The Accuracy of BI-RADS Classification of Breast Ultrasound as a First-Line Imaging Method

Abstract Background A virilizing ovarian tumor (VOT) is a rare cause of hyperandrogenism in pre- and postmenopausal women. Although transvaginal ultrasound is considered as the first-line imaging method for ovarian tumors, it is examiner-dependent. We aimed to summarize the clinical and ultrasound manifestations of VOTs to help establish the diagnosis with emphasis on those causing diagnostic difficulty. Method We retrospectively identified 31 patients with VOTs who underwent surgery at Peking Union Medical College Hospital. Results Patients with VOTs were predominantly premenopausal. All patients showed androgenic manifestations with serum testosterone levels elevated to varying degrees. The tumor size of VOTs was significantly correlated with age (P < 0.001). The VOTs in the postmenopausal group were significantly smaller than those in the premenopausal group (median 1.8 cm [range, 1.3–4.8 cm] vs 4.5 cm [range, 0.7–11.9 cm]; P = 0.018). Twenty-seven out of 31 VOTs were successfully identified by ultrasound. On ultrasound, VOTs are mostly solid and hypoechoic masses with enhanced vascularity. Four VOTs (0.7–1.5 cm) were radiologically negative, and they were the smallest among all patients. Conclusion Patients with VOTs showed androgenic manifestations with varying degrees of hyperandrogenemia. Older patients tend to have smaller VOTs. Ultrasound is an effective method for the detection of VOTs. Some VOTs can be very small and difficult to visualize radiologically, especially in postmenopausal patients. Examiners must remain vigilant about very small VOTs on the basis of endocrine symptoms.

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Characterization of Focal Liver Lesions using Contrast Enhanced Ultrasound as a First Line Method: a Large Monocentric Experience

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld-1280 ◽

2014 ◽

Vol 23 (1) ◽

pp. 57-63 ◽

Cited By ~ 7

Author(s):

Ioan Sporea ◽

Alina Martie ◽

Simona Bota ◽

Roxana Sirli ◽

Alina Popescu ◽

...

Keyword(s):

Focal Liver Lesions ◽

Imaging Method ◽

Liver Lesions ◽

Contrast Enhanced Ultrasound ◽

First Line ◽

Clear Cut ◽

Contrast Enhanced ◽

Line Imaging ◽

Conclusive Diagnosis

Aim: To present a large monocentric experience in the characterization of focal liver lesions (FLLs) using Contrast Enhanced Ultrasound (CEUS).Method: A retrospective study was performed in the Gastroenterology and Hepatology Department, Timisoara, including 1100 patients with 1329 FLLs evaluated between September 2009 and January 2013. A CEUS examination was considered conclusive if the FLL respected the typical enhancement pattern as described in the EFSUMB Guidelines.Results: From the 1329 FLLs, CEUS was conclusive for a specific pathology in 1102 cases (82.9%). For the differentiation of benign/malignant lesions, CEUS reached a conclusive diagnosis in 1196 (90%) cases. The percentage of conclusive CEUS examinations was significantly higher in patients without chronic liver disease as compared with those with chronic hepatopathies: 87.3% vs. 74.4% (p<0.0001).Conclusion: CEUS patterns of enhancement fell into clear cut specific diagnostic patterns in 83% of the FLLs discovered by US, and into clear cut benign versus malignant patterns in 90% of the cases. For this reason, we can strongly recommend CEUS as a first line imaging method to characterize FLLs found at US, at least in centers with a good experience in CEUS.

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Cone beam CT for identifying fractures of the wrist and hand – An alternative to plain radiography?

Trauma ◽

10.1177/1460408620984397 ◽

2021 ◽

pp. 146040862098439

Author(s):

Steven Vitéz ◽

Balázs Kovács ◽

Jürgen Ederer ◽

Anja-Carina Schulte ◽

Sasan Partovi ◽

...

Keyword(s):

Cone Beam Ct ◽

Plain Radiography ◽

Cone Beam ◽

Emergency Setting ◽

First Line ◽

Acute Trauma ◽

Imaging Tool ◽

Hand Fractures ◽

Line Imaging

Objective The purpose of this study was to investigate the value of cone beam computed tomography (CBCT) scanners versus plain radiography for detection and classification of fractures of the wrist and hand after acute trauma. Methods Images of 56 patients that received both plain radiography and CBCT after presenting to our emergency department with suspected fracture of the wrist or hand between November 2015 and July 2016 were analyzed retrospectively by three blinded observers. Results Using plain radiographs compared to CBCT, 69% of fractures of the carpals and 37% of fractures of metacarpals and phalanges remained undetected. Higher fracture classification reliability in radius fractures was observed when using CBCT. Conclusion CBCT is superior to plain radiography in detecting wrist and hand fractures in an emergency setting and presents an alternative first line imaging tool in the acute trauma patient population.

