measured, and histopathology evaluation was performed through Ki-67 staining. Linear regression modeling between radiomics and Ki-67 results was performed to establish a correlation between quantitative imaging and post-treatment histochemistry. There was no correlation between tumor volumes and Ki-67 values. Multiple CT- and MRI-derived features, however, correlated with histopathology with correlation coefficients greater than 0.8. MRI imaging helps in tumor delineation as well as an additional orthogonal imaging modality for quantitative imaging purposes. This is the first investigation correlating simultaneously CT- and MRI-derived radiomics to histopathology outcomes of combined radio-immunotherapy treatments in a preclinical setting applied to treatment naïve tumors. The findings indicate that imaging can guide discrimination between responding and non-responding tumors for the combined RT and ImT treatment regimen in TNBC.
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Schelling, M., N. Avril, J. Nährig, W. Kuhn, W. Römer, D. Sattler, M. Werner, et al. "Positron Emission Tomography Using [18F]Fluorodeoxyglucose for Monitoring Primary Chemotherapy in Breast Cancer." Journal of Clinical Oncology 18, no. 8 (April 8, 2000): 1689–95. http://dx.doi.org/10.1200/jco.2000.18.8.1689.
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PURPOSE: To address the role of positron emission tomography (PET) using [18F]fluorodeoxyglucose (FDG) to monitor primary (neoadjuvant) chemotherapy in patients with locally advanced breast cancer. PATIENTS AND METHODS: Quantification of regional FDG uptake of the breast acquired after the first and second courses of chemotherapy was compared with the baseline scan in 22 patients with a total of 24 breast carcinomas. To evaluate the predictive value of PET imaging, histopathologic response after completion of chemotherapy classified as gross residual disease (GRD) or minimal residual disease (MRD) served as the gold standard. RESULTS: Significant differences in tracer uptake between nonresponding tumors (GRD) and responding lesions (MRD) were observed (P < .05) as early as after the first course of chemotherapy. Tracer uptake showed little change in tumors with GRD found later in pathologic analysis but decreased sharply to the background level in most tumors with MRD. After the first course, all responders were correctly identified (sensitivity 100%, specificity 85%) by a standardized uptake value decrease below 55% of the baseline scan. At this threshold, histopathologic response could be predicted with an accuracy of 88% and 91% after the first and second courses of therapy, respectively. CONCLUSION: This study demonstrates that in patients with advanced breast cancer undergoing primary chemotherapy, FDG-PET differentiates responders from nonresponders early in the course of therapy. This may help improve patient management by avoiding ineffective chemotherapy and supporting the decision to continue dose-intensive preoperative chemotherapy in responding patients.
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Avril, N., C. A. Rosé, M. Schelling, J. Dose, W. Kuhn, S. Bense, W. Weber, S. Ziegler, H. Graeff, and M. Schwaiger. "Breast Imaging With Positron Emission Tomography and Fluorine-18 Fluorodeoxyglucose: Use and Limitations." Journal of Clinical Oncology 18, no. 20 (October 20, 2000): 3495–502. http://dx.doi.org/10.1200/jco.2000.18.20.3495.
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PURPOSE: To evaluate the diagnostic value of positron emission tomography (PET) using fluorine-18 fluorodeoxyglucose (FDG) for the diagnosis of primary breast cancer. PATIENTS AND METHODS: Preoperatively, 144 patients with masses suggestive of breast cancer underwent PET imaging of the breast. To identify breast cancer by increased metabolic activity, parametric FDG-PET images were analyzed for increased tracer uptake applying conventional image reading (CIR) and sensitive image reading (SIR). One hundred eighty-five breast tumors were evaluated by histology, revealing 132 breast carcinomas and 53 benign masses. RESULTS: Breast carcinomas were identified with an overall sensitivity of 64.4% (CIR) and 80.3% (SIR). The increase in sensitivity (SIR) resulted in a noticeable decrease in specificity, from 94.3% (CIR) to 75.5% (SIR). At stage pT1, only 30 (68.2%) of 44 breast carcinomas were detected, compared with 57 (91.9%) of 62 at stage pT2. A higher percentage of invasive lobular carcinomas were false-negative (65.2%) compared with invasive ductal carcinomas (23.7%). Nevertheless, positive PET scans provided a high positive-predictive value (96.6%) for breast cancer. CONCLUSION: Partial volume effects and varying metabolic activity (dependent on tumor type) seem to represent the most significant limitations for the routine diagnostic application of PET. The number of invasive procedures is therefore unlikely to be significantly reduced by PET imaging in patients presenting with abnormal mammography. However, the high positive-predictive value, resulting from the increased metabolic activity of malignant tissue, may be used with carefully selected subsets of patients as well as to determine the extent of disease or to assess therapy response.
