Assessment of the correlation between supracrestal gingival tissue dimensions and other periodontal phenotypes components via the digital registration method: a cross­sectional study in a Chinese population.

BACKGROUND: Supracrestal gingival tissue dimensions (SGTDs) has been considered to be an essential element of periodontal phenotype (PP) components. This study aimed to explore the relationship between SGTDs and other PP components by digital superposition method that integrated cone beam computed tomography (CBCT) with intraoral scanning. METHODS: This cross-sectional study was conducted at the Stomatology Hospital of Fujian Medical University. Participants were recruited based on the inclusion and exclusion criteria. The data obtained from the digital scanner (TRIOS 3, 3Shape, Denmark) and CBCT images were imported into the TRIOS software (Implant Studio, 3Shape, Denmark) for computing relevant parameters. The significant level was set at 0.05. RESULTS: A total of 83 participants with 498 maxillary anterior teeth were finally included. The mean values of supracrestal gingival height (SGH) and the distance from the cementoenamel junction (CEJ) to the crest of the alveolar ridge (CEJ-ABC) on the buccal site were significantly higher than palatal SGH (SGH-p) and palatal CEJ-ABC (CEJ-ABC-p). Men exhibited taller CEJ-ABC and SGH-p than women. Additionally, tooth type was significantly associated with the SGH, SGH-p and CEJ-ABC-p. Taller SGH was associated with wider crown, smaller papilla height (PH), flatter gingival margin, thicker bone thickness (BT) and gingival thickness (GT) at CEJ, the alveolar bone crest (ABC), and 2 mm apical to the ABC. Smaller SGH-p displayed thicker BT and GT at CEJ, the ABC, and 2 and 4 mm apical to the ABC. Higher CEJ-ABC showed lower interproximal bone height, smaller PH, flatter gingival margin, thinner GT and BT at CEJ, and 2 mm apical to the ABC. Smaller CEJ-ABC-p displayed thicker BT at CEJ and 2 and 4 mm apical to the ABC. On the buccal, thicker GT was correlated with thicker BT at 2 and 4 mm below the ABC. CONCLUSION: SGTDs exhibited a correlation with other PP components, especially crown shape, gingival margin and interdental PH. The relationship between SGTDs and gingival and bone phenotypes depended on the apico-coronal level evaluated. TRIAL REGISTRATION: This study was approved by the Biomedical Research Ethics Committee of Stomatology Hospital of Fujian Medical University (approval no. 2023-24).

Imaging classification and BIRADS assessment of cystic breast lesions with pathologic correlates. a 5-year experience in Zaria, North West Nigeria.

Background: Breast cysts encompass a variety of pathologies, both benign and malignant. Therefore, classifying cysts into different categories is needful to develop a management algorithm. This study aimed to describe and distinguish between simple, complicated and complex cysts; and compare the final BIRADS assessment with pathologic findings. Materials and methods: A 5-year retrospective review of our ultrasound database identified two hundred and seventy patients with cystic breast lesions. They were divided into simple, complicated and complex cysts according to ultrasound characteristics based on shape, orientation, margin, wall thickness, internal features (echogenicity, septa, mass) posterior acoustic features, surrounding tissue vascularity. The final BIRADS assessment was correlated with histological findings. Results: There were two hundred and sixty-six (98.5%) females and four (1.5%) males with a mean age 34.9 ± 11.8 years. The commonest presentation was a palpable mass, in 70% of the patients. There were 89 (33.0%) simple cysts, 61 (22.6%) complicated cysts and 120 (44.4%) complex cysts. Conclusion: Majority of the breast cysts (83%) were benign with overall 17% incidence of malignancy. Complex cysts were the most frequent cyst type in our study, it is also the category most frequently associated with breast cancer, obviating the need for histology.

