scholarly journals ROLE OF MULTI-SLICE SPIRAL CT IN EVALUATION OF NECK MASS WITH CYTOLOGICAL CORRELATION

Author(s):  
Das Runa ◽  
Aniruddha Ghosh

Abstract: The swellings in the neck can be caused by innumerable pathological lesions arising from the various anatomical structures lying therein. Multi-Detector CT (MDCT) has now become the new standard in a radiological imaging modality. The utilization of MDCT has resulted in improved resolution and considerable reductions in scan acquisition and display time. Aim and Objective: This study is an effort to assess the role of MDCT in detection, characterization and diagnosing neck pathologies that correlate cytologically. Material and Methods: A study of 50 cases in a clinically suspected neck mass was studied for 1 year. Contrast-enhanced Ct neck was done and Specific CT criteria were used to characterize the mass so that a probable diagnosis could be made. MDCT diagnoses then compared with cytological results to conclude the efficiency of MDCT analysis of neck mass. Conclusion: Multi-detector computed tomography helps in precise anatomical localization and characterization of neck masses. Hence, it will be a method of choice for initial evaluation, preoperative planning, and biopsy targeting and postoperative follow-up. Key Words: Neck mass; Cervical lymph node; Computed tomography; Carcinoma.

2021 ◽  
Vol 10 (11) ◽  
pp. 819-824
Author(s):  
Sharvari Shashikant Gulve ◽  
Pratapsingh Hanumantsingh Parihar ◽  
Rajasbala Pradeep Dhande

BACKGROUND Pancreatic lesions range from inflammation to malignancy and are associated with high morbidity and mortality. Imaging pancreatic lesion is challenging as pancreas is located retroperitoneally and with close proximity to bowel and major blood vessels. Abdominal pain, vomiting, and nausea are commonly reported symptoms. They are associated with high morbidity. Multi detector computed tomography (MDCT) is the modality of choice for detecting pancreatic pathology. It is highly sensitive in detecting necrosis, pancreatitis, peripancreatic fluid collections, calcification, neoplasm, pancreatic enlargement, atrophy and cystic lesions of pancreas. Computed tomography (CT) scan has made it possible to identify and detect various benign and malignant pancreatic lesions. METHODS A prospective observational study of 180 patients with complaints suggestive of pancreatic disease was done based on clinical, laboratory and ultrasonography in the Department of Radiodiagnosis, Acharya Vinoba Bhave Rural Hospital, Datta Meghe Institute of Medical Sciences, Sawangi (Meghe). Siemens Somatom 16 slice CT scan machine was used. All 180 patients underwent plain and contrast enhanced CT scan. RESULTS Out of 180 study participants 105 (58.33 %) were with acute pancreatitis followed by 43 (23.89 %) with chronic pancreatitis, 21 (11.67 %) with acute exacerbation of chronic pancreatitis, 10 (5.56 %) participants with carcinoma pancreas and 1 (0.56 %) participant with pancreatic injury participated in the study. CONCLUSIONS Contrast enhanced computed tomography (CECT) is an excellent diagnostic modality to stage severity of inflammatory process, staging of neoplastic lesions and traumatic injury. It is most accurate and affordable non-invasive imaging modality for the evaluation of pancreatic lesions. It is a standard investigation to identify and quantify distribution of various pancreatic lesions and also evaluates activeness and progression of disease. Thus, it helps in accurate diagnosis and characterization of lesion and in proper treatment of patients. KEY WORDS Pancreas, Imaging, Computed Tomography


2021 ◽  
Vol 6 (3) ◽  
pp. 237-241
Author(s):  
Gupta Vikrant ◽  
Abrol Deepak

Objective: Retroperitoneum is one of the largest spaces in the body. Retroperitoneal (RP) masses are common in paediatric age group and present with vague clinical features. Computed Tomography (CT) is an excellent imaging modality in the evaluation of RP masses. The aim of this study was to evaluate the role of CT in the detection and characterization of RP masses. Materials and Methods: 28 clinically suspected or sonographically detected RP masses formed the material of the study. Detailed clinical history was elicited from the patients/attendants and findings of general physical examination recorded. Non-contrast and Contrast Enhanced CT was performed and masses were evaluated with respect to site of origin, consistency, components and pattern of enhancement. Probable CT diagnosis was made and findings correlated with pathological/laboratory findings wherever possible. The results were subjected to statistical analysis and expressed as percentages and proportions.Results: Majority of patients were seen in 1-5 years age group with M:F ratio of 1.8:1. Lump abdomen was the commonest presenting feature followed by pain abdomen. Lymph nodal masses were the commonest primary RP space mass while renal masses accounted for the majority of secondary RP masses in our study. Pathological/Laboratory correlation was available in 21 cases and CT was able to differentiate benign and malignant lesions in 95.2% cases. Overall diagnostic accuracy of CT in the evaluation of RP masses was 85.7%. Conclusions: CT is a simple and reliable tool in diagnosing pediatric RP masses with a high diagnostic accuracy.