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Solaini, Leonardo, Anna Bianchi, Luigi Filippini, Laura Lucini, Edda Simoncini, and Fulvio Ragni. "A Mammary Nodule Mimicking Breast Cancer." International Surgery 99, no. 3 (May 1, 2014): 200–202. http://dx.doi.org/10.9738/intsurg-d-12-00019.1.
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Abstract Metastases to the breast from extramammary tumors are rare. Several clinical, radiologic, and histologic signs can help to distinguish metastases from breast primary tumors. In the present study, we present a case of a left-sided breast metastasis from renal cancer in a 44-year-old woman whose clinical presentation was a mammary nodule in the upper internal quadrant. The patient underwent quadrantectomy with sentinel lymph node biopsy. The histology revealed a clear cell carcinoma. On computed tomography scan a 5×8-cm left renal mass with pulmonary, liver, and intrapericardial nodules was found. The patient underwent palliative care and died after 4 months. Metastasis to the breast is rare, but all of those clinical, radiologic, and histologic signs more typical of extramammary malignancies should always be considered in order to choose the best treatment strategy.
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Huang, Chong, Yu Lin, Lian He, Daniel Irwin, Margaret M. Szabunio, and Guoqiang Yu. "Alignment of sources and detectors on breast surface for noncontact diffuse correlation tomography of breast tumors." Applied Optics 54, no. 29 (October 9, 2015): 8808. http://dx.doi.org/10.1364/ao.54.008808.
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Sözen, Mehmet, Zeynep Cantürk, Berrin Çetinarslan, Alev Selek, Emre Gezer, Çiğdem Vural, and Umay Kiraz. "Thyroid gland metastasis from breast cancer: a case report." Journal of Research in Clinical Medicine 8, no. 1 (April 30, 2020): 15. http://dx.doi.org/10.34172/jrcm.2020.015.
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Primary cancer metastasis to thyroid gland is rare. The most common metastatic tumors of the thyroid gland are from lung, breast and renal cell carcinoma. In this case report, a patient with breast cancer metastasized to the thyroid gland is presented. A 38-year-old female patient was diagnosed with breast cancer, and positron emission tomography-computed tomography (PET-CT) imaging for breast cancer staging revealed fluoro-2deoxy-D-glucose (FDG) uptake in the thyroid nodule. Fine needle aspiration biopsy (FNAB) of the nodule revealed atypia of undetermined significance (Bethesda III). After neoadjuvant chemotherapy, simultaneous breast conserving surgery and total thyroidectomy were performed. Immunohistochemical staining of the pathological specimens revealed breast cancer that had metastasized to the thyroid gland. Immunohistochemical methods helped distinguishing primary thyroid cancer from metastasis. Also, nodules that showed activity involvement were detected randomly in PET-CT, and had to be evaluated in terms of malignancy.
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Tibana, Tiago Kojun, Rômulo Florêncio Tristão Santos, Adalberto Arão Filho, Bernardo Bacelar, Leticia de Assis Martins, Rafael Oliveira de Souza, Edson Marchiori, and Thiago Franchi Nunes. "Detection of additional primary malignancies: the role of CT and PET/CT combined with multiple percutaneous biopsy." Radiologia Brasileira 52, no. 3 (June 2019): 166–71. http://dx.doi.org/10.1590/0100-3984.2018.0024.
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Abstract Objective: To evaluate the imaging findings of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and computed tomography (CT) in patients with additional primary tumors, correlating the results with those of the method used in order to elucidate the diagnosis and of the pathology reports. Materials and Methods: We retrospectively analyzed the medical records, pathology reports and images of 11 patients who underwent CT, 18F-FDG PET/CT, or both. We included patients with at least two tumors, with confirmed distinct histopathological profiles, at different sites. Patients in whom there was no diagnostic confirmation were excluded, as were those in whom the additional lesion was suspected of being a metastasis of the first. Results: New primary malignancies were identified in 11 patients, one new tumor being found in 10 and two new tumors being found in 1. The confirmed sites of the additional malignancies were the lung, kidney, prostate, jejunum, and breast. Single or multiple percutaneous biopsies were performed in 10 patients, and 1 patient underwent a surgical procedure for diagnostic and therapeutic purposes. The tumors were metachronous in 6 cases and synchronous in 5. Conclusion: CT and 18F-FDG PET-CT combined with multiple percutaneous biopsy could facilitate the diagnosis of additional lesions, thus optimizing the treatment and follow-up of the affected patients.
