Curated benchmark dataset for ultrasound based breast lesion analysis.

A new detailed dataset of breast ultrasound scans (BrEaST) containing images of benign and malignant lesions as well as normal tissue examples, is presented. The dataset consists of 256 breast scans collected from 256 patients. Each scan was manually annotated and labeled by a radiologist experienced in breast ultrasound examination. In particular, each tumor was identified in the image using a freehand annotation and labeled according to BIRADS features and lexicon. The histopathological classification of the tumor was also provided for patients who underwent a biopsy. The BrEaST dataset is the first breast ultrasound dataset containing patient-level labels, image-level annotations, and tumor-level labels with all cases confirmed by follow-up care or core needle biopsy result. To enable research into breast disease detection, tumor segmentation and classification, the BrEaST dataset is made publicly available with the CC-BY 4.0 license.

Enhanced biological activity of liposomal methylated resveratrol analog 3'-hydroxy-3,4,5,4'-tetramethoxystilbene (DMU-214) in 3D patient-derived ovarian cancer model.

3'-hydroxy-3,4,5,4'-tetramethoxystilbene (DMU-214) belongs to methoxystilbenes family and is an active metabolite of 3,4,5,4'-tetramethoxystilbene (DMU-212). In several of our previous studies, the anti-apoptotic activity of DMU-214 was significantly higher than that of the parent compound, especially in ovarian cancer cells. Due to increased lipophilicity and limited solubility, methoxystilbenes require a solubilization strategy enabling DMU-214 administration to the aqueous environment. In this study, DMU-214-loaded liposomes were developed for the first time, and its antitumor activity was tested in the ovarian cancer model.First, several liposomal formulations of DMU-214 were obtained by the thin lipid film hydration method followed by extrusion and then characterized. The diameter of the resulting vesicles was in the range of 118.0-155.5 nm, and samples presented monodisperse size distribution. The release of DMU-214 from the studied liposomes was governed by the contribution of two mechanisms, Fickian diffusion and liposome relaxation.Subsequently, in vitro activity of DMU-214 in the form of a free compound or liposome-bound was studied, including commercial cell line SK-OV-3 and patient-derived ovarian cancer cells in monolayer and spheroid cell culture models. DMU-214 liposomal formulations were found to be more potent (had lower IC50 values) than the free DMU-214 both in the monolayer and, more significantly, in both examined spheroid models. The above results, with particular emphasis on the patient-derived ovarian cancer model, indicate the importance of further development of liposomal DMU-214 as a potential anticancer formulation for ovarian cancer treatment.

Joint segmentation and classification of breast masses based on ultrasound radio-frequency data and convolutional neural networks.

In this paper, we propose a novel deep learning method for joint classification and segmentation of breast masses based on radio-frequency (RF) ultrasound (US) data. In comparison to commonly used classification and segmentation techniques, utilizing B-mode US images, we train the network with RF data (data before envelope detection and dynamic compression), which are considered to include more information on tissue's physical properties than standard B-mode US images. Our multi-task network, based on the Y-Net architecture, can effectively process large matrices of RF data by mixing 1D and 2D convolutional filters. We use data collected from 273 breast masses to compare the performance of networks trained with RF data and US images. The multi-task model developed based on the RF data achieved good classification performance, with area under the receiver operating characteristic curve (AUC) of 0.90. The network based on the US images achieved AUC of 0.87. In the case of the segmentation, we obtained mean Dice scores of 0.64 and 0.60 for the approaches utilizing US images and RF data, respectively. Moreover, the interpretability of the networks was studied using class activation mapping technique and by filter weights visualizations.

Comparison of the radial and brachial artery flow-mediated dilation in patients with hypertension.

