Relationship Between Shear Wave Elastography Findings and Histologic Prognostic Factors of Invasive Breast Cancer.

OBJECTIVE: Shear wave elastography (SWE) is an adjunct to grayscale ultrasound examinations for evaluating breast masses. This study aimed to determine the SWE features that correlated with prognostic parameters for breast cancer. METHODS: Between January 2018 and May 2018, 80 patients who were confirmed to have invasive cancers by core-needle biopsy and who were scheduled for surgery were imaged using B-mode ultrasound and SWE. Measurements were taken from a region of interest positioned over the stiffest part of the peripheral zone and mass. Three measurements were taken, and the average of the mean stiffness value was used for analysis. RESULTS: The mean tumor size, elasticity value of tumors, and elasticity of the peripheral zone were 2.9 ± 1.48 cm (range, 0.6-8 cm), 154.8 ± 8.55 kPa (range, 116.25-179 kPa), and 171.34 ± 5.22 kPa (range, 150.95-182.43 kPa), respectively. The types of breast cancer included were invasive ductal carcinoma (n = 71 [88.75%]; 69 invasive ductal carcinoma not otherwise specified, 1 solid papillary carcinoma, and 1 invasive micropapillary carcinoma), invasive lobular carcinoma (n = 2 [2.5%]), mixed invasive ductal and lobular carcinoma (n = 4 [5%]), mucinous carcinoma (n = 2 [2.5%]), and metaplastic cancer (n = 1 [1.25%]). A strong correlation was found between mean elasticity values and tumor grade (P = 0.018) and between mean elasticity values and lymphovascular invasion (LVI) positivity (P = 0.008). There were no significant differences between SWE values and tumor diameter or between histological tumor characteristics and SWE. CONCLUSIONS: We found that some clinicohistopathologic features of poor prognosis had higher elasticity values than those of favorable prognosis.

Clinical Significance of Serum NEDD9 Levels in Patients with Pancreatic Cancer.

INTRODUCTION: Pancreatic cancer (PC) is a lethal malignancy. Various diagnostic, predictive, and prognostic biomarkers have been evaluated. This study was conducted to investigate the serum levels of neural precursor cell expressed developmentally downregulated protein 9 (NEDD9) in patients with PC and the relationship between tumor progression and known prognostic parameters. MATERIALS AND METHODS: Serum samples were obtained on first admission before any treatment. Serum NEDD9 levels were determined using enzyme-linked immunosorbent assay (ELISA). Age- and sex-matched healthy controls were included in the analysis. RESULTS: In a three year period, 32 patients with a pathologically-confirmed diagnosis of PC were enrolled in this study. The median age at diagnosis was 61 years, range 38 to 84 years; the majority of the patients in the group were men (n = 20, 62.5%). The tumor was located in the head of pancreas in 21 (65.6%) patients. Forty-one percent of 17 metastatic patients who received palliative CTx (chemotherapy) were CTx-responsive. The baseline serum NEDD9 levels were significantly higher in patients with PA than in the control group (p = 0.03). Median OS of the whole group were 27 ± 7.3 weeks. Alcohol intake, performance status, and LDH levels were found to be significant prognostic factors (p = 0.006, p < 0.001, and p < 0.001, respectively). However, serum NEDD9 levels had no significantly effect on progression free survival (PFS) and overall survival (OS) (p = 0.71 and p = 0.58, respectively). CONCLUSIONS: NEDD9 is identified as a secretory biomarker for PC but it has no prognostic role.

Can 3.0 Tesla diffusion tensor Imaging parameters be prognostic indicators in breast cancer?

