PET/MR versus PET/CT for locoregional staging of oropharyngeal squamous cell cancer.

BACKGROUND: The value of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for TN staging in head and neck cancer (HNC) has been proven in numerous studies. A few studies have investigated the value of FDG-PET/magnetic resonance imaging (MRI) in the staging of HNC; the combined results indicate potential for FDG-PET/MRI, but the scientific evidence remains weak. PURPOSE: To compare performance of FDG-PET/CT and FDG-PET/MRI for locoregional staging in patients with oropharyngeal carcinomas. MATERIAL AND METHODS: Two radiologists independently of each other retrospectively reviewed primary pre-therapeutic FDG-PET/CT and FDG-PET/MRI examinations from 40 individuals with oropharyngeal carcinomas. TN stage and primary tumor size were noted. The results were compared between observers and modalities and against TN stage set at a multidisciplinary conference. RESULTS: For nodal staging, PET/MRI had slightly higher specificity and accuracy than PET/CT for the most experienced observer. Both methods demonstrated excellent sensitivity (≥ 0.97 and 1.00, respectively), as well as high negative predictive values (≥ 0.95 and 1.00, respectively). No significant differences were found for tumor staging or measurement of maximum tumor diameter. There was a weak agreement (κ = 0.35-0.49) between PET/CT and PET/MRI for T and N stages for both observers. Inter-observer agreement was higher for PET/MRI than for PET/CT, both for tumor staging (κ = 0.57 vs. 0.35) and nodal staging (κ = 0.69 vs. 0.55). The agreement between observers was comparable to the agreement between methods. CONCLUSION: PET/MRI may be a viable alternative to PET/CT for locoregional staging (TN staging) and assessment of maximal tumor diameter in oropharyngeal squamous cell cancer.

Diagnostic Accuracy of InitiaI Chest X-Rays in Thorax Trauma.

OBJECTIVE: To evaluate the efficacy, sensitivity and specificity of chest x-ray as a diagnostic imaging tool in management of thorax traumas. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey, between December 2014 and December 2015. METHODOLOGY: Case records of patients admitted to the emergency department with thoracic trauma were retrospectively analysed through the hospital database. Plain postero-anterior chest X-rays and thorax computerised tomography (CT) scans were evaluated seperately by same radiologist. Accurcy of signs of thoracic trama was determined using CT scan as gold standard. RESULTS: Nine of 23 pneumothorax patients were diagnosed by chest X-ray. Sensitivity and specificity of PA chest X-ray in the diagnosis of pneumothorax was 39.1% and 100%, respectively. Positive predictive values of chest X-ray for diagnosis of pneumothorax was 100% and negative predictive value was 97.1%. Twenty-four patients had pleural effusions on CT scans, while only 15 could be diagnosed in chest X-rays. Chest X-rays were 62.5% sensitive and 100% specific with positive and negative predictive values of 100% and 98.1%, respectively. Twenty of 41 rib fractures were diagnosed with X-rays. Chest x rays had a 48.8% sensitivity and 100% specificity, and positive and negative predictive values were 100% and 95.6%, respectively. CONCLUSION: Chest X-ray should not be used as a sole diagnostic imaging tool for exclusion of pneumothorax, hemothorax, and lung contusion. Due to high predictive values of chest X-rays, they can be used for follow-up.

A rare congenital liver anomaly: Hypoplasia of left hepatic lobe.

Morphologic anomalies of liver, as opposed to many other visceral organs, are very rare. Hypoplasia or agenesis of left lobe of the liver is defined as the absence of liver tissue on the left side of liver without previous disease or surgery. It is usually an incidental finding revealed by imaging exams or during abdominal surgery. A 44-year-old female patient was admitted to the hospital for abdominal pain and discomfort. Physical examination revealed no specific abnormality. Routine laboratory tests were normal. Imaging studies showed the absence of the left hepatic lobe. She had no history of surgery, trauma or liver disease and was diagnosed as having congenital hypoplasia of left hepatic lobe. Anomalies of hepatic morphology are due to developmental defects during embryogenesis and are rarely seen. They are generally diagnosed incidentally based on imaging techniques. Early diagnosis of such an anatomical anomaly is necessary for surgical planning, for appropriate evaluation of intraoperative surgical findings, and for the design of the postoperative approach to therapy.