Ultrasonography-based Staging of Inflammatory Granulomatous Mastitis and Estimation of Steroid Response.

OBJECTIVE: The aim of this study is to present novel diagnostic ultrasonography-based classification of inflammatory granulomatous mastitis (IGM) and to assess and compare dosage responses of locoregional steroid therapy. MATERIAL & METHODS: From January 2017 through March 2023 total of 230 biopsy-proven IGM patients were reclassified (Grade I, II, and III) according to ultrasonography-based morphological features.The injection applications were grouped in Group1 [40mg/mL between 2017-2019 years] vs. Group2 [80mg/mL between 2019-2023 years] and effectiveness analyzed for each grade in between groups. RESULTS: Total mean age was 31 years old (range: 19-60) with median follow-up period of 7 months. The most common clinical presentation was breast mass accompanying draining skin sinuses of the affected skin and hypoechogenic mass with tubular extensions was the most prevalent feature on USG examination. As per USG-based features 79 (34.3%) patients re-defined as Grade I, 64 (27.8%) as Grade II, and 87 (37.8%) as Grade III.All patients underwent loco-regional steroid injection only. The average treatment in the first group was 6 (±3 SD) with effective dose of 40mg/mL and 4 (±2 SD) with 80 mg/mL in the second group. Generalized linear mixed model investigated effects in between groups (p < 0.05). CONCLUSION: High dose steroid treatment was effective in burnout lesions (Grades II and III), and it was found to be statistically significant in lowering number of treatments irrespective of grade. ADVANCE IN KNOWLEDGE: This novel classification could be a convenient tool in terms of common language between radiologists and clinicians. And our study is the pioneer in comparing steroid dosage with no relapse on IGM patients.

Role of contrast agent in evaluation of periprostatic invasion in prostate cancer.

Objectives: Our study aims to demonstrate the detection of invasion by biparametric prostate MRI (bpMRI). Materials and methods: The cases whose histopathological diagnosis was prostate cancer (PCa) and whose mpMRI report was reported as PIRADS 4 and 5 were evaluated retrospectively by two radiologists with different prostate imaging experiences. The images were grouped into two data sets. Dataset-1 was bpMRI, and dataset-2 was mpMRI. Two radiologists first evaluated dataset-1 independently of each other, and 1 month later, dataset-2. They recorded whether there was an invasion and where it was seen in the patients. Then, the results were compared. Results: A total of 75 patients were included in the study. Periprostatic invasion was detected in 33 of the patients. Both the 1st reader and the 2nd reader image detected all the cases with invasion (100%) separately between dataset-1 and set-2. Compatibility for image dataset-1 and dataset-2 between both readers was observed to be excellent. Conclusions: There is no need to use contrast agent to evaluate periprostatic invasion and to have an idea about local staging in PCa patients.

Objetivo: Nuestro estudio tiene como objetivo demostrar la detección de la invasión por resonancia magnética biparamétrica de próstata (BPMRI). Material y métodos: Los casos cuyo diagnóstico histopatológico fue PCA y cuyo informe MPMRI se informó como Pirads 4 y 5 fueron evaluados retrospectivamente por dos radiólogos con diferentes experiencias de imágenes de próstata. Las imágenes se agruparon en dos conjuntos de datos. DataSet-1 fue BPMRI, DataSet-2 fue MPMRI. Dos radiólogos evaluaron por primera vez el conjunto de datos 1 independientemente el uno del otro, y 1 mes después, el conjunto de datos-2. Registraron si había una invasión y dónde se vio en los pacientes. Luego se compararon los resultados. Resultados: Se incluyeron un total de 75 pacientes en el estudio. La invasión periprostática se detectó en 33 de los pacientes. Tanto el primer lector como la imagen del segundo lector detectaron todos los casos con invasión (100%) por separado entre el conjunto de datos-1 y el set-2. Se observó que la compatibilidad para el conjunto de datos de imágenes-1 y el conjunto de datos entre ambos lectores era excelente. Conclusiones: No es necesario usar el agente de contraste para evaluar la invasión periprostática y tener una idea sobre la puesta en escena local en pacientes con PCA.

Anatomical-Based Imaging of Cystic Echinococcosis and Review of the Current Literature.

Echinococcosis is a zoonosis caused by cestodes of the genus Echinococcus. This serious disease continues to be an important public health problem as it is endemic in many parts of the world. Cystic disease affects many organs in the body, most commonly the liver. Hydatid disease can cause a diverse spectrum of symptoms, from asymptomatic infection to potential death. In the presence of clinical suspicion, the diagnosis is made by serology and imaging methods. Imaging findings can range from completely cystic lesions to completely solid appearance and calcification. The imaging method to be used depends on the involved organ and the stage of the cyst. The updated recommendations of the World Health Organization-Echinococcosis Informal Working Group for the stage and treatment of human echinococcosis have had important implications. Accordingly, there are 4 approaches to the clinical management of hydatid disease: surgery, percutaneous techniques and drug therapy for active cysts, and a "watch and wait" approach for inactive cysts. Since it directly affects the treatment, it is necessary to be familiar with the imaging findings of the cyst, especially in endemic areas.

Effect of thyroidectomy in patients with tracheal compression.

OBJECTIVE: Various therapeutic methods are employed to reduce thyroid gland compression of the trachea. Differences in the amount of shrinkage in the thyroid gland, in the amount of amelioration of tracheal compression, and in the amount of fibrosis after treatment may occur with these different methods. Although the compression of the trachea decreases after thyroidectomy, the number of studies showing the extent of this is limited. The purpose of this study was to investigate the effect of thyroidectomy performed due to tracheal compression, to reveal the extent of improvement using magnetic resonance imaging (MRI), and to evaluate our results. METHODS: In total, 30 patients, i.e., 24 women and 6 men, with tracheal compression secondary to thyroid gland enlargement and undergoing total thyroidectomy were included in this study. MRI performed before surgery and 6 months after surgery. The amount of deviation from the tracheal midline and the tracheal lateral and anteroposterior (AP) diameters were measured, compared, and subjected to statistical analysis. RESULTS: Statistical analysis revealed significant differences between pre- and postoperative tracheal deviations, and lateral and AP diameters (p<0.001, p<0.001, and p=0.006, respectively). Histopathologically, benign or malignant pathology caused no significant difference in the postoperative improvement of tracheal anatomy (p=0.348 and p=0.148, respectively). CONCLUSIONS: Thyroidectomy performed due to tracheal compression provides significant improvement in tracheal anatomy. Due to its rapid and effective results, thyroidectomy should be one of the first options considered in the treatment of thyroid diseases with compression findings.

Isolated pineal gland metastasis of acute lymphocytic leukemia: case report.

Metastasis in the pineal region is a rare condition. To best of our knowledge, there is no case report of isolated pineal metastasis secondary to acute lymphocytic leukemia (ALL). The aim of this study is to show the pineal gland involvement of ALL in a case for the first time in the literature. A 25-year-old male patient diagnosed with ALL 2 years ago presented with headache and visual impairment. Brain magnetic resonance imaging (MRI) revealed a well-defined solid lesion which was revealed intensive enhancement after contrast. On diffusion-weighted images, the lesion showed significant diffusion restriction. Three months after therapy, control MRI demonstrated a completely resorbed pineal lesion. The pineal region may be a possible site of metastasis and involvement due to the absence of a blood-brain barrier, and should not be overlooked in patients with not only solid cancers but also ALL.