Nonparallel Orientation Research Articles

Differences in ultrasonographic features between males and females with breast cancer of the luminal A and luminal B molecular subtypes.

To analyze the relationships between the ultrasonographic features and the molecular subtypes of breast cancer in men and women. Data were collected from 43 males and 80 females with breast cancer who were treated at our hospital. The following ultrasonographic characteristics of the tumors were evaluated: shape, orientation, margin, echo pattern, posterior features, calcifications, Color Doppler Flow Imaging, and Breast Imaging Reporting and Data System (BI-RADS) category. On ultrasound, a nonparallel orientation, noncircumscribed margin, and attenuating posterior features were associated with luminal A lesions. A parallel orientation (P=0.002), circumscribed margin (P=0.04), no change in posterior features (P<0.001), and the BI-RADS 4 category (P=0.001) were significantly associated with luminal B lesions. In the group with luminal A lesions, male patients were older (P=0.001) and a greater number of the tumors exhibited a regular shape (P=0.009), circumscribed margin (P<0.001), no change in posterior features (P<0.001), and the BI-RADS 4 category (P<0.001) than those in female patients. Male patients were older (P<0.001) and a greater number showed a no change in posterior features (P<0.001), spotty blood flow (P=0.002), and the BI-RADS 4 category (P<0.001) than female patients with masses of the luminal B subtype. Obvious differences in the ultrasonographic and pathological features were noted between breast cancer in males and females, which provided the theoretical basis for the individualized treatment of breast cancer, particularly breast cancer in males.

Highly efficient and fast batch adsorption of orange G dye from polluted water using superb organo-montmorillonite: Experimental study and molecular dynamics investigation

Natural montmorillonite (Mt) is modified with cetyltrimethylammonium bromide (CTAB) for obtaining an organoclay. The physicochemical properties of Mt and CTAB-modified Mt (CTAB@Mt) are characterized by Fourier transform infrared spectroscopy, X-ray diffraction, scanning electron microscopy coupled with energy-dispersive X-ray spectroscopy, nitrogen sorption, and thermogravimetric/differential thermal analysis. The CTAB@Mt is used as an adsorbent for the removal of orange G anionic dye from aqueous solutions. The adsorption process is examined as a function of adsorbent amount, contact time, temperature, pH, and initial dye concentration. The kinetic study indicates that the adsorption equilibrium of orange G dye onto CTAB@Mt is reached after 30 min and fits well to a pseudo-second-order kinetic model. Also, the adsorption isotherm data is best fitted by a Langmuir model, with the maximum adsorption capacity calculated using the non-linear form of the Langmuir isotherm being 167 mg g−1 at 298 K. The statistical physics model shows that the OG dye could be adsorbed with a non-parallel orientation on the surface of CTAB@Mt. Finally, CTAB@Mt is successfully employed for the treatment of a real wastewater sample from the textile industry. Molecular dynamics simulations are performed to investigate, on one hand, the structural properties of CTAB intercalated into the 2:1 layered Mt and coated on its external surface, and on the other hand, to provide atomic-level insight on the adsorptive characteristics of orange G dye on CTAB@Mt.

A New Practical Decision Rule to Better Differentiate BI-RADS 3 or 4 Breast Masses on Breast Ultrasound.

The BI-RADS classification provides a standardized way to describe ultrasound findings in breast cancer diagnostics. However, there is little information regarding which BI-RADS descriptors are most strongly associated with malignancy, to better distinguish BI-RADS 3 (follow-up imaging) and 4 (diagnostic biopsy) breast masses. Patients were recruited as part of an international, multicenter trial (NCT02638935). The trial enrolled 1294 women (6 excluded) categorized as BI-RADS 3 or 4 upon routine B-mode ultrasound examination. Ultrasound images were evaluated by three expert physicians according to BI-RADS. All patients underwent histopathological confirmation (reference standard). We performed univariate and multivariate analyses (chi-square test, logistic regression, and Krippendorff's alpha). Histopathologic evaluation showed malignancy in 368 of 1288 masses (28.6%). Upon performing multivariate analysis, the following descriptors were significantly associated with malignancy (P< .05): age ≥50 years (OR 8.99), non-circumscribed indistinct (OR 4.05) and microlobulated margin (OR 2.95), nonparallel orientation (OR 2.69), and calcification (OR 2.64). A clinical decision rule informed by these results demonstrated a 97% sensitivity and missed fewer cancers compared to three physician experts (range of sensitivity 79-95%) and a previous decision rule (sensitivity 59%). Specificity was 44% versus 22-83%, respectively. The inter-reader reliability of the BI-RADS descriptors and of the final BI-RADS score was fair-moderate. A patient should undergo a diagnostic biopsy (BI-RADS 4) instead of follow-up imaging (BI-RADS 3) if the patient is 50 years or older or exhibits at least one of the following features: calcification, nonparallel orientation of mass, non-circumscribed margin, or posterior shadowing.

