[Role of MRI and CT in the evaluation of postirradiation status and complications in head and neck cancer]. / Az MRI és a CT szerepe a sugárterápia utáni státusz értékelésében, szövõdményeinek vizsgálatában, fej-nyaki daganatoknál.

Most head and neck cancer patients are treated with combined modalities such as surgery, radiotherapy (RT), chemotherapy (ChT). Concurrent chemo-radiation has improved treatment outcomes with increased toxic effects. Reactions after RT are divided into early and late changes. Early reactions are seen during the course of therapy or within 3 months; these are reversible in most cases. Late complications are observed 3 months to years after RT and they are generally irreversible. As typical late reaction radiation induced necrosis may occur in soft tissues, cartilage, bones and brain. Tumor recurrence and post-radiation necrosis typically appear at the same time, within 2-3 years after RT; the differentiation may be difficult. Computed tomography (CT) and magnetic resonance imaging (MRI) have become the gold standards not only for staging and assessing tumor response, but also to evaluate posttreatment status, to distinguish residual or recurrent tumor and RT complications. Using baseline CT or MRI between 2-3 months after treatment and performing standard follow-up imaging with strict clinical follow-up are required to establish early salvage treatment.

[Breast cancer care quality analysis of the National Institute of Oncology in Hungary according to the requirements of European Society of Breast Cancer Specialists (EUSOMA)]. / A European Society of Breast Cancer Specialists (EUSOMA) eloírásainak megfelelo emlorákellátás minoségbiztosítási elemzése az Országos Onkológiai Intézetben.

INTRODUCTION: The European Society of Breast Cancer Specialists has created quality indicators for breast units to establish minimum standards and to ensure specialist multimodality care with the conscious aim of improving outcomes and decreasing breast cancer mortality. AIM: The aim of this study was to analyse the breast cancer care in the National Institute of Oncology according to the European Society of Breast Cancer Specialists requirements and in a large number of cases in order to present representative clinico-pathological data on the incidence of breast cancer in Hungary. METHOD: According to the European Society of Breast Cancer Specialists uniformed criteria clinico-pathological data of multimodality treated breast cancer cases were retrospectively analysed between June 1, 2011 and May 31, 2012. RESULTS: During the period of interest 906 patients underwent breast surgery for malignant or benign lesions. According to the European Society of Breast Cancer Specialists quality indicators the breast cancer care of the National Institute of Oncology is eligible. CONCLUSIONS: The diagnostic modalities and multimodality care of breast cancer of the National Institute of Oncology breast unit meets the critical mass and minimum standards of the European Society of Breast Cancer Specialists criteria. Orv. Hetil., 2016, 157(42), 1674-1682.

Docetaxel, cisplatin and 5-fluorouracil induction chemotherapy followed by chemoradiotherapy or chemoradiotherapy alone in stage III-IV unresectable head and neck cancer: Results of a randomized phase II study.

PURPOSE: Concurrent chemoradiotherapy (CRT) is the standard treatment for advanced head and neck squamous cell carcinoma. In this phase II randomized study, the efficacy and toxicity of docetaxel, cisplatin and 5-fluorouracil induction chemotherapy (ICT) followed by concurrent CRT was compared with those after standard CRT alone in patients with locally advanced, unresectable head and neck cancer. PATIENTS AND METHODS: Between January 2007 and June 2009, 66 patients with advanced (stage III or IV) unresectable squamous cell carcinoma of the head and neck (oral cavity, oropharynx, hypopharynx, and larynx) were randomly assigned to two groups: one receiving two cycles of docetaxel, cisplatin, and 5-fluorouracil ICT followed by CRT with three cycles of cisplatin and one treated by CRT alone. Response rate, local tumor control (LTC), locoregional tumor control (LRTC), overall survival (OS), progression-free survival (PFS), and toxicity results were assessed. RESULTS: Three patients from the ICT + CRT group did not appear at the first treatment, so a total of 63 patients were evaluated in the study (30 ICT + CRT group and 33 CRT group). Three patients died of febrile neutropenia after ICT. The median follow-up time for surviving patients was 63 months (range 53-82 months). The rate of radiologic complete response was 63% following ICT + CRT, whereas 70% after CRT alone. There were no significant differences in the 3-year rates of LTC (56 vs. 57%), LRTC (42 vs. 50%), OS (43 vs. 55%), and PFS (41 vs. 50%) in the ICT + CRT group and in the CRT group, respectively. The rate of grade 3-4 neutropenia was significantly higher in the ICT + CRT group than in the CRT group (37 and 12%; p = 0.024). Late toxicity (grade 2 or 3 xerostomia) developed in 59 and 42% in the ICT + CRT and CRT groups, respectively. CONCLUSION: The addition of ICT to CRT did not show any advantage in our phase II trial, while the incidence of adverse events increased. The three deaths as a consequence of ICT call attention to the importance of adequate patient selection if ICT is considered.

