Method for detecting disease flow at mammary cancer chemotherapy

FIELD: medicine, oncology.

SUBSTANCE: before the onset and 10-14 d after the end of chemotherapy course it is necessary to carry out chromatic Doppler mapping to evaluate maximal tumor rate of circulation, and at its decreased value being 25% lower against initial data one should establish process stabilization, and at its increase being 25% higher against the initial data - process progressing should be stated upon. The innovation enables to objectively evaluate efficiency of chemotherapy at applying safe, simple ultrasound trial for the purpose to specify subsequent therapeutic tactics.

EFFECT: higher efficiency and accuracy of detection.

8 dwg, 3 ex

 

The aim of the invention is identifying the objective of informative factors determine the course of the disease after preoperative chemotherapy for breast cancer, stabilization or progression of the process.

This goal is achieved by the fact that chemotherapy for breast cancer, including her ultrasound, prior to chemotherapy treatment and 10-14 days after the end of chemotherapy spend with color Doppler mapping, estimate the maximum velocity of the blood flow in the tumor and decreasing the maximum flow velocity is less than 25% of the original define the stabilization process, and when it increased by more than 25% from the baseline - determine the progression of the process.

The invention "method for determining the course of the disease with chemotherapy for breast cancer" is new, because it is unknown the level of medicine in the field of Oncology, chemotherapy for breast cancer.

The novelty of the invention lies in the fact that before the treatment is performed ultrasonography of mammary glands, supplemented modes color Doppler mapping (DDC).

The principal difference of the proposed method is the introduction of a new clear digital criterion of the disease, the effectiveness of the treatment, determine what is possible, thus, stabilization or progression of the process, determine the tactics of the patient.

Examples of a specific implementation method of determining the course of the disease with chemotherapy for breast cancer

1. Patient L.,aged 65, IB. No. 1103/R.

Diagnos: breast Cancer, nodular form, with metastases in the left cushion lymph nodes (TIMO), St, gr. diagnosed cytologically verified (PB No. 14003-006 from 05.01.03).

Ultrasound from 09.01.02 before treatment: lazerette hypoechoic formation of heterogeneous echostructure with a rough contour, size 5,3×4.8 cm (figure 5) with intense peripheral and Central blood flow Vmax- 46.2 cm/s (Fig.6).

With 10.01.02 on 24.01.02 held chemotherapy: methotrexate 60 mg, 5-fluorouracil 2500 mg, cyclophosphamide 1000 mg, doxorubicin 150 mg

Repeated ultrasound from 08.02.03. lazerette education hypoechoic density of heterogeneous echostructure size of 4.9×4.1 cm (Fig.7) is a mixed type of tumor vascularization Vmax77,6 (Fig).

The size of the tumor indicate the absence of regression of the tumor, with a marked increase in Vmaxmore than 25% (46,2 to 77.6 cm, 67%), which predicted an unfavorable course of disease progression. Noted early in the generalization process after 2.5 months with bone metastases and the pleura. The patient is directed to the rate of production of therapy.

2. Patient K.,aged 45, IS 16002/p

Diagnosis: cancer of the left breast, the nodular form with metastasis in the left axillary lymph nodes (T2 II MO) St gr. Diagnosed cytologically verified (PB No. 12307-311 from 22.01.03).

Ultrasound from 23.01.02: at the bottom of the inner square of the left breast lazerette hypoechoic mass 3,22×3,31 cm (Fig) with peripheral type of flow Vmax- 17.5 cm/s (figure 1).

With 24.01 on 23.02.02 held chemotherapy: methotrexate 50 mg, 5-fluorouracil 3000 mg, cyclophosphamide 1200 mg, doxorubicin 120 mg

Repeated ultrasound 15.03.02: at the bottom of the inner square of the left breast is hypoechoic mass 2,1×1.5 cm (figure 4), inhomogeneous structure with an intense type of flow Vmax10 cm/s (figure 2).

Regression of the tumor was 78%, Vmaxdecreased by 43% (from 17.5 to 10 cm/s).

According to who criteria regression assessed as partial. Sick the next step carried out surgical treatment, as the disease is estimated as the stabilization process.

