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Biomedical subjects

D von Heyden

Publications and source records attributed to D von Heyden.

At least 19 recordsLinked to original sources
PubMed2002

Comparative study in patients with microcalcifications: full-field digital mammography vs screen-film mammography.

The goal of this prospective study was to compare a full-field digital mammography system (FFDM) to a conventional screen-film mammography system (SFM) for the detection and characterization of microcalcifications. Fifty-five patients with 57 isolated microcalcification clusters were examined using a FFDM system (Senographe 2000D, GE Medical Systems, Milwaukee, Wis.) and a SFM system (Senographe DMR, GE Medical Systems, Milwaukee, Wis.). A conventional screen-film mammogram and a digital contact mammogram were obtained of each cluster. The image quality and the number of calcification particles were evaluated, and a characterization (BI-RADS 1-5) of microcalcifications was given by four experienced readers. Histopathology revealed 16 benign lesions (sclerosing adenosis, dysplasia, hamartoma, radial scar) in 15 patients and 21 malignant tumors (in situ carcinoma, invasive carcinoma) in 20 patients. Twenty patients had benign changes verified by long-term follow-up. Image quality of FFDM was assessed as superior to SFM in more than 50% of the cases. The FFDM showed more calcifications in 41% of all cases. Sensitivity and specificity for FFDM vs SFM were 95.2 vs 91.9% and 41.4 vs 39.3%, respectively. Moreover, FFDM demonstrated a higher diagnostic accuracy (deviation: 0.86 BI-RADS steps) compared with FSM (deviation 0.93 BI-RADS steps). The FFDM system with a 100- micro m pixel size provides better image quality than SFM in patients with mammographic microcalcifications. The FFDM has a higher sensitivity and a higher reliability in characterizing microcalcifications.

Breast Neoplasms↗
PubMed2002

Screen film vs full-field digital mammography: image quality, detectability and characterization of lesions.

The objective of this study was to compare screen-film mammography (SFM) to full-field digital mammography (FFDM) regarding image quality as well as detectability and characterization of lesions using equivalent images of the same patient acquired with both systems. Two mammography units were used, one with a screen-film system (Senographe DMR) and the other with a digital detector (Senographe 2000D, both GEMS). Screen-film and digital mammograms were performed on 55 patients with cytologically or histologically proven tumors on the same day. Together with these, 75 digital mammograms of patients without tumor and the corresponding previous screen-film mammograms not older than 1.5 years were reviewed by three observers in a random order. Contrast, exposure, and the presence of artifacts were evaluated. Different details, such as the skin, the retromamillary region, and the parenchymal structures, were judged according to a three-point ranking scale. Finally, the detectability of microcalcifications and lesions were compared and correlated to histology. Image contrast was judged to be good in 76%, satisfactory in 20%, and unsatisfactory in 4% of screen-film mammograms. Digital mammograms were judged to be good in 99% and unsatisfactory in 1% of cases. Improper exposure of screen-film system occurred in 18% (10% overexposed and 8% underexposed). Digital mammograms were improperly exposed in 4% of all cases but were of acceptable quality after post-processing. Artifacts, most of them of no significance, were found in 78% of screen-film and in none of the digital mammograms. Different anatomical regions, such as the skin, the retromamillary region, and dense parenchymal areas, were better visualized in digital than in screen-film mammography. All malignant tumors were seen by the three radiologists; however, digital mammograms allowed a better characterization of these lesions to the Breast Imaging Reporting and Data System (BI-RADS;) [corrected] categories (FFDM better than SFM in 23 of 165 vs 9 of 165 judged cases in SFM). In conclusion, digital mammography offers a consistent, high image quality in combination with a better contrast and without artifacts. Lesion detection in digital images was equal to that in screen-film images; however, categorization of the lesions to the BI-RADS classification was slightly better.

Adult↗
PubMed1997

[Digital magnification mammography in computed radiography. Initial clinical results].

INTRODUCTION: The combination of direct magnification mammography and computed radiography provides an improvement in spatial resolution of storage phosphor-based digital systems. A clinical study comparing conventional and digital direct magnification mammograms was performed. METHODS: 100 survey mammograms in 1.5-or 1.7-fold magnification and 50 4-fold spot magnification views were obtained with a prototype direct magnification mammography system and a storage phosphor-based digital system. An intraindividual comparison of these with previous conventional radiograms of the same patients was carried out. RESULTS: The diagnostic value of digital survey mammograms using the direct magnification technique is comparable to that of conventional radiograms of the breast, especially with regard to the identification of microcalcifications and lesions and the clinical consequences. Spot magnification views performed with this combination of techniques allowed improvement in the evaluation of microcalcifications. In 15% of cases, diagnostic procedures were adjusted accordingly. CONCLUSION: The combination of the direct magnification technique with digital storage phosphor radiography systems allows the performance of digital mammography by improving the overall spatial resolution. The diagnostic value of digital direct magnification survey mammograms was comparable to that of conventional mammograms. Digital 4-fold spot magnification views improved visualisation of the morphologic aspects of microcalcifications.

Breast Neoplasms↗
PubMed1994

[Inflammatory lesions of the breast: indication for MR-mammography?].

