scholarly journals P183 Osteitis condensans ilii or axial spondyloarthritis: a diagnostic challenge!

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Sadaf Saeed ◽  
Muhammad Safwan Jamal ◽  
Dave Ostry ◽  
Graham Robinson ◽  
Rajiv Sengupta
Keyword(s):  
Large Scale ◽  
Axial Spondyloarthritis ◽  
Cancer Surveillance ◽  
Imaging Features ◽  
X Rays ◽  
Electronic Patient Records ◽  
Diagnostic Challenge ◽  
Pet Ct ◽  
Initial Imaging ◽  
Osteitis Condensans Ilii

Abstract Background/Aims  Osteitis condensans ilii (OCI) is a rare cause of chronic non-inflammatory axial lower back pain. It has become an important differential diagnosis of axial spondyloarthritis. Bone marrow oedema can be present in 48% of patients. Although 'aunt minnie' appearance on MRI is pathognomonic, specialised imaging like SPECT/PET CT can be considered in difficult cases to confirm the diagnosis. We reviewed case notes of patients with incidental diagnosis of OCI on imaging and followed their clinical progression to see if the diagnosis was modified later. Methods  Retrospective radiological database analysis was performed to find imaging reported as OCI or osteitis from 2015-2020. Electronic patient records were analyzed and data was compiled through Microsoft Excel. Results  Data from 24 patients was reviewed. Most patients were females (91.7%), with a median age of 43 years (range 19-79 years). CT and MRI were the chief modalities of imaging (46% and 38% respectively) while 20% had plain x-rays of the pelvis. The main indications for imaging were pelvic or hip girdle pain (58.3%), cancer surveillance (25%), abdominal pain (6%), and infection (6%). 20% had an underlying rheumatological diagnosis of which 8% had spondyloarthritis. 12.5% of patients had seronegative features of spondyloarthritis and 8.3% were HLA B27 positive. Approximately 40% of patients were seen by the Rheumatology team for further assessment after imaging and 12.5% of patients were diagnosed with axial spondyloarthritis and remained under follow-up. Conclusion  OCI can mimic sacroiliitis on imaging. Although only a minority of patients with OCI reported on initial imaging were subsequently diagnosed with axial spondyloarthritis, thorough clinical assessment and multidisciplinary discussion can reduce the chance of a missed axial spondyloarthritis diagnosis. Further large-scale studies are required to find the exact incidence of spondyloarthritis in patients with imaging features of OCI. Disclosure  S. Saeed: None. M. Jamal: None. D. Ostry: None. G. Robinson: None. R. Sengupta: None.

Clinical and imaging characteristics of osteitis condensans ilii as compared with axial spondyloarthritis

Rheumatology ◽  
2020 ◽  
Vol 59 (12) ◽  
pp. 3798-3806 ◽  
Author(s):  
Denis Poddubnyy ◽  
Henning Weineck ◽  
Torsten Diekhoff ◽  
Imke Redeker ◽  
Nino Gobejishvili ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Back Pain ◽  
Axial Spondyloarthritis ◽  
Clinical Laboratory ◽  
Lower Percentage ◽  
Imaging Features ◽  
Lower Prevalence ◽  
Sacroiliac Joints ◽  
Mri Characteristics ◽  
Osteitis Condensans Ilii

Abstract Objectives Osteitis condensans ilii (OCI) has become an important differential diagnosis for axial spondyloarthritis (axSpA). The objective of this matched case–control study was to investigate demographic, clinical, laboratory and MRI characteristics of OCI as compared with axial spondyloarthritis (axSpA). Methods A total of 60 patients diagnosed with OCI were included in the final analysis. From 27 of these patients, MRIs of the sacroiliac joints were available. OCI patients were matched with a 1:1 ratio by back pain duration to patients with definite axSpA in order to compare clinical, laboratory and MRI characteristics. Results The OCI patients were nearly all females (96.7 vs 46.7%), had a significantly lower prevalence of inflammatory back pain (39.5 vs 88.9%), a significantly lower percentage of HLA-B27 positives (35.2 vs 80.0%) and a lower prevalence of the majority of other SpA features as compared with axSpA patients. Interestingly, there was no difference in the prevalence of osteitis in the sacroiliac joints (92.6 vs 85.2% in OCI and axSpA, respectively, P = 0.44), but there was a difference in the prevalence of erosions (7.4 vs 66.7%, respectively, P = 0.0001). In addition, in OCI nearly all lesions were localized in the anterior part of the sacroiliac joints while in axSpA lesions were localized predominantly in the middle part of the joint (for osteitis: 96 vs 4% in OCI and 28.6 vs 71.4% in axSpA; P = 0.0002 for the inter-group difference). Conclusion Clinical and imaging features of OCI compared with axSpA are described that should help in differential diagnosis.