Thus, the above cases show that when similar types of tumor vascularization (1 and 2 examples) possible different effect of treatment, assessing with the help of qualitative parameters (Vmaxit is possible to predict prognosis and to choose a proper treatment.

Feasibility effectively the beat "Method for determining the course of the disease with chemotherapy for breast cancer is the method provides an objective assessment of current tumor process with the use of harmless, simple, affordable ultrasound, allows to identify effective regimen in the early stages of pre-treatment and impact on primary tumor site and metastasis in a timely manner to determine the correct tactics of the further treatment and in the postoperative period.

The method of determining the course of the disease with chemotherapy for breast cancer, including her ultrasound, characterized in that before and after 10-14 days after chemotherapy spend with color Doppler mapping, estimate the maximum velocity of the blood flow in the tumor and decreasing the maximum flow velocity is less than 25% of the original define the stabilization process, and when it increased by more than 25% of the original determine the progression of the process.



 

Same patents:

FIELD: urology.

SUBSTANCE: one performs ultrasonic echo-dopplerometric investigation of regional blood flow in prostate before and after treatment to determine quantitative parameters. When pulsation index is reduced from 1.39±0.12 before treatment to 1.10±0.09 after treatment and venous blood flow velocity increases, respectively, from 3,91±0.36 to 5,22±0.47, treatment is regarded effective and completed.

EFFECT: increased accuracy of estimation.

1 tbl

FIELD: medicine.

SUBSTANCE: method involves determining microcirculation indices in rest state by applying Doppler laser flowmetry method and capillary blood circulation reserve indices in occlusion sample under cuff pressure being 30 mm of mercury column as high as the systolic patient blood pressure during 3 min. Cardiorespiratory disorders development is predicted in postoperative period, The microcirculation indices being greater than 6.0 perfusion units in combination with capillary blood circulation reserve indices being greater than 300% or microcirculation indices being below than 4.5 perfusion units in combination with capillary blood circulation reserve indices being greater than 200%.

EFFECT: high accuracy of prognosis.

FIELD: medicine.

SUBSTANCE: method involves carrying out visual and rectal examination. Peripheral blood circulation speed is measured in rectovaginal partition blood vessels. Rectovaginal partition folds are detected and increase in its thickness. Levators separation exceeding 20 mm is determined. Fibrous degeneration of rectovaginal partition is detected. Reduced blood circulation speed in levators is detected. Anterior rectocele is diagnosed. Values are measured by introducing ultrasonic transducer into the rectum. One of versions assumes introduction of hygienic intravaginal tampon into the vagina.

EFFECT: high reliability of diagnosis.

2 cl, 8 dwg

FIELD: medicine.

SUBSTANCE: method involves examining retina light sensitivity degree using computer-aided perimetry approach within 60° bandwidth from fixation point. Direct orbital muscle thickness and retrobulbar space volume is additionally determined by applying ultrasonic b-scanning method. Linear blood circulation speed and resistance index are also determined in the central retinal artery and posterior short ciliary arteries. Macular or general light sensitivity reduction 25% and more relative to age-specific norm being observed together with 50% growth and more in direct orbital muscle thickness, retrobulbar space volume growth by more than 35% in combination with linear blood circulation speed reduction in the central retinal artery and posterior short ciliary arteries by 40% and more and increasing resistance index by 20% and more relative to physiologic norm, optic nerve abnormality is diagnosed at early disease stages.

EFFECT: high reliability of diagnosis.

2 tbl

FIELD: medicine.

SUBSTANCE: method involves diagnosing gestosis severity degree with clinical signs and blood circulation being studied. Ultrasonic examination with Doppler color mapping is carried out in female patients manifesting fuzzy clinical symptoms. Intrarenal artery resistance index is determined. The value being within 0.62-0.65%, mild gestosis is to be diagnosed. The value being within 0.66-0.69%, moderate severity degree gestosis is to be diagnosed. The intrarenal artery resistance index being equal to or greater than 0.7%, severe gestosis cases are to be diagnosed.

EFFECT: high accuracy of diagnosis; noninvasive diagnosis method.

FIELD: medicine.

