scholarly journals Possibilities of Diffusion-Weighted MRI in the Differential Diagnosis of Early Recurrences of Retroperitoneal Liposarcomas and Postoperative Changes

2021 ◽  
Vol 4 (3) ◽  
pp. 44-55
Author(s):  
E. S. Kolobanova ◽  
B. M. Medvedeva
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Cavity ◽  
Dynamic Control ◽  
Greater Omentum ◽  
Intravenous Contrast ◽  
Diffusion Weighted ◽  
Postoperative Changes ◽  
Contrast Enhanced ◽  
Mri Protocol ◽  
Suspected Recurrence

Purpose: To evaluate contrast-enhanced magnetic resonance imaging (CE‑MRI) and diffusion-weighted (DWI) in the detection and differential diagnosis of recurrent of retroperitoneal liposarcomas with postoperative changes.Material and methods: The retrospective study included of 23 patients previously operated on for retroperitoneal inorganic liposarcomas. All patients underwent MRI of the abdominal cavity and pelvis with intravenous contrast with further assessment of the size, shape, structure and characteristics of the accumulation of contrast agent in the detected formation.Results: Morphological verification were performed in 17 patients (74 %), in 6 cases (26 %) patients were left for dynamic control for 1–3 years. Local relapses were detected in 16 patients (67 %), postoperative changes — in 7 (33 %) patients, of which in 2 cases deformation of adipose tissue and fibrotic changes in the area of surgery was determined, in 3 patients granulomas were revealed, and in two patients — volvulus of the greater omentum and lymphocele. The sensitivity of MRI with intravenous contrast enhancement was 68.7 %, specificity 71.4 % and accuracy 69.6 %. The addition of DWI to the standard MRI protocol in patients with suspected recurrence of retroperitoneal liposarcoma to increase the sensitivity of the method in the differential diagnosis of recurrent drugs from postoperative changes to 93.7 % (15 out of 16), specificity up to 100 % (7 out of 7) and accuracy up to 95.6 % (22 out of 23).Conclusion: The joint use of MRI with intravenous contrast and DW‑MRI increases the information content in the detection and differential diagnosis of small-sized recurrent tumors in dedifferentiated and myxoid types of liposarcomas with postoperative changes. 

scholarly journals Evaluation of diffusion-weighted imaging for the differential diagnosis of poorly contrast-enhanced and T2-prolonged bone masses: Initial experience

2006 ◽  
Vol 23 (3) ◽  
pp. 377-382 ◽  
Author(s):  
Yoshiko Hayashida ◽  
Toshinori Hirai ◽  
Toshitake Yakushiji ◽  
Kazuhiro Katahira ◽  
Osamu Shimomura ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Diffusion Weighted Imaging ◽  
Initial Experience ◽  
Diffusion Weighted ◽  
Contrast Enhanced

scholarly journals Diffusion-weighted imaging of the breast: current status as an imaging biomarker and future role

BJR|Open ◽  
2019 ◽  
Vol 1 (1) ◽  
pp. 20180049 ◽  
Author(s):  
Julia Camps-Herrero
Keyword(s):  
Diffusion Weighted Imaging ◽  
Point Of View ◽  
Current Status ◽  
Imaging Biomarker ◽  
Proof Of Concept ◽  
Tissue Architecture ◽  
Intravenous Contrast ◽  
Diffusion Weighted ◽  
Contrast Enhanced ◽  
Proof Of Mechanism

Diffusion-weighted imaging (DWI) of the breast is a MRI sequence that shows several advantages when compared to the dynamic contrast-enhanced sequence: it does not need intravenous contrast, it is relatively quick and easy to implement (artifacts notwithstanding). In this review, the current applications of DWI for lesion characterization and prognosis as well as for response evaluation are analyzed from the point of view of the necessary steps to become a useful surrogate of underlying biological processes (tissue architecture and cellularity): from the proof of concept, to the proof of mechanism, the proof of principle and finally the proof of effectiveness. Future applications of DWI in screening, DWI modeling and radiomics are also discussed.

scholarly journals Problems in the differential diagnosis of abdominal non-organ tumors

2020 ◽  
Vol 49 ◽  
Author(s):  
E. S. Kolobanova ◽  
B. M. Medvedeva
Keyword(s):  
Differential Diagnosis ◽  
Small Intestine ◽  
Medical Treatment ◽  
Contrast Enhancement ◽  
Abdominal Cavity ◽  
Castleman Disease ◽  
Intravenous Contrast ◽  
National Medical ◽  
Abdominal Masses ◽  
Ct Data

