Agreement between dynamic contrast-enhanced magnetic resonance imaging and pathologic tumour size of breast cancer and analysis of the correlation with BI-RADS descriptors

Purpose: The purpose of this study was to evaluate magnetic resonance imaging (MRI)-pathology concordance of tumour size in patients with invasive breast carcinoma, with an emphasis on Breast Imaging Reporting and Data System (BI-RADS) descriptors of dynamic contrast-enhanced MRI (DCE-MRI). Material and methods: Of patients who had preoperative DCE-MRI, 94 were enrolled. Concordance between MRI and the pathological findings was defined as a difference in tumour size of 5 mm or less. The greatest dimension was measured by two radiologists, and BI-RADS descriptives were described in accordance. The gold standard was chosen as the pathologic assessment. Results: Tumour measurements determined by MRI and the pathological reports were not statistically different (2.64 ± 1.16 cm, Wilcaxon Z = -1.853, p = 0.064). Tumour sizes were concordant in 72/94 patients (76.6%). The mean difference between the pathological and MRI tumour sizes was -0.1 cm. MRI overestimated the size of 17/94 tumours (18.1%) and underestimated the size of 5/94 tumours (5.3%). Discordance was associated with larger tumour size. Histologic and molecular type of tumours, patient age, histologic grade, lymphovascular invasion or perineural invasion positivity, fibroglandular volume, background parenchymal enhancement, and being mass or non-mass were not associated with concordance. Irregular margin and heterogenous enhancement in DCE-MRI were associated with discordance in logistic regression analysis (p = 0.035, OR: 4.24; p = 0.021, OR: 4.96). Conclusions: Two BI-RADS descriptors of irregular contour and heterogeneous contrast uptake were found to be associated with tumour size discrepancy. This might be attributed to the dynamic and morphologic specialities of tumours primarily rather than tumour biology

Analysis of Obesity And Axillary Lymph Nodes on Mammography

Fat-infiltrated lymph nodes mostly seen on mammograms (MG) of the elderly and obese women. We analyzed the fat infiltration of lymph nodes for its potential use in estimating body mass index (BMI). 2D digital MG of 157 women assessed by one breast radiologist and one radiology resident. For each patient, the largest lymph node chosen as the index by analyzing the medial, lateral oblique (MLO) views. The width and length of the node and the hilum, the cortex, and the Hilo-cortical ratio (HCR) were measured. Breast density was categorized according to the ACR BI-RADS 4th edition and divided into two groups as dense and non-dense. Obesity was defined as BMI ≥ 30 kg/m2, overweight as BM

Učinak mamografskog postupka na serumske razine upalnih i/ili tumorskih biljega

Mammography is one of the gold standard screening tests for breast cancer. The effects of mammography procedure on blood parameters are not known. This study aimed to investigate whether the procedure-associated breast compression affects the widely and simultaneously performed blood measurements of C-reactive protein (CRP), carcinoembryonic antigen (CEA), and cancer antigen (CA) 15-3. According to breast ultrasound examination results, participants were divided into 3 groups as follows: group 1 (participants with breast mass size ≥20.0 mm, n=48); group 2 (participants with breast mass size <20.0 mm, n=17); and group 3 (participants with no breast mass, n=23). In groups 1 and 2, on the day of the mammographic imaging study, serum CRP, CEA, and CA 15-3 levels were measured before and after the imaging study. Participants in group 3 had their blood parameters measured without mammography and/or any breast compression. Post-mammography blood measurements displayed a significant increase in serum CRP levels, and a significant decrease in serum CEA and CA 15-3 levels in group 1 (in comparison with the same day pre-mammography blood sampling levels; p<0.05 all). Although pre-mammography serum CEA levels in group 1 participants were significantly higher than those in group 2 and 3 participants, this significant elevation became nonsignificant at post-mammography measurements (p0.05, respectively). On the day of the mammographic imaging study, the optimal time of blood sampling for testing CRP, CEA and CA 15-3 levels in persons with a breast mass is before, but not after the mammographic imaging procedure. This issue requires additional detailed studies.Mamografija je jedan od ‘zlatnih’ standardnih testova probira za rak dojke. Učinci mamografskog postupka na krvne parametre nisu poznati. Cilj ovog istraživanja bio je ispitati djeluje li kompresija dojke povezana s ovim postupkom na često i istodobno izvođena mjerenja C-reaktivnog proteina (CRP), karcinoembrijskog antigena (CEA) i karcinom antigen (CA) 15-3 u krvi. Ispitanice su podijeljene u 3 skupine prema rezultatima ultrazvučnog pregleda dojki: 1. skupina (ispitanice s masom u dojci ≥20,0 mm, n=48); 2. skupina (ispitanice s masom u dojci <20,0 mm, n=17); 3. skupina (ispitanice bez mase u dojci, n=23). U 1. i 2. skupini serumske razine CRP, CEA i CA 15-3 mjerene su prije i nakon mamografskog postupka. Kod ispitanica 3. skupine krvni parametri mjereni su bez mamografije i/ili bilo kakve kompresije dojke. Mjerenja provedena nakon mamografije pokazala su značajan porast serumskih razina CRP i značajan pad serumskih razina CEA i CA-15-3 u 1. skupini u usporedbi s razinama tih parametara zabilježenim istoga dana prije mamografije (p<0,05 sve). Iako su razine CEA u serumu prije mamografije bile značajno više u 1. skupini u usporedbi s 2. i 3. skupinom, značajnost tog porasta izgubila se kod mjerenja nakon mamografije (p0,05). Dakle, u danu kad je zakazana mamografija optimalno vrijeme za uzorkovanje krvi za mjerenje razina CRP, CEA i CA 15-3 kod osoba s masom u dojci je prije, a ne poslije mamografskog postupka. Ovo pitanje zahtijeva daljnje podrobne studije

