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R Schulz-Wendtland

Publications and source records attributed to R Schulz-Wendtland.

At least 19 recordsLinked to original sources
PubMed2006

Experimental phantom lesion detectability study using a digital breast tomosynthesis prototype system.

PURPOSE: To compare the sensitivity of conventional two-dimensional (2D) projection imaging with tomosynthesis with respect to the detectability of mammographic phantom lesions. MATERIALS AND METHODS: Using a breast tomosynthesis prototype based on a commercial FFDM system (Siemens MAMMOMAT Novation), but modified for a wide angle tube motion and equipped with a fast read-out amorphous selenium detector, we acquired standard 2D images and tomosynthesis series of projection views. We used the Wisconsin mammographic random phantom, model RMI 152A. The anode filter combinations Mo/Mo and W/Rh at two different doses were used as typical radiographic techniques. Slice images through the phantom parallel to the detector were reconstructed with a distance of 1 mm employing a filtered back-projection algorithm. The image data sets were read by five radiologists and evaluated with respect to the detectability of the phantom details. RESULTS: For all studied radiographic techniques, the detection rate in the tomosynthesis mode was 100 %, i. e. 75 true positive findings out of 75 possible hits. In contrast, the conventional projection mode yielded a detection rate between 80 and 93 % (corresponding to 60 and 70 detected details) depending on the dose and X-ray spectrum. CONCLUSION: Tomosynthesis has the potential to increase the sensitivity of digital mammography. Overlapping structures from out-of-plane tissue can be removed in the tomosynthesis reconstruction process, thereby enhancing the diagnostic accuracy.

Algorithms↗
PubMed2005

[Clinical results of digital mammography].

Digital mammography is the technology of the future in breast diagnosis. This article provides an overview of all digital mammography units admitted by the Food and Drug Administration (FDA), results of clinical studies, soft copy reading, CAD (computer aided detection), and presents an overview on possible further developments. It is obvious that clinical results are equivalent to conventional screen film mammography and digital mammography.

Breast Neoplasms↗
PubMed2005

Assessment of breast cancer tumor size depends on method, histopathology and tumor size itself*.

PURPOSE: Mammography (MG), breast (BU) and axillary ultrasound (AU), and clinical examination (CE) are commonly used for clinical staging. These different methods were compared in order to assess the accuracy of clinical tumor staging (cT). METHOD: About 503 breast cancer (BC) patients were prospectively measured by MG, ultrasound and clinical examination. Pearson's correlation to pathological tumor size (pT) was tested and the deviation of MG, BU and CE to pT was analyzed in subgroups defined by pT, grading (G), estrogen receptor (ER), progesteron receptor (PR), proliferation (MIB-1) and HER2/neu. Association of AU to pN was examined by chi(2)-test. Receiver operating characteristics (ROC) were used to test the prediction of a pT > 2 cm. RESULTS: Mammography correlated best with pT (r = 0.752). Mammography (mean (MG) = 2.17 cm) overestimated tumors in size (mean (pT) = 2.04 cm) rather than ultrasound (mean (BU) = 1.86 cm) and clinical examination (mean (cT) = 1.70 cm). pT of invasive ductal BC could be estimated significantly better than pT of invasive lobular BC. Smaller tumors were better to assess than larger ones. Tumors with a grading G1 were easier to estimate than tumors with G2/3. Best predictor of a pT > 2 cm was the mammography with an area under the curve of 0.876. The combination of all three modalities by linear regression performed even better with an AUC of 0.906. CONCLUSIONS: The dimension of invasive ductal carcinomas, small and low grading tumors is significantly better to estimate. Concerning treatment decisions, we propose a combination of all three modalities, as the best predictive value was seen for the complementary use of mammography, ultrasound and clinical examination.

Axilla↗
PubMed2005

[Digital mammography with high-resolution storage plates (CR) versus full-field digital mammography (CCD) (DR) for microcalcifications and focal lesions -- a retrospective clinical histologic analysis (n = 102)].