[Technical novelties, latest diagnostic options in the MRI and CT diagnostics of colorectal cancer]. / Technikai újdonságok, legújabb diagnosztikus lehetoségek a colorectalis daganatok MR- és CT-diagnosztikájában.

Diagnostic and therapeutic options of colorectal cancer (CRC) have changed over the past decade. Imaging plays a major role, thus the use of scanning methods is recommended by guidelines. Accurate staging, evaluation of treatment efficacy and identification of residual and recurrent tumors are required for the modern management of colorectal cancer. If adequate technical background is provided, magnetic resonance imaging (MRI) gives the information upon which therapeutic options may be determined. High-resolution MRI scans can be interpreted as maps providing functional and molecular information. Diffusion-weighted MRI (DW-MRI) has shown promising results regarding the determination of tumor volume and evaluation of treatment efficacy. Perfusion dynamic contrast-enhanced MRI (P-DCE-MRI) is the subject of research in the early assessment of treatment efficacy. Magnetic resonance spectroscopic imaging (MRSI) is a procedure utilizing biochemical analysis. Its application in CRC is under investigation. Clinical effectiveness of PET-MRI (hardware-based combination of MRI and positron emission tomography) is also being studied. Diagnostic value of computed tomographic colonography (CTC) has been proven in the detection of CRC as well as of polyps.

[New opportunities, MRI biomarkers in the evaluation of gynaecological cancer]. / Új lehetoségek, MRI-biomarkerek a nogyógyászati daganatok értékelésében.

The determination and classification of gynaecological tumour stage which is based on clinical and pathological examinations became more precise due to the development of imaging techniques. Recently new MRI methods are being introduced which serve functional, tissue-specific, molecular information; beyond the excellent anatomical and contrast resolution with the aid of high resolution morphological measurements as well as quantification can also be performed. Diffusion-weighted MRI (DW-MRI) is based on the mobility of water molecules and provides information about the cell density of a given tissue and the integrity of cell membranes. Quantification can also be performed using an apparent diffusion coefficient (ADC). DW-MRI is a useful tool in determining myometrium invasion in endometrium carcinomas especially if a tumour has the same signal intensity as the makromomyometrium on the T2-weighted images and the use of contrast agents are contraindicated. The extra-uterine tumour invasion, the peritoneal metastatic foci can be determined by DW-MRI as well. Lymph node status is the most important predictive factor regarding survival. Both CT and MRI have low sensitivity (70-80%) in revealing metastatic lymph nodes. DW-MRI is a promising method with a sensitivity of 87% and specificity of 80% in distinguishing benign and malignant lymph nodes. Dynamic contrastenhanced MRI (DCE-MRI), as a marker of angiogenesis, provides information about vascularisation at the tissue level. In endometrial carcinoma with application of T2-weighted sequence together with DCE-MRI in determining the stage MRI has the accuracy about 90%. DCE-MRI has proven to be useful for distinguishing benign from malignant ovarian tumours, for detecting tumour extension; it can help predict peritoneal carcinomatosis. It is proven by high-level evidence that multiparametric MRI (MP-MRI) is the most precise diagnostic tool in determining the status of cervical carcinoma, its accuracy being above 90%. In the case of parametrial tumour invasion the accuracy of the clinical examination is 78%, while that of CT and MRI are 70% and 92%, respectively. DCE-MRI and DWMRI are promising imaging biomarkers in the early assessment of the effectiveness of the therapy and also in detecting residual as well as recurrent tumours.

