Increased risk of death in community-dwelling older people with white matter hyperintensities on MRI.

Background: Previous studies in subjects with a history of stroke have shown that white matter hyperintensities (WMH) on MRI are associated with increased risk of death. However, it has not been determined whether WMH are independently related to death in community-dwelling older people without stroke.

Methods: In a sample of community-dwelling people over 75 years with no history of stroke or other neurological diseases, WMH on brain MRI T2-weighted sequences were classified as grade 0, grade 1, or grade 2.

Receiver operating characteristic analysis for the detection of simulated microcalcifications on mammograms using hardcopy images.

The aim of this study was to compare mammography systems based on three different detectors--a conventional screen-film (SF) combination, an a-Si/CsI flat-panel (FP)-based detector, and a charge-coupled device (CCD)-based x-ray phosphor-based detector--for their performance in detecting simulated microcalcifications (MCs). 112-150 microm calcium carbonate grains were used to simulate MCs and were overlapped with a slab phantom of simulated 50% adipose/50% glandular breast tissue-equivalent material referred to as the uniform background. For the tissue structure background, 200-250 microm calcium carbonate grains were used and overlapped with an anthropomorphic breast phantom.

Specimen radiography in confirmation of MRI-guided needle localization and surgical excision of breast lesions.

Objective: Confirmation of lesion retrieval after MRI-guided needle localization and surgical excision of breast lesions are difficult because the targeted lesion is not enhanced ex vivo. The aim of this study was to determine the feasibility of using specimen radiography to verify lesion removal after MRI-guided needle localization and surgical excision.

Conclusion: To our knowledge, our study was the first to examine the use of specimen radiography in the localization and excision of breast lesions.

BI-RADS-MRI: a primer.

Objective: Variations in breast MRI techniques and descriptions of morphologic findings led to the development of a breast MRI lexicon. This lexicon, the American College of Radiology's BI-RADS-MRI, includes terminology for describing lesion architecture and enhancement characteristics. We show the use of these descriptors on breast MR images obtained at our institution.

Imaging of breast cancer diagnosed and treated with chemotherapy during pregnancy.

Purpose: To retrospectively assess mammography, high-frequency-transducer ultrasonography (US), and color Doppler US for the initial and subsequent evaluation of breast cancer diagnosed and treated with chemotherapy during pregnancy.

Materials And Methods: A retrospective study of clinical records between January 1989 and December 2003 of women with breast cancer diagnosed and treated with chemotherapy during pregnancy was performed after waiver of informed consent was obtained. The study was approved by an institutional review board and was HIPAA compliant.

Sudden deafness as a sign of stroke with normal diffusion-weighted brain MRI.

Sudden deafness without associated neurological signs and symptoms is typically attributed to a viral inflammation of the labyrinth. Sudden deafness as a heralding manifestation of basilar occlusion has rarely been described. A 60-year-old male with hypertension presented with an acute onset of isolated sudden deafness with vertigo.

Visibility of simulated microcalcifications--a hardcopy-based comparison of three mammographic systems.

Full-field digital mammography systems are currently available for clinical use. These digital systems offer improved image quality, flexible image processing, display, storage, retrieval, and transmission. These systems employ a variety of different x-ray detectors based on storage phosphors (in computed radiography), charge-coupled devices (CCDs), or amorphous silicon flat panels (FPs).

Clinically relevant pneumonitis after sequential paclitaxel-based chemotherapy and radiotherapy in breast cancer patients.

Background: Taxane-based chemotherapy has been associated with an increased risk of radiation pneumonitis in patients with breast cancer. To obtain additional information about this association, we investigated the association between paclitaxel chemotherapy and radiation pneumonitis in patients participating in a phase III randomized study.

Methods: Five hundred and twenty-four breast cancer patients were prospectively and randomly assigned to receive either four cycles of paclitaxel followed by four cycles of 5-fluorouracil, doxorubicin, cyclophosphamide (FAC) or eight cycles of FAC.

Nursing-sensitive outcomes in cardiac surgery patients.

Achieving optimum patient outcomes has always been the primary focus of healthcare providers. The degree to which any healthcare discipline can impact outcomes varies since patient outcomes are multiple and diverse. As the measurement and reporting of outcomes has moved into the arena of public reporting, it has become essential for disciplines to be able to identify which outcomes they can either partially or completely influence.

Extramedullary relapse in a patient with acute promyelocytic leukemia: successful treatment with arsenic trioxide, all-trans retinoic acid and gemtuzumab ozogamicin therapies.

Acute promyelocytic leukemia (APL) is characterized by the presence of the t(15;17) translocation, resulting in the PML-RAR fusion protein. Standard treatment consists of the combination of all-trans retinoic acid (ATRA) with an anthracycline that results in complete remission (CR) rates in excess of 90%. Recently, several new agents have been shown to have clinical activity in APL.

Gene expression profiles predict complete pathologic response to neoadjuvant paclitaxel and fluorouracil, doxorubicin, and cyclophosphamide chemotherapy in breast cancer.

Purpose: The goal of this study was to examine the feasibility of developing a multigene predictor of pathologic complete response (pCR) to sequential weekly paclitaxel and fluorouracil + doxorubicin + cyclophosphamide (T/FAC) neoadjuvant chemotherapy regimen for breast cancer.

Patients And Methods: All patients underwent one-time pretreatment fine-needle aspiration to obtain RNA from the cancer for transcriptional profiling using cDNA arrays containing 30721 human sequence clones. Analysis was performed after profiling, and 42 patients' clinical results were available, 24 of which were used for predictive marker discovery; 18 patients' results were used as an independent validation set.

Needle localization for excisional biopsy of breast lesions: comparison of effect of use of full-field digital versus screen-film mammographic guidance on procedure time.

The time required to perform needle localization with full-field digital (FFD) mammography was compared with the time required to perform it with screen-film (SF) mammography in 158 women with breast lesions. The time needed to position the patient before the first image was acquired, needle placement time, and total procedure time were compared between techniques. Regression modeling was performed to assess the effect of mammographic guidance method while simultaneously adjusting for other significant covariates.

Change in tumor cellularity of breast carcinoma after neoadjuvant chemotherapy as a variable in the pathologic assessment of response.

Background: Complete pathologic response of breast carcinoma to neoadjuvant chemotherapy is a well defined outcome that correlates with prolonged survival. Categorization of incomplete response depends on accurate measurement of residual tumor size but is complicated by the variable histopathologic changes that occur within the tumor bed. In the current study, the authors investigated the contribution of assessing tumor cellularity in the pathologic evaluation of response to chemotherapy.