Digital Dermoscopy Photographs Outperform Handheld Dermoscopy in Melanoma Diagnosis

2016 ◽  
Vol 20 (6) ◽  
pp. 602-605 ◽  
Author(s):  
Danielle Mintsoulis ◽  
Jennifer Beecker
Keyword(s):  
High Risk ◽  
Medical Records ◽  
Ottawa Hospital ◽  
Melanoma Diagnosis ◽  
Pigmented Lesion ◽  
Clinical Advantage ◽  
The Difference ◽  
Total Body ◽  
Digital Dermoscopy

Background: Pigmented lesion clinics (PLCs) that use technology such as digital dermoscopy and total-body photography are thought to confer a clinical advantage for patients at high risk of developing melanoma over general dermatology clinics (GDCs) with regular dermoscopy. Objective: To examine the difference between depths of melanomas diagnosed in a PLC and a GDC. Methods: Medical records from 257 patients at the PLC at The Ottawa Hospital and 441 patients from a GDC were reviewed. Results: Invasive melanoma was less frequent than in situ melanoma at the PLC (7.14% vs 38.27%; P = .02). The average Breslow depth for melanomas at the PLC was also smaller compared with the GDC (0.0371 vs 0.3450 mm; P = .02). Conclusions: The use of digital dermoscopy and total-body photography together in a PLC appears to be an effective way to monitor patients at high risk of melanoma.

scholarly journals Evaluation of the efficacy of 3D total-body photography with sequential digital dermoscopy in a high-risk melanoma cohort: protocol for a randomised controlled trial

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e032969 ◽  
Author(s):  
Clare Amy Primiero ◽  
Aideen M McInerney-Leo ◽  
Brigid Betz-Stablein ◽  
David C Whiteman ◽  
Louisa Gordon ◽  
...  
Keyword(s):  
High Risk ◽  
Controlled Trial ◽  
Clinical Care ◽  
Melanoma Risk ◽  
Surveillance Programme ◽  
High Risk Melanoma ◽  
Risk Melanoma ◽  
Total Body ◽  
Randomised Controlled ◽  
Digital Dermoscopy

IntroductionMelanoma is Australia’s fourth most common cancer. Early detection is fundamental in maximising health outcomes and minimising treatment costs. To date, population-based screening programmes have not been justified in health economic studies. However, a skin surveillance approach targeting high-risk individuals could improve the cost-benefit ratio.Methods and analysisThis paper describes a 2-year longitudinal randomised controlled trial (RCT) to compare routine clinical care (control) with an intensive skin surveillance programme (intervention) consisting of novel three-dimensional (3D) total-body photography (TBP), sequential digital dermoscopy and melanoma-risk stratification, in a high-risk melanoma cohort. Primary outcomes will evaluate clinical, economic and consumer impact of the intervention. Clinical outcomes will evaluate differences in the rate of lesion excisions/biopsies per person, benign to malignant ratio for excisions and thickness of melanomas diagnosed. A health economic analysis using government data repositories will capture healthcare utilisation and costs relating to skin surveillance. Consumer questionnaires will examine intervention acceptability, the psychological impact, and attitudes towards melanoma risk and sun protective behaviour. Secondary outcomes include the development of a holistic risk algorithm incorporating clinical, phenotypic and genetic factors to facilitate the identification of those most likely to benefit from this surveillance approach. Furthermore, the feasibility of integrating the intervention with teledermatology to enhance specialist care in remote locations will be evaluated. This will be the first RCT to compare a targeted surveillance programme utilising new 3D TBP technology against current routine clinical care for individuals at high risk of melanoma.Ethics and disseminationThis study has received Human Research Ethics Committee (HREC) approval from both Metro South Health HREC (HREC/17/QPAH/816) and The University of Queensland HREC (2018000074).Trial registration numberANZCTR12618000267257; Pre-results.

The Fine Structure of Irradiated Mouse Heart

1976 ◽  
Vol 34 ◽  
pp. 184-185
Author(s):  
Vivian V. Yang ◽  
S. Phyllis Stearner
Keyword(s):  
Microscopic Level ◽  
Ultrastructural Changes ◽  
Mouse Heart ◽  
Blood Vessel Wall ◽  
Histopathological Changes ◽  
Light Microscopic Level ◽  
Γ Rays ◽  
Fission Neutrons ◽  
Total Body

The heart is generally considered a radioresistant organ, and has received relatively little study after total-body irradiation with doses below the acutely lethal range. Some late damage in the irradiated heart has been described at the light microscopic level. However, since the dimensions of many important structures of the blood vessel wall are submicroscopic, investigators have turned to the electron microscope for adequate visualization of histopathological changes. Our studies are designed to evaluate ultrastructural changes in the mouse heart, particularly in the capillaries and muscle fibers, for 18 months after total-body exposure, and to compare the effects of 240 rad fission neutrons and 788 rad 60Co γ-rays.Three animals from each irradiated group and three control mice were sacrificed by ether inhalation at 4 days, and at 1, 3, 6, 12, and 18 months after irradiation. The thorax was opened and the heart was fixed briefly in situwith Karnofsky's fixative.

