In order to investigate the reliability of ultrasonography in the diagnosis of fatty liver, retrospective evaluation was made of abdominal echograms in 45 patients with various diffuse liver diseases who underwent liver biopsy within 2 weeks after the ultrasound study. Instead of the well-recognized but subjective diagnostic criterion, i.e. the bright liver pattern, liver-kidney contrast is proposed as a new criterion. The liver-kidney contrast is based on the brightness of the liver in comparison to the renal parenchyma where fatty change seldom occurs. Combination of this liver-kidney contrast with two other well-known ultrasonographical findings of fatty liver, vascular blurring and deep attenuation, enables us to grade fatty change semiquantitatively. When fatty change of over 30% in the hepatic lobule was adopted as the definition of fatty liver, the satisfaction of both liver-kidney contrast and vascular blurring presented an ultrasound diagnostic criterion for fatty liver, with sensitivity of 83%, specificity of 100%, and an accuracy of 96%.

In Japan, BRCA1/2 testing has been made available to the public as a companion diagnostic test for olaparib since July 2018. This testing indication has been expanded to diagnosis of hereditary breast and ovarian cancer. The Japanese breast cancer society (JBCS) issued original guidance and criteria to estimate eligibility for BRCA testing among breast cancer patients. This retrospective study aimed to evaluate the current Japanese situation of BRCA testing and the utility of JBCS criteria. We retrospectively reviewed medical records of 1,136 early breast cancer patients. The number of the patients who were eligible for BRCA testing based on JBCS criteria was retrospectively counted. The relationship between the six categories of JBCS and BRCA pathogenicity was evaluated using multivariate analysis. Among the entire cohort, 40.2% met at least one criterion. Being diagnosed with breast cancer at 45 years or younger of age, having two or more primary breast cancers, and being diagnosed with triple negative breast cancer at 60 years or younger significantly increased the likelihood of having BRCA mutation (OR: 8.8, 20.8, 8.6, respectively). In addition, the patients that met two or more testing criteria had higher rates of BRCA mutation than those that met only one criterion. This study suggests that approximately 40% of early breast cancer patients are potential candidates for BRCA testing and/or genetic counseling based on JBSC criteria. Prioritizing the six categories may make the criteria more applicable for use in the current Japanese clinical setting, as genetic practice has limited specialist human resources.

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The ultrasonographic appearance of hepatic hemangiomas was studied in 19 patients (31 lesions). The detectability rate by real-time ultrasonography was 77%. A hyperechoic, sharply-marginated and internally homogeneous lesion is highly suggestive of hemangioma. If the hypoechoic lesion has homogeneous internal echoes and/or strong marginal echoes, it is also suggestive of hemangioma. It is difficult to detect small lesions in the lower lateral part of the right lobe and lesions in the right lobe immediately under the diaphragm. Computed tomography should be the next procedure of choice in the evaluation process. If the computed tomography is not characteristic, angiography should be done to confirm the diagnosis.