Search

Mammography is the central diagnostic method for clinical diagnostics of breast cancer and the breast cancer screening program. In the clinical routine complementary methods, such as ultrasound, tomosynthesis and optional magnetic resonance imaging (MRI) are already combined for the diagnostic procedure. Future developments will utilize investigative procedures either as a hybrid (combination of several different imaging modalities in one instrument) or as a fusion method (the technical fusion of two or more of these methods) to implement fusion imaging into diagnostic algorithms. For screening there are reasonable hypotheses to aim for studies that individualize the diagnostic process within the screening procedure. Individual breast cancer risk prediction and individualized knowledge about sensitivity and specificity for certain diagnostic methods could be tested. The clinical implementation of these algorithms is not yet in sight.

Die Mammographie ist die zentrale diagnostische Methode der klinischen symptombezogenen Abklarung von Brusterkrankungen und des Brustkrebsscreenings. In der klinischen Diagnostik wird sie heute schon oft durch zusatzliche Untersuchungsmethoden wie dem Ultraschall, der Tomosynthese und ggf. auch der MRT-Bildgebung unterstutzt. Zukunftige Entwicklungen gehen in die Richtung, dass diese Kombination aus 2 oder mehr Untersuchungsverfahren entweder in Hybrid- (Aufnahme mehrerer unterschiedlicher Bildmodalitaten in einem einzigen Gerat) oder in Fusionsmethoden (Zusammenfuhrung und Registrierung von Bilddaten aus verschiedenen Modalitaten) technisch professionalisiert werden. Des Weiteren konnten an subgruppenbezogene Erkrankungsrisiken und individuelle Sensitivitaten und Spezifitaten angepasste Diagnostikkombinationen fur eine Screeningdiagnostik Gegenstand kunftiger Studien sein. Wir stellen die aktuellen Entwicklungen auf diesen Gebieten und deren momentane Relevanz fur die klinische Praxis und Entwicklungspotenzial fur die Zukunft dar.

To evaluate the diagnostic value of multidetector CT angiography (MDCTA) of the renal arteries.27 patients underwent MDCTA of the renal arteries. Scan parameters were: collimation 4 x 1 mm, pitch 1.5, effective slice thickness 1.25 mm, reconstruction increment 0.8 mm, circulation time measurement, power injection of 80 ml iomeprol 400, flow 4 ml/sec. Independent reading on laser film was done by two radiologists using edited maximum intensity projections, multiplanar reconstructions and source images. Standard of reference was a 3D-FLASH MR angiography (1.5 T, 3.9/1.2, 10 degrees 0.2 mmol GdDTPA/kg bw) in 10 and intraarterial angiography in 17 patients.Analysing 63 arteries, sensitivity, specificity, positive predictive value and negative predictive value in terms of detection of moderate and high grade renal artery stenosis (n = 10) were 90, 98, 90 and 98 % for reader A, and 90 % each for reader B, respectively (kappa = 0.91 interobserver agreement). 1/11 accessory renal arteries was missed by both angiography and MDCTA. Image quality was graded as excellent or good in 26/27 of cases by both readers.MDCTA proved to be a highly accurate tool in the detection of therapeutically relevant renal artery stenosis.