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A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (30 November 2024) | Viewed by 10347

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Special Issue Editor

Dr. Luca Nicosia

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Guest Editor

Breast Imaging Division, Radiology Department, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy
Interests: breast imaging
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The diagnosis of breast disease has become increasingly challenging in recent years. Breast radiologists face new opportunities with potential developments such as radiomics, artificial intelligence, and CEM.

With this Special Issue dedicated to breast imaging, we want to encourage research in the most innovative sectors of breast imaging diagnosis. The aim is to provide the patient with increasingly innovative and personalized means to combat an ever-challenging breast disease landscape.

This Special Issue will explore, but is not restricted to, the following topics:

Radiomics and AI for breast cancer diagnosis and staging;
Contrast-enhanced mammography;
Advancements in breast imaging technology;
Breast biopsy.

Dr. Luca Nicosia
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

contrast-enhanced mammography (CEM)
artificial intelligence
radiomics
breast biopsy
breast imaging

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Published Papers (7 papers)

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Research

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11 pages, 1004 KiB

Open AccessArticle

Comparative Analysis of Automated and Handheld Breast Ultrasound Findings for Small (≤1 cm) Breast Cancers Based on BI-RADS Category

by Han Song Mun, Eun Young Ko, Boo-Kyung Han, Eun Sook Ko, Ji Soo Choi, Haejung Kim, Myoung Kyoung Kim and Jieun Kim

Diagnostics 2025, 15(2), 212; https://doi.org/10.3390/diagnostics15020212 - 17 Jan 2025

Viewed by 448

Abstract

Objectives: This study aimed to compare ultrasound (US) findings between automated and handheld breast ultrasound (ABUS and HHUS, respectively) in small breast cancers, based on the breast imaging reporting and data system (BI-RADS) category. Methods: We included 51 women (mean age: 52 years; range: 39–66 years) with breast cancer (invasive or DCIS), all of whom underwent both ABUS and HHUS. Patients with tumors measuring ≤1 cm on either modality were enrolled. Two breast radiologists retrospectively evaluated multiple imaging features, including shape, orientation, margin, echo pattern, and posterior characteristics and assigned BI-RADS categories. Lesion sizes were compared between US and pathological findings. Statistical analyses were performed using Bowker’s test of symmetry, a paired t-test, and a cumulative link mixed model. Results: ABUS assigned lower BI-RADS categories than HHUS while still maintaining malignancy suspicion in categories 4A or higher (54.8% consistent with HHUS; 37.3% downcategorized in ABUS, p = 0.005). While ABUS demonstrated less aggressive margins in some cases (61.3% consistent with HHUS; 25.8% showing fewer suspicious margins in ABUS), this difference was not statistically significant (p = 0.221). Similarly, ABUS exhibited slightly greater height–width ratios compared to HHUS (median, interquartile range: 0.98, 0.7–1.12 vs. 0.86, 0.74–1.10, p = 0.166). No significant differences were observed in other US findings or tumor sizes between the two modalities (all p > 0.05). Conclusions: Small breast cancers exhibited suspicious US features on both ABUS and HHUS, yet they were assigned lower BI-RADS assessment categories on ABUS compared to HHUS. Therefore, when conducting breast cancer screening with ABUS, it is important to remain attentive to even subtle suspicious findings, and active consideration for biopsy may be warranted. Full article

(This article belongs to the Special Issue Recent Advances in Breast Imaging)

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11 pages, 1660 KiB

Open AccessArticle

Reliability of Kaiser Score in Assessing Additional Breast Lesions Identified on Staging MRI in Patients with Breast Cancer

by Madiha Hijazi, Reve Chahine, Ghina Berjawi, Yara Jabbour, Tamara El Annan, Roy Ibrahim and Lara Nassar

Diagnostics 2024, 14(16), 1726; https://doi.org/10.3390/diagnostics14161726 - 8 Aug 2024

Viewed by 1122

Abstract

(1) Background: The Kaiser score is a user-friendly tool that evaluates lesions on breast MRI and has been studied in the general population and a few specific clinical scenarios. We aim to evaluate the performance of the Kaiser score in the characterization of additional lesions identified on staging breast MRI. (2) Methods: The Kaiser score of the biopsied additional lesions identified on staging MRI in recently diagnosed breast cancer patients was retrospectively determined. Statistical analysis was performed to evaluate the diagnostic capability of the Kaiser score and whether it is affected by different imaging and pathological parameters of the additional and the index lesion. (3) Results: Seventy-six patients with ninety-two MRI-detected lesions constitute the studied population. There was a statistically significant difference in the Kaiser score between benign and malignant lesions, irrespective of the pathology of the index cancer (p = 0.221) or the size and the imaging features of the additional lesion. Using a cutoff of 5 and above for suspicious lesions, biopsy could have been avoided in 34/92 lesions. (4) Conclusions: The Kaiser score can assist radiologists in the evaluation of additional MRI lesions identified in recently diagnosed breast cancer patients, thus decreasing the number of unneeded biopsies and delays in definitive surgical management. Full article

