Pub Date : 2024-04-05DOI: 10.1186/s43055-024-01243-w
Ebtsam Ahmed Mohammed Abdelbary, Amal Rayan Ibrahim, Khalid Mohammad Rezk, Nagham Nabil Omar
Since many newly diagnosed breast cancer patients have breast MRI, the value of preoperative breast magnetic resonance imaging would improve if molecular subtypes could be consistently identified, and prognostic information provided in addition to diagnostic imaging. Breast edema may improve the ability to predict molecular subtypes and clinical and pathological outcomes in invasive breast cancer patients. The prognosis for breast cancer prognosis based on the findings of breast edema by magnetic resonance imaging will be useful in both pretreatment planning and prognosis. Breast edema on T2-weighted images and STIR was scored on a scale of 1 to 4, as follows: (a) breast edema score (BES) 1, no edema; (b) BES 2, peritumoral edema; (c) BES 3, pre pectoral edema; and (d) BES 4, subcutaneous edema (suspicious for occult inflammatory breast cancer “IBC”). Axillary lymph node status and number were also evaluated in T2 and STIR and after contrast administration. The aim of this work was to assess the role of tumour-related breast edema MRI features in distinguishing molecular subtypes of breast cancer and its effect on pathological axillary lymph nodes in patients with breast cancer. There was a highly significant difference between BES with respect to the molecular subtypes of breast cancer, size of the mass, Ki-67 expression, LN status, and LN number (p < 0.0001, 0.045, < 0.0001, < 0.0001, and < 0.0001 respectively). However, there was no significant difference between BES and histopathological grade in studied masses, such as p-value = 0.49. Tumour-related breast edema MRI characteristics may be useful in distinguishing molecular subtypes of breast cancer and could be used as a promising feature to improve the predictive performance of pathological axillary lymph nodes in patients with breast cancer, contributing to preoperative treatment planning and prognostic outcome.
{"title":"Breast edema score at breast MRI: its value in prediction of molecular subtype of breast cancer and its impact on axillary LN metastasis","authors":"Ebtsam Ahmed Mohammed Abdelbary, Amal Rayan Ibrahim, Khalid Mohammad Rezk, Nagham Nabil Omar","doi":"10.1186/s43055-024-01243-w","DOIUrl":"https://doi.org/10.1186/s43055-024-01243-w","url":null,"abstract":"Since many newly diagnosed breast cancer patients have breast MRI, the value of preoperative breast magnetic resonance imaging would improve if molecular subtypes could be consistently identified, and prognostic information provided in addition to diagnostic imaging. Breast edema may improve the ability to predict molecular subtypes and clinical and pathological outcomes in invasive breast cancer patients. The prognosis for breast cancer prognosis based on the findings of breast edema by magnetic resonance imaging will be useful in both pretreatment planning and prognosis. Breast edema on T2-weighted images and STIR was scored on a scale of 1 to 4, as follows: (a) breast edema score (BES) 1, no edema; (b) BES 2, peritumoral edema; (c) BES 3, pre pectoral edema; and (d) BES 4, subcutaneous edema (suspicious for occult inflammatory breast cancer “IBC”). Axillary lymph node status and number were also evaluated in T2 and STIR and after contrast administration. The aim of this work was to assess the role of tumour-related breast edema MRI features in distinguishing molecular subtypes of breast cancer and its effect on pathological axillary lymph nodes in patients with breast cancer. There was a highly significant difference between BES with respect to the molecular subtypes of breast cancer, size of the mass, Ki-67 expression, LN status, and LN number (p < 0.0001, 0.045, < 0.0001, < 0.0001, and < 0.0001 respectively). However, there was no significant difference between BES and histopathological grade in studied masses, such as p-value = 0.49. Tumour-related breast edema MRI characteristics may be useful in distinguishing molecular subtypes of breast cancer and could be used as a promising feature to improve the predictive performance of pathological axillary lymph nodes in patients with breast cancer, contributing to preoperative treatment planning and prognostic outcome.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"52 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140589773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Children with human immunodeficiency virus (HIV) infection frequently present with opportunistic infections of the lung that may be associated with high mortality rate. There is no study, to the best of our knowledge, correlating specific radiographic patterns of chest infections with CD4 levels of immunity in HIV-infected children of Indian subcontinent (where prevalence of respiratory tuberculosis is very high). To study the radiological patterns of chest infections in HIV-infected children, and to correlate these radiological findings with CD4 cell count and final diagnosis. Forty-five HIV-infected children (1–18 years of age) with suspected chest infections were included in the study. The baseline and the most recent CD4 counts were recorded for each patient. Chest X-ray (CXR) was obtained in all the patients, and multi-detector computed tomography (MDCT) chest was done in 27 patients having clinical suspicion of infection with normal or equivocal findings on CXR. Chest radiographs and MDCT chest were analyzed for different radiological patterns of chest infections. Imaging findings were correlated with CD4 count range for disease spectrum. The final etiopathological diagnosis was achieved in combination with clinico-radiological findings, laboratory data, cytohistopathology and follow-up imaging. Out of 45 children confirmed to be HIV-infected, 27 (60%) had bacterial infection, 14 (31.11%) had tuberculosis, and four (8.89%) had fungal infection. Consolidation on CXR/CT strongly suggested bacterial etiology (P < 0.05). Mediastinal/hilar lymphadenopathy (with or without necrosis) strongly suggested tubercular etiology (P value < 0.05). Diffuse GGO/haziness on CXR/CT strongly suggested fungal etiology (P value < 0.05). On correlation with CD4 count (cells/mm3), the bacterial infections occurred at early stages of HIV infection when immune status was relatively preserved, and most of the patients with tubercular infection had moderate immunosuppression. On the other hand, all patients of fungal infection showed severe immunosuppression. A wide spectrum of pulmonary disease encountered in HIV-infected children warrants an integrated approach of image interpretation. Familiarity with the imaging patterns, combined with relevant clinical/laboratory details, may greatly help to improve the diagnostic confidence and to reach to a more meaningful differential diagnosis.
