ABSTRACT
OBJECTIVE: The conventional breast Diffusion-weighted imaging (DWI) was subtly influenced by microcirculation owing to the insufficient selection of the b values. However, the multiparameter derived from multiple b-value exhibits more reliable image quality and maximize the diagnostic accuracy. We aim to evaluate the diagnostic performance of stand-alone parameter or in combination with multiparameter derived from multiple b-value DWI in differentiating malignant from benign breast lesions. METHODS: A total of forty-one patients diagnosed with benign breast tumor and thirty-eight patients with malignant breast tumor underwent DWI using thirteen b values and other MRI functional sequence at 3.0 T magnetic resonance. Data were accepted mono-exponential, bi-exponential, stretched-exponential, aquaporins (AQP) model analysis. A receiver operating characteristic curve (ROC) was used to evaluate the diagnostic performance of quantitative parameter or multiparametric combination. The Youden index, sensitivity and specificity were used to assess the optimal diagnostic model. T-test, logistic regression analysis, and Z-test were used. P value < 0.05 was considered statistically significant. RESULT: The ADCavg, ADCmax, f, and α value of the malignant group were lower than the benign group, while the ADCfast value was higher instead. The ADCmin, ADCslow, DDC and ADCAQP showed no statistical significance. The combination (ADCavg-ADCfast) yielded the largest area under curve (AUC = 0.807) with sensitivity (68.42%), specificity (87.8%) and highest Youden index, indicating that multiparametric combination (ADCavg-ADCfast) was validated to be a useful model in differentiating the benign from breast malignant lesion. CONCLUSION: The current study based on the multiple b-value diffusion model demonstrated quantitatively multiparametric combination (ADCavg-ADCfast) exhibited the optimal diagnostic efficacy to differentiate malignant from benign breast lesions, suggesting that multiparameter would be a promising non-invasiveness to diagnose breast lesions.
Subject(s)
Breast Neoplasms , Diffusion Magnetic Resonance Imaging , Humans , Female , Reproducibility of Results , Diffusion Magnetic Resonance Imaging/methods , Breast/diagnostic imaging , Breast/pathology , Magnetic Resonance Imaging/methods , Breast Neoplasms/pathology , Sensitivity and Specificity , ROC CurveABSTRACT
Improving parent-child interaction and play are important outcomes for children with autism spectrum disorder (ASD). Play is the primary occupation of children. In this pilot study conducted in Taiwan, we investigated the effects of the developmental, individual difference, and relationship-based (DIR)/Floortime home-based intervention program on social interaction and adaptive functioning of children with ASD. The participants were 11 children with ASD, ages from 45-69 months, and their mothers. Mothers were instructed the principles of the approach by an occupational therapist. All 11 children and their mothers completed the 10-week home-based intervention program, undergoing an average of 109.7 hr of intervention. Children made significant changes in mean scores for emotional functioning, communication, and daily living skills. Moreover, the mothers perceived positive changes in their parent-child interactions. The findings of this pilot study contribute to knowledge regarding the effects of home-based DIR/Floortime intervention program on increasing the social interaction and adaptive behaviors of children with ASD in Taiwan.
Subject(s)
Child Behavior , Child Development Disorders, Pervasive/rehabilitation , Mother-Child Relations , Mothers/education , Play Therapy/methods , Activities of Daily Living , Adult , Child , Child Development Disorders, Pervasive/psychology , Child, Preschool , Communication , Emotions , Female , Humans , Male , Mothers/psychology , Perception , Pilot Projects , Play and PlaythingsABSTRACT
PURPOSE: We consider the speed of ice growth as an indicator of the speed of cooling and investigated its impact on the factors at the cell death boundary in an in vitro simulated cryosurgical system. MATERIALS AND METHODS: PC-3 cells were cultured in culture plates and simulated cryosurgery was performed under different speeds of ice growth using an in vitro simulated cryosurgical system. The freezing front was closely monitored. Cells were fixed and stained 24 hours after cryosurgery. The distance from the cell death boundary to the ice front was measured and defined as the distance gap. It was correlated with the speed of ice growth. Temperature history at the cell death boundary was retrieved and also correlated with the speed of ice growth. RESULTS: A high correlation between the speed of ice growth and the temperature gradient plus an inverse correlation between the speed of ice growth and the distance gap were found. The distance gap narrowed when the speed of ice growth was around 3 mm per minute but widened when the speed of ice growth was slower than 1.5 mm per minute. CONCLUSIONS: Changes in ice growth speed indicate changes in the temperature gradient, and the distance between the ice front and the cell death boundary. Different treatment end points should be chosen according to the speed of ice growth to increase accurate cell killing.