Birads 3: correlacion histopatologica de bajo potencial de malignidad, con conglomerados quisticos imagenologicos en pacientes de tegucigalpa / Birads 3: correlation of low histopathological potential for malignancy with breast clustered microcysts in patients from tegucigalpa

La categoría 3 del Breast Imaging Reporting and Data System (BIRADS) son hallazgos probablemente benignos y en menos del 2% de estos existe la posibilidad de carcinoma. El establecimiento de esta categoría precisa la realización de pruebas complementarias de imagen que incluye: proyecciones mamográficas adicionales, la ecografía, comparar las imágenes actuales con los estudios previos de la paciente y en casos especiales se recurre a la biopsia. Dentro de esta categoría se incluyen los conglomerados quísticos en los que se centró este estudio. Objetivo: Correlacionar hallazgos ecográficos y mamográficos, con estudio histopatológico de lesiones categorizadas como conglomerados quísticos (en imagenología). Población y Métodos: Pacientes que acuden al Hospital de Especialidades del Instituto Hondureño de Seguridad Social a quienes se les realizó mamografía y ecografía categorizadas como BIRADS 3 a las cuales se les confirmó diagnóstico mediante biopsia. Resultados: De las pacientes categorizadas BI-RADS 3, a 55(100%) se les realizó biopsia, el reporte histopatológico corroboró patología benigna en 55(100%) y no se encontró patología maligna. Discusión: Los conglomerados quísticos de mama son relativamente comunes, observados en ecografía en el 5,8% de los casos, ecográficamente, se observa un nódulo circunscrito, microlobulado u oval, compuesto de múltiples quistes pequeños adyacentes separados por tabiques delgados. Se encuentra generalmente como hallazgo incidental en mamografía, ecografía o en ambos.

Category 3 of the Breast Imaging Reporting and Data System (BIRADS) are probably benign findings and in less than 2% of these there is the possibility of carcinoma. The establishment of this category requires the performance of complementary imaging tests that include: additional mammographic projections, ultrasound, compare current images with previous studies of the patient and in special cases, biopsy is used. This category includes the cystic conglomerates that this study focused on. Objective: To correlate ultrasound and mammographic findings, with histopathological study of lesions categorized as cystic conglomerates (in imaging). Population and Methods: Patients who attend the Specialties Hospital of the Honduran Social Security Institute, who underwent mammography and ultrasound categorized as BIRADS 3, which were confirmed by biopsy. Results: Of the patients categorized BI-RADS 3, to 55 (100%) a biopsy was performed, the histopathological report corroborated benign pathology in 55 (100%) and no malignant pathology was found. Discussion: The breast cystic conglomerates are relatively common, observed in ultrasound in 5.8% of cases, ultrasound, we can observe a circumscribed, microlobulated or oval nodule, composed of multiple small adjacent cysts separated by thin septa. It is usually found as an incidental finding on mammography, ultrasound or both.

Appearance of breast cysts in planar geometry photoacoustic mammography using 1064-nm excitation.

In the search for improved imaging modalities for detection and diagnosis of breast cancer, a high negative prediction value is also important. Photoacoustic (optoacoustic) imaging is a relatively new technique that has high potential for visualizing breast malignancies, but little is known about the photoacoustic appearance of benign lesions. In this work, we investigate the visibility of benign breast cysts in forward-mode photoacoustic mammography using 1064-nm light, as currently applied in the Twente photoacoustic mammoscope. Results from (Monte Carlo and k-wave) simulations and phantom measurements were used to interpret results from patient measurements. There was a strong agreement among the results from simulations, phantom, and patient measurements. Depending on the absorption contrast between cyst and breast tissue, cysts were visible as either one or two confined high-contrast areas representing the front and the back of the cyst, respectively. This edge enhancement is most likely the consequence of the local sudden change in the absorbed energy density and Grüneisen coefficients. Although the current forward-mode single-wavelength photoacoustic mammoscope cannot always unambiguously discriminate cysts from malignancies, this study reveals specific features of cysts compared to malignancies, which can be exploited for discrimination of the two abnormalities in future modifications of the imager.

Slip imaging: reducing ambiguity in breast lesion assessment.

