Pub Date : 2024-05-02DOI: 10.1186/s43055-024-01231-0
Sara Mohamed, Eman Abo Elhamd, Noha M. Attia
Non-mass enhancement (NME) seen on dynamic contrast enhanced breast MRI (DCE-MRI) may be caused by benign, high risk or malignant lesions. Making a clear distinction between these lesions is challenging due to the significant overlap in their imaging appearance. Our study aims to assess the various patterns of distribution, internal enhancement patterns (IEPs) and kinetics of NME using the BI-RADS lexicon fifth edition with histopathologic correlation to aid in making a more confident recommendation regarding clinical management. Sixty-six female patients with NME on DCE-MRI were included. Thirty-four lesions (51.5%) were histopathologically proven to be benign and 32 (48.5%) were malignant. Segmental distribution was the most common pattern and was found in 22 cases (33.3%), 14 of them were malignant with p-value < 0.05. Linear distribution was reported in 14 cases, (21.2%), five of which were malignant, with p-value > 0.05. Thirteen cases (19.7%) had focal distribution, only two of them were malignant with p-value < 0.05. Twelve cases (18.2%) were of regional distribution, seven of which were malignant. Multiregional and diffuse distribution were the least common and were found in 3% and 4.5% of cases respectively. As for the enhancement pattern, 30 cases (45.5%) had heterogeneous enhancement. Nineteen of which were malignant with a p-value < 0.05. Clumped enhancement was found in 24 cases (36.4%); 12 cases were found to be malignant. Nine cases (13.6%) were of homogeneous enhancement, all of them were benign and three cases (4.5%) were of clustered ring enhancement with p-value > 0.05. Restricted diffusion value was detected in 75% of malignant cases with p-value < 0.05. In terms of kinetic curve, the most frequent curve was found to be type II plateau curve (26 cases, 39.4%), 15 cases were of benign pathology and the other 11 cases were proven to be malignant. Followed by type III washout curve which was detected in 25 cases (37.9%), 20 cases were malignant and five cases were benign. And type I persistent curve was found in 15 cases (22.7%); 14 cases were histopathologically proven to be benign, and only one case was of malignant pathology, with a total p-value < 0.05. Our study found that the most common distribution pattern was segmental distribution, being statistically significant with p-value < 0.05, being more common among malignant lesions. As for the enhancement pattern, heterogeneous enhancement was the most common pattern, mainly detected in malignant lesions, with p-value < 0.05. The most common type of kinetic curve was type II curve.
{"title":"Non-mass enhancement on breast MRI: Clues to a more confident diagnosis","authors":"Sara Mohamed, Eman Abo Elhamd, Noha M. Attia","doi":"10.1186/s43055-024-01231-0","DOIUrl":"https://doi.org/10.1186/s43055-024-01231-0","url":null,"abstract":"Non-mass enhancement (NME) seen on dynamic contrast enhanced breast MRI (DCE-MRI) may be caused by benign, high risk or malignant lesions. Making a clear distinction between these lesions is challenging due to the significant overlap in their imaging appearance. Our study aims to assess the various patterns of distribution, internal enhancement patterns (IEPs) and kinetics of NME using the BI-RADS lexicon fifth edition with histopathologic correlation to aid in making a more confident recommendation regarding clinical management. Sixty-six female patients with NME on DCE-MRI were included. Thirty-four lesions (51.5%) were histopathologically proven to be benign and 32 (48.5%) were malignant. Segmental distribution was the most common pattern and was found in 22 cases (33.3%), 14 of them were malignant with p-value < 0.05. Linear distribution was reported in 14 cases, (21.2%), five of which were malignant, with p-value > 0.05. Thirteen cases (19.7%) had focal distribution, only two of them were malignant with p-value < 0.05. Twelve cases (18.2%) were of regional distribution, seven of which were malignant. Multiregional and diffuse distribution were the least common and were found in 3% and 4.5% of cases respectively. As for the enhancement pattern, 30 cases (45.5%) had heterogeneous enhancement. Nineteen of which were malignant with a p-value < 0.05. Clumped enhancement was found in 24 cases (36.4%); 12 cases were found to be malignant. Nine cases (13.6%) were of homogeneous enhancement, all