降级时代的成像管道癌在现场:风险适应管理的作用,限制和临床影响
Marcella Buono1, Luigi Schiavone2, Sighelgaita Rizzo1
1Department of Interventional and Emergency Radiology, San Giuseppe Moscati Hospital, 83100 Avellino, Italy.
Diagnostics (Basel, Switzerland)
|March 14, 2026
概括
通过乳房镜检测在位管道癌 (DCIS) 的增加引发了过度诊断的担忧. 图像对监测至关重要,但其在引导治疗减缓和DCIS积极监测方面的作用需要仔细评估风险.
科学领域:
- 放射学 放射学是一门学科.
- 在瘤学瘤学.
- 乳房成像 乳房成像
背景情况:
- 基于人口的乳房扫描查增加了管道癌在位 (DCIS) 检测.
- 这种增加,而乳腺癌死亡率没有相应的下降,加剧了人们对过度诊断和过度治疗的担忧.
- 对治疗缓和和DCIS的积极监测越来越感兴趣.
研究的目的:
- 审查各种成像模式在当代DCIS管理中的作用.
- 检查DCIS主动监控试验中成像技术的实施情况.
- 提出一个框架,将成像纳入风险适应的DCIS管理.
主要方法:
- 在DCIS中对乳房影像,超声波,MRI,CEM和AI的当前文献进行审查.
- 在主动监控试验中分析成像的实用性 (LORIS,COMET,LORD,LORETTA).
- 评估成像能够预测个体疾病进展与人口层面的风险因素相比的成像能力.
主要成果:
- 图像对DCIS检测,范围评估和监控至关重要.
- 图像特征与风险因素相关,但对个体进展的预测能力有限.
- 图像处理作为一种风险过工具,以排除观察不安全的场景.
结论:
- 在DCIS管理中成像能力很重要,但具有固有的局限性.
- 提出了一个结构化的框架,在这个框架中,成像支持,但不要求,风险适应管理.
- 在多学科决策中严格整合成像是安全降级和以患者为中心的护理的关键.
相关概念视频
01:29Chronic Obstructive Pulmonary Disease-V: Management
3.3K
Managing Chronic Obstructive Pulmonary Disease (COPD) involves a multifaceted approach to reduce symptoms, prevent exacerbations, improve overall health status, and slow disease progression. Key strategies include lifestyle modifications, pharmacotherapy, supportive therapies, and, in some cases, surgery. Here is an overview of the primary COPD management strategies:
Smoking Cessation
Smoking Cessation
3.3K
01:28Esophageal Varices-II: Clinical Features and Management
884
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
884
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
627
Biopharmaceutical studies constitute a vital field aiming to enhance drug delivery methods and refine therapeutic approaches, drawing upon diverse interdisciplinary knowledge. In research methodologies, the choice between controlled and non-controlled studies significantly influences the study's reliability and accuracy.
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
627
01:29Therapeutic Drug Monitoring: Affecting Factors
429
Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
429
01:21Cancer Survival Analysis
863
Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
863
01:12Hazard Ratio
756
The hazard ratio (HR) is a widely used measure in clinical trials to compare the risk of events, such as death or disease recurrence, between two groups over time. It reflects the ratio of hazard rates—the instantaneous risk of the event occurring—between a treatment group and a control group. This measure provides valuable insights into the relative effectiveness of a treatment by assessing how the risk of an event differs between the two groups.
For example, in a clinical trial...
For example, in a clinical trial...
756