Proton density fat fraction (PDFF) MRI for differentiation of benign and malignant vertebral lesions.

Science.gov (United States)

Schmeel, Frederic Carsten; Luetkens, Julian Alexander; Wagenhäuser, Peter Johannes; Meier-Schroers, Michael; Kuetting, Daniel Lloyd; Feißt, Andreas; Gieseke, Jürgen; Schmeel, Leonard Christopher; Träber, Frank; Schild, Hans Heinz; Kukuk, Guido Matthias

2018-06-01

To investigate whether proton density fat fraction (PDFF) measurements using a six-echo modified Dixon sequence can help to differentiate between benign and malignant vertebral bone marrow lesions. Sixty-six patients were prospectively enrolled in our study. In addition to conventional MRI at 3.0-Tesla including at least sagittal T2-weighted/spectral attenuated inversion recovery and T1-weighted sequences, all patients underwent a sagittal six-echo modified Dixon sequence of the spine. The mean PDFF was calculated using regions of interest and compared between vertebral lesions. A cut-off value of 6.40% in PDFF was determined by receiver operating characteristic curves and used to differentiate between malignant (benign and malignant vertebral lesions with a high diagnostic accuracy. • Establishing a diagnosis of indeterminate vertebral lesions is a common clinical problem • Benign bone marrow processes may mimic the signal alterations observed in malignancy • PDFF differentiates between benign and malignant lesions with a high diagnostic accuracy • PDFF of non-neoplastic vertebral lesions is significantly higher than that of malignancy • PDFF from six-echo modified Dixon may help avoid potentially harmful bone biopsy.

Diagnostic importance of 18F-FDG PET/CT parameters and total lesion glycolysis in differentiating between benign and malignant adrenal lesions.

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Ciftci, Esra; Turgut, Bulent; Cakmakcilar, Ali; Erturk, Seyit A

2017-09-01

Benign adrenal lesions are prevalent in oncologic imaging and make metastatic disease diagnoses difficult. This study evaluates the diagnostic importance of metabolic, volumetric, and metabolovolumetric parameters measured by fluorine-18-fluorodeoxyglucose (F-FDG) PET/CT in differentiating between benign and malignant adrenal lesions in cancer patients. In this retrospective study, we evaluated F-FDG PET/CT parameters of adrenal lesions of follow-up cancer patients referred to our clinic between January 2012 and November 2016. The diagnosis of adrenal malignant lesions was made on the basis of interval growth or reduction after chemotherapy. Patient demographics, analysis of metabolic parameters such as maximum standard uptake value (SUVmax), tumor SUVmax/liver SUVmean ratio (T/LR), morphologic parameters such as size, Hounsfield Units, and computed tomography (CT) volume, and metabolovolumetric parameters such as metabolic tumor volume and total lesion glycolysis (TLG) of adrenal lesions were calculated. PET/CT parameters were assessed using the Mann-Whitney U-test and receiving operating characteristic analysis. In total, 186 adrenal lesions in 163 cancer patients (108 men/54 women; mean±SD age: 64±10.9 years) were subjected to F-FDG PET/CT for tumor evaluation. SUVmax values (mean±SD) were 2.8±0.8 and 10.6±6; TLG were 10.8±9.2 and 124.4±347.9; and T/LR were 1±0.3 and 4.1±2.6 in benign and malignant adrenal lesions, respectively. On the basis of the area under the curve, adrenal lesion SUVmax and T/LR had similar highest diagnostic performance for predicting malignant lesions (area under the curve: 0.993 and 0.991, respectively, P<0.001). Multivariate logistic regression analysis showed that T/LR, adrenal lesion SUVmax, and Hounsfield Units were independent predictive factors for malignancy rather than TLG. Irrespective of whether TLG was statistically highly significant for differentiating benign from malignant adrenal lesions, it did not reach the

Malignant pulmonary lesion. Possible causes of CT misdiagnosis

International Nuclear Information System (INIS)

Mancini, J.; Feragalli, B.; Ciccotosto, C.; Storto, M.L.; Guidotti, A.

1999-01-01

The purpose of this work is to describe the radiological appearance of overlooked malignant pulmonary lesions at CT and to analyze the reasons of misdiagnosis. Ten patient with pulmonary lesion (PML) overlooked at forst CT examination were selected among patients with lung cancer. Endobronchial location of the tumors and their small size were the most frequent causes of misdiagnosis of PML at chest CT in the series. However, a systematic evaluation of CT scans can reduce the percentage of missed lesions [it

Elastography for the differentiation of benign and malignant liver lesions: a meta-analysis.

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Ma, Xuelei; Zhan, Wenli; Zhang, Binglan; Wei, Benling; Wu, Xin; Zhou, Min; Liu, Lei; Li, Ping

2014-05-01

The objective of this paper was to evaluate the overall accuracy of elastography in the diagnosis of benign and malignant liver lesions by liver biopsy as the gold standard. Literature databases were searched. The studies which were related to evaluate the diagnostic value of elastography for differentiation in benign and malignant liver lesions in English or Chinese were included. The summary receiver operating characteristic (SROC) curve was performed, and the areas under the curve (AUC) were also calculated to present the accuracy of the elastography for the diagnosis of benign and malignant liver lesions. Six studies which included a total of 448 liver lesions in 384 patients were analyzed. The summary sensitivity and specificity of elastography for the differentiation of malignant liver lesions were 85% (95% CI, 80 to 89%) and 84% (95% CI, 80 to 88%), respectively. And the summary diagnostic odds ratio was 46.33 (95% CI, 15.22 to 141.02), and the SROC was 0.9328. Elastography has a high sensitivity and specificity differentiation for benign and malignant liver lesions. As a non-invasive method, it is promising to be applied to clinical practice. To estimate elastography objectively, a large, prospective, international, and multi-center study is still needed.

Cholestatic jaundice by malignant lesions: pictorial essay

International Nuclear Information System (INIS)

Santa Anna, Tatiana Kelly Brasileiro de; Santana, Alex Menezes; Rizzuto, Mauricio Soares; Chagas, Alessandro Rosa Rodrigues; Zuppani, Aguinaldo Cunha; Rezende, Marcelo Bruno; Viveiros, Marcelo de Melo

2009-01-01

Malignant obstructive jaundice is most commonly caused by cancer of pancreatic head, papilla tumor, cholangiocarcinoma and biliary obstruction induced by secondary lesions of the liver or lymph nodes. Patients usually present with weight loss, abdominal pain, jaundice and progressive increase of direct bilirubin, being essential the evaluation by imaging methods for the proper diagnosis, staging and therapeutic planning. This essay illustrates the imaging aspects of ultrasound and computed tomography - and in specific situations magnetic resonance cholangiography - of the major malignancies that lead to cholestatic jaundice. (author)

Use of shear wave elastography to differentiate benign and malignant breast lesions.

Science.gov (United States)

Çebi Olgun, Deniz; Korkmazer, Bora; Kılıç, Fahrettin; Dikici, Atilla Süleyman; Velidedeoğlu, Mehmet; Aydoğan, Fatih; Kantarcı, Fatih; Yılmaz, Mehmet Halit

2014-01-01

We aimed to determine the correlations between the elasticity values of solid breast masses and histopathological findings to define cutoff elasticity values differentiating malignant from benign lesions. A total of 115 solid breast lesions of 109 consecutive patients were evaluated prospectively using shear wave elastography (SWE). Two orthogonal elastographic images of each lesion were obtained. Minimum, mean, and maximum elasticity values were calculated in regions of interest placed over the stiffest areas on the two images; we also calculated mass/fat elasticity ratios. Correlation of elastographic measurements with histopathological results were studied. Eighty-three benign and thirty-two malignant lesions were histopathologically diagnosed. The minimum, mean, and maximum elasticity values, and the mass/fat elasticity ratios of malignant lesions, were significantly higher than those of benign lesions. The cutoff value was 45.7 kPa for mean elasticity (sensitivity, 96%; specificity, 95%), 54.3 kPa for maximum elasticity (sensitivity, 95%; specificity, 94%), 37.1 kPa for minimum elasticity (sensitivity, 96%; specificity, 95%), and 4.6 for the mass/fat elasticity ratio (sensitivity, 97%; specificity, 95%). SWE yields additional valuable quantitative data to ultrasonographic examination on solid breast lesions. SWE may serve as a complementary tool for diagnosis of breast lesions. Long-term clinical studies are required to accurately select lesions requiring biopsy.

Impact of radioguided occult lesion localization on the correct excision of malignant breast lesions. Effect of histology and tumor size

International Nuclear Information System (INIS)

Woll, J.P.P.; Garcia Vicente, A.M.; Gonzalez Garcia, B.; Delgado Portela, M.; Cordero Garcia, J.M.; Pardo Garcia, R.; Molino Trinidad, C.; Soriano Castrejon, A.M.; Cortes Romera, M.

2011-01-01

The aim of this study was to evaluate the impact of radioguided occult lesion localization (ROLL) in the correct location and excision of malignant breast lesions, and analyze if these results are affected by the histology and tumor size. A total of 105 patients with occult breast lesions were studied. The mean age was 55 years. An intralesional dose of 18.5 MBq of 99mTc-labeled macroaggregated human albumin (AMA) was administered using stereotaxic mammography or ultrasound. Surgical resection was carried out with the help of a gammadetector probe. In the histological study, disease-free margin was defined by a distance between the tumor lesion and the surgical margin of more than 1 mm. The possible influence of tumor histology and lesion diameter with respect to free/affected margins was analyzed. Correct radiotracer placement was achieved in 100/105 of the cases (95.2%). In the remaining 5 cases (4.8%), radiotracer placement was incorrect, with 2 of them being malignant lesions that were found by macroscopic inspection, and the other 3 having benign pathology. Among the malignant lesions (44 cases), correct placement of the radiotracer was achieved in 42 cases (95.5%). Of these 42 malignant lesions, in which the ROLL was correctly performed, free surgical margins were obtained in 24 cases (57.1%), while the other 18 (42.9%) had infiltrated surgical margins. The most common histological type among the malignant lesions was invasive ductal carcinoma (71.4%). The histological types with an increased frequency of infiltration of surgical margins were invasive and microinvasive cancer (94.4%). All the affected margins were in lesions greater than 10 mm, and the highest incidence was in those between 20 and 30 mm (55.5%). In our experience, the advantages of the ROLL technique are a precise localization of malignant breast lesions (95.5%) and an increased probability of a complete excision with free margins in more than one half of them. Nevertheless, special

Apparent diffusion coefficient measurements in the differentiation between benign and malignant lesions: a systematic review.

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Vermoolen, M A; Kwee, T C; Nievelstein, R A J

2012-08-01

To systematically review the value of apparent diffusion coefficient (ADC) measurement in the differentiation between benign and malignant lesions. A systematic search of the Medline/Pubmed and Embase databases revealed 109 relevant studies. Quality of these articles was assessed using the Quality Assessment of the Studies of Diagnostic Accuracy Included in Systematic Reviews (QUADAS) criteria. Reported ADC values of benign and malignant lesions were compared per organ. The mean quality score of the reviewed articles was 50%. Comparison of ADC values showed marked variation among studies and between benign and malignant lesions in various organs. In several organs, such as breast, liver, and uterus, ADC values discriminated well between benign and malignant lesions. In other organs, such as the salivary glands, thyroid, and pancreas, ADCs were not significantly different between benign and malignant lesions. The potential utility of ADC measurement for the characterisation of tumours differs per organ. Future well-designed studies are required before ADC measurements can be recommended for the differentiation of benign and malignant lesions. These future studies should use standardised acquisition protocols and provide complete reporting of study methods, to facilitate comparison of results and clinical implementation of ADC measurement for tumour characterisation.

Diffusion kurtosis imaging for differentiating between the benign and malignant sinonasal lesions.

Science.gov (United States)

Jiang, Jing Xuan; Tang, Zuo Hua; Zhong, Yu Feng; Qiang, Jin Wei

2017-05-01

The study aimed to evaluate diffusion kurtosis imaging (DKI) in the differentiation between benign and malignant sinonasal lesions, and to compare the diagnostic performance of DKI with diffusion weighted imaging (DWI). Eight-one patients with solid sinonasal lesions confirmed by surgery and pathology (46 malignant and 35 benign) underwent conventional MRI, DWI, and DKI. DKI was performed employing a 13 extended b-value ranging from 0 to 2500 s/mm 2 . Apparent diffusion coefficient (ADC) from DWI, kurtosis (K), and diffusion coefficient (D) from DKI were measured and compared between two groups. ADC and D values were significantly lower in the malignant sinonasal lesions than in the benign sinonasal lesions (1.11 ± 0.41 versus 1.58 ± 0.50 × 10 -3 mm 2 /s and 1.45 ± 0.36 versus 2.03 ± 0.49 × 10 -3 mm 2 /s, respectively, both P benign and malignant lesions, with a sensitivity of 69.6%, a specificity of 77.1% and an accuracy of 74.0%; a cutoff D value of 1.75 × 10 -3 mm 2 /s, with a sensitivity of 82.6%, a specificity of 77.1% and an accuracy of 80.2%; a cutoff K value of 0.63 with a sensitivity of 95.7%, a specificity of 77.1% and an accuracy of 87.7%. The area under the curve of K value was significantly larger than that of ADC value (0.875 versus 0.762; P benign and malignant sinonasal lesions. DKI may be a noninvasive method to evaluate the sinonasal lesions. 1 J. MAGN. RESON. IMAGING 2017;45:1446-1454. © 2016 International Society for Magnetic Resonance in Medicine.

MRI of superficial soft tissue masses: analysis of features useful in distinguishing between benign and malignant lesions

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Calleja, Michele; Dimigen, Marion; Saifuddin, Asif [Royal National Orthopaedic Hospital, Stanmore (United Kingdom)

2012-12-15

To identify the MRI features of superficial soft tissue masses, that may allow differentiation between malignant and non-malignant lesions. A total of 136 consecutive patients referred to a supra-regional musculoskeletal oncology center over a 10-year period with the diagnosis of a superficial soft tissue mass were included in this retrospective study. Features analyzed included patient demographics, lesion size, MRI signal characteristics, margins, lobulation, hemorrhage, necrosis, fascial edema, relationship to the fascia, as well as involvement of the skin. Comparison was then made with the final histological diagnosis. Of the patients reviewed, 58 were male and 78 were female, and the mean age was 49.9 years. The mean age for malignant lesions was 57.9 years, and that for non-neoplastic and benign conditions 41.9 years (p < 0.001). A significant relationship was identified between malignancy and lobulation (p < 0.01), hemorrhage (p < 0.001), fascial edema (p < 0.001), hemorrhage (p < 0.0001) and necrosis (p < 0.001). The relationship between skin thickening and skin contact and malignancy was also found to be significant. However, size was not found to be an important determining factor for malignancy, with a significant proportion of malignant superficial sarcomas measuring less than 5 cm in maximal diameter. This study has shown that a significant proportion of malignant superficial sarcomas measured less than 5 cm in maximal diameter. Fascial edema, skin thickening, skin contact, hemorrhage, and necrosis were found to be highly significant factors indicative of malignancy. Lobulation and peritumoral edema were also significant MRI features. (orig.)

An automatic system to discriminate malignant from benign massive lesions on mammograms

International Nuclear Information System (INIS)

Retico, A.; Delogu, P.; Fantacci, M.E.; Kasae, P.

2006-01-01

Mammography is widely recognized as the most reliable technique for early detection of breast cancers. Automated or semi-automated computerized classification schemes can be very useful in assisting radiologists with a second opinion about the visual diagnosis of breast lesions, thus leading to a reduction in the number of unnecessary biopsies. We present a computer-aided diagnosis (CADi) system for the characterization of massive lesions in mammograms, whose aim is to distinguish malignant from benign masses. The CADi system we realized is based on a three-stage algorithm: (a) a segmentation technique extracts the contours of the massive lesion from the image; (b) 16 features based on size and shape of the lesion are computed; (c) a neural classifier merges the features into an estimated likelihood of malignancy. A data set of 226 massive lesions (109 malignant and 117 benign) has been used in this study. The system performances have been evaluated in terms of the receiver-operating characteristic (ROC) analysis, obtaining A z =0.80+/-0.04 as the estimated area under the ROC curve

Topography of Protein Kinase C βII in Benign and Malignant Melanocytic Lesions.

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Krasagakis, Konstanin; Tsentelierou, Eleftheria; Chlouverakis, Gregory; Stathopoulos, Efstathios N

2017-09-01

Protein kinase C βII promotes melanogenesis and affects proliferation of melanocytic cells but is frequently absent or decreased in melanoma cells in vitro. To investigate PKC-βII expression and spatial distribution within a lesion in various benign and malignant melanocytic proliferations. Expression of PKC-βII was semiquantitatively assessed in the various existing compartments (intraepidermal [not nested], junctional [nested], and dermal) of benign (n = 43) and malignant (n = 28) melanocytic lesions by immunohistochemistry. Melanocytes in the basal layer of normal skin or in lentigo simplex stained strongly for PKC-βII. Common nevi lacked completely PKC-βII. All other lesions expressed variably PKC-βII, with cutaneous melanoma metastases displaying the lowest rate of positivity (14%). In the topographical analysis within a lesion, PKC-βII expression was largely retained in the intraepidermal and junctional part of all other lesions (dysplastic nevus, lentigo maligna, and melanoma). Reduced expression of PKC-βII was found in the dermal component of benign and malignant lesions ( P = .041 vs intraepidermal). PKC-βII expression in the various compartments did not differ significantly between benign and malignant lesions. The current study revealed a significant correlation between PKC-βII expression and spatial localization of melanocytes, with the lowest expression found in the dermal compartment and the highest in the epidermal compartment.

Evaluation of malignant and benign renal lesions using diffusion-weighted MRI with multiple b values

International Nuclear Information System (INIS)

Erbay, Gurcan; Koc, Zafer; Karadeli, Elif; Kuzgunbay, Baris; Goren, M. Resit; Bal, Nebil

2012-01-01

Background: Limited data are available regarding the use of diffusion-weighted (DW) magnetic resonance imaging (MRI) with multiple b values for characterization of renal lesions. Purpose: To demonstrate and compare the diagnostic performance of DW-MRI with multiple b values for renal lesion characterization. Material and Methods: Sixty-three lesions (36 malignant, 27 benign) in 60 consecutive patients (48 men, 12 women; age 60 ± 12.5 years) with solid/cystic renal lesion diagnosed after MRI were included prospectively. Single-shot echo-planar DW abdominal MRI (1.5T) was obtained using seven b values with eight apparent diffusion coefficient (ADC) maps. Contrast-to-noise ratios (CNRs), signal intensities, lesion ADCs, and lesion/normal parenchyma ADC ratios were analyzed. Receiver-operating characteristic analysis was performed. Results: The mean signal intensities of malignant lesions (at b0, 50, and 200 s/mm 2 ) were significantly lower than those of benign lesions (P 2 . ADC with all b values could better distinguish between benign and malignant lesions. A 1.35 x 10 -3 mm 2 /s threshold ADC value permitted this distinction with 85.2% sensitivity and 65.6% specificity. The lesion/normal parenchyma ADC ratio was more effective than the lesion ADC. Conclusion: In addition to the ADC value, the signal intensity curve on DW images using multiple b values could be helpful for differentiation of malignant and benign renal lesions

Metallothionein Isoform Expression in Benign and Malignant Thyroid Lesions.

Science.gov (United States)

Wojtczak, Beata; Pula, Bartosz; Gomulkiewicz, Agnieszka; Olbromski, Mateusz; Podhorska-Okolow, Marzena; Domoslawski, Paweł; Bolanowski, Marek; Daroszewski, Jacek; Dziegiel, Piotr

2017-09-01

Metallothioneins (MTs) are involved in numerous cell processes such as binding and transport of zinc and copper ions, differentiation, proliferation and apoptosis, therefore contributing to carcinogenesis. Scarce data exist on their expression in benign and malignant lesions of the thyroid. mRNA expression of functional isoforms of MT genes (MT1A, MT1B, MT1E, MT1F, MT1G, MT1H, MT1X, MT2A, MT4) was studied in 17 nodular goiters (NG), 12 follicular adenomas (FA) and 26 papillary thyroid carcinomas (PTC). One-way ANOVA revealed significant differences in mRNA expression levels of MT1A (pbenign and malignant lesions. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Usefulness of acoustic radiation force impulse elastography in the differential diagnosis of benign and malignant solid pancreatic lesions

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Park, Min Kyoung; Jo, Jeong Hyun; Kwon, Hee Jin; Cho, Jin Han; Oh, Jong Young; Noh, Myung Hwan; Nam, Kyung Jin [Dong-A University College of Medicine, Busan (Korea, Republic of)

2014-03-15

The aim of this study was to evaluate the tissue stiffness of solid pancreatic lesions by using acoustic radiation force impulse (ARFI) elastography to differentiate benign from malignant pancreatic lesions. ARFI elastography was performed in 26 patients who had 27 focal solid pancreatic lesions, including 8 benign lesions (mass-forming pancreatitis, 5; autoimmune pancreatitis, 3) and 19 malignant lesions (pancreatic adenocarcinoma, 16; metastasis from colorectal cancer, 2; malignant neuroendocrine tumor, 1). On the elastographic images of virtual touch tissue imaging (VTI), the echogenicity of the mass was categorized on a 5-grade scale. On the elastographic image of virtual touch tissue quantification (VTQ), the shear wave velocities (SWVs) of the lesion and surrounding parenchyma were measured. On the VTI images, the mean echogenicity score of the malignant lesions (3.7±1.0) was higher than that of the benign lesions (3.1±0.4; P=0.023). On the VTQ images, there were no statistical differences in the mean SWV between the benign (2.4±1.1 m/sec) and malignant (3.3±1.0 m/sec) lesions (P=0.101). However, the mean SWV difference values between the lesion and background parenchyma of the malignant lesions (1.5±0.8 m/sec) were higher than those of the benign lesions (0.4±0.3 m/sec; P=0.011). ARFI elastography can determine the relative stiffness between a lesion and the background pancreatic parenchyma using VTI and VTQ, which is helpful in the differentiation between benign and malignant solid pancreatic lesions.

Morbidity and mortality after liver resection for benign and malignant hepatobiliary lesions

NARCIS (Netherlands)

Erdogan, Deha; Busch, Olivier R. C.; Gouma, Dirk J.; van Gulik, Thomas M.

2009-01-01

Aim: Although most partial liver resections are performed for malignant lesions, an increasing contingent of benign lesions is also considered for surgery. The aim was to assess post-operative morbidity and mortality after liver resection for benign hepatobiliary lesions in comparison with outcome

Angiogenesis and dynamic contrast enhanced MRI of benign and malignant breast lesions: preliminary results

International Nuclear Information System (INIS)

Liu Peifang; Bao Runxian; Niu Yun; Yu Yong

2002-01-01

Objective: To determine whether dynamic contrast enhanced MRI features of early-phase enhancement rate, enhancement amplitude, and signal intensity (SI) time course are associated with the microvessel density (MVD) and vascular endothelial growth factor (VEGF) expression of malignant and benign breast lesions. Methods: Thirty-eight patients with histopathologically verified breast lesions underwent dynamic contrast enhanced MRI. SI changes during dynamic scanning were assessed quantitatively. Early-phase enhancement rate and enhancement amplitude were calculated. Time-SI curves of the lesions were obtained and classified according to their shapes as type I (which was steady enhancement to the end of the dynamic data acquisition at 7.5 min), type II (plateau of SI after avid initial contrast enhancement), or type III (washout of SI after avid initial contrast enhancement). the mean MVD and VEGF expression of the lesions were measured with immuno-histochemical staining method in all the histologic specimens by pathologists without the knowledge of the results of the MR examination. The relationships among dynamic contrast enhanced MRI features, MVD, and VEGF expression of benign and malignant breast lesions were analyzed. Results: Histology revealed 21 malignancies and 17 benign lesions. The mean MVD and VEGF expression for 21 malignant lesions were statistically higher than the mean MVD and VEGF expression for 17 benign lesions. High VEGF expression of benign and malignant breast lesions showed an association with increased MVD. Among all 38 lesions, greater (> 60%) MR early-phase enhancement rate and time-SI curve type II and III showed an association with increased MVD and higher VEGF expression level. All the differences mentioned above showed statistical significance except that the difference between VEGF expression and the distribution of curve types had no statistical significance. No significant relationships were observed between the mean of enhancement

Anisotropy of Solid Breast Lesions in 2D Shear Wave Elastography is an Indicator of Malignancy.

Science.gov (United States)

Skerl, Katrin; Vinnicombe, Sarah; Thomson, Kim; McLean, Denis; Giannotti, Elisabetta; Evans, Andrew

2016-01-01

To investigate if anisotropy at two-dimensional shear wave elastography (SWE) suggests malignancy and whether it correlates with prognostic and predictive factors in breast cancer. Study group A of 244 solid breast lesions was imaged with SWE between April 2013 and May 2014. Each lesion was imaged in radial and in antiradial planes, and the maximum elasticity, mean elasticity, and standard deviation were recorded and correlated with benign/malignant status, and if malignant, correlated with conventional predictive and prognostic factors. The results were compared to a study group B of 968 solid breast lesions, which were imaged in sagittal and in axial planes between 2010 and 2013. Neither benign nor malignant lesion anisotropy is plane dependent. However, malignant lesions are more anisotropic than benign lesions (P ≤ 0.001). Anisotropy correlates with increasing elasticity parameters, breast imaging-reporting and data system categories, core biopsy result, and tumor grade. Large cancers are significantly more anisotropic than small cancers (P ≤ 0.001). The optimal anisotropy cutoff threshold for benign/malignant differentiation of 150 kPa(2) achieves the best sensitivity (74%) with a reasonable specificity (63%). Anisotropy may be useful during benign/malignant differentiation of solid breast masses using SWE. Anisotropy also correlates with some prognostic factors in breast cancer. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

Association of human papilloma virus with atypical and malignant oral papillary lesions.

Science.gov (United States)

McCord, Christina; Xu, Jing; Xu, Wei; Qiu, Xin; Muhanna, Nidal; Irish, Jonathan; Leong, Iona; McComb, Richard John; Perez-Ordonez, Bayardo; Bradley, Grace

2014-06-01

This study aimed to examine atypical and malignant papillary oral lesions for low- and high-risk human papillomavirus (HPV) infection and to correlate HPV infection with clinical and pathologic features. Sections of 28 atypical papillary lesions (APLs) and 14 malignant papillary lesions (MPLs) were examined for HPV by in situ hybridization and for p16 and MIB-1 by immunohistochemistry; 24 conventional papillomas were studied for comparison. Low-risk HPV was found in 10 of 66 cases, including 9 APLs and 1 papilloma. All low-risk HPV-positive cases showed suprabasilar MIB-1 staining, and the agreement was statistically significant (P < .0001). Diffuse p16 staining combined with high-risk HPV was not seen in any of the cases. A subset of HPV(-) APLs progressed to carcinoma. Oral papillary lesions are a heterogeneous group. Low-risk HPV infection is associated with a subset of APLs with a benign clinical course. Potentially malignant APLs and MPLs are not associated with low- or high-risk HPV. Copyright © 2014 Elsevier Inc. All rights reserved.

A conditional mouse model for malignant mesothelioma

NARCIS (Netherlands)

Jongsma, Johan; van Montfort, Erwin; Vooijs, Marc; Zevenhoven, John; Krimpenfort, Paul; van der Valk, Martin; van de Vijver, Marc; Berns, Anton

2008-01-01

Malignant mesothelioma is a devastating disease that has been associated with loss of Neurofibromatosis type 2 (NF2) and genetic lesions affecting RB and P53 pathways. We introduced similar lesions in the mesothelial lining of the thoracic cavity of mice. Mesothelioma developed at high incidence in

Differentiation of benign and malignant skeletal lesions with quantitative diffusion weighted MRI at 3 T

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Ahlawat, Shivani, E-mail: sahlawa1@jhmi.edu [The Russell H. Morgan Department of Radiology & Radiological Science, The Johns Hopkins University School of Medicine, 601 North Wolfe Street, Baltimore MD 21287 (United States); Khandheria, Paras, E-mail: pkhandh1@jhmi.edu [The Russell H. Morgan Department of Radiology & Radiological Science, The Johns Hopkins University School of Medicine, 601 North Wolfe Street, Baltimore MD 21287 (United States); Subhawong, Ty K., E-mail: TSubhawong@med.miami.edu [Department of Radiology (R-109), University of Miami Leonard M. Miller Miami, FL 33101 (United States); Fayad, Laura M., E-mail: lfayad1@jhmi.edu [The Russell H. Morgan Department of Radiology & Radiological Science, The Johns Hopkins University School of Medicine, 601 North Wolfe Street, Baltimore MD 21287 (United States)

2015-06-15

Highlights: • DWI may have predictive value for the characterization of bone lesions. • Benign lesions have higher minimum, and mean ADC values than malignancies. • Minimum ADC has the highest accuracy in discerning benign from malignant lesion. • Minimum ADC of 0.9 × 10. • All ADC measurements were made with high inter-observer concordance. - Abstract: Objectives: To investigate the accuracy of quantitative diffusion-weighted imaging with apparent diffusion coefficient (ADC) mapping for characterizing bone lesions as benign or malignant. Methods: At 3 T, 31 subjects with intramedullary lesions imaged by DWI (b-values 50, 400, 800 s/mm{sup 2}) were included. ADC values (minimum, mean, maximum) were recorded by three observers independently. Interobserver variability and differences between ADC values in benign and malignant lesions were assessed (unpaired t-test, receiver operating characteristic (ROC) analysis). Results: Of 31 lesions, 18 were benign (osteoblastic (n = 1), chondroid (n = 6), cysts (n = 4), hemangiomatosis (n = 1), fibrous (n = 3), eosinophilic granuloma (n = 1), giant cell tumor (n = 1), osteomyelitis (n = 1)) and 13 were malignant (primary (n = 5), metastases (n = 8)). Overall, there were higher minimum (1.27 × 10{sup −3} mm{sup 2}/s vs 0.68 × 10{sup −3} mm{sup 2}/s, p < 0.001), mean (1.68 × 10{sup −3} mm{sup 2}/s vs 1.13 × 10{sup −3} mm{sup 2}/s, p < 0.001), and maximum (2.09 × 10{sup −3} mm{sup 2}/s vs 1. 7 × 10{sup −3} mm{sup 2}/s, p = 0.03). ADC values in benign lesions compared with those in malignancies. ROC analysis revealed areas under the curve for minimum, mean, and maximum ADC values of 0.91, 0.85, and 0.71, respectively. ADC measurements were made with high inter-observer concordance (ρ = 0.83–0.96). Conclusion: Quantitative ADC maps may have predictive value for the characterization of bone lesions. Benign lesions generally have higher minimum, mean, and maximum ADC values than malignancies, with the

The preponderance and dye-tissue receptive variability analyses of malignant and benign lesions of the female genitalia

Directory of Open Access Journals (Sweden)

F.M. Onyije

2017-04-01

Conclusion: Our study reported the preponderance of benign lesions than malignant lesions in the sample population. Comparatively, MT exhibited the best dye-tissue receptivity in both benign and malignant lesions than the baseline dye (H&E and remains a valuable tool for the diagnosis of gynecological lesions.

Association of malignancy with rapid growth in early lesions induced by irradiation of rat skin

International Nuclear Information System (INIS)

McGregor, J.F.

1979-01-01

Epithelial lesions induced by irradiation of rat skin were studied to determine (a) the relationship of malignancy to dose, (b) the types of lesions and circumstances leading to overt malignancy, and (c) the growth rates of lesions progressing to malignancy versus those of lesions remaining benign. High doses of radiation were shown to be associated with the production of epidermal cancers, the maximum yield being obtained at 6,400 rads. Conversely, a peak yield of noncancerous lesions was obtained at 1,600 rads. This association between malignancy and high dose was consistent for cancers evolving from warts, cysts, and chronic ulcers. Although the proportion of warts among the induced lesions was much higher than that of the cysts or chronic ulcers (76, 14, and 10%, respectively), the likelihood of warts becoming cancerous was substantially lower (14, 23, and 21%). The combined data for all doses showed that the latency period of the epidermal cancers was significantly (P = 0.015) shorter than that of the benign tumors. Rapid growth rates were observed for warts, cysts, and chronic ulcers progressing to overt cancer, and these did not overlap at any point on the growth scale with rates for benign tumors. This finding suggested that the potential for malignant development had been established early in the carcinogenic process, very likely at induction

Application of Single Voxel 1H Magnetic Resonance Spectroscopy in Hepatic Benign and Malignant Lesions.

Science.gov (United States)

Yang, Zifeng; Sun, Shiqiang; Chen, Yuanli; Li, Rui

2016-12-19

BACKGROUND To quantify the metabolite changes in hepatic tumors by single-voxel 1H magnetic resonance spectroscopy (MRS) at 3.0 T and explore the application value of 1HMRS in the diagnosis of hepatic benign and malignant lesions. MATERIAL AND METHODS A total of 45 patients (55 lesions) diagnosed with hepatic lesions by ultrasound and/or computer topography (CT) from November 2006 to March 2007 were included in this study. All patients underwent 3D-dynamic enhanced scan with liver acquisition with acceleration volume acquisition (LAVA) sequence and single-voxel 1HMRS imaging with PRESS (point-resolved spectroscopy) sequence. The metabolite concentrations such as choline (Cho) and lipids (Lip) were measured. RESULTS There was significant difference regarding the occurrence rate of the obvious elevated Cho peaks between benign and malignant tumors (7/27 vs. 21/28, p=0.000). There was statistical significant differences regarding the Cho/Lip ratios in hepatic benign (0.0686±0.0283, 95% CI: 0.0134-0.1245) and malignant (0.1266 ±0.1124, 95% CI: 0.0937-0.2203) lesions (pbenign and malignant lesions. Combined use of 1HMRS and MRI can greatly improve the application value of MRI assessment in the diagnosis of hepatic benign and malignant lesions with a higher sensitivity, negative predictive value, and overall accuracy.

Differentiation of malignant and degenerative bone lesions using dexamethasone interventional 3- and 24-hour bone scintigraphy

International Nuclear Information System (INIS)

Bhatnagar, A.; Mondal, A.; Kashyap, R.; Sharma, R.K.; Sharma, R.; Chakravarty, S.K.; Bihari, V.; Sawroop, K.; Chopra, M.K.; Soni, N.L.

1994-01-01

Seventy-seven adult patients with suspected skeletal metastases were divided into two groups. In group A (n=30), following intravenous administration of 20 mCi (740 MBq) of technetium-99m methylene diphosphonate ( 99m Tc-MDP), 3- and 24-h scintigraphy of bone lesions was performed. The 24/3 h lesion to bone background radiouptake ratio (RUR) was calculated for each lesion. In group B (n=47), the same procedure was followed with dexamethasone intervention (10 mg in 24 h) following the 3-h acquisition. In group A, after determination of the critical point, malignant and degenerative bone lesions could be separated with a sensitivity, specificity and accuracy of 0.76, 0.72 and 0.73, respectively. The mean RUR of the malignant lesions was 1.20± 0.23, and that of the benign lesions, 0.95± 0.15. In group B cases, significantly increased sensitivity, specificity and accuracy of 0.87, 0.94 and 0.92, respectively, were found (P<0.001). The mean RUR of the malignant lesions was 1.48± 0.34, and that of degenerative lesions, 0.88± 0.19. Dexamethasone interventional bone scintigraphy seems to be a new cost-effective method for differentiating malignant from degenerative bone lesions using the RUR. (orig.)

Benign and malignant skull-involved lesions: discriminative value of conventional CT and MRI combined with diffusion-weighted MRI.

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Tu, Zhanhai; Xiao, Zebin; Zheng, Yingyan; Huang, Hongjie; Yang, Libin; Cao, Dairong

2018-01-01

Background Little is known about the value of computed tomography (CT) and magnetic resonance imaging (MRI) combined with diffusion-weighted imaging (DWI) in distinguishing malignant from benign skull-involved lesions. Purpose To evaluate the discriminative value of DWI combined with conventional CT and MRI for differentiating between benign and malignant skull-involved lesions. Material and Methods CT and MRI findings of 58 patients with pathologically proven skull-involved lesions (43 benign and 15 malignant) were retrospectively reviewed. Conventional CT and MRI characteristics and apparent diffusion coefficient (ADC) value of the two groups were evaluated and compared. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess the differential performance of each parameter separately and together. Results The presence of cortical defects or break-through and ill-defined margins were associated with malignant skull-involved lesions (both P benign and malignant skull-involved lesions. Conclusion The combination of CT, MRI, and DWI can help to differentiate malignant from benign skull-involved lesions. CT + MRI + DWI offers optimal sensitivity, while DWI offers optimal specificity.

Lesions of uncertain malignant potential in the breast (B3): what do we know?

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Purushothaman, H.N.; Lekanidi, K.; Shousha, S.; Wilson, R.

2016-01-01

Breast lesions classified as of uncertain malignant potential (B3) on biopsy form a diverse group of abnormalities, which pose a diagnostic and management challenge. In this paper, we discuss the imaging and pathology features as well as the management of the most controversial B3 lesions, consisting of papillary lesions, complex sclerosing lesions/radial scars, lobular intraepithelial neoplasia, and atypical epithelial proliferation of ductal type. As there is an association with malignancy at the time of diagnosis, as well as an increase in the risk of subsequent development of cancer, a multidisciplinary discussion is almost always required to tailor treatment.

Differentiation of benign and malignant lesions of the tongue by using diffusion-weighted MRI at 3.0 T.

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Li, S; Cheng, J; Zhang, Y; Zhang, Z

2015-01-01

Diffusion-weighted MRI (DWI) has been introduced in head and neck lesions and adds important information to the findings obtained through conventional MRI. The purpose of this study was to assess the role of DWI in differentiating benign and malignant lesions of the tongue at 3.0-T field strength imaging. 78 patients with 78 lingual lesions underwent conventional MRI and DWI with b-values of 0 and 1000 s mm(-2) before therapy. The apparent diffusion coefficient (ADC) maps were reconstructed, and the ADC values of the lingual lesions were calculated and compared between benign and malignant lesions of the tongue. The mean ADC values of the malignant tumours, benign solid lesions and cystic lesions were (1.08±0.16)×10(-3), (1.68±0.33)×10(-3) and (2.21±0.35)×10(-3) mm2 s(-1), respectively. The mean ADC values of malignant tumours were significantly lower (pbenign and malignant lesions are significantly different at 3.0-T imaging. DWI can be applied as a complementary tool in the differentiation of benign and malignant lesions of the tongue.

Genetic polymorphisms of matrix metalloproteinases and their inhibitors in potentially malignant and malignant lesions of the head and neck

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Asotra Kamlesh

2010-02-01

Full Text Available Abstract Matrix metalloproteinases (MMPs are a family of zinc-dependent proteinases that are capable of cleaving all extra cellular matrix (ECM substrates. Degradation of matrix is a key event in progression, invasion and metastasis of potentially malignant and malignant lesions of the head and neck. It might have an important polymorphic association at the promoter regions of several MMPs such as MMP-1 (-1607 1G/2G, MMP-2 (-1306 C/T, MMP-3 (-1171 5A/6A, MMP-9 (-1562 C/T and TIMP-2 (-418 G/C or C/C. Tissue inhibitors of metalloproteinases (TIMPs are naturally occurring inhibitors of MMPs, which inhibit the activity of MMPs and control the breakdown of ECM. Currently, many MMP inhibitors (MMPIs are under development for treating different malignancies. Useful markers associated with molecular aggressiveness might have a role in prognostication of malignancies and to better recognize patient groups that need more antagonistic treatment options. Furthermore, the introduction of novel prognostic markers may also promote exclusively new treatment possibilities, and there is an obvious need to identify markers that could be used as selection criteria for novel therapies. The objective of this review is to discuss the molecular functions and polymorphic association of MMPs and TIMPs and the possible therapeutic aspects of these proteinases in potentially malignant and malignant head and neck lesions. So far, no promising drug target therapy has been developed for MMPs in the lesions of this region. In conclusion, further research is required for the development of their potential diagnostic and therapeutic possibilities.

Differentiating between benign and malignant sinonasal lesions using dynamic contrast-enhanced MRI and intravoxel incoherent motion.

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Jiang, Jingxuan; Xiao, Zebin; Tang, Zuohua; Zhong, Yufeng; Qiang, Jinwei

2018-01-01

To explore the value of dynamic contrast-enhanced MRI (DCE-MRI) and intravoxel incoherent motion (IVIM) for distinguishing between benign and malignant sinonasal lesions and investigate the correlations between the two methods. Patients with sinonasal lesions (42 benign and 31 malignant) who underwent DCE-MRI and IVIM before confirmation by histopathology were enrolled in this prospective study. Parameters derived from DCE-MRI and IVIM were measured, the optimal cut-off values for differential diagnosis were determined, and the correlations between the two methods were evaluated. Statistical analyses were performed using the Wilcoxon rank sum test, receiver operating characteristic (ROC) curve analysis, and Spearman's rank correlation. Significantly higher K trans and K ep values but lower D and f values were found in malignant lesions than in benign lesions (all pbenign and malignant sinonasal lesions. IVIM findings correlate with DCE-MRI results and may represent an alternative to DCE-MRI. Copyright © 2017 Elsevier B.V. All rights reserved.

Differentiation of benign and malignant lung lesions: Dual-Energy Computed Tomography findings

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González-Pérez, Víctor; Arana, Estanislao; Barrios, María; Bartrés, Albert; Cruz, Julia; Montero, Rafael; González, Manuel; Deltoro, Carlos; Martínez-Pérez, Encarnación; De Aguiar-Quevedo, Karol; Arrarás, Miguel

2016-01-01

Purpose: To determine whether parameters generated by Dual-Energy Computed Tomography (DECT) can distinguish malignant from benign lung lesions. Methods: A prospective review of 125 patients with 126 lung lesions (23 benign and 103 malignant) who underwent lung DECT during arterial phase. All lesions were confirmed by tissue sampling. A radiologist semi-automatically contoured lesions and placed regions of interest (ROIs) in paravertebral muscle (PVM) for normalization. Variables related to absorption in Hounsfield units (HU), effective atomic number (Z eff ), iodine concentration (ρ I ) and spectral CT curves were assessed. Receiver operating characteristic (ROC) curves were generated to calculate sensitivity and specificity as predictors of malignancy. Multivariate logistic regression analysis was performed. Results: Reproducibility of measures normalized with PVM was poor. Bivariate analysis showed minimum Z eff and normalized mean Z eff to be statistically significant (p = 0.001), with area under the curve (AUC) values: 0.66 (CI 95% 0.54–0.80) and 0.72 (CI 95%, 0.60–0.84), respectively. Logistic regression models showed no differences between raw and normalized measurements. In both models, minimum HU (OR: 0.9) and size (OR: 0.1) were predictive of benign lesions. Conclusions: A quantitative approach to DECT using raw measurements is simpler than logistic regression models. Normalization to PVM was not clinically reliable due to its poor reproducibility. Further studies are needed to confirm our findings.

Differentiation of benign and malignant lung lesions: Dual-Energy Computed Tomography findings.

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González-Pérez, Víctor; Arana, Estanislao; Barrios, María; Bartrés, Albert; Cruz, Julia; Montero, Rafael; González, Manuel; Deltoro, Carlos; Martínez-Pérez, Encarnación; De Aguiar-Quevedo, Karol; Arrarás, Miguel

2016-10-01

To determine whether parameters generated by Dual-Energy Computed Tomography (DECT) can distinguish malignant from benign lung lesions. A prospective review of 125 patients with 126 lung lesions (23 benign and 103 malignant) who underwent lung DECT during arterial phase. All lesions were confirmed by tissue sampling. A radiologist semi-automatically contoured lesions and placed regions of interest (ROIs) in paravertebral muscle (PVM) for normalization. Variables related to absorption in Hounsfield units (HU), effective atomic number (Zeff), iodine concentration (ρI) and spectral CT curves were assessed. Receiver operating characteristic (ROC) curves were generated to calculate sensitivity and specificity as predictors of malignancy. Multivariate logistic regression analysis was performed. Reproducibility of measures normalized with PVM was poor. Bivariate analysis showed minimum Zeff and normalized mean Zeff to be statistically significant (p=0.001), with area under the curve (AUC) values: 0.66 (CI 95% 0.54-0.80) and 0.72 (CI 95%, 0.60-0.84), respectively. Logistic regression models showed no differences between raw and normalized measurements. In both models, minimum HU (OR: 0.9) and size (OR: 0.1) were predictive of benign lesions. A quantitative approach to DECT using raw measurements is simpler than logistic regression models. Normalization to PVM was not clinically reliable due to its poor reproducibility. Further studies are needed to confirm our findings. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Differentiation between benign and malignant breast lesions using fat-suppressed dynamic MR imaging

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Koshiishi, Takeshi; Isomoto, Ichirou; Nakamura, Kazukuni; Kajiwara, Yoshifumi; Izawa, Kunihide

1998-01-01

To assess the value and problems of fat-suppressed dynamic MR imaging in differentiating between benign and malignant lesions. In twenty-nine patients who underwent excisional biopsy or surgical resection, fat-suppressed dynamic MR imaging was performed with a 0.5 T superconducting magnet. Pre- and post-contrast 3D-spoiled gradient echo sequences were employed with fat suppression. We calculated and evaluated the contrast-to-noise ratio (CNR) and contrast enhancement ratio (CER) at each contrast determination time (CDT), which is the intermediate time in the scan. Time intensity curves of CNR showed no statistically significant difference between cancers and other benign lesions. The difference in CER between malignant and benign disease was highly significant (p=0.006) at CDT 45 sec., but there was great overlap in the time intensity curve of CER after CDT 45 sec. When we attempt to differentiate malignant from benign breast lesions by dynamic MR imaging, comparison of CNR is impertinent, and we should evaluate the differential diagnosis of cancer versus benign lesions by means of CER at CDT points of about 45 sec. (author)

Utility of dual echo T2-weighted turbo spin echo MR imaging for differentiation of solid, malignant hepatic lesions from nonsolid, benign hepatic lesions

International Nuclear Information System (INIS)

Yang, Dal Mo; Yoon, Myung Hwan; Kim, Hak Soo; Lee, Eun Joo; Kim, Jong Ho; Kim, Hyung Sik; Chung, Jin Woo

1999-01-01

To evaluate the additive value of multiphasic contrast-enhanced dynamic MR imaging as a supplement to dual-echo T2-weighted TSE MR imaging for the differentiation of solid, malignant hepatic lesions from nonsolid, benign hepatic lesions. Two radiologists retrospectively reviewed dual-echo T2-weighted TSE MR images and gadolinium-enhanced MR images in 51 patients with hepatic lesions (28 malignant, 69 benign). For the differentiation of malignant from benign lesions, as seen on dual-echo T2-weighted TSE MR images, we evaluated sensitivity, specificity, and accuracy, and compared with the results with those for dual echo T2-weighted MR images plus multiphasic contrast-enhanced dynamic MR images. In addition, Az values for dual echo T2-weighted MR images were compared with those for dual echo T2-weighted MR images plus multiphasic contrast-enhanced dynamic MR images. For the differentiation of malignant from benign hepatic lesions, as seen on dual-echo T2-weighted TSE images, sensitivity, specificity, and accuracy were 80.0%, 97.5%, and 93.9%, respectively, for lesions less than 3cm in diameter, and 92.3%, 95.0%, and 93.5%, respectively, for those that were 3cm or larger. The results for dual-echo T2-weighted MR imaging plus multiphasic contrast-enhanced dynamic MR imaging were 86.7%, 100.0%, and 97.3%, respectively, for lesions less than 3cm, and 92.3%, 100.0%, and 95.7%, respectively for those that were 3cm or larger. There were no significant differences in sensitivity, specificity, or accuracy between the results obtained using dual-echo T2-weighted MR imaging and those obtained with dual-echo T2-weighted MR imaging plus multiphasic contrast-enhanced dynamic MR imaging. Nor were these statistically significant differences in Az values between the two groups. For the differentiation of solid, malignant hepatic lesions from nonsolid, benign hepatic lesions, there is no difference in accuracy between dual-echo T2-weighted TSE MR imaging and the additional use of

Comparison of magnetic resonance elastography and diffusion-weighted imaging for differentiating benign and malignant liver lesions.

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Hennedige, Tiffany P; Hallinan, James Thomas Patrick Decourcy; Leung, Fiona P; Teo, Lynette Li San; Iyer, Sridhar; Wang, Gang; Chang, Stephen; Madhavan, Krishna Kumar; Wee, Aileen; Venkatesh, Sudhakar K

2016-02-01

Comparison of magnetic resonance elastography (MRE) and diffusion-weighted imaging (DWI) for differentiating malignant and benign focal liver lesions (FLLs). Seventy-nine subjects with 124 FLLs (44 benign and 80 malignant) underwent both MRE and DWI. MRE was performed with a modified gradient-echo sequence and DWI with a free breathing technique (b = 0.500). Apparent diffusion coefficient (ADC) maps and stiffness maps were generated. FLL mean stiffness and ADC values were obtained by placing regions of interest over the FLLs on stiffness and ADC maps. The accuracy of MRE and DWI for differentiation of benign and malignant FLL was compared using receiver operating curve (ROC) analysis. There was a significant negative correlation between stiffness and ADC (r = -0.54, p 4.54kPa) and DWI (cut-off, benign and malignant FLLs. • MRE is superior to DWI for differentiating benign and malignant focal liver lesions. • Benign lesions with large fibrous components may have higher stiffness with MRE. • Cholangiocarcinomas tend to have higher stiffness than hepatocellular carcinomas. • Hepatocellular adenomas tend to have lower stiffness than focal nodular hyperplasia. • MRE is superior to conventional MRI in differentiating benign and malignant liver lesions.

The use of diffusion-weighted magnetic resonance imaging in the differentiation between benign and malignant breast lesions

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Pereira, Fernanda Philadelpho Arantes; Martins, Gabriela; Domingues, Marisa Nassar Aidar; Domingues, Romeu Cortes [Clinica de Diagnostico por Imagem (CDPI), Rio de Janeiro, RJ (Brazil)], e-mail: fephila@gmail.com; Figueiredo, Eduardo [GE Healthcare, Sao Paulo, SP (Brazil); Fonseca, Lea Mirian Barbosa da [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Faculdade de Medicina

2009-09-15

Objective: to study the utility of diffusion-weighted magnetic resonance imaging in the differentiation between benign and malignant breast lesions. Materials and methods: forty-five women (mean age, 46.1 years) with 52 focal breast lesions underwent diffusion-weighted magnetic resonance imaging. The calculation of apparent diffusion coefficient (ADC) was based on the ADC map reflecting five b values (0, 250, 500, 750, and 1000 s/mm{sup 2}). The mean ADC value of each lesion was correlated with imaging findings and histopathologic results. Cutoff ADC, sensitivity and specificity of diffusion-weighted imaging in the differentiation between benign and malignant lesions were calculated. P < 0.05 was considered as statistically significant. Results: the mean ADC was significantly lower for malignant lesions (0.92 {+-} 0.26 x 10{sup -3} mm{sup 2}/s) as compared with benign lesions (1.50 {+-} 0.34 x 10{sup -3} mm{sup 2}/s) (P < 0.0001). Diffusion-weighted imaging showed high sensitivity and specificity (both, 92.3%) in the differentiation between benign and malignant lesions. Conclusion: diffusion-weighted imaging is a potential resource as an adjuvant to breast magnetic resonance imaging to differentiate benign from malignant lesions. Such sequence can be easily added to the standard breast magnetic resonance imaging protocol, without implying any significant increase in examination time. (author)

Discrimination between benign and malignant breast lesions using volumetric quantitative dynamic contrast-enhanced MR imaging

International Nuclear Information System (INIS)

Cheng, Ziliang; Wu, Zhuo; Shen, Jun; Shi, Guangzi; Yi, Zhilong; Xie, Mingwei; Zeng, Weike; Song, Chao; Zheng, Chushan

2018-01-01

To determine the diagnostic performance of volumetric quantitative dynamic contrast-enhanced MRI (qDCE-MRI) in differentiation between malignant and benign breast lesions. DCE-MRI was performed in 124 patients with 136 breast lesions. Quantitative pharmacokinetic parameters K trans , K ep , V e , V p and semi-quantitative parameters TTP, MaxCon, MaxSlope, AUC were obtained by using a two-compartment extended Tofts model and three-dimensional volume of interest. Morphologic features (lesion size, margin, internal enhancement pattern) and time-signal intensity curve (TIC) type were also assessed. Logistic regression analysis was used to determine predictors of malignancy, followed by receiver operating characteristics (ROC) analysis to evaluate the diagnostic performance. qDCE parameters (K trans , K ep , V p , TTP, MaxCon, MaxSlope and AUC), morphological parameters and TIC type were significantly different between malignant and benign lesions (P≤0.001). Multivariate logistic regression analyses showed that K trans , K ep , MaxSlope, size, margin and TIC type were independent predictors of malignancy. The diagnostic accuracy of logistic models based on qDCE parameters alone, morphological features plus TIC type, and all parameters combined was 94.9%, 89.0%, and 95.6% respectively. qDCE-MRI can be used to improve diagnostic differentiation between benign and malignant breast lesions in relation to morphology and kinetic analysis. (orig.)

Discrimination between benign and malignant breast lesions using volumetric quantitative dynamic contrast-enhanced MR imaging

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Cheng, Ziliang; Wu, Zhuo; Shen, Jun [Sun Yat-Sen University, Department of Radiology, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong (China); Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Malignant Tumour Epigenetics and Gene Regulation, Medical Research Centre, Sun Yat-Sen Memorial Hospital, Guangzhou (China); Shi, Guangzi; Yi, Zhilong; Xie, Mingwei; Zeng, Weike; Song, Chao; Zheng, Chushan [Sun Yat-Sen University, Department of Radiology, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong (China)

2018-03-15

To determine the diagnostic performance of volumetric quantitative dynamic contrast-enhanced MRI (qDCE-MRI) in differentiation between malignant and benign breast lesions. DCE-MRI was performed in 124 patients with 136 breast lesions. Quantitative pharmacokinetic parameters K{sup trans}, K{sub ep}, V{sub e}, V{sub p} and semi-quantitative parameters TTP, MaxCon, MaxSlope, AUC were obtained by using a two-compartment extended Tofts model and three-dimensional volume of interest. Morphologic features (lesion size, margin, internal enhancement pattern) and time-signal intensity curve (TIC) type were also assessed. Logistic regression analysis was used to determine predictors of malignancy, followed by receiver operating characteristics (ROC) analysis to evaluate the diagnostic performance. qDCE parameters (K{sup trans}, K{sub ep}, V{sub p}, TTP, MaxCon, MaxSlope and AUC), morphological parameters and TIC type were significantly different between malignant and benign lesions (P≤0.001). Multivariate logistic regression analyses showed that K{sup trans}, K{sub ep}, MaxSlope, size, margin and TIC type were independent predictors of malignancy. The diagnostic accuracy of logistic models based on qDCE parameters alone, morphological features plus TIC type, and all parameters combined was 94.9%, 89.0%, and 95.6% respectively. qDCE-MRI can be used to improve diagnostic differentiation between benign and malignant breast lesions in relation to morphology and kinetic analysis. (orig.)

Molecular pathology of chondroid neoplasms: part 2, malignant lesions

International Nuclear Information System (INIS)

Bell, W.C.; Klein, M.J.; Pitt, M.J.; Siegal, G.P.

2006-01-01

This is the second part of a two-part review presenting an overview of the molecular findings associated with both benign and malignant chondroid neoplasms. The first part presented a brief review of modern methods in molecular pathology, along with a review of the cytogenetic and molecular genetic findings in benign chondroid neoplasms. This second part reviews the cytogenetic and molecular genetic findings in malignant chondroid neoplasms. Clinical aspects of the various lesions are briefly discussed, and each tumor is illustrated with representative radiographic and pathologic images. (orig.)

Molecular pathology of chondroid neoplasms: part 2, malignant lesions

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Bell, W.C. [University of Alabama at Birmingham, Department of Pathology, Birmingham, AL (United States); University of Alabama at Birmingham, Center for Metabolic Bone Disease, Birmingham, AL (United States); Klein, M.J. [University of Alabama at Birmingham, Center for Metabolic Bone Disease, Birmingham, AL (United States); University of Alabama at Birmingham, Department of Pathology, Birmingham, AL (United States); Pitt, M.J. [University of Alabama at Birmingham, Department of Diagnostic Radiology, Birmingham, AL (United States); University of Alabama at Birmingham, Center for Metabolic Bone Disease, Birmingham, AL (United States); Siegal, G.P. [University of Alabama at Birmingham, Departments of Pathology, Cell Biology, and Surgery, Birmingham, AL (United States); University of Alabama at Birmingham, Center for Metabolic Bone Disease, Birmingham, AL (United States)

2006-12-15

This is the second part of a two-part review presenting an overview of the molecular findings associated with both benign and malignant chondroid neoplasms. The first part presented a brief review of modern methods in molecular pathology, along with a review of the cytogenetic and molecular genetic findings in benign chondroid neoplasms. This second part reviews the cytogenetic and molecular genetic findings in malignant chondroid neoplasms. Clinical aspects of the various lesions are briefly discussed, and each tumor is illustrated with representative radiographic and pathologic images. (orig.)

Can CT and MR Shape and Textural Features Differentiate Benign Versus Malignant Pleural Lesions?

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Pena, Elena; Ojiaku, MacArinze; Inacio, Joao R; Gupta, Ashish; Macdonald, D Blair; Shabana, Wael; Seely, Jean M; Rybicki, Frank J; Dennie, Carole; Thornhill, Rebecca E

2017-10-01

The study aimed to identify a radiomic approach based on CT and or magnetic resonance (MR) features (shape and texture) that may help differentiate benign versus malignant pleural lesions, and to assess if the radiomic model may improve confidence and accuracy of radiologists with different subspecialty backgrounds. Twenty-nine patients with pleural lesions studied on both contrast-enhanced CT and MR imaging were reviewed retrospectively. Three texture and three shape features were extracted. Combinations of features were used to generate logistic regression models using histopathology as outcome. Two thoracic and two abdominal radiologists evaluated their degree of confidence in malignancy. Diagnostic accuracy of radiologists was determined using contingency tables. Cohen's kappa coefficient was used to assess inter-reader agreement. Using optimal threshold criteria, sensitivity, specificity, and accuracy of each feature and combination of features were obtained and compared to the accuracy and confidence of radiologists. The CT model that best discriminated malignant from benign lesions revealed an AUC CT  = 0.92 ± 0.05 (P textural and shape analysis may help distinguish malignant from benign lesions. A radiomics-based approach may increase diagnostic confidence of abdominal radiologists on CT and MR and may potentially improve radiologists' accuracy in the assessment of pleural lesions characterized by MR. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Prehistological evaluation of benign and malignant pigmented skin lesions with optical computed tomography

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Kokolakis, Athanasios; Zacharakis, Giannis; Krasagakis, Konstantin; Lasithiotakis, Konstantinos; Favicchio, Rosy; Spiliopoulos, George; Giannikaki, Elpida; Ripoll, Jorge; Tosca, Androniki

2012-06-01

Discrimination of benign and malignant melanocytic lesions is a major issue in clinical dermatology. Assessment of the thickness of melanoma is critical for prognosis and treatment selection. We aimed to evaluate a novel optical computed tomography (optical-CT) system as a tool for three-dimensional (3-D) imaging of melanocytic lesions and its ability to discriminate benign from malignant melanocytic lesions while simultaneously determining the thickness of invasive melanoma. Seventeen melanocytic lesions, one hemangioma, and normal skin were assessed immediately after their excision by optical-CT and subsequently underwent histopathological examination. Tomographic reconstructions were performed with a back-propagation algorithm calculating a 3-D map of the total attenuation coefficient (AC). There was a statistically significant difference between melanomas, dysplastic nevi, and non-dysplastic nevi, as indicated by Kruskal-Wallis test. Median AC values were higher for melanomas compared with dysplastic and non-dysplastic nevi. No statistically significant difference was observed when thickness values obtained by optical-CT were compared with histological thickness using a Wilcoxon sighed rank test. Our results suggest that optical-CT can be important for the immediate prehistological evaluation of biopsies, assisting the physician for a rapid assessment of malignancy and of the thickness of a melanocytic lesion.

Preliminary study of 24 h bone scintigraphy after dexamethason intervention for differentiating the benign from malignant bone lesions

International Nuclear Information System (INIS)

Fan Yang; Li Yaming; Han Chunqi; Li Deshun; Ma Aiping; Liang Chenrong; Sun Zhenqiu; Liu Hao; Sun Xiaorong; Yin Yafu

2001-01-01

Objective: To explore the clinical value of 24 h bone scintigraphy after dexamethason intervention for differentiating the benign and malignant bone lesions. Methods: Twenty patients with malignant bone lesion (242 foci) and 21 patients with benign bone lesion (102 foci) were randomly divided into non-intervention group and intervention group for the comparative study. The patients in the non-intervention group underwent bone scintigraphy 3 and 24 h after the tracer administration, while the patients in the intervention group were given dexamethason 6.75 mg orally after 3 h bone imaging, then underwent 24 h bone in aging. Different regions of interest were drawn in 3 and 24 h imaging, then the radionuclide uptake ratios (RUR) of 24 h to 3 h was calculated. Results: There were no significant differences in RUR of benign lesions between the non-intervention group and intervention group (q =0.94, P > 0.05). There were significant differences in RUR between the malignant lesions in the non-intervention group and that in the intervention group (q 20.10, P < 0.01); there were significant differences in RUR between the benign and the malignant lesions in the non-intervention group (q = 1.81, P < 0.05); and there were also significant differences in RUR between the benign and the malignant lesions in the intervention group (q = 16.39, P < 0.01). The sensitivity, specificity and accuracy of differentiating the benign and malignant bone lesions by RUR with non-intervention and intervention were 75.5%, 86.2%, 65.8% and 81.5%, 87.5%, 83.1%, respectively. Conclusions: Comparing with the routine bone imaging, 24 h bone scintigraphy after dexamethason intervention elevated the diagnosis efficiency for differentiation of the benign and malignant bone lesions. 24 h bone scintigraphy associated with dexamethason intervention is convenient and acceptable in differentiation of benign and malignant bone lesions, and it is proved to be of great value for clinical application

Prevalence of precancerous lesions and conditions in Telangana region, Andhra Pradesh, India

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B Hari Vinay

2014-01-01

Full Text Available Aim: To assess the prevalence of oral precancerous lesions and conditions and to determine the potential risk factors associated among general population aged 20-70 years of Telangana region, Andhra Pradesh. Materials and Methods: An oral screening campaign was organized with the help of local general dental practitioners in each district. All the relevant information regarding the subject was documented and clinical examination of the oral soft tissues was carried out. Clinically diagnosed as precancerous lesion or condition were subjected to punch (incisional biopsy biopsy and evaluated histopathologically to confirm the diagnosis. Results: Among 1200 screened, 150 subjects were chewers and 136 subjects were smokers with 29 chewers and 16 smokers had precancerous lesions and conditions. An overall prevalence of oral precancerous lesions and conditions were found to be 4.2% (males 5.5%; females 2.5%. Leukoplakia was seen in 0.8%, Oral submucous fibrosis in 1.3% and lichen planus in 2% of the study population. Conclusions: The prevalence of precancerous lesions and conditions in our study is higher when compared with the reports from different parts of the country and in South East Asia. These lesions can be prevented from malignant transformation by mass screening, close monitoring, early detection, appropriate treatment plan and prognosis.

