Magnetic resonance imaging for assessment of parametrial tumour spread and regression patterns in adaptive cervix cancer radiotherapy.

PURPOSE: To investigate the impact of magnetic resonance imaging (MRI)-morphologic differences in parametrial infiltration on tumour response during primary radiochemotherapy in cervical cancer. MATERIAL AND METHODS: Eighty-five consecutive cervical cancer patients with FIGO stages IIB (n = 59) and IIIB (n = 26), treated by external beam radiotherapy (± chemotherapy) and image-guided adaptive brachytherapy, underwent T2-weighted MRI at the time of diagnosis and at the time of brachytherapy. MRI patterns of parametrial tumour infiltration at the time of diagnosis were assessed with regard to predominant morphology and maximum extent of parametrial tumour infiltration and were stratified into five tumour groups (TG): 1) expansive with spiculae; 2) expansive with spiculae and infiltrating parts; 3) infiltrative into the inner third of the parametrial space (PM); 4) infiltrative into the middle third of the PM; and 5) infiltrative into the outer third of the PM. MRI at the time of brachytherapy was used for identifying presence (residual vs. no residual disease) and signal intensity (high vs. intermediate) of residual disease within the PM. Left and right PM of each patient were evaluated separately at both time points. The impact of the TG on tumour remission status within the PM was analysed using χ(2)-test and logistic regression analysis. RESULTS: In total, 170 PM were analysed. The TG 1, 2, 3, 4, 5 were present in 12%, 11%, 35%, 25% and 12% of the cases, respectively. Five percent of the PM were tumour-free. Residual tumour in the PM was identified in 19%, 68%, 88%, 90% and 85% of the PM for the TG 1, 2, 3, 4, and 5, respectively. The TG 3-5 had significantly higher rates of residual tumour in the PM in comparison to TG 1 + 2 (88% vs. 43%, p < 0.01). CONCLUSION: MRI-morphologic features of PM infiltration appear to allow for prediction of tumour response during external beam radiotherapy and chemotherapy. A predominantly infiltrative tumour spread at the time of diagnosis resulted in a significantly higher rate of residual tumour in the PM at the time of brachytherapy in comparison to a predominantly expansive tumour spread.

Early Diagnosis of Canine Hip Laxity: Correlation between Clinical Orthopedic Examinations and the FCI Scoring Method in a Closed Cohort of Rottweilers.

Canine hip dysplasia is a multifactorial disorder characterized by hip laxity and osteoarthritis. The early diagnosis of hip laxity is an important topic in small animal orthopedics. This study aimed to evaluate the correlation between clinical orthopedic examinations and the Fédération Cynologique Internationale (FCI) scoring method. Thirty purebred Rottweilers were examined at approximately four (20 ± 2 weeks), eight (35 ± 2 weeks), and twelve months of age (54 ± 1 weeks), respectively. The Ortolani, Barlow, and Bardens tests and reduction/subluxation angle measurements were performed at each time. FCI scoring was conducted at the third examination time. Positive correlations were recorded between the reduction angle and Ortolani test, reduction angle and FCI score, and Ortolani test and FCI score for the second and third examination dates. No correlation was observed between the subluxation angle and other methods. Despite previous studies reporting 16-20 weeks as the earliest age for diagnosing hip laxity in dogs, in our study, early diagnosis was possible from the age of 35 ± 2 weeks. This difference might originate from the small sample size, low number of the dogs with severe grades of laxity, and breed differences.