Breast imaging techniques Flashcards
Type major types of mammography
Screening mammography - Every 2 years, starting at age 40-65, for patients with no complaints or symptoms
Clinical mammography - for women with complaints
Imaging methods
Analog mammography - X-ray with physical film. Soft beam technique with low voltage but high beam intensity
Digital mammography - Slightly lower spatial resolution,
but; significantly lowered radiation, higher contrast, better depiction of microcalcifications, digital storage and computer aided diagnostics.
Tomosynthesis: X-ray in two directions, and then tomography. Improves detection rates of lesions with only slight increase in radiation exposure. Significantly less exposure than a full CT scan.
US: 1st choice for examining women under 35 years or during pregnancy OR lactation and breastfeeding. 2nd choice as a supplement to mammography for women over 35yrs.
Uses the 7.5 MHz linear head, or even a high 12-18 MHz linear head.
The large majority of lesions are detectable with mammography/US
Doppler US - to depict increased vasculature of malignant lesions.
MRI imaging - always used with contrast, to differentiate types of lesions that have different contrast enhancements.
PET, SPECT, PET/CT, using FDG. 18 FluoroDeoxyGlucose, increased uptake into malignant cells.
To locate small non-palpable lesions prior to surgery, and marking of sentinel lymph nodes for resection.
Pneumocystography - after cystic drainage to rule out intracystic tumors
Galacto/Ductography- Contrast material injection to the duct, used when there is breast bleeding or discharge after mammography, US, and cytological evaluations have all been done.
What do microcalcifications indicate
They are actually quite common and USUALLY accompany benign processes.
A small percentage does indicate malignancy and should be evaluated farther, by biopsy.
Multiple, pleiomorphic microcalcifications usually indicates pathology however.
What types of breast lesions are round or oval shaped masses
Usually benign,
Fibroadenomas
Cysts
Hamartomas
Lipomas
How do malignant lesions usually appear on breast imaging
Uneven, ill defined margins.
On US, echo-attenuation usually occurs behind them, and they are often HyPOechogenic.
Star shaped lesions are very typical of malignant lesions
White star lesions of the breast
Tumor body with dense spiculations around a core - indicates Carcinoma
Black star lesion of the breast
Transparent central core, with long thin spiculations
These can be either bneign or malignant.
May be lobular carcinoma
May be post-radiation scar tissue
Fatty necrosis.