PURPOSE: To determine the diagnostic accuracy of microcalcifications and focal lesions in a retrospective clinical-histological study using high-resolution digital phosphor storage plates (hard copy) and full-field digital mammography (hard copy). MATERIALS AND METHODS: From May 2003 to September 2003, 102 patients underwent digital storage plate mammography (CR), using a mammography unit (Mammomat 3000 N, Siemens) in combination with a high resolution (9 lp/mm) digital storage phosphor plate system (pixel size 50 microm) (Fuji/Siemens). After diagnosis and preoperative wire localization, full-field digital mammography (CCD) (DR) was performed with the same exposure parameters. The full-field digital mammography used a CCD-detector (SenoScan) (Fisher Imaging) with a resolution of 10 Ip/mm and a pixel size of 50 microm. Five investigators determined the diagnosis (BI-RADS I - V) retrospectively after the operation from randomly distributed mediolateral views (hard copy reading). These results were correlated with the final histology. RESULTS: The diagnostic accuracy of digital storage plate mammography (CR) and full-field digital mammography (CCD) (DR) was 73 % and 71 % for all findings (n = 102), 73 % and 71 % for microcalcifications (n = 51), and 72 % and 70 % for focal lesions (n = 51). The overall results showed no difference. CONCLUSION: Our findings indicate the equivalence of high-resolution digital phosphor storage plate mammography (CR) and full-field digital mammography (CCD) (DR).

Adult↗
PubMed2005

[Ultrasound examination of the breast with 7.5 MHz and 13 MHz-transducers: scope for improving diagnostic accuracy in complementary breast diagnostics?].

AIM: Complementary diagnostic methods in early diagnosis of breast cancer are used to increase diagnostic accuracy and minimize unnecessary invasive diagnostic procedures. Aim of the following prospective, open multicenter clinical study was to define the value of high-frequency breast ultrasound with 13 MHZ transducers compared to standard breast ultrasound with 7.5 MHz. METHOD: Data of 810 female patients, aged 45 to 60 years, with 819 suspicious breast lesions evaluated by four participating centres between October 1996 and December 1997. Standardised breast ultrasound was performed uniformly using a AU4 IDEA diagnostic ultrasound system by Esaote-Biomedica in addition to a standardised procedure of clinical examination and standard-2view-mammography. Analysis of all aquired data and the correlating histopathological findings was done by means of descriptive statistics on the basis of an access datafile (Version 2.0). RESULTS: The histopathological evaluation showed 435 benign and 384 malignant findings. Overall sensitivity and specificity of the clinical examination were 71.1 % and 88.9 % and for mammography 84.7 % and 76.5 %, respectively. Standard ultrasound with 7,5 MHz reached a sensitivity of 82,6 % and a specificity of 80.8 % high-frequency ultrasound with 13 MHz came to 87.2 % and 78.4 %, respectively. Regarding tumour size, mammography gave the highest sensitivity in detection of pre-invasive cancers (DCIS). High-frequency breast ultrasound (13 MHz) proved to have a higher diagnostic accuracy compared to standard breast ultrasound (7,5 MHz) regardless of tumour size. Sensitivity was especially improved in case of small invasive tumours (pT1a) with 78 % versus 56 %, respectively. CONCLUSIONS: We conclude that high-frequency ultrasound is a valueable additive tool especially in the diagnosis of small tumours, improving diagnostic safety and reducing unnecessary invasive diagnostic procedures.

Breast Diseases↗
PubMed2005

[Measuring the contrast-enhancement in the skin and subcutaneous fatty tissue with the NMR-MOUSE: a feasibility study].

PURPOSE: The NMR-MOUSE is an open and mobile sensor for measuring NMR relaxation parameters in organic matters. T1-measurements of the subcutaneous fatty tissue and the skin are reported. MATERIAL AND METHOD: For the first time, the NMR-MOUSE was employed to measure the signal recovery following saturation of the skin and the subcutaneous fatty tissue of three patients, before and after administering a contrast agent. RESULTS: Despite a low signal-to-noise ratio, changes in the relaxation behaviour of the skin could be detected. Malignant tissue exhibits faster signal recovery than scar tissue and healthy tissue, which only show a small difference. CONCLUSIONS: Changes in the relaxation behavior can be monitored with the NMR-MOUSE. Before the clinical use of the NMR-MOUSE, sensitivity, sensor mounting device, and sensor tuning must be improved. Further investigations need to be performed on a statistically relevant number of patients.

