An educational intervention designed to promote the use of mammography among women at risk of developing breast cancer was conducted in Blacksburg, Virginia in the spring of 1989. The intervention employed the theories of planned behavior and diffusion to raise women's intention to seek a mammogram. The study employed a posttest-only control group design and was delivered at a hairstyling salon. Eight hairstylists were trained to promote mammography as a breast cancer early detection method and to provide educational materials about the importance of early detection and the advantages of mammography. Eighty-seven women (35 or older), were subjects in the study. At follow-up, independent t-tests showed that women randomly assigned to the experimental group (n=43) had higher breast cancer early detection knowledge scores (p=O.03), stronger belief scores about their control over obtaining a mammogram (p=O.03), and higher behavioral intention scores to seek a mammogram appointment Cp<O.OOl) than controls (n=44). Direct benefits for the experimental group were an increased awareness about the risks of developing breast cancer, a stronger perception of affordability of mammography, and a stronger perception of their ability to fit a mammogram into their schedule. The results of the intervention show that hairstylists trained as lay health educators may be valuable change agents in promoting breast cancer early detection in community educational interventions focusing on mammography. / Master of Science

[Truncated abstract] In this thesis, we introduce a mammogram analysis system developed for the automatic segmentation and analysis of mammograms. This original system has been designed to aid radiologists to detect breast cancer on mammograms. The system embodies attribute-driven segmentation in which the attributes of an image are extracted progressively in a step-by-step, hierarchical fashion. Global, low-level attributes obtained in the early stages are used to derive local, high-level attributes in later stages, leading to increasing refinement and accuracy in image segmentation and analysis. The proposed system can be characterized as: • a bootstrap engine driven by the attributes of the images; • a solid framework supporting the process of hierarchical segmentation; • a universal platform for the development and integration of segmentation and analysis techniques; and • an extensible database in which knowledge about the image is accumulated. Central to this system are three major components: 1. a series of applications for attribute acquisition; 2. a standard format for attribute normalization; and 3. a database for attribute storage and data exchange between applications. The first step of the automatic process is to segment the mammogram hierarchically into several distinctive regions that represent the anatomy of the breast. The adequacy and quality of the mammogram are then assessed using the anatomical features obtained from segmentation. Further image analysis, such as breast density classification and lesion detection, may then be carried out inside the breast region. Several domain-specific algorithms have therefore been developed for the attribute acquisition component in the system. These include: 1. automatic pectoral muscle segmentation; 2. adequacy assessment of positioning and exposure; and 3. contrast enhancement of mass lesions. An adaptive algorithm is described for automatic segmentation of the pectoral muscle on mammograms of mediolateral oblique (MLO) views

Electrical parameter profiles of human breast images can be used to simulate and analyze the anticipated effects on tissue from its interaction with electromagnetic fields involved in the cancer treatment exposure. In part, the success of this approach depends on the accuracy and precision in identifying the different tissue types. In this work, we propose two methods of segmenting human breast images with malignant tumors. The first method of algorithmic partitioning of the image involves manual color-edge contouring of the tissues using a cursor and subsequent identification of the tissue types. For the second method, MRI T1 values and thresholds are used to perform segmentation and we investigate the potential of incorporating edge detection. The first method is effective, while the second lacks precision, but eliminates the need of manual contouring. The images are imported as BMP files into SEMCAD, an electromagnetic simulation tool based on finite-difference time-domain method, which recognizes the grouped tissues and creates a model of the image. The model allows the user to easily assign electrical parameter values to the grouped tissues, according to the measured values reported in the literature.

