Radioproteomics in Breast Cancer: Prediction of Ki-67 Expression With MRI-based Radiomic Models.

RATIONALE AND OBJECTIVES: We aimed to investigate the value of magnetic resonance image (MRI)-based radiomics in predicting Ki-67 expression of breast cancer. METHODS: In this retrospective study, 159 lesions from 154 patients were included. Radiomic features were extracted from contrast-enhanced T1-weighted MRI (C+MRI) and apparent diffusion coefficient (ADC) maps, with open-source software. Dimension reduction was done with reliability analysis, collinearity analysis, and feature selection. Two different Ki-67 expression cut-off values (14% vs 20%) were studied as reference standard for the classifications. Input for the models were radiomic features from individual MRI sequences or their combination. Classifications were performed using a generalized linear model. RESULTS: Considering Ki-67 cut-off value of 14%, training and testing AUC values were 0.785 (standard deviation [SD], 0.193) and 0.849 for ADC; 0.696 (SD, 0.150) and 0.695 for C+MRI; 0.755 (SD, 0.171) and 0.635 for the combination of both sequences, respectively. Regarding Ki-67 cut-off value of 20%, training and testing AUC values were 0.744 (SD, 0.197) and 0.617 for ADC; 0.629 (SD, 0.251) and 0.741 for C+MRI; 0.761 (SD, 0.207) and 0.618 for the combination of both sequences, respectively. CONCLUSION: ADC map-based selected radiomic features coupled with generalized linear modeling might be a promising non-invasive method to determine the Ki-67 expression level of breast cancer.

The comparison of the histopathological results of the thyroid fine-needle aspiration biopsies in the 795 patients with thyroidectomy.

BACKGROUND: We aimed to evaluate the effectiveness of preoperative fine-needle aspiration biopsies (FNAB) by the postthyroidectomy pathology results. METHOD: Seven hundred and ninety-five patients with FNAB and following thyroid operations which have been performed between April 2008 and December 2019 were included in this study. By comparing the results of the FNAB and final pathologies, the specificity, sensitivity, FNR, false positivity ratio (FPR), accuracy and also the effect of nodule diameter on these have been evaluated. In Bethesda III subgroup according to FNAB, we investigated the malignancy rates and in whom this risk has been increased more. RESULTS: In our study, the sensitivity of FNAB is 73.40%, the specificity is 95.33%, the accuracy is 91.81%, FNR is 26.60% and FPR is 4.67%. In the patients with nodules ≥4 cm and < 4 cm respectively, we calculated the sensitivity 20.0% vs 79.76%, specificity 95.73% vs 95.19%, accuracy 89.82% vs 92.78%, FNR 80.0% vs 20.24%, FPR 4.27% vs 4.8%. CONCLUSION: Thyroid FNAB is an easy procedure with a high specificity and sensitivity. Nevertheless, when the nodule diameter was ≥4 cm, increased FNR and decreased sensitivity should be kept in mind while evaluating the patients.

A Case of Lafora Disease Diagnosed by Axillary Skin Biopsy.

Lafora disease is a severe form of progressive myoclonic epilepsy with autosomal recessive inheritance diagnosed by inclusion body in biopsy. A 26-year-old woman was admitted due to complaints of frequent twitches and fainting. The 0.5x0.3x0.3 cm axillary skin punch biopsy was subjected to routine histopathological evaluation. Cytoplasmic PAS-positive inclusion bodies were observed at the basal side of the eccrine and apocrine glands. The diagnosis of Lafora disease can also be made by the observation of the polyglycosan cytoplasmic inclusion bodies in the brain, liver and skeletal muscle biopsies. Although we need more work to understand the etiopathogenesis of Lafora disease, we would like to draw attention to the importance of skin biopsy in the differential diagnosis of young patients with clinically refractory epilepsy, myoclonus, and cognitive decline.