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Transvaginal Sonographic Imaging and Associated Techniques for Diagnosis of Ovarian, Deep Endometriosis, and Adenomyosis: A Comprehensive Review

Seminars in Reproductive Medicine ◽

10.1055/s-0040-1718740 ◽

2020 ◽

Vol 38 (02/03) ◽

pp. 216-226

Author(s):

Mee Kristine Aas-Eng ◽

Eliana Montanari ◽

Marit Lieng ◽

Joerg Keckstein ◽

Gernot Hudelist

Keyword(s):

Tertiary Care ◽

Transvaginal Sonography ◽

Imaging Method ◽

First Line ◽

Deep Endometriosis ◽

Delay In Diagnosis ◽

Line Imaging ◽

Magnetic Resonance Imaging Mri ◽

Ovarian Endometriomas ◽

Sonographic Imaging

AbstractImaging of endometriosis and in particular deep endometriosis (DE) is crucial in the clinical management of women facing this debilitating condition. Transvaginal sonography (TVS) is the first-line imaging method and magnetic resonance imaging (MRI) may provide supplemental information. However, the delay in diagnosis of up to 10 years and more is of concern. This problem might be overcome by simple steps using imaging with emphasis on TVS and referral to tertiary care. Finally, TVS is crucial in mapping extent and location of disease in planning surgical therapy and counseling women regarding various therapeutic options. This review presents the available data on imaging of endometriosis with a focus on TVS and MRI for DE, adenomyosis, and ovarian endometriomas including endometriomas in pregnancy as well as the use of “soft markers.” The review presents an approach that is in accordance with the International Deep Endometriosis Analysis (IDEA) group consensus statement.

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Contrast Enhanced Ultrasound As First Line Imaging Method for the Evaluation of Focal Liver Lesions - A Large Monocentric Experience

Ultrasound in Medicine & Biology ◽

10.1016/j.ultrasmedbio.2013.02.383 ◽

2013 ◽

Vol 39 (5) ◽

pp. S81

Author(s):

I. Sporea ◽

A. Martie ◽

A. Popescu ◽

R. Sirli ◽

M. Danila ◽

...

Keyword(s):

Focal Liver Lesions ◽

Imaging Method ◽

Liver Lesions ◽

Contrast Enhanced Ultrasound ◽

First Line ◽

Contrast Enhanced ◽

Line Imaging

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Radiological Findings From 101 Patients With Novel Coronavirus Disease 2019 (COVID-19) in Hamadan, West of Iran: Typical and Atypical Features

International journal of epidemiologic research ◽

10.34172/ijer.2021.23 ◽

2021 ◽

Vol 8 (3) ◽

pp. 122-128

Author(s):

Farideh Gharekhanloo ◽

Seyyed Hamid Hashemi ◽

Fariba Keramat ◽

Farzaneh Esna-Ashari ◽

Mojgan Mamani ◽

...

Keyword(s):

Clinical Laboratory ◽

Anterior Segment ◽

Clinical Manifestations ◽

Lower Lobe ◽

Chest Ct ◽

Imaging Method ◽

First Line ◽

Ct Findings ◽

Line Imaging ◽

Sensitive Method

Background and aims: Coronavirus disease 2019 (COVID-19) has spread widely throughout the world and become a pandemic disease. In this study, we decided to investigate the chest computed tomography (CT) findings in COVID-19 patients in Hamadan, west of Iran. Methods: This cross-sectional study was conducted on 101 patients with confirmed COVID-19 infection from February to March 2020. Demographic, clinical, laboratory, and chest CT findings of identified COVID-19 patients were assessed. Results: The mean age of the patients was 55.21 ± 14.08 years, and 54 (53.47%) of them were male. With regard to clinical manifestations, 82.18%, 72.28% and 54.46% of COVID-19 patients had dry cough, dyspnea, and fever, respectively. The right lower lobe was the most commonly and severely involved lope (69%), followed by left lower lobe, right middle lobe, and lingual segment; however, the anterior segment of upper lobes showed the least involvement with abnormality in the late course of the disease. The most common pattern was ground glass opacity (GGO), but atypical patterns such as round pneumonia, moderate to severe pleural effusion, and segmental lobar consolidation were seen without evidence of mediastinal adenopathy, cavitation, or nodular lesion. Chest X-ray (CXR) was not a sensitive method as the first-line imaging method because 34.65% of them were normal. Conclusion: CXR is not a sensitive method as the first-line imaging method (34.65% normal first CXR), but chest CT is a very sensitive and nonspecific modality for diagnosis of COVID-19. The lower lobe and posterior basal segments of the lungs are the most involved sites in most cases. About 12% showed atypical chest CT findings.