Differentiation of benign and malignant lung lesions: Dual-Energy Computed Tomography findings

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González-Pérez, Víctor [Dept Radiophysics, Foundation IVO, Valencia (Spain); Arana, Estanislao, E-mail: aranae@uv.es [Dept Radiology, Foundation IVO, Valencia (Spain); Barrios, María [Dept Radiology, Foundation IVO, Valencia (Spain); Bartrés, Albert [Dept Radiophysics, Foundation IVO, Valencia (Spain); Cruz, Julia [Dept Pathology, Foundation IVO, Valencia (Spain); Montero, Rafael [GE Healthcare Diagnostic Imaging, Iberia (Spain); González, Manuel; Deltoro, Carlos [Dept Radiology, Foundation IVO, Valencia (Spain); Martínez-Pérez, Encarnación [Dept Pneumology, Foundation IVO, Valencia (Spain); De Aguiar-Quevedo, Karol; Arrarás, Miguel [Dept Thoracic Surgery, Foundation IVO, Valencia (Spain)

2016-10-15

Purpose: To determine whether parameters generated by Dual-Energy Computed Tomography (DECT) can distinguish malignant from benign lung lesions. Methods: A prospective review of 125 patients with 126 lung lesions (23 benign and 103 malignant) who underwent lung DECT during arterial phase. All lesions were confirmed by tissue sampling. A radiologist semi-automatically contoured lesions and placed regions of interest (ROIs) in paravertebral muscle (PVM) for normalization. Variables related to absorption in Hounsfield units (HU), effective atomic number (Z{sub eff}), iodine concentration (ρ{sub I}) and spectral CT curves were assessed. Receiver operating characteristic (ROC) curves were generated to calculate sensitivity and specificity as predictors of malignancy. Multivariate logistic regression analysis was performed. Results: Reproducibility of measures normalized with PVM was poor. Bivariate analysis showed minimum Z{sub eff} and normalized mean Z{sub eff} to be statistically significant (p = 0.001), with area under the curve (AUC) values: 0.66 (CI 95% 0.54–0.80) and 0.72 (CI 95%, 0.60–0.84), respectively. Logistic regression models showed no differences between raw and normalized measurements. In both models, minimum HU (OR: 0.9) and size (OR: 0.1) were predictive of benign lesions. Conclusions: A quantitative approach to DECT using raw measurements is simpler than logistic regression models. Normalization to PVM was not clinically reliable due to its poor reproducibility. Further studies are needed to confirm our findings.

The use of diffusion-weighted magnetic resonance imaging in the differentiation between benign and malignant breast lesions

International Nuclear Information System (INIS)

Pereira, Fernanda Philadelpho Arantes; Martins, Gabriela; Domingues, Marisa Nassar Aidar; Domingues, Romeu Cortes; Figueiredo, Eduardo; Fonseca, Lea Mirian Barbosa da

2009-01-01

Objective: to study the utility of diffusion-weighted magnetic resonance imaging in the differentiation between benign and malignant breast lesions. Materials and methods: forty-five women (mean age, 46.1 years) with 52 focal breast lesions underwent diffusion-weighted magnetic resonance imaging. The calculation of apparent diffusion coefficient (ADC) was based on the ADC map reflecting five b values (0, 250, 500, 750, and 1000 s/mm 2 ). The mean ADC value of each lesion was correlated with imaging findings and histopathologic results. Cutoff ADC, sensitivity and specificity of diffusion-weighted imaging in the differentiation between benign and malignant lesions were calculated. P -3 mm 2 /s) as compared with benign lesions (1.50 ± 0.34 x 10 -3 mm 2 /s) (P < 0.0001). Diffusion-weighted imaging showed high sensitivity and specificity (both, 92.3%) in the differentiation between benign and malignant lesions. Conclusion: diffusion-weighted imaging is a potential resource as an adjuvant to breast magnetic resonance imaging to differentiate benign from malignant lesions. Such sequence can be easily added to the standard breast magnetic resonance imaging protocol, without implying any significant increase in examination time. (author)

Point shear wave speed measurement in differentiating benign and malignant focal liver lesions.

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Dong, Yi; Wang, Wen-Ping; Xu, Yadan; Cao, Jiaying; Mao, Feng; Dietrich, Cristoph F

2017-06-26

To investigate the value of ElastPQ measurement for differential diagnosis of benign and malignant focal liver lesions (FLLs) by using histologic results as a reference standard. A total of 154 patients were included. ElastPQ measurement was performed for each lesion in which the shear wave speed (SWS) was measured. The difference in SWS and SWS ratio of FLL to surrounding liver were evaluated, and the cut off value was investigated. Receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic performance. Histology as a gold standard was obtained by surgery in all patients. A total of 154 lesions including 129 (83.7 %) malignant FLLs and 25 (16.3 %) benign ones were analysed. The SWS of malignant and benign FLLs was significantly different, 2.77±0.68 m/s and 1.57±0.55 m/s (p<0.05). The SWS ratio of each FLL to surrounding liver parenchyma was 2.23±0.49 for malignant and 1.14±0.36 for benign FLLs (p<0.05). The cut off value for differential diagnosis was 2.06 m/s for SWS and 1.67 for SWS ratio.  ElastPQ measurement provides reliable quantitative stiffness information of FLLs and may be helpful in the differential diagnosis between malignant and benign FLLs.

Benign versus malignant osseous lesions in spine: differentiation by means of bone SPECT/CT fused image

International Nuclear Information System (INIS)

Yao Zhiming; Qu Wanying

2004-01-01

This study compared the efficiency of SPECT-CT fused image with planar bone scan, bone SPECT and CT in differentiating malignant from benign lesions and detecting metastases to the spine. Methods. Total 144 patients with spinal lesions underwent planar bone scan (WB), single photon tomography (SPECT), CT and SPECT-CT fused image by a SPECT/CT system. The malignant or benign nature of lesions was proved by radiological Methods, histological findings, 6-24 month follow-up, or all of these. The diagnostic results was divided into 4 types, i.e., normal, benign, doubtful malignant and malignant. Results. There were 137 malignant and 252 benign lesions in 144 patients, respectively. The percentages of doubtful malignant diagnosed by WB, SPECT, CT and fused image are 22.6%, 5.1%, 9.5% and 0%, respectively, p < 0.01-0.001, except for the comparison between the percentages of SPECT and CT. Sensitivities in detection of malignant lesions by WB, SPECT, CT and fused image are 75.2%, 94.2%, 96.6% and 99.3%, respectively, P < 0.001, excepting for the comparisons between those of SPECT and CT, and between those of CT and fused image. The sensitivities m detection of benign lesions by WB, SPECT, CT and fused image are, 56.7%, 86.5%, 90.1% and 96.8%, respectively, P < 0.005 - 0.001, excepting for the comparison between those of SPECT and CT. The specificities in detection of maliganant lesions by WB, SPECT, CT and fused image are 70.6%, 88.9%, 97.2% and 97.6%, respectively, P < 0.001, excepting for the comparison between those of CT and fused image. Conclusion. Bone SPECT-CT fused image has highest diagnostic and differentiating diagnostic values in detection of spinal abnormalities over the planar bone scanning and SPECT. The CT by present SPECT/CT system can complement planar bone scanning and SPECT and is clinically valuable in detection of spinal abnormalities. (authors)

Prominent papilla of vater at CT: differentiation between benign and malignant lesion

International Nuclear Information System (INIS)

Park, Sun Won; Han, Joon Koo; Choi, Byung Ihn and others

1998-01-01

To establish the criteria for differential diagnosis between malignant tumor and benign prominence of papilla of Vater, as seen on CT. Sixteen consecutive patients with prominent patilla of Vater, as seen on CT during a ten-month period were included in this study. Final diagnosis was papilla of Vater cancer (n=3D5), chronic inflammation (n=3D3), benign tumor (n=3D3), or and normal (n=3D5), and this was confirmed by surgery in 11 cases, and endoscopy in five. Papilla size and attenuation, the presence of accompanied dilatation of the bile or pancreatic duct, and lymph node enlargement were analyzed by two experienced radiologists, who reached a concensus. A past history of stone disease, laboratory findings such as serum bilirubin, serum alkaline phosphatase, or endoscopic findings of duodenal diverticulum were additionally analyzed. Papilla size was the only significantly different CT finding between malignant and benign lesions, and serum alkaline phosphatase levels were also significantly different between the two groups. The smallest malignant tumor was 18 mm and the largest benign lesion was 15 mm. The presence of bile or pancreatic duct dilatation, serum bilirubin level, attenuation of the mass, a history of stone disease, and lymph node enlargement were not significantly different between the two groups. In patients with prominent papilla of Vater, as seen on CT, a mass larger than 18 mm is the only reliable radiologic finding to indicate malignant tumor of papilla of Vater. Serum alkaline phosphatase levels can, in addition, be helpful for the differential diagnosis of benign and malignant lesions.=20

Imaging characteristics of malignant and benign lesions of skeletal muscle

International Nuclear Information System (INIS)

Leonard, L.; Meyer, H.J.; Surov, A.

2017-01-01

There are many different tumors and tumor-like lesions with variable biological behavior that may affect the skeletal musculature. The aim of this study was to review the different intramuscular lesions and to provide a classification based on their radiological patterns. Intramuscular lesions can present as solid, liquid, semiliquid or fat equivalent manifestations and also as diffuse muscle enlargement and muscle calcification. Additionally, lesions with mixed patterns of the aforementioned alterations can also occur. Benign and malignant muscle lesions can often manifest with identical radiological patterns, which is why a certain differentiation is often difficult. A systematic radiological description and when possible assignment with respect to etiology and dignity depending on the patient history is necessary in order to recommend a subsequent histological confirmation or to avoid unnecessary confirmation. (orig.) [de

The role of diffusion-weighted MRI (DWI) in the differentiation of benign from malignant skeletal lesions of the pelvis

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Douis, Hassan, E-mail: douis.hassan@hotmail.co.uk [Department of Radiology, University Hospital Birmingham NHS Foundation Trust, Birmingham, B15 2GW (United Kingdom); Department of Radiology, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, B31 2AP (United Kingdom); Davies, Mark A. [Department of Radiology, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, B31 2AP (United Kingdom); Sian, Parmjit [Department of Spinal Surgical Oncology, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, B31 2AP (United Kingdom)

2016-12-15

Purpose: To evaluate the utility of Diffusion-weighted MRI in the differentiation of benign from malignant skeletal lesions of the pelvis. Materials and methods: In this retrospective study 33 patients with indeterminate skeletal lesions of the pelvis were evaluated with DWI. Minimum, mean, maximum ADC-values of the skeletal lesions were measured followed by qualitative assessment of DWI. All patients underwent histological confirmation using CT-guided biopsy or surgical resection. The histology of the skeletal lesions was correlated with the findings on DWI. Results: There were 13 malignant lesions and 20 benign lesions. The mean, minimum and maximum ADC values (×10–6mm2/s) for benign skeletal lesions was higher than the mean ADC-values for malignant lesions (1422.2 vs 1263.7; 780.4 vs 771.8; 1969.6 vs 1676.8 respectively). These differences were however not statistically significant (P-values = 0.29; 0.94; 0.149 respectively). The sensitivity, specificity, positive predictive value and negative predictive value for qualitative assessment of Diffusion-weighted MRI in the differentiation of benign from malignant skeletal lesions were: 53.9%, 85%, 70%, 73.9% respectively. Qualitative assessment of DWI (restricted diffusion versus non-restricted diffusion) allowed differentiation of benign from malignant skeletal lesions (P-value = 0.0259). Conclusions: Qualitative assessment of DWI may aid in the differentiation of benign skeletal lesions from malignant skeletal lesions of the pelvis. Although DWI has a low sensitivity in the distinction of the two disease entities, it may be a useful adjunct due to its relatively high specificity. This is of particular importance in lymphoma where biopsy may only show chronic inflammatory cells and hence may be false negative.

The role of diffusion-weighted MRI (DWI) in the differentiation of benign from malignant skeletal lesions of the pelvis

International Nuclear Information System (INIS)

Douis, Hassan; Davies, Mark A.; Sian, Parmjit

2016-01-01

Purpose: To evaluate the utility of Diffusion-weighted MRI in the differentiation of benign from malignant skeletal lesions of the pelvis. Materials and methods: In this retrospective study 33 patients with indeterminate skeletal lesions of the pelvis were evaluated with DWI. Minimum, mean, maximum ADC-values of the skeletal lesions were measured followed by qualitative assessment of DWI. All patients underwent histological confirmation using CT-guided biopsy or surgical resection. The histology of the skeletal lesions was correlated with the findings on DWI. Results: There were 13 malignant lesions and 20 benign lesions. The mean, minimum and maximum ADC values (×10–6mm2/s) for benign skeletal lesions was higher than the mean ADC-values for malignant lesions (1422.2 vs 1263.7; 780.4 vs 771.8; 1969.6 vs 1676.8 respectively). These differences were however not statistically significant (P-values = 0.29; 0.94; 0.149 respectively). The sensitivity, specificity, positive predictive value and negative predictive value for qualitative assessment of Diffusion-weighted MRI in the differentiation of benign from malignant skeletal lesions were: 53.9%, 85%, 70%, 73.9% respectively. Qualitative assessment of DWI (restricted diffusion versus non-restricted diffusion) allowed differentiation of benign from malignant skeletal lesions (P-value = 0.0259). Conclusions: Qualitative assessment of DWI may aid in the differentiation of benign skeletal lesions from malignant skeletal lesions of the pelvis. Although DWI has a low sensitivity in the distinction of the two disease entities, it may be a useful adjunct due to its relatively high specificity. This is of particular importance in lymphoma where biopsy may only show chronic inflammatory cells and hence may be false negative.

Improving malignancy prediction in breast lesions with the combination of apparent diffusion coefficient and dynamic contrast-enhanced kinetic descriptors

International Nuclear Information System (INIS)

Nogueira, Luisa; Brandão, Sofia; Matos, Eduarda; Gouveia Nunes, Rita; Ferreira, Hugo Alexandre; Loureiro, Joana; Ramos, Isabel

2015-01-01

Aim: To assess how the joint use of apparent diffusion coefficient (ADC) and kinetic parameters (uptake phase and delayed enhancement characteristics) from dynamic contrast-enhanced (DCE) can boost the ability to predict breast lesion malignancy. Materials and methods: Breast magnetic resonance examinations including DCE and diffusion-weighted imaging (DWI) were performed on 51 women. The association between kinetic parameters and ADC were evaluated and compared between lesion types. Models with binary outcome of malignancy were studied using generalized estimating equations (GEE), (GEE), and using kinetic parameters and ADC values as malignancy predictors. Model accuracy was assessed using the corrected maximum quasi-likelihood under the independence confidence criterion (QICC). Predicted probability of malignancy was estimated for the best model. Results: ADC values were significantly associated with kinetic parameters: medium and rapid uptake phase (p<0.001) and plateau and washout curve types (p=0.004). Comparison between lesion type showed significant differences for ADC (p=0.001), early phase (p<0.001), and curve type (p<0.001). The predicted probabilities of malignancy for the first ADC quartile (≤1.17×10 −3  mm 2 /s) and persistent, plateau and washout curves, were 54.6%, 86.9%, and 97.8%, respectively, and for the third ADC quartile (≥1.51×10 −3  mm 2 /s) were 3.2%, 15.5%, and 54.8%, respectively. The predicted probability of malignancy was less than 5% for 18.8% of the lesions and greater than 33% for 50.7% of the lesions (24/35 lesions, corresponding to a malignancy rate of 68.6%). Conclusion: The best malignancy predictors were low ADCs and washout curves. ADC and kinetic parameters provide differentiated information on the microenvironment of the lesion, with joint models displaying improved predictive performance. -- Highlights: •ADC and kinetic parameters provide diverse information regarding lesion environment. •The best predictors

mHealth App for Risk Assessment of Pigmented and Nonpigmented Skin Lesions-A Study on Sensitivity and Specificity in Detecting Malignancy.

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Thissen, Monique; Udrea, Andreea; Hacking, Michelle; von Braunmuehl, Tanja; Ruzicka, Thomas

2017-12-01

With the advent of smartphone devices, an increasing number of mHealth applications that target melanoma identification have been developed, but none addresses the general context of melanoma and nonmelanoma skin cancer identification. In this study a smartphone application using fractal and classical image analysis for the risk assessment of skin lesions is systematically evaluated to determine its sensitivity and specificity in the diagnosis of melanoma and nonmelanoma skin cancer along with actinic keratosis and Bowen's disease. In the Department of Dermatology, Catharina Hospital Eindhoven, The Netherlands, 341 melanocytic and nonmelanocytic lesions were imaged using SkinVision app; 239 underwent histopathological examination, while the rest of 102 lesions were clinically diagnosed as clearly benign and not removed. The algorithm has been calibrated using the images of the first 233 lesions. The calibrated version of the algorithm was used in a subset of 108 lesions, and the obtained results were compared with the medical findings. On the 108 cases used for evaluation the algorithm scored 80% sensitivity and 78% specificity in detecting (pre)malignant conditions. Although less accurate than the dermatologist's clinical eye, the app may offer support to other professionals who are less familiar with differentiating between benign and malignant lesions. An mHealth application for the risk assessment of skin lesions was evaluated. It adds value to diagnosis tools of its type by taking into consideration pigmented and nonpigmented lesions all together and detecting signs of malignancy with high sensitivity.

Effect analysis of percutaneous osteoplasty for the treatment of malignant osteolytic lesions outside the vertebrae

International Nuclear Information System (INIS)

Zhou Bing; Wu Chungen; Cheng Yongde; Li Minghua; Gu Yifeng; Wang Jue; Zhang Peilei

2009-01-01

Objective: To assess the clinical efficacy and safety of percutaneous osteoplasty (POP) in treating malignant osteolytic lesions outside the vertebrae. Methods: From Jan. 2005 to Dec. 2008, POP was performed in 11 patients with malignant osteolytic lesions outside the vertebrae. Biopsy was carried out before POP when the lesion's pathology was undefined. A follow-up was made for at least 6 months. Brief Pain Inventory (BPI) was used to evaluate the clinical efficacy, and a statistic analysis was made with the help of software SAS 6.12. Results: POPS were successfully performed in all 11 patients, with the technical successful rate of 100%. Cement leakage was found in 3 patients, but did not cause serious complications. Obvious pain relief was revealed clinically with a significant difference in BPI before and after POP (P 0.05). Conclusion: POP is an effective and safe technique in treating malignant osteolytic lesions outside the vertebrae. (authors)

[Value of intravoxel incoherent motion diffusion-weighted imaging in differential diagnosis of benign and malignant hepatic lesions and blood perfusion evaluation].

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Ying, M L; Xiao, W W; Xu, S L; Shu, J E; Pan, J F; Fu, J F; Lu, J H; Pan, Y H; Jiang, Y

2016-11-20

Objective: To investigate the value of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in the differential diagnosis and blood perfusion evaluation of benign and malignant hepatic lesions. Methods: A retrospective analysis was performed for 86 patients (96 lesions) with pathologically or clinically confirmed hepatic lesions or hepatic lesions diagnosed based on follow-up results, among whom 48 had malignant lesions (53 lesions) and 38 had benign lesions (43 lesions). The patients underwent conventional magnetic resonance (MR) plain scan, contrast-enhanced scan, and diffusion-weighted imaging (DWI) with different b values (b = 0, 50, 100, 150, 200, 400, 600, 800, 1 000, and 1 200 s/mm 2 ) to determine the parameters of the double exponential model for intravoxel incoherent motion (IVIM): fast diffusion coefficient Dfast, slow diffusion coefficient Dslow, and percentage of fast-diffusion constituent F value. The patients were divided into groups according to the blood supply to lesions on conventional MR plain scan and contrast-enhanced scan, and there were 47 lesions in abundant blood supply group and 49 in poor blood supply group. The data for analysis were Dfast, Dslow, and F values of benign/malignant lesion groups and abundant/poor blood supply groups. The independent samples t-test was used for statistical analysis; the independent samples non-parametric test Mann-Whitney U test was used for the comparison of F value; the receiver operating characteristic (ROC) curve was used to evaluate the value of above parameters in the differentiation of benign and malignant lesions and blood supply evaluation. Results: Compared with the malignant lesion group, the benign lesion group had significantly higher Dslow, and F values ( P benign and malignant hepatic lesions, and F value can show blood perfusion in benign and malignant hepatic lesions without the need for contrast-enhanced scan, which provides a reference for the qualitative diagnosis of liver

First histologically confirmed case of a classic chordoma arising in a precursor benign notochordal lesion: differential diagnosis of benign and malignant notochordal lesions

International Nuclear Information System (INIS)

Yamaguchi, Takehiko; Yamato, Minoru; Saotome, Koichi

2002-01-01

The first histologically confirmed case of a classic chordoma arising in a precursor benign notochordal lesion is presented and the differential diagnosis between benign and malignant notochordal lesions is discussed. A 57-year-old man presented with a classic chordoma in the coccyx. The resected specimen demonstrated a small intraosseous benign notochordal lesion in the coccyx, which was adjacent to the classic chordoma. Also seen were two separate, similar benign lesions in the sacrum. The classic chordoma consisted of multiple lobules that were separated by thin fibrous septa and that showed cords or strands of atypical physaliphorous cells set within an abundant myxoid matrix. In contrast, the benign lesions consisted of intraosseous sheets of bland physaliphorous cells without any extracellular matrix. The affected bone trabeculae showed sclerotic reactions. It was concluded that benign and malignant notochordal lesions can be distinguished microscopically. (orig.)

MCM-2 expression differentiates potentially malignant verrucous lesions from oral carcinomas.

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Niranjan, Kochli Channappa; Sarathy, Niharika Abhay; Alrani, Devendra

2018-03-13

Mcm-2 is a biomarker belonging to Mcm family of proteins which has rarely been used in oral potentially malignant and malignant lesions of the verrucous type. The objective of this study is to assess the expression of Mcm-2 in Normal Oral Mucosa (NM), Verrucous Hyperplasia (VH), Verrucous Carcinoma (VC) and Oral Squamous Cell Carcinoma (OSCC) and compare it with the clinicopathological characteristics. A total of 70 formalin fixed paraffin embedded tissue samples (10 cases of Normal Mucosa NM- Group A, 10 cases of Verrucous Hyperplasia- VH without Dysplasia- Group B, 10 cases of Verrucous Hyperplasia- VH with Dysplasia- Group C, 20 cases of Verrucous Carcinoma VC-Group D, 20 cases of Oral Squamous Cell Carcinoma OSCC- Group E) were subjected to immunohistochemistry with Mcm-2 antibody. Statistical analysis was carried out with various tests like ANOVA, Tukey HSD, Chi-Square and Shapiro-Wilk test by using the SPSS software. There was a significant difference in Mcm-2 expression with quantitative analysis among all the groups (p Mcm-2 may be a sensitive proliferation marker in oral potentially malignant and malignant lesions which may be useful for differentiating between VH with/ without dysplasia, VC and OSCC. Copyright © 2018. Published by Elsevier Inc.

Diagnostic Criteria on 18F-FDG PET/CT for Differentiating Benign from Malignant Focal Hypermetabolic Lesions of Parotid Gland

International Nuclear Information System (INIS)

Park, Soo Bin; Choi, Joon Young; Lee, Eun Jeong; Yoo, Jang; Cheon, Miju; Cho, Suk Kyong; Choe, Yearn Seong; Lee, Kyung-Han; Kim, Byung-Tae

2012-01-01

We investigated PET/CT diagnostic criteria for differentiating benign from malignant parotid lesions with focal 18 F-FDG uptake. The subjects of the study were 272 patients who exhibited focal 18 F-FDG uptake of the parotid gland. Sixty-eight pathologically confirmed parotid lesions from 67 patients were included. The maximum SUV (SUVmax), uptake patterns (homogeneous vs. heterogeneous), size measured by CT, maximum Housfield units (HUmax) and margins on CT (well vs. ill defined) of each parotid lesion on PET/CT images were compared with final diagnoses. Thirty- two parotid lesions were histologically proven to be malignant. There were significant differences in uptake patterns (cancer incidence, heterogeneous:homogeneous=79.2%:29.5%, p<0.0001) and margins on CT (cancer incidence, ill:well defined=84.4%:13.3%, p<0.0001) between benign and malignant lesions. The cancer risks of parotid lesions were 89.5% with heterogeneous uptake and ill-defined margins, 70.6% with heterogeneous uptake or ill-defined margins (no overlap in subjects) and 9.3% with homogeneous uptake and well-defined margins (p<0.0001). When any lesion with heterogeneous uptake or ill-defined margins was regarded as malignant, the sensitivity, positive predictive value, negative predictive value and accuracy were 90.6% (29/32) and 85.6% (58/68), respectively. For predicting malignancy, combined PET/CT criteria showed better sensitivity, NPV and accuracy than PET-only criteria, and had a tendency to have more accurate results than CT-only criteria, and had a tendency to have more accurate results than CT-only criteria. There were no significant differences in SUVmax, size or HUmax between benign and malignant lesions. Uptake patterns and margins on CT are useful PET/CT diagnostic criteria for differentiating benign from malignant lesions

Quantification of the magnetization-transfer contrast effect: can it yield additional information in differentiation of musculoskeletal lesions particularly in separation of benign from malignant lesions

International Nuclear Information System (INIS)

Vahlensieck, M.; Traeber, F.; Schild, H.; Gieseke, J.

1999-01-01

Purpose: To investigate the potential information of the amount of magnetization-transfer effect in musculoskeletal lesions and to compare MT ratios from benign and malignant musculoskeletal lesions. Material and Method: 49 patients with malignant tumors (3 osteosarcoma, 3 malignant fibrous histiocytoma, 4 chondrosarcoma, 2 Ewing sarcomas) and benign lesions (8 chondroma, 2 fibrous dysplasia, 3 osteoid-osteoma, 6 ganglion cyst, 3 cyst, 3 osteomyelitis, 4 tendinitis, 3 rotator cuff tear, 5 scar tissue) were scanned using routine MRI protocols including T 1 - and T 2 -weighted spin echo as well as T 2 *-weighted gradient echo (FFE) sequences at 1.5 Tesla (ACS II, Philips Medical). Additionally MTC images were generated by combining the FFE sequence and the off-resonance MT technique (-1500 Hz off-resonance frequency, 1770 flip angle and 50 ms pulse duration). MT ratios were calculated as SI o -SI m /SI o . Results: The MT ratio of benign lesions was 26±15%, that of malignant lesions was 22±6%. The difference was statistically not significant. As expected muscle showed a high MT ratio of 50±8%. Scar tissue demonstrated an MT ratio of 39±16% which was significantly higher than the tumor MT ratios. Conclusion: MTC (MT ratios) failed to show significant differences between benign and malignant lesions as was expected due to basic differences in cellularity, rate of mitosis and chromatin content. MTC might however gain more importance in separating scar tissue from recurrent tumor in the future. (orig.) [de

Utility of Diffusion Weighted Magnetic Resonance Imaging with Multiple B Values in Evaluation of Pancreatic Malignant and Benign Lesions and Pancreatitis.

Science.gov (United States)

Karadeli, Elif; Erbay, Gurcan; Parlakgumus, Alper; Koc, Zafer

2018-02-01

To determine the feasibility of diffusion-weighted imaging in evaluation of pancreatic lesions and in differentiation of benign from malignant lesions. Descriptive study. Baskent University Adana Teaching and Research Center, Adana, Turkey, between September 2013 and May 2015. Forty-three lesions [pancreas adenocarcinoma (n=25)], pancreatitis (n=10), benign lesion (n=8)] were utilized with diffusion-weighted magnetic resonance imaging with multiple b-values. Different ADC maps of diffusion weighted images by using b-values were acquired. The median ADC at all b values for malignant lesions was significantly different from that for benign lesions (pvalues were compared between benign lesions/normal parenchyma and malignant lesions/normal parenchyma, there was a significant statistical difference in all b values between benign and malignant lesions except at b 50 and b 200 (pvalue (AUC=0.804) was more effective than the lesion ADC for b 600 value (AUC=0.766) in differentiation of benign and malignant lesions. The specificity and sensitivity of the lesion/normal parenchyma ADC ratio were higher than those of ADC values of lesions. When the ADC was compared between benign lesions and pancreatitis, a significant difference was found at all b values (pvalue combinations (p>0.05). Diffusion-weighted magnetic resonance images can be helpful in differentiation of pancreatic carcinoma and benign lesions. Lesion ADC / normal parenchyma ADC ratios are more important than lesion ADC values in assessment of pancreatic lesions.

Ultrasound-Guided Optical Tomographic Imaging of Malignant and Benign Breast Lesions: Initial Clinical Results of 19 Cases

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Quing Zhu

2003-09-01

Full Text Available The diagnosis of solid benign and malignant tumors presents a unique challenge to all noninvasive imaging modalities. Ultrasound is used in conjunction with mammography to differentiate simple cysts from solid lesions. However, the overlapping appearances of benign and malignant lesions make ultrasound less useful in differentiating solid lesions, resulting in a large number of benign biopsies. Optical tomography using near-infrared diffused light has great potential for imaging functional parameters of 1 tumor hemoglobin concentration, 2 oxygen saturation, 3 metabolism, as well as other tumor distinguishing characteristics. These parameters can differentiate benign from malignant lesions. However, optical tomography, when used alone, suffers from low spatial resolution and target localization uncertainty due to intensive light scattering. Our aim is to combine diffused light imaging with ultrasound in a novel way for the detection and diagnosis of solid lesions. Initial findings of two earlystage invasive carcinomas, one combined fibroadenoma and fibrocystic change with scattered foci of lobular neoplasia/lobular carcinoma in situ, 16 benign lesions are reported in this paper. The invasive cancer cases reveal about two-fold greater total hemoglobin concentration (mean 119 μmol than benign cases (mean 67 μmol, suggest that the discrimination of benign and malignant breast lesions might be enhanced by this type of achievable optical quantification with ultrasound localization. Furthermore, the small invasive cancers are well localized and have wavelength-dependent appearance in optical absorption maps, whereas the benign lesions appear diffused and relatively wavelength-independent.

Expression of c-kit in common benign and malignant breast lesions.

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Kondi-Pafiti, Agatha; Arkadopoulos, Nikolaos; Gennatas, Constantinos; Michalaki, Vassiliki; Frangou-Plegmenou, Matrona; Chatzipantelis, Paschalis

2010-01-01

c-kit (CD117) is a transmembrane tyrosine kinase that acts as a type III receptor for mast cell growth factor. In recent years, the role of c-kit in the development of preinvasive and invasive breast carcinomas has been investigated. The aim of our study was to detect c-kit expression in the entire spectrum of common benign and malignant breast lesions in correlation with a well-studied myoepithelial or stem-cell like marker (p63). We evaluated 270 cases of benign and malignant breast lesions including fibrocystic disease, fibroadenoma, sclerosing adenosis, atypical ductal hyperplasia, ductal/lobular carcinoma in situ, and ductal/lobular/mixed type carcinoma. C-kit staining was evaluated in the cytoplasm/cell membrane in epithelial and myoepithelial cells and p63 in the nuclei of myoepithelial cells. c-kit was highly expressed (85.3%) in benign lesions (fibrocystic disease, sclerosing adenosis, fibroadenoma), and p63 expression was 95.5% in the aforementioned lesions. c-kit distribution in preinvasive and invasive lesions was as follows: ductal/lobular carcinoma in-situ, 43%/35%; ductal/lobular carcinoma, 36%/39%; and mixed type carcinoma, 20%. c-kit was highly expressed in myofibroblast/fibroblast cells only in grade III ductal/lobular carcinomas. c-kit was totally absent in stromal cells in benign lesions and in situ carcinomas whereas expression was weak in grade I and II carcinomas. Combined overexpression of c-kit and p63 is indicative of benign breast lesions. In contrast, there is reduced expression of c-kit in in situ and invasive breast carcinomas, with simultaneous overexpression in the stromal cells. This suggests that c-kit may play a role in breast cancer progression.

Optical coherence tomography accurately identifies patients with penile (pre malignant lesions: A single center prospective study

Directory of Open Access Journals (Sweden)

Ronni Wessels

2015-01-01

Conclusion: In this preliminary study, qualitative and quantitative analysis of OCT-images of suspicious penile lesions shows differences between benign lesions and (pre malignant lesions. These results encourage further research in a larger study population.

HPV and oral lesions: preventive possibilities, vaccines and early diagnosis of malignant lesions.

Science.gov (United States)

Testi, D; Nardone, M; Melone, P; Cardelli, P; Ottria, L; Arcuri, C

2015-01-01

The importance of HPV in world healthy is high, in fact high-risk HPV types contribute significantly to viral associated neoplasms. In this article we will analyze vary expression of HPV in oral cavity both benign and malignant, their prevalence and the importance in early diagnosis and prevention. The classical oral lesions associated with human papillomavirus are squamous cell papilloma, condyloma acuminatum, verruca vulgaris and focal epithelial hyperplasia. Overall, HPV types 2, 4, 6, 11, 13 and 32 have been associated with benign oral lesions while HPV types 16 and 18 have been associated with malignant lesions, especially in cancers of the tonsils and elsewhere in the oropharynx. Transmission of the virus can occur with direct contact, genital contact, anal and oral sex; latest studies suggest a salivary transmission and from mother to child during delivery. The number of lifetime sexual partners is an important risk factor for the development of HPV-positive head-neck cancer. Oral/oropharyngeal cancer etiologically associated with HPV having an increased survival and a better prognostic (85%-90% to five years). There is no cure for the virus. There are two commercially available prophylactic vaccines against HPV today: the bivalent (16 and 18) Cervarix® and the tetravalent (6, 11, 16 and 18) Gardasil® and new vaccine Gardasil 9 (6, 11, 16, 18, 31, 33, 45, 52, 58) was approved in the United States. To be effective, such vaccination should start before "sexual puberty". The vaccine could be an important preventive strategy, in fact the scientific community is in agreement on hypothesis that blocking the contagion it may also limit the distance complications as the oropharyngeal cancer.

Radio-isotope scanning using labelled bleomycin in positive and differential diagnosis of primary and secondary malignant pulmonary lesions

International Nuclear Information System (INIS)

Robert, J.; Bertrand, A.; Nouel, J.P.; Witz, H.

1975-01-01

A lung scan using bleomycin labelled with cobalt 57 was carried out in 308 patients representing 191 primary malignant tumours, 48 pulmonary metastases and 69 benign lesions. The primary and secondary malignant lesions always gave rise to a hyperactive focus except in 8 cases of primary lung tumour. The negative examination may be explained, either by the small size of the lesion or by radiotherapy in progress. Among the benign lesions, only advanced tuberculosis and very inflammatory lung diseases frequently took up labelled bleomycin (15 hyperactive foci out of 69 benign lesions). Quantitative measurements, i.e. ratio of the lesional activity/activity of healthy lung tissue, were carried out in all patients. The malignant lesions were usually more active than the benign lesions. There was no definite correlation between the uptake of labelled bleomycin and the histological nature of the lesion. However, undifferentiated and anaplastic carcinomas were often more active. One should emphasize that these results show that a hyperactive focus has a 94% chance of being a carcinoma. The absence of bleomycin uptake means that there is a 92% chance of a benign lesion [fr

Reflectance spectroscopy of pigmented cutaneous benign and malignant lesions

Science.gov (United States)

Borisova, E.; Jeliazkova, Al.; Pavlova, E.; Troyanova, P.; Kundurdjiev, T.; Pavlova, P.; Avramov, L.

2014-10-01

For the DRS measurements of skin benign, dysplastic and malignant lesions in vivo we applied halogen lamp (LS-1, OceanOptics Inc, Dunedin, Fl, USA) as a continuous light source in the region of 400-900 nm, optical probe (6+1 fibers) for the delivery of illumination and diffuse reflected light from the skin investigated and microspectrometer USB4000 (OceanOptics Inc., Dunedin, Fl, USA) for a storage and display of the spectra detected. As a diffuse reflectance standard Spectralon® plate was used to calibrate the spectrometer. The reflectance spectra obtained from normal skin in identical anatomic sites of different patients have similar spectral shape features, slightly differ by the reflectance intensity at different wavelengths, depending on the particular patient' skin phototype. One could find diagnostically important spectral features, related to specific intensity changes for a given wavelength due to specific pigments appearance, slope changes by value and sign for the reflectance spectra curves in a specific spectral range, disappearance or manifestation of minima, related to hemoglobin absorption at 410-420 nm, 543, 575 nm. Based on the observed peculiarities multispectral analysis of the reflectance spectra of the different lesions was used and diagnostically specific features are found. Discrimination using the DRS data obtained between benign compound and dermal nevi (45 cases), dysplastic nevi (17 cases) and pigmented malignant melanoma (41 cases) lesions is achieved with a diagnostic accuracy of 96 % for the benign nevi vs. MM, and 90 % for the dysplastic nevi vs. MM.

Local Control of Perivascular Malignant Liver Lesions Using Percutaneous Irreversible Electroporation: Initial Experiences

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Eller, Achim, E-mail: Achim.Eller@uk-erlangen.de; Schmid, Axel, E-mail: axel.schmid@uk-erlangen.de [University Hospital Erlangen, University of Erlangen-Nuremberg, Department of Radiology (Germany); Schmidt, Joachim, E-mail: joachim.schmidt@kfa.imed.uni-erlangen.de [University Hospital Erlangen, University of Erlangen-Nuremberg, Department of Anesthesiology (Germany); May, Matthias, E-mail: matthias.may@uk-erlangen.de; Brand, Michael, E-mail: michael.brand@uk-erlangen.de; Saake, Marc, E-mail: marc.saake@uk-erlangen.de; Uder, Michael, E-mail: michael.uder@uk-erlangen.de; Lell, Michael, E-mail: michael.lell@uk-erlangen.de [University Hospital Erlangen, University of Erlangen-Nuremberg, Department of Radiology (Germany)

2015-02-15

PurposeThis study was designed to assess efficacy and safety in the treatment of perivascular malignant liver lesions using percutaneous, computed tomography (CT)-guided irreversible electroporation (IRE).MethodsFourteen patients (mean age 58 ± 11 years) with 18 malignant liver lesions were consecutively enrolled in this study. IRE was performed in patients not eligible for surgery and lesions abutting large vessels or bile ducts. Follow-up exams were performed using multislice-CT (MS-CT) or MRI.ResultsMedium lesion diameter was 20 ± 5 mm. Ten of 14 (71 %) were successfully treated with no local recurrence to date (mean follow-up 388 ± 160 days). One case left initial tumor control unclear and additional RFA was performed 4 weeks after IRE. Complications occurred in 4 of 14 (29 %) cases. In one case, intervention was terminated and abdominal bleeding required laparotomy. In two cases, a postinterventional hematothorax required intervention. In another case, abdominal bleeding could be managed conservatively. No complications related to the bile ducts occurred.ConclusionsPercutaneous IRE seems to be effective in perivascular lesions but is associated with a higher complication rate compared with thermoablative techniques.

Imaging characteristics of malignant and benign lesions of skeletal muscle; Bildgebende Charakteristika maligner und benigner Laesionen der Skelettmuskulatur

Energy Technology Data Exchange (ETDEWEB)

Leonard, L.; Meyer, H.J.; Surov, A. [Universitaetsklinikum Leipzig, Klinik fuer Diagnostische und Interventionelle Radiologie, Leipzig (Germany)

2017-12-15

There are many different tumors and tumor-like lesions with variable biological behavior that may affect the skeletal musculature. The aim of this study was to review the different intramuscular lesions and to provide a classification based on their radiological patterns. Intramuscular lesions can present as solid, liquid, semiliquid or fat equivalent manifestations and also as diffuse muscle enlargement and muscle calcification. Additionally, lesions with mixed patterns of the aforementioned alterations can also occur. Benign and malignant muscle lesions can often manifest with identical radiological patterns, which is why a certain differentiation is often difficult. A systematic radiological description and when possible assignment with respect to etiology and dignity depending on the patient history is necessary in order to recommend a subsequent histological confirmation or to avoid unnecessary confirmation. (orig.) [German] Es gibt eine Vielzahl an Tumoren und tumorartigen Veraenderungen mit unterschiedlichem biologischem Verhalten, die die Skelettmuskulatur befallen. Das Ziel dieser Arbeit ist es, unterschiedliche Laesionen der Skelettmuskulatur aufzuzeigen und anhand ihrer radiologischen Muster zu klassifizieren. Laesionen der Skelettmuskulatur koennen sich solide, liquide/semiliquide oder fettaequivalent manifestieren sowie auch als diffuse Muskelauftreibungen und als Muskelkalzifikationen. Darueber hinaus gibt es Laesionen mit Mischverhalten der genannten Veraenderungen. Benigne und maligne Veraenderungen koennen die gleichen radiologischen Muster aufweisen, weshalb eine sichere Differenzierung haeufig schwierig ist. Eine systematische radiologische Beschreibung und wenn moeglich Einordnung bez. Aetiologie und Dignitaet ist in Abhaengigkeit der Anamnese notwendig, um eine konsekutive histologische Sicherung zu empfehlen oder unnoetige invasive Eingriffe zu verhindern. (orig.)

Role of MRI in differentiating benign from malignant breast lesions ...

African Journals Online (AJOL)

Mohamed Ahmed Youssef

2017-02-15

Feb 15, 2017 ... renal dysfunction or previous reactions to contrast agents and will relieve the cost of examination.4,5. The aim of the study was to evaluate the role of the magnetic resonance imaging in differentiation of benign from malignant breast lesions using dynamic contrast enhanced MRI (DCE-MRI) and diffusion ...

Critical evaluation of the specificity of MRI and TVUS for differentiation of malignant from benign adnexal lesions

International Nuclear Information System (INIS)

Reuter, M.; Steffens, J.C.; Muhle, C.; Brinkmann, G.; Spielmann, R.P.; Heller, M.; Schueppler, U.; Weisner, D.; Luettges, J.; Maschek, A.

1998-01-01

The aim of our work was to study the specificity of MRI in comparison with transvaginal US for differentiation of malignant from benign adnexal lesions. A total of 67 patients with clinically suspicious adnexal lesions were evaluated by MRI. Transaxial and coronal images were acquired using T1-weighted sequences before and following IV contrast and T2-weighted sequences. In all patients transvaginal ultrasound examinations (TVUS) were performed. For both imaging modalities each lesion was classified separately as either benign or malignant according to previously published criteria. Pathologic findings were available in 65 cases. Both MRI and TVUS correctly classified the 12 malignant lesions (sensitivity 100 %). Specificity (MRI: 78.2 %, TVUS: 65.5 %) and accuracy (MRI: 82 %, TVUS: 71.6 %) were higher with MRI than with TVUS, but differences were statistically not significant (p = 0.18 and p = 0.20, chi-square test). There was agreement/disagreement between findings of MRI and US in 52/15 lesions. The macroscopic criteria for malignancy are unspecific and result in a limitation of the specificity of both MRI and TVUS. The MRI technique is a valuable adjunct to TVUS by enabling further clarification of adnexal tumors with equivocal complex or solid vaginal sonographic findings. (orig.)

First International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions).

Science.gov (United States)

Rageth, Christoph J; O'Flynn, Elizabeth Am; Comstock, Christopher; Kurtz, Claudia; Kubik, Rahel; Madjar, Helmut; Lepori, Domenico; Kampmann, Gert; Mundinger, Alexander; Baege, Astrid; Decker, Thomas; Hosch, Stefanie; Tausch, Christoph; Delaloye, Jean-François; Morris, Elisabeth; Varga, Zsuzsanna

2016-09-01

The purpose of this study is to obtain a consensus for the therapy of B3 lesions. The first International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions) including atypical ductal hyperplasia (ADH), flat epithelial atypia (FEA), classical lobular neoplasia (LN), papillary lesions (PL), benign phyllodes tumors (PT), and radial scars (RS) took place in January 2016 in Zurich, Switzerland organized by the International Breast Ultrasound School and the Swiss Minimally Invasive Breast Biopsy group-a subgroup of the Swiss Society of Senology. Consensus recommendations for the management and follow-up surveillance of these B3 lesions were developed and areas of research priorities were identified. The consensus recommendation for FEA, LN, PL, and RS diagnosed on core needle biopsy or vacuum-assisted biopsy (VAB) is to therapeutically excise the lesion seen on imaging by VAB and no longer by open surgery, with follow-up surveillance imaging for 5 years. The consensus recommendation for ADH and PT is, with some exceptions, therapeutic first-line open surgical excision. Minimally invasive management of selected B3 lesions with therapeutic VAB is acceptable as an alternative to first-line surgical excision.

Ultrasound-Guided Optical Tomographic Imaging of Malignant and Benign Breast Lesions: Initial Clinical Results of 19 Cases1

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Zhu, Quing; Huang, Minming; Chen, NanGuang; Zarfos, Kristen; Jagjivan, Bipin; Kane, Mark; Hedge, Poornima; Kurtzman, H. Scott

2003-01-01

Abstract The diagnosis of solid benign and malignant tumors presents a unique challenge to all noninvasive imaging modalities. Ultrasound is used in conjunction with mammography to differentiate simple cysts from solid lesions. However, the overlapping appearances of benign and malignant lesions make ultrasound less useful in differentiating solid lesions, resulting in a large number of benign biopsies. Optical tomography using near-infrared diffused light has great potential for imaging functional parameters of 1) tumor hemoglobin concentration, 2) oxygen saturation, and 3) metabolism, as well as other tumor distinguishing characteristics. These parameters can differentiate benign from malignant lesions. However, optical tomography, when used alone, suffers from low spatial resolution and target localization uncertainty due to intensive light scattering. Our aim is to combine diffused light imaging with ultrasound in a novel way for the detection and diagnosis of solid lesions. Initial findings of two earlystage invasive carcinomas, one combined fibroadenoma and fibrocystic change with scattered foci of lobular neoplasia/lobular carcinoma in situ, and 16 benign lesions are reported in this paper. The invasive cancer cases reveal about two-fold greater total hemoglobin concentration (mean 119 µmol) than benign cases (mean 67 µmol), and suggest that the discrimination of benign and malignant breast lesions might be enhanced by this type of achievable optical quantification with ultrasound localization. Furthermore, the small invasive cancers are well localized and have wavelength-dependent appearance in optical absorption maps, whereas the benign lesions appear diffused and relatively wavelength-independent. PMID:14670175

Immunohistochemical localization of HE4 in benign, borderline, and malignant lesions of the ovary.

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Georgakopoulos, Penelope; Mehmood, Saira; Akalin, Ali; Shroyer, Kenneth R

2012-11-01

Despite advances in the development of novel methods to improve treatment, ovarian carcinoma is still the leading cause of gynecologic cancer death in the United States and other industrialized nations. Improvements in the clinical outcome of ovarian cancer will be achieved if methods can be developed to enable the detection of these tumors at the earliest possible stage. Thus, it is critically important to identify and validate new biomarkers of ovarian cancer. HE4 expression was defined by immunohistochemical analysis of a wide range of benign, borderline, and malignant ovarian lesions, including serous, endometrioid, mucinous, and clear cell lesions of the ovary and in primary tubal carcinomas and the normal fallopian tube. At the cellular level, HE4 was highly expressed in malignant ovarian tumors and in a wide range of benign and borderline ovarian lesions. In addition, HE4 was highly expressed in primary fallopian tube carcinomas and benign fallopian tubal epithelial cells. These results support the conclusion that HE4 is widely expressed in most benign, borderline, and malignant lesions of the ovary and the fallopian tube. The detection of HE4 expression at high levels in some benign lesions and normal tissues suggests that HE4 could have limited specificity as a marker of ovarian or tubal carcinoma. Furthermore, the relatively weak expression that was observed in many ovarian carcinomas indicates that HE4 could fail to detect some cases of primary or recurrent disease.

Optimization of Region of Interest Drawing for Quantitative Analysis: Differentiation Between Benign and Malignant Breast Lesions on Contrast-Enhanced Sonography.

Science.gov (United States)

Nakata, Norio; Ohta, Tomoyuki; Nishioka, Makiko; Takeyama, Hiroshi; Toriumi, Yasuo; Kato, Kumiko; Nogi, Hiroko; Kamio, Makiko; Fukuda, Kunihiko

2015-11-01

This study was performed to evaluate the diagnostic utility of quantitative analysis of benign and malignant breast lesions using contrast-enhanced sonography. Contrast-enhanced sonography using the perflubutane-based contrast agent Sonazoid (Daiichi Sankyo, Tokyo, Japan) was performed in 94 pathologically proven palpable breast mass lesions, which could be depicted with B-mode sonography. Quantitative analyses using the time-intensity curve on contrast-enhanced sonography were performed in 5 region of interest (ROI) types (manually traced ROI and circular ROIs of 5, 10, 15, and 20 mm in diameter). The peak signal intensity, initial slope, time to peak, positive enhancement integral, and wash-out ratio were investigated in each ROI. There were significant differences between benign and malignant lesions in the time to peak (P benign and malignant lesions in the time to peak (P benign and malignant breast lesions. © 2015 by the American Institute of Ultrasound in Medicine.

Comparison of morphological and kinetic parameters in distinction of benign and malignant breast lesions in dynamic contrast enhanced magnetic resonance imaging

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Direnç Özlem Aksoy

2013-12-01

Full Text Available Objective: To evaluate the value of qualitative morphologicaland kinetic data and quantitative kinetic data indistinction of malignancy in dynamic contrast enhancedmagnetic resonance imaging (DCE-MRI of the breast.Methods: DCE-MRIs of 49 subjects were evaluated.Morphological and contrast enhancement parameters of95 lesions were recorded in these subjects. Post-contrastkinetic behavior of these lesions were also investigated.Among the quantitative parameters, relative enhancements(E1, E2, Epeak, time-to-peak (Tpeak, slope ofcurve (Slope, signal enhancement ratio (SER, and maximumintensity time ratio (MITR were calculated. Theseresults were compared with the pathological diagnosis.Results: Spiculated contour (100%, rim enhancement(97.87%, irregular shape (95.74%, and irregular margin(91.49% were the most specific morphological featuresof malignancy in mass lesions. In non-mass lesions, focalzone (91.49% was the most specific feature of malignancy.74.5% of the benign lesions showed type 1, 77.1%of the malignant lesions showed type 2 and 3 curves accordingto the kinetic curve evaluation. All quantitativeparameters except Epeak were found to be statisticallysignificant in distinction of malignancy.Conclusion: None of the morphological features of thebenign lesions were found to be significantly specific.More specific features can be described for malignantlesions. Early behavior of the kinetic curve is not usefulfor diagnosis of malignancy but the intermediate and latebehavior gives useful information. Quantitative data involvedin this study might be promising.Key words: Morphological, kinetic, breast lesions, magnetic resonance imaging, dynamic

Application of cytology and molecular biology in diagnosing premalignant or malignant oral lesions

Science.gov (United States)

Mehrotra, Ravi; Gupta, Anurag; Singh, Mamta; Ibrahim, Rahela

2006-01-01

Early detection of a premalignant or cancerous oral lesion promises to improve the survival and the morbidity of patients suffering from these conditions. Cytological study of oral cells is a non-aggressive technique that is well accepted by the patient, and is therefore an attractive option for the early diagnosis of oral cancer, including epithelial atypia and squamous cell carcinoma. However its usage has been limited so far due to poor sensitivity and specificity in diagnosing oral malignancies. Lately it has re-emerged due to improved methods and it's application in oral precancer and cancer as a diagnostic and predictive method as well as for monitoring patients. Newer diagnostic techniques such as "brush biopsy" and molecular studies have been developed. Recent advances in cytological techniques and novel aspects of applications of scraped or exfoliative cytology for detecting these lesions and predicting their progression or recurrence are reviewed here. PMID:16556320

Benign thyroid and neck lesions mimicking malignancy with false positive findings on positron emission tomography-computed tomography

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Yoon, Ye Ri; Kim, Shin Young; Lee, Sang Mi [Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of); Lee, Deuk Young [Dept. of Surgery, Younsei Angelot Women' s Clinic, Cheonan (Korea, Republic of)

2017-02-15

The increasing use of positron emission tomography-computed tomography (PET/CT) has led to the frequent detection of incidental thyroid and neck lesions with increased 18F-deoxyglucose (FDG) uptake. Although lesions with increased FDG uptake are commonly assumed to be malignant, benign lesions may also exhibit increased uptake. The purpose of this pictorial essay is to demonstrate that benign thyroid and neck lesions can produce false-positive findings on PET/CT, and to identify various difficulties in interpretation. It is crucial to be aware that differentiating between benign and malignant lesions is difficult in a considerable proportion of cases, when relying only on PET/CT findings. Correlation of PET/CT findings with additional imaging modalities is essential to avoid misdiagnosis.

The differentiation of benign from malignant soft tissue lesions using FDG-PET: comparison between semi-quantitative indices

International Nuclear Information System (INIS)

Choi, Joon Young; Lee, Kyung Han; Choe, Yearn Seong; Choi, Yong; Kim, Sang Eun; Kim, Byung Tae; Seo, Jae Gon

1997-01-01

The purpose of this study is to evaluate the diagnostic accuracy of various quantitative indices for the differentiation of benign from malignant primary soft tissue tumors by FDG-EPT. A series of 32 patients with a variety of histologically or clinically confirmed benign (20) or malignant (12) soft tissue lesions were evaluated with emission whole body (5min/bed position) PET after injection of [ 18 F]FDG. Regional 20min transmission scan for the attenuation correction and calculation of SUV was performed in 16 patients (10 benign, 6 malignnant) followed by dynamic acquisition for 56 min. Postinjection transmission scan for the attenuation correction and calculation of SUV was executed in the other 16 patients (10 benign, 6 malignant ). The following indices were obtained: the peak and average SUV (pSUV, aSUV) of lesions, tumor-to-background ratio acquired at images of 51 min p.i. (TBR 51 ), tumor-to-background ratio of areas under time-activity curves (TBR area ) and the ratio between the activities of tumor ROI at 51 min p.i. and at the time which background ROI reaches maximum activity on the time-activity curves (T 51 /T max ). The pSUV, aSUV, TBR 51 , and TBR area in malignant lesions were significantly higher than those in benign lesions. We set the cut-off values of pSUV, aSUV, TBR 51 , TBR area and T 51 /max for the differentiation of benign and malignant lesions at 3.5, 2.8, 5.1, 4.3 and 1.55, respectively. The sensitivity, specificity and accuracy were 91.7%, 80.0%, 84.4% by pSUV and aSUV, 83.3%, 85.0%, 84.4% by TBR 51 , 83.3%, 100%, 93.8% by TBR area and 66.7%, 70.0%, 68.8% by T 51 /T max . The time-activity curves did not give additional information compared to SUV or TBR. The one false negative was a case with low-grade fibrosarcoma and all four false positives were cases with inflammatory change on histology. The visual analysis of FDG-PET also detected the metastatic lesions in malignant cases with comparable accuracy. In conclusion, all pSUV, a

Comparing disciplines: outcomes of non melanoma cutaneous malignant lesions in oral and maxillofacial surgery and dermatology.

Science.gov (United States)

Thavarajah, M; Szamocki, S; Komath, D; Cascarini, L; Heliotis, M

2015-01-01

300 cases of non-melanoma cutaneous lesion procedures carried out by the Oral and Maxillofacial Surgery and Dermatology departments in a North West London hospital over a 6 month period between September 2011 and February 2012 were included in a retrospective case control study. The results from each speciality were compared. The mean age of the OMFS group was 75.8 years compared to 69.9 years in the dermatology group. There was no statistically significant difference in gender between the 2 groups. The OMFS group treated a higher proportion of atypical (17%) and malignant (64.9%) cases compared to the dermatology group (11.3% and 50.5% respectively). This could also account for the fact that the OMFS group carried out a higher number of full excisions compared to dermatology. Both groups had a similar number of false positives (a benign lesion initially diagnosed as malignant) and a similar proportion of false negatives (a malignant lesion initially diagnosed as benign). Overall, the results show that both specialities had similar outcomes when managing non-melanoma cutaneous lesions. Both groups adhere to the guidelines set out by the British Association of Dermatologists and the National Institute of Clinical Excellence when managing such lesions. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Diagnostic accuracy of contrast-enhanced ultrasound in differentiating benign and malignant focal liver lesions: a retrospective study

International Nuclear Information System (INIS)

Ooi, Chin-Chin; Low, Su-Chong Albert; Lim, Sze-Ying; Bakar, Rafidah Abu; Lo, Richard Hoau-Gong; Schneider-Kolsky, Michal; Lombardo, Paul

2010-01-01

Full text: Purpose: The purpose of this study was to access the diagnostic accuracy of our early experience with contrast-enhanced ultrasound (CEUS) in the characterisation of focal liver lesions (FLLs) using histopathology, contrastenhanced computed tomography (CT), magnetic resonance imaging (MRI) or other imaging follow-up as the standard of reference. Materials and Methods: Seventy-three patients with 82 FLLs who underwent liver CEUS from January 2006 to December 2008 were retrospectively reviewed. CEUS was performed with up to 4.8 mL of SonoVue (Bracco, Milan, Italy) using a low mechanical index mode. The CEUS findings were compared with histopathology, or where histopathology was not available, clinical and imaging follow-up over at least 12 months was used as the standard of reference. Results: Of the 82 FLLs, 50 were malignant and 32 were benign at final diagnosis. CEUS correctly identified 43 malignant FLLs, with final diagnosis confirmed by histopathology in 13 lesions and clinico-radiological follow-up in 30 lesions. Twenty-nine lesions were correctly identified as benign on CEUS, with all these lesions confirmed on c1inico-radiological follow-up. CEUS demonstrated a sensitivity of 86.0% and a specificity of 90.6% in the characterisation of liver lesions as malignant, with an overall accuracy of 87.8% (P< 0.05). Conclusion: Our early experience has shown that CEUS can be accurate in differentiating malignant from benign FLLs and may become a useful first-line imaging tool where CT or MRI are not available or contra-indicated.

Risks of Being Malignant or High Risk and Their Characteristics in Breast Lesions 20 mm or Larger After Benign Results on Ultrasonography-Guided 14-Gauge Core Needle Biopsy.

Science.gov (United States)

Moon, Hee Jung; Kim, Min Jung; Yoon, Jung Hyun; Kim, Eun-Kyung

2016-06-01

The malignancy risk, risk of being high-risk lesions after benign results on ultrasonography-guided 14-gauge core needle biopsies (US-CNBs), and their characteristics in breast lesions of 20 mm or greater were investigated. Eight hundred forty-seven breast lesions with benign results on US-CNB were classified as benign, high risk, and malignant through excision and clinical follow-up. The risks of being malignant or high risk were analyzed in all lesions, lesions 20 to 29 mm, and lesions 30 mm or greater. Their clinicopathological characteristics were evaluated. Of 847, 18 (2.1%) were malignant, 53 (6.3%) were high-risk lesions, and 776 (91.6%) were benign. Of 18 malignancies, 6 (33.3%) were malignant phyllodes tumors and 12 (66.7%) were carcinomas. In benign lesions 20 to 29 mm, risks of being malignant or high risk were 1.6% (9 of 566) and 4.4% (25 of 566). In 281 lesions 30 mm or greater, the risks of being malignant or high risk were 3.2% and 10%. The risk of being high risk in lesions 30 mm or greater was 10%, significantly higher than 4.4% of lesions 20 to 29 mm (P = 0.002). Excision can be considered in lesions measuring 20 mm or larger because of the 2.1% malignancy risk and the 6.3% risk of being high-risk lesions despite benign results on US-CNB. Excision should be considered in lesions measuring 30 mm or larger because of the 3.2% malignancy risk and the 10% risk of being high-risk lesions.

Intravoxel Incoherent Motion MR Imaging in the Differentiation of Benign and Malignant Sinonasal Lesions: Comparison with Conventional Diffusion-Weighted MR Imaging.

Science.gov (United States)

Xiao, Z; Tang, Z; Qiang, J; Wang, S; Qian, W; Zhong, Y; Wang, R; Wang, J; Wu, L; Tang, W; Zhang, Z

2018-01-25

Intravoxel incoherent motion is a promising method for the differentiation of sinonasal lesions. This study aimed to evaluate the value of intravoxel incoherent motion in the differentiation of benign and malignant sinonasal lesions and to compare the diagnostic performance of intravoxel incoherent motion with that of conventional DWI. One hundred thirty-one patients with histologically proved solid sinonasal lesions (56 benign and 75 malignant) who underwent conventional DWI and intravoxel incoherent motion were recruited in this study. The diffusion coefficient ( D ), pseudodiffusion coefficient ( D *), and perfusion fraction ( f ) values derived from intravoxel incoherent motion and ADC values derived from conventional DWI were measured and compared between the 2 groups using the Student t test. Receiver operating characteristic curve analysis, logistic regression analysis, and 10-fold cross-validation were performed to evaluate the diagnostic performance of single-parametric and multiparametric models. The mean ADC and D values were significantly lower in malignant sinonasal lesions than in benign sinonasal lesions (both P benign and malignant sinonasal lesions. © 2018 by American Journal of Neuroradiology.

Malignant lympho-epithelial lesion of salivary gland: a case report and review of literature

International Nuclear Information System (INIS)

Borg, M.F.; Benjamin, C.S.; Morton, R.; Llewellyn, H.R.

1993-01-01

Malignant lympho-epithelial lesion of the salivary gland is an undifferentiated squamous cell carcinoma which is associated with a prominent lymphocyte-rich stroma. This study reviews the current literature pertaining to this rare tumour with reference to the single recorded case of malignant lympho-epithelial lesion of the salivary gland presenting in Auckland, New Zealand. Forty-one per cent of patients present with regional lymph node metastases and 20% with distant metastases. Given the rarity of this disease, treatment is controversial. Current data suggest that early radical combined modality treatment using surgery and radiotherapy leads to prolonged survival and cure with 5 year survival rates greater than 50%. 25 refs., 2 tabs., 4 figs

Retrospective analysis of the utility of multiparametric MRI for differentiating between benign and malignant breast lesions in women in China.

Science.gov (United States)

Fan, Wei Xiong; Chen, Xiao Feng; Cheng, Feng Yan; Cheng, Ya Bao; Xu, Tai; Zhu, Wen Biao; Zhu, Xiao Lei; Li, Gui Jin; Li, Shuai

2018-01-01

We explored the utility of time-resolved angiography with interleaved stochastic trajectories dynamic contrast-enhanced magnetic resonance imaging (TWIST DCE-MRI), readout segmentation of long variable echo-trains diffusion-weighted magnetic resonance imaging- diffusion-weighted magnetic resonance imaging (RESOLVE-DWI), and echo-planar imaging- diffusion-weighted magnetic resonance imaging (EPI-DWI) for distinguishing between malignant and benign breast lesions.This retrospective analysis included female patients with breast lesions seen at a single center in China between January 2016 and April 2016. Patients were allocated to a benign or malignant group based on pathologic diagnosis. All patients received routine MRI, RESOLVE-DWI, EPI-DWI, and TWIST DCE-T1WI. Variables measured included quantitative parameters (K, Kep, and Ve), semiquantitative parameters (rate of contrast enhancement for contrast agent inflow [W-in], rate of contrast decay for contrast agent outflow [W-out], and time-to-peak enhancement after contrast agent injection [TTP]) and apparent diffusion coefficient (ADC) values for RESOLVE-DWI (ADCr) and EPI-DWI (ADCe). Receiver-operating characteristic (ROC) curve analysis was used to evaluate the diagnostic utility of each parameter for differentiating malignant from benign breast lesions.A total of 87 patients were included (benign, n = 20; malignant, n = 67). Compared with the benign group, the malignant group had significantly higher K, Kep and W-in and significantly lower W-out, TTP, ADCe, and ADCr (all P benign and malignant lesions. Combining 3 parameters (Kep, W-out, and ADCr) had a higher diagnostic efficiency (AUC, 0.965) than any individual parameter and distinguished between benign and malignant lesions with high sensitivity (91.0%), specificity (95.0%), and accuracy (91.9%).An index combining Kep, W-out, and ADCr could potentially be used for the differential diagnosis of breast lesions.

