scholarly journals Value of 18F-PSMA-PET/MRI for Assessment of Recurring Ranula

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1462
Author(s):  
Felix Tilsen ◽  
Siegmar Reinert ◽  
Jürgen Frank Schäfer ◽  
Christian la Fougère ◽  
Anthony Valentin ◽  
...  
Keyword(s):  
Imaging Modality ◽  
Glandular Tissue ◽  
Imaging Protocol ◽  
Submandibular Region ◽  
Surgical Interventions ◽  
Psma Pet ◽  
Head And Neck Imaging ◽  
Gland Tissue ◽  
Suspected Recurrence ◽  
Rule Out

We report the case of a 6-year-old patient with suspected recurrence of a plunging ranula in clinical and ultrasonographic examination. Surgical resection of the left submandibular and sublingual glands had already been performed. Since persistent glandular tissue could not be excluded with certainty via MRI, we expanded diagnostics by performing a PET/MRI using a head and neck imaging protocol and the radiotracer 18F-PSMA-1007, which is physiologically expressed by salivary gland tissue. The 18F-PSMA-PET/MRI provided evidence of a cystically transformed, diminishing seroma in the left retro-/submandibular region. No 18F-PSMA expressing glandular tissue could be detected in the area of resection, excluding a relapse of a plunging ranula. As a consequence, we opted for a conservative treatment without further surgical intervention. We conclude that a simultaneous 18F-PSMA-PET/MRI is a comprehensive imaging modality, which can help to rule out persistent salivary tissue and recurring plunging ranula. It is a useful tool to facilitate the decision making of surgical interventions.

scholarly journals Surgical Strategies in the Treatment of Gynecomastia Grade I-II: The Combination of Liposuction and Subcutaneous Mastectomy Provides Excellent Patient Outcome and Satisfaction

Breast Care ◽  
2015 ◽  
Vol 10 (3) ◽  
pp. 184-188 ◽  
Author(s):  
Lars Schröder ◽  
Christian Rudlowski ◽  
Gisela Walgenbach-Brünagel ◽  
Claudia Leutner ◽  
Walther Kuhn ◽  
...  
Keyword(s):  
Chart Review ◽  
Glandular Tissue ◽  
Benign Condition ◽  
Surgical Strategies ◽  
Pathological Conditions ◽  
Gland Tissue ◽  
Male Patients ◽  
Preoperative Examination ◽  
Low Rate ◽  
Rule Out

Background: Gynecomastia (GM) is a benign condition with glandular tissue enlargement of the male breast. GM is classified into 4 grades of increasing severity. We describe a series of GM grade I-II, diagnosed, treated surgically and analyzed regarding feasibility, complication rate, and satisfaction. Methods: From 2005 to 2012, a chart review was performed for 53 patients. Preoperative examination included endocrine and urological examination and exclusion of other pathological conditions. The surgical technique consisted of liposuction through an inframammarian-fold incision and excision of the glandular tissue by a minimal periareolar approach. Results: A total number of 53 male patients with 104 breasts were available for analysis. By liposuction, a median of 300 ml (range: 10-1000 ml) was aspirated from each breast and 25.1 g (range: 3-233 g) gland tissue was resected. Surgery lasted between 25 and 164 min per patient (median: 72 min). 2 postoperative hemorrhages occurred (n = 2, 3.8%). 2 patients underwent re-operation due to cosmetic reasons (n = 2, 3.8%). Conclusions: This analysis demonstrates that treatment of GM grade I-II can easily be performed by liposuction combined with subcutaneous resection of the glandular tissue as a minimally invasive and low-impact surgical treatment with a low rate of complications and excellent patient satisfaction. Preoperative workup is important to rule out specific diseases or malignancy causing the GM.

scholarly journals Encephalocele: know it to deal with it

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Nilkanth Laxman Pal ◽  
Ambika Sumeet Juwarkar ◽  
Sanjaya Viswamitra
Keyword(s):  
Prognostic Factors ◽  
Imaging Modality ◽  
Point Of View ◽  
Extensive Literature ◽  
Resonance Imaging ◽  
Imaging Protocol ◽  
Imaging Protocols ◽  
Associated Malformations ◽  
Associated Abnormalities