SUBSTANCE: method involves making lumbar puncture and measuring liquor pressure, taking pleocytosis into account, making ultrasonic transcranial Doppler flowmetric examination of brain, determining linear blood circulation speed on interior carotid artery and posterior cerebral artery, detecting intracranial venous discharge disorders through orbital and vertebral veins. Regression coefficient is calculated from a formula

where X1 is patient age (in years); X2 is the pleocytosis in the first lumbar sample (in cells number per 1 mcl of liquor); X3 is the meningitis symptoms duration (in days); X4 is the focal symptoms availability (1- yes, 0- no); X5 is the general cerebral symptoms duration (in days); X6 is the liquor pressure when taking the first lumbar puncture (in mm of mercury column); X7 is the linear blood circulation speed in interior carotid artery (in Hz/s); X8 is the linear blood circulation speed in posterior cerebral artery (in Hz/s); X9 is the intracranial venous discharge disorders based on ultrasonic transcranial Doppler flowmetric examination data; retrograde discharge through orbital veins, increased one through vertebral veins and others (1- yes, 0- no). Value of y≤0.5, unfavorable outcome is to be predicted with cerebroasthenic, asthenoneurotic and hypertension syndromes being formed. If y>0.5, favorable infectious process outcome is to be predicted.

EFFECT: high accuracy of diagnosis.

4 tbl

FIELD: medicine, ophthalmology.

SUBSTANCE: the present innovation deals with methods for diagnostics of vascular pathology of optic nerve (ischemic opticopathies) and, also, predicting vascular pathology of optic nerve lesion and counterlateral eyeball. One should perform dopplerographic registration of circulatory parameters: peak systolic velocity PSV cm/sec and end diastolic velocity EDV cm/sec on the 2nd, 3d min both before and at the background of functional loading: dealing with lifting legs up to 90° in area of internal carotid artery, central retinal artery and ciliary artery. Moreover, calculation of resistant index RI c. u. should be performed by the following formula (PSV cm/sec - EDV cm/sec)/PSV cm/sec and reactivity index RY c.u. by the following formula PSV cm/sec after loading/PSV cm/sec before loading. At RI value being above 0.7 and RY value being below 1.0 one should detect deterioration of visual functions and the absence of circulatory reserves in tested eye and counterlateral one. At RI value being below 0.7 and RY value being above 1.0 it is possible to detect the maintenance of visual functions and circulatory reserves in tested and counterlateral eyes. The innovation enables to accelerate and simplify the trial and carry out it with available physical loading for a patient without applying any additional appliances and medicinal preparations.

EFFECT: higher efficiency and accuracy of diagnostics and prediction.

6 dwg, 3 ex, 2 tbl

FIELD: medicine, cardio-vascular surgery.

SUBSTANCE: one should perform ultrasound scanning of the 1st volar metacarpal artery both before and at the background of radial artery compression, moreover, at decreased peak systolic rate of circulation in the 1st volar metacarpal artery at the background of compression by 40% or less against peak systolic rate of circulation before compression one should diagnose ulnar type of wrist's circulation and at decreased peak systolic rate of circulation at the background of compression by more than 40% against peak systolic rate of circulation before compression or at appearance of retrograde circulation one should diagnose radial type of wrist's circulation.

EFFECT: higher efficiency and accuracy of diagnostics.

6 dwg, 2 ex

FIELD: medicine, otorhinolaryngology.

SUBSTANCE: one should detect amplitude-frequency circulatory characteristics in mucosal microcirculation system of inferior concha at the side of lesion due to laser Doppler flowmetry: AmaxCF/σ - circulatory fluctuations synchronized with cardiorhythm; IFM - index of flux motions, the ratio between active and passive mechanisms of circulatory regulation in microcirculation system. In 3-4 d all measurements should be repeated. If AmaxCF/σ value is increased at simultaneous decrease of IFM value one should consider the treatment to be efficient. The present innovation enables to obtain objective parameters of maxillary sinus state.

EFFECT: higher accuracy of detection.

3 ex

FIELD: medicine, cardiology.

SUBSTANCE: one should perform colored duplex sonography by measuring the resistance index in tibial arteries to evaluate the degree of functional insufficiency in lower limbs, that is at R1 being above 1.0 - the first stage, at R1 being 1.0-0.4 - the second stage, at R1 being below 0.4 and up to 0.2 - the third stage and at R1 being below 0.2 - the fourth stage should be detected. The method enables to objectively and quantitatively evaluate ischemic stages in case of occluding arterial diseases of lower limbs.