Seminal epithelium in prostate biopsy can mimic malignant and premalignant prostatic lesions.

Science.gov (United States)

Arista-Nasr, J; Trolle-Silva, A; Aguilar-Ayala, E; Martínez-Benítez, B

2016-01-01

In most prostate biopsies, the seminal epithelium is easily recognised because it meets characteristic histological criteria. However, some biopsies can mimic malignant or premalignant prostatic lesions. The aims of this study were to analyse the histological appearance of the biopsies that mimic adenocarcinomas or preneoplastic prostatic lesions, discuss the differential diagnosis and determine the frequency of seminal epithelia in prostate biopsies. We consecutively reviewed 500 prostate puncture biopsies obtained using the sextant method and selected those cases in which we observed seminal vesicle or ejaculatory duct epithelium. In the biopsies in which the seminal epithelium resembled malignant or premalignant lesions, immunohistochemical studies were conducted that included prostate-specific antigen and MUC6. The most important clinical data were recorded. Thirty-six (7.2%) biopsies showed seminal epithelium, and 7 of them (1.4%) resembled various prostate lesions, including high-grade prostatic intraepithelial neoplasia, atypical acinar proliferations, adenocarcinomas with papillary patterns and poorly differentiated carcinoma. The seminal epithelium resembled prostate lesions when the lipofuscin deposit, the perinuclear vacuoles or the nuclear pseudoinclusions were inconspicuous or missing. Five of the 7 biopsies showed mild to moderate cellular atypia with small and hyperchromatic nuclei, and only 2 showed cellular pleomorphism. The patients were alive and asymptomatic after an average of 6 years of progression. The seminal epithelium resembles prostatic intraepithelial neoplasia, atypical acinar proliferations and various types of prostatic adenocarcinomas in approximately 1.4% of prostate biopsies. Copyright © 2015 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Mass lesions in chronic pancreatitis: benign or malignant? An "evidence-based practice" approach.

LENUS (Irish Health Repository)

Gerstenmaier, Jan F

2012-02-01

The diagnosis of a pancreatic mass lesion in the presence of chronic pancreatitis can be extremely challenging. At the same time, a high level of certainty about the diagnosis is necessary for appropriate management planning. The aim of this study was to establish current best evidence about which imaging methods reliably differentiate a benign from a malignant lesion, and show how that evidence is best applied. A diagnostic algorithm based on Bayesian analysis is proposed.

Expression of ABCG2 and Bmi-1 in oral potentially malignant lesions and oral squamous cell carcinoma

International Nuclear Information System (INIS)

Dalley, Andrew J; Pitty, Luke P; Major, Aidan G; AbdulMajeed, Ahmad A; Farah, Camile S

2014-01-01

Early diagnosis is vital for effective treatment of oral squamous cell carcinoma (OSCC). The optimal time for clinical intervention is prior to malignancy when patients present with oral potentially malignant lesions such as leukoplakia or erythroplakia. Transformation rates for oral dysplasia vary greatly and more rigorous methods are needed to predict the malignant potential of oral lesions. We hypothesized that the expression of two putative stem cell markers, ABCG2 and Bmi-1, would correlate with disease severity for non diseased, potentially malignant and OSCC specimens and cell lines derived from an equivalent range of tissues. We compared immunoreactive protein and relative gene expression of ABCG2 and Bmi-1 in eight cell lines derived from source tissues ranging in disease severity from normal (OKF6-TERT2) through mild and moderate/severe dysplasia (DOK, POE-9n) to OSCC (PE/CA-PJ15, SCC04, SCC25, SCC09, SCC15). We also analyzed immunoreactive protein expression of ABCG2 and Bmi-1 in 189 tissue samples with the same range of disease severity. A trend between oral lesion severity to ABCG2 and Bmi-1 immunostain intensity was observed. Flow cytometry of oral cell lines confirmed this trend and gave good correlation with RT-PCR results for ABCG2 (r = 0.919, P = 0.001; Pearson) but not Bmi-1 (r = −0.311). The results provide evidence of increased density of ABCG2 and Bmi-1-positive populations in malignant and oral potentially malignant lesions and derived cell lines, but that intragroup variability within IHC, flow cytometry, and RT-PCR results compromise the diagnostic potential of these techniques for discriminating oral dysplasia from normal tissue or OSCC

CT findings of pleural lesions: differential diagnosis between malignant benign diseases

Energy Technology Data Exchange (ETDEWEB)

Baek, Seung Yon; Lim, Tae Hwan; Kim, Woo Sun; Park, Kwang Gil [Asan Medical Center, University of Ulsan, College of Medicine, Seoul (Korea, Republic of)

1991-05-15

A number of benign and malignant diseases may cause pleural abnormalities. Since the resolution of computed tomography (CT) has been improved, the detailed anatomy of pleura can now be well delineated in various pleural diseases. We reviewed retrospectively the CT findings of 60 patients with pathologically proved pleural diseases in order to find out the differential points between benign and malignant diseases. Thirty-six patients had malignant diseases (20 adenocarcinoma, 8 squamous cell carcinoma, 4 small cell carcinoma, 2 lung metastasis, 1 large cell carcinoma, 1 small and large cell carcinoma), and 24 patients had benign diseases (16 tuberculosis including empyema, 3 bacterial empyema, 3 pneumonia, 1 lung abscess, 1 lung contusion). The CT features that suggested malignant pleural diseases were high-grade mediastinal involvement (57.9%, {rho} < 0.1), thick and irregular thickening with nodularity and mass formations (38.5%, {rho} < 0.1), Circumferential pleural thickening 132.1%, {rho} < 0.01), and aggressive pleural effusion 122.2%, {rho} < 0.05). Benign pleural lesions were typically represented by pleural calcification (50%) and extrapleural fat accumulation (45.8%)

Malignant vascular lesions of bone: radiologic and pathologic features

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Wenger, D.E. [Dept. of Diagnostic Radiology, Mayo Foundation, Rochester, MN (United States); Wold, L.E. [Dept. of Laboratory Medicine and Pathology, Mayo Foundation, Rochester, MN (United States)

2000-11-01

The malignant vascular tumors of bone represent an uncommon diverse group of tumors with widely variable clinical and radiographic presentations. Although the radiographic imaging features of the lytic osseous lesions typically seen with this group of tumors are relatively nonspecific, the propensity to develop multifocal disease in an anatomic region is a feature that can be helpful in suggesting the diagnosis of a vascular tumor. The differential diagnosis varies according to the age of the patient and presence of solitary or multifocal disease. The histologic features are variable and range from tumors with vasoformative features to those that mimic mesenchymal neoplasm or metastatic carcinoma. Familiarity with the radiographic and pathologic spectrum of disease is essential for making an accurate diagnosis in this diverse group of neoplasms. This paper will provide a review of the nomenclature for the malignant vascular tumors of bone and discuss the radiographic and pathologic differential diagnosis. (orig.)

Computer-Aided Diagnosis of Micro-Malignant Melanoma Lesions Applying Support Vector Machines

Directory of Open Access Journals (Sweden)

Joanna Jaworek-Korjakowska

2016-01-01

Full Text Available Background. One of the fatal disorders causing death is malignant melanoma, the deadliest form of skin cancer. The aim of the modern dermatology is the early detection of skin cancer, which usually results in reducing the mortality rate and less extensive treatment. This paper presents a study on classification of melanoma in the early stage of development using SVMs as a useful technique for data classification. Method. In this paper an automatic algorithm for the classification of melanomas in their early stage, with a diameter under 5 mm, has been presented. The system contains the following steps: image enhancement, lesion segmentation, feature calculation and selection, and classification stage using SVMs. Results. The algorithm has been tested on 200 images including 70 melanomas and 130 benign lesions. The SVM classifier achieved sensitivity of 90% and specificity of 96%. The results indicate that the proposed approach captured most of the malignant cases and could provide reliable information for effective skin mole examination. Conclusions. Micro-melanomas due to the small size and low advancement of development create enormous difficulties during the diagnosis even for experts. The use of advanced equipment and sophisticated computer systems can help in the early diagnosis of skin lesions.

Stereological estimation of nuclear volume in benign melanocytic lesions and cutaneous malignant melanomas

DEFF Research Database (Denmark)

Sørensen, Flemming Brandt

1989-01-01

a favorable prognosis. No significant differences in vV could be demonstrated among different noninvasive tumor types. Two-dimensional estimates only distinguished benign from malignant tumors with considerable overlap and with significantly varying influence from other factors among different benign lesional...

Intestinal lesions induced by radiotherapy of malignant pelvic tumors. 2 cases

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Manigand, G; Pointud, P; Foulon, D; Montely, J M; Testas, P; Paillas, J; Deparis, M [Hopital de Bicetre, 94 - le Kremlin-Bicetre (France)

1976-11-16

Intestinal lesions after radiotherapy for pelvic malignant tumors are of two types: ulcerative colitis with stenosis and hemorrhage sometimes severe and repeated, and ileal involvement with focal ischemic lesions and malabsorption responsible for nutritional disorders. It is difficult to distinguish them from a recurrence of the tumor in spite of endoscopy, arteriography and biopsy. The course in 3 stages is of great value in diagnosis. A reduction in the frequency of such complications may be hoped for by assessment and exclusion of predisposing factors, by strict observance of therapeutic rules. They are serious owing to the marked irreversible conjunctivo-vascular changes and the fragility of the irradiated tissues during operation.

Contralateral lesions detected by preoperative MRI in patients with recently diagnosed breast cancer: Application of MR CAD in differentiation of benign and malignant lesions

International Nuclear Information System (INIS)

Cho, Nariya; Kim, Sun Mi; Park, Jeong Seon; Jang, Mijung; Kim, Soo-Yeon; Chang, Jung Min; Moon, Woo Kyung

2012-01-01

Objectives: To retrospectively investigate the added value of kinetic features measured by computer-aided diagnosis (CAD) for differentiating benign and malignant contralateral breast lesions detected by preoperative MRI in breast cancer patients. Methods: This study was approved by our institutional review board, and the requirement for informed consent was waived. Fifty-two breast MR images and their CAD kinetic features were obtained for 52 consecutive breast cancer patients with contralateral breast lesions detected by preoperative MRI and confirmed by excision (23 cancers and 29 benign lesions). Three experienced radiologists independently reviewed the MR images without CAD information and assessed probabilities of malignancy. Four weeks later, these probabilities were reanalyzed using stored CAD data. Diagnostic performances and detection rates of delayed washout components were compared between interpretations without and with CAD for each reader. Results: Use of MR CAD increased detection of washout component by 2.4- to 3.7-fold than visual assessment for enhancing contralateral lesions, which increased sensitivity (91% vs. 87% in reader 1; 96% vs. 74% in reader 2; 91% vs. 70% in reader 3) and decreased specificity, but statistical significance was only found for decreased specificity in one reader (52% vs. 28%, P = 0.039), and overall performance (areas under ROC curves 0.672 vs. 0.616 in reader 1; 0.624 vs. 0.603 in reader 2; 0.706 vs. 0.590 in reader 3) remained unimproved. Conclusion: Addition of MR CAD increased sensitivity and decreased specificity than radiologist's assessment alone for differentiating benign and malignant contralateral lesions in breast cancer patients and overall performance remained unimproved.

The value of dual time point 18F-FDG PET imaging for the differentiation between malignant and benign lesions

International Nuclear Information System (INIS)

Lan, X.-L.; Zhang, Y.-X.; Wu, Z.-J.; Jia, Q.; Wei, H.; Gao, Z.-R.

2008-01-01

Aim: To assess the clinical value of dual time point 2-[ 18 F]-fluoro-2-deoxy-D-glucose positron emission tomography ( 18 F-FDG PET) imaging for the differentiation between malignant and benign lesions. Materials and methods: Ninety-six patients (28 patients with primary lung cancer, 18 patients with digestive system carcinoma, 13 patients with other malignant tumours, and 37 patients with benign lesions) underwent FDG-PET/CT at two time points: examination 1 at 45-55 min and examination 2 at 160 ± 24 (150-180) min after the intravenous injection of 233 ± 52 (185-370) MBq 18 F-FDG. Reconstructed images were evaluated qualitatively and quantitatively. The maximum standardized uptake values (SUVmax) of the lesions were calculated for both time points. An increase was considered to have occurred if the SUVs at examination 2 had increased by >10% as compared with those at the examination 1. Results: The lesions in 24 of 28 (86%) patients with primary lung cancer had an SUVmax ≥2.5 at examination 1. Of these, SUVmax values increased in 23 patients, but had not changed in one patient, at examination 2. The lesions in the other four patients with primary lung tumour had SUVmax values between 1.5 and 2.5 at examination 1, which were considered as suspected positive, increased SUVmax values were observed in three of these patients at examination 2. The malignant lesions in 17 of 18 patients with digestive system carcinoma showed SUVmax values ≥2.5 and only one patient had an SUVmax value 18 F-FDG PET imaging is an important noninvasive method for the differentiation of malignant and nonmalignant lesions

Clinical Significance of Cannabinoid Receptors CB1 and CB2 Expression in Human Malignant and Benign Thyroid Lesions

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Eleftheria Lakiotaki

2015-01-01

Full Text Available The endocannabinoid system is comprised of cannabinoid receptors (CB1 and CB2, their endogenous ligands (endocannabinoids, and proteins responsible for their metabolism participate in many different functions indispensable to homeostatic regulation in several tissues, exerting also antitumorigenic effects. The present study aimed to evaluate the clinical significance of CB1 and CB2 expression in human benign and malignant thyroid lesions. CB1 and CB2 proteins’ expression was assessed immunohistochemically on paraffin-embedded thyroid tissues obtained from 87 patients with benign (n=43 and malignant (n=44 lesions and was statistically analyzed with clinicopathological parameters, follicular cells’ proliferative capacity, and risk of recurrence rate estimated according to the American Thyroid Association (ATA staging system. Enhanced CB1 and CB2 expression was significantly more frequently observed in malignant compared to benign thyroid lesions (p=0.0010 and p=0.0005, resp.. Enhanced CB1 and CB2 expression was also significantly more frequently observed in papillary carcinomas compared to hyperplastic nodules (p=0.0097 and p=0.0110, resp.. In malignant thyroid lesions, elevated CB2 expression was significantly associated with the presence of lymph node metastases (p=0.0301. Enhanced CB2 expression was also more frequently observed in malignant thyroid cases with presence of capsular (p=0.1165, lymphatic (p=0.1989, and vascular invasion (p=0.0555, as well as in those with increased risk of recurrence rate (p=0.1165, at a nonsignificant level though, whereas CB1 expression was not associated with any of the clinicopathological parameters examined. Our data suggest that CB receptors may be involved in malignant thyroid transformation and especially CB2 receptor could serve as useful biomarker and potential therapeutic target in thyroid neoplasia.

Clonal relatedness between lobular carcinoma in situ and synchronous malignant lesions

Science.gov (United States)

2012-01-01

Introduction Lobular carcinoma in situ (LCIS) has been accepted as a marker of risk for the development of invasive breast cancer, yet modern models of breast carcinogenesis include LCIS as a precursor of low-grade carcinomas. We provide evidence favoring a clonal origin for LCIS and synchronous estrogen receptor-positive malignant lesions of the ductal and lobular phenotype. Methods Patients with prior LCIS undergoing mastectomy were identified preoperatively from 2003 to 2008. Specimens were widely sampled, and frozen blocks were screened for LCIS and co-existing malignant lesions, and were subject to microdissection. Samples from 65 patients were hybridized to the Affymetrix SNP 6.0 array platform. Cases with both an LCIS sample and an associated ductal carcinoma in situ (DCIS) or invasive tumor sample were evaluated for patterns of somatic copy number changes to assess evidence of clonal relatedness. Results LCIS was identified in 44 of the cases, and among these a DCIS and/or invasive lesion was also identified in 21 cases. A total of 17 tumor pairs had adequate DNA/array data for analysis, including nine pairs of LCIS/invasive lobular cancer, four pairs of LCIS/DCIS, and four pairs of LCIS/invasive ductal cancer. Overall, seven pairs (41%) were judged to be clonally related; in five (29%) evidence suggested clonality but was equivocal, and five (29%) were considered independent. Clonal pairs were observed with all matched lesion types and low and high histological grades. We also show anecdotal evidence of clonality between a patient-matched triplet of LCIS, DCIS, and invasive ductal cancer. Conclusion Our results support the role of LCIS as a precursor in the development of both high-grade and low-grade ductal and lobular cancers. PMID:22776144

Predictors of Malignancy and Recommended Follow-Up for Patients with Negative Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Suspected Pancreatic Lesions

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Bret J Spier

2009-01-01

Full Text Available BACKGROUND: Endoscopic ultrasound (EUS with fine-needle aspiration (FNA can characterize and diagnose pancreatic lesions as malignant, but cannot definitively rule out the presence of malignancy. Outcome data regarding the length of follow-up in patients with negative or nondiagnostic EUS-FNA of pancreatic lesions are not well-established.

Effects of insulin and glucose loading on FDG uptake in experimental malignant tumours and inflammatory lesions

International Nuclear Information System (INIS)

Zhao, Songji; Tsukamoto, Eriko; Kato, Takashi; Tamaki, Nagara; Kuge, Yuji; Hikosaka, Kenji; Mochizuki, Takafumi; Hosokawa, Masuo; Kohanawa, Masashi

2001-01-01

Fluorine-18 2-deoxy-2-fluoro-D-glucose (FDG) accumulation in tumours has been well investigated, but much less is known regarding FDG accumulation in inflammatory lesions. In this study, we determined the effects of hypo- and hyperglycaemia on FDG uptake in inflammatory lesions of infectious and non-infectious origin and compared them with those in malignant tumours in rats, to provide a biological basis for differentiating malignant lesions from benign lesions by means of FDG-PET. Rats were inoculated with a suspension of allogenic hepatoma cells (KDH-8) or Staphylococcus aureus, or with turpentine oil into the left calf muscle. Two weeks after KDH-8 inoculation and 1 week after S. aureus and turpentine oil inoculations, the rats were divided into three subgroups: insulin-loaded (2 U/kg body weight, i.p.), glucose-loaded (1.2 g/kg body weight, p.o.) and control groups. Radioactivity in tissues was determined 1 h after i.v. injection of FDG. Intraperitoneal injection of insulin and oral administration of glucose induced hypoglycaemia and hyperglycaemia, respectively. In the control animals, tumours showed a level of FDG uptake which was 2.2 and 3.0 times higher than the levels in the inflammatory lesions induced by S. aureus and turpentine oil, respectively (P<0.0001). There was no significant difference in the level of FDG uptake between the two inflammatory lesions of infectious and non-infectious origin. Insulin loading significantly decreased the level of FDG uptake in tumours and in both types of inflammatory lesion to approximately one-half of the control values (P=0.001 in the tumour group and P<0.0001 in the two inflammatory lesion groups). In the glucose-loaded group, the level of FDG uptake in both types of inflammatory lesion decreased significantly to 50%-61% of the control value (P=0.0002 in the S.aureus group and P<0.0001 in the turpetine group), while the tumour uptake did not decrease significantly (86% of the control value) (P=NS). It is concluded

Benign papilloma diagnosed on image-guided 14 G core biopsy of the breast: Effect of lesion type on likelihood of malignancy at excision

International Nuclear Information System (INIS)

Maxwell, A.J.; Mataka, G.; Pearson, J.M.

2013-01-01

Aim: To ascertain the negative predictive value (NPV) for atypia and malignancy of 14 G core biopsy of papillomas and to determine whether lesion type influences the likelihood of malignancy at lesion excision. Materials and methods: Ninety-six lesions with a 14 G core biopsy diagnosis of benign papilloma without atypia in 95 women were included. The imaging features (mass or microcalcification), biopsy mode, and number of core samples taken were documented. All patients subsequently underwent lesion excision with either extensive vacuum-assisted biopsy (VAB; 72 lesions) or surgery (24 lesions). Mammographic follow-up of at least 2 years was available for 32 lesions that were benign at VAB. Results: Atypia or malignancy was found more commonly in association with microcalcification (six of 29 lesions: 21%; median number of nine 14 G cores) than a mass (five of 67 lesions: 7%; median number of three 14 G cores), although the difference does not reach statistical significance (p = 0.088). The NPV of a 14 G core biopsy diagnosis of papilloma for atypia or malignancy is 89% (85/96). Disease underestimation may be more common in microcalcification lesions despite the greater number of cores obtained. Conclusion: Excision (using VAB or surgically) of all papillomas diagnosed as benign on 14 G needle core biopsy is recommended. Surgery may be more appropriate than VAB for some microcalcification lesions unless they are small and can be confidently removed in their entirety using VAB

Clinicopathological importance of Papanicolaou smears for the diagnosis of premalignant and malignant lesions of the cervix.

Science.gov (United States)

Bukhari, Mulazim Hussain; Saba, Kanwal; Qamar, Samina; Majeed, Muhammad Muddasar; Niazi, Shahida; Naeem, Samina

2012-01-01

Premalignant and malignant lesions are not uncommon in Pakistani women, especially in the older age-groups This study was conducted to determine the clinicopathological importance of conventional Papanicolaou (Pap) smears for the diagnosis of premalignant and malignant lesions of the cervix. Pap smears of 1000 women were examined from January 2007 to June 2009. Only cases with neoplastic cytology were included. The overall frequency of normal, inadequate, neoplastic, and infective smears was 50%, 1.8%, 10.2%, and 38.3%, respectively. Most of the patients (67%) were in the postmenopausal age-group, with the mean age being 44.7±15.63 years. The commonest clinical signs/symptoms seen among the 102 patients with neoplastic gynecological lesions were vaginal discharge and abnormal bleeding (93/102;(91.2% and 62/102;60.7%). Of the 102 cases with neoplastic lesions 46 patients (45%) had low-grade squamous cell intraepithelial lesions (LSILs), 22 (21.5%) had high-grade squamous cell intraepithelial lesions (HSILs), 14 (13.7%) had squamous cell carcinoma, and 6 (5.8%) showed features of adenocarcinoma. Ten (9.8%) cases showed cytology of atypical squamous cells of undetermined significance (ASCUS) and four (3.9%) cases had atypical glandular cells of undetermined significance (AGUS). We conclude that cervical smear examination is well suited for diagnosing neoplastic disease. It is clear that cervical neoplastic lesions are becoming a problem in Pakistan.

Differentiation between benign and malignant breast lesions using quantitative diffusion-weighted sequence on 3 T MRI

International Nuclear Information System (INIS)

Tan, S.L.L.; Rahmat, K.; Rozalli, F.I.; Mohd-Shah, M.N.; Aziz, Y.F.A.; Yip, C.H.; Vijayananthan, A.; Ng, K.H.

2014-01-01

Aim: To investigate the capability and diagnostic accuracy of diffusion-weighted imaging (DWI) in differentiating benign from malignant breast lesions using 3 T magnetic resonance imaging (MRI). Materials and methods: Women with suspicious or indeterminate breast lesions detected at MRI, mammogram and/or ultrasound were recruited for dynamic contrast-enhanced (DCE)-MRI and DWI prior to their biopsy. Image fusion of DCE-MRI with apparent diffusion coefficient (ADC) map was utilized to select the region of interest (ROI) for ADC calculation in the area that showed the most avid enhancement. DWI was performed using two sets of b-values at 500 and 1000 s/mm 2 , respectively. Results: Fifty women were recruited and the final analysis comprised 44 breast lesions, 31 of which were malignant and 13 were benign. Significant results were obtained between ADC values of benign and malignant lesions (p −3 mm 2 /s for b = 500 s/mm 2 and 1.22 × 10 −3 mm 2 /s for b = 1000 s/mm 2 , respectively. The sensitivity of DCE-MRI alone was 100% with a specificity of 66.7%. When DCE-MRI was combined with b = 1000 s/mm 2 , the specificity rose to 100%, while only mildly affecting sensitivity (90.6%). No significant correlation was found between ADC values and prognostic factors, such as lymph node metastasis, tumour size, oestrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) status, and tumour grades. Conclusion: The present study provides consistent evidence to support DWI as a diagnostic tool for breast lesion characterization. A combination of DCE-MRI with DWI is suggested to improve the sensitivity and specificity of lesion characterization

Study of nuclear morphometry on cytology specimens of benign and malignant breast lesions: A study of 122 cases.

Science.gov (United States)

Kashyap, Anamika; Jain, Manjula; Shukla, Shailaja; Andley, Manoj

2017-01-01

Breast cancer has emerged as a leading site of cancer among women in India. Fine needle aspiration cytology (FNAC) has been routinely applied in assessment of breast lesions. Cytological evaluation in breast lesions is subjective with a "gray zone" of 6.9-20%. Quantitative evaluation of nuclear size, shape, texture, and density parameters by morphometry can be of diagnostic help in breast tumor. To apply nuclear morphometry on cytological breast aspirates and assess its role in differentiating between benign and malignant breast lesions with derivation of suitable cut-off values between the two groups. The present study was a descriptive cross-sectional hospital-based study of nuclear morphometric parameters of benign and malignant cases. The study included 50 benign breast disease (BBD), 8 atypical ductal hyperplasia (ADH), and 64 carcinoma cases. Image analysis was performed on Papanicolaou-stained FNAC slides by Nikon Imaging Software (NIS)-Elements Advanced Research software (Version 4.00). Nuclear morphometric parameters analyzed included 5 nuclear size, 2 shape, 4 texture, and 2 density parameters. Nuclear morphometry could differentiate between benign and malignant aspirates with a gradually increasing nuclear size parameters from BBD to ADH to carcinoma. Cut-off values of 31.93 μm 2 , 6.325 μm, 5.865 μm, 7.855 μm, and 21.55 μm for mean nuclear area, equivalent diameter, minimum feret, maximum ferret, and perimeter, respectively, were derived between benign and malignant cases, which could correctly classify 7 out of 8 ADH cases. Nuclear morphometry is a highly objective tool that could be used to supplement FNAC in differentiating benign from malignant lesions, with an important role in cases with diagnostic dilemma.

The value of quantitative parameters of dynamic-enhanced MRI and the significance of the maximum linearity slope ratio in the differential diagnosis of benign and malignant breast lesions

International Nuclear Information System (INIS)

Ouyang Yi; Xie Chuanmiao; Wu Yaopan; Lv Yanchun; Ruan Chaomei; Zheng Lie; Peng Kangqiang; He Haoqiang; Chen Lin; Zhang Weizhang

2008-01-01

Objective: To find the effective quantitative parameters for the differentiation of the breast lesions using the post-processing of time-signal curve of 3D dynamic-enhanced MRI. Methods: Thirty patients with 35 lesions underwent 3D dynamic-enhanced MRI and the time-signal curve was deduced. The four quantitative parameters including SImax, PH, Slope and Slope R were analyzed in benign and malignant lesions of the breast. Independent samples t test and rank sum test were used for the statistics. Results: Seyenteen benign lesions and 18 malignant lesions were included in this study. The SImax (M) of benign and malignant lesions were 375.2 and 158.1, the 95% confidence intervals of SImax were 278.2- 506. 0 and 160.5--374. 8. The PH (M) of benign and malignant lesions were 114.4 and 87. 8, the 95% confidence intervals of PH were 73.7-196.5 and 71.3-162. 9. The Slope (M) of benign and malignant lesions were 22.3 x 10 -3 and 44.0 x 10 -3 , the 95% confidence intervals of Slope were 13.7 x 10 -3 - 41.1 x 10 -3 and 46.1 x 10 -3 -81.8 x 10 -3 . The Slopea (M) of benign and malignant lesions were 2.6 and 11.4, the 95% confidence intervals of Slopea were 1.9-3.4 and 9.8-14.5. There were no significant differences on SImax and PH between benign and malignant lesions (P>0.05). The significant differences existed on Slope (P<0.01) and Slopea (P <0.01) between benign and malignant lesions of the breast. Conclusion: Slopea is a very effective parameter in the differential diagnosis of breast lesions. (authors)

Masticator space lesions: MRI and CT findings

International Nuclear Information System (INIS)

Kim, Seung Hoon; Han, Moon Hee; Chang, Kee Kyun; Kim, Kwang Hyun; Song, Jae Uoo; Jo, In Cheol; Yeon, Kyung Mo

1995-01-01

We evaluated the MR and CT findings of the masticator space lesions in order to identify the differences among the malignant and benign tumors and infectious conditions. MR and CT findings in 46 cases with proven masticator space lesions were reviewed retrospectively. We analysed the involvement of masticator muscles, adjacent spaces, orbit and intracranium, homogeneity, necrosis, cystic changes, growth patterns, calcifications, enhancement patterns, MR signal intensity, and CT attenuation. Among the 29 cases of malignant tumors, seven cases were mandibular tumors including four chondrosarcomas, and 22 cases were extramandibular tumors. Malignant tumors of mandibular origin showed large masses with severe bone destruction and epicenter of mandible. Extramandibular malignant tumors showed the epicenter out of the mandible and less severe bone destruction than mandibular tumors. Among the nine benign tumors, four cases were ameloblastomas which showed the well-defined masses and the expansion of the mandible, and four cases were extramandibular tumors which showed well-marginated extramandibular masses with no bone destruction. Among the eight infectious conditions, five cases were mandibular osteomyelitis with or without abscess formations, and the other three cases were infections from adjacent soft tissue or limited to the soft tissue. By careful observations of growth patterns, involvement of the masticator and adjacent spaces, bone changes, and epicenter of the lesions, one can discriminate a mandibular lesion from an extramandibular lesion. With this approach, it is thought to be easier to suggest a diagnosis among a wide spectrum of masticator lesions

Value of diffusion weighted MRI in differentiating benign from malignant bony tumors and tumor like lesions

Directory of Open Access Journals (Sweden)

Samir Zaki Kotb

2014-06-01

Conclusion: DWI has been proven to be highly useful in the differentiation of benign, malignant bone tumors and tumor like bony lesions. Measurement of ADC values improves the accuracy of the diagnosis of bone tumors and tumor like lesions. Moreover, measurement of ADC values can be used in the follow up of tumors and their response to therapy.

Pulmonary MRI at 3T: Non-enhanced pulmonary magnetic resonance Imaging Characterization Quotients for differentiation of infectious and malignant lesions

Energy Technology Data Exchange (ETDEWEB)

Nagel, Sebastian Niko, E-mail: sebastian.nagel@charite.de [Klinik und Hochschulambulanz für Radiologie, Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin (Germany); Kim, Damon, E-mail: damon.kim@charite.de [Klinik und Hochschulambulanz für Radiologie, Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin (Germany); Institut für Röntgendiagnostik, HELIOS Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125 Berlin (Germany); Penzkofer, Tobias, E-mail: tobias.penzkofer@charite.de [Klinik und Hochschulambulanz für Radiologie, Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin (Germany); Steffen, Ingo G., E-mail: ingo.steffen@charite.de [Klinik und Hochschulambulanz für Radiologie, Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin (Germany); Wyschkon, Sebastian, E-mail: sebastian.wyschkon@charite.de [Klinik und Hochschulambulanz für Radiologie, Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin (Germany); and others

2017-04-15

Objective: To investigate 3T pulmonary magnetic resonance imaging (MRI) for characterization of solid pulmonary lesions in immunocompromised patients and to differentiate infectious from malignant lesions. Materials and methods: Thirty-eight pulmonary lesions in 29 patients were evaluated. Seventeen patients were immunocompromised (11 infections and 6 lymphomas) and 12 served as controls (4 bacterial pneumonias, 8 solid tumors). Ten of the 15 infections were acute. Signal intensities (SI) were measured in the lesion, chest wall muscle, and subcutaneous fat. Scaled SIs as Non-enhanced Imaging Characterization Quotients ((SI{sub Lesion} − SI{sub Muscle})/(SI{sub Fat} − SI{sub Muscle})*100) were calculated from the T2-weighted images using the mean SI (T2-NICQ{sub mean}) or the 90th percentile of SI (T2-NICQ{sub 90th}) of the lesion. Simple quotients were calculated by dividing the SI of the lesion by the SI of chest wall muscle (e.g. T1-Q{sub mean}: SI{sub Lesion}/SI{sub Muscle}). Results: Infectious pulmonary lesions showed a higher T2-NICQ{sub mean} (40.1 [14.6–56.0] vs. 20.9 [2.4–30.1], p < 0.05) and T2-NICQ{sub 90th} (74.3 [43.8–91.6] vs. 38.5 [15.8–48.1], p < 0.01) than malignant lesions. T1-Q{sub mean} was higher in malignant lesions (0.85 [0.68–0.94] vs. 0.93 [0.87–1.09], p < 0.05). Considering infections only, T2-NICQ{sub 90th} was lower when anti-infectious treatment was administered >24 h prior to MRI (81.8 [71.8–97.6] vs. 41.4 [26.6–51.1], p < 0.01). Using Youden’s index (YI), the optimal cutoff to differentiate infectious from malignant lesions was 43.1 for T2-NICQ{sub mean} (YI = 0.42, 0.47 sensitivity, 0.95 specificity) and 55.5 for T2-NICQ{sub 90th} (YI = 0.61, 0.71 sensitivity, 0.91 specificity). Combining T2-NICQ{sub 90th} and T1-Q{sub mean} increased diagnostic performance (YI = 0.72, 0.77 sensitivity, 0.95 specificity). Conclusion: Considering each quotient alone, T2-NICQ{sub 90th} showed the best diagnostic performance and

Malignant Transformation of Oral Lichen Planus

Directory of Open Access Journals (Sweden)

Sangeeta Wanjari

2010-01-01

Full Text Available Oral lichen planus (OLP is a chronic inflammatory mucocutaneous disease that frequently involves the oral mucosa. It has been regarded by many authors as a premalignant condition. There has been a continuous debate regarding the possible malignant potential of OLP, and these patients have been recommended to have their lesions monitored two to four times annually. A case of a lichen planus transformed into malignancy is reported here. This case does not provide answers to the ongoing controversy about the innate propensity of OLP to become malignant. However, in view of common occurrence of OLP and unresolved issue regarding its malignant potential (MP, thus case report illustrates the need for histologic confirmation and close follow-up of patients with clinical lesions that have lichenoid features.

Implementation and analysis of relief patterns of the surface of benign and malignant lesions of the skin by microtopography

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Lopez Pacheco, Maria del Carmen Lopez [Laboratorio de CitopatologIa Ambiental, Departamento de MorfologIa, ENCB-IPN, UP Lazaro Cardenas, Casco de Santo Tomas, 11340 (Mexico); Martins-Costa, Manuel Filipe Pereira da Cunha [Departamento de Fisica, Universidad do Minho, Escola de Ciencias Campus de Gualtar-PT-4710-057 Braga (Portugal); Zapata, Aura Judith Perez [Laboratorio de CitopatologIa Ambiental, Departamento de MorfologIa, ENCB-IPN, UP Lazaro Cardenas, Casco de Santo Tomas, 11340 (Mexico); Cherit, Judith DomInguez [Departamento de DermatologIa, Hospital General Dr Manuel Gea Gonzalez, Calzada de Tlalpan No 4800, 14000 (Mexico); Gallegos, Eva Ramon [Laboratorio de CitopatologIa Ambiental, Departamento de MorfologIa, ENCB-IPN, UP Lazaro Cardenas, Casco de Santo Tomas, 11340 (Mexico)

2005-12-07

The objective of this study was to be able to distinguish between healthy skin tissue and malignant ones, furthermore determining a unique pattern of roughness for each skin lesion by microtopographic analysis of the skin surface of Mexican patients during the period from April to October 2002. The standard technique used in this study for the diagnosis of skin cancer and the comparison of the results was the haematoxylin-eosin histopathological technique. Latex impressions were taken from skin lesions as well as from the healthy skin of each patient to serve as control samples. These impressions were analysed by the MICROTOP.03.MFC microtopographic system inspection. It was observed that when the tumour becomes rougher, more malign will be the lesion. On average, the melanoma present an increase of roughness of 67% compared to healthy skin, obtaining a roughness relation of 1:2.54. The percentage decreases to 49% (49%, 1:60) in the case of basal cell carcinoma and to 40% in pre-malignant lesions such as melanocytic nevus (40%, 1:150). In benign lesions such as the seborrhoea keratosis only a small increase in roughness was noted (4%, 1:0.72). Microtopographic inspection of the skin surface can be considered as a complementary diagnostic technique for skin cancer.

Implementation and analysis of relief patterns of the surface of benign and malignant lesions of the skin by microtopography

International Nuclear Information System (INIS)

Lopez Pacheco, Maria del Carmen Lopez; Martins-Costa, Manuel Filipe Pereira da Cunha; Zapata, Aura Judith Perez; Cherit, Judith DomInguez; Gallegos, Eva Ramon

2005-01-01

The objective of this study was to be able to distinguish between healthy skin tissue and malignant ones, furthermore determining a unique pattern of roughness for each skin lesion by microtopographic analysis of the skin surface of Mexican patients during the period from April to October 2002. The standard technique used in this study for the diagnosis of skin cancer and the comparison of the results was the haematoxylin-eosin histopathological technique. Latex impressions were taken from skin lesions as well as from the healthy skin of each patient to serve as control samples. These impressions were analysed by the MICROTOP.03.MFC microtopographic system inspection. It was observed that when the tumour becomes rougher, more malign will be the lesion. On average, the melanoma present an increase of roughness of 67% compared to healthy skin, obtaining a roughness relation of 1:2.54. The percentage decreases to 49% (49%, 1:60) in the case of basal cell carcinoma and to 40% in pre-malignant lesions such as melanocytic nevus (40%, 1:150). In benign lesions such as the seborrhoea keratosis only a small increase in roughness was noted (4%, 1:0.72). Microtopographic inspection of the skin surface can be considered as a complementary diagnostic technique for skin cancer

Time to enhancement derived from ultrafast breast MRI as a novel parameter to discriminate benign from malignant breast lesions

International Nuclear Information System (INIS)

Mus, Roel D.; Borelli, Cristina; Bult, Peter; Weiland, Elisabeth; Karssemeijer, Nico; Barentsz, Jelle O.; Gubern-Mérida, Albert; Platel, Bram; Mann, Ritse M.

2017-01-01

Highlights: • New view-sharing sequences (e.g. TWIST) enable ultrafast dynamic breast MRI. • TWIST sequences accurately characterize the inflow of contrast in breast lesions. • TTE evaluation allows breast lesion classification with very high accuracy. • The use of TTE significantly increases the specificity of breast MRI. • TWIST imaging may increase the potential of breast MRI as screening tool. - Abstract: Objectives: To investigate time to enhancement (TTE) as novel dynamic parameter for lesion classification in breast magnetic resonance imaging (MRI). Methods: In this retrospective study, 157 women with 195 enhancing abnormalities (99 malignant and 96 benign) were included. All patients underwent a bi-temporal MRI protocol that included ultrafast time-resolved angiography with stochastic trajectory (TWIST) acquisitions (1.0 × 0.9 × 2.5 mm, temporal resolution 4.32 s), during the inflow of contrast agent. TTE derived from TWIST series and relative enhancement versus time curve type derived from volumetric interpolated breath-hold examination (VIBE) series were assessed and combined with basic morphological information to differentiate benign from malignant lesions. Receiver operating characteristic analysis and kappa statistics were applied. Results: TTE had a significantly better discriminative ability than curve type (p < 0.001 and p = 0.026 for reader 1 and 2, respectively). Including morphology, sensitivity of TWIST and VIBE assessment was equivalent (p = 0.549 and p = 0.344, respectively). Specificity and diagnostic accuracy were significantly higher for TWIST than for VIBE assessment (p < 0.001). Inter-reader agreement in differentiating malignant from benign lesions was almost perfect for TWIST evaluation (κ = 0.86) and substantial for conventional assessment (κ = 0.75). Conclusions: TTE derived from ultrafast TWIST acquisitions is a valuable parameter that allows robust differentiation between malignant and benign breast lesions with high

Time to enhancement derived from ultrafast breast MRI as a novel parameter to discriminate benign from malignant breast lesions

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Mus, Roel D., E-mail: aroel.mus@radboudumc.nl [Department of Radiology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA Nijmegen (Netherlands); Borelli, Cristina, E-mail: cristinaborelli@hotmail.it [Department of Radiology, Scientific Institute “Casa Sollievo della Sofferenza” Hospital, Viale Cappuccini 1, 71013, San Giovanni Rotondo, Foggia (Italy); Department of Radiology, Radboud University Medical Center (internal address 766), Geert Grooteplein Zuid 10, 6525GA Nijmegen (Netherlands); Bult, Peter, E-mail: peter.bult@radboudumc.nl [Department of Pathology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA Nijmegen (Netherlands); Weiland, Elisabeth, E-mail: elisabeth.weiland@siemens.com [Siemens Healthcare, Erlangen (Germany); Karssemeijer, Nico, E-mail: nico.karssemeijer@radboudumc.nl [Department of Radiology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA Nijmegen (Netherlands); Barentsz, Jelle O., E-mail: jelle.barentsz@radboudumc.nl [Department of Radiology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA Nijmegen (Netherlands); Gubern-Mérida, Albert, E-mail: albert.gubernmerida@radboudumc.nl [Department of Radiology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA Nijmegen (Netherlands); Platel, Bram, E-mail: bram.platel@radboudumc.nl [Department of Radiology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA Nijmegen (Netherlands); Mann, Ritse M., E-mail: ritse.mann@radboudumc.nl [Department of Radiology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA Nijmegen (Netherlands)

2017-04-15

Highlights: • New view-sharing sequences (e.g. TWIST) enable ultrafast dynamic breast MRI. • TWIST sequences accurately characterize the inflow of contrast in breast lesions. • TTE evaluation allows breast lesion classification with very high accuracy. • The use of TTE significantly increases the specificity of breast MRI. • TWIST imaging may increase the potential of breast MRI as screening tool. - Abstract: Objectives: To investigate time to enhancement (TTE) as novel dynamic parameter for lesion classification in breast magnetic resonance imaging (MRI). Methods: In this retrospective study, 157 women with 195 enhancing abnormalities (99 malignant and 96 benign) were included. All patients underwent a bi-temporal MRI protocol that included ultrafast time-resolved angiography with stochastic trajectory (TWIST) acquisitions (1.0 × 0.9 × 2.5 mm, temporal resolution 4.32 s), during the inflow of contrast agent. TTE derived from TWIST series and relative enhancement versus time curve type derived from volumetric interpolated breath-hold examination (VIBE) series were assessed and combined with basic morphological information to differentiate benign from malignant lesions. Receiver operating characteristic analysis and kappa statistics were applied. Results: TTE had a significantly better discriminative ability than curve type (p < 0.001 and p = 0.026 for reader 1 and 2, respectively). Including morphology, sensitivity of TWIST and VIBE assessment was equivalent (p = 0.549 and p = 0.344, respectively). Specificity and diagnostic accuracy were significantly higher for TWIST than for VIBE assessment (p < 0.001). Inter-reader agreement in differentiating malignant from benign lesions was almost perfect for TWIST evaluation (κ = 0.86) and substantial for conventional assessment (κ = 0.75). Conclusions: TTE derived from ultrafast TWIST acquisitions is a valuable parameter that allows robust differentiation between malignant and benign breast lesions with high

Expression of DNA repair proteins MSH2, MLH1 and MGMT in human benign and malignant thyroid lesions: An immunohistochemical study

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Giaginis, Constantinos; Michailidi, Christina; Stolakis, Vasileios; Alexandrou, Paraskevi; Tsourouflis, Gerasimos; Klijanienko, Jerzy; Delladetsima, Ioanna; Theocharis, Stamatios

2011-01-01

Summary Background DNA repair is a major defense mechanism, which contributes to the maintenance of genetic sequence, and minimizes cell death, mutation rates, replication errors, DNA damage persistence and genomic instability. Alterations in the expression levels of proteins participating in DNA repair mechanisms have been associated with several aspects of cancer biology. The present study aimed to evaluate the clinical significance of DNA repair proteins MSH2, MLH1 and MGMT in benign and malignant thyroid lesions. Material/Methods MSH2, MLH1 and MGMT protein expression was assessed immunohistochemically on paraffin-embedded thyroid tissues from 90 patients with benign and malignant lesions. Results The expression levels of MLH1 was significantly upregulated in cases with malignant compared to those with benign thyroid lesions (p=0.038). The expression levels of MGMT was significantly downregulated in malignant compared to benign thyroid lesions (p=0.001). Similar associations for both MLH1 and MGMT between cases with papillary carcinoma and hyperplastic nodules were also noted (p=0.014 and p=0.026, respectively). In the subgroup of malignant thyroid lesions, MSH2 downregulation was significantly associated with larger tumor size (p=0.031), while MLH1 upregulation was significantly associated with the presence of lymphatic and vascular invasion (p=0.006 and p=0.002, respectively). Conclusions Alterations in the mismatch repair proteins MSH2 and MLH1 and the direct repair protein MGMT may result from tumor development and/or progression. Further studies are recommended to draw definite conclusions on the clinical significance of DNA repair proteins in thyroid neoplasia. PMID:21358597

Malignant focal hepatic lesions complicating underlying liver disease: dual-phase contrast-enhanced spiral CT sensitivity and specificity in orthotopic liver transplant patients

International Nuclear Information System (INIS)

Mortele, K.J.; De Keukeleire, K.; Praet, M.; Van Vlierberghe, H.; Hemptinne, B. de; Ros, P.R.

2001-01-01

The aim of this study was to determine the accuracy of contrast-enhanced biphasic spiral CT as a screening tool in the preoperative evaluation of orthotopic liver transplant (OLT) patients. Spiral-CT examinations were performed before liver transplantation in 53 patients. Scans were retrospectively reviewed and compared with pathologic findings in fresh-sectioned livers. When findings between spiral CT and pathology were discordant, formalized livers were reexamined with lesion-by lesion evaluation. Fresh pathologic evaluation revealed 23 liver lesions (16 HCC, 7 macro-regenerative nodules). Malignancy was identified in 13 of 53 patients (24.5%). Pre-transplantation spiral CT depicted 27 liver lesions (23 HCC, 4 macro-regenerative nodules). Malignancy was suspected in 14 patients (26.4%). In 10 of 53 (18.9%), spiral CT and pathologic evaluation were discordant. Subsequent retrospective pathologic evaluation showed malignancy in 4 additional patients. Spiral CT compared with the retrospective pathologic findings revealed 36 real-negative, 14 real-positive, 0 false-positive, and 3 false-negative patients with malignancy. Sensitivity and specificity of spiral CT in detection of malignancy was 82 and 100%, respectively. Contrast-enhanced biphasic spiral CT is an accurate technique in the evaluation of patients preceding OLT. Routine fresh-sectioned liver pathologic findings are not as sensitive as previously estimated. (orig.)

E-cadherin and CD10 expression in atypical hyperplastic and malignant endometrial lesions

International Nuclear Information System (INIS)

Ahmed, A.R.H.; Muhammad, E.M.S.

2014-01-01

Background: Loss of E-cadherin is a critical step for development and progression of malignant tumors. CD10; a marker of non-neoplastic and neoplastic endometrial stroma, is associated with aggressiveness of many epithelial malignancies. Aims: To evaluate expression and correlation of E-cadherin and CD10 in endometrial lesions and their possible role in differentiating atypical endometrial hyperplasia from endometrial carcinoma. The association of E-cadherin and CD10 expression with clinico-pathological parameters of endometrial carcinoma was also investigated. Materials and methods: Fifty four cases including 28 endometrial carcinomas; 19 endometrial hyperplasia and 7 cases of normal endometrial changes were enrolled for this study. The expression of E-cadherin and CD10 was evaluated by immunohistochemistry using the streptavidin–biotin technique. Results: There was a strong association between malignant change of endometrial glands and membrano- cytoplasmic localization of E-cadherin (p< 0.001). Expression of E-cadherin but not CD10 was significantly higher in endometrial carcinomas compared to atypical endometrial hyperplasia (p < 0.01). Expression of E-cadherin was not associated with CD10 expression in different endometrial lesions. High grade tumors expressed low levels of both E-cadherin (p<0.01) and CD10 (p < 0.05) and serous endometrial carcinoma had low E-cadherin and CD10 expression compared to endometrioid carcinoma (p< 0.01 and <0.05, respectively). Expression of both molecules showed no association with depth of tumor invasion or FIGO stage. Tumors with lower E-cadherin or CD10 expression had higher rates of vascular tumor emboli (p< 0.01 and <0.07, respectively). Conclusions: Although expression of E-cadherin and CD10 in endometrial lesions was not correlated, reduced expression of both molecules could be critical for progression of endometrial carcinoma.

Diagnostic value of virtual touch tissue imaging quantification for benign and malignant breast lesions with different sizes

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Liu, Hui; Zhao, Li-Xia; Xu, Guang; Yao, Ming-Hua; Zhang, Ai-Hong; Xu, Hui-Xiong; Wu, Rong

2015-01-01

The study was to explore diagnostic value of the virtual touch tissue imaging quantification (VTIQ) in distinguishing benign and malignant breast lesions of variable sizes. We performed conventional ultrasound and VTIQ in 139 breast lesions. The lesions were categorized into three groups according to size (group 1, ≤ 10 mm; group 2, 10-20 mm; and group 3, > 20 mm), and their mean, min, and max shear wave velocities (SWVs) were measured. Diagnoses were confirmed by pathological examination after surgery or needle biopsy. Receiver-operating characteristic curves (ROC) were constructed to determine the optimum cut-off values, calculate the area under curve (AUC), the sensitivity, specificity and accuracy for each velocity. For all groups, the mean, min, and max SWVs of malignant lesions were significantly higher than those of benign lesions (P < 0.05). The cut-off values of mean, min, and max SWVs were not significantly different among the three groups. In addition, the diagnostic performance of mean, min, and max SWV values is analogous, regardless of lesion size. In conclusion, VTIQ is a strong complement to conventional ultrasound, which is a promising method in the differential diagnosis of the breast lesions with different sizes. Further studies validate our results as well as reduce the number of unnecessary biopsies, regardless of size is warranted. PMID:26550234

Knowledge of human papillomavirus and its association with head and neck benign and malignant lesions in a group of dental patients in pakistan.

Science.gov (United States)

Gichki, Abdul Samad; Buajeeb, Waranun; Doungudomdacha, Sombhun; Khovidhunkit, Siribang-On Pibooniyom

2015-01-01

Human papillomaviruses (HPVs) remain a serious world health problem due to their association with cervical and head and neck cancers. While over 100 HPV types have been identified, only a few subtypes are associated with malignancies. HPV 16 and 18 are the most prevalent oncogenic types in head and neck cancers. Although it has been proven that some subsets of benign and malignant head and neck lesions are associated with HPV, the general population have very little awareness and knowledge of their association with HPV. Therefore, the purpose of this study was to determine the knowledge of HPV and its links with head and neck benign and malignant lesions in a group of Pakistani dental patients who attended the Dental Department of the Sandeman provincial hospital in Quetta, Pakistan. One hundred and ninety-two patients were recruited and requested to answer a questionnaire. It was revealed that there was a low level of knowledge about HPV and its association with head and neck benign and malignant lesions among the participants. This result suggested that more education regarding the relationship of HPV in inducing head and neck benign and malignant lesions is required in this group of patients.

YKL-40 expression in benign and malignant lesions of the breast: a methodologic study

DEFF Research Database (Denmark)

Roslind, Anne; Johansen, Julia S; Junker, Nanna

2007-01-01

as well as in benign and malignant breast lesions. The presence of YKL-40 in breast tissue was verified by in situ hybridization and protein extraction procedures. An immunohistochemical method was developed and 4 different antibodies directed against YKL-40 were tested. Ten patients with normal breast...

Fluorescence cytology with 5-aminolevulinic acid in EUS-guided FNA as a method for differentiating between malignant and benign lesions (with video).

Science.gov (United States)

Ikeura, Tsukasa; Takaoka, Makoto; Uchida, Kazushige; Shimatani, Masaaki; Miyoshi, Hideaki; Kato, Kota; Ohe, Chisato; Uemura, Yoshiko; Kaibori, Masaki; Kwon, A-Hon; Okazaki, Kazuichi

2015-01-01

EUS-guided FNA (EUS-FNA) has been increasingly performed to obtain specimens for the pathological evaluation of patients with GI and pancreaticobiliary masses as well as lymphadenopathies of unknown origin. Photodynamic diagnosis by using 5-aminolebulinic acid (ALA) has been reported to be useful for enabling the visual differentiation between malignant and normal tissue in various cancers. To evaluate the diagnostic accuracy of fluorescence cytology with ALA in EUS-FNA. A prospective study. A single center. A total of 28 consecutive patients who underwent EUS-FNA for the pathological diagnosis of a pancreaticobiliary mass lesion or intra-abdominal lymphadenopathy of unknown origin. Patients were orally administered ALA 3 to 6 hours before EUS-FNA. The sample was obtained via EUS-FNA for fluorescence cytology and conventional cytology. A single gastroenterologist performed the fluorescence cytology by using fluorescence microscopy after the procedure, independently of the conventional cytology by pathologists. The accuracy of fluorescence cytology with ALA in the differentiation between benign and malignant lesions by comparing the results of fluorescence cytology with the final diagnosis. Of the 28 patients included in the study, 22 were considered as having malignant lesions and 6 patients as having benign lesions. Fluorescence cytology could correctly discriminate between benign and malignant lesions in all patients. Therefore, both the sensitivity and specificity of fluorescence cytology were 100% in our study. Fluorescence cytology was performed by only 1 gastroenterologist with a small number of patients. Fluorescence cytology with ALA in EUS-FNA may be an effective and simple method for differentiating between benign and malignant lesions. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

PREDICTION OF MALIGNANT BREAST LESIONS FROM MRI FEATURES: A COMPARISON OF ARTIFICIAL NEURAL NETWORK AND LOGISTIC REGRESSION TECHNIQUES

Science.gov (United States)

McLaren, Christine E.; Chen, Wen-Pin; Nie, Ke; Su, Min-Ying

2009-01-01

Rationale and Objectives Dynamic contrast enhanced MRI (DCE-MRI) is a clinical imaging modality for detection and diagnosis of breast lesions. Analytical methods were compared for diagnostic feature selection and performance of lesion classification to differentiate between malignant and benign lesions in patients. Materials and Methods The study included 43 malignant and 28 benign histologically-proven lesions. Eight morphological parameters, ten gray level co-occurrence matrices (GLCM) texture features, and fourteen Laws’ texture features were obtained using automated lesion segmentation and quantitative feature extraction. Artificial neural network (ANN) and logistic regression analysis were compared for selection of the best predictors of malignant lesions among the normalized features. Results Using ANN, the final four selected features were compactness, energy, homogeneity, and Law_LS, with area under the receiver operating characteristic curve (AUC) = 0.82, and accuracy = 0.76. The diagnostic performance of these 4-features computed on the basis of logistic regression yielded AUC = 0.80 (95% CI, 0.688 to 0.905), similar to that of ANN. The analysis also shows that the odds of a malignant lesion decreased by 48% (95% CI, 25% to 92%) for every increase of 1 SD in the Law_LS feature, adjusted for differences in compactness, energy, and homogeneity. Using logistic regression with z-score transformation, a model comprised of compactness, NRL entropy, and gray level sum average was selected, and it had the highest overall accuracy of 0.75 among all models, with AUC = 0.77 (95% CI, 0.660 to 0.880). When logistic modeling of transformations using the Box-Cox method was performed, the most parsimonious model with predictors, compactness and Law_LS, had an AUC of 0.79 (95% CI, 0.672 to 0.898). Conclusion The diagnostic performance of models selected by ANN and logistic regression was similar. The analytic methods were found to be roughly equivalent in terms of

1H-MRS evaluation of breast lesions by using total choline signal-to-noise ratio as an indicator of malignancy: a meta-analysis.

Science.gov (United States)

Wang, Xin; Wang, Xiang Jiang; Song, Hui Sheng; Chen, Long Hua

2015-05-01

The aim of this study was to evaluate the diagnostic performance of the use of total choline signal-to-noise ratio (tCho SNR) criteria in MRS studies for benign/malignant discrimination of focal breast lesions. We conducted (1) a meta-analysis based on 10 studies including 480 malignant breast lesions and 312 benign breast lesions and (2) a subgroup meta-analysis of tCho SNR ≥ 2 as cutoff for malignancy based on 7 studies including 371 malignant breast lesions and 239 benign breast lesions. (1) The pooled sensitivity and specificity of proton MRS with tCho SNR were 0.74 (95 % CI 0.69-0.77) and 0.76 (95 % CI 0.71-0.81), respectively. The PLR and NLR were 3.67 (95 % CI 2.30-5.83) and 0.25 (95 % CI 0.14-0.42), respectively. From the fitted SROC, the AUC and Q* index were 0.89 and 0.82. Publication bias was present (t = 2.46, P = 0.039). (2) Meta-regression analysis suggested that neither threshold effect nor evaluated covariates including strength of field, pulse sequence, TR and TE were sources of heterogeneity (all P value >0.05). (3) Subgroup meta-analysis: The pooled sensitivity and specificity were 0.79 and 0.72, respectively. The PLR and NLR were 3.49 and 0.20, respectively. The AUC and Q* index were 0.92 and 0.85. The use of tCho SNR criteria in MRS studies was helpful for differentiation between malignant and benign breast lesions. However, pooled diagnostic measures might be overestimated due to publication bias. A tCho SNR ≥ 2 as cutoff for malignancy resulted in higher diagnostic accuracy.

Value of the hypointensive internal septation on MR for the differentiation between benign and malignant breast lesions

International Nuclear Information System (INIS)

Gao Peihong; Cai Shifeng; Zhao Bin; Wang Guangbin; Peng Hongjuan; Liu Shaoling

2007-01-01

Objective: To investigate the diagnostic value of internal septation for differentiating benign from malignant breast lesions. Methods: A total of 26 patients were included in the study, in which 12 patients had 20 lesions of breast carcinoma and 14 patients had 25 lesions of fibroadenoma diagnosed either pathologically or clinically. The differential diagnoistic value of the hypointensive internal septation was analyzed. Results: The signal intensity of fibroadenomas and malignant lesions on T 2 -weighted fat-suppressed images could be classified as iso- to hyper- intensity, hypointensity and mixed intensity. According to the signal intensity classification, there were 5, 11 and 4 cases in patients with breast carcinoma respectively, while 11, 10, 4 cases in patients with fibroadenoma respectively. There was no statistical difference in the distribution between the two patient groups (χ 2 =1.764, P=0.414). The shape of fibroadenomas and malignant lesions could be classified as irregular, roundish or lobulated. According to the morphological classification, there were 12, 7 and 1 case in patients with breast carcinoma respectively, while 1, 7, 17 cases in patients with fibroadenoma respectively. There was statistical difference in the distribution between the two patient groups (χ 2 =23.262, P=0.000). The typical features of fibroadenomas were as follows: lobulated shape, hypointensive internal septations on T 2 -weighted or postcontrast images. The diagnostic sensitivity of the three imaging features for fibroadenoma was 68%(17/25), 52%(13/25), and 72%(18/25) respectively; and the diagnostic specificity was 95%(19/20), 90%(18/20), 95% (19/20) respectively. Conclusion: The internal septation is a rather specific sign for diagnosis of fibroadenomas. (authors)

[Potentially malignant character of oral lichen planus and lichenoid lesions].

Science.gov (United States)

Mares, S; Ben Slama, L; Gruffaz, F; Goudot, P; Bertolus, C

2013-11-01

Many authors have reported the possible malignant transformation of oral lichen. The incidence of this event remains controversial. Many authors make a distinction between the "true" oral lichen planus (OLP) and lichenoid lesions (LL) according to the WHO clinical and histological classification. For these authors an increased risk of development of oral cancer could occur only on LL. Our aim was to check this hypothesis on a cohort followed for 10 years. We included patients who were referred to our team for the first time between 1995 and 1997, still followed in 2010, with a histological diagnosis of buccal lichen planus. We classified lesions as OLP or LL according to the WHO clinical and histological classification: the two clinical criteria for OLP were a reticulated aspect and bilateral and symmetric lesions. Three histological criteria were necessary for the diagnosis: dense inflammatory infiltrate in the upper lamina propria, liquefaction degeneration of basal keratinocytes, and no signs of dysplasia. The final diagnosis was OLP, when all clinical ad histological criteria were met otherwise it was LL. We studied the patient's outcome between their first consultations and May 2010. Thirty-two patients, whose data was available, met inclusion criteria. Eight were diagnosed with OLP and 24 with LL. The mean follow-up was 164 months [154-183]. No oral cancer was observed in the OLP group. Two patients in the LL group presented with oral cancer after 45 and 143 months of follow-up. Malignant transformations were observed only in the LL group. Our results correlate with those of Van Der Meij et al. published in 2006. The strict use of the WHO diagnostic criteria seems to allow identifying patients at risk of developing oral cancer (LL) and others with only a benign course of this chronic oral mucosal disease. These results need to be confirmed by prospective multicentric studies. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

[Profitability of the bronchoscopy in the diagnosis of focal pulmonary malignant lesions].

Science.gov (United States)

García Quero, C; García Luján, R; González Torralba, F; de Miguel Poch, E; Alfaro Abreu, J; Villena Garrido, V; López Ríos, F; López Encuentra, A

2008-12-01

We define focal pulmonary lesion (FPL) as an intra-parenchymatous pulmonary lesion that is well circumscribed and completely surrounded by healthy lung. It is considered that the profitability of the fine needle aspiration puncture (FNAP) in FPL profitability of the FNAP in the malignant FPL and study if it varies according to site, size and histology. We analyzed all the FBCs of our Unit between 01/2000 and 12/2001 in patients with solitary FLP profitability by size, site and histology was analyzed with Pearson's chi(2) statistics. 124 patients. Mean FBC per patient was 1.3. A total of 101 cases (82%) were diagnosed with FBC, 15 by thoracotomy and 8 by FNAP. Global diagnostic profitability of the FBC was 0.82 and the transbronchial biopsy 0.76. There are no diagnostic profitability differences by size ( 2 cm) (0.81 vs 0.82 p = 0.96), site (peripheral vs central) (0.79 vs 0.85 p = 0.41) and histology (epidermoid vs adenocarcinoma) (0.89 vs 0.75 p = 0.21). Profitability of the FBC in malignant FPL in our hospital is elevated without differences by size, site or histology. In our site, the initial diagnostic approach of the FLP is done with FBC.

The study of mucin histochemistry in benign and malignant lesions of prostate

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Durgaprasad N Agrawal

2014-01-01

Full Text Available Objective: To evaluate the usefulness of mucin stains in differentiating benign and malignant lesions of prostate. Materials and Methods: Sections were obtained from archival paraffin blocks which included randomly selected 70 cases of benign hyperplasia and 30 cases of carcinoma prostate. After confirming the diagnosis, sections were stained for Periodic Acid Schiff (PAS to study neutral mucins, Alcian blue (2.5 pH to study acidic mucins and combined Alcian blue - PAS to study the mucin character. Results: Benign hyperplasia of prostate showed positivity for neutral mucins (98.57% but not for acidic mucins, whereas prostatic carcinomas showed positivity for acidic mucins (46.66% in addition to the positivity for neutral mucins (56.66%. All the cases of low grade prostatic carcinomas showed positivity for acidic mucins but none of the high grade carcinomas showed positivity for the same. Conclusion: Positivity for acidic mucins with Alcian Blue (2.5 pH technique can be used to differentiate well differentiated adenocarcinomas of prostate from benign hyperplasia especially in those cases where prostatic lesion is a questionable malignancy either because it is so well differentiated histologically or have altered architecture so as to make it cytologically un diagnosable (P = 0.001.

