scholarly journals Accuracy of whole-body diffusion-weighted MRI (WB-DWI/MRI) in diagnosis, staging and follow-up of gastric cancer, in comparison to CT: a pilot study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sofie De Vuysere ◽  
Vincent Vandecaveye ◽  
Yves De Bruecker ◽  
Saskia Carton ◽  
Koen Vermeiren ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Predictive Value ◽  
Peritoneal Metastases ◽  
Whole Body ◽  
Diffusion Weighted Mri ◽  
Diffusion Weighted ◽  
Sensitivity Specificity ◽  
Malignant Lymph Nodes

Abstract Background Accurate staging of patients with gastric cancer is necessary for selection of the most appropriate and personalized therapy. Computed tomography (CT) is currently used as primary staging tool, being widely available with a relatively high accuracy for the detection of parenchymal metastases, but with low sensitivity for the detection of peritoneal metastases. Magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI) has a very high contrast resolution, suggesting a higher diagnostic performance in the detection of small peritoneal lesions. The aim of this study was to retrospectively evaluate the added value of whole-body diffusion-weighted MRI (WB-DWI/MRI) to CT for detection of peritoneal carcinomatosis (PC) and distant metastases in the preoperative staging of gastric cancer. Methods This retrospective study included thirty-two patients with a suspicion of gastric cancer/recurrence, who underwent WB-DWI/MRI at 1.5 T, in addition to CT of thorax and abdomen. Images were evaluated by two experienced abdominal radiologists in consensus. Histopathology, laparoscopy and/or 1-year follow-up were used as reference standard. Results For overall tumour detection (n = 32), CT sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) was 83.3%, 100%, 100% and 82.4% respectively. For WB-DWI/MRI these values were 100%, 92.9%, 94.7% and 100%, respectively. For staging (n = 18) malignant lymph nodes and metastases, CT had a sensitivity, specificity/PPV/NPV of 50%/100%/100%/71.4%, and 15.4%/100%/100%/31.3% respectively. For WB-DWI/MRI, all values were 100%, for both malignant lymph nodes and metastases. WB-DWI/MRI was significantly better than CT in detecting tumour infiltration of the mesenteric root, serosal involvement of the small bowel and peritoneal metastases for which WB-DWI/MRI was correct in 100% of these cases, CT 0%. Conclusions WB-DWI/MRI is highly accurate for diagnosis, staging and follow-up of patients with suspected gastric cancer.

scholarly journals Accuracy of Whole-Body Diffusion-Weighted MRI (WB-DWI/MRI) in Diagnosis, Staging and Follow-Up of Gastric Cancer, in Comparison to CT: A Pilot Study. 

2020 ◽  
Author(s):  
Sofie De Vuysere ◽  
Vincent Vandecaveye ◽  
Yves De Bruecker ◽  
Saskia Carton ◽  
Koen Vermeiren ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Predictive Value ◽  
Peritoneal Metastases ◽  
Whole Body ◽  
Diffusion Weighted Mri ◽  
Diffusion Weighted ◽  
Sensitivity Specificity ◽  
Malignant Lymph Nodes

Abstract Background: Accurate staging of patients with gastric cancer is necessary for selection of the most appropriate and personalized therapy. Computed Tomography (CT) is currently used as primary staging tool, being widely available with a relatively high accuracy for the detection of parenchymal metastases, but with low sensitivity for the detection of peritoneal metastases. Magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI) has a very high spatial and contrast resolution, suggesting a higher diagnostic performance in the detection of small peritoneal lesions. The aim of this study was to retrospectively evaluate the added value of whole-body diffusion-weighted MRI (WB-DWI/MRI) to CT for detection of peritoneal carcinomatosis (PC) and distant metastases in the preoperative staging of gastric cancer.Methods: This retrospective study included thirty-two patients with a suspicion of gastric cancer/recurrence, who underwent WB-DWI/MRI at 1.5 Tesla, in addition to CT of thorax and abdomen. Images were evaluated by two experienced abdominal radiologists in consensus. Histopathology, laparoscopy and/or 1-year follow-up were used as reference standard.Results: For overall tumor detection (n=32), CT sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) was 83.3%, 100%, 100% and 82.4% respectively. For WB-DWI/MRI these values were 100%, 92.9%, 94.7% and 100%, respectively. For staging (n=18) malignant lymph nodes and metastases, CT had a sensitivity, specificity/ PPV/ NPV of 50%/ 100%/ 100%/ 71.4%, and 15.4%/ 100%/ 100%/ 31.3% respectively. For WB-DWI/MRI, all values were 100%, for both malignant lymph nodes and metastases. WB-DWI/MRI was significantly better than CT in detecting tumor infiltration of the mesenteric root, serosal involvement of the small bowel and peritoneal metastases for which WB-DWI/MRI was correct in 100% of these cases, CT 0%.Conclusions: WB-DWI/MRI is highly accurate for diagnosis, staging and follow-up of patients with suspected gastric cancer. These results need to be confirmed in larger studies.

