An Exceptional Response to Dostarlimab in Mismatch Repair Deficient, Microsatellite Instability-High and Platinum Refractory Endometrial Cancer.

Until recently, effective therapies for advanced endometrial cancer progressing to a platinum-based combination were lacking. In this setting, immunotherapy with anti PD-1/PDL-1 monoclonal antibodies is rising as a new paradigm in particular for patients with microsatellites instability/mismatch repair deficiency. In this case report, we describe an exceptional and rapid response to dostarlimab in a platinum refractory endometrial cancer patient with high disease burden harboring a mismatch repair deficiency.

The infected liver: radiologic-pathologic correlation.

Recent technologic advances have significantly enhanced the role of imaging in the detection, characterization, and management of infectious diseases involving the liver. In addition, imaging-guided percutaneous drainage has greatly improved the clinical treatment of patients with focal liver abscess. Infectious liver diseases can be accurately evaluated with ultrasonography (US), computed tomography (CT), and magnetic resonance (MR) imaging. Characteristic changes in US echogenicity, CT attenuation, or MR imaging signal intensity and typical enhancement patterns can contribute to the diagnosis of specific infectious diseases, including abscesses, parasitic diseases, fungal diseases, granulomatous diseases, viral hepatitis, and other less common infections. CT is particularly helpful in revealing the presence of calcifications and gas and in detailing the enhancement pattern. The multiplanar capability of MR imaging and its sensitivity to small differences in tissue composition increase its specificity for certain hepatic infections, including hydatid cyst and candidiasis. Radiologic findings may be sufficient to obviate aspiration or histologic examination, although in most instances they are less specific. Nevertheless, imaging findings taken together with appropriate clinical information may provide the most likely diagnosis, even if biopsy is sometimes required for confirmation.

Acute small bowel ischemia: CT imaging findings.

Small bowel ischemia is a disorder related to a variety of conditions resulting in interruption or reduction of the blood supply of the small intestine. It may present with various clinical and radiologic manifestations, and ranges pathologically from localized transient ischemia to catastrophic necrosis of the intestinal tract. The primary causes of insufficient blood flow to the small intestine are various and include thromboembolism (50% of cases), nonocclusive causes, bowel obstruction, neoplasms, vasculitis, abdominal inflammatory conditions, trauma, chemotherapy, radiation, and corrosive injury. Computed tomography (CT) can demonstrate changes because of ischemic bowel accurately, may be helpful in determining the primary cause of ischemia, and can demonstrate important coexistent findings or complications. However, common CT findings in acute small bowel ischemia are not specific and, therefore, it is often a combination of clinical, laboratory and radiologic signs that may lead to a correct diagnosis. Understanding the pathogenesis of various conditions leading to mesenteric ischemia and being familiar with the spectrum of diagnostic CT signs may help the radiologist recognize ischemic small bowel disease and avoid delayed diagnosis. The aim of this article is to provide a review of the pathogenesis and various causes of acute small bowel ischemia and to demonstrate the contribution of CT in the diagnosis of this complex disease.

Real-time compound sonography of the rotator-cuff: evaluation of artefact reduction and image definition.

PURPOSE: The aim of this study was to compare real time compound sonography with conventional sonography in the evaluation of rotator cuff tears. MATERIALS AND METHODS: A prospective study was performed on 50 supraspinatus tendons in 101 patients treated by surgical acromioplasty. The surgeon described 33 (66%) full-thickness tears and 17 (34%) partial-thickness tears. All tendons were examined by conventional sonography and real time compound sonography on the day before surgery. The techniques were compared by evaluating the images for freedom from artefacts, contrast resolution and overall image definition. RESULTS: Real time compound sonography proved to be superior to conventional sonography as regards freedom from artefacts in 50 cases out of 50 (100%). It was superior to conventional sonography in evaluating the image contrast resolution in 45 cases out of 50 (90%), and superior to conventional sonography in overall image definition in 45 out of 50 cases (90%). CONCLUSIONS: Real-time compound sonography reduces the intrinsic artefacts of conventional sonography and allows better overall image definition. In particular, the digital technique allowed us to study the rotator cuff with better contrast resolution and sharper and more detailed images than did conventional sonography.