In a retrospective study the value of MR imaging of the breast in inflammatory changes was evaluated. The signal enhancement of 8 patients with histopathologically verified inflammatory carcinomas and 9 patients with global mastitis as well as local inflamed lesions was analysed. Neither signal behaviour nor signal/time relation were suitable to differentiate between malignant and benign changes. In conclusion inflammatory changes of the female breast are not indicated to be examined with MR imaging.

Adenocarcinoma↗
PubMed1993

[Signal characteristics of malignant and benign lesions in dynamic 2D-MRT of the breast].

In a retrospective study of 400 dynamic MR examinations of the breast the signal/time ratio of 62 histopathologically correlated lesions (19 benign, 42 malignant) was evaluated. Points of evaluation were initial signal enhancement (1st and 2nd minute), post-initial signal appearance (2nd to 5th minute) and signal distribution (homogeneous, marginal). Based on these criteria, a point system was defined to help in the assessment of lesions in dynamic breast-MR imaging. The overall sensitivity of this method was 95.3%, the specificity to 89.5% and the accuracy to 93.5%. Pitfalls resulted in two cases of non-invasive carcinoma and in two patients with fibroadenoma.

Adenofibroma↗
PubMed1987

[Lymphography in Hodgkin's lymphoma. Diagnostic value based on the current status of experience and knowledge].

Lymphography was carried out at least once in 355 patients with Hodgkin's lymphoma (HL). In 229 patients, there was a histological subclassification: 26 LP, 63 NS, 122 NC and 18 LD cases. The lymphographic manifestations could be subdivided empirically into two superordinate groups: 1. lymph nodes closely linked together in chains (LC) with dense structures as well as LC destructions, LC debris and 2. LC of varying size with pathological internal structure. Apart from in the NS type, a correlation between the lymphological appearance and the histological subtype could not be discerned in any other histological subgroup. After lymphography, 61.6% of stages I and II were assigned to stage III. The staging of the lymphography was: stage I 24.5%, stage II 47.3%, stage III 10% and stage IV 9%, and after lymphography: stage I 9.9%, stage II 17.7%, stage III 63.1% and stage IV 9.3%. From a qualitative point of view, lymphography is superior to all other methods in the diagnosis of malignant lymphomas and should hence be carried out obligatorily in suspicion of a malignant lymphoma.

Adolescent↗
PubMed1985

[Computed tomography and nuclear spin tomography in peripheral lymphedema].

The first reported findings on CT and N.M.R. in two cases of idiopathic peripheral lymphoedema are described. These methods have compared with the generally available volume estimations (volume estimation according to Kuhnke, immersion plethysmography) and have been considered in relation to visual and lymphographic examinations.

Adult↗
PubMed1984

Hyperprolactinemia is an indicator of progressive disease and poor prognosis in advanced breast cancer.

In a long-term follow-up study, prolactin levels were measured in 149 patients with advanced metastatic breast cancer. Control groups included 221 patients with primary operable breast cancer and 150 women with benign breast disease. Hyperprolactinemia (greater than 1,000 mIU/I; HYPRL) occurs in 44% of patients with metastatic breast cancer in the course of the disease (p less than 0.001 compared to patients with non-metastatic disease). HYPRL is associated with progressive breast cancer in 88% of cases. In patients experiencing several episodes of disease remission and relapse, incidence of HYPRL increases with each relapse. Prolactin blood levels return to normal if hyperprolactinemic patients experience remission after chemotherapy. Patients expressing HYPRL have a shorter survival time after mastectomy when compared to patients who never developed HYPRL (154/89 months, p = 0.01). It is concluded that HYPRL is of prognostic significance and a reliable indicator of progressive disease in advanced metastatic breast cancer.

Breast Diseases↗
PubMed1983

[Plasma-prolactin concentrations in breast cancer at various stages, in mastopathy and other malignant tumors].

7% of 204 patients with metastatic breast cancer had hyperprolactinemia (greater than 1000 mIU/1 = 30.8 ng/ml) in the measurements of morning plasma prolactin basal levels. The incidence of hyperprolactinemia was significantly higher in patients with metastatic breast cancer than in 173 patients with non-metastatic breast cancer (p less than 0.001), in 151 patients with mastopathy (p = 0.01), in 63 patients with local (p = 0.001) and 56 patients with advanced solid tumors of different histology without prolactin stimulating medication (p = 0.001). After 5 measurements with a median interval of 2 months, elevated prolactin levels over 1000 mIU/l were found at least once in 35% of the patients with metastatic breast cancer. 93% of the women with hyperprolactinemic breast cancer were in progression at the time of the measurements, and none in remission; on the other hand, all patients with advanced breast cancer in remission had normal prolactin levels.

Adult↗
PubMed1983

[Primary lymphedema].

Secondary peripheral lymphedemas (all edemas based on pontine symptoms) are very much more frequent than primary edemas which are either congenital or due to a predisposition. Of the latter, only hereditary (essential) lymphedema and idiopathic lymphedema (lymphedema praecox) play a role in clinical practise with the regard to their incidence. The exceedingly rare hereditary lymphedemas, which differ from the primary noncongenital lymphedemas only with regard to the demonstrated heritability merely have a clinical significance. Thus for example only six such cases occurred amongst our patients in the last 20 years. Most primary lymphedemas occur at the time of puberty with a time span of 10 to 30 years. Primary lymphedemas can also occur within a genuine clinical picture (flat nevi, Recklinghausen disease etc.), so that underlying symptoms must be looked for when they occur.

Adolescent↗