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Clinical Ultrasound in Inflammatory Bowel Disease

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/a-0869-8799 ◽

2019 ◽

Vol 40 (02) ◽

pp. 132-162 ◽

Cited By ~ 6

Author(s):

Georg Kunze ◽

Karlheinz Seitz ◽

Martin Mauch ◽

Frauke Petersen

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Medical Care ◽

Bowel Disease ◽

Physician Training ◽

Imaging Method ◽

First Line ◽

Inflammatory Bowel ◽

Line Imaging

AbstractUltrasound should be the first-line imaging method in the medical care of patients with inflammatory bowel disease. It can be used to differentiate between Crohn’s disease and ulcerative colitis and to detect numerous complications like stenoses, fistulas, and abscesses. As the method is also highly suitable for follow-up, stressful endoscopic procedures and examinations involving radiation are less necessary. Comparison studies with MRI and CT show that ultrasound is not an inferior method and it is therefore included in all guidelines. Intensifying physician training in this method will help to ensure its comprehensive use.

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Upfront F18-choline PET/CT versus Tc99m-sestaMIBI SPECT/CT guided surgery in primary hyperparathyroidism: the randomized phase III diagnostic trial APACH2

BMC Endocrine Disorders ◽

10.1186/s12902-020-00667-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Elske Quak ◽

Audrey Lasne Cardon ◽

Renaud Ciappuccini ◽

Charline Lasnon ◽

Vianney Bastit ◽

...

Keyword(s):

Primary Hyperparathyroidism ◽

Patient Care ◽

Phase Iii ◽

Imaging Method ◽

Complication Rates ◽

First Line ◽

Ct Guided ◽

Pet Ct ◽

Line Imaging ◽

Mibi Spect

Abstract Background The common endocrine disorder primary hyperparathyroidism (PHPT) can be cured by surgery. Preoperative localization of parathyroid adenoma (PTA) by imaging is a prerequisite for outpatient minimally invasive parathyroidectomy (MIP). Compared to inpatient bilateral cervical exploration (BCE) which is performed if imaging is inconclusive, MIP is superior in terms of cure and complication rates and less costly. The imaging procedure F18-choline (FCH) PET/CT outperforms Tc99m-sestaMIBI (MIBI) SPECT/CT for PTA localization, but it is much costlier. The aim of this study is to identify the most efficient first-line imaging modality for optimal patient care in PHPT without added cost to society. Methods We will conduct a multicenter open diagnostic intervention randomized phase III trial comparing two diagnostic strategies in patients with PHPT: upfront FCH PET/CT versus MIBI SPECT/CT. The primary endpoint is the proportion of patients in whom the first-line imaging method results in successful MIP and cure. Follow-up including biological tests will be performed 1 and 6 months after surgery. The main secondary endpoint is the social cost of both strategies. Other secondary endpoints are as follows: FCH PET/CT and MIBI SPECT/CT diagnostic performance, performance of surgical procedure and complication rate, FCH PET/CT inter- and intra-observer variability and optimization of FCH PET/CT procedure. Fifty-eight patients will be enrolled and randomized 1:1. Discussion FCH PET/CT is a highly efficient but expensive imaging test for preoperative PTA localization and costs three to four times more than MIBI SPECT/CT. Whether FCH PET/CT improves patient outcomes compared to the reference standard MIBI SPECT/CT is unknown. To justify its added cost, FCH PET/CT-guided parathyroid surgery should lead to improved patient management, resulting in higher cure rates and fewer BCEs and surgical complications. In the previous phase II APACH1 study, we showed that second-line FCH PET/CT led to a cure in 88% of patients with negative or inconclusive MIBI SPECT/CT. BCE could be avoided in 75% of patients and surgical complication rates were low. We therefore hypothesize that upfront FCH PET/CT would improve patient care in PHPT and that the reduction in clinical costs would offset the increase in imaging costs. Trial registration NCT04040946, registered August 1, 2019. Protocol version Version 2.1 dated from 2020/04/23.

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