scholarly journals PET/CT Radiomics in Lung Cancer: An Overview

2020 ◽  
Vol 10 (5) ◽  
pp. 1718 ◽  
Author(s):  
Francesco Bianconi ◽  
Isabella Palumbo ◽  
Angela Spanu ◽  
Susanna Nuvoli ◽  
Mario Luca Fravolini ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Large Scale ◽  
Field Analysis ◽  
Response To Treatment ◽  
Computer Assisted ◽  
Imaging Features ◽  
Research Attention ◽  
Full Field ◽  
Pet Ct ◽  
Potential Applications

Quantitative extraction of imaging features from medical scans (‘radiomics’) has attracted a lot of research attention in the last few years. The literature has consistently emphasized the potential use of radiomics for computer-assisted diagnosis, as well as for predicting survival and response to treatment. Radiomics is appealing in that it enables full-field analysis of the lesion, provides nearly real-time results, and is non-invasive. Still, a lot of studies suffer from a series of drawbacks such as lack of standardization and repeatability. Such limitations, along with the unmet demand for large enough image datasets for training the algorithms, are major hurdles that still limit the application of radiomics on a large scale. In this paper, we review the current developments, potential applications, limitations, and perspectives of PET/CT radiomics with specific focus on the management of patients with lung cancer.

scholarly journals Imaging analysis of 13 rare cases of renal collecting (Bellini) duct carcinoma in northern China: a case series and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhehao Lyu ◽  
Lili Liu ◽  
Huimin Li ◽  
Haibo Wang ◽  
Qi Liu ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Ct Scan ◽  
Clinical Manifestations ◽  
Northern China ◽  
Renal Tumors ◽  
Imaging Features ◽  
Duct Carcinoma ◽  
Pet Ct ◽  
Bellini Duct Carcinoma ◽  
Mass Type

Abstract Background Collecting (Bellini) duct carcinoma (CDC) is a highly malignant and rare kidney tumor. We report our 12-year experience with CDC and the results of a retrospective analysis of patients and tumor characteristics, clinical manifestations, and imaging features by computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET)/CT. Methods Retrospective examination of tumors between January 2007 and December 2019 identified 13 cases of CDC from three medical centers in northern China. All 13 patients underwent CT scan, among which eight underwent dynamic enhanced CT scan, two underwent PET/CT scan, and one underwent magnetic resonance cholangiopancreatography (MRCP) examination. The lesions were divided into nephritis type and mass type according to the morphology of the tumors. Results The study group included ten men and three women with an average age of 64.23 ± 10.74 years. The clinical manifestations were gross hematuria, flank pain, and waist discomfort. The mean tumor size was 8.48 ± 2.48 cm. Of the 13 cases, six (46.2%) were cortical-medullary involved type and seven (53.8%) were cortex–medullary–pelvis involved type. Eleven (84.6%) cases were nephritis type and two (15.4%) were mass type. The lesions appeared solid or complex solid and cystic on CT and MRI. The parenchymal area of the tumors showed isodensity or slightly higher density on unenhanced CT scan in the 13 cases. PET/CT in two cases showed increased radioactivity intake. Evidence of intra-abdominal metastatic disease was present on CT in nine (69.2%) cases. Conclusions The imaging characteristics of CDC differ from those of other renal cell carcinomas. In renal tumors located in the junction zone of the renal cortex and medulla that show unclear borders, slight enhancement, and metastases in the early stage, a diagnosis of CDC needs to be considered. PET/CT provides crucial information for the diagnosis of CDC, as well as for designing treatment strategies including surgery.