SONOGRAPHIC FOLLOW-UP OF PATIENTS WITH DIFFERENTIATED THYROID CARCINOMA: A COMPARISON OF THE ULTRASOUND ELASTOGRAPHY, POWER DOPPLER ULTRASOUND, AND B-MODE ULTRASOUND FEATURES IN DETECTING MALIGNANT LYMPH NODES

2019 ◽  
Vol 25 (10) ◽  
pp. 1049-1055
Author(s):  
Berna İmge Aydoğan ◽  
Ugur Ünlütürk ◽  
Funda Seher Özalp Ateş ◽  
Murat Faik Erdoğan
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Positive Predictive Value ◽  
Lymph Nodes ◽  
Predictive Value ◽  
Differentiated Thyroid Cancer ◽  
Power Doppler ◽  
Ultrasound Elastography ◽  
Malignant Lymph Nodes

Objective: The aim of this study was to assess and compare the diagnostic power of B-mode ultrasonography (US), power Doppler US (PD), and ultrasound elastography (USE) in detecting malignant lymph nodes (LNs) during follow-up of patients who were operated on for differentiated thyroid cancer (DTC). Methods: In this prospective study, a total of 103 cervical LNs having suspicious malignant features from 72 patients with DTC were examined using US, PD, and USE. USE scores were classified from 1 to 3 according to the presence of elasticity (1, soft; 2, intermediate; 3, hard). The strain ratios (SRs) of all LNs were calculated according to adjacent muscle tissue. Results: The most-sensitive ultrasonographic features were hilum loss and hypoechogenicity, with 94.4% and 80.6% sensitivity and 93.5% and 84.4% negative predictive value, respectively. The most-specific feature was the presence of cystic component, with 98.5% specificity and 85.7% positive predictive value. Presence of diffuse/chaotic or irregular vascularity in PD had 47.2% sensitivity and 83.6% specificity in predicting metastasis. In USE, the sensitivity and specificity of score 3 were 56.7% and 74.2%, respectively. The median SR of metastatic LNs was higher than that of benign LNs (median SR [min–max], 3.0 [0.16 and 29] vs. 1.89 [0.26 and 37.9]), but the difference was not significant ( P = .07). Multivariate logistic regression analyses revealed 4.9-, 6.6-, and 10-fold increases in metastasis risk for short/long axis ratio ≥0.5, nodal vascularity, and score 3 USE, respectively ( P<.05). Conclusion: While USE had higher sensitivity, PD had higher specificity in detecting malignant LNs, but none of these techniques was as sensitive and specific as gray-scale US features. Abbreviations: CI = confidence interval; DTC = differentiated thyroid cancer; LN = lymph node; LN-Tg = lymph node–thyroglobulin; NPV = negative predictive value; PD = power Doppler; PPV = positive predictive value; ROI = region of interest; SR = strain ratio; US = ultrasonography; USE = ultrasound elastography

scholarly journals Whole-body diffusion-weighted MRI for operability assessment in patients with colorectal cancer and peritoneal metastases

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Raphaëla Carmen Dresen ◽  
Sofie De Vuysere ◽  
Frederik De Keyzer ◽  
Eric Van Cutsem ◽  
Hans Prenen ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Peritoneal Metastases ◽  
Whole Body ◽  
Diffusion Weighted Mri ◽  
Diffusion Weighted ◽  
Operability Assessment