[New trends and novel possibilities in the diagnostic imaging of breast cancer]. / Újdonságok, új lehetoségek az emlodaganatok képalkotó diagnosztikájában.

Complex tumor therapy development and new opportunities in surgery, which take into account both oncological principles as well as esthetic aspects, have set the requirements far higher for diagnostic imaging of the breast and for radiologists. Despite these new opportunities, X-ray mammography remains the basic examination. However, part of the cancers is hidden on the mammogram, which is partly a consequence of the dense glandular tissue and may also be influenced by the histological type of cancer. Besides reducing radiation dose, digital X-ray mammography improves the examination sensitivity of the dense breast. State of the art digital examination methods, such as tomosynthesis and contrast-enhanced mammography, increase the accuracy of examination. Ultrasound mammography is the most important supplementary method of X-ray mammography. Among the new applications of ultrasound mammography, US elastography, which is based on different tissue elasticity, as well as automatic 3D ultrasound, can be highlighted. Furthermore, among imaging methods that provide functional or metabolic data, MR mammography is the most appropriate non-invasive, non-ionising method for the detection of malignancy and for structure examination. MR mammography is the most sensitive method for the detection of breast cancer and in 20-30% of cases, results in changes of the therapy, and it is also effective in the examination of the dense breast. High level of evidence proves that MR mammography is very useful in the screening of women at risk of breast cancer. Promising results prove that MR mammography will play more considerable role in the evaluation of the effectiveness of the therapy. Diffusion-weighted MR imaging is based on the different diffusion of tissue water, qualitative analysis and quantitative evaluation can be performed. DCE-MR examines that contrast enhancement over time, which can mainly be useful for the qualitative and quantitative evaluation of perfusion changes which may indicate the biological response to tumor therapy. The MR spectroscopic (MRSI) biochemical analysis increases the characterization of the lesions. Multimodal imaging techniques provide more accurate analysis, which is confirmed by more and more evidence, but none of the imaging methods are sufficiently specific to provide histological diagnosis. However, imaging-guided biopsies enable precise histological or cytological confirmation. Technical development, new imaging methods, experienced radiologists and multi-disciplinary cooperation increase the accuracy of the diagnosis and the effectiveness of personalized therapy.

[New opportunities, MRI biomarkers in the evaluation of head and neck cancer]. / Új lehetoségek, MRI-biomarkerek a fej-nyaki daganatok értékelésében.

Magnetic resonance imaging (MRI) has developed rapidly during the past few years and, according to the needs of therapy, has opened new perspectives in oncologic imaging with better and better realization of the latest technological advances. After the introduction of "organ preservation" protocols the role of imaging has become more important. New therapeutic methods (improvement in radiation therapy and chemotherapy) need better tumor characterization and prognostic information along with the most accurate anatomical information. Multiparametric anatomical and functional MR imaging (MM-MRI) using high magnetic field strength (3 Tesla) are useful in determining tumor-specific MRI biomarkers and in evaluating the changes in these parameters during therapy to provide early assessment of the therapeutic response. Diffusion-weighted MRI (DW-MRI) provides information at the cellular level about cell density and the integrity of the plasma membrane. DW-MRI shows potential in improving the detection of cancer due to its high specificity and high negative predictive value. Quantification is performed using an apparent diffusion coefficient (ADC), the values are independent of the magnetic field strength. In the latest publications the accuracy of DW-MRI has been reported around 90% for the differentiation between malignant versus benign tumor using an ADC cut-off mean value of 0.700-1.200 10(-3) mm(2)/s units, but no common threshold ADC value exists in clinical routine for the differentiation of malignant and benign tissues. Dynamic contrast-enhanced MRI (DCE-MRI), as a marker of angiogenesis, provides information about vascularization at the tissue level. Angiogenetic alterations cause changes in the parameters of vascular physiology (perfusion, blood volume, capillary permeability) and thus alter the contrast enhancement observed on contrast MRI. High-grade and/or advanced stage tumors are associated with increased blood volume, increased permeability and increased perfusion; the data can be evaluated using semiquantitative or quantitative methods. Magnetic resonance spectroscopic imaging (MRSI) provides biochemical analysis at the molecular level. The results are promising, although further studies are required to determine whether MRSI can be used to identify or exclude cancer within regions where the cancer is not evident on conventional MRI or with the other functional imaging methods. Some of the studies demonstrated the usefulness of these functional MRI methods also in the head and neck region to differentiate benign from malignant tumors, to quantify the response to radiation therapy and chemotherapy, to identify residual or recurrent tumor and to correlate the perfusion or diffusion data with prognosis. There are still some overlaps between benign and malignant changes, and the use of these functional MR measurements in routine diagnostics are still not fully validated today. Functional MR measurements are useful parts of the high quality multiparametric MRI, they offer important supportive biological and molecular information with the aid of high resolution morphological imaging.