2008 ◽  
Vol 149 (23) ◽  
pp. 1059-1065 ◽  
Author(s):  
Szabolcs Halász ◽  
Tamás Puskás

A többszeletes spirál-CT-berendezések széles körű alkalmazása és a perfúziós szoftverek bevezetése lehetővé tette az agyi véráramlás CT-vizsgálatát. Cél és módszerek: A szerzők ismertetik az agyi perfúziós CT-vizsgálatok elvét, technikáját, amelyet az elmúlt másfél évben 96 betegükön végzett vizsgálatuk tapasztalataival egészítenek ki. A folyamatos technikai fejlődés eredményeként a közeljövőben lehetővé válik a teljes agy perfúziós CT-vizsgálata. Következtetések: Az agy perfúziós CT-vizsgálata gyors, viszonylag olcsó és a stroke kórismézésében pontos diagnózist eredményez.


Author(s):  
Monica Maher Amin Nawar ◽  
Sameh Abdel Aziz Zaky Hanna ◽  
Shereen Sadik El-Sawy ◽  
Sally Yehia Shokralla

Abstract Background The term adrenal incidentaloma (AI), by definition, is an adrenal mass that is unexpectedly detected through an imaging procedure performed for reasons unrelated to adrenal dysfunction or suspected dysfunction. Despite their frequent appearance, the challenge remains in recognizing and treating the small percentage of AI that poses a significant risk, either because of their hormonal activity or because of their malignant histology. The aim of this study is to study the role of MRI, specifically chemical shift imaging (CSI), against various MDCT scans (non-enhanced, enhanced, and delayed) in the characterization of incidentally discovered adrenal masses to offer a way for the patients to avoid unnecessary time and money-wasting imaging modalities used to reach a diagnosis of their incidentally discovered adrenal lesions. We examined a total number of 20 patients with total of 22 adrenal lesions. The mean age was 51.1 ± 15.27. Results In our study, we found that among CT parameters, APW and RPW showed the highest sensitivity and specificity for detection of lipid-rich adenomas. CSI has also proven to be the best MR technique. However, there is no statistically significant difference in the diagnostic capability of CSI versus the CT washout technique. Both modalities could be conducted, according to specific patient preferences and/or limitations, with comparable highly accurate outcomes. Conclusion This study demonstrates that a similar diagnostic outcome is obtained from contrast-enhanced CT (CECT) and MRI with CSI of adrenal lesions.


Author(s):  
Mohamed M. Harraz ◽  
Ahmed H. Abouissa

Abstract Background Although gall bladder perforation (GBP) is not common, it is considered a life-threating condition, and the possibility of occurrence in cases of acute cholecystitis must be considered. The aim of this study was to assess the role of multi-slice computed tomography (MSCT) in the assessment of GBP. Results It is a retrospective study including 19 patients that had GBP out of 147, there were 11 females (57.8%) and 8 males (42.1%), aged 42 to 79 year (mean age 60) presented with acute abdomen or acute cholecystitis. All patients were examined with abdominal ultrasonography and contrast-enhanced abdominal MSCT after written informed consent was obtained from the patients. This study was between January and December 2018. Patients with contraindications to contrast-enhanced computed tomography (CT) (pregnancy, acute kidney failure, or allergy to iodinated contrast agents) who underwent US only were excluded. Patients with other diagnoses, such as acute diverticulitis of the right-sided colon or acute appendicitis, were excluded. The radiological findings were evaluated such as GB distention; stones; wall thickening, enhancement, and defect; pericholecystic free fluid or collection; enhancement of liver parenchyma; and air in the wall or lumen. All CT findings are compared with the surgical results. Our results revealed that the most important and diagnostic MSCT finding in GBP is a mural defect. Nineteen patients were proved surgically to have GBP. Conclusion GBP is a rare but very serious condition and should be diagnosed and treated as soon as possible to decrease morbidity and mortality. The most accurate diagnostic tool is the CT, MSCT findings most specific and sensitive for the detection of GBP and its complications.


2016 ◽  
Author(s):  
S. Dash ◽  
A. Goel ◽  
S. Sogani

Purpose: To evaluate the role of 18F-FDG PET with contrast enhanced CT (PET-CECT) in early detection of recurrence in follow up patients of carcinoma cervix. Methods: Patients with histopathologically proven carcinoma cervix who underwent chemotherapy, radiotherapy and/or surgery and on follow up were recruited in the study. Fifty-two patients underwent 18F-FDG PET-CECT for detection of recurrence. The median age was 51.5 (average = 53.4) years. PET-CECT studies were evaluated and analyzed separately by an experienced nuclear medicine physician and a radiologist independently. The physicians were blinded for the patient history. PET-CECT results were validated with histopathological correlation, conventional radiologic imaging/follow up PET-CECT study and clinical follow up. Results: Out of 52 patients, 34 patients were reported as positive for recurrence, 17 of these were having active local recurrence and 31 patients had regional lymph nodal metastases, 14 patients had distant metastases (out of them 6 patients had distant lymph node metastases, 6 had pulmonary metastases, 4 had skeletal metastases and two had liver metastases). Remaining 18 patients were reported as negative for recurrence. The lung was the most common site for distant metastasis. Patient were then further evaluated based on histopathological correlation, conventional radiologic imaging and follow up PET-CECT scan and five were found to be false positive and one patient was identified as false negative. The sensitivity, specificity, positive and negative predictive value were derived to be 96.7%, 77.3%, 85.3% and 94.4%, respectively. Accuracy was calculated to be 88.5%. Conclusions: 18F-FDG PET-CECT is a very useful non-invasive modality for the early detection of recurrence and metastatic workup in patients with carcinoma cervix with a very high sensitivity and negative predictive value. It is also useful in targeting biopsy sites in suspected cases of recurrence.


