Microbreweries and celebrating the holidays

Holiday Season is well upon us again, and the hospital has closed down for the holiday break. We return to work on Wednesday (Boxing Day).



Celebrating "Christmas cheer" in a micrbrewery here, means drinking the seasonal beers, and last night we went to the Gordon Biersch microbrewery on the Embarcadero. As part of the welcome you are offered a taster of small glasses of several beers, including the seasonal beer, which had both a subtle taste of fruit, along with quite a kick at the end (8% wbv alcohol)

The beers are placed on the informative sheet of paper, shown above, which allows you to choose the beer of choice for the evening.

Happy Holidays everyone

RSNA Breast Imaging - Ultrasound

1. US screening of women with personal history of breast cancer: Cancer detection in the contralateral breast (Korea) - US can detect mammographically occult cancers - increased from 4 to 9 cancers in 1314 women
2. Breast Ca staging using cortical thickness of axillary lymph nodes at ultrasound (Boston, MA) - Maximum cortical thickness of >3mm (compared with Nottingham Criteria of 2mm) is a simple and accurate sonographic criterion (US + FNAC/core gave sensitivity of 91%, specificity of 100%, PPV 100%, NPV 72%)
3. 3D US for the identification and diagnosis of breast cancer (Peoria, IL) - SomoVu 3D reconstruction enabled visualization of mammo occult and MR occult lesions
4. US screening of mastectomy site for detection of non-palpable recurrent cancer (Korea) - some recurrences visible when non-palpable
5. Reproducibility of tool for breast ultrasound assessment and reporting (San Diego, CA)
6. Adjunct diagnostic value of US in patients with suspected ductal breast disease (Rome, Italy) - Important role in the diagnosis of benign focal masses and duct ectasia. Can replace galactography
7. Elasticity imaging of the breast: results of a multi-center trial (Korea) - high sensitivity in characterizing malignant breast lesions. Variability in specificity between centers requires standardization of the technique
8. US Elastography of breast lesions associated with suspicious microcalcifications detected at mammography (Korea) - Malignant calcifications have less strain (HARDER) than benign calcifications
9. Inter and Intra-observer agreement in interpretation of US elastography (Korea) - Interobserver agreement was moderate to substantial and intraobserver agreement was substantial to perfect for the visual assessment of strain images

RSNA Breast Imaging - Computer Aided Detection

1. CAD of malignant and benign clustered microcalcifications in temporal pairs of mammograms and it's effect on Radiologists characterization performance (Ann Arbor, MI) - increased diagnostic accuracy when using interval change analysis
2. CAD review of false -ve FFDM exams on priors (Korea) - CAD correctly identified 34 0f 46 (73%) of retrospectively visible lesions and 14 of 14 (100%) of actionable lesions
3. Critical analysis of studies measuring the effectiveness of CAD in screening (Chicago, IL) - while each individual study is small, the aggregate of studies indicate that performance is comparable to double reading by radiologists
4. An inductive CAD system using genetic algorithms for detection of calcification on mammograms (Orinda, CA) - CAD teaching itself and learning from it's mistakes
5. US CAD into clinical practice: and observational study (Chicago, IL) - cautious optimism using CADx
6. Independent US CAD BI RADS assessment of breast lesions (Philadelphia, PA) - Initial study showed significant improvement in the hands of trained users
7. MRI detected suspicious findings: comparison of kinetic feature measurement using CAD in benign and malignant lesions (Seattle, WA) - ONLY delayed kinetics categorized by the most suspicious type of enhancement were significantly different between B/M. In keeping with MRI BI RADS recommendation of reporting the most suspicious kinetic curve. Any washout enhancement was assoc with malignancy in nearly 50%, entirely persistent with 13.3%
8. Application of CAD in MRM: do we really need whole lesion time curve distribution analysis? (Jena, Germany) - Higher diagnostic accuracy for curve distribution data after application of a statistical regression model compared to semi-automatic detected 'most suspect curve' type

RSNA Breast Imaging - Mammography

1. Assessment of microcalcifications with large core biopsy (VAB) in a screening population (Weisbaden, Germany) - biopsy of all clusters of microcalcification lead to an improvement in their benign/malignant ratio through increased detection of DCIS
2. Coronary Artery Calcification on mammograms ? correlates with coronary artery disease? (Staten Island, NY) - No correlate with C.A.Disease, but with age only
3. Mammo features post Mammosite therapy (Norfolk, VA) - 7x more likely to get seromas and 3.3x to get fat necrosis compared with whole breast irradiation
4. Single dilated duct at Mammography - outcomes (San Francisco, CA) - Rare finding with a greater than 2% chance of malignancy. Should be called a BIRADS 4A rather than a 3 assessment
5. Breast density evaluations from mammograms and central tomosynthesis projections (Philadelphia, PA) - Correlation better with tomosynthesis
6. LCD vs CRT displays for digital mammography calcs and masses (Korea) - Comparable performance, but LCDs better than CRT for microcalcifications - non significant