scholarly journals 469 Novel Applications of Cross-Sectional Imaging in Oncoplastic Surgical Planning for Breast Cancer Following Neoadjuvant Chemotherapy

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Begaj ◽  
R McLean ◽  
P Bhaskar
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Surgical Planning ◽  
Skin Flap ◽  
Breast Mri ◽  
Observer Agreement ◽  
Arterial Supply ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

Abstract Background Cross-sectional imaging using MRI is most commonly used to evaluate the response to neoadjuvant chemotherapy. Furthermore, CT scan of chest, abdomen, and pelvis (CAP) is used in staging the breast cancer. This study seeks to evaluate the feasibility of using preoperative cross-sectional imaging in oncoplastic surgical planning for patients undergoing neoadjuvant chemotherapy for breast cancer. Method All female patients who underwent neoadjuvant chemotherapy for breast cancer between January 2019 and January 2020 and underwent breast MRI pre- and post-neoadjuvant chemotherapy and staging CTCAP were included. All images were independently reviewed and analysed by two consultant breast radiologists. Chest wall symmetry, breast volume differences, skin flap thickness, arterial supply to nipple, intercostal perforators and LD pedicle were assessed on both CT and MRI. Results Nineteen women were included in this study. Breast measurements were best made by MRI due to difficulty interpreting the CT images when supine. The majority of the patients had a dual arterial supply. There was substantial inter–observer agreement in visualisation of MICAP and AICAP. The inter–observer reliability reduced when the radiologists were asked to visualize the LICAP and the thoracodorsal artery with moderate inter–observer agreement, as the MRI images were difficult to interpret laterally. Conclusions This study shows that MRI is suitable to detect most intercostal perforators and is the first study to highlight cross-sectional modalities for assessment of intercostal perforators and may aid preoperative surgical planning and choice of perforator. We have suggested potential addition of CT angiography in cases where the surgeon plans oncoplastic surgery.

Radiology of acute mastoiditis and its complications: a pictorial review and interpretation checklist

2019 ◽  
Vol 133 (10) ◽  
pp. 856-861
Author(s):  
M W Mather ◽  
P D Yates ◽  
J Powell ◽  
I Zammit-Maempel
Keyword(s):  
Head And Neck ◽  
Surgical Planning ◽  
Systematic Approach ◽  
Acute Mastoiditis ◽  
Cross Sectional ◽  
Imaging Technology ◽  
Radiological Features ◽  
Pictorial Review ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

AbstractBackgroundMastoiditis is an otological emergency, and cross-sectional imaging has a role in the diagnosis of complications and surgical planning. Advances in imaging technology are becoming increasingly sophisticated and, by the same token, the ability to accurately interpret findings is essential.MethodsThis paper reviews common and rare complications of mastoiditis using case-led examples. A radiologist-derived systematic checklist is proposed, to assist the ENT surgeon with interpreting cross-sectional imaging in emergency mastoiditis cases when the opinion of a head and neck radiologist may be difficult to obtain.ResultsA 16-point checklist (the ‘mastoid 16’) was used on a case-led basis to review the radiological features of both common and rare complications of mastoiditis; this is complemented with imaging examples.ConclusionAcute mastoiditis has a range of serious complications that may be amenable to treatment, once diagnosed using appropriate imaging. The proposed checklist provides a systematic approach to identifying complications of mastoiditis.

scholarly journals A rare imaging case of bilateral plasmacytoma of the breast

2020 ◽  
Vol 6 (2) ◽  
pp. 20190131
Author(s):  
Joleen Kirsty Eden ◽  
Rita Borgen ◽  
Rabea Haq ◽  
Richard Dobrashian
Keyword(s):  
Breast Cancer ◽  
Multiple Myeloma ◽  
Learning Outcomes ◽  
Case Reports ◽  
Definitive Diagnosis ◽  
High Grade ◽  
Nodal Involvement ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

This case reports on secondary extramedullary multiple myeloma within both breasts in the absence of axillary nodal involvement and discusses the difficulty in interpretation with clinical recommendations and learning outcomes. Differentiating plasmacytic lesions in the breast is often difficult as clinical and radiological appearances are known to mimic benignity and high-grade primary breast cancer. Extramedullary presentation can determine progression of the disease and can necessitate cross-sectional imaging. Therefore definitive diagnosis is essential as the clinical management of the patient may be altered.

scholarly journals 671 Fetus-In-Fetu Found at Excision of An Antenatally Diagnosed Abdominal Mass: Multi-Disciplinary Approach

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
K Smith ◽  
A Moore ◽  
S Popov ◽  
M Adams ◽  
E Folaranmi ◽  
...  
Keyword(s):  
Current Literature ◽  
Surgical Planning ◽  
Abdominal Mass ◽  
Female Infant ◽  
Cross Sectional ◽  
Treatment Pathways ◽  
Fetus In Fetu ◽  
Cross Sectional Imaging ◽  
Sectional Imaging ◽  
Multi Disciplinary Team

