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Marilyn J Morton

Publications and source records attributed to Marilyn J Morton.

5 recordsLinked to original sources
PubMed2006

Screening mammograms: interpretation with computer-aided detection--prospective evaluation.

PURPOSE: To prospectively determine the effect of a commercially available computer-aided detection (CAD) system on interpretations of screening mammograms. MATERIALS AND METHODS: Institutional review board approval was granted; informed consent and HIPAA compliance were waived. A total of 21 349 screening mammograms obtained in 18 096 women were interpreted first without and then with review of CAD images to determine the effect of CAD analysis on the screening breast cancer detection rate, recall rate, and positive predictive value (PPV) for biopsy. The percentage of total cancers detected by the radiologists independent of CAD and the percentage correctly marked by the CAD system were determined. RESULTS: On the basis of pre-CAD interpretations, 2101 patients were recalled for diagnostic evaluation, 256 biopsies were performed, and 105 breast cancers were diagnosed. The breast cancer detection rate per 1000 screening mammograms was 4.92 (105 of 21 349 mammograms), the recall rate was 9.84% (2101 of 21 349 mammograms), and the PPV for biopsy was 41.0% (105 of 256 biopsies). After CAD image review, 199 additional patients were recalled, 21 additional biopsies were performed, and eight additional cancers were detected. The effect was a 7.62% (eight of 105) increase in the number of breast cancers detected, an increase in the recall rate to 10.77% (2300 of 21 349 mammograms), and a slight decrease in the PPV to 40.8% (113 of 277 biopsies). Radiologists detected 92.9% (105 of 113 cancers) of the total cancers, and CAD correctly marked 76.1% (86 of 113 cancers). CONCLUSION: The use of CAD improved the detection of breast cancer, with an acceptable increase in the recall rate and a minimal increase in the number of biopsies with benign results.

Adult↗
PubMed2006

Breast lesions: evaluation with US strain imaging--clinical experience of multiple observers.

PURPOSE: To prospectively determine the accuracy of using an ultrasonographic (US) strain imaging technique known as lesion size comparison to differentiate benign from malignant breast lesions. MATERIALS AND METHODS: Institutional Review Board approval and patient informed consent were obtained for this HIPPA-compliant study. US strain imaging was performed prospectively for 89 breast lesions in 88 patients. Lesions were imaged by using freehand compression and a real-time strain imaging algorithm. Five observers obtained manual measurements of lesion height, width, and area from B-mode and strain images. By using these size measurements, individual observer and group performances were assessed by using the area under the receiver operating characteristic curve (A(z)). The performance of a single size parameter versus that of a combination of size parameters was evaluated by using univariate and multivariate logistic regression. RESULTS: Group A(z) values showed that width ratio and area ratio yielded the best results for differentiating benign and malignant breast lesions, and they were not statistically different from one another (P = .499). For the group, the performance of area and width, which was superior to that of height and aspect ratio, was statistically significant for all cases (P < .011) except for those that compared area with aspect ratio (P = .118). By using a group threshold of 1.04 for width ratio and 1.13 for area ratio, the sensitivity and specificity of the technique were 96% and 21%, respectively, for width and 96% and 24%, respectively, for area. The best observer achieved a sensitivity of 96% and a specificity of 61% by using the area ratio. For all but one observer, combined size parameters did not improve observer performance (P > .258). Significant interobserver performance variability was observed (P < .001). CONCLUSION: Results suggest that US strain imaging has the potential to aid diagnosis of breast lesions. However, manually tracing lesion boundaries for size ratio differentiation in a busy clinical setting did not match the diagnostic performance levels previously reported. Focusing on measurements of lesion width, along with additional observer training or automated processes, may yield a suitable method for routine clinical application.

Adult↗
PubMedDate not supplied

Spontaneous unilateral nipple discharge: when screening tests are negative--a case report and review of current diagnostic management of a pathologic nipple discharge.

We describe a 45-year-old woman who presented with a spontaneous unilateral nipple discharge. With a negative breast examination and screening tests (mammography and ultrasonography) she underwent mammary ductography, which revealed a small 3-4 mm intraluminal filling defect. A core biopsy showed high-grade ductal carcinoma in situ (DCIS). An attempted wide local excision was unsuccessful, and the patient underwent a mastectomy. Pathologic assessment revealed high-grade DCIS and multiple foci of invasive mucinous ductal adenocarcinoma. Rare tumor cells were identified in the subcapsular sinuses in both sentinel lymph nodes. We report this case to point out the importance of the diagnostic examination for patients with a pathologic nipple discharge and review current and possible future diagnostic management.

Biopsy, Needle↗