Nomogram based on multimodal ultrasound features for evaluating breast nonmass lesions: a single center study.

BACKGROUND: It is challenging to correctly identify and diagnose breast nonmass lesions. This study aimed to explore the multimodal ultrasound features associated with malignant breast nonmass lesions (NMLs), and evaluate their combined diagnostic performance. METHODS: This retrospective analysis was conducted on 573 breast NMLs, including 309 were benign and 264 were malignant, their multimodal ultrasound features (B-mode, color Doppler and strain elastography) were assessed by two experienced radiologists. Univariate and multivariate logistic regression analysises were used to explore multimodal ultrasound features associated with malignancy, and a nomogram was developed. Diagnostic performance and clinical utility were evaluated and validated by the receiver operating characteristic (ROC) curve, calibration curve and decision curve in the training and validation cohorts. RESULTS: Multimodal ultrasound features including linear (odds ratio [OR] = 4.69) or segmental distribution (OR = 7.67), posterior shadowing (OR = 3.14), calcification (OR = 7.40), hypovascularity (OR = 0.38), elasticity scored 4 (OR = 7.00) and 5 (OR = 15.77) were independent factors associated with malignant breast NMLs. The nomogram based on these features exhibited diagnostic performance in the training and validation cohorts were comparable to that of experienced radiologists, with superior specificity (89.4%, 89.5% vs. 81.2%) and positive predictive value (PPV) (89.2%, 90.4% vs. 82.4%). The nomogram also demonstrated good calibration in both training and validation cohorts (all P > 0.05). Decision curve analysis indicated that interventions guided by the nomogram would be beneficial across a wide range of threshold probabilities (0.05-1 in the training cohort and 0.05-0.93 in the validation cohort). CONCLUSIONS: The combined use of linear or segmental distribution, posterior shadowing, calcification, hypervascularity and high elasticity score, displayed as a nomogram, demonstrated satisfied diagnostic performance for malignant breast NMLs, which may contribute to the imaging interpretation and clinical management of tumors.

The effect of maternal voice and non-nutritional sucking on repeated procedural pain of heel prick in neonates: a quasi-experimental study.

BACKGROUND: Neonates in the neonatal intensive care unit undergo frequent painful procedures. It is essential to reduce pain using safe and feasible methods. PURPOSE: To evaluate the effects of non-nutritional sucking, mother's voice, or non-nutritional sucking combined with mother's voice on repeated procedural pain in hospitalized neonates. METHODS: A quasi-experimental study was conducted in which 141 neonates were selected in a hospital in Changsha, China. Newborns were divided into four groups: non-nutritional sucking (NNS) (n = 35), maternal voice (MV) (n = 35), NNS + MV (n = 34), and control (n = 37) groups. The Preterm Infant Pain Profile-Revised Scale (PIPP-R) was used to assess pain. RESULTS: During the heel prick, the heart rate value and blood oxygen saturation were significantly different between the groups (P < 0.05). Both non-nutritional sucking and maternal voice significantly reduced PIPP-R pain scores of hospitalized newborns (P < 0.05). The pain-relief effect was more robust in the combined group than in other groups. CONCLUSIONS: This study showed that both non-nutritional sucking and the mother's voice alleviated repeated procedural pain in neonates. Therefore, these interventions can be used as alternatives to reduce repeated procedural pain.

Placement of peripherally inserted central catheters in neonates: A retrospective study.

