Background: The multifocality and multicentrality of breast cancer (MFMCC) are the significant aspects that determine a specialist’s choice between applying breast-conserving therapy (BCT) or performing a mastectomy. This study aimed to assess the usefulness of mammography (MG), contrast-enhanced spectral mammography (CESM), and magnetic resonance imaging (MRI) in women diagnosed with breast cancer before qualifying for surgical intervention to visualize other (additional) cancer foci. Methods: The study included 60 breast cancer cases out of 630 patients initially who underwent surgery due to breast cancer from January 2015 to April 2019. MG, CESM, and MRI were compared with each other in terms of the presence of MFMCC and assessed for compliance with the postoperative histopathological examination (HP). Results: Histopathological examination confirmed the presence of MFMCC in 33/60 (55%) patients. The sensitivity of MG in detecting MFMCC was 50%, and its specificity was 95.83%. For CESM, the sensitivity was 85.29%, and the specificity was 96.15%. For MRI, all the above-mentioned parameters were higher as follows: sensitivity—91.18%; specificity—92.31%. Conclusions: In patients with MFMCC, both CESM and MRI are highly sensitive in the detection of additional cancer foci. Both CESM and MRI change the extent of surgical intervention in every fourth patient.
17 January 2022 in Computers in Biology and Medicine
Metastatic brain cancer is a condition characterized by the migration of cancer cells to the brain from extracranial sites. Notably, metastatic brain tumors surpass primary brain tumors in prevalence by a significant factor, they exhibit an aggressive growth potential and have the capacity to spread across diverse cerebral locations simultaneously. Magnetic resonance imaging (MRI) scans of individuals afflicted with metastatic brain tumors unveil a wide spectrum of characteristics. These lesions vary in size and quantity, spanning from tiny nodules to substantial masses captured within MRI. Patients may present with a limited number of lesions or an extensive burden of hundreds of them. Moreover, longitudinal studies may depict surgical resection cavities, as well as areas of necrosis or edema. Thus, the manual analysis of such MRI scans is difficult, user-dependent and cost-inefficient, and - importantly - it lacks reproducibility. We address these challenges and propose a pipeline for detecting and analyzing brain metastases in longitudinal studies, which benefits from an ensemble of various deep learning architectures originally designed for different downstream tasks (detection and segmentation). The experiments, performed over 275 multi-modal MRI scans of 87 patients acquired in 53 sites, coupled with rigorously validated manual annotations, revealed that our pipeline, built upon open-source tools to ensure its reproducibility, offers high-quality detection, and allows for precisely tracking the disease progression. To objectively quantify the generalizability of models, we introduce a new data stratification approach that accommodates the heterogeneity of the dataset and is used to elaborate training-test splits in a data-robust manner, alongside a new set of quality metrics to objectively assess algorithms. Our system provides a fully automatic and quantitative approach that may support physicians in a laborious process of disease progression tracking and evaluation of treatment efficacy.
Background: A reliable assessment of liver volume, necessary before transplantation, remains a challenge. Our work aimed to assess the differences in the evaluation and measurements of the liver between independent observers and compare different formulas calculating its volume in relation to volumetric segmentation. Methods: Eight researchers measured standard liver dimensions based on 105 abdominal computed tomography (CT) scans. Based on the results obtained, the volume of the liver was calculated using twelve different methods. An independent observer performed a volumetric segmentation of the livers based on the same CT examinations. Results: Significant differences were found between the formulas and in relation to volumetric segmentation, with the closest results obtained for the Heinemann et al. method. The measurements of individual observers differed significantly from one another. The observers also rated different numbers of livers as enlarged. Conclusions: Due to significant differences, despite its time-consuming nature, the use of volumetric liver segmentation in the daily assessment of liver volume seems to be the most accurate method.
Cognitive impairment (CI) is a common and disabling manifestation of multiple sclerosis (MS), yet it remains underdiagnosed in clinical settings. This study aims to identify the volumetric MRI markers of CI in MS patients. A total of 79 MS patients were enrolled; after exclusions, 63 with relapsing-remitting MS (RRMS) and 7 with primary progressive MS were analyzed. All participants underwent neuropsychological testing (CVLT, BVRT, CTT, VFT, VST, and SDMT). Brain volumes were analyzed using FreeSurfer. In RRMS, 59% had CI (35% single-domain, 24% multidomain). Multidomain CI was linked to reduced left cerebellar white matter and bilateral pallidum volumes, slight choroid plexus enlargement, and higher lesion volume versus cognitively preserved patients. Significant correlations were found between brain volumes and cognitive test scores: cerebellar and cerebral white matter, corpus callosum, subcortical gray matter, and thalamus volumes correlated positively with measures of processing speed, memory, and verbal fluency, while higher lesion load and larger choroid plexus volumes were associated with poorer cognitive performance. CI in MS is linked to both global and regional brain atrophy, as well as lesion load. Volumetric MRI, including choroid plexus analysis, may represent candidate imaging correlates of CI; however, longitudinal and externally validated studies are needed to confirm their predictive value and clinical utility.