The Relationship Between Breast Density Change During Menopause and the Risk of Breast Cancer in Korean Women.

BACKGROUND: The aim of this study was to investigate the relationship between changes in breast density during menopause and breast cancer risk. METHODS: This study was a retrospective, longitudinal cohort study for women over 30 years of age who had undergone breast mammography serially at baseline and postmenopause during regular health checkups at Samsung Medical Center. None of the participants had been diagnosed with breast cancer at baseline. Mammographic breast density was measured using the American College of Radiology Breast Imaging Reporting and Data System. RESULTS: During 18,615 person-years of follow-up (median follow-up 4.8 years; interquartile range 2.8-7.5 years), 45 participants were diagnosed with breast cancer. The prevalence of dense breasts was higher in those who were younger, underweight, had low parity or using contraceptives. The cumulative incidence of breast cancer increased 4 years after menopause in participants, and the consistently extremely dense group had a significantly higher cumulative incidence (CI) of breast cancer compared with other groups [CI of extremely dense vs. others (incidence rate per 100,000 person-years): 375 vs. 203, P < 0.01]. CONCLUSION: Korean women whose breast density was extremely dense before menopause and who maintained this density after menopause were at two-fold greater risk of breast cancer. PREVENTION RELEVANCE: Extremely dense breast density that is maintained persistently from premenopause to postmenopause increases risk of breast cancer two fold in Korean women. Therefore, women having risk factors should receive mammography frequently and if persistently extremely dense breast had been detected, additional modalities of BC screening could be considered.

Validation of intra- and interobserver reproducibility of shearwave elastography: Phantom study.

PURPOSE: To assess intra- and interobserver reproducibility of quantitative ultrasound (US) elastography for breast masses using shearwave elastography (SWE). MATERIALS AND METHODS: The US elastography phantom was used. This training phantom contained 12 masses with dimensions from 6 to 11mm and varying B-mode (hypo- iso- and hyperechoic) characteristics and viscoelastic properties varying from about 50 to 250kPa. Four attending radiologists participated as operators and used Supersonic Imaging 15-4 MHz array to acquire images. In each session, B-mode US features were assessed once and US elastography values were assessed twice in a consecutive and distinct manner. A total of three identical sessions of data acquisition were performed at 2-week intervals. For categorical variables such as BI-RADS features of mass on B-mode image and qualitative SWE features, kappa (k) values were calculated by the generalized linear mixed model. For continuous variables, kPa, and ratio, intraclass correlation coefficients (ICCs) were calculated. RESULTS: Interobserver agreement for SWE image similarity was moderate (k=0.57). With respect to quantitative SWE values, intraobserver ICCs were 0.65, 0.77, 0.92, and 0.91 for maximum elasticity; 0.70, 0.83, 0.94, and 0.94 for mean elasticity; and 0.67, 0.83, 0.92, and 0.92 for elasticity ratio for operators 1, 2, 3, and 4, respectively. Interobserver reproducibility showed good agreement with ICC values of 0.77 for maximum elasticity, 0.82 for mean elasticity, and 0.79 for elasticity ratio. CONCLUSION: Quantitative US elastography for breast masses was highly reproducible with good agreement across operators. With respect to intraobserver reproducibility, ICC values varied but three out of four operators showed good agreement.

Evaluation of the hepatic artery anastomosis by intraoperative sonography with high-frequency transducer in right-lobe graft living donor liver transplantation.

OBJECTIVE: To describe the usefulness of intraoperative ultrasonography (IOUS) with high-frequency transducer in living donor liver transplantation (LDLT) using right-lobe graft (RLG). METHOD: This retrospective study was approved by our institutional review board. We performed IOUS in 22 patients (17 men and 5 women, aged 51 +/- 9.0 years) during LDLT with RLG using a Sequoia 512 scanner with an 8-12-MHz linear transducer. Hepatic artery (HA) anastomosis was identified on gray-scale US, and the diameter and percentage of stenosis of the anastomosis were measured. The HA was evaluated to detect thrombus or dissection in the region of anastomosis. Doppler study of the graft HA was also performed. Patients were divided into those with and without abnormalities, including thrombosis, dissection, and abnormal Doppler parameters (peak systolic velocity < 30 cm/s or > 2 m/s, resistance index < 0.5, and systolic acceleration time > 80 msec). RESULT: On gray-scale and Doppler IOUS study, abnormalities were found in 10 of 22 patients. Diagnoses were anastomotic stenosis (n = 2), celiac stenosis (n = 1), compromise of HA inflow due to systemic hypotension (n = 1), HA thrombosis (n = 2), and HA dissection (n = 4). Re-anastomoses were done in 3 case (2 stenoses and 1 thrombosis). Uneventful postoperative recovery occurred in the other 7 patients without re-anastomosis. CONCLUSION: IOUS with high-frequency transducer is a useful method to make an early diagnosis of HA complications of LDLT with RLG.

Uncommon causes of hepatic congestion in patients after living donor liver transplantation.

OBJECTIVE: The purpose of this article is to illustrate the radiologic findings of various uncommon conditions that cause hepatic congestion in patients after living donor liver transplantation. CONCLUSION: Radiologic findings of hepatic congestion may vary according to the cause and the level of outflow obstruction. It is important for radiologists to be aware of such variations in order to make an early diagnosis of hepatic congestion and to enable timely proper management in recipients after living donor liver transplantation.

Graft rejection in the xenogeneic transplantation of mice: diagnosis with in vivo MR imaging using the homing trait of macrophages.

BACKGROUND: To evaluate the feasibility of magnetic resonance (MR) imaging to depict the in vivo recruitment of superparamagnetic iron oxide (SPIO)-labeled macrophages and to diagnose graft rejection in xenogeneic transplantation. METHODS: We transplanted the trachea of SD rat (xenogeneic) or C3H/HeN mouse (syngeneic) into the left thighs of six male C3H/HeN mice. The SPIO-labeled macrophage was administered through the tail vein 2 days (acute) or 14 days (chronic) after transplantation in each group. The left thighs of the mice were imaged on a 4.7-T MR scanner 24 h after macrophage administration. We evaluated the extent and pattern of the susceptibility effect (macrophage distribution) and compared them in the two groups. The MR findings were then correlated with the histopathologic results. We also measured in both groups the monocyte chemoattractant protein (MCP)-1 level before and 2 days, 2 weeks, and 4 weeks after transplantation. RESULTS: The band-shaped lower signal intensity (SI) zone was noted around the graft in the acute and chronic phases of xenogeneic group and in the acute phase of syngeneic group, but it was not noted in the chronic phase of syngeneic transplantation. The lower SI zone corresponded to the distribution of SPIO-labeled macrophages on histopathological analyses. On histologic examination, the severe inflammation developed around the xenogeneic graft, but only slightly around the syngeneic graft. MCP-1 was elevated 2 days after transplantation in both groups, but then gradually decreased in the syngeneic group; in xenogenic group, the MCP-1 value decreased by week 2 but then increased by week 4. CONCLUSIONS: This study demonstrates that the homing of intravenously administered SPIO-labeled macrophages can be monitored on MR imaging and is correlated with the MCP-1 level and the histopathologic findings of the xenograft rejection.