Imaging characteristics of bilateral CSCR cases:12 months follow up

Objective: Determine the multiparametric magnetic resonance imaging (mpMRI) appearance of the prostate following focal laser ablation (FLA) for PCa and to identify imaging characteristics associated with recurrent disease. Methods: Retrospective analysis of patients who underwent FLA for low-intermediate risk PCa between 2010 and 2014 was performed. Early (median 4 months) and late mpMRI (median 49 months) follow-up were qualitatively assessed for T2-weighted, dynamic contrast enhanced (DCE) and diffusion weighted imaging (DWI) appearances and also compared to corresponding PSA values and biopsy results. Results: 55 cancers were treated in 54 men (mean age 61.0 years). Early mpMRI was performed in 30 (54.5%) patients while late follow-up mpMRI in 42 (84%). Ill-defined scarring with and without atrophy at the treatment site were the most common appearances. In patients with paired MRI and biopsy, one of four patients with clinically significant PCa on biopsy (≥GG2 or≥6 mm GG1) showed hyperenhancement or restricted diffusion at early follow-up. At late follow-up, positive biopsies were seen in 5/8 (63%) cases with hyperenhancement and 5/6 (83%) cases with restricted diffusion at the treatment site. PSA change was not associated with biopsy results at either time point. Conclusion: mpMRI is able to document the morphological and temporal changes following focal therapy. It has limited ability to detect recurrent disease in early months following treatment. Late-term mpMRI is sensitive at identifying patients with recurrent disease. Small sample size is, however, a limitation of the study. Advances in knowledge: Implementing MRI in follow-up after FT may be useful in predicting residual or recurrent PCa and therefore provide reliable outcome data.

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Spinal artery aneurysms: clinical presentation, radiological findings and outcome

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2017-013687 ◽

2018 ◽

Vol 10 (7) ◽

pp. 644-648 ◽

Cited By ~ 3

Author(s):

Leonardo Renieri ◽

Eytan Raz ◽

Giuseppe Lanzino ◽

Timo Krings ◽

Maksim Shapiro ◽

...

Keyword(s):

Back Pain ◽

Retrospective Review ◽

Clinical Presentation ◽

Treated Patient ◽

Demographic Data ◽

Treatment Options ◽

Treatment Strategies ◽

Imaging Characteristics ◽

Arterial Aneurysms

Background and purposeSpinal arterial aneurysms are a rare cause of spinal subarachnoid hemorrhage (SAH). We performed a retrospective review of spinal arterial aneurysms not associated with spinal arteriovenus shunts from three institutions in order to better understand the clinical and imaging characteristics of these lesions.Materials and methodsWe performed a retrospective review of spinal arterial aneurysms managed at three North American institutions. For each patient, the following information was collected: demographic data, clinical presentation, comorbidities, imaging findings, and neurological status at the last follow-up. Treatment strategies and outcomes were reported.Results11 patients were included; 7 were women and median age was 60 years. The most common presentation was sudden back pain (81.8%). We found 3 aneurysms on the radiculomedullary artery and 8 along the radiculopial arteries. Of the 3 aneurysms on the radiculomedullary artery, 1 was treated conservatively, 1 was treated with coiling of the aneurysm and sacrifice of the radiculomedullary artery, and 1 was treated with surgical trapping. The 8 aneurysms on the radiculopial artery were treated endovascularly in 4 cases, surgically in 1 case, and conservatively in 3 cases. One surgically treated patient had a spinal subdural hematoma. There were no other complications. Mean clinical follow-up time was 20 months, and 87.5% of patients were functionally independent.ConclusionsSpinal arterial aneurysms are lesions which commonly present with sudden back pain and spinal SAH. Conservative, surgical, and endovascular treatment options are safe and effective. Long term outcomes in these patients are generally good.