BACKGROUND: Blood flow-mediated dilation (FMD) is a noninvasive assessment of vascular endothelial function in humans. The study of the FMD in hypertensive (HT) patients is an important factor supporting the recognition of the early mechanisms of cardiovascular pathologies, and also of the pathogenesis related to hypertension. OBJECTIVES: To investigate whether FMD measured on the radial artery (FMD-RA) using high-frequency ultrasounds can be used as an alternative to FMD assessed with the lower frequency system on the brachial artery in patients with HT. MATERIAL AND METHODS: The simultaneous measurements of FMD-RA and FMD measurements in the brachial artery (FMD-BA) were performed on 76 HT patients using 20 MHz and 7-12 MHz linear array probes, and were compared to the FMD measured in healthy groups. All quantitative data are presented as mean ± standard deviation (SD); the p-values of the normality and tests for variables comparisons are listed. The agreement of the FMD-RA and FMD-BA in HT patients was assessed with the Bland-Altman method, and using the intraclass correlation coefficient (ICC). In some statistical calculations, the FMD-RA values were rescaled by dividing them by a factor of 2. RESULTS: The mean FMD-RA and FMD-BA in HT patients were 5.16 ±2.18% (95% confidence interval (95% CI): [4.50%, 5.82%]) and 2.13 ±1.12% (95% CI: [1.76%, 2.49%]), respectively. The FMD-RA and FMD-BA values of HT patients were significantly different than those in respective control groups. The p-values of Mann-Whitney-Wilcoxon tests were less than 0.05. The Bland-Altman coefficient for both measurement methods, FMD-RA and FMD-BA, was 3%, and the ICC was 0.69. CONCLUSIONS: Our findings show that FMD-RA, supplementary to FMD-BA measurements, can be used to assess endothelial dysfunction in the group of HT patients. In addition, the FMD-RA measurements met the criteria of high concordance with the FMD-BA measurements.

Ovarian Cancer and Cancer Stem Cells-Cellular and Molecular Characteristics, Signaling Pathways, and Usefulness as a Diagnostic Tool in Medicine and Oncology.

Despite the increasing development of medicine, ovarian cancer is still a high-risk, metastatic disease that is often diagnosed at a late stage. In addition, difficulties in its treatment are associated with high resistance to chemotherapy and frequent relapse. Cancer stem cells (CSCs), recently attracting significant scientific interest, are considered to be responsible for the malignant features of tumors. CSCs, as the driving force behind tumor development, generate new cells by modifying different signaling pathways. Moreover, investigations on different types of tumors have shown that signaling pathways are key to epithelial-mesenchymal transition (EMT) regulation, metastasis, and self-renewal of CSCs. Based on these established issues, new therapies are being investigated based on the use of inhibitors to block CSC growth and proliferation signals. Many reports indicate that CSC markers play a key role in cancer metastasis, with hopes placed in their targeting to block this process and eliminate relapses. Current histological classification of ovarian tumors, their epidemiology, and the most recent knowledge of ovarian CSCs, with particular emphasis on their molecular background, are important aspects for consideration. Furthermore, the importance of signaling pathways involved in tumor growth, development, and metastasis, is also presented.

DOES FLOW-MEDIATED DILATION NORMALIZATION FOR BASE-SCALED SHEAR RATE IMPROVE ITS VALUE IN CORONARY ARTERY DISEASE DIAGNOSTICS?

The article presents a new normalization of flow-mediated dilation (FMD) in the radial artery, taking into account the parameter BSSR being equal to the ratio of the basal shear rate (BS) measured before the cuff inflation and post occlusive shear rate (SR). The in vivo usefulness of the new normalization algorithm was evaluated in two groups of patients. In group I, comprising 15 healthy volunteers, the normalized FMD/SR was (3.19 ± 1.4)•10-4, while in group II, comprising 13 patients with stable coronary artery disease (CAD), it was (1.02 ± 0.76)•10-4. We calculated almost 50% larger difference between the average values after normalizing FMD/BSSR. Specifically, the FMD/BSSR was equal to 28 ± 9.40 in group I and 6.01 ± 3.74 in group II. The prediction of CAD patients based on FMD/SR values had a sensitivity of 83.3% and a specificity of 84.6%, whereas the prediction of CAD patients based on the FMD/BSSR values revealed 100% sensitivity and specificity. These results confirm the usefulness of the novel normalization algorithm of the FMD in differentiation of normal patients from those with stable CAD.

The Effect of 4'-hydroxy-3,4,5-trimetoxystilbene, the Metabolite of Resveratrol Analogue DMU-212, on Growth, Cell Cycle and Apoptosis in DLD-1 and LOVO Colon Cancer Cell Lines.