of them were benign and three cases (4.5%) were of clustered ring enhancement with p-value > 0.05. Restricted diffusion value was detected in 75% of malignant cases with p-value < 0.05. In terms of kinetic curve, the most frequent curve was found to be type II plateau curve (26 cases, 39.4%), 15 cases were of benign pathology and the other 11 cases were proven to be malignant. Followed by type III washout curve which was detected in 25 cases (37.9%), 20 cases were malignant and five cases were benign. And type I persistent curve was found in 15 cases (22.7%); 14 cases were histopathologically proven to be benign, and only one case was of malignant pathology, with a total p-value < 0.05. Our study found that the most common distribution pattern was segmental distribution, being statistically significant with p-value < 0.05, being more common among malignant lesions. As for the enhancement pattern, heterogeneous enhancement was the most common pattern, mainly detected in malignant lesions, with p-value < 0.05. The most common type of kinetic curve was type II curve.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"28 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140835420","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 : 2024-04-30DOI: 10.1186/s43055-024-01257-4
C. S. Sreehari, Jyoti Gupta, Rupi Jamwal
Pelvic dermoid cysts are extremely rare in males, with an even rare occurrence of rupture. Only a handful of cases of male pelvic dermoid cysts have been published with no reported case of ruptured male pelvic dermoid causing small bowel obstruction to the best of our knowledge. Herein we report a case of ruptured pelvic dermoid presenting with intestinal obstruction in an adult male patient with situs inversus totalis. Pelvic dermoid cyst should be considered even in males the presence of classical radiological signs. Knowledge of usual and unusual imaging signs as well as the associated life-threatening complications of a ruptured dermoid cyst can help in prompt diagnosis and timely patient management.
{"title":"Small bowel obstruction in ruptured male pelvic dermoid with situs inversus totalis: a singular case presentation","authors":"C. S. Sreehari, Jyoti Gupta, Rupi Jamwal","doi":"10.1186/s43055-024-01257-4","DOIUrl":"https://doi.org/10.1186/s43055-024-01257-4","url":null,"abstract":"Pelvic dermoid cysts are extremely rare in males, with an even rare occurrence of rupture. Only a handful of cases of male pelvic dermoid cysts have been published with no reported case of ruptured male pelvic dermoid causing small bowel obstruction to the best of our knowledge. Herein we report a case of ruptured pelvic dermoid presenting with intestinal obstruction in an adult male patient with situs inversus totalis. Pelvic dermoid cyst should be considered even in males the presence of classical radiological signs. Knowledge of usual and unusual imaging signs as well as the associated life-threatening complications of a ruptured dermoid cyst can help in prompt diagnosis and timely patient management.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"116 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140835282","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 : 2024-04-30DOI: 10.1186/s43055-024-01254-7
R. Rashma, Jyoti Kumar, Anju Garg, Radhika Batra, Ravi Meher, Ankita Phulia
To compare the image quality of normal anatomical structures and radiation dose on low-dose (LDCT) and standard-dose (SDCT) temporal bone CT in children. The study included 45 LDCT (80 kV and 130 mAs) and 45 SDCT (120 kV and 170 mAs) scans in children, 1–15 years of age. LDCT and SDCT scans were analyzed on H60s and H70h reconstruction kernels, respectively. Two readers assessed the image quality for 25 anatomical structures, using a 5-point scale. A score of 3 and above was considered “sufficient” and 2 and below was considered “insufficient” image quality. Image noise, contrast, age and size-specific effective doses were calculated. Despite an increase in image noise on LDCT, image quality remained sufficient for most structures owing to increased image contrast. The median effective dose on LDCT, calculated with age-specific conversion factor, decreased by 72.9% and that calculated with size-specific conversion factor decreased by 81.8% compared to the dose on SDCT. LDCT provides comparable image quality for evaluation of temporal bone with significant reduction in radiation dose in children.