BACKGROUND: Peripherally inserted central catheters (PICCs) are commonly used in neonatal intensive care units for extended intravenous nutrition and therapy. The selection of PICCs insertion sites can significantly influence insertion outcomes and neonatal safety. AIM: This study aimed to determine the most suitable insertion site in the lower extremities for neonatal PICCs. STUDY DESIGN: A retrospective case note review was conducted on PICCs inserted through lower extremity (LE) sites in a 40-bed tertiary-level neonatal intensive care unit at a university teaching hospital. The dates when data were accessed for research purposes were from June 2019 to June 2022. In total, 223 neonates were identified as having had PICCs, with 254 catheters inserted in the lower extremities. The STROBE checklist guided the reporting of this study. RESULTS: Neonates underwent PICC insertion via the LE vein, with an overall complication rate of 13.4% and a one-attempt success rate of puncture of 86.2%. The rates of complications, catheter occlusion, and catheter-related infection in the PICC group with insertion through the great saphenous vein were significantly lower than those in the femoral vein group (p < .05). The success rate was significantly higher than that in the femoral vein group (p < .05). Additionally, the incidence of total complications and catheter occlusion complications with PICC insertion via the right LE was significantly lower than that with insertion via the left LE (p < .05). CONCLUSION: Our study suggested that, when feasible, the saphenous vein in the right LE could be the most suitable insertion site for neonatal PICCs. RELEVANCE TO CLINICAL PRACTICE: These findings provide insights into the complications, indwelling time, and safety of neonatal PICCs in different LE sites, serving as a valuable reference for clinical practice. This study was retrospective in nature, and all staff involved obtained approved access to patient clinical data. Ethical approval was granted by the Ethics Committee of Xiangya Hospital, Central South University (registry number 2022010001).

Value of multimodal imaging in the diagnosis of breast sclerosing adenosis associated with malignant lesions.

AIM: To explore the diagnostic value of multimodal imaging techniques, including automatic breast volume scanner (ABVS), mammography (MG), and magnetic resonance (MRI) in breast sclerosing adenosis (SA) associated with malignant lesions. METHODS: From January 2018 to October 2020, 76 patients (88 lesions) with pathologically confirmed as SA associated with malignant or benign lesions were retrospective analyzed. All patients completed ABVS examination, 58 patients (67 lesions) with MG and 50 patients (62 lesions) with MRI were also completed before biopsy or surgical excision, of which, six patients (eight lesions) diagnosed as Breast Imaging Reporting and Data System (BI-RADS) category 3 by all imaging examinations underwent surgical excision without biopsy, other 70 patients (80 lesions) with BI-RADS category 4 or above by any imaging examination completed biopsy, including 65 patients (75 lesions) were further surgical excised and the other five patients (five lesions) were just followed up. All lesions were retrospectively described and classified, and were divided into benign group and malignant group according to their pathological results. Image features of different examination methods between the two groups were compared and analyzed. A ROC curve was established using the sensitivity of BI-RADS categories to predict malignant lesions in different imaging techniques as the ordinate and 1-specificity as the abscissa. RESULTS: 88 lesions including 26 purely SA and 45 SA associated with benign lesions were classified as benign group, and the remaining 17 SA associated with malignant lesions were classified as malignant group. On ABVS, 40 mass lesions, their heterogeneous echo, not circumscribed margin and coronal convergence signs were statistically significant for malignant lesions (p < .05), but the remain 48 nonmass lesions lack specific sonographic features. On MG, 12 showed negative results, 55 showed with microcalcification, mass, structural distortion, and asymmetric density shadow, of which 11 lesions had the above two signs at the same time, but only microcalcification had statistical difference between the two groups. 35 mass enhanced lesions and 27 nonmass enhanced lesions on MRI, but there were no significant difference between their pathological results. Time signal intensity curves showed no differences, but ADC value <1.10 × 10-3  mm2 /s is more significant in malignant lesions (p < .05). The area under the ROC curve (AUC) of BI-RADS classification of ABVS, MG, and MRI in the diagnosis of malignant lesions were 0.611, 0.474, and 0.751, respectively, and the AUC of the combined diagnosis of the three was 0.761. CONCLUSION: Mass lesions with heterogeneous echo, not circumscribed margin and coronal convergence sign on ABVS, microcalcification on MG and the ADC value <1.10 × 10-3  mm2 /s on MRI are significant signs for SA associated with malignant lesions. The combined diagnosis of the three methods was the highest, and the following were MRI, ABVS, and MG. Therefore, be cognizant of significant characteristics in SA associated with malignancy showed in different imaging examinations can improve the preoperative evaluation of SA and better provide basis for subsequent clinical decision-making.

Efficiency and impact factors of anatomical intelligence for breast and hand-held ultrasound in lesion detection.