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Farrugia, Mark K., Geraldine M. Jacobson, and Mohamad Adham Salkeni. "Prognostic factors in breast cancer patients evaluated by PET/CT prior to neoadjuvant chemotherapy." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): e12113-e12113. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e12113.
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e12113 Background: Neoadjuvant chemotherapy (NAC) is an important modality in breast cancer treatment. We sought to identify pre-treatment prognostic factors in patients who had positron emission tomography paired with diagnostic quality contrast-enhanced CT (PET/CT) prior to neoadjuvant chemotherapy with respect to pathologic complete response (pCR) , survival and relapse-free survival (RFS). Methods: We retrospectively analyzed 118 breast cancer patients who had pre-treatment PET/CT imaging and received NAC from 2008-2014. We collected data on molecular markers, PET/CT, pCR, survival, and disease status. Results: The median follow up was 44 months(range 7.3-101.5),median age was 51 years; 47% were stage II, 53% stage III. 52% of patients had hormone receptor (HR) positive/HER2 negative disease, 31% of tumors were HER2 positive, and 17% of tumors were triple-negative. 92.5% with HER2 positive tumors received NAC containing at least one HER2 targeted agent. Pre-treatment standard uptake value (SUV) max of the primary breast tumor showed no statistically significant relationship to survival, RFS, or pCR. PET avid (>2 SUV) extra-axillary nodes such as internal mammary and supraclavicular was associated with a non-statistically significant trend towards reduced RFS (p=0.06, HR=0.13-1.06). pCR overall was 37.5% for HER2 positive tumors, 15% in triple-negative tumors, and 8% in HR positive/HER2 negative tumors. Log-rank analysis with post-hoc pairwise comparisons showed a significant difference between the RFS of triple-negative tumors and HER2 positive tumors (p=0.001), while comparison between HR positive/HER2 negative and HER2 positive was not statistically significant (p=0.11). Multivariate cox regression analysis, which included grade and stage of tumors, showed HER2 positivity to be associated with a favorable outcome (p=0.04, HR=0.22 (0.05-0.94)). Conclusions: Within this cohort, pre-treatment SUV max of the primary tumor showed no prognostic value with regard pCR or RFS. PET avid extra-axillary metastasis trended towards reduced RFS. Patients with HER2 positive tumors had the highest pCR and RFS comparable to classically favorable subgroups such as HR positive/HER 2 negative.
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Fujioka, Tomoyuki, Mio Mori, Iichiroh Onishi, Yuka Yashima, Emi Yamaga, Jun Oyama, Kota Yokoyama, et al. "A Rare Case of Primary Breast Osteosarcoma Evaluated with Multiple Modalities." Diagnostics 11, no. 7 (June 28, 2021): 1170. http://dx.doi.org/10.3390/diagnostics11071170.
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Primary breast osteosarcoma (PBO) is very rare. This report presents a case of POB that was evaluated by multiple modalities. A woman in her 70s presented with a mass of increasing size in her right breast. A mammogram and an ultrasound visualized a lobulated mass containing coarse calcification in the right breast. Magnetic resonance imaging showed a strong enhancement effect and high signal on diffusion-weighted imaging. Further imaging on 18F-fluorodeoxyglucose positron-emission tomography and computed tomography exhibited a high uptake. A right total mastectomy was performed. Histologic examination revealed abundant periosteal formation, areas of calcification and moderately pleomorphic oval to spindle-shaped stromal cells, leading to the diagnosis of PBO. The presence of calcified breast tumors exhibiting aggressive growth indicates that PBO should be added to the differential diagnosis.
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Sasada, Shinsuke, Yuri Kimura, Norio Masumoto, Akiko Emi, Takayuki Kadoya, Koji Arihiro, and Morihito Okada. "Breast cancer detection by dedicated breast positron emission tomography according to the World Health Organization classification of breast tumors." European Journal of Surgical Oncology 47, no. 7 (July 2021): 1588–92. http://dx.doi.org/10.1016/j.ejso.2021.02.026.
