The heterogeneous presentation of DCIS on MRI reflects underlying histopathologic differences.

OBJECTIVE We implemented and monitored a clinical service, Consultation Planning, Recording and Summarizing (CPRS), in which trained facilitators elicit patient questions for doctors, and then audio-record, and summarize the doctor-patient consultations. METHODS We trained 8 schedulers to offer CPRS to breast cancer patients making treatment decisions, and trained 14 premedical interns to provide the service. We surveyed a convenience sample of patients regarding their self-efficacy and decisional conflict. We solicited feedback from physicians, schedulers, and CPRS staff on our implementation of CPRS. RESULTS 278 patients used CPRS over the 22 month study period, an exploitation rate of 32% compared to our capacity. Thirty-seven patients responded to surveys, providing pilot data showing improvements in self-efficacy and decisional conflict. Physicians, schedulers, and premedical interns recommended changes in the program’s locations; delivery; products; and screening, recruitment and scheduling processes. CONCLUSION Our monitoring of this implementation found elements of success while surfacing recommendations for improvement. PRACTICE IMPLICATIONS We made changes based on study findings. We moved Consultation Planning to conference rooms or telephone sessions; shortened the documents produced by CPRS staff; diverted slack resources to increase recruitment efforts; and obtained a waiver of consent in order to streamline and improve ongoing evaluation.

"Investigation of the sensitivity of functional near-infrared spectroscopy brain imaging to anatomical variations in 5-to 11-year-old children," Neurophoton. 5(1), 011009 (2017), doi: 10.1117/1.NPh.5.1.011009. Abstract. Functional near-infrared spectroscopy (fNIRS) is a noninvasive brain imaging technique that uses scalp-placed light sensors to measure evoked changes in cerebral blood oxygenation. The portability, low overhead cost, and ability to use this technology under a wide range of experimental environments make fNIRS wellsuited for studies involving infants and children. However, since fNIRS does not directly provide anatomical or structural information, these measurements may be sensitive to individual or group level differences associated with variations in head size, depth of the brain from the scalp, or other anatomical factors affecting the penetration of light into the head. This information is generally not available in pediatric populations, which are often the target of study for fNIRS. Anatomical magnetic resonance imaging information from 90 school-age children (5 to 11 years old) was used to quantify the expected effect on fNIRS measures of variations in cerebral and extracerebral structure. Monte Carlo simulations of light transport in tissue were used to estimate differential and partial optical pathlengths at 690, 780, 808, 830, and 850 nm and their variations with age, sex, and head size. This work provides look-up tables of these values and general guidance for future investigations using fNIRS sans anatomical information in this child population.

Background-Imaging patterns of benign proliferative processes often complicate the assessment of ductal carcinoma in situ (DCIS) by magnetic resonance imaging (MRI). We investigated the pathologic and biologic characteristics of false positive enhancement by breast MRI.