Pub Date : 2024-07-09DOI: 10.1186/s43055-024-01311-1
Chanittha Buakhao, Sira Vachatimanont
Parathyroid scan is an important imaging modality for localizing hyperfunctioning parathyroid tissue in patients with hyperparathyroidism. Unfortunately, whether early or delayed timing is the optimal protocol for [99mTc]Tc-MIBI SPECT/CT parathyroid remains under debate. This study aimed to evaluate the agreement and compare the confidence levels of physicians when interpreting early and delayed [99mTc]Tc-MIBI SPECT/CT parathyroid scans. Additionally, it sought to identify clinical factors that related to positive scan result. We conducted a prospective study where the early and delayed [99mTc]Tc-MIBI SPECT/CT was separately interpreted as either positive or negative. Furthermore, these interpretations were categorized based on whether they fell within more or less confidence levels of the readers and were correlated with clinical information. We enrolled 39 patients with hyperparathyroidism with 158 possible locations of parathyroid glands. The per-location agreement between the early and delayed scans was moderate (concordant rate: 80.3%, Kappa = 0.558), and the per-patient agreement was slight (concordant rate: 71.8%, Kappa = 0.093). The confidence of interpretation was significantly higher for the delayed scans. Calcium supplementation, low serum parathyroid hormone levels, and low serum phosphate levels were associated with positive early scans. High calcium level and high parathyroid hormone levels were associated with positive delayed scans. Our study highlights the impact of the timing of SPECT/CT in [99mTc]Tc-MIBI parathyroid scans. The different confidence levels between early and delayed scans, along with clinical factors, imply that various factors affect parathyroid scan interpretation, and individualized scanning protocols adjusted for specific settings may be needed to optimize the successful localization of hyperfunctioning parathyroid tissue.
{"title":"Comparing early and delayed [99mTc]Tc-MIBI SPECT/CT parathyroid scans: agreement, confidence levels, and clinical predictive factors","authors":"Chanittha Buakhao, Sira Vachatimanont","doi":"10.1186/s43055-024-01311-1","DOIUrl":"https://doi.org/10.1186/s43055-024-01311-1","url":null,"abstract":"Parathyroid scan is an important imaging modality for localizing hyperfunctioning parathyroid tissue in patients with hyperparathyroidism. Unfortunately, whether early or delayed timing is the optimal protocol for [99mTc]Tc-MIBI SPECT/CT parathyroid remains under debate. This study aimed to evaluate the agreement and compare the confidence levels of physicians when interpreting early and delayed [99mTc]Tc-MIBI SPECT/CT parathyroid scans. Additionally, it sought to identify clinical factors that related to positive scan result. We conducted a prospective study where the early and delayed [99mTc]Tc-MIBI SPECT/CT was separately interpreted as either positive or negative. Furthermore, these interpretations were categorized based on whether they fell within more or less confidence levels of the readers and were correlated with clinical information. We enrolled 39 patients with hyperparathyroidism with 158 possible locations of parathyroid glands. The per-location agreement between the early and delayed scans was moderate (concordant rate: 80.3%, Kappa = 0.558), and the per-patient agreement was slight (concordant rate: 71.8%, Kappa = 0.093). The confidence of interpretation was significantly higher for the delayed scans. Calcium supplementation, low serum parathyroid hormone levels, and low serum phosphate levels were associated with positive early scans. High calcium level and high parathyroid hormone levels were associated with positive delayed scans. Our study highlights the impact of the timing of SPECT/CT in [99mTc]Tc-MIBI parathyroid scans. The different confidence levels between early and delayed scans, along with clinical factors, imply that various factors affect parathyroid scan interpretation, and individualized scanning protocols adjusted for specific settings may be needed to optimize the successful localization of hyperfunctioning parathyroid tissue.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"1 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141569734","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 : 2024-07-09DOI: 10.1186/s43055-024-01310-2
Ghazaleh Jamalipour Soufi, Ali Hekmatnia, Farzaneh Hekmatnia, Andrew Parviz Zarei, Farshad Riahi, Shamim Shafieyoon, Sara Azizollahi
Mitochondrial neurogastrointestinal encephalopathy (MNGIE) is an autosomal recessive disease associated with alterations in mitochondrial DNA (mtDNA). The typical age of onset of MNGIE is between the first and second decade of life. Diagnosis requires the presence of several key clinical features: sensorimotor neuropathy, external ophthalmoplegia, ocular ptosis, leukoencephalopathy, and gastrointestinal (GI) dysmotility. Unfortunately, MNGIE diagnosis is very challenging, and patients often undergo multiple diagnostic and surgical operations that are unnecessary. This case is of a 51-year-old male presenting with a 2-year history of limb weakness, GI problems and cachexia. There was also a 1-year history of progressive ptosis and ophthalmoplegia. The patient’s uncle and brother had both died from GI-related issues prior to the age of 40. On physical examination, ocular motility was impaired in all directions and there was atrophy and reduction in power in both lower and upper extremities. FLAIR and T2-weighted sequences of brain MRI demonstrated diffuse cerebral white matter hyperintensity (leukoencephalopathy). On discharge, the patient was referred for genetic consultation for bone marrow transplantation and had regular follow-up with a gastroenterology specialist. In patients presenting with chronic progressive ophthalmoplegia, severe gastrointestinal complications, sensorimotor neuropathy and white matter lesions on MRI, it is important to consider investigating for MNGIE.
