scholarly journals Sonographic Findings of Additional Malignant Lesions in Breast Carcinoma Seen by Second Look Ultrasound

2011 ◽  
Vol 1 ◽  
pp. 34 ◽  
Author(s):  
Ana Delgado Laguna ◽  
S Jimenez Arranz ◽  
V Quintana Checa ◽  
S Alonso Roca ◽  
D Expósito Jiménez ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
Primary Lesion ◽  
Resonance Imaging ◽  
Double Blind ◽  
Additional Lesion ◽  
Second Look ◽  
The Us ◽  
Malignant Lesions ◽  
Magnetic Resonance Imaging Mri ◽  
Us Findings

Objective: The aim is to show ultrasound (US) findings of additional malignant lesions of breast carcinoma visualized on targeted second-look US that were not identified by mammography or US prior to the time of diagnosis. Materials and Methods: A double-blind retrospective review of the US results from January 2008 through August 2010 of 228 patients with known breast cancer was conducted by two expert radiologists. The focus of the review was on the second-look US characteristics (following BI-RADS criteria) of 26 documented additional malignant lesions of the 76 with successful sonographic correlation from the 123 lesions detected by magnetic resonance imaging (MRI). All of them, before the MRI, had an initial mammography and a US with a histopathological biopsy of the primary lesion. Results: Approximately 60 to 70% of the findings were classified as BI-RADS 2 and BI-RADS 3, while assessing the final US category. The review of the second-look US showed the size of the second malignant additional lesion ranged from 3 to 22 mm, of which 90% were smaller than 10 mm and 66% were smaller than 7 mm. Conclusions: Most additional malignant lesions, nonpalpable carcinomas, which were previously not detected by mammography and US at first-look diagnosis, were detected by a targeted second-look US examination. These lesions were of category BI-RADS 2 and BI-RADS 3 and smaller than 7 mm.

scholarly journals Evaluation of AGA and Fukuoka Guidelines for EUS and surgical resection of incidental pancreatic cysts

2017 ◽  
Vol 05 (02) ◽  
pp. E116-E122 ◽  
Author(s):  
Alexander Lee ◽  
Vivek Kadiyala ◽  
Linda Lee
Keyword(s):  
Predictive Value ◽  
International Association ◽  
Pancreatic Cysts ◽  
Lower Sensitivity ◽  
Resonance Imaging ◽  
American Gastroenterological Association ◽  
Risk Patients ◽  
Malignant Lesions ◽  
Selection For ◽  
Magnetic Resonance Imaging Mri

Abstract Objectives Management of asymptomatic pancreatic cysts is challenging. Guidelines by the American Gastroenterological Association (AGA) and International Association of Pancreatology (Fukuoka) seek to identify high-risk patients. We assessed performance of these guidelines in selecting patients for endoscopic ultrasound (EUS) and/or surgery. Methods PART I – We retrospectively studied 143 asymptomatic cysts with magnetic resonance imaging (MRI) followed by EUS. Appropriate selection for EUS was defined as: malignant cytology or surgical pathology, or development of concerning features on MRI as defined by the guidelines. PART II – We retrospectively studied 152 resected cysts to assess the performance of guidelines in selecting cysts for surgery using malignant histology as the outcome. Results PART I – Of 143 EUS, 43 (30.1 %) were male with median age 65.0 years (interquartile range [IQR] 58.0 – 73.0). AGA guideline demonstrated lower sensitivity (17.6 % versus 35.3 %, P = 0.03), higher specificity (94.5 % versus 66.1 %, p < 0.001), and higher accuracy (76.2 % versus 58.7 %, P = 0.002) than Fukuoka. There was no difference in positive predictive value (50.0 % versus 24.5 %, P = 0.15) and negative predictive value (78.6 % versus 76.6 %, p=0.75). PART II – Of 152 resected cysts, 45 (29.8 %) were male with median age 59.0 years (IQR 47.3 – 66.7). There was no difference in performance characteristics of the guidelines in selecting cysts for surgery. AGA and Fukuoka guidelines missed 25.0 % and 18.8 % of malignant cysts, respectively (P = 1.00). Conclusions For referral to EUS, the AGA guideline was highly specific compared to Fukuoka; both suffered from poor sensitivity, although the Fukuoka guideline was relatively more sensitive than AGA. For referral to surgery, both guidelines have modest sensitivity and specificity and miss a similar percentage of malignant lesions.

