3D rendering of an anonymized patient’s abdomen with a ductal pancreatic mass, version A.

<p>Organs displayed in this rendering include <b>a)</b> rib cage, <b>b)</b> liver, <b>c)</b> intestines, <b>d)</b> stomach, <b>e)</b> pancreas, and <b>f)</b> aorta.</p

Average surgeon evaluation scores for version A and version B of the 3D visualization.

<p>Average scores, with error bars, are shown for questions on <b>a)</b> the ease of use and accuracy of models, <b>b)</b> how these models, with/without PET, changed their understanding of the tumor, and <b>c)</b> what are the best applications of the 3D visualization.</p

3D rendering of an anonymized patient’s abdomen with a ductal pancreatic mass, version B.

<p>Organs displayed in this rendering include <b>a)</b> rib cage, <b>b)</b> spine, <b>c)</b> liver, <b>d)</b> intestines, <b>e)</b> stomach, <b>f)</b> right gastroepiploic vein, and <b>g)</b> superior mesenteric vein, <b>h)</b> superior mesenteric artery, <b>i)</b> left common iliac artery, and <b>j)</b> right common iliac artery.</p

Score distribution on the ease of use and accuracy of models.

<p>Percentages of surgeons who assigned a particular score for both Version A (solid colors with hatch marks) and Version B (solid colors) [Q1: The display hardware is easy/comfortable to use, Q2: I found it easy to manipulate/re-position the image, Q3: The organs/structures are accurately represented (accuracy of segmentation), Q4: Colors/textures are appropriate (accuracy of rendering), Q5: I am satisfied with the level of detail that is presented, Q6: The model provides me with adequate reference to surrounding structures, Q7: The overall 3D image appears realistic (matches what I expect to see in the OR)].</p

Score distribution on what are the best applications of the 3D visualization.

<p>Percentages of surgeons who assigned a particular score for both Version A (solid colors with hatch marks) and Version B (solid colors) [Q12: I would want to use this 3D image to plan an operation for a patient with a specific tumor, Q13: I would want to use this 3D image with PET overlay to plan an operation for a patient with a specific tumor, Q14: I would want to have this system available to me in the OR, for the reference during an actual operation, Q15: I believe that this system would help residents/assistant better prepare for the operation].</p

3D rendering of the abdomen with organs stripped away to display the pancreatic tumor.

<p>The liver, stomach, and intestines were not visualized for a clearer view of the pancreas. Organs displayed in this rendering include <b>a)</b> rib cage, <b>b)</b> spine, <b>c)</b> spleen, <b>d)</b> pancreas, <b>e)</b> duodenum, <b>f)</b> right kidney, <b>g)</b>, left kidney <b>h)</b> aorta, <b>i)</b> vena cava, <b>j)</b> portal vein, <b>k)</b> right gastroepiploic vein, <b>l)</b> superior mesenteric vein, <b>m)</b> celiac artery, <b>n)</b> superior mesenteric and intestinal arteries <b>o)</b> left common iliac artery, <b>p)</b> right common iliac artery, and <b>q)</b> pancreatic tumor.</p

2D CT/PET fusion image slice of an anonymized patient with a ductal pancreatic mass.

<p>Regions with the highest 2′-[¹⁸F]fluorodeoxyglucose emission are colored red here while the lowest emissions are colored blue. A surgeon currently looks back and forth through a stack of such images to gain an understanding of anatomy surrounding the lesion. For this image in the coronal plane, the displayed PET window was narrowed to accentuate the location of high uptake in the pancreas as well as another hotspot in the liver.</p

3D rendering of the abdomen with organs stripped away to display the pancreatic tumor.

<p>The liver, stomach, and intestines were not visualized for a clearer view of the pancreas and its surroundings. Organs displayed in this rendering include <b>a)</b> rib cage, <b>b)</b> spleen, <b>c)</b> pancreas, <b>d)</b> duodenum, <b>e)</b> right kidney, <b>f)</b> left kidney, <b>g)</b> aorta, <b>h)</b> vena cava, <b>i)</b> superior mesenteric artery, <b>j)</b> adrenal gland, and <b>k)</b> pancreatic tumor.</p

3D rendering of the ductal pancreatic mass, version A, fused with PET data.

<p>A transparent overlay of (<b>a</b>) the pancreas over (<b>b</b>) the surface rendering of the high ¹⁸FDG uptake region of the pancreatic tumor (orange).</p

Positive Association of Fibroadenomatoid Change with HER2-Negative Invasive Breast Cancer: A Co-Occurrence Study

<div><p>Background</p><p>Risk assessment of a benign breast disease/lesion (BBD) for invasive breast cancer (IBC) is typically done through a longitudinal study. For an infrequently-reported BBD, the shortage of occurrence data alone is a limiting factor to conducting such a study. Here we present an approach based on co-occurrence analysis, to help address this issue. We focus on fibroadenomatoid change (FAC), an under-studied BBD, as our preliminary analysis has suggested its previously unknown significant co-occurrence with IBC.</p><p>Methods</p><p>A cohort of 1667 female patients enrolled in the Clinical Breast Care Project was identified. A single experienced breast pathologist reviewed all pathology slides for each case and recorded all observed lesions, including FAC. Fibroadenoma (FA) was studied for comparison since FAC had been speculated to be an immature FA. FA and Fibrocystic Changes (FCC) were used for method validation since they have been comprehensively studied. Six common IBC and BBD risk/protective factors were also studied. Co-occurrence analyses were performed using logistic regression models.</p><p>Results</p><p>Common risk/protective factors were associated with FA, FCC, and IBC in ways consistent with the literature in general, and they were associated with FAC, FA, and FCC in distinct patterns. Age was associated with FAC in a bell-shape curve so that middle-aged women were more likely to have FAC. We report for the first time that FAC is positively associated with IBC with odds ratio (OR) depending on BMI (OR = 6.78, 95%CI = 3.43-13.42 at BMI<25 kg/m²; OR = 2.13, 95%CI = 1.20-3.80 at BMI>25 kg/m²). This association is only significant with HER2-negative IBC subtypes.</p><p>Conclusions</p><p>We conclude that FAC is a candidate risk factor for HER2-negative IBCs, and it is a distinct disease from FA. Co-occurrence analysis can be used for initial assessment of the risk for IBC from a BBD, which is vital to the study of infrequently-reported BBDs.</p></div