53 research outputs found
ESUR recommendations for MR imaging of the sonographically indeterminate adnexal mass: an update
An update of the 2010 published ESUR recommendations of
MRI of the sonographically indeterminate adnexal mass integrating
functional techniques is provided. An algorithmic approach
using sagittal T2 and a set of transaxial T1 and T2WI
allows categorization of adnexal masses in one of the following
three types according to its predominant signal characteristics.
T1 'bright' masses due to fat or blood content can be
simply and effectively determined using a combination of
T1W, T2W and FST1W imaging. When there is concern for a solid component within such a mass, it requires additional
assessment as for a complex cystic or cystic-solid mass. For
low T2 solid adnexal masses, DWI is now recommended.
Such masses with low DWI signal on high b value image
(e.g. > b 1000 s/mm2
) can be regarded as benign. Any other
solid adnexal mass, displaying intermediate or high DWI signal,
requires further assessment by contrast-enhanced
(CE)T1W imaging, ideally with DCE MR, where a type 3
curve is highly predictive of malignancy. For complex cystic
or cystic-solid masses, both DWI and CET1Wâpreferably DCE MRIâis recommended. Characteristic enhancement
curves of solid components can discriminate between lesions
that are highly likely malignant and highly likely benign
Impact of DWI and ADC values in ovarian-adnexal reporting and data system (O-RADS) MRI score
Purpose: Introduce DWI and quantitative ADC evaluation in O-RADS MRI system and observe how diagnostic performance changes. Assess its validity and reproducibility between readers with different experience in female pelvic imaging. Finally, evaluate any correlation between ADC value and histotype in malignant lesions. Materials and methods: In total, 173 patients with 213 indeterminate adnexal masses (AMs) on ultrasound were subjected to MRI examination, from which 140 patients with 172 AMs were included in the final analysis. Standardised MRI sequences were used, including DWI and DCE sequences. Two readers, blinded to histopathological data, retrospectively classified AMs according to the O-RADS MRI scoring system. A quantitative analysis method was applied by placing a ROI on the ADC maps obtained from single-exponential DWI sequences. AMs considered benign (O-RADS MRI score 2) were excluded from the ADC analysis. Results: Excellent inter-reader agreement was found in the classification of lesions according to the O-RADS MRI score (Kâ=â0.936; 95% CI). Two ROC curves were created to determine the optimal cut-off value for the ADC variable between O-RADS MRI categories 3-4 and 4-5, respectively, 1.411âĂâ10-3 mm2/sec and 0.849âĂâ10-3 mm2/sec. Based on these ADC values, 3/45 and 22/62 AMs were upgraded, respectively, to score 4 and 5, while 4/62 AMs were downgraded to score 3. ADC values correlated significantly with the ovarian carcinoma histotype (p valueâ<â0.001). Conclusion: Our study demonstrates the prognostic potential of DWI and ADC values in the O-RADS MRI classification for better radiological standardisation and characterisation of AMs
DiffusionĂą weighted imaging outside the brain: Consensus statement from an ISMRMĂą sponsored workshop
Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/134160/1/jmri25196_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/134160/2/jmri25196.pd
Axillary lymphadenopathy at the time of COVID-19 vaccination: ten recommendations from the European Society of Breast Imaging (EUSOBI).
Unilateral axillary lymphadenopathy is a frequent mild side effect of COVID-19 vaccination. European Society of Breast Imaging (EUSOBI) proposes ten recommendations to standardise its management and reduce unnecessary additional imaging and invasive procedures: (1) in patients with previous history of breast cancer, vaccination should be performed in the contralateral arm or in the thigh; (2) collect vaccination data for all patients referred to breast imaging services, including patients undergoing breast cancer staging and follow-up imaging examinations; (3) perform breast imaging examinations preferentially before vaccination or at least 12Â weeks after the last vaccine dose; (4) in patients with newly diagnosed breast cancer, apply standard imaging protocols regardless of vaccination status; (5) in any case of symptomatic or imaging-detected axillary lymphadenopathy before vaccination or at least 12Â weeks after, examine with appropriate imaging the contralateral axilla and both breasts to exclude malignancy; (6) in case of axillary lymphadenopathy contralateral to the vaccination side, perform standard work-up; (7) in patients without breast cancer history and no suspicious breast imaging findings, lymphadenopathy only ipsilateral to the vaccination side within 12Â weeks after vaccination can be considered benign or probably-benign, depending on clinical context; (8) in patients without breast cancer history, post-vaccination lymphadenopathy coupled with suspicious breast finding requires standard work-up, including biopsy when appropriate; (9) in patients with breast cancer history, interpret and manage post-vaccination lymphadenopathy considering the timeframe from vaccination and overall nodal metastatic risk; (10) complex or unclear cases should be managed by the multidisciplinary team