English

BACKGROUND Lobular breast carcinomas have always been a diagnostic challenge, over the years, to the radiologist. They are one of the most commonly missed lesions on breast cancer screening checks, due to their varied presentation. We wanted to provide a concise and practical approach to characterise their morphology and presentation on mammography and ultrasound. METHODS A retrospective study was done for four years and a total of 699 patients with histopathologically proven breast cancer were chosen. Those patients with invasive lobular carcinoma (N = 56) and invasive ductal carcinoma (N = 538) were segregated and 50 cases from each group were selected randomly. RESULTS On mammography, an irregular, high-density mass was the most common presentation of both lobular (68 %) and ductal (86 %) carcinomas. Presentation as focal asymmetry (28 %) was significantly more prevalent in lobular breast carcinomas. Sonographically, an architectural distortion (30 %) and non-parallel orientation (28 %) was predominantly seen in invasive lobular carcinomas (ILCs). Mass (88 %) with micro lobulated (34 %) or angular (22 %) margins was more in favour of ductal carcinoma. Other general parameters like age at presentation, positive family history, multifocality, bilaterality, tumour size and lymph nodal involvement were not significantly different between both the groups. CONCLUSIONS A careful analysis of digital breast tomosynthesis and ultrasonography, keeping in mind all the clear differentiating features, along with experience in the field, will dramatically increase the early detection of lobular breast cancers. KEY WORDS Invasive Lobular Carcinoma (ILC), Invasive Ductal Carcinoma (IDC), X-Ray Mammography, Sono-Mammography

Assessment of Ultrasound Features and BI-RADS Categories of Malignant Breast Masses in Women ≤40.

To evaluate ultrasound (US) characteristics and BI-RADS (Breast imaging-reporting and data system) of malignant breast masses in women <40 years and to compare with older patients. In a retrospective, descriptive-analytical study, we assessed the US images and BI-RADS category of 78 malignant masses with a final pathology of invasive ductal carcinoma (IDC, NOS type). Overall, the most frequent US descriptors of IDC were indistinct margin (45%), irregular shaped (63.5%), posterior shadowing (38.8%), heterogeneous internal echogenicity (56.3%) and non-parallel orientation (76.3%). In this study, most malignant masses of young patients were categorized as BI-RADS 4a while in the older patients (over 40), they were mostly BI-RADS 4b and 5 with P=0.03 and odds ratio (OR) of 2.57 (95% confidence interval (CI), 0.74-8.8). In addition, the mean dimension of the mass in young cases was greater (18.3 mm) compared with older patients (13.2 mm) with P value of 0.04 and OR of 3.8 (95% CI, 1.1-13.4). Similar to previous studies, malignant masses were diagnosed in greater dimensions in younger cases which may be due to the delay in diagnosis, the rapid growth of the tumor and the absence of routine screening guidelines. Radiologists should be aware of the possibility of malignancy in palpable slightly suspicious masses (BI-RADS 4A) in young cases.

Mass transfer in platinum by crowdion clusters initiated by the impact of a Pt2 molecule

This work presents a molecular dynamics study of the propagation scenario of the crowdion complex initiated in the platinum crystal by means of atom or molecule bombardment with parallel and non-parallel orientations. The obtained results enable to conclude that the crowdion initiated by the Pt2 molecule bombardment is significantly more effective for the mass transfer comparing to the crowdion excited by the single atom impact. It was detected that the atoms involved in the crowdion motion bear a vibrational mode with the frequency above the phonon spectrum. The obtained results contribute to the understanding of the mechanisms of mass transfer under equilibrium conditions.

