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Background: Diffusion weighted magnetic resonance imaging (DWI) is known to differentiate between malignant and benign lesions via the apparent diffusion coefficient (ADC). Here, the value of diffusion kurtosis imaging (DKI) for differentiation and further characterization of benign and malignant breast lesions and their subtypes in a clinically feasible protocol is investigated., Material and Methods: This study included 85 patients (with 68 malignant and 73 benign lesions) who underwent 3 T breast DWI using three b values (50, 750, 1500 s/mm 2 ), with a total measurement time < 5 min. ADC maps were calculated from b values 50, 750 s/mm 2 . The diffusion kurtosis model was fitted to the diffusion weighted images, yielding in each lesion the average kurtosis-corrected diffusion coefficient D K and mean kurtosis K. Histopathology was obtained of radiologically suspicious lesions; follow-up scans were used as a standard of reference for benign appearing lesions. Receiver operating characteristic curves were used to evaluate the parameters' diagnostic performance for differentiation of lesion types and grades. The difference in diffusion parameters between subgroups was analysed statistically using the Wilcoxon rank sum test and Kruskal-Wallis test, applying a Bonferroni correction for multiple testing where necessary., Results: ADC, D K and K showed significant differences between malignant and benign lesions (p < 10 -5 ). All parameters had similar areas under the curve (AUC) (ADC: 0.92, D K : 0.91, K: 0.89) for differentiation of malignant and benign lesions. Sensitivity was highest for ADC (ADC: 0.96, D K : 0.94, K: 0.93), as well as specificity (ADC: 0.85, D K : 0.82, K: 0.82). ADC and D K showed significant differences between tumor histologic grades (p = 6.8⋅10 -4 , p = 6.6 · 10 -5 , respectively), whereas K did not (p = 0.99). All three parameters differed significantly between subtypes of benign lesions (ADC: p < 10 -5 , D K : p< 10 -5 , K: p = 4.1·10 -4 ), but not between subtypes of malignant lesions (ADC: p = 0.21, D K : p = 0.25, K: p = 0.08)., Conclusion: DKI parameters and conventional ADC can differentiate between malignant and benign lesions. Differentiation performance was best for ADC. Different tumor grades were significantly different in ADC and D K , which may have an impact on therapy planning and monitoring. In our study, K did not add value to the diagnostic performance of DWI in a clinical setting., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Purpose: To compare direct magnetic resonance galactography (dMRG) and conventional galactography (CGal)., Materials and Methods: Thirty women underwent CGal and dMRG. Duct localization and the depth of the assumed underlying pathology in CGal and dMRG were analyzed., Results: Comparing CGal and dMRG, there was no significant difference regarding sector localization, but for depth of pathology (P=.023)., Conclusion: Duct localization with dMRG was possible with the same reliability as with CGal. Thus, dMRG may have the potential to become an alternative method to CGal., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Aim: The aim of this study was to evaluate factors affecting the risk for reexcision following breast-conserving surgery. Positive tumor margins are critical for local disease control following surgery for breast cancer. Several factors, including tumor size, multifocality, and an extensive in situ component, may be associated with a higher rate of repeat operations due to positive margins. This study included mammographic density in the analysis., Methods: A total of 565 breast cancer patients were considered eligible for breast-conserving therapy after a core biopsy had confirmed malignancy. The patients' mammographic findings were reviewed, and mammographic density was documented in addition to the histopathological features of the lesions. Associations between these factors and the risk for a second operation were analyzed using the chi-squared test, and a model was developed for multivariate analysis., Results: At least one repeat operation was necessary in 121 patients (21.4%), and mastectomy was ultimately necessary in 54 patients (9.6%). Tumor size, multifocality, and the presence of an in situ component were identified as risk factors. A mammographic density of category 4 was associated with a need for further surgery (OR 3.2; 95% CI, 1.2-11)., Conclusions: Mammographic density is an additional risk factor for a second operation following breast-conserving procedures, and it may make radiographic and intraoperative localization of the tumor technically difficult. Using mammographic density to define a group of patients with a higher risk of reexcision might allow these patients to benefit from more sophisticated methods of localization and margin assessment.

Purpose: A retrospective clinical-histological study to determine the diagnostic accuracy using high-resolution digital phosphor storage plates (CR) (hardcopy) and full-field digital mammography (DR) (hardcopy) for microcalcifications and focal lesions (BI-RADS category 4 or 5) (n = 100)., Materials and Methods: From 01/2004 to 06/2004, 100 patients underwent digital storage plate mammography (CR) and, after diagnosis and preoperative wire localization, full-field digital mammography (a-Se) (DR) with the same exposure parameters. Five investigators retrospectively determined the diagnosis after the operation from randomly distributed mediolateral views (hardcopy reading). These results were correlated with the final histology., Results: The accuracy of digital storage plate mammography (CR) and full-field digital mammography (DR) was 73% and 76% for all findings (n = 100), 74%, 78% for microcalcifications (n = 50) and 72%, 74% for focal lesions (n = 50). The overall results showed no difference., Conclusion: Our findings indicate equivalence of high-resolution digital phosphor storage plate mammography (CR) and full-field digital mammography (a-Se) (DR).

Comparison of image quality in X-ray mammography between conventional film screen film system (SFS), digital phosphor storage plate in and without magnification technique (CR) and digital CCD-technique (CCD). Radiograms of an RMI-mammography phantom were acquired using a conventional screen film system, three digital storage plate systems and two digital systems in CCD-technique. Additionally, the radiograms of one digital phosphor storage plate system were post-processed regarding contrast and included in the comparison. The detectability of details was best with the digital mammography in CCD-technique. After confirming these promising results in clinical studies, digital mammography should be able to replace conventional screen film technique.