Molecular subtypes of invasive breast cancer: correlation between PET/computed tomography and MRI findings.

OBJECTIVE: The aim of the study was to investigate the diagnostic value of fluorodeoxyglucose-18 (FDG)-PET/computed tomography (CT) and MRI parameters in determining the molecular subtypes of invasive breast cancer. METHODS: Data from 55 primary invasive breast cancer masses in 51 female patients who underwent pre-treatment PET/CT and MRI scans, and histopathological diagnosis at the authors' center were retrospectively reviewed. The relationship between FDG-PET/CT and MRI parameters, including maximum and mean standard uptake values (SUVmax and SUVmean, respectively), mean metabolic index (MImean) and metabolic tumor volume (MTV) values obtained from FDG-PET, and shape, margin, internal contrast-enhancement characteristics, kinetic curve types, functional tumor volume (FTV), apparent diffusion coefficient (ADC) values obtained from MRI was evaluated. Subsequently, differences among molecular subtypes (i.e. luminal A, luminal B, c-erbB-2 positive, and triple-negative) in terms of PET/CT and MRI parameters were evaluated. RESULTS: The luminal B subtype of invasive breast cancer had higher SUVmax and SUVmean (P = 0.002 and P = 0.017, respectively) values than the luminal A subtype. In addition, the triple-negative subtype had a higher SUVmax (P = 0.028) than the luminal A subtype. There was a statistically significant positive correlation between pathological tumor volume (PTV) and SUVmean (P = 0.019, r = 0.720). SUVmax and ADC were negatively correlated (P = 0.001; r = -0.384). A very strong positive correlation was detected between MTV and FTV (P = 0.000; r = 0.857), and between MTV and PTV (P = 0.006, r = 0.796), and between FTV and PTV (P = 0.006, r = 0.921). CONCLUSION: Results of the present study suggest that SUVmax was superior to MRI findings in predicting molecular subtypes and that MRI was superior to PET/CT in predicting PTV.

Evaluation of abnormal radiological findings in children aged 2 to 36 months followed by recurrent urinary tract infection: a retrospective study.

Our aim is to determine the rational usage of imaging techniques in order to prevent or minimize permanent renal damage in recurrent urinary tract infections (UTIs). This study was enrolled children aged between 2 and 36 months, following-up with the diagnosis of recurrent UTI. All children had ultrasonography (USG) and dimercaptosuccinic acid scanning, 39 of them had underwent on voiding cystourethrography. There were 133 children (87 girls, 46 boys) with the mean age of 32.82 ± 38.10 months included into the study. Forty-three kidney units were normal in ultrasonogram of which seven units had reflux whereas among 35 units with hydronephrosis 22 units had reflux. Sensitivity and specificity presence of hydronephrosis in ultrasonogram for prediction of reflux was 75.9% and 73.5%, respectively. There were 19 dilated ureters in ultrasonogram, and among them 14 had reflux. Sensitivity and specificity of presence with ureteral dilatation in ultrasonogram for prediction of reflux was found as 48.3% and 89.8%, respectively. The sensitivity of parenchymal thinning seen in ultrasonogram for the evaluation of renal parenchyma was 15.9%, whereas specificity was 98.2% .Sensitivity and specificity of dimercaptosuccinic acid for prediction of reflux was 51.6% and 72.3%, respectively. The normal ultrasonogram findings cannot rule out neither possibility of reflux presence nor development of renal scarring. Therefore, DMSA scanning has major role both in determination of parenchymal damage and prevention of scarring. Also we get an important result as ureteral dilatation seen in USG, related to presence of reflux.

The effects of lornoxicam on brain edema and blood brain barrier following diffuse traumatic brain injury in rats.

