140 results on '"Trop I"'
Search Results
2. Current opinion on clip placement after breast biopsy: A survey of practising radiologists in France and Quebec
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Thomassin-Naggara, I., Jalaguier-Coudray, A., Chopier, J., Tardivon, A., and Trop, I.
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- 2013
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3. Diffusion-weighted MR imaging of the breast: Advantages and pitfalls
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Thomassin-Naggara, I., De Bazelaire, C., Chopier, J., Bazot, M., Marsault, C., and Trop, I.
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- 2013
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- View/download PDF
4. Astuces et nouveautés techniques en IRM mammaire
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Thomassin-Naggara, I., Trop, I., Lalonde, L., David, J., Péloquin, L., and Chopier, J.
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- 2012
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5. Tips and techniques in breast MRI
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Thomassin-Naggara, I., Trop, I., Lalonde, L., David, J., Péloquin, L., and Chopier, J.
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- 2012
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6. Accuracy of screening women at familial risk of breast cancer without a known gene mutation: Individual patient data meta-analysis
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Phi, X.-A. (Xuan-Anh), Houssami, N. (Nehmat), Hooning, M.J. (Maartje), Riedl, C.C. (Christopher C), Leach, M.O. (Martin), Sardanelli, F. (Francesco), Warner, E. (Ellen), Trop, I. (Isabelle), Saadatmand, S. (Sepideh), Tilanus-Linthorst, M.M.A. (Madeleine), Helbich, T. (Thomas), Heuvel, E.R. (E.) van den, Koning, H.J. (Harry) de, Obdeijn, A.I.M. (Inge-Marie), Bock, G.H. (Geertruida) de, Phi, X.-A. (Xuan-Anh), Houssami, N. (Nehmat), Hooning, M.J. (Maartje), Riedl, C.C. (Christopher C), Leach, M.O. (Martin), Sardanelli, F. (Francesco), Warner, E. (Ellen), Trop, I. (Isabelle), Saadatmand, S. (Sepideh), Tilanus-Linthorst, M.M.A. (Madeleine), Helbich, T. (Thomas), Heuvel, E.R. (E.) van den, Koning, H.J. (Harry) de, Obdeijn, A.I.M. (Inge-Marie), and Bock, G.H. (Geertruida) de
- Abstract
Introduction Women with a strong family history of breast cancer (BC) and without a known gene mutation have an increased risk of developing BC. We aimed to investigate the accuracy of screening using annual mammography with or without magnetic resonance imaging (MRI) for these women outside the general population screening program. Methods An individual patient data (IPD) meta-analysis was conducted using IPD from six prospective screening trials that had included women at increased risk for BC: only women with a strong familial risk for BC and without a known gene mutation were included in this analysis. A generalised linear mixed model was applied to estimate and compare screening accuracy (sensitivity, specificity and predictive values) for annual mammography with or without MRI. Results There were 2226 women (median age: 41 years, interquartile range 35–47) with 7478 woman-years of follow-up, with a BC rate of 12 (95% confidence interval 9.3–14) in 1000 woman-years. Mammography screening had a sensitivity of 55% (standard error of mean [SE] 7.0) and a specificity of 94% (SE 1.3). Screening with MRI alone had a sensitivity of 89% (SE 4.6) and a specificity of 83% (SE 2.8). Adding MRI to mammography increased sensitivity to 98% (SE 1.8, P < 0.01 compared to mammography alone) but lowered specificity to 79% (SE 2.7, P < 0.01 compared with mammography alone). Conclusion In this population of women with strong familial BC risk but without a known gene mutation, in whom BC incidence was high both before and after age 50, adding MRI to mammography substantially increased screening sensitivity but also decreased its specificity.
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- 2017
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7. Accuracy of screening women at familial risk of breast cancer without a known gene mutation: individual patient data meta-analysis
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Phi, X.A., Houssami, N., Hooning, M.J., Riedl, C.C., Leach, M.O., Sardanelli, F., Warner, E., Trop, I., Saadatmand, S., Tilanus-Linthorst, M.M.A., Helbich, T.H., van den Heuvel, E.R., de Koning, H.J., Obdeijn, I.M., de Bock, G.H., Phi, X.A., Houssami, N., Hooning, M.J., Riedl, C.C., Leach, M.O., Sardanelli, F., Warner, E., Trop, I., Saadatmand, S., Tilanus-Linthorst, M.M.A., Helbich, T.H., van den Heuvel, E.R., de Koning, H.J., Obdeijn, I.M., and de Bock, G.H.
- Abstract
Introduction Women with a strong family history of breast cancer (BC) and without a known gene mutation have an increased risk of developing BC. We aimed to investigate the accuracy of screening using annual mammography with or without magnetic resonance imaging (MRI) for these women outside the general population screening program. Methods An individual patient data (IPD) meta-analysis was conducted using IPD from six prospective screening trials that had included women at increased risk for BC: only women with a strong familial risk for BC and without a known gene mutation were included in this analysis. A generalised linear mixed model was applied to estimate and compare screening accuracy (sensitivity, specificity and predictive values) for annual mammography with or without MRI. Results There were 2226 women (median age: 41 years, interquartile range 35–47) with 7478 woman-years of follow-up, with a BC rate of 12 (95% confidence interval 9.3–14) in 1000 woman-years. Mammography screening had a sensitivity of 55% (standard error of mean [SE] 7.0) and a specificity of 94% (SE 1.3). Screening with MRI alone had a sensitivity of 89% (SE 4.6) and a specificity of 83% (SE 2.8). Adding MRI to mammography increased sensitivity to 98% (SE 1.8, P < 0.01 compared to mammography alone) but lowered specificity to 79% (SE 2.7, P < 0.01 compared with mammography alone). Conclusion In this population of women with strong familial BC risk but without a known gene mutation, in whom BC incidence was high both before and after age 50, adding MRI to mammography substantially increased screening sensitivity but also decreased its specificity.
