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Purpose: To investigate the feasibility of low-dose Positron Emission Mammography (PEM) to identify breast cancer. Materials and Methods: In an REB-approved ongoing clinical trial, which started in December 2019, all newly diagnosed women with breast cancer who had not undergone neoadjuvant chemotherapy and consented to the study were randomly assigned independently of their mammographic breast density, tumor size, and histopathology cancer subtype to perform PEM using a novel organ-targeted PET system(Radialis PET Imager, Radialis Inc., FDA cleared to image and measure the distribution of injected positron-emitting radiopharmaceuticals) with either 1mCi, 2mCi or 5 mCi of 18F-FDG. The PEM images acquired 1 and 4 hours after 18F-FDG administration were reviewed in consensus by two fellowship-trained breast radiologists blinded to cancer location. PEM imaging features of known malignancies and additional PEM findings were recorded and correlated with histopathology as the ground truth. Results: Our cohort comprised 22 women with a median age of 51 years (range 32-85) with 88 completed bilateral sets of images where 23 cancers (18 invasives, and 5 in situ) were present. The median invasive cancer size on surgical pathology was 28 mm (range: 3-120). Out of 18 invasive cancers, the only PEM images that did not visualize cancer (2 invasive lobular cancers and 2 in-situ cancers) were acquired with the lowest dose of 18F-FDG (1 mCi). A total of 6 (27.3%) subjects received 1mCi 18F-FDG with 5 invasive cancers, 7 (31.8%) of patients received 5 mCi 18F-FDG with 7 invasive cancers, and 9 (40.9%) of patients received 5 mCi 18F-FDG with 6 invasive cancers. A total of 3 false-positive images of benign findings were also present. No additional cancers were identified exclusively by PEM. The PEM performance was similar following an additional 3-hour interval for radiotracer uptake. Conclusion: This preliminary data results show the feasibility of invasive breast cancer detection with a decreased 18F-FDG dose, possibly due to the novel PEM system detectors increasing the sensitivity to radiotracer and the perceived spatial resolution by the visual assessment. Larger-scale clinical trials are required to consolidate our preliminary findings. Clinical Relevance: A novel organ-targeted PET system enables the detection of invasive breast cancer using low-dose PEM, potentially emerging as a promising novel imaging tool. Citation Format: Vivianne Freitas, Michael L. Waterston, Ken O. Olsen, Oleksandr Bubon, Shayna Parker, Brandon Baldassi, Borys Komarov, Samira Taeb, Alla Reznik. An Emerging Technology for Breast Cancer Detection - Preliminary Data of Breast Cancer Detection using Novel Low Dose Positron Emission Mammography [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P2-09-01.

Access to breast imaging was restricted during the first wave of the COVID-19 pandemic. We assessed the impact of healthcare restrictions on the Gattuso Rapid Diagnostic Centre (GRDC) at the Princess Margaret Cancer Centre.A retrospective review of patients seen at the GRDC between March 12 - August 31, 2020 and the corresponding period from 2019 was performed.There was an 18.6% decrease in patients seen at the GRDC (n = 429 in 2020 vs. 527 in 2019). Time from the first abnormal breast image to diagnosis was significantly shorter (17.4 days [IQR 13.0-21.8] in 2020 vs. 25.9 days [21.0-30.8] in 2019; p = 0.020) with no appreciable difference in time from diagnosis to consult or from consult to surgery.The GRDC enabled patients with concerning breast symptoms to access breast imaging, which helped to ensure timely treatment during the first wave of the pandemic.

Background The diagnostic value of screening the contralateral breast with MRI in patients with newly diagnosed breast cancer is poorly understood. Purpose To assess the impact of MRI for screening the contralateral breast on long-term outcomes in patients with newly diagnosed breast cancer and to determine whether subgroups with unfavorable prognoses would benefit from MRI in terms of survival. Materials and Methods Data on consecutive patients with newly diagnosed breast cancer seen from January 2008 to December 2010 were reviewed retrospectively. Patients with neoadjuvant chemotherapy, previous breast cancer, distant metastasis, absence of contralateral mammography at diagnosis, and no planned surgical treatment were excluded. Groups that did and did not undergo preoperative MRI were compared. Survival analysis was performed using the Kaplan-Meier method for propensity score-matched groups to estimate cause-specific survival (CSS) and overall survival (OS). A marginal Cox proportional hazards model was used to evaluate association of MRI and clinicopathologic variables with OS. Results Of 1846 patients, 1199 fulfilled the inclusion criteria. Median follow-up time was 10 years (range, 0-14 years). The 2:1 matched sample comprised 705 patients (470 in the MRI group and 235 in the no-MRI group); median ages at surgery were 59 years (range, 31-87 years) and 64 years (range, 37-92 years), respectively. MRI depicted contralateral synchronous disease more frequently (27 of 470 patients [5.7%] vs five of 235 patients [2.1%]