[Salvage 125I brachytherapy of locally recurrent prostate cancer]. / Prosztatadaganat sugárkezelését követo helyi kiújulás "salvage" kezelése 125I brachyterápiával.

The purpose of the study is to report a case of salvage low dose rate (LDR) prostate brachytherapy in a patient with locally recurrent prostate cancer, four years after his first treatment with combined external beam radiation therapy (EBRT) and high dose rate (HDR) brachytherapy. A 61-year-old man was treated with 1x10 Gy HDR brachytherapy and a total of 60 Gy EBRT for an organ confined intermediate risk carcinoma of the prostate in 2009. The patient's tumor had been in regression with the lowest PSA level of 0.09 ng/ml, till the end of 2013. After slow but continuous elevation, his PSA level had reached 1.46 ng/ml by February 2014. Pelvis MRI and whole body acetate PET/CT showed recurrent tumor in the dorsal-right region of the prostate. Bone scan was negative. After discussing the possible salvage treatment options with the patient, he chose LDR brachytherapy. In 2014, in spinal anesthesia 21 125I "seeds" were implanted with transrectal ultrasound guidance into the prostate. The prescribed dose to the whole prostate was 100 Gy, to the volume of the recurrent tumor was 140 Gy. The patient tolerated the salvage brachytherapy well. The postimplant dosimetry was evaluated using magnetic resonance imaging-computed tomography (MR-CT) fusion and appeared satisfactory. PSA level decreased from the pre-salvage value of 1.46 ng/ml to 0.42 ng/ml by one month and 0.18 ng/ml by two months after the brachytherapy. No gastrointestinal side effects appeared, the patient's urination became slightly more frequent. In selected patients, salvage LDR brachytherapy can be a good choice for curative treatment of locally recurrent prostate cancer, after primary radiation therapy. Multiparametric MRI is fundamental, acetate PET/CT can play an important role when defining the localization of the recurrent tumor.

Ewing Sarcoma of the Larynx with Thyroid Cartilage Destruction: A Case Report.

Ewing sarcoma of the larynx is extremely rare, only a few number of cases have been reported. In this report, we describe a case of extraskeletal Ewing sarcoma of the larynx with thyroid cartilage destruction. Laryngoscope, 2024.

[Quality assurance of rapid on-site evaluation of CT-guided fine-needle aspiration cytology of lung nodules]. / A CT-vezérelt vékonytu-aspirációs citológiai vizsgálat minoségbiztosítása a tüdodaganatok diagnosztikájában.

INTRODUCTION: The methods available for the diagnosis of lung cancer include radiologic, cytologic and pathologic procedures. AIMS: The aim of this study was to determine the quality assurance of CT guided fine needle aspiration cytology of lung nodules. METHODS: Cytology results were rated to 4 categories (positive; suspicious; negative; not representative). All cytology reports were compared with the final histology diagnosis. RESULTS: A total of 128 patients underwent CT-guided percutaneous fine-needle aspiration biopsy cytology (63 males; 65 females; mean age 62.8 years). Smears were adequate in 99 cases and inadequate in 29 cases. The average diameter of the nodules was 3.28 cm. Thirty three (25.6%) of the cases were histologically verified and 2 falsely negative and 2 falsely positive cases were detected. The sensitivity and the positive predictive value were 88.8% and 88.8%, respectively. Pneumothorax developed in 7 (5.4%) cases. CONCLUSION: These results suggest that CT-guided transthoracic fine needle aspiration cytology has a high diagnostic accuracy and an acceptable complication rate. The auditing valves of the results meet the proposed threshold values.

