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The purpose of our study was to evaluate the reproducibility of size measurement of breast lesions using automated breast ultrasonography (ABUS) compared with that with handheld ultrasonography (HHUS). Three breast radiologists performed HHUS and measured the lesions size in 2 different phantoms: lesions with various shape, size, and same stiffness (phantom 1) and lesions with same shape, size, and various stiffness (phantom 2). After 1 month, the same radiologists measured the lesion size of the same breast phantoms in the images obtained using ABUS. We evaluated interobserver variability between 3 radiologists in ABUS and HHUS, and intraobserver variability of radiologists between ABUS and HHUS. Intraclass correlation coefficient (ICC) was used in statistical analysis. The measured size of lesions on HHUS was slightly larger than that on ABUS in both phantom 1 and 2, although not statistically significant (P = 0.314, P = 0.858). There were no significant differences in size measurements between the radiologists' measurements and the reference size in phantom 2 (P = 0.862). The ICCs for the interobserver agreement between the 3 radiologists were 0.98 to 0.99 on ABUS and 0.99 to 1.00 on HHUS, respectively. The ICCs for the intraobserver agreement between ABUS and HHUS were 0.97 to 0.97 in phantom 1 and 0.98 to 0.99 in phantom 2. In conclusion, ABUS showed excellent interobserver and intraobserver agreement with HHUS in measuring size of the lesions, regardless of shape, size, and stiffness. Therefore, ABUS mixed with HHUS can be used reliably in following up breast lesions size.

Aim To report 17-mo experience of femoral artery puncture site closure during angiographic procedures using ExoSeal vascular closure devices (VCDs). Methods Between November 2015 and April 2017, we performed 179 diagnostic and interventional angiographic procedures via a common femoral arterial access. The ExoSeal VCD was used at the puncture site to achieve hemostasis in 125 patients. We evaluated the technical and procedural success rates, the complications, and the factors affecting the hemostasis time of the ExoSeal VCDs. Results Technical and procedural successes were achieved in 176 cases (98.0%) and 128 cases (71.5%), respectively. Device failure occurred in 3 (1.7%) cases. In 1 case (0.6%) a small hematoma developed, but there were no major complications. Among the hemostasis-relevant variables, a history of drinking alcohol, low platelet (PLT) count, and high prothrombin time-international normalized ratio (commonly known as PT-INR) values were the statistically significant predictors of the need for longer manual compression (MC). There was no difference in the success rates between the repeat and single ExoSeal procedure groups, and repeated use of the ExoSeal did not affect hemostasis time. Conclusion The ExoSeal VCD effectively achieves hemostasis, with few complications. Longer light MC may be needed with alcohol drinkers, low PLT count, and high PT-INR values.

Unilateral pulmonary artery hypoplasia or agenesis without congenital cardiovascular anomalies is rare in adults. We report a case of a 36-year-old man with isolated left unilateral pulmonary artery hypoplasia with recurrent hemoptysis. On computed tomography (CT), the left pulmonary artery showed hypoplasia with multiple collateral vessels seen in the mediastinum and the left hemithorax. Also, parenchymal bands and peripheral linear opacities were seen in the affected lung, which were probably due to chronic infarction induced by unilateral pulmonary artery hypoplasia. There are only a few reports focusing on the radiologic findings in the pulmonary parenchyma induced by unilateral pulmonary artery hypoplasia, such as parenchymal bands and peripheral linear opacities. Therefore we report this case, which focused on the CT findings in the pulmonary parenchyma due to isolated unilateral pulmonary artery hypoplasia.

To develop a classification system using imaging features to interpret breast non-mass lesions (NMLs) detected on US and to stratify their cancer risk. This retrospective study included 715 patients with 715 breast NMLs detected on breast US from 2012 to 2016. Each patient underwent mammography at the time of diagnosis. Radiologists assessed US and mammographic features and final BI-RADS categories. Multivariable logistic regression was used to find imaging features associated with malignancy in a development dataset (n = 460). A system to classify BI-RADS categories (3 to 5) was developed based on the odds ratios (ORs) of imaging features significantly associated with malignancy and validated in a distinct validation dataset (n = 255). Among 715 NMLs, 385 (53.8%) were benign and 330 (46.2%) were malignant. In the development dataset, the following B-mode US features were associated with malignancy (all p < 0.001): segmental distribution (OR = 3.03; 95% confidence interval [CI], 1.50–6.15), associated calcifications (OR = 4.26; 95% CI, 1.62–11.18), abnormal ductal change (OR = 4.91; 95% CI, 2.07–11.68), and posterior shadowing (OR = 20.20; 95% CI, 6.46–63.23). The following mammographic features were also associated with malignancy (all p < 0.001): calcifications (OR = 7.98; 95% CI, 3.06–20.81) and focal asymmetry (OR = 4.75; 95% CI, 1.90–11.88). In the validation dataset, our classification system using US and mammography showed a higher area under the curve (0.951–0.956) compared to when it was not applied (0.908–0911) to predict malignancy with BI-RADS categories (p < 0.05). Our classification system which incorporates US and mammographic features of breast NMLs can help interpret and manage all NMLs detected on breast US by stratifying cancer risk according to BI-RADS categories. • When diagnosing breast NMLs detected on US, suspicious US features are segmental distribution, associated abnormal ductal change, calcifications, and posterior shadowing within or around the NML on B-mode US, while a probably benign US feature is the presence of multiple small cysts. • Corresponding suspicious mammographic features of breast NMLs detected on US are associated calcifications and focal asymmetry. • Our classification system which incorporates US features with and without mammography can potentially be used to interpret and manage any NMLs detected on breast US in clinical practice.

Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis that involves medium- and small-sized arteries. PAN may affect any organ, and the presenting symptom of PAN varies depending on the organs affected. However, PAN generally spares the lung; thus, a report of PAN involving the bronchial artery is extremely rare, and hemoptysis has not been reported as the sole presenting symptom. Here, we report the case of a 39-year-old woman with hemoptysis who was diagnosed with PAN involving only the bronchial artery by angiography without involvement of the visceral arteries. Details of this case and a literature review are presented.

Aims : To evaluate the caveolin-1 status of invasive ductal carcinoma and its correlation with other important parameters of breast carcinogenesis. Caveolin-1, the main structural protein of caveolae, is involved in the regulation of several intracellular signalling pathways and also functions as a tumour suppressor in breast carcinogenesis. Methods and results : One hundred and thirty cases of invasive ductal carcinomas with matched normal breast tissue were evaluated immunohistochemically for caveolin-1 expression. Using a tissue microarray, caveolin-1 expression was also correlated with the expression of other antigens such as eostrogen receptor, progesterone receptor, epidermal growth factor receptor (EGFR), HER2, β-catenin, E-cadherin, p53, Ki67 and with clinicopathological parameters. Immunohistochemical results showed strong expression of caveolin-1 in all normal breast epithelial cells, but a reduction of caveolin-1 expression in 56 cases (43.1%) of invasive ductal carcinoma. Furthermore, a statistically significant inverse correlation between caveolin-1 and EGFR and HER2 was noted (P