Mammography is currently used to screen women in targeted risk classes for breast cancer. Computer assisted diagnosis of mammograms attempts to lower the workload on radiologists by either automating some of their tasks or acting as a second reader. The task of mammogram segmentation based on pixel intensity is addressed in this thesis. The mammographic process leads to images where intensity in the image is related to the composition of tissue in the breast; it is therefore possible to segment a mammogram into several regions using a combination of global thresholds, local thresholds and higher-level information based on the intensity histogram. A hierarchical view is taken of the segmentation process, with a series of steps that feed into each other. Methods are presented for segmentation of: 1. image background regions; 2. skin-air interface; 3. pectoral muscle; and 4. segmentation of the database by classification of mammograms into tissue types and determining a similarity measure between mammograms. All methods are automatic. After a detailed analysis of minimum cross-entropy thresholding, multi-level thresholding is used to segment the main breast tissue from the background. Scanning artefacts and high intensity noise are separated from the breast tissue using binary image operations, rectangular labels are identified from the binary image by their shape, the Radon transform is used to locate the edges of tape artefacts, and a filter is used to locate vertical running roller scratching. Orientation of the image is determined using the shape of the breast and properties of the breast tissue near the breast edge. Unlike most existing orientation algorithms, which only distinguish between left facing or right facing breasts, the algorithm developed determines orientation for images flipped upside down or rotated onto their side and works successfully on all images of the testing database. Orientation is an integral part of the segmentation process, as skin-air interface and pectoral muscle extraction rely on it. A novel way to view the skin-line on the mammogram is as two sets of functions, one set with the x-axis along the rows, and the other with the x-axis along the columns. Using this view, a local thresholding algorithm, and a more sophisticated optimisation based algorithm are presented. Using fitted polynomials along the skin-air interface, the error between polynomial and breast boundary extracted by a threshold is minimised by optimising the threshold and the degree of the polynomial. The final fitted line exhibits the inherent smoothness of the polynomial and provides a more accurate estimate of the skin-line when compared to another established technique. The edge of the pectoral muscle is a boundary between two relatively homogenous regions. A new algorithm is developed to obtain a threshold to separate adjacent regions distinguishable by intensity. Taking several local windows containing different proportions of the two regions, the threshold is found by examining the behaviour of either the median intensity or a modified cross-entropy intensity as the proportion changes. Image orientation is used to anchor the window corner in the pectoral muscle corner of the image and straight-line fitting is used to generate a more accurate result from the final threshold. An algorithm is also presented to evaluate the accuracy of different pectoral edge estimates. Identification of the image background and the pectoral muscle allows the breast tissue to be isolated in the mammogram. The density and pattern of the breast tissue is correlated with 1. Breast cancer risk, and 2. Difficulty of reading for the radiologist. Computerised density assessment methods have in the past been feature-based, a number of features extracted from the tissue or its histogram and used as input into a classifier. Here, histogram distance measures have been used to classify mammograms into density types, and ii also to order the image database according to image similarity. The advantage of histogram distance measures is that they are less reliant on the accuracy of segmentation and the quality of extracted features, as the whole histogram is used to determine distance, rather than quantifying it into a set of features. Existing histogram distance measures have been applied, and a new histogram distance presented, showing higher accuracy than other such measures, and also better performance than an established feature-based technique.

M.Tech. / Mammography is most important in the detection of breast cancer but due to its intimate nature and the perception that it is uncomfortable and painful, many women do not optimally support mammography as a diagnostic and screening tool for breast cancer. Many factors influence the mammogram experience of patients. This research explored the preferences and perceptions of patients regarding mammographer gender and personality traits as well as student involvement in mammogram procedures. To promote positive perceptions of mammography and to ensure the availability of adequately trained mammographers to meet the future demands of the profession, the preferences and perceptions of patients and training needs of students should be carefully balanced. The study was empirical in nature and data was collected using a valid and reliable self-formulated questionnaire. The approach was quantitative and a small qualitative component added dimension to the quantitative results. A nonprobability, convenience sampling method was employed and questionnaires were distributed in radiography training centres affiliated to the University of Johannesburg. Data analysis indicated that while many women accept males in the mammography setting, most prefer female mammographers and -students. In general, women accept student presence during mammogram procedures. Personality traits that enhance effective communication and promote patient emotions such as trust, being safe and being cared for are favoured by patients. This research adhered to stipulations of the South African Patients' Rights Charter and the call of the Breast Cancer Advocacy Coalition for South African research into breast health care. The findings serve as benchmarks for patient opinions regarding mammography staff and will be of use in various fields concerning mammography, such as human resources, training and education and quality assurance of care.

