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Objective:To comparative analyze mammographic and clinicopathological findings of ductal carcinoma in situ (DCIS) and DCIS with microinvasion (DCISM), and to investigate the predictive factors for DCISM.Methods:A total of 626 patients with DCISM and DCIS confirmed by surgery and pathology in the Affiliated Hospital of Qingdao University from January 2016 to July 2020 were collected and underwent preoperative mammography. The X-ray findings of DCISM and DCIS patients were classified and diagnosed according to the Breast Imaging Reporting and Data System (BI-RADS) criteria. The differences in clinicopathological and radiographic findings between DCISM and DCIS patients were analyzed using χ 2 test or Fisher exact test. The risk factors of DCISM were evaluated by using univariate and multivariate binary logistic regression analysis. Results:Among the 626 cases, 171 were diagnosed as DCISM, 455 were diagnosed as DCIS. Large diameter (≥2.7 cm), high nuclear grade, comedo type, axillary lymph node metastasis, high Ki67 proliferation index, negativity of estrogen receptor and progesterone receptor were found to be predictors of DCISM in the univariate analysis (all P<0.05). And large diameter (≥2.7 cm)(OR 2.229,95% CI 1.505-3.301, P<0.001), high nuclear grade(OR 1.711,95%CI 1.018-2.875, P=0.043) and axillary lymph node metastasis(OR 4.140,95% CI 1.342-12.773, P=0.013) were found to be independent predictors of DCISM in the multivariate analysis (all P<0.05). Mammographically, the lesion types, the presence and distribution of calcification were statistically significant between DCIS and DCISM patients (χ 2=17.42, 9.65, 9.10, P<0.05). Up to 17.6% (80/455) of DCIS were occult leisions, and DCISM showed more lesions with calcification in mass, asymmetry, and architectural distortion (49.1%, 84/171). Grouped calcifications were usually associated with DCIS (41.5%, 120/289), while regional calcification were commonly found in DCISM (35.9%, 47/131). Conclusions:Lesions with calcification and regional calcification were more likely associated with DCISM on mammography. Large diameter (≥2.7 cm), high nuclear grade and axillary lymph node metastasis were found to be independent predictors of DCISM.
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Objective To investigate the differential diagnostic value of 18F-fluorodeoxyglucose (FDG) PET/CT for benign and malignant vertebral compression fractures in patients with malignant tumor.Methods From August 2007 to July 2016,79 patients with vertebral compression fractures were enrolled.Patients were divided into 3 groups based on clinical follow-up or pathological results:osteoporosis group (n =40;13 males,27 females,median age:77 years),metastasis group (n=27;18 males,9 females,median age:64 years) and myeloma group (n=12;7 males,5 females,median age:67.5 years).Characteristics of 18 F-FDG PET/CT imaging and maximum standardized uptake value (SUVmax) of involved vertebrae were compared using x2 test,one-way analysis of variance and the least significant difference t test.SUVmax of normal L2 vertebral body was regarded as the control.Results (1) There were 53,41 and 16 compression fractures identified in osteoporosis group,metastasis group and myeloma group,respectively.No paravertebral soft tissue mass or spinal accessory involvement was found in osteoporosis group.In metastasis group,14(34.15％,14/41) paravertebral soft tissue masses and 28 spinal accessory involvements (68.29％,28/41) were detected,and the numbers were 2 (2/16) and 16 (16/16) for myeloma group respectively.There were significant differences for paravertebral soft tissue masses and spinal accessory involvements among 3 groups (x2 values:21.75,73.10,both P＜0.01).(2)In osteoporosis group,all lesions displayed strip-like (100％,53/53) 18F-FDG accumulation.In metastasis group,there were nodular accumulation (12.20％,5/41),bulk accumulation (43.90％,18/41),and irregular accumulation (43.90％,18/41).In myeloma group,the 18 F-FDG accumulation were strip-like (14/16) and irregular (2/16).The accumulation patterns among 3 groups were significantly different (x2=103.67,P＜0.01).(3)SUVmax of osteoporosis group,metastasis group,myeloma group and control group was 4.00±0.14,7.33±4.05,4.17±0.39 and 2.33±0.06,respectively (F=46.45,P＜0.01).The SUVmax between each 2 groups were significant (t values:12.38-29.51,all P＜0.05) except for that between osteoporosis group and myeloma group (t=0.26,P＞0.05).Conclusions Strip-like 18F-FDG accumulation,SUVmax of vertebral body,paravertebral soft tissue masses and spinal accessory involvements in 18F-FDG PET/CT imaging are important for differential diagnosis of benign and malignant compression fractures.