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- 2017
8. Breast Magnetic Resonance Imaging: Are Those Who Need It Getting It?
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Tan, Stephanie, primary, David, J., additional, Lalonde, L., additional, El Khoury, M., additional, Labelle, M., additional, Younan, R., additional, Patocskai, E., additional, Richard, J., additional, and Trop, I., additional
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- 2017
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9. Contribution of mammography to MRI screening in BRCA mutation carriers by BRCA status and age: Individual patient data meta-analysis
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Phi, X.-A. (Xuan-Anh), Saadatmand, S. (Sepideh), Bock, G.H. (Geertruida) de, Warner, E. (Ellen), Sardanelli, F. (Francesco), Leach, M.O. (Martin O), Riedl, C.C. (Christopher C), Trop, I. (Isabelle), Hooning, M.J. (Maartje), Mandel, R. (Rodica), Santoro, F. (Filippo), Kwan Lim, G.E. (Gek), Helbich, T. (Thomas), Tilanus-Linthorst, M.M.A. (Madeleine), Van Den Heuvel, E.R. (Edwin R.), Houssami, N. (Nehmat), Phi, X.-A. (Xuan-Anh), Saadatmand, S. (Sepideh), Bock, G.H. (Geertruida) de, Warner, E. (Ellen), Sardanelli, F. (Francesco), Leach, M.O. (Martin O), Riedl, C.C. (Christopher C), Trop, I. (Isabelle), Hooning, M.J. (Maartje), Mandel, R. (Rodica), Santoro, F. (Filippo), Kwan Lim, G.E. (Gek), Helbich, T. (Thomas), Tilanus-Linthorst, M.M.A. (Madeleine), Van Den Heuvel, E.R. (Edwin R.), and Houssami, N. (Nehmat)
- Abstract
Background:We investigated the additional contribution of mammography to screening accuracy in BRCA1/2 mutation carriers screened with MRI at different ages using individual patient data from six high-risk screening trials.Methods:Sensitivity and specificity of MRI, mammography and the combination of these tests were compared stratified for BRCA mutation and age using generalised linear mixed models with random effect for studies. Number of screens needed (NSN) for additional mammography-only detected cancer was estimated.Results:In BRCA1/2 mutation carriers of all ages (BRCA1=1219 and BRCA2=732), adding mammography to MRI did not significantly increase screening sensitivity (increased by 3.9% in BRCA1 and 12.6% in BRCA2 mutation carriers, P>0.05). However, in women with BRCA2 mutation younger than 40 years, one-third of breast cancers were detected by mammography only. Number of screens needed for mammography to detect one breast cancer not detected by MRI was much higher for BRCA1 compared with BRCA2 mutation carriers at initial and repeat screening.Conclusions:Additional screening sensitivity from mammography above that from MRI is limited in BRCA1 mutation carriers, whereas mammography contributes to screening sensitivity in BRCA2 mutation carriers, especially those ≤40 years. The evidence from our work highlights that a differential screening schedule by BRCA status is worth considering.
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- 2016
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10. Contribution of mammography to MRI screening in BRCA mutation carriers by BRCA status and age: individual patient data meta-analysis
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Phi, X.A., Saadatmand, S., de Bock, G.H., Warner, E., Sardanelli, F., Leach, M.O., Riedl, C.C., Trop, I., Hooning, M.J., Mandel, R., Santoro, F., Kwan-Lim, G., Helbich, T.H., Tilanus-Linthorst, M.M.A., Van Den Heuvel, E.R., Houssami, N., Phi, X.A., Saadatmand, S., de Bock, G.H., Warner, E., Sardanelli, F., Leach, M.O., Riedl, C.C., Trop, I., Hooning, M.J., Mandel, R., Santoro, F., Kwan-Lim, G., Helbich, T.H., Tilanus-Linthorst, M.M.A., Van Den Heuvel, E.R., and Houssami, N.
- Abstract
Background:We investigated the additional contribution of mammography to screening accuracy in BRCA1/2 mutation carriers screened with MRI at different ages using individual patient data from six high-risk screening trials.Methods:Sensitivity and specificity of MRI, mammography and the combination of these tests were compared stratified for BRCA mutation and age using generalised linear mixed models with random effect for studies. Number of screens needed (NSN) for additional mammography-only detected cancer was estimated.Results:In BRCA1/2 mutation carriers of all ages (BRCA1=1219 and BRCA2=732), adding mammography to MRI did not significantly increase screening sensitivity (increased by 3.9% in BRCA1 and 12.6% in BRCA2 mutation carriers, P>0.05). However, in women with BRCA2 mutation younger than 40 years, one-third of breast cancers were detected by mammography only. Number of screens needed for mammography to detect one breast cancer not detected by MRI was much higher for BRCA1 compared with BRCA2 mutation carriers at initial and repeat screening.Conclusions:Additional screening sensitivity from mammography above that from MRI is limited in BRCA1 mutation carriers, whereas mammography contributes to screening sensitivity in BRCA2 mutation carriers, especially those ≤40 years. The evidence from our work highlights that a differential screening schedule by BRCA status is worth considering.
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- 2016
11. Contribution of mammography to MRI screening in BRCA mutation carriers by BRCA status and age: individual patient data meta-analysis
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Phi, XA, Saadatmand, Sepideh, de Bock, GH, Warner, E, Sardanelli, F, Leach, MO, Riedl, CC, Trop, I, Hooning, Maartje, Mandel, R, Santoro, F, Kwan-Lim, G, Helbich, TH, Tilanus - Linthorst, Madeleine, van den Heuvel, ER, Houssami, N, Phi, XA, Saadatmand, Sepideh, de Bock, GH, Warner, E, Sardanelli, F, Leach, MO, Riedl, CC, Trop, I, Hooning, Maartje, Mandel, R, Santoro, F, Kwan-Lim, G, Helbich, TH, Tilanus - Linthorst, Madeleine, van den Heuvel, ER, and Houssami, N
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- 2016
12. Magnetic resonance imaging improves breast screening sensitivity in BRCA mutation carriers age ≥50 years: Evidence from an individual patient data meta-analysis
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Phi, X.-A. (Xuan-Anh), Houssami, N. (Nehmat), Obdeijn, A.I.M. (Inge-Marie), Warner, E. (Ellen), Sardanelli, F. (Francesco), Leach, M.O. (Martin), Riedl, C.C. (Christopher C), Trop, I. (Isabelle), Tilanus-Linthorst, M.M.A. (Madeleine), Mandel, R. (Rodica), Santoro, F. (Filippo), Kwan Lim, G.E. (Gek), Helbich, T. (Thomas), Koning, H.J. (Harry) de, Van Den Heuvel, E.R. (Edwin R.), Bock, G.H. (Geertruida) de, Phi, X.-A. (Xuan-Anh), Houssami, N. (Nehmat), Obdeijn, A.I.M. (Inge-Marie), Warner, E. (Ellen), Sardanelli, F. (Francesco), Leach, M.O. (Martin), Riedl, C.C. (Christopher C), Trop, I. (Isabelle), Tilanus-Linthorst, M.M.A. (Madeleine), Mandel, R. (Rodica), Santoro, F. (Filippo), Kwan Lim, G.E. (Gek), Helbich, T. (Thomas), Koning, H.J. (Harry) de, Van Den Heuvel, E.R. (Edwin R.), and Bock, G.H. (Geertruida) de
- Abstract
Purpose There is no consensus on whether magnetic resonance imaging (MRI) should be included in breast screening protocols for women with BRCA1/2 mutations age ≥ 50 years. Therefore, we investigated the evidence on age-related screening accuracy in women with BRCA1/2 mutations using individual patient data (IPD) meta-analysis. Patients and Methods IPD were pooled from six high-risk screening trials including women with BRCA1/2 mutations who had completed at least one screening round with both MRI and mammography. A generalized linear mixed model with repeated measurements and a random effect of studies estimated sensitivity and specificity of MRI, mammography, and the combination in all women and specifically in those age ≥ 50 years. Results Pooled analysis showed that in women age ≥ 50 years, screening sensitivity was not different from that in women age <50 years, whereas screening specificity was. In women age ≥ 50 years, combining MRI and mammography significantly increased screening sensitivity compared with mammography alone (94.1%; 95% CI, 77.7% to 98.7% v 38.1%; 95% CI, 22.4% to 56.7%; P < .001). The combination was not significantly more sensitive than MRI alone (94.1%; 95% CI, 77.7% to 98.7% v 84.4%; 95% CI, 61.8% to 94.8%; P =.28). Combining MRI and mammography in women age ≥ 50 years resulted in sensitivity similar to that in women age ≥ 50 years (94.1%; 95% CI, 77.7%
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- 2015
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13. Paget’s disease of the axilla arising from an underlying accessory mammary tissue
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El Khoury, M., Lalonde, L., David, J., Issa-Chergui, B., Peloquin, L., and Trop, I.
