William R. Poller

Multicenter evaluation of the breast lesion excision system, a percutaneous, vacuum‐assisted, intact‐specimen breast biopsy device

Percutaneous, vacuum‐assisted, large‐gauge core needle biopsy (VACNB) provides an alternative to open surgical biopsy as an initial diagnostic tool for breast lesions, yet rates of underestimating malignant diagnoses remain sufficiently high to warrant surgical biopsy in some cases. The current study was performed to determine if the Breast Lesion Excision System (BLES) provides a feasible alternative to VACNB.

Recall and detection rates in screening mammography: A review of clinical experience: Implications for practice guidelines

The authors investigated the correlation between recall and detection rates in a group of 10 radiologists who had read a high volume of screening mammograms in an academic institution.

Study of the sensitivity and specificity of computerized tomography in the detection of calcified gallstones which appear radiolucent by conventional roentgenography

Radiolucent gallstones frequently contain significant calcium deposits. Their detection is important in the evaluation of patients for medical gallstone dissolution treatment. The sensitivity and specificity of computerized tomography (CT) in detecting calcium was studied in 20 patients with radiolucent and in 3 with radiopaque gallstones. Although the sensitivity of the CT scan was somewhat higher than that of conventional radiography — 46% versus 23%, respectively, for a calcium content of at least 4% — the CT scan was negative in 4 out of 6 patients in whom the percentage of calcium in the gallstones ranged between 10 and 100. The CT scan was specific: there were no false positive results. The results of the CT scan were not related to the amount or type of calcium salt present. The study shows that the presently used CT scan of the gallbladder is not sensitive enough to select gallstone patients for medical dissolution treatment.

Detecting abnormalities in noncued areas of digitized mammograms: an observer experience

To assess the performance levels of a radiologist in detecting non-cued masses and microcalcification clusters depicted on digitized mammograms, 120 mammograms depicting 57 verified masses and 38 microcalcification clusters were selected. During an observer performance study, the images were displayed on a computer monitor. Except for the first mode where no regions were cued, the images were cued in the other four modes using a combination of two cueing sensitivities (90% and 50%) and two false-positive rates (0.5 and 2 per image). One reader ignored all cued regions and identified suspicious regions only in non-cued areas. We examined how the performance of this observer was affected using the different cueing modes. Detection sensitivities of non-cued mammographic abnormalities ranged from 43% to 60%, which were lower (P<EQ0.05) than the 76% sensitivity achieved in the non-cued mode. Increasing the false-positive cueing rate from 0.5 to 2 per image reduced (<0.05) the detection sensitivity in the non-cued areas. When using a low performing cueing system, the performance reduction in non-cued areas might offset performance gains in cued areas, resulting in a negative impact on overall performance of the radiologists.

Sternal destruction in rheumatoid arthritis

In rheumatoid arthritis, erosive destruction of articular surfaces is a common finding. The diarthrodial joints primarily are involved and gross destruction of the amphiarthrodial joint of the manubriosternal area is rare.The radiographic findings of gross lytic destruction of the amphiarthrodial joint of the manubriosternal region, associated with obvious rheumatoid arthritic changes in other joint areas, should alert the observer to include rheumatoid granulomas high on the list in the differential diagnosis of lytic sternal destruction.