Abstract Background Encephaloceles refer to the herniation of intracranial contents through the defect in the dura and calvarium. This article aims to equip the radiologists with all the necessary information to approach a case of encephalocele in a systematic manner and report in an organized format. Thus reduce the reporting time without overlooking any detail. Main text An extensive literature review was performed searching through the standard textbooks and electronic databases to obtain thorough information on the various encephaloceles particularly from a radiological point of view. The author’s observations were also incorporated in the review. Among the available imaging modalities, magnetic resonance imaging is the most versatile and considered the imaging modality of choice because of superior anatomic resolution in the characterization of central nervous system malformation. This study provides the reporting radiologist with a methodical guide to approach a case of encephalocele discussing the imaging protocol, relevant anatomy, classification, associated abnormalities, and imaging prognostic factors. Conclusion Encephalocele has always been a subject of predicament for radiologists. Understanding the relevant terminologies, anatomy, imaging protocols, classification, associated malformations/anomalies, and imaging prognostic factors will help to methodically approach each case and provide a systematic and comprehensive report.

scholarly journals Metal artifacts in intraoperative O-arm CBCT scans

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Juha I. Peltonen ◽  
Touko Kaasalainen ◽  
Mika Kortesniemi
Keyword(s):  
Image Quality ◽  
Imaging Modality ◽  
Nonlinear Effects ◽  
Exposure Level ◽  
Metal Artifacts ◽  
Imaging Protocol ◽  
Metal Implants ◽  
Comprehensive Determination

Abstract Background Cone-beam computed tomography (CBCT) has become an increasingly important medical imaging modality in orthopedic operating rooms. Metal implants and related image artifacts create challenges for image quality optimization in CBCT. The purpose of this study was to develop a robust and quantitative method for the comprehensive determination of metal artifacts in novel CBCT applications. Methods The image quality of an O-arm CBCT device was assessed with an anthropomorphic pelvis phantom in the presence of metal implants. Three different kilovoltage and two different exposure settings were used to scan the phantom both with and without the presence of metal rods. Results The amount of metal artifact was related to the applied CBCT imaging protocol parameters. The size of the artifact was moderate with all imaging settings. The highest applied kilovoltage and exposure level distinctly increased artifact severity. Conclusions The developed method offers a practical and robust way to quantify metal artifacts in CBCT. Changes in imaging parameters may have nonlinear effects on image quality which are not anticipated based on physics.

scholarly journals 3D Reconstruction and Prediction of Sialolith Surgery

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Jamyson Oliveira Santos ◽  
Brunna da Silva Firmino ◽  
Matheus Santos Carvalho ◽  
Jean de Pinho Mendes ◽  
Lucas Novaes Teixeira ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Preoperative Assessment ◽  
Final Diagnosis ◽  
Adequate Treatment ◽  
Submandibular Region ◽  
Present Case Report ◽  
Surgical Interventions ◽  
Transcervical Approach ◽  
Dimensional Reconstruction ◽  
Processing Techniques

Imaging examinations play an important role in the diagnosis of sialolithiasis, whose symptoms are initially confounded with other diseases. The objective of the present case report is to highlight imaging and processing techniques as well as image analysis for the preoperative assessment and planning of surgical interventions and adequate treatment of massive sialoliths. A 35-year-old male patient presented complaining of pain in the submandibular region and purulent secretions from a lingual caruncle with slightly increased volume in the region. Imaging examinations were ordered as follows: cone beam computed tomography, ultrasonography, and three-dimensional reconstruction, including clinical evaluation. A final diagnosis of sialolithiasis was established. Surgery was indicated and carried out by using a lateral transcervical approach for complete resection of the gland, which was based on the calculation of the total volume of the sialolith, thus increasing the surgery’s success.

scholarly journals Diagnostic accuracy of ultrasonography with laparoscopy for assessment of benign adnexal masses