Abstract We present a case of antenatally detected abdominal mass and an alternative diagnostic course for suspected neonatal neuroblastoma as a result of investigative findings. A female infant presented antenatally with a left upper quadrant mass initially managed as a suspected neonatal neuroblastoma; further cross-sectional imaging suggested a wider differential including teratoma and aided surgical planning. The multi-disciplinary team (MDT) decision was for an early excision at 31 days and post-operative histology identified a diagnosis of fetus-in-fetu (FIF). We describe this case as a compliment to the current literature and an example of a necessary variation to recognised diagnostic and treatment pathways as a result of investigative findings.

scholarly journals A Probabilistic Cross Sectional Imaging Atlas of Healthy Axillary and Paraclavicular Lymph Nodes in Breast Cancer Patients

2021 ◽  
Author(s):  
Lucia Ernst ◽  
Kai Joachim Borm ◽  
Stephanie E Combs ◽  
Mathias Düsberg ◽  
Marciana Nona Duma
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Lymphatic Drainage ◽  
Breast Cancer Patients ◽  
Cross Sectional ◽  
Primary Tumor Site ◽  
Cross Sectional Imaging ◽  
The Mean ◽  
Sectional Imaging

Abstract BACKGROUNDThe aim of the present study was to generate an atlas of lymphatic drainage in breast cancer patients to be used in cross sectional diagnostic and therapeutic imaging. METHODSThe distribution of healthy lymph nodes is investigated as a surrogate for lymphatic drainage in cross sectional imaging. 2094 healthy LN were contoured contralateral to the primary tumor site on PET-CT datasets of 153 breast cancer patients. Using rigid and non-rigid registration techniques 1939 LN were transferred to a “standard patient” CT data set. Thus, a healthy lymph node atlas was generated. The location of the healthy LN was compared to the RTOG and ESTRO clinical target volumes radiotherapy contouring recommendations.RESULTSThe mean volume of healthy LN was 0.17cm3±0.28cm3 and the mean diameter was 0.77cm±0.36cm. Most LN were in level I (69.20%), supraclavicular (14.80%) and level II (10.50%). The remaining LN were in the internal mammary (2.70%), intraglandular (1.80%) and level III (1.00%). The ESTRO guideline encompassed the healthy LN in 35.00% completely, in 31.10% partly and in 33.90% not at all. The RTOG encompassed 48.00% of the healthy LN completely, 28.80% in part and 23.20% not at all.CONCLUSIONOur study lead to the most comprehensive 3D-imaging atlas of healthy LN in cross sectional imaging. The results can be used to generate a strategy to further reduce the rate of lymphedema by irradiation. Further, the atlas can be used to determine the probability of a visible LN in a specific location to be healthy.

scholarly journals Evaluation of Different Imaging Modalities for Axillary Lymph Node Staging in Breast Cancer Patients to Provide A Personalized and Optimized Therapy Algorithm

2021 ◽  
Author(s):  
Joachim Diessner ◽  
Laura Anders ◽  
Saskia Herbert ◽  
Matthias Kiesel ◽  
Thorsten Bley ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Imaging Modalities ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

Abstract Purpose The prognostic importance of lymph node infiltration in breast cancer patients before and after neoadjuvant therapy has increased significantly in recent years. For that reason, the reliable detection of tumor-infiltrated axillary lymph nodes at the time of diagnosis plays a decisive role in further therapy. We therefore focused on the sensitivity of different pretherapeutic imaging modalities (sonography, mammography, computed tomography [CT] and magnetic resonance imaging [MRI]) in nodal positive breast cancer patients and aimed to find out whether cross-sectional imaging techniques (MRI, CT) could improve sensitivity for pretherapeutic axillary staging compared to conventional imaging such as mammography and sonography. Methods Breast cancer patients with tumor-infiltrated axillary lymph nodes between 2014 and 2020 having a surgery for breast cancer were included in the study. Results All included 382 breast cancer patients had received conventional imaging, while 52.61% of the patients had received cross-sectional imaging. The sensitivity of the combination of all imaging modalities was 68.89%. The combination of MRI and CT showed 63.83% and the combination of sonography and mammography showed 36.11% sensitivity.Conclusion We could demonstrate that cross-sectional imaging can improve the sensitivity of the detection of tumor-infiltrated axillary lymph nodes in breast cancer patients. Considering the increasing importance of neoadjuvant and post-neoadjuvant therapeutic algorithms, the reliable detection of tumor-infiltrated lymph nodes gains increasing importance. Only the safe detection of tumor-infiltrated lymph nodes at the time of diagnosis enables the evaluation of the response to neoadjuvant therapy and thereby allows access to prognosis–improving post-neoadjuvant therapies.

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