{"title":"Low-dose versus standard-dose normal temporal bone CT in children: a comparison study","authors":"R. Rashma, Jyoti Kumar, Anju Garg, Radhika Batra, Ravi Meher, Ankita Phulia","doi":"10.1186/s43055-024-01254-7","DOIUrl":"https://doi.org/10.1186/s43055-024-01254-7","url":null,"abstract":"To compare the image quality of normal anatomical structures and radiation dose on low-dose (LDCT) and standard-dose (SDCT) temporal bone CT in children. The study included 45 LDCT (80 kV and 130 mAs) and 45 SDCT (120 kV and 170 mAs) scans in children, 1–15 years of age. LDCT and SDCT scans were analyzed on H60s and H70h reconstruction kernels, respectively. Two readers assessed the image quality for 25 anatomical structures, using a 5-point scale. A score of 3 and above was considered “sufficient” and 2 and below was considered “insufficient” image quality. Image noise, contrast, age and size-specific effective doses were calculated. Despite an increase in image noise on LDCT, image quality remained sufficient for most structures owing to increased image contrast. The median effective dose on LDCT, calculated with age-specific conversion factor, decreased by 72.9% and that calculated with size-specific conversion factor decreased by 81.8% compared to the dose on SDCT. LDCT provides comparable image quality for evaluation of temporal bone with significant reduction in radiation dose in children.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"38 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140835280","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 : 2024-04-30DOI: 10.1186/s43055-024-01258-3
Walaa Gouda, Rabab Yasin, Mohamed Ibrahim Yasin, Suzan Omar
Full-field digital mammography (FFDM) is the primary screening method for breast cancer, yet the number of cancers that can be missed with mammography is considerable, notably in female with dense breast. In this study, we compared the diagnostic yield and the clinical significance of FFDM for breast cancer detection in female with dense breasts versus its performance when complemented by automated breast ultrasound (ABUS). This retrospective study was performed during the period between January 2022 and December 2022 including 500 females with dense breast (ACR C&D), who underwent screening using FFDM and ABUS. The images were retrospectively interpreted, and statistical assessments were done comparing the FFDM results alone and after complemented with ABUS. Significance was considered at a p value less than 0.05. The use of FFDM with supplemental ABUS has reduced the numbers of recall and showed improved breast cancer detection with increased positive predictive value (from 74.5 to 83.5%). In comparison, using FFDM alone and associated with ABUS, there was moderate agreement with a kappa test of 0.51; p < 0.001. ABUS can be a useful and powerful diagnostic imaging tool when adjunct to FFDM for screening of dense breast. In this study, ABUS showed less false-negative results and improved the sensitivity of cancer detection.
{"title":"Automated breast ultrasound in breast cancer screening of mammographically dense breasts: added values","authors":"Walaa Gouda, Rabab Yasin, Mohamed Ibrahim Yasin, Suzan Omar","doi":"10.1186/s43055-024-01258-3","DOIUrl":"https://doi.org/10.1186/s43055-024-01258-3","url":null,"abstract":"Full-field digital mammography (FFDM) is the primary screening method for breast cancer, yet the number of cancers that can be missed with mammography is considerable, notably in female with dense breast. In this study, we compared the diagnostic yield and the clinical significance of FFDM for breast cancer detection in female with dense breasts versus its performance when complemented by automated breast ultrasound (ABUS). This retrospective study was performed during the period between January 2022 and December 2022 including 500 females with dense breast (ACR C&D), who underwent screening using FFDM and ABUS. The images were retrospectively interpreted, and statistical assessments were done comparing the FFDM results alone and after complemented with ABUS. Significance was considered at a p value less than 0.05. The use of FFDM with supplemental ABUS has reduced the numbers of recall and showed improved breast cancer detection with increased positive predictive value (from 74.5 to 83.5%). In comparison, using FFDM alone and associated with ABUS, there was moderate agreement with a kappa test of 0.51; p < 0.001. ABUS can be a useful and powerful diagnostic imaging tool when adjunct to FFDM for screening of dense breast. In this study, ABUS showed less false-negative results and improved the sensitivity of cancer detection.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"129 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140835275","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 : 2024-04-18DOI: 10.1186/s43055-024-01252-9
Rania Mostafa A. Hassan, Saeed Abdel Monem Ebrahim, Marwa Rashad Ahmad Kamal, Heba Fathy Ahmad Tantawy
Adnexal masses (AMs) are prevalent, leading to a substantial clinical effort including imaging for diagnosis, surgery, and pathology. The goal of this research was to evaluate the reliability of the Ovarian-Adnexal Reporting Data System Magnetic Resonance Imaging (O-RADS MRI) scale for diagnosing the sonographically indeterminate adnexal masses and to discriminate between malignant and benign ones using the O-RADS MRI scoring system. This study included 72 cases with indeterminate adnexal masses in any age group. We excluded patients with previous history of operated adnexal lesion and patients who had contraindications for MRI as pacemakers or iron clips. Based on O-RADS MRI score, 44.4% of masses were diagnosed as O-RADS II indicating that they were almost certainly benign, 11.1% as O-RADS III indicating low risk malignancy, 8.3% as O-RADS IV indicating intermediate risk malignancy and 36.1% were diagnosed as O-RADS V indicating high risk malignancy. O-RADS MRI score for malignancy gave sensitivity of 92.31% (95%CI 63.97–99.81), specificity of 82.61% (95%CI 61.22–95.05), PPV of 75% (95%CI 54.84–88.11) and NPV of 95% (95%CI 74.12–99.21) with an overall accuracy of 86.11% (95%CI 70.50–95.33). The O-RADS MRI score has excellent accuracy and validity in determining whether an AM is malignant or benign. Using this score in clinical practice may enable a tailored, patient-centered approach for masses that are sonographically indeterminate, avoiding unnecessary surgery, and in certain cases allows less extensive surgery, or even fertility preservation when appropriate.