Papillary Lesions of the Breast: A Review

Papillary breast lesions are rare breast tumors that comprise a broad spectrum of diseases. Pathologically they present as mass-like projections attached to the wall of the ducts, supported by fibrovascular stalks lined by epithelial cells. On mammogram they appear as masses that can be associated with microcalcifications. Ultrasound is the most used imaging modality. On ultrasound papillary lesions appear as homogeneous solid lesions or complex intracystic lesions. A nonparallel orientation, an echogenic halo or posterior acoustic enhancement associated with microcalcifications are highly suggestive of malignancy. MRI has proven to be useful to establish the extent of the lesion. Core needle biopsy is the gold standard for diagnosis. Surgical excision is usually recommended, although treatment for papillomas without atypia is still controversial.

Physicochemical interpretation of the adsorption of 4-Bromophenol and 4-Chloroaniline on an activated carbon

Statistical physics theory was used to interpret the adsorption mechanism of 4-Chloroaniline and 4-Bromophenol on an activated carbon which was prepared from cashew nut shell. The adsorption of these organic molecules fits with a single-layer model assuming a single adsorption energy among five mechanisms explored. Experimental data were successfully analyzed via theoretical steric and energetic parameters that were associated to the adsorption mechanisms of tested pollutants. It was concluded that parallel, non-parallel and mixed orientations could be involved for the adsorption of these adsorbates on activated carbon. Calculated adsorption energies ranged from -16.3 to -14.3 kJ/mol for these two molecules, where a physisorption process occurred. Thermodynamic adsorption functions were also studied and discussed for the removal of these organic molecules with activated carbon. Overall, this paper attributed new insights about the adsorption mechanism of the tested adsorbates on activated carbon.

The Utility of the Fifth Edition of the BI-RADS Ultrasound Lexicon in Category 4 Breast Lesions: A Prospective Multicenter Study in China

The objective of this study was to evaluate the utility of the fifth edition of the Breast Imaging-Reporting and Data System (BI-RADS) in clinical breast radiology by using prospective multicenter real-time analyses of ultrasound (US) images. We prospectively studied 2049 female patients (age range, 19-86 years; mean age 46.88 years) with BI-RADS category 4 breast masses in 32 tertiary hospitals. All the patients underwent B-mode, color Doppler US, and US elastography examination. US features of the mass and associated features were described and categorized according to the fifth edition of the BI-RADS US lexicon. The pathological results were used as the reference standard. The positive predictive values (PPVs) of subcategories 4a-4c were calculated. A total of 2094 masses were obtained, including 1124 benign masses (54.9%) and 925 malignant masses (45.1%). For BI-RADS US features of mass shape, orientation, margin, posterior features, calcifications, architectural distortion, edema, skin changes, vascularity, and elasticity assessment were significantly different for benign and malignant masses (p< 0.05). Typical signs of malignancy were irregular shape (PPV, 57.2%), spiculated margin (PPV, 83.7%), nonparallel orientation (PPV, 63.9%), and combined pattern of posterior features (PPV, 60.6%). For the changed or newly added US features, the PPVs for intraductal calcifications were 80%, 56.4% for internal vascularity, and 80% for a hard pattern on elastography. The associated features such as architectural distortion (PPV, 89.3%), edema (PPV, 69.2%), and skin changes (PPV, 76.2%) displayed high predictive value for malignancy. The rate of malignant was 7.4% (72/975) in category 4a, 61.4% (283/461) in category 4b, and 93.0% (570/613) in category 4c. The PPV for category 4b was higher than the likelihood ranges specified in BI-RADS and the PPVs for categories 4a and 4c were within the acceptable performance ranges specified in the fifth edition of BI-RADS in our study. Not only the US features of the breast mass, but also associated features, including vascularity and elasticity assessment, have become an indispensable part of the fifth edition of BI-RADS US lexicon to distinguish benign and malignant breast lesions. The subdivision of category 4 lesions into categories 4a, 4b, and 4c for US findings is helpful for further assessment of the likelihood of malignancy of breast lesions.