2019 ◽  
Vol 9 (1) ◽  
pp. 283
Author(s):  
Vinita Sarbhai ◽  
Medha Yadav
Keyword(s):  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Ovarian Cyst ◽  
Imaging Modality ◽  
Age Groups ◽  
Serous Cystadenoma ◽  
Histopathological Diagnosis ◽  
Adnexal Masses ◽  
Adnexal Pathology ◽  
Rule Out

Background: Adnexal masses are one of the most common pathologies among women of all age groups. Objective of this study was to assess efficacy of ultrasonography in diagnosing adnexal pathology, rule out malignancy and its comparison with laparoscopy and pathology results.Methods: A total 32 women with benign adnexal mass were evaluated by clinical examination, ultrasonography and laparoscopy. Findings of ultrasound were compared with laparoscopy and histopathology reports and diagnostic accuracy was calculated.Results: Sensitivity of USG in diagnosing simple ovarian cyst is 20% and specificity is 88.9% while laparoscopy has sensitivity of 100% and specificity of 94.4%. USG versus laparoscopy has sensitivity of 50% versus 100% and specificity of 94.1% versus 100% in diagnosing endometrioma. Sensitivity of USG in diagnosing dermoid cyst is 66.7% and specificity is 95% while laparoscopy has both sensitivity and specificity of 100%. USG and laparoscopy, both have 100% sensitivity and specificity in diagnosing ectopic pregnancy, para-ovarian cyst and TO abscess. Benign serous cystadenoma is a histopathological diagnosis and is missed by both laparoscopy and ultrasonography.Conclusions: Ultrasonography should be the primary imaging modality used to identify and characterize adnexal masses, as it is readily available, and noninvasive.

scholarly journals Establishing a Provincial Registry for Recurrent Prostate Cancer: Providing Access to PSMA PET/CT in Ontario, Canada

2021 ◽  
Vol 11 ◽  
Author(s):  
Sympascho Young ◽  
Ur Metser ◽  
Golmehr Sistani ◽  
Deanna L. Langer ◽  
Glenn Bauman
Keyword(s):  
Prostate Cancer ◽  
Imaging Modality ◽  
Cancer Recurrence ◽  
Steering Committee ◽  
Primary Therapy ◽  
Psma Pet ◽  
Pet Ct ◽  
Prostate Cancer Recurrence ◽  
Health Canada ◽  
Pet Radiopharmaceuticals

Prostate Specific Membrane Antigen (PSMA) positron emission tomography/computed tomography (PET/CT) is becoming established as a standard of care for the (re)staging of high-risk primary and prostate cancer recurrence after primary therapy. Despite the favorable performance of this imaging modality with high accuracy in disease detection, the availability of PSMA PET/CT varies across jurisdictions worldwide due to variability in the selection of PSMA PET/CT agent, regulatory approvals and funding. In Canada, PSMA based radiopharmaceuticals are still considered investigational new drug (IND), creating limitations in the deployment of these promising imaging agents. While regulatory approval rests with Health Canada, as a single payer health system, funding for Health Canada approved drugs and devices is decided by Provincial Health Ministries. Ontario Health (Cancer Care Ontario) (OH-CCO) is the agency of the Ministry of Health (MOH) in Ontario responsible for making recommendations to the MOH around the organization and funding of cancer services within Ontario (population of 15 million), and the PET Steering Committee of OH-CCO is responsible for providing recommendations on the introduction of new PET radiopharmaceuticals and indications. For Health Canada approved PET radiopharmaceuticals like 18F-FDG, OH-CCO (on behalf of the MOH) provides coverage based on levels of evidence and specific PET Registries are established to aid in real-world evidence collection to inform OH-CCO regarding emerging PET applications. In the case of PSMA PET/CT, adapting this model to an IND PSMA PET/CT agent, 18F-DCFPyL, necessitated the creation of a hybrid Registry-Study model to leverage the existing OH-CCO Registry structure while respecting the need for a Health Canada Clinical Trials Application (CTA) for the deployment of this agent in the province. Within the first 2 years of the registry, over 1700 men have been imaged resulting in a change in management (compared to pre-PET management plans) in over half of the men imaged. In this article, we describe the organization and deployment of the PSMA PET/CT (PREP) Registry throughout the province to provide access for men with suspected prostate cancer recurrence along with key stakeholder perspectives and preliminary results.