Diffusion-Weighted Magnetic Resonance Imaging of Cholesteatoma Using PROPELLER at 1.5T: A Single-Centre Retrospective Study

2017 ◽  
Vol 68 (2) ◽  
pp. 116-121 ◽  
Author(s):  
Sharon E. Clarke ◽  
Dipan Mistry ◽  
Talal AlThubaiti ◽  
M. Naeem Khan ◽  
David Morris ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Retrospective Study ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Resonance Imaging ◽  
Predictive Values ◽  
Second Look ◽  
Diffusion Weighted ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

Purpose The purpose of this study was to evaluate the sensitivity, specificity, and positive and negative predictive values of the diffusion-weighted periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) technique in the detection of cholesteatoma at our institution with surgical confirmation in all cases. Methods A retrospective review of 21 consecutive patients who underwent diffusion-weighted PROPELLER magnetic resonance imaging (MRI) on a 1.5T MRI scanner prior to primary or revision/second-look surgery for suspected cholesteatoma from 2009-2012 was performed. Results Diffusion-weighted PROPELLER had a sensitivity of 75%, specificity of 60%, positive predictive value of 86%, and negative predictive value of 43%. In the 15 patients for whom the presence or absence of cholesteatoma was correctly predicted, there were 2 cases where the reported locations of diffusion restriction did not correspond to the location of the cholesteatoma observed at surgery. Conclusion On the basis of our retrospective study, we conclude that diffusion-weighted PROPELLER MRI is not sufficiently accurate to replace second look surgery at our institution.

scholarly journals Cervical Thymic Cyst in an Adult

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Hassan A. Alzahrani ◽  
Javeria M. Iqbal ◽  
Amani K. Abu Shaheen ◽  
Bandar N. Al Harthi
Keyword(s):  
Correct Diagnosis ◽  
Surgical Excision ◽  
Neck Swelling ◽  
Thymic Tissue ◽  
Rare Differential Diagnosis ◽  
Essential Components ◽  
The Us ◽  
Magnetic Resonance Imaging Mri ◽  
Us Findings ◽  
Lateral Neck Swelling

Cervical thymic cysts (CTCs) are unusual lesions, representing only 1% of cystic cervical masses. Diagnosis of this condition in adults is even rarer. We report a 34-year-old female who presented with asymptomatic progressively growing left-sided neck swelling. Neck ultrasound (US) showed a large cystic lesion with septation, compressing the ipsilateral vessels. Magnetic resonance imaging (MRI) confirmed the US findings. Surgical excision was performed which subsequently showed findings consistent with CTC. CTC in adult is extremely rare, with few reported cases identified in the literature. Thymic gland anomalies in the neck are the consequences of an arrest in the descent of the gland, sequestration of the thymic tissue, or failure of involution. The diagnosis of this condition is rarely done prior to surgical excision. The clinical presentation, radiologic imaging, surgical findings, and histologic appearance are all essential components to make the correct diagnosis of this very rare differential diagnosis of cystic lateral neck swelling.

scholarly journals Histopathologic Correlates of Nonmass Enhancement Detected by Breast Magnetic Resonance Imaging

2021 ◽  
Author(s):  
Vanda F. Torous ◽  
Nancy A. Resteghini ◽  
Jordana Phillips ◽  
Vandana Dialani ◽  
Priscilla J. Slanetz ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Ductal Carcinoma ◽  
Imaging Modality ◽  
Breast Mri ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Malignant Lesions ◽  
Magnetic Resonance Imaging Mri