This study reports a clinical case of rehabilitation of a patient who had her left little finger amputated at the mesial phalanx because of a gunshot wound. The finger prosthesis was custom- made using a silicone.This study presents a clinical case of a female patient who had her left little finger amputated at the mesial phalanx because of a gunshot wound in 2016. The patient was attended at a reference center in maxillofacial rehabilitation in the city of Brasilia, Distrito Federal, Brazil, for the manufacture of a finger prosthesis. After molding, a finger waxing was obtained using the right little finger as a template. The waxing was later adjusted on the plaster model of the affected stump. The prosthesis was manufactured with silicone and intrinsically stained with a makeup powder. A water-based adhesive and a ring were used to generate a slight compression so that the prosthesis was retained on the stump.The rehabilitation showed satisfactory levels of stability, retention, and aesthetics, and it was usable and clinically acceptable, as observed in a follow-up appointment in February 2020.The complete or partial reestablishment of functions performed by important structures, such as the fingers, is essential to increase the quality of life of individuals, improving their performance of daily activities. In addition, reporting on this public health problem allows scientific advancement in the area.

Made available in DSpace on 2022-04-29T08:36:53Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Objectives The aim of this study was to verify during facial expressions (happy, sad, fearful, angry, surprised, and disgusted) if: (1) there would be difference in the electromyography (EMG) of the occipitofrontalis, temporal, masseter, and sternocleidomastoid muscles on the normal side (NS) compared with the affected side (AS) (without the use of an ocular prosthesis) in individuals with unilateral absence of the eyeball, and (2) the rehabilitation with a new ocular prosthesis would affect the EMG of the muscles studied on the AS in these individuals. Materials and Methods Thirteen individuals, without temporomandibular disorder, with good health, with unilateral absence of the eyeball (the eye must have been removed by evisceration or enucleation), and users or nonusers of an ocular prosthesis were included. EMG of the occipitofrontalis, temporal, masseter, and sternocleidomastoid muscles was performed during rest and facial expressions (happy, sad, fearful, angry, surprised, and disgusted) before (T0) and 90 days after (T1) rehabilitation with a new ocular prosthesis. The analyses were performed in T0 on NS and AS (without the use of an ocular prosthesis), and in T1 on AS with the new ocular prosthesis. Statistical Analysis All data were submitted to the Student's t -test with p < 0.05. Results There was no statistically significant difference comparing the AS with the NS in T0 for all muscles studied, during all facial expressions evaluated (p > 0.05). There was no statistically significant difference comparing the AS in T0 with itself in T1 for all muscles studied, during all facial expressions evaluated (p > 0.05). Conclusion Eye loss did not affect the EMG of studied muscles when comparing NS with AS (without the use of an ocular prosthesis). The rehabilitation with ocular prosthesis was not capable of changing the EMG on AS. Department of Dental Materials and Prosthodontics Araçatuba Dental School São Paulo State University, José Bonifácio Street, 1193, Araçatuba Oral Oncology Center School of Dentistry São Paulo State University, Araçatuba Department of Pediatric and Social Dentistry School of Dentistry São Paulo State University, Araçatuba Department of Dental Materials and Prosthodontics Araçatuba Dental School São Paulo State University, José Bonifácio Street, 1193, Araçatuba Oral Oncology Center School of Dentistry São Paulo State University, Araçatuba Department of Pediatric and Social Dentistry School of Dentistry São Paulo State University, Araçatuba

