Epicardial adipose tissue (EAT) thickness on non-gated chest CT as an alternative to EAT volume on cardiac CT.

BACKGROUND: Epicardial adipose tissue (EAT) volume is usually measured with ECG-gated computed tomography (CT). Measurement of EAT thickness is a more convenient method; however, it is not clear whether EAT thickness measured with non-gated CT is reliable and at which localization it agrees best with the EAT volume. PURPOSE: To examine the agreement between ECG-gated EAT volume and non-gated EAT thickness measured from various localizations and to assess the predictive role of EAT thickness for high EAT volume. MATERIAL AND METHODS: EAT thickness was measured at six locations using non-contrast thorax CT and EAT volume was measured using ECG-gated cardiac CT (n = 68). The correlation and agreement (Bland-Altman plots) between the thicknesses and EAT volume were assessed. RESULTS: EAT thicknesses were significantly correlated with EAT volume (P < 0.001). The highest correlation (r = 0.860) and agreement were observed for the thickness adjacent to the right ventricular free wall. Also, EAT thickness at this location has a strong potential for discriminating high (>125 cm3) EAT volume (area under the ROC curve=0.889, 95% CI=0.801-0.977; P < 0.001). The sensitivity, specificity, and positive and negative predictive values of EAT thickness for high EAT volume were 76.5%, 88.2%, 68.4%, and 91.8%, respectively, for the cutoff value of 5.75 cm; and 47.1%, 100%, 100%, and 85%, respectively, for the cutoff value of 8.10 cm. CONCLUSION: EAT thickness measured on non-gated chest CT adjacent to the right ventricular free wall is a reliable and easy-to-use alternative to the volumetric quantification and has a strong potential to predict high EAT volume.

Intra- and interobserver agreement of rectal cancer staging with MRI.

BACKGROUND: Reliable preoperative staging of rectal cancers is crucial for treatment decision making. PURPOSE: To assess the intra- and inter-observer agreement of rectal cancer staging, including the sub-categories, with magnetic resonance imaging (MRI). MATERIAL AND METHODS: The study includes 85 patients (35.3% women; mean age = 62.2 ± 11.2 years) who underwent MRI for rectal cancer staging between August 2020 and April 2021. All the stored images were evaluated independently by two radiologists with 10-15 years of experience. For intra-observer agreement, the evaluations were done two months apart. Analyses were made using kappa, prevalence and bias-adjusted kappa (PABAK), and intraclass correlation coefficient (ICC), where appropriate. RESULTS: There was a substantial inter-observer agreement for tumor localization (kappa = 0.665, PABAK = 0.682), mesorectal fascia invasion (kappa = 0.663, PABAK = 0.822), internal and external sphincter involvement (kappa 0.804 and 0.751, PABAK 0.859 and 0.929, respectively), and moderate to substantial agreement for M-staging (kappa = 0.451, PABAK = 0.742) and extramural vascular invasion (kappa = 0.569, PABAK = 0.741). There was also a good inter-observer agreement for T staging and N staging (ICC = 0.862, 95% confidence interval [CI] = 0.788-0.911; and ICC = 0.841, 95% CI = 0.595-0.922, respectively). As expected, intra-observer agreement was better than inter-observer agreement. CONCLUSION: Intra- and inter-observer agreement for MRI staging of rectal cancers using the structured reporting template is good.

The Relationship Between Breast Cancer and Risk Factors: A Single-Center Study.

OBJECTIVE: To determine the relationship between breast cancer and known risk factors in patients who had mammography (MG) for breast cancer screening or ultrasonography and/or MG for diagnostic purposes. MATERIALS AND METHODS: In the period of January-December, 2011, a questionnaire composed of 17 questions was applied to 2862 female patients and MG and/or US examination was performed afterwards. Chi-square and Kruskal-Wallis tests were used for statistical analysis. RESULTS: The mean age was 51.05±8.98, age at menarche was 13.0±1.6 and age at menopause was 47±5.2. The first pregnancy was at 20±4.6. Out of 2862 cases, 242 had breast cancer diagnosis and 32 were newly diagnosed. There was no correlation between menarche age, age at menopause or first pregnancy and breast cancer. There was no relationship between breast cancer risk and hormone replacement therapy or oral contraceptive use. In patients with the diagnosis of breast cancer (242 cases), 61 had (25%) a positive family history. There was a significant correlation between the presence of a positive family history and having breast cancer (p=0.003). CONCLUSION: The presence of breast cancer in the family has the strongest relationship among all risk factors. It is important to have regular followup of these patients and to raise the awareness of patients.

Evaluation of the relationship between epicardial fat volume and left ventricular diastolic dysfunction.

PURPOSE: The aim of the present study was to evaluate the relationship between epicardial fat tissue (EFT) volume and left ventricular diastolic function. MATERIALS AND METHODS: A total of 63 patients (29 male, 34 female, mean age 57.8 ± 10.9 years) were enrolled in the study. Multidetector computed tomography (MDCT) and 2D transthoracic echocardiography were performed in 29 patients with left ventricular diastolic dysfunction and 34 patients with normal diastolic function. EFT volume and coronary calcium score were measured by MDCT. RESULTS: Mean EFT volume was 137.2 ± 56.2 cm(3) for the whole study group. Mean EFT was 114.1 ± 46.6 cm(3) in patients with normal left ventricular diastolic function and 164.4 ± 54.9 cm(3) in those with left ventricular diastolic dysfunction (p = 0.0002). Diastolic dysfunction had no significant correlation with diabetes, hypertension, and coronary calcium scoring (p > 0.05). Also in our patient group EFT volume had no significant correlation with coronary calcium score (r = 0.148, p = 0.248). CONCLUSION: Patients with left ventricular diastolic dysfunction had significantly increased EFT volume.