Elodia B. Cole

This paper explores the design considerations and hurdles encountered by the CHinA National CancEr Screening (CHANCES) Trial and the Tomosynthesis Mammographic Imaging Screening Trial (TMIST), both aimed at advancing cancer screening research. Before population-based cancer screening programs are launched, it is important to have confidence that the potential benefits of the screening process and resulting interventions outweigh harms, an ethical imperative because the people actively invited into the programs are relatively healthy. Large randomized screening trials provide the strongest, direct evidence regarding the balance of benefits and harms. The implementation of cancer screening programs involves a series of steps, with outcomes influenced by factors such as the prevalence of the disease, availability of effective treatment within the health-care system, and acceptance by the target population—all of which may vary considerably from country to country. This paper examines how these factors shaped the design and statistical approach of the CHANCES Trial for lung and colorectal cancers and the TMIST trial for breast cancer. We discuss the rationale, objectives, endpoint definitions, trial designs, and sample size considerations, highlighting both the challenges and opportunities presented in different settings. Ultimately, the goal is to foster collaboration and develop screening strategies that are scientifically robust and practically effective for diverse populations worldwide.

OBJECTIVE. The purpose of this study was to assess the impact of computer-aided detection (CAD) systems on the performance of radiologists with digital mammograms acquired during the Digital Mammog...

As a potential biomarker for women's cardiovascular and chronic kidney diseases, breast arterial calcification (BAC) in mammography has become an emerging research topic in recent years. To provide more objective measurement for vascular structures with calcium depositions in mammography, a new computerized method is introduced in this paper to delineate the calcified vessels. Specifically, we leverage two underlying cues, namely calcification and vesselness, into a multiple seeded tracking with uncertainty scheme. This new vessel-tracking scheme generates plenty of sampling paths to describe the complicated topology of the vascular structures with calcium depositions. A compiling and linking process is further carried out to organize the sampling paths together to be the vessel segments that likely belong to the same vessel tract. The proposed method has been evaluated on 63 mammograms, by comparison with manual delineations from two experts using various assessment metrics. The experiment results confirm the efficacy and stability of the proposed method, and also indicate that the proposed method can be potentially used as a convenient BAC measurement tool in replacement of the trivial and tedious manual delineation tasks.

OBJECTIVE. The purpose of this study was to assess the sensitivities and false-detection rates of two computer-aided detection (CADe) systems when applied to digital or film-screen mammograms in detecting the known breast cancer cases from the Digital Mammographic Imaging Screening Trial (DMIST) breast cancer screening population. MATERIALS AND METHODS. Available film-screen and digital mammograms of 161 breast cancer cases from DMIST were analyzed by two CADe systems, iCAD Second-Look and R2 ImageChecker. Three experienced breast-imaging radiologists reviewed the CADe marks generated for each available cancer case, recording the number and locations of CADe marks and whether each CADe mark location corresponded with the known location of the cancer. RESULTS. For the 161 cancer cases included in this study, the sensitivities of the DMIST reader without CAD were 0.43 (69/161, 95% CI 0.35–0.51) for digital and 0.41 (66/161, 0.33–0.49) for film-screen mammography. The sensitivities of iCAD were 0.74 (119/161...

Diffraction enhanced imaging (DEI), also called analyzer-based imaging (ABI), cultivated within the synchrotron community, has the potential to revolutionize medical imaging through reduced dose and enhanced contrast imaging.