Diagnostic Performance of an Artificial Intelligence System in Breast Ultrasound.

OBJECTIVES: We study the performance of an artificial intelligence (AI) program designed to assist radiologists in the diagnosis of breast cancer, relative to measures obtained from conventional readings by radiologists. METHODS: A total of 10 radiologists read a curated, anonymized group of 299 breast ultrasound images that contained at least one suspicious lesion and for which a final diagnosis was independently determined. Separately, the AI program was initialized by a lead radiologist and the computed results compared against those of the radiologists. RESULTS: The AI program's diagnoses of breast lesions had concordance with the 10 radiologists' readings across a number of BI-RADS descriptors. The sensitivity, specificity, and accuracy of the AI program's diagnosis of benign versus malignant was above 0.8, in agreement with the highest performing radiologists and commensurate with recent studies. CONCLUSION: The trained AI program can contribute to accuracy of breast cancer diagnoses with ultrasound.

Role of apparent diffusion coefficient values in prostate diseases characterization on diffusion-weighted magnetic resonance imaging.

BACKGROUND: To evaluate if normal and pathological prostate tissue can be distinguished by using apparent diffusion coefficient (ADC) values on magnetic resonance imaging (MRI) and to understand if it is possible to differentiate among pathological prostate tissues using ADC values. METHODS: Our population consisted in 81 patients (mean age 65.4 years) in which 84 suspicious areas were identified. Regions of interest were placed over suspicious areas, detected on MRI, and over areas with normal appearance, and ADC values were recorded. Statistical differences between ADC values of suspicious and normal areas were evaluated. Histopathological diagnosis, obtained from targeted biopsy using MRI-US fusion biopsies in 39 patients and from prostatectomy in 42 patients, were correlated to ADC values. RESULTS: Histopathological diagnosis revealed 58 cases of prostate cancer (PCa), 19 patients with indolent PCa (Gleason Score ≤6) and 39 patients with clinically significant PCa (Gleason Score ≥7), 16 of high-grade prostatic intraepithelial neoplasia (HG-PIN) and 10 of atypical small acinar proliferation (ASAP). Significant statistical differences between mean ADC values of normal prostate tissue versus PCa (P<0.00001), HG-PIN (P<0.00001) and ASAP (P<0.00001) were found. Significant differences were observed between mean ADC values of PCa versus HG-PIN (P<0.00001) and ASAP (P<0.00001) with many overlapping values. Differences between mean ADC values of HG-PIN versus ASAP (P=0.015) were not significant. Significant differences of ADC values were also observed between patients with indolent and clinically significant PCa (P<0.00001). CONCLUSIONS: ADC values allow differentiation between normal and pathological prostate tissue and between indolent and clinically significant PCa but do not allow a definite differentiation between PCa, HG-PIN, and ASAP.

Minor hepatic resection for hepatocellular carcinoma in cirrhotic patients: Kelly clamp crushing resection versus heat coagulative necrosis with bipolar radiofrequency device.

Hemorrhage and postoperative liver insufficiency are frequent and serious complications of hepatic resection in cirrhotic patients. The aim of this study was to assess retrospectively whether the surgical techniques using Kelly clamp crushing resection or heat coagulative necrosis with a bipolar radiofrequency device can reduce the incidence of the above complications and an eventual recurrence of neoplasia on the liver slice. We retrospectively reviewed the results of 35 patients who had undergone resection for monofocal hepatocellular carcinoma at our center. Thirteen patients (Group A) had undergone liver resection with Kelly clamp crushing resection, 22 patients (Group B) had had liver resection assisted with a bipolar radiofrequency device. Radiofrequency-assisted liver resection was associated with diminished blood loss (P < 0.0001), a lower blood transfusion rate (P < 0.005), reduced operative time (P < 0.0001), and better postoperative serum albumin levels (P < 0.03). This nonrandomized retrospective study suggests that radiofrequency-assisted liver resection is associated with better results than the Kelly clamp crushing resection technique in cirrhotic patients with focal hepatocellular carcinoma and preserved liver function. These results should now be assessed prospectively in a randomized clinical trial.

Giant hepatocellular adenoma as cause of severe abdominal pain: a case report.

The authors describe the case of a large hepatocellular adenoma diagnosed in a 30-year old woman who came to us complaining of acute pain in the upper abdominal quadrants. The patient had been taking an oral contraceptive pill for the last ten years. We present the clinical features, the diagnostic work-up and the treatment prescribed.