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- 2011
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14. Recommendations on breast cancer screening and prevention in the context of implementing risk stratification: impending changes to current policies.
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Gagnon, J., Lévesque, E., Borduas, F., Chiquette, J., Diorio, C., Duchesne, N., Dumais, M., Eloy, L., Foulkes, W., Gervais, N., Lalonde, L., L'Espérance, B., Meterissian, S., Provencher, L., Richard, J., Savard, C., Trop, I., Wong, N., Knoppers, B. M., and Simard, J.
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BREAST cancer ,CANCER diagnosis ,MEDICAL screening ,CANCER patients ,CANCER prevention - Abstract
In recent years, risk stratification has sparked interest as an innovative approach to disease screening and prevention. The approach effectively personalizes individual risk, opening the way to screening and prevention interventions that are adapted to subpopulations. The international perspective project, which is developing risk stratification for breast cancer, aims to support the integration of its screening approach into clinical practice through comprehensive tool-building. Policies and guidelines for risk stratification--unlike those for population screening programs, which are currently well regulated--are still under development. Indeed, the development of guidelines for risk stratification reflects the translational aspects of perspective. Here, we describe the risk stratification process that was devised in the context of perspective, and we then explain the consensus-based method used to develop recommendations for breast cancer screening and prevention in a risk-stratification approach. Lastly, we discuss how the recommendations might affect current screening policies. [ABSTRACT FROM AUTHOR]
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- 2016
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15. 80 oral LOCALISATION OF THE SURGICAL CAVITY USING SUPINE MAGNETIC RESONANCE AND COMPUTED TOMOGRAPHY SCAN FUSION FOR PLANIFICATION OF BREAST INTERSTITIAL BRACHYTHERAPY
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Jolicoeur, M., primary, Racine, M.L., additional, Hathout, L., additional, David, S., additional, and Trop, I., additional
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- 2011
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16. Multimodality Breast Cancer Screening in Women with a Familial or Genetic Predisposition
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Trop, I., primary, Lalonde, L., additional, Mayrand, M.H., additional, David, J., additional, Larouche, N., additional, and Provencher, D., additional
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- 2010
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17. Imagerie du sein de l'homme
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Thomassin-Naggara, I., primary, Thomassin, L., additional, David, J., additional, Lalonde, L., additional, Trop, I., additional, and Chopier, J., additional
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- 2010
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18. McGill-medicine student initiative. Project report
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Trop, I., Troquet, J. M., and Lelorier, P.
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Cultural Characteristics ,Students, Medical ,Primary Health Care ,Argentina ,Quebec ,Humans ,International Educational Exchange ,Family Practice ,Developing Countries ,Research Article - Published
- 1993
19. Comment je fais une IRM mammaire ?
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Thomassin-Naggara, I., primary, Trop, I., additional, Salem, C., additional, Marsault, C., additional, and Chopier, J., additional
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- 2009
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20. Comment je gere les « trouvailles » en IRM mammaire ?
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Trop, I., primary, David, J., additional, Lalonde, L., additional, and Péloquin, L., additional
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- 2009
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21. Impact de l’IRM mammaire sur la prise en charge des patientes
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Thomassin-Naggara, I., primary, Péloquin, L., additional, Lalonde, L., additional, David, J., additional, and Trop, I., additional
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- 2009
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22. SEIN-WP-18 Approche et traitement par aspiration de l’abces mammaire. Revue de la litterature et algorithme de traitement
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Dugas, A., primary, Trop, I., additional, Lalonde, L., additional, Boileau, J.F., additional, and David, J., additional
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- 2009
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23. 1089
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Racine, M., primary, Trop, I., additional, Milbéo, Y., additional, David, S., additional, Fortin, B., additional, Michalowski, S., additional, Blais, D., additional, Besner, R., additional, Goulet, P., additional, and Jolicoeur, M., additional
- Published
- 2006
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24. 131 Planification of breast interstitial brachytherapy using magnetic resonance imaging and computed tomography scan fusion for localization of the surgical bed
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Doiron-Racine, M.-L., primary, Trop, I., additional, Milbeo, Y., additional, David, S., additional, Fortin, B., additional, Michelovski, S., additional, Blais, D., additional, Besner, R., additional, Potvin, G., additional, Landry, I., additional, and Jolicoeur, M., additional
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- 2006
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25. 149 Feasibility of magnetic resonance and computed tomography scan fusion for identification of the surgical bed following tumourectomy in view of partial breast irradiation
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Jolicoeur, M., primary, Milbeo, Y., additional, Doiron-Racine, M.-L., additional, Trop, I., additional, David, S., additional, Fortin, B., additional, Michelovski, S., additional, Blais, D., additional, Besner, R., additional, Potvin, G., additional, and Landry, I., additional
- Published
- 2006
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26. Management of radial scars found at percutaneous breast biopsy.
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Becker L, Trop I, David J, Latour M, Ouimet-Oliva D, Gaboury L, and Lalonde L
- Abstract
Objective: To determine whether percutaneous biopsy can safely differentiate radial scars (RS) that can be followed from those that require excision. Methods: Retrospective analysis of prospectively collected data regarding 15 986 biopsies was performed at the Centre Hospitalier de l'Université de Montréal between October 1995 and December 2003 and yielded 227 RS. The type of biopsy, number of cores, and mammographic characteristics were recorded. Only lesions with surgical pathology or 24 months of mammographic stability were considered for analysis. Subgroup analyses were performed for patients who underwent 14-gauge core biopsy (CB), 11-gauge vacuum-assisted biopsy (VAB), or both. Results: Among the 14-gauge CBs (n = 176), data were available for 144 (81.8%); among the 11-gauge VABs (n = 51), data were available for 40 (78.4%). Thirty lesions had 14-gauge CB followed by 11-gauge VAB. RS were associated with cancer in 19.6%, with a high-risk lesion in 20.1% and a benign lesion in 60.3%. Overall, 4% of cancers were missed (5% for 14-gauge CB and 0% for 11-gauge VAB), and cancer was underestimated in 22.2% (25% for 14-gauge CB and 16.7% for 11-gauge VAB). One (3.7%) additional cancer was found when benign radial scar on 14-gauge CB underwent subsequent 11-gauge VAB. Cancer was associated with 37% of RS presenting as masses but with only 17.1% of distortions and 12.3% of microcalcifications. Conclusions: If benign radial scar is found on 14-gauge CB, further evaluation is needed with 11-gauge VAB or surgery. Our data support mammographic follow-up for RS that are benign on 11-gauge VAB. [ABSTRACT FROM AUTHOR]
