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36


Axillary Adenopathy after COVID-19 Vaccine: No Reason to Delay Screening Mammogram

Wolfson, Stacey; Kim, Eric; Plaunova, Anastasia; Bukhman, Rita; Sarmiento, Ruth D; Samreen, Naziya; Awal, Divya; Sheth, Monica M; Toth, Hildegard B; Moy, Linda; Reig, Beatriu
PMID: 35994402
ISSN: 1527-1315
CID: 5639432

Differences between human and machine perception in medical diagnosis

Makino, Taro; Jastrzębski, Stanisław; Oleszkiewicz, Witold; Chacko, Celin; Ehrenpreis, Robin; Samreen, Naziya; Chhor, Chloe; Kim, Eric; Lee, Jiyon; Pysarenko, Kristine; Reig, Beatriu; Toth, Hildegard; Awal, Divya; Du, Linda; Kim, Alice; Park, James; Sodickson, Daniel K; Heacock, Laura; Moy, Linda; Cho, Kyunghyun; Geras, Krzysztof J
Deep neural networks (DNNs) show promise in image-based medical diagnosis, but cannot be fully trusted since they can fail for reasons unrelated to underlying pathology. Humans are less likely to make such superficial mistakes, since they use features that are grounded on medical science. It is therefore important to know whether DNNs use different features than humans. Towards this end, we propose a framework for comparing human and machine perception in medical diagnosis. We frame the comparison in terms of perturbation robustness, and mitigate Simpson's paradox by performing a subgroup analysis. The framework is demonstrated with a case study in breast cancer screening, where we separately analyze microcalcifications and soft tissue lesions. While it is inconclusive whether humans and DNNs use different features to detect microcalcifications, we find that for soft tissue lesions, DNNs rely on high frequency components ignored by radiologists. Moreover, these features are located outside of the region of the images found most suspicious by radiologists. This difference between humans and machines was only visible through subgroup analysis, which highlights the importance of incorporating medical domain knowledge into the comparison.
PMCID:9046399
PMID: 35477730
ISSN: 2045-2322
CID: 5205672

Axillary Adenopathy after COVID-19 Vaccine: No Reason to Delay Screening Mammogram

Wolfson, Stacey; Kim, Eric; Plaunova, Anastasia; Bukhman, Rita; Sarmiento, Ruth D; Samreen, Naziya; Awal, Divya; Sheth, Monica M; Toth, Hildegard B; Moy, Linda; Reig, Beatriu
PMCID:8855316
PMID: 35133198
ISSN: 1527-1315
CID: 5156732

Lessons Learned From the Pediatric Overflow Planning Contingency Response Network: A Transdisciplinary Virtual Collaboration Addressing Health System Fragmentation and Disparity During the COVID-19 Pandemic

El-Hage, Laura; Ratner, Leah; Sridhar, Shela; Jenkins, Ashley; [Alvarez, F; Boggs, E; Boykan, R; Caldwell, A; Chumpia, MM; Couser, KN; Coria, AL; Crosh, CC; Dias, M; Foti, J; Giordano, M; Gupta, S; Hodo, Laura N; Kumar, A; Lowe, MC; Middleton, B; Myers, S; Patel, A; Stehouwer, N; Szalda, D; Sylvester, J; Toth, H; Tuomela, K; Williams, R]
PMID: 34424187
ISSN: 1553-5606
CID: 5477512

Response to COVID-19 in breast imaging [Editorial]

Moy, L; Toth, H K; Newell, M S; Plecha, D; Leung, J W T; Harvey, J A
EMBASE:2010701196
ISSN: 2631-6129
CID: 4782242

Breast MRI for Evaluation of Response to Neoadjuvant Therapy

Reig, Beatriu; Lewin, Alana A; Du, Linda; Heacock, Laura; Toth, Hildegard K; Heller, Samantha L; Gao, Yiming; Moy, Linda
Neoadjuvant therapy is increasingly being used to treat early-stage triple-negative and human epidermal growth factor 2-overexpressing breast cancers, as well as locally advanced and inflammatory breast cancers. The rationales for neoadjuvant therapy are to shrink tumor size and potentially decrease the extent of surgery, to serve as an in vivo test of response to therapy, and to reveal prognostic information for the patient. MRI is the most accurate modality to demonstrate response to therapy and to help ensure accurate presurgical planning. Changes in lesion diameter, volume, and enhancement are used to predict complete response, partial response, or nonresponse to therapy. However, residual disease may be overestimated or underestimated at MRI. Fibrosis, necrotic tumors, and residual benign masses may be causes of overestimation of residual disease. Nonmass lesions, invasive lobular carcinoma, hormone receptor-positive tumors, nonconcentric shrinkage patterns, the use of antiangiogenic therapy, and late-enhancing foci may be causes of underestimation of residual disease. In patients with known axillary lymph node metastasis, neoadjuvant therapy may be followed by targeted axillary dissection to avoid the potential morbidity associated with an axillary lymph node dissection. Diffusion-weighted imaging, radiomics, machine learning, and deep learning methods are under investigation to improve MRI accuracy in predicting treatment response.©RSNA, 2021.
PMID: 33939542
ISSN: 1527-1323
CID: 4858892