{"title":"Mitochondrial neurogastrointestinal encephalopathy: a case report","authors":"Ghazaleh Jamalipour Soufi, Ali Hekmatnia, Farzaneh Hekmatnia, Andrew Parviz Zarei, Farshad Riahi, Shamim Shafieyoon, Sara Azizollahi","doi":"10.1186/s43055-024-01310-2","DOIUrl":"https://doi.org/10.1186/s43055-024-01310-2","url":null,"abstract":"Mitochondrial neurogastrointestinal encephalopathy (MNGIE) is an autosomal recessive disease associated with alterations in mitochondrial DNA (mtDNA). The typical age of onset of MNGIE is between the first and second decade of life. Diagnosis requires the presence of several key clinical features: sensorimotor neuropathy, external ophthalmoplegia, ocular ptosis, leukoencephalopathy, and gastrointestinal (GI) dysmotility. Unfortunately, MNGIE diagnosis is very challenging, and patients often undergo multiple diagnostic and surgical operations that are unnecessary. This case is of a 51-year-old male presenting with a 2-year history of limb weakness, GI problems and cachexia. There was also a 1-year history of progressive ptosis and ophthalmoplegia. The patient’s uncle and brother had both died from GI-related issues prior to the age of 40. On physical examination, ocular motility was impaired in all directions and there was atrophy and reduction in power in both lower and upper extremities. FLAIR and T2-weighted sequences of brain MRI demonstrated diffuse cerebral white matter hyperintensity (leukoencephalopathy). On discharge, the patient was referred for genetic consultation for bone marrow transplantation and had regular follow-up with a gastroenterology specialist. In patients presenting with chronic progressive ophthalmoplegia, severe gastrointestinal complications, sensorimotor neuropathy and white matter lesions on MRI, it is important to consider investigating for MNGIE.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"3 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141569778","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 : 2024-07-08DOI: 10.1186/s43055-024-01309-9
Amine Ben Lakhal, Seif Boukriba, Rim Bechraoui, Sondes Mannoubi, Habiba Mizouni
Ménière’s disease is a chronic condition of the inner ear that causes vertigo, tinnitus and hearing loss. Its diagnosis relies on clinical criteria that are subjective and pure-tone audiometry results that are not specific. Its pathological substrate is endolymphatic hydrops. Its imaging was recently made possible by the late-enhanced 3D FLAIR sequence. This technique was primarily tested on 3 T. Our objective was to prove its feasibility using a 1.5 T magnet. We conducted a prospective study including 30 patients who fulfilled the Bárány society criteria for Ménière’s disease. We performed the late-enhanced 3D FLAIR sequence on all patients. We used it to look for and grade endolymphatic hydrops in the utricle, the saccule and the cochlear canal using the Kahn method. We found endolymphatic hydrops in all of the 30 patients who fulfilled the diagnostic criteria for Ménière’s disease. We had no false positives and only one false negative with a patient presenting with bilateral disease clinically but having endolymphatic hydrops only on one side. Thus, our correspondence rate between clinical and imaging findings was 97%. It is possible to diagnose endolymphatic hydrops with the late-enhanced 3D FLAIR sequence using a 1.5 T MRI machine. Since Ménière’s disease diagnosis is sometimes tricky, imaging endolymphatic hydrops can aid in the diagnosis when the clinical picture is incomplete. It also helps guide invasive treatment plans. Feasibility at 1.5 T ensures broader access to the late-enhanced 3D FLAIR sequence. Beyond the scope of Ménière’s disease, this sequence offers the possibility to better understand pressure-related inner ear diseases.
梅尼埃病是一种慢性内耳疾病，会导致眩晕、耳鸣和听力损失。其诊断依赖于主观的临床标准和不具特异性的纯音测听结果。其病理基础是内淋巴水肿。最近，后期增强三维 FLAIR 序列使其成像成为可能。我们的目标是使用 1.5 T 磁体证明其可行性。我们进行了一项前瞻性研究，纳入了 30 名符合巴拉尼学会梅尼埃病标准的患者。我们对所有患者进行了晚期增强三维 FLAIR 序列检查。我们采用 Kahn 方法对宫角、囊腔和耳蜗管的内淋巴水肿进行了检查和分级。我们在所有符合梅尼埃病诊断标准的 30 名患者中发现了内淋巴水肿。我们没有发现假阳性病例，只有一名假阴性病例，患者临床表现为双侧患病，但只有一侧出现内淋巴水肿。因此，我们的临床和成像结果之间的对应率为 97%。使用 1.5 T 磁共振成像仪，通过后期增强的三维 FLAIR 序列可以诊断内淋巴水肿。由于梅尼埃病的诊断有时比较棘手，当临床表现不完整时，内淋巴水肿的成像可帮助诊断。它还有助于指导有创治疗计划。1.5 T 的可行性确保了后期增强三维 FLAIR 序列更广泛的应用。除了梅尼埃病，该序列还能更好地了解与压力相关的内耳疾病。
{"title":"MR imaging of endolymphatic hydrops in Ménière’s disease: feasibility at 1.5 T","authors":"Amine Ben Lakhal, Seif Boukriba, Rim Bechraoui, Sondes Mannoubi, Habiba Mizouni","doi":"10.1186/s43055-024-01309-9","DOIUrl":"https://doi.org/10.1186/s43055-024-01309-9","url":null,"abstract":"Ménière’s disease is a chronic condition of the inner ear that causes vertigo, tinnitus and hearing loss. Its diagnosis relies on clinical criteria that are subjective and pure-tone audiometry results that are not specific. Its pathological substrate is endolymphatic hydrops. Its imaging was recently made possible by the late-enhanced 3D FLAIR sequence. This technique was primarily tested on 3 T. Our objective was to prove its feasibility using a 1.5 T magnet. We conducted a prospective study including 30 patients