Physicochemical assessment of prednisone adsorption on two molecular composites using statistical physics formalism in cosmetics

In this paper, we consider two different polyethylene filter plates coated with multi-walled carbon nanotubes (MWCNTs) and synthesized by surface molecularly imprinted technique, namely plate@MWCNTs@MIPs (PMIPs) and plate@MWCNTs@NIPs (PNIPs). They were used as effective adsorbents for selective adsorption and detection of prednisone (PS) in cosmetics. As a first assessment to investigate the performance of these adsorbents, the PS adsorption isotherms were analyzed using an advanced multilayer statistical physics model at three different temperatures (293, 303 and 313 K) and over a wide PS concentration range (0.09–1.5 mg/mL). The obtained analyzing results from the best fitting model showed that the PMIPs adsorbent displayed a high adsorption capacity (27.4 mg/g) due to the contribution of the number of PS molecules per site (nm) combined with the receptor sites density (Dm), which displayed a high recognition ability due to the adsorption energy. Modeling analysis process indicated that the PS molecules could be anchored on the PMIPs and PNIPs surfaces via a non-parallel orientation where the adsorption is a multi-molecular process. The calculated adsorption energies globally varied from 4.51 to 7.62 kJ/mol, confirming the physical nature of the adsorption process for the studied systems, which is beneficial in cosmetics. Finally, three thermodynamic potentials (entropy, internal energy and free enthalpy) were evaluated for a better understanding of the physico-chemical behavior of the adsorption process.

Features of breast tuberculosis determined by ultrasound imaging: report of 45 cases.

ObjectiveThis study aimed to characterize the ultrasound (US) imaging features of breast tuberculosis (BTB) to clarify the process of disease progression and provide valuable clinical information.MethodsWe retrospectively reviewed 45 patients with pathologically or GeneXpert-confirmed BTB from January 2010 to December 2017. We assessed the US features of target lesions including size, shape, orientation, margin, echogenicity, calcification, posterior acoustic features, and blood-flow signal.ResultsThe patients were classified with nodular (55.5%, 25/45), abscess (15.6%, 7/45), or sinus (28.9%, 13/45) type according to their US features. Forty lesions (88.9%, 40/45) extended in a parallel orientation and five extended in a non-parallel orientation. Calcifications were found in eight cases, including six macrocalcifications and two microcalcifications. Enlarged axillary lymph nodes were observed in three cases (6.7%, 3/45). In addition, 44 of the 45 cases (97.8%, 44/45) exhibited hypovascularity or avascularity according to color Doppler flow imaging (CDFI).ConclusionBTB lesions can be classified as nodular, abscess, or sinus type according to their US imaging features. Poor blood supply detected by CDFI might be a common US feature of BTB. Characterization of its US features may facilitate the clinical diagnosis of BTB.

Systematic Review and Meta-analysis of the Malignant Ultrasound Features of Triple-Negative Breast Cancer.

The malignant ultrasound (US) features of breast cancer are known to include an irregular shape, a noncircumscribed margin, an echogenic halo, a nonparallel orientation, posterior acoustic attenuation, microcalcification, and others. However, these US features are uncertain and controversial for the diagnosis of triple-negative breast cancer (TNBC). This study aimed to analyze the diagnostic value of malignant US features for TNBC by a systematic review and meta-analysis, analyze the US characteristics of TNBC, and provide US evidence for clinical diagnosis. A comprehensive search was performed to identify relevant English articles concerning the US diagnosis of TNBC (from the date of database establishment to November 2019). The pooled sensitivity, pooled specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio with 95% confidence interval, summary receiver operating characteristic curve, and area under the curve for the different malignant US features were calculated. Ten studies (620 patients) met the eligibility criteria. The sensitivity (range, 0.14-0.68) and specificity (range, 0.19-0.66) of the malignant US features were not high. Summary receiver operating characteristic curves showed that the area under the curve (range, 0.25-0.47) of the malignant US features was low, demonstrating that these features have poor diagnostic value for TNBC. The positive likelihood ratio (range, 0.4-to 0.9) of the malignant US features was low, and the negative likelihood ratio (range, 1.09-2.02) was not low, revealing that these features had a poor ability to confirm or exclude TNBC. Triple-negative breast cancer lacks the typical malignant US features of breast cancer and has its own US features.