- Published
- 2006
27. Breast cancer staging: the role of the radiologist.
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Trop I, David J, and Lalonde L
- Abstract
The role of the breast radiologist has evolved over the past years, with an increasing involvement in patient care. Improvements in diagnostic technology and surgical techniques allow for better preoperative staging and surgeries with decreased morbidity. This article reviews the elements of investigation that are important to the surgeon and oncologist in optimizing care for the newly diagnosed breast cancer patient, with the 6th edition of the TNM classification of the American Joint Committee on Cancer used as a reference. [ABSTRACT FROM AUTHOR]
- Published
- 2005
28. Breast procedures guided by magnetic resonance imaging.
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David J, Trop I, and Lalonde L
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- 2005
29. Normal fetal anatomy as visualized with fast magnetic resonance imaging.
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Trop, Isabelle, Levine, Deborah, Trop, I, and Levine, D
- Published
- 2001
30. Virological Research in the Far East (Virusologicheskie Issledovaniya na Dalnem Vostoke)
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ARMY FOREIGN SCIENCE AND TECHNOLOGY CENTER CHARLOTTESVILLE VA, Somov,G. P., Reifman,V. G., Trop,I. E., ARMY FOREIGN SCIENCE AND TECHNOLOGY CENTER CHARLOTTESVILLE VA, Somov,G. P., Reifman,V. G., and Trop,I. E.
- Abstract
A conference devoted to the investigation of virological diseases of human beings, animals, and plants was convoked in Vladivostok at the end of August, 1969. The choice of the location for this complex conference was determined by the extraordinary spread of virological infections in the Far East. These infections are related to the unique climatic, geographic, and ecological peculiarities of this region. The basic tasks of this conference were to bring together virologists of different specialties, primarily in the fields of general virology, the evaluation and generalization of theoretical and practical achievements in the fields of medical and veterinary virology, as well as the virology of plants, and the exchange of actual experiences in the use of present day methods of investigation in each of these branches., Trans. of Voprosy Virusologii (USSR) v16 n2 p250-252 1971.
- Published
- 1971
31. 1089: Localisation of the Surgical Bed Following Tumorectomy Using Magnetic Resonance and Computed Tomography Scan Fusion for Planification of Breast Interstitial Brachytherapy
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Racine, M., Trop, I., Milbéo, Y., David, S., Fortin, B., Michalowski, S., Blais, D., Besner, R., Goulet, P., and Jolicoeur, M.
- Published
- 2006
- Full Text
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32. Magnetic resonance imaging of the breast: current indications.
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Lalonde L, David J, and Trop I
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Breast magnetic resonance imaging (MRI) plays an increasing role in the management of selected breast cancer patients. MRI is recognized as the most sensitive modality for the detection of invasive breast cancer. Several valuable clinical applications of MRI have emerged for breast cancer detection and diagnosis from clinical investigations. Breast MRI is helpful for women diagnosed with breast cancer who contemplate breast conserving surgery; it provides valuable information on the extent of the disease. MRI can also help assess for residual invasive cancer in patients who have undergone lumpectomy with positive margins at pathology. It is very reliable in differentiating scar tissue from recurrence at the lumpectomy site. MRI is also reliable in finding a breast cancer in women with axillary nodal metastases and unknown primary tumour. MRI can help to monitor the response to chemotherapy. Breast MRI could be a better screening tool than mammography in women with very high risks of developing breast cancer, such as breast cancer gene carriers and patients treated with chest radiation. Other potential uses of MRI include evaluation of the integrity of silicone breast implants and evaluation of the parenchyma in women with silicone gel implants or free injection of silicone gel. However, like any other technique, breast MRI has some drawbacks, including low-to-moderate specificity, high costs, and variability in technique and interpretation. Radiologists must have a clear understanding of valid indications and selection criteria to use this technique appropriately. [ABSTRACT FROM AUTHOR]
- Published
- 2005
33. Medico-Legal Cases in Breast Imaging in Canada: A Trend Analysis.
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Seely JM, Payant L, Zhang C, Aslanova R, Chothia S, MacIntyre A, Trop I, Yang Q, Garber G, and Patlas M
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- Canada, Breast Neoplasms diagnostic imaging, Diagnostic Errors legislation & jurisprudence, Diagnostic Errors trends, Radiologists legislation & jurisprudence, Radiologists statistics & numerical data, Radiologists trends, Radiology legislation & jurisprudence, Radiology trends, Mammography statistics & numerical data, Mammography trends, Legal Services statistics & numerical data, Legal Services trends
- Abstract
Purpose: Breast imaging accounts for a large proportion of medico-legal cases involving radiologists in several countries and may be a disincentive to breast imaging. As this has not been well studied in Canada, we evaluated the key medico-legal issues of breast imaging in Canada and their implications for health care providers and patient safety. Methods: In collaboration with Canadian Medical Protective Association (CMPA), we obtained information from the medico-legal repository, including civil-legal, medical regulatory authority (College) and hospital complaints occurring between 2002-2021. Canadian Classification of Health Interventions (CCI) codes were used for breast imaging and biopsy. Trend analysis was done comparing cases involving breast imaging/biopsy to all cases where a radiologist was named. Results: Radiologists were named in 3108 medico-legal cases, 188 (6%, 188/3108) of which were CCI coded for breast imaging or biopsy. Factors related to radiologists were most frequent (64%, 120/188), followed by team (23.4%, 44/188) and system (6.9%, 13/188). Equal representation of male and female radiologists was found (IRR = 1.22; 95% CI: .89, 1.56). In a 10-year test window from 2006 - 2015 we identified an increasing trend for all cases involving radiologists ( P = 0,0128) but a decreasing trend for cases coded with breast imaging or biopsy ( P = 0,0099). Conclusions: A significant decrease in cases involving breast imaging were found from 2006-2015, accounting for 6% of the medico-legal cases. The lower risk of breast imaging medico-legal issues may encourage more radiologists in breast imaging., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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- 2024
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34. Education Research: Neuroradiology Curriculum and Competencies Among Canadian Adult Neurology Residency Programs: A Cross-Sectional Study.