scholarly journals Correlation of 18F-FDG PET/CT SUVmax with clinical features, D-dimer and LDH in patients with primary intestinal lymphoma

2021 ◽  
Vol 49 (7) ◽  
pp. 030006052110298
Author(s):  
Shuo Zhou ◽  
Wenxin Chen ◽  
Meifu Lin ◽  
Guobao Chen ◽  
Cailong Chen ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Clinical Staging ◽  
Imaging Features ◽  
Intestinal Lymphoma ◽  
Ki 67 ◽  
Positive Correlation ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct ◽  
D Dimer

Objective To investigate the characteristics of fluorine-18-deoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) maximum standardized uptake value (SUVmax) in primary intestinal lymphoma (PIL) and its correlation with D-dimer and lactate dehydrogenase (LDH). Methods Fifty-two patients diagnosed with PIL from June 2016 to December 2019 were analyzed. All patients underwent 18F-FDG PET/CT. The relationships between SUVmax and different pathological subtypes, clinical stages and risk grades were analyzed. The correlations between SUVmax and Ki-67, LDH and D-dimer were determined. Additionally, PET/CT imaging results were collected from 35 patients with primary intestinal cancer (PIC) and compared with the imaging features of PIL. Results SUVmax was significantly different between PIL and PIC groups and various PIL pathological subgroups. Patients in the high-risk PIL group had markedly higher SUVmax values than the intermediate-risk and low-risk groups. A significant positive correlation was observed between SUVmax and Ki-67 in patients with PIL. SUVmax was significantly different between the elevated and normal D-dimer groups. D-dimer showed a positive correlation with SUVmax. Conclusion 18F-FDG PET/CT SUVmax reflects the aggressiveness of lymphoma to a certain degree, is correlated with Ki-67 and determines the risk grades of PIL. Moreover, it facilitates differential diagnosis, clinical staging and treatment based on D-dimer levels.

scholarly journals Automated quantification of baseline imaging PET metrics on FDG PET/CT images of pediatric Hodgkin lymphoma patients

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Amy J. Weisman ◽  
Jihyun Kim ◽  
Inki Lee ◽  
Kathleen M. McCarten ◽  
Sandy Kessel ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Correlation Coefficient ◽  
Pet Imaging ◽  
Fdg Pet ◽  
Relative Difference ◽  
Ct Images ◽  
Imaging Features ◽  
Pediatric Hodgkin Lymphoma ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Purpose For pediatric lymphoma, quantitative FDG PET/CT imaging features such as metabolic tumor volume (MTV) are important for prognosis and risk stratification strategies. However, feature extraction is difficult and time-consuming in cases of high disease burden. The purpose of this study was to fully automate the measurement of PET imaging features in PET/CT images of pediatric lymphoma. Methods 18F-FDG PET/CT baseline images of 100 pediatric Hodgkin lymphoma patients were retrospectively analyzed. Two nuclear medicine physicians identified and segmented FDG avid disease using PET thresholding methods. Both PET and CT images were used as inputs to a three-dimensional patch-based, multi-resolution pathway convolutional neural network architecture, DeepMedic. The model was trained to replicate physician segmentations using an ensemble of three networks trained with 5-fold cross-validation. The maximum SUV (SUVmax), MTV, total lesion glycolysis (TLG), surface-area-to-volume ratio (SA/MTV), and a measure of disease spread (Dmaxpatient) were extracted from the model output. Pearson’s correlation coefficient and relative percent differences were calculated between automated and physician-extracted features. Results Median Dice similarity coefficient of patient contours between automated and physician contours was 0.86 (IQR 0.78–0.91). Automated SUVmax values matched exactly the physician determined values in 81/100 cases, with Pearson’s correlation coefficient (R) of 0.95. Automated MTV was strongly correlated with physician MTV (R = 0.88), though it was slightly underestimated with a median (IQR) relative difference of − 4.3% (− 10.0–5.7%). Agreement of TLG was excellent (R = 0.94), with median (IQR) relative difference of − 0.4% (− 5.2–7.0%). Median relative percent differences were 6.8% (R = 0.91; IQR 1.6–4.3%) for SA/MTV, and 4.5% (R = 0.51; IQR − 7.5–40.9%) for Dmaxpatient, which was the most difficult feature to quantify automatically. Conclusions An automated method using an ensemble of multi-resolution pathway 3D CNNs was able to quantify PET imaging features of lymphoma on baseline FDG PET/CT images with excellent agreement to reference physician PET segmentation. Automated methods with faster throughput for PET quantitation, such as MTV and TLG, show promise in more accessible clinical and research applications.