Background: Breast arterial calcification (BAC) on mammography correlates with increased cardiovascular risk. Reporting BAC is not standard practice. Our study evaluates the awareness of Canadian radiologists who report mammography of the clinical significance of BAC and their attitudes towards reporting BAC compared to their European and American counterparts. Methods: Following local institutional ethics approval, a 25 question survey (SurveyMonkey) was disseminated to Canadian radiologists via provincial and national society email lists. Responses were collected over 5 weeks (April–June 2022). Results: One hundred and eighty-six complete responses were collected. Sixty percent (112/186) were aware of the association between BAC and cardiovascular risk and 16% (29/186) document its presence in mammogram reports. Thirty five percent (65/186) occasionally document BAC if severe or in a young patient. Four percent (7/186) had local departmental guidelines on BAC reporting and 82% (153/186) agreed there is a need for national BAC reporting guidelines. Fewer Canadian radiologists were aware of the association between BAC and cardiovascular risk compared to European radiologists (60% vs 81%), report the presence of BAC compared to both European (15% vs 62%) and American (15% vs 35%) radiologists, and inform the patient of the presence of BAC compared to European radiologists (1% vs 46%). Conclusion: Canadian radiologists who report mammography were less aware of the association between BAC and cardiovascular risk than their European and American counterparts and were less likely to document the presence of BAC. Given the correlation of BAC with increased cardiovascular event risk, there is increased need for awareness as well as national BAC reporting guidelines.

To assess the reproducibility of four different centric relation (CR) recording techniques, and time spent performing each technique in edentulous individuals.Four techniques were assessed: extraoral gothic arch tracing (EOGA), intraoral gothic arch tracing (IOGA), deglutition (D), and frontal manipulation with tongue elevation (FMTE). Twelve subjects participated in the study; four technique records were performed on each volunteer by the same operator. Each record was repeated three times, in the same period of the day, with a 30 min interval between each technique. The reproducibility of each technique was assessed by the tri-dimensional displacement of the position of the condylar housing (mandible condyle) to the wall of the condylar guide (glenoid cavity) in the semi-adjustable articulator (anteroposterior, mediolateral, and superior-inferior). The time spent on each technique was timed in seconds (from the beginning of each technique until the wax occlusion fixation). The analysis of variance and the Tukey test were performed for anteroposterior displacement (two-way) and for time spent on CT recording techniques (one-way) (α0.05). Regarding mediolateral and superior-inferior displacements, the non-parametric Kruskal-Wallis was performed for the comparison between recording methods, while the Mann-Whitney test was performed for the comparison between sides (α0.05).The factor recording technique interfered with the anteroposterior displacement (ANOVA: α0.001; F = 11.396). The technique D (right side: 3.78 ± 0.69 mm; left side: 3.45 ± 0.74 mm) showed a statistically significant difference compared to the other techniques (EOGA: right side: 3.00 ± 0.00 mm; left side: 3.00 ± 0.00 mm; FMTE: right side: 2.81 ± 0.52 mm; left side: 2.82 ± 0.79 mm; IOGA: right side: 2.90 ± 0.65 mm; left side: 3.12 ± 0.44 mm). The time spent on the recording technique influenced the results (ANOVA: α0.001; F = 21.118). The IOGA (340.40 ± 163.41 seconds) and EOGA (285.93 ± 133.84 seconds) required more time compared to the D (86.00 ± 34.33 seconds) and FMTE (101.33 ± 36.72 seconds) techniques.Graphic recordings showed better reproducibility and accuracy of the position of the centric relation. This article is protected by copyright. All rights reserved.

To characterize the clinical, pathological, and imaging features of DCIS occult on conventional imaging diagnosed on MRI-guided biopsy associated with increased risk of invasive disease on surgical excision. All consecutive patients with MRI-detected DCIS occult on conventional imaging between January 2009 and December 2018 were included. Women were divided into two groups based on final pathology: Pure DCIS or DCIS with invasive component. Clinical, imaging, and pathological risk factors for upgrade to invasion were evaluated. Of 50 patients who met the inclusion criteria, 12 (24%) were upgraded to invasive malignancy in the final pathology. The only parameters that showed statistically significant association with upgrade were related to kinetic characteristics: 53% of patients with the combination of fast early upstroke and either plateau or washout curve were upgraded, compared to 12% of women without this combination (p = 0.006). The sensitivity of combined kinetic features for predicting upgrade was 67% (95% CI 35–90%), specificity was 84% (CI 95% 68–94%), positive predictive value was 57% (CI 95% 37–75%), negative predictive value was 89% (CI 95% 77–95%), and OR was 78% (64–88%). Kinetic characteristics show the strongest association with upgrade to invasion in DCIS occult on mammogram and US. Larger studies should be encouraged to consolidate our findings, which may have implication for treatment planning.