Resveratrol is a phytoalexin that naturally occurs in grapes, blueberries, cranberries, peanuts and many other plants. Although resveratrol inhibits carcinogenesis in all three stages, its clinical application is restricted due to poor pharmacokinetics. The methylated analogues of resveratrol have been found to have higher bioavailability and cytotoxic activity than that of the prototupe compound. Among the various methoxy derivatives of resveratrol, 3,4,5,4'-tetrametoxystilbene (DMU-212) is suggested to be one of the strongest activators of cytotoxicity and apoptosis. DMU-212 has been shown to exert anti-tumor activity in DLD-1 and LOVO colon cancer cells. Since colorectal cancer is the third most common cause of cancer-related deaths worldwide, the development of new anticancer agents is nowadays of high significance. The aim of the present study was to assess the anticancer activity of 4'-hydroxy-3,4,5-trimetoxystilbene (DMU-281), the metabolite of DMU-212, in DLD-1 and LOVO cell lines. We showed for the first time the cytotoxic activity of DMU-281 triggered via cell cycle arrest at G2/M phase and apoptosis induction accompanied by the activation of caspases-9, -8, -3/7. Furthermore, DMU-281 has been found to change the expression pattern of genes and proteins related to intrinsic as well as extrinsic apoptosis. Since the activation of these pathways of apoptosis is still the most desired strategy in anticancer research, DMU-281 seems to provide a promising approach to the treatment of colon cancer.

Safety of ultrasonic examinations; thermal and mechanical indices.

This review article combines the reports on the biophysical effects in ultrasonography and provides the rationale behind the mechanical index (MI) and thermal index (TI) complying with the Output Display Standard (ODS). Safe ultrasonic doses are determined according to specific rules, and the screen displays the associated quantities MI and TI. The introduced indices MI and TI take into account the physical mechanism of interaction between ultrasounds and biological tissue, which depends on the temporal and spatial parameters of the acoustic field generated by ultrasound transducers. The predicted temperature increase is determined using three different tissue models: homogeneous, layered and bone/tissue interface.

The Effect of 3'-Hydroxy-3,4,5,4'-Tetramethoxy -stilbene, the Metabolite of the Resveratrol Analogue DMU-212, on the Motility and Proliferation of Ovarian Cancer Cells.

Targeting tumor cell motility and proliferation is an extremely important challenge in the prevention of metastasis and improving the effectiveness of cancer treatment. We recently published data revealing that DMU-214, the metabolite of firmly cytotoxic resveratrol analogue DMU-212, exerted significantly higher biological activity than the parent compound in ovarian cancer cells. The aim of the present study was to assess the molecular mechanism of the potential anti-migration and anti-proliferative effect of DMU-214 in ovarian cancer cell line SKOV-3. We showed that DMU-214 reduced the migratory capacity of SKOV-3 cells. The microarray analysis indicated ontology groups of genes involved in processes of negative regulation of cell motility and proliferation. Furthermore, we found DMU-214 triggered changes in expression of several migration- and proliferation-related genes (SMAD7, THBS1, IGFBP3, KLF4, Il6, ILA, SOX4, IL15, SRF, RGCC, GPR56) and proteins (GPR56, RGCC, SRF, SMAD7, THBS1), which have been shown to interact to each other to reduce cell proliferation and motility. Our study showed for the first time that DMU-214 displayed anti-migratory and anti-proliferative activity in SKOV-3 ovarian cancer cells. On the basis of whole transcriptome analysis of these cells, we provide new insight into the role of DMU-214 in inhibition of processes related to metastasis.

Sense of coherence and acceptance of the disease in patients with lung cancer during palliative chemotherapy.

INTRODUCTION: An important part of the therapeutic process of patients with lung cancer undergoing palliative chemotherapy is to assess their mental well-being. Evaluation of the sense of coherence and acceptance of the disease, which reflects the degree of adaptation of the patient to live with the disease, provides information on this topic. OBJECTIVE: The primary objective was to assess the level of sense of coherence and acceptance of the disease in patients with lung cancer during palliative chemotherapy as well as coherence and acceptance together with socio-demographic factors. The secondary objective was to assess the economic impact of lung cancer on these patients. MATERIAL AND METHODS: The study involved 100 patients with lung cancer during palliative chemotherapy. The study was conducted using the Sense of Coherence Questionnaire (SOC-29), the Acceptance of Illness Scale, and a socio-demographic questionnaire. RESULTS: The study group consisted mainly of men (66%), people with primary/vocational education (63%) and patients living in cities (59%). The average age of respondents was 62.8 years. 45% of patients had a high level of sense of coherence, and 44% had an average level. The average overall score of SOC was 143.9 points inside the upper range of average results. Levels of a sense of comprehensibility, manageability, and meaningfulness remained in close relation to the average level: 48.91, 51.33, and 43.66 points, respectively. The average acceptance of the disease was 45% with the average total of 27.21 points. CONCLUSIONS: Most patients during palliative chemotherapy because of lung cancer had average or high level of coherence and acceptance of the disease. The level of sense of coherence and acceptance of the disease was not affected by gender, age, education, or place of residence. Almost all patients incur costs associated with treatment, and in some of them the disease affected the source of income.

