Carotid intima-media thickness (IMT), an indicator of atherosclerosis and coronary heart disease (CHD) is usually evaluated by eye measurement under B-scope carotid artery ultrasonography. However, the axial resolution of this system is >/=0.1 mm, which causes difficulties in respect to accuracy and reproducibility. We evaluated a newly developed B-scope carotid artery ultrasonography programmed by an innovative measurement software, Intimascope (Media Cross Co. Ltd., Tokyo, Japan), which measures IMT with 10 times higher axial resolution at an estimated scale of 0.01 mm. Intraobserver or interobserver coefficient of variation (CV) of the computer-based average IMT (aver-IMT) value and 3-point IMT value were much smaller than the corresponding value by conventional eye-measurement method (3-point value). We measured IMT of 427 asymptomatic subjects undergoing medical checkups (243 men and 184 women, 23 to 73 years of age). Although the mean values of aver-IMT and 3-point IMT of 427 subjects were comparable with that of the eye measurement method, the aver-IMT showed the smallest SD (standard deviation) and CV values. In both men and women, multivariate regression analysis revealed significant contributions of age and LDL-C to the aver-IMT value. Univariate regression analysis revealed that the aver-IMT value of total subjects showed the highest correlation coefficient values with most risk factors and risk assessment score, Framingham Risk Assessment, or Prospective Cardiovascular Munster study (PROCAM) Risk Score. These results may suggest superiority of computer-based aver-IMT over 3-point IMT by either computer-based or eye measurement method. Carotid aver-IMT measurement using the new Intimascope software may provide a more precise and reproducible index of atherosclerosis than does conventional IMT measurement.
Clinical breast examination (CBE), ultrasonography (US) and mammography (MMG) have been used as a standard breast cancer screening methods in the practice of Automatic Multiphasic Health Testing and Service (AMHTS). Of 12,950 subjects screened, 855 cases (6.6%) were recalled for a close examination and the examination were performed in 681 cases (80.0%). As a results, 58 cases (0.45%) were diagnosed as having breast cancer, and 38 of them were in the early stage of the cancer (66.7%). In the 58 cases detected, the detection rates with CBE, US and MMG were 29.3%, 86.3% and 75.9%, respectively. In the 38 subjects of early cancer, the detection rate for CBE, US and MMG were 17.9%, 84.6% and 71.8%, respectively. The sensitivity was the highest in US. The detection rate with CBE was remarkably lower than US. All subjects detected with CBE were detectable with US.
In 89 breast cancer lesions found during clinical breast cancer screening with combined usage of mammography (MMG) and Ultrasonography (US) between February 1995 and August 2002, we found 20 cases were negative for MMG and 13 were negative for US detection. In this study we reexamined those cases of breast cancer undetectable either by MMG or breast US. The 11 of the 20 MMG negative cases, lesions were still undetectable by secondary extended examination using MMG, however, we found 9 lesions were positive for MMG by refined technique of delineation. In the 12 US negative lesions, a secondary extended examination performed using US showed 7 lesions were positive for detection; the remaining 5 lesions were still negative for US examination.In summary, of the 89 breast cancer lesions it failed to detect 14 lesions (15.7%) by MMG, and 10 lesions (11.5%) by US in a course of clinical breast cancer screening.
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