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Benea D, Di Ioia R, Bejjani J, Nguyen AX, Hardy I, Trop I, and Jodoin N
- Abstract
Background and Objectives: While benefitting from neuroradiologists' reports, neurologists use their own image interpretation to guide clinical decisions, especially in acute care settings. This calls for robust neuroradiology training in neurology residency, informed by current educational gaps and practices. This study aims to (1) characterize the formal neuroradiology curriculum among Canadian neurology residency programs; (2) assess neurology residents' neuroimaging interpretation competencies; and (3) define neurology residents' and program directors' (PDs) attitudes toward the current curriculum and future directions., Methods: Anonymous surveys were sent to Canadian neurology residents and PDs, querying neuroradiology learning activities, imaging modalities covered, assessment modalities, perceived residents' competencies to interpret different modalities, and attitudes regarding neuroradiology training. Residents were asked to interpret 15 neuroimaging cases. Descriptive and inferential analyses were performed. Potential differences in residents' interpretation success rates by seniority, self-perceived proficiency, and perception of curriculum sufficiency were examined using 2-tailed Welch tests with a 95% CI and Holm-Bonferroni comparison adjustment. Statistics were computed using Excel., Results: Seventy-eight (32.6%) residents and 11 (68.8%) PDs participated. Ten of 11 PDs reported including a mandatory neuroradiology rotation, and 9/11 offered a formal neuroradiology curriculum covering head CT, head and neck CT angiography (CTA), spine MRI, and head MRI. Programs predominantly offered additional didactic lectures (9/11), teaching cases (8/11), and imaging websites (8/11). Most of the residents agreed with a minimum 1-month long rotation and desired regular didactics from neuroradiologists. Residents favored learning about head MRI (88.5%), head and neck CTA (76.9%), and spine MRI (69.2%). Senior residents' self-perceived competencies were highest for head CT, head MRI, and head and neck CTA, but lower than PDs' perception. Senior residents had greater interpretation scores than juniors (84.5% ± 13.2% vs 69.1% ± 19.9%; p < 0.0001). Most PDs (7/11, 63.6%) expressed satisfaction with current curricula vs 32.1% of residents. PDs identified time and educator shortages as main barriers to increased training., Discussion: Neuroradiology training varies among programs. Residents expressed strong interest in commonly taught modalities, for which they also expressed high self-perceived competencies. However, PDs expressed greater satisfaction than residents with the current training. Leveraging interactions with neuroradiologists and online case-based learning while emphasizing trainees' interests can enhance postgraduate neuroradiology training for this useful skill., Competing Interests: The authors report no relevant disclosures. Go to Neurology.org/NE for full disclosures., (© 2023 American Academy of Neurology.)
- Published
- 2023
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35. Knowledge of Medicolegal Risks to Improve Health Care Delivery.
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Trop I
- Subjects
- Humans, Delivery of Health Care legislation & jurisprudence
- Published
- 2023
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36. Canadian radiology workforce demographics: Results from a national survey.
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Hillier E, Hodgson CS, Lebel K, Spalluto LB, Trop I, Yap WW, Hillier T, Darras KE, Sharma S, and Yong-Hing CJ
- Abstract
Rationale and Objective: Demographic data collected about Canadian radiologists and trainees has been limited primarily to binary gender and geographic location. The purpose of this study was to investigate: (1) demographic characteristics of Canadian radiologists and trainees; (2) types of diversity important to radiologists; (3) relationship of radiologist demographics to practice characteristics; and (4) relationship of radiologist demographics to years in practice, (YIP)., Materials and Methods: French and English surveys were distributed via email through radiology associations and social media. Frequency counts of demographic variables were calculated, and chi-square and Fisher's Exact tests were performed to explore the relationships between demographic characteristics and role., Results: 611 individuals responded to the survey. 573 respondents were included in the analysis. 454 (78.8%) were practicing radiologists and 119 (20.7%) were residents/fellows. Half identified as women (50.4%). English was the primary language for most respondents. There was an association between role and sexual orientation (p = 0.02), visible minority (χ2 = 4.79, p < 0.05), religion (χ2 = 4.11, p < 0.05), and having children (χ2 = 136.65, p < 0.05). For radiologists, being a visible minority (χ2 = 11.59, p < 0.05) and age (χ2 = 56.3, p < 0.05) were associated with academic rank while gender (χ2 = 3.83, p < 0.05) and age (χ2 = 13.74, p < 0.05) were related to part-/full-time status. Less women, visible minorities, and women with children had been in practice for long., Discussion: This study represents a comprehensive analysis of Canadian radiology demographics. Results suggest there is increasing diversity among trainees; however, significant demographic underrepresentation compared to the diversity of Canada exists., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)
- Published
- 2023
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37. Canadian Radiology Gender Pay Gap-Reality or Myth?
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Yap WW, Hodgson CS, Spalluto L, Lebel K, Trop I, Hillier E, Darras K, Hillier T, and Yong-Hing CJ
- Subjects
- Child, Humans, Male, Female, Canada, Cross-Sectional Studies, Radiography, Radiologists, Radiology
- Abstract
Introduction: Prior studies on Canadian physicians' income have demonstrated a gender pay gap (GPG); however, there is a paucity of data in the Radiology specialty. A cross-sectional study was conducted to determine if practicing Canadian radiologists' self-reported income is related to gender, controlling for demographic and work variables. Methods: English and French online surveys were distributed by email and social media to radiologists and trainees (May-July 2021). The association between Gender (controlling for Ethnicity variables, Region, having Children, Full-/Part-Time work, and Academic position) and Self-Reported Income was examined using chi-square tests. Pearson correlations examined relationships between opinion variables. Analyses were conducted using SPSS V28.0. A priori significance was P < .05. Study had ethics approval. Results: Four hundred and fifty-four practicing Canadian radiologists responded. Majority were women (51.2%, n = 227), a non-visible Minority (71.7%, n = 317), and from Western Provinces (67.8%, n = 308). Significant relationship was established between Self-Reported Income and Gender (χ2 = 10.44, df = 2, P < .05). More men (70.6%, n = 120) than women (56.4%, n = 110), reported income "greater than $500 000"; fewer men (20.6%, n = 35) than women (35.9%, n = 70) reported "$300 000-$500 000"; a similar percent of men (8.8%, n = 15) and women (7.7%, n = 15) reported "less than $300 000." No relationship was found between self-reported income and gender for ethnicity variables, those without children, part-time, or non-academic radiologists. The opinion "Addressing the GPG is important" correlated to "Canadian Association of Radiologists should collect demographic data" (r = 0.63). Responses were low for ethnic minorities and non-western provinces. Conclusion: Our results suggest a GPG exists in Canadian radiology and is an important first step for future studies.
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- 2023
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38. Current State of Bibliometric Research on the Scholarly Activity of Academic Radiologists.