who fulfilled the Bárány society criteria for Ménière’s disease. We performed the late-enhanced 3D FLAIR sequence on all patients. We used it to look for and grade endolymphatic hydrops in the utricle, the saccule and the cochlear canal using the Kahn method. We found endolymphatic hydrops in all of the 30 patients who fulfilled the diagnostic criteria for Ménière’s disease. We had no false positives and only one false negative with a patient presenting with bilateral disease clinically but having endolymphatic hydrops only on one side. Thus, our correspondence rate between clinical and imaging findings was 97%. It is possible to diagnose endolymphatic hydrops with the late-enhanced 3D FLAIR sequence using a 1.5 T MRI machine. Since Ménière’s disease diagnosis is sometimes tricky, imaging endolymphatic hydrops can aid in the diagnosis when the clinical picture is incomplete. It also helps guide invasive treatment plans. Feasibility at 1.5 T ensures broader access to the late-enhanced 3D FLAIR sequence. Beyond the scope of Ménière’s disease, this sequence offers the possibility to better understand pressure-related inner ear diseases.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"25 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141569777","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}
Acute spontaneous bleeding from renal angiomyolipoma (AML) is one of the causes of Wunderlich syndrome, a rare and potentially fatal clinical condition. Clinical deterioration will occur if there is a delay in urgent management. There are several management options for renal angiomyolipoma rupture. However, until now little is known about the case of recanalization from post-coil embolization of renal angiomyolipoma. There is no guideline about embolization technique for the management of recurrent bleeding after embolization or coil recanalization of renal angiomyolipoma. A 55-year-old male has Wunderlich syndrome caused by recurrent bleeding of giant AML of the left renal due to coil recanalization compounded by a pseudoaneurysm and other bleeding site in bilateral giant renal angiomyolipoma which is showed by contrast-enhanced abdominal computed tomography scan. The patient underwent urgent transarterial embolization and some blood transfusion. Clinical improvement occurred and the patient discharged several days later. Embolization for spontaneous bleeding or rebleeding of renal pseudoaneurysms may become the first choice of treatment in bilateral multiple renal angiomyolipoma rather than other managements which are available to preserve renal function.
肾血管脂肪瘤（AML）引起的急性自发性出血是 Wunderlich 综合征的病因之一，这是一种罕见且可能致命的临床症状。如果延误紧急处理，临床症状就会恶化。肾血管肌脂肪瘤破裂有多种治疗方案。然而，迄今为止，人们对肾血管肌脂肪瘤盘绕后栓塞再通的病例知之甚少。对于肾血管肌脂肪瘤栓塞或线圈再通术后复发性出血的处理，目前还没有关于栓塞技术的指南。一名 55 岁的男性患有 Wunderlich 综合征，其原因是双侧巨大肾血管肌脂肪瘤的假性动脉瘤和其他出血部位导致线圈再通术后左肾巨大 AML 反复出血，造影剂增强腹部计算机断层扫描显示了这一情况。患者接受了紧急经动脉栓塞治疗，并输了一些血。临床症状有所改善，数天后患者出院。栓塞治疗自发性出血或肾脏假性动脉瘤再出血可能会成为双侧多发性肾血管瘤的首选治疗方法，而不是其他可用于保护肾功能的治疗方法。
{"title":"Transarterial embolization in Wunderlich syndrome due to recanalization of giant renal angiomyolipoma pseudoaneurysm: a case report and literature review","authors":"Koesbandono, Prijo Sidipratomo, Raditya Utomo, Christiano Tansol, Yohanes Chandra Kurniawan","doi":"10.1186/s43055-024-01301-3","DOIUrl":"https://doi.org/10.1186/s43055-024-01301-3","url":null,"abstract":"Acute spontaneous bleeding from renal angiomyolipoma (AML) is one of the causes of Wunderlich syndrome, a rare and potentially fatal clinical condition. Clinical deterioration will occur if there is a delay in urgent management. There are several management options for renal angiomyolipoma rupture. However, until now little is known about the case of recanalization from post-coil embolization of renal angiomyolipoma. There is no guideline about embolization technique for the management of recurrent bleeding after embolization or coil recanalization of renal angiomyolipoma. A 55-year-old male has Wunderlich syndrome caused by recurrent bleeding of giant AML of the left renal due to coil recanalization compounded by a pseudoaneurysm and other bleeding site in bilateral giant renal angiomyolipoma which is showed by contrast-enhanced abdominal computed tomography scan. The patient underwent urgent transarterial embolization and some blood transfusion. Clinical improvement occurred and the patient discharged several days later. Embolization for spontaneous bleeding or rebleeding of renal pseudoaneurysms may become the first choice of treatment in bilateral multiple renal angiomyolipoma rather than other managements which are available to preserve renal function.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"43 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141551518","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 : 2024-07-03DOI: 10.1186/s43055-024-01298-9
Marwa Romeih, Tarek Ahmed Raafat, Gehad Ahmed, Shymaa Abd El-Mawla Shalaby, Wafaa Ali Heidar Ahmed