PURPOSE: To investigate the efficiency and impact factors of anatomical intelligence for breast (AI-Breast) and hand-held ultrasound (HHUS) in lesion detection. METHODS: A total of 172 outpatient women were randomly selected, underwent AI-Breast ultrasound (Group AI) once and HHUS twice. HHUS was performed by breast imaging radiologists (Group A) and general radiologists (Group B). For the AI-Breast examination, a trained technician performed the whole-breast scan and data acquisition, while other general radiologists performed image interpretation. The examination time and lesion detection rate were recorded. The impact factors for breast lesion detection, including breast cup size, number of lesions, and benign or malignant lesions were analyzed. RESULTS: The detection rates of Group AI, A, and B were 92.8 ± 17.0%, 95.0 ± 13.6%, and 85.0 ± 22.9%, respectively. Comparable lesion detection rates were observed in Group AI and Group A (P > 0.05), but a significantly lower lesion detection rate was observed in Group B compared to the other two (both P < 0.05). Regarding missed diagnosis rates of malignant lesions, comparable performance was observed in Group AI, Group A, and Group B (8% vs. 4% vs. 14%, all P > 0.05). Scan times of Groups AI, A, and B were 262.15 ± 40.4 s, 237.5 ± 110.3 s, 281.2 ± 86.1 s, respectively. The scan time of Group AI was significantly higher than Group A (P < 0.01), but was slightly lower than Group B (P > 0.05). We found a strong linear correlation between scan time and cup size in Group AI (r = 0.745). No impacts of cup size and number of lesions were found on the lesion detection rate in Group AI (P > 0.05). CONCLUSIONS: With the assist of AI-Breast system, the lesion detection rate of AI-Breast ultrasound was comparable to that of a breast imaging radiologist and superior to that of the general radiologist. AI-Breast ultrasound may be used as a potential approach for breast lesions surveillance.

The hidden breast lesions: A case report of bilateral breast cancer.

Bilateral breast cancer (BBC) is rare and is associated with an unfavorable prognosis. Consequently it is crucial to improve diagnostic performance of breast cancer in the clinical setting. We report a case of BBC in a 66-year-old woman and describe the imaging findings, including mammography, hand-held ultrasound, automated breast ultrasound, anatomical intelligence for breast ultrasound (AI-breast), and magnetic resonance imaging. Only AI-breast ultrasound successfully located the two tumors, while other imaging examinations failed to detect the tumor in the right breast.

Congenital thrombocytopenia associated with GNE mutations in twin sisters: a case report and literature review.

BACKGROUND: Neonatal thrombocytopenia is common in preterm and term neonates admitted to neonatal intensive care units. The etiology behind neonatal thrombocytopenia is complex. Inherited thrombocytopenia is rare and usually results from genetic mutations. CASE PRESENTATION: Here we report a case of twins with severe inherited thrombocytopenia presented in the neonatal period who were shown to be compound heterozygotes for 2 UDP-N-acetylglucosamine 2-epimerase (GNE) gene mutations, c.1351C > T and c.1330G > T, of which c.1330G > T is a novel mutation. CONCLUSION: These two GNE mutations may help in the diagnosis and management of thrombocytopenia diagnosed in neonates.

Selection of PICC catheter location in neonates via evidence-based ACE Star model. / 基于ACE Star循证模式选择新生儿经外周静脉穿刺的中心静脉导管置管部位.

