Physicians

Division Chief, Breast Imaging
Vice Chair for Clinical Operations

Department / Division
Radiology / Mammography

Address
DUMC 3808
Durham, NC 27710

Appointment Telephone
919-684-7999

Office Telephone
919-684-7645

Fax Telephone
919-684-7114

Training

• MD, Duke University School of Medicine, 1992

Residency

• Diagnostic Radiology, Duke University Medical Center, 1992-1997

Fellowship

• Breast Imaging, Duke University Medical Center, 1997-1998

Clinical Interests
All aspects of breast imaging including mammography, breast ultrasound, breast MRI, and needle biopsies; research topics include digital breast tomosynthesis and computer-aided diagnosis

Research Interests
As a radiologist in the Division of Breast Imaging, I am interested in studying techniques to better detect and assess breast lesions that may represent breast cancer. The major focus of my research activity includes both basic science and clinical approaches to developing computer-aided diagnosis, novel digital imaging techniques such as digital breast tomosynthesis, advanced ultrasound techniques, and MRI to detect and classify breast lesions.

Breast cancer is the most common malignancy occurring in women and the second most frequent cause of non-skin cancer deaths among women. Screening mammography programs have repeatedly shown a reduction in the mortality from breast cancer by 30 to 60%. However, breast imaging suffers from a lack of specificity. The result is that 60 to 80% of breast biopsies performed in this country are for benign lesions and are therefore - in retrospect - unnecessary. Because of the overlap in imaging features of benign and malignant lesions, however, these lesions cannot be differentiated without tissue sampling, and the extraordinary number of breast biopsies performed markedly increases the cost of breast cancer prevention programs and is an impediment to breast screening for some women. Our work has focused on building computer aided classification systems to assist the radiologist in differentiating benign from malignant breast lesions without the use of invasive biopsies. In our systems, imaging features of breast lesions are combined using artificial intelligence techniques with information such as the patient's age, family history, and change from prior imaging studies to determine the likelihood that a particular lesion is malignant. This information can guide the radiologist to offer follow-up imaging rather than biopsy for those women with lesions that are very unlikely to be breast cancer.

A new focus of research in our lab is the development of full field digital mammography (FFDM) systems that acquire mammographic information using a digital detector rather than film. The advantage of this technique is the possibility of developing advanced applications such as tomosynthesis, contrast enhanced mammography, and dual energy imaging, as well as clinical advantages such as the ability to manipulate the appearance of the image after acquisition and improve film storage and transport. We are collaborating with a major imaging equipment manufacturer to develop both their commercial FFDM system and to develop tomosynthesis using that system. Tomosynthesis is a technique in which several low dose X-ray images of the breast are obtained at various angles, and thin tomographic slices of the breast are reconstructed. This technique removes the problem of overlapping breast tissue, making detection of breast lesions easier, and, in theory, improving the sensitivity of mammography.
Other efforts in our lab have focused on evaluation of elastography in breast ultrasound. Elastography uses ultrasound systems to determine the stiffness of a breast lesion, often by applying a small burst of sound energy toward a breast mass and measuring changes in the shape of the mass. Since most breast cancers are firm, they will deform less than normal breast tissue or benign masses. Our preliminary work to-date suggests that elastography systems are not sufficiently accurately to safely avoid biopsy of a suspicious breast lesion. However, elastography systems may be aid in the accurate diagnosis of breast cysts and assist in avoiding unnecessary cyst aspirations.

Finally, we are also studying the use of spectroscopy in breast MRI. MR spectroscopy provides information on the chemical makeup of a small volume of breast tissue. Breast cancers often contain a substance called choline while normal tissue and benign lesions do not. We are studying ways to assess the level of choline in breast cancers before and shortly after administration of chemotheraphy to

Industry Relationships and Collaborations (What's this?)

This faculty member (or a member of their immediate family) has a working relationship (i.e. consulting, research, and/or educational services) with the companies listed below. These relations have been reported to the health system leadership and, when appropriate, management plans are in place to address potential conflicts.

