The Significance of Nuclear Size in Nuclear Grade of Invasive Ductal Carcinoma of the Breast / 대한세포병리학회지

To make the objective standard of nuclear size in grading nuclear pleomorphism of invasive ductal carcinoma of the breast, we measured maximal nuclear diameter of tumor cells on imprint cytology slides and histologic sections from 65 cases by using computer-based image analysis system(Optimas 6.0). The maximal diameter of red blood cells were also measured to evaluate the ratio of maximal nuclear diameter of tumor cells to maximal diameter of red blood cells. The mean values of maximal nuclear diameter of tumor cells on imprint cytology slides and histologic sections were 7.56 micrometer, 7.53 micrometer in nuclear grade 1, 8.92+/-0.98 micrometer, 9.02+/-0.74 micrometer in nuclear grade 2, and 12.90+/-1.47 micrometer, 12.44+/-1.41 micrometer in nuclear grade 3, respectively. There were no significant differences between values of imprint cytology and histologic section. The ratio of maximal nuclear diameter of tumor cells to maximal diameter of red blood cells were 1.3-1.4:1 in nuclear grade 1, 1.6-1.7:1 in nuclear grade 2, and 2.2-2.3:1 in nuclear grade 3. These values would be guidelines for grading nuclear pleomorphism of invasive ductal carcinoma of the breast on routine surgical pathology work.

Effects of Magnetization Transfer in Gadolinium-Enhanced Brain MR Imaging

PURPOSE: To evaluate the effect of magnetization transfer(MT) in contrast-enhanced brain MR imaging of the various intracranial diseases. MATERIALS AND METHODS: We prospectively studied the effect of MT incontrast-enhanced brain MR imaging 101 patients with a variety of intracranial diseases. In all patients contrast-enhanced T1-weighted(TR/TE = 550/14) SE MR images with and without MT were obtained on a 1.5 Tsuper conducting unit(Magnetom, Siemens). The MT pulse used for MT images was an 8.1 msec(=250 Hz band width) syncpulse, 1000 Hz off-resonance. We randomly divided the patients into two groups : group I and group II. Group I consisted of 54 patients in whom contrast-enhanced images without MT and then images with MT were obtained just ofter the injection of Gd-DTPA(0.1 mmol/kg). In group II(47 patients), contrast-enhanced images with MT and then the images without MT were obtained, considering the delayed-enhancement effect. The effect of MT was assessed visually and quantitatively. For quantitative assessment, contrast to noise ratios(CNR) were calculated in 27 cases with enhancing intracranial tumors larger than 1 cm. We then compared CNRs of contrast-enhanced images with and without MT. The paired t-test was used for statistical analysis. RESULTS: On visual assessment, only11.9%(12/101) of normally enhancing structures and only 20.3%(14/69) of enhancing lesions showed improved enhancement in images with MT. There was however, no case in which the enhancing lesion was seen only in MR image with MT but not in that without MT. On quantitative analysis there was no statistically significant difference between overall images with MT and those without MT(p>0.05). The average CNR of images with MT was higher than that of images without MT in group I, but not in group II. CONCLUSION: MT in contrast-enhanced brain MR imaging resulted in contrast improvement in a limited number(less than approximately 20%) of patients. Routine application of MT images to contrast-enhanced brain MR imaging may be of limited value. Further studies on the clinical usefulness of MT technique with more refined MT pulse are thus needed.