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Lungu E, Tang A, Trop I, Soulez G, and Bureau NJ
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- Bibliometrics, Cross-Sectional Studies, Female, Humans, Male, National Institutes of Health (U.S.), Radiologists, United States, Biomedical Research, Radiology
- Abstract
In this review article, we discuss the literature pertaining to the bibliometric analysis of academic radiologists' scholarly activity in order to identify current trends, knowledge gaps, and potential future directions. Current research provides cross-sectional analyses of bibliometrics on three main themes: academic ranking, gender disparity, and research funding. The most commonly used parameters are the publication and the citation counts, the h-index and the number of years in academia. The h-index correlates positively with academic ranking and, in the case of editorial board members, with the journal's impact factor. Scholars who have secured National Institutes of Health funding tend to have higher h-indexes than those who have not. Whereas gender balance has been achieved in medical school and in several medical specialties, women remain significantly fewer than men in most areas of radiology. The underrepresentation of women is particularly noticeable at higher academic ranks and in leadership positions, suggesting that significant barriers to female radiologists' career advancement exist. Scholarly productivity of radiology residents and the impact of research on academic productivity are subjects that have received less attention in the published literature. Future studies should focus on whether bibliometric parameters can be used as reliable measurements of scholarly activity to help determine appointments, promotions and grant allocations, and to assess interventions that promote gender parity., (Copyright © 2020 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)
- Published
- 2022
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39. How Well Are Radiology Residents Prepared for Practice After Training? A Survey of French-Speaking Quebec Recent Graduates and Department Chiefs.
- Author
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Labranche R, Lapierre C, and Trop I
- Subjects
- Female, Humans, Magnetic Resonance Imaging, Male, Physician Executives, Quebec, Radiology, Interventional education, Self Efficacy, Surveys and Questionnaires, Tomography, X-Ray Computed, Ultrasonography, Clinical Competence, Consumer Behavior, Curriculum standards, Internship and Residency standards, Radiology education
- Abstract
Objective: Radiology residents must fulfill a standardized curriculum to complete residency and pass a certification exam before they are granted a licence to practice. We sought to evaluate how well residency prepares trainees for practice as perceived by recent graduates and their department chiefs. Subjects and Methods: Radiologists who graduated from the 4 Quebec radiology residency programs between 2005 and 2016 (n = 237) and Quebec radiology department chiefs (n = 98) were anonymously surveyed. Two electronic surveys were created, for recent graduates (74 questions) and for department chiefs (11 questions), with multiple-choice questions and open questions covering all fields of radiology. Surveys were administered between April and June 2016 using the Association des radiologistes du Québec database., Results: Response rate was 75 (31.6%) of 237 from recent graduates and 96% rated their training as excellent or good. Satisfaction with training in computed tomography and magnetic resonance imaging was high, with musculoskeletal (MSK) imaging, particularly MSK ultrasound (US), as well as pediatric, cardiac, and vascular imaging needing more training. Thirty-nine (39.8%) of 98 department chiefs answered the survey and highlighted weaknesses in the interpretation of conventional radiography, obstetrical US, and invasive procedures, as well as limited leadership and administrative skills. Recent graduates and department chiefs both reported difficulties in the ability to interpret daily volume of examinations as scheduled and invasive procedure competency., Conclusion: This survey highlights areas of the radiology curriculum which may benefit from more emphasis during training. Adjustments in the residency program would ensure graduates are successful both in their certification exams and clinical practice.
- Published
- 2021
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40. Case 285: Primary Breast Lymphoma.
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El Khoury M, Maietta A, Tran A, Trop I, Lalonde L, and Mesurolle B
- Subjects
- Adult, Biopsy, Breast diagnostic imaging, Breast pathology, Breast Neoplasms pathology, Cyclophosphamide therapeutic use, Doxorubicin therapeutic use, Female, Fluorodeoxyglucose F18, Follow-Up Studies, Humans, Lymphoma pathology, Magnetic Resonance Imaging methods, Positron Emission Tomography Computed Tomography methods, Prednisone therapeutic use, Radiopharmaceuticals, Rituximab therapeutic use, Treatment Outcome, Ultrasonography, Mammary methods, Vincristine therapeutic use, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Breast Neoplasms diagnostic imaging, Breast Neoplasms drug therapy, Diagnostic Imaging methods, Lymphoma diagnostic imaging, Lymphoma drug therapy
- Abstract
History A 25-year-old woman was referred to our breast clinic for assessment of a palpable mass in her left breast that developed quickly in 2 weeks. She denied any associated fever, chills, redness, or pain. She had no relevant medical or surgical history; no evidence of recent pregnancy, abortion, or breastfeeding; and no family history of breast cancer. Clinical examination enabled confirmation of a firm mass occupying the retroareolar region and the outer quadrant of the left breast with no skin retraction, edema, or erythema. There was no evidence of enlarged axillary lymph nodes. US of the left breast, bilateral breast MRI, and fluorine 18 (
18 F) fluorodeoxyglucose (FDG) PET/CT were performed.- Published
- 2021
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41. Case 285.
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El Khoury M, Maietta A, Tran A, Trop I, Lalonde L, and Mesurolle B
- Abstract
History A 25-year-old woman was referred to our breast clinic for assessment of a palpable mass in her left breast that developed quickly in 2 weeks. She denied any associated fever, chills, redness, or pain. She had no relevant medical or surgical history; no evidence of recent pregnancy, abortion, or breastfeeding; and no family history of breast cancer. Clinical examination enabled confirmation of a firm mass occupying the retroareolar region and the outer quadrant of the left breast with no skin retraction, edema, or erythema. There was no evidence of enlarged axillary lymph nodes. US of the left breast (Fig 1), bilateral breast MRI (Fig 2), and fluorine 18 fluorodeoxyglucose PET/CT (Fig 3) were performed.
- Published
- 2020
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42. Venous malformation of the pectoral muscle depicted on mammogram.
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El Khoury M, Bejjani J, Trop I, Labelle M, and Mesurolle B
- Subjects
- Adult, Algorithms, Breast Neoplasms diagnostic imaging, Female, Humans, Radiographic Image Interpretation, Computer-Assisted, Mammography, Pectoralis Muscles diagnostic imaging
- Abstract
Venous malformation of the pectoral muscle diagnosed on a mammogram of a 41-year-old patient presenting with clinical suspicion of a gynecomastia., (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Published
- 2020
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43. Added Value of Quantitative Ultrasound and Machine Learning in BI-RADS 4-5 Assessment of Solid Breast Lesions.
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Destrempes F, Trop I, Allard L, Chayer B, Garcia-Duitama J, El Khoury M, Lalonde L, and Cloutier G
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Data Systems, Female, Humans, Middle Aged, Research Design, Young Adult, Breast Neoplasms diagnostic imaging, Machine Learning, Ultrasonography, Mammary methods
- Abstract
The purpose of this study was to evaluate various combinations of 13 features based on shear wave elasticity (SWE), statistical and spectral backscatter properties of tissues, along with the Breast Imaging Reporting and Data System (BI-RADS), for classification of solid breast lesions at ultrasonography by means of random forests. One hundred and three women with 103 suspicious solid breast lesions (BI-RADS categories 4-5) were enrolled. Before biopsy, additional SWE images and a cine sequence of ultrasound images were obtained. The contours of lesions were delineated, and parametric maps of the homodyned-K distribution were computed on three regions: intra-tumoral, supra-tumoral and infra-tumoral zones. Maximum elasticity and total attenuation coefficient were also extracted. Random forests yielded receiver operating characteristic (ROC) curves for various combinations of features. Adding BI-RADS category improved the classification performance of other features. The best result was an area under the ROC curve of 0.97, with 75.9% specificity at 98% sensitivity., (Copyright © 2019 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)
- Published
- 2020
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44. Abbreviated breast MRI combining FAST protocol and high temporal resolution (HTR) dynamic contrast enhanced (DCE) sequence.
