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- Learner’s perception, knowledge and behaviour assessment within a breast imaging E-Learning course for radiographersPublication . Moreira, Inês C.; Ramos, Isabel; Ventura, Sandra; Pereira Rodrigues, PedroE-learning has been revealed as an a useful tool among continuing education within health professionals, namely for radiographers or radiologic technologists. Therefore like traditional learning, this teaching approach needs continuous evaluation in order to validate its effectiveness and impact. Kirkpatrick's model has been widely used for this purpose by health information management instructors. Our aim was to assess an E-learning Course on Breast Imaging for radiographers based on the first three levels of Kirkpatrick's framework: reaction, learning and behaviour.
- Preoperative localisation techniques in breast conservative surgery: A systematic review and meta-analysisPublication . Moreira, Inês C.; Ventura, Sandra; Ramos, Isabel; Fougo, José Luís; Rodrigues, Pedro PereiraThe preoperative localisation of non-palpable lesions guided by breast imaging is an important and required procedure for breast-conserving surgery. We conducted a systematic review and meta-analysis of the literature on the comparative impact of different techniques for guided surgical excision of non-palpable breast lesions from reports of clinical or patient-reported outcomes and costs.
- INbreast: toward a full-field digital mammographic databasePublication . Moreira, Inês C.; Amaral, Igor; Domingues, Inês; Cardoso, António; Cardoso, Maria João; Cardoso, Jaime S.Rationale and Objectives Computer-aided detection and diagnosis (CAD) systems have been developed in the past two decades to assist radiologists in the detection and diagnosis of lesions seen on breast imaging exams, thus providing a second opinion. Mammographic databases play an important role in the development of algorithms aiming at the detection and diagnosis of mammary lesions. However, available databases often do not take into consideration all the requirements needed for research and study purposes. This article aims to present and detail a new mammographic database. Materials and Methods Images were acquired at a breast center located in a university hospital (Centro Hospitalar de S. João [CHSJ], Breast Centre, Porto) with the permission of the Portuguese National Committee of Data Protection and Hospital's Ethics Committee. MammoNovation Siemens full-field digital mammography, with a solid-state detector of amorphous selenium was used. Results The new database—INbreast—has a total of 115 cases (410 images) from which 90 cases are from women with both breasts affected (four images per case) and 25 cases are from mastectomy patients (two images per case). Several types of lesions (masses, calcifications, asymmetries, and distortions) were included. Accurate contours made by specialists are also provided in XML format. Conclusion The strengths of the actually presented database—INbreast—relies on the fact that it was built with full-field digital mammograms (in opposition to digitized mammograms), it presents a wide variability of cases, and is made publicly available together with precise annotations. We believe that this database can be a reference for future works centered or related to breast cancer imaging.
- Development and assessment of an E-Learning course on breast imaging for radiographers: a stratified randomized controlled trialPublication . Moreira, Inês C.; Ventura, Sandra; Ramos, Isabel; Rodrigues, Pedro PereiraMammography is considered the best imaging technique for breast cancer screening, and the radiographer plays an important role in its performance. Therefore, continuing education is critical to improving the performance of these professionals and thus providing better health care services. Our goal was to develop an e-learning course on breast imaging for radiographers, assessing its efficacy , effectiveness, and user satisfaction. A stratified randomized controlled trial was performed with radiographers and radiology students who already had mammography training, using pre- and post-knowledge tests, and satisfaction questionnaires. The primary outcome was the improvement in test results (percentage of correct answers), using intention-to-treat and per-protocol analysis. A total of 54 participants were assigned to the intervention (20 students plus 34 radiographers) with 53 controls (19+34). The intervention was completed by 40 participants (11+29), with 4 (2+2) discontinued interventions, and 10 (7+3) lost to follow-up. Differences in the primary outcome were found between intervention and control: 21 versus 4 percentage points (pp), P<.001. Stratified analysis showed effect in radiographers (23 pp vs 4 pp; P=.004) but was unclear in students (18 pp vs 5 pp; P=.098). Nonetheless, differences in students’ posttest results were found (88% vs 63%; P=.003), which were absent in pretest (63% vs 63%; P=.106). The per-protocol analysis showed a higher effect (26 pp vs 2 pp; P<.001), both in students (25 pp vs 3 pp; P=.004) and radiographers (27 pp vs 2 pp; P<.001). Overall, 85% were satisfied with the course, and 88% considered it successful. This e-learning course is effective, especially for radiographers, which highlights the need for continuing education.