OBJECTIVES: To explore the most suitable insertion site for neonatal placement of peripherally inserted central venous catheter (PICC) according to the evidence-based ACE Star model. METHODS: This study was carried out according to the evidence-based ACE Star model in 5 steps, including discovery research, evidence summary, guidelines translation, practice integration, and outcome evaluation. Based on the results of Meta-analysis, relevant guidelines, expert recommendations, clinical experience of nurses, and characteristics of neonates, the final recommendation was formed. A total of 87 neonates in a tertiary neonatal intensive care unit in Hunan Province were integrated into practice of PICC to evaluate the incidence of catheter-related complications and one-attempt success rate of puncture. RESULTS: The results of Meta-analysis showed that the incidence of complications of PICC in neonates via lower limb veins was significantly lower than that of upper limb veins (OR=0.83, 95% CI 0.75 to 0.92, P<0.05). The final result of guideline translation was that PICC should be performed first through lower limb veins if the lower limb vein before PICC catheterization was not damaged.The results of integrated practice showed that the incidence of complications of PICC via lower extremity vein was 17.24%. Compared with the left lower limb catheterization, the incidence of complications and the incidence of catheter blockage of the right lower limb catheterization were significantly lower (both P<0.05). Compared with femoral vein catheterization, one-attempt success rate of puncture via the saphenous vein catheterization was higher and the incidence of complications, the incidence of catheter blockage, and the incidence of infection were lower, with significant difference (all P<0.05). CONCLUSIONS: Saphenous vein in right lower limb could be the most suitable insertion site for neonatal PICC.

Diagnostic Performance of Automated Breast Ultrasound in Differentiating Benign and Malignant Breast Masses in Asymptomatic Women: A Comparison Study With Handheld Ultrasound.

OBJECTIVES: Our aim was to investigate the diagnostic potential of an automated breast ultrasound (ABUS) system in differentiating benign and malignant breast masses compared with handheld ultrasound (HHUS). METHODS: Women were randomly and proportionally selected from outpatients and underwent both HHUS and ABUS examinations. Masses with final American College of Radiology Breast Imaging Reporting and Data System categories 2 and 3 were considered benign. Masses with final Breast Imaging Reporting and Data System categories 4 and 5 were considered malignant. The diagnosis was confirmed by pathologic results or at least a 1-year follow-up. Automated breast US and HHUS were compared on the basis of their sensitivity, specificity, positive predictive value, negative predictive value, and accuracy. Diagnostic consistency and areas under the receiver operating characteristic curves were analyzed. The maximum diameters of masses were compared among HHUS, ABUS, and pathologic results. RESULTS: A total of 599 masses in 398 women were confirmed by pathologic results or at least a 1-year follow-up; 103 of 599 masses were malignant, and 496 were benign. There were no significant differences between ABUS and HHUS in terms of diagnostic accuracy (80.1% versus 80.6%), specificity (77.62% versus 80.24%), positive predictive value (46.12% versus 46.46%), and negative predictive value (97.96% versus 95.67%). There were significant differences in sensitivity (92.23% versus 82.52%; P < .01) and areas under the curve (0.85 versus 0.81; P < .05) between ABUS and HHUS. The correlation of the maximum diameter was slightly higher between ABUS and pathologic results (r = 0.885) than between HHUS and pathologic results (r = 0.855), but the difference was not significant (P > .05). CONCLUSIONS: Automated breast US is better than HHUS in differentiating benign and malignant breast masses, especially with respect to specificity.

[Clinical effect of maternal voice stimulation in alleviating procedural pain in hospitalized neonates].

OBJECTIVE: To study the clinical effect of maternal voice stimulation in alleviating procedural pain in neonates during heel blood collection. METHODS: A total of 72 neonates who were admitted to the neonate intensive care unit were randomly divided into an intervention group (n=35) and a control group (n=37). Heel blood collection was performed by the routine method in the control group. The intervention group listened to their mothers' voice from 1 minute before heel blood collection to the end of the procedure. Pain score, incidence of crying, and vital signs were recorded before and after heel blood collection. RESULTS: Compared with the control group, the heart rate was significantly reduced, the blood oxygen saturation significantly increased, the incidence of crying and the pain score were significantly reduced in the intervention group during the procedure of heel blood collection (P<0.05). CONCLUSIONS: Maternal voice stimulation helps to reduce procedural pain and maintain stable vital signs in neonates.

[Effect of placement of peripherally inserted central catheter via the upper versus lower extremity veins: a Meta analysis].