• Siemens Medical Solutions

Representative Publications
Saunders, RS; Samei, E; Lo, JY; Baker, JA. Can compression be reduced for breast tomosynthesis? Monte carlo study on mass and microcalcification conspicuity in tomosynthesis. Radiology. 2009;251:673-682. (2009) Abstract

Tebbit, CL; Zhai, J; Untch, BR; Ellis, MJ; Dressman, HK; Bentley, RC; Baker, JA; Marcom, PK; Nevins, JR; Marks, JR; Olson, JA. Novel tumor sampling strategies to enable microarray gene expression signatures in breast cancer: a study to determine feasibility and reproducibility in the context of clinical care. Breast Cancer Research and Treatment. 2009;118:635-643. (2009) Abstract

Chawla, AS; Samei, E; Saunders, RS; Lo, JY; Baker, JA. A mathematical model platform for optimizing a multiprojection breast imaging system. Medical Physics. 2008;35:1337-1345. (2008) Abstract

Mazurowski, MA; Habas, PA; Zurada, JM; Lo, JY; Baker, JA; Tourassi, GD. Training neural network classifiers for medical decision making: the effects of imbalanced datasets on classification performance. Neural Networks. 2008;21:427-436. (2008) Abstract

Singh, S; Tourassi, GD; Baker, JA; Samei, E; Lo, JY. Automated breast mass detection in 3D reconstructed tomosynthesis volumes: a featureless approach. Medical Physics. 2008;35:3626-3636. (2008) Abstract

Jesneck, JL; Lo, JY; Baker, JA. Breast mass lesions: computer-aided diagnosis models with mammographic and sonographic descriptors. Radiology. 2007;244:390-398. (2007) Abstract

Samei, E; Saunders, RS; Baker, JA; Delong, DM. Digital mammography: effects of reduced radiation dose on diagnostic performance. Radiology. 2007;243:396-404. (2007) Abstract

Ghate, SV; Rosen, EL; Soo, MS; Baker, JA. MRI-guided vacuum-assisted breast biopsy with a handheld portable biopsy system. American Journal of Roentgenology. 2006;186:1733-1736. (2006) Abstract

Jesneck, JL; Nolte, LW; Baker, JA; Floyd, CE; Lo, JY. Optimized approach to decision fusion of heterogeneous data for breast cancer diagnosis. Medical Physics. 2006;33:2945-2954. (2006) Abstract

Soo, MS; Ghate, SV; Baker, JA; Rosen, EL; Walsh, R; Warwick, BN; Ramachandran, AR; Nightingale, KR. Streaming detection for evaluation of indeterminate sonographic breast masses: a pilot study. American Journal of Roentgenology. 2006;186:1335-1341. (2006) Abstract

Baker, JA; Rosen, EL; Crockett, MM; Lo, JY. Accuracy of segmentation of a commercial computer-aided detection system for mammography. Radiology. 2005;235:385-390. (2005) Abstract

Bilska-Wolak, AO; Floyd, CE; Lo, JY; Baker, JA. Computer aid for decision to biopsy breast masses on mammography: validation on new cases. Academic Radiology. 2005;12:671-680. (2005) Abstract

Ghate, SV; Soo, MS; Baker, JA; Walsh, R; Gimenez, EI; Rosen, EL. Comparison of recall and cancer detection rates for immediate versus batch interpretation of screening mammograms. Radiology. 2005;235:31-35. (2005) Abstract

Hong, AS; Rosen, EL; Soo, MS; Baker, JA. BI-RADS for sonography: positive and negative predictive values of sonographic features. American Journal of Roentgenology. 2005;184:1260-1265. (2005) Abstract

Rosen, EL; Turkington, TG; Soo, MS; Baker, JA; Coleman, RE. Detection of primary breast carcinoma with a dedicated, large-field-of-view FDG PET mammography device: initial experience. Radiology. 2005;234:527-534. (2005) Abstract

