This study was conducted to compare quantifiable measures of vascularity obtained from contrastenhanced color flow images of breast lesions to pathologic vascularity measurements. Nineteen patients with solid breast masses received Levovist ® Injection (10 ml at 300 mg/ml; Berlex Laboratories, Montville, NJ, USA). Color flow images of the mass pre and post contrast were obtained using an HDI 3000 scanner (Philips Medical Systems, Bothell, WA, USA) optimized for clinical scanning on an individual basis. After surgical removal specimens were sectioned in the same planes as the ultrasound images and stained with an endothelial cell marker (CD31). Microvessel area (MVA) and intratumoral microvessel density (MVD) were determined for vessels 10-19μm, 20-29μm, 30-39μm, 40-49μm, and >50μm in diameter using a microscope and image processing software. From the ultrasound images the number of color pixels before and after contrast administration relative to the total area of the breast mass was calculated as a first order measure of fractional tumor vascularity. Vascularity measures were compared using reverse stepwise multiple linear regression analysis. In total, 58 pathology slides (with 8106 frames) and 185 ultrasound images were analyzed. There was a significant increase in flow visualization pre to post Levovist injection (p=0.001), but no differences were found between the 11 benign and the 8 malignant lesions (p>0.35). Ultrasound vascularity measurements post contrast correlated significantly with pathology (0.15≤r 2 ≤0.46; p<0.03). The 30-39μm vessel range contributed most significantly to the MVD relationship (p<0.001), while the MVA was mainly influenced by vessels 20-29μm (p<0.004). Pre contrast ultrasound only correlated with pathology for relative MVA (r 2 =0.16; p=0.01). In conclusion, contrast-enhanced color flow imaging provides a noninvasive measure of breast tumor neovascularity corresponding mainly to vessels 20-39μm in diameter, when used in a typical clinical setting.
An fMRI pitch memory task was administered to left and right anterior temporal lobectomy (ATL) patients. The goal was to verify the neuroanatomical correlates of non-verbal memory, and to determine if pitch memory tasks can identify cognitive risk prior to ATL. The data showed that the bilateral posterior superior temporal lobes implement pitch memory in both ATL patients and NCs (normal controls), indicating that the task can be accomplished with either anterior temporal lobe resected. NCs activate the posterior temporal lobes more strongly than ATL patients during highly accurate performance. In contrast, both ATL groups activate the anterior cingulate in association with accuracy. While our data clarifies the functional neuroanatomy of pitch memory, it also indicates that such tasks do not serve well to lateralize and functionally map potentially “at risk” non-verbal memory skills prior to ATL.
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