Multi-modality morphological correlation of axillary lymph nodes. 2010

Lina Arbash Meinel, and Hiroyuki Abe, and Martin Bergtholdt, and Jacob Ecanow, and Robert Schmidt, and Gillian Newstead
Philips Research of North America, Briarcliff Manor, NY, USA, lina.arbash-meinel@philips.com

OBJECTIVE The goal of this study is to develop a computerized method that identifies a specific axillary lymph node (ALN) seen on ultrasound (US) with its most likely corresponding node on breast MRI (BMRI). This goal is an important step in developing a preoperative non-invasive method for staging breast cancer on the basis of multi-modality imaging. METHODS Twenty patients with newly diagnosed breast cancer were scanned on US and MRI. Two expert breast imaging radiologists independently correlated ALNs seen on US with BMRI, and this correlation was used as the gold standard. To correlate ALNs on US and BMRI, the cortex and hilum of each ALN was segmented using an ellipse fitting algorithm, then the ALN long and short axes and maximum cortical thickness (MCT) were computed. Three ALNs were chosen as candidates from the BMRI datasets for each lymph node seen on US. Finally, the Euclidean distances across all measurements between the US ALN and each of the three BMRI candidates were computed, and the smallest distance was reported as the correlation result. RESULTS Using the expert radiologists identified correlated BMRI slice as the ground truth, the shortest Euclidean distance successfully identified the same lymph node as the radiologists in 13 out of 16 ALNs (81.25%). In negative ALNs, the standard deviation for long and short axes was relatively large but that of maximum cortical thickness was small. Average maximum cortical thickness and its standard deviation measured in US were very close to those measured in MRI. There were no significant differences among the long axis, short axis, and MCT measurements between US and MRI-T2 weighted sequence (P > 0.05 paired t-test). CONCLUSIONS We performed a feasibility study which showed that computerized measurements of ALNs might be used to identify the same ALN on different modalities such as US and BMRI. This type of correlation would be valuable as it would allow the use of combined imaging parameters to be applied to the evaluation of ALNs in patients with breast cancer. It is hoped that the combined multi-modality information would provide a more robust non-invasive method of staging the axilla than is currently available.

UI MeSH Term Description Entries
D007090 Image Interpretation, Computer-Assisted Methods developed to aid in the interpretation of ultrasound, radiographic images, etc., for diagnosis of disease. Image Interpretation, Computer Assisted,Computer-Assisted Image Interpretation,Computer-Assisted Image Interpretations,Image Interpretations, Computer-Assisted,Interpretation, Computer-Assisted Image,Interpretations, Computer-Assisted Image
D008207 Lymphatic Metastasis Transfer of a neoplasm from its primary site to lymph nodes or to distant parts of the body by way of the lymphatic system. Lymph Node Metastasis,Lymph Node Metastases,Lymphatic Metastases,Metastasis, Lymph Node
D008279 Magnetic Resonance Imaging Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D009367 Neoplasm Staging Methods which attempt to express in replicable terms the extent of the neoplasm in the patient. Cancer Staging,Staging, Neoplasm,Tumor Staging,TNM Classification,TNM Staging,TNM Staging System,Classification, TNM,Classifications, TNM,Staging System, TNM,Staging Systems, TNM,Staging, Cancer,Staging, TNM,Staging, Tumor,System, TNM Staging,Systems, TNM Staging,TNM Classifications,TNM Staging Systems
D001943 Breast Neoplasms Tumors or cancer of the human BREAST. Breast Cancer,Breast Tumors,Cancer of Breast,Breast Carcinoma,Cancer of the Breast,Human Mammary Carcinoma,Malignant Neoplasm of Breast,Malignant Tumor of Breast,Mammary Cancer,Mammary Carcinoma, Human,Mammary Neoplasm, Human,Mammary Neoplasms, Human,Neoplasms, Breast,Tumors, Breast,Breast Carcinomas,Breast Malignant Neoplasm,Breast Malignant Neoplasms,Breast Malignant Tumor,Breast Malignant Tumors,Breast Neoplasm,Breast Tumor,Cancer, Breast,Cancer, Mammary,Cancers, Mammary,Carcinoma, Breast,Carcinoma, Human Mammary,Carcinomas, Breast,Carcinomas, Human Mammary,Human Mammary Carcinomas,Human Mammary Neoplasm,Human Mammary Neoplasms,Mammary Cancers,Mammary Carcinomas, Human,Neoplasm, Breast,Neoplasm, Human Mammary,Neoplasms, Human Mammary,Tumor, Breast
D003287 Contrast Media Substances used to allow enhanced visualization of tissues. Radiopaque Media,Contrast Agent,Contrast Agents,Contrast Material,Contrast Materials,Radiocontrast Agent,Radiocontrast Agents,Radiocontrast Media,Agent, Contrast,Agent, Radiocontrast,Agents, Contrast,Agents, Radiocontrast,Material, Contrast,Materials, Contrast,Media, Contrast,Media, Radiocontrast,Media, Radiopaque
D003936 Diagnosis, Computer-Assisted Application of computer programs designed to assist the physician in solving a diagnostic problem. Computer-Assisted Diagnosis,Computer Assisted Diagnosis,Computer-Assisted Diagnoses,Diagnoses, Computer-Assisted,Diagnosis, Computer Assisted
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000465 Algorithms A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. Algorithm

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