PURPOSE: To investigate the relationship between diffusion tensor imaging (DTI) parameters such as fractional anisotropy (FA), mean diffusivity (MD), relative anisotropy (RA), and volume ratio (VR) values, and prognostic factors of invasive breast cancer. MATERIALS AND METHODS: This retrospective study examined 63 patients with pathologically confirmed invasive breast cancers. The patients underwent pre-operative diffusion-weighted magnetic resonance imaging (MRI) at 3.0 Tesla. The relationship between DTI parameters and tumor size, histologic and nuclear grade, axillary lymph node status, lymphovascular and perineural invasion status, estrogen receptor (ER), progesterone receptor (PR), CERB-B2, and Ki-67 were analyzed. RESULTS: Patients with lymph node metastasis (p = 0.018; p < 0.05) and/or lymphovascular invasion (p = 0.001; p < 0.01) and/or histologic grade 3 tumors (p < 0.05) had statistically significantly low MD values. There was a statistically significant relationship between ER and MD (r = 0.452, p < 0.01), PR and MD (p = 0.001, p < 0.01); CERB-B2 and RA (p = 0.047, p < 0.05); Ki-67 and RA (p = 0.026; p < 0.05); Ki-67 and VR (p = 0.021; p < 0.05); and lymphovascular invasion and FA (p = 0.045, p < 0.05) values. CONCLUSION: DTI parameters of malignant masses in breast cancer patients correlate with tumor size, lymph node status, histologic grade, lymphovascular invasion, Ki-67, CERB B2, ER, and PR.

Can ultrasonography-guided aspiration and steroid injection treat reflux venous blood flow around symptomatic Baker's cysts? Our short-term experience.

OBJECTIVE: The aim of the current study was to investigate the efficacy of ultrasonography-guided aspiration treatment with concomitant steroid injection on relieving reflux blood flow in veins located next to symptomatic Baker's cyst. METHODS: All patients were examined by ultrasonography at administration and 1 month follow-up after intervention. Puncture and aspiration of the cyst, as well as injection of 1 ml dexamethasone were performed by the same radiologist. Compression on popliteal vein and vena saphena parva and the degrees of reflux before and after treatment were recorded. RESULTS: Twenty-six patients were included in the study. An overall reduction of the cyst's size was observed in all patients of the study group. Reduction of the cyst size is more evident during the 1st week, which was observed by a slight enlargement during the 1st and the 3rd months controls. CONCLUSION: Ultrasonography-guided puncture, aspiration and steroid injection seems to yield promising outcomes in terms of relieving venous reflux flow around simple Baker's cysts.

Is there a relationship between talar osteochondral lesions and foot angles?

PURPOSE: We aimed to evaluate the relationship between talar osteochondral defects (OCDs) and foot angles in this study. MATERIALS AND METHODS: We performed a retrospective study that included 25 patients with talar OCD and 29 patients without OCD who underwent magnetic resonance imaging in our department between September 2013 and January 2015. We retrospectively measured the foot angles (Bohler's angle, lateral talocalcaneal angle and calcaneal inclination angle) on ankle radiographs in both groups. RESULTS: Bohler's angle showed no significant differences between the patients (range 20.50°-48.10°, mean 33.40° ± 6.09°) and the control group (range18.80°-42.40°, mean 31.95° ± 4.21°) (p = 0.397). Calcaneal inclination angle showed no significant differences between the patients (range 3°-29.2°, mean 20.55° ± 6.73°) and the control group (range 10.20°-29.80° mean 20.47° ± 4.21°) (p = 0.956). However, talocalcaneal angle was significantly higher in the patients (range 27.80°-44.80°, median 39.50° ± 6.18°) compared with the control group (range 22.60°-40.50°, median 34.10° ± 4.26°) (p = 0.032). CONCLUSION: There is an association between lateral talocalcaneal angle and non-traumatic talar OCD.

Evaluation of acute and chronic MRI features of sacroiliitis in asymptomatic primary hyperparathyroid patients.

