ABSTRACT
Objective To evaluate the influence of menopause status on breast fibrograndular tissue (FGT),background parenchymal enhancement volume ratio (BPEv) and intensity ratio (BPEI) by breast MR image automatic quantitative analysis.Methods From 14 033 consecutive patients who underwent breast MR in our center from 2009 to 2012,we randomly selected 101 normal cases (47cases of premenopausal and 54 cases of postmenopausal).Premenopausal status was subclassified into four groups (8 cases in the 1st week and 13 cases in the 2nd,3rd and 4th week,respectively) based on the menstrual cycle.We evaluated FGT,BPEv and BPEI at early (2 minutes),medium (4 minutes) and late (6 minutes) enhanced time phases of breast MRI for quantitative assessment.The FGT,BPEv and BPEI in premenopausal and postmenopausal women were compared using the Mann-Whitney U test.Comparison of each menstrual cycle was made using the Kruskal-Wallis test.Results The FGT,BPEv and middle-late BPEI of postmenopausal women were significantly lower than that of premenopausal women (P＜0.05).The maximum BPEI was in the 1st week,the minimum in the 2nd week in premenopausal women (P＜0.05).The FGT and BPEv in the 1st week were the highest among the 4 weeks,but there was no significant difference.Conclusions The FGT,BPEv and BPEI were significantly decreased after menopause.The optimal time of breast MR examination is in the 2nd week of menstrual cycle.
ABSTRACT
Nowadays there is still an insufficient understanding of monoclonal gammopathy of undetermined significance(MGUS) and asymptomatic multiple myeloma,which are considered as multiple myeloma (MM) precursor diseases. In this review, the advances in diagnosis, risk-stratification as well as views on the treatment of the two diseases were presented.
ABSTRACT
Objective To retrospectively analyze the outcomes and adverse effects of sequential therapy of BTD and MPT regimen for the newly-diagnosed multiple myeloma patients no eligible for high dose chemotherapy and stem cell transplantation. Methods Thirty-six patients were involved in this study and the patients were treated with tandem therapy of BTD and MPT regimen. The patients were treated with BTD regimen as induced therapy no less than 2 cycles. When the patients got PR or above PR,they were treated with MPT regimen as consolidation therapy which was no less than 2 cycles. Then,the patients who achieved PR or partial PR were received MPT chemotherapy regimen as consequent treatment. After that,low dose thalidomide was used as maintenance therapy. The outcomes and adverse effects were retrospectively evaluated. Results Thirty-six patients were treated with BTD regimen as induced therapy. The results were that 7 patients (19.4 %) achieved CR,8 (22.2 %) VGPR,14 (38.9 %) PR and the OR rate was 80.6 %. The patients (n=29) who achieved no less than PR was treated with MPT regimen as consequent therapy. The results were that four patients were in progression and the others were stable. Twenty-five patients were treated with low dose thalidomide as maintenance therapy. The median progression-free survival (PFS) did not reached yet until last follow-up (median follow-up time was 16.5 months). One-year overall survival rate was expected 86.0 % and 3-year expected overall survival rate was 77.0 %. The main regimen-associated toxicities included thrombocytopenia,peripheral neuropathy (PN),Herpes Zoster,gastrointestinal symptoms,anemia,neutropenia,constipation,fatigue,rash and so on. The incidence of grade 3 and 4 adverse events was low. Conclusion Sequential therapy of BTD and MPT regimen can be used as the front-line therapy for the newly-diagnosed multiple myeloma patients no eligible for high dose chemotherapy and stem cell transplantation.