DCE-MRI Radiomics Analysis in Differentiating Luminal A and Luminal B Breast Cancer Molecular Subtypes.

RATIONALE AND OBJECTIVES: The aim of the present study was to investigate the association between Luminal A and Luminal B molecular subtypes and radiomic features of dynamic contrast­enhanced magnetic resonance imaging in patients with invasive breast cancer. MATERIALS AND METHODS: Seventy-three patients with histopathologically proven invasive ductal cancer (IDC) were selected. Tumors were classified into molecular subtypes: Luminal A (estrogen receptor (ER)-positive and/or progesterone receptor (PR)-positive, human epidermal growth factor receptor type 2 (HER2) -negative, proliferation marker Ki-67<20) and Luminal B (ER-positive and/or PR-positive, HER2-positive or HER2-negative with high Ki-67 ≥20). A total of 81 tumoral lesions were evaluated on T1-weighted fat-suppressed sagittal post-contrast late-phase MRI images after the required "pre-process" steps and 3D segmentations were made. Forty-three radiomic features including: 1 conventional, 4 shape, 6 histogram, 7 Grey-Level Co-occurrence Matrix (GLCM), 11 Grey-Level Run-Length Matrix (GLRLM), 3 Neighborhood Grey-Level Difference Matrix (NGLDM), 11 Grey-Level Zone-Length Matrix (GLZLM) were extracted by using the software LIFEX. RESULTS: A statistically significant difference was found in radiomic features including; a) Histogram: "skewness", b) Shape: "volume-ml, volume-voxel," c) GLCM: "entropy.log10, entropy.log2, energy", d) GLRLM: "GLNU, RLNU, HGRE," e) NGLDM: "busyness," f) GLZLM: "GLNU, HGZE, ZLNU, SZE" between two different molecular subtypes. The model combining Shape-volume (ml) and GLZLM-HGZE yielded 0.746 area under the curve (AUC), 0.744 sensitivity, 0.643 specificity and 0.694 accuracy. CONCLUSION: Radiomic properties that may distinguish Luminal A and Luminal B molecular subtypes of IDC were identified. The radiomic features were thought to reflect the intratumoral heterogeneity in molecular subtypes. This study demonstrated that the characterization of Luminal A and Luminal B tumors could be made non-invasively by radiomics analysis.

Uterine abscess as an appendicitis complication: a case report.

INTRODUCTION: Acute appendicitis is a frequent cause of abdominal pain that requires surgical intervention. Rarely complications such as appendico-vesical, appendico-cutaneous, or appendico-uterine fistula formation may occur. CASE AND OUTCOMES: We present a case of an 83-year-old woman who suffered from a very rare complication of acute appendicitis. Multimodal radiologic examination including ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) revealed complicated appendicitis with an abscess formation involving the right adnexal region and uterine cavity. The patient was treated conservatively with percutaneous drainage of the abscess and IV antibiotics. DISCUSSION: Acute appendicitis is one of the common causes of emergency surgery. It is important to differentiate simple and complicated appendicitis to determine the best treatment option, thus, the diagnostic accuracy of certain US and CT findings in making this differentiation has been the subject of investigation. Even though some imaging findings suggest appendiceal perforation, deciding a conservative treatment plan based solely on imaging findings is still inaccurate. MRI is complementary to CT and US as a problem solving modality in certain situations. CONCLUSION: This case report reminds us that physicians and radiologists should be aware of rare complications of acute appendicitis such as fistula formation to visceral organs. MRI is superior in order to differentiate complex fluid collections such as abscess formations.

A rare case of bilateral proboscis lateralis: Prenatal US and MRI findings.

Proboscis lateralis is a very rare congenital craniofacial malformation characterized by a finger-like tubular appendage arising usually from the medial canthal region. It is mostly unilateral and associated with other craniofacial malformations. Occasionally, proboscis lateralis is seen with holoprosencephaly. A rare case of bilateral proboscis lateralis which was diagnosed prenatally by ultrasound and magnetic resonance imaging has been presented. In this case of bilateral proboscis lateralis, both lesions arose from a very lateral location and were associated with various central nervous system anomalies other than holoprosencephaly.