OBJECTIVE: To investigate the effect of placement of peripherally inserted central catheter (PICC) via the upper versus lower extremity veins in neonates through a Meta analysis. METHODS: CNKI, Wanfang Data, VIP Data, CBMdisc, PubMed, Web of Knowledge, Embase, Medline, Cochrane Library and Google Scholar were searched for control studies on the effect of PICC placement via the upper versus lower extremity veins in neonates. RevMan 5.3 was used to perform a Meta analysis of the studies which met the inclusion criteria. RESULTS: A total of 18 studies were included, among which there were 8 randomized controlled trials and 10 cohort studies, with 4 890 subjects in total. Compared with those undergoing PICC placement via the upper extremity veins, the neonates undergoing PICC placement via the lower extremity veins had significantly lower incidence rates of complications (RR=0.83, 95%CI: 0.75-0.92, P<0.05), catheter-related infections (RR=0.77, 95%CI: 0.60-0.99, P<0.05), catheter malposition (RR=0.28, 95%CI: 0.18-0.42, P<0.05), extravasation of the infusate (RR=0.52, 95%CI: 0.40-0.70, P<0.05), and unplanned extubation (RR=0.82, 95%CI: 0.69-0.98, P<0.05). They also had a significantly higher first-attempt success rate of puncture (RR=1.17, 95%CI: 1.05-1.30, P<0.05) and a significantly shorter PICC indwelling time (MD=-0.93, 95%CI: -1.26-0.60, P<0.05). CONCLUSIONS: The above evidence shows that PICC placement via the lower extremity veins has a better effect than PICC placement via the upper extremity veins in neonates.

A multicenter hospital-based diagnosis study of automated breast ultrasound system in detecting breast cancer among Chinese women.

OBJECTIVE: The automated breast ultrasound system (ABUS) is a potential method for breast cancer detection; however, its diagnostic performance remains unclear. We conducted a hospital-based multicenter diagnostic study to evaluate the clinical performance of the ABUS for breast cancer detection by comparing it to handheld ultrasound (HHUS) and mammography (MG). METHODS: Eligible participants underwent HHUS and ABUS testing; women aged 40-69 years additionally underwent MG. Images were interpreted using the Breast Imaging Reporting and Data System (BI-RADS). Women in the BI-RADS categories 1-2 were considered negative. Women classified as BI-RADS 3 underwent magnetic resonance imaging to distinguish true- and false-negative results. Core aspiration or surgical biopsy was performed in women classified as BI-RADS 4-5, followed by a pathological diagnosis. Kappa values and agreement rates were calculated between ABUS, HHUS and MG. RESULTS: A total of 1,973 women were included in the final analysis. Of these, 1,353 (68.6%) and 620 (31.4%) were classified as BI-RADS categories 1-3 and 4-5, respectively. In the older age group, the agreement rate and Kappa value between the ABUS and HHUS were 94.0% and 0.860 (P<0.001), respectively; they were 89.2% and 0.735 (P<0.001) between the ABUS and MG, respectively. Regarding consistency between imaging and pathology results, 78.6% of women classified as BI-RADS 4-5 based on the ABUS were diagnosed with precancerous lesions or cancer; which was 7.2% higher than that of women based on HHUS. For BI-RADS 1-2, the false-negative rates of the ABUS and HHUS were almost identical and were much lower than those of MG. CONCLUSIONS: We observed a good diagnostic reliability for the ABUS. Considering its performance for breast cancer detection in women with high-density breasts and its lower operator dependence, the ABUS is a promising option for breast cancer detection in China.

Catheter-related infection and pathogens of umbilical venous catheterization in a neonatal intensive care unit in China.

