Accuracy of Digital Breast Tomosynthesis for Detecting Breast Cancer in the Diagnostic Setting: A Systematic Review and Meta-Analysis
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- Korean Journal of Radiology
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- v.22 no.8
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- pp.1240-1252
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- 2021
Objective: To compare the accuracy for detecting breast cancer in the diagnostic setting between the use of digital breast tomosynthesis (DBT), defined as DBT alone or combined DBT and digital mammography (DM), and the use of DM alone through a systematic review and meta-analysis. Materials and Methods: Ovid-MEDLINE, Ovid-Embase, Cochrane Library and five Korean local databases were searched for articles published until March 25, 2020. We selected studies that reported diagnostic accuracy in women who were recalled after screening or symptomatic. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. A bivariate random effects model was used to estimate pooled sensitivity and specificity. We compared the diagnostic accuracy between DBT and DM alone using meta-regression and subgroup analyses by modality of intervention, country, existence of calcifications, breast density, Breast Imaging Reporting and Data System category threshold, study design, protocol for participant sampling, sample size, reason for diagnostic examination, and number of readers who interpreted the studies. Results: Twenty studies (n = 44513) that compared DBT and DM alone were included. The pooled sensitivity and specificity were 0.90 (95% confidence interval [CI] 0.86-0.93) and 0.90 (95% CI 0.84-0.94), respectively, for DBT, which were higher than 0.76 (95% CI 0.68-0.83) and 0.83 (95% CI 0.73-0.89), respectively, for DM alone (p < 0.001). The area under the summary receiver operating characteristics curve was 0.95 (95% CI 0.93-0.97) for DBT and 0.86 (95% CI 0.82-0.88) for DM alone. The higher sensitivity and specificity of DBT than DM alone were consistently noted in most subgroup and meta-regression analyses. Conclusion: Use of DBT was more accurate than DM alone for the diagnosis of breast cancer. Women with clinical symptoms or abnormal screening findings could be more effectively evaluated for breast cancer using DBT, which has a superior diagnostic performance compared to DM alone.
The properties of upland soils are much more dependent upon topography than those of paddy soils, and they give us very useful information to manage the upland fields. Therefore, we investigated the selected physical and chemical properties of upland soils at 84 and 150 topographic sampling sites, respectively. The topographic sites included 34.7% of local valley and fans, 18.7% of hilly and mountains, 20.0% of mountain foot slopes, 14.0% of alluvial plains, 8.0% of diluvium, and 4.6% of fluvio-marine deposits. Based on the investigation, soil textures in Jeonbuk upland fields were mostly sandy loam, sandy clay loam, clay loam, and clay soils, especially sandy clay loam soils were evenly distributed in all of the topographic sites. Soil slopes in the sites ranged from 0 to 15%, which showed an optimal condition for farm land. Soil bulk density and compaction values were from 1.19 to 1.24 g
We have successfully developed a more effective algorithm to extract the lineament in the area covered by wide alluvial deposits characterized by a relatively narrow range of brightness in the Landsat TM image, while the currently used algorithm is limited to the mountainous areas. In the new algorithm, flat areas mainly consisting of alluvial deposits were selected using the Local Enhancement from the Digital Elevation Model (DEM). The aspect values were obtained by 3
Water has always played a significant role in the lives of people. In urbanised Rome, with its million people. sophisticated supply systems developed and then fled with the empire. only to be rediscovered later But it was the industrial Revolution commencing in the eighteenth century that ushered in major paradigm shifts In use and altitudes towards water. Rapid and concentrated urbanisation brought problems of expanded demands for drinking supplies, waste management and disease. The strategy of using water from local streams, springs and village wells collapsed under the onslaughts of rising urban demands and pollution due to poor waste disposal practices. Expanding travel (railways. and steamships) aided the spread of disease. In England. public health crises peaks, related to water-borne typhoid and the three major cholera outbreaks occurred in the late eighteenth and early nineteenth century respectively. Technological, engineering and institutional responses were successful in solving the public health problem. it is generally accepted that the putting of water into pipe networks both for a clean drinking supply, as well as using it as a transport medium for removal of human and other wastes, played a significant role in towering death rates due to waterborne diseases such as cholera and typhoid towards the end of the nineteenth century. Today, similar principles apply. A recent World Bank report Indicates that there can be upto 76% reduction in illness when major water and sanitation improvements occur in developing countries. Water management, technology and thinking in Australia were relatively stable in the twentieth century up to the mid to late 1970s. Groundwater sources were investigated and developed for towns and agriculture. Dams were built, and pipe networks extended both for supply and waste water management. The management paradigms in Australia were essentially extensions of European strategies with the minor adaptions due to climate and hydrogeology. During the 1970s and 1980s in Australia, it was realised increasingly that a knowledge of groundwater and hydrogeological processes were critical to pollution prevention, the development of sound waste management and the problems of salinity. Many millions of dollars have been both saved and generated as a consequence. This is especially in relation to domestic waste management and the disposal of aluminium refinery waste in New South Wales. Major institutional changes in public sector water management are occurring in Australia. Upheveals and change have now reached ail states in Australia with various approaches being followed. Market thinking, corporatisation, privatisation, internationalisation, downsizing and environmental pressures are all playing their role in this paradigm shift. One casualty of this turmoil is the progressive erosion of the public sector skillbase and this may become a serious issue should a public health crisis occur such as a water borne disease. Such crises have arisen over recent times. A complete rethink of the urban water cycle is going on right now in Australia both at the State and Federal level. We are on the threshold of significant change in how we use and manage water, both as a supply and a waste transporter in Urban environments especially. Substantial replacement of the pipe system will be needed in 25 to 30 years time and this will cost billions of dollars. The competition for water between imgation needs and environmental requirements in Australia and overseas will continue to be an issue in rural areas. This will be especially heightened by the rising demand for irrigation produced food as the world's population grows. Rapid urbanisation and industrialisation in the emerging S.E Asian countries are currently producing considerable demands for water management skills and Infrastructure development. This trend e expected to grow. There are also severe water shortages in the Middle East to such an extent that wars may be fought over water issues. Environmental public health crises and shortages will help drive the trends.
