While the mass COVID-19 vaccination effort over the past four months is bringing closer the light at the end of the pandemic tunnel, as with all things in medicine, it is not without a cost.
Women's health news related to breast imaging, including mammography, breast MRI, automated breast ultrasound (ABUS), breast ultrasound, breast biopsy, and positron emission mammography (PEM). This channel also includes news on breast density and the issues it causes in detecting cancers. Mammography can be broken into two types of systems. 2-D full field digital mammography (FFDM) have almost completely replaced older X-ray film based systems. The newest generation systems use 3-D tomosynthesis mammography technology, where a series of digital images are shot in an arch around the breasts and a computer reconstructs the images into slices that can be scrolled through to see layers of tissue. This allows easier radiology reading of images, especially in women with dense breasts, because it can cancers where there are several layers of thick breast tissue that can mask cancers on 2-D mammography. Tomo is rapidly replacing FFDM.
A 37-year-old woman developed a new, palpable left supraclavicular lymphadenopathy lump five days after her first dose of the Moderna COVID-19 vaccine in the left arm. On the day of vaccination, the patient was asymptomatic. This is an example of how the vaccine can mimic cancer and swollen lymph nodes. Read more about this case study. Image used with permission of RSNA.
Left to right: Subtraction right mediolateral oblique (MLO) CEM was non-diagnostic because of artifact, potentially due to motion misregistration from extended exposure time; subtraction right MLO implant displaced CEM image shows 5.8 cm enhancing mass (arrow); contrast-enhanced MRI sagittal subtraction image shows concordant mass (arrow).
55-year-old woman who underwent screening mammogram and ultrasound 7 days after first COVID-19 vaccination dose. Screening mammogram and US demonstrated unilateral left axillary lymph node with cortical thickness of 5 mm on ultrasound (not shown). BI-RADS category 0 was assigned. Ultrasound from diagnostic work-up performed 7 days later showed no change in lymph node size. BI-RADS 3 was assigned.
F-18 FES PET images of patients with ER+/PR+/HER2- invasive ductal carcinoma. Left panel: Progressive disease seen at the 8-week time-point in a patient on sequential therapy. Right panel: Stable disease through all 3 time-points, remaining on study therapy for 6.7 months until disease progression on combined vorinostat aromatase inhibitor therapy. Image created by Lanell M Peterson, Research Scientist, University of Washington Medical Oncology, Seattle WA.
Examples of the imaging performance of XPCI-CT (b,e) compared to conventional specimen radiography (a,d) and benchmarked against histopathology (c,f). he top row focuses on the similarity between the XPCI-CT slice in (b) and the histological slice in (c). Arrow 1 indicates margin involvement, arrow 2 a variation in density in the internal structure of the tumour mass, arrow 3 tumour-induced inflammation. All this is confirmed by the histological slice in (c), and hardly visible in the conventional image in (a). The bottom row focuses on the detection of small calcifications, a key feature in DCIS. These are undetectable in (d), detected in (e), enhanced in the maximum intensity projection (MIP) image at the bottom of (f), and confirmed by histopathology in the top part of (f). The scale bar [shown in (b) and (e)] is the same for all images apart from (f), which has its own scale. Red arrows in (e) and (f) indicate the microcalcifications. Image courtesy of Professor Alessandro Olivo