Adipose Tissue↗
PubMed2005

[Interventional methods in diagnostics of the breast -- a new vacuum biopsy system for the breast in routine clinical practice].

AIM: To evaluate the diagnostic potential of the new vacuum-assisted method VacuFlash (VF) in clinical routine of breast diagnostics. METHOD: From april 2002 to march 2003, the new sonographically guided vacuum-assisted system VacuFlash was used in 75 patients with a BI-RADS 5 lesion (analogue). The patients were aged between 31-75 yrs (median: 51 yrs), the size of the lesions measured 8-33 mm (median: 14 mm). 5 specimens were taken from each lesion. RESULTS: In 69 of the 75 lesions (92 %, respectively), malignancy was confirmed. In 8 lesions (8 %, resp.), we found a benign histology, confirmed by consecutive surgery. CONCLUSION: The new vacuum-assisted device VacuFlash is a technically perfected and applicable diagnostic method. Especially in the view of the cost it has to be compared with high-speed core cut biopsy, the hand-held Mammotome system and open surgical biopsy. High-speed core cut biopsy seems to be the standard procedure in diagnostic percutaneous breast intervention to clarify sonographically detected breast lesions.

Adult↗
PubMed2004

Bilateral orbital tumour as the presentation of mammographically occult breast cancer.

We report a rare case of bilateral orbital metastases as the presentation in a 63-year-old woman. Biopsy of a diffusely infiltrated medial rectus muscle suggested metastatic adenocarcinoma. Investigation revealed a palpable mass of the right breast not shown on mammography or sonography. Invasive lobular carcinoma was found at core-needle biopsy with histological features identical to those of the orbital lesion. Metastases to the extraocular muscles are uncommon, particularly as the initial abnormality in the absence of disseminated disease.

Breast Neoplasms↗
PubMed2004

[Radiological diagnosis of mammary carcinomas. I: pathology and x-ray mammography].

Breast cancer is the most common malignant tumor in women: almost 10 % will suffer from breast cancer during their life and almost half of these will die of it. The spectrum of radiologic methods for diagnosing breast cancer is wide, including X-ray mammography, ultrasound, magnetic resonance mammography, and minimally invasive biopsies. After long-lasting controversies, breast cancer screening using X-ray mammography has now been introduced in Germany, following the projects in the Netherlands and Sweden. However, assessing mammographic films under screening conditions requires skills distinctly different from those needed under clinical conditions. This first part of two covers the histopathological basics and X-ray mammography; the second will deal with ultrasound of the breast and magnetic resonance mammography.

Breast Neoplasms↗
PubMed2004

[3D ultrasound in core breast biopsy].

AIM: To evaluate the potential of three-dimensional ultrasound (3D US) in core biopsy of suspicious breast lesions. METHOD: 3D US controlled core biopsy was performed in 107 breast masses in 100 women by using an automated biopsy system (11G coaxial needle, 12 G biopsy needle). Mean diameter of the lesions was 1.55 cm (0.5 - 3.5 cm). A linear 3D US volume scanner was used for the procedure. Localization of the lesion and placement of the needle were initially done under 2D US guidance. After core needle stroke a 3D US volume acquisition was performed to correlate lesion and needle position. In the case of eccentric needle position the needle was repositioned under 3D control. 5 specimens were taken from each lesion. The histological results from the specimens were correlated with the results from surgery or clinical follow-up (> 2.5 years). RESULTS: Biopsy was taken from 59 probably benign (BI-RADS 3 - 4) and 48 malignant (BI-RADS 5) lesions. 3D US revealed 61 central, 44 eccentric and 2 marginal needle positions after the initial 2D guidance. Central repositioning of the needle was achievable under 3D guidance in all patients. Histological examination of the specimens revealed 41 invasive carcinomas and one in-situ carcinoma (DCIS). In one lesion, the carcinoma was missed in the core biopsy, despite central hits of the biopsy needle. This led to a sensitivity of 98 %, specificity of 100 %, PPV of 100 %, NPV of 98.5 % and accuracy of 99 % for the diagnosis of a malignant lesion. CONCLUSION: 3D US improves needle positioning as well as the depiction of correct needle placement in freehand core biopsy.