EFFECT: higher efficiency of evaluation.

12 dwg, 2 ex, 1 tbl

FIELD: medicine.

SUBSTANCE: method involves puncturing subclavicular vein in subclavicular access. Alternating renal vein catheterizing is applied and invasive pressure in renal veins is measured first in orthostasis at Valsalva test level and then in clinostasis with finger compression at the level of upper middle one/third of the inguinal canal. Then, examination in orthostasis at Valsalva test level is carried out using piezoelectric transducer and retaining compression with finger. Selective retrograde renal phlebography is additionally applied. Pressure in the left renal vein is determined in orthostasis, clinostasis with finger compression at the level of upper middle one/third of the inguinal canal. Reflux contrast on testicular vein and vein diameter dilatation is determined. The criteria are used to diagnose hemodynamic type of varicocele.

EFFECT: minimized analytical error caused by hematocrit number.

9 cl, 1 dwg

FIELD: medicine.

SUBSTANCE: method involves determining uterus volume by means of ultrasonic examination. Conditional uterus volume X is calculated from formula X=axbxcxK, where K is the correlation coefficient equal to 0.5236, a is the transverse uterus diameter from a tubal angle to the other one, b is the uterus length from the internal fauces to the fundus, c is the anteroposterior uterus size from the most distant points; conditional uterus cavity volume X1 is calculated from formula X1=a1xb1xc1xK, where K is the coefficient equal to 0.5236, a1 is the transverse uterus diameter from a tubal angle to the other one, b1 is the uterus length from the internal fauces to the fundus, c1 is the anteroposterior uterus size from one myometrium edge to the other one; conditional uterus volume Y and conditional uterus cavity volume Y1 is calculated from formula Y=a2xb2xc2xK, where K is the correlation coefficient equal to 0.5236, a2 is the transverse uterus diameter from a tubal angle to the other one, b2 is the uterus length from the internal fauces to the fundus, c2 is the anteroposterior uterus size from the most distant points; Y1=a3xb3xc3xK, where K is the coefficient equal to 0.5236, a3 is the transverse uterus diameter from a tubal angle to the other one, b3 is the uterus length from the internal fauces to the fundus, c3 is the anteroposterior uterus size from one myometrium edge to the other one; measured at the second day after delivery. The calculated parameters are used for calculating uterus involution coefficient Kin. Ratio of conditional muscular mass of the uterus at the second day after delivery to conditional muscular mass of the uterus at the fifth day after delivery as Kin = (X-X1)/(Y-Y1), where X-X1 is the conditional muscular mass of the uterus at the second day and Y-Y1 is the conditional muscular mass of the uterus at the fifth day. The value of Kin. being greater than 1.5, adequate uterus involution is to be determined. The value of Kin. being less than 1.5, uterus subinvolution is considered to be the case.

EFFECT: high accuracy of estimation method.

3 dwg

FIELD: medicine.

SUBSTANCE: method involves carrying out ultrasonic examination of heart. Tissular Doppler study of the left and right ventricle function is carried out in Tissue Tracking mode from apical access at the level of 4 chambers before intraoperative radiotherapy and 2 weeks later and then in 3, 6 and 12 months. Tissular Doppler study echocardiogram video clip is frozen in Tissue Tracking mode at the systole end. Markers are set at the center of basal, middle and apical segments of free wall of the right ventricle. Tissue Tracking curve is used for comparing maximum displacement amplitudes in every segment with their values before intraoperative radiotherapy. Maximum displacement amplitude value drop of at least one of the segments being observed, postradiational myocardium injury is to be diagnosed.

EFFECT: high accuracy and reliability of diagnosis.

5 dwg

FIELD: medicine, cardiology.

SUBSTANCE: the present innovation deals with ways for ultrasound diagnostics of cardiac contractile function. It includes Doppler tissue myocardial studying followed by detecting regional value of deformation and myocardial deformation rate into diastole at curved M-mode Strain Rate, performing quantitative analysis at Strain mode, moreover one should calculate myocardial deformation value into diastole at ECG at the level of P tooth and at its value being above 5% it is possible to diagnose the syndrome of incomplete diastole.

EFFECT: higher accuracy and efficiency of diagnostics.