Quantitative analysis of 18F-NaF dynamic PET/CT cannot differentiate malignant from benign lesions in multiple myeloma.

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Sachpekidis, Christos; Hillengass, Jens; Goldschmidt, Hartmut; Anwar, Hoda; Haberkorn, Uwe; Dimitrakopoulou-Strauss, Antonia

2017-01-01

A renewed interest has been recently developed for the highly sensitive bone-seeking radiopharmaceutical 18 F-NaF. Aim of the present study is to evaluate the potential utility of quantitative analysis of 18 F-NaF dynamic PET/CT data in differentiating malignant from benign degenerative lesions in multiple myeloma (MM). 80 MM patients underwent whole-body PET/CT and dynamic PET/CT scanning of the pelvis with 18 F-NaF. PET/CT data evaluation was based on visual (qualitative) assessment, semi-quantitative (SUV) calculations, and absolute quantitative estimations after application of a 2-tissue compartment model and a non-compartmental approach leading to the extraction of fractal dimension (FD). In total 263 MM lesions were demonstrated on 18 F-NaF PET/CT. Semi-quantitative and quantitative evaluations were performed for 25 MM lesions as well as for 25 benign, degenerative and traumatic lesions. Mean SUV average for MM lesions was 11.9 and mean SUV max was 23.2. Respectively, SUV average and SUV max for degenerative lesions were 13.5 and 20.2. Kinetic analysis of 18 F-NaF revealed the following mean values for MM lesions: K 1 = 0.248 (1/min), k 3 = 0.359 (1/min), influx (K i ) = 0.107 (1/min), FD = 1.382, while the respective values for degenerative lesions were: K 1 = 0.169 (1/min), k 3 = 0.422 (1/min), influx (K i ) = 0.095 (1/min), FD = 1. 411. No statistically significant differences between MM and benign degenerative disease regarding SUV average , SUV max , K 1 , k 3 and influx (K i ) were demonstrated. FD was significantly higher in degenerative than in malignant lesions. The present findings show that quantitative analysis of 18 F-NaF PET data cannot differentiate malignant from benign degenerative lesions in MM patients, supporting previously published results, which reflect the limited role of 18 F-NaF PET/CT in the diagnostic workup of MM.

Linear Malignant Melanoma In Situ: Reports and Review of Cutaneous Malignancies Presenting as Linear Skin Cancer.

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Cohen, Philip R

2017-09-18

Melanomas usually present as oval lesions in which the borders may be irregular. Other morphological features of melanoma include clinical asymmetry, variable color, diameter greater than 6 mm and evolving lesions. Two males whose melanoma in situ presented as linear skin lesions are described and cutaneous malignancies that may appear linear in morphology are summarized in this report. A medical literature search engine, PubMed, was used to search the following terms: cancer, cutaneous, in situ, linear, malignant, malignant melanoma, melanoma in situ, neoplasm, and skin. The 25 papers that were generated by the search and their references, were reviewed; 10 papers were selected for inclusion. The cancer of the skin typically presents as round lesions. However, basal cell carcinoma and squamous cell carcinoma may arise from primary skin conditions or benign skin neoplasms such as linear epidermal nevus and linear porokeratosis. In addition, linear tumors such as basal cell carcinoma can occur. The development of linear cutaneous neoplasms may occur secondary to skin tension line or embryonal growth patterns (as reflected by the lines of Langer and lines of Blaschko) or exogenous factors such as prior radiation therapy. Cutaneous neoplasms and specifically melanoma in situ can be added to the list of linear skin lesions.

Utility of whole-lesion ADC histogram metrics for assessing the malignant potential of pancreatic intraductal papillary mucinous neoplasms (IPMNs).

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Hoffman, David H; Ream, Justin M; Hajdu, Christina H; Rosenkrantz, Andrew B

2017-04-01

To evaluate whole-lesion ADC histogram metrics for assessing the malignant potential of pancreatic intraductal papillary mucinous neoplasms (IPMNs), including in comparison with conventional MRI features. Eighteen branch-duct IPMNs underwent MRI with DWI prior to resection (n = 16) or FNA (n = 2). A blinded radiologist placed 3D volumes-of-interest on the entire IPMN on the ADC map, from which whole-lesion histogram metrics were generated. The reader also assessed IPMN size, mural nodularity, and adjacent main-duct dilation. Benign (low-to-intermediate grade dysplasia; n = 10) and malignant (high-grade dysplasia or invasive adenocarcinoma; n = 8) IPMNs were compared. Whole-lesion ADC histogram metrics demonstrating significant differences between benign and malignant IPMNs were: entropy (5.1 ± 0.2 vs. 5.4 ± 0.2; p = 0.01, AUC = 86%); mean of the bottom 10th percentile (2.2 ± 0.4 vs. 1.6 ± 0.7; p = 0.03; AUC = 81%); and mean of the 10-25th percentile (2.8 ± 0.4 vs. 2.3 ± 0.6; p = 0.04; AUC = 79%). The overall mean ADC, skewness, and kurtosis were not significantly different between groups (p ≥ 0.06; AUC = 50-78%). For entropy (highest performing histogram metric), an optimal threshold of >5.3 achieved a sensitivity of 100%, a specificity of 70%, and an accuracy of 83% for predicting malignancy. No significant difference (p = 0.18-0.64) was observed between benign and malignant IPMNs for cyst size ≥3 cm, adjacent main-duct dilatation, or mural nodule. At multivariable analysis of entropy in combination with all other ADC histogram and conventional MRI features, entropy was the only significant independent predictor of malignancy (p = 0.004). Although requiring larger studies, ADC entropy obtained from 3D whole-lesion histogram analysis may serve as a biomarker for identifying the malignant potential of IPMNs, independent of conventional MRI features.

The diagnostic value of diffusion-weighted imaging and the apparent diffusion coefficient values in the differentiation of benign and malignant breast lesions.

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Çabuk, Gonca; Nass Duce, Meltem; Özgür, Anıl; Apaydın, Feramuz Demir; Polat, Ayşe; Orekici, Gülhan

2015-04-01

The goal of our study was to evaluate the diagnostic efficacy of diffusion-weighted imaging (DWI) in the differentiation of benign and malignant breast lesions. Between June 2012 and March 2013, 60 patients with 63 lesions (age range 29-70 years, mean age 48.6 years) were included in our study. All lesions, except complicated cysts and intra-mammary lymph nodes, were confirmed histopathologically. The patients were evaluated with a 1.5 Tesla MR scanner using dedicated bilateral breast coil. DWI images were obtained by echo planar imaging sequence and 'b' values were selected as 200, 600 and 1000 s/mm(2). Apparent diffusion coefficient (ADC) values of both breast lesions and the normal fibroglandular tissue of the contralateral breast were calculated and statistically compared using Shapiro-Wilk test, Student's t-test, Mann-Whitney U test, chi-square test and the receiver operating curve. Of 63 lesions, 22 were malignant and 41 were benign. In malignant lesions, the mean ADC values were 1.40 ± 0.41 × 10(-3) mm(2)/s for b = 200, 1.05 ± 0.28 × 10(-3) mm(2)/s for b = 600 and 0.91 ± 0.20 × 10(-3) mm(2)/s for b = 1000 and in benign lesions, the mean ADC values were 2.13 ± 0.85 × 10(-3) mm(2)/s for b = 200, 1.64 ± 0.47 × 10(-3) mm(2)/s for b = 600 and 1.40 ± 0.43 × 10(-3) mm(2)/s for b = 1000. The success of ADC values in differentiation of benign and malignant lesions was statistically significant (P = 0.0001). The threshold values were determined to be 1.50 × 10(-3) mm(2)/s for b = 200, 1.22 × 10(-3) mm(2)/s for b = 600 and 0.98 × 10(-3) mm(2)/s for b = 1000 (P benign and malignant breast lesions. © 2015 The Royal Australian and New Zealand College of Radiologists.

Cutaneous malignant and premalignant conditions caused by chronic arsenicosis from contaminated ground water consumption: a profile of patients from eastern India.

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Ghosh, Sudip Kumar; Bandyopadhyay, Debabrata; Bandyopadhyay, Samik Kumar; Debbarma, Kuntal

2013-01-01

Natural arsenic pollution is a major global health problem. The two worst affected areas e Bangladesh and West Bengal, India. Arsenic is a well-documented human carcinogen that affects many organs including the skin. The authors sought to find out the clinical patterns of different malignant and premalignant conditions associated with chronic arsenicosis from drinking contaminated ground water in a group of patients from eastern India. This was a clinical observational study. Patients with chronic arsenicoses with suspected cutaneous malignancies for whom dermatology service was sought were enrolled in the study. A total of 24 patients (male to female ratio, 11:1; age range, 32-71 years; mean age, 52.2 years) were evaluated. Squamous cell carcinoma (SCC) was the commonest malignancies in our series, seen in 10 (41.7%) patients. This was followed by Bowen's disease (9 [37.5%]) and basal cell carcinoma (8 [33.3%]). Three patients (12.5%) had > 1 type of cutaneous malignancies. Multicentric lesions were seen in 3 cases. The most common site of involvement was the chest (8 [33.3%]). No statistically significant correlation was found between number of lesions and arsenic content in the hairs and nails of the patients.

Increased signal intensity of prostate lesions on high b-value diffusion-weighted images as a predictive sign of malignancy

International Nuclear Information System (INIS)

Quentin, Michael; Schimmoeller, Lars; Antoch, Gerald; Blondin, Dirk; Arsov, Christian; Rabenalt, Robert; Albers, Peter

2014-01-01

The evaluation of lesions detected in prostate magnetic resonance imaging (MRI) with increased signal intensity (SI) on high b-value diffusion-weighted images as a sign of malignancy. One hundred and three consecutive patients with prostate MRI examination and MRI-guided in-bore biopsy were retrospectively included in the study. MRI-guided in-bore biopsy histologically confirmed prostate cancer in 50 patients (n = 92 lesions). The other 53 patients (n = 122 lesions) had negative bioptical results. In patients with histologically confirmed prostate cancer, 46 of the 92 lesions had visually increased SI on the high b-value images compared with the peripheral zone (SI = +27 ± 16%) or the central gland (SI = +37 ± 19%, P < 0.001 respectively). In patients with a negative biopsy, ten of the 122 lesions had visually increased SI (compared with the peripheral zone, SI = +29 ± 18%, and with the central gland, SI = +41 ± 15%, P < 0.001 respectively). Neither the apparent diffusion coefficient (ADC) values nor the Gleason Score of lesions with increased SI were significantly different from lesions without increased SI. Visually increased SI on the high b-value images of diffusion-weighted imaging using standard b-values is a sign of malignancy but can occasionally also be a feature of benign lesions. However, it does not indicate more aggressive tumours. (orig.)

Evaluation of T1/T2 ratios in a pilot study as a potential biomarker of biopsy: proven benign and malignant breast lesions in correlation with histopathological disease stage.

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Malikova, Marina A; Tkacz, Jaroslaw N; Slanetz, Priscilla J; Guo, Chao-Yu; Aakil, Adam; Jara, Hernan

2017-08-01

Early breast cancer detection is important for intervention and prognosis. Advances in treatment and outcome require diagnostic tools with highly positive predictive value. To study the potential role of quantitative MRI (qMRI) using T1/T2 ratios to differentiate benign from malignant breast lesions. A cross-sectional study of 69 women with 69 known or suspicious breast lesions were scanned with mixed-turbo spin echo pulse sequence. Patients were grouped according to histopathological assessment of disease stage: untreated malignant tumor, treated malignancy and benign disease. Elevated T1/T2 means were observed for biopsy-proven malignant lesions and for malignant lesions treated prior to qMRI with chemotherapy and/or radiation, as compared with benign lesions. The qMRI-obtained T1/T2 ratios correlated with histopathology. Analysis revealed correlation between elevated T1/T2 ratio and disease stage. This could provide valuable complementary information on tissue properties as an additional diagnostic tool.

Comparison of peritumoral stromal tissue stiffness obtained by shear wave elastography between benign and malignant breast lesions.

Science.gov (United States)

Park, Hye Sun; Shin, Hee Jung; Shin, Ki Chang; Cha, Joo Hee; Chae, Eun Young; Choi, Woo Jung; Kim, Hak Hee

2018-01-01

Background Aggressive breast cancers produce abnormal peritumoral stiff areas, which can differ between benign and malignant lesions and between different subtypes of breast cancer. Purpose To compare the tissue stiffness of the inner tumor, tumor border, and peritumoral stroma (PS) between benign and malignant breast masses by shear wave elastography (SWE). Material and Methods We enrolled 133 consecutive patients who underwent preoperative SWE. Using OsiriX commercial software, we generated multiple 2-mm regions of interest (ROIs) in a linear arrangement on the inner tumor, tumor border, and PS. We obtained the mean elasticity value (E mean ) of each ROI, and compared the E mean between benign and malignant tumors. Odds ratios (ORs) for prediction of malignancy were calculated. Subgroup analyses were performed among tumor subtypes. Results There were 85 malignant and 48 benign masses. The E mean of the tumor border and PS were significantly different between benign and malignant masses ( P benign and malignant masses. Malignant masses with a stiff rim were larger in size and associated with more aggressive pathologic subtypes.

The diagnostic value of diffusion-weighted imaging and the apparent diffusion coefficient values in the differentiation of benign and malignant breast lesions

International Nuclear Information System (INIS)

Çabuk, Gonca; Duce, Meltem Nass; Özgür, Anil; Apaydin, Feramuz Demir; Polat, Ayşe; Orekici, Gülhan

2015-01-01

The goal of our study was to evaluate the diagnostic efficacy of diffusion-weighted imaging (DWI) in the differentiation of benign and malignant breast lesions. Between June 2012 and March 2013, 60 patients with 63 lesions (age range 29-70 years, mean age 48.6 years) were included in our study. All lesions, except complicated cysts and intra-mammary lymph nodes, were confirmed histopathologically. The patients were evaluated with a 1.5 Tesla MR scanner using dedicated bilateral breast coil. DWI images were obtained by echo planar imaging sequence and 'b' values were selected as 200, 600 and 1000 s/mm2. Apparent diffusion coefficient (ADC) values of both breast lesions and the normal fibroglandular tissue of the contralateral breast were calculated and statistically compared using Shapiro-Wilk test, Student's t-test, Mann-Whitney U test, chi-square test and the receiver operating curve. Of 63 lesions, 22 were malignant and 41 were benign. In malignant lesions, the mean ADC values were 1.40 ± 0.41 × 10 −3 mm 2 /s for b = 200, 1.05 ± 0.28 × 10 −3 mm 2 /s for b = 600 and 0.91 ± 0.20 × 10 −3 mm 2 /s for b = 1000 and in benign lesions, the mean ADC values were 2.13 ± 0.85 × 10 −3 mm 2 /s for b = 200, 1.64 ± 0.47 × 10 −3 mm 2 /s for b = 600 and 1.40 ± 0.43 × 10 −3 mm 2 /s for b = 1000. The success of ADC values in differentiation of benign and malignant lesions was statistically significant (P = 0.0001). The threshold values were determined to be 1.50 × 10 −3 mm 2 /s for b = 200, 1.22 × 10 −3 mm 2 /s for b = 600 and 0.98 × 10 −3 mm 2 /s for b = 1000 (P < 0.05). DWI can be an effective radiological method in the differentiation of benign and malignant breast lesions.

Cholestatic jaundice by malignant lesions: pictorial essay;Ictericia colestatica por lesoes de natureza maligna: ensaio iconografico

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Santa Anna, Tatiana Kelly Brasileiro de; Santana, Alex Menezes; Rizzuto, Mauricio Soares; Chagas, Alessandro Rosa Rodrigues; Zuppani, Aguinaldo Cunha, E-mail: tatianakelly@hotmail.co [Hospital Santa Marcelina, Sao Paulo, SP (Brazil). Setor de Radiologia e Diagnostico por Imagem; Rezende, Marcelo Bruno; Viveiros, Marcelo de Melo [Hospital Santa Marcelina, Sao Paulo, SP (Brazil). Servico de Cirurgia do Figado e Hipertensao Portal

2009-12-15

Malignant obstructive jaundice is most commonly caused by cancer of pancreatic head, papilla tumor, cholangiocarcinoma and biliary obstruction induced by secondary lesions of the liver or lymph nodes. Patients usually present with weight loss, abdominal pain, jaundice and progressive increase of direct bilirubin, being essential the evaluation by imaging methods for the proper diagnosis, staging and therapeutic planning. This essay illustrates the imaging aspects of ultrasound and computed tomography - and in specific situations magnetic resonance cholangiography - of the major malignancies that lead to cholestatic jaundice. (author)

Malignant eccrine paramar

International Nuclear Information System (INIS)

Al-Ahwal, Mahmoud S.; Zimmo, Sameer K; Sawan, Ali S.

2005-01-01

Benign eccrine poroma arises from the intraepidermal portion of the eccrine gland duct. Malignant transformation is rare and should be suspected when these lesions present with pain, bleeding or itching. We report a 44-year-old male patient who presented primarily with a lesion diagnostic of benign eccrine poroma of the right foot sole with no clear evidence of malignancy, which was incompletely excised, followed 5 months later by local recurrence, ulceration, occasional bleeding and right inguinal lymphadenopathy. Incomplete excision of the primary tumor as well as excision of a skin lesion on the right knee joint revealed malignant eccrine poroma with aggressive histology, lymphovascular and perineural invasion. Investigations revealed no evidence of distant metastasis. This tumor might be malignant at the first presentation, which was not confirmed histopathologically considering the short duration of only 5 months for malignant transformation. The patient received 3 cycles of Docetaxel Taxotere, Cisplatin combination chemotherapy with partial response. The management of metastatic malignant eccrine poroma is difficult. It has proven resistant to many chemotherapeutic agents and radiotherapy. (author)

Correlación cito-histológica de las lesiones premalignas y malignas de cuello uterino Cyto-histological correlation of the pre-malignant and malignant lesions of the cervix

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Gladys Rafaela Cirión Martínez

2010-03-01

Full Text Available El control de la calidad es obligatorio para cualquier programa. Es importante en el diagnóstico de lesiones de cuello uterino puesto que el cáncer cervical es la segunda causa de mortalidad en la mujer. Objetivos: Determinar la correlación cito-histológica de las lesiones premalignas y malignas de cuello uterino. Hospital Clínico Quirúrgico "Abel Santamaría" en el período 2004-2007 Diseño: Se realizó un estudio de validación externa de la citología orgánica del cuello uterino mediante un diseño observacional, descriptivo y transversal. Sujetos y método. Universo: 7174 mujeres con biopsia del cuello uterino, de las cuales 3240 provenían del Programa de Detección Precoz del Cáncer Cérvico-Uterino (PDPCCU. Se determinó la edad, correspondencia diagnóstica entre citología y biopsia y el rendimiento de la citología orgánica según tipo de lesión. Se usó la estadística descriptiva para resumir las variables categóricas y cuantitativas continuas. Se calculó la sensibilidad y la especificidad de los diagnósticos. Resultados. Se produjo un aumento progresivo de las biopsias de cuello realizadas, con un incremento significativo de los casos del PDPCCU. Predominó el diagnóstico de lesiones premalignas; las más frecuentes fueron las NIC I. La correlación cito-histológica y la sensibilidad aumentaron con la severidad de las lesiones. La especificidad se mantuvo constante para todas las lesiones. Conclusión. Se comprobó que la calidad se mantiene entre los estándares internacionales.Quality control is compulsory for any programs, being of a great importance the diagnosis of the lesions in the cervix, cervical cancer is the second cause of death in women. Objectives: To determine the cyto-histological correlation of the pre-malignant and malignant lesions of the cervix. This research paper was carried out at "Abel Santamaria Cuadrado" University Hospital during 2004-2007. Design: An external validation study was conducted

Evaluation of computed tomography for the diagnosis of malignant lesions in the liver

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Nakano, S; Hamano, H; Kitamura, K [Ogaki Municipal Hospital, Gifu (Japan)

1980-01-01

Thirty seven cases with malignant lesions in the liver underwent computed tomography and diagnostic evaluation was studied comparing with liver scanning, echogram and blood biochemistry. 1) In the cases with hepatocellular carcinoma, irregular shaped, low density area was detected in 94%. CT was superior to liver scanning and echogram in detection of space occupying lesion in the liver. 2) Remarkable dilatation of the intra-hepatic bile duct was observed in the cases with intra-hepatic biliary carcinoma and the visualization of the tumor was rather difficult. 3) Round shaped, low density area with various size were detected in the cases with metastatic liver carcinoma in 94%. The CT number of the tumors were significantly lower than that of hepatocellular carcinoma. Almost all cases accompanied remarkable hepatomegaly.

Performance comparison of deep learning and segmentation-based radiomic methods in the task of distinguishing benign and malignant breast lesions on DCE-MRI

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Antropova, Natasha; Huynh, Benjamin; Giger, Maryellen

2017-03-01

Intuitive segmentation-based CADx/radiomic features, calculated from the lesion segmentations of dynamic contrast-enhanced magnetic resonance images (DCE-MRIs) have been utilized in the task of distinguishing between malignant and benign lesions. Additionally, transfer learning with pre-trained deep convolutional neural networks (CNNs) allows for an alternative method of radiomics extraction, where the features are derived directly from the image data. However, the comparison of computer-extracted segmentation-based and CNN features in MRI breast lesion characterization has not yet been conducted. In our study, we used a DCE-MRI database of 640 breast cases - 191 benign and 449 malignant. Thirty-eight segmentation-based features were extracted automatically using our quantitative radiomics workstation. Also, 2D ROIs were selected around each lesion on the DCE-MRIs and directly input into a pre-trained CNN AlexNet, yielding CNN features. Each method was investigated separately and in combination in terms of performance in the task of distinguishing between benign and malignant lesions. Area under the ROC curve (AUC) served as the figure of merit. Both methods yielded promising classification performance with round-robin cross-validated AUC values of 0.88 (se =0.01) and 0.76 (se=0.02) for segmentationbased and deep learning methods, respectively. Combination of the two methods enhanced the performance in malignancy assessment resulting in an AUC value of 0.91 (se=0.01), a statistically significant improvement over the performance of the CNN method alone.

Chromosomal aberrations in benign and malignant Bilharzia-associated bladder lesions analyzed by comparative genomic hybridization

International Nuclear Information System (INIS)

Fadl-Elmula, Imad; Kytola, Soili; Leithy, Mona EL; Abdel-Hameed, Mohamed; Mandahl, Nils; Elagib, Atif; Ibrahim, Muntaser; Larsson, Catharina; Heim, Sverre

2002-01-01

Bilharzia-associated bladder cancer (BAC) is a major health problem in countries where urinary schistosomiasis is endemic. Characterization of the genetic alterations in this cancer might enhance our understanding of the pathogenic mechanisms of the disease but, in contrast to nonbilharzia bladder cancer, BAC has rarely been the object of such scrutiny. In the present study, we aimed to characterize chromosomal imbalances in benign and malignant post-bilharzial lesions, and to determine whether their unique etiology yields a distinct cytogenetic profile as compared to chemically induced bladder tumors. DNAs from 20 archival paraffin-embedded post-bilharzial bladder lesions (6 benign and 14 malignant) obtained from Sudanese patients (12 males and 8 females) with a history of urinary bilharziasis were investigated for chromosomal imbalances using comparative genomic hybridization (CGH). Subsequent FISH analysis with pericentromeric probes was performed on paraffin sections of the same cases to confirm the CGH results. Seven of the 20 lesions (6 carcinomas and one granuloma) showed chromosomal imbalances varying from 1 to 6 changes. The most common chromosomal imbalances detected were losses of 1p21-31, 8p21-pter, and 9p and gain of 19p material, seen in three cases each, including the benign lesion. Most of the detected imbalances have been repeatedly reported in non-bilharzial bladder carcinomas, suggesting that the cytogenetic profiles of chemical- and bilharzia-induced carcinomas are largely similar. However, loss of 9p seems to be more ubiquitous in BAC than in bladder cancer in industrialized countries

Quantification of the magnetization-transfer contrast effect: can it yield additional information in differentiation of musculoskeletal lesions particularly in separation of benign from malignant lesions; Quantifizierung des Magnetization Transfer Contrast (MTC) Effektes durch Berechnung von MT-Quotienten: Ergeben sich Zusatzinformationen fuer die Differenzierung benigner und maligner Erkrankungen des Bewegungsapparates?

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Vahlensieck, M.; Traeber, F.; Schild, H. [Radiologische Universitaetsklinik Bonn (Germany); Gieseke, J. [Philips Medizinsysteme (Germany)

1999-12-01

Purpose: To investigate the potential information of the amount of magnetization-transfer effect in musculoskeletal lesions and to compare MT ratios from benign and malignant musculoskeletal lesions. Material and Method: 49 patients with malignant tumors (3 osteosarcoma, 3 malignant fibrous histiocytoma, 4 chondrosarcoma, 2 Ewing sarcomas) and benign lesions (8 chondroma, 2 fibrous dysplasia, 3 osteoid-osteoma, 6 ganglion cyst, 3 cyst, 3 osteomyelitis, 4 tendinitis, 3 rotator cuff tear, 5 scar tissue) were scanned using routine MRI protocols including T{sub 1}- and T{sub 2}-weighted spin echo as well as T{sub 2}*-weighted gradient echo (FFE) sequences at 1.5 Tesla (ACS II, Philips Medical). Additionally MTC images were generated by combining the FFE sequence and the off-resonance MT technique (-1500 Hz off-resonance frequency, 1770 flip angle and 50 ms pulse duration). MT ratios were calculated as SI{sub o}-SI{sub m}/SI{sub o}. Results: The MT ratio of benign lesions was 26{+-}15%, that of malignant lesions was 22{+-}6%. The difference was statistically not significant. As expected muscle showed a high MT ratio of 50{+-}8%. Scar tissue demonstrated an MT ratio of 39{+-}16% which was significantly higher than the tumor MT ratios. Conclusion: MTC (MT ratios) failed to show significant differences between benign and malignant lesions as was expected due to basic differences in cellularity, rate of mitosis and chromatin content. MTC might however gain more importance in separating scar tissue from recurrent tumor in the future. (orig.) [German] Zielsetzung: Durch die Quantifizierung des Magnetization Transfer Contrastes sollte untersucht werden, ob sich Zusatzinformationen in der Magnetresonanztomographie des Stuetz- und Bewegungsapparates ergeben. Insbesondere sollte ermittelt werden, ob gut- und boesartige Laesionen unterschiedliche MT-Quotienten aufweisen. Material und Methode: 49 Patienten mit boesartigen Tumoren (3 Osteosarkom, 4 Chondrosarkom, 3 Malignes

Analysis of pulmonary coin lesions

International Nuclear Information System (INIS)

Kim, O; Kim, K. H.; Oh, K. K.; Park, C. Y.

1979-01-01

For A long time the solitary pulmonary nodule has remained a difficult problem to solve and has attracted a great deal of attension in recent years. Circumscribed coin lesions of the lung were generally peripheral in location with respect to the pulmonary hilus. Because of this, important clinical problem in management and diagnosis arise. Such a lesion is discovered through roentgenologic examination. So the roentgenologists is the first be in a position to offer advise. This presentation is an attempt to correlate a useful diagnosis with roentgenologic findings of pulmonary coin lesion which enables us to get differential diagnosis of benign and malignant lesion. Histologically proven 120 cases of the pulmonary coin lesion during the period of 8 years were reviewed through plain film, tomogram, bronchoscopy, variable laboratory findings, and clinical history. The results are as follows: 1. Male to female sex ratio was 3 : 1. In age distribution, most of the malignant pulmonary coin lesion appeared in 6th decade (39%) and 5th decade (27%). In benign lesion, the most cases were in 3 rd decade. 2. Pathological cell type are as follows: Primary bronchogenic cancer 43.3%, tuberculoma 25.8%, inflammatory lesion 17.5%, benign tumor 10%, and bronchial adenoma, harmartoma, A.V. malformation, mesothelioma, are 1 case respectively. As a result benign and malignant lesion showed equal distribution (49.1% : 50.3%). 3. In symptom analysis ; cough is the most common (43.5%) symptom in malignant lesion, next follows hemoptysis (20.9%) and chest pain (14.5%). In benign lesion, most of the patient (32.7%) did not complain any symptom. 4. In malignant lesion, the most common nodular size was 4 cm (32.3%), and in benign lesion 2 cm sized coin was most common (39.3%). 5. In general, margin of nodule was very sharp and well demarcated in benign lesion (83.3%), and in malignant lesion that was less demarcated and poorly defined. 6. Most case of calcification (82.7%) was seen in benign

Comparison of diagnostic value of conventional ultrasonography and shear wave elastography in the prediction of thyroid lesions malignancy.

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Ewelina Szczepanek-Parulska

Full Text Available INTRODUCTION: Thyroid nodular disease (TND is a very common disorder. However, since the rate of malignancy is reported to be 3-10%, only a minority of patients require aggressive surgical treatment. As a result, there is a need for diagnostic tools which would allow for a reliable differentiation between benign and malignant nodules. Although a number of conventional ultrasonographic (US features are proved to be markers of malignancy, Shear Wave Elastography (SWE is considered to be an improvement of conventional US. The aim of this study was to compare conventional US markers and SWE diagnostic values in the differentiation of benign and malignant thyroid nodules. MATERIALS AND METHODS: All patients referred for thyroidectomy, irrespective of the indications, underwent a US thyroid examination prospectively. Patients with TND were included into the study. Results of the US and SWE examinations were compared with post-surgical histopathology. RESULTS: One hundred and twenty two patients with 393 thyroid nodules were included into the study. Twenty two patients were diagnosed with cancer. SWE turned out to be a predictor of malignancy superior to any other conventional US markers (OR=54.5 using qualitative scales and 40.8 using quantitative data on maximal stiffness with a threshold of 50 kPa. CONCLUSIONS: Although most conventional US markers of malignancy prove to be significant, none of them are characterized by both high sensitivity and specificity. SWE seems to be an important step forward, allowing for a more reliable distinction of benign and malignant thyroid nodules. Our study, assessing SWE properties on the highest number of thyroid lesions at the time of publication, confirms the high diagnostic value of this technique. It also indicates that a quantitative evaluation of thyroid lesions is not superior to simpler qualitative methods.

Diagnostic value of 99mTc-bombesin scintigraphy for differentiation of malignant from benign breast lesions.

Science.gov (United States)

Shariati, Farzaneh; Aryana, Kamran; Fattahi, Asiehsadat; Forghani, Mohammad N; Azarian, Azita; Zakavi, Seyed R; Sadeghi, Ramin; Ayati, Narjes; Sadri, Keyvan

2014-06-01

In this study, we evaluated the diagnostic accuracy of (99m)Tc-bombesin scintigraphy for differentiation of benign from malignant palpable breast lesions. (99m)Tc-Bombesin is a tracer with high affinity for gastrin-releasing peptide receptor, which is overexpressed on a variety of human tumors including breast carcinoma. We examined 33 consecutive women who were referred to our center with suspicious palpable breast lesions but had no definitive diagnosis in other imaging procedures. A volume of 370-444 MBq of (99m)Tc-bombesin was injected and dynamic 1-min images were taken for 20 min immediately after injection in anterior view. Thereafter, two static images in anterior and prone-lateral views were taken for 5 min. Finally, single-photon emission computed tomography images were taken for each patient. Definitive diagnosis was based on biopsy and histopathological evaluation. The scan findings were positive in 19 patients and negative in 11 on visual assessment of the planar and single-photon emission computed tomography images. Pathologic examination confirmed breast carcinoma in 12 patients with positive scans and benign pathology for 18 patients. The overall sensitivity, specificity, negative and positive predictive values, and accuracy of this radiotracer for diagnosis of breast cancer were 100, 66.1, 100, 63, and 76%, respectively. Semiquantitative analysis improved the specificity of the visual assessment from 66 to 84%. Our study showed that (99m)Tc-bombesin scintigraphy has a high sensitivity and negative predictive value for detecting malignant breast lesions, but the specificity and positive predictive value of this radiotracer for differentiation of malignant breast abnormalities from benign ones are relatively low.

ADC mapping of benign and malignant breast tumors

International Nuclear Information System (INIS)

Woodhams, R.; Matsunaga, Keiji; Kan, Shinichi; Hata, Hirofumi; Iwabuchi, Keiichi; Kuranami, Masaru; Watanabe, Masahiko; Hayakawa, Kazushige; Ozaki, Masanori

2005-01-01

The purpose of this study was to investigate the utility of diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC) value in differentiating benign and malignant breast lesions and evaluating the detection accuracy of the cancer extension. We used DWI to obtain images of 191 benign and malignant lesions (24 benign, 167 malignant) before surgical excision. The ADC values of the benign and malignant lesions were compared, as were the values of noninvasive ductal carcinoma (NIDC) and invasive ductal carcinoma (IDC). We also evaluated the ADC map, which represents the distribution of ADC values, and compared it with the cancer extension. The mean ADC value of each type of lesion was as follows: malignant lesions, 1.22±0.31 x 10 -3 mm 2 /s; benign lesions, 1.67±0.54 x 10 -3 mm 2 /s; normal tissues, 2.09±0.27 x 10 -3 mm 2 /s. The mean ADC value of the malignant lesions was statistically lower than that of the benign lesions and normal breast tissues. The ADC value of IDC was statistically lower than that of NIDC. The sensitivity of the ADC value for malignant lesions with a threshold of less than 1.6 x 10 -3 mm 2 /s was 95% and the specificity was 46%. A full 75% of all malignant cases exhibited a near precise distribution of low ADC values on ADC maps to describe malignant lesions. The main causes of false negative and underestimation of cancer spread were susceptibility artifact because of bleeding and tumor structure. Major histologic types of false-positive lesions were intraductal papilloma and fibrocystic diseases. Fibrocystic diseases also resulted in overestimation of cancer extension. DWI has the potential in clinical appreciation to detect malignant breast tumors and support the evaluation of tumor extension. However, the benign proliferative change remains to be studied as it mimics the malignant phenomenon on the ADC map. (author)

VEGF-C Is a Thyroid Marker of Malignancy Superior to VEGF-A in the Differential Diagnostics of Thyroid Lesions.

Directory of Open Access Journals (Sweden)

Kosma Woliński

Full Text Available Thyroid nodular goiter is one of the most common medical conditions affecting even over a half of adult population. The risk of malignancy is rather small but noticeable-estimated by numerous studies to be about 3-10%. The definite differentiation between benign and malignant ones is a vital issue in endocrine practice. The aim of the current study was to assess the expression of vascular endothelial growth factor A (VEGF-A and VEGF-C on the mRNA level in FNAB washouts in case of benign and malignant thyroid nodules and to evaluate the diagnostic value of these markers of malignancy.Patients undergoing fine-needle aspiration biopsy (FNAB in our department between January 2013 and May 2014 were included. In case of all patients who gave the written consent, after ultrasonography (US and fine-needle aspiration biopsy (FNAB performed as routine medical procedure the needle was flushed with RNA Later solution, the washouts were frozen in -80 Celsius degrees. Expression of VEGF-A and VEGF-C and GADPH (reference gene was assessed in washouts on the mRNA level using the real-time PCR technique. Probes of patients who underwent subsequent thyroidectomy and were diagnosed with differentiated thyroid cancer (DTC; proved by post-surgical histopathology were analyzed. Similar number of patients with benign cytology were randomly selected to be a control group.Thirty one DTCs and 28 benign thyroid lesions were analyzed. Expression of VEGF-A was insignificantly higher in patients with DTCs (p = 0.13. Expression of VEGF-C was significantly higher in patients with DTC. The relative expression of VEGF-C (in comparison with GAPDH was 0.0049 for DTCs and 0.00070 for benign lesions, medians - 0.0036 and 0.000024 respectively (p<0.0001.Measurement of expression VEGF-C on the mRNA level in washouts from FNAB is more useful than more commonly investigated VEGF-A. Measurement of VEGF-C in FNAB washouts do not allow for fully reliable differentiation of benign and

Ultrasonography of chest wall lesion

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Park, Cheol Min; Kim, C. H.; Cha, I. H.; Chung, K. B.; Ser, W. H.; Choi, Y. H. [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1989-12-15

Thirty-one patients with chest wall diseases were studied with ultrasound to evaluate its role in chest wall lesions. There were eight infectious conditions, 9 benign tumors, 11 malignant lesions and 3 miscellaneous cases. Diffuse chest wall thickening with heterogeneous echogenicity and obliteration of subcutaneous fat layer are findings of acute infection. In cases of tuberculous smpyema necessitates, pleural abnormality extended to the chest wall through intercostal space. Benign tumors were well demarcated, except in 4 cases of lipoma/lipomatosis. Malignant lesions showed irregular soft tissue masses, bone destruction, pleural effusion and subcutaneous invasion. Multiple enlarged lymph nodes were also shown. Ultrasound can demonstrate te internal structure, extent, depth and associated findings such as pleural effusion, bone destruction and peripheral lung involvement. Ultrasound is not only safe, non-invasive and an effective diagnostic imaging modality for chest wall disease, but can also guide aspiration or biopsy for pathologic diagnosis

Ultrasonography of chest wall lesion

International Nuclear Information System (INIS)

Park, Cheol Min; Kim, C. H.; Cha, I. H.; Chung, K. B.; Ser, W. H.; Choi, Y. H.

1989-01-01

Thirty-one patients with chest wall diseases were studied with ultrasound to evaluate its role in chest wall lesions. There were eight infectious conditions, 9 benign tumors, 11 malignant lesions and 3 miscellaneous cases. Diffuse chest wall thickening with heterogeneous echogenicity and obliteration of subcutaneous fat layer are findings of acute infection. In cases of tuberculous smpyema necessitates, pleural abnormality extended to the chest wall through intercostal space. Benign tumors were well demarcated, except in 4 cases of lipoma/lipomatosis. Malignant lesions showed irregular soft tissue masses, bone destruction, pleural effusion and subcutaneous invasion. Multiple enlarged lymph nodes were also shown. Ultrasound can demonstrate te internal structure, extent, depth and associated findings such as pleural effusion, bone destruction and peripheral lung involvement. Ultrasound is not only safe, non-invasive and an effective diagnostic imaging modality for chest wall disease, but can also guide aspiration or biopsy for pathologic diagnosis

Computed Tomography-Assisted Thoracoscopic Surgery: A Novel, Innovative Approach in Patients With Deep Intrapulmonary Lesions of Unknown Malignant Status.

Science.gov (United States)

Kostrzewa, Michael; Kara, Kerim; Rathmann, Nils; Tsagogiorgas, Charalambos; Henzler, Thomas; Schoenberg, Stefan O; Hohenberger, Peter; Diehl, Steffen J; Roessner, Eric D

2017-06-01

Minimally invasive resection of small, deep intrapulmonary lesions can be challenging due to the difficulty of localizing them during video-assisted thoracoscopic surgery (VATS). We report our preliminary results evaluating the feasibility of an image-guided, minimally invasive, 1-stop-shop approach for the resection of small, deep intrapulmonary lesions in a hybrid operating room (OR). Fifteen patients (5 men, 10 women; mean age, 63 years) with a total of 16 solitary, deep intrapulmonary nodules of unknown malignant status were identified for intraoperative wire marking. Patients were placed on the operating table for resection by VATS. A marking wire was placed within the lesion under 3D laser and fluoroscopic guidance using a cone beam computed tomography system. Then, wedge resection by VATS was performed in the same setting without repositioning the patient. Complete resection with adequate safety margins was confirmed for all lesions. Marking wire placement facilitated resection in 15 of 16 lesions. Eleven lesions proved to be malignant, either primary or secondary; 5 were benign. Mean lesion size was 7.7 mm; mean distance to the pleural surface was 15.1 mm (mean lesion depth-diameter ratio, 2.2). Mean procedural time for marking wire placement was 35 minutes; mean VATS duration was 36 minutes. Computed tomography-assisted thoracoscopic surgery is a new, safe, and effective procedure for minimally invasive resection of small, deeply localized intrapulmonary lesions. The benefits of computed tomography-assisted thoracoscopic surgery are 1. One-stop-shop procedure, 2. Lower risk for the patient (no patient relocation, no marking wire loss), and 3. No need to coordinate scheduling between the CT room and OR.

Malignancy rates and diagnostic performance of the Bosniak classification for the diagnosis of cystic renal lesions in computed tomography - a systematic review and meta-analysis

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Sevcenco, Sabina; Shariat, Shahrokh F. [Medical University of Vienna, Department of Urology, Vienna (Austria); Spick, Claudio; Helbich, Thomas H.; Baltzer, Pascal A. [Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, General Hospital Vienna, Vienna (Austria); Heinz, Gertraud [University Hospital of Sankt-Poelten, Department of Radiology, Poelten (Austria); Klingler, Hans C. [Wilhelminenspital, Department of Urology, Vienna (Austria); Rauchenwald, Michael [Donauspital, Department of Urology, Vienna (Austria)

2017-06-15

To systematically review the literature on the Bosniak classification system in CT to determine its diagnostic performance to diagnose malignant cystic lesions and the prevalence of malignancy in Bosniak categories. A predefined database search was performed from 1 January 1986 to 18 January 2016. Two independent reviewers extracted data on malignancy rates in Bosniak categories and several covariates using predefined criteria. Study quality was assessed using QUADAS-2. Meta-analysis included data pooling, subgroup analyses, meta-regression and investigation of publication bias. A total of 35 studies, which included 2,578 lesions, were investigated. Data on observer experience, inter-observer variation and technical CT standards were insufficiently reported. The pooled rate of malignancy increased from Bosniak I (3.2 %, 95 % CI 0-6.8, I{sup 2} = 5 %) to Bosniak II (6 %, 95 % CI 2.7-9.3, I{sup 2} = 32 %), IIF (6.7 %, 95 % CI 5-8.4, I{sup 2} = 0 %), III (55.1 %, 95 % CI 45.7-64.5, I{sup 2} = 89 %) and IV (91 %, 95 % CI 87.7-94.2, I{sup 2} = 36). Several study design-related influences on malignancy rates and subsequent diagnostic performance indices were identified. The Bosniak classification is an accurate tool with which to stratify the risk of malignancy in renal cystic lesions. (orig.)

Analysis of diffusion-weighted MR in the differential diagnosis of benign and malignant breast lesions with Meta-analysis

International Nuclear Information System (INIS)

Chen Xin; Zhang Qiujuan; Zhao Xian; Bai Zhilan; Zhang Yili; Guo Youmin

2008-01-01

Objective: To evaluate the value of diffusion-weighted imaging (DWI) in the differential diagnosis of benign and malignant breast lesions with Meta-analysis. Methods: English and Chinese articles published from 1997 to 2007 were searched in Cochrane library, Pubmed, Ovid, Elsevier, Springer databases and Chinese National Knowledge Infrastructure (CNKI), and selected according to the criteria for diagnostic research recommended by Cochrane Method Group. The characteristics of selected articles including the study background, design, results and diagnostic indicators were analyzed. Statistical analysis was performed with Meta-test version 0.9. Results: Six articles were included with a total of 479 lesions. The sensitivity and specificity of DWI for breast lesions ranged from 64.0% to 92.8% and from 45.8% to 96.7% respectively. All groups had homogeneity, and a fixation effects regression was developed. The pooled weighted sensitivity and specificity with 95% CI and Az was 86% (76%-92%), 80% (61%-91%) and 92.19% respectively. Sensitivity analysis demonstrated no remarkable change on heterogeneity. Conclusion: The value of ADC in DWI can help to differentiate the benign breast lesions from the malignant with good sensitivity and specificity. The further study is needed to assess the clinical application of the b-value and diagnostic threshold. (authors)

The effect of quitting smoking on the risk of unfavorable events after surgical treatment of oral potentially malignant lesions

DEFF Research Database (Denmark)

Vladimirov, B S; Schiødt, Morten

2009-01-01

smokers at the time of diagnosis and were treated surgically. Patients were advised to quit smoking at each visit. The change of smoking habits and occurrence of unfavorable events were noted during follow-up. Descriptive statistics, Fischer's exact test, Kaplan-Meier curves with log-rank test, and Cox......The aim of this study was to examine if cessation of smoking after surgical excision of oral potentially malignant lesions in smokers reduced the risk of recurrences, development of new lesions or malignancies. 51 patients with oral leukoplakia or erythroplakia were included. They were daily...... proportional hazards model were used for analysis. 16 patients (31%) quit smoking during the observation period. Only one quitter (6%) developed recurrence compared with 11 continuing smokers (33%) (p

Rapid Discrimination of Malignant Breast Lesions from Normal Tissues Utilizing Raman Spectroscopy System: A Systematic Review and Meta-Analysis of In Vitro Studies.

Directory of Open Access Journals (Sweden)

Ke Deng

Full Text Available The aim of this study is to evaluate the diagnostic accuracy of Raman spectroscopy system in the detection of malignant breast lesions through a systemic review and meta-analysis of published studies.We conducted a comprehensive literature search of PubMed and Embase from 2000 to June 2015. Published studies that evaluated the diagnostic performance of Raman spectroscopy in distinguishing malignant breast lesions from benign lesions and normal tissues were included in our study. The pooled sensitivity, specificity, diagnostic odds ratio, and the area under the curve of summary receiver-operating characteristic curves was derived. A Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies guidelines was used to assess the quality of included studies.The initial search produced a total of 157 articles after removing duplicates. Nine studies (8 in vitro and 1 in vivo were eligible in this meta-analysis. We analyzed the eight in vitro studies with 1756 lesions, the pooled sensitivity and specificity of Raman spectroscopy system for the diagnosis of malignant breast lesions were 0.92 (95% CI 0.86-0.96 and 0.97 (97% CI 0.93-0.98, respectively. Diagnostic odds ratio was 266.70 (95% CI 89.38-795.79, and the area under the curve of summary receiver-operating characteristic curves was 0.98 (95% CI 0.97-0.99. Significant heterogeneity was found between studies. There was no evidence of considerable publication bias.Raman spectroscopy system is an optical diagnostic technology with great value for detecting malignant breast lesions. At the same time, it has advantages of being non-invasive, real-time, and easy to use. Thus it deserves to be further explored for intra-operatory breast tumor margin detection.

Differential diagnosis of tuberculous pleural effusion and malignant

International Nuclear Information System (INIS)

Na, Eui Sung; Kim, Young Nam; Lee, Mee Ran; Oh, Yu Whan; Kang, Eun Young

1997-01-01

The purpose of this study is to evaluate the diagnostic accuracy of CT in the differential diagnosis of tuberculous and malignant pleural effusion whether or not lung lesions are present, and to investigate the CT findings used for this differential diagnosis. This study involved 30 patients with tuberculous pleural effusion (mean age, 44.6 years; M : F = 19:11) and 20 with malignant pleural effusion (mean age, 57.2 years; M: F=10:10). All 50 patients underwent enhanced CT chest scans, and the respective conditions were pathologically confirmed. Two radiologists unaware of the pathologic results and distributions of patients reviewed these scans, CT findings of pleural effusions, their diagnoses, and the degree of confidence of their diagnoses. In most cases, CT provided correct differential diagnosis between tuberculous and malignant pleural effusion. It can help determine the nature of associated lung and pleural lesions, and specific findings of the latter, and can accurately differentiate tuberculous and malignant pleural effusion. (author). 20 refs., 3 tabs., 5 figs

Surface lesions of the bones of the hand

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James, S.L.J.; Davies, A.M. [Royal Orthopaedic Hospital, Department of Radiology, Birmingham (United Kingdom)

2006-01-01

Surface lesions involving the bones of the hand are uncommon. This pictorial review illustrates the spectrum of conditions including benign primary bone tumours, malignant primary bone tumours and non-neoplastic disorders. The review focuses on the radiographic appearances of these lesions and other techniques such as CT and MR imaging that may suggest a specific diagnosis. (orig.)

Malignant salivary gland tumours

International Nuclear Information System (INIS)

Thompson, S.H.

1982-01-01

The most frequent malignant salivary gland tumours are the mucoepidermoid tumour, adenoid cystic carcinoma and adenocarcinoma. The major salivary glands and the minor glands of the mouth and upper respiratory tract may potentially develop any of these malignant lesions. Malignant lesions most frequently present as a palpable mass and tend to enlarge more rapidly than benign neoplasms. Pain, paresthesia, muscle paralysis and fixation to surrounding tissue are all ominous signs and symptoms. The only reliable means of differential diagnosis of these lesions is biopsy and histologic analysis. Therapy involves surgery or a combination of surgery and radiation therapy. The ultimate prognosis is governed by the intrinsic biologic behaviour of the neoplasms, the extent of disease and adequate clinical therapy

Malignant salivary gland tumours

Energy Technology Data Exchange (ETDEWEB)

Thompson, S.H. (University of the Witwatersrand, Johannesburg (South Africa). Dept. of Oral Pathology)

1982-08-01

The most frequent malignant salivary gland tumours are the mucoepidermoid tumour, adenoid cystic carcinoma and adenocarcinoma. The major salivary glands and the minor glands of the mouth and upper respiratory tract may potentially develop any of these malignant lesions. Malignant lesions most frequently present as a palpable mass and tend to enlarge more rapidly than benign neoplasms. Pain, paresthesia, muscle paralysis and fixation to surrounding tissue are all ominous signs and symptoms. The only reliable means of differential diagnosis of these lesions is biopsy and histologic analysis. Therapy involves surgery or a combination of surgery and radiation therapy. The ultimate prognosis is governed by the intrinsic biologic behaviour of the neoplasms, the extent of disease and adequate clinical therapy.

Associated factors with cervical pre-malignant lesions among the married fisher women community at Sadras, Tamil Nadu

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Sornam Ganesan

2015-01-01

Full Text Available Objective: To identify the associated factors of cervical pre-malignant lesions among the married fisher women residing in the coastal areas of Sadras, Tamil Nadu. Methods: The study was conducted in five fishermen communities under Sadras, a coastal area in Tamil Nadu, India. Two hundred and fifty married fisher women residing in the area. Quantitative descriptive approach with a cross-sectional study design was used. Data were collected using a structured interview schedule for identifying the associated factors and Pap smear test was performed for identifying the pre-malignant cervical lesions among the married fisher women. Data were analyzed using descriptive and inferential statistics. Results: Among 250 women, about six (2.4% of them presented with pre-cancerous lesions such as atypical squamous cell of undifferentiated significance (ASCUS - five (2% and mild dysplasia one (0.4%. Majority of the women, about 178 (71.2% women, had abnormal cervical findings. Statistical analysis showed a significant association of risk factors such as advanced age, lack of education, low socioeconomic status, using tobacco, multiparity, premarital sex, extramarital relationship, using cloth as sanitary napkin, etc. Conclusion: The study findings clearly show the increased vulnerable state of the fisher women for acquiring cervical cancer as they had many risk factors contributing to the same.

Associated factors with cervical pre-malignant lesions among the married fisher women community at Sadras, Tamil Nadu

Science.gov (United States)

Ganesan, Sornam; Subbiah, Vasantha N.; Michael, Jothi Clara J.

2015-01-01

Objective: To identify the associated factors of cervical pre-malignant lesions among the married fisher women residing in the coastal areas of Sadras, Tamil Nadu. Methods: The study was conducted in five fishermen communities under Sadras, a coastal area in Tamil Nadu, India. Two hundred and fifty married fisher women residing in the area. Quantitative descriptive approach with a cross-sectional study design was used. Data were collected using a structured interview schedule for identifying the associated factors and Pap smear test was performed for identifying the pre-malignant cervical lesions among the married fisher women. Data were analyzed using descriptive and inferential statistics. Results: Among 250 women, about six (2.4%) of them presented with pre-cancerous lesions such as atypical squamous cell of undifferentiated significance (ASCUS) — five (2%) and mild dysplasia one (0.4%). Majority of the women, about 178 (71.2%) women, had abnormal cervical findings. Statistical analysis showed a significant association of risk factors such as advanced age, lack of education, low socioeconomic status, using tobacco, multiparity, premarital sex, extramarital relationship, using cloth as sanitary napkin, etc. Conclusion: The study findings clearly show the increased vulnerable state of the fisher women for acquiring cervical cancer as they had many risk factors contributing to the same. PMID:27981091

Associated factors with cervical pre-malignant lesions among the married fisher women community at Sadras, Tamil Nadu.

Science.gov (United States)

Ganesan, Sornam; Subbiah, Vasantha N; Michael, Jothi Clara J

2015-01-01

To identify the associated factors of cervical pre-malignant lesions among the married fisher women residing in the coastal areas of Sadras, Tamil Nadu. The study was conducted in five fishermen communities under Sadras, a coastal area in Tamil Nadu, India. Two hundred and fifty married fisher women residing in the area. Quantitative descriptive approach with a cross-sectional study design was used. Data were collected using a structured interview schedule for identifying the associated factors and Pap smear test was performed for identifying the pre-malignant cervical lesions among the married fisher women. Data were analyzed using descriptive and inferential statistics. Among 250 women, about six (2.4%) of them presented with pre-cancerous lesions such as atypical squamous cell of undifferentiated significance (ASCUS) - five (2%) and mild dysplasia one (0.4%). Majority of the women, about 178 (71.2%) women, had abnormal cervical findings. Statistical analysis showed a significant association of risk factors such as advanced age, lack of education, low socioeconomic status, using tobacco, multiparity, premarital sex, extramarital relationship, using cloth as sanitary napkin, etc. The study findings clearly show the increased vulnerable state of the fisher women for acquiring cervical cancer as they had many risk factors contributing to the same.

18F-FDG PET/CT to differentiate malignant necrotic lymph node from benign cystic lesions in the neck

DEFF Research Database (Denmark)

Mobarak-Abadi, Peymaneh; Johansen, Allan; Godballe, Christian

2017-01-01

OBJECTIVE: Patients presenting with cystic lesions in the neck without obvious signs of malignancy constitute a diagnostic challenge since fine needle aspiration is often insufficient and a diagnosis may not be reached until surgical resection/biopsy is performed. The differential diagnosis of a ...

Novel Breast Imaging and Machine Learning: Predicting Breast Lesion Malignancy at Cone-Beam CT Using Machine Learning Techniques.

Science.gov (United States)

Uhlig, Johannes; Uhlig, Annemarie; Kunze, Meike; Beissbarth, Tim; Fischer, Uwe; Lotz, Joachim; Wienbeck, Susanne

2018-05-24

The purpose of this study is to evaluate the diagnostic performance of machine learning techniques for malignancy prediction at breast cone-beam CT (CBCT) and to compare them to human readers. Five machine learning techniques, including random forests, back propagation neural networks (BPN), extreme learning machines, support vector machines, and K-nearest neighbors, were used to train diagnostic models on a clinical breast CBCT dataset with internal validation by repeated 10-fold cross-validation. Two independent blinded human readers with profound experience in breast imaging and breast CBCT analyzed the same CBCT dataset. Diagnostic performance was compared using AUC, sensitivity, and specificity. The clinical dataset comprised 35 patients (American College of Radiology density type C and D breasts) with 81 suspicious breast lesions examined with contrast-enhanced breast CBCT. Forty-five lesions were histopathologically proven to be malignant. Among the machine learning techniques, BPNs provided the best diagnostic performance, with AUC of 0.91, sensitivity of 0.85, and specificity of 0.82. The diagnostic performance of the human readers was AUC of 0.84, sensitivity of 0.89, and specificity of 0.72 for reader 1 and AUC of 0.72, sensitivity of 0.71, and specificity of 0.67 for reader 2. AUC was significantly higher for BPN when compared with both reader 1 (p = 0.01) and reader 2 (p Machine learning techniques provide a high and robust diagnostic performance in the prediction of malignancy in breast lesions identified at CBCT. BPNs showed the best diagnostic performance, surpassing human readers in terms of AUC and specificity.

[Diagnostic efficiency of decline rate of signal intensity and apparent diffusion coefficient with different b values for differentiating benign and malignant breast lesions on diffusion-weighted 3.0T magnetic resonance imaging].

Science.gov (United States)

Jiang, Jing; Liu, Wanhua; Ye, Yuanyuan; Wang, Rui; Li, Fengfang; Peng, Chengyu

2014-06-17

To investigate the diagnostic efficiency of decline rate of signal intensity and apparent diffusion coefficient with different b values for differentiating benign and malignant breast lesions on diffusion-weighted 3.0 T magnetic resonance imaging. A total of 152 patients with 162 confirmed histopathologically breast lesions (85 malignant and 77 benign) underwent 3.0 T diffusion-weighted magnetic resonance imaging. Four b values (0, 400, 800 and 1 000 s/mm²) were used. The signal intensity and ADC values of breast lesions were measured respectively. The signal intensity decline rate (SIDR) and apparent diffusion coefficient decline rate (ADCDR) were calculated respectively. SIDR = (signal intensity of lesions with low b value-signal intensity of lesions with high b value)/signal intensity of lesions with low b value, ADCDR = (ADC value of lesions with low b value-ADC value of lesions with high b value) /ADC value of lesions with low b value. The independent sample t-test was employed for statistical analyses and the receiver operating characteristic (ROC) curve for evaluating the diagnosis efficiency of SIDR and ADCDR values. Significant differences were observed in SIDR between benign and malignant breast lesions with b values of 0-400, 400-800 and 800-1 000 s/mm². The sensitivities of SIDR for differentiating benign and malignant breast lesions were 61.2%, 68.2% and 67.1%, the specificities 74.0%, 85.7% and 67.5%, the diagnosis accordance rates 67.3%, 76.5% and 67.3%, the positive predictive values 72.2%, 84.1% and 69.5% and the negative predictive values 63.3%, 71.0% and 65.0% respectively. Significant differences were observed in ADCDR between benign and malignant breast lesions with b values of 400-800 s/mm² and 800-1 000 s/mm². The sensitivities of SDR for differentiating benign and malignant breast lesions were 80.0% and 65.9%, the specificities 72.7% and 65.0%, the diagnostic accordance rates 76.5% and 65.4%, the positive predictive values 76.4% and 67

Impression cytology diagnosis of ulcerative eyelid malignancy.

Science.gov (United States)

Sen, S; Lyngdoh, A D; Pushker, N; Meel, R; Bajaj, M S; Chawla, B

2015-02-01

The utility of impression cytology in ocular diseases has predominantly been restricted to the diagnosis of dry eye, limbal stem cell deficiency and conjunctival neoplasias. Its role in malignant eyelid lesions remains largely unexplored. Although scrape cytology is more popular for cutaneous lesions, impression cytology, being non-traumatic, has an advantage in small and delicate areas such as the eyelid. The present study has been designed to evaluate its role in the diagnosis and management of malignant eyelid lesions. Thirty-two histopathologically proven malignant eyelid lesions diagnosed over a 2-year period, including 13 basal cell carcinomas, 11 sebaceous carcinomas, four squamous cell carcinomas, two malignant melanomas and two poorly differentiated carcinomas, formed the study group. The results of impression cytology were compared with those of histopathology in the study group and with an age- and sex-matched group of benign cases as controls. The sensitivity of impression cytology was 84% (27/32) for the diagnosis of malignancy and 28% (9/32) for categorization of the type of malignancy. Impression cytology is a simple, useful, non-invasive technique for the detection of malignant ulcerative eyelid lesions. It is especially useful as a follow-up technique for the detection of recurrences. © 2014 John Wiley & Sons Ltd.

Nuclear TK1 expression is an independent prognostic factor for survival in pre-malignant and malignant lesions of the cervix

International Nuclear Information System (INIS)

Chen, Gang; He, Cheng; Li, Ling; Lin, An; Zheng, Xiongwei; He, Ellen; Skog, Sven

2013-01-01

Thymidine kinase 1 (TK1) is a proliferation biomarker that has been found useful for prognostication in cancer patients. Here we investigate for the first time the use of TK1 expression as a prognostic factor for patients with premalignant and malignant lesions of the uterine cervix. TK1 expression was determined by immunohistochemistry in cervical lesions (cervical intraepithelial neoplasia (CIN), n = 216; invasive cervical carcinoma, n = 84). TK1 and Ki-67 expressions and pathological/FIGO stages and age were correlated with 5-year survival by Kaplan-Meier, log rank and COX hazard uni- and multivariate analyses. TK1 labeling index (LI) was significantly correlated with CIN grades and invasive cervical carcinoma stages, while TK1 labeling intensity was only correlated to CIN grades. TK1 LI was significantly higher compared with Ki-67 LI. TK1 LI correlated significantly to 5-year survival in patients with invasive cervical carcinoma, particularly nuclear TK1 LI. In a multivariate analysis, nuclear TK1 expression was independent prognostic factor in patients with in situ/invasive cervical carcinoma or in invasive cervical carcinoma alone. Interestingly, in invasive cervical carcinoma patients with advanced tumors, nuclear TK1 expression could identify patients with significantly better survival rates (80%), while Ki-67 could not. Nuclear TK1 expression in early grade CIN predicts risk for progression to malignancy. Nuclear TK1 expression is also a prognostic factor for treatment outcome, particularly in patients with advanced cervical carcinomas. Nuclear TK1 expression is more useful than Ki-67 and pathological/FIGO stages

Garre's chronic diffuse sclerosing osteomyelitis of the sacrum: a rare condition mimicking malignancy.

LENUS (Irish Health Repository)

Nasir, N

2012-02-03

Garre\\'s chronic diffuse sclerosing osteomyelitis (DSOM) is a rare disease that occurs most commonly in the mandible. We present a case of sacral DSOM that simulated an expanding destructive sacral tumour. Treatment was conducted on the basis of the available experience with the mandibular form of the disease, with partial symptomatic relief, but progressive sclerosis of the sacral lesion. To the best of our knowledge, this is the first case initially presenting in the sacrum. As an osteolytic expanding lesion simulating malignancy, it is important to recognize this entity in the sacrum.

Skin changes in internal malignancy

Directory of Open Access Journals (Sweden)

Rajagopal Ravi

2004-07-01

Full Text Available BACKGROUND: Internal malignancies are accompanied by various skin changes which may be specific infiltrates or non-specific changes. This study is aimed at determining the frequency of such changes in malignant disease treatment center attendees in India. METHODS: A study of 300 confirmed cases of internal malignancy at a malignant disease treatment center was undertaken to evaluate these skin changes. Specific infiltrates were confirmed by histopathology. Statistical methods were employed to calculate significance in non-specific lesions by comparing with 300 controls not suffering from internal malignancy. RESULTS: Skin changes were present in 82 (27.3%. Cutaneous metastases were found in 19 (6.3%; non-contiguous in 5 (1.6%; contiguous in 14 (4.3%. Non-specific skin lesions numbered 74 (11.6% in 52 patients. Statistically significant non-specific skin changes were acquired ichthyosis, herpes zoster and generalized pruritus. CONCLUSION: Metastases usually occurred late in internal malignancy (17, 5.6% except in a case each of histiocytic lymphoma and non-Hodgkin′s lymphoma (2, 0.7% where the lesions preceded malignancy by 3 months and 1 month respectively. Contiguous nodules were a marker of relapse after surgery in 3 (1%.

Outcome of retrograde ureteric stenting as a urinary drainage procedure in ureteric obstruction related to malignant lesions.