Patients with dense breasts have a higher risk factor for developing breast cancer. Digital mammography (DM) exhibits a reduced sensitivity in dense breast tissue as a result of overlapping fibro-glandular tissue. Digital breast tomosynthesis (DBT) solves this problem, so allows better characterization of masses, asymmetries, and parenchymal distortion. It is useful in screening studies for early detection of breast lesions by accurate detection and description of their margins, shape, and extent as well as surrounding structures. We aimed to evaluate the added value of DBT in characterizing of different breast lesions in dense breasts compared to DM. A Prospective Cohort study involved ninety female cases having dense breast parenchyma (ACR C & ACR D) having breast complaint lesions detected by DM or ultrasound or recalled from screening units, during the period from June 2021 to Jan 2023. All patient underwent DM and DBT with correlation with the pathological finding or follow up. As regards the characterization of breast mass DBT had higher sensitivity, higher specificity (98%, 87% respectively). However, DM showed less sensitivity, less specificity (58%, 80%,) with (p < 0.0001, p = 0.0005 respectively). DBT effectively visualizes overlapping tissue in dense breasts. DBT is important due to its ability to detect breast cancer earlier, characterize lesions accurately, and inspect the margins of masses precisely, along with decreasing recall rates for false-positive results.
{"title":"Value of digital breast tomosynthesis in characterization of breast lesions in dense breast","authors":"Marwa Romeih, Tarek Ahmed Raafat, Gehad Ahmed, Shymaa Abd El-Mawla Shalaby, Wafaa Ali Heidar Ahmed","doi":"10.1186/s43055-024-01298-9","DOIUrl":"https://doi.org/10.1186/s43055-024-01298-9","url":null,"abstract":"Patients with dense breasts have a higher risk factor for developing breast cancer. Digital mammography (DM) exhibits a reduced sensitivity in dense breast tissue as a result of overlapping fibro-glandular tissue. Digital breast tomosynthesis (DBT) solves this problem, so allows better characterization of masses, asymmetries, and parenchymal distortion. It is useful in screening studies for early detection of breast lesions by accurate detection and description of their margins, shape, and extent as well as surrounding structures. We aimed to evaluate the added value of DBT in characterizing of different breast lesions in dense breasts compared to DM. A Prospective Cohort study involved ninety female cases having dense breast parenchyma (ACR C & ACR D) having breast complaint lesions detected by DM or ultrasound or recalled from screening units, during the period from June 2021 to Jan 2023. All patient underwent DM and DBT with correlation with the pathological finding or follow up. As regards the characterization of breast mass DBT had higher sensitivity, higher specificity (98%, 87% respectively). However, DM showed less sensitivity, less specificity (58%, 80%,) with (p < 0.0001, p = 0.0005 respectively). DBT effectively visualizes overlapping tissue in dense breasts. DBT is important due to its ability to detect breast cancer earlier, characterize lesions accurately, and inspect the margins of masses precisely, along with decreasing recall rates for false-positive results.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"7 18 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141523171","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 : 2024-07-02DOI: 10.1186/s43055-024-01306-y
Osama M. Soliman, Amani Ezzat Mousa, Mona Zaky, Abdalla Abdelhamid
The detection of small renal masses has significantly increased due to the widespread use of cross-sectional imaging in recent years. Among these masses, clear cell renal cell carcinoma (ccRCC) is the most common subtype and progresses quickly, resulting in the advancement of the disease and the development of metastases. In this prospective study, our goal is to assess the effectiveness of multiparametric MRI clear cell Likelihood Score in small solid renal masses and its utility in predicting tumor grade. In total, 103 patients (mean age 52.5 ± 13.16 years) with small solid renal masses of stage T1a (≤ 4 cm) were identified. Mean tumor size was 3.4 ± 0.6 cm. According to our study results, the clear cell Likelihood Score (ccLS) had sensitivity of 75.6%, specificity of 93.5%, PPV of 88.6%, NPV of 85.3% and accuracy of 86.4% in diagnosing ccRCC using a ccLS threshold of 4 and 5. As regard the assessment of ccLS threshold of 1 or 2 in excluding ccRCC pathological subtype, our study found that out of 29 patients with ccLS 1 or 2, there was only 1 ccRCC case with false result (3% false positive). It was also noted that there is significant relation between Arterial-to-delayed-enhancement-ratio (ADER) value and the grade of the ccRCC. The median interquartile range (IQR) of ADER parameter was statistically significant higher in grade II compared to grade I (Median was 1.6 and 0.9 respectively) and much higher in grade III compared to grades I and II (Median was 2.9) with P value < 0.001. This ccLS showed promising efficacy in prediction and exclusion of ccRCC subtype. Moreover, it aids in predicting the ccRCC grade.
