performed in the appropriate phase of the menstrual cycle and without hormonal replacement therapy. Preoperative evaluation of residual tumor extent by three-dimensional magnetic resonance imaging in breast cancer patients treated with neoadjuvant chemotherapy Akazawa K, Tamaki Y, Taguchi T, Tanji Y, Miyoshi Y, Kim SJ, Ueda S, Yanagisawa T, Sato Y, Tamura S, Noguchi S (Department of Surgical Oncology, Osaka University Graduate School of Medicine, 2-2-E10, Yamadaoka, Suita, Osaka 565-0871, Japan). Breast J 2006;12:130–137. The purpose of this study is to evaluate the usefulness of three-dimensional magnetic resonance imaging (3D MRI) for the preoperative assessment of residual tumor extent in breast cancer patients treated with neoadjuvant chemotherapy (NAC). Thirty-eight breast cancer patients treated with NAC containing taxane and/or anthracycline for 3 to 6 months were enrolled in this study. Tumor size was measured by means of calipers, ultrasonography, and dynamic MRI before and after NAC. Three-dimensional maximum intensity projection MRIs to measure the tumor size were created for every case. The tumor size determined by calipers, ultrasonography, and 3D MRI after NAC was compared with that determined by pathologic examination. The tumor size determined by 3D MRI showed a strong correlation with that determined by pathologic examination (r =.896). Moderate but significant correlations were found between measurements obtained with calipers and pathology (r =.554), and between ultrasonography and pathology (r =.484). The response rates to NAC were estimated at 84.2% with calipers, 58.0% with ultrasonography, and 44.7% with 3D MRI. Calipers and ultrasonography thus tended to overestimate the response to NAC compared to 3D MRI ( P b.001 and .240, respectively). Three- dimensional MRI can visualize residual tumor extent after NAC more accurately than calipers and ultrasonography, and seems to be more reliable than other modalities for estimating response to NAC. It should also help surgeons with decision making for breast-conserving surgery after NAC. Status of mammography after digital mammography imaging screening: digital vs. film Dershaw D (Breast Imaging Section, Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021). Breast J 2006;12:99 – 102. Well-publicized results of the recent Digital Mammography Imaging Screening Trial have again shown that there is no clear advantage in mammographic screening of the general population with digital versus film mammography. However, several subgroups —women less than 50 years old, pre- or perimenopausal, and denser breasts — did better with digital mammography than with film. Data also suggest that women with the opposite characteristics might do better with film mammography. This article reviews the data of the four studies comparing digital and film mammographic screening. In addition, it describes the technology involved in the two types of mammographic image capture, the advantages and disadvantages of each type of imaging, and the future possibilities opened by digital technique. Because less than one tenth of mammography units in use in the United States are digital, the availability of this technology to women undergoing screening and to physicians referring patients to screening sites is very limited. The author suggests that the quality of mammography, rather than the technique used to capture the image, is more important in selecting a mammography facility. For those who have a facility that offers both digital and film mammography, consultation on which type of imaging might be better for an individual woman would be appropriate. Because digital mammography from different manufacturers is based on differing technologies and because data comparing the advantages or disadvantages of these differing types of equipment are not available, it is impossible to recommend which type of digital mammography equipment is best for those undergoing mammography with these types of units. Value of vacuum-assisted biopsies under sonographic guidance: results from a multicentric study of 650 lesions Sebag P, Tourasse C, Rouyer N, Lebas P, De ´nier JF, Michenet P (35 Blvd Victor Hugo, F-06000 Nice, France). J Radiol 2006;87:29–34. Objective: With this retrospective multicentric study, the authors are showing the technique of vacuum-assisted biopsies under ultrasound guidance and comparing it with the other widely used diagnostic techniques. Material and method: Six hundred fifty biopsies were performed, between May 2000 and December 2004, on 644 patients in 3 centers after a unique protocol. Lesions were categorized, using the classification from Stavros, as bprobably benign,Qbindeterminate,Qbprobably malignant,Q and bmalignant.Q Histology was validated only after review of the clinical and radiological data, as well as surgical data when available. All benign cases were included in an ongoing follow-up protocol. Results: We have identified 471 benign lesions and 179 malignant lesions. The mean size of the lesions was 9 mm. Three cancers were diagnosed in the cases of bprobably benign lesions,Q and in the cases of bprobably malignant lesions,Q 18 (27%) were inflammatory disorders. In 5 cases, vacuum biopsy underestimated the pathology with regard to surgery: 2 cases of atypical duct hyperplasia were in situ ductal carcinoma (DCIS) at surgery and 3 cases of DCIS were infiltrative ductal carcinoma at surgery. With this technique, we have avoided surgery for 71% of all women who presented an bindeterminateQ or bprobably malignantQ condition. Specificity is excellent with no cancer detected so far among the patients with benign findings, under follow-up. Conclusion: Ultrasound-guided vacuum-assisted biopsy is a fairly recent minimally invasive technique, with short learning curve. The ability to collect a larger volume of tissue overcomes the targeting issues on small lesions and avoids underestimation of heterogeneous and larger abnormal- ities and some specific at-risk lesions such as papilloma. This technique thus appears indicated in such cases because it overcomes some of the limitations of core needle biopsy and should be considered as an alternative to surgical biopsy. Methods of fetal MR: beyond T2-weighted imaging Brugger PC, Stuhr F, Lindner C, Prayer D (Center of Anatomy and Cell Biology, Integrative Morphology Group, Medical University of Vienna, Waehringerstrasse 13, A-1090 Vienna, Austria). Eur J Radiol 2006;57:172–181. The present work reviews the basic methods of performing fetal magnetic resonance imaging (MRI). Because fetal MRI differs in many respects from a postnatal study, several factors have to be taken into account to achieve satisfying image quality. Image quality depends on adequate positioning of the pregnant woman in the magnet, use of appropriate coils, and selection of sequences. Ultrafast T2-weighted sequences are regarded as the mainstay of fetal MR-imaging. However, additional sequences, such as T1-weighted images, diffusion-weighted images, and echoplanar imaging may provide further information, especially in extra central nervous system regions of the fetal body. A new look at the fetus: thick-slab T2-weighted sequences in fetal MRI Brugger PC, Mittermayer C, Prayer D (Center of Anatomy and Cell Biology, Integrative Morphology Group, Medical University of Vienna, Waehringerguertel 18-20, A-1090 Vienna, Austria). Eur J Radiol 2006;57:182 – 186. Although magnetic resonance imaging (MRI) of the fetus is considered an established adjunct to fetal ultrasound, stacks of images alone cannot provide an overall impression of the fetus. The present study evaluates the use of thick-slab T2-weighted magnetic resonance (MR) images to obtain a three-dimensional impression of the fetus using MRI. A thick-slab Abstracts / Clinical Imaging 30 (2006) 297–300 298