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Wijayarathna, S; Suvendran, S; Ishak, M; Weligamage, A; Epa, A; Munasinghe, S; Abeygunaskera, A M

2014-12-01

We investigated the outcome of endoscopic retrograde ureteric stenting (RUS) in patients with ureteric obstruction related to malignant lesions. Data were prospectively collected from patients with ureteric obstruction related to malignant lesions treated at a single urology unit from 1 January 2011 to 30 April 2014. All patients had radiologically significant hydronephrosis by ultrasonography and CT scanning. First choice of urinary drainage was placing a retrograde ureteric stent cystoscopically. Outcome of patients who had stenting were recorded after following them until death or removal of stents. Eighty two patients with ureteric obstruction related to malignant lesions had complete data. In 33 (25%) patients, retrograde ureteric stenting was possible. Fifteen of them had recurrent tumour in the pelvis at the time of stenting and 13 (87%) were dead within 3 months of stenting. Four of the five patients who did not have pelvic tumour recurrence were alive at the end of the study. All eight patients who underwent stenting before surgery as a prophylactic measure and three of the five patients who had retroperitoneal tumour mass and underwent RUS were alive. Stenting was not possible in 42 patients. Thirty eight of them had pelvic tumour recurrences and two were having retroperitoneal tumour masses. Only one did not have tumour in the pelvis.CT evidence of tumour recurrence in the pelvis (OR 12.7; 95% CI 1.3-117.6; p=0.026) and high serum creatinine (OR 4.3; 95% CI 1.6-11.7; p=0.004) were associated with failure to ureteric stenting. Chances of successful RUS were low in patients with ureteric obstruction in the presence of tumour recurrences or elevated serum creatinine. Even if ureteric stenting was successful, their life expectancy was short.

DW-MRI of liver lesions: Can a single ADC-value represent the entire lesion?

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Schmid-Tannwald, C.; Dahi, F.; Jiang, Y.; Ivancevic, M.K.; Rist, C.; Sethi, I.; Oommen, J.; Oto, A.

2014-01-01

Aim: To evaluate whether focal liver lesions (FLLs) exhibit a homogeneous appearance on apparent diffusion coefficient (ADC) maps and whether there is inter-section variation in the calculated ADC values of FLLs (inter-section range). Materials and methods: Eighty-eight patients with 128 FLLs (70 benign, 58 malignant) who underwent abdominal magnetic resonance imaging (MRI) including diffusion-weighted (DW)-MRI were included. Two observers evaluated variation of signal intensity of each FLL within each ADC map image (intra-section) and among different ADC map images through the lesion (inter-section). ADC values of each FLL and neighbouring liver parenchyma were measured on all sections. The inter-section range of FLLs was compared with the neighbouring liver parenchyma. Results: Intra-section inhomogeneity was noted in 39.8% (97/244 sections) and 38.9% (95/244) of benign lesions, and 61% (114/187 sections) and 61.5% (115/187) of malignant lesions, by observer 1 and observer 2, respectively. Inter-section inhomogeneity was noted in 25.7% (18/70) and 27.1% (19/70) of benign lesions, and 51.7% (30/58) and 50% (29/58) of malignant lesions, by observer 1 and observer 2, respectively. The inter-section range for both benign (0.28 × 10 −3  mm²/s) and malignant (0.25 × 10 −3  mm²/s) FLLs were significantly greater than that of liver parenchyma surrounding benign (0.16 × 10 −3  mm²/s, p < 0.001) and malignant (0.14 × 10 −3  mm²/s, p = 0.01) FLLs. Conclusion: Due to intra-/inter-section variations in ADC values of benign and malignant FLLs, a single ADC value may not reliably represent the entire lesion

Can diffusion-weighted imaging distinguish between benign and malignant pediatric liver tumors?

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Caro-Domínguez, Pablo; Gupta, Abha A; Chavhan, Govind B

2018-01-01

There are limited data on utility of diffusion-weighted imaging (DWI) in the evaluation of pediatric liver lesions. To determine whether qualitative and quantitative DWI can be used to differentiate benign and malignant pediatric liver lesions. We retrospectively reviewed MRIs in children with focal liver lesions to qualitatively evaluate lesions noting diffusion restriction, T2 shine-through, increased diffusion, hypointensity on DWI and apparent diffusion coefficient (ADC) maps, and intermediate signal on both, and to measure ADC values. Pathology confirmation or a combination of clinical, laboratory and imaging features, and follow-up was used to determine final diagnosis. We included 112 focal hepatic lesions in 89 children (median age 11.5 years, 51 female), of which 92 lesions were benign and 20 malignant. Interobserver agreement was almost perfect for both qualitative (kappa 0.8735) and quantitative (intraclass correlation coefficient [ICC] 0.96) diffusion assessment. All malignant lesions showed diffusion restriction. Most benign lesions other than abscesses were not restricted. There was significant association of qualitative restriction with malignancy and non-restriction with benignancy (Fisher exact test Pbenign and malignant lesions, with wide range for each diagnosis. Receiver operating characteristic (ROC) analysis revealed an area under the curve (AUC) of 0.63 for predicting malignancy using an ADC cut-off value of ≤1.20x10 -3  mm 2 /s, yielding a sensitivity of 78% and a specificity of 54% for differentiating malignant from benign lesions. Qualitative diffusion restriction in pediatric liver lesions is a good predictor of malignancy and can help to differentiate between benign and malignant lesions, in conjunction with conventional MR sequences. Even though malignant lesions demonstrated significantly lower ADC values than benign lesions, the use of quantitative diffusion remains limited in its utility for distinguishing them because of the

Association of BDNF and BMPR1A with clinicopathologic parameters in benign and malignant gallbladder lesions

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2013-01-01

Background Neurotrophic factors such as brain derived neurotrophic factor (BDNF) are synthesized in a variety of neural and non-neuronal cell types and regulate survival, proliferation and apoptosis. In addition, bone morphogenetic proteins (BMPs) inhibit the proliferation of pulmonary large carcinoma cells bone morphogenetic protein receptor, type IA (BMPR1A). Little is known about the expression of BDNF or BMPR1A in malignant gall bladder lesions. This study was to evaluate BDNF and BMPR1A expression and evaluate the clinicopathological significance in benign and malignant lesions of the gallbladder. Methods The BDNF and BMPR1A expression of gallbladder adenocarcinoma, peritumoral tissues, adenoma, polyp and chronic cholecystitis were Immunohistochemically determined. Results BDNF expression was significantly higher in gallbladder adenocarcinoma than in peritumoral tissues, adenoma, polyps and chronic cholecystitis samples. However, BMPR1A expression was significantly lower in gallbladder adenocarcinoma than in peritumoral tissues, adenomas, polyps and chronic cholecystitis tissues. The specimens with increased expression of BDNF in the benign lesions exhibited moderate- or severe-dysplasia of gallbladder epithelium. BDNF expression was significantly lower in well-differentiated adenocarcinomas with maximum tumor diameter 2 cm, metastasis of lymph node, and invasiveness of regional tissues in gallbladder adenocarcinoma. BMPR1A expression were significantly higher in the well-differentiated adenocarcinoma with maximal tumor diameter 2 cm, metastasis of lymph node, and invasiveness of regional tissues in gallbladder. Univariate Kaplan-Meier analysis indicated increased expression of BDNF or decreased expression of BMPR1A was associated with decreased disease specific survival (DSS) rates. Similarly, multivariate Cox regression analysis showed increased expression of BDNF or decreased expression of BMPR1A are independent predictors of poor DSS rates in gallbladder

The diagnostic value of double-contrast-technique cystography in the evaluation of benign and malignant lesions of the urinary bladder

International Nuclear Information System (INIS)

Beyer, D.; Koester, R.; Schuett, H.

1979-01-01

Cystography by double-contrast-technique as simple and quick method of evaluating benign and malignant lesions of the urinary bladder is being described. 301 examinations were reviewed and are being discussed in regard to diagnostic value, indication, complication and radiation exposure of this method. A few typical cases are being demonstrated to illustrate the value of this method in the spectrum of other diagnostic methods in the workup of urinary bladder lesions. (orig.) [de

A comparative evaluation of Imaging Efficiency for elevated lesions of gallbladder

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Shizuma, Toru; Karasawa, Eii; Azuma, Tsukasa; Takasaki, Ken; Hayashi, Naoaki

1999-01-01

Imaging Efficiency was analyzed in 118 cases of benign lesion, including adenoma and 36 cases of malignant lesion without lymph node metastasis (Stage I) of 154 cases histologically diagnosed as elevated lesions of the gallbladder (443 lesions). On ultrasonography, the maximum diameter of the benign lesions, except in the case of adenomyomatosis, was 17 mm; the minimum diameter in the case of adenocarcinoma was 7 mm. The frequency of malignancy among elevated mucosal lesions of gallbladder with a diameter of 13 to 16 mm, except in the case of adenomyomatosis was 42.1% (8/19 lesions). Of the 91 out of total 154 cases in which the elevated lesions were 10 mm or smaller in a diameter, malignant cases were observed in 5.5% (5/91 cases). Many of the malignant lesions had a solid pattern of internal echo and there was a significant difference in depiction rate on plain CT between benign and malignant lesions. We conclude that plan CT examination is helpful to differentiate benign from malignant lesions of the gallbladder. (author)

MRI-Guided Diffuse Optical Spectroscopy of Malignant and Benign Breast Lesions

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Vasilis Ntziachristos

2002-01-01

Full Text Available We present the clinical implementation of a novel hybrid system that combines magnetic resonance imaging (MRI and near-infrared (NIR optical measurements for the noninvasive study of breast cancer in vivo. Fourteen patients were studied with a MR-NIR prototype imager and spectrometer. A diffuse optical tomographic scheme employed the MR images as a priori information to implement an image-guided NIR localized spectroscopic scheme. All patients who entered the study also underwent gadolinium-enhanced MRI and biopsy so that the optical findings were crossvalidated with MR readings and histopathology. The technique quantified the oxy-and deoxyhemoglobin of five malignant and nine benign breast lesions in vivo. Breast cancers were found with decreased oxygen saturation and higher blood concentration than most benign lesions. The average hemoglobin concentration ([H] of cancers was 0.130±0.100 mM, and the average hemoglobin saturation (Y was 60±9% compared to [H]=0.018±0.005 mM and Y=69±6% of background tissue. Fibroadenomas exhibited high hemoglobin concentration [H]=0.060±0.010 mM and mild decrease in oxygen saturation Y=67±2%. Cysts and other normal lesions were easily differentiated based on intrinsic contrast information. This novel optical technology can be a significant add-on in MR examinations and can be used to characterize functional parameters of cancers with diagnostic and treatment prognosis potential. It is foreseen that the technique can play a major role in functional activation studies of brain and muscle as well.

The hook sign for differential diagnosis of malignant from benign lesions in magnetic resonance mammography: Experience in a study of 1084 histologically verified cases

International Nuclear Information System (INIS)

Dietzel, Matthias; Baltzer, Pascal A. T.; Vag, Tibor; Kaiser, Werner A.; Gajda, Mieczyslaw; Camara, Oumar

2010-01-01

Background: The hook sign (HS) has recently been introduced as a new descriptor for differential diagnosis in magnetic resonance mammography (MRM). Purpose: To analyze the diagnostic value of HS in a large collection of 1084 cases. Material and Methods: This study was approved by the local ethics committee, and 1084 consecutive lesions (no manipulations of the breast up to 12 months before MRM) with histological verification after MRM were included. HS was analyzed according to standard study protocols and was rated positive if a hook-like spiculated dendrite connecting a lesion with the pectoral muscle could be visualized. Examinations were rated by experienced observers (>500 examinations). Prevalence of HS was correlated with histological diagnosis, grading, and size (chi-square test). Diagnostic accuracy was assessed using sensitivity, specificity, positive likelihood ratio (LR+), and diagnostic odds ratio (DOR). Results: HS was significantly associated with malignancy (P 20 mm presented with HS significantly more often than those <20 mm (P < 0.001). HS was characteristic of invasive cancers and rare in preinvasive malignomas (P < 0.001). Prevalence of HS did not differ between invasive lobular and ductal carcinomas (n.s.). There was no correlation between HS and the grading of invasive carcinomas. Conclusion: In 1084 lesions, the hook sign was a specific descriptor for differentiation of benign and malignant lesions in MRM, with high evidence for prediction of malignancy, particularly in the case of advanced lesions and invasive carcinomas

Breast lesion characterization using whole-lesion histogram analysis with stretched-exponential diffusion model.

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Liu, Chunling; Wang, Kun; Li, Xiaodan; Zhang, Jine; Ding, Jie; Spuhler, Karl; Duong, Timothy; Liang, Changhong; Huang, Chuan

2018-06-01

Diffusion-weighted imaging (DWI) has been studied in breast imaging and can provide more information about diffusion, perfusion and other physiological interests than standard pulse sequences. The stretched-exponential model has previously been shown to be more reliable than conventional DWI techniques, but different diagnostic sensitivities were found from study to study. This work investigated the characteristics of whole-lesion histogram parameters derived from the stretched-exponential diffusion model for benign and malignant breast lesions, compared them with conventional apparent diffusion coefficient (ADC), and further determined which histogram metrics can be best used to differentiate malignant from benign lesions. This was a prospective study. Seventy females were included in the study. Multi-b value DWI was performed on a 1.5T scanner. Histogram parameters of whole lesions for distributed diffusion coefficient (DDC), heterogeneity index (α), and ADC were calculated by two radiologists and compared among benign lesions, ductal carcinoma in situ (DCIS), and invasive carcinoma confirmed by pathology. Nonparametric tests were performed for comparisons among invasive carcinoma, DCIS, and benign lesions. Comparisons of receiver operating characteristic (ROC) curves were performed to show the ability to discriminate malignant from benign lesions. The majority of histogram parameters (mean/min/max, skewness/kurtosis, 10-90 th percentile values) from DDC, α, and ADC were significantly different among invasive carcinoma, DCIS, and benign lesions. DDC 10% (area under curve [AUC] = 0.931), ADC 10% (AUC = 0.893), and α mean (AUC = 0.787) were found to be the best metrics in differentiating benign from malignant tumors among all histogram parameters derived from ADC and α, respectively. The combination of DDC 10% and α mean , using logistic regression, yielded the highest sensitivity (90.2%) and specificity (95.5%). DDC 10% and α mean derived from

CT bronchus sign in malignant solitary pulmonary lesions: value in the prediction of cell type

International Nuclear Information System (INIS)

Choi, J.A.; Kim, J.H.; Hong, K.T.; Kim, H.S.; Oh, Y.W.; Kang, E.Y.

2000-01-01

The aim of this study was to evaluate differences in the prevalence of patterns of CT bronchus sign in malignant solitary pulmonary lesions (SPLs), according to their histologic cell types and with respect to size, location, and degree of cell differentiation. Computed tomography scans of 78 patients, in whom pathologically confirmed malignant SPLs with CT bronchus sign were present, were randomly selected and reviewed by two radiologists under consensus. All 78 were CT scans done using spiral technique with 10-mm collimation and 10-mm reconstruction intervals with enhancement, and 75 included additional high-resolution CT scans. Lesions were classified into four cell types as squamous cell carcinoma (n=24), small cell carcinoma (n=12), adenocarcinoma (n=23), bronchioloalveolar carcinoma (BAC; n=9), and others (n=12), into three degrees of differentiation, into three size groups, and according to location (central or peripheral). Patterns of CT bronchus sign were classified into abruptly obstructing (I), patent (II), displacing (III), or tapered narrowing (IV) types. The relationships between the patterns of CT bronchus sign and cell type and degree of cell differentiation were evaluated. Eighty patterns of CT bronchus sign were observed in 78 patients. According to cell type, squamous cell carcinoma showed most often type-I pattern (45.8%) but no type-II pattern, which was the most common pattern observed in BAC (77.8%) and adenocarcinoma (34.8%; p<0.01). Small cell carcinoma showed a varied distribution among the four patterns of CT bronchus sign. According to location, in central squamous cell carcinomas, type-I pattern was more common(55%; p<0.01). Bronchioloalveolar carcinoma showed more peripheral lesions and in both central and peripheral lesions, type-II pattern was significantly more common (100 and 66.7%; p<0.01). In SPLs with CT bronchus sign of obstructing pattern, especially if central location, squamous cell carcinoma should be suspected, whereas in

Can diffusion-weighted imaging distinguish between benign and malignant pediatric liver tumors?

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Caro-Dominguez, Pablo; Chavhan, Govind B. [University of Toronto, Department of Diagnostic Imaging, The Hospital for Sick Children, Medical Imaging, Toronto, ON (Canada); Gupta, Abha A. [The Hospital for Sick Children, Department of Hematology and Oncology, Toronto, ON (Canada)

2018-01-15

There are limited data on utility of diffusion-weighted imaging (DWI) in the evaluation of pediatric liver lesions. To determine whether qualitative and quantitative DWI can be used to differentiate benign and malignant pediatric liver lesions. We retrospectively reviewed MRIs in children with focal liver lesions to qualitatively evaluate lesions noting diffusion restriction, T2 shine-through, increased diffusion, hypointensity on DWI and apparent diffusion coefficient (ADC) maps, and intermediate signal on both, and to measure ADC values. Pathology confirmation or a combination of clinical, laboratory and imaging features, and follow-up was used to determine final diagnosis. We included 112 focal hepatic lesions in 89 children (median age 11.5 years, 51 female), of which 92 lesions were benign and 20 malignant. Interobserver agreement was almost perfect for both qualitative (kappa 0.8735) and quantitative (intraclass correlation coefficient [ICC] 0.96) diffusion assessment. All malignant lesions showed diffusion restriction. Most benign lesions other than abscesses were not restricted. There was significant association of qualitative restriction with malignancy and non-restriction with benignancy (Fisher exact test P<0.0001). Mean normalized ADC values of malignant lesions (1.23 x 10{sup -3} mm{sup 2}/s) were lower than benign lesions (1.62 x 10{sup -3} mm{sup 2}/s; Student's t-test, P<0.015). However, there was significant overlap of ADC between benign and malignant lesions, with wide range for each diagnosis. Receiver operating characteristic (ROC) analysis revealed an area under the curve (AUC) of 0.63 for predicting malignancy using an ADC cut-off value of ≤1.20 x 10{sup -3} mm{sup 2}/s, yielding a sensitivity of 78% and a specificity of 54% for differentiating malignant from benign lesions. Qualitative diffusion restriction in pediatric liver lesions is a good predictor of malignancy and can help to differentiate between benign and malignant lesions

Malignant transformation of breast fibroadenoma to malignant phyllodes tumor: long-term outcome of 36 malignant phyllodes tumors.

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Abe, Makoto; Miyata, Satoshi; Nishimura, Seiichiro; Iijima, Kotaro; Makita, Masujiro; Akiyama, Futoshi; Iwase, Takuji

2011-10-01

Malignant phyllodes tumor of the breast is a rare neoplasm for which clinical findings remain insufficient for determination of optimal management. We examined the clinical behavior of these lesions in an attempt to determine appropriate management. We evaluated long-term outcome and clinical characteristics of malignant phyllodes tumors arising from fibroadenomas of the breast. A total of 173 patients were given a diagnosis of phyllodes tumor and underwent surgery at the Cancer Institute Hospital in Japan between January 1980 and December 1999. Of these patients, 39 (22.5%) were given a diagnosis of malignant phyllodes tumor; in three of these cases, detailed medical records were lost. Malignant phyllodes tumors were classified into two groups based on history of malignant transformation. Of the 36 malignant cases, 11 (30.6%) were primary and were given a diagnosis of fibroadenoma, experienced recurrence during the follow-up period, and were diagnosed with malignant phyllodes tumor (cases with a history of fibroadenoma). The other group was defined as cases without history of fibroadenoma and in whom lesions initially occurred as malignant phyllodes tumors. Based on differences between the two groups, overall survival curves were plotted using the Kaplan–Meier method, and statistical comparisons were performed using the log-rank test and Peto and Peto’s test. The outcome of cases with history of fibroadenoma was significantly better than that of cases without history of fibroadenoma. Patients with malignant phyllodes tumors but without prior history of malignant transformation who exhibit rapid growth within 6 months require aggressive treatment.

Utility of FDG-PETCT and magnetic resonance spectroscopy in differentiating between cerebral lymphoma and non-malignant CNS lesions in HIV-infected patients

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Westwood, Thomas D., E-mail: tdwestwood@googlemail.com [Department of Radiology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester (United Kingdom); Hogan, Celia, E-mail: celiahogan@hotmail.com [Monsall Unit, Department of Infectious Diseases and Tropical Medicine, North Manchester General Hospital, Pennine Acute Hospitals NHS Trust (United Kingdom); Julyan, Peter J., E-mail: Peter.Julyan@christie.nhs.uk [Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Wilmslow Road, Manchester (United Kingdom); Coutts, Glyn, E-mail: Glyn.Coutts@christie.nhs.uk [Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Wilmslow Road, Manchester (United Kingdom); Bonington, Suzie, E-mail: suzi.bonington@christie.nhs.uk [Department of Radiology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester (United Kingdom); Carrington, Bernadette, E-mail: Bernadette.Carrington@christie.nhs.uk [Department of Radiology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester (United Kingdom); Taylor, Ben, E-mail: Ben.taylor@christie.nhs.uk [Department of Radiology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester (United Kingdom); Khoo, Saye, E-mail: S.H.Khoo@liverpool.ac.uk [Department of Infectious Diseases and Tropical Medicine, Royal Liverpool Hospital, Liverpool (United Kingdom); Bonington, Alec, E-mail: Alec.Bonington@pat.nhs.uk [Monsall Unit, Department of Infectious Diseases and Tropical Medicine, North Manchester General Hospital, Pennine Acute Hospitals NHS Trust (United Kingdom)

2013-08-15

Background and purpose: In HIV infected patients, MRI cannot reliably differentiate between central nervous system (CNS) lymphoma and non-malignant CNS lesions, particularly cerebral toxoplasmosis (CTOX). This study prospectively investigates the utility of FDG PET-CT and magnetic resonance spectroscopy (MRS) in discriminating CNS lymphoma from non-malignant CNS lesions in HIV infected patients, and assesses the ability of FDG PET-CT to guide the use of early brain biopsy. Methods: 10 HIV patients with neurological symptoms and contrast enhancing lesions on MRI were commenced on anti-toxoplasmosis therapy before undergoing FDG PET-CT and MRS. Brain biopsies were sought in those with FDG PET-CT suggestive of CNS lymphoma, and in those with a negative FDG PET-CT scan who failed to respond to therapy. Final diagnosis was based on histology or treatment response. Results: Two patients were confirmed to have CNS lymphoma and FDG PET-CT was consistent with this diagnosis in both. Six patients had cerebral toxoplasmosis in all of whom FDG PET-CT was consistent with non-malignant disease. One patient had progressive multifocal leukoencephalopathy (PML), FDG PET-CT was equivocal. One patient had a haemorrhagic brain metastasis and FDG PET-CT wrongly suggested non-malignant disease. MRS was performed successfully in eight subjects: three results were suggestive of CNS lymphoma (one true positive, two false positive), four suggested CTOX (two false negative, two true negative), one scan was equivocal. Conclusion: FDG PET-CT correctly identified all cases of CNS lymphoma and CTOX, supporting its use in this situation. MRS was unhelpful in our cohort.

Utility of FDG-PETCT and magnetic resonance spectroscopy in differentiating between cerebral lymphoma and non-malignant CNS lesions in HIV-infected patients

International Nuclear Information System (INIS)

Westwood, Thomas D.; Hogan, Celia; Julyan, Peter J.; Coutts, Glyn; Bonington, Suzie; Carrington, Bernadette; Taylor, Ben; Khoo, Saye; Bonington, Alec

2013-01-01

Background and purpose: In HIV infected patients, MRI cannot reliably differentiate between central nervous system (CNS) lymphoma and non-malignant CNS lesions, particularly cerebral toxoplasmosis (CTOX). This study prospectively investigates the utility of FDG PET-CT and magnetic resonance spectroscopy (MRS) in discriminating CNS lymphoma from non-malignant CNS lesions in HIV infected patients, and assesses the ability of FDG PET-CT to guide the use of early brain biopsy. Methods: 10 HIV patients with neurological symptoms and contrast enhancing lesions on MRI were commenced on anti-toxoplasmosis therapy before undergoing FDG PET-CT and MRS. Brain biopsies were sought in those with FDG PET-CT suggestive of CNS lymphoma, and in those with a negative FDG PET-CT scan who failed to respond to therapy. Final diagnosis was based on histology or treatment response. Results: Two patients were confirmed to have CNS lymphoma and FDG PET-CT was consistent with this diagnosis in both. Six patients had cerebral toxoplasmosis in all of whom FDG PET-CT was consistent with non-malignant disease. One patient had progressive multifocal leukoencephalopathy (PML), FDG PET-CT was equivocal. One patient had a haemorrhagic brain metastasis and FDG PET-CT wrongly suggested non-malignant disease. MRS was performed successfully in eight subjects: three results were suggestive of CNS lymphoma (one true positive, two false positive), four suggested CTOX (two false negative, two true negative), one scan was equivocal. Conclusion: FDG PET-CT correctly identified all cases of CNS lymphoma and CTOX, supporting its use in this situation. MRS was unhelpful in our cohort

Reduced-intensity conditioning for the treatment of malignant and life-threatening non-malignant disorders.

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Slavin, Shimon; Aker, Mehmet; Shapira, Michael Y; Resnick, Igor; Bitan, Menachem; Or, Reuven

2003-01-01

Allogeneic bone marrow or blood stem cell transplantation (BMT) represents an important therapeutic tool for the treatment of an otherwise incurable broad spectrum of malignant and non-malignant diseases. Until recently, BMT was used primarily to replace a malignant, genetically abnormal or deficient immunohematopoietic compartment and therefore, highly toxic myeloablative regimens were considered mandatory for more effective eradication of all undesirable host-derived hematopoietic cells, including stem cells and their progeny. Our preclinical and ongoing clinical studies indicated that much more effective eradication of host immunohematopoietic system cells can be mediated by donor lymphocytes in the process of adoptive allogeneic cell therapy following BMT. Thus, eradication of all malignant cells, especially in patients with CML and, to a lesser extent, in patients with other hematologic malignancies can be accomplished despite complete resistance of puch tumor cells to maximally tolerated doses of chemoradiotherapy. Our cumulative experience suggested that graft-versus-malignancy effects might be used as a tool for eradication of otherwise resistant tumor cells of host origin. We speculated that the therapeutic benefit of BMT may be improved by using safer conditioning for engraftment of donor stem cells induce host-versus-graft unresponsiveness to enable engraftment of donor lymphocytes for subsequent induction of graft-versus-malignancy effects, or even graft-versus-autoimmunity and graft-versus-genetically abnormal cells. In other words, focusing on more selective and smarter rather than stronger modalities. Effective BMT procedures may be accomplished without lethal conditioning of the host, using a new, well-tolerated and user-friendly non-myeloablative regimen, thus eliminating or minimizing immediate and late procedure-related toxicity and mortality. It appears that initial induction of graft tolerance, mediated by engraftment of donor stem cells, leads

Malignancy rates and diagnostic performance of the Bosniak classification for the diagnosis of cystic renal lesions in computed tomography - a systematic review and meta-analysis.

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Sevcenco, Sabina; Spick, Claudio; Helbich, Thomas H; Heinz, Gertraud; Shariat, Shahrokh F; Klingler, Hans C; Rauchenwald, Michael; Baltzer, Pascal A

2017-06-01

To systematically review the literature on the Bosniak classification system in CT to determine its diagnostic performance to diagnose malignant cystic lesions and the prevalence of malignancy in Bosniak categories. A predefined database search was performed from 1 January 1986 to 18 January 2016. Two independent reviewers extracted data on malignancy rates in Bosniak categories and several covariates using predefined criteria. Study quality was assessed using QUADAS-2. Meta-analysis included data pooling, subgroup analyses, meta-regression and investigation of publication bias. A total of 35 studies, which included 2,578 lesions, were investigated. Data on observer experience, inter-observer variation and technical CT standards were insufficiently reported. The pooled rate of malignancy increased from Bosniak I (3.2 %, 95 % CI 0-6.8, I 2  = 5 %) to Bosniak II (6 %, 95 % CI 2.7-9.3, I 2  = 32 %), IIF (6.7 %, 95 % CI 5-8.4, I 2  = 0 %), III (55.1 %, 95 % CI 45.7-64.5, I 2  = 89 %) and IV (91 %, 95 % CI 87.7-94.2, I 2  = 36). Several study design-related influences on malignancy rates and subsequent diagnostic performance indices were identified. The Bosniak classification is an accurate tool with which to stratify the risk of malignancy in renal cystic lesions. • The Bosniak classification can accurately rule out malignancy. • Specificity remains moderate at 74 % (95 % CI 64-82). • Follow-up examinations should be considered in Bosniak IIF and Bosniak II cysts. • Data on the influence of reader experience and inter-reader variability are insufficient. • Technical CT standards and publication year did not influence diagnostic performance.

Correlation between histopathological and endoscopic findings of non-malignant gastrointestinal lesions: an experience of a tertiary care teaching hospital from Northern India

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Manpreet Kaur

2018-04-01

Full Text Available Background: Gastrointestinal tract endoscopy along with biopsy is an established procedure for investigating a wide range of gastrointestinal conditions especially inflammatory and malignant diseases. The aim was to study and categorizing the morphological lesions of non-malignant origin at various sites of gastrointestinal tract and to compare with its endoscopic findings.Materials and Methods: This study was conducted on 280 benign GI biopsies received in the Department of Pathology of Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India.Results: Maximum cases (39% were observed in the age group of 41-60 years. Male patients outnumbered the females (male to female ratio was 1.4:1. There were total 33 esophageal biopsies amongst which the most common lesion was non-specific esophagitis with least common being Barrett’s esophagus. Correlating the results of endoscopic and histopathological features of acute and chronic gastritis a positive predictive value of 80% with sensitivity of 44.4% was seen. Total 83 duodenal biopsies were analyzed with non-specific duodenitis being the most commonly diagnosed lesion followed by celiac disease. Correlation of endoscopic and histopathological findings in celiac disease revealed a sensitivity of 50% and positive predictive value of 42.86%. In both sigmoid colon and rectum, non-specific colitis was the commonest diagnosis followed by ulcerative colitis. Endoscopic findings were correlated with the histopathological features in ulcerative colitis, revealing a sensitivity of 57.14% along with the positive predictive value of 80%.  Conclusion: Histopathology remains the gold standard for diagnosing a case along with endoscopic findings and endoscopic findings alone cannot make the final diagnosis.

Performance of intra-procedural 18-fluorodeoxyglucose PET/CT-guided biopsies for lesions suspected of malignancy but poorly visualized with other modalities

International Nuclear Information System (INIS)

Cornelis, F.; Silk, M.; Takaki, H.; Durack, J.C.; Erinjeri, J.P.; Sofocleous, C.T.; Siegelbaum, R.H.; Maybody, M.; Solomon, S.B.; Schoder, H.

2014-01-01

We sought to evaluate the safety and the diagnostic success rate of percutaneous biopsies performed under intra-procedural 18 F-deoxyglucose (FDG) positron-emission tomography/computed tomography (PET/CT) guidance for lesions difficult to see with conventional cross-sectional imaging. From 2011 to 2013, consecutive clinically indicated percutaneous PET/CT-guided biopsies of 106 masses (mean size, 3.3 cm; range, 0.7-15.9 cm; SD, 2.9 cm) in bones (n = 33), liver (n = 26), soft tissues (n = 18), lung (n = 15) and abdomen (n = 14) were reviewed. The biopsy procedures were performed following injection of a mean of 255 MBq (SD, 74) FDG. Mean maximal standardized uptake value (SUV) of lesions was 8.8 (SD, 6.3). A systematic review of the histopathological results and outcomes was performed. Biopsies were positive for malignancy in 76 cases (71.7 %, 76/106) and for benign tissue in 30 cases (28.3 %, 30/106). Immediate results were considered adequate for 100 PET/CT biopsies (94.3 %, 100/106) requiring no further exploration, and for the six others (5.7 %, 6/106) benign diagnoses were confirmed after surgery (n = 4) or follow-up (n = 2). The consequent overall sensitivity and the diagnostic success of biopsy were therefore 100 %. No significant differences in terms of detection of malignancy were observed between the different locations. Lesions > 2 cm or with SUV > 4 were not significantly more likely to be malignant. Complications occurred after four biopsies (3.7 %, 4/106). Intra-procedural PET/CT guidance appears as a safe and effective method and allows high diagnostic success of percutaneous biopsies for metabolically active lesions. (orig.)

Comparison of magnetic resonance elastography and diffusion-weighted imaging for differentiating benign and malignant liver lesions

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Hennedige, Tiffany P.; Hallinan, James Thomas Patrick Decourcy; Teo, Lynette Li San [National University Hospital, National University Health System, Department of Diagnostic Imaging, Singapore (Singapore); Leung, Fiona P. [National University Hospital, National University Health System, Department of Diagnostic Imaging, Singapore (Singapore); South West Radiology, Liverpool, NSW (Australia); Iyer, Sridhar; Chang, Stephen; Madhavan, Krishna Kumar [National University Health System, Department of Surgery, Singapore (Singapore); Wang, Gang [National University Hospital, National University Health System, Department of Diagnostic Imaging, Singapore (Singapore); University of Calgary, Alberta (Canada); Wee, Aileen [National University Hospital, National University Health System, Department of Pathology, Singapore (Singapore); Venkatesh, Sudhakar K. [Mayo Clinic, Department of Radiology, Rochester, MN (United States)

2016-02-15

Comparison of magnetic resonance elastography (MRE) and diffusion-weighted imaging (DWI) for differentiating malignant and benign focal liver lesions (FLLs). Seventy-nine subjects with 124 FLLs (44 benign and 80 malignant) underwent both MRE and DWI. MRE was performed with a modified gradient-echo sequence and DWI with a free breathing technique (b = 0.500). Apparent diffusion coefficient (ADC) maps and stiffness maps were generated. FLL mean stiffness and ADC values were obtained by placing regions of interest over the FLLs on stiffness and ADC maps. The accuracy of MRE and DWI for differentiation of benign and malignant FLL was compared using receiver operating curve (ROC) analysis. There was a significant negative correlation between stiffness and ADC (r = -0.54, p < 0.0001) of FLLs. Malignant FLLs had significantly higher mean stiffness (7.9kPa vs. 3.1kPa, p < 0.001) and lower mean ADC (129 vs. 200 x 10{sup -3}mm{sup 2}/s, p < 0.001) than benign FLLs. The sensitivity/specificity/positive predictive value/negative predictive value for differentiating malignant from benign FLLs with MRE (cut-off, >4.54kPa) and DWI (cut-off, <151 x 10{sup -3}mm{sup 2}/s) were 96.3/95.5/97.5/93.3 % (p < 0.001) and 85/81.8/88.3/75 % (p < 0.001), respectively. ROC analysis showed significantly higher accuracy for MRE than DWI (0.986 vs. 0.82, p = 0.0016). MRE is significantly more accurate than DWI for differentiating benign and malignant FLLs. (orig.)

Confocal endomicroscopy for in vivo microscopic analysis of upper gastrointestinal tract premalignant and malignant lesions.

Science.gov (United States)

Gheorghe, Cristian; Iacob, Razvan; Becheanu, Gabriel; Dumbrav Abreve, Mona

2008-03-01

Confocal LASER endomicroscopy (CLE) is a new endoscopic technique which allows subsurface in vivo microscopic analysis during ongoing endoscopy, using systemically or topically administered fluorescent agents. It allows targeted biopsies to be taken, potentially improving the diagnostic rate in certain gastrointestinal diseases. Worldwide experience with CLE for upper gastrointestinal malignant and premalignant lesions is still reduced. Potential clinical applications are presented, including diagnosis of NERD, Barrett's esophagus, atrophic gatritis, gastric intestinal metaplasia and dysplasia, gastric adenomatous or hyperplastic polyps, gastric cancer.

Human papilloma virus 18 detection in oral squamous cell carcinoma and potentially malignant lesions using saliva samples.

Science.gov (United States)

Goot-Heah, Khor; Kwai-Lin, Thong; Froemming, Gabriele Ruth Anisah; Abraham, Mannil Thomas; Nik Mohd Rosdy, Nik Mohd Mazuan; Zain, Rosnah Binti

2012-01-01

Oral cancer has become one of the most prevalent cancers worldwide and human Papillomavirus is one of the risk factors for developing oral cancer. For this study HPV18 was chosen as it is one of the high risk HPV types and may lead to carcinogenesis. However, prevalence of HPV18 infection in Oral Squamous Cell Carcinoma in Malaysia remains unclear. This study aimed to investigate the viral load of HPV18 DNA in OSCC and potentially malignant lesions using saliva samples. Genomic DNAs of thirty saliva samples of normal subjects and thirty saliva samples compromised of 16 samples from potentially malignant lesions and 14 of OSCC patients were amplified for HPV18 DNA using a nested polymerase chain reaction analysis. All PCR products were then analyzed using the Bioanalyzer to confirm presence of HPV18 DNA. From thirty patients examined, only one of 30 (3.3%) cases was found to be positive for HPV18 in this study. The finding of this study revealed that there is a low viral detection of HPV18 in Malaysian OSCC by using saliva samples, suggesting that prevalence of HPV18 may not be important in this group of Malaysian OSCC.

Diffusion-weighted imaging in characterization of cystic pancreatic lesions

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Sandrasegaran, K., E-mail: ksandras@iupui.edu [Department of Radiology, Indiana University School of Medicine, Indianapolis, IN (United States); Akisik, F.M.; Patel, A.A.; Rydberg, M. [Department of Radiology, Indiana University School of Medicine, Indianapolis, IN (United States); Cramer, H.M.; Agaram, N.P. [Department of Pathology, Indiana University School of Medicine, Indianapolis, IN (United States); Schmidt, C.M. [Department of Surgery, Indiana University School of Medicine, Indianapolis, IN (United States)

2011-09-15

Aim: To evaluate whether apparent diffusion coefficient (ADC) measurements from diffusion-weighted imaging (DWI) can characterize or predict the malignant potential of cystic pancreatic lesions. Materials and methods: Retrospective review of the magnetic resonance imaging (MRI) database over a 2-year period revealed 136 patients with cystic pancreatic lesions. Patients with DWI studies and histological confirmation of cystic mass were included. In patients with known pancreatitis, lesions with amylase content of >1000 IU/l that resolved on subsequent scans were included as pseudocysts. ADC of cystic lesions was measured by two independent reviewers. These values were then compared to categorize these lesions as benign or malignant using conventional MRI sequences. Results: Seventy lesions were analysed: adenocarcinoma (n = 4), intraductal papillary mucinous neoplasm (IPMN; n = 28), mucinous cystic neoplasm (MCN; n = 9), serous cystadenoma (n = 16), and pseudocysts (n = 13). There was no difference between ADC values of malignant and non-malignant lesions (p = 0.06), between mucinous and serous tumours (p = 0.12), or between IPMN and MCN (p = 0.42). ADC values for low-grade IPMN were significantly higher than those for high-grade or invasive IPMN (p = 0.03). Conclusion: ADC values may be helpful in deciding the malignant potential of IPMN. However, they are not useful in differentiating malignant from benign lesions or for characterizing cystic pancreatic lesions.

Diagnostic value of breast ultrasound in mammography BI-RADS 0 and clinically indeterminate or suspicious of malignancy breast lesions

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Dobrosavljević Aleksandar

2016-01-01

Full Text Available Background/Aim. Not only that ultrasound makes the difference between cystic and solid changes in breast tissue, as it was the case at the beginning of its use, but it also makes the differential diagnosis in terms of benign-malignant. The aim of this study was to assess the role of sonography in the diagnosis of palpable breast masses according to the American College of Radiology Ultrasonographic Breast Imaging Reporting and Data System (BI-RADS and to correlate the BI-RADS 4 and BI-RADS 5 category with pathohistological findings. Methods. A retrospective study was conducted with the breast sonograms of 30 women presented with palpable breast masses found to be mammography category BI-RADS 0 and ultrasonographic BI-RADS categories 4 and 5. The sonographic categories were correlated with pathohistological findings. Results. Surgical biopsy in 30 masses revealed: malignancy (56.7%, fibroadenoma (26.7%, fibrocystic dysplasia with/without atypia (10%, lipoma (3.3% and intramammary lymph node (3.3%. Correlation between BI-RADS categories and pathohistological findings was found (p < 0.05. All BI-RADS 5 masses were malignant, while in BI-RADS 4A category fibroadenomas dominated. A total of 53.8% of all benign lesions were found in women 49 years of age or younger as compared with 35.3% of all malignancies in this group (p < 0.05. Conclusion. Ultrasonography BI-RADS improved classification of breast masses. The ultrasound BI-RADS 4 (A, B, C and BI-RADS 5 lesions should be worked-up with biopsy.

Primary cystic pancreatic neoplasms and tumor-like conditions. MR cholangiopancreatographic evaluation of lesions and Wirsung's duct

International Nuclear Information System (INIS)

Garcia, Adriana; Spina, Juan C. h; Rogondino, Jose; Chacon, Carolina; Gutierrez, Silvia

2003-01-01

Objective: To evaluate the contribution of single shot fast spin echo (SSFSE) in the diagnosis of cystic lesions in the pancreas, and their relation to Wirsung's duct. Material and methods: In 66 patients (33 women and 33 men; mean age: 66 years) cystic pancreatic lesions were retrospectively analyzed. The SSFSE technique was used, including an evaluation of Wirsung's duct. Conventional pancreatic sequences were added. The following lesion features were assessed: location, number, size, relation to Wirsung's duct, nature of the cystic image and signal intensity of the neoplasm or tumor-like condition. Surgical and anatomopathological correlation was obtained in 31/66 cases (47%). Results: The cystic lesions were divided in 2 groups: A) cystic lesions related to Wirsung's duct, 30 patients: all lesions measured less than 30 mm in size. Seven patients underwent surgical treatment; in 22 cases surgery was not indicated. One patient refused surgery. A mucinous papilliferous intraductal tumor was diagnosed in 3 cases, ampullar carcinoma in 1 case, pancreatic carcinoma, 1 case, autoimmune pancreatitis, 1 case, and cystic duct dilatation due to benign fibrous stenosis, 1 case. B) Cystic lesions not related to Wirsung's duct (36 patients): 7 serous cystadenomas, 7 adenocarcinomas with a cystic component, 1 mucinous cystadenoma, 1 duodenal diverticulum, 7 pseudocysts and 1 neuroendocrine tumor. In 12 patients surgery was not carried out due to clinical contraindication or patient's refusal. Conclusion: SSFSE allowed a clear differentiation between cystic lesions related (Group A) and non-related (Group B) to Wirsung's duct. The diagnosis could not be achieved by usual MRI sequences. However, benign and malignant lesions were observed in both groups. In all cases SSFSE afforded useful data either for surgical treatment or clinical follow-up. (author)

Automated diagnosis of focal liver lesions using bidirectional empirical mode decomposition features.

Science.gov (United States)

Acharya, U Rajendra; Koh, Joel En Wei; Hagiwara, Yuki; Tan, Jen Hong; Gertych, Arkadiusz; Vijayananthan, Anushya; Yaakup, Nur Adura; Abdullah, Basri Johan Jeet; Bin Mohd Fabell, Mohd Kamil; Yeong, Chai Hong

2018-03-01

Liver is the heaviest internal organ of the human body and performs many vital functions. Prolonged cirrhosis and fatty liver disease may lead to the formation of benign or malignant lesions in this organ, and an early and reliable evaluation of these conditions can improve treatment outcomes. Ultrasound imaging is a safe, non-invasive, and cost-effective way of diagnosing liver lesions. However, this technique has limited performance in determining the nature of the lesions. This study initiates a computer-aided diagnosis (CAD) system to aid radiologists in an objective and more reliable interpretation of ultrasound images of liver lesions. In this work, we have employed radon transform and bi-directional empirical mode decomposition (BEMD) to extract features from the focal liver lesions. After which, the extracted features were subjected to particle swarm optimization (PSO) technique for the selection of a set of optimized features for classification. Our automated CAD system can differentiate normal, malignant, and benign liver lesions using machine learning algorithms. It was trained using 78 normal, 26 benign and 36 malignant focal lesions of the liver. The accuracy, sensitivity, and specificity of lesion classification were 92.95%, 90.80%, and 97.44%, respectively. The proposed CAD system is fully automatic as no segmentation of region-of-interest (ROI) is required. Copyright © 2018 Elsevier Ltd. All rights reserved.

Non-invasive optical estimate of tissue composition to differentiate malignant from benign breast lesions: A pilot study

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Taroni, Paola; Paganoni, Anna Maria; Ieva, Francesca; Pifferi, Antonio; Quarto, Giovanna; Abbate, Francesca; Cassano, Enrico; Cubeddu, Rinaldo

2017-01-01

Several techniques are being investigated as a complement to screening mammography, to reduce its false-positive rate, but results are still insufficient to draw conclusions. This initial study explores time domain diffuse optical imaging as an adjunct method to classify non-invasively malignant vs benign breast lesions. We estimated differences in tissue composition (oxy- and deoxyhemoglobin, lipid, water, collagen) and absorption properties between lesion and average healthy tissue in the same breast applying a perturbative approach to optical images collected at 7 red-near infrared wavelengths (635-1060 nm) from subjects bearing breast lesions. The Discrete AdaBoost procedure, a machine-learning algorithm, was then exploited to classify lesions based on optically derived information (either tissue composition or absorption) and risk factors obtained from patient’s anamnesis (age, body mass index, familiarity, parity, use of oral contraceptives, and use of Tamoxifen). Collagen content, in particular, turned out to be the most important parameter for discrimination. Based on the initial results of this study the proposed method deserves further investigation.

Sonographic-pathologic correlation of complex cystic breast lesions

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Saravech Pongrattanaman

2013-02-01

Full Text Available Objective: To understand the pathologic basis for sonographic features of complex cystic lesions. Methods: From 2 646 female patients underwent breast sonography at King Chulalongkorn Memorial Hospital from January 2005 through December 2010, 103 cystic lesions were included. Pathologic confirmation was performed by fine-needle aspiration (n=42, core needle biopsy (n=6, excision (n=54 and mastectomy (n=1. Complex cystic breast masses were classified into 3 types as followings; thick outer wall and/or thick internal septa (type I; thick septation and thick wall were defined as equal or more than 0.5 cm, masses containing mixed cystic and solid components (at least 50% of cystic component (type II, predominantly solid with eccentric cystic foci (at least 50% of solid component (type III. Results: In 103 complex cystic masses, there are 27 lesions (26% classified as type I cystic breast masses, 37 lesions (36% as type II cystic breast masses and 39 lesions (38% type III cystic breast masses, 26 lesions (25.2% are proved to be malignant. All of type I cystic breast masses in our study are benign, and 14 (38% of type II cystic breast masses and 12 lesions (31% of type III cystic breast lesions are proved to be malignant. Conclusions: Type II and III lesions should suggest possibility of malignancy and biopsy should be performed in all lesions. All type I lesion in this study are benign. None of other parameters we included in this study (size or margin can effectively differentiate between benign or malignant cystic breast lesions. Also, grading of the malignant lesions by using type of cystic breast mass cannot be applied.

Incidentally Detected Enhancing Breast Lesions on Chest Computed Tomography

International Nuclear Information System (INIS)

Lin, Wen Chiung; Hsu, Hsian He; Yu, Jyh Cherng; Hsu, Giu Cheng; Yu, Cheng Ping; Chang, Tsun Hou; Huang, Guo Shu; Li, Chao Shiang

2011-01-01

To evaluate the nature and imaging appearance of incidental enhancing breast lesions detected on a routine contrast-enhanced chest CT. Twenty-three patients with incidental enhancing breast lesions on contrast-enhanced chest CT were retrospectively reviewed. The breast lesions were reviewed by unenhanced and enhanced CT, and evaluated by observing the shapes, margins, enhancement patterns and backgrounds of breast lesions. A histopathologic diagnosis or long-term follow-up served as reference standard. Sixteen (70%) patients had malignant breast lesions and seven (30%) had benign lesions. In 10 patients, the breast lesions were exclusively detected on contrast-enhanced CT. Using unenhanced CT, breast lesions with fi broglandular backgrounds were prone to be obscured (p < 0.001). Incidental primary breast cancer showed an non-significant trend of a higher percentage irregular margin (p = 0.056). All of the four incidental breast lesions with non-mass-like enhancement were proven to be malignant. Routine contrast-enhanced chest CT can reveal sufficient details to allow for the detection of unsuspected breast lesions, in which some cases may be proven as malignant. An irregular margin of incidental enhancing breast lesion can be considered a suggestive sign of malignancy

Radiation cancer in man, especially on the cases developed after irradiation for malignant conditions

International Nuclear Information System (INIS)

Kikuchi, Akira

1975-01-01

Twelve cases in which radiation cancer was observed at the Tohoku University are reported. Half of them had been treated for tuberculous cervical lymphadenitis, one for lupus vulgaris and five for various malignant conditions. The average latent period was 27 years in 7 cases which were treated for benign conditions and 13 years in 5 cases treated for malignant conditions. In Japan, 12 cases of radiation cancer after irradiation for malignant conditions, excluding leukemia, have been reported. The clinical features of these 17 cases in addition to 5 cases are reviewed. (auth.)

Radiation cancer in man, especially on the cases developed after irradiation for malignant conditions

Energy Technology Data Exchange (ETDEWEB)

Kikuchi, A [Tohoku Univ., Sendai (Japan). School of Medicine

1975-06-01

Twelve cases in which radiation cancer was observed at the Tohoku University are reported. Half of them had been treated for tuberculous cervical lymphadenitis, one for lupus vulgaris and five for various malignant conditions. The average latent period was 27 years in 7 cases which were treated for benign conditions and 13 years in 5 cases treated for malignant conditions. In Japan, 12 cases of radiation cancer after irradiation for malignant conditions, excluding leukemia, have been reported. The clinical features of these 17 cases in addition to 5 cases are reviewed.

How to approach breast lesions in children and adolescents

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Gao, Yiming, E-mail: yiminggao@gmail.com [New York University Langone Medical Center, 221 Lexington Ave., New York, NY 10016 (United States); Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114 (United States); Saksena, Mansi A.; Brachtel, Elena F.; Meulen, Deborah C. ter; Rafferty, Elizabeth A. [Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114 (United States)

2015-07-15

Highlights: • Recognize why the diagnostic approach to the developing breast differs from that to the adult breast. • Review of embryology, early breast development, and later pubescent breast development. • Learn the spectrum of common and uncommon pediatric breast lesions. • Develop an algorithm for diagnostic evaluation and management of pediatric breast lesions. - Abstract: Assessment of a pediatric breast lesion always starts with clinical evaluation. When imaging of a pediatric breast is indicated, ultrasound is the mainstay. The vast majority of pediatric breast complaints are of benign etiology, therefore the diagnostic/management approach emphasizes “first do no harm”. Correlation with age and clinical history helps to direct diagnosis. It is essential to be familiar with the imaging appearance of the normal developing breast at various Tanner stages, in order to diagnose physiologic breast findings and to minimize unnecessary biopsies in young breasts vulnerable to injury. Normal anatomic structures, developmental conditions, benign neoplastic and non-neoplastic lesions are common causes of breast complaints in children. Uncommon benign masses and rarely, secondary more than primary malignancies may present in a pediatric breast. Chest wall masses such as Ewing's sarcoma or rhabdomyosarcoma occur in children and may involve the breast via contiguous growth or locoregional metastasis. In addition, special attention should be given to any breast lesion in a child with risk factors predisposing to breast cancer, such as known extramammary malignancy, genetic mutations, prior mantle irradiation, or strong family history of breast cancer, which usually requires biopsy to exclude the possibility of malignancy. Conclusion: The developing breast is vulnerable to injury, and because breast malignancy is uncommon in children, diagnostic and management approach emphasizes “first do no harm”. Understanding normal breast development and the

Petrous apex lesions in the pediatric population

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Radhakrishnan, Rupa [University of Cincinnati College of Medicine, Department of Radiology, Cincinnati, OH (United States); Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Son, Hwa Jung [University of Cincinnati College of Medicine, Department of Otolaryngology-Head and Neck Surgery, Cincinnati, OH (United States); Koch, Bernadette L. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States)

2014-03-15

A variety of abnormal imaging findings of the petrous apex are encountered in children. Many petrous apex lesions are identified incidentally while images of the brain or head and neck are being obtained for indications unrelated to the temporal bone. Differential considerations of petrous apex lesions in children include ''leave me alone'' lesions, infectious or inflammatory lesions, fibro-osseous lesions, neoplasms and neoplasm-like lesions, as well as a few rare miscellaneous conditions. Some lesions are similar to those encountered in adults, and some are unique to children. Langerhans cell histiocytosis (LCH) and primary and metastatic pediatric malignancies such as neuroblastoma, rhabomyosarcoma and Ewing sarcoma are more likely to be encountered in children. Lesions such as petrous apex cholesterol granuloma, cholesteatoma and chondrosarcoma are more common in adults and are rarely a diagnostic consideration in children. We present a comprehensive pictorial review of CT and MRI appearances of pediatric petrous apex lesions. (orig.)

The effects of dorsal bundle lesions on serial and trace conditioning.

Science.gov (United States)

Tsaltas, E; Preston, G C; Gray, J A

1983-12-01

The performance of rats with neurotoxic lesions of the dorsal ascending noradrenergic bundle (DB) was compared with that of sham-operated control animals under two behavioural conditions. Animals with DB lesions were slower than controls to acquire a classically-conditioned emotional response (conditioned suppression) with a trace interval interposed between the clicker conditioned stimulus (CS) and the shock reinforcer. However, if the latter half of the trace interval was filled by a second stimulus, a light, the DB-lesioned animals acquired conditioned suppression to the clicker faster than did controls under the same conditions. These results are discussed in terms of the attentional theory of DB function.

Histomorphological spetrum of breast lesions.

Science.gov (United States)

Parajuli, S; Koirala, U; Khatri, R; Acharya, L; Suwal, A

2011-04-01

Cancer of the breast is the second most common cause of cancer in women. Mass in the breast, whether benign or malignant is a cause of anxiety to the patients and the family members. All breast lumps are considered to be carcinomas until proved otherwise and are the causes of concern both for the patient and surgeon. This is a retrospective study conducted in Kathmandu Model Hospital for a total duration of three years from August 2007 to August 2010. 114 sample of breast tissue sent for histopathology were studied. Peak incidence of benign lesion was in between 21-30 years and malignant lesions in between 31-50 years. No breast lesions were seen in the first decade of life. Cancer of the breast was seen in 12.28% of cases. Fibroadenoma and fibrocystic disease were the commonest benign lesion and infiltrating ductal carcinoma was the commonest malignant lesion. Specimens from 10 male breasts were received. Gynaecomastia was the most common lesion encountered in males. Infiltrating ductal carcinoma was seen in a 70 year old male. Breast cancer is one of the commonest causes of breast lump particularly in women and is growing public health problem in Nepal.

Awareness of patients about existing oral precancerous lesions/conditions in Nashik city of Maharashtra

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Bhushan Sukdeo Ahire

2016-01-01

Full Text Available Introduction: Many oral squamous cell carcinomas develop from premalignant lesions/conditions of oral cavity. Hence, the awareness of such lesions/conditions is important. Aim: To assess the awareness about existing oral precancerous lesions/conditions among patients arriving for dental treatment at a dental hospital, in Nashik city of Maharashtra. Materials and Methods: A questionnaire was used to collect information from 80 patients with existing oral precancerous lesions/conditions attending the dental hospital, in Nashik city of Maharashtra. The questionnaire included questions to ascertain information on sociodemographic parameters, awareness, and sources of information about of oral precancerous lesions/conditions, habit of tobacco, areca nut chewing, smoking, alcohol, and combined habits. Results: We found that 40% (n = 32 respondents knew about the existence of lesion in their mouth of which only 50% (out of 40% had thought that it was precancerous lesion/condition. Among all subjects, only 47.5% (n = 38 were aware of oral precancerous lesions/conditions. Television was the major source of information about oral precancerous lesions/conditions almost all the subjects (97.5% wanted more information about oral precancerous lesions/conditions but through television (42.5% and lectures (27.5%. Conclusion: Awareness of patients (coming to hospital about oral precancerous lesions/conditions was found to be low. The people must be made aware of symptoms, signs, and preventive strategies of oral precancerous lesions/conditions through their preferred media – television and lectures.

Morphological patterns of malignant cercival lessons in Warri, Niger ...

African Journals Online (AJOL)

Of this, 77 cases (43.7%) were malignant and 99 cases (56.3%) were either benign neoplasm, pseudoneoplastic and inflammatory lesions. The patients' age range for all malignant cervical lesions was 30-87 years. The peak age and mean age incidence for all malignant cervical tumours were 40-49 years and 49.6±8.4 ...

Enhancing second-order conditioning with lesions of the basolateral amygdala.

Science.gov (United States)

Holland, Peter C

2016-04-01

Because the occurrence of primary reinforcers in natural environments is relatively rare, conditioned reinforcement plays an important role in many accounts of behavior, including pathological behaviors such as the abuse of alcohol or drugs. As a result of pairing with natural or drug reinforcers, initially neutral cues acquire the ability to serve as reinforcers for subsequent learning. Accepting a major role for conditioned reinforcement in everyday learning is complicated by the often-evanescent nature of this phenomenon in the laboratory, especially when primary reinforcers are entirely absent from the test situation. Here, I found that under certain conditions, the impact of conditioned reinforcement could be extended by lesions of the basolateral amygdala (BLA). Rats received first-order Pavlovian conditioning pairings of 1 visual conditioned stimulus (CS) with food prior to receiving excitotoxic or sham lesions of the BLA, and first-order pairings of another visual CS with food after that surgery. Finally, each rat received second-order pairings of a different auditory cue with each visual first-order CS. As in prior studies, relative to sham-lesioned control rats, lesioned rats were impaired in their acquisition of second-order conditioning to the auditory cue paired with the first-order CS that was trained after surgery. However, lesioned rats showed enhanced and prolonged second-order conditioning to the auditory cue paired with the first-order CS that was trained before amygdala damage was made. Implications for an enhanced role for conditioned reinforcement by drug-related cues after drug-induced alterations in neural plasticity are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Meningeal Melanomas Associated With Transforming Ota Nevus to Malignant Melanoma: A Case Report

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Seyed-Mohammad Fereshtehnejad

2010-11-01

Full Text Available Intracranial invasion of cellular blue nevus (CBN from the skin is extremely rare and such a condition with malignant transformation is even rarer.A case of meningeal melanoma with malignant transformation which was derived from an Ota   nevus is presented in this report.   A21-year-old man with a neurocutaneous syndrome since childhood was referred with headache and mild left hemiparesia. CT scan and MRI demonstrated intracranial lesions and conjunctival biopsy leads to the pathologic diagnosis of blue nevus.Thereafter his parietal lesion was operated by craniotomy with total gross excision.On histopathological examination, diagnosis of malignant melanoma was confirmed.Approximately 2 months after radiotherapy and chemotherapy, he afflicted to diplopia and blurred vision on the leftside due to enlargement of orbital and cavernous sinus lesion. Following one year follow-up,he was survived and thrived with diffuse leptomeningeal nodular enhancement in favor of melanoma dissemination.Primary intracranial melanomas are though rare, but it should be suspected especially in the presence of periorbital blue nevus or nevus of Ota. Moreover, although CBN is considered benign, scalp or periorbital CBN has the potential for intracranial invasion and malignant ransformation.

Computerized classification of mass lesions in digital mammograms

International Nuclear Information System (INIS)

Giger, M.L.; Doi, K.; Yin, F.F.; Schmidt, R.A.; Vyborny, C.J.

1989-01-01

Subjective classification of masses on mammograms is a difficult task. On average, about 25% of masses referred for surgical biopsy are actually malignant. The authors are developing, as an aid to radiologists, a computerized scheme for the classification of lesions in mammograms to reduce the false-negative and false-positive diagnoses of malignancies. The classification scheme involves the extraction of border information from the mammographic lesion in order to quantify the degree of spiculation, which is related to the possibility of malignancy. Clinical film mammograms are digitized with an optical drum scanner (0.1-mm pixel size) for analysis on a Micro VAX 3500 computer. Border information (fluctuations) is obtained from the difference between the lesion border and its smoothed border. Using the rms variation of the frequency content of these fluctuations, approximately 85% of the cancerous lesions were correctly classified as malignant, while 15% of benign lesions were misclassified, in a preliminary study

Evaluation of Potential Risk Factors that contribute to Malignant Transformation of Oral Lichen Planus: A Literature Review.

Science.gov (United States)

Agha-Hosseini, Farzaneh; Sheykhbahaei, Nafiseh; SadrZadeh-Afshar, Maryam-Sadat

2016-08-01

Many studies have suggested that a lesion originally diagnosed as oral lichen planus (OLP) has different possibilities of undergoing malignant transformation in time, although these findings remain a controversial issue; for example, some studies reported different values of potential malignancy of OLP. World Health Organization (WHO) classifies OLP as a "potentially malignant disorder" with unspecified malignant transformation risk, and suggests that OLP patients should be closely monitored. Numerous studies have attempted to confirm the malignant transformation potential of OLP. The Cochrane Controlled Trials Register, Medline and EMBASE databases, PubMed, Google Scholar, Ovid, Up To Date, BMJ Clinical Evidence, MD Consult, and Science Direct were searched for papers published between 1997 and 2015. The medical subject heading search terms were "lichen planus," "oral lichen planus," "erosive oral lichen planus," "dysplasia," "oral precancerous condition," "oral premalignant condition," oral cancer, oral squamous cell carcinoma (OSCC), and atrophic lichen planus. A total of 120 English language abstracts were reviewed, and 50 relevant articles identified. Because of the extensive literature on the association between OLP and SCC, we have divided the data into genetic and non-genetic factors for more accurate assessment. In this evidence base, malignant transformation ranges from 0 to 37% with a mean of 4.59%. The highest rate of malignancy was noted in erythematosus and erosive lesions. In this way, follow-up of OLP patients could be carried out more efficiently and appropriately. Oral lichen planus is a premalignant lesion. All types of OLP in any site of oral mucosa must be monitored regularly.

Breast imaging reports for malignant lesions: are we maintaining recommended BI-RADS® lexicon standards?

International Nuclear Information System (INIS)

Masroor, Imrana; Azeemuddin, Muhammad; Sakhawat, Saima; Beg, Madiha; Sohail, Saba; Ahmed, Rashid; Irfan-Ul-Haq; Mehboob, Javed

2012-01-01

The purpose of this study was to evaluate mammography reports for diagnosed breast cancer cases in major government and private centers in Karachi, Pakistan, with respect to concordance with the Breast Imaging Reports And Data System (BI-RADS ® ) lexicon. A prospective, descriptive, multicenter study was conducted in the radiology sections of the Aga Khan University Hospital, Pakistan Naval Station Shifa Hospital, Advanced Radiology Clinic, Karachi Institute of Radiotherapy and Nuclear Medicine, and Civil Hospital Karachi between May and October 2010 after approval from the ethical review committee of Aga Khan University. Mammograms reported as BI-RADS category 4 and 5 were included in the study. Mammograms reported as BI-RADS category 0, 1, 2 and 3 were excluded. Fifty reports were collected from each center. Data were collected about the clinical indication, breast density, location and description of the lesion, calcification, and comments on axillary lymph nodes. This description was compared with the BI-RADS lexicon. The mean age of the patients was 50 ± 12 years. The clinical indication, breast parenchymal density, lesion location, and presence of calcification were better described by the private centers, while description of lymph node status was better stated by the government centers. This difference was statistically significant, except for lesion description. The description of masses by the two reporting groups was comparable. Mammographic reporting of malignant breast lesions in the private sector is more in line with the BI-RADS lexicon, as compared with government sector hospitals in Karachi, Pakistan. Lymph node documentation was better in government sector reports

Does supplementation of contrast MR imaging with thallium-201 brain SPECT improve differentiation between benign and malignant ring-like contrast-enhanced cerebral lesions?