Adsorption of methylene blue on comminuted raw avocado seeds: Interpretation of the effect of salts via physical monolayer model

In this work, the effect of salts on the adsorption of a textile pollutant (Methylene blue: MB) on comminuted raw avocado seeds (CRAS) was interpreted via a physical monolayer model (PMM). To this aim, ten MB adsorption isotherms were determined at 25 °C and pH 10 in the presence of the next salts: NaCl, Na 2 CO 3 , Na 2 SO 3 , NaHCO 3, C 6 H 5 Na 3 O 7 , NaHSO 3, Na 2 B 4 O 7 ·10H 2 O, Na 2 S 2 O 3, NaNO 2 and Na 2 HPO 4 . Under the same experimental conditions, a further adsorption isotherm was also determined without any salt addition and taken as reference data. In order to achieve a theoretical interpretation of the experimental data and to address the effect of salts on adsorption mechanism, a physical monolayer model (PMM) was applied to all the retrieved data. The model showed that Na 2 CO 3 , NaHCO 3 , Na 2 B 4 O 7 , Na 2 S 2 O 3 , and NaNO 2 salts have no effect on the adsorption of MB dye, while the presence of NaCl, Na 2 SO 3 , C 6 H 5 Na 3 O 7 , NaHSO 3 and Na 2 HPO 4 salts in the solution caused a slight decrement of MB adsorption capacity due to a competitive effect between MB dye and salts on CRAS adsorption site. The modeling analysis showed that MB was adsorbed with a mixed parallel and non-parallel orientation on CRAS adsorbent surface. Moreover, the adsorption energies varied from 19.44 to 22.36 kJ/mol in tested systems. Adsorption energy values revealed that the process evolved via a physical adsorption, regardless the salt present in solution. All the investigated salts did not functionalize the CRAS adsorbent surface and also did not change the interaction energy between MB molecules and the adsorbent receptor sites. The interpretation of all the model parameters contributed to explain the adsorption mechanism of MB dye on CRAS. Specifically, the effect of salt on the reduction of MB adsorption capacity seems to be likely due to both steric hindrance effect and to MB molecule aggregation hindrance exerted by the salts, which prevented the formation of subsequent MB adsorbed layers, thus limiting its overall adsorption capacity. • MB dye adsorption mechanism was analyzed via statistical physical modeling. • Salts effect on dye adsorption on a lignocellulosic biomass was performed. • Description of the adsorption mechanism through an energetic factor.

Value of Hand-held Ultrasound in the Differential Diagnosis and Accurate Breast Imaging Reporting and Data System Subclassification of Complex Cystic and Solid Breast Lesions

To explore the value of hand-held ultrasound (HHUS) for diagnosing complex cystic and solid breast lesions, 472 pathologically proven lesions were analyzed. The lesions were divided into four types based on ultrasound features. Positive predictive values (PPVs) for lesion types and risk factor performances were assessed. Furthermore, HHUS and mammography (MAM) performances were compared: 27 lesions missed in MAM were detected in HHUS. Ultrasound feature analysis revealed higher PPVs for type III and IV lesions than for type I and II lesions. In patients older than 51 y, a type III or IV lesion with a diameter greater than 18 mm, an irregular shape, a non-parallel orientation, an uncircumscribed margin, calcification, vascularity and abnormal axillary lymph nodes were suggestive of malignancy; the area under the curve reached 0.869. Thus, ultrasound is useful in diagnosing complex cystic and solid breast lesions, which should be categorized as Breast Imaging Reporting and Data System (BI-RADS) 4B or 4C.

Association of BRAFV600E mutation with ultrasonographic features and clinicopathologic characteristics of papillary thyroid microcarcinoma: A retrospective study of 116 cases.

To analyze the association of BRAFV600E mutation with ultrasonographic (US) features and clinicopathologic characteristics in Chinese patients with papillary thyroid microcarcinoma (PTMC). We retrospectively reviewed 116 consecutive Chinese patients with PTMC diagnosed by postoperative pathology. The incidence of the BRAFV600E mutation was calculated. The US features and clinicopathologic characteristics were compared between BRAF-positive and BRAF-negative patients. The BRAFV600E mutation was detected in 60.3% of patients (70 of 116). Multifocality (OR: 3.681, P = 0.031), non-parallel orientation (OR: 3.181, P = 0.041) and lymph node metastasis (OR: 4.615, P = 0.009) were significantly associated with BRAFV600E mutation. Other US and clinicopathologic characteristics were not significantly related to the presence of BRAF mutation. Multifocality, non-parallel orientation and cervical lymph node metastasis are risk factors for BRAFV600E mutation in PTMC. These factors potentially guide treatment planning or prognosis evaluation.