附件肿块（AMs）很常见，临床上需要进行大量的工作，包括影像诊断、手术和病理检查。本研究的目的是评估卵巢-附件报告数据系统磁共振成像（O-RADS MRI）量表诊断声像图不确定附件肿块的可靠性，并使用 O-RADS MRI 评分系统区分恶性和良性肿块。本研究纳入了 72 例任何年龄段的未确定附件肿块患者。我们排除了既往有附件病变手术史的患者，以及有心脏起搏器或铁夹等磁共振成像禁忌症的患者。根据 O-RADS MRI 评分，44.4% 的肿块被诊断为 O-RADS II 级，表示几乎肯定是良性的；11.1% 被诊断为 O-RADS III 级，表示恶性风险低；8.3% 被诊断为 O-RADS IV 级，表示恶性风险中等；36.1% 被诊断为 O-RADS V 级，表示恶性风险高。恶性肿瘤的 O-RADS MRI 评分敏感性为 92.31%（95%CI 63.97-99.81），特异性为 82.61%（95%CI 61.22-95.05），PPV 为 75%（95%CI 54.84-88.11），NPV 为 95%（95%CI 74.12-99.21），总体准确性为 86.11%（95%CI 70.50-95.33）。O-RADS MRI 评分在确定 AM 是恶性还是良性方面具有极高的准确性和有效性。在临床实践中使用该评分可为声像图无法确定的肿块提供量身定制的、以患者为中心的方法，避免不必要的手术，在某些情况下可减少手术范围，甚至在适当时保留生育能力。
{"title":"The impact of using ovarian-adnexal reporting data system magnetic resonance imaging (O-RADS MRI) score on risk stratification of sonographically indeterminate adnexal masses","authors":"Rania Mostafa A. Hassan, Saeed Abdel Monem Ebrahim, Marwa Rashad Ahmad Kamal, Heba Fathy Ahmad Tantawy","doi":"10.1186/s43055-024-01252-9","DOIUrl":"https://doi.org/10.1186/s43055-024-01252-9","url":null,"abstract":"Adnexal masses (AMs) are prevalent, leading to a substantial clinical effort including imaging for diagnosis, surgery, and pathology. The goal of this research was to evaluate the reliability of the Ovarian-Adnexal Reporting Data System Magnetic Resonance Imaging (O-RADS MRI) scale for diagnosing the sonographically indeterminate adnexal masses and to discriminate between malignant and benign ones using the O-RADS MRI scoring system. This study included 72 cases with indeterminate adnexal masses in any age group. We excluded patients with previous history of operated adnexal lesion and patients who had contraindications for MRI as pacemakers or iron clips. Based on O-RADS MRI score, 44.4% of masses were diagnosed as O-RADS II indicating that they were almost certainly benign, 11.1% as O-RADS III indicating low risk malignancy, 8.3% as O-RADS IV indicating intermediate risk malignancy and 36.1% were diagnosed as O-RADS V indicating high risk malignancy. O-RADS MRI score for malignancy gave sensitivity of 92.31% (95%CI 63.97–99.81), specificity of 82.61% (95%CI 61.22–95.05), PPV of 75% (95%CI 54.84–88.11) and NPV of 95% (95%CI 74.12–99.21) with an overall accuracy of 86.11% (95%CI 70.50–95.33). The O-RADS MRI score has excellent accuracy and validity in determining whether an AM is malignant or benign. Using this score in clinical practice may enable a tailored, patient-centered approach for masses that are sonographically indeterminate, avoiding unnecessary surgery, and in certain cases allows less extensive surgery, or even fertility preservation when appropriate.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"60 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140610987","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 : 2024-04-16DOI: 10.1186/s43055-024-01253-8
Hammed A. Ninalowo, Peter T. Adenigba, Aderemi O. Oluyemi
A major challenge of either endoscopic or percutaneous approach to placing palliative biliary stents is the difficulty in traversing tight perihilar malignant obstructions. This can be overcome with a rendezvous approach (combined endoscopic retrograde cholangiopancreatography (ERCP)/percutaneous approach) or may require initial placement of an external drain and reattempting later. Interventional radiology for biliary obstruction is still in infant days in our locality. Herein, we describe two cases of perihilar malignant biliary obstruction (MBO) managed at a private facility in Lagos, Nigeria, in which we had to come up with a creative approach to crossing these tight junctions in the absence of ERCP facilities. This was done by securing percutaneous retrograde access into the common bile duct and combining it with the initially unsuccessful anterograde approach. In both cases, this combined percutaneous anterograde/retrograde approach resulted in successful traversal of the malignant obstruction and placement of internal biliary stents. We present the case of two elderly patients with tight malignant biliary obstruction (MBO), one from a suspected cholangiocarcinoma and the other from hepatic metastatic colorectal carcinoma. Both patients had successful traversal of the obstruction via a combined percutaneous anterograde/retrograde approach and biliary stenting. Our case reports demonstrate an unusual approach that should assist interventional radiologists in resource-limited setting who seek for a viable option to those presently available for traversing perihilar MBOs in the percutaneous placement of internal stents.