Ultrasound elasticity imaging (elastography) is gaining popularity as an adjunct to B-mode ultrasound for breast cancer diagnosis. Cancerous masses are usually stiffer than normal tissue, hence, using elasticity imaging should lead to better differentiation between benign and malignant masses than using B-mode alone. Clinicians assess the mobility of masses on palpation; cancers usually being less mobile. We introduce a method to estimate mobility, called slip imaging and combine it with conventional B-mode and elasticity data. In the reported evaluation on 70 women recalled to a breast assessment clinic, images were scored by three breast radiologists independently. Diagnostic accuracy increased from 75.7% with B-mode alone, to 78.1% when including elasticity imaging, to 80.0% when further including slip imaging. Specificity increased (74.6%:75.4%:82.5% respectively), with an apparent trade-off in sensitivity (77.1%:81.3%:77.1%). We conclude that Slip imaging is potentially a useful adjunct to B-mode and elasticity imaging and should undergo further research and development.

Evaluación de los quistes complejos de mama / Assessment of the complex breast cysts

Detalles que deben tenerse en cuenta al realizar estudios ecográficos de las lesiones quísticas, especialmente en su visualización y en la interpretación diagnóstica: forma, pared, contenido, tabiques internos, formaciones intraquísticas, y artefactos...

Quantitative assessment of breast lesion viscoelasticity: initial clinical results using supersonic shear imaging.

This paper presents an initial clinical evaluation of in vivo elastography for breast lesion imaging using the concept of supersonic shear imaging. This technique is based on the combination of a radiation force induced in tissue by an ultrasonic beam and an ultrafast imaging sequence capable of catching in real time the propagation of the resulting shear waves. The local shear wave velocity is recovered using a time-offlight technique and enables the 2-D mapping of shear elasticity. This imaging modality is implemented on a conventional linear probe driven by a dedicated ultrafast echographic device. Consequently, it can be performed during a standard echographic examination. The clinical investigation was performed on 15 patients, which corresponded to 15 lesions (4 cases BI-RADS 3, 7 cases BI-RADS 4 and 4 cases BI-RADS 5). The ability of the supersonic shear imaging technique to provide a quantitative and local estimation of the shear modulus of abnormalities with a millimetric resolution is illustrated on several malignant (invasive ductal and lobular carcinoma) and benign cases (fibrocystic changes and viscous cysts). In the investigated cases, malignant lesions were found to be significantly different from benign solid lesions with respect to their elasticity values. Cystic lesions have shown no shear wave propagate at all in the lesion (because shear waves do not propage in liquid). These preliminary clinical results directly demonstrate the clinical feasibility of this new elastography technique in providing quantitative assessment of relative stiffness of breast tissues. This technique of evaluating tissue elasticity gives valuable information that is complementary to the B-mode morphologic information. More extensive studies are necessary to validate the assumption that this new mode potentially helps the physician in both false-positive and false-negative rejection.

Accuracy of segmentation of a commercial computer-aided detection system for mammography.

PURPOSE: To assess the accuracy of segmentation in a commercially available computer-aided detection (CAD) system. MATERIALS AND METHODS: Approval for this study was obtained from the authors' institutional review board. Informed consent was not required by the board for this review, as data were stripped of patient identifiers. Two thousand twenty mammograms from 507 women were analyzed with the hardware and software of a commercial CAD system. The accuracy of the segmentation process was determined semiquantitatively and categorized as near perfect if the skin line of the breast was accurately detected, acceptable if only subcutaneous fat was excluded, or unacceptable if any breast parenchyma was excluded from consideration. The accuracy of segmentation was compared for different breast densities and film sizes by using logistic regression (P < .05). RESULTS: Overall, segmentation was near perfect or acceptable in almost 96.8% of images. However, segmentation defects were significantly more common in mammograms with heterogeneously dense breast tissue (8% unacceptable) than in those with fatty replaced (0% unacceptable), scattered (1.2% unacceptable), or extremely dense (1.8% unacceptable) breast parenchyma (P < .05). For images with unacceptable segmentation, the average percentage of breast parenchyma excluded was almost 25% (range, 5%-100%), with no significant differences among breast densities. CONCLUSION: For one commercial CAD system, segmentation was usually near perfect or acceptable but was unacceptable more than five times more frequently for mammograms of breasts with heterogeneously dense parenchyma than for those with all other breast densities. On average, one-quarter of the breast parenchyma was excluded from CAD analysis for images with unacceptable segmentation.