ABSTRACT
To practically apply photoacoustic (PA) imaging technology in medicine, we have developed prototypes of a photoacoustic mammography (PAM) device to acquire images for diagnosing breast cancer in the Kyoto University/Canon joint research project (CK project supported by MEXT, Japan). First, the basic ability of the PAM system to visualize the network of blood vessels and the Hb saturation index was evaluated using a prototype of PAM that has a flat scanning detector and is capable of simultaneously acquiring photoacoustic (PA) and ultrasound images. Next, another prototype of a PAM device with hemispherical sensors was developed to improve the visibility of the 3D structure of vessels by reducing the limited view effect. In clinical examination of breast cancer cases, the PAM system allowed 3D visualization of fine vessel networks with a spatial resolution of a half-millimeter and enabled us to determine the features of tumor-related vascular structures in human breast cancer. In addition, the oxygen saturation status of Hb was visualized using two different wavelengths, enabling more precise characterization of the tumor microenvironment. Results of clinical evaluation using our developed prototype of a PAM device confirmed that PA imaging technology has the potential to promote early detection of breast cancer, and realization of its practical use is expected in the near future.
Subject(s)
Humans , Blood Vessels , Breast Neoplasms , Joints , Mammography , Oxygen , Tumor Microenvironment , UltrasonographyABSTRACT
RESUMO Objetivo: comparar dois protocolos de triagem auditiva neonatal com critérios de referência de passa e falha distintos. Métodos: estudo retrospectivo. Foram avaliados os prontuários de 312 indivíduos, entre eles, RN(s) e bebês de ambos os sexos com até 90 dias de nascidos, sendo de baixo e alto risco para a deficiência auditiva, no período de setembro de 2013 a setembro de 2014 no Serviço de Triagem Auditiva Neonatal da Clínica Escola da instituição de origem. Os prontuários consultados referem-se a RN(s) ou bebês submetidos à triagem auditiva neonatal por meio das Emissões Otoacústicas Evocadas Transientes (EOAT). As EOAT foram analisadas considerando tanto o critério de referência proposto por FINITZO (1998) (PROTOCOLO 1) quanto os critérios de referência vindos de fábrica no equipamento (PROTOCOLO 2), e os mesmos foram comparados. Foi realizada uma análise descritiva para caracterização da amostra. Resultados: dos 312 indivíduos avaliados, observou-se maior número do sexo masculino (53,85%), a maioria tinha 30 dias ou menos (65,06%) e somente 6,09% tinham mais de 60 dias. A proporção de concordância observada foi de 43,91% e o índice de Kappa foi de 0,0628, com o intervalo de confiança de 95% de (0,03; 0,0942) e uma significância estatística de 0,001 (p=0,001). Observa-se que o valor do Kappa é bem baixo, considerando que a concordância perfeita é de 1,00. Conclusão: não houve concordância estatística entre os protocolos analisados, houve mais falhas na etapa da TAN pelo critério de referência do protocolo 1.
ABSTRACT Purpose: to compare two newborn hearing screening protocols with benchmarks of passes and failure distinct. Methods: a retrospective study. It was evaluated the records of 312 infants (s) and babies of both sexes and up to 90 days after birth in September 2013 to September 2014 in the Neonatal Hearing Screening Service of Clinical Speech and Hearing Division School of the origin instituition. TEOAE were analyzed in two different benchmarks and they were compared. Results: of the 312 patients evaluated, there was a greater number of male patients (53.85%), the majority of patients aged 30 days or less (65.06%) and only 6.09% had more than 60 days. The proportion of observed agreement was 43.91%, that is, both methods coincide in 43.91% of the results and the Kappa index was 0.0628, with a confidence interval of 95% (0.03; 0.0942) and 0.001 statistical significance (p = 0.001). It is observed that the value of Kappa is very low, considering that the perfect agreement is 1.00. Conclusion: there was no statistical correlation between the protocols analyzed, there were more failures in the NHS by step benchmark protocol 1.