{"title":"Overcoming tight perihilar malignant biliary obstructions during percutaneous biliary intervention in Nigerian patients: case reports","authors":"Hammed A. Ninalowo, Peter T. Adenigba, Aderemi O. Oluyemi","doi":"10.1186/s43055-024-01253-8","DOIUrl":"https://doi.org/10.1186/s43055-024-01253-8","url":null,"abstract":"A major challenge of either endoscopic or percutaneous approach to placing palliative biliary stents is the difficulty in traversing tight perihilar malignant obstructions. This can be overcome with a rendezvous approach (combined endoscopic retrograde cholangiopancreatography (ERCP)/percutaneous approach) or may require initial placement of an external drain and reattempting later. Interventional radiology for biliary obstruction is still in infant days in our locality. Herein, we describe two cases of perihilar malignant biliary obstruction (MBO) managed at a private facility in Lagos, Nigeria, in which we had to come up with a creative approach to crossing these tight junctions in the absence of ERCP facilities. This was done by securing percutaneous retrograde access into the common bile duct and combining it with the initially unsuccessful anterograde approach. In both cases, this combined percutaneous anterograde/retrograde approach resulted in successful traversal of the malignant obstruction and placement of internal biliary stents. We present the case of two elderly patients with tight malignant biliary obstruction (MBO), one from a suspected cholangiocarcinoma and the other from hepatic metastatic colorectal carcinoma. Both patients had successful traversal of the obstruction via a combined percutaneous anterograde/retrograde approach and biliary stenting. Our case reports demonstrate an unusual approach that should assist interventional radiologists in resource-limited setting who seek for a viable option to those presently available for traversing perihilar MBOs in the percutaneous placement of internal stents.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"55 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140589681","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 : 2024-04-12DOI: 10.1186/s43055-024-01248-5
Alaa Mohamed Reda, Ahmed Elsharkawy, Mostafa Mamdouh Kamel, Sara Essam Hasby
Smartphones provide various functions that facilitate our communication, organization, and entertainment in different situations. Diffusion tensor imaging (DTI) is a method measuring tissue microstructure as well as white matter integrity of the brain and detecting early changes. Several research studies recently aim to utilize conventional MRI for assessing brain structural alterations among smartphone users, but our study was aimed at identifying the DTI value while assessing white matter alterations in Egyptian youth with smartphone dependence. Our prospective case–control study involved fifty-three individuals with smart phone dependence (SPD group) as well as twenty-five volunteers who represented the control group. SPD individuals and controls were right-handed. The SPD group mean age exhibited 20.54 ± 1.56 years, while controls exhibited 26.8 ± 15.1 years. When utilizing smart phone addiction scale-short version, SPD group median total score exhibited 33. The diagnostic performance of fornix (fractional anisotropy) FA and external capsule fractional anisotropy (EC FA) regarding area under curve (AUC) exhibited significant increase as opposed to all other tested regions, with a sensitivity of 90.6% as well as a specificity of 96%. While regarding the mean diffusivity (MD), the greatest (AUC) was for EC (0.927, p < 0.001), in which the MD value = 0.825 was the cutoff value and able to diagnose the smart phone dependency with a sensitivity of 92.5% as well as a specificity of 76%. Quantitative DTI parameters (FA, MD) in different white matter regions can diagnose and detect white matter changes in excessive smartphone users even when conventional MRI data are normal. This study demonstrates the recent noninvasive MRI technique value while revealing covered brain white matter alterations in Egyptian youth due to smartphone overuse.