Thesis (MSc (Radiography))--Cape Peninsula University of Technology, 2019 / INTRODUCTION: The Breast Imaging Reporting and Data System (BI-RADS) was developed by the American College of Radiology (ACR). The BI-RADS is an internationally accepted method of assessing and reporting on mammograms and breast ultrasound images. The BI-RADS consists of a lexicon (descriptors) and assessment categories. The ACR aimed to standardise mammography reporting and placing the findings in the appropriate assessment category. The aim of this study was to establish the accuracy of the BI-RADS assessment categories for mammography and breast ultrasound images in women diagnosed with breast cancer. METHOD: Data were retrieved from 77 patients who were diagnosed with breast cancer from 1 January 2013 to 31 December 2014. Seven did not meet the inclusion criteria and were excluded. The study sample size was 70 (n=70) patients. All mammography reports included a BI-RADS assessment category of all patients diagnosed with breast cancer within the study period. These reports were analysed and compared with histopathology results. The BI-RADS assessment category and descriptors were collected from the mammogram reports; the histopathology report indicated the type of breast cancer. All reports were obtained from the patients' folders at the research site. In addition, questionnaires were distributed among radiologists to assess whether their experience and training had an influence on the accuracy of reporting in the BI-RADS assessment categories. Descriptive and inferential statistical analysis was used for data analysis. RESULTS: The most common malignancy diagnosed was invasive ductal carcinoma with a total of 70% (n=54), followed by ductal carcinoma in situ with 10.4% (n=8) and invasive lobular carcinoma with 9.1% (n=7). The histology results confirmed breast cancer for all BI-RADS 4 and 5 assessment categories. The mammogram was able to detect 93.5% of abnormalities and breast ultrasound 84.4% of abnormalities in this study sample. Breast ultrasound was used as an adjunct to mammography and hence an overall combined diagnostic rate was 100%. Mammography descriptors: The more common malignancy findings were spiculated mass margin, 35.1% (n=27). Ultrasound descriptors: The more common malignancy findings were hypoechoic echo pattern, 55.8% (n=43). There was no significant association (p=0.152) between the radiologists' years of experience and BI-RADS 3, 4 and 5 assessment category reporting. Of the 15 responses, 67% agreed that the BI-RADS standardises breast imaging reporting and reduces confusion, 33% agreed that the BI-RADS allows better communication between radiologists and referring physicians, and 40% agreed that the BI-RADS clarifies further management for patients by helping to stratify risk management. CONCLUSION: The outcome of this study indicated that the use of BI-RADS assessment categories is useful for predicting the likelihood of malignancy when used correctly. The outcome of BI-RADS 4 and BI-RADS 5 had a positive predictive value of 100%, which corresponded well with histology results. The descriptor findings suggested that spiculated mass margins, irregular-shaped masses, hypoechoic echo pattern and posterior shadowing were high predictors of malignancy and warranted a placement in the BI-RADS 5 assessment category.

No description available.