Whole-Body Diffusion-Weighted MRI Compared to 18 FFDG PET/CT in Initial Staging and Therapy Response Assessment of Hodgkin Lymphoma in Pediatric Patients

2020 ◽  
Vol 71 (2) ◽  
pp. 217-225 ◽  
Author(s):  
Gali Shapira-Zaltsberg ◽  
Nagwa Wilson ◽  
Esther Trejo Perez ◽  
Lesleigh Abbott ◽  
Stephen Dinning ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Fdg Pet ◽  
Pediatric Patients ◽  
Whole Body ◽  
Diffusion Weighted Mri ◽  
Diffusion Weighted ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Initial Staging

Purpose: The aim of our study was to compare whole-body diffusion-weighted MRI (WB-DWI-MRI) to fluoro-2-deoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in the assessment of initial staging and treatment response in pediatric patients with Hodgkin lymphoma. Materials and Methods: This prospective study comprised 11 children with Hodgkin lymphoma. Whole-body DWI-MRI and FDG-PET/CT were obtained at baseline and after 2 cycles of chemotherapy. Two radiologists measured the apparent diffusion coefficient (ADC) values of the sites of involvement agreed upon in consensus and 1 nuclear medicine physician assessed the PET/CT. Reliability of radiologists’ ratings was assessed by intraclass correlation coefficients (ICC2,1). The sensitivity and positive predictive value (PPV) of DW-MRI relative to PET/CT were calculated for nodal and extranodal sites. The patients were staged according to both modalities. Association of treatment responses was assessed through the Pearson correlation between the ADC ratios and the change standardized uptake value (SUV) between baseline and follow-up. Results: There was good agreement between the raters for nodal and extranodal ADC measurements. The sensitivity and PPV of DW-MRI relative to PET/CT of nodal disease was 0.651 and 1.0, respectively, at baseline, and 0.697 and 0.885 at follow-up. The sensitivity and PPV of extranodal disease were 0.545 and 0.6 at baseline, and 0.167 and 0.333 at follow-up. Diffusion-weighted MRI determined correct tumor stage in 8 of 11 examinations. There was poor correlation between the ADC ratios and the absolute change in SUV between baseline and follow-up (0.348). Conclusion: Our experience showed that WB-DWI-MRI is inferior to PET/CT for initial staging and assessment of treatment response of Hodgkin lymphoma in pediatric patients.

scholarly journals P2.11-21 Usefulness of Diffusion-Weighted Whole-Body Imaging with Background Suppression in the Postoperative Follow-up Period

2019 ◽  
Vol 14 (10) ◽  
pp. S800
Author(s):  
K. Suemori ◽  
M. Kataoka ◽  
D. Okutani ◽  
T. Fujita ◽  
I. Togami ◽  
...  
Keyword(s):  
Whole Body ◽  
Background Suppression ◽  
Whole Body Imaging ◽  
Body Imaging ◽  
Diffusion Weighted

Classification of Male Breast Lesions According to the IAC Yokohama System for Reporting Breast Cytopathology

2020 ◽  
pp. 1-8
Author(s):  
Melissa Oosthuizen ◽  
Rubina Razack ◽  
Jenny Edge ◽  
Pawel Tomasz Schubert
Keyword(s):  
Predictive Value ◽  
Best Practice ◽  
Internal Audit ◽  
Needle Aspiration ◽  
Male Breast ◽  
Histopathological Diagnosis ◽  
Breast Lesions ◽  
Risk Of Malignancy ◽  
Sensitivity Specificity