- Author
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Milon A, Vande Perre S, Poujol J, Trop I, Kermarrec E, Bekhouche A, and Thomassin-Naggara I
- Subjects
- Adult, Aged, Aged, 80 and over, Breast pathology, Breast Neoplasms pathology, Contrast Media, Female, Humans, Image Interpretation, Computer-Assisted, Middle Aged, Retrospective Studies, Sensitivity and Specificity, Breast diagnostic imaging, Breast Neoplasms diagnostic imaging, Diffusion Magnetic Resonance Imaging
- Abstract
Purpose: We evaluated the diagnostic value of a high temporal resolution (HTR) dynamic contrast enhanced (DCE) sequence added to a FAST protocol., Materials and Methods: 120 women (mean age = 55 years (28-88)) who underwent breast MRI between July 2016 and March 2017 and in whom a biopsy was performed (i.e., gold standard) (n = 179: 69 benign, 7 borderline and 103 malignant lesions) were retrospectively and consecutively included. Two readers classified lesions according to the Breast Imaging-Reporting and Data System (BI-RADS) by reading: a FAST protocol (T1W, T2W, T1W-fat saturated 2 min after injection) and then a FULL standard protocol. Independently they determined if lesions were visible and when (Time To Enhancement (TTE)) on the HTR-DCE sequence. An Abbreviated protocol was then built using data from the HTR-DCE sequence added to the FAST protocol., Results: All lesions were visible with the FAST protocol. 171/179 (95.5%) lesions were detected by reading theHTR-DCE sequence. There were a higher number of cancers rated BI-RADS 3 (PPV of malignancy of 27.6% (8/29) in FAST versus 18.7% (3/16) FULL protocol). An early enhancement on the HTR-DCE sequence (TTE < 31 s) was associated with malignancy with an OR 5.6 (CI 95%: 3.3-20.4) (p < 0.0001). Adding a TTE < 31 s to FAST analysis (AUROC = 0.826) significantly improved lesion characterization with a diagnostic gain of 10.6% (19/179) lesions correctly reclassified (p = 0.0034) compared to FAST protocol; with shorter acquisition time (7 min 48 s versus 13 min 54 s)., Conclusion: Adding an HTR-DCE sequence to a FAST protocol increases diagnostic performance reaching that of the FULL protocol while reducing acquisition time., (Copyright © 2019 Elsevier B.V. All rights reserved.)
- Published
- 2019
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45. Is There a Role for Imaging Surveillance after Mastectomy and Autologous Breast Reconstruction?
- Author
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Trop I
- Subjects
- Early Detection of Cancer, Humans, Mammography, Mastectomy, Breast Neoplasms surgery, Mammaplasty
- Published
- 2018
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46. Accuracy of screening women at familial risk of breast cancer without a known gene mutation: Individual patient data meta-analysis.
- Author
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Phi XA, Houssami N, Hooning MJ, Riedl CC, Leach MO, Sardanelli F, Warner E, Trop I, Saadatmand S, Tilanus-Linthorst MMA, Helbich TH, van den Heuvel ER, de Koning HJ, Obdeijn IM, and de Bock GH
- Subjects
- Adult, Breast Neoplasms epidemiology, Clinical Trials as Topic, DNA Mutational Analysis, Female, Genetic Predisposition to Disease, Heredity, Humans, Middle Aged, Pedigree, Phenotype, Predictive Value of Tests, Reproducibility of Results, Risk Assessment, Risk Factors, Biomarkers, Tumor genetics, Breast Neoplasms diagnostic imaging, Breast Neoplasms genetics, Early Detection of Cancer methods, Magnetic Resonance Imaging, Mammography, Mutation
- Abstract
Introduction: Women with a strong family history of breast cancer (BC) and without a known gene mutation have an increased risk of developing BC. We aimed to investigate the accuracy of screening using annual mammography with or without magnetic resonance imaging (MRI) for these women outside the general population screening program., Methods: An individual patient data (IPD) meta-analysis was conducted using IPD from six prospective screening trials that had included women at increased risk for BC: only women with a strong familial risk for BC and without a known gene mutation were included in this analysis. A generalised linear mixed model was applied to estimate and compare screening accuracy (sensitivity, specificity and predictive values) for annual mammography with or without MRI., Results: There were 2226 women (median age: 41 years, interquartile range 35-47) with 7478 woman-years of follow-up, with a BC rate of 12 (95% confidence interval 9.3-14) in 1000 woman-years. Mammography screening had a sensitivity of 55% (standard error of mean [SE] 7.0) and a specificity of 94% (SE 1.3). Screening with MRI alone had a sensitivity of 89% (SE 4.6) and a specificity of 83% (SE 2.8). Adding MRI to mammography increased sensitivity to 98% (SE 1.8, P < 0.01 compared to mammography alone) but lowered specificity to 79% (SE 2.7, P < 0.01 compared with mammography alone)., Conclusion: In this population of women with strong familial BC risk but without a known gene mutation, in whom BC incidence was high both before and after age 50, adding MRI to mammography substantially increased screening sensitivity but also decreased its specificity., (Copyright © 2017 Elsevier Ltd. All rights reserved.)
- Published
- 2017
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47. Comparative Evaluation of Iodine-125 Radioactive Seed Localization and Wire Localization for Resection of Breast Lesions.
- Author
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Tran VT, David J, Patocskai E, Zummo-Soucy M, Younan R, Lalonde L, Labelle M, El Khoury M, Robidoux A, and Trop I
- Subjects
- Breast diagnostic imaging, Breast surgery, Female, Humans, Middle Aged, Reproducibility of Results, Retrospective Studies, Titanium, Breast Neoplasms diagnostic imaging, Breast Neoplasms surgery, Fiducial Markers, Iodine Radioisotopes, Mastectomy, Segmental methods, Ultrasonography, Interventional
- Abstract
Purpose: Radioactive seed localization (RSL) uses a titanium seed labeled with iodine-125 energy for surgery of nonpalpable breast lesions. RSL facilitates radiology-surgery scheduling and allows for improved oncoplasty compared with wire localization (WL). The purpose of this work was to compare the 2 techniques., Methods: We performed a retrospective study of all breast lesions operated with RSL between February 2013 and March 2015 at our university institution, and compared with an equivalent number of surgeries performed with a single WL. Imaging and pathology reports were reviewed for information on guidance mode, accuracy of targeting, nature of excised lesion, size and volume of surgical specimen, status of margins, and reinterventions., Results: A total of 254 lesions (247 women) were excised with RSL and compared with 257 lesions (244 women) whose surgery was guided by WL. Both groups were comparable in lesion pathology, guidance mode for RSL or WL positioning, and accuracy of targeting (98% correct). Mean delay between biopsy and surgery was 84 days for RSL versus 103 after WL (P = .04). No differences were noted after RSL or WL for surgical specimen mean weight, largest diameter, and volume excised. For malignancies, the rate of positive margins was comparable (2.8%-3%), with 5 of 10 women in the RSL group who underwent a second surgery displaying residual malignancy compared with 3 of 9 women in the WL group., Conclusions: RSL is safe and accurate, and has comparable surgical endpoints to WL. Because RSL offers flexible scheduling and facilitated oncoplasty, RSL may replace WL for resection of nonpalpable single breast lesions., (Copyright © 2017 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.)
