Biomedical subjects

D L Monticciolo

Publications and source records attributed to D L Monticciolo.

7 recordsLinked to original sources

PubMed1995

Discovery method and stage of breast cancer in two different patient populations.

Our purpose was to determine the discovery method and stage of newly discovered breast cancers at two different medical centers. To do this, we conducted a retrospective chart review at our urban and suburban teaching hospitals during 1991 through 1992 and 1992, respectively. Only 29 (26%) of 112 cancers at our urban hospital were discovered mammographically; 38 (38%) of 100 neoplasms were discovered using mammography at our suburban hospital. At both institutions, the mammographically discovered cancers had a lower stage than those detected clinically. Despite proven benefits and the efforts of organizations such as the American College of Radiology and the American Cancer Society, screening mammography remains underused in the patient populations that we studied.

Adult↗

PubMed1994

MR detection of leakage from silicone breast implants: value of a silicone-selective pulse sequence.

OBJECTIVE: The purpose of this study was to determine the value of MR imaging with a silicone-selective pulse sequence for detecting leakage from silicone breast implants. SUBJECTS AND METHODS: Women with silicone breast implants were referred for this study on the basis of clinical or imaging findings suggestive of implant rupture. Twenty-eight patients with 38 implants were examined with silicone-selective MR imaging and also underwent surgical removal of the studied implant. All but four also had mammography before MR imaging. Results of silicone-selective MR imaging for the detection of silicone leakage were compared with mammographic and surgical findings. Surgical proof was considered the gold standard. RESULTS: Silicone-selective MR imaging showed an apparently intact implant in 21 cases; 20 of these were found to be intact at surgery. Silicone-selective MR imaging showed evidence of leakage in 17 implants, all of which showed leakage at surgery. The sensitivity for detection of leakage was 94%; the specificity was 100%. The findings of silicone-selective MR imaging and mammography were in agreement in 30 of 34 cases in which both studies were performed. In the four cases of disagreement, surgical findings agreed with MR findings in three and with mammographic findings in one. When the findings of mammography and silicone-selective MR imaging were combined, the correct status (leakage or no leakage) of all implants examined was determinable. CONCLUSION: Silicone-selective MR imaging is highly effective for detecting leakage from silicone breast implants. Accuracy is improved when mammographic and MR findings are considered together.

Adult↗

PubMed1992

Breast ultrasonography.

Ultrasound of the breast has a role both as the primary and as an ancillary modality in the work-up of breast abnormalities. Its main role is to differentiate cystic from solid abnormalities and to thereby guide further work-up and intervention. Only the diagnosis of a simple cyst will obviate the need for further evaluation or therapy. Doppler ultrasonography of breast lesions may give further information in the future, although this is currently not employed in clinical practice. Various types of ultrasound examinations may yield useful information in the patient with breast cancer or in women with breast prostheses.

Adenofibroma↗

PubMed1990

Medical audit of a rapid-throughput mammography screening practice: methodology and results of 27,114 examinations.

Medical audit results from the entire experience of a rapid-throughput mammography screening practice are presented, comprising 27,114 examinations conducted from April 1985 to September 1989. The authors screened a self-selected physician-referred population, almost 94% of whom were asymptomatic. Estimated sensitivity of initial mammography interpretation was 93.1% with a specificity of 94.2% and a positive predictive value of 10.0%. Biopsies prompted by screening yielded a diagnosis of malignancy in 32.1% of cases; 170 breast cancers were identified, 67.1% requiring mammographic needle localization. Median cancer size was 12 mm, the rate of axillary nodal metastasis was 11.0%, and the systemic metastasis rate was 1.2%. Of the cancers found, 76.5% were stage 0 or stage 1. Conducting a medical audit is the most convincing way to demonstrate the success of a mammography screening practice, thereby providing this important information for the benefit of screenees, referring physicians, third-party payers, and the personnel who perform the screening.

Adult↗

PubMed1990

Computerized follow-up of abnormalities detected at mammography screening.

Obtaining follow-up information after abnormal interpretations is an important aspect of a mammography practice, but it can be tedious, time-consuming, and produce suboptimal results. This study demonstrates the effect of computer-generated reminders on the collection of follow-up data for patients in whom abnormalities were detected at mammography screening. From April 1985 until December 1987, follow-up data for 1009 abnormal examinations were collected by using standard procedures, supplemented by occasional searches of pathology records and sporadic letters and telephone calls to referring physicians. Results showed that follow-up was limited to a normal physical examination in 104 women (10.3%); eight other women (0.8%) were lost to follow-up. For over 90% of these inadequately followed cases, referring physicians were first contacted more than 3 months after screening. Since December 1987, follow-up data for 777 abnormal examinations were collected, supplemented by computer-generated reminders sent to referring physicians for cases apparently unresolved 3 months after screening. Only four (0.5%) of these women have had inadequate follow-up (normal physical examination alone). We conclude that use of a computer-generated reminder system prompts more timely and more appropriate patient management. It also makes follow-up data collection much less onerous.

Appointments and Schedules↗

PubMed1987

Radiologic case study. Chondroblastoma.

Chondroblastoma is a benign cartilaginous tumor nearly always found in the epiphysis of long bones. It is usually a well-defined, radiolucent lesion with a thin, sclerotic margin that varies in size from 1 cm to 4 cm; it may contain small calcifications. Most patients are 5 to 25 years of age and males predominate 2:1. The treatment of choice is curettage; a favorable prognosis is expected.

Adult↗

PubMedDate not supplied

MR imaging of silicone gel-filled breast implants in vivo with a method that visualizes silicone selectively.

The lack of an adequately sensitive method for detecting silicone leakage and reported serious complications due to silicone leakage were cited as justification by the U.S. Food and Drug Administration for imposing the current restrictions on silicone gel-filled breast prostheses. The authors report a new magnetic resonance imaging method for visualizing silicone leakage: the silicone-only sequence (SOS). The method uses the conventional STIR (short-inversion-time inversion-recovery) technique combined with a 1331 radio-frequency pulse train widely used for water suppression in spectroscopy. With the SOS, silicone can be imaged while signals from fat and water are suppressed. The authors used the SOS to image phantoms and normal and ruptured silicone gel-filled breast prostheses.

Breast↗