We studied the incidence of umbilical venous catheterization (UVC)-related infection and pathogens in a neonatal intensive care unit (NICU) in China. Patients were grouped into <2000-g UVC or <2000-g non-UVC groups or ≥2001-g UVC or ≥2001-g non-UVC groups. Blood culture and umbilical root skin swab culture were taken following UVC insertion and extraction. UVCs were removed after 7 days and cultures of UVC tips were performed then. A total of 516 patients were enrolled. The incidence of UVC-related septicemia was 9.5%. The incidence of UVC-related septicemia per 1000 UVC days was 13.6. No significant difference was noted between <2000-g UVC and <2000-g non-UVC groups and between ≥2001-g UVC group and ≥2001-g non-UVC groups, in the number of positive blood cultures and skin cultures, the percentage of catheter-related septicemia, the incidence of catheter-related septicemia per 1000 catheter days, and the increase in the number of positive cultures between two skin cultures following UVC insertion and extraction. The predominant pathogen in all cultures was gram-positive pathogens. Coagulase-negative Staphylococcus was the most frequently noted pathogen. UVC did not increase the incidence of catheter-related infection in the NICU. It is necessary to consider local pathogen spectrum when choosing antibiotic therapy before specific culture results become available.

Predicting the molecular subtypes of breast cancer using nomograms based on three-dimensional ultrasonography characteristics.

Background: Molecular subtyping of breast cancer is commonly doneforindividualzed cancer management because it may determines prognosis and treatment. Therefore, preoperativelyidentifying different molecular subtypes of breast cancery can be significant in clinical practice.Thisretrospective study aimed to investigate characteristic three-dimensional ultrasonographic imaging parameters of breast cancer that are associated with the molecular subtypes and establish nomograms to predict the molecular subtypes of breast cancers. Methods: A total of 309 patients diagnosed with breast cancer between January 2017and December 2019 were enrolled. Sonographic features were compared between the different molecular subtypes. A multinomial logistic regression model was developed, and nomograms were constructed based on this model. Results: The performance of the nomograms was evaluated in terms of discrimination and calibration.Variables such as maximum diameter, irregular shape, non-parallel growth, heterogeneous internal echo, enhanced posterior echo, lymph node metastasis, retraction phenomenon, calcification, and elasticity score were entered into the multinomial model.Three nomograms were constructed to visualize the final model. The probabilities of the different molecular subtypes could be calculated based on these nomograms. Based on the receiver operating characteristic curves of the model, the macro-and micro-areaunder the curve (AUC) were0.744, and 0.787. The AUC was 0.759, 0.683, 0.747 and 0.785 for luminal A(LA), luminal B(LB), human epidermal growth factor receptor 2-positive(HER2), and triple-negative(TN), respectively.The nomograms for the LA, HER2, and TN subtypes provided good calibration. Conclusions: Sonographic features such as calcification and posterior acoustic features were significantly associated with the molecular subtype of breast cancer. The presence of the retraction phenomenon was the most important predictor for the LA subtype. Nomograms to predict the molecular subtype were established, and the calibration curves and receiver operating characteristic curves proved that the models had good performance.

[Retracted] MicroRNA­138 inhibits migration and invasion of non­small cell lung cancer cells by targeting LIMK1.

Following the publication of this paper, it was drawn to the Editors' attention by a concerned reader that certain of the western blotting data shown in Figs. 3C and 5A were strikingly similar to data appearing in different form in another article by different authors, which had already been published elsewhere at the time of the present article's submission. Furthermore, cell Transwell assay data in the article (featured in Fig. 4B) were strikingly similar to data appearing in different form in other articles by different authors, which were either already under consideration for publication or had already been published elsewhere at the time of the present article's. Owing to the fact that the contentious data in the above article were either already under consideration for publication, or had already been published elsewhere, prior to its submission to Molecular Medicine Reports, the Editor has decided that this paper should be retracted from the Journal. The authors were asked for an explanation to account for these concerns, but the Editorial Office never received any reply. The Editor apologizes to the readership for any inconvenience caused. [the original article was published in Molecular Medicine Reports 14: 4422­4428, 2016; DOI: 10.3892/mmr.2016.5769].

[Umbilical venous catheterization related infection in the neonatal intensive care unit].