{"title":"Lung infections in HIV-infected children: imaging pattern recognition and its correlation with CD4 counts","authors":"Vishal Goel, Mahender K. Narula, Shahina Bano, Rama Anand, Vikas Chaudhary, Varinder Singh, Sonal Saxena","doi":"10.1186/s43055-024-01240-z","DOIUrl":"https://doi.org/10.1186/s43055-024-01240-z","url":null,"abstract":"Children with human immunodeficiency virus (HIV) infection frequently present with opportunistic infections of the lung that may be associated with high mortality rate. There is no study, to the best of our knowledge, correlating specific radiographic patterns of chest infections with CD4 levels of immunity in HIV-infected children of Indian subcontinent (where prevalence of respiratory tuberculosis is very high). To study the radiological patterns of chest infections in HIV-infected children, and to correlate these radiological findings with CD4 cell count and final diagnosis. Forty-five HIV-infected children (1–18 years of age) with suspected chest infections were included in the study. The baseline and the most recent CD4 counts were recorded for each patient. Chest X-ray (CXR) was obtained in all the patients, and multi-detector computed tomography (MDCT) chest was done in 27 patients having clinical suspicion of infection with normal or equivocal findings on CXR. Chest radiographs and MDCT chest were analyzed for different radiological patterns of chest infections. Imaging findings were correlated with CD4 count range for disease spectrum. The final etiopathological diagnosis was achieved in combination with clinico-radiological findings, laboratory data, cytohistopathology and follow-up imaging. Out of 45 children confirmed to be HIV-infected, 27 (60%) had bacterial infection, 14 (31.11%) had tuberculosis, and four (8.89%) had fungal infection. Consolidation on CXR/CT strongly suggested bacterial etiology (P < 0.05). Mediastinal/hilar lymphadenopathy (with or without necrosis) strongly suggested tubercular etiology (P value < 0.05). Diffuse GGO/haziness on CXR/CT strongly suggested fungal etiology (P value < 0.05). On correlation with CD4 count (cells/mm3), the bacterial infections occurred at early stages of HIV infection when immune status was relatively preserved, and most of the patients with tubercular infection had moderate immunosuppression. On the other hand, all patients of fungal infection showed severe immunosuppression. A wide spectrum of pulmonary disease encountered in HIV-infected children warrants an integrated approach of image interpretation. Familiarity with the imaging patterns, combined with relevant clinical/laboratory details, may greatly help to improve the diagnostic confidence and to reach to a more meaningful differential diagnosis.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"13 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140589885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-04DOI: 10.1186/s43055-024-01234-x
Sara Mahmoud Ragaee, Enas A. Abdel Gawad, Sara Gamal, Mohab Mohamed Nageeb, Ahmed Sayed Ibrahim
Cervical spondylotic myelopathy (CSM) is the most prevalent form of dysfunction in the cervical cord. For best results, CSM must be identified and treated quickly, before spinal cord injury develops. We aimed at determining the diagnostic value of quantitative and qualitative diffusion tensor imaging (DTI) indices in the assessment of CSM. Thirty patients were included in this prospective study with clinically suspected CSM of both sexes. This study aimed at determining the diagnostic value of quantitative and qualitative DTI indices in early assessment of CSM and subsequently early and proper management decision rendering better clinical outcome. This prospective study included 30 patients: with clinically suspected CSM with a mean age of 51.88 ± 10.28 years. Patients with CSM were graded to 3 grades, mild (No. = 17), moderate (No. = 13) and severe (No. = 0) according to the modified Japanese orthopedic association (mJOA) grading system. Correlation test was performed between mJOA grades of severity with fractional anisotropy (FA), apparent diffusion coefficient (ADC) and T2 cord signal. We found a negative correlation between ADC and FA with Spearman’s rho value of − 0.612 and “P value 0.000” (P value < 0.05), a positive correlation between FA with mJOA clinical score with Spearman’s rho value of − 0.504 & “P value 0.036” (P value < 0.05) and a negative correlation between ADC and mJOA clinical score with Spearman’s rho value of 0.385 and P value 0.005 (P value < 0.05), and no significant correlation was found between mJOA clinical score and T2 hyperintense signal with Spearman’s rho value of − 0.304 and “P value 0.102” (P value < 0.05). Qualitative maps grading by 3D tractography images were done, and 18 patients in the study (60%) showed homogenous intact fiber tracts (grade I), 9 patients (30%) showed reduction or alteration of anisotropy or mixed colors intensity (grade II), and 3 patients (10%) showed fiber tract disruption or displaced cord (grade III). Three DTI parameters (other than FA and ADC) were measured, and two of them show significant difference between their measures in the stenotic and non-stenotic portions of the spinal cord—RA (P value = 0.00) and RD (P value = 0.00). We concluded that DTI is a crucial tool for early diagnosis and grading of CSM (cervical spondylosis myelopathy)—quantitatively and qualitatively—hence, it should be routinely integrated with conventional cervical spine MRI in case of clinically or radiologically suspected cervical cord compression, as the FA parameter together with the clinical assessment formulates the management plan decision for the CSM whether surgical or non-surgical and depicts the need for early surgical decision rendering better clinical outcome compared to that based on T2 hyperintense cord signal.