Clinical value of colonoscopy and positron emission tomography with computed tomography for colorectal cancer diagnosis.

INTRODUCTION: Colonoscopy and PET / CT are among the major diagnostic tests for colorectal cancer. The sensitivity, specificity, and accuracy of these studies are still being assessed differently. OBJECTIVE: The aim of the study was to compare the sensitivity, specificity and accuracy of colonoscopy and PET / CT in the diagnosis of colorectal cancer. MATERIAL AND METHODS: The medical records of 125 patients with colonoscopy and PET / CT in the years 2014-2015 were analyzed retrospectively. The research was done at the Professor Franciszek Lukaszczyk Oncology Center in Bydgoszcz. Based on the macroscopic description of colonoscopy, the results were divided into two groups: with and without probability of cancer. The average SUV value in PET / CT for colorectal cancer was calculated and without this diagnosis. The average value of SUV 14 and higher was considered probable, while 11 or less had no probability of cancer. Standardized mathematical formulas were used to evaluate the sensitivity, specificity and accuracy. RESULTS: More than half of the patients - 78 (62.4%) were males. The majority of patients -42 (36.6%) were aged 65-74. The majority (106) (68.8%) were diagnosed as polyps and 24 (15.6%) as tumor-like lesions. Polyps were placed in the rectum -32 (30.2%), in the sigmoid colon - 26 (24.5%) and 15 (13.2%) in the ascending colon. Tumors were located in the rectum - 11 (45.8%) and 4 (16.7%) in the recto-sigmoid junction. 38 (24.6%) adenocarcinomas and 67 (43.5%) adenomas were diagnosed. The detection rate of RJG was 32% in colonoscopy and PET / CT. The sensitivity of the colonoscopy was 80%, the specificity - 68.4% and the accuracy - 71.4%. The sensitivity, specificity and accuracy of PET / CT were 65%, 75%, 4% and 72.7%, respectively. CONCLUSIONS: Colonoscopy has a higher sensitivity in colorectal cancer diagnosis, but specificity and accuracy are higher in PET / CT.

Incidence, morbidity and 5-year survival of colorectal cancer patients in the Kujawsko-Pomorskie voivodship in 2005-2011, based on data from the National Health Fund.

INTRODUCTION: The incidence, morbidity and 5-year survival rates illustrate the epidemiological situation of colorectal cancer and assess the effectiveness of the treatment. In Poland, the National Health Fund is the payer of benefits. The data related to morbidity, incidence, and 5-year survival may be supplementary to the epidemiological data of the National Cancer Registry. OBJECTIVE: Analysis of benefits granted by NHF in Bydgoszcz to persons with diagnosed colorectal cancer in 2006-2011 including the assessment of incidence, morbidity and 5-year survival of the population in the Kujawsko-Pomorskie province. MATERIAL AND METHODS: The study analyzed the benefits recorded in the database of the National Health Fund in Bydgoszcz in 2006-2011 given to patients with colorectal cancer. The Kaplan-Meier method and the gambling rate were used to determine the probability of survival. RESULTS: In 2006-2011 men were offered 10.1% more benefits than women. The most frequent benefits were colorectal cancer (48.9%), rectal cancer (43.8%) and esophageal cancer (7.2%). In total, 50410 benefits were provided. Despite the increase in the number of women in the population, 388 more men died than women. The probability of survival was 46.8 %% and 42.6% for men and women, respectively, and 41.8%, 44.2% and 48.9% for colon cancer, esophageal and rectal folds, respectively. CONCLUSIONS: In the Kujawsko-Pomorskie province during the period of 2006-2011 the number of diagnosed colorectal cancers increased as did the overall number of benefits provided.There was also a downward trend for the total number of benefits granted in relation to the trend of the increase in the number of new diagnosed cases. Incidence and morbidity rates were variable, gradually increasing in subsequent years and amounted to 59/100000 and 67/100000, 355/100000 and 408/100000 in 2010 and 2011, respectively. The probability of 5-year survival was 45.2%. Diagnosis of a disease in patients above 69 years of age increased the likelihood of death.