{"title":"Prospective evaluation of the diagnostic efficacy of multiparametric MRI clear cell Likelihood Score in small solid renal masses and its predictive value for tumor grade","authors":"Osama M. Soliman, Amani Ezzat Mousa, Mona Zaky, Abdalla Abdelhamid","doi":"10.1186/s43055-024-01306-y","DOIUrl":"https://doi.org/10.1186/s43055-024-01306-y","url":null,"abstract":"The detection of small renal masses has significantly increased due to the widespread use of cross-sectional imaging in recent years. Among these masses, clear cell renal cell carcinoma (ccRCC) is the most common subtype and progresses quickly, resulting in the advancement of the disease and the development of metastases. In this prospective study, our goal is to assess the effectiveness of multiparametric MRI clear cell Likelihood Score in small solid renal masses and its utility in predicting tumor grade. In total, 103 patients (mean age 52.5 ± 13.16 years) with small solid renal masses of stage T1a (≤ 4 cm) were identified. Mean tumor size was 3.4 ± 0.6 cm. According to our study results, the clear cell Likelihood Score (ccLS) had sensitivity of 75.6%, specificity of 93.5%, PPV of 88.6%, NPV of 85.3% and accuracy of 86.4% in diagnosing ccRCC using a ccLS threshold of 4 and 5. As regard the assessment of ccLS threshold of 1 or 2 in excluding ccRCC pathological subtype, our study found that out of 29 patients with ccLS 1 or 2, there was only 1 ccRCC case with false result (3% false positive). It was also noted that there is significant relation between Arterial-to-delayed-enhancement-ratio (ADER) value and the grade of the ccRCC. The median interquartile range (IQR) of ADER parameter was statistically significant higher in grade II compared to grade I (Median was 1.6 and 0.9 respectively) and much higher in grade III compared to grades I and II (Median was 2.9) with P value < 0.001. This ccLS showed promising efficacy in prediction and exclusion of ccRCC subtype. Moreover, it aids in predicting the ccRCC grade.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"29 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141501136","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 : 2024-07-01DOI: 10.1186/s43055-024-01305-z
S. Damini, S. H. Chandrashekhara, M. D. Ray
Budd–Chiari syndrome (BCS) is a rare condition, usually associated with hematological disorders such as thrombotic diathesis and hypercoagulability. Serum CA-125 level is an established tumor marker of ovarian malignancy; however, cases of primary BCS may also show raised CA-125 levels. BCS in a case of ovarian carcinoma is usually primary in nature due to hypercoagulable state, and raised CA-125 levels with tender hepatomegaly in a treated case of ovarian carcinoma usually imply metastatic recurrence in the liver. However, our case demonstrates an atypical secondary cause of BCS in such a patient caused by extrinsic compression of IVC due to recurrent disease. We report an unusual case of a 69-year-old female who presented with nausea and abdominal pain. She had a 7-year-old history of endometrioid carcinoma of the right ovary for which she underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy and pelvic lymph node dissection along with adjuvant chemotherapy. Currently, she had right hypochondrium tenderness, deranged liver function tests (LFT) and raised CA-125 levels, which raised suspicion of hepatic metastasis. However, CECT abdomen revealed peripheral mottled enhancement of liver with multifocal extrahepatic tumor deposits, one of them causing compression of inferior vena cava (IVC) implying a diagnosis of secondary Budd–Chiari syndrome. In a background of treated ovarian malignancy with raised CA-125 levels and deranged LFT, primary suspicion is of hepatic tumor recurrence. However, in our case, radiological investigation revealed diagnosis of secondary Budd–Chiari syndrome due to perihepatic metastatic recurrence with the absence of frank intrahepatic lesions.
{"title":"Rare presentation of recurrent ovarian carcinoma with secondary Budd–Chiari syndrome: a case report","authors":"S. Damini, S. H. Chandrashekhara, M. D. Ray","doi":"10.1186/s43055-024-01305-z","DOIUrl":"https://doi.org/10.1186/s43055-024-01305-z","url":null,"abstract":"Budd–Chiari syndrome (BCS) is a rare condition, usually associated with hematological disorders such as thrombotic diathesis and hypercoagulability. Serum CA-125 level is an established tumor marker of ovarian malignancy; however, cases of primary BCS may also show raised CA-125 levels. BCS in a case of ovarian carcinoma is usually primary in nature due to hypercoagulable state, and raised CA-125 levels with tender hepatomegaly in a treated case of ovarian carcinoma usually imply metastatic recurrence in the liver. However, our case demonstrates an atypical secondary cause of BCS in such a patient caused by extrinsic compression of IVC due to recurrent disease. We report an unusual case of a 69-year-old female who presented with nausea and abdominal pain. She had a 7-year-old history of endometrioid carcinoma of the right ovary for which she underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy and pelvic lymph node dissection along with adjuvant chemotherapy. Currently, she had right hypochondrium tenderness, deranged liver function tests (LFT) and raised CA-125 levels, which raised suspicion of hepatic metastasis. However, CECT abdomen revealed peripheral mottled enhancement of liver with multifocal extrahepatic tumor deposits, one of them causing compression of inferior vena cava (IVC) implying a diagnosis of secondary Budd–Chiari syndrome. In a background of treated ovarian malignancy with raised CA-125 levels and deranged LFT, primary suspicion is of hepatic tumor recurrence. However, in our case, radiological investigation revealed diagnosis of secondary Budd–Chiari syndrome due to perihepatic metastatic recurrence with the absence of frank intrahepatic lesions.