Image-guided breast biopsy and localisation: recommendations for information to women and referring physicians by the European Society of Breast Imaging
Abstract: We summarise here the information to be provided to women and referring physicians about percutaneous breast biopsy and lesion localisation under imaging guidance. After explaining why a preoperative diagnosis with a percutaneous biopsy is preferred to surgical biopsy, we illustrate the criteria used by radiologists for choosing the most appropriate combination of device type for sampling and imaging technique for guidance. Then, we describe the commonly used devices, from fine-needle sampling to tissue biopsy with larger needles, namely core needle biopsy and vacuum-assisted biopsy, and how mammography, digital breast tomosynthesis, ultrasound, or magnetic resonance imaging work for targeting the lesion for sampling or localisation. The differences among the techniques available for localisation (carbon marking, metallic wire, radiotracer injection, radioactive seed, and magnetic seed localisation) are illustrated. Type and rate of possible complications are described and the issue of concomitant antiplatelet or anticoagulant therapy is also addressed. The importance of pathological-radiological correlation is highlighted: when evaluating the results of any needle sampling, the radiologist must check the concordance between the cytology/pathology report of the sample and the radiological appearance of the biopsied lesion. We recommend that special attention is paid to a proper and tactful approach when communicating to the woman the need for tissue sampling as well as the possibility of cancer diagnosis, repeat tissue sampling, and or even surgery when tissue sampling shows a lesion with uncertain malignant potential (also referred to as âhigh-riskâ or B3 lesions). Finally, seven frequently asked questions are answered
Développement et validation d'un modÚle d'interprétation en IRM pelvienne pour caractériser une masse annexielle complexe
MONTPELLIER-BU MĂ©decine UPM (341722108) / SudocMONTPELLIER-BU MĂ©decine (341722104) / SudocSudocFranceF
Apport de l IRM fonctionnelle pour la caractérisation des masses annexielles
PARIS7-Xavier Bichat (751182101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF
Impact de l'IRM mammaire en SĂ©nologie en 2011 (intĂ©rĂȘt de l'IRM en cas de Bilan Conentionnel Non Concluant)
Le cancer du sein est un enjeu majeur de santĂ© publique, puisqu'une femme sur huit sera concernĂ©e au cours de sa vie. De nombreuses techniques d'imagerie peuvent ĂȘtre utilisĂ©es mais certaines questions restent en suspens. Quel est l'impact de l'IRM dans la prise en charge des patients et quel est la place de l'IRM en cas de bilan conventionnel non concluant ? MatĂ©riels et mĂ©thodes Dans un premier temps, l'analyse rĂ©trospective de 422 IRM mammaires consĂ©cutives pratiquĂ©es Ă l'hĂŽpital Tenon entre le 01/01 et le 31/12/2008 a concernĂ© par indication, le classement ACR de l'IRM, la VPP de malignitĂ© des prĂ©lĂšvements percutanĂ©s et l'impact de l'IRM sur la prise en charge des patientes. Ces donnĂ©es ont Ă©tĂ© comparĂ©es Ă une population similaire de 428 patientes Ă©tudiĂ©e en IRM au CHU de MontrĂ©al, la mĂȘme annĂ©e.Dans un second temps, 66 patientes explorĂ©es en IRM Ă l'hĂŽpital Tenon entre le 01/01/2008 et le 30/06/2009 pour anomalie mammographique visible sur une incidence sans traduction clinique ou Ă©chographique ont Ă©tĂ© Ă©tudiĂ©es. Le Gold standard Ă©tait l'analyse anatomopathologique obtenue par chirurgie pour les lĂ©sions malignes. La preuve histologique Ă©tait obtenue par biopsie et suivi de 2 ans voire par un suivi de 2 ans pour les lĂ©sions bĂ©nignes. RĂ©sultats A l'hĂŽpital Tenon, les IRM Ă©taient classĂ©es ACR I ou II dans 62.8%, ACR III dans 11% et ACR IV ou V dans 26.2%. La VPP de malignitĂ© Ă©tait de 35.2%. L'IRM avait un impact contributif dans 23.6%. un impact dĂ©lĂ©tĂšre dans 28% et enfin, l'IRM n'avait aucun impact sur la prise en charge des patientes dans 48.4%. Concernant les HM pratiquĂ©es pour anomalie mammographique visible sur une incidence sans traduction clinique ou Ă©chographique, la sensibilitĂ©, la spĂ©cificitĂ©, la valeur prĂ©dictive positive, la valeur prĂ©dictive nĂ©gative et la performance diagnostique Ă©taient de 100%, 79.1%, 44.4%, 100%, 82.1%. Dans 12.5%, un cancer, diagnostiquĂ© par l'IRM, Ă©tait responsable de l'anomalie mammographique. Aucun cancer n'a Ă©tĂ© manquĂ© aprĂšs deux ans de suivi. Conclusion L'IRM mammaire est utile Ă la prise en charge des patientes, lorsqu'elle est pratiquĂ©e dans certaines indications. Son utilisation n'est pas encore validĂ©e en cas de bilan conventionnel non concluant mais il semblerait qu'elle permette, grĂące Ă sa forte valeur prĂ©dictive nĂ©gative, de surseoir Ă une surveillance inutile voire d'Ă©viter la rĂ©alisation de prĂ©lĂšvements percutanĂ©s dans cette indication.ROUEN-BU MĂ©decine-Pharmacie (765402102) / SudocSudocFranceF
- âŠ