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Background Higher categories of background parenchymal enhancement (BPE) increase breast cancer risk. However, current clinical BPE categorization is subjective. Objective Using a semi-automated segmentation algorithm, we calculated quantitative BPE measures and investigated the utility of individual features and feature pairs to significantly predict subsequent breast cancer risk, compared to radiologist-assigned BPE category. Methods In this retrospective case control study, we identified 95 high risk women without a personal history of breast cancer who underwent breast MRI. Nineteen subsequently developed breast cancer. Each case was age-matched to four controls (76 controls total). Sociodemographic characteristics were compared for the matched cases and controls using the Mann-Whitney U test. From each dynamic contrast-enhanced MRI, quantitative fibroglandular tissue (FGT) and BPE measures were computed by averaging enhancing voxels above enhancement ratio thresholds (0-100%), totaling the enhancing volu Compared to BPE category, the first post-gadolinium (phase 1) BPE% at the 30% and 40% enhancement ratio thresholds (Ph1BPE%30% and Ph1BPE%40%) yielded significantly higher AUC values of 0.85 (p=0.0007) and 0.84 (p=0.0004), respectively. Feature combinations demonstrated similar AUC with improved sensitivity. PBIT research buy Conclusion Preliminary data indicate that quantitative BPE measures may outperform radiologist-assigned category in breast cancer risk prediction. Clinical impact Future risk prediction models that incorporate quantitative measures warrant additional investigation.BACKGROUND Based on expert consensus, PI-RADS version 2.1 introduced the transition zone (TZ) 'atypical' BPH nodule, defined as a TZ lesion with incomplete or absent capsule (T2 score 2), as well as a revised scoring pathway whereby such nodules, if showing marked restricted diffusion (DWI score 4-5) are upgraded from overall PI-RADS category 2 to 3 ('2+1 TZ lesion'). OBJECTIVE To compare clinically significant prostate cancer (csPCa) detection rates in prospectively reported '2+1 TZ lesions' as defined by PI-RADS v2.1 and conventional '3+0 TZ lesions', using targeted biopsies as reference standard. METHODS This retrospective study evaluated men with no known PCa or treatment-naïve grade group (GG) 1 PCa who underwent 3T multiparametric prostate MRI prospectively reported using PI-RADS v2.1. Patients with at least one category 3 TZ lesion that underwent targeted biopsy formed the final cohort. Biopsy results were summarized descriptively for '2+1' and '3+0' lesions. Generalized estimating equations were used that of conventional '3+0 TZ lesions' (11%). CLINICAL IMPACT Our results provide prospective clinical data about the revised TZ scoring criterion and pathway in PI-RADS v2.1 for atypical BPH nodules with marked restricted diffusion.Background Breast cancer is very common, and the incidence is growing every year. Most breast cancers are treated with radiation after surgery. As a side effect of radiation therapy, inflammation, as well as the neutrophil-lymphocyte ratio (NLR), level increases. However, high NLR levels act as independent prognostic factors for increased mortality in all cancers. In this study, the authors investigated whether administration of vitamin C, which is effective in suppressing inflammation, may help to reduce high levels of NLR produced by radiation therapy. Methods This study was performed retrospectively among 424 patients who were diagnosed with breast cancer and were treated with postoperative radiotherapy at Kosin University Gospel Hospital from January 2011 to December 2017. Among them, 354 patients received radiation therapy without vitamin C (the control group), and 70 experimental patients received vitamin C intravenously twice a week for at least 4 weeks during radiation therapy. The experimental group with higher mortality cancer patients, including breast cancer patients. In this observational study, NLR was significantly decreased during radiation therapy in patients administered high-dose vitamin C.Imaging surveillance is an important component of the post-treatment management of head and neck cancers. There is variability in the surveillance regimen utilized by various practitioners and institutions, with no official National Comprehensive Cancer Network guidelines for asymptomatic patients beyond 6 months post-treatment. Moreover, the post-treatment neck is a complex imaging exam with significant inter-reader heterogeneity, particularly in terms of the manner in which degree of suspicion for disease recurrence is expressed. The Neck Imaging Reporting and Data System (NI-RADS) was introduced by the ACR in 2018 as a practical guide to the interpreting radiologist. NI-RADS is a proposed interpretive framework that can be applied to any standardized or institutional surveillance imaging protocol. NI-RADS simplifies communication between radiologists and referring clinicians and provides management guidance linked to specific levels of suspicion. The ACR NI-RADS committee also provided general best practice recommendations for imaging surveillance modality and timing in the 2018 white paper. The manuscript will begin with a review of existing literature regarding choice of modality and timeline for surveillance in treated cancer of the head and neck. NI-RADS will then be presented as an approach to imaging reporting, interpretation and design of next steps in management.Rationale Obesity is characterized by elevated pleural pressure (PPL) and worsening atelectasis during mechanical ventilation in patients with acute respiratory distress syndrome (ARDS). Objectives To determine the effects of lung recruitment maneuver (LRM) in the presence of elevated PPL on hemodynamics, left and right ventricular pressures and pulmonary vascular resistance. We hypothesized that elevated PPL protects the cardiovascular system against high airway pressures and prevents lung overdistension. Methods First, an interventional crossover trial in adult subjects with ARDS and BMI ≥35 kg/m2 (n=21) was performed to explore the hemodynamic consequences of LRM. Second, cardiovascular function was studied during low/high PEEPs in a model of swine with ARDS and high PPL (n=9) versus healthy swine with normal PPL (n=6). Measurements and Main Results Subjects with ARDS and obesity (BMI=57±12 kg/m2), following LRM, required an increase in PEEP of 8[7, 10] cmH2O above traditional ARDSnet settings to improve lung function, oxygenation and ventilation/perfusion matching, without impairment of hemodynamics or right heart function.
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