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Objective To analyze the clinical value of digital breast tomosynthesis (DBT) compared with digital mammography (DM) and ultrasound for diagnosing non-calcified masses in dense breasts.Methods Images taken with DBT,DM and ultrasound of 1144 patients with non-calcified masses in dense breasts were retrospectively analyzed using breast imaging reporting and data system (BI-RADS).Taking histopathologic results as golden standards,the detection rate and diagnostic accuracy,sensitivity,specificity,false negative and BI-RADS category were evaluated and compared statistically.Results The detection rate of DBT,DM and ultrasound for non-calcified massed in dense breasts was 86.62％ (991/1 144),77.80％ (890/1 144) and 99.65％ (1 140/1 144),respectively (P＜0.05),while the diagnostic accuracy was 83.92％ (960/1 144),75.00％ (858/1 144) and 94.67％ (1 083/1 144),respectively (P＜0.01).The sensitivity of DBT,DM and ultrasound was 89.39％ (312/349),79.93％ (231/289) and 92.70％ (432/466),the specificity was 81.51％ (648/795),73.33％ (627/855) and 96.02％ (651/678),while the false negative rate was 10.60％(37/349),20.07％ (58/289) and 7.30％ (34/466),respectively.No significant difference was found for benign lesions among three examination methods (P=0.75),while there was significant difference for malignant lesions among three examination methods (P＜0.01),and the differences of ultrasonography with DM and DBT,DBT and DM in the for BI-RADS category of malignant lesions were statistically significant (all P＜0.016 7).Conclusion For suspected masses in dense breasts,DBT shows significant advantage than DM,while DBT has the similar advantage compared with ultrasound for the detection and diagnosis of non-calcified masses in dense breasts.
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Objective To compare the effects of different methods of honey sunburn on the contents of calycosin and formononetin in Hedysari Radix; To provide the basis for the establishment of the optimum processing technology. Methods By frying (traditional method), baking, and microwave methods put Hedysari Radix under honey sunburn. Agilent HC-C18 column (4.6 mm × 250 mm, 5 μm) was used; the mobile phase was acetonitrile-0.01% phosphoric acid solution, gradient elution (0–12 min, 30%–33% acetonitrile; 12–13 min, 31%–40% acetonitrile; 13–25 min, 40% acetonitrile) with velocity of 1.0 mL/min; detection wavelength was 248 nm;the column temperature was 30 ℃; sample volume was 10 μL. Results There was statistical significance in the contents of calycosin and formononetin of different methods of honey sunburn for Hedysari Radix. Among them, the contents of calycosin and formononetin in Hedysari Radix processed by honey roast were the highest, 7.9116 and 49.6996 μg/g, respectively; the contents of calycosin and formononetin in Hedysari Radix processed by traditional method were the lowest, 4.7767 and 37.2910 μg/g, respectively; the contents of calycosin and formononetin in raw Hedysari Radix and Hedysari Radix by honey microwave method were the same, 5.0802, 42.7989 μg/g, and 3.9839, 42.3145 μg/g, respectively. Conclusion Different honey sunburn methods for the contents of calycosin and formononetin in Hedysari Radix have certain effects, and honey roast method is the optimum method.