{"title":"Leverage of applying diffusion tensor imaging (DTI) indices in assessment of cervical spondylotic myelopathy","authors":"Sara Mahmoud Ragaee, Enas A. Abdel Gawad, Sara Gamal, Mohab Mohamed Nageeb, Ahmed Sayed Ibrahim","doi":"10.1186/s43055-024-01234-x","DOIUrl":"https://doi.org/10.1186/s43055-024-01234-x","url":null,"abstract":"Cervical spondylotic myelopathy (CSM) is the most prevalent form of dysfunction in the cervical cord. For best results, CSM must be identified and treated quickly, before spinal cord injury develops. We aimed at determining the diagnostic value of quantitative and qualitative diffusion tensor imaging (DTI) indices in the assessment of CSM. Thirty patients were included in this prospective study with clinically suspected CSM of both sexes. This study aimed at determining the diagnostic value of quantitative and qualitative DTI indices in early assessment of CSM and subsequently early and proper management decision rendering better clinical outcome. This prospective study included 30 patients: with clinically suspected CSM with a mean age of 51.88 ± 10.28 years. Patients with CSM were graded to 3 grades, mild (No. = 17), moderate (No. = 13) and severe (No. = 0) according to the modified Japanese orthopedic association (mJOA) grading system. Correlation test was performed between mJOA grades of severity with fractional anisotropy (FA), apparent diffusion coefficient (ADC) and T2 cord signal. We found a negative correlation between ADC and FA with Spearman’s rho value of − 0.612 and “P value 0.000” (P value < 0.05), a positive correlation between FA with mJOA clinical score with Spearman’s rho value of − 0.504 & “P value 0.036” (P value < 0.05) and a negative correlation between ADC and mJOA clinical score with Spearman’s rho value of 0.385 and P value 0.005 (P value < 0.05), and no significant correlation was found between mJOA clinical score and T2 hyperintense signal with Spearman’s rho value of − 0.304 and “P value 0.102” (P value < 0.05). Qualitative maps grading by 3D tractography images were done, and 18 patients in the study (60%) showed homogenous intact fiber tracts (grade I), 9 patients (30%) showed reduction or alteration of anisotropy or mixed colors intensity (grade II), and 3 patients (10%) showed fiber tract disruption or displaced cord (grade III). Three DTI parameters (other than FA and ADC) were measured, and two of them show significant difference between their measures in the stenotic and non-stenotic portions of the spinal cord—RA (P value = 0.00) and RD (P value = 0.00). We concluded that DTI is a crucial tool for early diagnosis and grading of CSM (cervical spondylosis myelopathy)—quantitatively and qualitatively—hence, it should be routinely integrated with conventional cervical spine MRI in case of clinically or radiologically suspected cervical cord compression, as the FA parameter together with the clinical assessment formulates the management plan decision for the CSM whether surgical or non-surgical and depicts the need for early surgical decision rendering better clinical outcome compared to that based on T2 hyperintense cord signal.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"6 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140589679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amelanotic/hypomelanotic melanoma is an extremely rare cancer and accounts for less than 1/10,000 in the population. For losing and hypomelanotic pigment, amelanotic melanoma can lead to misdiagnosis with benign skin lesions. Therefore, early recognition and diagnosis is important to avoid a delay in treatment. A 73-year-old man presented for a gradually enlarged nodule on the surface skin of the left crus, with no color change, ulceration, or bleeding. Malignant lesion was suspected based on computed tomography (CT) and magnetic resonance imaging (MRI), and biopsy was scheduled. Immunohistochemical (IHC) revealed amelanotic melanoma followed by biopsy.18Florine-fluoro-2-deoxy-2-d-glucose (18F-FDG) positron emission tomography-computed tomography (PET-CT) was employed to explore whether there are metastases or not. 18F-FDG PET-CT showed increased FDG accumulation with standardized uptake value max (SUVmax) of 5.6 of the lesion, and no other lesions were detected. The patient refused to be hospitalized and died 12 months later. This case highlights the need of considering melanoma even if there is no color change. Increased FDG uptake from PET-CT is prone to be consistent with malignant disease as well as whole body scan is crucial in determining the accurate TNM stage. Moreover, prompt treatment according to guidelines is necessary even if the disease is at its early stage.