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Solitary Fibrous Tumors of the Chest: An Analysis of Fifty Patients

Frontiers in Oncology ◽

10.3389/fonc.2021.697156 ◽

2021 ◽

Vol 11 ◽

Author(s):

Jingwen Zhang ◽

Jumin Liu ◽

Zhihao Zhang ◽

Beizong Tian

Keyword(s):

Solitary Fibrous Tumor ◽

Chest Tightness ◽

Ki 67 ◽

Imaging Characteristics ◽

Enhanced Ct ◽

The Common ◽

The Difference ◽

Low Incidence ◽

Fibrous Tumor

BackgroundA solitary fibrous tumor of the chest (SFTC) is a subtype of solitary fibrous tumor (SFT) with a low incidence rate. The purpose of this study is to analyze the diagnosis and treatment of SFTC and the difference between benign and malignant solitary fibrous tumor of the pleura (SFTP) to improve the understanding of this rare disease.MethodsA retrospective analysis of fifty patients with SFTC (33 cases in the pleura and 17 in the lung) was performed. Clinical and imaging characteristics, pathological features, and treatment follow-up outcomes were analyzed.ResultsThe common symptoms of the 50 patients included a cough, expectoration, chest tightness, fever, and chest pain. Space occupying lesions were found via plain computed tomography (CT) and enhanced CT was used for enhancement of the tumors. It was also found that 18 cases had necrosis, and 5 cases had calcification. The histopathology results showed that frequent nuclear division, obvious morphological variation, necrosis, and the high expression of Ki-67 cells are markers of malignant SFTC. There were significant differences in age, chest tightness, necrotic foci in CT, and expression of Ki-67 between the benign and malignant SFTP cases. All the patients who received treatment were given an excellent prognosis.ConclusionA combination of enhanced CT, histopathology, and immunohistochemistry can be used for the accurate diagnosis of SFTC. Advanced age, chest tightness, necrotic foci in CT, and a high Ki-67 index were more likely to be malignant SFTP. Operation and radiofrequency ablation can provide favorable outcomes for both benign and malignant SFTC.

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Pediatric Peritoneal Epithelial Malignant Mesothelioma Case Report

Case Reports in Radiology ◽

10.1155/2021/5581757 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Elizabeth Bellew ◽

Samantha Lee ◽

Hiren Patel ◽

Carolyn Fein Levy ◽

Rachelle Goldfisher ◽

...

Keyword(s):

Case Report ◽

Malignant Mesothelioma ◽

Crucial Role ◽

Clinical Course ◽

Pediatric Population ◽

Adult Population ◽

Initial Evaluation ◽

Peritoneal Mesothelioma ◽

Imaging Characteristics

We present a 14-year-old boy with peritoneal epithelial malignant mesothelioma (PEMM). While pathology is required to make this diagnosis, radiology plays a crucial role throughout the clinical course of this disease. The key imaging characteristics of peritoneal mesothelioma have been previously well-described in the adult population, but there are rare reports in the pediatric population. This pediatric report highlights the multidimensional use of imaging in this disease, from the initial evaluation to therapeutic supplementation and subsequent follow-up.

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Pilomatrixoma, a Rare Mimicker of Male Breast Cancer

Journal of Clinical Imaging Science ◽

10.25259/jcis_64_2019 ◽

2019 ◽

Vol 9 ◽

pp. 46

Author(s):

Aurela Clark ◽

Rebecca Leddy ◽

Laura Spruill ◽

Abbie Cluver

Keyword(s):

Benign Lesion ◽

Surgical Excision ◽

Male Breast ◽

Skin Tumor ◽

Imaging Features ◽

Histologic Diagnosis ◽

Outer Quadrant ◽

Imaging Characteristics ◽

Suspicious Feature

Pilomatrixoma or calcifying epithelioma of Malherbe is a benign skin tumor arising from the hair follicle; breast occurrence is considered a rarity. Clinically presenting as a palpable abnormality and with both benign and malignant mammographic and sonographic features, it can be easily misdiagnosed as a breast neoplasm. We report a very rare case of pilomatrixoma of the male breast in a 36-year-old male presenting with a firm, superficial nodule in the upper outer quadrant. Though the sonographic trifecta of imaging features (shape- margins-orientation/oval, circumscribed mass, parallel to the skin) is consistent with a benign lesion, a histologic diagnosis was warranted based on its most suspicious feature of internal pleomorphic calcifications. Pathologic diagnosis revealed the uncommon benign entity of pilomatrixoma in the male breast. Our patient was recommended for surgical excision based on current literature recommendations for management in most reports of pilomatrixoma. One alternative recommendation presented in a single report of pilomatrixoma in the breast supported follow-up imaging based on benign imaging characteristics.