Comparison of Mammography and Ultrasonography for Tumor Size of DCIS of Breast Cancer

2019 ◽  
Vol 15 (2) ◽  
pp. 209-213
Author(s):  
Yu Wang ◽  
Jiantao Wang ◽  
Haiping Wang ◽  
Xinyu Yang ◽  
Liming Chang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Correlation Coefficient ◽  
Tumor Size ◽  
Ductal Carcinoma ◽  
Pearson Correlation ◽  
Dense Breast ◽  
Pathological Examination ◽  
Negative Group ◽  
The Difference

Objective: Accurate assessment of breast tumor size preoperatively is important for the initial decision-making in surgical approach. Therefore, we aimed to compare efficacy of mammography and ultrasonography in ductal carcinoma in situ (DCIS) of breast cancer. Methods: Preoperative mammography and ultrasonography were performed on 104 women with DCIS of breast cancer. We compared the accuracy of each of the imaging modalities with pathological size by Pearson correlation. For each modality, it was considered concordant if the difference between imaging assessment and pathological measurement is less than 0.5cm. Results: At pathological examination tumor size ranged from 0.4cm to 7.2cm in largest diameter. For mammographically determined size versus pathological size, correlation coefficient of r was 0.786 and for ultrasonography it was 0.651. Grouped by breast composition, in almost entirely fatty and scattered areas of fibroglandular dense breast, correlation coefficient of r was 0.790 for mammography and 0.678 for ultrasonography; in heterogeneously dense and extremely dense breast, correlation coefficient of r was 0.770 for mammography and 0.548 for ultrasonography. In microcalcification positive group, coeffient of r was 0.772 for mammography and 0.570 for ultrasonography. In microcalcification negative group, coeffient of r was 0.806 for mammography and 0.783 for ultrasonography. Conclusion: Mammography was more accurate than ultrasonography in measuring the largest cancer diameter in DCIS of breast cancer. The correlation coefficient improved in the group of almost entirely fatty/ scattered areas of fibroglandular dense breast or in microcalcification negative group.

scholarly journals Clinicopathological predictors of postoperative upstaging to invasive ductal carcinoma (IDC) in patients preoperatively diagnosed with ductal carcinoma in situ (DCIS): a multi-institutional retrospective cohort study

Breast Cancer ◽  
2021 ◽  
Author(s):  
Kiyo Tanaka ◽  
Norikazu Masuda ◽  
Naoki Hayashi ◽  
Yasuaki Sagara ◽  
Fumikata Hara ◽  
...  
Keyword(s):  
Invasive Ductal Carcinoma ◽  
Ductal Carcinoma In Situ ◽  
Tumor Size ◽  
Medical Records ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Palpable Mass ◽  
Combined Use ◽  
A Prospective Study

Abstract Background We conducted a prospective study with the intention to omit surgery for patients with ductal carcinoma in situ (DCIS) of the breast. We aimed to identify clinicopathological predictors of postoperative upstaging to invasive ductal carcinoma (IDC) in patients preoperatively diagnosed with DCIS. Patients and methods We retrospectively analyzed patients with DCIS diagnosed through biopsy between April 1, 2010 and December 31, 2014, from 16 institutions. Clinical, radiological, and histological variables were collected from medical records. Results We identified 2,293 patients diagnosed with DCIS through biopsy, including 1,663 DCIS (72.5%) cases and 630 IDC (27.5%) cases. In multivariate analysis, the presence of a palpable mass (odds ratio [OR] 1.8; 95% confidence interval [CI] 1.2–2.6), mammography findings (≥ category 4; OR 1.8; 95% CI 1.2–2.6), mass formations on ultrasonography (OR 1.8; 95% CI 1.2–2.5), and tumor size on MRI (> 20 mm; OR 1.7; 95% CI 1.2–2.4) were independent predictors of IDC. Among patients with a tumor size on MRI of ≤ 20 mm, the possibility of postoperative upstaging to IDC was 22.1%. Among the 258 patients with non-palpable mass, nuclear grade 1/2, and positive for estrogen receptor, the possibility was 18.1%, even if the upper limit of the tumor size on MRI was raised to ≤ 40 mm. Conclusion We identified four independent predictive factors of upstaging to IDC after surgery among patients with DCIS diagnosed by biopsy. The combined use of various predictors of IDC reduces the possibility of postoperative upstaging to IDC, even if the tumor size on MRI is larger than 20 mm.

scholarly journals Comparison of In-Situ and Retrospective Self-Reports on Assessing Hearing Aid Outcomes