{"title":"Alterations in white matter integrity in Egyptian youth with smartphone dependence: does DTI have a role?","authors":"Alaa Mohamed Reda, Ahmed Elsharkawy, Mostafa Mamdouh Kamel, Sara Essam Hasby","doi":"10.1186/s43055-024-01248-5","DOIUrl":"https://doi.org/10.1186/s43055-024-01248-5","url":null,"abstract":"Smartphones provide various functions that facilitate our communication, organization, and entertainment in different situations. Diffusion tensor imaging (DTI) is a method measuring tissue microstructure as well as white matter integrity of the brain and detecting early changes. Several research studies recently aim to utilize conventional MRI for assessing brain structural alterations among smartphone users, but our study was aimed at identifying the DTI value while assessing white matter alterations in Egyptian youth with smartphone dependence. Our prospective case–control study involved fifty-three individuals with smart phone dependence (SPD group) as well as twenty-five volunteers who represented the control group. SPD individuals and controls were right-handed. The SPD group mean age exhibited 20.54 ± 1.56 years, while controls exhibited 26.8 ± 15.1 years. When utilizing smart phone addiction scale-short version, SPD group median total score exhibited 33. The diagnostic performance of fornix (fractional anisotropy) FA and external capsule fractional anisotropy (EC FA) regarding area under curve (AUC) exhibited significant increase as opposed to all other tested regions, with a sensitivity of 90.6% as well as a specificity of 96%. While regarding the mean diffusivity (MD), the greatest (AUC) was for EC (0.927, p < 0.001), in which the MD value = 0.825 was the cutoff value and able to diagnose the smart phone dependency with a sensitivity of 92.5% as well as a specificity of 76%. Quantitative DTI parameters (FA, MD) in different white matter regions can diagnose and detect white matter changes in excessive smartphone users even when conventional MRI data are normal. This study demonstrates the recent noninvasive MRI technique value while revealing covered brain white matter alterations in Egyptian youth due to smartphone overuse.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"9 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140589668","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 : 2024-04-12DOI: 10.1186/s43055-024-01247-6
Salma M. Borg, Gehad A. Saleh, Nihal M. Batouty, Amani Ezzat Mousa
Lymphoma is the most common primary hematological malignancy. FDG PET/CT has recently become the standard imaging modality for clinical management owing to its ability to provide precise, non-invasive anatomical and functional data. The purpose of this study was to highlight the role of 18F FDG-PET/CT in the management of lymphoma by monitoring treatment response, providing a guide for response-adapted therapy, and predicting the final therapeutic outcome. This was a prospective monocentric cohort observational study in which thirty-three patients with histopathologically proved lymphoma of different types performed FDG-PET/CT scanning several times throughout the 24-month duration of the study. Early-stage interim SUVmax of the most active lesion (both nodal and/or extra-nodal) was measured and statistically analyzed together with data of the international prognostic index parameters and score. Among the included 33 patients of lymphoma, international prognostic index parameters and score together with the early-stage interim SUVmax of the predominant nodal and extra-nodal sites showed statistical significance in predicting the initial as well as the final treatment response after 24 months. Using ROC analysis, we could obtain cutoff values of SUVmax of the predominant nodal lesion of 2.75 (AUC 72%, 95% CI 0.42–1.0) and SUVmax of the predominant extra-nodal lesion of 3 (AUC 70.8% and 95% CI 0.23–1.0); therefore, SUVmax of higher than these values was related to stable or progressive disease, and lower levels than these values were related to complete or partial metabolic response based on Deauville 5-point scale and Lugano response criteria. Early-stage interim PET-CT SUVmax of the predominant nodal and extra-nodal lesion could be a reliable parameter in predicting initial and final therapeutic outcome in lymphoma patients.