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"4 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141523173","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 : 2024-06-28DOI: 10.1186/s43055-024-01294-z
Kamala Manogna Nibhanupudi, Monika Gangapatnam, Elamparidhi Padmanaban, Umamageswari Amirthalingam, Joe Vimal Raj, M. Bharathi
<p><b>Correction to: Egypt J Radiol Nucl Med (2024) 55:120</b> <b>https://doi.org/10.1186/s43055-024-01290-3</b></p><br/><p>Following the publication of the Original Article, the authors reported an error regarding the affiliation of the fourth author: Umamageswari Amirthalingam.</p><br/><p><b>Incorrect</b></p><br/><p>Department of Pathology, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, 605107, India.</p><br/><p><b>Correct</b></p><br/><p>Department of Radiodiagnosis, Sri Manakula Vinayagar Medical College and Hospital, Puducherry 605107, India.</p><p>The original article has been corrected.</p><h3>Authors and Affiliations</h3><ol><li><p>Department of Radiodiagnosis, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, 605107, India</p><p>Kamala Manogna Nibhanupudi, Monika Gangapatnam, Elamparidhi Padmanaban, Umamageswari Amirthalingam, Joe Vimal Raj & M. Bharathi</p></li></ol><span>Authors</span><ol><li><span>Kamala Manogna Nibhanupudi</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Monika Gangapatnam</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Elamparidhi Padmanaban</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Umamageswari Amirthalingam</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Joe Vimal Raj</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>M. Bharathi</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li></ol><h3>Corresponding author</h3><p>Correspondence to Monika Gangapatnam.</p><h3>Publisher's Note</h3><p>Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.</p><p><b>Open Access</b> This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.</p> <p>Repri
更正：Egypt J Radiol Nucl Med (2024) 55:120 https://doi.org/10.1186/s43055-024-01290-3Following 原文发表时，作者报告了第四作者所属单位的错误：IncorrectDepartmentofPathology，Sri Manakula Vinayagar Medical College and Hospital，Puducherry，605107，India.CorrectDepartment of Radiodiagnosis，Sri Manakula Vinayagar Medical College and Hospital，Puducherry，605107，India.The original article has been corrected.Authors and AffiliationsDepartment of Radiodiagnosis, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, 605107, IndiaKamala Manogna Nibhanupudi, Monika Gangapatnam, Elamparidhi Padmanaban, Umamageswari Amirthalingam, Joe Vimal Raj & M. BharathiAuthorsKamala Manogna Nibhanupudi, Monika Gangapatnam, Elamparidhi Padmanaban, Umamageswari Amirthalingam, Joe Vimal Raj & M. Bharathi.Bharathi作者Kamala Manogna Nibhanupudi查看作者发表的文章您也可以在PubMed Google Scholar中搜索该作者Monika Gangapatnam查看作者发表的文章您也可以在PubMed Google Scholar中搜索该作者Elamparidhi Padmanaban查看作者发表的文章您也可以在PubMed Google Scholar中搜索该作者您也可以在 PubMed Google Scholar中搜索该作者Umamageswari Amirthalingam查看作者发表的作品您也可以在 PubMed Google Scholar中搜索该作者Joe Vimal Raj查看作者发表的作品您也可以在 PubMed Google Scholar中搜索该作者M.BharathiView author publications您也可以在PubMed Google Scholar中搜索该作者Corresponding authorCorrespondence to Monika Gangapatnam.Publisher's NoteSpringer Nature对于出版地图和机构隶属关系中的管辖权主张保持中立。开放获取 本文采用知识共享署名 4.0 国际许可协议进行许可，该协议允许以任何媒介或格式使用、共享、改编、分发和复制，只要您适当注明原作者和来源，提供知识共享许可协议的链接，并说明是否进行了修改。本文中的图片或其他第三方材料均包含在文章的知识共享许可协议中，除非在材料的署名栏中另有说明。如果材料未包含在文章的知识共享许可协议中，且您打算使用的材料不符合法律规定或超出许可使用范围，则您需要直接从版权所有者处获得许可。如需查看该许可的副本，请访问 http://creativecommons.org/licenses/by/4.0/.Reprints and permissionsCite this articleNibhanupudi, K.M., Gangapatnam, M., Padmanaban, E. et al. Correction：探索未知领域：偎依在颞骨中的腺样囊性癌。Egypt J Radiol Nucl Med 55, 125 (2024). https://doi.org/10.1186/s43055-024-01294-zDownload citationPublished: 28 June 2024DOI: https://doi.org/10.1186/s43055-024-01294-zShare this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative
