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Evaluation of the diagnostic performance of infrared imaging of the breast: a preliminary study.

Wang J, Chang KJ, Chen CY, Chien KL, Tsai YS, Wu YM, Teng YC, Shih TT - Biomed Eng Online (2010)

Bottom Line: We established an interpretive age-adjusted multivariate model for IR imaging of the breast.The cut-off values and the corresponding sensitivity and specificity can be inferred from the model in a subpopulation for diagnostic purpose.NCT00166998.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medical Imaging, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100, Taiwan.

ABSTRACT

Background: The study was conducted to investigate the diagnostic performance of infrared (IR) imaging of the breast using an interpretive model derived from a scoring system.

Methods: The study was approved by the Institutional Review Board of our hospital. A total of 276 women (mean age = 50.8 years, SD 11.8) with suspicious findings on mammograms or ultrasound received IR imaging of the breast before excisional biopsy. The interpreting radiologists scored the lesions using a scoring system that combines five IR signs. The ROC (receiver operating characteristic) curve and AUC (area under the ROC curve) were analyzed by the univariate logistic regression model for each IR sign and an age-adjusted multivariate logistic regression model including 5 IR signs. The cut-off values and corresponding sensitivity, specificity, Youden's Index (Index = sensitivity+specificity-1), positive predictive value (PPV), negative predictive value (NPV) were estimated from the age-adjusted multivariate model. The most optimal cut-off value was determined by the one with highest Youden's Index.

Results: For the univariate model, the AUC of the ROC curve from five IR signs ranged from 0.557 to 0.701, and the AUC of the ROC from the age-adjusted multivariate model was 0.828. From the ROC derived from the multivariate model, the sensitivity of the most optimal cut-off value would be 72.4% with the corresponding specificity 76.6% (Youden's Index = 0.49), PPV 81.3% and NPV 66.4%.

Conclusions: We established an interpretive age-adjusted multivariate model for IR imaging of the breast. The cut-off values and the corresponding sensitivity and specificity can be inferred from the model in a subpopulation for diagnostic purpose.

Trial registration: NCT00166998.

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Related in: MedlinePlus

A 76-year-old woman with left breast cancer. IR imaging reveals focal increased surface temperature (positive IR1 sign with dT = 1.5°C compared with the contralateral mirror image site; positive IR2 sign with dT = 2°C compared with the remaining breast tissue at the ipsilateral side), abnormal vascular pattern (IR3 signs including closed vascular pattern, and vascular completeness) (arrows) and asymmetric vascular pattern (IR5 sign), and subtle focal bulging with back heat (IR4 sign) in left lower breast (arrowheads). Surgical pathological finding revealed a 4 cm infiltrating ductal carcinoma.
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Figure 1: A 76-year-old woman with left breast cancer. IR imaging reveals focal increased surface temperature (positive IR1 sign with dT = 1.5°C compared with the contralateral mirror image site; positive IR2 sign with dT = 2°C compared with the remaining breast tissue at the ipsilateral side), abnormal vascular pattern (IR3 signs including closed vascular pattern, and vascular completeness) (arrows) and asymmetric vascular pattern (IR5 sign), and subtle focal bulging with back heat (IR4 sign) in left lower breast (arrowheads). Surgical pathological finding revealed a 4 cm infiltrating ductal carcinoma.

Mentions: The interpreting radiologists read the IR images based only on the findings at the lesion sites of concern and scored the findings according to the five independently diagnostic IR signs modified from the Ville Marie Infrared (IR) grading scale [7] and other reported literature [13-15]. The readers then recorded individual scores for each diagnostic IR sign for each lesion. We defined the IR signs as follows (Figures 1, 2, 3, &4):


Evaluation of the diagnostic performance of infrared imaging of the breast: a preliminary study.

Wang J, Chang KJ, Chen CY, Chien KL, Tsai YS, Wu YM, Teng YC, Shih TT - Biomed Eng Online (2010)

A 76-year-old woman with left breast cancer. IR imaging reveals focal increased surface temperature (positive IR1 sign with dT = 1.5°C compared with the contralateral mirror image site; positive IR2 sign with dT = 2°C compared with the remaining breast tissue at the ipsilateral side), abnormal vascular pattern (IR3 signs including closed vascular pattern, and vascular completeness) (arrows) and asymmetric vascular pattern (IR5 sign), and subtle focal bulging with back heat (IR4 sign) in left lower breast (arrowheads). Surgical pathological finding revealed a 4 cm infiltrating ductal carcinoma.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2818658&req=5

Figure 1: A 76-year-old woman with left breast cancer. IR imaging reveals focal increased surface temperature (positive IR1 sign with dT = 1.5°C compared with the contralateral mirror image site; positive IR2 sign with dT = 2°C compared with the remaining breast tissue at the ipsilateral side), abnormal vascular pattern (IR3 signs including closed vascular pattern, and vascular completeness) (arrows) and asymmetric vascular pattern (IR5 sign), and subtle focal bulging with back heat (IR4 sign) in left lower breast (arrowheads). Surgical pathological finding revealed a 4 cm infiltrating ductal carcinoma.
Mentions: The interpreting radiologists read the IR images based only on the findings at the lesion sites of concern and scored the findings according to the five independently diagnostic IR signs modified from the Ville Marie Infrared (IR) grading scale [7] and other reported literature [13-15]. The readers then recorded individual scores for each diagnostic IR sign for each lesion. We defined the IR signs as follows (Figures 1, 2, 3, &4):

Bottom Line: We established an interpretive age-adjusted multivariate model for IR imaging of the breast.The cut-off values and the corresponding sensitivity and specificity can be inferred from the model in a subpopulation for diagnostic purpose.NCT00166998.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medical Imaging, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100, Taiwan.

ABSTRACT

Background: The study was conducted to investigate the diagnostic performance of infrared (IR) imaging of the breast using an interpretive model derived from a scoring system.

Methods: The study was approved by the Institutional Review Board of our hospital. A total of 276 women (mean age = 50.8 years, SD 11.8) with suspicious findings on mammograms or ultrasound received IR imaging of the breast before excisional biopsy. The interpreting radiologists scored the lesions using a scoring system that combines five IR signs. The ROC (receiver operating characteristic) curve and AUC (area under the ROC curve) were analyzed by the univariate logistic regression model for each IR sign and an age-adjusted multivariate logistic regression model including 5 IR signs. The cut-off values and corresponding sensitivity, specificity, Youden's Index (Index = sensitivity+specificity-1), positive predictive value (PPV), negative predictive value (NPV) were estimated from the age-adjusted multivariate model. The most optimal cut-off value was determined by the one with highest Youden's Index.

Results: For the univariate model, the AUC of the ROC curve from five IR signs ranged from 0.557 to 0.701, and the AUC of the ROC from the age-adjusted multivariate model was 0.828. From the ROC derived from the multivariate model, the sensitivity of the most optimal cut-off value would be 72.4% with the corresponding specificity 76.6% (Youden's Index = 0.49), PPV 81.3% and NPV 66.4%.

Conclusions: We established an interpretive age-adjusted multivariate model for IR imaging of the breast. The cut-off values and the corresponding sensitivity and specificity can be inferred from the model in a subpopulation for diagnostic purpose.

Trial registration: NCT00166998.

Show MeSH
Related in: MedlinePlus