Technical standards and practice parameters - MRI, mammo, US Flashcards
screening MRI of the contralateral breast in patents with newly diagnosed breast ca detects cancer in what percent of patients?
3-5%
in what percent does MRI detect occult cancer in the ipsilateral breast, in a patient with newly diagnosed cancer?
12-27%
in what time frame is recurrence seen in a patient that has undergone mastectomy, and where is the recurrence usually seen?
within 5 years in the skin or subcutaneous tissue around the scar
should screening mammo be performed in the residual tissue after a patient has undergone mastectomy?
no
how should gad be administered in breast MRI?
0.1 mmol/kg bolus with 10 ml saline flush
what are the ACR slice thickness recommendations for breast MRI?
3 mm or less
what are the ACR recommendations for in plane axial resolution in breast MRI?
1 mm or less to decrease volume averaging
what is the best sequence to evaluate axillary nodes on MRI?
non enhanced T1 without fat saturation
in what subset of patients is MRI most useful to evaluate for extent of ipsilateral disease?
in patients with ILC or with dense breasts
what is the recurrence rate per year in patients that have undergone surgery and radiation?
1-2% per year usually in the same quadrant
what percent of patients get fat necrosis after BCT?
1/3 to 1/2
in what types of tumors is MRI best for evaluating response to treatment?
ER negative/Her2+ and those that are more aggressive. MRI is not as good for ER/PR+ and Her 2- tumors.
what are the high risk lesions?
lobular neoplasia, papilloma, ADH, flat epithelial atypia, radial scar
what are the ACR parameters for breast US transducer?
high resolution, real time linear array broad bandwidth with center of frequency at leas 12MHz or more
what is the upgrade rate of DCIS to invasive cancer?
20-25%
how soon does a health care provider have to be notified of a bi rads 4 or 5? how soon does the patient have to be informed?
within 3 days of the interpretation. patient has to be informed within 5 days
the average dose of a single CC view of a 4.2 cm compressed breast that is half fat and half FGT should not exceed?
3 mGy
MQSA requires that facilities have audit outcomes on what Bi Rads? ACR recommends what?
MQSA requires Bi rads 4 and 5 audits. ACR recommends Bi rads 0,4,5.
what can facilities refer to for information on their audit outcomes compared to other facilities?
ACR national mammography database provides benchmarking for outcomes data
what should lightbox luminance be?
3000 cd/m2
what should ambient light in mammo reading room be?
20-45 lux
mammo grids mut fit which size receptors?
18X 24 and 24X30
how much magnification should mag mammo produce?
1.4-2.0
what are the grid ratios for contact mammography?
3.5:1 and 5:1
what size monitors are used in digital mammo?
2K X 2.5K or 5 megapixel
what is the technique for ductography?
identify single pore of discharge, 30G cannula tip is placed on the duct, when cannula is in the duct inject 0.2-0.3 mL of contrast - once contrast is in, get magnification CC and ML mammograms of the retroareolar breast
what is artifact that can mimic filling defects in ductography?
air bubbles
if filling defect is indented on ductogram, what can be done to localize?
place clip during diagnostic ductogram or do wire localization on day of surgery
what is the T staging of breast ca?
T1: less than 2 cm, T2: 2-5 cm, T3: greater than 5 cm, T4: any size with invasion to chest wall or skin, T4d: Inflammatory breast cancer
what is the N staging of breast ca?
N0: no regional LN, N1: ipsilateral moveable axillary nodes, N2: ipsilateral fixed axillary nodes, N3: ipsilateral supraclav or infraclav or ipsilateral intramammary nodes
what is the M staging of breast ca?
MX: mets can’t be assessed, M0: no distant mets, M1: distant mets
what is stage 4 breast cancer?
M1 (any T, any M)
what artifact is seen on US of implants?
reverberation artifact is seen in the near field - but can tell its artifact bc it spans the same depth as breast tissue and can still see deeper structures
what is the salad oil sign of rupture?
rupture of double lumen implant - see saline from inner lumen within silicone which is the outer lumen