A Odontologia estética está em evidência na atualidade, sendo assim, cada vez mais pessoas buscam por reabilitações orais para suprir exigências pessoais e sociais de beleza ideal do sorriso. Dessa forma, avanços na qualidade dos materiais restauradoras além de novas técnicas de moldagem, como uso do escâner digital, foram apresentados e discutidos. O propósito desse artigo foi descrever um relato de caso clínico de reabilitação oral com laminados do sistema cerâmico IPS E.max, associado ao uso de escaneamento digital. Uma paciente do gênero feminino procurou atendimento odontológico com interesse de restabelecer a harmonia do incisivos centrais e laterais, por insatisfação com as restaurações antigas. Foram analisadas as suas queixas e expectativas e proposto um planejamento, além de registro fotográfico, moldagem dos arcos, montagem em articulador semi-ajustável, planejamento digital do sorriso e o encaminhamento ao laboratório para confecção do enceramento diagnóstico, que auxiliou na etapa de mock-up. Os dentes foram preparados e submetidos à impressão óptica por um escâner especial Bluecam da CEREC Sistema CAD / CAM (desenho assistido por computador / manufatura assistida por computador). Os laminados de dissilicato de lítio (IPS E.max) foram cimentados com cimento resinoso fotopolimerizável na cor translúcida. Conclui-se que um planejamento apropriado ocorre desde um bom diagnóstico, preparos dentários e uma boa técnica de moldagem. Além disso, o uso do escâner digital é um recurso que pode auxiliar no sucesso do tratamento reabilitador com o uso do sistema IPS E.max.

Introdução: O objetivo deste trabalho foi avaliar a influência de diferentes métodos de tratamento de superfície em pinos de fibra de vidro com relação a sua força de união com a resina composta e avaliar os tipos de falhas ocorridas. Materiais e Métodos: Foram utilizados 36 pinos da WhitepostDC (grupo GF) e Exacto Cônicos (grupo GA), divididos em: Grupos controle GF-1 e GA-1 – aplicação de silano de acordo com as especificações do fabricante; Grupos GF-2 e GA-2 – condicionamento com peróxido de hidrogênio a 10% e silanização; Grupos GF-3 e GA-3 – Jateamento com óxido de alumínio por 10 segundos e silanização. A adição da resina composta foi realizada em incrementos de 2 mm, com fotopolimerização de cada incremento por 40 segundos, até o preenchimento de toda extensão da matriz. Então, o conjunto pino e resina composta foi seccionado em três porções (cervical, médio e apical) (n = 18). As amostras foram submetidas à análise de resistência de união através do teste Push-Out em uma Máquina de Ensaio Universal (EMIC), e os tipos de falhas foram avaliados com aumento 30 × com um microscópio óptico. Os dados foram submetidos à análise de variância, ao teste de Tukey e ao teste de qui-quadrado com significância de 5%. Resultados: Nos grupos GA, o tratamento com silano (23,10 MPa) resultou em resistência de união estatisticamente maior que os tratamentos com peróxido (17,19 MPa) e com jateamento (16,28 MPa). No tratamento com peróxido, a resistência de união foi estatisticamente maior no terço médio (21,16 MPa) que no terço apical (12,55 MPa). A falha do tipo mista teve a maior prevalência (57,01%). Conclusão: O tratamento com silano apresentou maior resistência de união, com diferença estatística dos demais grupos na marca Angelus., Introduction: The aim of this study was to evaluate the influence of different surface treatment methods on glass-fiber posts relative to their bond strength with the composite resin and to evaluate the types of failures that occurred. Materials and Methods: Thirty-six posts from WhitepostDC (FG group) and Exacto Conics (AG group) were used, divided into: Control FG-1 and AG-1 groups – application of silane, according to manufacturers’ specifications; FG-2 and AG-2 groups – conditioning with 10% hydrogen peroxide and silanization; FG-3 and AG-3 groups – aluminum oxide blasting for 10 seconds and silaniza-tion. The composite resin was added in 2-mm increments, each increment was photopolymerized for 40 seconds, until the entire length of the matrix was filled. Then, the assembly (fiber post and composite resin) was sectioned into three portions (cervical, middle and apical) (n = 18). Samples were submitted to the bond strength analysis by a push-out test in a Universal Testing Machine and the failure types were evaluated with a 30 × magnification with an optical micro-scope. Data were submitted to the analysis of variance, the Tukey test, and the chi-square test with a 5% significance level. Results: For AG groups, the treatment with silane (23.10 MPa) resulted in statistically greater bond strength than the treatments with peroxide (17.19 MPa) and blasting (16.28 MPa). It was found that the bond strength was statistically higher in the middle third (21.16 MPa) than in the apical third (12.55 MPa) for the peroxide treatment. The mixed-type failure had the highest prevalence (57.01%). Conclusion: Silane treatment showed statistically greater bond strength values, when the Angelus brand was tested.