- Published
- 2017
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48. Abbreviated breast magnetic resonance protocol: Value of high-resolution temporal dynamic sequence to improve lesion characterization.
- Author
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Oldrini G, Fedida B, Poujol J, Felblinger J, Trop I, Henrot P, Darai E, and Thomassin-Naggara I
- Subjects
- Adult, Aged, Breast diagnostic imaging, Breast pathology, Breast Neoplasms pathology, Female, Humans, Middle Aged, Reproducibility of Results, Retrospective Studies, Sensitivity and Specificity, Young Adult, Breast Neoplasms diagnostic imaging, Magnetic Resonance Imaging methods
- Abstract
Purpose: To evaluate the added value of ULTRAFAST-MR sequence to an abbreviated FAST protocol in comparison with FULL protocol to distinguish benign from malignant lesions in a population of women, regardless of breast MR imaging indication., Materials and Methods: From March 10th to September 22th, 2014, we retrospectively included a total of 70 consecutive patients with 106 histologically proven lesions (58 malignant and 48 benign) who underwent breast MR imaging for preoperative breast staging (n=38), high-risk screening (n=7), problem solving (n=18), and nipple discharge (n=4) with 12 time resolved imaging of contrast kinetics (TRICKS) acquisitions during contrast inflow interleaved in a regular high-resolution dynamic MRI protocol (FULL protocol). Two readers scored MR exams as either positive or negative and described significant lesions according to Bi-RADS lexicon with a TRICKS images (ULTRAFAST), an abbreviated protocol (FAST) and all images (FULL protocol). Sensitivity, specificity, positive and negative predictive values, and accuracy were calculated for each protocol and compared with McNemar's test., Results: For all readers, the combined FAST-ULTRAFAST protocol significantly improved the reading with a specificity of 83.3% and 70.8% in comparison with FAST protocol or FULL protocol, respectively, without change in sensitivity. By adding ULTRAFAST protocol to FAST protocol, readers 1 and 2 were able to correctly change the diagnosis in 22.9% (11/48) and 10.4% (5/48) of benign lesions, without missing any malignancy, respectively. Both interpretation and image acquisition times for combined FAST-ULTRAFAST protocol and FAST protocol were shorter compared to FULL protocol (p<0.001)., Conclusion: Compared to FULL protocol, adding ULTRAFAST to FAST protocol improves specificity, mainly in correctly reclassifying benign masses and reducing interpretation and acquisition time, without decreasing sensitivity., (Copyright © 2017 Elsevier B.V. All rights reserved.)
- Published
- 2017
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49. Lupus mastitis as a first manifestation of systemic disease: About two cases with a review of the literature.
- Author
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Voizard B, Lalonde L, Sanchez LM, Richard-Chesnay J, David J, Labelle M, El Khoury M, and Trop I
- Subjects
- Aged, Biopsy, Needle methods, Breast pathology, Female, Humans, Middle Aged, Subcutaneous Fat pathology, Lupus Erythematosus, Systemic pathology, Mastitis pathology, Panniculitis, Lupus Erythematosus pathology
- Abstract
Lupus mastitis is an uncommon manifestation of systemic lupus erythematosus (SLE) that affects the subcutaneous fat in the breast, much like lupus panniculitis, but additionally involves the mammary gland. We report on two women for whom lupus mastitis was the initial manifestation of SLE and provide a literature review of 34 additional cases reported in the Anglo-Saxon and French literature since 1971, making this the largest review to date. Lupus mastitis (LM) can manifest clinically as subcutaneous masses that may be painful, or may present cutaneous involvement such as thickening and discolouration. The radiologic manifestations of LM are broad and include calcifications, masses and asymmetries. Most often, excluding malignancy requires percutaneous biopsy, with histologic findings that are virtually pathognomonic for SLE. Thus, surgery is avoided and medical management can begin, antimalarial drugs and corticosteroids in most cases., (Copyright © 2017 Elsevier B.V. All rights reserved.)
- Published
- 2017
- Full Text
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50. Assessment of Breast Asymmetry in Adolescent Idiopathic Scoliosis Using an Automated 3D Body Surface Measurement Technique.
- Author
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Ramsay J, Seoud L, Barchi S, Cheriet F, Joncas J, Turgeon I, Debanné P, Trop I, Labelle H, and Parent S
- Subjects
- Adolescent, Body Surface Area, Breast pathology, Cohort Studies, Feasibility Studies, Female, Humans, Posture, Scoliosis pathology, Thoracic Vertebrae diagnostic imaging, Thoracic Vertebrae pathology, Thoracic Wall diagnostic imaging, Thoracic Wall pathology, Torso diagnostic imaging, Anthropometry methods, Breast diagnostic imaging, Imaging, Three-Dimensional methods, Magnetic Resonance Imaging methods, Scoliosis diagnostic imaging
- Abstract
Study Design: Cohort study., Objectives: To assess breast asymmetry (BA) directly with 3D surface imaging and to validate it using MRI values from a cohort of 30 patients with significant adolescent idiopathic scoliosis (AIS). Also, to study the influence of posture (prone vs standing) on BA using the automated method on both modalities., Summary of Background Data: BA is a common concern in young female patients with AIS. In a previous study using MRI, we found that the majority of patients with significant AIS experienced BA of up to 21% in addition to their chest wall deformity. MRI is costly and not always readily available. 3D surface topography, which offers fast and reliable breast acquisitions without radiation or distortion of the body surface, is an alternative method in the clinical setting., Methods: Thirty patients with AIS were enrolled in the study on the basis of their thoracic curvature, skeletal and breast maturity, without regard to their perception of their BA. Each patient underwent two imaging studies of their torso: a 3D trunk surface topography and a breast MRI. An automated breast volume measuring method was proposed using a program developed with Matlab programming., Results: Strong correlations were obtained when comparing the proposed method to the MRI on the left breast volumes (LBV) (r = 0.747), the right breast volumes (RBV) (r = 0.805) and the BA (r = 0.614). Using the same method on both imaging modalities also yielded strong correlation coefficients on the LBV (r = 0.896), the RBV (r = 0.939) and the BA (r = 0.709)., Conclusions: The proposed 3D body surface automated measurement technique is feasible clinically and correlates very well with breast volumes measured using MRI. Additionally, breast volumes remain comparable despite being measured in different body positions (standing and prone) in a young cohort of AIS patients., Level of Evidence: Level IV., (Copyright © 2017 Scoliosis Research Society. Published by Elsevier Inc. All rights reserved.)
- Published
- 2017
- Full Text
- View/download PDF
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