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Objective To investigate the effective indicators for the prognosis assessment in pa?tients with multiple myeloma (MM) by 18F?FDG PET/CT imaging. Methods A total of 36 patients(22 males, 14 females;median age 63.5 years) with MM confirmed by clinical or pathology from July 2007 to November 2014 were retrospectively reviewed. The number of lesions detected by PET/CT, the number of lesions with SUVmax>2.5, the SUVmax and MTV of each lesion were calculated. The correlation analysis was performed between the number of lesions detected by PET or CT,the number of lesions with SUVmax>2.5, the SUVmax , MTV and serumβ2?microglobulin (β2?M) , respectively. The patients were divided into differ?ent groups according to the development of lesions and the survival situation during the follow?up ( 4-92 months) . Kaplan?Meier analysis and multivariate Cox model were used to analyze the prognostic significance of the number of lesions detected by PET or CT and the number of lesions with SUVmax>2.5, the SUVmax and MTV. Results Both the number of lesions with SUVmax>2. 5 and MTV showed positive correlations with blood β2?M (r=0.776, 0.954, both P0.05) . The number of lesions with SUVmax>2.5 and MTV in the progressive group( n=14) were significantly higher than those in the regressive group(n=22):66.57±4.59 vs 31.95±4.75, t=4.95, P2.5 and MTV were significantly higher in the dead group(n=15) than those in the survival group(n=21):65.73±4.32 vs 30.90±4.87, t=5.10, P2. 5, and those were 114.74 and 105.48 cm3 for MTV, respectively. The progression?free survival rate was worse in the patients with higher index than those with lower value (χ2=18.20, 29.74, both P2.5 and MTV on 18 F?FDG PET/CT images could predict the progression?free survival and overall survival rates of patients with MM, which may provide accurate prognosis information.
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Objective To compare the diagnostic value of digital breast tomosynthesis (DBT) versus digital mammography (DM) in the evaluation mass like lesions in dense breasts. Methods Eight hundred and fifty eight patients, who had DBT and DM, with breast diseases confirmed by pathology were retrospectively reviewed. The breast density and the imaging features were classified according to the standard of American College of Radiology(2013) and breast imaging reporting and data system (BI?RADS) scores. Six hundred and thirty one patients with mass lesions in dense breasts were chosen to included. All 631 patients had DM of both breasts and DBT of affected breast prior to mastectomy. Pathological results were used as the golden standard. Detection rate and diagnostic accuracy of masses, sensitivity and specificity of diagnosis, false negative and recall rates, the margins and spicules and BI?RADS category were calculated. The detection rate and diagnostic accuracy, the margins and spicules of masses were compared with Chi?square test, the BI?RADS scores were analyzed with rank test. Results With DBT, average detection rate increased from 77.3%(488/631) to 84.3% (532/631), average diagnostic accuracy rate increased from 73.4%(463/631) to 82.3%(519/631),with statistical significant difference between groups (c2=27.191,36.890,P<0.01).Sensitivity for DBT and DM were 68.1%(205/301) and 58.8%(177/301), respectively. Specificity for DBT and DM were 95.2%(314/330)and 86.7%(286/330), respectively. Recall rate for DBT and DM were 3.6%(23/631)and 9.8%(62/631), respectively. One hundred and seventy two cases and 75 cases with circumscribed masses of benign cases were detected by DBT and DM, respectively. One hundred and eighty-two cases and 115 cases with spiculated masses of malignant cases were detected by DBT and DM, respectively, with statistical significant difference between groups (c2=70.471 and 21.707, P<0.01). Of 330 malignant cases, the numbers of BI?RADS category 0, 2, 3, 4A, 4B, 4C, 5 on DM images were 19,4,8,13,52,93,141, respectively, the numbers on DBT images were 3,1,7,5,52,83,179, respectively, with statistical significant difference(Z=-2.235,P=0.025). Of 301 benign cases, the number of BI?RADS category 0, 2, 3, 4A, 4B, 4C, 5 on DM images were 43,10,60,117,58,11,2, respectively, the number on DBT images were 20,4,64,150,55,7,1, respectively, with no statistical significant difference between groups(Z=-1.846,P=0.065). Conclusion DBT significantly improves the detection of mass?like lesions in dense breasts, display of mass margin and architectural distortion of surrounding tissue.