Transfer learning with deep convolutional neural network for liver steatosis assessment in ultrasound images.

PURPOSE: The nonalcoholic fatty liver disease is the most common liver abnormality. Up to date, liver biopsy is the reference standard for direct liver steatosis quantification in hepatic tissue samples. In this paper we propose a neural network-based approach for nonalcoholic fatty liver disease assessment in ultrasound. METHODS: We used the Inception-ResNet-v2 deep convolutional neural network pre-trained on the ImageNet dataset to extract high-level features in liver B-mode ultrasound image sequences. The steatosis level of each liver was graded by wedge biopsy. The proposed approach was compared with the hepatorenal index technique and the gray-level co-occurrence matrix algorithm. After the feature extraction, we applied the support vector machine algorithm to classify images containing fatty liver. Based on liver biopsy, the fatty liver was defined to have more than 5% of hepatocytes with steatosis. Next, we used the features and the Lasso regression method to assess the steatosis level. RESULTS: The area under the receiver operating characteristics curve obtained using the proposed approach was equal to 0.977, being higher than the one obtained with the hepatorenal index method, 0.959, and much higher than in the case of the gray-level co-occurrence matrix algorithm, 0.893. For regression the Spearman correlation coefficients between the steatosis level and the proposed approach, the hepatorenal index and the gray-level co-occurrence matrix algorithm were equal to 0.78, 0.80 and 0.39, respectively. CONCLUSIONS: The proposed approach may help the sonographers automatically diagnose the amount of fat in the liver. The presented approach is efficient and in comparison with other methods does not require the sonographers to select the region of interest.

Detecting cerebrovascular changes in the brain caused by hypertension in atrial fibrillation group using acoustocerebrography.

Acoustocerebrography is a novel, non-invasive, transcranial ultrasonic diagnostic method based on the transmission of multispectral ultrasound signals propagating through the brain tissue. Dedicated signal processing enables the estimation of absorption coefficient, frequency-dependent attenuation, speed of sound and tissue elasticity. Hypertension and atrial fibrillation are well known factors correlated with white matter lesions, intracerebral hemorrhage and cryptogenic stroke numbers. The aim of this study was to compare the acoustocerebrography signal in the brains of asymptomatic atrial fibrillation patients with and without hypertension. The study included 97 asymptomatic patients (40 female and 57 male, age 66.26 ± 6.54 years) who were clinically monitored for atrial fibrillation. The patients were divided into two groups: group I (patients with hypertension) n = 75, and group II (patients without hypertension) n = 22. Phase and amplitude of all spectral components for the received signals from the brain path were extracted and compared to the phase and amplitude of the transmitted pulse. Next, the time of flight and the attenuation of each frequency component were calculated. Additionally, a fast Fourier transformation was performed and its features were extracted. After introducing a machine learning technique, the ROC plot of differentiations between group I and group II with an AUC of 0.958 (sensitivity 0.99 and specificity 0.968) was obtained. It can be assumed that the significant difference in the acoustocerebrography signals in patients with hypertension is due to changes in the brain tissue, and it allows for the differentiating of high-risk patients with asymptomatic atrial fibrillation and hypertension.

Barrett's esophagus and gland cancer - the experience of one center.

OBJECTIVE: The aim of the study was to evaluate the prevalence and clinical aspects of Barrett's esophagus and adenocarcinoma of the lower part of esophagus in gastroscopy. MATERIAL AND METHODS: Retrospective review of 10000 upper gastrointestinal endoscopic examinations were performed at the Department of Oncology Endoscopy in Bydgoszcz from 2004 to 2014 in terms of incidence of Barrett's esophagus and adenocarcinoma in the lower part of esophagus. RESULTS: The medical records of 5378 (53.8%) women and 4622 (46.2%) men were analyzed. The average age of men and women was 62.4 and 62.7, respectively. Barrett's esophagus was diagnosed in 67 patients, including 38 (56.7%) of men where the average age of men and women was 56.9 and 60.2 years, respectively. The most commonly reported symptom was heartburn occurred in 45 (67.2%) of patients. During ten years of follow-up PB examination the adenocarcinomas were detected in 3 (4.47%) cases. Adenocarcinoma was diagnosed in 46 patients, of whom 37 in men. In the case of 27 patients (58.7%), esophageal cancer was treated with the intention of radicalization. The probability of 5-year survival in these patients was 10.2% for women and 9.2% for men. CONCLUSIONS: The number of Barrett's esophagus and adenocarcinoma are increasing at 0.67% and 0.46% annually, respectively. The risk of adenocarcinoma developed from Barrett's esophagus during endoscopic follow-up period was 4.47%. Barrett's esophagus is more common in men before the age of 60, and nearly half of them have intestinal metaplasia without dysplasia. Probability of 5-year survival in patients with adenocarcinoma was 9.7%.