Este trabalho foi motivado por um estudo maio, proposto pela Agência Internacional de Energia Atômica (IAEA). O objetivo do trabalho foi estimar o kerma incidente (Ki) e a dose glandular média (Dg) em pacientes submetidas a mamografias nas projeções crânio-caudal (CC) e médio-lateral-oblíqua (MLO), nos sistemas de aquisição de imagens analógico e digital CR. A estimativa foi realizada através de cálculos matemáticos, tendo como base estudos computacionais utilizando simulações de Monte Carlo. Este estudo fez parte de um estudo maior em mamografia, coordenado pela IAEA, cujos dados fizeram parte da representação dos dados brasileiros no estudo da América Latina. Foram escolhidas mamografias cuja mama exposta tinha aproximadamente 50% de glandularidade e 50% de adiposidade. Dados da técnica radiográfica utilizada nos exames, assim como a espessura da mama comprimida, foram registrados em planilhas especificas e o cálculo foi realizado com base em testes de rendimento do tubo de raios X dos mamógrafos. Além disso, as mamografias acompanhadas foram analisadas quanto a critérios de qualidade da imagem. Foram acompanhadas 100 exposições, sendo 50 analógicas e d 50 digitais. Os resultados mostraram que as imagens foram predominantemente aceitas quanto aos critérios de qualidade da imagem estabelecidos pala IAEA, com melhores resultados do sistema digital. Os valores de Ki e Dg encontrados para o objeto simulador estavam de acordo com o recomendado, mas os calculados para as pacientes estavam mais altos, principalmente o Ki. O sistema digital obteve doses mais baixas e melhor qualidade de imagem. Os resultados sugerem que os exames devem ser realizados com o devido cuidado, de maneira a oferecer qualidade de imagem para o diagnóstico em doses tão baixas quanto razoavelmente exeqüíveis. O treinamento contínuo dos profissionais da mamografia deve ser realizado de maneira e oferecer exames adequados ao diagnóstico, protegendo os pacientes e mantendo a qualidade do serviço a todos. / This work has been motivated by a larger study, proposed by the International Atomic Energy Agency (IAEA). The aim of this work was to estimate the incident kerma (Ki) and mean glandular dose (Dg) in patients who underwent mammograms in craniocaudal projections (CC) and mediolateral-ablique (MLO), at analog and digital systems. The estimation was performed using mathematical calculations based on computational studies using Monte Carlo simulations. This study was part of a larger study in mammography, coordinated by the IAEA, whose data were included in the representation of Brazilian data in the study of Latin America. Mammograms with 50% of glandular tissue and 50% of fat were selected. Data from the radiographic technique used in the examinations, as well as the compressed breast thickness were recorded in spreadsheets and specific calculation was made based on output tests of the X-ray tube for mammography. In addition, the mammograms were analysed with the criteria of image quality. The amount of examinations was 100 mammograms, 50 analog and 50 digital. The results showed that the images were largely accepted as the criteria for image quality established by the IAEA, with better results from digital system. The values of Ki and Dg for the phantom were according to the recommended, but those calculate for the patients were higher, especially the Ki. Digital system produced lower dosis and better results on image quality. The results suggests that the examinations must be conducted with due care in order to offer image quality in dosis as low as reasonably achievable. The permanent training of mammographers should be conducted in a manner to provide exams with quality, protecting the patient and maintaining the quality of service to all patients treated.

Breast cancer is a major health concern in the United States. Mammography is the gold standard for screening breast cancer and screen-film technology is still widely used in the screening for breast cancer. However, screen-film systems have limited dynamic range and contrasts compared to digital systems, and do not offer integrated image processing capabilities. Recently, digital mammography has seen an upsurge in clinical adoption but current digital mammography systems are limited in terms of their spatial resolution. Therefore, high-resolution digital mammography systems with superior signal-to-noise ratio and contrast characteristics need to be explored. A monolithic, single module high-resolution (39 um) digital x-ray platform (Fairchild Imaging Inc., Milpitas, CA) was developed and characterized for digital mammography. The architecture was extended to a large area (16 x 24-cm) multi-module solid-state imager with variable resolution (39 and 78-um). In addition, a four module (16 x 16-cm) imaging architecture with 78-um pixel was explored for high-resolution contrast enhanced digital mammography for the detection of malignancy-associated angiogenesis. Simulations based on the cascaded linear systems framework were performed in order to characterize the physical properties of the imaging platforms such as the modulation transfer function (MTF), noise power spectra (NPS), and detective quantum efficiency (DQE). Experimental measurements of imager performance was also conducted and compared to model predicted results. Further, perceptual analysis of the prototype imaging platform for digital mammography was performed. Various imaging platforms were successfully developed and investigated to identify essential parameters for high-resolution digital x-ray breast imaging. The single module prototype exhibited physical characteristics that are favorable for digital mammography. Good agreement between model and experimental results were observed demonstrating the utility of such models for further system improvement. The large area 16 x 24-cm prototype demonstrated superior contrast-detail characteristics compared to a clinical FFDM system (100 um pixel) at both 39 and 78-um pixel sizes. Both experimental and theoretical results pointed towards the feasibility of contrast enhanced mammography at mean x-ray glandular dose levels substantially lower than mammography under the conditions investigated. Qualitative analysis of contrast enhanced digital mammography indicated favorable image quality.

