VI-RADS in bladder cancer: Overview, pearls and pitfalls.

Multiparametric magnetic resonance imaging (mpMRI) of the urinary bladder has shown high diagnostic performance in accurate staging of bladder cancer. Vesical Imaging Reporting and Data System (VI-RADS) scoring was developed in 2018 to standardize imaging and reporting of bladder cancer on mpMRI and is an excellent tool in preoperative T-staging of patients with high risk bladder cancer. However, there is no concise guide in the literature for practical use of VI-RADS in everyday clinical reporting. In this review, we describe our experience with mpMRI in pretreatment workup of bladder cancer, illustrate the imaging characteristics of VI-RADS categories 1 to 5 using case review, and discuss practical pearls and pitfalls in the use of mpMRI and VI-RADS in the hope of providing an accessible reference for radiologists in daily reporting.

SingHealth Radiology Archives pictorial essay Part 2: gastroenterology, musculoskeletal, and obstetrics and gynaecology cases.

The Singapore Health Services cluster (SingHealth) radiology film archives are a valuable repository of local radiological cases dating back to the 1950s. Some of the cases in the archives are of historical medical interest, i.e. cerebral angiography in the workup of patients with hemiplegia. Other cases are of historical social interest, being conditions seen during earlier stages of Singapore's development, i.e. bound feet. The archives form a unique portal into the development of local radiology as well as the national development of Singapore. A selection from the archives is published in commemoration of the International Day of Radiology in 2020, as well as the 200th anniversary of the Singapore General Hospital in 2021. This pictorial essay comprises gastroenterology, musculoskeletal and obstetrics and gynaecology cases from the archives.

SingHealth Radiology Archives pictorial essay Part 1: cardiovascular, respiratory and neurological cases.

The Singapore Health Services cluster (SingHealth) radiology film archives are a valuable repository of local radiological cases dating back to the 1950s. Some of the cases in the archives are of historical medical interest, i.e. cerebral angiography in the workup of patients with hemiplegia. Other cases are of historical social interest, being conditions seen during earlier stages of Singapore's development, i.e. bound feet. The archives form a unique portal into the development of local radiology as well as the national development of Singapore. A selection from the archives is published in 2020 in commemoration of the 20th anniversary of the formation of SingHealth, the 55th National Day of Singapore, and the 125th anniversary of the International Day of Radiology. This pictorial essay comprises cardiovascular, respiratory and neurological cases from the archives.

Extradural cervical spinal meningioma mimicking malignancy.

The vast majority of intraspinal meningiomas occur in an intradural extramedullary location. A meningioma in a purely extradural location in the cervical spine as reported here is quite exceptional. Extradural meningiomas tend to show more aggressive features than intradural meningiomas and are often confused with malignant neoplasms. We report an invasive extradural meningioma in the cervical spine with multi-segmental involvement, extension through the neural foramina and encasement of the subjacent vertebral artery, mimicking malignancies such as lymphoma and sarcoma. Although rare, meningiomas may demonstrate extradural multi-segmental growth and should be considered in the differential diagnosis of such lesions.

Notes from the field: use of genotyping to disprove a presumed outbreak of Mycobacterium tuberculosis - Los Angeles County, 2013-2014.

In early 2013, the Los Angeles County Department of Public Health learned of two patients diagnosed with tuberculosis (TB) who had received care at the same outpatient health care facility (facility A). Facility A is a center for infusions of chemotherapeutic and biologic agents and serves a large number of immunocompromised persons who were potentially exposed to infectious TB. If infected, immunocompromised persons are at elevated risk for progression to TB disease. The two patients (patient A and patient B) both had pulmonary TB, with acid-fast bacilli found on sputum-smear microscopy, and had visited facility A multiple times during their infectious periods. Despite initial concerns that these two cases could be the result of person-to-person transmission at facility A, genotyping of the Mycobacterium tuberculosis isolates from these two patients showed that they were infected with unrelated strains.