Usefulness of color Doppler and strain elastography adjunctive to B-mode ultrasonography in the diagnosis of non-mass abnormalities of the breast: results of the BC-07 multicenter study of 385 cases.

PURPOSE: The concept of non-mass abnormalities of the breast has been employed in Japan for approximately 20 years. Although B-mode findings are classified as non-mass abnormalities, the usefulness of adding color Doppler ultrasonography (US) and strain elastography to B-mode US is unclear. Therefore, we conducted a multicenter study (JABTS BC-07) to establish the diagnostic criteria for breast US, including color Doppler and elastography, for non-mass abnormalities of the breast and verify their diagnostic usefulness. METHODS: We registered US images of non-mass abnormalities of the breast and their clinical and histopathological data from 13 institutions (202 malignant and 183 benign non-mass lesions). Furthermore, we evaluated the centralized image interpretation usefulness of the diagnostic criteria for B-mode and color Doppler US, as well as the sensitivity and specificity when color Doppler US and elastography were added to B-mode US. RESULTS: Echogenic foci in the mammary gland (odds ratio 3.45, 95% confidence interval [CI] 1.92-6.19, p < 0.0001) and the configuration of internal solid components of the ducts (odds ratio 0.056, 95% CI 0.005-0.591, p < 0.0165) significantly differentiated benign and malignant non-mass abnormalities. The sensitivity of B-mode alone (83.7%) was significantly improved by adding color Doppler US (93.1%) (p = 0.0004); however, adding color Doppler US and elastography to B-mode US made no significant difference in either sensitivity or specificity. CONCLUSION: Although adding color Doppler US and elastography to B-mode US improved sensitivity, the diagnostic significance was limited. Therefore, a comprehensive diagnostic method comprising mammography and magnetic resonance imaging is warranted.

Utility of B-Mode, Color Doppler and Elastography in the Diagnosis of Breast Cancer: Results of the CD-CONFIRM Multicenter Study of 1351 Breast Solid Masses.

The usefulness of color Doppler ultrasound (CD) in distinguishing between benign and malignant breast lesions remains controversial. Our prior study, the Japan Association of Breast and Thyroid Sonology (JABTS) BC-04 study (malignant: 839, benign: 569), found CD was useful in breast cancer diagnosis, and we developed CD diagnostic criteria. The first aim of the current study (the CD-CONFIRM study) was to evaluate the usefulness of the CD diagnostic criteria. The second aim was to evaluate the relationship between CD and elastography. We evaluated ultrasound images of breast masses from 13 institutions (malignant: 639, benign: 712). While the sensitivity of B-mode alone was very high and was not significantly improved with CD, the specificity was significantly improved with CD (61.2%-69.2%, p < 0.0001). Furthermore, the specificity of the combination of B-mode and CD improved significantly with the addition of elastography (72.8%-79.0%, p < 0.0001). This study found that the CD criteria are useful, and CD and elastography are independent.

Verification of recall criteria for masses detected on ultrasound breast cancer screening.

PURPOSE: Mammography is the only modality for breast cancer screening demonstrated to reduce the mortality rate. However, ultrasonographic screening is already being widely performed as opportunistic screening in Japan. The recall criteria for masses are very important as quality controls. The purpose of this study was to verify these criteria at multiple institutions. METHODS: Screening was performed by five institutions in various regions in Japan. The total number of cases screened at all five institutions was 10,519. RESULTS: The findings that could be concluded to be benign were a cystic pattern and three features of a solid pattern. The cystic pattern was noted in 6512 cases, typical fibroadenoma in 1483 cases, and typical complicated cyst in 70 cases. Only three of these 8065 cases were cancers, so the negative predictive value was 99.9%. The solid pattern with obvious malignant features, i.e., masses with an echogenic halo and/or interruption of the interface and masses with multiple echogenic foci, were noted in 33 cases. Twenty of the 33 cases were malignancy, resulting in a positive predictive value of 66.7%. CONCLUSION: Although some parts of the criteria should be considered further for verification and revision, the current recall criteria are mostly valid.

Fabrication of arrays of sub-20-nm silica walls via photolithography and solution-based molecular coating.

We report herein fabrication of arrays of sub-20-nm silica walls via photolithography and the surface sol-gel process. A photolithographically fabricated line template on a silicon wafer was coated with a silica nanolayer using the surface sol-gel process, and then the topmost portion of the silica layer and the template were successively removed using CHF(3) and oxygen plasma, respectively, leaving the sidewalls of the silica layers remaining on the substrate. These walls were fully self-supporting, and the thicknesses of silica wall were 6, 8, and 12 nm at 20, 30, and 60 cycles, respectively. The height/width ratio of the wall was 38 at the 30-cycle coating. This ratio is surprisingly high when compared to that of the conventional photolithography processes. Successive formation of the silica, polymer, and silica layers yielded a trilayer sidewall, and the spacer polymer layer could be selectively removed to form a doubled sidewall. Size reduction and proliferation of sub-20-nm silica wall was thus achieved. The reported method is simple and cost-efficient and opens a gateway to further miniaturization of nanostructures.

Nanocopying of individual DNA strands and formation of the corresponding surface pattern of titania nanotube.

Titania nanotube was prepared by nanocopying of the individual DNA double strand as template. DNA was first spread on a solid substrate, and its molecular surface was coated with an ultrathin titania layer by 3 cycles of the surface sol-gel process. Fluorescence microscopic images before and after titania coating of the DNA/YOYO-1 complex were essentially identical, showing that the titania coating did not change the chemical properties of the complex. Titania coating effectively prohibited chemical degradation of titania-coated DNA with DNase I and physically separated the DNA strand from the surrounding environment with an ultrathin titania barrier. The morphology of the DNA strand was preserved, as confirmed by microscopic and spectroscopic observations. The presence of the hollow (tubular) structure was confirmed by a silver staining experiment coupled with scanning transmission electron microscopy-energy-dispersive X-ray spectroscopy (STEM-EDX) analysis. The present finding shows the effectiveness of nanocopying of the individual DNA strand.