Orientador: Carlos Manuel Giles Antunez de Mayolo / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Fisica Gleb Wataghin / Made available in DSpace on 2018-08-12T20:54:38Z (GMT). No. of bitstreams: 1 Mardegan_JoseRenatoLinares_M.pdf: 9598511 bytes, checksum: eff03242148c4fb5d74188492a5542d5 (MD5) Previous issue date: 2009 / Resuno: Esta dissertação de mestrado teve por objetivo a realização de imagens pela técnica de imagens por contraste de fase utilizando o método de imagens realçadas por difração (IRD) para analisar amostras histológicas de mama in vitro. Os sistemas para produção das IRD foram desenvolvidos utilizando um gerador convencional no Laboratório de Cristalografia Aplicada e Raios X (LCARX - UNICAMP) e também com radiação síncrotron no Laboratório Nacional de Luz Síncrotron (XRD2 - LNLS). As amostras estudadas foram corpos de provas, um inseto e tecidos de mama com carcinoma lobular invasivo e carcinoma ductal invasivo fornecidas pelo Centro de Atenção Integral a Saúde da Mulher (CAISM - UNICAMP). As imagens foram realizadas pelo método convencional e também pelo método de IRD. As imagens realçadas por difração de corpos de prova, do inseto e dos tecidos com câncer de mama mostraram resolução superior ao comparadas com imagens convencionais principalmente das interfaces entre tecidos em uma amostra, o que resulta em um diagnostico mais preciso do paciente. As imagens obtidas pelo método IRD apresentam contraste, visibilidade e razão-sinal ruído muito superiores quando comparados com as imagens obtidas pela técnica convencional de absorção. A imagem obtida do tecido com carcinoma lobular invasivo apresentou maiores detalhes ao compará-la com a imagem convencional porém não foi possível visualizar precisamente as bordas do tumor. As imagens realçadas por difração têm qualidade superior devido à utilização de um cristal analisador colocado após a amostra. Este cristal funciona como uma estreita fenda angular resultando em imagens com ganho de contraste em relação às imagens pelos métodos convencionais. Utilizando o algoritmo de tratamento das IRD foram obtidas as imagens de Absorção Aparente e Refração ajustando o cristal analisador em diferentes posições da curva de difração e não apenas na posição de meia altura da curva de refletividade. A escolha de diferentes posições da curva mostrou que as imagens de absorção aparente, refração e as imagens obtidas nestes flancos ganham em resolução quando ajustadas para posições distantes do topo. Valores calculados para os parâmetros sinal ruído borda e visibilidade em imagens obtidas em posições distantes do topo chegaram a ser cerca de dez vezes maiores que nas imagens convencionais para as amostras de corpos de prova. Isto ocorre porque o cristal analisador está selecionando diferentes feixes refratados na amostra. / Abstract: In this dissertation we have produced in vitro breast images by a phase contrast imaging technique using the diffraction enhanced imaging (DEI) method. The DEI setup was implemented both at the X-ray applied Crystallography Laboratory (LCARX) using a conventional generator and at the XRD2 beamline of the Brazilian National Synchrotron Light Laboratory (LNLS) in Campinas. Two types of breast cancer were investigated from breast tissues provided by the University Center for Women Health (CAISM-UNICAMP) through collaboration with a professional mastologist: invasive lobular carcinoma and invasive ductal carcinoma. Other images were performed on well characterized test objects and biological samples. The images obtained were compared with images obtained by the conventional absorption contrast method. The diffraction enhanced images of test objects, insect and breast tissues with cancer showed higher resolution as compared with the conventional images mainly from the boundaries of the sample. The tissue with invasive lobular carcinoma had details increased when compared with a conventional image, but it was not possible to clearly visualize the interfaces of the tumour in this case. The diffraction enhanced images had higher quality because this system uses an analyzer crystal placed after the sample. This crystal serves as a narrow angular slit which resulted in images with gain in contrast as compared to the conventional images methods. The DEI algorithm to obtain two new images so called "Apparent Absorption" and "Refraction" images were used to the breast tissue and test objects images taken at symmetrical half intensity sides of the rocking curve. Furthermore, this algorithm was also used to images taken at symmetrical positions of the analyzer further away from the top resulting in images with higher resolution and signal to noise ratio. / Mestrado / Física da Matéria Condensada / Mestre em Física