Soo, MS; Rosen, EL; Xia, JQ; Ghate, S; Baker, JA. Computer-aided detection of amorphous calcifications. American Journal of Roentgenology. 2005;184:887-892. (2005) Abstract

Baker, JA; Lo, JY; Delong, DM; Floyd, CE. Computer-aided detection in screening mammography: variability in cues. Radiology. 2004;233:411-417. (2004) Abstract

Baker, JA; Rosen, EL; Lo, JY; Gimenez, EI; Walsh, R; Soo, MS. Computer-aided detection (CAD) in screening mammography: sensitivity of commercial CAD systems for detecting architectural distortion. American Journal of Roentgenology. 2003;181:1083-1088. (2003) Abstract

Rosen, EL; Baker, JA; Soo, MS. Accuracy of a collagen-plug biopsy site marking device deployed after stereotactic core needle breast biopsy. American Journal of Roentgenology. 2003;181:1295-1299. (2003) Abstract

Rosen, EL; Blackwell, KL; Baker, JA; Soo, MS; Bentley, RC; Yu, D; Samulski, TV; Dewhirst, MW. Accuracy of MRI in the detection of residual breast cancer after neoadjuvant chemotherapy. American Journal of Roentgenology. 2003;181:1275-1282. (2003) Abstract

Soo, MS; Baker, JA; Rosen, EL. Sonographic detection and sonographically guided biopsy of breast microcalcifications. American Journal of Roentgenology. 2003;180:941-948. (2003) Abstract

Baker, JA; Soo, MS. Breast US: assessment of technical quality and image interpretation. Radiology. 2002;223:229-238. (2002) Abstract

Lo, JY; Markey, MK; Baker, JA; Floyd, CE. Cross-institutional evaluation of BI-RADS predictive model for mammographic diagnosis of breast cancer. American Journal of Roentgenology. 2002;178:457-463. (2002) Abstract

Pisano, ED; Cole, EB; Kistner, EO; Muller, KE; Hemminger, BM; Brown, ML; Johnston, RE; Kuzmiak, CM; Braeuning, MP; Freimanis, RI; Soo, MS; Baker, JA; Walsh, R. Interpretation of digital mammograms: comparison of speed and accuracy of soft-copy versus printed-film display. Radiology. 2002;223:483-488. (2002) Abstract

Rosen, EL; Baker, JA; Soo, MS. Malignant lesions initially subjected to short-term mammographic follow-up. Radiology. 2002;223:221-228. (2002) Abstract

Rosen, EL; Bentley, RC; Baker, JA; Soo, MS. Imaging-guided core needle biopsy of papillary lesions of the breast. American Journal of Roentgenology. 2002;179:1185-1192. (2002) Abstract

Soo, MS; Baker, JA; Rosen, EL; Vo, TT. Sonographically guided biopsy of suspicious microcalcifications of the breast: a pilot study. American Journal of Roentgenology. 2002;178:1007-1015. (2002) Abstract

Baker, JA; Soo, MS; Rosen, EL. Artifacts and pitfalls in sonographic imaging of the breast. American Journal of Roentgenology. 2001;176:1261-1266. (2001) Abstract

Soo, MS; Rosen, EL; Baker, JA; Vo, TT; Boyd, BA. Negative predictive value of sonography with mammography in patients with palpable breast lesions. American Journal of Roentgenology. 2001;177:1167-1170. (2001) Abstract

Baker, JA; Soo, MS. The evolving role of sonography in evaluating solid breast masses. Seminars in Ultrasound, CT and MRI. 2000;21:286-296. (2000) Abstract

Baker, JA; Kornguth, PJ; Soo, MS; Walsh, R; Mengoni, P. Sonography of solid breast lesions: observer variability of lesion description and assessment. American Journal of Roentgenology. 1999;172:1621-1625. (1999) Abstract

Baker, JA; Soo, MS; Mengoni, P. Sonographically guided percutaneous interventions of the breast using a steerable ultrasound beam. American Journal of Roentgenology. 1999;172:157-159. (1999) Abstract

