Imaging of Skull Base and Orbital Invasion in Sinonasal Cancer: Correlation with Histopathology

Background: Pretreatment assessment of local extension in sinonasal cancer is essential for prognostic evaluation and surgical planning. The aim of this study was to assess the diagnostic performance of two common imaging techniques (CT and MRI) for the diagnosis of skull base and orbital invasion by comparing imaging findings to histopathological data. Methods: This was a retrospective two-center study including patients with sinonasal cancer involving the skull base and/or the orbit operated on between 2000 and 2019. Patients were included only if pre-operative CT and/or MRI, operative and histopathologic reports were available. A double prospective blinded imaging review was conducted according to predefined radiological parameters. Radiologic tumor extension was compared to histopathological reports, which were considered the gold standard. The predictive positive value (PPV) for the diagnosis of skull base/orbital invasion was calculated for each parameter. Results: A total of 176 patients were included. Ethmoidal intestinal-type adenocarcinoma was the most common type of cancer (41%). The PPV for major modification of the bony skull base was 78% on the CT scan, and 89% on MRI. MRI signs of dural invasion with the highest PPVs were: contact angle over 45° between tumor and dura (86%), irregular deformation of dura adjacent to tumor (87%) and nodular dural enhancement over 2 mm in thickness (87%). Signs of orbital invasion had low PPVs (<50%). Conclusions: This retrospective study provides objective data about the diagnostic value of pretreatment imaging in patients with sinonasal cancer.

THEEFFICIENCY OF ORTHODONTIC TREATMENT OF CLASSII MALOCCLUSION IN CHILDREN WITH β -THALASSEMIA MAJO

Aims: Evaluation of the effectiveness of orthodontic treatment of Class II malocclusion with the Twin-block appliance in children withβ-thalassemia major. Methods: The study was conducted with 49 patients with Class II malocclusion aged 10-14 years. The control group included 23 healthy patients. The main group included 26 patients with β-thalassemia major. Patients had received orthodontic treatment with a Twin-block appliance. The duration of orthodontic treatment was 1.5–2 years. Results: In both groups, a statistically significant increase in the SNB angle was observed. Subsequently, the ANB angle was normalized. The effective length of the maxilla growing and mandibular length increasing was observed. Overjet distance is decreased due to favorable torque changes. Pretreatment assessment revealed that overbite was smaller in children with β-thalassemia major. As the effect of orthodontic treatment, statistically, significant changes were observed on both overjet and overbite distances (p <0.001). Conclusions: Orthodontic treatment of β-thalassemia major of patients with Twin-block appliance in mixed dentition stage is effective in improving inter arch relationships and the orofacial functions.

Concurrent thoracic pathology identified with radiology in hyperthyroid cats referred for radioiodine therapy

Objectives Radioiodine (RAI) treatment for hyperthyroidism is becoming increasingly available in the UK. Pretreatment assessment is commonly performed, as patient handling is limited once RAI has been administered. The aims of this study were to determine the prevalence of thoracic pathology using thoracic radiography in hyperthyroid cats referred for RAI treatment and to determine the value of this technique pretreatment. Methods The hospital databases were searched for hyperthyroid cats referred for RAI treatment at the Feline Centre, Langford Vets, between January 2012 and July 2016. Radiographs were reviewed by Diplomates of the European College of Veterinary Diagnostic Imaging at the time of treatment and each set of radiographs was subsequently reviewed by one radiologist for the study. Cardiorespiratory signs were recorded, if present, and any change in treatment plan or suitability for RAI treatment was documented. Results Two hundred and fifty-two cats were included in the study. Thoracic pathology was identified in 77% (n = 194/252) of the cats, of which 59% (n = 115/194) had pulmonary abnormalities with bronchial and bronchointerstitial patterns most frequently; 57% (n = 111/194) had skeletal abnormalities and 43% (n = 84/194) had cardiac abnormalities, with mild-to-moderate cardiomegaly most prevalent. Other abnormalities included sternal lymphadenomegaly (7%; n = 13/194), mediastinal pathology (3%; n = 5/194), oesophageal pathology (2%; n = 4/194) and pleural space disease (0.5%; n = 1/194).Twelve cases (6%) had a change in their treatment plan as a result of thoracic radiographic abnormalities, of which five subsequently underwent RAI treatment. Conclusions and relevance A low prevalence of significant thoracic pathology was identified on radiographs in hyperthyroid cats referred for RAI treatment. Incidental thoracic abnormalities were found much more commonly; hence, results of thoracic radiology need to be combined with the clinical picture, to decide whether further investigations or alterations to the treatment plan are required pre-RAI.