Context.— Dynamic, contrast-enhanced magnetic resonance imaging (MRI) is a highly sensitive imaging modality used for screening and diagnostic purposes. Nonmass enhancement (NME) is commonly seen on MRI of the breast. However, the pathologic correlates of NME have not been extensively explored. Consequently, concordance between MRI and pathologic findings in such cases may be uncertain and this uncertainty may cause the need for additional procedures. Objective.— To examine the histologic alterations that correspond to NME on MRI. Design.— We performed a retrospective search for women who underwent breast MRI between March 2014 and December 2016 and identified 130 NME lesions resulting in biopsy. The MRI findings and pathology slides for all cases were reviewed. The follow-up findings on any subsequent excisions were also noted. Results.— Among the 130 cases, the core needle biopsy showed 1 or more benign lesions without atypia in 80 cases (62%), atypical lesions in 21 (16%), ductal carcinoma in situ in 22 (17%), and invasive carcinoma in 7 (5%). Review of the imaging features demonstrated some statistically significant differences in lesions that corresponded to malignant lesions as compared with benign alterations, including homogeneous or clumped internal enhancement, type 3 kinetics, and T2 dark signal; however, there was considerable overlap of features between benign and malignant lesions overall. Of 130 cases, 54 (41.5%) underwent subsequent excision with only 6 cases showing a worse lesion on excision. Conclusions.— This study illustrates that NME can be associated with benign, atypical, and/or malignant pathology and biopsy remains indicated given the overlap of radiologic features.

scholarly journals Switching from branded to generic glatiramer acetate: 15-month GATE trial extension results

2017 ◽  
Vol 23 (14) ◽  
pp. 1909-1917 ◽  
Author(s):  
Krzysztof Selmaj ◽  
Frederik Barkhof ◽  
Anna N Belova ◽  
Christian Wolf ◽  
Evelyn RW van den Tweel ◽  
...  
Keyword(s):  
Glatiramer Acetate ◽  
Efficacy And Safety ◽  
Resonance Imaging ◽  
Open Label ◽  
Double Blind ◽  
Disability Status ◽  
Mri Scans ◽  
The Mean ◽  
Magnetic Resonance Imaging Mri

Background: Open-label 15-month follow-up of the double-blind, placebo-controlled Glatiramer Acetate clinical Trial to assess Equivalence with Copaxone® (GATE) trial. Objective: To evaluate efficacy, safety, and tolerability of prolonged generic glatiramer acetate (GTR) treatment and to evaluate efficacy, safety, and tolerability of switching from brand glatiramer acetate (GA) to GTR treatment. Methods: A total of 729 patients received GTR 20 mg/mL daily. Safety was assessed at months 12, 15, 18, 21, and 24 and Expanded Disability Status Scale and magnetic resonance imaging (MRI) scans at months 12, 18, and 24. The presence of glatiramer anti-drug antibodies (ADAs) was tested at baseline and months 1, 3, 6, 9, 12, 18, and 24. Results: The mean number of gadolinium-enhancing lesions in the GTR/GTR and GA/GTR groups was similar at months 12, 18, and 24. The change in other MRI parameters was also similar in the GTR/GTR and GA/GTR groups. The annualized relapse rate (ARR) did not differ between the GTR/GTR and GA/GTR groups, 0.21 and 0.24, respectively. The incidence, spectrum, and severity of reported adverse events did not differ between the GTR/GTR and GA/GTR groups. Glatiramer ADA titers were similar in the GTR/GTR and GA/GTR groups. Conclusion: Efficacy and safety of GTR is maintained over 2 years. Additionally, switching from GA to GTR is safe and well tolerated.

Ultrasonography of invasive lobular breast carcinoma

1998 ◽  
Vol 39 (3) ◽  
pp. 285-291 ◽  
Author(s):  
T. Rissanen ◽  
T. Tikkakoski ◽  
A.-L. Autio ◽  
M. Apaja-Sarkkinen
Keyword(s):  
Breast Carcinoma ◽  
Invasive Lobular Carcinoma ◽  
Lobular Carcinoma ◽  
Architectural Distortion ◽  
Dense Breasts ◽  
The Us ◽  
Lobular Breast Carcinoma ◽  
Us Findings ◽  
Acoustic Shadowing