International Nuclear Information System (INIS)

Kita, Tamotsu; Hayashi, Katsumi; Yamamoto, Masayoshi; Kawauchi, Toshio; Sakata, Ikuko; Iwasaki, Yoshie; Kosuda, Shigeru

2007-01-01

The objective of this study was to determine whether thallium-201 ( 201 Tl) brain single photon emission computed tomography (SPECT) could supplement magnetic resonance (MR) imaging diagnostic information by visual comparison of two separate data sets from patients with ring-like contrast-enhanced cerebral lesions. A combination of MR imaging and 201 Tl brain SPECT sets obtained from 13 patients (10 men, 3 women) ranging in age from 26 years to 86 years (mean 61.0 years) were retrospectively reviewed. A total of 12 patients had a solitary lesion, and the others had multiple lesions. All but two intracranial foci were pathologically confirmed. The final diagnoses were six glioblastomas, two cerebral metastases from lung cancer, and one each of abscess, resolving hematoma, primary central nervous system lymphoma, toxoplasmosis, and radiation necrosis. The two separate image formats (MR images and SPECT) were shown to ten readers with practical experience. All of the MR images for each patient were shown to each reader first. After interpreting them, the readers were shown the SPECT images. Images were scored in terms of how benign or malignant the foci were on a 5-point scale from ''definitely benign'' to ''definitely malignant.'' The improvement in the performance of all ten readers was from 67.7% to 93.8% in mean accuracy (P=0.0028) and from 0.730 to 0.971 in mean Az value (P=0.0069) after they were shown the 201 Tl brain SPECT images. 201 Tl brain SPECT should substantially increase confidence in the diagnosis of intracranial lesions with ring-like contrast enhancement when MR imaging does not permit differentiation between benign and malignant disease. (author)

MR imaging of hepatic metastasis in patients with malignant melanoma: Evaluation of suspected lesions screened at contrast-enhanced CT

International Nuclear Information System (INIS)

Sofue, Keitaro; Tateishi, Ukihide; Tsurusaki, Masakatsu; Arai, Yasuaki; Yamazaki, Naoya; Sugimura, Kazuro

2012-01-01

Purpose: To evaluate the magnetic resonance (MR) imaging feature of suspected hepatic metastasis in patients with malignant melanoma which showed intermediate findings on screened contrast-enhanced computed tomography (CECT). Materials and methods: MR imaging was performed in 38 patients (22 men, 16 women; mean age, 58 years) whose CECT findings were intermediate. Hepatic metastases had been diagnosed on MR imaging in 23 of the 38 patients. Verification of hepatic metastasis was made by histological examination: ultrasonographic-guided needle biopsy (n = 3), autopsy (n = 3), and surgical resection (n = 1), or by an obvious progression in number and/or size of the lesions on follow-up MR imaging (n = 24). Two diagnostic radiologists reviewed MR images by consensus. The median follow-up duration was 14.2 months. Results: Abnormal findings were detected in 31 patients on MR images, and undetected in the remaining seven patients resulting in false-positive on CECT. The mean size of the lesion was 11.0 mm. False-positive results were obtained in two lesions which disappeared on follow-up MR imaging. In six patients, lesions were considered as hepatic cysts on MR images. As a result, a total of 35 hepatic metastases were detected on MR images. Of these, 18 patients demonstrated typical melanotic appearance on MR images which showed shortened T1 and T2 relaxation times, and five patients demonstrated atypical melanotic appearance. In 16 patients, extra-hepatic metastases were also developed. Conclusion: MR imaging could rule out hepatic metastasis in patients with malignant melanoma which showed intermediate findings on screened CECT, and could detect additional extra-hepatic metastases.

Differential CT features between malignant mesothelioma and pleural metastasis from lung cancer or extra thoracic primary tumor mimicking malignant mesothelioma

Energy Technology Data Exchange (ETDEWEB)

Lee, Sung Il; Ryu, Young Hoon; Lee, Kwang Hun; Choe, Kyu Ok; Kim, Sang Jin [College of Medicine, Yonsei University, Seoul (Korea, Republic of)

2000-01-01

To evaluate the differential CT features found among malignant mesothelioma and pleural metastasis from lung cancer and from extra-thoracic primary tumor which on CT mimic malignant mesothelioma. Forty-four patients who on chest CT scans showed pleural thickening suggesting malignant pleural disease and in whom this condition was pathologically confirmed were included in this study. On the basis of their pathologically proven primary disease (malignant mesothelioma (n=3D14), pleural metastasis of lung cancer (n=3D18), extra thoracic primary tumor (n=3D12). They were divided into three groups. Cases of lung which on CT showed a primary lung nodule or endobronchial mass with pleural lesion, or manifested only pleural effusion, were excluded. The following eight CT features were retrospectively analyzed: (1) configuration of pleural lesion (type I, single or multiple separate nodules, type II, localized flat pleural thickening, type III, diffuse flat pleural thickening; type IV, type III with pleural nodules superimposed; type V, mass filling the hemithorax), (2) the presence of pleural effusion, (3) chest wall or rib invasion, (4) the involvement of a major fissure, (5) extra-pleural fat proliferation, (6) calcified plaque, (7) metastatic lymph nodes, (8) metastatic lung modules. In malignant mesothelioma, type IV (8/14) or II (4/14) pleural thickening was relatively frequent. Pleural metastasis of lung cancer favored type IV (8/18) or I (6/18) pleural thickening, while pleural metastasis from extrathoracic primary tumor showed a variable thickening configuration, except type V. Pleural metastasis from lung cancer and extrapleural primary tumor more frequently showed type I configuration than did malignant mesothelioma, and there were significant differences among the three groups. Fissural involvement, on the other hand, was significantly more frequent in malignant mesothelioma than in pleural metastasis from lung cancer or extrapleural primary tumor. Metastatic

Retrospective review of pediatric oral lesions from a dental school biopsy service.

Science.gov (United States)

Shah, Suhani K; Le, Mary C; Carpenter, William M

2009-01-01

This report presents a review of the results from 5457 biopsies of patients, 0-16 years of age, received over 15 years at the University of the Pacific School of Dentistry (Pacific Oral and Maxillofacial Pathology Laboratory). To carry out the largest and most up to date U.S. survey of oral specimens from children. The computerized data was retrieved and compiled for age and diagnoses. The lesions were divided by the MIND classification system into 1) Metabolic 2) Inflammatory 3) Neoplastic and 4) Developmental. Inflammatory lesions formed the largest group of biopsies (2758, 51%) followed by Developmental conditions (1928, 35%) and Neoplasms (734, 13%). Dentigerous cysts were the most common lesions, followed by the mucous retention phenomenon (mucocele). The 15 most frequently occurring lesions accounted for 80% of all biopsies. Eight malignancies and 22 benign aggressive tumors were also included. 1. Pathoses increase with age. 2. Results from our study are similar to most of the other studies. 3. More serious pathoses occur in some countries where there is limited access to care, resulting in patients seeking care only when symptomatic. 4. Oral malignancies are rare, but as with any malignancy, early diagnosis renders a more favorable prognosis.

Multiple cutaneous malignancies in xeroderma pigmentosum

Directory of Open Access Journals (Sweden)

Mohanty Prasenjeet

2001-01-01

Full Text Available A case of xeroderma pigmentosum with multiple cutaneous malignancies is being reported. The case presented with freckles, letigens, and keratosis, a non-tender ulcerated nodular lesion on the nose, a nodular ulcerated lesion on the right outer canthus of the conjunctiva, and a nodular growth which developed on the right cheek which on histopathology was found to be squamous cell cercinoma, basal cell carcinoma and malignant melanoma respectively.

Preoperative differential diagnosis of adnexal lesions: Double contrast-MRI

International Nuclear Information System (INIS)

Reuter, M.; Steffens, J.C.; Schueppler, U.; Muhle, C.; Brinkmann, G.; Kohl, G.; Weisner, D.; Luettges, J.; Spielmann, R.P.; Heller, M.

1996-01-01

46 patients with benign (n=42) and malignant (n=4) cystic adnexal tumours underwent MRI of the pelvis. Transaxial and coronal images were acquired using conventional T 1 - and T 2 -weighted SE-sequences after oral administration of superparamagnetic iron oxide particles (Ferristene). Additional T 1 -weighted SE-images were obtained immediately following gadoliamide (Gd DTPA-BMA) injection. MRI correctly classified the four malignant lesions, whereas nine histologically benign lesions were misdiagnosed as malignant. Intravenous contrast yielded a superior delineation of intratumoural architecture. Due to exclusion of solid structures, MRI with oral and i.v. contrast enables to dismiss suspected malignity in cystic adnexal lesions. Because of the non-specificity of the macroscopic criteria of dignity, the MR diagnosis 'malignity' is of limited value. (orig./MG) [de

Differentiation between malignant and benign thyroid nodules and stratification of papillary thyroid cancer with aggressive histological features: Whole-lesion diffusion-weighted imaging histogram analysis.

Science.gov (United States)

Hao, Yonghong; Pan, Chu; Chen, WeiWei; Li, Tao; Zhu, WenZhen; Qi, JianPin

2016-12-01

To explore the usefulness of whole-lesion histogram analysis of apparent diffusion coefficient (ADC) derived from reduced field-of-view (r-FOV) diffusion-weighted imaging (DWI) in differentiating malignant and benign thyroid nodules and stratifying papillary thyroid cancer (PTC) with aggressive histological features. This Institutional Review Board-approved, retrospective study included 93 patients with 101 pathologically proven thyroid nodules. All patients underwent preoperative r-FOV DWI at 3T. The whole-lesion ADC assessments were performed for each patient. Histogram-derived ADC parameters between different subgroups (pathologic type, extrathyroidal extension, lymph node metastasis) were compared. Receiver operating characteristic curve analysis was used to determine optimal histogram parameters in differentiating benign and malignant nodules and predicting aggressiveness of PTC. Mean ADC, median ADC, 5 th percentile ADC, 25 th percentile ADC, 75 th percentile ADC, 95 th percentile ADC (all P histogram analysis might help to differentiate malignant nodules from benign ones and show the PTCs with extrathyroidal extension. J. Magn. Reson. Imaging 2016;44:1546-1555. © 2016 International Society for Magnetic Resonance in Medicine.

ADC as a useful diagnostic tool for differentiating benign and malignant vertebral bone marrow lesions and compression fractures: a systematic review and meta-analysis.

Science.gov (United States)

Suh, Chong Hyun; Yun, Seong Jong; Jin, Wook; Lee, Sun Hwa; Park, So Young; Ryu, Chang-Woo

2018-07-01

To assess the sensitivity and specificity of quantitative assessment of the apparent diffusion coefficient (ADC) for differentiating benign and malignant vertebral bone marrow lesions (BMLs) and compression fractures (CFs) METHODS: An electronic literature search of MEDLINE and EMBASE was conducted. Bivariate modelling and hierarchical summary receiver operating characteristic modelling were performed to evaluate the diagnostic performance of ADC for differentiating vertebral BMLs. Subgroup analysis was performed for differentiating benign and malignant vertebral CFs. Meta-regression analyses according to subject, study and diffusion-weighted imaging (DWI) characteristics were performed. Twelve eligible studies (748 lesions, 661 patients) were included. The ADC exhibited a pooled sensitivity of 0.89 (95% confidence interval [CI] 0.80-0.94) and a pooled specificity of 0.87 (95% CI 0.78-0.93) for differentiating benign and malignant vertebral BMLs. In addition, the pooled sensitivity and specificity for differentiating benign and malignant CFs were 0.92 (95% CI 0.82-0.97) and 0.91 (95% CI 0.87-0.94), respectively. In the meta-regression analysis, the DWI slice thickness was a significant factor affecting heterogeneity (p benign and malignant vertebral BMLs and CFs. • Quantitative assessment of ADC is useful in differentiating vertebral BMLs. • Quantitative ADC assessment for BMLs had sensitivity of 89%, specificity of 87%. • Quantitative ADC assessment for CFs had sensitivity of 92%, specificity of 91%. • The specificity is highest (95%) with thinner (< 5 mm) DWI slice thickness.

Premalignant and malignant oral lesions are associated with changes in the glycosylation pattern of carbohydrates related to ABH blood group antigens

DEFF Research Database (Denmark)

Dabelsteen, Erik; Clausen, H; Holmstrup, P

1988-01-01

of expression of these antigens in the benign lesions was similar to that of normal oral mucosa, i.e. expression of: N-acetyllactosamine on basal cells, H antigen on parabasal cells, and Lex and Ley on spinous cells. However, lesions with epithelial dysplasia showed H antigen on all spinous cells, and often......The distribution of carbohydrate structures related to the ABO(H) blood group antigen system was studied in biopsies from eight squamous cell carcinomas, and eight erythroplakias with epithelial dysplasia. Twenty oral lesions without histological evidence of malignancy (13 lichen planus lesions...... also on basal cells, with expression of Lex and Ley restricted to the most superficial part of the epithelium above the H-positive cell layers. In carcinomas most cells were negative for H antigen but were positive for Ley and Lex in 5 out of 8 cases....

Significance of localization of nonpalpable breast lesions

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Oh, Ki Keun; Choi, Hyun Ju [Yongdong Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

1990-12-15

As mammography has become more popular for the evaluation of breast symptoms and for the screening of asymptomatic women, the smaller lesions are being detected before they become palpable, therefore preoperative localization became necessary. This has led to the development of several methods for preoperative localization of nonpalpable lesions. Authors analyzed 50 cases with preoperative localization in 45 patients which had abnormal findings on film mammogram or ultrasonomammogram since October 1985 through March 1990 at Yongdong Severance Hospital, College of Medicine, Yonsei University. The results were as follows: 1. Techniques of localization were spot method in 8 cases, conventional needle localization method in 38 cases and Kopan's needle localization method in 4 cases. 2. The most common mammographic indication for localization was focal calcifications in 29 cases(58%), which was followed by a newly developed mass in 25 cases(50%). 3. Outcome of pathologically confirmed diagnosis put into benign lesions in 37 cases(74%) and malignant lesions in 13 cases(26%). 4. Among the cases with localization of lesions which has suggested as benign lesions in film and ultrasonomammogram,all cases(100%) were confirmed in benign lesions pathologically. Among the cases with localization of lesions which has suggested as malignant lesions in film and ultrasonomammogram, pathologic malignant has been proved of 44% and possible histopathologic precursor of malignant was resulted in 25% such as atypical hyperplasia and adenosis. Conclusively, authors consider that the abnormal areas should be removed in their entirety with the sacrifice of minimum volume of contiguous normal breast tissue through the preoperative localization, hence our preoperative localization has contributed favorable prognosis based on material lesions in early stage breast cancer.

Significance of localization of nonpalpable breast lesions

International Nuclear Information System (INIS)

Oh, Ki Keun; Choi, Hyun Ju

1990-01-01

As mammography has become more popular for the evaluation of breast symptoms and for the screening of asymptomatic women, the smaller lesions are being detected before they become palpable, therefore preoperative localization became necessary. This has led to the development of several methods for preoperative localization of nonpalpable lesions. Authors analyzed 50 cases with preoperative localization in 45 patients which had abnormal findings on film mammogram or ultrasonomammogram since October 1985 through March 1990 at Yongdong Severance Hospital, College of Medicine, Yonsei University. The results were as follows: 1. Techniques of localization were spot method in 8 cases, conventional needle localization method in 38 cases and Kopan's needle localization method in 4 cases. 2. The most common mammographic indication for localization was focal calcifications in 29 cases(58%), which was followed by a newly developed mass in 25 cases(50%). 3. Outcome of pathologically confirmed diagnosis put into benign lesions in 37 cases(74%) and malignant lesions in 13 cases(26%). 4. Among the cases with localization of lesions which has suggested as benign lesions in film and ultrasonomammogram,all cases(100%) were confirmed in benign lesions pathologically. Among the cases with localization of lesions which has suggested as malignant lesions in film and ultrasonomammogram, pathologic malignant has been proved of 44% and possible histopathologic precursor of malignant was resulted in 25% such as atypical hyperplasia and adenosis. Conclusively, authors consider that the abnormal areas should be removed in their entirety with the sacrifice of minimum volume of contiguous normal breast tissue through the preoperative localization, hence our preoperative localization has contributed favorable prognosis based on material lesions in early stage breast cancer

Biopsy results of Bosniak 2F and 3 cystic lesions

DEFF Research Database (Denmark)

Rasmussen, René; Hørlyck, Arne; Nielsen, Tommy Kjærgaard

be helpful in clinical decisions. Material and Methods: From March 2013 - December 2014 a total of 295 percutaneous ultrasound guided biopsies from 287 patients with a suspected malignant renal lesion were performed at our institution. All cases were reviewed in PACS by (RR) and lesions presenting...... with a cystic change were re-evaluated and re-categorized after the Bosniak classification system. The re-evaluation and re-categorization was performed in consensus by a junior radiologist (RR) and an uro-radiological expert (OG). Results: Biopsies from eighteen Bosniak 2F cystic lesions were pathologically...... analyzed and three (17%) proved to be malignant. Biopsies from seventeen Bosniak 3 cystic lesions were pathologically analyzed and five (29%) were found to be malignant. Conclusion: Our results reveal a considerable malignancy rate among both Bosniak 2F and 3 cystic renal lesions. Biopsy seems...

Malignant skin lesions in Oshogbo, Nigeria | Oseni | Pan African ...

African Journals Online (AJOL)

Results: ninety- eight patients presented with skin cancers out of which 60 ... Malignant melanoma affects male more than female and it commonly affects lower ... Conclusion: skin malignancies pose a burden to the economy of the country.

Intravoxel incoherent motion diffusion-weighted magnetic resonance imaging of focal vertebral bone marrow lesions: initial experience of the differentiation of nodular hyperplastic hematopoietic bone marrow from malignant lesions

Energy Technology Data Exchange (ETDEWEB)

Park, Sunghoon; Kwack, Kyu-Sung; Kim, Jae Ho [Ajou University School of Medicine, Division of Musculoskeletal Radiology, Department of Radiology, Suwon, Gyeonggi-do (Korea, Republic of); Ajou University Medical Center, Musculoskeletal Imaging Laboratory, Suwon (Korea, Republic of); Chung, Nam-Su [Ajou University School of Medicine, Department of Orthopaedic Surgery, Suwon (Korea, Republic of); Hwang, Jinwoo [Philips Healthcare, Department of Clinical Science, Seoul (Korea, Republic of); Lee, Hyun Young [Ajou University Medical Center, Regional Clinical Trial Center, Suwon (Korea, Republic of); Yonsei University College of Medicine, Department of Biostatistics, Seoul (Korea, Republic of)

2017-05-15

To evaluate the ability of intravoxel incoherent motion (IVIM) diffusion-weighted magnetic resonance imaging (MRI) parameters to differentiate nodular hyperplastic hematopoietic bone marrow (HHBM) from malignant vertebral bone marrow lesions (VBMLs). A total of 33 patients with 58 VBMLs, including 9 nodular HHBM lesions, 39 bone metastases, and 10 myelomas, were retrospectively assessed. All diagnoses were confirmed either pathologically or via image assessment. IVIM diffusion-weighted MRI with 11 b values (from 0 to 800 s/mm{sup 2}) were obtained using a 3.0-T MR imager. The apparent diffusion coefficient (ADC), pure diffusion coefficient (D), perfusion fraction (f), and pseudodiffusion coefficient (D*) were calculated. ADC and IVIM parameters were compared using the Mann-Whitney U test. Receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic performances of ADC, D, f, and D* in terms of VBML characterization. The diagnostic performance of morphological MR sequences was also assessed for comparison. The ADC and D values of nodular HHBM were significantly lower than those of malignant VBML (both p values < 0.001), whereas the f value was significantly higher (p < 0.001). However, there were no significant differences in D* between the two groups (p = 0.688). On ROC analysis, the area under the curve (AUC) for D was 1.000, which was significantly larger than that for ADC (AUC = 0.902). Intravoxel incoherent motion diffusion-weighted MRI can be used to differentiate between nodular HHBM and malignant VBML. The D value was significantly lower for nodular HHBM, and afforded a better diagnostic performance than the ADC, f, and D* values in terms of such differentiation. (orig.)

Retrospective analysis of nonendodontic periapical lesions misdiagnosed as endodontic apical periodontitis lesions in a population of Taiwanese patients.

Science.gov (United States)

Huang, Hsun-Yu; Chen, Yuk-Kwan; Ko, Edward Cheng-Chuan; Chuang, Fu-Hsiung; Chen, Ping-Ho; Chen, Ching-Yi; Wang, Wen-Chen

2017-07-01

We aimed to evaluate nonendodontic periapical lesions clinically misdiagnosed as endodontic periapical pathoses in a population of Taiwanese patients. Cases (2000-2014) of histopathological diagnoses of nonendodontic periapical lesions were retrieved from all cases with a clinical diagnosis of radicular cyst, apical granuloma, or apical periodontitis in the institution. These cases were regarded as misdiagnosed nonendodontic periapical lesions, of which the types and frequencies, in addition to the demographic data, were determined. Four thousand and four specimens were clinically diagnosed as endodontically associated pathoses, of which 118 cases (2.95%) received a histopathological diagnosis of a nonendodontic pathologic entity, the most frequent lesion being keratocystic odontogenic tumor (KCOT, n = 38, 32.20%), followed by fibro-osseous lesion (n = 18, 15.25%), and dentigerous cyst (n = 13, 11.02%). Nine malignant lesions in the periapical area [squamous cell carcinoma (n = 7, 5.93%), adenoid cystic carcinoma (n = 1, 0.85%), and Langerhans cell histiocytosis (n = 1, 0.85%)] were also noted. A wide variety of histopathological diagnoses, including benign odontogenic and non-odontogenic cystic and tumorous lesions and infectious diseases, as well as malignant lesions, was noted in these 118 cases of nonendodontic periapical lesions. Squamous cell carcinoma was the most predominant malignancy of nonendodontic periapical lesions misdiagnosed as apical periodontitis lesions from imaging examination overlooking the clinical findings. The current data form a useful basis for clinicopathological investigation and educational teaching regarding nonendodontic periapical lesions misdiagnosed as endodontic apical periodontitis lesions.

Whole-lesion histogram analysis metrics of the apparent diffusion coefficient as a marker of breast lesions characterization at 1.5 T

International Nuclear Information System (INIS)

Bougias, H.; Ghiatas, A.; Priovolos, D.; Veliou, K.; Christou, A.

2017-01-01

Introduction: To retrospectively assess the role of whole-lesion apparent diffusion coefficient (ADC) in the characterization of breast tumors by comparing different histogram metrics. Methods: 49 patients with 53 breast lesions underwent magnetic resonance imaging (MRI). ADC histogram parameters, including the mean, mode, 10th/50th/90th percentile, skewness, kurtosis, and entropy ADCs, were derived for the whole-lesion volume in each patient. Mann–Whitney U-test, area under the receiver-operating characteristic curve (AUC) were used for statistical analysis. Results: The mean, mode and 10th/50th/90th percentile ADC values were significantly lower in malignant lesions compared with benign ones (all P < 0.0001), while skewness was significantly higher in malignant lesions P = 0.02. However, no significant difference was found between entropy and kurtosis values in malignant lesions compared with benign ones (P = 0.06 and P = 1.00, respectively). Univariate logistic regression showed that 10th and 50th percentile ADC yielded the highest AUC (0.985; 95% confidence interval [CI]: 0.902, 1.000 and 0.982; 95% confidence interval [CI]: 0.896, 1.000 respectively), whereas kurtosis value yielded the lowest AUC (0.500; 95% CI: 0.355, 0.645), indicating that 10th and 50th percentile ADC values may be more accurate for lesion discrimination. Conclusion: Whole-lesion ADC histogram analysis could be a helpful index in the characterization and differentiation between benign and malignant breast lesions with the 10th and 50th percentile ADC be the most accurate discriminators. - Highlights: • DWI is a noninvasive technique that allows quantification of water diffusion in tissues. • ADC histogram analysis is a useful index in the differentiation benign and malignant breast tumors. • The 10th, 50th percentile ADC values being the best discriminators between breast lesions.

Differentiating benign and malignant breast lesions with T2*-weighted first pass perfusion imaging

International Nuclear Information System (INIS)

Kvistad, K.A.; Smenes, E.; Haraldseth, O.; Lundgren, S.; Fjoesne, H.E.; Smethurst, H.B.

1999-01-01

Purpose: Invasive breast carcinomas and fibroadenomas are often difficult to differentiate in dynamic contrast-enhanced T1-weighted MR imaging of the breast, because both tumors can enhance strongly after contrast injection. The purpose of this study was to evaluate whether the addition of T2*-weighted first pass perfusion imaging can increase the differentiation of malignant from benign lesions. Material and Methods: Nine patients with invasive carcinomas and 10 patients with contrast enhancing fibroadenomas were examined by a dynamic contrast-enhanced T1-weighted 3D sequence immediately followed by a single slice T2*-weighted first pass perfusion sequence positioned in the contrast-enhancing lesion. Results: The carcinomas and the fibroadenomas were impossible to differentiate based on the contrast enhancement characteristics in the T1-weighted sequence. The signal loss in the T2*-weighted perfusion sequence was significantly stronger in the carcinomas than in the fibroadenomas (p=0.0004). Conclusion: Addition of a T2*-weighted first pass perfusion sequence with a high temporal resolution can probably increase the differentiation of fibroadenomas from invasive carcinomas in contrast-enhanced MR imaging of the breast. (orig.)

Usefulness of FDG PET/CT in determining benign from malignant endobronchial obstruction

International Nuclear Information System (INIS)

Cho, Arthur; Kang, Won Jun; Cho, Ho Jin; Lee, Jae-hoon; Yun, Mijin; Lee, Jong Doo; Hur, Jin

2011-01-01

To evaluate the usefulness of FDG PET/CT to differentiate malignant endobronchial lesions with distal atelectasis from benign bronchial stenosis. This retrospective study reviewed 84 patients who underwent contrast-enhanced chest CT and then PET/CT and had histological (n = 81) or follow-up imaging (n = 3) confirmation. Two chest radiologists reviewed initial chest CT and determined endobronchial lesions to be malignant or benign. Two nuclear medicine physicians reviewed PET/CT for FDG uptake at the obstruction site and measured SUV. Malignancy was considered when increased FDG uptake was seen in the obstruction site, regardless of FDG within the atelectatic lung. The sensitivity, specificity and accuracy of chest CT was 95%, 48% and 84%, compared with 95%, 91% and 94% for PET/CT. Benign obstructive lesions showed statistically lower FDG uptake than malignant obstructions (benign SUV 2.5 ± 0.84; malignant SUV 11.8 ± 5.95, p < 0.001). ROC analysis showed an SUV cut-off value of 3.4 with highest sensitivity of 94% and specificity of 91%. Increased FDG PET/CT uptake at the obstruction site indicates a high probability of malignancy, while benign lesions show low FDG uptake. Careful evaluation of FDG uptake pattern at the obstruction site is helpful in the differentiation between benign and malignant endobronchial lesions. (orig.)

Usefulness of FDG PET/CT in determining benign from malignant endobronchial obstruction

Energy Technology Data Exchange (ETDEWEB)

Cho, Arthur; Kang, Won Jun; Cho, Ho Jin; Lee, Jae-hoon; Yun, Mijin; Lee, Jong Doo [Yonsei University Health System, Division of Nuclear Medicine, Department of Radiology, Seoul (Korea, Republic of); Hur, Jin [Yonsei University Health System, Department of Radiology, Seoul (Korea, Republic of)

2011-05-15

To evaluate the usefulness of FDG PET/CT to differentiate malignant endobronchial lesions with distal atelectasis from benign bronchial stenosis. This retrospective study reviewed 84 patients who underwent contrast-enhanced chest CT and then PET/CT and had histological (n = 81) or follow-up imaging (n = 3) confirmation. Two chest radiologists reviewed initial chest CT and determined endobronchial lesions to be malignant or benign. Two nuclear medicine physicians reviewed PET/CT for FDG uptake at the obstruction site and measured SUV. Malignancy was considered when increased FDG uptake was seen in the obstruction site, regardless of FDG within the atelectatic lung. The sensitivity, specificity and accuracy of chest CT was 95%, 48% and 84%, compared with 95%, 91% and 94% for PET/CT. Benign obstructive lesions showed statistically lower FDG uptake than malignant obstructions (benign SUV 2.5 {+-} 0.84; malignant SUV 11.8 {+-} 5.95, p < 0.001). ROC analysis showed an SUV cut-off value of 3.4 with highest sensitivity of 94% and specificity of 91%. Increased FDG PET/CT uptake at the obstruction site indicates a high probability of malignancy, while benign lesions show low FDG uptake. Careful evaluation of FDG uptake pattern at the obstruction site is helpful in the differentiation between benign and malignant endobronchial lesions. (orig.)

Signal/time-relation of benign and malignant lesions in dynamic 2D-MR imaging of the breast. Signalverhalten maligner und benigner Laesionen in der dynamischen 2D-MRT der Mamma

Energy Technology Data Exchange (ETDEWEB)

Fischer, U. (Abteilung Roentgendiagnostik 1, Univ. Goettingen (Germany)); Heyden, D. v. (Abteilung Roentgendiagnostik 1, Univ. Goettingen (Germany)); Vosshenrich, R. (Abteilung Roentgendiagnostik 1, Univ. Goettingen (Germany)); Vieweg, I. (Abteilung Roentgendiagnostik 1, Univ. Goettingen (Germany)); Grabbe, E. (Abteilung Roentgendiagnostik 1, Univ. Goettingen (Germany))

1993-04-01

In a retrospective study of 400 dynamic MR examinations of the breast the signal/time ratio of 62 histopathologically correlated lesions (19 benign, 42 malignant) was evaluated. Points of evaluations were initial signal enhancement (1st and 2nd minute), post-initial signal apperance (2nd to 5th minute) and signal distribution (homogeneous, marginal). Based on these criteria, a point system was defined to help in the assessment of lesions in dynamic breast-MR imaging. The overall sensitivity of this method was 95.3%, the specificity to 89.5% and the accuracy to 93.5%. Pitfalls resulted in two cases of non-invasive carcinoma and in two patients with fibroadenoma. (orig.)

201Tl scintigraphy in the evaluation of palpable and nonpalpable breast lesions: correlation with mammography and ultrasonography

International Nuclear Information System (INIS)

Vural, G.; Atasever, T.; Oezdemir, A.; Oeznur, I.; Karabacak, N.I.; Goekcora, N.; Isik, S.; Uenlue, M.

1997-01-01

Tl-201 scintigraphy were performed in sixty-eight patients with 70 breast abnormalities (51 palpable, 19 nonpalpable) and compared with mammography and ultrasonography (US). Early (15 min) and late (3 h) images of the breasts were obtained following the injection of 111 MBq (3 mCi) of Tl-201. Visual and semiquantitative interpretation was performed. Final diagnosis confirmed 52 malignant breast lesions and 18 benign conditions. Tl-201 visualized 47 of 52 (90%) overall malignant lesions. Thirty-eight of 40 (95%) palpable and 9 of 12 (75%) nonpalpable breast cancers were detected by Tl-201 scintigraphy. The smallest mass lesion detected by Tl-201 measured 1.5x1.0 cm. Eleven breast lesions were interpreted as indeterminate by mammography and/or sonography. Tl-201 scintigraphy excluded malignancy in 7 of 8 (88%) patients with benign breast lesions interpreted as indeterminate. Five of the 18 (28%) benign breast lesions showed Tl-201 uptake. None of the fibroadenoma and fibrocystic changes accumulated Tl-201. Tl-201 scintigraphy, mammography and ultrasonography showed 90%, 92%, 85% overall sensitivity and 72%, 56%, 61% overall specificity respectively. Twenty-one of the 28 (75%) axillary nodal metastatic sites were also detected by Tl-201. In malignant and benign lesions, early and late lesion/contralateral normal side (L/N) ratios were 1.58±0.38 (mean±SD) and 1.48±0.32 (p>0.05), 1.87±0.65 and 1.34±0.20 (p 0.05). (orig./MG) [de

Quantitative analysis of diffusion-weighted magnetic resonance imaging in malignant breast lesions using different b value combinations

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Nilsen, Line B. [Oslo University Hospital, Department of Radiation Biology, Norwegian Radium Hospital, P.O. Box 4959, Oslo (Norway); University of Oslo, Faculty of Medicine, P.O. Box 1078, Oslo (Norway); Fangberget, Anne [Oslo University Hospital, Department of Radiology and Nuclear Medicine, Division of Diagnostics and Intervention, Norwegian Radium Hospital, P.O. Box 4959, Oslo (Norway); Geier, Oliver [Oslo University Hospital, Department of Diagnostic Physics, The Interventional Centre, Division of Diagnostics and Intervention, P.O. Box 4950, Oslo (Norway); Seierstad, Therese [Oslo University Hospital, Department of Radiology and Nuclear Medicine, Division of Diagnostics and Intervention, Norwegian Radium Hospital, P.O. Box 4959, Oslo (Norway); Buskerud University College, Department of Health Sciences, P.O. Box 7053, Drammen (Norway)

2013-04-15

To explore how apparent diffusion coefficients (ADCs) in malignant breast lesions are affected by selection of b values in the monoexponential model and to compare ADCs with diffusion coefficients (Ds) obtained from the biexponential model. Twenty-four women (mean age 51.3 years) with locally advanced breast cancer were included in this study. Pre-treatment diffusion-weighted magnetic resonance imaging was performed using a 1.5-T system with b values of 0, 50, 100, 250 and 800 s/mm{sup 2}. Thirteen different b value combinations were used to derive individual monoexponential ADC maps. All b values were used in the biexponential model. Median ADC (including all b values) and D were 1.04 x 10{sup -3} mm{sup 2}/s (range 0.82-1.61 x 10{sup -3} mm{sup 2}/s) and 0.84 x 10{sup -3} mm{sup 2}/s (range 0.17-1.56 x 10{sup -3} mm{sup 2}/s), respectively. There was a strong positive correlation between ADCs and Ds. For clinically relevant b value combinations, maximum deviation between ADCs including and excluding low b values (<100 s/mm{sup 2}) was 11.8 %. Selection of b values strongly affects ADCs of malignant breast lesions. However, by excluding low b values, ADCs approach biexponential Ds, demonstrating that microperfusion influences the diffusion signal. Thus, care should be taken when ADC calculation includes low b values. (orig.)

Evaluation of AgNORs in Oral Potentially Malignant Lesions

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Karin Berria Tomazelli

2015-01-01

Full Text Available Oral squamous cell carcinoma (OSCC is usually preceded by detectable mucosal changes, as leukoplakias and erythroplakia. Histologically, these lesions can range from hyperkeratosis and acanthosis to epithelial dysplasia and even OSCC. The aim of this study was to investigate the proliferative activity, using AgNORs quantification proteins, in low- and high-risk oral epithelial dysplasia, OSCC, and nondysplastic epithelium (inflammatory fibrous hyperplasia. The sample was divided into 4 groups: G1: 10 cases of inflammatory fibrous hyperplasia (IFH, G2: 11 cases of low-risk epithelial dysplasia (LD, G3: 10 cases of high-risk epithelial dysplasia (HD, and G4: 11 cases of OSCC. The quantitative analysis was performed using an image processing software in photomicrographs at 1000x magnification. The one-way ANOVA was used for comparison of the mean AgNORs counts between the study groups. The mean AgNORs count was significantly higher P≤0.01 in OSCC when compared to IFH and the LD; however, it was not statistically different from HD. The mean number of LD was significantly lower than the HD and OSCC, with no difference related to IFH. AgNORs quantification can be an important and cheap method to help in the determination of the degree of epithelial dysplasia and, consequently, in the analysis of their potential for malignant transformation.

Malignant Giant Cell Tumour of Bone with Axillary Metastasis

African Journals Online (AJOL)

2002-06-06

Jun 6, 2002 ... SUMMARY. Giant Cell Tumour of bone is a typically benign and solitary tumour. However, multiple lesions have been described and 5-10% of lesions may be malignant. We present a case of a malignant giant cell tumour of the distal radius with metastasis to the ipsilateral axilla (an uncommon location).

The hippocampus and appetitive Pavlovian conditioning: effects of excitotoxic hippocampal lesions on conditioned locomotor activity and autoshaping.

Science.gov (United States)

Ito, Rutsuko; Everitt, Barry J; Robbins, Trevor W

2005-01-01

The hippocampus (HPC) is known to be critically involved in the formation of associations between contextual/spatial stimuli and behaviorally significant events, playing a pivotal role in learning and memory. However, increasing evidence indicates that the HPC is also essential for more basic motivational processes. The amygdala, by contrast, is important for learning about the motivational significance of discrete cues. This study investigated the effects of excitotoxic lesions of the rat HPC and the basolateral amygdala (BLA) on the acquisition of a number of appetitive behaviors known to be dependent on the formation of Pavlovian associations between a reward (food) and discrete stimuli or contexts: (1) conditioned/anticipatory locomotor activity to food delivered in a specific context and (2) autoshaping, where rats learn to show conditioned discriminated approach to a discrete visual CS+. While BLA lesions had minimal effects on conditioned locomotor activity, hippocampal lesions facilitated the development of both conditioned activity to food and autoshaping behavior, suggesting that hippocampal lesions may have increased the incentive motivational properties of food and associated conditioned stimuli, consistent with the hypothesis that the HPC is involved in inhibitory processes in appetitive conditioning. (c) 2005 Wiley-Liss, Inc.

PROSPECTIVE STUDY OF CYTO HISTOPATHOLOGICAL CORRELATION OF BREAST LESIONS

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Vijayabharathi

2015-06-01

Full Text Available INTRODUCTION: Cancer of breast is the second most common cause of cancer in women. In the present era, late marriage, late child birth, shorter period of breast feeding and nulliparity or low parity have contributed to increase in the number of cases. Fine needle aspiration cytology (FNAC is a useful method for initial evaluation and diagnosis of breast cancers and it has the ability of providing necessary prognostic predictive information. AIMS AND OBJECTIVES: The aim of the present study is to evaluate t he accuracy of FNAC of breast lesions with histopathological correlation. To study the cytomorphological features of palpable breast lumps. To study the various cytological patterns in aspirates from breast lesions and to classify them into non - neoplastic, benign and malignant lesions. To correlate the cytology findings with subsequent histopathological diagnosis wherever possible. To establish accuracy and efficacy of aspiration cytology as an early and preoperative diagnostic aid. To compare the statistic al analysis of present study with other contemporary studies. MATERIALS AND METHODS: The present study includes the study of aspiration smears of all cases referred to the Department of Pathology, Andhra medical college, Visakhapatnam from various outpatient departments from King George Hospital, with a palpable breast lesion. True cut Biopsy and Mastectomy specimens for Histopathological correlation RESULTS: Out of 952 analyzed cases benign lesions were 691 (72.58%, malignant lesions were 146 (15. 33%,non - neoplastic lesions were common in the age group of 21 - 30 years, benign lesions in 21 - 30 years, and malignant lesions were common in the age group of 41 - 50 years. Majority of the patients were female with 913 (95.90% and male patents are 39 (4 .09%.The results of sensitivity (97.18%, specificity (98.74%, positive predictive value (97.18% and negative predictive value (98.74% with diagnostic accuracy of 98.26%. CONCLUSION: FNAC

The hazards of using ionising radiation for non-malignant conditions - a case study

International Nuclear Information System (INIS)

Morton, Tracy

1989-01-01

A case study is presented in which a patient received low dose radiotherapy at seven months for a non-malignant cavernous haemangioma on the upper chest. She subsequently developed three separate malignancies before the age of 40 years: a thyroid carcinoma, a breast carcinoma and a basal cell carcinoma of the skin on the upper chest. This case illustrates the hazards of using ionizing radiation for the treatment of non-malignant conditions. (U.K.)

Image processing can cause some malignant soft-tissue lesions to be missed in digital mammography images.

Science.gov (United States)

Warren, L M; Halling-Brown, M D; Looney, P T; Dance, D R; Wallis, M G; Given-Wilson, R M; Wilkinson, L; McAvinchey, R; Young, K C

2017-09-01

To investigate the effect of image processing on cancer detection in mammography. An observer study was performed using 349 digital mammography images of women with normal breasts, calcification clusters, or soft-tissue lesions including 191 subtle cancers. Images underwent two types of processing: FlavourA (standard) and FlavourB (added enhancement). Six observers located features in the breast they suspected to be cancerous (4,188 observations). Data were analysed using jackknife alternative free-response receiver operating characteristic (JAFROC) analysis. Characteristics of the cancers detected with each image processing type were investigated. For calcifications, the JAFROC figure of merit (FOM) was equal to 0.86 for both types of image processing. For soft-tissue lesions, the JAFROC FOM were better for FlavourA (0.81) than FlavourB (0.78); this difference was significant (p=0.001). Using FlavourA a greater number of cancers of all grades and sizes were detected than with FlavourB. FlavourA improved soft-tissue lesion detection in denser breasts (p=0.04 when volumetric density was over 7.5%) CONCLUSIONS: The detection of malignant soft-tissue lesions (which were primarily invasive) was significantly better with FlavourA than FlavourB image processing. This is despite FlavourB having a higher contrast appearance often preferred by radiologists. It is important that clinical choice of image processing is based on objective measures. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Malignant peripheral nerve sheath tumours in neurofibromatosis type 1: MRI supports the diagnosis of malignant plexiform neurofibroma

Energy Technology Data Exchange (ETDEWEB)

Mautner, V.F. [Department of Neurology, Klinikum Nord Hamburg, Langenhorner Chaussee 560, 22419, Hamburg (Germany); Friedrich, R.E. [Department of Maxillofacial Surgery, Universitaetsklinikum Eppendorf, Hamburg (Germany); Deimling, A. von [Department of Neuropathology, Charite, Berlin (Germany); Hagel, C. [Department of Neuropathology, Universitaetsklinikum Eppendorf, Hamburg (Germany); Korf, B. [Center for Human Genetics, Harvard Institutes of Medicine, Boston, MA (United States); Knoefel, M.T. [Department of Surgery, Universitaetsklinikum Eppendorf, Hamburg (Germany); Wenzel, R.; Fuensterer, C. [MRI-Institute Hamburg Othmarschen, Hamburg (Germany)

2003-09-01

Plexiform neurofibroma (PNF) is a typical feature of neurofibromatosis 1 (NF1). About 10% of patients with NF1 develop malignant peripheral nerve-sheath tumours (MPNST), usually arising from PNF, and this is the major cause of poor survival. A better prognosis can be achieved if the tumours are diagnosed at an early stage. Our objective was to establish MRI criteria for MPNST and to test their usefulness in detecting early malignant change in PNF. MRI was performed on 50 patients with NF1 and nerve-sheath tumours, of whom seven had atypical pain, tumour growth or neurological deficits indicative of malignancy; the other 43 were asymptomatic. On MRI all seven symptomatic patients had inhomogeneous lesions, due to necrosis and haemorrhage and patchy contrast enhancement. In one patient, the multiplicity of confluent tumours with inhomogeneous areas in addition to central lesions did not allow exclusion of malignancy. Only three of the 43 asymptomatic patients had comparable changes; the other 40 patients had tumours being of relatively homogeneous structure on T1- and T2-weighted images before and after contrast enhancement. All three asymptomatic patients with inhomogeneous lesions were shown to have MPNST. (orig.)

Incidence of abnormal retropharyngeal lymph nodes in sinonasal malignancies among adults

Energy Technology Data Exchange (ETDEWEB)

Sai, Asari; Shimono, Taro; Yamamoto, Akira; Takeshita, Toru; Miki, Yukio [Osaka City University Graduate School of Medicine, Department of Diagnostic and Interventional Radiology, Osaka (Japan); Ohsawa, Masahiko; Wakasa, Kenichi [Osaka City University Graduate School of Medicine, Department of Diagnostic Pathology, Osaka (Japan)

2014-12-15

The aim of this study is to investigate the relationship between abnormal retropharyngeal lymph nodes (RPLNs) and sinonasal malignancies among adults. Magnetic resonance and computed tomography images from 89 patients over 20 years old who were all histopathologically confirmed to have sinonasal malignancies from September 2001 to April 2014 were assessed retrospectively. Abnormal RPLNs were determined as those >5 mm in shortest axis or showing heterogeneous enhancement on axial images. Locations of sinonasal malignancies were categorized using the anterior border of the pterygopalatine fossa as a boundary: (a) anterior lesions, only present anterior to the boundary, or (b) posterior lesions, present or extending posterior to the boundary. Fisher's exact test was used for the analysis of the relationship between frequency of abnormal RPLNs and lesion location. Abnormal RPLNs were present in 13 of 89 patients (15 %), including 6 of 41 squamous cell carcinomas (15 %), 4 of 24 malignant lymphomas (17 %), 3 of 5 olfactory neuroblastomas (60 %), and 0 of 19 others (0 %). Four of the 39 patients (10 %) with anterior lesions showed abnormal RPLNs, compared to 9 of 50 patients (18 %) with posterior lesions. No significant difference in frequency of abnormal RPLNs was apparent between anterior and posterior lesions (P = 0.37). In primary sinonasal malignancies among adults, the highest incidence of abnormal RPLNs was seen with olfactory neuroblastoma. The frequency of abnormal RPLNs was unaffected by the location of sinonasal malignancies among adults. (orig.)

Sonography and computed tomography of splenic nonsystemic lesions

International Nuclear Information System (INIS)

Garretti, L.; Cassinis, M.C.; Gandini, G.

1987-01-01

Differential diagnosis problems are caused by the increased, at time occasional detection of benignant and malignant spleen focal lesions in routine superior abdomen ultrasound (US). The following pathologic conditions were reported in 29 patients with focal lesions (excepted systemic diseases): 6 plain cysts, 1 cystic lymphangioma, 3 echinococcus cysts, 3 abscesses, 7 hematomas and 9 metastases. US examination and clinical data together have permitted the differentiation of cysts from solid nodules but has limits in the characterzation of lesions and in the diagnosis of abscesses. Metastases did non present specific US or CT aspects and have been correctly charaterized only with aid of anamnestical data and for the coexhistence of hepatic lesions. CT has proven superior specificity, compared to US, only in the diagnosis of abscesses and should thus be utilized only in selected cases

Breast cancer in situ. From pre-malignant lesion of uncertain significance to well-defined non-invasive malignant lesion

DEFF Research Database (Denmark)

Laenkholm, Anne-Vibeke; Jensen, Maj-Britt; Kroman, Niels

2008-01-01

receptor (ER) and Progesteron receptor (PR) status. Also mastectomy specimens were included. In 2004 the previous malignancy grading was replaced by the Van Nuys classification, and information on microcalcifications was introduced. The axillary status now included the sentinel node technique only. In 2006...

Renal malignancies with normal excretory urograms

International Nuclear Information System (INIS)

Kass, D.A.; Hricak, H.; Davidson, A.J.

1983-01-01

Four patients with malignant renal masses showed no abnormality of excretory urograms with tomography. Of the four lesions, two were primary renal cell carcinomas, one was a metastatic focus from a contralateral renal cell carcinoma, and one was a metastatic lesion from rectal adenocarcinoma. A normal excretory urogram should not be considered sufficient to exclude a clinically suspected malignant renal mass. In such an instance, diagnostic evaluation should be pursued using a method capable of topographic anatomic display, such as computed tomography or sonography

Clinical analysis of bone scanning in solitary lesion

International Nuclear Information System (INIS)

Zhu Jun; Zhu Ruisen; Zhu Jifang

2002-01-01

A rational analysis procedure for solitary lesions on whole bone scanning was offered. This study was undertaken to analyze retrospectively solitary lesions which obtained final diagnose through the following aspects: (1) diagnosis of bone metastasis, (2) the incidence of bone metastasis in different tumor, (3) the most possible lesion sites indicating bone metastasis, (4) morphological analysis of solitary lesions. The results are: (1) The incidence of solitary lesions in 2465 cases on whole bone scanning is 15.3%. (2) The rate of bone metastasis is 24.8% in 282 patients with primary malignancy. The rate of bone metastasis of 6.3% in 64 patients without primary malignancy, and the total diagnostic rate of bone metastasis is 21.4% in 346 patients. (3) In patients with primary malignancy, the incidence of bone metastasis of solitary lesions is as follows respectively; bronchi cancer 36.1%(22/61); breast cancer 23.8%(20/84); prostate gland 17.2%(5/29); other urinary system cancer 22.2%(4/18); G.I. system cancer 16.9%(10/59); others 29.0%(9/31). There is no significant difference in different cancer. (4) In patients without primary malignancy, 93.7%(60/64) of solitary lesions are benign. (5) From anatomical point of view, the authors found the diagnostic rate of bone metastasis is as follow: 30% in spine; 34.2% in pelvis; 36.4% in skull; 10.8% in other bones. There are significant differences in four groups. It is concluded that: (1) The diagnostic rate of bone metastasis in solitary lesions is 21.4%. (2) The most possible solitary lesions indicating osseous tumor spread are at spine, pelvic and skull. (3) Special attention to 'cold' and streak like lesions should be paid. (4) A clinical analysis procedure for diagnosis of solitary lesions has been summarized out here

Bilateral primary malignant lymphoma of the breast.

Science.gov (United States)

Shpitz, B; Witz, M; Kaufman, Z; Griffel, B; Manor, Y; Dinbar, A

1985-08-01

A rare case of bilateral primary malignant lymphoma of breast in a 76 year old woman is presented. The lesion was examined by electron microscopy and immunochemistry. The diagnosis of primary malignant lymphoma remains a diagnosis by exclusion and requires extensive work-up to exclude widespread malignant process. The behaviour of this malignancy tends to be an aggressive one and the prognosis is generally poor.

RADIODIAGNOSIS OF PLEURAL LESIONS WITH USG AND CT SCAN

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Bheemashanker

2017-09-01

Full Text Available BACKGROUND Ultrasound is easy available, less expensive study. It differentiates pleural effusion, consolidation and masses. CT scores in diagnosing early pleural lesions and helps in localising lesions differentiating benign and malignant. The aim of the study is to- 1. Assess the value of ultrasonography and computed tomography in evaluation of pleural lesions. 2. Determine the sensitivity and specificity of ultrasound and CT in pleural lesions. MATERIALS AND METHODS The present study was aimed at assessing the value of ultrasonography and CT in evaluating the pleural lesions. In our study, during the period of 12 months, 100 patients with pleural effusions were evaluated. The most common cause was transudate. Exudates consist of malignant and non-malignant causes. RESULTS The study group was defined into two groups- Malignant and non-malignant group based on pleural effusion of transudate and exudate types. CT and ultrasound has success rate of 100% and 85% respectively to identify neoplastic and non-neoplastic disease. Diagnostic accuracy of CT and ultrasound are comparable while CT scores over ultrasound in failed cases. CT has 100% sensitivity and 100% specificity in pleural lesions. CT has more therapeutic value compared to ultrasound. CONCLUSION The role of ultrasound and CT are complimentary, give high yield of positive results for pleural mass differentiation; useful for guided procedures like pleural biopsy and pleural drainage. Combined study not only useful for localisation of lesion, but also gives information about the extent of disease and characterising the tissue density by analysis of attenuation coefficient.

Sonographic Findings of Hashimoto's Thyroiditis and Associated Nodular Lesions

International Nuclear Information System (INIS)

Kang, Bong Joo; Park, Young Ha; Jung, So Lyung; Chung, Soo Kyo

2007-01-01

To evaluate the sonographic findings of Hashimoto's thyroiditis and associated nodular lesions. We retrospectively reviewed the sonographic findings of twenty patients who had surgically confirmed Hashimoto's thyroiditis between 1 March 2005, and 26 November 2005. In these patients, we reviewed the sonographic findings of the associated focal nodular lesion. Assessed were size, homogeneity, and echogenicity of the diseased thyroid gland and shape, echogenicity, margin, rim, microcal cification of the associated nodules. Without knowledge of the pathological diagnosis of the nodular lesions, based on the sonographic criteria, the nodules were classified as either malignant or benign. Hashimoto's thyroiditis demonstrates a variety of sonographic findings for size, homogeneity, and echogenicity. Among the nineteen nodules that were sonographically diagnosed and pathologically confirmed, nine papillary cancers, seven nodular hyperplasias, two Huthle cell adenomas, and one focal hyalinized fibrosing nodule were included. All of the nine papillary cancers showed more than one malignant finding such as marked hypoechogenicity, an irregular shape, a taller than wide shape, a spiculated margin, or microcalcifications that were classified as malignant nodulea, and all of the ten benign nodules showed no malignant findings. Circumscribed isoechoic, hyperechoic, or hypoechoic nodules without calcification were classified as bending nodules. Hashimoto's thyroiditis demonstrates various findings on a sonographic examination,and associated various benign and malignant lesions. Moreover, a sonographic examination is helpful to differentiate between malignant and benign lesions in Hashimoto's thyroiditis as in the normal thyroid

Increased expression of brother of the regulator of imprinted sites in peripheral blood neutrophils is associated with both benign and malignant breast lesions.

Science.gov (United States)

El-Sharkawy, Nahla M; Radwan, Wafaa M; Essa, Enas S; Kandeel, Eman Z; Abd El-Fattah, Eman K; Kandil, Samia H; Kamel, Azza M

2017-09-01

BORIS, a paralog of the multifunctional CCCTC-binding factor (CTCF) gene is restricted to testis and normally not present in females. It is aberrantly activated in various human cancers including cancer breast. Using immunohistochemistry, western blot and/or RT-PCR, significantly higher levels of BORIS expression were reported in the neutrophils of cancer breast patients. We hypothesized that Flow Cytometry might be a better technique for objective quantitative evaluation of BORIS in neutrophils and we wanted to investigate if BORIS would discriminate between benign and malignant breast lesions. The study included 85 females; 52 breast cancer, 13 benign breast lesions and 20 age-matched healthy controls. BORIS expression in the neutrophils was detected by Flow Cytometry. High level of BORIS was detected in all malignant (64.4 ± 16.6%) and benign cases (67 ± 12.3), mean florescent intensity ratio (MFIR) of 7.2 ± 4.1 and 7 ± 3.5, median 5.8 and 6.6%; and staining index (SI) 8.3 ± 3.9 and 8.2 ± 3.4, median 7.6 and 7.9 respectively vs.13.4 ± 11.5% MFI 1.8 ± 0.7, median1.6 and SI 2.6 ± 0.69, median 2.5 for the control. BORIS level was comparable in the malignant and benign group (P = 0.934) and significantly higher than control (P = 0.0001). There was no correlation between neutrophil BORIS expression and ER/PR status, HER-2/neu expression or tumor stage or size. Increased BORIS expression in peripheral blood neutrophils is associated with both benign and malignant breast lesions; apparently, increased proliferation of breast tissue is the determining factor. This excludes BORIS as a tumor marker but it does not jeopardize its value as a potential therapeutic target. © 2016 International Clinical Cytometry Society. © 2016 International Clinical Cytometry Society.

Microscopic analysis of the chromium content in the chromium-induced malignant and premalignant bronchial lesions of the rat

International Nuclear Information System (INIS)

Takahashi, Yuji; Kondo, Kazuya; Ishikawa, Sumiyo; Uchihara, Hiroshi; Fujino, Haruhiko; Sawada, Naruhiko; Miyoshi, Takanori; Sakiyama, Shoji; Izumi, Keisuke; Monden, Yasumasa

2005-01-01

Objective: Our previous studies demonstrated that the frequency of gene instability in lung cancer of chromate workers was very high, but the frequencies of the p53 and ras gene mutations were low. To clarify the carcinogenesis of chromate in the lung, we established a chromate-induced cancer model in the rat proximal airway and examined the relationship between chromium accumulations and the chromium-induced cancer and premalignant bronchial lesions of the rat. Methods: Fifteen male, bred, 12-week-old Jcl-Wister rats were used. A pellet of strontium chromate were inserted into the bronchus of the rats. The rats were sacrificed 9 months after the pellet was inserted. We pathologically examined the region of the bronchi to which the pellet was attached. We quantified the amount of chromium accumulation in the bronchial lesions using a microscopic X-ray fluorescence analyzer. Results: Of the 15 rats, 1 rat had a lesion of squamous cell carcinoma (SCC), 7 rats had carcinoma in situ (CIS) or dysplasia, 8 rats had squamous metaplasia, and 5 rats had goblet cell hyperplasia. The amounts of chromium accumulation in normal epithelium (n=24), goblet cell hyperplasia (n=14), squamous metaplasia (n=8), and dysplasia plus CIS plus SCC (n=9) were 500±1354, 713±1062, 941±1328, and 3511±4473 (mean±SD) counts/s/mA, respectively. The amount of chromium accumulation was significantly increased according to the progression of malignant change of the bronchial epithelium (Spearman's correlation coefficient by ranks, rs=0.454, P<0.01). Conclusions: The amount of chromium accumulation was significantly increased according to the progression of malignant change of the bronchial epithelium. Examining the genetic alterations of histologic changes in this model was helpful in elucidating the process of carcinogenesis of chromium in the lung

Topical treatment of malignant and premalignant skin lesions by very low concentrations of a standard mixture (BEC) of solasodine glycosides.

Science.gov (United States)

Cham, B E; Daunter, B; Evans, R A

1991-09-01

A cream formulation containing high concentrations (10%) of a standard mixture of solasodine glycosides (BEC) has been shown to be effective in the treatment of malignant and benign human skin tumours. We now report that a preparation (Curaderm) which contains very low concentrations of BEC (0.005%) is effective in the treatment of keratoses, basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) of the skin of humans. In an open study, clinical and histological observations indicated that all lesions (56 keratoses, 39 BCCs and 29 SCCs) treated with Curaderm had regressed. A placebo formulation had no effect on a smaller number of treated lesions. Curaderm had no adverse effect on the liver, kidneys or haematopoietic system.

MR imaging of malignant ovarian tumors

International Nuclear Information System (INIS)

Kim, Jun Ho; Kang, Heoung Keun; Moon, Woong Jae; Seo, Jeong Jin; Kim, Jae Kyu; Choi, Ho Sun

1994-01-01

To evaluate MRI findings of malignant ovarian tumors. MRI findings were retrospectively reviewed in 25 patients with surgically confirmed 30 malignant ovarian tumors(common epithelial tumor; 23, sex cord stromal tumor; 2, endo dermal sinus tumor; 1, metastatic tumor; 4). The findings evaluated were the lesion size, solid and/or cystic component, wall thickness, septal thickness, necrosis, invasion of adjacent organ, ascites, and adenopathy. MRI findings of the malignant ovarian tumors were as follow: Size of lesion was 5-35cm(mean 14cm); solid component was present in 80%(24/30); wall thickness was more than 3mm in 90%(27/30); septal thickness was more than 3mm in 70%(21/30); tumor necrosis was present in 40%(12/30%); invasion of adjacent organ was present in 76%(19/25); ascites was present in 56%(14/25); lymphadenopathy was present in 24% (6/25). MRI findings of absence of solid component(6/6), even wall and septal thickness(7/7, 19/19) were found only in epithelial tumors. Uneven septal thickness more than 3mm(7/11) was a predominant MRI findings of non-epithelial tumors. Well-defined cystic lesion within solid component was seen in Krukenberg tumors. Evaluation of the lesion size, internal architecture, invasion of adjacent organ, ascites, and lymphadenopathy in MRI would enable diagnosis of malignant ovarian tumors and could lead to possible differential diagnosis of epithelial tumors from non-epithelial tumors

Chemical shift MRI can aid in the diagnosis of indeterminate skeletal lesions of the spine

Energy Technology Data Exchange (ETDEWEB)

Douis, H. [University Hospital Birmingham, Department of Radiology, Birmingham (United Kingdom); Royal Orthopaedic Hospital, Department of Radiology, Birmingham (United Kingdom); Davies, A.M. [Royal Orthopaedic Hospital, Department of Radiology, Birmingham (United Kingdom); Jeys, L. [Royal Orthopaedic Hospital, Department of Orthopaedic Oncology, Birmingham (United Kingdom); Sian, P. [Royal Orthopaedic Hospital, Department of Spinal Surgery and Spinal Oncology, Birmingham (United Kingdom)

2016-04-15

To evaluate the role of chemical shift MRI in the characterisation of indeterminate skeletal lesions of the spine as benign or malignant. Fifty-five patients (mean age 54.7 years) with 57 indeterminate skeletal lesions of the spine were included in this retrospective study. In addition to conventional MRI at 3 T which included at least sagittal T1WI and T2WI/STIR sequences, patients underwent chemical shift MRI. A cut-off value with a signal drop-out of 20 % was used to differentiate benign lesions from malignant lesions (signal drop-out <20 % being malignant). There were 45 benign lesions and 12 malignant lesions. Chemical shift imaging correctly diagnosed 33 of 45 lesions as benign and 11 of 12 lesions as malignant. In contrast, there were 12 false positive cases and 1 false negative case based on chemical shift MRI. This yielded a sensitivity of 91.7 %, a specificity of 73.3 %, a negative predictive value of 97.1 %, a positive predictive value of 47.8 % and a diagnostic accuracy of 82.5 %. Chemical shift MRI can aid in the characterisation of indeterminate skeletal lesions of the spine in view of its high sensitivity in diagnosing malignant lesions. Chemical shift MRI can potentially avoid biopsy in a considerable percentage of patients with benign skeletal lesions of the spine. (orig.)

Lobular neoplasia found on breast biopsy: marker of increased risk of malignancy or direct pre-cancerous lesion?

Directory of Open Access Journals (Sweden)

Jan Kornafel

2011-10-01

Full Text Available The aim of this study was to compare the imaging symptoms and microscopic findings in females with lobular neoplasia (LN found on biopsy. 1,478 women who underwent primary open biopsy or surgical excision after percutaneous biopsy were reviewed. In 24 of them (1.6%, LN was found. In four patients, excisional biopsy with hook-wire localization was done primarily due to the radial scar. In 20 females, surgical excision of BIRADS 4 lesion was performed because of the presence of LN in specimens from the vacuum-assisted or core-needle percutaneous biopsy. Postoperative pathologic findings were compared to the radiological symptoms. In 13 women, LN did not produce any radiological symptoms and was an additional histologic finding existing near the other lesion: fibroadenoma and radial scar. In none of these lesions was an invasive cancer noticed. In one single patient, ductal carcinoma in situ was observed in the other segment of the breast. Invasive ductal cancer developed in the contralateral breast in one patient. In 11 patients, LN was diagnosed due to radiological symptoms produced by itself. In this group, the invasive lobular cancer was found in seven lesions (64%. Our finding suggests that LN producing suspicious radiological symptoms can be a different biologic type of this lesion when compared asymptomatic LN diagnosed which is usually found on biopsy as additional microscopic pathology. Symptomatic LN is probably associated with a higher potential of malignant transformation. (Folia Histochemica et Cytobiologica 2011; Vol. 49, No. 3, pp. 417–424

Is routine biopsy of sonographically benign breast lesions in black ...

African Journals Online (AJOL)

6.8%). Size did not predict malignancy (p=0.22). Family history and HIV status were not significant. Conclusion. A high proportion (11.0%) of lesions that appeared benign on ultrasound were malignant. The size of the lesion did not correlate ...