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Clinical, Endocrine and Imaging Characteristics of Patients with Primary Hypophysitis

Hormone and Metabolic Research ◽

10.1055/s-0044-101036 ◽

2018 ◽

Vol 50 (04) ◽

pp. 296-302 ◽

Cited By ~ 12

Author(s):

Anna Angelousi ◽

Carolina Cohen ◽

Soledad Sosa ◽

Karina Danilowicz ◽

Lina Papanastasiou ◽

...

Keyword(s):

Natural History ◽

Immunosuppressive Agents ◽

Hormonal Treatment ◽

Response To Treatment ◽

High Dose ◽

Partial Recovery ◽

Gonadal Dysfunction ◽

Imaging Characteristics ◽

Primary Hypophysitis

AbstractPrimary hypophysitis (PH) is a rare disease with a poorly-defined natural history. Our aim was to characterise patients with PH at presentation and during prolonged follow-up. Observational retrospective study of 22 patients was conducted from 3 centres. In 14 patients, PH was confirmed histologically and in the remaining 8 clinically, after excluding secondary causes of hypophysitis. All patients had hormonal and imaging investigations before any treatment. Median follow up was 48 months (25–75%: 3–60). There was a female predominance with a female/male ratio: 3.4:1. Eight out of 22 patients had another autoimmune disease. Headaches and gonadal dysfunction were the most common symptoms. Five patients presented with panhypopituitarism; 17 patients had anterior pituitary deficiency, and 7 had diabetes insipidus. At presentation, 9 patients were treated surgically, 5 received replacement hormonal treatment, and 8 high-dose glucocorticoids from whom 5 in association with other immunosuppressive agents. Six patients showed complete recovery of pituitary hormonal deficiencies while 6 showed a partial recovery during a 5-year follow-up period. No difference was found between patients treated with surgery and those treated medically. The overall relapse rate was 18%. PH can be manifested with a broad spectrum of clinical and hormonal disturbances. Long-term follow-up is required to define the natural history of the disease and response to treatment, since pituitary hormonal recovery or relapse may appear many years after initial diagnosis. We suggest that surgery and immunosuppressive therapy be reserved for exceptional cases.

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Radiologic and Pathologic Correlation for Lactating Adenomas

Journal of Breast Imaging ◽

10.1093/jbi/wbaa108 ◽

2021 ◽

Vol 3 (2) ◽

pp. 208-214

Author(s):

Hoiwan Cheung ◽

Elizabeth U Parker ◽

Mark R Kilgore ◽

John R Scheel

Keyword(s):

Breast Imaging ◽

Short Interval ◽

Malignant Potential ◽

Postpartum Women ◽

Breast Lesions ◽

Lactating Women ◽

Neoplastic Processes ◽

Imaging Characteristics ◽

Benign Breast Lesions

Abstract Lactating adenomas are benign breast lesions that occur in pregnant, lactating, and postpartum women. These lesions have no associated malignant potential; their origin is disputed with no consensus on whether they represent hyperplastic or neoplastic processes. On ultrasound, lactating adenomas are classically described as solid, circumscribed, parallel masses with iso/hypoechoic internal echotexture and posterior enhancement. Histologically, lactating adenomas appear as circumscribed nodules of tightly packed lobular acini with extensive lactational change during pregnancy or the postpartum period. Masses in pregnant and lactating women with probably benign imaging characteristics—oval, circumscribed, parallel, iso/hypoechoic—can be managed with short interval follow-up (BI-RADS 3) rather than biopsy. However, lactating adenomas can also demonstrate characteristics that overlap with pregnancy-associated breast cancer, such as margins that are not circumscribed, prompting biopsy to exclude pregnancy-associated carcinoma. Breast imaging radiologists must be aware of the variable appearances of lactating adenomas to appropriately manage pregnant and lactating women presenting with palpable lumps.