scholarly journals Not all that glitters is COVID! Differential diagnosis of FDG-avid interstitial lung disease in low-prevalence regions

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Annalisa Papa ◽  
Chiara Pozzessere ◽  
Francesco Cicone ◽  
Fabiola Rizzuto ◽  
Giuseppe Lucio Cascini
Keyword(s):  
Differential Diagnosis ◽  
Interstitial Lung Diseases ◽  
Routine Activity ◽  
Imaging Features ◽  
Pet Ct ◽  
Oncologic Patients ◽  
The Many ◽  
Fdg Pet Ct ◽  
Low Prevalence ◽  
Similar Imaging

Abstract Coronavirus disease-19 (COVID-19) is only one of the many possible infectious and non-infectious diseases that may occur with similar imaging features in patients undergoing [18F]-fluorodeoxyglucose (18FDG) monitoring, particularly in the most fragile oncologic patients. We briefly summarise some key radiological elements of differential diagnosis of interstitial lung diseases which, in our opinion, could be extremely useful for physicians reporting 18FDG PET/CT scans, not only during the COVID-19 pandemic, but also for their normal routine activity.

scholarly journals POS1288 TUBERCULOUS SPONDYLODISCITIS IN ELDERLY: EPIDEMIOLOGY, CLINICAL, FEATURES, TREATMENT AND OUTCOMES

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 926.1-926
Author(s):  
M. Mrabet ◽  
S. Boussaid ◽  
S. Jemmali ◽  
H. Sahli ◽  
H. Ajlani ◽  
...  
Keyword(s):  
Clinical Features ◽  
The Elderly ◽  
Lumbar Pain ◽  
Elderly Subjects ◽  
Normocytic Anemia ◽  
Imaging Features ◽  
X Rays ◽  
Significant Difference ◽  
Young Subjects ◽  
Tuberculous Spondylodiscitis

Background:Tuberculosis is still endemic all over the world. The incidence of tuberculous spondylodiscitis (TS) is steadily increasing. Clinical features and outcomes of this affection are various and depending on various parameters, including age.Objectives:Our objective was to explore the differences in presentation and the results of further investigations and the prognosis of TS between young and elderly subjects.Methods:We conduct a retrospective and descriptive study in a single rheumatology department. Data were collected from files of patients hospitalized in the past 20 years (2000-2020) who have been diagnosed with TS. We carried out a comparative study concerning the clinical biological, imaging features and outcomes between young subjects and subjects aged over 65 years.Results:Fifty-two cases of TS were collected (37F/15M). The mean age of the population was 55.21 years ± 17.79 [19-91]. Thirty-three patients (69.2%) were classified as young versus 16 elderly patients (30.8%), with female predominance in both groups (69.4% and 75% respectively, p = 0.57). Young subjects was more frequently vaccinated (88.9%) by Bacillus Calmette–Guérin (BCG) (p < 0.001). A delayed diagnosis was noted in both groups (p = 0.24). Lumbar spine involvement was the most common (57.7%). In the two age ranges, the onset of the disease was progressive (p = 0.22), characterized by segmental spine stiffness (p = 0.57) and lumbar pain with general signs (p = 0.27), such as: impaired general condition, fever, night sweats and weight loss. Biological inflammatory syndrome and normochrome normocytic anemia were encountered in both cases (p = 0.08 and p = 0.2, respectively). Standard X-rays and Computed tomography were more performed in young subjects (94.4% and 69.4%, respectively; p < 0.001), unlike magnetic resonance imaging which was more common in elderly subjects but with no statistically significant difference (p = 0.22). Disc pinch, erosion of vertebral plateaus and vertebral collapse were the major signs (82.7%, 65.4% and 67.3%, respectively). Clinical, biological and imaging arguments contributed to positive diagnosis in both groups (p = 0.24). Common medical treatment was anti-tuberculosis: Isoniazid (H), Rifampicin (R), Pyrazinamide (Z), Ethambutol (E) and physical treatment such as immobilization witch was more common in the eldery (56.3%, p = 0.16). The evolution of the disease was characterized by a clear improvement of young subjects during the second week of treatment (p < 0.001). A more frequent clinical improvement in older subjects was during the fourth week but with no statistically significant difference (p = 0.13). The occurrence of immediate complications was more frequent in the elderly (p = 0.23) with a predominance for drug complications (56.3%) such as: hepatic cytolysis (12.5%), hyperuricemia (18.8%) and major intolerance to anti-tuberculosis (18.8%).Conclusion:TS is a frequent condition that needs to be treated rapidly. the clinical presentation of TS in the elderly is less noisy which leads to more frequent complications and mortality.Disclosure of Interests:None declared