Squamous Cell Carcinoma Arising from an Oral Lichenoid Lesion: A Case Report

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Ali Taghavi Zenouz

2012-02-01

Full Text Available Lichenoid reactions represent a family of lesions with different etiologic factors and a common clinical and histologic appearance. Lichen planus is included with lichenoid reactions and is a relatively common chronic mucocutaneous disorder. The most important complication of lichenoid reactions is the possibility of malignant transformation. That is why it has been considered a precancerous condition. Although the malignant transformation rate varies widely in the literature, from 0.4 to 6.5 percent, in most studies it does not exceed 1%. The aim of this paper is to report a rare case of squamous cell carcinoma (SCC arising within an oral lichenoid lesion in a 17-year-old woman, where SCC is very uncommon. The patient did not have any risk factors and was healthy. The lesion was located on the border of the tongue. In view of the common occurrence of OLP (oral lichen planus and the unresolved issues regarding its premalignant potential, this case report illustrates the need for histologic confirmation and a close follow-up of clinical lesions with lichenoid features.

The diagnostic value of CT bronchial sign in peripheral solitary pulmonary lesions

International Nuclear Information System (INIS)

Sun Pengfei; Xiao Xiangsheng; Liu Shiyuan; Yu Hong; Li Huimin

2008-01-01

Objective: To investigate the differential diagnostic values of CT bronchial sign for peripheral solitary pulmonary lesions (SPLs). Methods: One hundred and eleven patients with peripheral SPLs were scanned using multi-slice helical CT (MSCT), and multiplanar reconstruction was performed to show the relationship between the lesion and bronchus, the differences between the benign and malignancy were compared by using chi-square test. Results: Bronchial cutoff rate in malignant lesions (47/95, 49.5%) was markedly higher than that in benign lesions (10/42,23.8%. χ 2 =7.896, P 2 =6.975,4.818, P 2 =7.390,P 2 =0.641,0.062, P>0.05). The focal bronchial wall thickening in malignancy (21/22) was markedly higher than benign lesions (1/22. χ 2 =4.185, P 2 =8.650, P<0.05). Conclusion: CT bronchial sign is very important in the differentiation of benign and malignant pulmonary lesions. (authors)

Allergic conditions and risk of hematological malignancies in adults: a cohort study

Directory of Open Access Journals (Sweden)

Schwartzbaum Judith

2004-11-01

Full Text Available Abstract Background Two contradictory hypotheses have been proposed to explain the relationship between allergic conditions and malignancies, the immune surveillance hypothesis and the antigenic stimulation hypothesis. The former advocates that allergic conditions may be protective against development of cancer, whereas the latter proposes an increased risk. This relationship has been studied in several case-control studies, but only in a few cohort studies. Methods The association between allergic conditions and risk of developing leukemia, Hodgkin's disease, non-Hodgkin's lymphoma and myeloma was investigated in a cohort of 16,539 Swedish twins born 1886–1925. Prospectively collected, self-reported information about allergic conditions such as asthma, hay fever or eczema was obtained through questionnaires administered in 1967. The cohort was followed 1969–99 and cancer incidence was ascertained from the Swedish Cancer Registry. Results Hives and asthma tended to increase the risk of leukemia (relative risk [RR] = 2.1, 95% Confidence Interval [CI] 1.0–4.5 and RR = 1.6, 95% CI 0.8–3.5, respectively. There was also an indication of an increased risk of non-Hodgkin's lymphoma associated with eczema during childhood (RR = 2.3, 95% CI 1.0–5.3. Conclusion In contrast to most previous studies, our results do not indicate a protective effect of allergic conditions on the risk of developing hematological malignancies. Rather, they suggest that allergic conditions might increase the risk of some hematological malignancies.

Role of acoustic radiation force impulse elastography in the characterization of focal solid hepatic lesions

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Harshavardhan Nagolu

2018-01-01

Full Text Available Objective: The purpose of the study is to investigate the usefulness of acoustic radiation force impulse (ARFI elastography in the characterization of focal solid liver lesions as benign, malignant, or metastatic using ARFI two-dimensional (2D imaging and ARFI quantification (shear wave velocities [SWVs]. Materials and Methods: Sixty lesions were included in this study. The lesions were classified into three groups: Group I included benign lesions (n = 25, Group II included malignant lesions (n = 27, and Group III included metastatic lesions (n = 8. ARFI elastography was performed in all these patients using a Siemens ACUSON S 2000TM ultrasound machine. Stiffness and size of the lesions were assessed on ARFI 2D images in correlation with B-mode ultrasound images. SWVs were obtained in these lesions for the quantification of stiffness. Results: In ARFI 2D images, malignant lesions were predominantly stiffer and larger, while benign lesions were softer and similar in size (P < 0.05. The mean SWVs in benign, malignant, and metastatic lesions were 1.30 ± 0.35 m/s, 2.93 ± 0.75 m/s, and 2.77 ± 0.90 m/s, respectively. The area under receiver operating characteristic curve of SWV for differentiating benign from malignant lesions was 0.877, suggesting fair accuracy (95% confidence interval: 0.777–0.976; with a cutoff value of 2 m/s, showing sensitivity: 92%; specificity: 96%; positive predictive value: 96%; negative predictive value: 93% (P < 0.05. Statistically significant difference exists in SWV of benign and malignant or metastatic lesions. Conclusion: ARFI elastography with 2D imaging and quantification might be useful in the characterization of benign and malignant liver lesions.

Differentiation of thyroid lesion detected by FDG PET/CT using SUV ratio

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Kim, Bom Sahn; Kang, Won Jun; Lee, Dong Soo; Chung, June Key; Lee, Myung Chul [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

2007-07-01

We investigated the usefulness of SUV ratio to discriminate focal thyroid lesion incidentally detected on 18F-FDG PET/CT (FDG PET) in patients with malignant disease. A total of 2167 subjects with malignant tumor underwent PET/CT for staging. Forty-five of 2167 subjects (2.1%) showed hypermetabolic thyroid lesions on FDG PET. Of 45, 21 lesions were confirmed by pathology (n = 16) or follow up exam (n=5). Seventeen patients had focal FDG uptakes, while 4 patients had diffuse thyroid uptakes. Standardized uptake value (SUV) was measured by drawing region of interest (ROI) on bilateral thyroid lobes and liver. From 21 patients, 12 thyroid lesions were confirmed as malignant lesions and 9 lesions as benign lesions. All of bilateral thyroid FDG uptakes were determined as benign disease such as thyroiditis. From seventeen focal thyroid incidentaloma, FDG PET had 100 % (12/12) of sensitivity and 60 % (3/5) of specificity, retrospectively. Malignant nodules had a significantly higher lesion to liver ratio than those of benign nodules (2.10.9 vs. 1.20.6, p=0.029). With ROC curve, the best cut-off value of lesion to liver was 1.0 with sensitivity of 100% and specificity of 60 % (area under the curve=0.783). The SUV ratio of lesion to contralateral lobe do not have statistical significance to determine malignancy (3.72.1 vs. 2.61.7, p=0.079). This study showed that focal thyroidal FDG uptake detected by FDG PET could be differentiated with best performance by SUV ratio of lesion to liver.

Fluoroscopically guided automated gun biopsy of chest lesions: diagnostic accuracy and complications

International Nuclear Information System (INIS)

Oh, Hee Sul; Han, Young Min; Choi, Ki Chul and others

1998-01-01

To determine the diagnostic accuracy and frequency of complications of fluoroscopyguided transthoracic needle biopsy, using an automated gun biopsy system. We retrospectively reviewed 86 patients who underwent automated gun biopsy between October 1995 and October 1996. An 18-gauge cutting needle was used in all cases. All biopsies were performed under fluoroscopic guidance by one interventional radiologist. Tissue sufficient for histologic diagnosis was obtained in 73 of 86 biopsies(84.9%). Fifty-six lesions were malignent and 30 were benign. Sensitivity and diagnostic accuracy for malignant lesions were 87.5% and 87.5%, respectively while cell type specificity in malignant diagnosis was 91.7%(11/12). Sensitivity and diagnostic accuracy for benign lesions were 80.0% and 73.3%, respectively. Postbioptic pneumothorax occurred in three of 86 biopsies(3.5%), one of which required placement of a chest tube. Automated gun biopsy is a simple, safe method for the diagnosis of focal chest lesions. An automated biopsy device offers high diagnostic accuracy in casis involving malignant and benign lesions of the chest, and is particularly useful for determining malignant cell type and specific diagnosis of benign lesions.=20

Differentiation of malignant and degenerative benign bone disease using 99mTc-citrate scintigraphy

International Nuclear Information System (INIS)

Guo Rui; Jin Jianhua; Li Sijin; Li Xianfeng; Zhang Xiaojuan; Ren Yuan

2008-01-01

Objective: To differentiate malignant and degenerative benign bone disease using 99m Tc- citrate scintigraphy. Methods: Thirty-nine patients (92 lesions) with confirmed malignant bone disease or degenerative benign bone disease were studied, for which the results of 99m Te-methylene diphosphonate( 99m Tc- MDP) scintigraphy were positive. 99m Tc-citrate scintigraphy was performed within a time interval of 2-7 days after 99m Tc-MDP scintigraphy. Visual analysis and semiquantitative analysis were applied. Each lesion was scored as malignant or benign, which was independently verified, using conventional techniques (histopathology, X-ray, CT, MRI and clinical follow up). Results: In visual analysis of 99m Tc-citrate imaging, most malignant lesions (35/48, 72.92%) clearly showed high radioactivity accumulation, while most benign lesions (39/44, 88.64%) had not obviously visible uptake of 99m Tc-citrate. In semiquantitative analysis of 99m Tc- citrate image, malignant lesions demonstrated a higher lesion-to-background radioisotope uptake ratio (RUR) than that of benign degenerative lesions (1.47 ± 0.42 vs. 1.09 ± 0.38, t=2.887, P 99m Tc-MDP in the two groups is of the same (1.96 ± 0.25 vs. 1.87 ± 0.21, t=1.178, P>0.20). Conclusion: 99m Tc- citrate scintigraphy is a promising method to differentiate malignant from benign degenerative lesions seen as areas of increased activity on 99m Tc-MDP bone scintigraphy. (authors)

Malignant transformation of superficial peritoneal endometriosis lesion.

Science.gov (United States)

Marchand, Eva; Hequet, Delphine; Thoury, Anne; Barranger, Emmanuel

2013-08-26

A 63-year-old woman with no medical history underwent an abdominal surgery with hysterectomy and bilateral salpingo-oophorectomy for a 10 cm peritoneal cyst with increased cancer antigene-125. A large suspicious tumour of the Douglas space, with contact to the uterus and the rectal wall was described. The rest of the exploration was normal, specially the rest of the peritoneum. Histopathology revealed a malignant transformation of a superficial peritoneal endometriosis. Secondary surgery was thus completed by laparoscopy with bilateral pelvic and para-aortic lymph node dissections, omentectomy and multiple peritoneal biopsies. All staging samples were free of cancer; therefore no complementary therapy was administered. After 18 months of follow-up, consisting of clinical examination and pelvis magnetic resonance imaging every 6 months, we did not observe any recurrence. Malignant transformation of superficial peritoneal endometriosis is a rare disease and surgical management seems to be the main treatment.

Multimodality imaging and state-of-art GPU technology in discriminating benign from malignant breast lesions on real time decision support system

International Nuclear Information System (INIS)

Kostopoulos, S; Glotsos, D; Kalatzis, I; Asvestas, P; Cavouras, D; Sidiropoulos, K; Dimitropoulos, N

2014-01-01

The aim of this study was to design a pattern recognition system for assisting the diagnosis of breast lesions, using image information from Ultrasound (US) and Digital Mammography (DM) imaging modalities. State-of-art computer technology was employed based on commercial Graphics Processing Unit (GPU) cards and parallel programming. An experienced radiologist outlined breast lesions on both US and DM images from 59 patients employing a custom designed computer software application. Textural features were extracted from each lesion and were used to design the pattern recognition system. Several classifiers were tested for highest performance in discriminating benign from malignant lesions. Classifiers were also combined into ensemble schemes for further improvement of the system's classification accuracy. Following the pattern recognition system optimization, the final system was designed employing the Probabilistic Neural Network classifier (PNN) on the GPU card (GeForce 580GTX) using CUDA programming framework and C++ programming language. The use of such state-of-art technology renders the system capable of redesigning itself on site once additional verified US and DM data are collected. Mixture of US and DM features optimized performance with over 90% accuracy in correctly classifying the lesions

Local treatment of solitary intrapulmonary, malignant nodules; Lokaltherapie solitaerer intrapulmonaler maligner Rundherde

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Winkel, J. op den; Eichhorn, F. [Universitaetsklinikum Heidelberg, Abteilung Thoraxchirurgie, Thoraxklinik, Heidelberg (Germany); Rieken, S. [Universitaetsklinikum Heidelberg, Klinik fuer Strahlentherapie und Radioonkologie, Heidelberg (Germany); Dienemann, H. [Universitaetsklinikum Heidelberg, Abteilung Thoraxchirurgie, Thoraxklinik, Heidelberg (Germany); TLRC-H - Translational Lung Research Center Heidelberg, Heidelberg (Germany)

2017-02-15

Intrapulmonary nodules generally represent an incidental finding in the roentgenogram or computed tomography (CT) scan of the chest. They are defined as single, well-circumscribed, radiographic opaque lesions that measures up to 3 cm in diameter and are surrounded completely by aerated lung. The probability of malignancy directly correlates with increasing diameter. Lesions that have a diameter of 1 cm or larger require direct evaluation. Surgery is the first option for patients with a malignant lesion, given an acceptable perioperative risk; for high-risk patients either radiofrequency ablation (RFA) or stereotactic body radiation therapy (SBRT) should be offered. In these cases the malignant histology has to be established beforehand or verified by radiologic proven growth. Complete surgical resection is superior to RFA and SBRT with respect to local tumor control. (orig.) [German] Intrapulmonale Rundherde stellen in der Regel einen Zufallsbefund im Roentgenbild oder Computertomogramm des Thorax dar. Sie sind definiert als relativ gut abgegrenzte Laesionen von bis zu 3 cm Durchmesser, die allseits von Lungengewebe umgeben sind. Die Wahrscheinlichkeit fuer das Vorliegen eines malignen Tumors steigt mit ihrer Groesse. Rundherde ab 1 cm Durchmesser beduerfen der aktiven Abklaerung. Zur Behandlung solitaerer maligner Tumoren steht fuer Patienten ohne nennenswert erhoehtes Operations- und Narkoserisiko der chirurgische Eingriff an erster Stelle. Patienten, die aus funktionellen Gruenden fuer einen solchen nicht geeignet sind, koennen mit Radiofrequenzablation (RFA) oder Einzeitbestrahlung (SBRT) behandelt werden. In diesen Faellen muessen vor Therapiebeginn die Malignitaet nachgewiesen oder zumindest ueber einen begrenzten Zeitraum eine Groessenzunahme der Laesion dokumentiert worden sein. In Bezug auf die lokale Tumorfreiheit ist die Operation unter den Voraussetzungen einer R0-Resektion den anderen Verfahren ueberlegen. (orig.)

A clinico-radiologic study of the various lesions in the oral and maxillofacial region of children

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Choi, Soon Chul; Lee, Young Ho; Park, Tae Won; You, Dong Soo [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

1995-08-15

Two thousand-two hundred-forty-three cases of various lesions of the oral and maxillofacial region in children under 16 years of age were reviewed. The lesions were classified by 10 groups, osteomyelitis, cysts, benign tumors, malignant tumors, fibro-osseous lesions, developmental disturbances, antral lesions, TMJ lesions, salivary gland lesions, and other lesions. The obtained results were as follows; 1. Developmental disturbances, especially cleft alveolus and palate, was the most common lesions (25.7%), followed by cysts (22.5%), antral lesions (12.7%), benign tumors (11.9%) and osteomyelitis (9.3%). 2. With the time, the incidence of osteomyelitis and malignant tumors has been decreased, but that of developmental disturbances, cysts and antral lesions has been increased. 3. The sex distribution was relatively equal for the entire series, with male predominence in cysts, malignant tumors, developmental disturbances and salivary gland lesions and with female predominance in TMJ lesions. 4. Children with malignant tumors and osteomyelitis were somewhat younger and those with TMJ lesions were somewhat older. 5. Heading the list of each group except osteomyelitis was dentigerous cyst, odontoma, malignant lymphoma, fibrous dysplasia, cleft alveolus and palate, inflammatory change, degenerative change of condylar process, sialolithiasis and simple bone cyst respectively.

A clinico-radiologic study of the various lesions in the oral and maxillofacial region of children

International Nuclear Information System (INIS)

Choi, Soon Chul; Lee, Young Ho; Park, Tae Won; You, Dong Soo

1995-01-01

Two thousand-two hundred-forty-three cases of various lesions of the oral and maxillofacial region in children under 16 years of age were reviewed. The lesions were classified by 10 groups, osteomyelitis, cysts, benign tumors, malignant tumors, fibro-osseous lesions, developmental disturbances, antral lesions, TMJ lesions, salivary gland lesions, and other lesions. The obtained results were as follows; 1. Developmental disturbances, especially cleft alveolus and palate, was the most common lesions (25.7%), followed by cysts (22.5%), antral lesions (12.7%), benign tumors (11.9%) and osteomyelitis (9.3%). 2. With the time, the incidence of osteomyelitis and malignant tumors has been decreased, but that of developmental disturbances, cysts and antral lesions has been increased. 3. The sex distribution was relatively equal for the entire series, with male predominence in cysts, malignant tumors, developmental disturbances and salivary gland lesions and with female predominance in TMJ lesions. 4. Children with malignant tumors and osteomyelitis were somewhat younger and those with TMJ lesions were somewhat older. 5. Heading the list of each group except osteomyelitis was dentigerous cyst, odontoma, malignant lymphoma, fibrous dysplasia, cleft alveolus and palate, inflammatory change, degenerative change of condylar process, sialolithiasis and simple bone cyst respectively.

Contrast enhanced ultrasound in CT-undetermined focal liver lesions

DEFF Research Database (Denmark)

Sandrose, Sebastian; Karstrup, S.; Gerke, Oke

2016-01-01

, surgical resection, PET/CT and clinical follow-up. Results: The 78 included patients had 163 undetermined focal liver lesions, mean size 1.1 cm, range 0.1–5.3 cm. There were 18 malignant and 145 benign liver lesions, as defined by the standard of reference. In differentiating between benign vs. malignant...

Value of 18F-FDG PET/CT in the detection of ovarian malignancy

International Nuclear Information System (INIS)

Park, Tae Gyu; Lee, Si Nae; Park, So Yeon

2015-01-01

Ovarian cancer is a leading cause of gynecologic malignancy. As symptoms of ovarian cancer are nonspecific, only 20 % of ovarian cancers are diagnosed while they are still limited to the ovaries. Thus, early and accurate detection of disease is important for an improved prognosis. For the accurate and effective diagnosis of ovarian malignancy on 18 F-fluorodeoxyglucose ( 18 F--FDG) positron emission tomography/computed tomography (PET/CT), we analyzed several parameters, including visual assessment. A total of 51 peritoneal lesions in 19 patients who showed ovarian masses with diffuse peritoneal infiltration were enrolled. Twelve patients were confirmed to have ovarian malignancy and seven patients with benign disease by pathologic examination. All patients were examined by 18 F--FDG PET/CT, and an additional 2-h delayed 18 F--FDG PET/CT was also performed for 15 patients with 42 peritoneal lesions. We measured semiquantitative parameters including maximum and mean standardized uptake values (SUV max , SUV mean ), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) on a 1-h initial 18 F--FDG PET/CT image (Parameter1) and on a 2-h delayed image (Parameter2). Additionally, retention indices of each parameter were calculated, and each parameter among the malignant and benign lesions was compared by Mann-Whitney U test. We also assessed the visual characteristics of each peritoneal lesion, including metabolic extent, intensity, shape, heterogeneity, and total visual score. Associations between visual grades and malignancy were analyzed using linear by linear association methods. Moreover, a receiver operating characteristic (ROC) curve was analyzed to compare the effectiveness of significant parameters. In a comparison between the malignant and benign groups in the analysis of 51 total peritoneal lesions, SUV max1 , SUV mean1 , and TLG1 showed significant differences. Also, in the analysis of 42 peritoneal lesions that underwent an additional 2-h 18 F

Non-mass-like breast lesions at ultrasonography: Feature analysis and BI-RADS assessment

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Ko, Kai-Hsiung [Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC (China); Hsu, Hsian-He, E-mail: hsianhe@yahoo.com.tw [Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC (China); Yu, Jyh-Cherng [Department of Surgery, Division of General Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC (China); Peng, Yi-Jen [Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC (China); Tung, Ho-Jui [Department of Healthcare Administration, Asia University, Taichung, Taiwan, ROC (China); Chu, Chi-Ming [Section of Health Informatics, Institute of Public Health, National Defense Medical Center and University, Taipei, Taiwan, ROC (China); Chang, Tsun-Hou; Chang, Wei-Chou; Wu, Yu-Cheng; Lin, Yu-Pang; Hsu, Giu-Cheng [Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC (China)

2015-01-15

Highlights: • The positive predictive value of an NML lesion on ultrasound ranges from 10 to 79%. • A sizable number of NML malignant lesions are pure DCIS or ILC. • Biopsy is indicated for histopathological diagnosis when an ultrasound NML lesion is recognized. - Abstract: Objective: To analyze the features of non-mass-like (NML) breast lesions on ultrasound (US) and determine their corresponding malignancy rate and to stratify these lesion patterns according to US BI-RADS categories. Materials and methods: One hundred sixty-four consecutive lesions were retrospectively classified into four types according to the US features, the corresponding positive predictive values (PPVs) were obtained. Clinical, imaging, and histopathological findings were reviewed. Results: Among the 164 lesions, 39 (24%) were classified as type Ia, 14 (8%) as type Ib, 39 (24%) as type IIa, 19 (12%) as type IIb, 19 (12%) as type III, and 34 (21%) as type IV. The PPVs for malignancy were 21% for type Ia, 79% for type Ib, 10% for type IIa, 58% for type IIb, 16% for type III, and 21% for type IV. All NML lesions were classified as BI-RADS category 4a (type IIa), 4b (type Ia, III and IV) and 4c (type Ib and IIb) according to their PPVs. There was a significantly higher frequency of malignancy among lesions of type Ib and type IIb compared with the other types (P < 0.01 for each). Lesions with associated calcifications, presence of abnormal axillary nodes, or a mammographic finding of suspected malignancy had a higher probability of malignancy (P < 0.05 for each). Conclusion: US is useful in clarifying the indication for biopsy of NML lesions. The types of US classifications used in our study establish reliable references for the NML patterns when stratified according to the BI-RADS categories.

Non-mass-like breast lesions at ultrasonography: Feature analysis and BI-RADS assessment

International Nuclear Information System (INIS)

Ko, Kai-Hsiung; Hsu, Hsian-He; Yu, Jyh-Cherng; Peng, Yi-Jen; Tung, Ho-Jui; Chu, Chi-Ming; Chang, Tsun-Hou; Chang, Wei-Chou; Wu, Yu-Cheng; Lin, Yu-Pang; Hsu, Giu-Cheng

2015-01-01

Highlights: • The positive predictive value of an NML lesion on ultrasound ranges from 10 to 79%. • A sizable number of NML malignant lesions are pure DCIS or ILC. • Biopsy is indicated for histopathological diagnosis when an ultrasound NML lesion is recognized. - Abstract: Objective: To analyze the features of non-mass-like (NML) breast lesions on ultrasound (US) and determine their corresponding malignancy rate and to stratify these lesion patterns according to US BI-RADS categories. Materials and methods: One hundred sixty-four consecutive lesions were retrospectively classified into four types according to the US features, the corresponding positive predictive values (PPVs) were obtained. Clinical, imaging, and histopathological findings were reviewed. Results: Among the 164 lesions, 39 (24%) were classified as type Ia, 14 (8%) as type Ib, 39 (24%) as type IIa, 19 (12%) as type IIb, 19 (12%) as type III, and 34 (21%) as type IV. The PPVs for malignancy were 21% for type Ia, 79% for type Ib, 10% for type IIa, 58% for type IIb, 16% for type III, and 21% for type IV. All NML lesions were classified as BI-RADS category 4a (type IIa), 4b (type Ia, III and IV) and 4c (type Ib and IIb) according to their PPVs. There was a significantly higher frequency of malignancy among lesions of type Ib and type IIb compared with the other types (P < 0.01 for each). Lesions with associated calcifications, presence of abnormal axillary nodes, or a mammographic finding of suspected malignancy had a higher probability of malignancy (P < 0.05 for each). Conclusion: US is useful in clarifying the indication for biopsy of NML lesions. The types of US classifications used in our study establish reliable references for the NML patterns when stratified according to the BI-RADS categories

Spontaneous regression of intracranial malignant lymphoma

International Nuclear Information System (INIS)

Kojo, Nobuto; Tokutomi, Takashi; Eguchi, Gihachirou; Takagi, Shigeyuki; Matsumoto, Tomie; Sasaguri, Yasuyuki; Shigemori, Minoru.

1988-01-01

In a 46-year-old female with a 1-month history of gait and speech disturbances, computed tomography (CT) demonstrated mass lesions of slightly high density in the left basal ganglia and left frontal lobe. The lesions were markedly enhanced by contrast medium. The patient received no specific treatment, but her clinical manifestations gradually abated and the lesions decreased in size. Five months after her initial examination, the lesions were absent on CT scans; only a small area of low density remained. Residual clinical symptoms included mild right hemiparesis and aphasia. After 14 months the patient again deteriorated, and a CT scan revealed mass lesions in the right frontal lobe and the pons. However, no enhancement was observed in the previously affected regions. A biopsy revealed malignant lymphoma. Despite treatment with steroids and radiation, the patient's clinical status progressively worsened and she died 27 months after initial presentation. Seven other cases of spontaneous regression of primary malignant lymphoma have been reported. In this case, the mechanism of the spontaneous regression was not clear, but changes in immunologic status may have been involved. (author)

Contrast-enhanced spectral mammography: Impact of the qualitative morphology descriptors on the diagnosis of breast lesions.

Science.gov (United States)

Mohamed Kamal, Rasha; Hussien Helal, Maha; Wessam, Rasha; Mahmoud Mansour, Sahar; Godda, Iman; Alieldin, Nelly

2015-06-01

To analyze the morphology and enhancement characteristics of breast lesions on contrast-enhanced spectral mammography (CESM) and to assess their impact on the differentiation between benign and malignant lesions. This ethics committee approved study included 168 consecutive patients with 211 breast lesions over 18 months. Lesions classified as non-enhancing and enhancing and then the latter group was subdivided into mass and non-mass. Mass lesions descriptors included: shape, margins, pattern and degree of internal enhancement. Non-mass lesions descriptors included: distribution, pattern and degree of internal enhancement. The impact of each descriptor on diagnosis individually assessed using Chi test and the validity compared in both benign and malignant lesions. The overall performance of CESM were also calculated. The study included 102 benign (48.3%) and 109 malignant (51.7%) lesions. Enhancement was encountered in 145/211 (68.7%) lesions. They further classified into enhancing mass (99/145, 68.3%) and non-mass lesions (46/145, 31.7%). Contrast uptake was significantly more frequent in malignant breast lesions (p value ≤ 0.001). Irregular mass lesions with intense and heterogeneous enhancement patterns correlated with a malignant pathology (p value ≤ 0.001). CESM showed an overall sensitivity of 88.99% and specificity of 83.33%. The positive and negative likelihood ratios were 5.34 and 0.13 respectively. The assessment of the morphology and enhancement characteristics of breast lesions on CESM enhances the performance of digital mammography in the differentiation between benign and malignant breast lesions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Usefulness of diffusion-weighted MR imaging for differentiating between benign and malignant superficial soft tissue tumours and tumour-like lesions

Science.gov (United States)

Jeon, Ji Young; Lee, Min Hee; Lee, Sang Hoon; Shin, Myung Jin

2016-01-01

Objective: To evaluate the usefulness of adding diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) mapping to conventional 3.0-T MRI to differentiate between benign and malignant superficial soft-tissue masses (SSTMs). Methods: The institutional review board approved this study and informed consent was waived. The authors retrospectively analyzed conventional MR images including diffusion-weighted images (b-values: 0, 400, 800 s mm−2) in 60 histologically proven SSTMs (35 benign and 25 malignant) excluding lipomas. Two radiologists independently evaluated the conventional MRI alone and again with the additional DWI for the evaluation of malignant masses. The mean ADC values measured within an entire mass and the contrast-enhancing solid portion were used for quantitative analysis. Diagnostic performances were compared using receiver-operating characteristic analysis. Results: For an inexperienced reader, using only conventional MRI, the sensitivity, specificity and accuracy were 84%, 80% and 81.6%, respectively. When combining conventional MRI and DWI, the sensitivity, specificity and accuracy were 96%, 85.7% and 90%, respectively. Additional DWI influenced the improvement of the rate of correct diagnosis by 8.3% (5/60). For an experienced reader, additional DWI revealed the same accuracy of 86.7% without added value on the correct diagnosis. The group mean ADCs of malignant SSTMs were significantly lower than that of benign SSTMs (p benign and malignant SSTMs. Advances in knowledge: Because the imaging characteristics of many malignant superficial soft-tissue lesions overlap with those of benign ones, inadequate surgical resection due to misinterpretation of MRI often occurs. Adding DWI to conventional MRI yields greater diagnostic performances [area under the receiver-operating characteristic curve (AUC), 0.83–0.99] than does the use of conventional MRI alone (AUC, 0.71–0.93) in the evaluation of malignant superficial masses by

Computed tomography in intracranial malignant lymphoma

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Naruse, S; Odake, G; Fujimoto, M; Yamaki, T; Mizukawa, N [Kyoto Prefectural Univ. of Medicine (Japan)

1978-09-01

Malignant lymphoma of the central nervous system has been found more and more often in recent years, partly because of the increased use of radiation and such drugs as steroids and antibiotics. However, the definite diagnosis of this disease is difficult until histological verification has been done by operation or autopsy. Since the revolutionary development of computed tomography, however, several reports have been presented, on the computed tomography of malignant lymphoma of the thorax and abdomen. Nevertheless, only a few cases of intracranial malignant lymphoma have been reported. The purpose of this paper, using four patients, is to emphasize the value of computed tomography in the diagnosis of intracranial malignant lymphoma. The characteristic CT findings of intracranial malignant lymphoma may be summarized follows: (1) the tumors are demonstrated to be well-defined, nodular-shaped, and homogenous isodensity - or slightly high-density - lesions in plain scans, and the tumors homogenously increase in density upon contrast enhancement; (2) the disease always has multifocal intracranial lesions, which are shown simultaneously or one after another, and (3) perifocal edema is prominent around the tumors in the cerebral hemisphere.

Maligne adnekstumorer i huden

DEFF Research Database (Denmark)

Klit, Anders; Hærskjold, Ann; Lei, Ulrikke

2016-01-01

types entirely on their clinical appearance. The histologic diagnosis is troublesome, and the lesions are often mistaken for their benign counterpart, basal cell carcinoma or squamous cell carcinoma. The lesions are treated with surgery. Radiotherapy and chemotherapy may play a role in treatment......Malignant adnexal carcinomas of the skin are rare but associated with high propensity for local recurrence, and for some of the distinct subgroups they are known to metastasize regionally or distant. Biopsy is necessary for correct diagnosis, as the lesions cannot be separated from other tumour...

CT findings of benign omental lesions following abdominal cancer surgery

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Lee, Sang Yun; Kim, Dong Won; Cho, Jin Han; Kwon, Hee Jin; Ha, Dong Ho; Oh, Jong Young [Diagnostic Radiology, Dong-A University College of Medicine, Busan (Korea, Republic of)

2016-07-15

The greater omentum is the largest peritoneal fold and can be the origin of primary pathologic conditions, as well as a boundary and conduit for disease processes. Most diseases involving the omentum manifest with nonspecific and overlapping features on computed tomography (CT). In particular, varying benign disease processes of traumatic, inflammatory, vascular, or systemic origin can occur in the omentum during the follow-up period after surgery for intra-abdominal malignancy. It can be challenging for radiologists due to various spectrum of CT findings. Thus, we reviewed the CT findings of various benign omental lesions after surgery for intra-abdominal malignancy.

Cervical pre-malignant lesions in HIV infected women attending Care and Treatment Centre in a tertiary hospital, Dar es Salaam, Tanzania.

Science.gov (United States)

Balandya, Belinda S; Pembe, Andrea B; Mwakyoma, Henry A

2011-09-01

The aims of this study was to determine proportion of HIV infected women with cervical pre-malignant lesions; and compare the use of Visual Inspection of the cervix after application of Acetic acid (VIA) and Papanicolau (Pap) smear in screening for cervical premalignant lesions in HIV positive women attending Care and Treatment Centre (CTC) at Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania. A total of 316 women aged 18-70 years had a Pap smear taken for cytology, followed by spraying onto the cervix with 4% acetic acid and then inspecting it. Cytology was considered negative when there was no Cervical Intraepithelial Neoplasia (CIN) lesion reported from the Pap smear taken, and positive if CIN lesion 1, 2 or 3 was reported. Detection of a well-defined, opaque acetowhite lesion close to the squamocolumnar junction or close to the external cervical os constituted a positive VIA. Out of 316 women, 132 women had acetowhite lesions on VIA, making the proportion of abnormal cervical lesions to be 42.4%. One hundred and one out of 312 women (32.4%) had CIN lesions detected on Pap smear. The proportion of agreement between these two tests was 0.3. The proportion of agreement was moderate in women with advanced WHO HIV clinical stage of the disease and in women not on ART (Anti Retroviral Therapy). Women with CD-4 count less than 200 cells/mm3 had more abnormal cervical lesions. There is considerable proportion of HIV positive women with premalignant lesions of the cervix. Considering the proportion of HIV women with abnormal lesions and the difficulty in logistics of doing Pap smear in low resource settings, these results supports the recommendation to introduce screening of premalignant lesions of the cervix using VIA to all HIV infected women.

Fibroblast Growth Factor (FGF-2) and Its Receptors FGFR-2 and FGFR-3 May Be Putative Biomarkers of Malignant Transformation of Potentially Malignant Oral Lesions into Oral Squamous Cell Carcinoma.

Science.gov (United States)

Nayak, Seema; Goel, Madhu Mati; Makker, Annu; Bhatia, Vikram; Chandra, Saumya; Kumar, Sandeep; Agarwal, S P

2015-01-01

There are several factors like angiogenesis, lymphangiogenesis, genetic alterations, mutational factors that are involved in malignant transformation of potentially malignant oral lesions (PMOLs) to oral squamous cell carcinoma (OSCC). Fibroblast growth factor-2 (FGF-2) is one of the prototypes of the large family of growth factors that bind heparin. FGF-2 induces angiogenesis and its receptors may play a role in synthesis of collagen. FGFs are involved in transmission of signals between the epithelium and connective tissue, and influence growth and differentiation of a wide variety of tissue including epithelia. The present study was undertaken to analyze expression of FGF-2 and its receptors FGFR-2 and FGFR-3 in 72 PMOLs, 108 OSCC and 52 healthy controls, and their role in risk assessment for malignant transformation of Leukoplakia (LKP) and Oral submucous fibrosis (OSMF) to OSCC. Immunohistochemistry was performed using antibodies against FGF-2, FGFR-2 and FGFR-3. IHC results were validated by Real Time PCR. Expression of FGF-2, FGFR-2 and FGFR-3 was upregulated from PMOLs to OSCC. While 90% (9/10) of PMOLs which showed malignant transformation (transformed) expressed FGF-2, only 24.19% cases (15/62) of PMOLs which were not transformed (untransformed) to OSCC expressed FGF-2. Similarly, FGFR-2 expression was seen in 16/62 (25.81%) of untransformed PMOLs and 8/10 (80%) cases of transformed PMOLs. FGFR-3 expression was observed in 23/62 (37.10%) cases of untransformed PMOLs and 6/10 (60%) cases of transformed PMOLs. A significant association of FGF-2 and FGFR-2 expression with malignant transformation from PMOLs to OSCC was observed both at phenotypic and molecular level. The results suggest that FGF-2 and FGFR-2 may be useful as biomarkers of malignant transformation in patients with OSMF and LKP.

Solitary sternal lesions in breast cancer. Lesiones esternales unicas en cancer de mama

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Morales, R; Cano, R; Mendoza, G [Instituto Peruano de Energia Nuclear, Lima (Peru); Guzman, C; Cotrina, M; Aguilar, C [Instituto Nacional de Enfermedades Neoplasicas, Lima (Peru)

1993-12-01

In a retrospective review of bone scans performed in 1740 patients with breast cancer from January 1988 to April 1993, twenty had a solitary sternal lesion. Etiology was found correlating this finding with pathology, x-rays and/or final outcome. Nineteen lesions were due to metastases and one to infection. This experience suggests that solitary sternal lesions in breast cancer patients are uncommon and are most frequently (95%) associated with malignant etiology. (Authors). 10 refs., 2 figs.

Radiofrequency ablation guided by contrast-enhanced ultrasound for hepatic malignancies: Preliminary results

International Nuclear Information System (INIS)

Dong, Y.; Wang, W.-P.; Gan, Y.-H.; Huang, B.-J.; Ding, H.

2014-01-01

Aim: To evaluate whether contrast-enhanced ultrasound (CEUS)-guided radiofrequency ablation (RFA) can be performed effectively in small hepatic malignancies that are invisible or poorly visualized at traditional grey-scale ultrasonography (US). Materials and methods: The institutional ethics committee approved the study, and all patients provided written informed consent before their enrolment. The study focused on 55 patients (43 men, 12 women, age 57.4 ± 10.9 years) with 60 hepatic lesions from May 2010 to March 2011. All lesions were treated with multipolar radiofrequency ablation (RFA). During the RFA procedure, with the injection of ultrasound contrast agent (sulphur hexafluoride; SonoVue, Bracco Imaging Spa, Milan, Italy), RFA was conducted under CEUS guidance when the optimal depiction of a lesion was obtained. Artificial pleural effusions were used in those cases obstructed by the lungs. Twenty-four hours after RFA, contrast-enhanced MRI was used as the reference standard to evaluate the primary effectiveness rate and complete tumour necrosis. The follow-up time was 12–24 months (median 15 months). Results: Among 60 hepatic malignancies, CEUS detected 57 lesions (95%), which was higher than that at US (26.6%). Artificial pleural effusions were performed in three cases, resulting in the detection of three additional lesions. The insertion of RFA electrodes was monitored by CEUS in all lesions. Immediately after RFA, complete tumour necrosis were achieved in all 60 lesions as apparent at MRI, for a primary effectiveness rate of 100%. Conclusion: CEUS-guided RFA is a promising technique for targeting and improving the efficiency of treatment of hepatic malignancies. - Highlights: • CEUS guided RFA improved the detectability of hepatic malignancies indistinctive on gray-scale ultrasound. • Pre-operation CEUS helped localization of indistinctive hepatic malignancies. • CEUS guided RFA of hepatic malignancies achieved a more complete ablation

Clinical Significance of Focal Breast Lesions Incidentally Identified by 18F-FDG PET/CT

International Nuclear Information System (INIS)

Cho, Young Seok; Choi, Joon Young; Lee, Su Jin; Hyun, Seung Hyup; Lee, Ji Young; Choi, Yong; Choe, Yearn Seong; Lee, Kyung Han; Kim, Byung Tae

2008-01-01

We evaluated the incidence and malignant risk of focal breast lesions incidentally detected by 18 F-FDG PET/CT. Various PET/CT findings of the breast lesions were also analyzed to improve the differentiation between benign from malignant focal breast lesions. The subjects were 3,768 consecutive 18 F-FDG PET/CT exams performed in adult females without a history of breast cancer. A focal breast lesion was defined as a focal 18 F-FDG uptake or a focal nodular lesion on CT image irrespective of 18 F-FDG uptake in the breasts. The maximum SUV and CT pattern of focal breast lesions were evaluated, and were compared with final diagnosis. The incidence of focal breast lesions on PET/CT in adult female subjects was 1.4% (58 lesions in 53 subjects). In finally confirmed 53 lesions of 48 subjects, 11 lesions of 8 subjects (20.8%) were proven to be malignant. When the PET/CT patterns suggesting benignancy (maximum attenuation value > 75 HU or 20) were added as diagnostic criteria of PET/CT to differentiate benign from malignant breast lesions along with maximum SUV, the area under ROC curve of PET/CT was significantly increased compared with maximum SUV alone (0.680±0.093 vs. 0.786±0.076, p 18 F-FDG PET/CT is not low, deserving further diagnostic confirmation. Image interpretation considering both 18 F-FDG uptake and PET/CT pattern may be helpful to improve the differentiation from malignant and benign focal breast lesion

Usefulness of Diffusion-Weighted MR Imaging for Breast Lesions: Comparing the Apparent Diffusion Coefficient (ADC) Values and the Pathologic Results

International Nuclear Information System (INIS)

Ahn, Hye Shin; Chang, Yun Woo; Choi, Kyung Hee; Kim, Hyun Joo; Hong, Seong Suk; Hwang, Jung Hwa; Kwon, Kui Hyang; Kim, Yong Bae

2011-01-01

We wanted to evaluate the ability of the apparent diffusion coefficient (ADC) values to differentiate between benign and malignant breast lesions and the normal breast parenchyma. We used breast MRI, including DWI, to obtain images of 167 breast lesions (18 benign lesions and 149 malignant lesions) of 152 women (mean age: 48.6 years, range: 24-80 years). The mean ADC values of the malignant lesions were compared to those of the benign lesions and the normal parenchyma. We compared the ADC values of IDC, DCIS and other types of breast cancer and we also compared the ADC values with the nuclear grade of IDC. The mean ADC values of the malignant lesions were lower than those of the benign lesions and the normal parenchyma (p -3 mm 2 /s for discriminating between malignant and benign lesion showed a specificity of 53% and a sensitivity of 100%, and the ADC threshold value of 1.33 X 10 -3 mm 2 /s showed a specificity of 93% and a sensitivity of 94% for discriminating between malignant and benign lesion.

Contrast-enhanced spectral mammography: Impact of the qualitative morphology descriptors on the diagnosis of breast lesions

International Nuclear Information System (INIS)

Mohamed Kamal, Rasha; Hussien Helal, Maha; Wessam, Rasha; Mahmoud Mansour, Sahar; Godda, Iman; Alieldin, Nelly

2015-01-01

Highlights: • We studied interpretation criteria for enhancing lesions on CESM. • We evaluated the enhancement patterns of 211 breast lesions. • Our results proved that CESM minimized positive and negative falsies in DM. • The proposed CESM lexicon helped in characterization and categorization. - Abstract: Objective: To analyze the morphology and enhancement characteristics of breast lesions on contrast-enhanced spectral mammography (CESM) and to assess their impact on the differentiation between benign and malignant lesions. Materials and method: This ethics committee approved study included 168 consecutive patients with 211 breast lesions over 18 months. Lesions classified as non-enhancing and enhancing and then the latter group was subdivided into mass and non-mass. Mass lesions descriptors included: shape, margins, pattern and degree of internal enhancement. Non-mass lesions descriptors included: distribution, pattern and degree of internal enhancement. The impact of each descriptor on diagnosis individually assessed using Chi test and the validity compared in both benign and malignant lesions. The overall performance of CESM were also calculated. Results: The study included 102 benign (48.3%) and 109 malignant (51.7%) lesions. Enhancement was encountered in 145/211 (68.7%) lesions. They further classified into enhancing mass (99/145, 68.3%) and non-mass lesions (46/145, 31.7%). Contrast uptake was significantly more frequent in malignant breast lesions (p value ≤0.001). Irregular mass lesions with intense and heterogeneous enhancement patterns correlated with a malignant pathology (p value ≤0.001). CESM showed an overall sensitivity of 88.99% and specificity of 83.33%. The positive and negative likelihood ratios were 5.34 and 0.13 respectively. Conclusion: The assessment of the morphology and enhancement characteristics of breast lesions on CESM enhances the performance of digital mammography in the differentiation between benign and malignant

Contrast-enhanced spectral mammography: Impact of the qualitative morphology descriptors on the diagnosis of breast lesions

Energy Technology Data Exchange (ETDEWEB)

Mohamed Kamal, Rasha [Radiology Department (Women' s Imaging unit), Kasr ElAiny Hospital, Cairo University (Egypt); Hussien Helal, Maha [Radiology Department (Breast Imaging unit), National Cancer Institute, Cairo University (Egypt); Wessam, Rasha [Radiology Department (Women' s Imaging unit), Kasr ElAiny Hospital, Cairo University (Egypt); Mahmoud Mansour, Sahar, E-mail: sahar_mnsr@yahoo.com [Radiology Department (Breast Imaging unit), National Cancer Institute, Cairo University (Egypt); Godda, Iman [Pathology Department, National Cancer Institute, Cairo University (Egypt); Alieldin, Nelly [Statistics Department, National Cancer Institute, Cairo University (Egypt)

2015-06-15

Highlights: • We studied interpretation criteria for enhancing lesions on CESM. • We evaluated the enhancement patterns of 211 breast lesions. • Our results proved that CESM minimized positive and negative falsies in DM. • The proposed CESM lexicon helped in characterization and categorization. - Abstract: Objective: To analyze the morphology and enhancement characteristics of breast lesions on contrast-enhanced spectral mammography (CESM) and to assess their impact on the differentiation between benign and malignant lesions. Materials and method: This ethics committee approved study included 168 consecutive patients with 211 breast lesions over 18 months. Lesions classified as non-enhancing and enhancing and then the latter group was subdivided into mass and non-mass. Mass lesions descriptors included: shape, margins, pattern and degree of internal enhancement. Non-mass lesions descriptors included: distribution, pattern and degree of internal enhancement. The impact of each descriptor on diagnosis individually assessed using Chi test and the validity compared in both benign and malignant lesions. The overall performance of CESM were also calculated. Results: The study included 102 benign (48.3%) and 109 malignant (51.7%) lesions. Enhancement was encountered in 145/211 (68.7%) lesions. They further classified into enhancing mass (99/145, 68.3%) and non-mass lesions (46/145, 31.7%). Contrast uptake was significantly more frequent in malignant breast lesions (p value ≤0.001). Irregular mass lesions with intense and heterogeneous enhancement patterns correlated with a malignant pathology (p value ≤0.001). CESM showed an overall sensitivity of 88.99% and specificity of 83.33%. The positive and negative likelihood ratios were 5.34 and 0.13 respectively. Conclusion: The assessment of the morphology and enhancement characteristics of breast lesions on CESM enhances the performance of digital mammography in the differentiation between benign and malignant

Mammographic evaluation of suspicious malignant lesions based on ACR(American College of Radiology) breast imaging reporting and data system(BI-RADS)

International Nuclear Information System (INIS)

Lee, Jei Hee; Oh, Ki Keun; Chang, So Yong; Kim, Eun Kyung; Kim, Mi Hye

1999-01-01

The purpose of this study was to assess the mammographic features and pathologic outcome of category 4 lesions using the Breast Imaging Reporting and Data System(BI-RADS), and to evaluate the significance of final assessment categories. Using BI-RADS, the interpretations of 8,134 mammograms acquired between January 1997 and May 1998 were categorized. From among 161 lesions categorized as '4' ('suspicious abnormality') and pathologically confirmed by surgery or biopsy, we analysed 113, found in 66 patients. The pathologic outcome of these 113 lesions was as follows:infiltrating ductal carcinoma, 17.7%(20/113); DCIS(ductal carcinoma in sitv), 8.0%(9/113); ADH(atypical ductal hyperplasia), 5.3%(6/113); DEH(ductal epithelial hyperplasia), 1.8%(2/113); ductectasia, 0.9%(1/113), FCD(fibrocystic change), 27.4%(31/113); firoadenoma, 7.1%(8/113); stromal fibrosis, 9.7%(11/113); normal parenchyma, 7.1%(8/113); other pathology, 15.0%(17/113). The most frequent mammographic features of BI-RADS category 4 lesions were irregular mass shape(41.2%), spiculated mass margin(52.3%), amorphous calcification(47.3%) and clustered calcification distribution(37.1%). Because category 4 lesions account for about 25.7% of all breast malignancies, mammographic lesions in this category ('suspicious abnormality') should be considered for supplementary study and breast biopsy rather than short-term follow-up. Initial pathologic findings can thus be confirmed

Correlation of needle core biopsy with excision histology in screen-detected B3 lesions: the Merrion Breast Screening Unit experience.

LENUS (Irish Health Repository)

Hayes, B D

2012-02-01

AIMS: Needle core biopsy (NCB) is a widely-used technique for non-operative evaluation of screen-detected breast lesions. Although most NCBs are B2 (benign) or B5 (malignant), some fall into the B3 category of "uncertain malignant potential". This study aims to categorise the lesions prompting a B3 NCB in the Merrion Breast Screening Unit, and establish the incidence of malignancy on subsequent excision biopsy. METHODS: Patients attending the Merrion Breast Screening Unit in Dublin between 2000 and 2008 who had a B3 NCB were identified. The NCB pathology reports were reviewed and the diagnosis correlated with excision histology; the latter was classified as benign, atypical or malignant. Lesion-specific positive predictive values (PPVs) for malignancy were derived. RESULTS: 141 patients with a B3 NCB were identified. The most frequent lesions on NCB were radial scar (RS; n = 57), atypical intraductal epithelial proliferation (AIDEP; n = 25) and papillary lesion (n = 24). The final diagnosis was malignant in 22 patients (16%), atypical in 40 (28%) and benign in 79 (56%). Two of the patients with a malignant diagnosis had invasive carcinoma. The lesion-specific PPVs were: lobular neoplasia 50%, AIDEP 32%, columnar cell lesion with atypia 12.5%, RS 12.3%, papillary lesion 8.3%, suspected phyllodes tumour 7.7%, and spindle cell lesion 0%. Atypia on RS NCB predicted an atypical or malignant excision diagnosis, but atypia on papillary lesion NCB did not. CONCLUSIONS: One-sixth of B3 NCBs in this series proved to be malignant on excision. The PPV for malignancy varied according to lesion type.

Sonographic Findings of Hashimoto's Thyroiditis and Associated Nodular Lesions

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Kang, Bong Joo; Park, Young Ha; Jung, So Lyung; Chung, Soo Kyo [Catholic University of Korea College of Medicine, Seoul (Korea, Republic of)

2007-12-15

To evaluate the sonographic findings of Hashimoto's thyroiditis and associated nodular lesions. We retrospectively reviewed the sonographic findings of twenty patients who had surgically confirmed Hashimoto's thyroiditis between 1 March 2005, and 26 November 2005. In these patients, we reviewed the sonographic findings of the associated focal nodular lesion. Assessed were size, homogeneity, and echogenicity of the diseased thyroid gland and shape, echogenicity, margin, rim, microcal cification of the associated nodules. Without knowledge of the pathological diagnosis of the nodular lesions, based on the sonographic criteria, the nodules were classified as either malignant or benign. Hashimoto's thyroiditis demonstrates a variety of sonographic findings for size, homogeneity, and echogenicity. Among the nineteen nodules that were sonographically diagnosed and pathologically confirmed, nine papillary cancers, seven nodular hyperplasias, two Huthle cell adenomas, and one focal hyalinized fibrosing nodule were included. All of the nine papillary cancers showed more than one malignant finding such as marked hypoechogenicity, an irregular shape, a taller than wide shape, a spiculated margin, or microcalcifications that were classified as malignant nodulea, and all of the ten benign nodules showed no malignant findings. Circumscribed isoechoic, hyperechoic, or hypoechoic nodules without calcification were classified as bending nodules. Hashimoto's thyroiditis demonstrates various findings on a sonographic examination,and associated various benign and malignant lesions. Moreover, a sonographic examination is helpful to differentiate between malignant and benign lesions in Hashimoto's thyroiditis as in the normal thyroid

DIAGNOSTIC UTILITY OF USG-GUIDED FNAC IN HEPATIC LESIONS

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Sudha P. Meena

2016-06-01

Full Text Available INTRODUCTION Guided fine-needle aspiration cytology (FNAC is an easy, rapid, minimally invasive and a cost effective diagnostic method for detecting benign and malignant lesions of liver. AIM The main aim of the present study was to establish the incidence of various hepatic lesions and to find out adequacy and utility of the procedure. MATERIAL AND METHOD A total of 174 cases were included in the study from Government Medical College, Kota and associated hospitals. All cases diagnosed to have single or multiple hepatic mass lesions on USG were included in the study. RESULTS Most common age group affected by hepatic lesion was 51-60 years (34.0%. 91.4% cases were having adequate aspirates. 95.6% of the total diagnosed cases were malignant and among malignant cases majority were metastatic. CONCLUSION USG-guided FNAC is a very useful procedure in the diagnosis of hepatic lesions as the procedure is simple and safe. Thus, FNAC is a simple and effective diagnostic tool in our hand.

Solitary fibrous tumour of pleura: CT differentiation of benign and malignant types.

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Gupta, A; Souza, C A; Sekhon, H S; Gomes, M M; Hare, S S; Agarwal, P P; Kanne, J P; Seely, J M

2017-09-01

To analyse and compare the computed tomography (CT) features of benign and malignant types of histopathologically proven cases of solitary fibrous tumours of pleura (SFTP). Retrospective analysis of preoperative CT images of 28 cases of histopathologically proven and classified SFTP from three participating institutions was performed. Patient demographics and lesion characteristics including size, borders, presence of a pedicle, extension into the fissure, attenuation, enhancement, pleural effusion, and calcifications were recorded and correlated with the final histopathological diagnosis. Type and results of preoperative biopsy were also recorded. Follow-up imaging and the clinical charts were reviewed to identify recurrence. Out of 28 cases (15 women and 13 men), 18 were proven to be benign and 10 were malignant. The mean age of patients was 58.1±15.9 and 66.5±11.8 years (p=0.1564) for benign and malignant tumours, respectively. The median (interquartile range) diameter was 6.05 (3.2-10.9) cm for benign and 15.7 (7.1-17.5) cm for malignant type tumours (p=0.0291). Tumours had lobulate borders in 28% (5/18) of benign cases and in 80% (8/10) of malignant cases (p=0.0163). Extension into adjacent fissure was seen in 22% (4/18) of benign lesions and 40% (4/10) of malignant lesions (p=0.40). A pedicle was present in 17% (3/18) of benign and 10% (1/10) of malignant lesions (p=1). Heterogeneous attenuation was present in 61% (11/18) of benign and 90% (9/10) of malignant lesions (p=0.19). Calcification was present in 17% (3/18) of benign tumours and in 70% (7/10) of malignant tumours (p=0.0113). Pleural effusion was present in 6% (1/18) of benign and 40% (4/10) of malignant lesions (p=0.04). Only 1/13 preoperative fine-needle aspirates yielded diagnosis of SFTP. Preoperative diagnosis of SFTP was made in all cases (11/11) with core biopsies. At follow-up (1-10 years, mean 3 years), local recurrence occurred in 3/6 (50%) patients with malignant SFTP and in none of the

Histo-blood group ABO antigen in oral potentially malignant lesions and squamous cell carcinoma--genotypic and phenotypic characterization

DEFF Research Database (Denmark)

Gao, Shan; Bennett, Erik Paul; Reibel, Jesper

2004-01-01

Loss of histo-blood group A/B antigens is frequent in oral cancer. It is unclear whether this alteration is due to loss of the chromosomal region encoding the genes. The aim was to investigate genotypic alterations in the ABO locus in oral potentially malignant lesions and carcinomas. Seventy...... to establish the ABO genotype. Total and patchy loss of A/B antigen expression was found in 24/32 carcinomas, 6/7 leukoplakias with severe dysplasia, 12/17 leukoplakias with mild and moderate dysplasia, and 6/17 leukoplakias without dysplasia. Specific A/B allele loss was found in 8/24 cases with carcinoma...

Multi-site abdominal tuberculosis mimics malignancy on ~(18)F-FDG PET/CT:Report of three cases

Institute of Scientific and Technical Information of China (English)

无

2010-01-01

18 F-fluorodeoxyglucose positron emission/computed tomography( 18 F-FDG PET/CT)imaging,an established procedure for evaluation of malignancy,shows an increased 18 F-FDG uptake in inflammatory conditions.We present three patients with abdominal pain and weight loss.Conventional imaging studies indicated that abdominal neoplasm and 18 F-FDG PET/CT for assessment of malignancy showed multiple lesions with intense 18 FFDG uptake in abdomen of the three cases.However,the three patients were finally diagnosed wit...

Improved malignant melanoma prognosis at a consultant-delivered multidisciplinary pigmented lesion clinic in Cork.

Science.gov (United States)

Field, S; Deady, S; Fitzgibbon, J; Murphy, M; Comber, H

2010-02-01

Early detection and excision is the only effective treatment for malignant melanoma. To assess the effect of a consultant-delivered, rapid-access pigmented lesion clinic (PLC) established at the South Infirmary-Victoria University Hospital (SIVUH), we analyzed melanoma tumour-stage prior to (1998-2002) and after (2003-2007) the advent of the PLC. Patients attending SIVUH had a greater proportion of early-stage tumours (65.3%) compared to the rest of Cork (51.2%), County Cork as a whole (56.7%) and all of Ireland (57.4%). The proportion of SIVUH males with early-stage tumours was statistically significantly higher than the rest of County Cork (chi2 = 11.23, P 50y with early-stage tumours was also statistically significantly higher than the rest of County Cork (chi2 = 18.88, P Cork (chi2 = 7.84, P Cork melanoma patients is at least partly due to the PLC.

Characterization of Breast Lesions: Comparison of Digital Breast Tomosynthesis and Ultrasonography

International Nuclear Information System (INIS)

Kim, Sun Ah; Chang, Jung Min; Cho, Nariya; Yi, Ann; Moon, Woo Kyung

2015-01-01

To compare the diagnostic performance of digital breast tomosynthesis (DBT) and conventional breast ultrasound (US) to characterize breast lesions as benign or malignant. A total of 332 women, presenting for screening examinations or for breast biopsy between March and June 2012 were recruited to undergo digital mammography (DM), DBT, and breast US examination. Among them, 113 patients with 119 breast lesions depicted on DM were finally included. Three blinded radiologists performed an enriched reader study and reviewed the DBT and US images. Each reader analyzed the lesions in random order, assigned Breast Imaging Reporting and Data System (BI-RADS) descriptors, rated the images for the likelihood of malignancy (%) and made a BI-RADS final assessment. Diagnostic accuracy, as assessed by the area under the receiver operating characteristic curve, sensitivity, and specificity of DBT and US were compared. Among the 119 breast lesions depicted on DM, 75 were malignant and the remaining 44 were benign. The average diagnostic performance for characterizing breast lesions as benign or malignant in terms of area under the curve was 0.899 for DBT and 0.914 for US (p = 0.394). Mean sensitivity (97.3% vs. 98.7%, p = 0.508) and specificity (44.7% vs. 39.4%, p = 0.360) were also not significantly different. Digital breast tomosynthesis may provide similar reader lesion characterization performance to that of US for breast lesions depicted on DM

Characterization of Breast Lesions: Comparison of Digital Breast Tomosynthesis and Ultrasonography

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Kim, Sun Ah [Department of Radiology, Human Medical Imaging & Intervention Center, Seoul 135-120 (Korea, Republic of); Chang, Jung Min; Cho, Nariya [Department of Radiology, Seoul National University Hospital, Seoul 110-744 (Korea, Republic of); Yi, Ann [Department of Radiology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul 135-984 (Korea, Republic of); Moon, Woo Kyung [Department of Radiology, Seoul National University Hospital, Seoul 110-744 (Korea, Republic of)

2015-11-01

To compare the diagnostic performance of digital breast tomosynthesis (DBT) and conventional breast ultrasound (US) to characterize breast lesions as benign or malignant. A total of 332 women, presenting for screening examinations or for breast biopsy between March and June 2012 were recruited to undergo digital mammography (DM), DBT, and breast US examination. Among them, 113 patients with 119 breast lesions depicted on DM were finally included. Three blinded radiologists performed an enriched reader study and reviewed the DBT and US images. Each reader analyzed the lesions in random order, assigned Breast Imaging Reporting and Data System (BI-RADS) descriptors, rated the images for the likelihood of malignancy (%) and made a BI-RADS final assessment. Diagnostic accuracy, as assessed by the area under the receiver operating characteristic curve, sensitivity, and specificity of DBT and US were compared. Among the 119 breast lesions depicted on DM, 75 were malignant and the remaining 44 were benign. The average diagnostic performance for characterizing breast lesions as benign or malignant in terms of area under the curve was 0.899 for DBT and 0.914 for US (p = 0.394). Mean sensitivity (97.3% vs. 98.7%, p = 0.508) and specificity (44.7% vs. 39.4%, p = 0.360) were also not significantly different. Digital breast tomosynthesis may provide similar reader lesion characterization performance to that of US for breast lesions depicted on DM.

Salivary detection of human Papilloma virus 16 & 18 in pre-malignant and malignant lesions of oral cavity: Is it feasible in Pakistani context of Socio-Cultural Taboos?

Science.gov (United States)

Khyani, Iqbal A Muhammad; Qureshi, Masood A; Mirza, Talat; Farooq, M Umar

2015-01-01

To evaluate salivary detection of HPV-16 & 18 would be feasible and informative biomarker for oral pre-malignant and malignant lesion in our population. This non-interventional, case control study was carried out at department of E.N.T, Head and Neck Surgery, Dow University of Health Sciences, Dow Medical College and Civil Hospital Karachi, Pakistan between July 2011 to December 2012. Total of 105 cases were recruited. These were divided in three groups 'A', 'B' & 'C' having 35 subjects each. Group'A' constitutes patients having strong clinical evidence of oral pre-malignant lesions (PML). Group 'B' includes histologically proven oral squamous cell carcinoma (OSCC) and Group 'C' comprised disease free subjects as controls. After taking informed consent, relevant clinical history was recorded on institutional approved performa. Saliva from all subjects was procured by standard 'drooling method'. Samples were stored at +4°C and later transferred to Laboratory to store at-20°C before further process. Samples were centrifuged at 4500 rpm for 15 minutes at 4°C. Cell pellets sediments were used for identification of HPV-16 & 18 by real-time PCR method. Data was entered and analysed using SPSS version 16. P-value of 0.05 was taken as standard. In group 'A', HPV-16 was detected in 3 (8.6%) cases while HPV-18 was not detected in any of the subject. In group 'B', HPV-16 was detected in 07 (20%) while HPV-18 was found in 06 (17.1%) cases. Mixed HPV-16 and HPV-18 were found in 02 (5.7%) cases. In group 'C', HPV-16 was detected in 03(8.6%) while HPV-18 was not detected in any of the subjects. Significant relationship was observed between the groups for HPV-18 detection (P= 0.002) while for HPV-16, no significant association was found (P= 0.245). HPV infection for the causation of oral cancer cannot be fully established possibly due to small sample size. More over differences in genetic makeup, environment, indulgence in peculiar risk factor habits, sexual practices and

Unveiling the 'unique bone': a study of the distribution of focal clavicular lesions

International Nuclear Information System (INIS)

Suresh, S.; Saifuddin, A.

2008-01-01

Clavicle is a unique bone for many reasons. There is no study discussing the differential diagnosis of clavicular lesions based on the site of occurrence or age at presentation. This study aims to determine whether the distribution of lesions affecting the clavicle and age at presentation aid in the differential diagnosis of focal clavicular lesions. Clinical notes, imaging and histopathological reports of the clavicular lesions between Jan 1999 and Jan 2006 were reviewed. Virtually, all patients had been referred as suspected neoplasm. Fifty-nine patients were identified. Patients 50 years (n=18) had predominantly malignant lesions. The lesions most commonly affected the medial third (n=35) and were predominantly non-neoplastic or benign. The middle third was affected in 15 patients and showed both benign and malignant lesions. The lateral third was least affected with predominance of malignant lesions. The clavicle is not a primary common site for any particular tumour; hence, diagnosis of the lesions can be challenging. Our study has suggested that few factors like age and site of the lesions may be helpful in diagnosis. (orig.)

