Objective: To explore whether the pretreatment dynamic contrast enhancement magnetic resonance imaging (DCE-MRI) and radiomics signatures were associated with pathologic complete response (pCR) to neoadjuvant therapy (NAT) in breast cancer. Method: A retrospective review of 70 patients with breast invasive carcinomas proved by biopsy between June 2017 and October 2020 (26 patients were pathological complete response, and 44 patients were non-pathological complete response). Within the pre-contrast and five post-contrast dynamic series, a total of 1037 quantitative imaging features were extracted from in each phase. Additionally, the Δfeatures (the difference between the features before and after the comparison) were used for subsequent analysis. The least absolute shrinkage and selection operator (LASSO) regression method was used to select features related to pCR, and then use these features to train multiple machine learning classifiers to predict the probability of pCR for a given patient. The area under the curve (AUC), accuracy, sensitivity, and specificity were calculated to assess the predictive performances of the radiomics model for each of the five phases of time points. Result: Among the five phases, each individual phase performed with AUCs ranging from 0.845 to 0.919 in predicting pCR. The best single phases performance was given by the 3rd phase (AUC = 0.919, sensitivity 0.885, specificity 0.864). 5 of the features have significant differences between pCR and non-pCR groups in each phase, most features reach their maximum or minimum in the 2nd or 3rd phase. Conclusion: The radiomic features extracted from each phase of pre-treatment DCE-MRI possess discriminatory power to predict tumor response.

To investigate the feasibility and effectiveness of high-resolution readout-segmented echo planar imaging (rs-EPI), diffusion-weighted imaging (DWI) is used simultaneously with multi-slice (SMS) imaging (SMS rs-EPI) for the differentiation of breast malignant and benign lesions in comparison to conventional rs-EPI on a 3T MR scanner. A total of 102 patients with 113 breast lesions underwent bilateral breast MRI using a prototype SMS rs-EPI sequence and a conventional rs-EPI sequence. Subjective image quality was assessed using a 5-point Likert scale (1 = poor, 5 = excellent). Signal-to-noise ratio (SNR), lesion contrast-to-noise ratio (CNR) and apparent diffusion coefficients (ADC) value of the lesion were measured for comparison. Receiver operating characteristic curve analysis was performed to evaluate the diagnosis performance of ADC, and the corresponding area under curve (AUC) was calculated. The image quality scores in anatomic distortion, lesion conspicuity, sharpness of anatomical details and overall image quality of SMS rs-EPI were significantly higher than those of conventional rs-EPI. CNR was enhanced in the high-resolution SMS rs-EPI acquisition (6.48 ± 1.71 vs. 4.23 ± 1.49; p < 0.001). The mean ADC value was comparable in SMS rs-EPI and conventional rs-EPI (benign 1.45 × 10⁻³ vs. 1.43 × 10⁻³ mm²/s, p = 0.702; malignant 0.91 × 10⁻³ vs. 0.89 × 10⁻³ mm²/s, p = 0.076). The AUC was 0.957 in SMS rs-EPI and 0.983 in conventional rs-EPI. SMS rs-EPI technique allows for higher spatial resolution and slight reduction of scan time in comparison to conventional rs-EPI, which has potential for better differentiation between malignant and benign lesions of the breast.