Lo, JY; Baker, JA; Kornguth, PJ; Floyd, CE. Effect of patient history data on the prediction of breast cancer from mammographic findings with artificial neural networks. Academic Radiology. 1999;6:10-15. (1999) Abstract

Freed, KS; Lo, JY; Baker, JA; Floyd, CE; Low, VH; Seabourn, JT; Nelson, RC. Predictive model for the diagnosis of intraabdominal abscess. Academic Radiology. 1998;5:473-479. (1998) Abstract

Lo, JY; Baker, JA; Kornguth, PJ; Iglehart, JD; Floyd, CE. Predicting breast cancer invasion with artificial neural networks on the basis of mammographic features. Radiology. 1997;203:159-163. (1997) Abstract

Vittitoe, NF; Baker, JA; Floyd, CE. Fractal texture analysis in computer-aided diagnosis of solitary pulmonary nodules. Academic Radiology. 1997;4:96-101. (1997) Abstract

Baker, JA; Kornguth, PJ; Floyd, CE. Breast imaging reporting and data system standardized mammography lexicon: observer variability in lesion description. American Journal of Roentgenology. 1996;166:773-778. (1996) Abstract

Baker, JA; Kornguth, PJ; Lo, JY; Floyd, CE. Artificial neural network: improving the quality of breast biopsy recommendations. Radiology. 1996;198:131-135. (1996) Abstract

Baker, JA; Carroll, BA. The sonographic appearance of anomalous circumrenal vein mimicking perirenal fluid collection. Journal of Ultrasound in Medicine. 1995;14:244-246. (1995) Abstract

Baker, JA; Kornguth, PJ; Lo, JY; Williford, ME; Floyd, CE. Breast cancer: prediction with artificial neural network based on BI-RADS standardized lexicon. Radiology. 1995;196:817-822. (1995) Abstract

Floyd, CE; Baker, JA; Chotas, HG; Delong, DM; Ravin, CE. Selenium-based digital radiography of the chest: radiologists' preference compared with film-screen radiographs. American Journal of Roentgenology. 1995;165:1353-1358. (1995) Abstract

Lo, JY; Baker, JA; Kornguth, PJ; Floyd, CE. Computer-aided diagnosis of breast cancer: artificial neural network approach for optimized merging of mammographic features. Academic Radiology. 1995;2:841-850. (1995) Abstract

Lo, JY; Floyd, CE; Baker, JA; Ravin, CE. Scatter compensation in digital chest radiography using the posterior beam stop technique. Medical Physics. 1994;21:435-443. (1994) Abstract

Baker, JA; Floyd, CE; Lo, JY; Ravin, CE. Observer evaluation of scatter subtraction for digital portable chest radiographs. Investigative Radiology. 1993;28:667-670. (1993) Abstract

Berry, JJ; Hoffman, JM; Steenbergen, C; Baker, JA; Floyd, C; Van Trigt, P; Hanson, MW; Coleman, RE. Human pathologic correlation with PET in ischemic and nonischemic cardiomyopathy. Journal of Nuclear Medicine. 1993;34:39-47. (1993) Abstract

Lo, JY; Floyd, CE; Baker, JA; Ravin, CE. An artificial neural network for estimating scatter exposures in portable chest radiography. Medical Physics. 1993;20:965-973. (1993) Abstract

Floyd, CE; Baker, JA; Lo, JY; Ravin, CE. Measurement of scatter fractions in clinical bedside radiography. Radiology. 1992;183:857-861. (1992) Abstract

Floyd, CE; Baker, JA; Lo, JY; Ravin, CE. Posterior beam-stop method for scatter fraction measurement in digital radiography. Investigative Radiology. 1992;27:119-123. (1992) Abstract

Berry, JJ; Baker, JA; Pieper, KS; Hanson, MW; Hoffman, JM; Coleman, RE. The effect of metabolic milieu on cardiac PET imaging using fluorine-18-deoxyglucose and nitrogen-13-ammonia in normal volunteers. Journal of Nuclear Medicine. 1991;32:1518-1525. (1991) Abstract