BACKGROUND: In this experiment, the effects of lornoxicam on brain edema and the blood brain barrier (BBB) following diffuse traumatic brain injury (TBI) were studied. METHODS: Twenty adult male Wistar albino rats were anesthetized, and experimental closed head trauma was induced by the Marmarou method. After head injury, the rats were randomly divided into two groups: Group I was the control group, to which 2 ml saline was administered intraperitoneally, and Group II was the lornoxicam group, to which 2 ml 1.3 mg kg-1 lornoxicam was administered intraperitoneally. Twenty-four hours after head trauma, 99 mTc pentetate (DTPA) was injected at a dose of 37 MBq, and posterior planar images of each rat were obtained using an Infinia gamma camera. After imaging of BBB permeability, brain tissues were dissected from the cranium. The brain water content (BWC) of each sample was calculated using the wet-dry method. RESULTS: The lesion/background (L/b) ratio of Group I was 3.76±0.46 and 3.02±0.66 for early (5th min) and late (60th min) imaging, respectively. In Group II, the L/b ratios were 3.52±0.96 and 2.63±0.63 for early and late imaging, respectively (p>0.05). BWC was 79.6±2.5% and 77.5±1.1% for Groups I and II, respectively (p<0.05). CONCLUSION: In this rat model of TBI, lornoxicam reduced brain edema but did not affect BBB permeability.

The diagnosis of yo-yo reflux with dynamic renal scintigraphy in a patient with incomplete ureteral duplication.

UNLABELLED: The diagnosis of yo-yo reflux in patients with incomplete upper collecting system duplications is difficult. We report a case with recurrent urinary tract infections and ultrasonographically detected duplication in the left collecting system in which the presence of yo-yo reflux is demonstrated with dynamic renal scintigraphy. CONFLICT OF INTEREST: None declared.

Effects of 99mTc-MIBI and 99mTc-MDP administration on dual-energy X-ray absorptiometry bone mineral density measurements.

OBJECTIVE: Nuclear medicine procedures are often performed in close-time proximity to bone densitometry studies. The purpose of this study was to determine the effects of Tc-hexakis-2-methoxyisobutyl isonitrile (MIBI) and Tc-methylene diphosphonate (MDP) on the accuracy of bone mineral density (BMD) measurements performed using dual-energy X-ray density. METHODS: The effect of a diagnostic dose of Tc-MIBI on BMD estimations in the lumbar spine and the left total hip was assessed in 30 patients (19 female, 11 male; mean age: 55.5+/-10.5 years) by using a Lunar DPX-NT scanner. Thirty patients, admitted to the nuclear medicine department for bone scintigraphy (15 female, 15 male; mean age: 56+/-15.92 years), were included into the study. Each patient underwent dual-energy X-ray density assessment for which a Lunar DPX-NT scanner was used before and 2 h after intravenous injection of Tc-MDP (925 MBq) and Tc-MIBI (1110 MBq). BMD measurements were calculated from lumbar spine (including L2-4) and left hip (including femoral neck, trochanter, and total hip). For statistical analysis, the Wilcoxon test was used and a P value of less than 0.05 was accepted as statistically significant. RESULTS: According to Wilcoxon's statistical test, we found extremely significant changes on the measured BMD, T-score, before and 2 h after the injection of Tc-MIBI for lumbar spine and left hip in 30 patients. We found statistically significant decrement on measured BMD from lumbar spine and trochanter before and 2 h after the injection of Tc-MDP. Although MDP BMD values in femoral neck and total hip were decreased after the injection of Tc-99m, they did not reach a statistically significant value. The comparison of pre-T-score and post-T-score values showed a statistically significant decrease after the injection for only L2-4 lumbar spine (P = 0.002), but left hip of pre-T-score and post-T-score values did not reach a statistically significant value. CONCLUSION: In this study, it was determined that measured BMD values are decreased in lumbar spine for all patients. The magnitude of the effect is dependent on the location of the activity. We assume that some radioactivity from Tc is counted by the densitometer's detector, thus resulting in a decrease in the measured BMD. Scintigraphy and bone densitometry should be performed on different days to avoid artifactual reduction in BMD measurements.