Value of Endorectal MRI in Romanian Men for High Risk of Prostate Cancer: MRI Findings Compared with Saturation Biopsy.

PURPOSE: To evaluate the potentials of T2 weighted (T2W)MRI and diffusion weighted (DW) MRI for prostate cancer(PCa) detection, local staging and treatment planning in high-risk group. MATERIAL AND METHODS: Endorectal MRI was performed in 17 Romanian men (median age: 66 years; range: 58 75 years), prostate specific antigen (PSA) serum levels (median: 20 ng mL; range: 8.6 100 ng mL) with positive findings for PCa(median Gleason score: 8; range: 7 - 9). Imaging findings were compared to standarised 20-core transperineal saturation biopsy. The prostate was divided into 16 standart sectors(10 posterior and 6 anterior). RESULTS: Overall, prostate cancer was detected in 16 patients(94%) on DW-MRI alone and in all 17 patients (100%) on T2W-MRI alone, and on combined imaging. On T2W-MRI165 sectors out of 272 were suspicious for PCa and 124 (75%)were cancer positive. On DW-MRI 126 sectors out of 272 were suspicious for PCa and 118 (95%) were cancer positive. On the combined imaging approach 134 sectors out of 272 were suspicious for PCa and 126 (94%) were cancer positive. This resulted in diagnostic accuracies per sector of 76% for T2WMRI, 86% for DW-MRI and 89% for combined imaging. Multifocal PCa was confirmed both on MR imaging and by biopsy in 8 of the 17 men (47%) Extra capsular extension(ECE) or seminal vesicles invasion (SVI) was highly suspected in 8 (47%) respectively 7 (41%) of the 17 patients. 6 patients(35%) presented both ECE and SVI. MRI findings were taken into account for treatment planning and none of these patients underwent radical prostatectomy and instead was treated with palliative cryotherapy, radiotherapy and hormone therapy. CONCLUSIONS: Endorectal MRI is highly accurate in PCa detection in the high-risk group and seems to have an important role in local staging and treatment planning for Romanian population.

Diffusion weighted imaging with background body signal suppression / T2 image fusion in magnetic resonance mammography for breast cancer diagnosis.

INTRODUCTION: Dynamic Contrast-Enhanced Magnetic Resonance Mammography (DCE-MRM) represents the most sensitive examination for breast cancer (BC) diagnosis. However literature data reports very inhomogeneous specificity. The aim of our study was to evaluate the clinical efficiency of a new MRM technique - diffusion weighted imaging with background body signal suppression T2 image fusion in BC diagnosis, compared to DCE-MRM. METHODS: We retrospectively analyzed 50 consecutive DCE-MRM examinations with DWIBS sequence from the archives of the Department of Radiology, Lyon Sud Hospital, (02.2010- 02.2011), summing up to 64 breast lesions. Fusions were created using the Osirix software from the DWIBS images (b=1000 s mm2) and their T2 correspondents. Interpretation was performed using an adapted BI-RADS system. The final histopathological examination or a minimum 6-months follow-up served as gold standard. RESULTS: Out of the 64 examined breast lesions, 35(54.7%) were classified as malignant by DCE-MRM and 24(37.5%) cases by DWIBS T2, respectively. Thus the DWIBS T2 fusion had a Sensitivity of 62.5%(95%CI:35.4-84.8) and a Specificity of 70.8%(95%CI:55.9-83.3) while DCE-MRM had a higher Sensitivity: 87.5%(95%CI:61.6-98.4) but a lower Specificity: 56.2%(95%CI:41.1-70.5). CONCLUSION: DWIBS T2 fusion is an innovative MRM technique, with a specificity superior to DCE-MRM, showing a large potential for improving the clinical efficiency of classical MRM.

Morphometric and ultrasonographic study of the human fetal hip joint during intrauterine development.

UNLABELLED: The main method for the early screening of the developmental dysplasia of the hip (DDH) is the ultrasound imaging. There are several studies about the ultrasound imaging of newborns' hips, but only a few studies include the prenatal period of life. Our aim was to examine the prenatal development of the hip joint through the evolution of the α angle seen on the ultrasound, described in the Graf R method, combined with anatomical dissection. MATERIALS AND METHODS: Thirty-one post-mortem fetal hips were analyzed trough anatomical dissection, in 25 cases trough ultrasound imaging, in which the α angle was measured. Based on the morphometric examination, we applied the sine rule and we calculated the α1 angle, which also represents the coverage of the femoral head. RESULTS: Based on the morphometric examination, not only the diameters of the femoral head and of the acetabulum, but also the joint cavity (X) showed an increase during development. Both of the α angles (measured α, calculated α1) showed a decrease as the fetus developed. CONCLUSIONS: The decrease of the angles (α, α1) and the increase of the joint cavity during development correspond to the findings of the main research papers: the hip joint is less stable in the perinatal life. The α angle can be accurately determined only after the ossification of the acetabulum had started, in our case after the fetus is older than 18 weeks.

Estrogen and progesterone receptor expression in the mammary gland tumors.

In the primary mammary malignant tumors, including in situ carcinoma, it is recommended the carrying out of immunohistochemical diagnosis for the estrogen (ER) and the progesterone receptors (PR). We have studied the ER and the PR expression in malignant tumors, trying to identify the corresponding phenotypes according to the presence of these tumors. We have carried out a study on a total number of 80 carcinomas, divided into two groups: the first one constituted of 54 cases of carcinomas on which we had clinical data, and another group, constituted of 26 cases of mammary carcinoma, where no clinical data was available. We have observed that the values and the distribution of the ER and PR taken from the biopsies made in the patients with mammary carcinoma are influenced by the age and menopausal status. The combination of the ER/PR results lead to the definition of many tumoral phenotypes.