Asymptomatic primary hyperparathyroidism (PHPT) is characterized with autonomous overproduction of parathyroid hormone without signs or symptoms associated with hyperparathyroidism. Before symptoms become obvious, PHPT may affect structures like sacroiliac joints, which consist of bone. So, in the asymptomatic PHPT patients, structural and inflammatory changes in sacroiliac joints may lead to confusion during diagnosis workup of axial spondyloarthropathy. In this study, we evaluated active and chronic sacroiliac magnetic resonance imaging (MRI) changes relevant to sacroiliitis in the patients with asymptomatic PHPT and interpreted bone marrow edema within the scope of Assessment of SpondyloArthritis International Society-Outcome Measures in Rheumatology Clinical Trials (ASAS-OMERACT) criteria. Forty-nine patients with asymptomatic PHPT, 26 patients with newly diagnosed axial spondyloarthropathy (SpA), and 37 healthy controls were enrolled. All subjects were evaluated by sacroiliac MRI for four active (bone marrow edema, enthesitis, capsulitis, and synovitis) and four chronic (subchondral sclerosis, subchondral/periarticular erosions, periarticular fat deposition, and bony bridges/ankylosis) lesions relevant to sacroiliitis. Bone marrow edema compatible with ASAS-OMERACT active sacroiliitis criteria in sacroiliac MRI was fulfilled by 16.3 % (8/49) of the asymptomatic PHPT patients which was similar with controls but statistically lower than axial SpA. Moreover, asymptomatic PHPT patients and controls were similar for other chronic or active MRI findings. Also, we detected lower frequency of all other MRI findings, except enthesis, in asymptomatic PHPT patients according to axial SpA. Acute inflammatory including bone marrow edema fulfilling ASAS-OMERACT active sacroiliitis criteria and chronic structural sacroiliac lesions relevant to sacroiliitis in MRI were detected in asymptomatic PHPT similar frequency with controls but as expected, lower than axial SpA. But, these findings could not be attributed to excessive secretion of parathyroid hormone.

Are there any novel radiological diagnostic clues in magnetic resonance imaging for vertebrobasilar insufficiency?

BACKGROUND: The aim of the current study was to investigate whether signal intensities on magnetic resonance imaging (MRI) views and radiological findings on Doppler ultrasonography may have a diagnostic value for vertebrobasilar insufficiency (VBI). METHODS: This case-control study was performed on demographic and radiologic data derived from 18 VBI patients and 58 healthy controls in the radiology department of a tertiary care center. The blood flow characteristics including peak systolic and end diastolic flow rates, resistance and pulsatility indices, mean velocities, flow rates, diameters and intensity pattern of vertebral arteries on cervical and cranial MRI sequences were noted. The association between blood flow characteristics and signal patterns on MRI views was investigated in VBI patients and controls. RESULTS: Blood flow and vessel diameter were significantly decreased in VBI patients compared to controls on both sides (P<0.001). In contrast, other parameters did not exhibit any remarkable difference between VBI and control groups. The distribution of hypo- or hyperintense signals in VBI and control groups was similar. No remarkable variabilities were detected in blood flow characteristics of cases presenting with signals having different intensities on MRI sequences. CONCLUSIONS: In conclusion, results of the current study have demonstrated that assessment of blood flow and vascular diameter may be important for ruling in VBI. Nevertheless, the intensity of signals derived from vessels seems not reveal any data of diagnostic significance in these cases. Further studies on larger populations may allow development and exploration of newer diagnostic techniques and clues for VBI.

Correlation between computerized tomography density measurements of urinary bladder and urinalysis results.

Our aim was to investigate whether there is a correlation between computerized tomography (CT) density measurements of the urinary bladder and urinalysis results. Patients were subdivided into three groups with respect to urinalysis results: Group 1, no leukocytes or erythrocytes detected in urine (n=25); Group 2, erythrocytes detected in urine (n=50); and Group 3, leukocytes and erythrocytes detected in urine (n=98). In CT sections, densitometric measurements had been performed from three zones on each section and groups were compared in terms of densitometry results. Our results indicate that density measurements of CT views form the urinary bladder may provide valuable data on hematuria and leukocyturia.