脂肪抑制法の新手法を用いた乳腺の造影MRIの画質評価とその乳癌描出能に関する研究

金沢大学附属病院昨年度に引き続き今年度も,周波数選択励起IRパルスによる新しい脂肪抑制法を用いてこれまでに約100例の乳腺dynamic MRIを施行した.この方法では簡単な撮像操作で恒常的に均一な脂肪抑制効果を得ることができ,検査時間の短縮が可能となった.腫瘤形成のある乳癌は全例描出できた.当院では乳癌の外科治療として乳房温存療法を積極的に取り入れているが,切除標本の断端部の術中迅速病理診断で癌陽性となれば,術式の変更を余儀なくされる場合もあり,術前の正確な癌の進展度診断が重要となる.術中断端陽性の主な原因は腫瘤形成のない微小な乳管内癌であり,我々の方法による乳腺dynamic MRIの乳管内癌の描出能を検討した.乳管内癌の中でも大きさが大きいもの,しかも高密度に存在する場合はMRIでの描出が可能だった.当院での乳房温存療法施行例の約25%が術中断端陽性となり追加切除が必要だったが,断端陽性の原因は微小かつ低密度な乳管内癌の存在であることが多かった.乳癌の摘出生検後の癌残存の有無の診断も重要であるが,生検部位の周囲には造影剤投与による濃染がかなり長期間持続し,特に微小な残存乳癌の場合造影MRIによる存在診断は困難だった.今回検討した脂肪抑制法の新手法と従来からの主流であるFat Sat法の画像を比較したが,新手法では造影MRI上の濃染を異常濃染ととるかどうかの判断が,特に微小濃染の場合難しかった.今後は旧法でさらに空間分解能を高めた画像とも比較することによって,乳腺MRIの最適な撮像方法の確立を目指す予定である.研究課題/領域番号:10770441, 研究期間(年度):1998 – 1999出典：「脂肪抑制法の新手法を用いた乳腺の造影MRIの画質評価とその乳癌描出能に関する研究」研究成果報告書　課題番号10770441（KAKEN：科学研究費助成事業データベース（国立情報学研究所））（https://kaken.nii.ac.jp/ja/grant/KAKENHI-PROJECT-10770441/)を加工して作

Clinical usefulness of super high-resolution liquid crystal displays using independent sub-pixel driving technology

金沢大学医薬保健研究域保健学系We have developed and reported super-high resolution liquid crystal displays (SHR-LCDs) using a new resolution enhancement technology of the independent sub-pixel driving (ISD) that utilizes three sub-pixels contained in each pixel element. This technology realizes the three-times resolution enhancement of monochrome LCDs. A 15 mega-pixel (MP) SHR-LCD out of a 5MP LCD and a 9MP SHR-LCD out of a 3MP LCD, for example, are realized by this technology, which improves the depiction ability of detailed image shapes such as micro-calcifications of a mammography. Furthermore, the ISD technology brings not only resolution enhancement but also noise reduction effect by the high-frequency data sampling in displaying the clinical images. In this study, we have investigated the clinical efficacy of the SHR-LCDs by means of phantom observation studies and blind observer comparison studies using clinical mammography images performed by radiologists. We used a conventional 5MP LCD for a comparison of a 15MP SHR-LCD and a 9MP SHR-LCD to evaluate their efficacy. From the results of the studies, it was indicated that the SHR-LCDs using the ISD technology had the excellent ability to display the high-resolution digital mammography images. © 2008 Springer-Verlag Berlin Heidelberg

Gene amplification of ESR1 in breast cancers-fact or fiction? A fluorescence in situ hybridization and multiplex ligation-dependent probe amplification study

Oestrogen receptor-alpha (ERα), encoded by the ESR1 gene located on 6q25, is a nuclear transcription factor. Since it was reported in 2007 that more than 20% of breast cancers show ESR1 gene amplification, there has been considerable controversy about its frequency and clinical significance. We set out to assess the frequency and levels of ESR1 amplification in breast cancers. In a total of 106 breast needle biopsy specimens examined by immunohistochemistry, 78 tumours contained more than 10% ERα-positive cancer cells. In fluorescence in situ hybridization (FISH) analysis with an ESR1-specific probe, variously extended ESR1 signals were found in ERα-expressing cells. Some of these were indistinguishable from large clustered signals generally accepted to mean high-level gene amplification in homogeneously staining regions (HSRs), and could be considered to represent gene amplification. However, with RNase treatment, the \u27HSR-like\u27 signals changed to small compact signals, and are thus thought to represent concentrated RNA. FISH using two differently labelled probes corresponding to the non-overlapping 5\u27- and 3\u27-end portions of the ESR1 gene on touch smears showed a preserved spatial relationship of the 3\u27 to 5\u27 sequence of ESR1, therefore strongly suggesting that the RNA consisted of primary transcripts. Using touch smears obtained from 51 fresh tumours, precise enumeration of ESR1 signals with a correction by the number of centromere 6 on FISH after RNase A treatment revealed that three tumours (5.9%) had tumour cells with one to three additional copies of ESR1 as predominant subpopulations. This infrequent and low level of gene amplification of ESR1 was also detected as a \u27gain\u27 of the gene by analysis with multiplex ligation-dependent probe amplification (MLPA). The consistent results from immunohistochemistry, FISH, and MLPA in the present study settle the long-standing debate concerning gene amplification of ESR1 in breast carcinoma. © 2012 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Lt