Abbreviated MR Imaging for Breast Cancer

Heacock, Laura; Lewin, Alana A; Toth, Hildegard K; Moy, Linda; Reig, Beatriu
Breast MR imaging is the most sensitive imaging method for the detection of breast cancer and detects more aggressive malignancies than mammography and ultrasound examination. Despite these advantages, breast MR imaging has low use rates for breast cancer screening. Abbreviated breast MR imaging, in which a limited number of breast imaging sequences are obtained, has been proposed as a way to solve cost and patient tolerance issues while preserving the high cancer detection rate of breast MR imaging. This review discusses abbreviated breast MR imaging, including protocols, multicenter clinical trial results, clinical workflow implementation challenges, and future directions.
PMID: 33223003
ISSN: 1557-8275
CID: 4680132

Abbreviated Breast MRI: Road to Clinical Implementation

Heacock, Laura; Reig, Beatriu; Lewin, Alana A; Toth, Hildegard K; Moy, Linda; Lee, Cindy S
Breast MRI offers high sensitivity for breast cancer detection, with preferential detection of high-grade invasive cancers when compared to mammography and ultrasound. Despite the clear benefits of breast MRI in cancer screening, its cost, patient tolerance, and low utilization remain key issues. Abbreviated breast MRI, in which only a select number of sequences and postcontrast imaging are acquired, exploits the high sensitivity of breast MRI while reducing table time and reading time to maximize availability, patient tolerance, and accessibility. Worldwide studies of varying patient populations have demonstrated that the comparable diagnostic accuracy of abbreviated breast MRI is comparable to a full diagnostic protocol, highlighting the emerging role of abbreviated MRI screening in patients with an intermediate and high lifetime risk of breast cancer. The purpose of this review is to summarize the background and current literature relating to abbreviated MRI, highlight various protocols utilized in current multicenter clinical trials, describe workflow and clinical implementation issues, and discuss the future of abbreviated protocols, including advanced MRI techniques.
PMID: 38424988
ISSN: 2631-6129
CID: 5639442

Abbreviated breast MRI: Road to clinical implementation

Heacock, Laura; Reig, Beatriu; Lewin, Alana A.; Toth, Hildegard K.; Moy, Linda; Lee, Cindy S.
Breast MRI offers high sensitivity for breast cancer detection, with preferential detection of high-grade invasive cancers when compared to mammography and ultrasound. Despite the clear benefits of breast MRI in cancer screening, its cost, patient tolerance, and low utilization remain key issues. Abbreviated breast MRI, in which only a select number of sequences and postcontrast imaging are acquired, exploits the high sensitivity of breast MRI while reducing table time and reading time to maximize availability, patient tolerance, and accessibility. Worldwide studies of varying patient populations have demonstrated that the comparable diagnostic accuracy of abbreviated breast MRI is comparable to a full diagnostic protocol, highlighting the emerging role of abbreviated MRI screening in patients with an intermediate and high lifetime risk of breast cancer. The purpose of this review is to summarize the background and current literature relating to abbreviated MRI, highlight various protocols utilized in current multicenter clinical trials, describe workflow and clinical implementation issues, and discuss the future of abbreviated protocols, including advanced MRI techniques.
SCOPUS:85090429600
ISSN: 2631-6110
CID: 4612692

Overstated Harms of Breast Cancer Screening? A Large Outcomes Analysis of Complications Associated With 9-Gauge Stereotactic Vacuum-Assisted Breast Biopsy

Lin, Leng Leng Young; Gao, Yiming; Lewin, Alana A; Toth, Hildegard K; Heller, Samantha L; Moy, Linda
OBJECTIVE:The purpose of this study was to assess the rate, type, and severity of complications related to 9-gauge stereotactic vacuum-assisted breast biopsy (SVAB) and to delineate associated factors that may contribute to a higher rate of complications. MATERIALS AND METHODS/METHODS:This retrospective study included 4776 patients who underwent SVAB between 2003 and 2016. A total of 319 patients with documented postbiopsy complications were identified. Complications were subcategorized as bleeding, pain, lightheadedness, bruising, and other complications, and their severity was classified as minor, moderate, or severe. Hematoma volumes were correlated with biopsy location and complication severity. A group of control subjects who underwent SVAB but had no complications was compared with the group of study patients with regard to age, biopsy location, lesion type, and pathologic findings. Postbiopsy screening adherence was assessed. Statistical analyses were performed using the Fisher exact, Mann-Whitney, Kruskal-Wallis, and Spearman rank correlation tests. RESULTS:) did not correspond to the severity of complications. Larger hematoma volumes were associated with a posterior biopsy location (p = 0.008). The rate of return to annual screening after biopsy was not adversely affected by the presence of biopsy complications. CONCLUSION/CONCLUSIONS:Clinically significant complications associated with SVAB were exceedingly rare (0.3%) in this large study spanning 13 years.
PMID: 30741561
ISSN: 1546-3141
CID: 3656012