2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii93-ii93
Author(s):  
Kate Connor ◽  
Emer Conroy ◽  
Kieron White ◽  
Liam Shiels ◽  
William Gallagher ◽  
...  

Abstract Despite magnetic resonance imaging (MRI) being the gold-standard imaging modality in the glioblastoma (GBM) setting, the availability of rodent MRI scanners is relatively limited. CT is a clinically relevant alternative which is more widely available in the pre-clinic. To study the utility of contrast-enhanced (CE)-CT in GBM xenograft modelling, we optimized CT protocols on two instruments (IVIS-SPECTRUM-CT;TRIUMPH-PET/CT) with/without delivery of contrast. As radiomics analysis may facilitate earlier detection of tumors by CT alone, allowing for deeper analyses of tumor characteristics, we established a radiomic pipeline for extraction and selection of tumor specific CT-derived radiomic features (inc. first order statistics/texture features). U87R-Luc2 GBM cells were implanted orthotopically into NOD/SCID mice (n=25) and tumor growth monitored via weekly BLI. Concurrently mice underwent four rounds of CE-CT (IV iomeprol/iopamidol; 50kV-scan). N=45 CE-CT images were semi-automatically delineated and radiomic features were extracted (Pyradiomics 2.2.0) at each imaging timepoint. Differences between normal and tumor tissue were analyzed using recursive selection. Using either CT instrument/contrast, tumors > 0.4cm3 were not detectable until week-9 post-implantation. Radiomic analysis identified three features (waveletHHH_firstorder_Median, original_glcm_Correlation and waveletLHL_firstorder_Median) at week-3 and -6 which may be early indicators of tumor presence. These features are now being assessed in CE-CT scans collected pre- and post-temozolomide treatment in a syngeneic model of mesenchymal GBM. Nevertheless, BLI is significantly more sensitive than CE-CT (either visually or using radiomic-enhanced CT feature extraction) with luciferase-positive tumors detectable at week-1. In conclusion, U87R-Luc2 tumors > 0.4cm3 are only detectable by Week-8 using CE-CT and either CT instrument studied. Nevertheless, radiomic analysis has defined features which may allow for earlier tumor detection at Week-3, thus expanding the utility of CT in the preclinical setting. Overall, this work supports the discovery of putative prognostic pre-clinical CT-derived radiomic signatures which may ultimately be assessed as early disease markers in patient datasets.


2022 ◽  
Author(s):  
Inés Califano ◽  
Fabian Pitoia ◽  
Roxana Chirico ◽  
Alejandra de Salazar ◽  
Maria Bastianello

Abstract Purpose 18F-DOPA Positron Emission Tomography/Computed Tomography (18F-DOPA PET/CT) is a sensitive functional imaging method (65-75%) for detecting disease localization in medullary thyroid cancer (MTC). We aimed: i) to assess the clinical usefulness of 18F-DOPA PET/CT in patients with MTC and elevated calcitonin (Ctn) and CEA levels and, ii) to evaluate changes in disease management secondary to the findings encountered with this methodology. Methods thirty-six patients with MTC and Ctn levels ≥150 pg/ml were prospectively included. Neck ultrasound, chest contrast-enhanced CT, liver magnetic resonance imaging/ abdominal 3-phase contrast-enhanced CT and bone scintigraphy were carried out up to 6 months before the 18F DOPA PET/CT. Results 77.7% were female and 27% had hereditary MTC. Median Ctn level was 1450 pg/ml [150-56620], median CEA level 413 ng/ml [2.9-7436]. Median Ctn DT was 37.5 months [5.7-240]; median CEA DT was 31.8 [4.9-180]. 18F-DOPA PET/CT was positive in 33 patients (91.6%); in 18 (56%) uptake was observed in lymph nodes in the neck or mediastinum, in 7 cases (22%) distant metastases were diagnosed, and in 8 additional patients (24%) both locoregional and distant sites of disease were found. Ctn and CEA levels were higher in patients with ≥ 3 foci of distant metastases. In 14 patients (38.8%), findings on 18F-DOPA PET/CT led to changes in management; surgery for locoregional lymph nodes was the most frequent procedure in 8 patients (22%). Conclusion 18F-DOPA PET/CT was useful for the detection of recurrent disease in MTC and provided helpful information for patient management.


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