BREAST ULTRASONOGRAPHY: State of the Art

Abstract

Ultrasonography (US) is an indispensable tool in breast imaging and is complementary to both mammography and magnetic resonance (MR) imaging of the breast. Advances in US technology allow confident characterization of not only benign cysts but also benign and malignant solid masses. Knowledge and understanding of current and emerging US technology, along with the application of meticulous scanning technique, is imperative for image optimization and diagnosis. The ability to synthesize breast US findings with multiple imaging modalities and clinical information is also necessary to ensure the best patient care. US is routinely used to guide breast biopsies and is also emerging as a supplemental screening tool in women with dense breasts and a negative mammogram. This review provides a summary of current state-of-the-art US technology, including elastography, and applications of US in clinical practice as an adjuvant technique to mammography, MR imaging, and the clinical breast examination. The use of breast US for screening, preoperative staging for breast cancer, and breast intervention will also be discussed.

© RSNA, 2013

ULTRASOUND and THYROID CANCER in LOW-RISK GROUP

Researchers from the University of California, San Francisco, undertook a study to quantify the risk of thyroid cancer associated with thyroid nodules, based on ultrasound imaging characteristics.
The retrospective, case-controlled study assessed 8,806 patients who underwent 11,618 thyroid ultrasound examinations from January 2000 through March 2005. A total of 105 patients were subsequently diagnosed with thyroid cancer.
It was found that thyroid nodules were common among patients who had thyroid cancer (96.9 percent) and also among those who did not (56.4 percent).
The researchers noted that there were three ultrasound nodule characteristics that were only associated with the risk of thyroid cancer:
· Microcalcifications
· Size greater than 2 cm
· Entirely solid composition
It was determined that most cases of thyroid cancer could be detected if biopsies were performed based on using one characteristic as indication for the procedure. Two characteristics as basis for biopsy would bring the sensitivity and false-positive rates lower with a higher positive likelihood ratio.
These results showed the rate of unnecessary biopsies could be reduced by 90 percent while maintaining a low risk of cancer if there were a more stringent approach for performing biopsies, researchers said.
"Adoption of uniform standards for the interpretation of thyroid sonograms would be a first step toward standardizing the diagnosis and treatment of thyroid cancer and limiting unnecessary diagnostic testing and treatment," the study concluded.

- See more at: http://www.diagnosticimaging.com/ultrasound/ultrasound-images-identify-thyroid-cancer-low-risk-group?