Can Combined Screening of Ultrasound and Elastography Improve Breast Cancer Identification Compared with MRI in Women with Dense Breasts-a Multicenter Prospective Study.

Objectives: To assess the performance of elastography (ES) and ultrasound (US) in predicting the malignancy of breast lesions and to compare their combined diagnostic value with that of magnetic resonance imaging (MRI).Materials and Methods: The study prospectively enrolled 242 female patients with dense breasts treated in 35 heath care facilities in China between November 2018 and October 2019. Based on conventional US and elastography, radiologists classified the degree of suspicion of breast lesions according to the US Breast Imaging Reporting and Data System (BI-RADS) criteria. The diagnostic value was compared between US BI-RADS and MRI BI-RADS, with pathological results used as the reference standard.Results: The results demonstrated that irregular tumor shape, a nonparallel growth orientation, indistinct margins, angular contours, microcalcifications, color Doppler flow and ES score on US imaging were significantly related to breast cancer in dense breasts (P=0.001; P=0.001; P=0.008; P<0.001; P=0.019; P=0.008; P=0.002, respectively). The sensitivity, specificity, PPV, NPV, accuracy and AUC of US BI-RADS category were 94.7%, 90.7%, 95.8%, 88.0%, 93.4% and 0.93 (95%CI, 0.88-0.97), respectively, while those of MRI BI-RADS category were 98.2%, 57.5%, 84.3%, 83.3%, 86.0% and 0.78 (95%CI, 0.71-0.85), respectively. MRI BI-RADS showed a significantly higher sensitivity than US BI-RADS (98.2% vs 94.7%, P=0.043), whereas US BI-RADS showed significantly higher specificity (90.7% vs 57.5%, P<0.001). US BI-RADS showed better diagnostic efficiency in differentiating nodules in dense breasts than MRI BI-RADS (AUC 0.93 vs 0.78, P<0.001).Conclusion: By combining the use of ES and conventional US, US BI-RADS had better diagnostic efficiency in differentiating nodules in dense breasts than MRI. For the diagnosis of malignant tumors in patients with dense breasts, MRI and US BI-RADS can be used as supplemental diagnostic tools to detect lesions, with US BI-RADS considered the preferred adjunctive resource.

Adsorption of amoxicillin and tetracycline on activated carbon prepared from durian shell in single and binary systems: Experimental study and modeling analysis

The adsorption mechanism of two antibiotics, namely amoxicillin (AMX) and tetracycline (TCN), on durian shell activated carbon (AC) was investigated in single and binary systems. Adsorption isotherms were determined under the same experimental conditions and they showed that the adsorption capacities of AMX were higher than those of TCN at all tested temperatures suggesting that this adsorbent preferred to remove AMX from the aqueous solution. It was also observed that all adsorption capacities decreased from single to binary systems, which was reasonably explained by an antagonistic adsorption between AMX and TCN on the active sites of AC creating an inhibition effect between these adsorbates. Monolayer and competitive monolayer models were developed via statistical physics theory and they were applied to explain and understand the adsorption mechanism of AMX and TCN via steric and energetic parameters. Results suggested that the parallel and non-parallel orientations of both antibiotics on the adsorbent surface of AC could be possible at tested experimental conditions. Modeling results demonstrated that the numbers of accepted antibiotic molecules per active site of AC varied with linear and inverse trends in single and binary systems, respectively, at all tested temperatures thus corroborating the adsorption inhibition effect caused by both adsorbates. An estimation of adsorption energies was also performed to describe and characterize the interactions between both antibiotics and AC surface. The assessment of the parameters of statistical physics models contributed to the explanation of the single and binary adsorption mechanisms of these water pollutants.

Diagnostic performance of ultrasound strain elastography for differentiation of malignant breast lesions.