[Role and responsibility of multimodal imaging in head and neck cancer]. / A multimodális képalkotói diagnosztika szerepe és felelõssége fej-nyaki daganatoknál.

Hungary is first in head and neck cancer mortality in Europe in men and also in women. Head and neck (HN) is a difficult region, its anatomy and also pathology is very complex, various connection points exist between the sites which determine the extension of the disease. Diagnostic algorithms as well as imaging techniques have to be optimized to examine in standard manner. Like most other cancers, prognosis depends largely on the stage of the tumor. Accuracy of tumor detection and evaluation is very important because it affects treatment planning. As non-surgical organ-preserving therapeutic modalities (chemotherapy, chemoradiotherapy, targeted biological therapy) gain general acceptance, the importance of noninvasive diagnostic accuracy as well as radiologic evaluation of the extent of the tumor has increased. Clinical examinations including endoscopy should be combined with radiologic imaging to assess the precise local (T), regional nodal (N), and distant (M) extent of the tumor. Computed tomography (CT) and magnetic resonance imaging (MRI) have become basic tools in the diagnosis of head and neck tumors. They are both useful for assessing deep tumor extensions, able to detect changes missed by endoscopy. It has been shown that the primary determined tumor stage increases in up to 90% of patients after the results of cross sectional imaging. MRI is being increasingly used and has become the gold standard in head and neck cancer for staging, assessing tumor response, finding recurrent tumor and also for treatment planning in radiotherapy. The field strength of MRI scanners has been increasing to 1.5 T and now 3 T with better signal-to-noise ratio, higher resolution images and better tissue diagnosis. Functional MR techniques such as dynamic contrast enhanced MRI (DCE-MRI) and diffusion weighted MRI (DW-MRI) may provide further characterization. PET/CT is beneficial in detecting unsuspected metastatic nodes, distant disease and second primary tumor. PET/CT and MRI both appeared almost similarly accurate in the detection of an occult primary tumor. The effective management of patients depends highly on the competece of radiologists and requires close collaboration between clinical and surgical oncologists, diagnostic and therapeutic radiologists as well as pathologists.

[Role of imaging in the diagnostic and therapeutic algorithms of breast cancer]. / Képalkotói vizsgálatok szerepe az emlodaganatok onkológiai diagnosztikus és terápiás algoritmusában.

Early diagnosis and prevention have the most significant effect on overall disease specific outcome; 90% of all breast cancer cases could be cured if diagnosed early and treated accurately. As for all diagnostic methods the most important requirement for diagnostic imaging is to detect breast cancer in its early stage, and to determine accurate tumor staging, in order to select the appropriate therapy. Its role is to monitor the effectiveness of therapy, to follow up patients reliably for early detection of recurrent disease. The spectrum of radiological imaging methods in breast cancer became broader in the past two decades; imaging that provides functional or metabolic data and whole body information such as CT, MRI and PET-CT are now available besides common X-ray and ultrasound mammography. The MRI is getting more and more important for the detection and characterization of breast cancer. Multimodal imaging techniques provide more accurate analysis, which is confirmed by increasing statistics authentically, but none of the imaging methods was specific enough to provide histological diagnosis. However, imaging-guided biopsies enable precise histological or cytological confirmation.

[Diagnostic imaging and histologic background of nipple discharge -- our experience with 40 patients]. / A váladékozó emlo képalkotó diagnosztikája és szövettani háttere -- tapasztalataink 40 betegünk kapcsán.