{"title":"Correction: Exploring the uncharted: adenoid cystic carcinoma nestled in temporal bone","authors":"Kamala Manogna Nibhanupudi, Monika Gangapatnam, Elamparidhi Padmanaban, Umamageswari Amirthalingam, Joe Vimal Raj, M. Bharathi","doi":"10.1186/s43055-024-01294-z","DOIUrl":"https://doi.org/10.1186/s43055-024-01294-z","url":null,"abstract":"<p><b>Correction to: Egypt J Radiol Nucl Med (2024) 55:120</b> <b>https://doi.org/10.1186/s43055-024-01290-3</b></p><br/><p>Following the publication of the Original Article, the authors reported an error regarding the affiliation of the fourth author: Umamageswari Amirthalingam.</p><br/><p><b>Incorrect</b></p><br/><p>Department of Pathology, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, 605107, India.</p><br/><p><b>Correct</b></p><br/><p>Department of Radiodiagnosis, Sri Manakula Vinayagar Medical College and Hospital, Puducherry 605107, India.</p><p>The original article has been corrected.</p><h3>Authors and Affiliations</h3><ol><li><p>Department of Radiodiagnosis, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, 605107, India</p><p>Kamala Manogna Nibhanupudi, Monika Gangapatnam, Elamparidhi Padmanaban, Umamageswari Amirthalingam, Joe Vimal Raj & M. Bharathi</p></li></ol><span>Authors</span><ol><li><span>Kamala Manogna Nibhanupudi</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Monika Gangapatnam</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Elamparidhi Padmanaban</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Umamageswari Amirthalingam</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Joe Vimal Raj</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>M. Bharathi</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li></ol><h3>Corresponding author</h3><p>Correspondence to Monika Gangapatnam.</p><h3>Publisher's Note</h3><p>Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.</p><p><b>Open Access</b> This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.</p>\u0000<p>Repri","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"39 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141523176","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 : 2024-06-28DOI: 10.1186/s43055-024-01299-8
Sachin Girdhar, Alisha Naik, Maneesh Uniyal
Encapsulating peritoneal sclerosis (EPS) or abdominal cocoon is a very rare cause of subacute intestinal obstruction. We hereby report an elderly male presenting with recent-onset subacute intestinal obstruction with characteristic imaging findings of this entity in a background of abdominal tuberculosis on computed tomography (CT) scan that enabled timely diagnosis and appropriate clinical management. The report aims to highlight the typical radiological findings of this rare entity that may otherwise go undetected on imaging investigations, thereby causing a delay in diagnosis with adverse clinical outcomes. A 57-year-old male patient presented to the hospital with complaints of diffuse abdominal pain with obstipation and recurrent episodes of vomiting since last three days. Clinical evaluation also revealed an ill-defined lump in right lower abdomen. An urgent contrast-enhanced CT scan after oral contrast administration was performed that revealed dilated, clumped up small bowel loops in a ‘whorl-like’ pattern in right iliac fossa region. These obstructed loops were encased by a thick peritoneal membrane giving a ‘cocoon-like’ appearance. Also appreciated were scattered punctate calcific foci in jejunal walls and adjacent peritoneum along with mild ascites. On the basis of typical imaging findings, provisional diagnosis of tubercular cocoon abdomen was given that was later confirmed by laboratory investigations and diagnostic laparoscopy. Encapsulating peritoneal sclerosis or cocoon abdomen is an extremely rare cause of subacute intestinal obstruction. Further, cocoon abdomen in a background of abdominal tuberculosis is even rarer. However, this case report highlights the characteristic imaging findings for broader audience that enabled prompt diagnosis and appropriate clinical management in this case, achieving optimal clinical outcome.
{"title":"Tubercular abdominal cocoon: a rare cause of subacute small bowel obstruction","authors":"Sachin Girdhar, Alisha Naik, Maneesh Uniyal","doi":"10.1186/s43055-024-01299-8","DOIUrl":"https://doi.org/10.1186/s43055-024-01299-8","url":null,"abstract":"Encapsulating peritoneal sclerosis (EPS) or abdominal cocoon is a very rare cause of subacute intestinal obstruction. We hereby report an elderly male presenting with recent-onset subacute intestinal obstruction with characteristic imaging findings of this entity in a background of abdominal tuberculosis on computed tomography (CT) scan that enabled timely diagnosis and appropriate clinical management. The report aims to highlight the typical radiological findings of this rare entity that may otherwise go undetected on imaging investigations, thereby causing a delay in diagnosis with adverse clinical outcomes. A 57-year-old male patient presented to the hospital with complaints of diffuse abdominal pain with obstipation and recurrent episodes of vomiting since last three days. Clinical evaluation also revealed an ill-defined lump in right lower abdomen. An urgent contrast-enhanced CT scan after oral contrast administration was performed that revealed dilated, clumped up small bowel loops in a ‘whorl-like’ pattern in right iliac fossa region. These obstructed loops were encased by a thick peritoneal membrane giving a ‘cocoon-like’ appearance. Also appreciated were scattered punctate calcific foci in jejunal walls and adjacent peritoneum along with mild ascites. On the basis of typical imaging findings, provisional diagnosis of tubercular cocoon abdomen was given that was later confirmed by laboratory investigations and diagnostic laparoscopy. Encapsulating peritoneal sclerosis or cocoon abdomen is an extremely rare cause of subacute intestinal obstruction. Further, cocoon abdomen in a background of abdominal tuberculosis is even rarer. However, this case report highlights the characteristic imaging findings for broader audience that enabled prompt diagnosis and appropriate clinical management in this case, achieving optimal clinical outcome.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"20 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141523175","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 : 2024-06-28DOI: 10.1186/s43055-024-01296-x
