Hepatocellular Carcinoma: correlations between Gadobenate Dimeglumine-enhanced Magnetic Resonance (MR) Imaging and pathological findings.

RATIONALE AND OBJECTIVES: To correlate the appearance of hepatocellular carcinoma on delayed (60 minutes) postcontrast T1-weighted gradient echo images with the mode of action of gadobenate dimeglumine (Gd-BOPTA) and the anatomic and pathologic characteristics of the lesions. METHODS: A total of 34 patients with hepatocellular carcinoma and varying degrees of diffuse liver disease were studied. T2-weighted spin echo and T1-weighted spin echo and gradient echo images were acquired before and 60 minutes after the intravenous administration of 0.1 mmol/kg Gd-BOPTA. Qualitative and quantitative evaluations of the images were performed and correlated with histologic findings. The quantitative evaluation, performed on T1-weighted gradient echo images, looked at the percentage increase of liver enhancement after Gd-BOPTA administration, the lesion-to-liver contrast/noise (C/N) ratio before and after Gd-BOPTA administration, and the C/N variation after Gd-BOPTA administration. Qualitative assessment considered the morphologic features of the lesions as well as the visual variation of contrast before and after Gd-BOPTA administration. Finally, a histologic evaluation was made of the degree of differentiation of the lesions and of the presence of fatty metaplasia, necrosis, bile, or intratumoral peliosis. RESULTS: Among the parameters affecting lesion identification were the extent of liver function, degree of vascularization, residual functionality of the tumor cells, and characteristics of the neoplastic tissue. Positive correlations (Spearman coefficients = 0.359 and 0.393, respectively) were observed precontrast between the degree of liver failure and the amount of contrast noise, and postcontrast between the amount of intralesional fatty metaplasia and the extent to which lesion conspicuity worsened after Gd-BOPTA administration. An inverse correlation (Spearman coefficient = -0.330) was observed between the degree of lesion differentiation and the visible appearance after Gd-BOPTA administration, with well-differentiated lesions tending toward worsened conspicuity postcontrast. A statistically significant difference (P = 0.001) was observed in the mean precontrast C/N ratio for lesions later showing unchanged conspicuity and worse conspicuity on postcontrast images, respectively. Marked variation (P = 0.019) was also observed between Child A and B cirrhotic patients for the degree of hepatic enhancement on postcontrast images. CONCLUSIONS: The results suggest that liver parenchyma signal intensity is influenced by the extent to which liver function is compromised, that residual hepatocytic functionality permits Gd-BOPTA uptake by certain lesions and that this uptake might subsequently impair the observed C/N ratio on delayed images, and that the worsening of lesion conspicuity on postcontrast images is influenced also by high quantities of intralesional fatty metaplasia

Dermoscopic diagnosis of amelanotic/hypomelanotic melanoma

20N/Apartially_openopenPizzichetta MA; Kittler H; Stanganelli I; Ghigliotti G; Corradin MT; Rubegni P; Cavicchini S; De Giorgi V; Bono R; Alaibac M; Astorino S; Ayala F; Quaglino P; Pellacani G; Argenziano G; Guardoli D; Specchio F; Serraino D; Talamini R; Italian Melanoma Intergroup (IMI)Pizzichetta, Ma; Kittler, H; Stanganelli, I; Ghigliotti, G; Corradin, Mt; Rubegni, P; Cavicchini, S; De Giorgi, V; Bono, R; Alaibac, M; Astorino, S; Ayala, F; Quaglino, P; Pellacani, G; Argenziano, G; Guardoli, D; Specchio, F; Serraino, D; Talamini, R; Italian Melanoma Intergroup, (IMI

Progresso da ferrugem do cafeeiro irrigado em diferentes densidades de plantio pós-poda Progress of rust in coffee plants in various densities of cultivation in irrigated planting after pruning