The authors present the diverse etiology of nipple discharge, which background may be a tumor. They discuss the checkup ways of nipple discharge and review in detail the galactographic technique and evaluation. The examination of pathologic nipple discharge is essentially based on contact cytology, x-ray-, and ultrasound mammography. Consequently, galactography is applied by filling the ducts with contrast material. The final diagnosis is rendered by histologic examination, following the operation. The authors demonstrate the application and role of galactography through various cases.

[Role of MRI in determining the therapy of rectal cancer]. / Az MR-vizsgálat szerepe a rectumcarcinomák terápiájának meghatározásában.

Over the past decade, significant progress has been made in the management of rectal cancer. Advances in surgical technique and adjuvant therapies have led to significant improvements in outcome for some patients. The advances in preoperative therapies have led to the need for an accurate preoperative staging technique to select those patients who are expected to benefit from these interventions without subjecting others to unnecessary treatment. Performing neoadjuvant therapy knowledge of the relationship of the tumor to the circumferential resection margin is of importance. In Hungary, respecting European guidelines, the high resolution magnetic resonance imaging is mandatory in the staging of rectal cancer, and in early rectal cancer transrectal endosonography has a complementary role. The current role of multidetector computer tomography is for detecting distant metastasis and in local tumor staging of advanced cancers.

[The potential role of SPECT/CT in the preoperative detection of sentinel lymph nodes in breast cancer]. / A SPECT/CT szerepe az orszemnyirokcsomó preoperatív meghatározásában, emlorákban.

Regional lymph node status is the most important prognostic factor in breast cancer. Sentinel lymph node biopsy is the standard method of axillary staging in early breast cancer patients with clinically negative nodes. Preoperative lymphoscintigraphy might support refining biopsy findings by determining the number and location of sentinel lymph nodes. In aged or overweight patients, in the presence of atypical or extra-axillary lymphatic drainage, non-visualized lymph nodes, or sentinel lymph nodes close to the isotope injection site, detection could be aided by a new, hybrid imaging tool: the single-photon emission computed tomography combined with computed tomography (3D SPECT/CT). For the first time in Hungarian language, authors overview the literature: all 14 English-language articles on the implementation of 3D SPECT/CT in sentinel lymph node detection in breast cancer are included. It is concluded that 3D SPECT/CT increases the success rate and quality of preoperative sentinel node identification, and is capable of providing a more accurate staging of breast cancer patients in routine clinical practice.

[The "gray zone" in organized mammography screening: histocytological correlations]. / A "szürke zóna" az emlorák mammográfiás szervezett szurésében. Citológiai-hisztológiai tanulmány.

UNLABELLED: The National Public Health Program has established the organized mammography screening in Hungary. The aim of this study was to conduct an audit of "gray zone" smears of the organized mammography screening in comparison with histopathological diagnoses. METHODS: Cytology results were rated to C3 atypia probably benign and C4 suspicious of malignancy. RESULTS: 1361 women had aspiration cytology performed from a total of 47,718 mammography non-negative lesions. 105 (7.8%) were diagnosed as C3, whereas 78 (5.7) as C4. Of the 105 patients with C3 diagnosis 61 (58%) patients underwent surgical biopsy. Histology proved malignancy in 20 (32.8%) cases, and benign lesion in 41 (67.2%) cases. All (100%) of the 78 patients with C4 diagnosis had open biopsies; 69 (88.4%) cases were histologically malignant and 9 (11.6%) cases were benign lesions. CONCLUSION: The auditing results of fine needle aspiration cytology of "gray zone" in organized mammography screening meet the proposed threshold values. Authors conclude that the "gray zone" category in breast cytology is useful and of value if used judiciously.

[Sentinel lymph node biopsy after neoadjuvant chemotherapy in breast cancer]. / Orszemnyirokcsomó-biopszia neoadjuváns kemoterápiát igénylõ emlõrákoknál.

The indication of neoadjuvant chemotherapy has been recently extended; it is now applied not only in locally advanced breast cancer but in primarily resecable tumours as well, in order to promote breast conservation. Based on recent clinical results, the reconsideration of traditional lymph node dissection in axillary staging is timely in patients receiving neoadjuvant chemotherapy. Precise axillary staging needs surgical removal of lymph nodes. Based on prospective randomised trials, sentinel lymph node biopsy appears to be appropriate for axillary staging even in tumours requiring neoadjuvant treatment. The extended indication of sentinel lymph node biopsy raises several questions and problems. In the present paper the authors review the results and possible limitations of sentinel lymph node biopsy in relation to neoadjuvant chemotherapy.

