Evaluating the role of strain ratio elastography in determining malignancy potential and calculating objective BIRADS US scores using ultrasonography and elastography features

Purpose: The aims of this study were, firstly, to evaluate solid breast masses based on their malignancy potential and to determine whether the strain elastography ratio (SER) can contribute to classical grey-scale ultrasonography findings, and secondly, to define objective BIRADS US scores using ultrasound (US) and SER findings. Material and methods: A total of 280 patients and 297 solid breast masses were evaluated using sonographic and elastographic data. The SER was measured for each lesion. Results: The positive predictive values (PPV) for each criterion was calculated to be between 35% and 83.3%. The lowest PPV was obtained from hypoechogenicity (35%) and the highest PPV was obtained for anti-parallel features (83.3%). The difference between the mean SER of benign and malignant lesions was statistically significant. After ROC analysis, the SER cut-off value was calculated to be 3.1 for determining if the mass was benign or malignant. Mass scores were calculated for each solid breast mass based on positive predictive values, and BIRADS US score was defined as the sum of mass scores. Conclusions: SER findings can be used as malignancy criteria in evaluating solid breast masses. BIRADS US score can be objectively determined based on US and elastography features instead of doing subjective scoring. As an additional result, all solid breast masses have the possibility to be malignant, even though US and elastography findings indicate the opposite

Evaluation of diagnostic value of conventional and color Doppler ultrasound with elastography strain ratios in differentiation between benign and malignant lymph nodes

Introduction: The aim of this study was to evaluate the diagnostic value of conventional ultrasonography (USG) and color Doppler ultrasonography (CDU) with elastography strain ratios (ESR) in discrimination between benign and malignant lymphatic nodes. Material and methods: Two hundred and forty-seven patients (252 lymph nodes) were included in this study. USG and CDU with ESR were performed. Materials were obtained by using fine-needle or vacuum-assisted aspiration methods depending on the site and condition of lymph nodes. The χ2 test and Student’s t-test were used for comparisons. Results: Ninety-two of 252 (36.5%) lymph nodes were malignant, and 160 (63.5%) were benign. Short axis, S/L ratio, presence or absence of the fatty hilum and extra-hilar vascularity were valuable, statistically significant indicators of malignancy. In contrast, long axis and ESR were not significant indicators of malignancy. The short axis cut-off value was calculated to be 12 mm and the S/L ratio cut-off value was calculated to be 1. Conclusions: Long axis of lymph nodes and strain ratios cannot be used as malignancy criteria, and their use is controversial despite the fact that some studies have found them valuable. On the other hand, our results support common knowledge that the short axis, S/L ratio, absence of the fatty hilum, and extrahilar vascularity are significant indicators

Evaluating qualitative and quantitative computerized tomography indicators of chronic obstructive pulmonary disease and their correlation with pulmonary function tests

Background: With increasingly aging populations, chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death today. Emphysematous changes, an important component of the disease, must be determined on HRCT, either qualitatively or quantitatively. The purpose of this study was to evaluate features that help determine emphysematous changes and correlate them with respiratory function tests (RFTs). Material/Methods: A total of thirty COPD patients and a control group of the same size, matched for age, were included in the study. The mean lung parenchyma density values on inspiration and expiration, visual HRCT scores, and pulmonary function tests were obtained. IBM SPSS statistical software (version 22) was used to perform correlation analysis (Pearson's coefficient) and the Mann-Whitney U test. Results: The most valuable RFTs for determining emphysematous changes were DLCO, FEV1, and FEV1/FVC, in that order. Quantitative measures of the mean lung density had the highest correlation with coefficient on expiration. Conclusions: As regards the comparison between objective and subjective density values, the HRCT-based visual density values are satisfactory. On the other hand, the best assessment can be performed with the use of mean density values on expiration. DLCO, FEV1, and FEV1/FVC were found to be valuable parameters in determining parenchymal changes

Effectiveness of computed tomography guided percutaneous radiofrequency ablation therapy for osteoid osteoma : initial results and review of the literature

BACKGROUND: The aim of this retrospective study is to determine our experience of technique success rate, complications and clinical results in long term follow up for computed tomography (CT)-guided radiofrequency ablation [RA] therapy for osteoid osteoma (OO). MATERIAL AND METHODS: We performed RA therapy to 18 patients with OO referred to interventional radiology from other clinics primarily from orthopedics; between January 2011 to May 2014. Daytime and nighttime pain intensity of 18 patients was noted according to visual analog scale (VAS). After procedure pain intensity was compared with before one. We also discussed other factors can affect it. RESULTS: All procedures were completed technically successful for all patients [100%]. We did not experience any major complication or mortality. However we had 3 minor complications. Pain came back in 1 patient after 5 months from procedure and it was considered as recurrence. Dramatic pain intensity fall was seen in patients after procedure, both daytime and nighttime. However we did not find and statistically significant change in comparison of pain intensity reduce and time needed to return back to routine life when using patients demographic data and lesion size. CONCLUSIONS: CT guided RA therapy of OO is minimally invasive, effective and secure procedure