Objetivou-se, no presente trabalho, avaliar o efeito de diferentes critérios para manejo da irrigação em quatro densidades de plantio, sob sistema de gotejamento na incidência e severidade da ferrugem do cafeeiro e avaliar a influência do enfolhamento na curva de progresso dessa doença. Conduziu-se, o experimento, em área experimental da Universidade Federal de Lavras MG, utilizando a cultivar Rubi MG-1192 com seis anos. O delineamento experimental foi em blocos ao acaso com quatro repetições. Os tratamentos foram constituídos por quatro parcelas representadas pelas densidades de plantio (convencionais e adensados): 2500 (4,0x1,0 m), 3333 (3,0x1,0 m), 5000 (2,0x1,0 m), 10000 (2,0x0,5 m) plantas ha-1, quatro subparcelas sendo: irrigações quando a tensão da água no solo atingiu valores de 20 e 60kPa; irrigações utilizando o manejo do balanço hídrico (calculado através do software IRRIPLUS), com turnos de irrigação fixos de três dias por semana e uma testemunha sem irrigação, perfazendo um total de 16 tratamentos. Cada subparcela foi constituída por 10 plantas, sendo consideradas como plantas úteis as seis centrais. Foram avaliadas a incidência e severidade da ferrugem e a porcentagem de enfolhamento das plantas de cafeeiros. Após análise estatística, os dados foram convertidos em área abaixo da curva de progresso da doença e do crescimento. Verificou-se que os critérios para manejo da irrigação influenciaram a curva de progresso do crescimento, porém, não interferiu na curva de progresso da incidência e da severidade da ferrugem. Os sistemas de plantios adensados favoreceram a incidência da ferrugem. Mas as densidades de plantio não interferiram no enfolhamento.<br>The objective of this study was to evaluate the effect of different irrigation controls implemented in four planting densities on a system of drip on the incidence and severity of rust and to assess the influence of leaf growth on the progress curve of this disease. The experiment was conducted in the experimental area of the Federal University of Lavras - MG, using the cultivar Rubi MG-1192 with 6 years. The experimental design was randomized blocks with four replicates. The treatments consisted of four tranches represented by planting densities (conventional and non-conventional): 2500 (4.0 x1.0 m), 3333 (3.0 x 1.0 m), 5000 (2.0 x 1.0 m), 10,000 (2.0 x 0.5 m) plants / ha, with four subplots: the tension when irrigation water in the soil reaches values of 20 and 60kPa; using water balance management of irrigation (calculated by the software IRRIPLUS) with rounds of irrigation fixed three days per week and a control without irrigation, making a total of 16 treatments. Each subplot line consisted of 10 plants with the six central plants considered as useful. The incidence and severity of rust and the percentage of grown of coffee plants were evaluated. After statistical analyses the data were converted to area under the curve of disease and growth progress. It was verified that the management of irrigation influenced the progress curve of growth, but it did not interfere in the progress curve of the incidence and severity of coffee rust. The dense system of plantation favored the incidence of rust. However, the planting densities did not affect growth

Pigmented nodular melanoma: The predictive value of dermoscopic features using multivariate analysis

Background Nodular melanoma (NM), representing 10-30% of all melanomas, plays a major role in global mortality related to melanoma. Nonetheless, the literature on dermoscopy of NM is scanty. Objectives To assess odds ratios (ORs) to quantify dermoscopic features of pigmented NM vs. pigmented superficial spreading melanoma (SSM), and pigmented nodular nonmelanocytic and benign melanocytic lesions. Methods To assess the presence or absence of global patterns and dermoscopic criteria, digitized images of 457 pigmented skin lesions from patients with a histopathological diagnosis of NM (n = 75), SSM (n = 93), and nodular nonmelanocytic and benign melanocytic lesions (n = 289; namely, 39 basal cell carcinomas, 85 seborrhoeic keratoses, 81 blue naevi, and 84 compound/dermal naevi) were retrospectively collected and blindly evaluated by three observers. Results Multivariate analysis showed that ulceration (OR 4\ub707), homogeneous disorganized pattern (OR 10\ub776), and homogeneous blue pigmented structureless areas (OR 2\ub737) were significantly independent prognostic factors for NM vs. SSM. Multivariate analysis of dermoscopic features of NM vs. nonmelanocytic and benign melanocytic lesions showed that the positive correlating features leading to a significantly increased risk of NM were asymmetric pigmentation (OR 6\ub770), blue-black pigmented areas (OR 7\ub715), homogeneous disorganized pattern (OR 9\ub762), a combination of polymorphous vessels and milky-red globules/areas (OR 23\ub765), and polymorphous vessels combined with homogeneous red areas (OR 33\ub788). Conclusions Dermoscopy may be helpful in improving the recognition of pigmented NM by revealing asymmetric pigmentation, blue-black pigmented areas, homogeneous disorganized pattern and abnormal vascular structures, including polymorphous vessels, milky-red globules/areas and homogeneous red areas. What's already known about this topic? Nodular melanoma (NM) often exhibits features associated with deep tumour extension and less commonly displays the classic dermoscopic features of superficial spreading melanoma (SSM). What does this study add? The study identifies dermoscopic features that are significantly associated with pigmented NM compared with pigmented SSM and nonmelanoma nodular lesions. This study validates, with a multivariate analysis, the dermoscopic features leading to a significantly increased likelihood of a diagnosis of pigmented NM