{"title":"Amelanotic melanoma detected by 18F-FDG PET-CT","authors":"Ningning Chen, Xin Liu, Yongzhu Pu, Chengtao Feng, Fake Yang, Conghui Yang, Long Chen","doi":"10.1186/s43055-024-01238-7","DOIUrl":"https://doi.org/10.1186/s43055-024-01238-7","url":null,"abstract":"Amelanotic/hypomelanotic melanoma is an extremely rare cancer and accounts for less than 1/10,000 in the population. For losing and hypomelanotic pigment, amelanotic melanoma can lead to misdiagnosis with benign skin lesions. Therefore, early recognition and diagnosis is important to avoid a delay in treatment. A 73-year-old man presented for a gradually enlarged nodule on the surface skin of the left crus, with no color change, ulceration, or bleeding. Malignant lesion was suspected based on computed tomography (CT) and magnetic resonance imaging (MRI), and biopsy was scheduled. Immunohistochemical (IHC) revealed amelanotic melanoma followed by biopsy.18Florine-fluoro-2-deoxy-2-d-glucose (18F-FDG) positron emission tomography-computed tomography (PET-CT) was employed to explore whether there are metastases or not. 18F-FDG PET-CT showed increased FDG accumulation with standardized uptake value max (SUVmax) of 5.6 of the lesion, and no other lesions were detected. The patient refused to be hospitalized and died 12 months later. This case highlights the need of considering melanoma even if there is no color change. Increased FDG uptake from PET-CT is prone to be consistent with malignant disease as well as whole body scan is crucial in determining the accurate TNM stage. Moreover, prompt treatment according to guidelines is necessary even if the disease is at its early stage.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"15 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140589882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-04DOI: 10.1186/s43055-024-01246-7
Fenny Susilo, Michaela Alexandra Charlee, Yopi Simargi, Ronny Ronny
Amyand’s hernia is characterized as an inguinal hernia in which the hernia sac contains the appendix. It is highly atypical for the appendix structure to be contained within the hernia sac. Patients with Amyand’s hernia are typically asymptomatic and are frequently identified intraoperatively. Rarely seen in medical literature, this case report details the incidental finding of Amyand’s hernia and the successful preoperative diagnosis. A 61-year-old male presented to the urology clinic for his urinary tract complaint. An incidental finding of Amyand’s hernia was found in a non-contrast computerized tomography of the abdomen. Following the evaluation of computed tomography scan images showing the condition of the appendix and radiological findings regarding Amyand’s hernia, the surgeon planned the patient’s herniorrhaphy with mesh. Amyand’s hernia is often overlooked; therefore, radiologic examination can help to confirm this diagnosis.
