Non-mass-like breast lesions detected on MRI showing a clustered ring enhancement, a branching-ductal pattern, and clumped architecture should be evaluated further by biopsy (category 4), while lesions not showing these characteristics may be observed without unnecessary intervention (category 3a). Lesions showing a linear-ductal pattern may be followed carefully or evaluated by biopsy as needed (category 3b).

Purpose:To assess the efficacy of 1 H MR spectroscopy (MRS) to evaluate early responses to neoadjuvant chemotherapy in breast cancer patients, as compared to that of the standardized uptake value (SUV) in 18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET). Materials and Methods:This retrospective study included seven patients with breast cancer who had both single-voxel 1 H MRS and PET/computed tomography (CT) acquired before, during, and after neoadjuvant chemotherapy. Results:The averages of the Choline (Cho) integral value and peak SUV before chemotherapy were 2.5 (range, 1.2-5.3) and 7.5 (range, 1.9 -19), respectively. Three cases became negative for both Cho and peak SUV after two cycles of chemotherapy, and one patient became negative before surgery. In the remaining three patients, the curves of both values paralleled the time course of chemotherapy treatment. The difference between Cho and peak SUV before, during, and after chemotherapy was r ϭ 0.65 (P ϭ 0.12), r ϭ 0.80 (P ϭ 0.03), and r ϭ 0.99 (P Ͻ 0.001), respectively. The reduction rate (RR) of both values after chemotherapy was also correlated (r ϭ 0.84, P ϭ 0.02). Conclusion:A change in the Cho integral value is well correlated with that of peak SUV in the time course of neoadjuvant chemotherapy; thus, breast 1 H MRS is thought to be an alternative to sequential 18 F-FDG PET.

Microtubule-associated protein MAP1A is expressed abundantly in mature neurons and is necessary for maintenance of neuronal morphology and localization of some molecules in association with the microtubulebased cytoskeleton. Previous studies indicated that its complementary expression together with MAP1B during nervous system development is regulated at the transcriptional level and that the mouse Map1A gene is transcribed under the control of 5 and intronic promoters. In this study, we investigated the regulatory mechanisms that govern the neuronal cell-specific activation of the MAP1A 5 promoter. We found that two regulatory factor for X box (RFX) binding sites in exon1 of both the mouse and human genes are important for effective transcriptional repression observed only in non-neuronal cells by reporter assays. Among RFX transcription factor family members, RFX1 and 3 mainly interact with repressive elements in vitro. Cotransfection studies indicated that RFX1, which is expressed ubiquitously, down-regulated the MAP1A 5 promoter activity in nonneuronal cells. Unexpectedly, RFX3, which is abundantly expressed in neuronal cells, down-regulated the transactivity as well, when it was expressed in nonneuronal cells. Both RFX1 and 3 did not down-regulate the transactivity in neuronal cells. These results suggest that RFX1 and 3 are pivotal factors in down-regulation of the MAP1A 5 promoter in non-neuronal cells. The cell type-specific down-regulation, however, does not depend simply on which RFX interacts with the elements, but seems to depend on underlying profound mechanisms.MAP1A is a high molecular weight MAP 1 that plays an important role in determining neuronal morphology and in determining the balance between plasticity and stability of neuritis (1, 2). MAP1A and 1B are particularly abundant filamentous MAPs in the brain and possess highly similar structures and functions in their stabilization of microtubule bands.Recent studies have demonstrated that MAP1A interacts with postsynaptic density-93, a membrane-associated guanylate kinase (3), and is involved in the general attachment of mRNA to the cytoskeleton (4). Thus, MAP1A seems to act not only in stabilizing microtubule bands but also in regulating the distribution of associated molecules as a linker between them and the microtuble-based cytoskeleton. MAP1B has been shown to link ␥-aminobutyric acid, type C receptors to microtubule (5), indicating that MAP1A and 1B anchor distinct target molecules to the cytoskeleton. The different expression patterns of MAP1A and 1B, which are transcriptionally regulated (6), also support the functional dichotomy of these two filamentous MAPs. MAP1B is the earliest MAP expressed during central nervous system development; it is most highly expressed during the postneonatal period, diminishing as the animal matures to adulthood (6 -9). In contrast, MAP1A expression increases continually during the postneonatal period and is maintained at a high level throughout adulthood (6, 8 -10).Multiple promoters, cell type-specific c...

The high rate of DCIS might be a unique feature among Japanese women. However, MRI-guided VAB is necessary for MRI-only visible suspicious lesions in Japan.

MR-guided VAB can be performed safely and it is needed for MR-only visible suspicious lesions in Japan.