<b><i>Objective:</i></b> This study aims to determine the diagnostic utility of the International Academy of Cytology (IAC) Yokohama System for reporting breast cytopathology in lesions of the male breast. <b><i>Study Design:</i></b> Fine-needle aspiration biopsy (FNAB) reports between 2015 and 2019 were retrospectively recategorized according to the 5-tiered IAC Yokohama Reporting System. Our database yielded a total of 1,532 FNAB reports from breast lesions, obtained from 1,350 male patients. The risk of malignancy (ROM) and diagnostic performance of FNAB were determined using follow-up histopathological diagnosis and/or clinical follow-up, where available, for each category. <b><i>Results:</i></b> The category distribution were as follows: inadequate, 40%; benign, 57%; atypical, 0.6%; suspicious for malignancy, 0.7%; and malignant, 1.6%. The ROM in each category was nondiagnostic, 11%; benign, 3%; atypical, 28%; suspicious for malignancy, 56%; and malignant, 100%. The sensitivity, specificity, positive predictive value, and negative predictive value were recorded as 63, 100, 100, and 84.6% respectively, when only malignant cases were considered as positive tests. <b><i>Conclusion:</i></b> This study validates the IAC Yokohama System for reporting male breast cytopathology. In accordance with the aim of the Yokohama System to establish best practice guidelines for reporting breast cytopathology, this comprehensive scheme facilitates comparisons between local and international institutions. The ROM acts as an internal audit for quality assurance within one’s own laboratory and provides guidance for clinical management. It highlights inefficiencies such as high inadequacy rates for category 1 and also features strengths with impressive specificity for categories 4 and 5.

scholarly journals New screening approach to detecting congenital syphilis in China: a retrospective cohort study

2020 ◽  
pp. archdischild-2020-320549
Author(s):  
Fang Hu ◽  
Shuai-Jun Guo ◽  
Jian-Jun Lu ◽  
Ning-Xuan Hua ◽  
Yan-Yan Song ◽  
...  
Keyword(s):  
Predictive Value ◽  
Congenital Syphilis ◽  
Area Under The Curve ◽  
Diagnostic Tools ◽  
Operating Characteristics ◽  
Loss To Follow Up ◽  
Sensitivity Specificity ◽  
Mother To Child ◽  
Rule Out

BackgroundDiagnosis of congenital syphilis (CS) is not straightforward and can be challenging. This study aimed to evaluate the validity of an algorithm using timing of maternal antisyphilis treatment and titres of non-treponemal antibody as predictors of CS.MethodsConfirmed CS cases and those where CS was excluded were obtained from the Guangzhou Prevention of Mother-to-Child Transmission of syphilis programme between 2011 and 2019. We calculated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) using receiver operating characteristics (ROC) in two situations: (1) receiving antisyphilis treatment or no-treatment during pregnancy and (2) initiating treatment before 28 gestational weeks (GWs), initiating after 28 GWs or receiving no treatment for syphilis seropositive women.ResultsAmong 1558 syphilis-exposed children, 39 had confirmed CS. Area under the curve, sensitivity and specificity of maternal non-treponemal titres before treatment and treatment during pregnancy were 0.80, 76.9%, 78.7% and 0.79, 69.2%, 88.7%, respectively, for children with CS. For the algorithm, ROC results showed that PPV and NPV for predicting CS were 37.3% and 96.4% (non-treponemal titres cut-off value 1:8 and no antisyphilis treatment), 9.4% and 100% (non-treponemal titres cut-off value 1:16 and treatment after 28 GWs), 4.2% and 99.5% (non-treponemal titres cut-off value 1:32 and treatment before 28 GWs), respectively.ConclusionsAn algorithm using maternal non-treponemal titres and timing of treatment during pregnancy could be an effective strategy to diagnose or rule out CS, especially when the rate of loss to follow-up is high or there are no straightforward diagnostic tools.

scholarly journals Feasibility of whole-body diffusion-weighted MRI for detection of primary tumour, nodal and distant metastases in women with cancer during pregnancy: a pilot study

2017 ◽  
Vol 28 (5) ◽  
pp. 1862-1874 ◽  
Author(s):  
Sileny N. Han ◽  
Frédéric Amant ◽  
Katrijn Michielsen ◽  
Frederik De Keyzer ◽  
Steffen Fieuws ◽  
...  
Keyword(s):  
Pilot Study ◽  
Primary Tumour ◽  
Distant Metastases ◽  
Whole Body ◽  
Diffusion Weighted Mri ◽  
Diffusion Weighted
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