{"title":"Incidental finding of Amyand’s hernia in a non-contrast CT of the abdomen: a case report","authors":"Fenny Susilo, Michaela Alexandra Charlee, Yopi Simargi, Ronny Ronny","doi":"10.1186/s43055-024-01246-7","DOIUrl":"https://doi.org/10.1186/s43055-024-01246-7","url":null,"abstract":"Amyand’s hernia is characterized as an inguinal hernia in which the hernia sac contains the appendix. It is highly atypical for the appendix structure to be contained within the hernia sac. Patients with Amyand’s hernia are typically asymptomatic and are frequently identified intraoperatively. Rarely seen in medical literature, this case report details the incidental finding of Amyand’s hernia and the successful preoperative diagnosis. A 61-year-old male presented to the urology clinic for his urinary tract complaint. An incidental finding of Amyand’s hernia was found in a non-contrast computerized tomography of the abdomen. Following the evaluation of computed tomography scan images showing the condition of the appendix and radiological findings regarding Amyand’s hernia, the surgeon planned the patient’s herniorrhaphy with mesh. Amyand’s hernia is often overlooked; therefore, radiologic examination can help to confirm this diagnosis.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"27 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140589683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-04DOI: 10.1186/s43055-024-01245-8
Alaa Mostafa, Ahmed Mostafa Mohamed, Ahmed Mohamed Osman, Nourhan Mohammed Hossam El Din
Ankle joint cartilage injury is frequently associated with degenerative changes, even in the absence of symptoms. Earlier treatment of cartilage damage with joint preservation is clearly more successful. The main limitation of morphologic cartilage magnetic resonance imaging sequences is that they are not very sensitivity in the detection of early cartilage degeneration. Recent advances in biochemical magnetic resonance imaging have yielded sequences that are sensitive to molecular changes in the composition of cartilage matrix. This includes water- and collagen-sensitive T2T2* mapping. The aim of this study was to determine the extent of improvement of the diagnostic performance of routine magnetic resonance imaging protocol in the evaluation of ankle joint articular cartilage lesions following the addition of a T2 mapping sequence. A total of 45 cases, 30 patients (12 male and 18 female) and 15 controls (10 male and 5 female) who underwent routine ankle magnetic resonance imaging with additional T2 mapping sequence, were included in the study. Out of 30 patients, four patients were misdiagnosed as being normal, while having changes of cartilage composition of early degenerative changes, discovered by T2 mapping sequence. The patients group as well as the-control groups had significantly higher T2-values in the superficial cartilage layer (P < 0.001) compared to the deep layer. When comparing between the medial and the lateral compartments at patients group, the T2-relaxation times were more pronounced in the medial talar cartilage compartment compared to the lateral talar cartilage compartment. Magnetic resonance imaging can observe not only the destruction of the structural integrity but also the change of the components in articular cartilage. In this study, the addition of a T2 mapping of the ankle cartilage sequence to a routine MR ankle protocol improved sensitivity and accuracy in the detection of early cartilage lesions within the ankle joint.
{"title":"The value of adding T2 mapping sequence to the routine MRI protocol in the evaluation of cartilage lesions of the ankle joint","authors":"Alaa Mostafa, Ahmed Mostafa Mohamed, Ahmed Mohamed Osman, Nourhan Mohammed Hossam El Din","doi":"10.1186/s43055-024-01245-8","DOIUrl":"https://doi.org/10.1186/s43055-024-01245-8","url":null,"abstract":"Ankle joint cartilage injury is frequently associated with degenerative changes, even in the absence of symptoms. Earlier treatment of cartilage damage with joint preservation is clearly more successful. The main limitation of morphologic cartilage magnetic resonance imaging sequences is that they are not very sensitivity in the detection of early cartilage degeneration. Recent advances in biochemical magnetic resonance imaging have yielded sequences that are sensitive to molecular changes in the composition of cartilage matrix. This includes water- and collagen-sensitive T2T2* mapping. The aim of this study was to determine the extent of improvement of the diagnostic performance of routine magnetic resonance imaging protocol in the evaluation of ankle joint articular cartilage lesions following the addition of a T2 mapping sequence. A total of 45 cases, 30 patients (12 male and 18 female) and 15 controls (10 male and 5 female) who underwent routine ankle magnetic resonance imaging with additional T2 mapping sequence, were included in the study. Out of 30 patients, four patients were misdiagnosed as being normal, while having changes of cartilage composition of early degenerative changes, discovered by T2 mapping sequence. The patients group as well as the-control groups had significantly higher T2-values in the superficial cartilage layer (P < 0.001) compared to the deep layer. When comparing between the medial and the lateral compartments at patients group, the T2-relaxation times were more pronounced in the medial talar cartilage compartment compared to the lateral talar cartilage compartment. Magnetic resonance imaging can observe not only the destruction of the structural integrity but also the change of the components in articular cartilage. In this study, the addition of a T2 mapping of the ankle cartilage sequence to a routine MR ankle protocol improved sensitivity and accuracy in the detection of early cartilage lesions within the ankle joint.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"6 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140589689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-02DOI: 10.1186/s43055-024-01244-9
Mohammad Abdullah Dhulaimi, Moroj Ahmad Aldarmasi, Areen Ghazi Almasri, Syed Mohammad Mosharraf
Multiparametric magnetic resonance imaging (MRI) is valuable in detecting prostate cancer due to its high sensitivity to malignant lesions. It is commonly utilized to improve the identification of clinically significant cancers within the prostate. This study aimed to correlate the findings from 3T multiparametric MRI of the prostate using the updated Prostate Imaging Reporting and Data System version 2.1 (PIRADSv2.1) from 2019 with reference to prostate biopsy results. Additionally, PIRADSv2.1 was used to calculate the sensitivity, specificity, positive predictive value, and negative predictive value of the 3T multiparametric MRI of the prostate. A retrospective study was conducted at a tertiary center, wherein we identified patients who underwent a prostate biopsy between June 2019 and June 2021 and had a corresponding MRI of the prostate performed at the same institution, evaluated with PIRADSv2.1 criteria. A total of 50 patients were eligible for final analysis. The prevalence of prostate cancer was 69% (95% confidence interval (CI) 54–81%). Receiver operating characteristic (ROC) curves were generated for 3T multiparametric MRI of the prostate using PIRADSv2.1 to diagnose prostate cancer; the area under the ROC curve was 0.81 (95% CI 0.68–0.95, p < 0.001). The sensitivity, specificity, positive predictive value, and negative predictive value of the 3T multiparametric prostate MRI using PIRADSv2.1 were 74.0%, 87.0%, 92.9%, and 59.1%, respectively. PIRADSv2.1 exhibited good overall performance in the diagnosis of prostate cancer.