Rationale: The differential diagnosis between lesions requiring surgical intervention and those necessitating medical treatment poses a significant problem for current imaging methods of fat-containing masses in the small intestine mesenterium.Aim: To identify differential diagnostic criteria for various fat-containing neoplasms of abdominal cavity at the preoperative stage.Materials and methods: This retrospective study included data from 29  patients (16  women and 13 men, aged 32 to 81 years, mean age 56 years) with fat-containing masses in the small intestine mesenterium who had undergone preoperative examination at N.N. Blokhin National Medical Research Center of Oncology from 2016 to 2020. Abdominal computed tomography (CT) with intravenous contrast enhancement and assessment of the size, contours, structure and involvement of main vessels was performed in all patients. To interpret single soft tissue nodes within the mass, we used our own list of main CT symptoms (number, size, shape, contours and structure of nodes, degree of their contrast enhancement, and maximal amplification).Results: Fat-containing abdominal masses were morphologically verified as follows: mesenteric panniculitis 13  (45%), well differentiated liposarcoma 10  (35%), lymphoproliferative disorders 4  (14%), lipoma and Castleman disease 1  case each (3%). Twelve (12) of 29  patients (41%) had surgery for various types of tumors, while 17  (59%) patients received appropriate medical treatment after a puncture biopsy-based morphological diagnosis. The CT sensitivity for the detection of fat-containing abdominal neoplasms in our series was 93,1%. The paper describes the radiological signs of the above mentioned mass types with an emphasis on the complexity of their diagnosis.Conclusion: In most cases, CT data can accurately differentiate abdominal liposarcomas from other benign and malignant masses in the small intestine mesenterium.

Ultrasonic differential diagnostics of cyst and cystic tumors of the spleen

2020 ◽  
Vol 24 (3) ◽  
pp. 63-75
Author(s):  
Yu. A. Stepanova ◽  
M. Z. Alimurzaeva ◽  
D. A. Ionkin
Keyword(s):  
Differential Diagnosis ◽  
Cancer Metastasis ◽  
Malignant Tumors ◽  
Dynamic Control ◽  
Differential Diagnostics ◽  
Epithelial Lining ◽  
Focal Lesions ◽  
Morphological Form ◽  
Cystic Tumors ◽  
Number Of Patients

The incidence of focal lesions in the spleen is 3.2–4.2% per 100,000 population. Spleen cysts are rare (incidence 0.75 per 100,000). These are single or multiple, thin- and smooth-walled cavities filled with a transparent liquid. Distinguish between primary (or true) cysts, lined with epithelium, and secondary (or false), devoid of epithelial lining. Among the primary cysts, there are congenital cysts formed in the embryonic period due to the migration of peritoneal cells into the spleen tissue, dermoid and epidermoid cysts. A special group of primary cysts are parasitic cysts. Cystic tumors of the spleen include lymphangioma and lymphoma.The main difficulties in the diagnosis and differential diagnosis of cysts and cystic tumors of the spleen are associated with the rarity of this pathology and, as a consequence, a small number of works, including a significant number of the cases. However, in those works where a large number of the cases are described, most often this is one morphological form and an analysis of its various characteristics.Purpose. Based on the analysis of our own examination data of a significant number of patients with cysts and cystic tumors of the spleen, to assess the possibility of differential diagnosis of individual morphological forms according to ultrasound data.Materials and methods. 323 patients with cysts and cystic tumors of the spleen from 15 to 77 years old (men – 105 (32.5%); women – 218 (67.5%) were treated at A.V. Vishnevsky National Medical Research Center of Surgery for the period from 1980 to 2020. All patients underwent ultrasound during examination. Surgical treatment was carried out in various ways – (85.1%), when making a preoperative diagnosis of an uncomplicated spleen cyst of small size, dynamic observation was carried out (verification by puncture biopsy data).Results. Morphological verification of cysts and cystic tumors of the spleen was presented as follows (taking into account possible difficulties in identifying the epithelial lining): true cyst – 182 (56.4%); dermoid cyst – 3 (0.9%) (malignant – in 1 case); pseudocyst – 16 (5.0%); pancreatogenic – 34 (10.5%); echinococcus – 52 (16.1%); lymphangioma – 24 (7.4%); lymphoma – 10 (3.1%); ovarian cancer metastasis – 2 (0.6%). The article describes the ultrasound signs of the above forms of the lesions with an emphasis on the complexity of diagnosis.Conclusions. Primary and parasitic spleen cysts are well differentiated according to ultrasound; false cysts of the spleen, depending on the cause of their occurrence, can create difficulties in their identification and differentiation (they require careful dynamic control); cystic tumors of the spleen should be differentiated from malignant tumors and metastases of a cystic structure, as a result of which such vigilance should always be present when they are detected.