Objective of the study was to assess the performance of ultrasound strain elastography combined with conventional B-mode ultrasound to diagnose suspicious breast lesions (BI-RADS 4 and 5). Between January 2015 and December 2017, a total of 86 patients (55±17.9 years) with solid or unclear, non-cystic breast lesions were enrolled in the study. The breast lesions were evaluated by B-mode ultrasound and subsequent ultrasound strain elastography. Ultrasound features including echo pattern, lesion shape, marginal characteristics, calcifications, orientation and posterior features are useful for differentiating benign breast lesions from malignant ones. Malignant ultrasound features are irregular shape, hypoechoic pattern, spiculated margin, nonparallel orientation and posterior shadowing. Lesions with benign features such a circumscribed margin were classified as low conspicuous. In patients with highly conspicuous malignant masses ultrasound-guided core needle biopsy or surgical excision was performed. Among the 86 patients, 60 masses were histologically proven and 36 of these were malignant. Of the malignant lesions 26 invasive carcinomas were of no special type (NST), 1 invasive lobular carcinoma, 3 ductal carcinomas in situ and 6 metastases. 20 of these patients had breast density classified as ACR 3 or 4. The mean size of the masses was 1.2 cm (range: 0.5-5 cm). Based on ultrasound B-mode imaging, the lesions were classified as BI-RADS category 4 (n = 20; three 4a, nine 4b and eight 4c) and BI-RADS category 5 (n = 16). One patient had to be reclassified after strain elastographxy to BI-RADS 3.The sensitivity of ultrasound with strain elastography and additional B-Mode ultrasound for the characterization of solid breast lesions was 97%, for conventional B-mode alone 92%; the respective specificities were 82% and 73%, respectively. Ultrasound elastography can be a supplementary approach to conventional ultrasound to improve the diagnostic accuracy of malignant breast lesions.

Positive predictive value of biopsy of palpable masses following mastectomy.

Determine the positive predictive value (PPV) of biopsy of palpable masses following mastectomy (MX). Determine if there are patient characteristics, tumor, or imaging features more predictive of cancer. IRB-approved retrospective review of 16396 breast ultrasounds June 2008-December 2015 identified patients with MX presenting with palpable masses. Medical records and imaging studies were reviewed. Statistical analysis was performed using Fisher's exact test. 95% confidence intervals (CI) were calculated. In all, 117 patients presented with palpable masses on the MX side. 101/117 patients who had a palpable mass on physical examination had a true sonographic mass to correlate with the clinical findings. 91/101 (90%) underwent biopsy: 19/91 (21%, 95% CI; 13-31) biopsies were malignant. 72/91 (79%) were benign. All 19 cancers were on the original cancer side. Recurrences ranged from 0.4 to 4.5cm maximum diameter, mean 1.3cm. Prophylactic vs therapeutic mastectomy was very statistically significant (P=.01). The use of tamoxifen or an AI was also statistically significant (P=.04). Patient age (P=1.0), radiation therapy (P=1.05), chemotherapy (P=.2), immediate breast reconstruction (P=.2), or implant vs flap (P=.2) had no statistically significant association with finding cancer on biopsy. Lesion shape (irregular vs oval/round) was highly statistically significant (P=.0003) as was non-parallel orientation on ultrasound (P=.008). Circumscribed vs non-circumscribed margins was also statistically significant (P=.008). The PPV of biopsy of palpable masses on the side of MX was 21% (95% CI; 13-31). All recurrences were on the original cancer side and this was very statistically significant.

Surface Anchoring and Director Distribution in a Grandjean–Cano Wedge

Theoretical calculations of the director distribution in a Grandjean–Cano wedge in relation to the anchoring strength and mutual orientation of the easy axes at the wedge surfaces are performed for various model surface anchoring potentials. Comparison of the theory and experiment allows one to propose the socalled model D-potential, quadratic in angle of director deviation from the easy axes, as the best one in fitting the experiment in the angular range of performed measurements. To satisfy general requirements on the wedge surface, a modified D-potential is proposed. The optimal conditions of the experiment aimed at restoring the potential in the whole range of its definition (in particular, nonparallel orientation of the easy axes at the wedge surfaces) are formulated.