20-MHz Ultrasound for Measurements of Flow-Mediated Dilation and Shear Rate in the Radial Artery.

A high-frequency scanning system consisting of a 20-MHz linear array transducer combined with a 20-MHz pulsed Doppler probe was introduced to evaluate the degree of radial artery flow-mediated dilation (FMD [%]) in two groups of patients after 5 min of controlled forearm ischemia followed by reactive hyperemia. In group I, comprising 27 healthy volunteers, FMD (mean ± standard deviation) was 15.26 ± 4.90% (95% confidence interval [CI]: 13.32%-17.20%); in group II, comprising 17 patients with chronic coronary artery disease, FMD was significantly less at 4.53 ± 4.11% (95% CI: 2.42%-6.64%). Specifically, the ratio FMD/SR (mean ± standard deviation), was equal to 5.36 × 10-4 ± 4.64 × 10-4 (95% CI: 3.54 × 10-4 to 7.18 × 10-4) in group I and 1.38 × 10-4 ± 0.89 × 10-4 (95% CI: 0.70 × 10-4 to 2.06 × 10-4) in group II. Statistically significant differences between the two groups were confirmed by a Wilcoxon-Mann-Whitney test for both FMD and FMD/SR (p <0.01). Areas under receiver operating characteristic curves for FMD and FMD/SR were greater than 0.9. The results confirm the usefulness of the proposed measurements of radial artery FMD and SR in differentiation of normal patients from those with chronic coronary artery disease.

The acceptance of illness in lung cancer patients before and after surgical treatment.

Lung cancer is the most common malignant tumor in the world, as well as one of the cancers with the most fatal prognosis. The acceptance of the disease is the most important element of the adaptive process. The better the illness acceptance, the lower the stress level and the higher the self-esteem, which facilitates the adaptation to the health status. AIM: The aim of this study was to assess the acceptance of the disease in patients before and after lung cancer surgery. MATERIALS AND METHODS: The study was conducted in 2016 at the Center of Oncology in Bydgoszcz and the Kuyavian and Pomeranian Pulmonology Center in Bydgoszcz. The study involved 87 patients who were assessed both before and after lung cancer surgery. The original questionnaire, as well as the Acceptance of Illness Scale, were used. RESULTS: Men accounted for 75% of the probands, 65% of the study population were 50-69 years old. The highest number of patients - 25 (28.7%) had a 5-pack-year history, and the lowest amount of patients - 8 (9.2%) had a 2.5-pack-year history. The level of acceptance of illness before and after surgery differed in 58 persons. In 29, the level of acceptance remained the same, in 45, the level of acceptance decreased, and in 13 - it increased. Before surgery, the mean acceptance of illness score was 26.2 points, and after surgery - 20.89 points. The patients both after and before surgery had acceptance of illness scores regardless of their gender, age, education, place of residence or occupational activity. CONCLUSIONS: In more than a half of the patients, the acceptance of illness decreases after surgery and is at an average level. Male patients, patients aged 50-69 years, with primary, middle or vocational education, employed persons show a significantly worse illness acceptance, regardless of their place of residence, and occupational activity do not influence the acceptance of the disease.

Open access database of raw ultrasonic signals acquired from malignant and benign breast lesions.