(This article belongs to the Special Issue Recent Advances in Breast Imaging)

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17 pages, 3245 KiB

Open AccessArticle

Improving Lesion Location Reproducibility in Handheld Breast Ultrasound

by James Chiu, Davide Bova, Georgia Spear, Jacob Ecanow, Alyssa Choate, Pierre Besson and Calin Caluser

Diagnostics 2024, 14(15), 1602; https://doi.org/10.3390/diagnostics14151602 - 25 Jul 2024

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Abstract

Interoperator variability in the reproducibility of breast lesions found by handheld ultrasound (HHUS) can significantly interfere with clinical care. This study analyzed the features associated with breast mass position differences during HHUS. The ability of operators to reproduce the position of small masses and the time required to generate annotations with and without a computer-assisted scanning device (DEVICE) were also evaluated. This prospective study included 28 patients with 34 benign or probably benign small breast masses. Two operators generated manual and automated position annotations for each mass. The probe and body positions were systematically varied during scanning with the DEVICE, and the features describing mass movement were used in three logistic regression models trained to discriminate small from large breast mass displacements (cutoff: 10 mm). All models successfully discriminated small from large breast mass displacements (areas under the curve: 0.78 to 0.82). The interoperator localization precision was 6.6 ± 2.8 mm with DEVICE guidance and 19.9 ± 16.1 mm with manual annotations. Computer-assisted scanning reduced the time to annotate and reidentify a mass by 33 and 46 s on average, respectively. The results demonstrated that breast mass location reproducibility and exam efficiency improved by controlling operator actionable features with computer-assisted HHUS. Full article

(This article belongs to the Special Issue Recent Advances in Breast Imaging)

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16 pages, 2828 KiB

Open AccessArticle

Validation of Contrast-Enhanced Mammography as Breast Imaging Modality Compared to Standard Mammography and Digital Breast Tomosynthesis

by Nina Bartolović, Ana Car Peterko, Manuela Avirović, Doris Šegota Ritoša, Emina Grgurević Dujmić and Petra Valković Zujić

Diagnostics 2024, 14(14), 1575; https://doi.org/10.3390/diagnostics14141575 - 21 Jul 2024

Viewed by 1280

Abstract

Contrast-enhanced mammography (CEM) is a relatively new imaging technique that allows morphologic, anatomic and functional imaging of the breast. The aim of our study was to validate contrast-enhanced mammography (CEM) compared to mammography (MMG) and digital breast tomosynthesis (DBT) in daily clinical practice. This retrospective study included 316 consecutive patients who underwent MMG, DBT and CEM at the Centre for Prevention and Diagnosis of Chronic Diseases of Primorsko-goranska County. Two breast radiologists independently analyzed the image data, without available anamnestic information and without the possibility of comparison with previous images, to determine the presence of suspicious lesions and their morphological features according to the established criteria of the Breast Imaging Reporting and Data System (BI-RADS) lexicon. The diagnostic value of MMG, DBT and CEM was assessed by ROC analysis. The interobserver agreement was excellent. CEM showed higher diagnostic accuracy in terms of sensitivity and specificity compared to MMG and DBT, the reporting time for CEM was significantly shorter, and CEM findings resulted in a significantly lower proportion of equivocal findings (BI-RADS 0), suggesting fewer additional procedures. In conclusion, CEM achieves high diagnostic accuracy while maintaining simplicity, reproducibility and applicability in complex clinical settings. Full article

(This article belongs to the Special Issue Recent Advances in Breast Imaging)

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16 pages, 6044 KiB

Open AccessArticle

Diffusion-Weighted Imaging for Skin Pathologies of the Breast—A Feasibility Study

by Dominika Skwierawska, Frederik B. Laun, Evelyn Wenkel, Lorenz A. Kapsner, Rolf Janka, Michael Uder, Sabine Ohlmeyer and Sebastian Bickelhaupt

Diagnostics 2024, 14(9), 934; https://doi.org/10.3390/diagnostics14090934 - 29 Apr 2024