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Abbruzzese, J. L., M. C. Abbruzzese, R. Lenzi, K. R. Hess, and M. N. Raber. "Analysis of a diagnostic strategy for patients with suspected tumors of unknown origin." Journal of Clinical Oncology 13, no. 8 (August 1995): 2094–103. http://dx.doi.org/10.1200/jco.1995.13.8.2094.
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PURPOSE Diagnostic strategies designed to identify the underlying primary malignancies in patients with unknown primary tumors (UPTs) have relied on retrospective analyses. We analyzed 879 consecutive patients referred with suspected UPTs to determine the yield and cost of a limited diagnostic evaluation, assess the contribution of specific studies to diagnosis, and analyze the survival patterns of patients in whom the primary tumor was diagnosed. PATIENTS AND METHODS Data from patients with a suspected UPT were entered into a computerized data base, and the patients underwent a predefined limited diagnostic evaluation. Primary malignancies were diagnosed by pathologic review alone or by pathologic criteria plus a physical or radiographic finding. Survival was measured from diagnosis, estimated using the Kaplan-Meier method, and compared using the Cox-Mantel log-rank test. RESULTS A primary tumor was found in 179 of 879 patients (20%). The survival duration of patients in whom the primary tumor was diagnosed was superior to that of patients in whom the primary tumor remained unknown. Specific patient subsets contributed most to the improved survival duration of the group in which the primary tumor was found, including lymphoma patients diagnosed solely by pathologic criteria and female patients with primary breast or ovarian cancer. The cost of diagnosis was mostly due to the extensive use of computed tomography. Except for ovarian cancer, computed tomography rarely identified treatable primary tumors. CONCLUSION The limited diagnostic evaluation used in this study identified patients with treatable malignancies and increased the survival duration of a population of suspected UPT patients. Primary malignancies with the best survival can be diagnosed through careful pathologic review and focused evaluations for breast and ovarian cancer in women.
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Shojaku, Hiroko, Hikaru Seto, Hisakazu Iwai, Shinji Kitazawa, Wataru Fukushima, and Katsuhiko Saito. "Detection of incidental breast tumors by noncontrast spiral computed tomography of the chest." Radiation Medicine 26, no. 6 (July 2008): 362–67. http://dx.doi.org/10.1007/s11604-008-0241-z.
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Kosik, Ivan, Muriel Brackstone, Anat Kornecki, Astrid Chamson-Reig, Philip Wong, and Jeffrey J. L. Carson. "Lipid-weighted intraoperative photoacoustic tomography of breast tumors: Volumetric comparison to preoperative MRI." Photoacoustics 18 (June 2020): 100165. http://dx.doi.org/10.1016/j.pacs.2020.100165.
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Moskvicheva, L. I. "High-intensity focused ultrasonic ablation of breast cancer." Research'n Practical Medicine Journal 5, no. 3 (September 9, 2018): 67–76. http://dx.doi.org/10.17709/2409-2231-2018-5-3-6.
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Breast cancer is the most frequent and socially signifi cant malignant tumor disease of the female popula on of the Russian Federa on. At present, for the treatment of this pathology, the methods of the organ-preserving surgical manual allowing to achieve the maximum cosme c eff ect along with the observance of the principles of cancer safety are ge ng more and more developed,. In recent decades, researchers from diff erent countries demonstrate the feasibility and technical safety of various mini-invasive methods of thermal abla on of early stages of breast cancer, characterized by rela ve simplicity of implementa on, excellent cosme c results, short-term rehabilita on of pa ents. These include hyperthermic techniques (radiofrequency, microwave, laser abla on) and hypothermic method (cryoabla on). Each technique has unique characteris cs of impact on the tumor and is performed under the control of ultrasound, computer tomography or magne c resonance imaging. The technical success of these abla on techniques is achieved in 93–98% of cases. Complete tumor necrosis a er radiofrequency abla on is observed in 76–100% of pa ents with breast cancer, laser abla on – in 13–76%, microwave abla on – in 0–8%, cryoabla on – in 36–83%. The frequency of development of specifi c complica ons of local thermal destruc on is 4–13%. To date, there is only one method of noninvasive extracorporeal thermal abla on of tumors of diff erent localiza on – high-intensity focused ultrasound therapy, the eff ec veness and safety of which as a method of local destruc on of benign and malignant tumors of the breast demonstrated by many authors. Like all methods of thermal abla on, high-intensity focused ultrasound therapy has its limita ons, complica ons and disadvantages. This ar cle presents a literary review that highlights the possibili es of this method of local destruc on in pa ents with malignant tumors of the breast.