- Mammogram retrieval system: Aggregating image classifiers for enhanced breast cancer diagnosisPublication . Roriz, Cátia; Moreira, Inês; Vasconcelos, Verónica; Domingues, Inês; Moreira, Inês C.Breast cancer remains a significant global health concern. This study presents an image retrieval system to aid specialists in the analysis of mammogram images. The system employs individual classifiers for eight dimensions: laterality, view, breast density, BI-RADS classification, masses, calcifications, distortions, and asymmetries. Four pre-trained networks, ResNet50, VGG16, InceptionV3, and InceptionResNetV2, were used to train these classifiers. The retrieval model combines these classifiers through a weighted sum. Four weight assignment strategies were explored, ranging from equal weights to weights based on empirical, literature-based, and specialist-informed considerations. Results are illustrated using the INBreast database, which comprises 410 images. Besides the native annotations, ground truth to validate retrieval models had to be acquired. Classification accuracy is as high as 100% for some of the dimensions. Results also demonstrate the effectiveness of the proposed weighted-sum approach, with variations in weight assignments impacting model performance.
- Need and outcomes of a 3D breast image to aid conservative cancer surgery planning: results of a multidisciplinary focus groupPublication . Moreira, Inês C.; Ramos, Isabel; Oliveira, Bruno; Fougo, José Luís; Rodrigues, Pedro Pereira; Moreira, Inês C.The preoperative localization of nonpalpable breast lesions (smaller than 10mm) guided by imaging is an important and required procedure for conservative breast surgery. The purpose of this study is to identify needs and outcomes that can be explored in order to develop and assess a new 3D breast image to aid preoperative localization of nonpalpable breast lesions and surgical planning.
- Comunicar para pertencer: uma iniciativa colaborativa entre estudantes e docentes na licenciatura em terapia da falaPublication . Pinto, Marta; Araújo, André; Moreira, Inês; de Sousa Pinto, Marta Joana; Guerreiro Martins Araújo, Pedro André; Moreira, Inês C.A promoção do envolvimento estudantil e do sentimento de pertença constitui atualmente um dos principais desafios do ensino superior, sendo reconhecida a sua relevância para a participação ativa dos estudantes, para a construção de comunidades de aprendizagem e para a qualidade da experiência académica. Neste contexto, as iniciativas que favorecem a colaboração entre estudantes e docentes e que potenciam a comunicação e a partilha de experiências assumem particular importância. Com o objetivo de reforçar a ligação entre os diferentes anos da licenciatura em Terapia da Fala, aumentar a visibilidade das atividades desenvolvidas no âmbito curricular e extracurricular e promover uma maior proximidade entre estudantes e docentes, foi criado um grupo de comunicação constituído por docentes e estudantes do curso. Esta iniciativa assenta numa lógica participativa, em que os estudantes assumem um papel ativo na identificação, seleção e divulgação de atividades consideradas por eles relevantes para a comunidade académica. O grupo reúne regularmente para planear estratégias de comunicação e identificar oportunidades de divulgação de projetos, atividades pedagógicas, eventos científicos, iniciativas de extensão à comunidade e outras experiências formativas desenvolvidas ao longo do curso. Através desta dinâmica colaborativa, procura-se não apenas disseminar informação, mas também criar espaços de reconhecimento mútuo, valorização das experiências de aprendizagem e construção de uma identidade coletiva da licenciatura. A iniciativa enquadra-se numa perspetiva de parceria entre estudantes e docentes, reconhecendo os estudantes como agentes ativos na vida académica e na construção da cultura do curso. Simultaneamente, promove o desenvolvimento de competências transversais relacionadas com a comunicação, o trabalho colaborativo, a liderança e a responsabilidade partilhada. A participação no grupo é voluntária, envolvendo estudantes e docentes que assumem um compromisso colaborativo na dinamização e divulgação das atividades do curso. A avaliação da iniciativa tem sido realizada através de questionários de autoanálise aplicados aos estudantes e docentes participantes e através da observação direta efetuada pelos docentes ao longo dos dois últimos anos letivos. Os resultados preliminares evidenciam indicadores positivos de aceitação e envolvimento entre os participantes, nomeadamente ao nível da perceção de proximidade entre estudantes e docentes, do reconhecimento das atividades desenvolvidas no curso e do reforço do sentimento de pertença. Para além dos benefícios observados junto dos membros do grupo, identificam-se potenciais efeitos indiretos na restante comunidade académica, através do aumento da visibilidade das atividades e da circulação de informação. Contudo, tratando-se de uma iniciativa ainda numa fase inicial de implementação, a avaliação dos seus impactos mais abrangentes constitui um objetivo a desenvolver e aprofundar a médio prazo. Esta comunicação pretende descrever a implementação da iniciativa, apresentar os dados recolhidos através dos questionários e da observação realizada, refletir sobre os seus princípios orientadores e discutir o seu contributo para a promoção de uma comunidade académica mais participativa, colaborativa e inclusiva no contexto do ensino superior.