Division Chief, Breast Imaging

Department / Division:
Radiology / Breast Imaging

Address:
DUMC 3808
Durham, NC 27710

Appointment Telephone:
919-684-7641

Office Telephone:
919-684-7645

Fax Telephone:
919-684-7125

• MD, Duke University School of Medicine, 1992

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

• 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 determine whether a patient’s cancer will respond to a particular chemotherapy.  Although these studies are only in preliminary stages, if successful they may help clinicians determine whether a particular chemotherapy regimen is likely to be successful.

Representative Publications:
Tebbit CL, Zhai J, Untch BR, Ellis MJ, Dressman HK, Bentley RC, Baker JA, Marcom PK, Nevins JR, Marks JR, Olson JA Jr. 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 Res Treat. 2009 Feb 18. (2009) Abstract

Saunders RS Jr, 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 Jun;251(3):673-82. (2009) Abstract

Singh S, Tourassi GD, Baker JA, Samei E, Lo JY. Automated breast mass detection in 3D reconstructed tomosynthesis volumes: a featureless approach. Med Phys. 2008 Aug;35(8):3626-36. (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 Netw. 2008 Mar-Apr;21(2-3):427-36. (2008) Abstract

Chawla AS, Samei E, Saunders RS, Lo JY, Baker JA. A mathematical model platform for optimizing a multiprojection breast imaging system. Med Phys. 2008 Apr;35(4):1337-45. (2008) Abstract

Samei E, Saunders RS Jr, Baker JA, Delong DM. Digital mammography: effects of reduced radiation dose on diagnostic performance. Radiology. 2007 May;243(2):396-404. (2007) Abstract

Jesneck JL, Lo JY, Baker JA. Breast mass lesions: computer-aided diagnosis models with mammographic and sonographic descriptors. Radiology. 2007 Aug;244(2):390-8. (2007) 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. AJR Am J Roentgenol. 2006 May;186(5):1335-41. (2006) Abstract

Jesneck JL, Nolte LW, Baker JA, Floyd CE, Lo JY. Optimized approach to decision fusion of heterogeneous data for breast cancer diagnosis. Med Phys. 2006 Aug;33(8):2945-54. (2006) Abstract

Ghate SV, Rosen EL, Soo MS, Baker JA. MRI-guided vacuum-assisted breast biopsy with a handheld portable biopsy system. AJR Am J Roentgenol. 2006 Jun;186(6):1733-6. (2006) Abstract

Soo MS, Rosen EL, Xia JQ, Ghate S, Baker JA. Computer-aided detection of amorphous calcifications. AJR Am J Roentgenol. 2005 Mar;184(3):887-92. (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 Feb;234(2):527-34. (2005) Abstract

Hong AS, Rosen EL, Soo MS, Baker JA. BI-RADS for sonography: positive and negative predictive values of sonographic features. AJR Am J Roentgenol. 2005 Apr;184(4):1260-5. (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 Apr;235(1):31-5. (2005) Abstract

Bilska-Wolak AO, Floyd CE Jr, Lo JY, Baker JA. Computer aid for decision to biopsy breast masses on mammography: validation on new cases. Acad Radiol. 2005 Jun;12(6):671-80. (2005) Abstract

Baker JA, Rosen EL, Crockett MM, Lo JY. Accuracy of segmentation of a commercial computer-aided detection system for mammography. Radiology. 2005 May;235(2):385-90. (2005) Abstract

Baker JA, Lo JY, Delong DM, Floyd CE. Computer-aided detection in screening mammography: variability in cues. Radiology. 2004 Nov;233(2):411-7. (2004) Abstract

Soo MS, Baker JA, Rosen EL. Sonographic detection and sonographically guided biopsy of breast microcalcifications. AJR Am J Roentgenol. 2003 Apr;180(4):941-8. (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. AJR Am J Roentgenol. 2003 Nov;181(5):1275-82. (2003) Abstract

Rosen EL, Baker JA, Soo MS. Accuracy of a collagen-plug biopsy site marking device deployed after stereotactic core needle breast biopsy. AJR Am J Roentgenol. 2003 Nov;181(5):1295-9. (2003) 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. AJR Am J Roentgenol. 2003 Oct;181(4):1083-8. (2003) Abstract

Soo MS, Baker JA, Rosen EL, Vo TT. Sonographically guided biopsy of suspicious microcalcifications of the breast: a pilot study. AJR Am J Roentgenol. 2002 Apr;178(4):1007-15. (2002) Abstract

Rosen EL, Bentley RC, Baker JA, Soo MS. Imaging-guided core needle biopsy of papillary lesions of the breast. AJR Am J Roentgenol. 2002 Nov;179(5):1185-92. (2002) Abstract

Rosen EL, Baker JA, Soo MS. Malignant lesions initially subjected to short-term mammographic follow-up. Radiology. 2002 Apr;223(1):221-8. (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 May;223(2):483-8. (2002) Abstract

Lo JY, Markey MK, Baker JA, Floyd CE Jr. Cross-institutional evaluation of BI-RADS predictive model for mammographic diagnosis of breast cancer. AJR Am J Roentgenol. 2002 Feb;178(2):457-63. (2002) Abstract

