29 research outputs found
Diffusion-weighted imaging in oral squamous cell carcinoma using 3 Tesla MRI: is there a chance for preoperative discrimination between benign and malignant lymph nodes in daily clinical routine?
Background Preoperative staging of cervical lymph nodes is important to determine the extent of neck dissection in patients with oral squamous cell carcinoma (OSCC). Purpose To evaluate whether a preoperative discrimination of benign and malignant cervical lymph nodes with diffusion-weighted imaging (DWI) (3T) is feasible for clinical application. Material and Methods Forty-five patients with histological proven OSCC underwent preoperative 3T-MRI. DWI (b=0, 500, and 1000s/mm(2)) was added to the standard magnetic resonance imaging (MRI) protocol. Mean apparent diffusion coefficients (ADC(mean)) were measured for lymph nodes with 3mm or more in short axis by two independent readers. Finally, these results were matched with histology. Results Mean ADC was significantly higher for malignant than for benign nodes (1.1430.188 * 10(-3) mm(2)/s vs. 0.987 +/- 0.215 * 10(-3) mm(2)/s). Using an ADC value of 0.994 * 10(-3) mm(2)/s as threshold results in a sensitivity of 80%, specificity of 65%, positive predictive value of 31%, and negative predictive value of 93%. Conclusion Due to a limited sensitivity and specificity DWI alone is not suitable to reliably discriminate benign from malignant cervical lymph nodes in daily clinical routine. Hence, the preoperative determination of the extent of neck dissection on the basis of ADC measurements is not meaningful
Survey Evidence on Conditional Norm Enforcement
We discuss survey evidence on individuals' willingness to sanction norm violations - such as evading taxes, drunk driving, fare dodging, or skiving o work - by expressing disapproval or social exclusion. Our data suggest that people condition their sanctioning behavior on their belief about the frequency of norm violations. The more commonly a norm violation is believed to occur, the lower the individuals' inclination to punish it. Based on an instrumental variable approach, we demonstrate that this pattern reflects a causal relationship
High resolution contrast-enhanced ultrasound and 3-tesla dynamic contrast-enhanced magnetic resonance imaging for the preoperative characterization of cervical lymph nodes: First results
The reliable detection of cervical lymph node (LN) metastases is the planning basis of a selective neck dissection for patients with oral squamous cell carcinoma (OSCC). The aim of this study was to evaluate whether contrast-enhanced ultrasound (CEUS) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) together are able to improve the preoperative characterisation of LNs. A time intensity curve analysis has been performed using CEUS and DCE-MRI for ten LNs, where one LN has been examined per patient. The studied LNs consist of five with and five without metastases. In CEUS the mean time to peak (TTP) was 18 s (range 13–29 s, standard deviation (SD) ± 7 s) for benign and 12 s (range 9–16 s, SD ± 4 s) for malignant LNs. In DCE-MRI the mean TTP was 27 s (range 18–36 s, SD ± 9 s) for benign and 21 s (range 18–27 s, SD ± 5 s) for malignant LNs. Moreover, the relative signal change with respect to reference tissue was significantly higher for LNs with than for those without metastases in both CEUS and DCE-MRI. A combination of imaging morphology, CEUS and DCE-MRI might be a promising method for a reliable differentiation of benign and malignant LNs