scholarly journals FDG PET/CT imaging features and clinical utility in COVID-19

2021 ◽  
Author(s):  
Randy Yeh ◽  
Ahmed Elsakka ◽  
Rick Wray ◽  
Rocio Perez Johnston ◽  
Natalie C. Gangai ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Clinical Utility ◽  
Ct Imaging ◽  
Imaging Features ◽  
Pet Ct ◽  
Fdg Pet Ct

scholarly journals Inflammatory myofibroblastic tumor of the liver mimicking an infiltrative malignancy in computed tomography and magnetic resonance imaging with Gd-EOB

2014 ◽  
Vol 3 (7) ◽  
pp. 204798161454440 ◽  
Author(s):  
Tahir Durmus ◽  
Carsten Kamphues ◽  
Hendrik Blaeker ◽  
Christian Grieser ◽  
Timm Denecke
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Liver Tumors ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Diagnostic Challenge ◽  
Number Of Patients ◽  
Inflammatory Myofibroblastic Tumors ◽  
Malignant Liver

Inflammatory myofibroblastic tumors (IMT) are a benign tumor entity, which rarely develop in the liver. Surgery is the most common treatment for these lesions as it is difficult to distinguish them from malignant liver tumors and local recurrent growth may occur. IMT is a diagnostic challenge for imaging. Only a limited number of reports of single cases or small number of patients described the imaging features on computed tomography. Reports on IMT appearance on magnetic resonance imaging are scarce. We present a case of IMT of the liver with infiltration of the abdominal wall treated with surgery and describe the imaging features with the use of the hepatobiliary contrast agent, gadoxetic acid (Gd-EOB).

scholarly journals The Added Value of [18F]FDG PET/CT in the Management of Invasive Fungal Infections

Diagnostics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 137
Author(s):  
Alfred O. Ankrah ◽  
Dina Creemers-Schild ◽  
Bart de Keizer ◽  
Hans C. Klein ◽  
Rudi A. J. O. Dierckx ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Fungal Infections ◽  
Invasive Fungal Infections ◽  
Added Value ◽  
X Rays ◽  
Imaging Studies ◽  
Imaging Methods ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Anatomy-based imaging methods are the usual imaging methods used in assessing invasive fungal infections (IFIs). [18F]FDG PET/CT has also been used in the evaluation of IFIs. We assessed the added value of [18F]FDG PET/CT when added to the most frequently used anatomy-based studies in the evaluation of IFIs. The study was conducted in two University Medical Centers in the Netherlands. Reports of [18F]FDG PET/CT and anatomy-based imaging performed within two weeks of the [18F]FDG PET/CT scan were retrieved, and the presence and sites of IFI lesions were documented for each procedure. We included 155 [18F]FDG PET/CT scans performed in 73 patients. A total of 216 anatomy-based studies including 80 chest X-rays, 89 computed tomography studies, 14 magnetic resonance imaging studies, and 33 ultrasound imaging studies were studied. The anatomy-based studies were concordant with the [18F]FDG PET/CT for 94.4% of the scans performed. [18F]FDG PET/CT detected IFI lesions outside of the areas imaged by the anatomy-based studies in 48.6% of the scans. In 74% of the patients, [18F]FDG PET/CT added value in the management of the IFIs.

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