2020 ◽  
Author(s):  
Yu-Hsiang Wu ◽  
Elizabeth Stangl ◽  
Octav Chipara ◽  
Anna Gudjonsdottir ◽  
Jacob Oleson ◽  
...  
Keyword(s):  
Hearing Aids ◽  
Hearing Aid ◽  
Outcome Data ◽  
Self Report ◽  
Data Collection And Analysis ◽  
Self Reports ◽  
Outcome Difference ◽  
The Difference ◽  
Ecological Momentary

Abstract Background Ecological momentary assessment (EMA) is a methodology involving repeated surveys to collect in-situ self-reports that describe respondents' current or recent experiences. Audiology literature comparing in-situ and retrospective self-reports is scarce. Purpose To compare the sensitivity of in-situ and retrospective self-reports in detecting the outcome difference between hearing aid technologies, and to determine the association between in-situ and retrospective self-reports. Research Design An observational study. Study Sample Thirty-nine older adults with hearing loss. Data Collection and Analysis The study was part of a larger clinical trial that compared the outcomes of a prototype hearing aid (denoted as HA1) and a commercially available device (HA2). In each trial condition, participants wore hearing aids for 4 weeks. Outcomes were measured using EMA and retrospective questionnaires. To ensure that the outcome data could be directly compared, the Glasgow Hearing Aid Benefit Profile was administered as an in-situ self-report (denoted as EMA-GHABP) and as a retrospective questionnaire (retro-GHABP). Linear mixed models were used to determine if the EMA- and retro-GHABP could detect the outcome difference between HA1 and HA2. Correlation analyses were used to examine the association between EMA- and retro-GHABP. Results For the EMA-GHABP, HA2 had significantly higher (better) scores than HA1 in the GHABP subscales of benefit, residual disability, and satisfaction (p = 0.029–0.0015). In contrast, the difference in the retro-GHABP score between HA1 and HA2 was significant only in the satisfaction subscale (p = 0.0004). The correlations between the EMA- and retro-GHABP were significant in all subscales (p = 0.0004 to <0.0001). The strength of the association ranged from weak to moderate (r = 0.28–0.58). Finally, the exit interview indicated that 29 participants (74.4%) preferred HA2 over HA1. Conclusion The study suggests that in-situ self-reports collected using EMA could have a higher sensitivity than retrospective questionnaires. Therefore, EMA is worth considering in clinical trials that aim to compare the outcomes of different hearing aid technologies. The weak to moderate association between in-situ and retrospective self-reports suggests that these two types of measures assess different aspects of hearing aid outcomes.

scholarly journals Intratumoral heterogeneity of surrogate molecular subtypes in urothelial carcinoma in situ of the urinary bladder: implications for prognostic stratification of high-risk non-muscle-invasive bladder cancer

2021 ◽  
Author(s):  
Stefan Garczyk ◽  
Felix Bischoff ◽  
Ursula Schneider ◽  
Reinhard Golz ◽  
Friedrich-Carl von Rundstedt ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
High Risk ◽  
Carcinoma In Situ ◽  
Molecular Subtypes ◽  
Smoking Status ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Prognostic Stratification ◽  
Muscle Invasive

AbstractReliable factors predicting the disease course of non-muscle-invasive bladder cancer (NMIBC) with carcinoma in situ (CIS) are unavailable. Molecular subtypes have potential for prognostic stratification of muscle-invasive bladder cancer, while their value for CIS patients is unknown. Here, the prognostic impact of both clinico-pathological parameters, including CIS focality, and immunohistochemistry-based surrogate subtypes was analyzed in a cohort of high-risk NMIBC patients with CIS. In 128 high-risk NMIBC patients with CIS, luminal (KRT20, GATA3, ERBB2) and basal (KRT5/6, KRT14) surrogate markers as well as p53 were analyzed in 213–231 biopsies. To study inter-lesional heterogeneity of CIS, marker expression in independent CIS biopsies from different bladder localizations was analyzed. Clinico-pathological parameters and surrogate subtypes were correlated with recurrence-free (RFS), progression-free (PFS), cancer-specific (CSS), and overall survival (OS). Forty-six and 30% of CIS patients exhibited a luminal-like (KRT20-positive, KRT5/6-negative) and a null phenotype (KRT20-negative, KRT5/6-negative), respectively. A basal-like subtype (KRT20-negative, KRT5/6-positive) was not observed. A significant degree of inter-lesional CIS heterogeneity was noted, reflected by 23% of patients showing a mixed subtype. Neither CIS surrogate subtype nor CIS focality was associated with patient outcome. Patient age and smoking status were the only potentially independent prognostic factors predicting RFS, PFS, OS, and PFS, respectively. In conclusion, further clarification of heterogeneity of surrogate subtypes in HR NMIBC and their prognostic value is of importance with regard to potential implementation of molecular subtyping into clinical routine. The potential prognostic usefulness of patient age and smoking status for high-risk NMIBC patients with CIS needs further validation.

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