Imaging following thermal ablation of early lung cancers: expected post-treatment findings and tumour recurrence.

Thermal ablation is a minimally invasive technique that is growing in acceptance and popularity in the management of early lung cancers. Although curative resection remains the optimal treatment strategy for stage I pulmonary malignancies, percutaneous ablative treatments may also be considered for selected patients. These techniques can additionally be used in the treatment of oligometastatic disease. Thermal ablation of early lung tumours can be achieved using several different techniques. For example, microwave ablation (MWA) and radiofrequency ablation (RFA) utilise extreme heat, whereas cryoablation uses extremely cold temperatures to cause necrosis and ultimately cell death. Typically, post-ablation imaging studies are performed within the first 1-3 months with subsequent imaging performed at regular intervals to ensure treatment response and to evaluate for signs of recurrent disease. Surveillance imaging is usually undertaken with computed tomography (CT) and integrated positron-emission tomography (PET)/CT. Typical imaging findings are usually seen on CT and PET/CT following thermal ablation of lung tumours, and it is vital that radiologists are familiar with these appearances. In addition, radiologists should be aware of the imaging findings that indicate local recurrence following ablation. The objective of this review is to provide an overview of the expected post-treatment findings on CT and PET/CT following thermal ablation of early primary lung malignancies, as well as describing the imaging appearances of local recurrence.

Transarterial chemoembolization for hepatocellular carcinoma: a bibliometric analysis of the most cited articles.

PURPOSE: Bibliometric analysis is a quantitative assessment of the academic literature in a particular field. The aim of our study was to characterize the 100 top-cited articles regarding transarterial chemoembolization (TACE) for the treatment of hepatocellular carcinoma (HCC). MATERIALS AND METHODS: The 'Web of Science' database was used to identify the leading articles regarding TACE for HCC. We determined the top 100 articles according to citations and performed an analysis on year of publication, authorship, department affiliation, publishing journal, institution and country of origin, subject matter and article type. RESULTS: The top-cited articles received between 92 and 2254 citations (median 283.4). The top 100 papers were published in 32 journals between 1983 and 2016. Cancer, Radiology and Hepatology published the most articles (n = 40). Internal medicine was the department affiliation of the first author in 49%. The country providing the most highly cited articles was Japan (n = 24). CONCLUSION: We performed an analysis of the 100 top-cited articles dealing with TACE for HCC, presenting a detailed list of the most influential and historically significant papers. Japan was the country that produced the most top-cited articles, highlighting its key contribution to this field of the literature.

Diagnostic performance of MDCT, PET/CT and gadoxetic acid (Primovist(®))-enhanced MRI in patients with colorectal liver metastases being considered for hepatic resection: initial experience in a single centre.

PURPOSE: To compare the relative diagnostic performance of MDCT, PET/CT and Primovist-enhanced MRI (P-MRI) in the pre-resection work-up of colorectal cancer (CRC) liver metastases. METHOD AND MATERIALS: This was a retrospective study of consecutive referrals for CRC liver metastases. All patients had MDCT, PET/CT and P-MRI examinations within 3 months of each other. They were divided into 2 groups: resected and unresected. Patients in the resected group underwent liver resection within 3 months of the imaging studies. In the unresected group, patients were unresectable by imaging criteria or are awaiting surgery. Standard of reference (SOR) was intra-operative ultrasound findings and pathology for the resected group. Intermodality comparison was the SOR for the unresected group. Number of lesions identified by each imaging modality for each patient was recorded. Sensitivity (95% CI) and PPV were calculated for each imaging modality in the resected group. RESULTS: There were 19 patients in the resected group and 11 patients in the unresected group. The sensitivity (96%) and PPV (0.91) of P-MRI were both superior to that of MDCT (P = 0.0009) and PET/CT (P = 0.0003). Intermodality comparison showed that P-MRI detected more lesions than MDCT and PET/CT. CONCLUSION: The sensitivity and PPV of P-MRI was superior to that of MDCT and PET/CT. P-MRI probably has the most added value if used after MDCT and PET/CT in patients still considered eligible for liver resection.

Apical hypertrophic cardiomyopathy, a clinical and noninvasive study of 11 cases.

Eleven patients of apical hypertrophic cardiomyopathy were studied by clinical, electrocardiography, systolic and diastolic time intervals, echocardiographic and pulsed Doppler methods. The patients were between 20-55 years of age. There were 10 males and 1 female. Chest discomfort was the predominant symptom. ECG revealed giant T wave inversion in precordial leads in six cases, LAHB and LBBB in 2 cases and abnormal Q waves in 2 cases. Systolic function was normal. However indices of diastolic function (IVRT, RF wave, a/H, LAEI) were abnormal. There was marked increase in the thickness of left ventricle towards the appex (septum 30.4 +/- 3 mm, LVPW 23.2 +/- 7 mm with cavity obliteration). SAM of AML was not observed. Doppler flow studies across aortic and mitral valves were normal.

Neurofibromatosis and psychological processes.

A minimal degree of mental handicap is commonly seen in neurofibromatosis (NF). Despite the prevalence, little is known about the nature of the mental handicap. In this study, schoolchildren with NF and unaffected siblings were studied clinically and given a series of psychological tests. The psychological battery consisted of standardized tests of intelligence and cognitive processing, laboratory tests of cognitive processing, and personality and mood questionnaires. Clinical data included a medical and family history, results of physical, audiological, and ophthalmological examinations, EEG, tissue biopsy when necessary, and (in NF individuals) a CT scan. Results demonstrate slightly deficient cognitive processing in the NF individuals, particularly in terms of visual-spatial integration. These deficits are related to age-independent severity with more severely affected individuals exhibiting more severe deficits. The findings are discussed in terms of their diagnostic and prescriptive implications.

Specific heart muscle disease in diabetes mellitus--a functional structural correlation.

We report the morphology of diabetic myocardium obtained by endomyocardial biopsy in 16 diabetics. The material was divided into three groups. The first comprised six patients with unexplained cardiomegaly and obscure congestive cardiac failure. The second group, also of six patients, had no cardiac signs and symptoms but exhibited abnormal systolic time intervals. The third group, of 4 patients, was without any cardiac symptoms or signs and had normal systolic time intervals. The vascular and extravascular changes observed were more pronounced in the symptomatic group, intermediate in the asymptomatic patients with abnormal intervals and least in those without symptoms and normal intervals. This provides supporting evidence for the existence of a specific primary myocardial disease in diabetes with good functional structural correlation.