ROLE OF FACET JOINT ORIENTATION AND FACET TROPISM IN NONSPESIFIC LOW BACK PAIN

Background: Low Back Pain is a complaint at least once we experience all through our life. Although low back pain can be caused by several reasons, mostly low back pain due to nonspecific reasons can be encountered. In this study, our main goal is to examine facet tropism types and facet joint orientation in patients with nonspecific low back pain we have grouped according to age and determine if there is a relationship between the low back pain and facet joint morphology. Patients and methods: We have retrospectively examined magnetic resonance imaging of 135 patients who applied to the neurosurgery clinic with low back pain complaint in the period of 2017-2018 year. For each phenomenon, facet joint angles have been measured at all vertebra levels. Average values of facet joint angles have been taken and facet orientation has been determined. The difference between right and left facet joint angle has been calculated; degree and type of facet tropism have been determined. Results: It has been observed that facet joint orientation at L1-2 level was more coronalized in age group of 70-80 when compared to age group of 10-20. ‘No type’ facet tropism has been observed in majority of the phenomenon and no significant difference has been observed between lumbar levels and age groups. Conclusion: As a result of our study; it has been concluded that facet joint orientation and facet tropism are not effective in the etiology of nonspecific low back pain. Furthermore, facet tropism is not related to age and maybe it is an inborn characteristic

Shear wave elastography of the uterine cervix under different conditions with inter-operator agreement analysis

Purpose: Shear wave elastography (SWE) is a relatively new technique for measuring tissue elasticity. Its implementation for assessing the tissue of the cervix is evolving, and SWE analyses of healthy, nonpregnant cervixes is the first step in understanding other SWE changes related to cervical pathologies; nevertheless, some challenges in the use of the technique still require investigation. We aimed to target the consistency of healthy cervix shear wave elastography measurements and examine the changes induced by patient-related factors. Material and methods: Elastograms were obtained at the internal and external os in the anterior (IA, EA) and posterior (IP, EP) portions of the cervix using a transvaginal approach in eight postmenopausal and 25 premenopausal women. Measurements with a standard deviation of over 20% and patients who presented with colour loss or heterogeneity were excluded from the study. Shear wave elastography assessments were performed using a Toshiba Aplio 500 version 6. Statistical significance was defined as a p value less than 0.10, due to the small number of patients. Results: The mean speeds obtained at the external os on the anterior and posterior aspects was 3.17 ± 0.85 m/s and 3.18 ± 0.84 m/s, respectively, and at the internal os, the results on the anterior and posterior aspects were 3.38 ± 0.73 m/s and 3.53 ± 0.81 m/s, respectively. The difference in speed among all regions was statistically significant (p < 0.05). Fifteen patients were also analysed by a second radiologist with a similar experience level as that of the first. Nine measurements for IP, 13 measurements for IA, 11 measurements for EP, and 15 measurements for EA were performed. The correlation coefficients between the two sets of measurements were 0.46, 0.30, 0.67, and 0.51, respectively. There was no difference in the SWE values with respect to age, parity, and gravidity for any of the regions. The SWE values at the IA, IP, and EA regions between the postmenopausal and premenopausal women were significantly different (p = 0.038, p = 0.059, p = 0.065). Conclusions: The posterior portion of the internal os is most likely to undergo inaccurate SWE measurement among the different anatomical positions. The correlation between radiologists was found to be different for different locations in the cervix. More studies are needed to determine the SWE values of the healthy cervix and the agreement levels between radiologists

Effect of Mammography Imaging Procedure on Serum Inflammatory and/or Tumor Marker Levels

Mammography is one of the gold standard screening tests for breast cancer. The effects of mammography procedure on blood parameters are not known. This study aimed to investigate whether the procedure-associated breast compression affects the widely and simultaneously performed blood measurements of C-reactive protein (CRP), carcinoembryonic antigen (CEA), and cancer antigen (CA) 15-3. According to breast ultrasound examination results, participants were divided into 3 groups as follows: group 1 (participants with breast mass size ≥20.0 mm, n=48); group 2 (participants with breast mass size <20.0 mm, n=17); and group 3 (participants with no breast mass, n=23). In groups 1 and 2, on the day of the mammographic imaging study, serum CRP, CEA, and CA 15-3 levels were measured before and after the imaging study. Participants in group 3 had their blood parameters measured without mammography and/or any breast compression. Post-mammography blood measurements displayed a significant increase in serum CRP levels, and a significant decrease in serum CEA and CA 15-3 levels in group 1 (in comparison with the same day pre-mammography blood sampling levels; p<0.05 all). Although pre-mammography serum CEA levels in group 1 participants were significantly higher than those in group 2 and 3 participants, this significant elevation became nonsignificant at post-mammography measurements (p0.05, respectively). On the day of the mammographic imaging study, the optimal time of blood sampling for testing CRP, CEA and CA 15-3 levels in persons with a breast mass is before, but not after the mammographic imaging procedure. This issue requires additional detailed studies

Comparison of Qualitative and Volumetric Assessments of Breast Density and Analyses of Breast Compression Parameters and Breast Volume of Women in Bahcesehir Mammography Screening Project

Objective: We aimed to compare visual and quantitative measurements of breast density and to reveal the density profile with compression characteristics