The Adjunct Screening With Tomosynthesis or Ultrasound in Women With Mammography-Negative Dense Breasts' interim analysis shows that ultrasound has better incremental BC detection than tomosynthesis in mammography-negative dense breasts at a similar FP-recall rate. However, future application of adjunct screening should consider that tomosynthesis detected more than 50% of the additional BCs in these women and could potentially be the primary screening modality.
Although breast density is considered a strong predictor of breast cancer risk, its quantitative assessment is difficult. The aim of this study is to demonstrate that breast density assessment with a fully automated software is feasible and correlates with the semi-automated evaluation and the quantitative BI-RADS standards. A data set of 160 mammograms was evaluated by three blinded radiologists. Intra-observer (reader 1: k=0.71; reader 2: k=0.76; reader 3: k=0.62) and inter-observer (reader 1 vs reader 2: k=0.72; reader 2 vs reader 3: k=0.80; reader 3 vs reader 1: k=0.72) variability for the semi-automated software were good on a four-grade scale (D1/D2/D3/D4) and correlated with BI-RADS evaluation made by other two blinded radiologists (r=0.65, p<0.01). Inter-observer (reader 1 vs reader 2: k=0.85; reader 2 vs reader 3: k=0.91; reader 3 vs reader 1: k=0.85) variability for the semi-automated software was very good on a two-grade scale (D1-D2/D3-D4). The use of the fully automated software eliminated intra- and inter-observer differences, correlated with BI-RADS categories (r=0.62, p<0.01) and can replace the semi-automated one (Bland-Altman statistics). Our study demonstrates that automated estimation of breast density is feasible and eliminates subjectivity. Furthermore both the semi-automated and the fully automated density estimation are more accurate than BI-RADS quantitative evaluation and could also be used in the daily clinical practice.
Computerized BPE quantitative evaluation is feasible with both semi-automatic and automatic software. Computerized BPE quantitative scores correlate with radiologists' estimation.
The purpose of this study was to verify whether it is possible to use insulin glargine (Lantus) subcutaneously in patients receiving artificial nutrition (AN) and if the analogue is capable of obtaining and maintaining good glycaemic control without inducing hypoglycaemia. The sample considers 25 patients receiving AN, diagnosed diabetics and non-diabetics, who had previously been prescribed traditional insulin therapy. All were to be given subcutaneous insulin glargine at a dosage equal to the average of insulin/day administered in the preceding days spent receiving AN. Twenty-five consecutive patients, not stratified in any way, were judged eligible in the last six months of 2004 and first two months of 2005. Four out of these 25 could not be evaluated, either because they did not begin or complete the treatment with Lantus (3/4) or because the proper number of glycaemic tests were not carried out (1/4); 21/25 patients, 84% of the sample with a mean age of 68.7 years (range 46-91 years), finished the study and could be evaluated. The mean glycaemic values after treatment with glargine were already better on the second day, and on the seventh day the difference was statistically significant. No hypoglycaemia requiring medical intervention occurred. This study confirms the possibility of using insulin glargine in patients receiving AN with hyperglycaemia regardless of the type of nutrition and whether or not the patient is diabetic.
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