Made available in DSpace on 2022-04-29T08:30:41Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Objectives This study aimed to assess the relation between the insertion torque and implant stability quotient (ISQ recorded immediately and 6 months after implant placement). Materials and Methods Twenty-five patients over the age of 18 years were selected for this study. One implant was placed per patient after tooth extraction. The implant site needed 15 mm in height and 8 mm in width. All implants had the same size (11.5 × 3.75 mm) and brand (Hexagonal Morse cone, DSP Biomedical). The insertion torque (Ncm) and resonance frequency analysis (ISQ value) (Osstell Mentor) were used to assess the primary stability (on the day of surgery). After 6 months, ISQ value was used to assess the secondary stability of each implant. Statistical Analysis The insertion torque data were correlated with ISQ measurements by using Pearson's correlation. The significance level was 5%. Results There was a positive correlation between insertion torque and initial ISQ (correlation: 0.457; p = 0.022); however, no correlation was found between insertion torque and final ISQ (p = 0.308). Conclusion The present study demonstrated that there is a positive correlation between the insertion torque and the initial ISQ. Therefore, the higher the insertion torque, the higher the initial ISQ (or vice versa). Department of Dental Materials and Prosthodontics Araçatuba Dental School São Paulo State University José Bonifácio, 1153, Vila Mendonça, Araçatuba Oral Oncology Center Araçatuba Dental School São Paulo State University Araçatuba Department of Dental Materials and Prosthodontics Araçatuba Dental School São Paulo State University José Bonifácio, 1153, Vila Mendonça, Araçatuba Oral Oncology Center Araçatuba Dental School São Paulo State University Araçatuba

Digital breast tomosynthesis (DBT) is gradually being implemented in routine clinical breast imaging practice. The technique of image acquisition reduces the confounding effect of overlapping breast tissue, which substantially affects cancer detection, abnormal recall, and interval cancer rates in a screening/ surveillance setting. In a diagnostic setting, tomosynthesis also allows for improved lesion localization and characterization over conventional imaging, which potentially improves the accuracy and improved workflow efficiency. To optimize the utility of tomosynthesis, imagers should be aware of the pertinent aspects of image acquisition as it relates to interpretation, the appearance of benign and malignant pathologies, and sources of possible misinterpretation. This article aims to provide a practical knowledge base of DBT and demonstrate its potential benefits when incorporated into routine clinical practice.

Purpose: Assess the upgrade rate of biopsy-proven stromal fibrosis without associated atypiato inform the most appropriate management approach in patients with biopsy-proven stromal fibrosis without associated atypia.Materials and Methods: REB-approved consecutive retrospective review of patient’s data of imaging-guided biopsy-proven stromal fibrosis carried out between 2014 and 2019. The upgrade rate of malignancy and the imaging features of the upgraded cases on surgical excision were recorded. The results were correlated with surgical histopathology as the ground truth or an uneventful clinical and radiological follow-up of at least 2 years. Predictors for malignancy were examined, and appropriate statistical tests were applied. Results: Out of 9814 consecutive imaging-guided breast biopsies performed during the study period, 334 patients (4.8%) median age 52 years, had biopsy-proven stromal fibrosis without atypia and fulfilled the inclusion criteria, representing the study cohort. Out of 334 cases, 4 cases (1.2%) were upgraded to malignancy in the two years follow-up. Older patients (> 50 years) are associated with an upgrade to malignancy (p ), and those with a personal history of breast cancer have a trend to upgrade to malignancy (p=0.066). No other clinical and imaging features are related to the malignancy upgrade.Conclusion: For benign radiology-pathology concordant stromal fibrosis on imaging-guided breast biopsy, the upgrade for biopsy results demonstrating stromal fibrosis without atypia is low at 1.2% but not 0; therefore diagnostic follow-up for 2 years as BI-RADS 3 (defined as > 50 years) and those with a personal history of breast cancer are subgroups of patients that may justify multidisciplinary discussion and possible re-sampling.