Pearls and Pitfalls of Contrast-Enhanced Mammography

2019 ◽  
Vol 1 (1) ◽  
pp. 64-72 ◽  
Author(s):  
Jordana Phillips ◽  
Valerie J Fein-Zachary ◽  
Priscilla J Slanetz
Keyword(s):  
Imaging Modality ◽  
Breast Mri ◽  
Successful Implementation ◽  
Newly Diagnosed ◽  
Disease Extent ◽  
Diagnostic Problem Solving ◽  
Contrast Enhanced ◽  
Comparable Performance ◽  
Mri Protocol ◽  
Monitoring Response

Abstract Contrast-enhanced mammography (CEM) is a promising new imaging modality that uses a dual-energy acquisition to provide both morphologic and vascular assessment of breast lesions. Although no official BI-RADS lexicon exists, interpretation entails using the mammographic BI-RADS lexicon in combination with that for breast MRI. CEM has comparable performance to breast MRI, with sensitivity of 93–100% and specificity of 80–94%. Currently FDA approved for diagnostic imaging, this technology can be helpful in determining disease extent in patients with newly diagnosed breast malignancy, monitoring response to neoadjuvant therapy, identifying mammographically occult malignancies, and diagnostic problem-solving. Studies are ongoing about its role in screening, especially in women with dense breasts or at elevated risk. There are some challenges to successful implementation into practice, but overall, patients tolerate the study well, and exam times are less than the full breast MRI protocol.

scholarly journals Non-contrast MRI can accurately characterize adnexal masses: a retrospective study

2021 ◽  
Author(s):  
Hilal Sahin ◽  
Camilla Panico ◽  
Stephan Ursprung ◽  
Vittorio Simeon ◽  
Paolo Chiodini ◽  
...  
Keyword(s):  
Contrast Medium ◽  
High Accuracy ◽  
Receiver Operating Curve ◽  
Intravenous Contrast ◽  
Random Subset ◽  
Adnexal Masses ◽  
Intravenous Contrast Medium ◽  
Mri Protocol ◽  
Malignant Lesions ◽  
Mri Score

Abstract Objective To determine the accuracy of interpretation of a non-contrast MRI protocol in characterizing adnexal masses. Methods and materials Two hundred ninety-one patients (350 adnexal masses) who underwent gynecological MRI at our institution between the 1st of January 2008 and the 31st of December 2018 were reviewed. A random subset (102 patients with 121 masses) was chosen to evaluate the reproducibility and repeatability of readers’ assessments. Readers evaluated non-contrast MRI scans retrospectively, assigned a 5-point score for the risk of malignancy and gave a specific diagnosis. The reference standard for the diagnosis was histopathology or at least one-year imaging follow-up. Diagnostic accuracy of the non-contrast MRI score was calculated. Inter- and intra-reader agreement was analyzed with Cohen’s kappa statistics. Results There were 53/350 (15.1%) malignant lesions in the whole cohort and 20/121 (16.5%) malignant lesions in the random subset. Good agreement between readers was found for the non-contrast MRI score (к = 0.73, 95% confidence interval [CI] 0.58–0.86) whilst the intra-reader agreement was excellent (к = 0.81, 95% CI 0.70–0.88). The non-contrast MRI score value of ≥ 4 was associated with malignancy with a sensitivity of 84.9%, a specificity of 95.9%, an accuracy of 94.2% and a positive likelihood ratio of 21 (area under the receiver operating curve 0.93, 95% CI 0.90–0.96). Conclusion Adnexal mass characterization on MRI without the administration of contrast medium has a high accuracy and excellent inter- and intra-reader agreement. Our results suggest that non-contrast studies may offer a reasonable diagnostic alternative when the administration of intravenous contrast medium is not possible. Key Points • A non-contrast pelvic MRI protocol may allow the characterization of adnexal masses with high accuracy. • The non-contrast MRI score may be used in clinical practice for differentiating benign from malignant adnexal lesions when the lack of intravenous contrast medium precludes analysis with the O–RADS MRI score.

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