CT - The Workhorse Head and Neck Imaging Modality

2021 ◽  
pp. 27-35
Author(s):  
Jane Adam ◽  
Enyi Ofo ◽  
Ashraf Messiha
Keyword(s):  
Head And Neck ◽  
Imaging Modality ◽  
Head And Neck Imaging

Head-to-head comparison of 68Ga-PSMA-11 PET/CT and mpMRI in the detection, intra-prostatic localization, and local extension of primary prostate cancer: A single-center imaging study with histopathology gold-standard.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 193-193
Author(s):  
Ida Sonni ◽  
Ely Felker ◽  
Andrew Thomas Lenis ◽  
Anthony E Sisk ◽  
Shadfar Bahri ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Imaging Modality ◽  
Imaging Study ◽  
Imaging Modalities ◽  
Detection Rates ◽  
Local Extension ◽  
Primary Prostate Cancer ◽  
Psma Pet ◽  
Pet Ct ◽  
Local Staging

193 Background: The local staging of prostate cancer relies on systematic or targeted biopsies and multiparametric magnetic resonance imaging (mpMRI). The role of prostate-specific membrane antigen (PSMA)-targeted PET in the evaluation of intraprostatic cancer foci and T-staging assessment is not well defined. The goal of this analysis was to compare the diagnostic performance of PSMA PET/CT, mpMRI and the combination of the two (PSMA PET/CT+mpMRI) in the detection, intra-prostatic localization and local extension of primary prostate cancer with histopathology as the gold standard.Methods: Patients with intermediate- or high-risk prostate cancer underwent a PSMA PET/CT scan and mpMRI prior to intended radical prostatectomy. Each imaging modality was interpreted by 3 blinded independent readers. A majority rule was applied (2:1). A standardized approach was used to assess presence, location and size of prostate cancer foci within the prostate. The analysis was conducted on a lesion- and segment-level. Whole mount pathology was interpreted by a Genito-Urinary pathologist using the same standardized method described above. Accuracy in determining the location, extra-capsular extension (ECE) and seminal vesicle invasion (SVI) of prostate cancer foci were assessed using receiver operating characteristic (ROC) analysis. A “raw-stringent” and “neighboring” approach were used to define imaging/pathology correlation for the detection of individual prostate cancer foci. Results: The final analysis included 74 patients. Detection rate was 75%, 79% and 82% using the “raw-stringent” approach, 86%, 83% and 87% using the “neighboring” approach for PSMA PET/CT, mpMRI and PSMA PET/CT+mpMRI, respectively. Differences in detection rates between PSMA PET/CT, mpMRI and PSMA PET/CT+mpMRI were not statistically significant. The two imaging modalities performed similarly (AUC = 0.70 vs 0.73, p = 0.09; AUC = 0.77 for the two together) in localizing prostate cancer. ΔAUC between PSMA PET/CT+mpMRI and the two imaging modalities alone was statistically significant (p < 0.001), but not between PSMA PET/CT and mpMRI (p = 0.093). mpMRI performed better than PSMA PET/CT in the T-staging assessment: ECE (AUC = 0.79 vs 0.59, p = 0.002) and SVI (AUC = 0.84 vs 0.63, p = 0.001). Conclusions: PSMA PET/CT and mpMRI have similar diagnostic accuracy in the detection and intra-prostatic localization of prostate cancer foci while mpMRI performs better in the assessment of ECE and SVI. The combination of the two imaging modalities improves performance of the two modalities alone, but this does not reach statistically significant levels on a lesion-level and might not justify changes in the current practices for local staging of prostate cancer.

scholarly journals Submandibular lipoma in elderly female in mid western Nepal: A Case Report

2017 ◽  
Vol 4 (2) ◽  
pp. 46-49
Author(s):  
Bishow Tulachan ◽  
Buddha Nath Borgohain
Keyword(s):  
Needle Aspiration ◽  
The Body ◽  
Rare Entity ◽  
Medical Sciences ◽  
Diagnostic Dilemma ◽  
Submandibular Region ◽  
Medical College ◽  
Needle Aspiration Cytology ◽  
The Right ◽  
Rule Out