PURPOSE: The aim of this paper is to provide access to a database consisting of the raw radio-frequency ultrasonic echoes acquired from malignant and benign breast lesions. The database is freely available for study and signal analysis. ACQUISITION AND VALIDATION METHODS: The ultrasonic radio-frequency echoes were recorded from breast focal lesions of patients of the Institute of Oncology in Warsaw. The data were collected between 11/2013 and 10/2015. Patients were examined by a radiologist with 18 yr' experience in the ultrasonic examination of breast lesions. The set of data includes scans from 52 malignant and 48 benign breast lesions recorded in a group of 78 women. For each lesion, two individual orthogonal scans from the pathological region were acquired with the Ultrasonix SonixTouch Research ultrasound scanner using the L14-5/38 linear array transducer. All malignant lesions were histologically assessed by core needle biopsy. In the case of benign lesions, part of them was histologically assessed and another part was observed over a 2-year period. DATA FORMAT AND USAGE NOTES: The radio-frequency echoes were stored in Matlab file format. For each scan, the region of interest was provided to correctly indicate the lesion area. Moreover, for each lesion, the BI-RADS category and the lesion class were included. Two code examples of data manipulation are presented. The data can be downloaded via the Zenodo repository (https://doi.org/10.5281/zenodo.545928) or the website http://bluebox.ippt.gov.pl/~hpiotrzk. POTENTIAL APPLICATIONS: The database can be used to test quantitative ultrasound techniques and ultrasound image processing algorithms, or to develop computer-aided diagnosis systems.

[Acceptance of the disease and tendency to pay higher health insurance fee by patients with lung cancer].

INTRODUCTION: Thanks to knowledge on the relationship between acceptance of disease and the willingness to co-pay for treatment in patients with lung cancer we can try to assess whether their introduction would be justified and acceptable. THE AIM: The purpose of the study was to examine the propensity of patients with lung cancer to pay higher rate of health insurance depending on their acceptance of the disease. MATERIALS AND METHODS: The study was conducted in 2016 at the Oncology Center in Bydgoszcz and the Kujawsko-Pomorskie Pulmonology Center in Bydgoszcz. The study involved the same group of 87 patients before and after surgery because of lung cancer. The original questionnaire and the Acceptance of Illness Scale were used in the study. RESULTS: Men accounted for 75% of the respondents, 65% of them were 50-69 years old. Before the surgery 34 (39.1%) patients stated that they are willing to pay a higher rate for health insurance, and 65 (74.7%) patients after the surgery (p <0.001). Among the 34 (39%) patients who were willing to pay a higher premium, before the surgery the most of them 21 (61.8%) by 10% higher, while least 2 (5.9%) by 100% higher. In contrast, after the surgery among the 65 (74.7%) patients 30 (46.2%) expressed a willingness to pay premiums by 10%, while the lowest 9 (13.8%) by 25% higher. Before the surgery 34 patients were willing to pay health insurance by 26% higheron average while 65 patients had an average increase of 36.5%. CONCLUSIONS: Patients with lower acceptance of the disease, living in the city, with secondary education and undergone surgeryare more likely to pay higher health insurance. More than half of the patients with lower acceptance of the disease are willing to pay higher premiums on health insurance by an average of 36%.

The assessment of cancer-related fatigue syndrome in patients with lung cancer during palliative chemotherapy.

INTRODUCTION: Cancer-related fatigue is one of the most common problems of patients with lung cancer. The assessment of cancer- -related fatigue is therefore a significant medical problem in patients during treatment with palliative chemotherapy. MATERIAL AND METHODS: The study included 100 patients during palliative chemotherapy because of lung cancer. The study was conducted in the Department of Pulmonary Diseases and Treatment of Lung Cancer in the Kuyavian and Pomeranian Centre of Pulmonology in Bydgoszcz, in the period from February to June 2016. The study used a socio-demographic questionnaire and Cancer Related Fatigue scale (CRF) consisting of 22 closed questions. RESULTS: Men accounted for 68% of the study group, people with vocational education - 61%, and people living in the city - 61%. People aged 51-65 formed the largest group. The mean value for behavioural fatigue was 5.34 points, the sensory one - 5.44 points, cognitive/mood fatigue - 4.29 points (moderate levels), whereas mean value for affective fatigue was at a serious level - 5.89 points. The average severity of general fatigue was 5.2 points (moderate level of fatigue). CONCLUSIONS: The moderate level of cancer-related fatigue occurs in half of patients treated with chemotherapy because of lung cancer, and lasts for several months. Behavioural, sensory, cognitive/mood and general fatigue have moderate levels but affective fatigue has a severe level. Radiation therapy affects the severity of cognitive/mood fatigue, lowers economic status, influences behavioural fatigue and education level, and has an effect on general fatigue. In multivariate analysis, only the reduction of economic status has a significant impact on the severity of fatigue.  .