OBJECTIVE: To study the incidence and pathogens of umbilical venous catheterization (UVC) related infection in the neonatal intensive care unit (NICU). METHODS: A total of 112 neonates (birth weight 1,500 g) who received UVC within 24 hrs after birth were included. Blood culture was performed right after UVC. At 24 hrs and 1 week after UVC, umbilical skin scrub cultures were performed. Skin redness and swelling for more than 24 h, or severe abdominal distension, or poor general condition for unknown reason after UVC, or positive blood culture results, were the criteria for catheterization related infection. RESULTS: The incidence rate for UVC related infection was 8.9%. Total culture positive rate was 9.4%. At 24 hrs and 1 week after UVC, the umbilical skin scrub culture positive rate was 7.1% and 16.2%, respectively. Rate of Gram positive and Gram negative pathogens was 55.2% and 44.8%, respectively. Group B Streptococcus was main Gram positive pathogen. Klebsiella and E.coli were the main Gram negative pathogens. CONCLUSIONS: UVC is, to some extent, related to nosocomial infection in the NICU. Among UVC related infection, Gram positive and Gram negative pathogens take almost the chance.

Diagnostic Performance Using Automated Breast Ultrasound System for Breast Cancer in Chinese Women Aged 40 Years or Older: A Comparative Study.

The purpose of this study was to investigate the diagnostic performance of the automated breast ultrasound system (ABUS) compared with hand-held ultrasonography (HHUS) and mammography (MG) for breast cancer in women aged 40 y or older. A total of 594 breasts in 385 patients were enrolled in the study. HHUS, ABUS and MG exams were performed for these patients. Follow-up and pathologic findings were used as the reference standard. Based on the reference standard, 519 units were benign or normal and 75 were malignant. The sensitivity, specificity, accuracy and Youden index were 97.33%, 89.79%, 90.74% and 0.87 for HHUS; 90.67%, 92.49%, 92.26% and 0.83 for ABUS; 84.00%, 92.87%, 91.75% and 0.77 for MG, respectively. The specificity of ABUS was significantly superior to that of HHUS (p = 0.024). The area under the receiver operating characteristic curve was 0.936 for HHUS, which was the highest, followed by 0.916 for ABUS and 0.884 for MG. However, the difference was not statistically significant (p > 0.05). In conclusion, the diagnostic performance of ABUS for breast cancer was equivalent to HHUS and MG and potentially can be used as an alternative method for breast cancer diagnosis.

1000-Case Reader Study of Radiologists' Performance in Interpretation of Automated Breast Volume Scanner Images with a Computer-Aided Detection System.

The objective of our study was to assess, in a reader study, radiologists' performance in interpretation of automated breast volume scanner (ABVS) images with the aid of a computer-aided detection (CADe) system. Our study is a retrospective observer study with the purpose of investigating the effectiveness of using a CADe system as an aid for radiologists in interpretation of ABVS images. The multiple-reader, multiple-case study was designed to compare the diagnostic performance of radiologists with and without CADe. The study included 1000 cases selected from ABVS examinations in our institution in 2012. Among those cases were 206 malignant, 486 benign and 308 normal cases. The cancer cases were consecutive; the benign and normal cases were randomly selected. All malignant and benign cases were confirmed by biopsy or surgery, and normal cases were confirmed by 2-y follow-up. Reader performance was compared in terms of area under the receiver operating characteristic curve, sensitivity and specificity. Additionally, the reading time per case for each reader was recorded. Nine radiologists from our institution participated in the study. Three had more than 8 y of ultrasound experience and more than 4 y of ABVS experience (group A); 3 had more than 5 y of ultrasound experience (group B), and 3 had more than 1 y of ultrasound experience (group C). Both group B and group C had no ABVS experience. The CADe system used was the QVCAD System (QView Medical, Inc., Los Altos, CA, USA). It is designed to aid radiologists in searching for suspicious areas in ABVS images. CADe results are presented to the reader simultaneously with the ABVS images; that is, the radiologists read the ABVS images concurrently with the CADe results. The cases were randomly assigned for each reader into two equal-size groups, 1 and 2. Initially the readers read their group 1 cases with the aid of CADe and their group 2 cases without CADe. After a 1-mo washout period, they re-read their group 1 cases without CADe and their group 2 cases with CADe. The areas under the receiver operating characteristic curves of all readers were 0.784 for reading with CADe and 0.747 without CADe. Areas under the curves with and without CADe were 0.833 and 0.829 for group A, 0.757 and 0.696 for group B and 0.759 and 0.718 for group C. All differences in areas under the curve were statistically significant (p <0.05), except that for group A. The average reading time was 9.3% (p < < 0.05) faster with CADe for all readers. In summary, CADe improves radiologist performance with respect to both accuracy and reading time for the detection of breast cancer using the ABVS, with the greater benefit for those inexperienced with ABVS.