{"title":"3T multiparametric MRI’s accuracy in detecting prostate cancer using Prostate Imaging Reporting and Data System (PIRADS) version 2.1 with prostate biopsy as a reference","authors":"Mohammad Abdullah Dhulaimi, Moroj Ahmad Aldarmasi, Areen Ghazi Almasri, Syed Mohammad Mosharraf","doi":"10.1186/s43055-024-01244-9","DOIUrl":"https://doi.org/10.1186/s43055-024-01244-9","url":null,"abstract":"Multiparametric magnetic resonance imaging (MRI) is valuable in detecting prostate cancer due to its high sensitivity to malignant lesions. It is commonly utilized to improve the identification of clinically significant cancers within the prostate. This study aimed to correlate the findings from 3T multiparametric MRI of the prostate using the updated Prostate Imaging Reporting and Data System version 2.1 (PIRADSv2.1) from 2019 with reference to prostate biopsy results. Additionally, PIRADSv2.1 was used to calculate the sensitivity, specificity, positive predictive value, and negative predictive value of the 3T multiparametric MRI of the prostate. A retrospective study was conducted at a tertiary center, wherein we identified patients who underwent a prostate biopsy between June 2019 and June 2021 and had a corresponding MRI of the prostate performed at the same institution, evaluated with PIRADSv2.1 criteria. A total of 50 patients were eligible for final analysis. The prevalence of prostate cancer was 69% (95% confidence interval (CI) 54–81%). Receiver operating characteristic (ROC) curves were generated for 3T multiparametric MRI of the prostate using PIRADSv2.1 to diagnose prostate cancer; the area under the ROC curve was 0.81 (95% CI 0.68–0.95, p < 0.001). The sensitivity, specificity, positive predictive value, and negative predictive value of the 3T multiparametric prostate MRI using PIRADSv2.1 were 74.0%, 87.0%, 92.9%, and 59.1%, respectively. PIRADSv2.1 exhibited good overall performance in the diagnosis of prostate cancer.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"298 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140589771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-29DOI: 10.1186/s43055-024-01235-w
Toqa El-Gohary, Soha T. Hamed, Hatem Mohamed El-Azizi, Hisham Mamdouh Haggag, Heba Azzam
Pelvic organ prolapse (POP) is a gynecological disease significantly associated with older age. A higher prevalence of women with symptomatic POP showed physical and emotional distress, negatively affecting their quality of life (QoL). The most widespread tool used is the prolapse quantification system (POP-Q) of the International Continence Society (ICS). The aim of this study was to evaluate the role of ultrasound (U/S) compared to POP-Q for the detection and quantification of POP in the anterior (urinary bladder) and apical (cervix/vaginal vault) compartments of the pelvic floor in Egyptian women. The current study revealed that among 83 women, 53 had POP with a mean age of 50.83 years, 96.2% had anterior compartment prolapse (either alone or with apical compartment prolapse), 52% had apical compartment prolapse (either alone or with anterior compartment prolapse), 47.2% had anterior compartment prolapse only, and 3.7% had apical compartment prolapse only. There was a strong agreement (almost linear) between (POP-Q) and U/S in detecting significant pelvic organ prolapse in the anterior compartment (Kappa value 0.925, P < 0.001) and the apical compartment (Kappa value 0.945 and P < 0.001). With higher value of sensitivity and specificity, our study assigned significant anterior compartment prolapse using a cutoff value of 0 for point Ba of POP-Q and −11.5 for bladder neck descent at valsalva using U/S. Pelvic floor ultrasound provides general and detailed anatomical overview of the pelvic floor as well as detection and assessment of the POP in anterior and middle compartments.