Adult↗
PubMed2004

[Phantom study for the detection of simulated lesions in five different digital and one conventional mammography system].

PURPOSE: Experimental phantom study for the detection of simulated lesions with five different digital and one conventional screen-film mammography system. MATERIALS AND METHODS: Three radiographs were obtained at various configurations of the phantom with one conventional screen-film system (Mammomat 3000 N) (Siemens), five digital systems (high resolution computed radiography system [Fuji/Siemens], one a-Si detector [GE Medical Systems], two a-Se detectors [Siemens; Hologic / Lorad] and one CCD detector [Fischer Imaging]), applying the same exposure parameters. The Wisconsin Mammographic Random Phantom, Model 152 A, was used. Five investigators with different experience in mammography (3 months to more than 4 years) evaluated the 18 randomly selected radiographs. RESULTS: No significant differences were found in the detection rate of simulated breast lesions for conventional screen-film mammography (84.9 %), high resolution computed radiography (86.7 %) and digital mammography with an a-Si detector (89.8 %). Highly significantly better results (p < 0.001) were found with the two a-Se systems (97.3 %) and the CCD system (100 %). CONCLUSION: Conventional screen-film mammography can be replaced by high resolution computed radiography and digital mammography with a-Si-, a-Se- and CCD-detectors. This has to be confirmed in further clinical studies.

Computer Simulation↗
PubMed2004

Multicenter clinical experience with large core soft tissue biopsy without vacuum assistance.

The increasing interest in accurate pretreatment diagnosis of solid tumours by morphology, immunohistochemistry, genetics and molecular biology requires clinicians to obtain undamaged large core biopsies. Simultaneously, medical imaging and surgery give priority to minimal tissue injury, affordable technology and optimal patient compliance. A new large core soft tissue biopsy device has been developed to meet the above criteria. After intensive preclinical testing, 30 patients gave informed consent and 26 underwent the new diagnostic biopsy procedure. The sample was studied by morphology, immunohistochemistry and, where indicated, by molecular biology. Successful diagnosis was considered when in line with clinical follow-up and, as for all malignant lesions, when confirmed by open biopsy or surgery. No difficulties in the technique were encountered in 25 patients. In one patient the procedure was prematurely stopped because of anxiety. In all other 25 procedures a complete diagnosis was reached with regard to morphology, immunohistochemistry and molecular biology. A number of radiologists suggested some automation of the technique. This new large core soft tissue biopsy system performs well in the clinical context without injury to the breast parenchyma or artefacts in the harvested tissue specimen. The system meets almost all of the proposed technical and financial requirements. Automation is underway.

Artifacts↗
PubMed2003

[Sonographical breast biopsy: how many core biopsy specimens are needed?].

PURPOSE: To determine the optimum number of specimens of a sonographically guided core biopsy of the breast. MATERIALS AND METHODS: From January 2001 to April 2001, sonographically guided core biopsies (coaxial needle: 11 G; core needle: 12 G) were performed on 106 patients with 115 BI-RADS trade mark 4-5 lesions that had corresponding sonographic findings. Five specimens were obtained in anteroposterior direction parallel to the chest wall and each specimen examined histologically. RESULTS: A total of 575 core biopsies produced 545 specimens (94.8 %), with no material obtained in 30 biopsies (5.2 %). The first and second specimen confirmed the diagnosis in 99 of 115 lesions (86 %), with subsequent specimens confirming the diagnosis in 87 % (3 rd specimen), 88 % (4 th specimen) and 82 % (5 th specimen). The additive accuracy of the five core breast specimens was 86 %, 96 %, 98 %, 99 % and 100 %. The possible volume of 78.9 mm 3 as determined by the sample notch of the core needle only furnished an average volume of 38.1 mm 3 (41.1 mm 3 for the 1 st, 40.1 mm 3 for the 2 nd, 37.5 mm 3 for the 3 rd, 36.7 mm 3 for the 4 th and 35.0 mm 3 for 5 th core specimen). CONCLUSION: Sonographically guided core breast biopsy (coaxial needle: 11 G; core needle: 12 G) may require five passes to achieve a diagnostic accuracy of more than 99 %.

