Sonographically Identified Echogenic Renal Masses Up to 1 cm in Size Are So Rarely Malignant They Can Be Safely Ignored

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135692/1/jum2016352323.pd

Patlak slope versus standardized uptake value image quality in an oncologic PET/CT population: A prospective cross-sectional study

Patlak slope (PS) images have the potential to improve lesion conspicuity compared with standardized uptake value (SUV) images but may be more artifact-prone. This study compared PS versus SUV image quality and hepatic tumor-to-background ratios (TBRs) at matched time points. Early and late SUV and PS images were reconstructed from dynamic positron emission tomography (PET) data. Two independent, blinded readers scored image quality metrics (a four-point Likert scale) and counted tracer-avid lesions. Hepatic lesions and parenchyma were segmented and quantitatively analyzed. Differences were assessed via the Wilcoxon signed-rank test (alpha, 0.05). Forty-three subjects were included. For overall quality and lesion detection, early PS images were significantly inferior to other reconstructions. For overall quality, late PS images (reader 1 [R1]: 3.95, reader 2 [R2]: 3.95) were similar

FDG-PET/MRI for nonoperative management of rectal cancer: A prospective pilot study

Nonoperative management (NOM) is increasingly utilized for rectal cancer patients with a clinical complete response (cCR) following total neoadjuvant therapy (TNT). The objective of this pilot study was to determine whether FDG-PET/MRI alters clinical response assessments among stage I-III rectal cancer patients undergoing TNT followed by NOM, relative to MRI alone. This prospective study included 14 subjects with new rectal cancer diagnoses. Imaging consisted of FDG-PET/MRI for initial staging, post-TNT restaging, and surveillance during NOM. Two independent readers assessed treatment response on MRI followed by FDG-PET/MRI. Inter-reader differences were resolved by consensus review. The reference standard for post-TNT restaging consisted of surgical pathology or clinical follow-up. 7/14 subjects completed post-TNT restaging FDG-PET/MRIs. 5/7 subjects had evidence of residual disease and underwent total mesorectal excision; 2/7 subjects had initial cCR with no evidence of disease after 12 months of NOM. FDG-PET/MRI assessments of cCR status at post-TNT restaging had an accuracy of 100%, compared with 71% for MRI alone, as FDG-PET detected residual tumor in 2 more subjects. Inter-reader agreement for cCR status on FDG-PET/MRI was moderate (kappa, 0.56). FDG-PET provided added value in 82% (9/11) of restaging/surveillance scans. Our preliminary data indicate that FDG-PET/MRI can detect more residual disease after TNT than MRI alone, with the FDG-PET component providing added value in most restaging/surveillance scans

The Effect of Inhaled Gases on Ultrasound Contrast Agent Longevity In Vivo

Purpose: The purpose of this study is to investigate the effect of the inhaled gas used alongside isoflurane in the anesthetization of small animals on the time-intensity curves (TICs) acquired from ultrasound contrast agents—microbubbles. Procedures: TICs were recorded over the common iliac vein of 12 mice receiving Definity®. Animals were anesthetized with isoflurane, the ventilator was driven by medical air (MA), then in random order, the driving gas was changed for 3 min to: MA (control); pure oxygen (O2); O2+ perfluorohexane (PFH:O2); or O2+octafluoropropane (OFP:O2), the perfluorocarbon (PFC) in Definity, followed by a return to MA 3 min later. Results: The mean slope of signal decay was −0.47, −1.05, −1.16, and −1.42 video-intensity units/s for MA, OFP:O2, PFH:O2, and O2, respectively; MA had the slowest decay (pG0.0001). Both PFC mixtures had slower signal decay than O2, but only OFP:O2 was significant (pG0.01). When MA was used immediately following dosing, slope gradually decreased (p=0.032) and was two times slower by the fourth injection (p=0.012). Conclusions: Microbubble kinetics are closely associated with the driving gas for inhaled anesthesia. MA has the least effect and should be used when inhaled anesthesia is used. Furthermore, when animals are given multiple injections in the same session, microbubbles last longer with subsequent injections

I-131 uptake in fat necrosis of the breast

I-131 uptake in the breast has been described with a variety of normal and pathologic conditions. We present the case of a 38-year-old female who received 317 millicuries of radioactive I-131 treatment for papillary thyroid carcinoma. Post-treatment scan demonstrated I-131 uptake in an area of fat necrosis in the breast

Lacrimal gland uptake on F-18 florbetapir amyloid positron emission tomography scan

In 2012, the Food and Drug Administration (FDA) approved the use of F-18 florbetapir to estimate β-amyloid neuritic plaque density when indicated. A normal scan will show increased radiotracer uptake in the white matter. Mild uptake in salivary glands, skin, muscles, and bones is considered normal. Being a new and infrequently performed study, familiarity with normal biodistribution and variants is important. We hereby present 2 cases with F-18 florbetapir uptake in lacrimal glands. Patients had no symptoms or known systemic conditions to explain this uptake. We speculate that lacrimal gland uptake of F-18 florbetapir could represent a normal variant

Calciphylaxis on bone scan: correlation between molecular and cross-sectional findings

Calciphylaxis is a rare devastating medical condition commonly associated with end-stage renal disease and characterized by extensive microvascular calcifications. We describe a case of calciphylaxis presenting on Tc-99m MDP bone scan imaging with asymmetric radiotracer uptake within the lower extremities corresponding to extensive soft tissue calcifications on Computed tomography. Familiarity with the classic clinical presentation and imaging features of this rare entity may help its early identification and treatment

Establishing a Women in Radiology Group: A Toolkit From the American Association for Women in Radiology

Despite increasing representation in medical schools and surgical specialties, recruitment of women into radiology has failed to exhibit commensurate growth. Furthermore, women in radiology are less likely to advance to leadership roles. A Women in Radiology (WIR) group provides a robust support system that has been shown to produce numerous benefits to the group\u27s individual participants as well as the group\u27s institution or practice. These benefits include development of mentorship relationships, guidance of career trajectories, improved camaraderie, increased participation in scholarly projects, and increased awareness of gender-specific issues. This article describes a recommended pathway to establishing a WIR group, with the goal of fostering sponsorship and promoting leadership, recruitment, and advancement of women in radiology. Barriers to implementation are considered, and resources to facilitate success, including a range of resources provided by the American Association for Women in Radiology, are reviewed. By implementing the provided framework, radiologists at any career stage can start a WIR group, to promote the advancement of their female colleagues

Peripheral nodular enhancement in adrenal and renal hematomas: A report of 3 cases

There are a wide range of benign and malignant pathologies that the radiologist may encounter in the adrenal glands and kidneys, often incidentally when imaging is performed for other indications. Many imaging modalities including CT, MR, and US are often used in an attempt to characterize these lesions. A definitive radiological diagnosis, however, is not always possible. This is at times due to atypical presentations of typical lesions which may be mistaken for more aggressive or concerning pathologic conditions. Adrenal lesions that do not demonstrate characteristic benign imaging features might require surgical excision. Similarly, cystic renal lesions that demonstrate nodular enhancement are concerning for Bosniak IV lesions and require surgical management. We report 3 cases in 3 different patients of incidentally discovered hematomas with peripheral enhancement, 2 involving the adrenal gland and 1 involving the kidney. All 3 of these histologically proven hematomas demonstrated similar radiological manifestations of peripheral nodular progressive enhancement, mimicking neoplastic conditions, and necessitating surgical removal