Limitations of non-echo planar diffusion weighted magnetic resonance imaging (non-EPI MRI) in cholesteatoma surveillance after ossicular chain reconstruction. A prospective study.

OBJECTIVE: Non-echo planar diffusion weighted magnetic resonance imaging is a reliable surveillance tool of residual cholesteatoma nowadays. It is not known whether the material of the ossicular chain prosthesis modifies the sensitivity and specificity of MRI in these cases. The aim of the study was to compare the sensitivity, specificity and a localization-specific accuracy of non-EPI DW MRI sequences for residual cholesteatoma in the following 3 subgroups: patients with titanium ossicular prosthesis (group T), with autologous cortical bone columella (group A) or without any reconstruction (group WR) of hearing bones. METHODS: This prospective study covered 28 cases with cholesteatoma of the middle ear undergone second-look surgery, who had preoperative PROPELLER DW-MRI. Surgical findings were compared to the results of the DWI-MRI. RESULTS: The overall sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were: 0.76-0.8-0.76-0.8. Group T, group A and group WR sensitivity was 0.83-0.6-1, specificity: 0.75-0.75-0.85, PPV: 0.83-0.75-0.66, NPV: 0.75-0.6-1. Overall accuracy was 0.78. Size of missed cholesteatoma was 2-4 mm (mean: 2.66±1.15). CONCLUSIONS: Various materials are suitable for ossicular chain reconstruction. The poor detectability of residual or recurrent cholesteatoma in the middle ears reconstructed with autologous bony prosthesis may still claim second-look surgery instead of the usage of non- EPI DWI sequences independently in these patients.

[Quality assurance of fine-needle aspiration cytology of the organized mammography screening]. / Az emlo mammográfiás szervezett szurésének citológiai minoségbiztosítása.

UNLABELLED: The National Public Health Program has established the organized mammography screening in Hungary. AIM: The aim of our study was to determine the quality assurance of breast aspiration cytology. METHOD: Cytology results were rated to 5 categories (C1, C2, C3, C4 and C5). All cytology reports were compared with the final histology diagnosis. RESULTS: 1361 women had aspiration cytology diagnosis performed from a total of 47718 mammography non-negative lesions. There were 805 (59.1%) benign and 187 (13.7%) malignant alterations. Sensitivity was 91%, specificity 88%, positive predictive value 96.6% and negative predictive value turned to be 71% (p<0.001). CONCLUSION: The auditing values of fine needle aspiration cytology in our laboratory meet, or in certain aspects exceed the proposed minimum threshold values.

Local immune parameters as potential predictive markers in head and neck squamous cell carcinoma patients receiving induction chemotherapy and cetuximab.

BACKGROUND: The aim of this study was to determine whether tumor-associated immune cells may predict response to therapy and disease outcome in head and neck squamous cell carcinoma (HNSCC) patients receiving induction chemotherapy and cetuximab. METHODS: Paraffin-embedded pretreatment biopsy samples from 45 patients with stage III-IV resectable HNSCC were investigated retrospectively by immunohistochemistry for density of different immune cell types based on expression of CD8, FOXP3, CD134, CD137, PD-1, CD20, NKp46, dendritic cell lysosomal-associated membrane protein (DC-LAMP), CD16, CD68, and myeloperoxidase. Results were analyzed for possible correlations with clinicopathologic parameters, response to therapy, and survival. RESULTS: Of the immune cell types studied, we found significant association with response to induction chemotherapy only in the case of DC-LAMP+ mature dendritic cells and PD-1+ lymphocytes; density of DC-LAMP+ cells also correlated with progression-free survival. CONCLUSION: DC-LAMP+ mature dendritic cells and PD-1+ cells may be implicated in response to induction chemotherapy and cetuximab in HNSCC patients.