Lesion characteristics, histopathologic results, and follow-up of breast lesions after MRI-guided biopsy

Purpose:We aimed to assess the effectiveness of magnetic resonance imaging (MRI)-guided vacuum-assisted breast biopsy (VABB), evaluate and compare the characteristics and histopathologic findings of lesions, and overview the follow-up results of benign lesions.Methods:MRI findings and histopathologic results of breast lesions biopsied by MRI-guided VABB between 2013 and 2016 were retrospectively analyzed. MRI findings closely related with malignancy were investigated in particular. Follow-up results of benign lesions were evaluated.Results:MRI-guided VABB was applied to 116 lesions of 112 women. Of the lesions, 75 (65%) were benign, while 41 (35%) were malignant. Segmental (94%), clustered (89%), and clustered ring (67%) non-mass-like enhancement patterns were found to be more related with malignancy. False-negative rate of MRI-guided VABB was 12%, underestimation rate was 21%. One of the 54 followed-up benign lesions had a malignant result.Conclusion:MRI-guided VABB is a reliable method for the diagnosis of breast lesions that are positive only on MRI. Follow-up results show that cancer detection rate is low for radio-pathologically concordant lesions. Further multicenter studies with larger patient population are needed to elucidate these results

Review of transrectal ultrasonography findings in the diagnosis of prostate cancer: radiopathological correlation

Amaç: Transrektal ultrasonografi (TRUS) esliginde prostat biyopsisi yapılan hastaları gözden geçirmek ve prostat kanseri tanısında yardımcı olabilecek ultrasonografik kriterleri degerlendirmek. Yöntem: Ocak 2003-Temmuz 2005 tarihleri arasında TRUS esliginde prostat biyopsisi alınan ve PSA degerleri gri zonda yer alan (410 ng/dl; ortalama PSA: 6.9 ± 2.7 ng/dl) 129 hasta retrospektif olarak degerlendirildi. TRUS\ud bulguları patoloji sonuçlarıyla karsılastırıldı. Periferik zon ekoyapısı (homojen ya da heterojen) ve prostat bezi konturları (düzgün ya da düzensiz) subjektif olarak sınıflandı. Bulgular: 44 hasta (% 34) prostat kanseri tanısı aldı. Incelenen kriterlerden periferik zon ekoyapısı ile periferik zonda hipoekoik nodül varlıgının patoloji sonuçlarıyla istatistiksel olarak anlamlı biçimde iliskili oldugu saptandı (p=0.000 ve p=0.007). Prostat kanseri yakalama olasılıgının, periferik zonun heterojen oldugu durumda 7 kat [Odds Oranı (OO): 7.06 (2.98-16.70) % 95 Güven Aralıgı (GA)], periferik zonda hipoekoik nodül varlıgında ise 3 kat [OO: 2.73 (1.18-6.28)%95 GA] arttıgı görüldü. Sonuç: Prostat kanseri tanısında TRUS'nin yeri sınırlıdır ve daha çok biyopsi kılavuzu olarak kullanılır. Bununla birlikte, bu çalısmanın sonuçları bahsedilen TRUS bulgularının varlıgında kanser yakalama olasılıgının anlamlı biçimde arttıgını ortaya koymaktadır. Nodüle yönelik biyopsi protokollerine benzer sekilde heterojen periferik zon varlıgında alınan biyopsi örneklerinin sayısının artırılmasına dayanan bir çalısma planı ile sunulan çalısmanın geçerliligi degerlendirilebilir.Purpose: To overview transrectal ultrasonography (TRUS) guided prostate biopsy cases and to evaluate the potentially useful sonographic criteria for the diagnosis of prostate cancer. Methods:Between January 2003 and June 2005, TRUS guided prostate biopsy specimens were obtained from 129 patients with a gray zone PSA level (4 - 10 ng/dl; average PSA: 6.9 ± 2.7 ng/dl). TRUS findings were compared with pathology results. Peripheral zone echostructure (homogenous or heterogeneous) and prostate contours (smooth or irregular) were classified subjectively. Presence of a hypoechoic nodule in the peripheral zone was noted, additional samples were obtained from the nodules. Results: 44 patients (34%) were found to have prostate adenocarcinoma. A statistically significant relationship was found between the peripheral zone echostructure - presence of hypoechoic nodule in the peripheral zone and pathological results (p=0.000 and 0.007, respectively). Prostate cancer detection rate increased 7 folds [Odds Ratio (OR): 7.06 (2.98-16.70) 95% Confidence Interval (CI)] when the peripheral zone was heterogeneous and 3 folds [OR: 2.73 (1.18-6.28) 95% CI] when there was a hypoechoic nodule in the peripheral zone. Conclusion:TRUS has a limited role in the diagnosis of prostate cancer and is especially used for biopsy guidance. On the other hand, the results of this study reveal a significant increase in cancer detection rate when the mentioned TRUS findings are present. Similar to the nodule targeted biopsies; the accuracy of the presented study can be evaluated with a prospective study including a larger number of biopsy specimens in case of peripheral zone heterogenity

Headache as the sole presenting symptom of cerebral venous sinuses thrombosis: Subgroup analysis of data from the VENOST study