6 dwg, 1 ex, 1 tbl

FIELD: medicine.

SUBSTANCE: method involves distinguishing four degrees in sexual development delay. Minimum sexual development delay degree is characterized by the following parameters. Uterus width and thickness corresponds to age-specific norm. Median uterine M-echo is recorded. Uterus neck is differentiated from uterus body with angle between them being well distinguished. All ovarian dimensions correspond to norm. Light sexual development delay degree is characterized as follows. All uterine dimensions are two years smaller, when compared to age-specific norm. Median uterine M-echo is recorded. Uterus neck is differentiated from the uterus body. Ovary length and thickness correspond to age-specific norm. Moderate sexual development delay degree is characterized as follows. All uterine dimensions are three-four years smaller, when compared to age-specific norm. Median uterine M-echo and reduced ovary length and thickness are recorded. Severe sexual development delay degree is characterized as follows. All uterine dimensions are six-eight years smaller, when compared to age-specific norm. No uterus neck is differentiation from the uterus body is available. No median uterine M-echo is recorded. Ratio coefficient of length and anteroposterior dimension of uterine body to length and anteroposterior dimension of uterus neck is additionally determined in each sexual development delay degree case. Uterine blood vessel lumen, ovary echostructure as number, diameter of minimum and maximum follicles in them are determined in energetic Doppler mapping mode. Uterus length having 1-2 years delay when compared to norm, ratio coefficient of uterus and neck dimensions being equal to 1.5-1.7, uterine blood vessel lumen being equal to 5-6 mm, follicle number being in norm, diameter of minimum and maximum follicles having 1-2 years delay when compared to age-specific norm, minimum sexual development delay degree is diagnosed (IA). Uterine blood vessel lumen being equal to 4-5 mm, coefficient of uterus and neck dimensions being equal to 1.3-1.5, follicle number being in norm, ovary width having 1-2 years delay when compared to norm, minimum follicles having 2 years delay when compared to age-specific norm, maximum follicles having 2-3 years delay, light sexual development delay degree is diagnosed (IB). All uterine dimensions being three-four years smaller, when compared to age-specific norm, uterus neck being differentiated from uterus body with angle between them being poorly distinguished, uterine blood vessel lumen being equal to 2-3 mm, ratio coefficient of uterus and neck dimensions being equal to 1.2-1.5, reduced follicle number having 1-2 years delay when compared to age-specific norm, ovary width having 2-3 years delay when compared to norm, minimum follicles diameter having 2 years delay when compared to age-specific norm, maximum follicles diameter having 2-3 years delay, moderate sexual development delay degree is diagnosed (II). Uterine blood vessel lumen diameter being equal to 1 mm, ovaries dimensions delay being of 2-3 years with lacking follicular apparatus in them, severe sexual development delay degree is diagnosed (III).

EFFECT: high accuracy and self-descriptiveness of the method.

FIELD: medicine.

SUBSTANCE: method involves giving a series of training exercises of growing complexity to a student for activating the organs of sense and/or intellect including competition in solving situation tasks with partner role of which is played by computer. The tasks are modeled in operation field bounded in space. The student forms operation field image in agreement with the partner and keeps it in mind together with the situation task during the whole time while doing the exercise. Computer controls correctness of task-solving process.

EFFECT: enhanced effectiveness of training.

FIELD: urology.

SUBSTANCE: one performs ultrasonic echo-dopplerometric investigation of regional blood flow in prostate before and after treatment to determine quantitative parameters. When pulsation index is reduced from 1.39±0.12 before treatment to 1.10±0.09 after treatment and venous blood flow velocity increases, respectively, from 3,91±0.36 to 5,22±0.47, treatment is regarded effective and completed.

EFFECT: increased accuracy of estimation.

1 tbl

FIELD: medicine, obstetrics.