盆腔器官脱垂（POP）是一种与年龄增长密切相关的妇科疾病。有症状的 POP 患者中，有较高患病率的妇女表现出身体和精神上的痛苦，这对她们的生活质量（QoL）产生了负面影响。最常用的工具是国际尿失禁协会（ICS）的脱垂量化系统（POP-Q）。本研究的目的是评估超声（U/S）与 POP-Q 相比在检测和量化埃及妇女盆底前部（膀胱）和顶部（子宫颈/阴道穹隆）的 POP 方面的作用。目前的研究显示，在 83 名妇女中，53 人患有 POP，平均年龄为 50.83 岁，96.2% 的妇女患有前壁脱垂（单独或伴有顶端脱垂），52% 的妇女患有顶端脱垂（单独或伴有前壁脱垂），47.2% 的妇女仅患有前壁脱垂，3.7% 的妇女仅患有顶端脱垂。POP-Q）和U/S在检测前部（Kappa值为0.925，P＜0.001）和顶部（Kappa值为0.945，P＜0.001）明显的盆腔器官脱垂方面有很好的一致性（几乎呈线性）。由于敏感性和特异性值较高，我们的研究使用 U/S 将 POP-Q 的 Ba 点和-11.5 的临界值分别定为 0 和-11.5。盆底超声可提供盆底的总体和详细解剖概况，并可检测和评估前房和中房的 POP。
{"title":"The role of pelvic floor ultrasound correlated with pelvic organ prolapse quantification in the assessment of anterior and apical compartments of pelvic organ prolapse","authors":"Toqa El-Gohary, Soha T. Hamed, Hatem Mohamed El-Azizi, Hisham Mamdouh Haggag, Heba Azzam","doi":"10.1186/s43055-024-01235-w","DOIUrl":"https://doi.org/10.1186/s43055-024-01235-w","url":null,"abstract":"Pelvic organ prolapse (POP) is a gynecological disease significantly associated with older age. A higher prevalence of women with symptomatic POP showed physical and emotional distress, negatively affecting their quality of life (QoL). The most widespread tool used is the prolapse quantification system (POP-Q) of the International Continence Society (ICS). The aim of this study was to evaluate the role of ultrasound (U/S) compared to POP-Q for the detection and quantification of POP in the anterior (urinary bladder) and apical (cervix/vaginal vault) compartments of the pelvic floor in Egyptian women. The current study revealed that among 83 women, 53 had POP with a mean age of 50.83 years, 96.2% had anterior compartment prolapse (either alone or with apical compartment prolapse), 52% had apical compartment prolapse (either alone or with anterior compartment prolapse), 47.2% had anterior compartment prolapse only, and 3.7% had apical compartment prolapse only. There was a strong agreement (almost linear) between (POP-Q) and U/S in detecting significant pelvic organ prolapse in the anterior compartment (Kappa value 0.925, P < 0.001) and the apical compartment (Kappa value 0.945 and P < 0.001). With higher value of sensitivity and specificity, our study assigned significant anterior compartment prolapse using a cutoff value of 0 for point Ba of POP-Q and −11.5 for bladder neck descent at valsalva using U/S. Pelvic floor ultrasound provides general and detailed anatomical overview of the pelvic floor as well as detection and assessment of the POP in anterior and middle compartments.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"235 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140324716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hepatocellular carcinoma (HCC) is classified as the sixth commonest cancer over the world and the fourth common in Egypt, representing the third leading cause of cancer-related mortality. Trans-arterial chemoembolization (TACE) is considered as one of the most effective treatment option for intermediate stage HCC. Lesions showing complete response (CR) after TACE can be classified according to their lipiodol retention pattern into complete (C-Lip, covering the entire tumor volume) or incomplete (I-Lip). The purpose of this study was to assess the prediction value of post-TACE lipiodol retention pattern on the local disease progression after complete response and thus to decide which patient should be carefully observed and considered to be incompletely treated. The study included 45 HCC lesions treated with TACE and showed complete response in the first follow-up CT performed 4–6 weeks after the procedure; 23 cases showed incomplete lipiodol retention pattern and 22 with complete lipiodol retention pattern which was carefully assessed on non-contrast CT images done 4 to 6 weeks after treatment. Follow-up CT was then performed every 3 months for at least 12 months or until local progression occurred. On the follow-up CT studies, 20 out of the 45 lesions showed persistent complete response (i.e., no local progression), while 25 of them showed local progression. Among the 25 cases with disease progression upon correlation with their lipiodol retention pattern, it was found that local progression occurred in 31.8% of tumors showed CR with complete lipiodol retention, as opposed to 78.2% of tumors showed CR with incomplete lipiodol retention with significant statistical difference and p value 0.010. Lipiodol retention pattern of HCC after TACE can predict the potential tumor local outcome. Lesions with incomplete lipiodol retention are at a higher risk of local tumor progression and therefore should probably observed and can be retreated; on the other hand, tumors with complete lipiodol retention have a much lower risk of local disease tumor progression.