Lamiaa M. R. Khalaf, Mostafa A. M. El-Sharkawy, Mohamed Zedan, Khaled Rezk, Marwa Mosaed, Hosam M. Kamel
Pathological nipple discharge (PND) commonly caused by benign diseases, but occasionally it signifies a major medical concern. Ultrasonography, in addition to mammography, is regarded as the standard imaging modality in the diagnosis of PND but their sensitivity in some cases are low, subsequently we used a contrast enhanced mammography (CEDM) as supplementary diagnostic modality in patients with PND. The purpose of our study was to investigate the diagnostic efficacy of CEDM in evaluating PND patients, added values of incorporating the CEDM in the diagnostic workup of patients with PND and to demonstrate its diagnostic significance as a predictor of malignancy in these patients as there have been few studies that have addressed the role of CEDM in the evaluation of PND. Forty seven patients with PND were enrolled in this prospective study and underwent CEDM. The CEDM had high specificity (83.2%) compared to the combined sonomammography (SM) (59.3%), as there was a decrease in the number of false positive cases detected by the CEDM (6 cases) compared to the combined SM (11 cases). Combined (SM) had a moderate degree of agreement (55%, P = 0.01) with the final diagnosis, whereas CEDM had a strong degree of agreement (75%, P < 0.001). Additionally, the combined SM reported 76.6% accuracy with an area under the curve of 0.8, whereas the CEDM had 87.2% accuracy with an area under the curve of 0.89. CEDM had higher specificity, positive predictive value, and accuracy than SM in PND patients, along with its stronger agreement with the final pathology results, subsequently reduce the rate of false positive cases and the rate of recall back, making it a highly accurate malignancy predictor in those patients and can be an invaluable diagnostic imaging tool for identifying associated malignancies.
病理性乳头溢液（PND）通常由良性疾病引起，但偶尔也会引发重大的医学问题。除了乳房 X 光检查外，超声波检查也被认为是诊断 PND 的标准成像方式，但在某些病例中，超声波检查的灵敏度较低，因此我们使用对比增强乳房 X 光检查（CEDM）作为 PND 患者的辅助诊断方式。我们的研究旨在探讨对比增强乳腺 X 线造影在评估 PND 患者中的诊断效果、将对比增强乳腺 X 线造影纳入 PND 患者诊断工作中的附加价值，并证明对比增强乳腺 X 线造影作为这些患者恶性肿瘤预测指标的诊断意义，因为目前很少有研究探讨对比增强乳腺 X 线造影在评估 PND 中的作用。在这项前瞻性研究中，47 名 PND 患者接受了 CEDM 检查。CEDM 的特异性（83.2%）高于联合超声造影（59.3%），因为 CEDM 检测出的假阳性病例（6 例）少于联合超声造影（11 例）。联合（SM）与最终诊断的吻合程度为中等（55%，P = 0.01），而 CEDM 的吻合程度很高（75%，P < 0.001）。此外，联合 SM 的准确率为 76.6%，曲线下面积为 0.8，而 CEDM 的准确率为 87.2%，曲线下面积为 0.89。在PND患者中，CEDM比SM具有更高的特异性、阳性预测值和准确性，而且它与最终病理结果的一致性更强，从而降低了假阳性病例率和回访率，使其成为这些患者中高度准确的恶性肿瘤预测指标，并可成为鉴别相关恶性肿瘤的宝贵影像诊断工具。
{"title":"Contrast enhanced digital mammography as a predictor of breast cancer in patient with pathological nipple discharge","authors":"Lamiaa M. R. Khalaf, Mostafa A. M. El-Sharkawy, Mohamed Zedan, Khaled Rezk, Marwa Mosaed, Hosam M. Kamel","doi":"10.1186/s43055-024-01296-x","DOIUrl":"https://doi.org/10.1186/s43055-024-01296-x","url":null,"abstract":"Pathological nipple discharge (PND) commonly caused by benign diseases, but occasionally it signifies a major medical concern. Ultrasonography, in addition to mammography, is regarded as the standard imaging modality in the diagnosis of PND but their sensitivity in some cases are low, subsequently we used a contrast enhanced mammography (CEDM) as supplementary diagnostic modality in patients with PND. The purpose of our study was to investigate the diagnostic efficacy of CEDM in evaluating PND patients, added values of incorporating the CEDM in the diagnostic workup of patients with PND and to demonstrate its diagnostic significance as a predictor of malignancy in these patients as there have been few studies that have addressed the role of CEDM in the evaluation of PND. Forty seven patients with PND were enrolled in this prospective study and underwent CEDM. The CEDM had high specificity (83.2%) compared to the combined sonomammography (SM) (59.3%), as there was a decrease in the number of false positive cases detected by the CEDM (6 cases) compared to the combined SM (11 cases). Combined (SM) had a moderate degree of agreement (55%, P = 0.01) with the final diagnosis, whereas CEDM had a strong degree of agreement (75%, P < 0.001). Additionally, the combined SM reported 76.6% accuracy with an area under the curve of 0.8, whereas the CEDM had 87.2% accuracy with an area under the curve of 0.89. CEDM had higher specificity, positive predictive value, and accuracy than SM in PND patients, along with its stronger agreement with the final pathology results, subsequently reduce the rate of false positive cases and the rate of recall back, making it a highly accurate malignancy predictor in those patients and can be an invaluable diagnostic imaging tool for identifying associated malignancies.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"40 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141523174","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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