Purpose: To review the US findings in invasive lobular breast carcinoma which is often difficult to diagnose clinically and mammographically Material and Methods: The mammographic and US findings in 63 cases of pure invasive lobular carcinoma diagnosed at our institution in 1990-1996 were reviewed retrospectively. The US findings were classified as positive, negative or indeterminate for malignancy Results: Forty-nine of the 63 lobular carcinomas (78%, 95% CI 65.5-87.3%) were US-positive, and 51 (81%, CI 95% 69.1-89.8%) were mammography-positive. The US visibility of the carcinomas was affected by their palpability and mammographic appearance, and the radiographic density of the breasts. Indeterminate US findings (architectural distortion with acoustic shadowing) were visualized in 4 of the 10 cases that had asymmetric densities at mammography Conclusion: The sensitivity of US for lobular carcinoma was not statistically different from that of mammography. The methods were complementary, especially with regard to evaluating dense breasts and lesions which were difficult to assess clinically and mammographically

scholarly journals AB0007 VALUE OF ULTRASOUND IN ASSESSMENT OF ACTIVE SACROILIITIS IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1307.3-1307
Author(s):  
M. Chen ◽  
S. M. Dai
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Axial Spondyloarthritis ◽  
Resonance Imaging ◽  
Predictive Values ◽  
Significant Difference ◽  
The Us ◽  
Active Sacroiliitis ◽  
Magnetic Resonance Imaging Mri ◽  
Research Consortium

Background:The inflammatory of the sacroiliac joints (SIJs) called sacroiliitis, is a characteristic of axial Spondyloarthritis (axSpA). The detection of sacroiliitis is meaningful to prevent irreversible changes. The tool of assessment of sacroiliitis including radiographs, computed tomography (CT) and magnetic resonance imaging (MRI). Ultrasound (US) has also been used in the evaluation of sacroiliitis in recent years.Objectives:We aimed to evaluate the value of US in the assessment of active sacroiliitis in axSpA patients.Methods:Fifty-one patients fulfilling Assessment of SpondyloArthritis International Society (ASAS) 2009 criteria for the classification of axSpA were recruited1. All the patients underwent MRI and US evaluation of bilateral SIJs. MRI was performed using the sequences of T1WI, T2WI and fat suppression T2WI (FS-T2WI). MRI sacroiliitis was defined according to ASAS criteria of active sacroiliitis2. The Spondyloarthritis research Consortium of Canada (SPARCC) scoring was used to evaluate the inflammatory lesions in SIJs3. US were performed by an ultrasonographer with 10 years of experience in musculoskeletal ultrasound, and resistive index (RI) value was recorded. The US sacroiliitis was defined as the presence of more flow signals at SIJ with an RI ≤ 0.75. The HLA-B27, erythrocyte sedimentation rate (ESR) and hypersensitive C-reactive protein (hsCRP) were also evaluated. Consistency rate, sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV)for the diagnosis of sacroiliitis by US were calculated, using MRI as the gold standard.Results:Of the 51 patients, 24 were female and 27 were male. The HLA-B27 positive rate was 90.2% (46/51). The consistency rate of US and MRI sacroiliitis was 55.88 (57/102). The sensitivity and specificity of US for the diagnosis of sacroiliitis were 55.93 (33/59) and 55.81 (24/43) respectively. The PPV and NPV were 63.46 (33/52) and 48 (24/50) respectively. There was no significant difference in ESR and hsCRP between the US positive sacroiliitis and the others (P= 0.7477 and 0.2268, respectively). The SPARCC scores have no significant difference between the US positive sacroiliitis and the others (P= 0.2206). The RI was not significantly associated with the MRI SPARCC score (P=0.4236).Conclusion:US may be an optional method for preliminary screening sacroiliitis. But its reliability as a diagnostic method needs further verification.References:[1]Rudwaleit M, et al. The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis. 2009; 68(6):777-83[2]Rudwaleit M, et al. Defining active sacroiliitis on magnetic resonance imaging (MRI) for classification of axial spondyloarthritis: a consensual approach by the ASAS/OMERACT MRI group. Ann Rheum Dis 2009;68(10):1520–7[3]Maksymowych WP, et al. Spondyloarthritis research Consortium of Canada magnetic resonance imaging index for assessment of sacroiliac joint inflammation in ankylosing spondylitis. Arthritis Rheum.2005;53(5):703-9.Acknowledgments:This project was supported by grants from National Natural Science Foundation of China (81900795)Disclosure of Interests:None declared

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