Baker JA, Soo MS. Breast US: assessment of technical quality and image interpretation. Radiology. 2002 Apr;223(1):229-38. (2002) Abstract

Soo MS, Rosen EL, Baker JA, Vo TT, Boyd BA. Negative predictive value of sonography with mammography in patients with palpable breast lesions. AJR Am J Roentgenol. 2001 Nov;177(5):1167-70. (2001) Abstract

Baker JA, Soo MS, Rosen EL. Artifacts and pitfalls in sonographic imaging of the breast. AJR Am J Roentgenol. 2001 May;176(5):1261-6. (2001) Abstract

Baker JA, Soo MS. The evolving role of sonography in evaluating solid breast masses. Semin Ultrasound CT MR. 2000 Aug;21(4):286-96. (2000) Abstract

Lo JY, Baker JA, Kornguth PJ, Floyd CE Jr. Effect of patient history data on the prediction of breast cancer from mammographic findings with artificial neural networks. Acad Radiol. 1999 Jan;6(1):10-5. (1999) Abstract

Baker JA, Soo MS, Mengoni P. Sonographically guided percutaneous interventions of the breast using a steerable ultrasound beam. AJR Am J Roentgenol. 1999 Jan;172(1):157-9. (1999) Abstract

Baker JA, Kornguth PJ, Soo MS, Walsh R, Mengoni P. Sonography of solid breast lesions: observer variability of lesion description and assessment. AJR Am J Roentgenol. 1999 Jun;172(6):1621-5. (1999) Abstract

Freed KS, Lo JY, Baker JA, Floyd CE Jr, Low VH, Seabourn JT, Nelson RC. Predictive model for the diagnosis of intraabdominal abscess. Acad Radiol. 1998 Jul;5(7):473-9. (1998) Abstract

Vittitoe NF, Baker JA, Floyd CE Jr. Fractal texture analysis in computer-aided diagnosis of solitary pulmonary nodules. Acad Radiol. 1997 Feb;4(2):96-101. (1997) Abstract

Lo JY, Baker JA, Kornguth PJ, Iglehart JD, Floyd CE Jr. Predicting breast cancer invasion with artificial neural networks on the basis of mammographic features. Radiology. 1997 Apr;203(1):159-63. (1997) Abstract

Baker JA, Kornguth PJ, Lo JY, Floyd CE Jr. Artificial neural network: improving the quality of breast biopsy recommendations. Radiology. 1996 Jan;198(1):131-5. (1996) Abstract

Baker JA, Kornguth PJ, Floyd CE Jr. Breast imaging reporting and data system standardized mammography lexicon: observer variability in lesion description. AJR Am J Roentgenol. 1996 Apr;166(4):773-8. (1996) Abstract

Lo JY, Baker JA, Kornguth PJ, Floyd CE Jr. Computer-aided diagnosis of breast cancer: artificial neural network approach for optimized merging of mammographic features. Acad Radiol. 1995 Oct;2(10):841-50. (1995) Abstract

Floyd CE Jr, Baker JA, Chotas HG, Delong DM, Ravin CE. Selenium-based digital radiography of the chest: radiologists' preference compared with film-screen radiographs. AJR Am J Roentgenol. 1995 Dec;165(6):1353-8. (1995) Abstract

Baker JA, Kornguth PJ, Lo JY, Williford ME, Floyd CE Jr. Breast cancer: prediction with artificial neural network based on BI-RADS standardized lexicon. Radiology. 1995 Sep;196(3):817-22. (1995) Abstract

Baker JA, Carroll BA. The sonographic appearance of anomalous circumrenal vein mimicking perirenal fluid collection. J Ultrasound Med. 1995 Mar;14(3):244-6. (1995) Abstract

Lo JY, Floyd CE Jr, Baker JA, Ravin CE. Scatter compensation in digital chest radiography using the posterior beam stop technique. Med Phys. 1994 Mar;21(3):435-43. (1994) Abstract

Lo JY, Floyd CE Jr, Baker JA, Ravin CE. An artificial neural network for estimating scatter exposures in portable chest radiography. Med Phys. 1993 Jul-Aug;20(4):965-73. (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. J Nucl Med. 1993 Jan;34(1):39-47. (1993) Abstract

Baker JA, Floyd CE Jr, Lo JY, Ravin CE. Observer evaluation of scatter subtraction for digital portable chest radiographs. Invest Radiol. 1993 Aug;28(8):667-70. (1993) Abstract

Floyd CE Jr, Baker JA, Lo JY, Ravin CE. Posterior beam-stop method for scatter fraction measurement in digital radiography. Invest Radiol. 1992 Feb;27(2):119-23. (1992) Abstract

Floyd CE Jr, Baker JA, Lo JY, Ravin CE. Measurement of scatter fractions in clinical bedside radiography. Radiology. 1992 Jun;183(3):857-61. (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. J Nucl Med. 1991 Aug;32(8):1518-25. (1991) Abstract