Adult↗
PubMed2003

Experimental investigations of image quality in X-ray mammography with a conventional screen film system (SFS) and a new full-field digital mammography unit (DR) with a-Se-detector.

PURPOSE: Determination of image quality of a new digital mammography system with an a-Se-detector. MATERIAL AND METHOD: Radiograms of the Wisconsin Mammographic Random Phantom, Modell 152 A (Radiation Measurements Inc., Wisconsin) were acquired using a conventional film screen and a digital system. RESULTS: With the conventional film screen system there were detected 191/a 38.2 and with the digital mammography 219/a 43.8 of 225 possible details. CONCLUSION: Based on these results there is the possibility to replace the conventional film screen system by the digital mammography with a-Se-detector--this has to be confirmed in further clinical trials.

Breast Neoplasms↗
PubMed2003

[Film-screen mammography versus digital storage plate mammography: hard copy and monitor display of microcalcifications and focal findings--a retrospective clinical and histologic analysis].

PURPOSE: A retrospective clinical-histological study to determine the diagnostic accuracy of mammography using conventional screen-film cassettes (hard copy), high-resolution digital phosphor storage plates (hard copy) and monitor display (soft copy) for microcalcifications and focal lesions (BI-RADS (TM) category 4 or 5). MATERIALS AND METHODS: From April to November 2001, 76 patients underwent conventional film-screen mammography and, after diagnosis and preoperative wire localization, digital mammography with the same exposure parameters. Five investigators retrospectively determined the diagnosis after the operation from randomly distributed mediolateral views (hard-copy reading) and from the monitor display (soft-copy reading). These results were correlated with the final histology. RESULTS: The accuracy of conventional screen-film mammography, digital mammography and monitor-displayed mammography was 67%, 65% and 68% for all findings, (n = 76), 59%, 59% and 68% for microcalcifications (n = 44) and 75%, 72% and 63% for focal lesions (n = 32). The overall results showed no difference. CONCLUSION: Our findings indicate equivalence of conventional screen-film mammography, high-resolution digital phosphor storage plate mammography and monitor-displayed mammography.

Adenocarcinoma↗
PubMed2003

[First experiences with a new vacuum-assisted device for breast biopsy].

OBJECTIVE AND METHODS: Stereotaxic and sonographically guided vacuum biopsies are standard methods in interventional breast procedures. We report about the newly developed sonographically guided and vacuum-assisted VacuFlash (VF) method for breast biopsy. In comparison to the Mammotome system, all components for vacuum biopsy are integrated in the hand-held gun of the VF biopsy system. Our first preliminary results in 5 patients are reported. RESULTS: VF was performed in five patients with a nonpalpable, sonographically detectable lesion. The histopathological examination diagnosed a fibroadenoma in 4 patients and established unremarkable breast parenchyma in 1 patient. Subsequent sonography immediately after the biopsy revealed that 3 of the 5 lesions were completely removed. CONCLUSION: The VF biopsy system is a new, technically perfected and applicable diagnostic method. Its costs, risks and accuracy have to be compared with high-speed core cut biopsy, hand-held Mammotome system and open surgical biopsy. Indications for the VF-biopsy are lesions that are too small, superficial or deep for conventional core biopsy as well as abnormalities where wide sampling is considered important. Complete removal can only be expected when the lesion is small and plays a secondary role in a diagnostic process. High-speed core cut biopsy remains the standard procedure in percutaneous breast interventions to clarify sonographically detected breast lesions.

Biopsy↗