RESUMO
Gliomas are the most common type of primary brain tumors. Although gliomas are relatively rare, they are among the deadliest types of cancer, with a survival rate of less than 2 years after diagnosis. Gliomas are challenging to diagnose, hard to treat and inherently resistant to conventional therapy. Years of extensive research to improve diagnosis and treatment of gliomas have decreased mortality rates across the Global North, while chances of survival among individuals in low- and middle-income countries (LMICs) remain unchanged and are significantly worse in Sub-Saharan Africa (SSA) populations. Long-term survival with glioma is associated with the identification of appropriate pathological features on brain MRI and confirmation by histopathology. Since 2012, the Brain Tumor Segmentation (BraTS) Challenge have evaluated state-of-the-art machine learning methods to detect, characterize, and classify gliomas. However, it is unclear if the state-of-the-art methods can be widely implemented in SSA given the extensive use of lower-quality MRI technology, which produces poor image contrast and resolution and more importantly, the propensity for late presentation of disease at advanced stages as well as the unique characteristics of gliomas in SSA (i.e., suspected higher rates of gliomatosis cerebri). Thus, the BraTS-Africa Challenge provides a unique opportunity to include brain MRI glioma cases from SSA in global efforts through the BraTS Challenge to develop and evaluate computer-aided-diagnostic (CAD) methods for the detection and characterization of glioma in resource-limited settings, where the potential for CAD tools to transform healthcare are more likely.
RESUMO
BACKGROUND: Breast cancer is the commonest female cancer in Nigeria. Despite its increased awareness, affordability of available screening tools is a bane. Mammography, the goal standard for screening is costly and not widely available in terms of infrastructure, technical/personnel capabilities. Ultrasound is accessible and affordable. OBJECTIVES: This study compared the use of ultrasound and mammography as breast cancer screening tools in women in South West Nigeria by characterizing and comparing the prevalent breast parenchyma, breast cancer features and the independent sensitivity of ultrasound and mammography. METHODS: This cross sectional comparative descriptive study used both ultrasound and mammography as screening tools in 300 consenting women aged 30 to 60 years who attended a free breast cancer screening campaign in a tertiary hospital in Lagos. Categorical variables were presented in tables and Chi squares for associations P-value set at ± 0.1. RESULTS: Mean age was 41.01 + 6.5years with majority in the 30 - 39 year age group 139 (55%). Fatty (BIRADS A and B) parenchyma predominated {ultrasound 237 (79%); mammography 233 (77.7%)} in all age groups. 7 (2.3%) were confirmed malignant by histology with (6) in the 30-39 age group and (1) in the 40-49 age group. Ultrasound detected all the confirmed cases 7(100%), whereas mammography detected 6 (85%). Sensitivity was higher using ultrasound (100%) than mammography (85.7%). CONCLUSION: Ultrasound can be utilized as a first line of screening especially in remote/rural areas in developing world. FUNDING: Part funding from Run for Cure governmental organization.