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Abstract 16541: Clinical and Imaging Phenotypes From a Registry of Segmental Arterial Mediolysis

Circulation ◽

10.1161/circ.142.suppl_3.16541 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Arvind K Pandey ◽

Marie Gerhard-Herman

Keyword(s):

Risk Score ◽

Clinical Laboratory ◽

Clinical Symptoms ◽

Intramural Hematoma ◽

Arterial Dissection ◽

Aged Patients ◽

Male Predominance ◽

Imaging Characteristics ◽

Vascular Segment

Background: Segmental arterial mediolsyis (SAM) is a non-inflammatory arteriopathy that is increasingly being recognized; however, its clinical characteristics and natural history remain poorly defined. Methods: A retrospective, single-institution review of 20 patients presenting with arterial dissection, intramural hematoma, aneurysm, or occlusion between 2015 and 2020 was performed. To establish a non-invasive diagnosis of SAM, patients with FMD, inflammatory, or genetic arteriopathy were excluded by clinical, laboratory, and imaging criteria according to multidisciplinary guidelines. Patient demographics, clinical features, imaging findings, and management were assessed. Results: The average age of patients was 56 years; 75% were male. CAD was present in 15% of patients and 45% had hypertension; 55% were current or prior smokers. In patients without diagnosed CAD, the 10-year ASCVD risk score was 8.7% and the Framingham risk score was 6.8%. The average hemoglobin A1c was 5.6%. Acute onset abdominal pain (70%) was the most frequent presenting symptom. On average, two different arterial beds were affected at the time of diagnosis, most often in the abdomen. Arterial dissection was present in 75% of patients, and intramural hematoma was seen in 35% of cases. The most affected vessel was the superior mesenteric artery (50%), followed by the celiac, renal, and iliac arteries (35% each). Over a mean follow-up period of 20 months, all patients survived; two patients required intervention due to worsening clinical symptoms. Anticoagulation (AC) was utilized in 50% of cases, most commonly for one month. Long-term follow-up imaging was available in 11 patients; 3 patients (27%) had progression in lesion size over the first month. By 1 year, only 1 patient continued to show enlargement, with all others showing regression. Conclusions: This cohort provides longitudinal follow-up on both clinical and imaging characteristics of non-invasively diagnosed SAM. The condition shows a male predominance, typically manifesting in middle-aged patients with low to intermediate cardiovascular risk. While a subset of patients shows growth in size of the affected vascular segment over the first month, longer follow-up imaging demonstrates regression.

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Improvement of bone-erosive temporomandibular joint (TMJ) abnormalities in adolescents undergoing non-surgical treatment: a longitudinal study

Dentomaxillofacial Radiology ◽

10.1259/dmfr.20190338 ◽

2020 ◽

Vol 49 (5) ◽

pp. 20190338 ◽

Cited By ~ 2

Author(s):

Anna-Karin Abrahamsson ◽

Linda Z Arvidsson ◽

Milada Cvancarova Småstuen ◽

Tore A Larheim

Keyword(s):

Chronic Pain ◽

Temporomandibular Joint ◽

Cone Beam Ct ◽

Functional Limitation ◽

Young Patients ◽

Pain Scale ◽

Imaging Characteristics ◽

Surgical Methods ◽

Patient Series

Objectives: To investigate the longitudinal changes of the imaging temporomandibular joint (TMJ) characteristics in young patients with TMJ-related symptoms and treated with non-surgical methods. The severity of self-reported symptoms at follow-up was also investigated. Methods: A cone beam CT (CBCT)/CT follow-up examination [median follow-up 4.1 (1.3–6.4) years] was performed in 22 patients with erosive TMJ abnormalities [baseline median age 16 (12–18) years]. Imaging characteristics were analyzed and the changes between the examinations were categorized as (A) improvement, (B) no change, or (C) worsening. Severity of follow-up symptoms was evaluated using Jaw Functional Limitation Scale (JFLS-8) and Graded Chronic Pain Scale (Grade 0–IV). Analyses were performed separately for left and right TMJ. Findings at baseline and follow-up were compared using McNemar test to account for dependencies. Changes in proportions of hard tissue findings between examinations were assessed using Wilcoxon signed ranks test. Results: A significant reduction in the proportion of patients with erosive abnormalities was found [59.1%, 95% CI (36.4–79.3) %]. Baseline erosions improved in 9/12 (75%) right and 14/15 (93%) left TMJs. About half repaired; developed an intact cortical outline. Number of joints with osteophytes increased (right: p < 0.04, left: p < 0.003). New osteophytes were mostly found in joints with erosive findings. Low or no limitation of jaw function (Jaw Functional Limitation Scale) was found in 12/22 (55%) and no or low intensity of pain (Graded Chronic Pain Scale Grade 0 or I) in 19/22 (86%) at follow-up. Conclusion: We found a high potential for repair of erosive TMJ abnormalities. However, the patient series was small. The majority of patients assessed their symptom severity at follow-up as low.

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