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Guo, Yihang, Honghong Wang, Jeni L. Gerberich, Samuel O. Odutola, Amanda K. Charlton-Sevcik, Maoping Li, Rajendra P. Tanpure, et al. "Imaging-Guided Evaluation of the Novel Small-Molecule Benzosuberene Tubulin-Binding Agent KGP265 as a Potential Therapeutic Agent for Cancer Treatment." Cancers 13, no. 19 (September 24, 2021): 4769. http://dx.doi.org/10.3390/cancers13194769.
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The selective disruption of tumor-associated vasculature represents an attractive therapeutic approach. We have undertaken the first in vivo evaluation of KGP265, a water-soluble prodrug of a benzosuberene-based tubulin-binding agent, and found promising vascular-disrupting activity in three distinct tumor types. Dose escalation in orthotopic MDA-MB-231-luc breast tumor xenografts in mice indicated that higher doses produced more effective vascular shutdown, as revealed by dynamic bioluminescence imaging (BLI). In syngeneic orthotopic 4T1-luc breast and RENCA-luc kidney tumors, dynamic BLI and oxygen enhanced multispectral optoacoustic tomography (OE-MSOT) were used to compare vascular shutdown following the administration of KGP265 (7.5 mg/kg). The BLI signal and vascular oxygenation response (ΔsO2) to a gas breathing challenge were both significantly reduced within 2 h, indicating vascular disruption, which continued over 24 h. A correlative histology confirmed increased necrosis and hemorrhage. Twice-weekly doses of KGP265 caused significant growth delay in both MDA-MB-231 and 4T1 breast tumors, with no obvious systemic toxicity. A combination with carboplatin produced significantly greater tumor growth delay than carboplatin alone, though significant carboplatin-associated toxicity was observed (whole-body weight loss). KGP265 was found to be effective at low concentrations, generating long-term vascular shutdown and tumor growth delay, thus providing strong rationale for further development, particularly in combination therapies.
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Jiang, Yaqun, Yongkang Gai, Yu Long, Qingyao Liu, Chunbao Liu, Yongxue Zhang, and Xiaoli Lan. "Application and Evaluation of [99mTc]-Labeled Peptide Nucleic Acid Targeting MicroRNA-155 in Breast Cancer Imaging." Molecular Imaging 19 (January 1, 2020): 153601212091612. http://dx.doi.org/10.1177/1536012120916124.
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It has been reported that dysregulation of microRNA-155 expression and function is associated with tumorigenesis, growth, tumor subtypes, invasion, and poor survival rates. Peptide nucleic acid (PNA), an artificially synthesized nucleic acid mimic, has been applied for molecular diagnosis. In this study, a PNA sequence that undergoes complementary binding to miR-155 was labeled with 99mTc to evaluate whether the tracer could visualize the expression of miR-155 in breast cancer. Both antisense PNA (anti-PNA, fully complementary bound to human mature miR-155, referred to as “anti-PNA-155”) and mismatched PNA (referred to as “mis-PNA”) single strands containing 23-mer were synthesized. The relative expression of miR-155 in MCF-7 cells and tumors was higher than that in MDA-MB-231 cells and tumors. Single-photon emission computed tomography (SPECT) scan showed that radioactivity mainly accumulated in kidney. MCF-7 tumors, but not MDA-MB-231 tumors, were clearly visualized after [99mTc]anti-PNA-155 injection. MCF-7 tumors were less visible when coinjected with 100-fold excess of anti-PNA-155 or injected with [99mTc]mis-PNA, which suggested specific binding. Biodistribution study results were consistent with SPECT imaging. We successfully demonstrated that [99mTc]anti-PNA-155 could visualize miR-155 expression in vivo, suggesting it may be a promising probe applied in breast cancer.
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Ferrière, Robert, Serge Mensah, and Jean-Pierre Lefebvre. "Weakly Inhomogeneous Media Tomography." Ultrasonic Imaging 25, no. 2 (April 2003): 122–33. http://dx.doi.org/10.1177/016173460302500204.
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Our objective is to develop an ultrasonic scanner for breast imaging. High resolution is obtained by using wide-band spherical waves transmitted and measured in the near field zone (i.e., close to the skin) all around the organ. The tomographic approach that we adopt allows us to use low central frequency waves (3–7 MHz) that are suitable for good penetration while maintaining high resolution and contrast. The procedure is thus suitable for early detection of tumors and increases the chances of total recovery. The novelty of the present reconstruction procedure is that it associates the signals acquired in transmission to the data measured in reflection over a large aperture. This enables us to correct the phase aberration induced by weak inhomogeneities whose sizes might be several wavelengths. Numerical tests based on Finite Difference Time Domain (FDTD) simulations demonstrate the greater fidelity of the reconstruction.