{"title":"Role of interim positron emission tomography/computed tomography in assessment of lymphoma treatment response","authors":"Salma M. Borg, Gehad A. Saleh, Nihal M. Batouty, Amani Ezzat Mousa","doi":"10.1186/s43055-024-01247-6","DOIUrl":"https://doi.org/10.1186/s43055-024-01247-6","url":null,"abstract":"Lymphoma is the most common primary hematological malignancy. FDG PET/CT has recently become the standard imaging modality for clinical management owing to its ability to provide precise, non-invasive anatomical and functional data. The purpose of this study was to highlight the role of 18F FDG-PET/CT in the management of lymphoma by monitoring treatment response, providing a guide for response-adapted therapy, and predicting the final therapeutic outcome. This was a prospective monocentric cohort observational study in which thirty-three patients with histopathologically proved lymphoma of different types performed FDG-PET/CT scanning several times throughout the 24-month duration of the study. Early-stage interim SUVmax of the most active lesion (both nodal and/or extra-nodal) was measured and statistically analyzed together with data of the international prognostic index parameters and score. Among the included 33 patients of lymphoma, international prognostic index parameters and score together with the early-stage interim SUVmax of the predominant nodal and extra-nodal sites showed statistical significance in predicting the initial as well as the final treatment response after 24 months. Using ROC analysis, we could obtain cutoff values of SUVmax of the predominant nodal lesion of 2.75 (AUC 72%, 95% CI 0.42–1.0) and SUVmax of the predominant extra-nodal lesion of 3 (AUC 70.8% and 95% CI 0.23–1.0); therefore, SUVmax of higher than these values was related to stable or progressive disease, and lower levels than these values were related to complete or partial metabolic response based on Deauville 5-point scale and Lugano response criteria. Early-stage interim PET-CT SUVmax of the predominant nodal and extra-nodal lesion could be a reliable parameter in predicting initial and final therapeutic outcome in lymphoma patients.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"55 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140589671","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 : 2024-04-10DOI: 10.1186/s43055-024-01250-x
Manar Mansour, Ali H. Elmokadem, Ahmed A. Abd Elrazek, Ayman Hammad, Marwa R. Abd-Almoaty, Khadiga M. Ali, Dina Abdalla Ibrahim, Tarek Elsayed Barakat
Children with chronic kidney disease (CKD) usually present with disease impact on growth besides cardiovascular problems that not only impact the patient's health during childhood but also affect their adult life. We aimed to identify the diagnostic role of diffusion tensor imaging (DTI) in CKD in pediatric using its metrics: apparent diffusion coefficient (ADC) and fraction anisotropy (FA). This prospective study was performed on thirty-five CKD patients (16 girls, 19 boys; mean age 12.3 ± 2.6 years) and 19 sex- and age-matched controls. Both groups underwent renal DTI and renal function tests. Based on renal biopsy, patients with CKD were further categorized into sclerotic CKD (n = 25) and non-sclerotic CKD (n = 10). Mean FA renal medulla/cortex in CKD (0.18 ± 0.18 and 0.20 ± 0.17) was lower significantly (p = 0.001) than volunteers' (0.31 ± 0.19, 0.27 ± 0.18). The cutoff FA of renal medulla/cortex used for CKD diagnosis was 0.22 and 0.23 with AUC of 0.828, 0.838 and accuracy of 80.8%, 82.8%. Mean of renal medulla/cortex ADC in CKD (2.13 ± 0.23 and 1.93 ± 0.22 × 10−3 mm2/s) was higher significantly (p = 0.001) than that of volunteers' (1.67 ± 0.15 and 1.64 ± 0.133 × 10−3 mm2/s. ADC cutoff value of renal medulla/cortex used for CKD diagnosis was 1.86 and 1.74 × 10−3 mm2/s with AUC of 0.827, 0.82, 0.827, and 0.911, and accuracy of 80.6%, 79.6%, 82.8%, and 84.2%. Renal medulla/cortex FA in sclerotic CKD was significantly different (p = 0.001) from non-sclerotic CKD (0.25 ± 0.07 and 0.26 ± 0.08). Cortical and medullary FA in CKD patients correlated with e-GFR (r = 0.363, r = 0.317) and serum creatinine (r = − 0.467, r = − 0.383). Renal cortical/medullary FA can assist in diagnosing pediatric CKD, predict sclerotic CKD, and correlate with some serum biomarkers.