Recognizing the problem of fallacy in geographical name of Changokbyeong(蒼玉屛), assumption has been made on the location of Changokbyeong through literature research on antique maps, ancient paintings, and old prose, through field survey on rock inscriptions and landscape characteristics, and through interviews with local people. Furthermore, Baegyeonwa, the Cuckoo Hut, and Iyangjung(二養亭), an annex to the cottage, both of which were managed by Saahm Park Soon(思菴 朴淳), the Subject of Jouissance, were studied in depth with emphasis on the spatial structure as well as special features of the area as a garden. The major findings are as follows: Changokbyeong is a spatial threshold that imparts a sense of unity with Okbyeng seowon(玉屛書院) and indeed Changokbyeong is presumed to have been the frontal river terrace of Okbyeng seowon according to the analysis of antique maps and rock inscriptions. This ancient location and the Ogari Stone Wall, the present day Changokbyeong, are only 460m away so that both areas are considered as falling under the influence of Changokbyeong landscape. The expression "Changokbyeong Geupsangeum(蒼玉屛及散襟)" written in an old prose tells us that the high rock wall with Sangeumdae inscribed on the rock might be the rock wall of Changokbyeong. In addition, while not a single rock inscription has been found on the Ogari Stone Wall, 11 rock inscriptions designed and ordered by Saahm Park Soon, the Subject of Jouissance, are found on every corner of the high rock wall standing in front of Okbyeng seowon, 8 of those 11 being place names and recitative poems(known as Jeyeongsi: 題詠詩) in close formation resembling the handwritings in a little notebook. This provides a strong evidence for assuming the location of Changokbyeong to be the frontal river terrace of Okbyeng seowon. The "Songgyun Jeoljo Suwol Jeongshin(松筠節調 水月精神)" rock inscription on Changokbyeong should be considered as the stamping ground and as the symbolic language of Changokbyeong that bears the high character and nobility of the Subject of Jouissance, Saahm Park Soon. The inscription should also be recognized as the handwritings of Wooahm Song Si-Yeol(尤庵 宋時烈) correcting the misconceptions that persisted until today. Meanwhile, the garden remains of Saahm's Changokbyeong are composed of four sites: Sangeumdae-Sugyeongdae-Cheonghakdae-Baekhakdae from the left. At the back of Sangeumdae, there is the original house, the Baegyeonwa(拜鵑窩), and on the fantastically shaped stone wall at the left of Baekhakdae, there is the annex, the Iyangjung, together creating a landscape composition that overlooks the splendor of the Ogari Stone Wall. The Iyangjung is located on the highest spot to the left of the four sites, and it is believed to have been a little outhouse and library for Saahm which remains to the present day as a place where Saahm's character can be felt. The drinking plates[窪樽] made of rock that are affectionately arranged on the broad flat rock in front of Iyangjung is part of the garden remains that reflects the artistic taste of Saahm regarding the drinking culture at the time.
The 2018 United Nations Development Programme (UNDP) report announced that deforestation in North Korea is the most extreme situation and in terms of climate change, this deforestation is a global scale issue. To respond deforestation, various study and projects are conducted based on remote sensing, but access to public data in North Korea is limited, and objectivity is difficult to be guaranteed. In this study, the forest detection based on density estimation in statistic using Landsat imagery was conducted in Gangwon province which is the only administrative district divided into South and North. The forest spatial data of South Korea was used as data for the labeling of forest and Non-forest in the Normalized Difference Vegetation Index (NDVI), and a threshold (0.6658) for forest detection was set by Gaussian Probability Density Function (PDF) estimation by category. The results show that the forest area decreased until the 2000s in both Korea, but the area increased in 2010s. It is also confirmed that the reduction of forest area on the local scale is the same as the policy direction of urbanization and industrialization at that time. The Kappa value for validation was strong agreement (0.8) and moderate agreement (0.6), respectively. The detection based on the Gaussian PDF estimation is considered a method for complementing the statistical limitations of the existing detection method using satellite imagery. This study can be used as basic data for deforestation in North Korea and Based on the detection results, it is necessary to protect and restore forest resources.
Background: The best dose-fractionation regimen of the definitive radiotherapy for cervix cancer remains to be clearly determined. It seems to be partially attributed to the complexity of the affecting factors and the lack of detailed information on external and intra-cavitary fractionation. To find optimal practice guidelines, our experiences of the combination of external beam radiotherapy (EBRT) and high-dose-rate intracavitary brachytherapy (HDR-ICBT) were reviewed with detailed information of the various treatment parameters obtained from a large cohort of women treated homogeneously at a single institute. Materials and Methods: The subjects were 743 cervical cancer patients (Stage IB 198, IIA 77, IIB 364, IIIA 7, IIIB 89 and IVA 8) treated by radiotherapy alone, between 1990 and 1996. A total external beam radiotherapy (EBRT) dose of
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70