Objectives: To explore the feasibility of time-dependent diffusion in clinical applications of breast MRI, as well as the capacity of quantitative microstructural mapping for characterizing the cellular properties in malignant and benign breast tumors. Methods: 38 patients with 45 lesions were enrolled. Diffusion MRI acquisition was conducted with a combination of pulsed gradient spin-echo sequences (PGSE) and oscillating gradient spin-echo (OGSE) on a 3T MRI scanner. The microstructural parameters including cellularity extracellular diffusivity (D_ex), mean cell size, intracellular volume fraction (ν_in), and the apparent diffusion coefficient (ADC) values were calculated. Each parameter was compared using the unpaired t-test between malignant and benign tumors. The area under the receiver operating characteristic curve (AUC) values was used to evaluate the diagnostic performance of different indices. Results: The mean diameter, D_ex, ADC_0Hz, ADC_25Hz, and ADC_50Hz were significantly lower in the malignant group than in the benign group (p < 0.001), while ν_in and cellularity were significantly higher in the malignant group (p < 0.001). All the microstructural parameters and time-dependent ADC values achieved high accuracy in differentiating between malignant and benign tumors of the breast. For microstructural parameters, the AUC of the cellularity was greater than others (AUC = 0.936). In an immunohistochemical subgroup comparison, the PR-positive group had significantly lower ν_in and cellularity, and significantly elevated D_ex and ADC_0Hz compared to the negative groups (p < 0.05). When combining diffusion parameters (cellularity, diameter, and ADC_25Hz), the highest diagnostic performance was obtained with an AUC of 0.969. Conclusions: DWI with a short diffusion time is capable of providing additional microstructural parameters in differentiating between benign and malignant breast tumors. The time-dependent diffusion MRI parameters have the potential to serve as a non-invasive tool to probe the differences in the internal structures of breast lesions.

Objectives: To compare the application value of digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM) in breast galactography. Materials and Methods: A total of 128 patients with pathological nipple discharge (PND) were selected to undergo galactography. DBT and FFDM were performed for each patient after injecting the contrast agent; the radiation dose of DBT and FFDM was calculated, and the image quality was evaluated in consensus by two senior breast radiologists. Histopathologic data were found in 49 of the 128 patients. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for both FFDM- and DBT-galactography were calculated using histopathologic results as a reference standard. Data were presented as percentages along with their 95% confidence intervals (CI). Results: The average age of the 128 patients was 46.53 years. The average glandular dose (AGD) of DBT-galactography was slightly higher than that of FFDM-galactography (p < 0.001). DBT-galactography was 30.7% higher than FFDM-galactography in CC view, while DBT-galactography increased by 21.7% compared with FFDM-galactography in ML view. Regarding catheter anatomic distortion, structure detail, and overall image quality groups, DBT scores were higher than FFDM scores, and the differences were significant for all measures (p < 0.05). In 49 patients with pathological nipple discharge, we found that the DBT-galactography had higher sensitivity, specificity, PPV, and NPV (93.3%, 75%, 97.7%, and 50%, respectively) than FFDM-galactography (91.1%, 50%, 95.3%, and 33.3%, respectively). Conclusions: Compared to FFDM-galactography, within the acceptable radiation dose range, DBT-galactography increases the sensitivity and specificity of lesion detection by improving the image quality, providing more confidence for the diagnosis of clinical ductal lesions.

Background: Osteoma is the most common benign tumor of the craniomaxillofacial region. Its etiology remains unclear, and the computed tomography and histopathologic examination contribute to its diagnosis. There are very rare reports of recurrence and malignant transformation after surgical resection. Furthermore, giant frontal osteomas that occurred repeatedly and were accompanied by skin multiple keratinous cysts and multinucleated giant cell granulomas have not been reported in previous literature. Methods: The previous cases of recurrent frontal osteoma in the literature and all cases of frontal osteoma in our department in the last 5 years were reviewed. Results: A total of 17 cases of frontal osteoma (mean age 40 y, all female) were reviewed in our department. All patients underwent open surgery to remove the frontal osteoma, and no evidence of complications was found during postoperative follow-up. Two patients underwent 2 or more operations due to the recurrence of osteoma. Conclusions: Two cases of recurrent giant frontal osteoma were reviewed emphatically in this study, including 1 case of giant frontal osteoma with skin multiple keratinous cysts and multinucleated giant cell granulomas. As far as we know, this is the first giant frontal osteoma that occurred repeatedly and was accompanied by skin multiple keratinous cysts and multinucleated giant cell granulomas.