{"title":"The diagnostic efficacy of diffusion tensor imaging in children with chronic kidney disease: correlation with histopathology and serum biomarkers","authors":"Manar Mansour, Ali H. Elmokadem, Ahmed A. Abd Elrazek, Ayman Hammad, Marwa R. Abd-Almoaty, Khadiga M. Ali, Dina Abdalla Ibrahim, Tarek Elsayed Barakat","doi":"10.1186/s43055-024-01250-x","DOIUrl":"https://doi.org/10.1186/s43055-024-01250-x","url":null,"abstract":"Children with chronic kidney disease (CKD) usually present with disease impact on growth besides cardiovascular problems that not only impact the patient's health during childhood but also affect their adult life. We aimed to identify the diagnostic role of diffusion tensor imaging (DTI) in CKD in pediatric using its metrics: apparent diffusion coefficient (ADC) and fraction anisotropy (FA). This prospective study was performed on thirty-five CKD patients (16 girls, 19 boys; mean age 12.3 ± 2.6 years) and 19 sex- and age-matched controls. Both groups underwent renal DTI and renal function tests. Based on renal biopsy, patients with CKD were further categorized into sclerotic CKD (n = 25) and non-sclerotic CKD (n = 10). Mean FA renal medulla/cortex in CKD (0.18 ± 0.18 and 0.20 ± 0.17) was lower significantly (p = 0.001) than volunteers' (0.31 ± 0.19, 0.27 ± 0.18). The cutoff FA of renal medulla/cortex used for CKD diagnosis was 0.22 and 0.23 with AUC of 0.828, 0.838 and accuracy of 80.8%, 82.8%. Mean of renal medulla/cortex ADC in CKD (2.13 ± 0.23 and 1.93 ± 0.22 × 10−3 mm2/s) was higher significantly (p = 0.001) than that of volunteers' (1.67 ± 0.15 and 1.64 ± 0.133 × 10−3 mm2/s. ADC cutoff value of renal medulla/cortex used for CKD diagnosis was 1.86 and 1.74 × 10−3 mm2/s with AUC of 0.827, 0.82, 0.827, and 0.911, and accuracy of 80.6%, 79.6%, 82.8%, and 84.2%. Renal medulla/cortex FA in sclerotic CKD was significantly different (p = 0.001) from non-sclerotic CKD (0.25 ± 0.07 and 0.26 ± 0.08). Cortical and medullary FA in CKD patients correlated with e-GFR (r = 0.363, r = 0.317) and serum creatinine (r = − 0.467, r = − 0.383). Renal cortical/medullary FA can assist in diagnosing pediatric CKD, predict sclerotic CKD, and correlate with some serum biomarkers.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"164 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140589888","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 : 2024-04-10DOI: 10.1186/s43055-024-01251-w
Priyank Sood, Jyoti Gupta, Rupesh Tholia
Twin pregnancy comprising of a complete hydatidiform mole with a coexisting twin live fetus is an uncommon condition with an incidence rate of 1 in 20,000 to 1 in 100,000 pregnancies, more so in assisted reproductive technologies. The primary diagnosis is made on ultrasound and adjunct fetal MRI helps in unequivocally differentiating it from other disorder. We present a case report of a twin pregnancy consisting of complete hydatidiform mole with a coexisting twin live fetus in a 27-year-old primigravida conception, primarily focusing on its diagnostic algorithm and related clinical aspects, adding to the paucity of existing literature. Following the correct diagnostic algorithm with imaging studies like USG and more importantly MRI, combined with the bioclinical picture helps in reaching the accurate diagnosis.
{"title":"Complete hydatidiform mole with a coexisting twin live fetus (CHMTF): the uncommon diagnostic enigma—simplified","authors":"Priyank Sood, Jyoti Gupta, Rupesh Tholia","doi":"10.1186/s43055-024-01251-w","DOIUrl":"https://doi.org/10.1186/s43055-024-01251-w","url":null,"abstract":"Twin pregnancy comprising of a complete hydatidiform mole with a coexisting twin live fetus is an uncommon condition with an incidence rate of 1 in 20,000 to 1 in 100,000 pregnancies, more so in assisted reproductive technologies. The primary diagnosis is made on ultrasound and adjunct fetal MRI helps in unequivocally differentiating it from other disorder. We present a case report of a twin pregnancy consisting of complete hydatidiform mole with a coexisting twin live fetus in a 27-year-old primigravida conception, primarily focusing on its diagnostic algorithm and related clinical aspects, adding to the paucity of existing literature. Following the correct diagnostic algorithm with imaging studies like USG and more importantly MRI, combined with the bioclinical picture helps in reaching the accurate diagnosis.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"6 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140589685","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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