Viewed by 1659

Abstract

Several breast pathologies can affect the skin, and clinical pathways might differ significantly depending on the underlying diagnosis. This study investigates the feasibility of using diffusion-weighted imaging (DWI) to differentiate skin pathologies in breast MRIs. This retrospective study included 88 female patients who underwent diagnostic breast MRI (1.5 or 3T), including DWI. Skin areas were manually segmented, and the apparent diffusion coefficients (ADCs) were compared between different pathologies: inflammatory breast cancer (IBC; n = 5), benign skin inflammation (BSI; n = 11), Paget’s disease (PD; n = 3), and skin-involved breast cancer (SIBC; n = 11). Fifty-eight women had healthy skin (H; n = 58). The SIBC group had a significantly lower mean ADC than the BSI and IBC groups. These differences persisted for the first-order features of the ADC (mean, median, maximum, and minimum) only between the SIBC and BSI groups. The mean ADC did not differ significantly between the BSI and IBC groups. Quantitative DWI assessments demonstrated differences between various skin-affecting pathologies, but did not distinguish clearly between all of them. More extensive studies are needed to assess the utility of quantitative DWI in supplementing the diagnostic assessment of skin pathologies in breast imaging. Full article

(This article belongs to the Special Issue Recent Advances in Breast Imaging)

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14 pages, 3060 KiB

Open AccessArticle

Radiological Features of Male Breast Neoplasms: How to Improve the Management of a Rare Disease

by Luca Nicosia, Luciano Mariano, Anna Carla Bozzini, Filippo Pesapane, Vincenzo Bagnardi, Samuele Frassoni, Chiara Oriecuia, Valeria Dominelli, Antuono Latronico, Simone Palma, Massimo Venturini, Federico Fontana, Francesca Priolo, Ida Abiuso, Claudia Sangalli and Enrico Cassano

Diagnostics 2024, 14(1), 104; https://doi.org/10.3390/diagnostics14010104 - 3 Jan 2024

Cited by 1 | Viewed by 1587

Abstract

The primary aim of our study was to assess the main mammographic and ultrasonographic features of invasive male breast malignancies. The secondary aim was to evaluate whether a specific radiological presentation would be associated with a worse receptor profile. Radiological images (mammography and/or ultrasound) of all patients who underwent surgery for male invasive breast cancer in our institution between 2008 and 2023 were retrospectively analyzed by two breast radiologists in consensus. All significant features of radiological presentation known in the literature were re-evaluated. Fifty-six patients were selected. The mean age at surgery of patients was 69 years (range: 35–81); in 82% of cases (46 patients), the histologic outcome was invasive ductal carcinoma. A total of 28 out of 56 (50%) patients had preoperative mammography; in 9/28 cases (32%), we found a mass with microcalcifications on mammography. The mass presented high density in 25 out of 28 patients (89%); the mass showed irregular margins in 15/28 (54%) cases. A total of 46 out of 56 patients had preoperative ultrasounds. The lesion showed a solid mass in 41/46 (89%) cases. In 5/46 patients (11%), the lesion was a mass with a mixed (partly liquid–partly solid) structure. We did not find any statistically significant correlation between major types of radiological presentation and tumor receptor arrangement. Knowledge of the main radiologic presentation patterns of malignant male breast neoplasm can help better manage this type of disease, which is rare but whose incidence is increasing. Full article

(This article belongs to the Special Issue Recent Advances in Breast Imaging)

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Review

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23 pages, 3159 KiB

Open AccessReview

Radiotracer Innovations in Breast Cancer Imaging: A Review of Recent Progress

by Mohamad Haidar, Joe Rizkallah, Omar El Sardouk, Nour El Ghawi, Nadine Omran, Zeinab Hammoud, Nina Saliba, Arafat Tfayli, Hiba Moukadem, Ghina Berjawi, Lara Nassar, Fahad Marafi, Partha Choudhary, Habibollah Dadgar, Alyaa Sadeq and Alain S. Abi-Ghanem

Diagnostics 2024, 14(17), 1943; https://doi.org/10.3390/diagnostics14171943 - 3 Sep 2024

Viewed by 2083

Abstract

This review focuses on the pivotal role of radiotracers in breast cancer imaging, emphasizing their importance in accurate detection, staging, and treatment monitoring. Radiotracers, labeled with radioactive isotopes, are integral to various nuclear imaging techniques, including positron emission tomography (PET) and positron emission mammography (PEM). The most widely used radiotracer in breast cancer imaging is ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG), which highlights areas of increased glucose metabolism, a hallmark of many cancer cells. This allows for the identification of primary tumors and metastatic sites and the assessment of tumor response to therapy. In addition to ¹⁸F-FDG, this review will explore newer radiotracers targeting specific receptors, such as estrogen receptors or HER2, which offer more personalized imaging options. These tracers provide valuable insights into the molecular characteristics of tumors, aiding in tailored treatment strategies. By integrating radiotracers into breast cancer management, clinicians can enhance early disease detection, monitor therapeutic efficacy, and guide interventions, ultimately improving patient outcomes. Ongoing research aimed at developing more specific and sensitive tracers will also be highlighted, underscoring their potential to advance precision medicine in breast cancer care. Full article

(This article belongs to the Special Issue Recent Advances in Breast Imaging)

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