Comparative evaluation between external phased array coil at 3 T and endorectal coil at 1.5 T - Preliminary results

Objective: The aim of this study was to compare the image quality and the diagnostic accuracy of endorectal coil 1.5 T MRI (erMRI) and phased-array coil 3 T MRI (3-T MRI) in the pretherapeutic staging of prostate cancer. Methods: Twenty-nine consecutive patients, with pathological proven prostate cancer, have been examined in the same week with both erMRI and 3-T MRI. Two radiologists independently evaluated the image quality focusing on the following points: cancer tissue conspicuity, capsular infiltration and tumor involvement of seminal vesicles, neuro-vascular bundles, and apex. The radiologists assigned to each one of the above findings an image-quality score ranging from 1 to 5 (with 1 meaning not visible, 2 poorly visible, 3 fairly visible, 4 well visible with some artifacts, and 5 clearly visible without artifacts). Afterwards a comparative evaluation of the mean score obtained respectively by erMRI and 3 T MRI was done. Twenty-two of these 29 patients underwent radical prostatectomy. Assuming as gold standard the pathological report from the resected specimen, we compared the diagnostic accuracy of 3TMRI and erMRI in differentiating between tumors confined within the prostate gland (stage <= T2) and tumors extending through the prostatic capsule (stages T3 and T4). Results: erMRI's image quality was found to be statistically significantly better than 3 T MRI's in evaluating tumor conspicuity, capsular infiltration, and seminal vesicles involvement. On the other hand, considering apex and NVB involvement no statistically significant difference was found between the 2 techniques. On the diagnosis of intracapsular or extracapsular tumor spread 3 T MRI and erMRI showed a comparable performance of sensitivity (75% vs. 83%), specificity (90% vs. 90%), positive predictive value (90% vs. 90%), and negative predictive value (75% vs. 81%). Conclusions: During preoperative prostate cancer staging, 3 T MRI, despite a slightly worse image quality, can provide comparable diagnostic information to erMRI

Tuberous sclerosis complex presenting as a pulmonary solitary nodule.

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Non-surgical Management of Blunt Splenic Trauma: A Comparative Analysis of Non-operative Management and Splenic Artery Embolization—Experience from a European Trauma Center

Purpose: The objective of our study was to retrospectively compare the outcomes of non-operative management (NOM) and splenic artery embolization (SAE) in the management of hemodynamically stable patients with splenic injuries. Materials and Methods: In a 5-year period, 109 patients were recorded; 60/109 were treated with NOM and 49/109 with SAE. For each patient, the following parameters were assessed: Glasgow coma scale, injury severity score, American Association for the Surgery of Trauma splenic injury grade, transfusion requirements, hemoglobin level, presence of a splenic vascular lesion (SVL) and amount of hemoperitoneum (Bessoud scale). Different SAE techniques (proximal, distal, combined) with different materials were employed. Clinical success was defined as spleen conservation at 30&nbsp;days; failure was defined as spleen re-bleeding within 30&nbsp;days, requiring splenectomy. Student’s t test or Chi-square analysis and the Kaplan–Mayer curve were used to analyse each group’s results and compare them with those of the other group. Results: In the SAE group, AAST splenic injury grade was higher and serum hemoglobin levels were lower. The SAE group had significantly more SVL and hemoperitoneum compared to the NOM group. The clinical success rate was not significantly different between groups (NOM = 95%, SAE = 87.8%; p = 0.16). Sixty-six percent of NOM failures were related to inadequate patient selection, while 67% of SAE failures were due to technical/procedural issues. Conclusion: Our study observed a high splenic salvage rate with the use of SAE as an adjunct to NOM, and suggests that it may be further improved with appropriate patient selection and an improved embolization technique

Octahedral iridium clusters: Synthesis, electrochemical mechanisms of formation, and solid-state structures of [Ir-6(CO)(14)(mu-TePh)](-) and [Ir-6(CO)(13)(mu-TePh)(2)]

The diphenyl ditelluride PhTeTePh reacts with [Ir-6(CO)(15)](2-) (in refluxing tetrahydrofuran) or Ir-6(CO)(16) (in toluene) yielding [Ir-6(CO)(14)(mu-TePh)](-) or [Ir-6(CO)(13)(mu-TePh)(2)], respectively. Analogous mono-and disubstituted iridium compounds were prepared with other diaryl disulfides or diselenides. Electrochemical experiments confirm the different reactivity of PhTeTePh and PhSSPh showing that the ditelluride adds to the electrogenerated transient radical [Ir-6(CO)(15)](-.) and the disulfide to [Ir-6(CO)(15)](0). The two clusters consists of octahedra of iridium atoms with one or two edges bridged by phenyltellurolate ligands. The Ir-Ir bonds trans to the TePh unit are remarkably short