ABSTRACT
AIMS: The purpose of the study was to determine if the color quantitative analysis obtained on elastographic images of breast lesions could improve the benign-malignant differentiation, and also to identify some of the circumstances which would benefit most from such an analysis. PATIENTS AND METHODS: The study design was a longitudinal prospective one, all data being acquired between May 2007 and September 2008. The US device used: Hitachi 8500 EUB machine with elastography option. For suspicious breast lesions histopathology was obtained by means of percutaneous biopsy or post-surgery. Studied color parameters (numeric values): average color (red, green, blue), color dispersion, average intensity, average hue, hue dispersion. Calculus modality: Image Processing Version 1.3, a program developed in collaboration with the Technical University of Cluj Napoca. RESULTS: Seventy-one (71) women were selected for the study. A hundred and six circumscribed breast lesions were detected by means of ultrasound in the studied group. Five color parameters were independently associated with the histological diagnosis (AvgBlue, AvgGreen and AvgRed; DispRed and DispIntensity) with AvgBlue parameter making the most important contribution (p<0.0001); the greater the values of AvgBlue (more than 92), the higher the chances of malignancy and the greater the values of AvgGreen (more than 88), the higher the chances for a benign lesion. CONCLUSION: High numeric values for Avg Blue (more than 92) would increase the probability of malignancy and thus recommend a more aggressive diagnostic management (biopsy), while high numeric values for AvgGreen (more than 88) would reassure the examiner to proceed conservatively with short interval or routine follow-ups.
ABSTRACT
AIMS: To establish the correlations between the ultrasound (US) BI-RADS classification and Tsukuba elastography score when assessing breast lesions. To determine which type of breast lesion (BI-RADS category) would benefit most from an elastographic assessment. PATIENTS AND METHODS: The investigated sample of imaging comprised a number of 129 images belonging to 92 subjects examined with a Hitachi 8500 US device. Each lesion was assessed according to the BI-RADS and Tsukuba elastography score. Histopathology was obtained by means of percutaneous biopsy or post-surgery. Fibroadenoma-like lesions unchanged over a period of 3 years were considered benign. RESULTS: The 1, 2 and BGR Tsukuba scores mostly correlated with BI-RADS II and III lesions such as cysts, hamartomas, lipomas, hematomas, non-palpable fibroadenomas. Palpable fibroadenomas initially included in BI-RADS IVa/b category, usually received benign elasticity scores (1 or 2), the exception being represented by a minority of cases of old, fibrotic or calcified lesions (elastic score 3 or 4). Non-specific BI-RADS IVa/b lesions, such as mastopathic nodules demonstrated rather soft, elastic properties on elastogram (score 1 or 2). The 4 and 5 Ueno-Itoh scores were predominantly correlated with BI-RADS IVc and V categories represented by high risk lesions (radial scar, papillomas, atypical epithelial ductal hyperplasia) and in situ or invasive carcinomas. CONCLUSIONS: Generally the BI-RADS classification correlates well with the Tsukuba elasticity score, the main exception being represented by fibrotic, calcified lesions which falsely appear more suspicious post-elastography. BI-RADS III and IV lesions would benefit most from an elastographic assessment, a low Tsukuba score allowing a less invasive approach, while a high score imposes histopathological evaluation.
ABSTRACT
BACKGROUND: Non-variceal upper gastrointestinal (UGI) bleeding is a common condition that requires prompt lifesaving therapy and traditional endoscopic treatments require high technical proficiency to perform. AIMS: This study was conducted to identify any local or systemic histopathologic effects of a hemostatic powder in a porcine model of active, severe, non-variceal UGI hemorrhage. METHODS: This prospective, non-blinded animal study was performed in accordance with Good Laboratory Practice and Animal Care and Use Guidelines. Six animals underwent gastrotomy and creation of a looped vascular bundle, which was placed into the stomach lumen. The transplanted vascular bundle was punctured with an endoscopic needle-knife to create Forrest grade Ia or Ib bleeding. The hemostatic powder was then applied until hemostasis was achieved. RESULTS: Initial hemostasis was achieved in all animals. Results of pre- and post-treatment coagulation studies were similar. All animals survived at least 9 days post-procedure. The hemostatic powder was not found in any local, regional, or systemic tissues. Gross and histologic analysis of systemic organs showed no infarct, particulate, or embolic effects. No gross or microscopic necropsy findings were treatment-related. CONCLUSIONS: The hemostatic powder achieved initial hemostasis (even in animals with spurting arterial bleeding) with no bowel obstruction or unintended luminal effects, no local or regional particulate effects, no systemic embolic effects, and no systemic coagulopathic effects.