Influence of the menstrual cycle on compression-induced pain during mammography: correlation with the thickness and volume of the mammary gland

金沢大学医薬保健研究域保健学系In mammography, breast compression is necessary and an important factor influencing image quality. The purpose of this study was to determine the influence of the menstrual cycle on compression-induced pain during mammography and to evaluate the association between the thickness and volume of the mammary gland and pain. We examined basal body temperature and categorized the menstrual cycle into five phases. We executed breast compression in the craniocaudal view using a customized compression plate, to which we introduced an opening. We measured the thickness of the mammary gland under compression using echography. Immediately after releasing the compression, we evaluated pain using the visual analogue scale. We performed magnetic resonance imaging (MRI) on the same day and measured the volume of the mammary gland. The thickness of the mammary gland, pain, and the volume of the mammary gland were minimal in the late follicular phase and maximal in the late luteal and early follicular phases. It was shown that the changes in the thickness and volume of the mammary gland during the menstrual cycle accounted for the changes in compression-induced pain. On MRI examination of each breast quadrant, the same changes were observed in areas A and C. In area A, it was shown that both the anatomical characteristics and the increase in volume of the mammary gland were associated with pain. We concluded that the late follicular phase constitutes the optimal timing for mammography. © 2017 Japanese Society of Radiological Technology and Japan Society of Medical PhysicsEmbargo Period 12 month

Localized Brain Activation Related to the Strength of Auditory Learning in a Parrot

Parrots and songbirds learn their vocalizations from a conspecific tutor, much like human infants acquire spoken language. Parrots can learn human words and it has been suggested that they can use them to communicate with humans. The caudomedial pallium in the parrot brain is homologous with that of songbirds, and analogous to the human auditory association cortex, involved in speech processing. Here we investigated neuronal activation, measured as expression of the protein product of the immediate early gene ZENK, in relation to auditory learning in the budgerigar (Melopsittacus undulatus), a parrot. Budgerigar males successfully learned to discriminate two Japanese words spoken by another male conspecific. Re-exposure to the two discriminanda led to increased neuronal activation in the caudomedial pallium, but not in the hippocampus, compared to untrained birds that were exposed to the same words, or were not exposed to words. Neuronal activation in the caudomedial pallium of the experimental birds was correlated significantly and positively with the percentage of correct responses in the discrimination task. These results suggest that in a parrot, the caudomedial pallium is involved in auditory learning. Thus, in parrots, songbirds and humans, analogous brain regions may contain the neural substrate for auditory learning and memory

Clonal profiling of mixed lobular and ductal carcinoma revealed by multiplex ligation-dependent probe amplification and fluorescence in situ hybridization

A needle biopsy of a mass in the right breast of a 36-year-old woman revealed invasive ductal carcinoma (IDC), and approximately 20% of cancer cells showed unequivocal membranous staining with the HercepTest. After systemic therapy with trastuzumab and paclitaxel followed by FEC (fluorouracil + epirubicin + cyclophosphamide), a right mastectomy was performed. By histological and immunohistochemical examinations, the resected tumor consisted mainly of E-cadherin-negative invasive lobular carcinoma (ILC), and the rest was ERBB2-positive IDC; thus, the diagnosis was mixed ductal and lobular carcinoma. Multiplex ligation-dependent probe amplification and fluorescence in situ hybridization (FISH) analyses revealed that ILC and IDC shared high-level amplification of CCND1 in homogeneously staining regions (HSR) and that IDC had an additional HSR-type amplicon of ERBB2. These findings strongly indicate that IDC and ILC had a common precursor cell with CCND1 amplification. Review of the biopsy specimen with FISH showed IDC with gene amplifications of CCND1 and ERBB2 as a minor component, IDC without amplification of CCND1 or ERBB2 as a major component, and a minute portion of ILC with CCND1 amplification. We speculate that chemotherapy and trastuzumab caused a marked reduction in IDC; however, ILC with CCND1 amplification was resistant to chemotherapy and grew. © 2014 Japanese Society of Pathology and Wiley Publishing Asia Pty Ltd

Preliminary investigation of the clinical usefulness of super-high-resolution LCDs with 9 and 15 mega-sub-pixels: Observation studies with phantoms

金沢大学附属病院放射線部Our purpose in this study was to evaluate the preliminary clinical efficacy of soft-copy reading of digital mammography, for a 15-mega-sub-pixel (MsP) and a 9-MsP super-high-resolution liquid-crystal display (SHR-LCD) by use of an independent sub-pixel driving technology. We performed three kinds of phantom observation studies by six radiological technologists. Detectability of a contrast-detail phantom and simulated small objects (SSOs) resembling microcalcifications (MCLs), and shape discrimination ability of SSOs with round and square shapes, were examined and compared with a 5-MP conventional LCD (5-MP LCD). In each study, four types of display magnification ratio were used. The detectability and the shape discrimination ability of the 15-MsP SHR-LCD were highest among the three LCDs of most of the display magnification ratios. The 9-MsP SHR-LCD indicated a higher or equal performance as compared with the 5-MP LCD in the SSO detection and shape studies. The results of our study demonstrated that the SHR-LCDs had good potential to detect MCLs and to evaluate the shape in high-resolution digital mammography. © 2009 Japanese Society of Radiological Technology and Japan Society of Medical Physics