Interobserver Variability of Ultrasound Features Based on American College of Radiology Thyroid Imaging Reporting and Data System Lexicon in American College of Radiology Thyroid Imaging Reporting and Data System System: A Single-Center Study With Radiologists and Radiology Residents.

ABSTRACT: The aim of this study is to evaluate the variability of selecting the ultrasound features used in American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS) and in assigning the ACR-TIRADS level in a single center among radiologists and radiology residents. The study cohort consisted of 108 thyroid nodules in 102 patients who had definite cytology results after thyroid fine needle aspiration biopsy (Bethesda category II, VI) or surgery. Seven observers including 3 radiologists and 4 radiology residents evaluated the nodules according to 5 ultrasound feature categories. The evaluation process was performed after a joint meeting session, in which the "white papers" of the ACR-TIRADS committee were discussed regarding the thyroid ultrasound reporting lexicon, and final TIRADS system. Variability of ultrasound features and assigning ACR-TIRADS level was measured using Fleiss kappa statistics. Agreement for ultrasound features was "substantial" to "almost perfect" among all observers, with composition (κ = 0.86), macrocalcification (κ = 0.89) and peripheral calcification (κ = 0.92) at the highest level of agreement. The level of agreement for large comet tail artifacts and punctate echogenic foci was "moderate" in residents, whereas in radiologists, that level was "substantial." The agreement for assigning ACR-TIRADS level was moderate in resident as well as in radiologist subgroup. Agreement of thyroid ultrasound features was "substantial to almost perfect" among all observers. Although the level of agreement among resident group decreased to "moderate" level, ACR-TIRADS is a useful system in thyroid nodule management.

Four Different Apparent Diffusion Coefficient Measurement Methods in Breast Masses.

OBJECTIVE: To compare the effect of different quantification methods of ADC values in the evaluation of breast lesions and compare contralateral normal breast tissue ADC value by calculating ADC ratios. STUDY DESIGN: Descriptive study. Place and Duration of the Study: Sisli Etfal Training and Research Hospital, Turkey, between February 2019 and December 2020. METHODOLOGY: Two hundred and forty-six breast MRI scans with DWI of the patients with biopsy proven unilateral breast lesions were studied. ADC measurements were done by placing ROI. Two ADC values and two ADC ratios were obtained by different methods. The diagnostic accuracies of these four techniques were compared. RESULTS: Mean ADC values and ratios of benign and malignant lesions were statistically significant in all of four methods to quantify ADC (p< 0.001). Highest positive value and negative predictive value, and diagnostic accuracy rates were achieved when the most restricted part ADC value was calculated. However; highest sensitivity rate and negative predictive value were achieved by calculating the ratio of darkest point ADC to contralateral breast tissue. Positive predictive value, negative predictive value, and diagnostic accuracy rate of calculated ADC values and ratios were higher when lesions were larger than the mean size (3.15 mm2). CONCLUSION: Highest diagnostic accuracy rate was obtained with most restricted part ADC value. Obtained ratios by calculating contralateral breast tissue ADC value did not improve the diagnostic accuracy rate. Positive and negative predictive values and diagnostic accuracy rates of ADC values and ratios increased as the lesion size increased. Key Words: Breast mass, Diffusion weighted imaging, ADC value, ADC ratio, Normalised ADC.

Measurement of iliotibial band diameter in iliotibial band friction syndrome and comparison with an asymptomatic population.

BACKGROUND: Iliotibial band friction syndrome (ITBFS) is an overuse injury of the lateral aspect of the knee. This syndrome classically affects the active young population. PURPOSE: To determine the diameter of the ITB using magnetic resonance imaging (MRI) in patients clinically diagnosed with ITBFS, compare the results with asymptomatic patients, and assess the inter-observer agreement between a senior and a junior radiologist with different levels of experience in musculoskeletal imaging. MATERIAL AND METHODS: From April 2014 to October 2019, 78 knee MRI scans of 78 patients were included in the study group who were referred from the orthopedic clinic with a clinical diagnosis of ITBFS. In the control group, there were 114 knee MRI scans of 114 patients who had knee MRI for various reasons and had no radiological abnormality on the performed knee MRI. The ITB diameters, cut-off values, and interclass correlation coefficient (ICC) were calculated. RESULTS: Mean thickness of the ITB was higher in the study group compared to the control group in measurements done by both the senior and junior radiologists and this was statistically significant (P < 0.001). Cut-off values of the diameters of the ITB were calculated as 2.385 for the senior radiologist and 2.420 for the junior radiologist. ICC of 0.80 was determined, which showed excellent agreement among interpreters. CONCLUSION: ITB thickness in the study group was significantly higher than in the control group. There was also excellent agreement among the two observers. Measurement of ITB thickness on axial plane knee MRI is one of the reliable criteria for ITBFS.

Idiopathic granulomatous mastitis in a male breast following intravesical Bacille Calmette-Guerin treatment.

Idiopathic granulomatous mastitis (IGM) is a benign chronic inflammatory disorder of the breast tissue, with unknown etiology. IGM is extremely rare among male gender. In this case report, we present a male patient with superficial high grade bladder cancer, who was complaining of a palpable mass in his right breast for two weeks following intravesical Bacillus Calmette-Guerin (BCG) treatment. There was an assymetrical, mass-like density without distinct contours in retroareolar area of the right breast. US guided core-needle biopsy was performed. Histopathology confirmed the diagnosis of IGM. To our knowledge, this is the first case of IGM following intravesical BCG administration.