MicroRNA-138 inhibits migration and invasion of non-small cell lung cancer cells by targeting LIMK1.

MicroRNA (miR)-138 has previously been demonstrated to have a suppressive role in numerous types of human cancer, including non-small cell lung cancer (NSCLC). LIM domain kinase 1 (LIMK1) is a serine/threonine kinase that regulates actin polymerization via phosphorylation and inactivation of cofilin. Previous studies have reported that LIMK1 is associated with NSCLC; however, the underlying regulatory mechanism of LIMK1, and the association between LIMK1 and miR­138 in NSCLC cells, remains largely unknown. The present study aimed to reveal the regulatory roles of miR­138 and LIMK1 in NSCLC cell migration and invasion. Reverse transcription­quantitative polymerase chain reaction and western blot analysis were used to examine the mRNA and protein expression levels. Transwell and wound healing assays were conducted to determine cell invasion and migration. A luciferase reporter assay was used to determine the target association between miR­138 and LIMK1. The present study demonstrated that miR­138 was markedly downregulated in NSCLC tissues and cell lines, whereas the expression levels of LIMK1 were significantly upregulated. LIMK1 was further identified as a direct target of miR­138 in NSCLC H460 cells. Furthermore, overexpression of miR­138 significantly inhibited the protein expression of LIMK1, whereas knockdown of miR­138 upregulated the protein expression of LIMK1 in H460 cells. In addition, overexpression of miR­138 significantly inhibited the migration and invasion of NSCLC cells; however, overexpression of LIMK1 significantly promoted NSCLC cell migration and invasion. An investigation into the underlying molecular mechanism revealed that overexpression of miR­138 significantly decreased cofilin signaling activity, whereas knockdown of miR­138 notably enhanced cofilin signaling activity. In conclusion, the present study suggests that miR­138 may inhibit the migration and invasion of NSCLC cells by targeting the LIMK1/cofilin signaling pathway. Therefore, miR-138/LIMK1/cofilin may be considered a potential therapeutic target for the treatment of NSCLC.

Evaluation of automated breast volume scanner for breast conservation surgery in ductal carcinoma in situ.

The present is a retrospective study examining the use of automated breast volume scanner (ABVS) for guiding breast conservation surgery in ductal carcinoma in situ (DCIS). A total of 142 patients with pathologically confirmed DCIS were initially included in the study. The patients underwent preoperative examination by conventional ultrasound and by ABVS. The BI-RADS category system was used to identify benign and malignant lesions, after which breast conservation surgery was performed, and the therapeutic effects were compared. DCIS lesions were found in each quadrant of the breasts. Typical symptoms included: Duct ectasia and filling in 23 cases, mass (mainly solid, occasionally cystic, with or without calcification) in 38 cases, hypoechoic area (with or without calcification) in 33 cases, calcifications (simple) in 23 cases, and architectural distortion in 17 cases. In addition, 110 cases (82.1%) were detected as grade ≥4 according to the BI-RADS category, and 92 cases (68.7%) were considered malignant lesions following conventional ultrasound scanning. The detection rate of ABVS was significantly higher than that of conventional ultrasound (χ2=268.000, P<0.001). The average tumor diameter was 2.5±0.8 cm using ABVS and 2.0±0.9 cm using conventional ultrasound (the former being significantly higher than the latter; t=6.325, P=0.034). Eight patients (5.6%) had recurrences of the cancer, and the tumor diameter in the 8 patients was significantly larger using ABVS as compared to conventional ultrasound. In the diagnosis of DCIS, ABVS was superior to conventional ultrasound scanner in guiding breast conservation surgery and predicting recurrence. However, large-scale studies are required for confirmation of the findings.