Search

Myeloid sarcoma (MS) is a rare extramedullary solid tumor arising most often in patients with current or subsequent acute myeloid leukemia (AML). Patients of all ages may present with involvement of the skin, lymph nodes, intestinal tract, bone, and/or central nervous system. Isolated involvement of the breast is rare, and only a small number of cases have been described in the literature. Breast MS may present as a palpable mass on clinical evaluation. In this broad literature review from 2010 to 2022, the most common findings on mammography are either solitary or multiple masses, followed by architectural distortion and, less commonly, no discrete findings. Sonography may demonstrate hypoechoic or mixed echogenicity mass(es) with circumscribed or indistinct, not discrete margins. Myeloid sarcoma may present as an enhancing mass or nonmass enhancement on breast MRI and is typically moderately radiotracer avid on 18F-fluorodeoxyglucose-PET. At histopathology, MS is characterized by myeloid blasts in varying stages of granulocytic or neutrophilic maturation; diagnosis typically requires immunophenotyping. There is no consensus for treatment of MS, although systemic chemotherapy for AML is often used as MS is considered the tissue equivalent of AML. This article will discuss and illustrate imaging and pathology findings when the breast is involved by MS.

Knowledge of normal central nervous system anatomy at prenatal US and an understanding of common abnormalities can improve a radiologist’s ability to identify fetal abnormalities earlier, facilitating appropriate additional testing, counseling and referral, and delivery planning.

Our results suggest that enactment of breast density notification legislation has an immediate small but not long-term impact on the reporting of dense breasts at mammography.

Mammography is currently the most widely accepted tool for detection and diagnosis of breast cancer. However, the sensitivity of mammography is reduced in women with dense breast tissue due to tissue overlap, which may obscure lesions. Digital breast tomosynthesis with contrast enhancement reduces tissue overlap and provides additional functional information about lesions (i.e. morphology and kinetics), which in turn may improve lesion characterization. The performance of such techniques is highly dependent on the structural composition of the breast, which varies significantly across patients. Therefore, optimization of breast imaging systems should be done with respect to this patient versatility. Furthermore, imaging techniques that employ contrast require the inclusion of a temporally varying breast composition with respect to the contrast agent kinetics to enable the optimization of the system. To these ends, we have developed a dynamic 4D anthropomorphic breast phantom, which can be used for optimizing a breast imaging system by incorporating material characteristics. The presented dynamic phantom is based on two recently developed anthropomorphic breast phantoms, which can be representative of a whole population through their randomized anatomical feature generation and various compression levels. The 4D dynamic phantom is incorporated with the kinetics of contrast agent uptake in different tissues and can realistically model benign and malignant lesions. To demonstrate the utility of the proposed dynamic phantom, contrast-enhanced digital mammography and breast tomosynthesis were simulated where a ray-tracing algorithm emulated the projections, a filtered back projection algorithm was used for reconstruction, and dual-energy and temporal subtractions were performed and compared.

Digital breast tomosynthesis (DBT) is a novel x-ray imaging technique that provides 3D structural information of the breast. In contrast to 2D mammography, DBT minimizes tissue overlap potentially improving cancer detection and reducing number of unnecessary recalls. The addition of a contrast agent to DBT and mammography for lesion enhancement has the benefit of providing functional information of a lesion, as lesion contrast uptake and washout patterns may help differentiate between benign and malignant tumors. This study used a task-based method to determine the optimal imaging approach by analyzing six imaging paradigms in terms of their ability to resolve iodine at a given dose: contrast enhanced mammography and tomosynthesis, temporal subtraction mammography and tomosynthesis, and dual energy subtraction mammography and tomosynthesis. Imaging performance was characterized using a detectability index d', derived from the system task transfer function (TTF), an imaging task, iodine contrast, and the noise power spectrum (NPS). The task modeled a 5 mm lesion containing iodine concentrations between 2.1 mg/cc and 8.6 mg/cc. TTF was obtained using an edge phantom, and the NPS was measured over several exposure levels, energies, and target-filter combinations. Using a structured CIRS phantom, d' was generated as a function of dose and iodine concentration. In general, higher dose gave higher d', but for the lowest iodine concentration and lowest dose, dual energy subtraction tomosynthesis and temporal subtraction tomosynthesis demonstrated the highest performance.