Impact of Colorized Display of Mammograms on Lesion Detection.

OBJECTIVE: To assess the effect of the colorized display of digital mammograms on observer detection of subtle breast lesions. METHODS: Three separate observer studies compared detection performance using grayscale versus color display of 1) low-contrast mass-like objects in a standardized mammography phantom; 2) simulated microcalcifications in a background of normal breast parenchyma; and 3) standard-of-care clinical digital mammograms with subtle calcifications and masses. Colorization of the images was done by displaying each image pixel in blue, green, and red hues, or gray, maintaining DICOM-calibrated luminance scale and consistent luminance range. For the simulated calcifications and clinical mammogram studies, comparison of detection rates was computed using McNemar's test for paired differences. RESULTS: For the phantom study, mass-like object detection was significantly better using a green colormap than grayscale (73.3% vs 70.8%, P = .009), with no significant improvement using blue or red colormaps (72.6% and 72.5%, respectively). For simulated microcalcifications, no significant difference was noted in detection using the green colormap, as compared with grayscale. For clinical digital screening mammograms, no significant difference was noted between gray and green colormaps for detection of microcalcifications. Green color display, however, resulted in decreased sensitivity for detection of subtle masses (63% vs 69%, P = .03). CONCLUSION: Although modest improvement was demonstrated for a detection task using colorized display of a standard mammography phantom, no significant improvement was demonstrated using a color display for a simulated clinical detection task, and actual clinical performance was worse for colorized display of mammograms in comparison to standard grayscale display.

Health, Secondhand Smoke Exposure, and Smoking Behavior Impacts of No-Smoking Policies in Public Housing, Colorado, 2014-2015.

INTRODUCTION: Exposure to secondhand smoke is problematic for residents living in multiunit housing, as the smoke migrates through shared ventilation systems, unsealed cracks, and door spaces. The objective of our research was to assess resident exposure to secondhand smoke, support for no-smoking policies, and the health impacts of no-smoking policies in multiunit housing. METHODS: Surveys of 312 heads of households who resided in 1 of 3 multiunit buildings managed by a Colorado public housing authority were administered before and after implementation of a no-smoking policy that prohibited smoking in all resident apartments and all indoor common areas. A matched-pairs analysis of initial surveys and 15-month post-policy implementation surveys for 115 respondents was conducted. RESULTS: Decreases were found in the number and percentage of smokers who smoked every day and the number of cigarettes smoked per day, and 30% had quit smoking 15 months after policy implementation. The percentage of residents who smelled secondhand smoke indoors declined significantly. A significant decrease in breathing problems was found after policy implementation. Although decreases were found in the incidence of asthma attacks, emphysema/chronic obstructive pulmonary disease, eye irritation, colds, nasal congestion, and ear/sinus infections, these decreases were not significant. CONCLUSION: Consistent findings across nearly all variables tested suggest that no-smoking policies reduce resident exposure to secondhand smoke, lower the incidence of secondhand smoke-associated breathing problems, decrease daily smoking and cigarette consumption, encourage smoking cessation, and increase quit attempts. If implemented in all multiunit housing, these policies could reduce exposure to secondhand smoke and health problems associated with secondhand smoke, promote smoking cessation, and reduce cigarette consumption.

Automation of ALK gene rearrangement testing with fluorescence in situ hybridization (FISH): a feasibility study.

In the past several years we have observed a significant increase in our understanding of molecular mechanisms that drive lung cancer. Specifically in the non-small cell lung cancer sub-types, ALK gene rearrangements represent a sub-group of tumors that are targetable by the tyrosine kinase inhibitor Crizotinib, resulting in significant reductions in tumor burden. Phase II and III clinical trials were performed using an ALK break-apart FISH probe kit, making FISH the gold standard for identifying ALK rearrangements in patients. FISH is often considered a labor and cost intensive molecular technique, and in this study we aimed to demonstrate feasibility for automation of ALK FISH testing, to improve laboratory workflow and ease of testing. This involved automation of the pre-treatment steps of the ALK assay using various protocols on the VP 2000 instrument, and facilitating automated scanning of the fluorescent FISH specimens for simplified enumeration on various backend scanning and analysis systems. The results indicated that ALK FISH can be automated. Significantly, both the Ikoniscope and BioView system of automated FISH scanning and analysis systems provided a robust analysis algorithm to define ALK rearrangements. In addition, the BioView system facilitated consultation of difficult cases via the internet.