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Lardinois, Didier, Walter Weder, Marina Roudas, Gustav K. von Schulthess, Michaela Tutic, Holger Moch, Rolf A. Stahel, and Hans C. Steinert. "Etiology of Solitary Extrapulmonary Positron Emission Tomography and Computed Tomography Findings in Patients With Lung Cancer." Journal of Clinical Oncology 23, no. 28 (October 1, 2005): 6846–53. http://dx.doi.org/10.1200/jco.2005.10.116.
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Purpose The aim of this prospective study was to assess the incidence and the nature of solitary extrapulmonary [18F] fluorodeoxyglucose (FDG) accumulations in patients with non–small-cell lung cancer (NSCLC) staged with integrated positron emission tomography and computed tomography (PET/CT) and to evaluate the impact on management. Patients and Methods A total of 350 patients with NSCLC underwent whole-body PET/CT imaging. All solitary extrapulmonary FDG accumulations were evaluated by histopathology, further imaging, or clinical follow-up. Results PET/CT imaging revealed extrapulmonary lesions in 110 patients. In 72 patients (21%), solitary lesions were present. A diagnosis was obtained in 69 of these patients, including 37 (54%) with solitary metastases and 32 (46%) with lesions unrelated to the lung primary. Histopathologic examinations of these 32 lesions revealed a second clinically unsuspected malignancy or a recurrence of a previous diagnosed carcinoma in six patients (19%) and a benign tumor or inflammatory lesion in 26 patients (81%). The six malignancies consisted of carcinoma of the breast in two patients, and carcinoma of the orbit, esophagus, prostate, and non-Hodgkin's lymphoma in one patient each. Benign tumors and inflammatory lesions included eight colon adenomas, four Warthin's tumors, one granuloma of the lower jaw, one adenoma of the thyroid gland, one compensatory muscle activity due to vocal chord palsy, two occurrences of arthritis, three occurrences of reflux esophagitis, two occurrences of pancreatitis, two occurrences of diverticulitis, one hemorrhoidal inflammation, and one rib fracture. Conclusion Solitary extrapulmonary FDG accumulations in patients with newly diagnosed lung cancer should be analyzed critically for correct staging and optimal therapy, given that up to half of the lesions may represent unrelated malignancies or benign disease.
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Jansson, T., J. E. Westlin, H. Ahlström, A. Lilja, B. Långström, and J. Bergh. "Positron emission tomography studies in patients with locally advanced and/or metastatic breast cancer: a method for early therapy evaluation?" Journal of Clinical Oncology 13, no. 6 (June 1995): 1470–77. http://dx.doi.org/10.1200/jco.1995.13.6.1470.
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PURPOSE To investigate if sequential positron emission tomographic (PET) scans with the glucose analog 18F-2-fluoro-2-deoxy-D-glucose (18FDG) and/or L-methyl-11C-methionine (11C-methionine) in patients with breast cancer could provide early information on the efficacy of polychemotherapy. PATIENTS AND METHODS Sixteen patients with breast cancer (11 with locally advanced tumors, three with recurrent disease in the contralateral breast, two of them with distant and regional metastases, and two with distant metastases) underwent a baseline and two follow-up PET scans after the first and third/fourth polychemotherapy course. Tumor response was determined clinically/radiographically after three/four polychemotherapy courses. RESULTS Five patients were investigated with 18FDG, seven with both 11C-methionine and 18FDG, and four with only 11C-methionine before polychemotherapy. 11C-methionine presented a more distinct visualization of primary/contralateral breast cancers in five of seven patients when compared with 18FDG. Twelve of 16 patients demonstrated a response using conventional methods after the third/fourth course of polychemotherapy. Eight of these 12 clinical responders had a significant decrease in tracer uptake at the first PET scan performed 6 to 13 days after the first polychemotherapy course, and these reductions were further augmented after the third/fourth course and corresponded to the conventional therapy evaluation (clinical examination, computed tomography [CT], ultrasonography, and mammography). CONCLUSION Our data indicate that PET may be of clinical value in predicting response to chemotherapy in patients with locally advanced breast cancer and/or metastatic disease earlier than any other method used.