{"title":"The prediction value of lipiodol retention pattern on post-TACE CT scan for local progression of HCC after complete response","authors":"Marie Nader Grace, Bahaa Eldin Mahmoud, Asmaa Mohamed Hussein Abdel-Latif, Shaima Fattouh Elkholy, Mahmoud Mohamed Saleh","doi":"10.1186/s43055-024-01242-x","DOIUrl":"https://doi.org/10.1186/s43055-024-01242-x","url":null,"abstract":"Hepatocellular carcinoma (HCC) is classified as the sixth commonest cancer over the world and the fourth common in Egypt, representing the third leading cause of cancer-related mortality. Trans-arterial chemoembolization (TACE) is considered as one of the most effective treatment option for intermediate stage HCC. Lesions showing complete response (CR) after TACE can be classified according to their lipiodol retention pattern into complete (C-Lip, covering the entire tumor volume) or incomplete (I-Lip). The purpose of this study was to assess the prediction value of post-TACE lipiodol retention pattern on the local disease progression after complete response and thus to decide which patient should be carefully observed and considered to be incompletely treated. The study included 45 HCC lesions treated with TACE and showed complete response in the first follow-up CT performed 4–6 weeks after the procedure; 23 cases showed incomplete lipiodol retention pattern and 22 with complete lipiodol retention pattern which was carefully assessed on non-contrast CT images done 4 to 6 weeks after treatment. Follow-up CT was then performed every 3 months for at least 12 months or until local progression occurred. On the follow-up CT studies, 20 out of the 45 lesions showed persistent complete response (i.e., no local progression), while 25 of them showed local progression. Among the 25 cases with disease progression upon correlation with their lipiodol retention pattern, it was found that local progression occurred in 31.8% of tumors showed CR with complete lipiodol retention, as opposed to 78.2% of tumors showed CR with incomplete lipiodol retention with significant statistical difference and p value 0.010. Lipiodol retention pattern of HCC after TACE can predict the potential tumor local outcome. Lesions with incomplete lipiodol retention are at a higher risk of local tumor progression and therefore should probably observed and can be retreated; on the other hand, tumors with complete lipiodol retention have a much lower risk of local disease tumor progression.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"23 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140324811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Doppler ultrasonography is essential to provide insights into hemodynamic alterations and liver function changes in pre-cirrhotic and cirrhotic patients. Utilizing Doppler examinations, this study aims to explore the correlation between hepatic arterial hemodynamics and Model for end-stage liver disease (MELD) scores in chronic liver disease patients. A study of 50 chronic liver disease patients included sonographic assessments, measuring liver, portal vein size, and flow. Hepatic artery velocity, resistive index (RI), pulsatility index (PI), and acceleration time (AT) were evaluated. Biochemical parameters (serum bilirubin, creatinine, INR) were used to calculate MELD scores, compared with different Doppler sonographic parameters. The study found a mean peak systolic velocity (PSV) of 107.42 ± 48.10, with end-diastolic velocity (EDV) of 26.40 ± 14.68, RI of 0.74 ± 0.06, and PI of 1.47 ± 0.24. The mean MELD score was 19.28 ± 6.09. Correlations between MELD scores and PSV, EDV, RI, PI, and AT did not yield statistically significant correlations. 80% of subjects displayed high RI (> 0.7) values in the hepatic artery, and a significant correlation was found between portal vein thrombosis and hepatic artery PSV and RI (p < 0.05). Hepatic artery RI and PSV show a significant correlation with portal vein thrombosis. Doppler ultrasonography, while not directly tied to MELD scores, is valuable for non-invasive liver disease monitoring when invasive methods are impractical. Further research is needed to unravel the relationships between hemodynamic changes, MELD scores, and clinical outcomes in a broader patient population.
{"title":"Hepatic arterial hemodynamics and model for end-stage liver disease (MELD) scores in chronic liver disease: insights from Doppler ultrasonography","authors":"Sasmita Tuladhar, Shailendra Katwal, Ghanshyam Gurung, Umesh Khanal","doi":"10.1186/s43055-024-01220-3","DOIUrl":"https://doi.org/10.1186/s43055-024-01220-3","url":null,"abstract":"Doppler ultrasonography is essential to provide insights into hemodynamic alterations and liver function changes in pre-cirrhotic and cirrhotic patients. Utilizing Doppler examinations, this study aims to explore the correlation between hepatic arterial hemodynamics and Model for end-stage liver disease (MELD) scores in chronic liver disease patients. A study of 50 chronic liver disease patients included sonographic assessments, measuring liver, portal vein size, and flow. Hepatic artery velocity, resistive index (RI), pulsatility index (PI), and acceleration time (AT) were evaluated. Biochemical parameters (serum bilirubin, creatinine, INR) were used to calculate MELD scores, compared with different Doppler sonographic parameters. The study found a mean peak systolic velocity (PSV) of 107.42 ± 48.10, with end-diastolic velocity (EDV) of 26.40 ± 14.68, RI of 0.74 ± 0.06, and PI of 1.47 ± 0.24. The mean MELD score was 19.28 ± 6.09. Correlations between MELD scores and PSV, EDV, RI, PI, and AT did not yield statistically significant correlations. 80% of subjects displayed high RI (> 0.7) values in the hepatic artery, and a significant correlation was found between portal vein thrombosis and hepatic artery PSV and RI (p < 0.05). Hepatic artery RI and PSV show a significant correlation with portal vein thrombosis. Doppler ultrasonography, while not directly tied to MELD scores, is valuable for non-invasive liver disease monitoring when invasive methods are impractical. Further research is needed to unravel the relationships between hemodynamic changes, MELD scores, and clinical outcomes in a broader patient population.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"181 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140298641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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