Objectives: Headache is the most common complaint in cerebral venous sinus thrombosis (CVST) and it may sometimes bethe only symptom in these patients. This retrospective and prospective study was an investigation of any differences in termsof clinical risk factors, radiological findings, or prognosis in patients with CVST who presented with isolated headache (IH) andcases with other concomitant findings (non-isolated headache [NIH]).Methods: A total of 1144 patients from a multicenter study of cerebral venous sinus thrombosis (VENOST study) were enrolled inthis research. The demographic, biochemical, clinical, and radiological aspects of 287 IH cases and 857 NIH cases were compared.Results: There were twice as many women as men in the study group. In the IH group, when gender distribution was evaluated byage group, no statistically significant difference was found. The onset of headache was frequently subacute and chronic in the IHgroup, but an acute onset was more common in the NIH group. Other neurological findings were observed in 29% of the IH groupduring follow-up. A previous history of deep, cerebral, or other venous thromboembolism was less common in the IH group thanin the NIH group. Transverse sinus involvement was greater in the IH group, whereas sagittal sinus involvement was greater in theNIH group. The presence of a plasminogen activator inhibitor (PAI) mutation was significantly greater in the IH group.Conclusion: IH and CVST should be kept in mind if a patient has subacute or chronic headache. PAI, which has an importantrole in thrombolytic events, may be a risk factor in CVST. Detailed hematological investigations should be considered. Additional studies are needed.Amaç: Baş ağrısı serebral venöz sinüs trombozunda (SVST) en sık görülen şikayettir ve bazen CVST ile başvuran hastalarda görülen tek semptom olabilir. Bu retrospektif ve prospektif çalışmada, izole başağrısı (IB) ile başvuran SVST olgularında ve baş ağrısı ile ilişkili diğer bulguları olan (izole olmayan başağrısı-İOBA) olgularda klinik risk faktörleri, radyoloji ve prognoz açısından herhangi bir farklılık olup olmadığını araştırdık. Gereç ve Yöntem: Serebral venöz sinüs trombozu (VENOST) çok merkezli çalışmasından 1144 hasta çalışmamıza alındı. Tüm demografik, biyokimyasal, klinik ve radyolojik yönler 287 IBA vakası ve 857 İOBA vakası için karşılaştırılmıştır. Bulgular: Toplam grup içinde kadın oranı iki kat daha yüksekti. İBA grubunda cinsiyet dağılımını yaş gruplarına göre değerlendirildiğinde istatistiksel olarak anlamlı bir fark bulunmadı. İBA grubunda, baş ağrısının başlangıcı sıklıkla subakut ve kronikti, ancak akut başlangıç, İOBA grubunda daha yaygındı. İBA grubunda% 29’luk takip sırasında diğer nörolojik bulgular eklenmiştir. Daha önce serebral, derin ve diğer venöz tromboembolizm öyküsü İBA grubunda İOBA grubuna göre daha azdı. Transvers sinüs tutulumu İBA grubunda daha yüksek iken sagital sinüs tutulumu İOBA grubunda daha fazlaydı. Plazminojen aktivatör inhibitörü (PAI) mutasyonu IBA grubunda anlamlı olarak daha yüksekti. Sonuç: Hastaların subakut veya kronik baş ağrısı varsa SVST tanısı için IBA akılda tutulmalıdır. Trombolitik olaylar için önemli bir role sahip olan PAI, SVST’da bir risk faktörü olabilir, bu nedenle ayrıntılı hematolojik araştırmalar düşünülmelidir. Daha ileri çalışmalara ihtiyaç vardırWOS:0006441978000022-s2.0-8510526695

Characteristics of Isolated Headache patients in Cerebral Venous Sinus Thrombosis (CVST): The Results of VENOST - national survey

karahan, ali yavuz/0000-0001-8142-913XWOS: 000452730900162

Epileptic seizures in cerebral venous sinus thrombosis: Subgroup analysis of VENOST study

Purpose: The aim of this study is to evaluate the presence and prognostic impact of early seizures in cerebral venous sinus thrombosis patients (CVST).Method: VENOST is a retrospective and prospective national multicenter observational study. CVST patients with or without epileptic seizures (ES) were analyzed and compared in terms of demographic and imaging data, causative factors, clinical variables, and prognosis in a total of 1126 patients.Results: The mean age of the patients in the ES group was 39.73 +/- 12.64 and 40.17 +/- 14.02 years in the non-ES group (p > 0.05). Epileptic seizures were more common (76.6 %) in females (p < 0.001). Early ES occurred in 269 of 1126 patients (23.9 %). Epileptic seizures mainly presented in the acute phase (71.4 %) of the disease (p < 0.001). Majority of these (60.5 %) were in the first 24 h of the CVST. The most common neurological signs were focal neurologic deficits (29.9 %) and altered consciousness (31.4 %) in the ES group. Superior sagittal sinus (SSS) and cortical veins (CV) involvement were the most common sites of thrombosis and the mostly related etiology were found puerperium in seizure group (30.3 % vs 13.9 %). Patients with seizures had worse outcome in the first month of the disease (p < 0.001) but these did not have any influence thereafter.Conclusions: In this largest CVST cohort (VENOST) reported female sex, presence of focal neurological deficits and altered consciousness, thrombosis of the SSS and CVs, hemorrhagic infarction were risk factors for ES occurrence in patients with CVST