SUBSTANCE: one should carry out clinical and ultrasound uterine testing, moreover, additionally, on the 3d and the 7th d of post-operational period it is necessary to detect conditional area of uterine sutures, systolo-diastolic ratio (SDR), percentage content of lymphocytes against total amount of cells in uterine aspirate to establish protein coefficient (PC) and leukocytic index of intoxication (LII) being necessary to state upon prognostic coefficients F1 and F2 by the following formulas: F1 = -6726.59 + 27.58 x K1 + 21.84 x K2 - 0.03 x K3 + 93.36 x K4 + 156.47 x K5 - 4.21 x K6 + 760.82 x K7 + 978.46 x K8 + 11.47 x K9 + 96.40 x K10 + 306.40 x K11 + 321.13 x K12 - 24.32 x K13 - 50.56 x K14; F2 = -57.81.76 + 35.89 x K1 + 26.50 x K2 + 0.00 x K3 + 96.81 x K4 + 146.78 x K5 - 3.89 x K6 + 500.76 x K7 + 651.60 x K8 + 4.83 x K9 + 34.83 x K10 + 276.16 x K11 + 535.35 x K12 - 14.26 x K13 - 17.28 x K14, where digital values - the constants of discriminant equation and discriminant coefficients, K1,2...14 - gradations and digital values of post-operational period flow: K1 - the length of uterine sutures on the 3d d, K2 - the width of uterine sutures on the 3d d, K3 - conditional area of sutures on the 3d d, K4 - the length of uterine sutures on the 7th d, K5 - the width of uterine sutures on the 7th d, K6 - conditional area of sutures on the 7th d, K7 - SDR right-hand on the 7th d, K8 - SDR left-hand on the 7th d, K9 - percentage content of lymphocytes against the total amount of cells in uterine aspirate on the 3d d, K10 - percentage content of lymphocytes against the total amount of cells in uterine aspirate on the 7th d, K11 - PC on the 3d d, K12 - PC on the 7th d, K13 - LII on the 3d d, K14 - LII on the 7th d, and at F1>F2 one should predict favorable nature in recovery of uterine wound and at F1<F2 - unfavorable nature.

EFFECT: higher accuracy and efficiency of evaluation.

2 ex

FIELD: medicine.

SUBSTANCE: while diagnosing cholecystitis and cholelithiasis due to ultrasound testing one should additionally study blood plasma and bile to detect there the content of prostaglandins PGE2 and PGF2α. At PGE2/PGF2α ratio in blood plasma being equal to 6 and more, and, also, at decreased level of biliary cholecystokinin-pancreosimin by 38% and more, biliary PGE2 by 59% and more and increased level of biliary prostaglandin PGF2α by 5.9 times and more against the norm one should diagnose chlecystitis and cholelithiasis. The innovation enables to detect the above-mentioned diseases at earlier stage.

EFFECT: higher accuracy of diagnostics.

3 ex

FIELD: medicine, diagnostics.

SUBSTANCE: ultrasound scanning should be performed in patient's stomach-lying position at frontal support, ultrasound pick-up unit should be located at patient's skin at the level of atlas' posterior tuberculum directly under inferior edge of occipital bone so that scanning area should be parallel to inferior edge of occipital bone; then one should detect the distance between axis' odontoid process and corresponding atlas' lateral weight from the left and from the right to calculate the value of asymmetry, moreover, if the value of asymmetry exceeds 0.6±0.3 mm one should diagnose dislocation of axis' odontoid process. The innovation in question enables to establish accurate site of dislocation of axis' odontoid process without any roentgenological loading and provide quantitative detection of the dislocation mentioned.

EFFECT: higher accuracy and efficiency of diagnostics.

4 dwg, 2 ex, 1 tbl

FIELD: medicine.

SUBSTANCE: method involves carrying out ultrasonic scanning examination of subclavian artery over its whole extent in physiological arm position with arterial blood pressure being measured in the middle one third of the arm. Next, when applying compression tests, blood circulation parameters variations are recorded in distal segment of the subclavian artery with arterial blood pressure being concurrently measured. Three degrees of superior thorax aperture syndrome severity are diagnosed depending on reduction of linear blood circulation velocity and arterial blood pressure compared to their initial values. Mild one takes place when linear blood circulation velocity reduction reaches 40% and arterial blood pressure 20% of initial level, moderate one when linear blood circulation velocity reduction reaches 70% and arterial blood pressure 50% and heavy one when linear blood circulation velocity reduction is greater than 70% of initial level and arterial blood pressure is greater than 50% to the extent of no blood circulation manifestation being observed in the subclavian artery.

EFFECT: high accuracy of diagnosis.

Up!