Discriminant Efficacy of mpMRI for Variant Pathology Associated with Prostate Adenocarcinoma.

Purpose - Implementation of multiparametric magnetic resonance imaging (mpMRI)  for prostate adenocarcinoma's variant pathology requires awareness. The aim of this retrospective study was to investigate the discriminant efficacy of multiparametric magnetic resonance imaging modality for variant pathology associated with prostate adenocarcinoma. Methods - Consecutive 247 prostate cancer patients who underwent radical prostatectomy in our university-based hospital between October 2014 and October 2019, were retrospectively reviewed. Data of mpMRI-associated contrast enhancements, T2 signals, apparent diffusion coefficients (ADC), ages and PSA values were compared. Clinical and demographic data of patients were noted including associated variant pathologies and reports of preoperative mpMRI images. Results - Among the patients, 63 (26%) had variant pathology and 14 (22%) had mpMRI before primary prostate biopsy. The group with variant pathology and the control group had similar perfusion curves and increased contrast when compared for mpMRI parameters, but different ADC values for each of the adjusted b-values for 400, 800 and 1400. Conclusion - Our study demonstrates that mpMRI appears to have no role in distinguishing rare variant pathologies associated with prostate adenocarcinoma despite different ADC values.

Endovascular recanalization and remodeling of abdominal aorta stent graft chronic total occlusion after failed extra-anatomic bypass surgery.

OBJECTIVES: Chronic total occlusion (CTO) of the EVAR graft is a rare and serious complication. Traditionally, surgical intervention with prosthetic graft replacement or bypass graft implantation is performed. However, there are limited data in endovascular era. METHODS: We present a case of a 68-year-old male with a history of late EVAR graft occlusion treated with multiple surgical interventions (femorofemoral crossover, extra-anatomic bypass surgery, and thrombectomy) five years ago. Color Doppler ultrasound (CDUS) and computed tomography (CT) angiography revealed thrombosis of the entire bypass graft. Endovascular recanalization and remodeling of the abdominal stent graft CTO was performed with a combination of bare stents and stent grafts. Rupture of the stent graft occurred on the right limb. A second covered stent was placed. RESULTS: At 12-month follow-up, the patient was symptom free. Color Doppler ultrasound surveillance showed patent aortic stent graft and downstream arteries. CONCLUSIONS: Endovascular recanalization of aortic stent graft CTO is a viable option in patients with failed bypass graft.

Evaluation of aging changes of the superficial fat compartments of the midface over time: A computed tomography study.

BACKGROUND: Previous studies on alterations in superficial fat compartments with age yielded contradictory results; the superficial fat tissue volume or thickness was reported to increase, decrease, or remain unchanged. AIMS: To investigate volumetric and dimensional changes in superficial midfacial fat tissue retrospectively in patients who underwent a repeated computed tomography (CT). METHODS: A total of 262 patients (mean age, 46 years; median elapsed time between two CT imagings, 56 months) were included. Axial and sagittal planes were used for measurements of the medial part of the superficial cheek fat (SCF), which is divided into three compartments. The thickness, width, and height of each compartment were measured, and volumes were calculated for both hemifaces. Additionally, results were compared between males and females, and between three age groups: <45, 45-54, and ≥55 years. RESULTS: The total volume of SCF and inferior compartment was significantly increased compared with the first CT findings (p < 0.05). Upper and middle compartment volumes were found to decrease with age (p < 0.05). Thickness was decreased in the upper and middle compartments but not in the lower compartment. The width of the lower and middle compartments increased (p < 0.05), while the upper compartment did not show a significant change with age (p > 0.05). The height of the superficial fat layer was significantly increased at follow-up (p < 0.05). The results were similar for both sexes and all age groups (p > 0.05). CONCLUSIONS: SCF undergoes significant volume and dimensional changes with aging. Therefore, superficial fat tissue should be considered for enhancement of cosmetic treatments.

Radiation doses from head, neck, chest and abdominal CT examinations: an institutional dose report.

PURPOSE: We aimed to obtain typical values for head, neck, chest, and abdominal computed tomography (CT) examinations from routine patients in 2018, and to review our data with national and international diagnostic reference levels (DRLs). METHODS: Single-phase head, neck, chest, and abdominal CT scans of adults performed in 64-slice CT in 2018 were included in this study. Radiation dose parameters of CT scans were obtained from the picture archiving and communication system of our hospital. Volumetric CT dose index (CTDIvol) and dose length product (DLP) values were recorded. Effective dose (ED) and scan length was calculated. A 16 cm diameter phantom is referenced for head CT, and 32 cm diameter phantom is referenced for neck, chest, and abdominal CT. Descriptive statistics of the variables were given according to the normality testing. RESULTS: Median CTDIvol value was 53 mGy for the head, 13.1 mGy for the neck, 8.3 mGy for the chest, and 8.6 mGy for the abdomen. Median DLP value was 988 mGy.cm for the head, 299 mGy.cm for the neck, 314 mGy.cm for the chest, and 457 mGy.cm for the abdomen. Median ED value was 2.07 mSv for the head, 1.76 mSv for the neck, 4.4 mSv for the chest, and 6.8 mSv for the abdomen. Considering national DRLs, median CTDIvol values of head, chest, and abdomen were lower, whereas median DLP and ED values of head and chest were higher. For the abdomen, the median DLP and ED values were lower. CONCLUSION: Overall radiation dose parameters obtained in this study points out the need for optimization of head CT examinations in our institution.

Aging Changes of the Superficial Fat Compartments of the Midface Over Time: A Magnetic Resonance Imaging Study.

BACKGROUND: Studies involving superficial facial fat compartments are few in number with conflicting results. Most of them involved small study groups and compared measurements between different populations of young and old subjects either on cadavers or living subjects. OBJECTIVE: To clarify volumetric and dimensional changes in midfacial superficial fat compartment retrospectively in patients who underwent a repeat magnetic resonance imaging (MRI) without gross pathology. MATERIALS AND METHODS: A total of 70 patients with a mean age of 60 years (range: 33-82 years) and a median elapsed time of 44.5 months (range: 32-64 months) between 2 MRIs were included. Magnetic resonance imaging scans were analyzed in the axial and sagittal planes to obtain measurements of the medial part of the superficial cheek fat. Superficial cheek fat was divided into 3 compartments. Thickness, width, and height were measured, and volumes were calculated for each compartment on both hemifaces. RESULTS: Volume and thickness were decreased significantly in all compartments (p < .05). The width was decreased in superior and middle compartments, whereas increased in lower compartment indicating dislocation of the fat tissue (p < .05). Height was also significantly increased (p < .05). A subgroup analysis has shown that there was no significant difference between men and women. CONCLUSION: This study clarifies that aging is associated with a significant decrease in superficial midfacial fat tissue volume and thickness both in women and men. The decrease in width in upper and middle compartments, but increase in lower compartment suggests a volume shift within superficial fat tissue.