Can digital breast tomosynthesis perform better than standard digital mammography work-up in breast cancer assessment clinic?

PURPOSE: To compare the efficacy of use of digital breast tomosynthesis (DBT) with standard digital mammography (DM) workup views in the breast cancer assessment clinic. MATERIALS AND METHODS: The Tomosynthesis Assessment Clinic trial (TACT), conducted between 16 October 2014 and 19 April 2016, is an ethics-approved, monocenter, multireader, multicase split-plot reading study. After written informed consent was obtained, 144 females (age > 40 years) who were recalled to the assessment clinic were recruited into TACT. These cases (48 cancers) were randomly allocated for blinded review of (1) DM workup and (2) DBT, both in conjunction with previous DM from the screening examination. Fifteen radiologists of varying experience levels in the Australia BreastScreen Program were included in this study, wherein each radiologist read 48 cases (16 cancers) in 3 non-overlapping blocks. Diagnostic accuracy was measured by means of sensitivity, specificity, and positive (PPV) and negative predictive values (NPV). The receiver-operating characteristic area under the curve (AUC) was calculated to determine radiologists' performances. RESULTS: Use of DBT (AUC = 0.927) led to improved performance of the radiologists (z = 2.62, p = 0.008) compared with mammography workup (AUC = 0.872). Similarly, the sensitivity, specificity, PPV, and NPV of DBT (0.93, 0.75, 0.64, 0.96) were higher than those of the workup (0.90, 0.56, 0.49, 0.92). Most radiologists (80%) performed better with DBT than standard workup. Cancerous lesions on DBT appeared more severe (U = 33,172, p = 0.02) and conspicuous (U = 24,207, p = 0.02). There was a significant reduction in the need for additional views (χ2 = 17.63, p < 0.001) and recommendations for ultrasound (χ2 = 8.56, p = 0.003) with DBT. CONCLUSIONS: DBT has the potential to increase diagnostic accuracy and simplify the assessment process in the breast cancer assessment clinic. KEY POINTS: • Use of DBT in the assessment clinic results in increased diagnostic accuracy. • Use of DBT in the assessment clinic improves performance of radiologists and also increases the confidence in their decisions. • DBT may reduce the need for additional views, ultrasound imaging, and biopsy.

Efficient control of air pollution through plants, a cost-effective alternative: studies on Dalbergia sissoo Roxb.

Plants can be used as both passive biomonitors and biomitigators in urban and industrial environments to indicate the environmental quality and to ameliorate pollution level in a locality. Many studies reveal that plants are negatively affected by the ambient levels of air pollutants. The present study was conducted to evaluate the impact of air pollution on comparative basis with reference to changes in photosynthetic pigments, plant height, leaves, as well as, biochemical parameters of plants of different sites around Udaipur city receiving varying levels of pollution load. The investigated tree species Dalbergia sissoo Roxb. (Family: Fabaceae) exhibited a reduction in various physiological and biochemical growth parameters that correspond with air pollution levels at different sites. The tree species growing in polluted and control areas were compared with respect to foliar dust load, leaf area, and chlorophyll and total carbohydrate and total protein concentration in the leaves. Our studies suggest that D. sissoo Roxb. can successfully be grown in an area for monitoring air pollution, where it is mild and droughts are common. It will prove as an ideal tree species to control pollution effectively beside acting as a shade tree and being a source of food for birds and animals. By plantation of D. sissoo Roxb., mitigative measure at the polluted sites to control generation of particulate matter and the air quality required can be ensured. Our results also confirm that industrial and vehicular air pollution level in Udaipur city is shifting beyond limits.