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Ueno E.,Tsukuba Medical Center Foundation | Tohno E.,Total Health Evaluation Center Tsukuba | Morishima I.,Tsukuba Medical Center Foundation | Umemoto T.,Tsukuba Medical Center Foundation | Waki K.,Hitachi Ltd.
Journal of Medical Ultrasonics | Year: 2015

Objectives: The objectives of this study were to demonstrate the non-inferiority of assist strain ratio (ASR)—a newly developed application tool—to manual strain ratio (MSR)—a currently available standard diagnostic tool—and to calculate the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of MSR and ASR. Methods: Ninety-eight mass lesions in the mammary gland (30 malignant and 68 benign) were included in the study. Skilled physicians performed the elastography scanning by applying minimal vibration. MSRs were obtained and compared with ASRs calculated from the same elastography image to test the correlation between the two groups of data. Results: Diagnostic performance of MSR at a cut-off of 5.0 showed a sensitivity of 84.4 %, a specificity of 80.4 %, an accuracy of 81.6 %, a PPV of 65.5 %, and an NPV of 92.1 %. Diagnostic performance of ASR at a cut-off of 5.0 showed a sensitivity of 74.4 %, a specificity of 84.3 %, an accuracy of 81.3 %, a PPV of 67.7 %, and an NPV of 88.2 %. The areas under the curve (AUCs) for MSR and ASR were found to be 0.885 and 0.875, respectively. Conclusion: ASR demonstrated excellent diagnostic potential and was highly correlated with MSR performed by skilled physicians (r = 0.69, p < 0.05). © 2015, The Japan Society of Ultrasonics in Medicine.

Tanaka Y.,Tsukuba Medical Center Hospital | Tanaka Y.,Kobe University | Uchida A.,Tsukuba Medical Center Hospital | Umemoto T.,Tsukuba Medical Center Hospital | And 4 more authors.
Journal of Medical Ultrasonics | Year: 2015

Angiosarcoma of the breast is a rare disease, and approximately 1 % of all affected patients are treated with breast-conserving therapy (BCT) and radiotherapy (RT) for primary breast cancer. The prognosis for this tumor is quite dismal, with high rates of recurrence and poor overall survival. This report presents the case of a 73-year-old female who underwent BCT followed by RT for left breast carcinoma 18 years previously. The patient visited the hospital with a complaint of a new mass in the left breast. The lesion initially decreased in size; however, it subsequently began to rapidly enlarge. A core needle biopsy of the mass was performed under ultrasonography, with a diagnosis of a spindle cell sarcoma, most conceivably an angiosarcoma, originating from the left breast, suspected to be induced by RT. The tumor was resected with the surrounding skin, and immunohistochemically diagnosed as angiosarcoma of the left breast, without evidence of breast cancer in any lesion, suggesting that RT induced the tumor formation. We herein report this rare case and the ultrasound imaging findings. © 2014, The Japan Society of Ultrasonics in Medicine.

Tohno E.,Total Health Evaluation Center Tsukuba | Umemoto T.,Tsukuba Medical Center Hospital | Sasaki K.,Tsukuba Medical Center Hospital | Morishima I.,Tsukuba Medical Center Hospital | Ueno E.,Tsukuba Medical Center Hospital
European Journal of Radiology | Year: 2013

Purpose: To determine whether adding screening ultrasonography to screening mammography can reduce patient recall rates and increase cancer detection rates. Materials and methods: We analyzed the results of mammography and ultrasonography breast screenings performed at the Total Health Evaluation Center Tsukuba, Japan, between April 2011 and March 2012. We also reviewed the modalities and results of diagnostic examinations from women with mammographic abnormalities who visited the Tsukuba Medical Center Hospital for further testing. Results: Of 11,753 women screened, cancer was diagnosed in 10 (0.22%) of the 4529 participants who underwent mammography alone, 23 (0.37%) of the 6250 participants who underwent ultrasonography alone, and 5 (0.51%) of the 974 participants who underwent mammography and ultrasonography. The recall rate due to mammographic abnormalities was 4.9% for women screened only with mammography and 2.6% for those screened with both modalities. The cancer detection rate was 0.22% for women screened only with mammography (positive predictive value, 4.5%) and 0.31% for those screened with both modalities (positive predictive value, 12.0%). Of the 211 lesions presenting as mammographic abnormalities investigated further, diagnostic ultrasonography found no abnormalities in 63 (29.9%) and benign findings in 69 (33.7%). The rest 36.4% needed mammography, cytological or histological examinations or follow-up in addition to diagnostic ultrasonography. Conclusions: It is possible to reduce the recall rate in screening mammography by combining mammography and ultrasonography for breast screening. © 2013 Elsevier Ireland Ltd.

Kaoku S.,Kyoto Prefectural University of Medicine | Konishi E.,Kyoto Prefectural University of Medicine | Fujimoto Y.,Tachibana Hospital | Tohno E.,Total Health Evaluation Center Tsukuba | And 6 more authors.
Ultrasound in Medicine and Biology | Year: 2013

The aims of this study were to elucidate sonographic and histologic features of pure mucinous carcinoma (P-MC) of the breast using quantitative analysis and to evaluate the relationship between quantitative analysis and visual qualitative assessment. Eleven P-MCs (nine patients) were evaluated qualitatively and quantitatively. Three experts assessed these sonographic images using the Breast Imaging Reporting and Data System (BI-RADS) lexicon. For assessment of internal echoes and posterior echoes, quantitative measures were determined using ImageJ software. Histologic thin sections were stained for classification into separate parts of the tumor (stroma, mucin and cancer cells) and were digitized. Internal echoes were isoechoic in 7 of 11 (63.6%) tumors and hypoechoic in 4 of 11 (36.4%); all P-MCs were " enhanced" in qualitative evaluation. As internal echoes increased, the proportion of stroma increased and that of mucin decreased. The high level of internal echoes is correlated with reflection and back-scattering, which are caused mainly by the interface between mucin and stroma. © 2013 World Federation for Ultrasound in Medicine & Biology.

Ueki R.,University of Tsukuba | Ichikawa M.,University of Tsukuba | Hiranuma Y.,Total Health Evaluation Center Tsukuba | Naito T.,Total Health Evaluation Center Tsukuba | And 3 more authors.
Diabetology International | Year: 2014

Objective: Whereas many people at high risk of developing type 2 diabetes are detected through screening in a Japanese healthcare setting, they do not necessarily seek primary care for diagnosis and treatment in the early stages of the disease. This study aimed to identify the most effective health communication method for the diabetes screening report to encourage primary care consultation. Methods: This facility-based cohort study involved 1,128 Japanese participants identified from the routine diabetes screening database from 2003 to 2009 who were considered to be at high risk of type 2 diabetes. Multiple logistic regression analyses were performed to estimate the relative effectiveness of the health communication method-a letter or an interview-regarding the likelihood of seeking primary care. The study controlled for sex, age, family history of diabetes, perceived symptoms, recommendation for diabetes care, undergoing treatment for other diseases, detection of comorbidity, request for referral to a specialist, and counseling by a public health nurse or dietician after screening. Results: The proportion of participants who sought primary care after screening was 7 %. Those who received feedback on diabetes screening via physician interview were more likely to seek primary care consultation (odds ratio 2.6, 95 % confidence interval 1.2-5.6). Conclusion: Health communication in the form of an interview with a physician after diabetes screening may encourage people at high risk of type 2 diabetes to seek primary care, yet very few seek primary care in the early stage of the disease. Therefore, more effective communication methods are needed. © 2013 The Japan Diabetes Society.

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