Evaluation of breast lesions by contrast enhanced ultrasound: Qualitative and quantitative analysis

International Nuclear Information System (INIS)

Wan Caifeng; Du Jing; Fang Hua; Li Fenghua; Wang Lin

2012-01-01

Objective: To evaluate and compare the diagnostic performance of qualitative, quantitative and combined analysis for characterization of breast lesions in contrast enhanced ultrasound (CEUS), with histological results used as the reference standard. Methods: Ninety-one patients with 91 breast lesions BI-RADS 3–5 at US or mammography underwent CEUS. All lesions underwent qualitative and quantitative enhancement evaluation. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance of different analytical method for discrimination between benign and malignant breast lesions. Results: Histopathologic analysis of the 91 lesions revealed 44 benign and 47 malignant. For qualitative analysis, benign and malignant lesions differ significantly in enhancement patterns (p z1 ), 0.768 (A z2 ) and 0.926(A z3 ) respectively. The values of A z1 and A z3 were significantly higher than that for A z2 (p = 0.024 and p = 0.008, respectively). But there was no significant difference between the values of A z1 and A z3 (p = 0.625). Conclusions: The diagnostic performance of qualitative and combined analysis was significantly higher than that for quantitative analysis. Although quantitative analysis has the potential to differentiate benign from malignant lesions, it has not yet improved the final diagnostic accuracy.

Localization of occult breast lesions: mammographic findings in non infiltrating carcinoma; Localizacion de lesiones ocultas de mama: hallazgos mamograficos del carcinoma no infiltrante

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Paul, L; Iribar, M; Vilarrasa, A; Lopez, M A; Hernandez, R; Carrasco, A [Departamento de Radiodiagnostico, Hospital Doce de Octubre, Madrid (Spain)

1995-08-01

A review was carried out of 169 biopsies of occult breast lesions, 32 of which were malignant. The radiological findings associated with in situ carcinomas were compared with those of malignant lesions in general. The signs that permit the detection of breast carcinoma in the earliest stages are described, and the positive predictive value of signs, such as a spicular form, clusters of microcalcifications, nodules and architectural disturbances, is discussed. Given the lack of specificity of these findings, many beginning lesions should be biopsied to ensure an early diagnosis of breast cancer. (Author)

Evaluation of the Significance of Incidental Breast Lesions Detected by Chest CT

International Nuclear Information System (INIS)

Kim, Jae Hyun; Chang, Yun Woo; Hwang, Jung Hwa; Kim, Hyung Hwan; Lee, Eun Hye; Yang, Seung Boo

2013-01-01

To evaluate the significance of incidentally detected breast lesions on a chest CT scan. Thirty-six incidental breast lesions in 26 patients were detected on a chest CT scan and were correlated with breast sonography, retrospectively. Among them, twenty-four breast lesions in 20 patients that were correlated with chest CT and sonography were available to pathology or follow up sonography. The CT findings were compared with sonographic findings according to the pathologic results. Incidentally detected breast lesions on a chest CT scan were correlated with sonography in 86% (31/36). Among 24 lesions that were available to pathology or follow up sonography, seven (29.2%) lesions were malignant and 17 (70.8%) lesions were benign. CT revealed a significant difference between benign and malignant lesions in terms of shape and margin (p = 0.007; p = 0.008, respectively). The CT findings were well correlated with sonographic findings in shape and margin (p = 0.001, respectively). Incidentally detected breast lesions on chest CT can be correlated with sonography. An irregular shape or a non-circumscribed margin of breast lesions on a CT scan can be considered as a suggestive sign of malignancy.

Xeroderma Pigmentosum With Early And Rapid Development Of Malignancy

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Ghosh Arghyaprasum

2000-01-01

Full Text Available A case of xeroderma pigmentosum in a 9 year old developing multiple tumours over a short period of 6 months is reported. The tumours showed two different types of malignancies-squamous cell carcinoma and malignant melanoma. Two other siblings exhibited cutaneous lesions of xeroderma pigmentosum without any malignant change.

Value of Quantitative Three-dimensional Doppler Ultrasound in the Differentiation of Benign and Malignant Thyroid Nodules.

Science.gov (United States)

Li, Wen-Bo; Zhang, Bo; Jiang, Yu-Xin; Zhu, Qing-Li; Zhang, Qing; Sun, Jian

2015-06-01

To investigate the role of quantitative three-dimensional (3D) power Doppler ultrasound in differentiating malignant and benign thyroid nodule. A total of 92 lesions in 86 patients were preoperatively examined using 3D power Doppler ultrasound. The Virtual Organ Computer-aided Analysis(VOCAL)-imaging program was used to analyze the stored volume ultrasound. The differences in the mean gray value (MG), vascularization index (VI), flow index(FI), and vascularization flow index (VFI) were compared between benign and malignant lesions. The MG of the malignant thyroid nodules was significantly lower than that of the benign ones (28.27±7.21 vs. 32.89±8.73,P=0.007). The benign nodules had significantly higher VI,FI,and VFI than the malignant nodules [VI:(40.43±26.55)% vs. (26.87±23.06)%,P=0.011;FI:41.03±7.19 vs. 37.51±7.17,P=0.022;VFI:18.23±14.60 vs. 11.47±12.47, P=0.009]. Also,76.5% (39/51) of the malignant nodules and 92.7% (38/41) of the benign nodules had higher VIs in the shell of the lesion than that of the whole lesion,and 80.4%(41/51) of the malignant nodules and 95.1% (39/41) of the benign nodules had higher FIs in the shell of the lesion than that of the whole lesion. Quantitative 3D power Doppler ultrasound provides a useful tool in distinguishing benign and malignant thyroid nodules. The malignant thyroid nodules have lower echoes than the benign nodules, wherese the benign nodules have larger blood flow than the malignant nodules.

Differential diagnosis of benign and malignant breast masses using diffusion-weighted magnetic resonance imaging.

Science.gov (United States)

Min, Qinghua; Shao, Kangwei; Zhai, Lulan; Liu, Wei; Zhu, Caisong; Yuan, Lixin; Yang, Jun

2015-02-07

Diffusion-weighted magnetic resonance imaging (DW-MRI) is different from conventional diagnostic methods and has the potential to delineate the microscopic anatomy of a target tissue or organ. The purpose of our study was to evaluate the value of DW-MRI in the diagnosis of benign and malignant breast masses, which would help the clinical surgeon to decide the scope and pattern of operation. A total of 52 female patients with palpable solid breast masses received breast MRI scans using routine sequences, dynamic contrast-enhanced imaging, and diffusion-weighted echo-planar imaging at b values of 400, 600, and 800 s/mm(2), respectively. Two regions of interest (ROIs) were plotted, with a smaller ROI for the highest signal and a larger ROI for the overall lesion. Apparent diffusion coefficient (ADC) values were calculated at three different b values for all detectable lesions and from two different ROIs. The sensitivity, specificity, positive predictive value, and positive likelihood ratio of DW-MRI were determined for comparison with histological results. A total of 49 (49/52, 94.2%) lesions were detected using DW-MRI, including 20 benign lesions (two lesions detected in the same patient) and 29 malignant lesions. Benign lesion had a higher mean ADC value than their malignant counterparts, regardless of b value. According to the receiver operating characteristic (ROC) curve, the smaller-range ROI was more effective in differentiation between benign and malignant lesions. The area under the ROC curve was the largest at a b value of 800 s/mm(2). With a threshold ADC value at 1.23 × 10(-3) mm(2)/s, DW-MRI achieved a sensitivity of 82.8%, specificity of 90.0%, positive predictive value of 92.3%, and positive likelihood ratio of 8.3 for differentiating benign and malignant lesions. DW-MRI is an accurate diagnostic tool for differentiation between benign and malignant breast lesions, with an optimal b value of 800 s/mm(2). A smaller-range ROI focusing on the

Categorization and evaluation of usefulness of breast lesions with using ultrasound BI-RADS (breast imaging reporting and data system)

International Nuclear Information System (INIS)

Kim, Youn Jeong; Choi, Hye Young; Moon, Byung In; Lee, Shi Nae

2006-01-01

The aim of our study was to determine the positive predictive value (PPV) and to evaluate the usefulness on ultrasound BI-RADS, as compared with the histologic results of breast lesions that were categorized and classified by the ultrasound BI-RADS lexicon. Between January and December 2004, the ultrasound features of 471 breast lesions in 368 patients were analyzed and categorized with using ultrasound BI-RADS. All of the lesions were compared with the histological results. We categorized category 2 and 3 lesions as benign lesions, and category 4 and 5 lesions as malignant lesions. We then calculated the sensitivity, specificity, positive, predictive value, negative predictive value and accuracy. The breast lesions were histologically diagnosed as 298 cases of category 2, 21 cases of category 3, 108 cases of category 4 and 44 cases of category 5. The categorical malignancy rate was 1% (3/298) in category 2 lesions, 4.7% (1/21) in category 3 lesions, 8.3% (9/108) in category 4 lesions and 90.9% (40/44) in category 5 lesions. Within category 4, the malignancy rate for category 4a lesions was 5.4% (5/92), the malignancy rate for category 4b lesions was 1.3% (1/8) and the malignancy rate for category 4c lesions was 50% (4/8). The sensitivity, specificity, positive predictive value and negative predictive value were 90.6%, 75.1%, 31.6% and 98.4%, respectively. The statistically valid ultrasound features that were correlated with malignancy were an ill defined margin, a microlobulated mass, an irregular mass, inhomogenic echogenicity, an echogenic halo and an older patient age. Ultrasound BI-RADS was useful in differentiating benign from malignant breast lesions

Application of whole-lesion histogram analysis of pharmacokinetic parameters in dynamic contrast-enhanced MRI of breast lesions with the CAIPIRINHA-Dixon-TWIST-VIBE technique.

Science.gov (United States)

Li, Zhiwei; Ai, Tao; Hu, Yiqi; Yan, Xu; Nickel, Marcel Dominik; Xu, Xiao; Xia, Liming

2018-01-01

To investigate the application of whole-lesion histogram analysis of pharmacokinetic parameters for differentiating malignant from benign breast lesions on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). In all, 92 women with 97 breast lesions (26 benign and 71 malignant lesions) were enrolled in this study. Patients underwent dynamic breast MRI at 3T using a prototypical CAIPIRINHA-Dixon-TWIST-VIBE (CDT-VIBE) sequence and a subsequent surgery or biopsy. Inflow rate of the agent between plasma and interstitium (K trans ), outflow rate of agent between interstitium and plasma (K ep ), extravascular space volume per unit volume of tissue (v e ) including mean value, 25th/50th/75th/90th percentiles, skewness, and kurtosis were then calculated based on the whole lesion. A single-sample Kolmogorov-Smirnov test, paired t-test, and receiver operating characteristic curve (ROC) analysis were used for statistical analysis. Malignant breast lesions had significantly higher K trans , K ep , and lower v e in mean values, 25th/50th/75th/90th percentiles, and significantly higher skewness of v e than benign breast lesions (all P 0.05). The 90th percentile of K trans , the 90th percentile of K ep , and the 50th percentile of v e showed the greatest areas under the ROC curve (AUC) for each pharmacokinetic parameter derived from DCE-MRI. The 90th percentile of K ep achieved the highest AUC value (0.927) among all histogram-derived values. The whole-lesion histogram analysis of pharmacokinetic parameters can improve the diagnostic accuracy of breast DCE-MRI with the CDT-VIBE technique. The 90th percentile of K ep may be the best indicator in differentiation between malignant and benign breast lesions. 4 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2018;47:91-96. © 2017 International Society for Magnetic Resonance in Medicine.

Differential diagnosis of benign and malignant breast tumors by high frequency molybdenum-target X-ray photography

International Nuclear Information System (INIS)

Mai Yuanqi; Wang Maosheng; Huang Jian; Cui Guoru; Liang Zhicong; Lu Yingying

2008-01-01

Objective: To explore the X-ray Image of benign and malignant breast lesions (tumors) in order to improve their differcatial diagnostic level. Methods: X-ray image changes of 63 malignant breast neoplasms were described by the mammography and in comparision with those of 43 benign masses. Results: The accordance percentages between the X-ray and histological examinations for the benign and malignant neoplasms were shown as 85% and 90.6% respectively. Spiculated mass, calcification granules in clusters and other images were found to be indication of benign or malignant breast lesion. Conclusion: The High Frequency Molybdenum-target X-ray Photography can provide effective imaging data for diagnosis and distinguish between the benign and malignant breast lesions. (authors)

Does Lesion Size Affect the Value of Shear Wave Elastography for Differentiating Between Benign and Malignant Thyroid Nodules?

Science.gov (United States)

Wang, Fen; Chang, Cai; Chen, Min; Gao, Yi; Chen, Ya-Ling; Zhou, Shi-Chong; Li, Jia-Wei; Zhi, Wen-Xiang

2018-03-01

We aimed to investigate the diagnostic performance of shear wave elastography (SWE) combined with conventional ultrasonography (US) for differentiating between benign and malignant thyroid nodules of different sizes. A total of 445 thyroid nodules from 445 patients were divided into 3 groups based on diameter (group 1, ≤ 10 mm; group 2, 10-20 mm; and group 3, > 20 mm). The mean elasticity index of the whole lesion was automatically calculated, and the threshold for differentiation between benign and malignant nodules was constructed by a receiver operating characteristic curve analysis. Diagnostic performances of conventional US and SWE were compared by using pathologic results as reference standards. The mean elasticity was significantly higher in malignant versus benign nodules for all size groups. The differences in mean elasticity in the size groups were not statistically significant for malignant or benign nodules. The specificity of US combined with SWE for group 1 was significantly higher than that for groups 2 and 3 (77.8% versus 62.9% and 53.3%; P < .05), and compared with group 1, the sensitivity was significantly higher for groups 2 and 3 (92.4% and 94.3% versus 80.7%; P < .05). When SWE was added, the specificity increased and the sensitivity and diagnostic accuracy decreased for group 1, and the sensitivity increased and the specificity decreased for groups 2 and 3; however, the differences were not significant. Combined with SWE, US yielded higher specificity for nodules of 10 mm and smaller and higher sensitivity for nodules larger than 10 mm. © 2017 by the American Institute of Ultrasound in Medicine.

Adrenal lesions encountered in current medical practice − a review of their radiological imaging

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Vanesha Naidu

2013-11-01

Full Text Available Modern radiological technology has transformed the way that adrenal lesions are currently investigated. The contemporary radiologist has been catapulted to the forefront in the management of adrenal disease. With the increasing use of cross-sectional imaging, adrenal lesions are being serendipitously discovered in radiological studies undertaken for non-adrenal-related conditions – the so-called adrenal ‘incidentaloma’. This review discusses the imaging modalities available for characterising these lesions, highlighting current concepts and controversies in differentiating benign from malignant pathology. The article also provides a brief overview of the spectrum of adrenal pathology commonly encountered in the adult population.

Guide for the realization of core needle biopsy through stereotaxy in the diagnosis of suspicious breast lesions of malignity

International Nuclear Information System (INIS)

Jimenez Zuniga, Jorge Luis

2012-01-01

Guides have been made for the realization of breast biopsies through stereotaxy in the management of breast lesions. The type of injuries that have been detected in mammography services, most have corresponded to nonpalpable lesions, that should be clarified through the take samples for an histological study with the purpose of categorize them. A bibliographic review was realized of the findings most frequent in the breast pathology. Also, before a nonpalpable breast lesion that requires a diagnosis biopsy, should be assessed the method of suitable guide for to access the same. The interventionist procedures of the breast have been developed in last years and have been guided by stereotaxy, in order to preoperative localization of these lesions or for obtaining valid cytologic-histologic material to reach a diagnosis, as it has often been difficult to differentiate, just for the image, between benign and malignant lesions. Thus, has emerged the necessity to guide the needle tip objectifying the lesion through mammography. A localization system based on triangulation is applied. The location of the lesion is calculated in the three axes of space (X, Y and Z) with a minimum error. The stereotactic devices have created to guide needles to injuries from a unique projection. This has allowed that breast and lesion are subject on a site while have taken samples several times. The complete mammography study that include the projections craniocaudal (CC) and mediolateral oblique (MLO) are analyzed to find out exactly on which quadrant has found the injury. Sometimes, the injury only has observed in a unique projection which is used for locating. The two main devices that have been used to perform stereotactic biopsy are automatic gun of biopsy and vacuum-assisted directional biopsy. Automatic gun of biopsy has used a long needle tru-cut type, with calibers between 18 and 14, although it is preferred 14-gauge needles. Multiple samples obtained from this needle have

Value of {sup 18}F-FDG PET/CT in the detection of ovarian malignancy

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Park, Tae Gyu; Lee, Si Nae; Park, So Yeon [Dept. of Nuclear Medicine, Korea University Guro Hospital, Seoul (Korea, Republic of); and others

2015-03-15

Ovarian cancer is a leading cause of gynecologic malignancy. As symptoms of ovarian cancer are nonspecific, only 20 % of ovarian cancers are diagnosed while they are still limited to the ovaries. Thus, early and accurate detection of disease is important for an improved prognosis. For the accurate and effective diagnosis of ovarian malignancy on {sup 18}F-fluorodeoxyglucose ({sup 18}F--FDG) positron emission tomography/computed tomography (PET/CT), we analyzed several parameters, including visual assessment. A total of 51 peritoneal lesions in 19 patients who showed ovarian masses with diffuse peritoneal infiltration were enrolled. Twelve patients were confirmed to have ovarian malignancy and seven patients with benign disease by pathologic examination. All patients were examined by {sup 18}F--FDG PET/CT, and an additional 2-h delayed {sup 18}F--FDG PET/CT was also performed for 15 patients with 42 peritoneal lesions. We measured semiquantitative parameters including maximum and mean standardized uptake values (SUV{sub max}, SUV{sub mean}), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) on a 1-h initial {sup 18}F--FDG PET/CT image (Parameter1) and on a 2-h delayed image (Parameter2). Additionally, retention indices of each parameter were calculated, and each parameter among the malignant and benign lesions was compared by Mann-Whitney U test. We also assessed the visual characteristics of each peritoneal lesion, including metabolic extent, intensity, shape, heterogeneity, and total visual score. Associations between visual grades and malignancy were analyzed using linear by linear association methods. Moreover, a receiver operating characteristic (ROC) curve was analyzed to compare the effectiveness of significant parameters. In a comparison between the malignant and benign groups in the analysis of 51 total peritoneal lesions, SUV{sub max1}, SUV{sub mean1}, and TLG1 showed significant differences. Also, in the analysis of 42 peritoneal lesions

Mammographic evaluation of suspicious malignant lesions based on ACR(American College of Radiology) breast imaging reporting and data system(BI-RADS)

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Lee, Jei Hee; Oh, Ki Keun; Chang, So Yong; Kim, Eun Kyung; Kim, Mi Hye [Yonsei Univ. College of Medicine, Research Institute of Radiological Science, Yonsei Univ., Seoul (Korea, Republic of)

1999-12-01

The purpose of this study was to assess the mammographic features and pathologic outcome of category 4 lesions using the Breast Imaging Reporting and Data System(BI-RADS), and to evaluate the significance of final assessment categories. Using BI-RADS, the interpretations of 8,134 mammograms acquired between January 1997 and May 1998 were categorized. From among 161 lesions categorized as '4' ('suspicious abnormality') and pathologically confirmed by surgery or biopsy, we analysed 113, found in 66 patients. The pathologic outcome of these 113 lesions was as follows:infiltrating ductal carcinoma, 17.7%(20/113); DCIS(ductal carcinoma in sitv), 8.0%(9/113); ADH(atypical ductal hyperplasia), 5.3%(6/113); DEH(ductal epithelial hyperplasia), 1.8%(2/113); ductectasia, 0.9%(1/113), FCD(fibrocystic change), 27.4%(31/113); firoadenoma, 7.1%(8/113); stromal fibrosis, 9.7%(11/113); normal parenchyma, 7.1%(8/113); other pathology, 15.0%(17/113). The most frequent mammographic features of BI-RADS category 4 lesions were irregular mass shape(41.2%), spiculated mass margin(52.3%), amorphous calcification(47.3%) and clustered calcification distribution(37.1%). Because category 4 lesions account for about 25.7% of all breast malignancies, mammographic lesions in this category ('suspicious abnormality') should be considered for supplementary study and breast biopsy rather than short-term follow-up. Initial pathologic findings can thus be confirmed.

Dynamics of contrast enhancement in MR imaging and power Doppler ultrasonography of solid breast lesions

International Nuclear Information System (INIS)

Reinikainen, H.; Paeaekkoe, E.; Suramo, I.; Paeivaensalo, M.; Rissanen, T.

2002-01-01

Purpose: To evaluate the dynamics of contrast enhancement in solid breast lesions at contrast-enhanced MR imaging and power Doppler ultrasonography (US) and to compare the methods to histology and to each other. Material and Methods: Forty breast lesions were prospectively examined with dynamic MR and power Doppler US. Time-signal intensity curves of enhancement were obtained for both methods. The shape of the curve was analyzed to be benign, indeterminate or malignant. The curves were also analyzed quantitatively by calculating the slope of the curve and the area under the curve (both methods), relative enhancement (MR), and time to peak (US). The lesions were divided into malignant lesions, fibroadenomas, and other benign lesions. The results were compared to histology. Results: In the subjective analysis of the MR curve in differentiating between benign and malignant lesions the accuracy was 90%. The MR curve also enabled differentiation between fibroadenomas and malignancies. The accuracy of the US curve was 38%. Quantitatively, statistically significant differences were found using all the MR variables, except between malignancies and fibroadenomas. Using the US variables, no significant difference was found between the groups. Conclusion: The dynamics of contrast-enhanced MR were reliable in the differential diagnosis of solid breast lesions, but contrast-enhanced power Doppler US was of limited value

How much we know about bisphosphonate lesions

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Pešić Zoran

2016-01-01

Full Text Available Introduction: Bisphosphonate drugs are used in the treatment of the osteoporosis and malignant processes in the bone tissue. As a result of this use bisphosphonate lesions are formed in bone tissue and oral mucosis, which representing a remarkable therapeutic problem. The aim of this study was to determine how many dentists in general practice are familiar with the character, diagnosis and therapy bisphosphonate lesions. Material and Methods: An anonymous questionnaire of 13 questions was conducted in dental practices in Nis County in the period from October 2015 to December 2015. The obtained data were statistically analyzed. Results: A total of 60% dentists knew what drugs are used in the treatment of osteoporosis and malignant processes in the bones. 25% knew what the bisphosphonate bone lesions are . 66, 6% of dentists knewn what is the prevention of bisphosphonate lesions. 63.3% of dentists are aware of the complications bisphosphonate lesions. Conclusion: Dentists in general practices are insufficiently familiar with the character, diagnosis and treatment of bisphosphonate lesions. We should activate all entities that participate in more continuous medical education, in order to achieve a higher level of prevention of these therapeutic ungrateful lesions.

Malignant pleural mesothelioma

International Nuclear Information System (INIS)

Wentz, K.U.; Irngartinger, G.; Georgi, P.; Kaick, G. van; Kleckow, M.; Vollhaber, H.H.; Deutsches Krebsforschungszentrum, Heidelberg; Krankenhaus Rohrbach

1986-01-01

In 34 patients with suspected malignant pleural mesothelioma the results of computed tomography are compared with the findings of 67 Ga-scintigraphy. The differential diagnosis of 14 pleural mesotheliomas, 7 pleural carcinoses, 10 inflammatory and 3 other pleural diseases is performed more accurately by CT than by scintigraphy. 67 Ga uptake depends on the thickness of inflammatory as well as malignant lesions. Thus, numerous pleural processes that can be localised by CT escape scintigraphic detection, CT is indicated if there is clinical and radiological suspicion of pleural mesothelioma; in that case, there is hardly any indication for 67 Ga scintigraphy. (orig.)

Role of FDG/CT in imaging of renal lesions

International Nuclear Information System (INIS)

Kochhar, R.; Manoharan, P.; Brown, R.K.; Dunnick, N.R.; Frey, K.A.; Wong, C.O.

2010-01-01

Full text: Focal incidental renal lesions are commonly encountered on positron emission tomography (PET)/computed tomography (CT) imaging. The wast majority of these lesions are benign. However, the interpretation of renal lesions can be problematic if the imaging criteria of simple cysts are not met. Limited literature exists on the characterisation of renal masses with metabolic imaging. The purpose of this article is to focus on the imaging features of benign and malignant renal masses with PET/CT. The lesions discussed include renal cyst, angiomyolipoma, oncocytoma, renal cell carcinoma, renal metastases and other infiltrating neoplastic processes affecting the kidney. Both the anatomical and metabolic features which characterise these benign and malignant entities are described. We emphasise the importance of viewing the CT component to identify the typical morphological features and discuss how to best use hybrid imaging for management of renal lesions. Metabolic imaging has a promising role in the imaging of renal lesions and can help prevent unnecessary biopsies and ensure optimal management of suspicious lesions.

The value of T/NT in FDG imaging with a coincidence camera for diagnosis of pulmonary nodules and mass lesions

International Nuclear Information System (INIS)

Sun Da; Zhan Hongwei; Xu Wei; Ye Xiaojuan; Liu Qichang

2004-01-01

Objectives: To assess the value of T/NT in FDG imaging with a coincidence camera for diagnosis of pulmonary nodules and mass lesions. Methods: 18F-FDG imaging were performed in 57 patients with a mean age of 62.18 (range from 33 83 years old) for diagnosis of pulmonary nodules and mass lesions using a gamma camera with 1 inch crystal in coincidence mode (Siemens E.comduet). 175 296 MBq (5 8 mci) of 18F-FDG was given by iv on an empty stomach at least for 6 hours, and a whole body imaging without brain and legs was performed after 40 60 minutes. The count rate of target ROI and no-target ROI (T/NT) were calculated as a semiquantative analysis to differentiate malignant from inflammatory lesions. The result was compared with CT, MRI, and/or pathology. Results: The mean value of T/NT in malignant lesions (N=45) in lungs is 4.32 (range 1.61 10.62). But it is 1.52 (range 1.37 1.95) in inflammatory lesions (N=17) in lungs, and 4.09 (range 2.2 7.01) in lung tuberculosis lesions (N=5). In 45 malignant, the value of T/NT is less than 2.0 in only 3 lesions. So the overlapping of T/NT value is very little between malignant and inflammatory lesions. But there is full overlapping of T/NT value between malignant and tuberculosis lesions. Conclusions: Focal pulmonary nodules and mass lesions are commonly encountered in clinical practice, and PET with 18F-FDG has proved to be an accurate noninvasive test for identifying pulmonary malignant lesions. The technique of semiquantity with T/NT is useful to differentiate malignant from inflammatory lesions. But it is invalidate for distinguishing malignant from tuberculosis lesions. (authors)

HuR and podoplanin expression is associated with a high risk of malignant transformation in patients with oral preneoplastic lesions.

Science.gov (United States)

Habiba, Umma; Kitamura, Tetsuya; Yanagawa-Matsuda, Aya; Higashino, Fumihiro; Hida, Kyoko; Totsuka, Yasunori; Shindoh, Masanobu

2016-11-01

The risk of malignant transformation in oral preneoplastic lesions (OPLs) is challenging to assess. The objective of the present study was to determine the expression of ELAV like RNA binding protein 1 (HuR) and podoplanin in OPLs, and to evaluate the use of each protein as biomarkers for the risk assessment of malignant transformations. Immunohistochemistry for HuR and podoplanin was performed on the tissues of 51 patients with OPL, including cases of low grade dysplasia (LGD) and high grade dysplasia (HGD). The association between the protein expression patterns and clinicopathological parameters, including oral cancer free survival (OCFS) time, was analyzed during the follow-up period. HuR and podoplanin expression was observed in 28 (55%) and 36 (71%) of 51 patients, respectively. Kaplan-Meier analysis showed that the expression of HuR and podoplanin was associated with the risk of progression to oral cancer (P<0.05). Multivariate analysis revealed that HuR and podoplanin expression was associated with a 2.93-fold (95% confidence interval (CI), 0.98-10.34; P=0.055) and 2.06-fold (95% CI, 0.55-8.01; P=0.283) increase in risk of malignant transformation, respectively. The risk of OPL malignant transformation was considerably increased with the coexpression of HuR and podoplanin compared with the histological grading (95% CI, 1.64-23.59; P=0.005). The results of the present study demonstrated that the expression of HuR and podoplanin associates with malignant transformation and suggests that the proteins may be used as biomarkers to identify OPL patients with an increased risk of cancer development.

MRI-only lesions: application of diffusion-weighted imaging obviates unnecessary MR-guided breast biopsies

Energy Technology Data Exchange (ETDEWEB)

Spick, Claudio; Pinker-Domenig, Katja; Helbich, Thomas H.; Baltzer, Pascal A. [Medical University of Vienna (AKH), General Hospital Vienna, Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Wien (Austria); Rudas, Margaretha [Medical University of Vienna (AKH), Clinical Institute of Pathology, Wien (Austria)

2014-06-15

To assess if the application of diffusion-weighted imaging (DWI) obviates unnecessary MR-guided biopsies in suspicious breast lesions visible only on contrast-enhanced MRI (CE-MRI). This institutional review board (IRB)-approved, retrospective, single-centre study included 101 patients (mean age, 49.5; SD 13.9 years) who underwent additional DWI at 1.5 T prior to MRI-guided biopsy of 104 lesions classified as suspicious for malignancy and visible on CE-MRI only. An experienced radiologist, blinded to histopathologic and follow-up results, measured apparent diffusion coefficient (ADC) values obtained from DWI. Diagnostic accuracy was investigated using receiver operating characteristics (ROC) analysis. Histopathology revealed 20 malignant and 84 benign lesions. Lesions were masses in 61 (15 malignant, 24.6 %) and non-masses in 43 cases (five malignant, 11.6 %). Mean ADC values were 1.53 ± 0.38 x 10{sup -3} mm{sup 2}/s in benign lesions and 1.06 ± 0.27 x 10{sup -3} mm{sup 2}/s in malignant lesions. ROC analysis revealed exclusively benign lesions if ADC values were greater than 1.58 x 10{sup -3} mm{sup 2}/s. As a consequence, 29 false-positive biopsies (34.5 %) could have been avoided without any false-negative findings. Both in mass and in non-mass lesions, rule-in and rule-out criteria were identified using flexible ADC thresholds based on ROC analysis. Additional application of DWI in breast lesions visible only on MRI can avoid false-positive, MR-guided biopsies. Thus, DWI should be an integral part of breast MRI protocols. (orig.)

Role of diffusion-weighted MR imaging in characterization of cervical lesions

International Nuclear Information System (INIS)

Salik, E.; Islim, F.; Ciftci, G.; Bayramoglu, S.; Sever, N.

2012-01-01

Full text: Introduction: Characterization of neck lesions is usually not possible without histopathological examination. Objective: To evaluate whether adhesion diffusion coefficient (ADC) values calculated from diffusion weighted magnetic resonance imaging can be used to characterize neck lesions. Material and methods: Diffusion-weighted echo planar MR imaging with b factors of 0, 500 and 1000 sec/mm 2 was prospectively performed with a 1.5 T MR unit in 119 neck lesions in 119 patients. ADC values were measured by 2 radiologists independently on an independent workstation console. Intraclass correlation coefficients were calculated. The mean ADC values were compared using Mann-whitney u test. Results: There was a statistically significant difference between the mean ADC values of benign and malign solid lesions (1.13±0.62 x 10 -3 mm 2 /s and 0.82±0.21 x 10 -3 mm 2 /s respectively). There was no malign lesion with an ADC value more than 1.15 x 10 -3 mm 2 /s. The mean ADC value of malignant lymphomas (0.61±0.14 x 10 -3 ) was significantly smaller than the mean ADC values of other cervical lymphadenopathies. But there was no statistically significant difference between the mean ADC values of reactive, granulomatous and metastatic lymph nodes. Conclusion: ADC values cannot totally distinguish the histopathological subgroups of the neck lesions but shows significant differences between malign and benign lesions.

Pitfalls and recommendations in cases of laser removal of decorative tattoos with pigmented lesions: case report and review of the literature.

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Pohl, Laura; Kaiser, Kathrine; Raulin, Christian

2013-09-01

Pigmented lesions in decorative tattoos cause diagnostic difficulties at a clinical and dermoscopic level. In cases of laser removal of tattoos, hidden suspicious nevi may be revealed gradually. We describe the first case of a malignant melanoma that developed on a preexisting nevus within a tattoo during and between the phases of laser removal. The patient refused to undergo excision of the nevus until we made excision conditional for continued laser treatment. The English literature reports 16 cases of malignant melanoma developing in tattoos. Correlation between the placement of tattoos and the development of malignant melanoma remains unclear. Our case emphasizes the diagnostic problems of pigmented lesions within tattoos. For safety reasons, tattoos should never be placed on pigmented lesions; if they are, the tattoos should not undergo laser treatment. We suggest an excision before starting laser tattoo removal. Dermoscopic assessments on a regular basis during the period of tattoo removal are recommended.

Computed-Tomography-Guided Percutaneous Core Needle Biopsies of Suspected Malignant Lymphomas: Impact of Biopsy, Lesion, and Patient Parameters on Diagnostic Yield

International Nuclear Information System (INIS)

Hesselmann, V.; Zaehringer, M.; Krug, B.; Wesselmann, C.; Haferkamp, K.; Wickenhauser, C.; Lackner, K.

2004-01-01

Purpose: To investigate the diagnostic yield of core needle biopsy in patients with malignant lymphoma. Material and Methods: Computed-tomography-guided core needle biopsies in patients with malignant lymphoma performed in the period 1996 to 2001 were evaluated retrospectively. A biopsy was considered as 'fully diagnostic' if a histological diagnosis, including the histologic subtype in the event of malignant lymphoma, was achieved and the clinical course and CT follow-up of at least 6 months confirmed the biopsy results. A biopsy was regarded as 'partly diagnostic' if histological work-up defined malignant lymphoma but not the histological subtype, and if histological diagnosis bore therapeutic relevance. Diagnostic yield was correlated with features such as size of specimen, location and depth of the target lesion, and experience of the investigator. Results: 45 biopsies were performed in 40 patients. With respect to definite histopathological diagnosis, 31 biopsies (68.9%) were diagnostic and 14 (31.1%) non-diagnostic. In 4 cases (8.8%), biopsies yielded partly diagnostic results, since therapy could be scheduled after biopsy without final sub-classification. Statistical analysis of biopsy parameters revealed that sample sizes were significantly larger in the diagnostic group. Conclusion: CT-guided biopsy can be considered as an alternative for lymphoma diagnosis and should be the first interventional procedure. The most important parameter for diagnostic success is the size of the specimen

The correlation between the ultrasonic elastic strain ratio of thyroid cancer and the malignant biological characteristics of cancer cells in the lesions

OpenAIRE

Li Ma; Rong Zhou; Yun-Zhu Li

2017-01-01

Objective: To study the correlation between the ultrasonic elastic strain ratio of thyroid cancer and the malignant biological characteristics of cancer cells in the lesions. Methods: A total of 90 patients with thyroid cancer who accepted surgical treatment in our hospital between March 2015 and September 2016 were selected as the observation group, and 50 patients who received surgery in our hospital during the same period and were with clear pathological diagnosis of thyroid...

Minimal invasive biopsy results of 'uncertain malignant potential' in digital mammography screening. High prevalence but also high predictive value for malignancy

International Nuclear Information System (INIS)

Weigel, S.; Heindel, W.; Universitaetsklinikum Muenster; Decker, T.; Universitaetsklinikum Muenster; Korsching, E.; Biesheuvel, C.; Woestmann, A.; Boecker, W.; Hungermann, D.; Roterberg, K.; Tio, J.

2011-01-01

Purpose: To evaluate the rate, the histological spectrum and the positive predictive value (PPV) for malignancy of minimally invasive biopsies with 'uncertain malignant potential (B3)' in digital mammography screening. Methods and Materials: Consecutive data of 37 178 participants of one digital unit of the German screening program were included. Results: The B 3 rate was 15.1 % (148/979). The frequencies of lesion subtypes were as follows: atypical epithelial proliferation of ductal type (AEPDT) 35.1 % (52/148), radial scar (RS) 28.4 % (42/148), papillary lesions (PAP) 20.3 % (30/148), lobular carcinoma in situ 8.8 % (13/148), flat epithelial atypia 5.4 % (8/148), and mucocele-like lesions 2.0 % (3/148). The PPV for malignancy in surgical excisions was overall 0.28 (25/91); in detail 0.40 (19/47) for AEPDT, 0.20 (5/25) for RS, 0.08 (1/12) for PAP. Conclusion: Despite a higher B 3 rate of minimally invasive biopsies with 'uncertain malignant potential' in digital screening, the benign surgical biopsy rate is not disproportionally increased compared with analog screening programs. Together with defined management protocols, this results in an increased cancer detection rate per screening participant with surgical excision. (orig.)

Diffusion magnetic resonance imaging of breast lesions: Initial ...

African Journals Online (AJOL)

Hebatallah Hassan Mamdouh Hassan

2013-03-31

Mar 31, 2013 ... breast cancer.2 Additional lesions seen by MRI that are not visible on ... characterization of lesions as benign or malignant on the basis ... lular density associated with numerous intact cell ..... ence for ADC values between the two MRI devices, the lesions .... Magnetic resonance imaging of brain and spine.

FDG-PET for preoperative differential diagnosis between benign and malignant soft tissue masses

International Nuclear Information System (INIS)

Aoki, J.; Koyama, Y.; Sato, N.; Watanabe, H.; Shinozaki, T.; Takagishi, K.; Tokunaga, M.; Endo, K.

2003-01-01

To evaluate the standardized uptake value (SUV) of [ 18 F]2-deoxy-2-fluoro-d-glucose at positron emission tomography (FDG-PET) for preoperative differential diagnosis between benign and malignant soft tissue masses.Design One hundred and fourteen soft tissue masses (80 benign, 34 malignant) were examined by FDG-PET prior to tissue diagnosis. The SUVs were calculated and compared between benign and malignant lesions and among different histologic subgroups which included three or more cases. There was a statistically significant difference in SUV between benign (1.80±1.42 [SD]) and malignant (4.20±3.16) soft tissue masses in total (P<0.0001). However, a considerable overlap in SUV was observed between many benign and malignant lesions. Liposarcomas (2.16±1.72) and synovial sarcomas (1.60±0.43) did not show significantly higher SUV than any benign lesions. Metastases (4.23±2.35) showed no statistically significant difference in SUV as compared with schwannomas (1.75±0.84), desmoids (2.77±1.32), sarcoidosis (3.62±1.53), or giant cell tumors of tendon sheath (GCT of TS; 5.06±1.63). Even malignant fibrous histiocytomas (5.37±1.40) could not be differentiated from sarcoidosis or GCT of TS, based on the SUV. A large accumulation of FDG can be observed in both benign and malignant histiocytic, fibroblastic, or neurogenic lesions. SUV at conventional FDG-PET is limited to differentiating benign from malignant soft tissue masses, when all kinds of histologic subtypes are included. (orig.)

MR first pass perfusion of benign and malignant cardiac tumours - significant differences and diagnostic accuracy

International Nuclear Information System (INIS)

Bauner, K.U.; Picciolo, M.; Theisen, D.; Sandner, T.A.; Reiser, M.F.; Huber, A.M.; Sourbron, S.; Schmitz, C.

2012-01-01

To determine the diagnostic value of magnetic resonance (MR) first pass perfusion in the differentiation of benign and malignant cardiac tumours. 24 patients with cardiac tumours (11 malignant, histopathological correlation present in all cases) were examined using MRI. In addition to morphological sequences a saturation-recovery T1w-GRE technique was implemented for tumour perfusion. The maximum relative signal enhancement (RSE[%]) and the slope of the RSE t -curve (slopeRSE[%/s]) of tumour tissue were assessed. A t-test was used to identify significant differences between benign and malignant tumours. Sensitivities and specificities were calculated for detection of malignant lesions and were compared with the sensitivity and specificity based on solely morphological image assessment. The RSE and slopeRSE of malignant cardiac tumours were significantly higher compared with benign lesions (p < 0.001 and p < 0.001). The calculated sensitivities and specificities of RSE and slopeRSE for identification of malignant lesions were 100% and 84.6% and 100% and 92.3%, respectively with cut-off values of 80% and 6%/s. The sensitivity and specificity for identification of malignant lesions on the basis of morphological imaging alone were 90.9% and 69.2%. With first pass perfusion, malignant cardiac masses can be identified with higher sensitivity and specificity compared with morphological image assessment alone. (orig.)

Quantitative 2- and 3-dimensional analysis of pharmacokinetic model-derived variables for breast lesions in dynamic, contrast-enhanced MR mammography

International Nuclear Information System (INIS)

Hauth, E.A.M.; Jaeger, H.J.; Maderwald, S.; Muehler, A.; Kimmig, R.; Forsting, M.

2008-01-01

Purpose: 2- and 3-dimensional evaluation of quantitative pharmacokinetic parameters derived from the Tofts model modeling dynamic contrast enhancement of lesions in MR mammography. Materials and methods: In 95 patients, MR mammography revealed 127 suspicious lesions. The initial rate of enhancement was coded by color intensity, the post-initial enhancement change is coded by color hue. 2D and 3D analysis of distribution of color hue and intensity, vascular permeability and extracellular volume were performed. Results: In 2D, malignant lesions showed significant higher number of bright red, medium red, dark red, bright green, medium green, dark green and bright blue pixels than benign lesions. In 3D, statistical significant differences between malignant and benign lesions was found for all this parameters. Vascular permeability was significant higher in malignant lesions than in benign lesions. Regression model using the 3D data found that the best discriminator between malignant and benign lesions was combined number of voxels and medium green pixels, with a sensitivity of 79.4% and a specificity of 83.1%. Conclusions: Quantitative analysis of pharmacokinetic variables of contrast kinetics showed significant differences between malignant and benign lesions. 3D analysis showed superior diagnostic differentiation between malignant and benign lesions than 2D analysis. The parametric analysis using a pharmacokinetic model allows objective analysis of contrast enhancement in breast lesions

Diagnostic value of (99m)Tc-3PRGD2 scintimammography for differentiation of malignant from benign breast lesions: Comparison of visual and semi-quantitative analysis.

Science.gov (United States)

Chen, Qianqian; Xie, Qian; Zhao, Min; Chen, Bin; Gao, Shi; Zhang, Haishan; Xing, Hua; Ma, Qingjie

2015-01-01

To compare the diagnostic value of visual and semi-quantitative analysis of technetium-99m-poly-ethylene glycol, 4-arginine-glycine-aspartic acid ((99m)Tc-3PRGD2) scintimammography (SMG) for better differentiation of benign from malignant breast masses, and also investigate the incremental role of semi-quantitative index of SMG. A total of 72 patients with breast lesions were included in the study. Technetium-99m-3PRGD2 SMG was performed with single photon emission computed tomography (SPET) at 60 min after intravenous injection of 749 ± 86MBq of the radiotracer. Images were evaluated by visual interpretation and semi-quantitative indices of tumor to non-tumor (T/N) ratios, which were compared with pathology results. Receiver operating characteristics (ROC) curve analyses were performed to determine the optimal visual grade, to calculate cut-off values of semi-quantitative indices, and to compare visual and semi-quantitative diagnostic values. Among the 72 patients, 89 lesions were confirmed by histopathology after fine needle aspiration biopsy or surgery, 48 malignant and 41 benign lesions. The mean T/N ratio of (99m)Tc-3PRGD2 SMG in malignant lesions was significantly higher than that in benign lesions (Pvalue for the detection of primary breast cancer, the sensitivity, specificity and accuracy were 81.3%, 70.7%, and 76.4%, respectively. When a T/N ratio of 2.01 was used as cut-off value, the sensitivity, specificity and accuracy were 79.2%, 75.6%, and 77.5%, respectively. According to ROC analysis, the area under the curve for semi-quantitative analysis was higher than that for visual analysis, but the statistical difference was not significant (P=0.372). Compared with visual analysis or semi-quantitative analysis alone, the sensitivity, specificity and accuracy of visual analysis combined with semi-quantitative analysis in diagnosing primary breast cancer were higher, being: 87.5%, 82.9%, and 85.4%, respectively. The area under the curve was 0.891. Results of

Pedunculopontine tegmental nucleus lesions impair stimulus--reward learning in autoshaping and conditioned reinforcement paradigms.

Science.gov (United States)

Inglis, W L; Olmstead, M C; Robbins, T W

2000-04-01

The role of the pedunculopontine tegmental nucleus (PPTg) in stimulus-reward learning was assessed by testing the effects of PPTg lesions on performance in visual autoshaping and conditioned reinforcement (CRf) paradigms. Rats with PPTg lesions were unable to learn an association between a conditioned stimulus (CS) and a primary reward in either paradigm. In the autoshaping experiment, PPTg-lesioned rats approached the CS+ and CS- with equal frequency, and the latencies to respond to the two stimuli did not differ. PPTg lesions also disrupted discriminated approaches to an appetitive CS in the CRf paradigm and completely abolished the acquisition of responding with CRf. These data are discussed in the context of a possible cognitive function of the PPTg, particularly in terms of lesion-induced disruptions of attentional processes that are mediated by the thalamus.

Diagnostic imaging strategy for MDCT- or MRI-detected breast lesions: use of targeted sonography

International Nuclear Information System (INIS)

Nakano, Satoko; Ohtsuka, Masahiko; Mibu, Akemi; Karikomi, Masato; Sakata, Hitomi; Yamamoto, Masahiro

2012-01-01

Leading-edge technology such as magnetic resonance imaging (MRI) or computed tomography (CT) often reveals mammographically and ultrasonographically occult lesions. MRI is a well-documented, effective tool to evaluate these lesions; however, the detection rate of targeted sonography varies for MRI detected lesions, and its significance is not well established in diagnostic strategy of MRI detected lesions. We assessed the utility of targeted sonography for multidetector-row CT (MDCT)- or MRI-detected lesions in practice. We retrospectively reviewed 695 patients with newly diagnosed breast cancer who were candidates for breast conserving surgery and underwent MDCT or MRI in our hospital between January 2004 and March 2011. Targeted sonography was performed in all MDCT- or MRI-detected lesions followed by imaging-guided biopsy. Patient background, histopathology features and the sizes of the lesions were compared among benign, malignant and follow-up groups. Of the 695 patients, 61 lesions in 56 patients were detected by MDCT or MRI. The MDCT- or MRI-detected lesions were identified by targeted sonography in 58 out of 61 lesions (95.1%). Patients with pathological diagnoses were significantly older and more likely to be postmenopausal than the follow-up patients. Pathological diagnosis proved to be benign in 20 cases and malignant in 25. The remaining 16 lesions have been followed up. Lesion size and shape were not significantly different among the benign, malignant and follow-up groups. Approximately 95% of MDCT- or MRI-detected lesions were identified by targeted sonography, and nearly half of these lesions were pathologically proven malignancies in this study. Targeted sonography is a useful modality for MDCT- or MRI-detected breast lesions

Incidental focal FDG uptake in the parotid glands on PET/CT in patients with head and neck malignancy

Energy Technology Data Exchange (ETDEWEB)

Seo, Young Lan; Yoon, Dae Young; Lim, Kyoung Ja; Yun, Eun Joo; Cho, Young Kwon [Hallym University College of Medicine, Department of Radiology, Kangdong Seong-Sim Hospital, Seoul (Korea, Republic of); Baek, Sora [Hallym University College of Medicine, Department of Nuclear Medicine, Kangdong Seong-Sim Hospital, Seoul (Korea, Republic of); Bae, Woo Jin; Chung, Eun Jae; Kwon, Kee Hwan [Hallym University College of Medicine, Department of Otorhinolaryngology, Ilsong Memorial Institute of Head and Neck Cancer, Kangdong Seong-Sim Hospital, Seoul (Korea, Republic of)

2015-01-15

To evaluate the prevalence and clinical significance of focal parotid lesions identified by {sup 18} F- FDG PET/CT in patients with nonparotid head and neck malignancies. From 3,638 PET/CT examinations using {sup 18} F-FDG conducted on 1,342 patients with nonparotid head and neck malignancies, we retrospectively identified patients showing incidental focal FDG uptake in the parotid glands. The diagnosis of parotid lesions was confirmed histopathologically or on imaging follow-up. Patient demographics, clinical features, maximum standardized uptake value (SUV{sub max}) on PET images, size and attenuation on corresponding contrast-enhanced CT images were assessed and correlated with the final diagnosis. The prevalence of incidental focal parotid FDG uptake on PET/CT was 2.1 % (95 % CI 1.4 - 3.0 %). Among 21 patients with focal parotid lesions confirmed histologically or on imaging follow-up, 7 (33.3 %) had malignant lesions (all metastases) and 14 (66.7 %) had benign lesions (four pleomorphic adenomas, two Warthin's tumours, one benign lymph node, one granulomatous lesion, six lesions without histopathological confirmation). There were no significant differences in age, sex, SUV{sub max} or CT findings between patients with benign and those with malignant lesions. Focal parotid FDG uptake on PET/CT in patients with head and neck malignancy warrants further investigations to ensure adequate therapy for incidental parotid lesions. (orig.)

Safety and effectiveness of percutaneous biopsy of focal splenic lesions under ultrasonographic guidance

Energy Technology Data Exchange (ETDEWEB)

Han, Hyun Young; Kim, Joo Heon [Eulji University College of Medicine, Taejeon (Korea, Republic of); Shin, Kyung Sook [Chungnam National University College of Medicine, Taejeon (Korea, Republic of)

2002-06-15

To evaluate the diagnostic yield and safety of ultrasound (US)-guided percutaneous needle biopsy for the diagnosis of focal splenic lesions. US guided, automated needle biopsy using an 18-gauge cutting needle was performed in 11 patients, consisted of nine men and two women (mean age=49 years), with focal splenic lesions detected on the CT or US. Six patients (55%) had multiple lesions while five (45%) had a single lesion. Two of eleven patients had splenomegaly. None of 11 patients had the prior diagnosis of extrasplenic or hematopoietic malignancies. The biopsy was considered successful if a specific pathological diagnosis was possible. The diagnostic yield and frequency of complication were retrospectively analyzed. Tissue adequate for histological diagnosis was obtained in nine (82%) of 11 patients, and no complications other than mild, localized discomfort occurred. Multifocal splenic lesions without splenomegaly in five patients were confirmed as Hodgkin's disease (n=2), tuberculosis (n=1), infarction (n=1), and hemangioma (n=1). All single lesion in four patients were proven as benign conditions including hamartoma (n=2), lymphangioma (n=1) and chronic organizing abscess (n=1), and only of them with a large hamartoma received splenectomy while others did not receive further treatment. Although in two (18%) patients with multiple lesions and splenomegaly, no specific diagnosis was established by US-guided biopsy, malignant lymphoma and Hodgkin's disease were confirmed by surgery. US-guided automated needle biopsy is a safe and valuable procedure that can provides a specific diagnosis in patients with splenic lesions.

An exploratory study on 99mTc-RGD-BBN peptide scintimammography in the assessment of breast malignant lesions compared to 99mTc-3P4-RGD2.

Directory of Open Access Journals (Sweden)

Qianqian Chen

Full Text Available This study aimed to explore the diagnostic performance of single photon emission computed tomography / computerized tomography (SPECT/CT using a new radiotracer 99mTc-RGD-BBN for breast malignant tumor compared with 99mTc-3P4-RGD2.6 female patients with breast malignant tumors diagnosed by fine needle aspiration cytology biopsy (FNAB who were scheduled to undergo surgery were included in the study. 99mTc-3P4-RGD2 and 99mTc-RGD-BBN were performed with single photon emission computed tomography (SPECT at 1 hour after intravenous injection of 299 ± 30 MBq and 293 ± 32 MBq of radiotracers respectively at separate day. The results were evaluated by the Tumor to non-Tumor ratios (T/NT. 99mTc-RGD-BBN and 99mTc-3P4-RGD2 SPECT/CT images were interpreted independently by 3 experienced nuclear medicine physicians using a 3-point scale system. All of the samples were analyzed immunohistochemically to evaluate the integrin αvβ3 and gastrin-releasing peptide receptor (GRPR expression. The safety, biodistribution and radiation dosimetry of 99mTc-RGD-BBN were also evaluated in the healthy volunteers.No serious adverse events were reported in any of the patients during the study. The effective radiation dose entirely conformed to the relevant standards. A total of 6 palpable malignant lesions were detected using 99mTc-RGD-BBN SPECT/CT with clear uptake. All malignant lesions were also detected using 99mTc-3P4-RGD2 SPECT/CT. The results showed that five malignant lesions were with clear uptake and the other one with barely an uptake. 4 malignant cases were found with both αvβ3 and GRPR expression, 1 case with only GRPR positive expression (integrin αvβ3 negative and 1 case with only integrin αvβ3 positive expression (GRPR negative.99mTc-RGD-BBN is a safe agent for detecting breast cancer. 99mTc-RGD-BBN may have the potential to make up for the deficiency of 99mTc-3P4-RGD2 in the detection of breast cancer with only GRPR positive expression (integrin �

Cystic lesion of pancreas - Intraductal papillary mucinous neoplasm

Directory of Open Access Journals (Sweden)

Rajiv Baijal

2013-01-01

Full Text Available Intraductal papillary mucinous neoplasm (IPMN of the pancreas is an intraductal mucin-producing epithelial neoplasm that arises from the main and/or branched pancreatic duct. It usually presents as cystic lesion of pancreas. There are well known differential diagnosis of cystic pancreatic lesion. Pancreatic cystic neoplasms are detected at an increasing frequency due to an increased use of abdominal imaging. The diagnosis and treatment of intraductal papillary mucinous tumors (IPMN of the pancreas has evolved over the past decade. IPMN represents a spectrum of disease, ranging from benign to malignant lesions, making the early detection and characterization of these lesions important. Definitive management is surgical resection for appropriate candidates, as benign lesions harbor malignant potential. IPMN has a prognosis, which is different from adenocarcinoma of the pancreas. We report a case of a 58-year-old male with intraductal papillary neoplasm involving main duct and side branches presenting to us with clinical symptoms of chronic pancreatitis with obstructive jaundice and cholangitis treated surgically.

Differentiation between focal malignant marrow-replacing lesions and benign red marrow deposition of the spine with T2*-corrected fat-signal fraction map using a three -echo volume interpolated breath-hold gradient echo dixon sequence

International Nuclear Information System (INIS)

Kim, Yong Pyo; Kim, Sung Jun; Chung, Tae Sub; Yoo, Yeon Hwa; Yoon, Choon Sik; Kanneengiesser, Stephan; Paek, Moon Young; Song, Ho Taek; Lee, Young Han; Suh, Jin Suck

2014-01-01

To assess the feasibility of T2 * -corrected fat-signal fraction (FF) map by using the three-echo volume interpolated breath-hold gradient echo (VIBE) Dixon sequence to differentiate between malignant marrow-replacing lesions and benign red marrow deposition of vertebrae. We assessed 32 lesions from 32 patients who underwent magnetic resonance imaging after being referred for assessment of a known or possible vertebral marrow abnormality. The lesions were divided into 21 malignant marrow-replacing lesions and 11 benign red marrow depositions. Three sequences for the parameter measurements were obtained by using a 1.5-T MR imaging scanner as follows: three-echo VIBE Dixon sequence for FF; conventional T1-weighted imaging for the lesion-disc ratio (LDR); pre- and post-gadolinium enhanced fat-suppressed T1-weighted images for the contrast-enhancement ratio (CER). A region of interest was drawn for each lesion for parameter measurements. The areas under the curve (AUC) of the parameters and their sensitivities and specificities at the most ideal cutoff values from receiver operating characteristic curve analysis were obtained. AUC, sensitivity, and specificity were respectively compared between FF and CER. The AUCs of FF, LDR, and CER were 0.96, 0.80, and 0.72, respectively. In the comparison of diagnostic performance between the FF and CER, the FF showed a significantly larger AUC as compared to the CER (p = 0.030), although the difference of sensitivity (p = 0.157) and specificity (p = 0.157) were not significant. Fat-signal fraction measurement using T2 * -corrected three-echo VIBE Dixon sequence is feasible and has a more accurate diagnostic performance, than the CER, in distinguishing benign red marrow deposition from malignant bone marrow-replacing lesions.

Whole-lesion histogram analysis metrics of the apparent diffusion coefficient as a marker of breast lesions characterization at 1.5 T.

Science.gov (United States)

Bougias, H; Ghiatas, A; Priovolos, D; Veliou, K; Christou, A

2017-05-01

To retrospectively assess the role of whole-lesion apparent diffusion coefficient (ADC) in the characterization of breast tumors by comparing different histogram metrics. 49 patients with 53 breast lesions underwent magnetic resonance imaging (MRI). ADC histogram parameters, including the mean, mode, 10th/50th/90th percentile, skewness, kurtosis, and entropy ADCs, were derived for the whole-lesion volume in each patient. Mann-Whitney U-test, area under the receiver-operating characteristic curve (AUC) were used for statistical analysis. The mean, mode and 10th/50th/90th percentile ADC values were significantly lower in malignant lesions compared with benign ones (all P histogram analysis could be a helpful index in the characterization and differentiation between benign and malignant breast lesions with the 10th and 50th percentile ADC be the most accurate discriminators. Copyright © 2017 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

Surgical treatment of gallbladder polypoid lesions

Directory of Open Access Journals (Sweden)

Pejić Miljko A.

2003-01-01

Full Text Available INTRODUCTION Polypoid lesions of the gallbladder can be divided into benign and malignant categories. Malignant polypoid lesions include carcinomas of the gallbladder, which is the fifth most common malignancy of the gastrointestinal tract and the most common malignancy of the biliary tract. Benign polypoid lesions of the gallbladder are divided into true tumors and pseudotumors. Pseudotumors account for most of polypoid lesions of the gallbladder, and include polyps, hyperplasia, and other miscellaneous lesions. Adenomas are the most common benign neoplasms of the gallbladder. Cholesterol polyps are the most common pseudotumors of the gallbladder. The polyps can be single or multiple, usually less than 10 mm in size. They have no predilection for any particular gallbladder site, and usually are attached to the gallbladder wall by a delicate, narrow pedicle. No malignant potential has been identified for this type of pseudotumor. Adenomas are the most common benign neoplasms of the gallbladder. They have no predilection site in the gallbladder, and may also be associated with gallstones or cholecystitis. The premalignant nature of adenomas remains controversial. Ultrasonography (US has been demonstrated to be significantly better in detecting polypoid lesions of the gallbladder as compared with computed tomography and cholecystography. A mass fixed to the gallbladder wall of normal thickness, without shadowing, is seen in case of gallbladder polyp. Since gallbladder cancers usually present as polypoid lesions, differentiation between benign polypoid lesion and malignant lesion can be very difficult, even with high-resolution imaging techniques. PATIENTS AND METHODS Retrospectively we have analyzed 38 patients with ultrasonographicaly detected gallbladder polyps during the period from January 1995 to December 2000, who were treated at surgical department of Health Centre in Uzice and at Surgical clinic of Clinical Centre in Nis. We have analyzed

Higher-order conditioning is impaired by hippocampal lesions.

Science.gov (United States)

Gilboa, Asaf; Sekeres, Melanie; Moscovitch, Morris; Winocur, Gordon

2014-09-22

Behavior in the real world is rarely motivated by primary conditioned stimuli that have been directly associated with potent unconditioned reinforcers. Instead, motivation and choice behavior are driven by complex chains of higher-order associations that are only indirectly linked to intrinsic reward and often exert their influence outside awareness. Second-order conditioning (SOC) [1] is a basic associative-learning mechanism whereby stimuli acquire motivational salience by proxy, in the absence of primary incentives [2, 3]. Memory-systems theories consider first-order conditioning (FOC) and SOC to be prime examples of hippocampal-independent nondeclarative memory [4, 5]. Accordingly, neurobiological models of SOC focus almost exclusively on nondeclarative neural systems that support motivational salience and reward value. Transfer of value from a conditioned stimulus to a neutral stimulus is thought to require the basolateral amygdala [6, 7] and the ventral striatum [2, 3], but not the hippocampus. We developed a new paradigm to measure appetitive SOC of tones in rats. Hippocampal lesions severely impaired both acquisition and expression of SOC despite normal FOC. Unlike controls, rats with hippocampal lesions could not discriminate between positive and negative secondary conditioned tones, although they exhibited general familiarity with previously presented tones compared with new tones. Importantly, normal rats' behavior, in contrast to that of hippocampal groups, also revealed different confidence levels as indexed by effort, a central characteristic of hippocampal relational memory. The results indicate, contrary to current systems models, that representations of intrinsic relationships between reward value, stimulus identity, and motivation require hippocampal mediation when these relationships are of a higher order. Copyright © 2014 Elsevier Ltd. All rights reserved.

Pattern of Histopathological Diagnosis of Breast lesions in Gombe ...

African Journals Online (AJOL)

neoplastic proliferative and benign neoplastic disorders, while 118 (40.5%) were malignant neoplasms. Fibroadenoma was the commonest benign breast lesion with 69 (23.7%) cases. Of all the malignancies, invasive ductal carcinoma was the most ...

Comparison of 18-FDG PET and CT for pretherapeutic staging of malignant lymphoma

International Nuclear Information System (INIS)

Thill, R.; Cremerius, U.; Wagenknecht, G.; Hellwig, D.; Buell, U.; Neuerburg, J.; Guenther, R.; Fabry, U.; Osieka, R.

1997-01-01

Aim: Comparison of diagnostic efficiency of FDG-PET and CT regarding localisation, histology, size and FDG-uptake of a lesion. Methods: CT- and FDG-PET studies of 27 patients with histologically confirmed malignant lymphoma as primary disease or relapse were evaluated retrospectively. In CT lesions with a diameter (D CT )>15 mm were regarded as positive. Focal accumulations of FDG, not explained by physiological metabolism, found by visual interpretation in iterative reconstructed, PET-scans, were quantified for diameter (D PET ) and corrected standardized uptake value (SUV), corrected for partial-volume-effect. Lesions were classified depending on histology and lesion quality (lymph nodes, bulks, extranodal lesions). Results: CT detected 78 lesions in 26 patients, all confirmed by FDG-PET. PET localized 18 additional lesions (+23%); in high grade NHL +25%. Both methods were equally efficient in cevical lymph nodes and lung lesions, in all other regions of lymphatic nodules and in case of liver and spleen lesions PET localized more lesions. SUV was significantly higher in high-grade NHL (19.0) than in low-grade NHL and Hodgkin's disease (10.6 resp. 11.1). D CT and D PET correlated significantly (r=0.75). Conclusion: Diagnostic efficiency of FDG-PET is equivalent or superior to CT in staging of malignant lymphoma before therapy. Qualitative interpretation seems sufficient for staging, quantitative analysis may add information about malignancy grade in NHL. (orig.) [de

Circulating Microparticles in Patients with Benign and Malignant Ovarian Tumors

NARCIS (Netherlands)

Rank, A.; Liebhardt, S.; Zwirner, J.; Burges, A.; Nieuwland, R.; Toth, B.

2012-01-01

Background: Microparticles are known to be increased in various malignancies. In this prospective study, microparticle levels were evaluated in patients with benign and malignant ovarian lesions. Patients and Methods: Microparticles from platelets/megakaryocytes, activated platelets and endothelial