Background and Objectives: The submandibular lipomas are relatively rare entity. The reported age of the patients were from birth to 84 years old, and average being 55.7 years. These are mainly asymptomatic and mostly cause aesthetic concerns. Deep lipomas, especially in the head and neck, are not commonly reported. To our knowledge there’s not even a single publication regarding the lipoma in the submandibular region in our mid western region as well as in our country.Presentation of case: A 72 years old female presented with complaints of painless progressive neck swelling in the right submandibular region for about 2 years. Clinically, it was thought to be submandibular gland neoplasm/ lymphadenopathy. Ultrasonography (USG) and fine-needle aspiration cytology (FNAC) were done. It was negative for malignancy. She underwent excision of the mass under general anesthesia without postoperative complications. The histopathology confirmed it to be lipoma. Discussion: Lipoma is a common benign mesenchymal tumour that is found almost anywhere in the body. However, a large lipoma is relatively rare in the submandibular region. On clinical doubt, one can rely on USG / MRI (magnetic resonance imaging) and FNAC to rule out diagnostic dilemma. The treatment of choice is simply excision. Conclusion: It’s a rare entity and may be the first report of a lipoma in the submandibular region in an elderly people. One should rule out its possibility while going through the submandibular region diseases.Janaki Medical College Journal of Medical Sciences (2016) Vol. 4 (2): 46-49

scholarly journals 18F-FDOPA PET/CT accurately identifies MEN1-associated pheochromocytoma

2020 ◽  
Vol 2020 ◽  
Author(s):  
Aisha A Tepede ◽  
James Welch ◽  
Maya Lee ◽  
Adel Mandl ◽  
Sunita K Agarwal ◽  
...  
Keyword(s):  
Imaging Modality ◽  
Standardized Uptake Value ◽  
Laboratory Evaluation ◽  
Adrenal Tumors ◽  
List Type ◽  
Post Contrast ◽  
Surgical Interventions ◽  
Catecholamine Excess ◽  
Pet Ct ◽  
Fdg Pet Ct

Summary Pheochromocytoma (PHEO) in multiple endocrine neoplasia type 1 (MEN1) is extremely rare. The incidence is reported as less than 2%. We report a case of a 76-year-old male with familial MEN1 who was found to have unilateral PHEO. Although the patient was normotensive and asymptomatic, routine screening imaging with CT demonstrated bilateral adrenal masses. The left adrenal mass grew from 2.5 to 3.9 cm over 4 years with attenuation values of 9 Hounsfield units (HU) pre-contrast and 15 HU post-contrast washout. Laboratory evaluation demonstrated an adrenergic biochemical phenotype. Both 18F-fluorodeoxyglucose (18F-FDG) PET/CT and 123I-metaiodobenzylguanidine (123I-mIBG) scintigraphy demonstrated bilateral adrenal uptake. In contrast, 18F-fluorodihydroxyphenylalanine (18F-FDOPA) PET/CT demonstrated unilateral left adrenal uptake (28.7 standardized uptake value (SUV)) and physiologic right adrenal uptake. The patient underwent an uneventful left adrenalectomy with pathology consistent for PHEO. Post-operatively, he had biochemical normalization. A review of the literature suggests that adrenal tumors >2 cm may be at higher risk for pheochromocytoma in patients with MEN1. Despite a lack of symptoms related to catecholamine excess, enlarging adrenal nodules should be biochemically screened for PHEO. 18F-FDOPA PET/CT may be beneficial for localization in these patients. Learning points: 18F-FDOPA PET/CT is a beneficial imaging modality for identifying pheochromocytoma in MEN1 patients. Adrenal adenomas should undergo routine biochemical workup for PHEO in MEN1 and can have serious peri-operative complications if not recognized, given that MEN1 patients undergo frequent surgical interventions. MEN1 is implicated in the tumorigenesis of PHEO in this patient.

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