The incidence of breast cancer in Egyptian females in correlation to different mammographic ACR densities

Introduction: The density of breast tissue, radiologically referred to as fibroglandular mammary tissue, was found to be a predisposing factor for breast cancer (BC). However, the stated degree of elevated BC risk varies widely in the literature. Aim: The purpose of this study was to determine the relationship between different breast mammography densities and the risk of breast cancer in Egyptian women.. Patients and methods: An analytical cross-sectional prospective study was conducted at Ain Shams University Hospital and Private Centre between December 2020 and December 2021. The study included 814 asymptomatic females 40 years old or above, who came for BC screening using full-field digital mammography. Results: The incidence of BC was found in 84 females (10.3%). Breast cancer incidence was 6.3% in females with ACR-A density, 8.5% in women with ACR-B density, 16.3% in women with ACR-C density, and 27.8% in women with ACR-D density (p<0.001). Using logistic regression analysis, we showed that three types of breast density increased the risk of BC, where patients with type B, type C, and type D breast density had a 1.39, 2.92, and 3.12 times more risk for BC, respectively (p=0.010, p=0.003, and p=0.036, respectively). Conclusion: Among Egyptian females, the incidence of BC is 10.3%. Our data revealed that the greater the breast density, the higher the incidence of BC, and affirmed that breast density is a risk factor for BC development

Diffusion tensor tractography as a supplementary tool to conventional MRI for evaluating patients with myelopathy

Purpose: The aim of this study was to assess the clinical utility of DTI including apparent diffusion coefficient (ADC), fractional anisotropy (FA), in patients with symptoms of spinal cord myelopathy. Patients and methods: Fifteen subjects with clinical symptoms of acute (n = 3) or slowly progressive (n = 12) spinal cord myelopathy and 11 healthy volunteers were prospectively selected. They all underwent magnetic resonance imaging of the spine at 3.0 T machine. In addition to conventional MRI, DTI was performed; maps of the apparent diffusion coefficient and of fractional anisotropy were reconstructed. Diffusion tensor tractography was used to visualize the morphological features of normal and impaired white matter at the level of the pathological lesions in the spinal cord. The patients were divided into two groups according to the signal intensity on T2WI (group A with no change in signal intensity and group B with high signal intensity). Results: There were no statistically significant differences in the apparent diffusion coefficient and fractional anisotropy values between the different spinal cord segments of the normal subjects. All of the patients in group B had increased apparent diffusion coefficient values and decreased fractional anisotropy values at the lesion level compared to the normal controls. However, there were no statistically significant diffusion index differences between group A patients and the normal controls. Conclusion: Diffusion tensor imaging is a reliable method for the evaluation of the diffusion properties of normal and compressed spinal cords. Furthermore, this technique can be used as an important supplementary tool to conventional MRI for the quantification of fiber damage in spinal cord compression, thus has the potential to be of great utility for treatment planning and follow up

The incidence of breast cancer in Egyptian females in correlation to different mammographic ACR densities

Introduction: The density of breast tissue, radiologically referred to as fibroglandular mammary tissue, was found to be a predisposing factor for breast cancer (BC). However, the stated degree of elevated BC risk varies widely in the literature. Aim: The purpose of this study was to determine the relationship between different breast mammography densities and the risk of breast cancer in Egyptian women.. Patients and methods: An analytical cross-sectional prospective study was conducted at Ain Shams University Hospital and Private Centre between December 2020 and December 2021. The study included 814 asymptomatic females 40 years old or above, who came for BC screening using full-field digital mammography. Results: The incidence of BC was found in 84 females (10.3%). Breast cancer incidence was 6.3% in females with ACR-A density, 8.5% in women with ACR-B density, 16.3% in women with ACR-C density, and 27.8% in women with ACR-D density (p<0.001). Using logistic regression analysis, we showed that three types of breast density increased the risk of BC, where patients with type B, type C, and type D breast density had a 1.39, 2.92, and 3.12 times more risk for BC, respectively (p=0.010, p=0.003, and p=0.036, respectively). Conclusion: Among Egyptian females, the incidence of BC is 10.3%. Our data revealed that the greater the breast density, the higher the incidence of BC, and affirmed that breast density is a risk factor for BC development

The incidence of breast cancer in Egyptian females in correlation to different mammographic ACR densities

Introduction: The density of breast tissue, radiologically referred to as fibroglandular mammary tissue, was found to be a predisposing factor for breast cancer (BC). However, the stated degree of elevated BC risk varies widely in the literature. Aim: The purpose of this study was to determine the relationship between different breast mammography densities and the risk of breast cancer in Egyptian women.. Patients and methods: An analytical cross-sectional prospective study was conducted at Ain Shams University Hospital and Private Centre between December 2020 and December 2021. The study included 814 asymptomatic females 40 years old or above, who came for BC screening using full-field digital mammography. Results: The incidence of BC was found in 84 females (10.3%). Breast cancer incidence was 6.3% in females with ACR-A density, 8.5% in women with ACR-B density, 16.3% in women with ACR-C density, and 27.8% in women with ACR-D density (p<0.001). Using logistic regression analysis, we showed that three types of breast density increased the risk of BC, where patients with type B, type C, and type D breast density had a 1.39, 2.92, and 3.12 times more risk for BC, respectively (p=0.010, p=0.003, and p=0.036, respectively). Conclusion: Among Egyptian females, the incidence of BC is 10.3%. Our data revealed that the greater the breast density, the higher the incidence of BC, and affirmed that breast density is a risk factor for BC development

Triple negative breast cancer: MRI features in comparison to other breast cancer subtypes with correlation to prognostic pathologic factors

Objective: This study aimed at determination of the MRI predictors of triple negative breast cancer (TNBC) in comparison to other breast cancer subtypes. Materials and methods: The study retrospectively enrolled 185 female patients with 206 pathologically confirmed invasive breast cancers with different subtypes by immunohistochemistry. Histopathological analysis as well as MRI features of TNBC was compared to those of other breast cancer subtypes. MRI features included the tumor size, shape, margin, internal enhancement, intratumoral signal intensity on T2-WI, detectability by DW-MRI and ADC values. Results: TNBCs showed higher histological grades (p < 0.0001) and younger patient age group (p = 0.006) compared to other tumor subtypes. At MRI, TNBCs were of larger size (p < 0.0001), round shape (p < 0.0001), smooth margin (p < 0.0001), with rim enhancement (p < 0.0001) and higher incidence of T2-WI tumoral hyperintensity (p = 0.0002) and intratumoral necrosis (p < 0.0001). No significant difference in tumor detectability was found by DW-MRI, however, TNBCs had higher ADC values (p < 0.0001). Conclusion: In our study, TNBC patients were of younger age with higher grade malignancy. TNBC MRI predictors were unifocal rim enhancing mass with round shape, smooth margin, higher signal intensity on T2-WI, in addition to relatively larger sizes of tumors associated with high incidence of intratumoral necrosis and higher ADC values

Agreement between multi-detector-row CT angiography and US-ECD in quantification of carotid artery stenosis and plaque characterization

Purpose: The purpose of this work was to evaluate the agreement between ultra-sound echo-color Doppler (US-ECD) and multi-detector-row CT angiography (MDCTA) in the quantification of carotid artery stenosis as well as plaque characterization. Materials and methods: From January 2012 to January 2013 forty-five patients who underwent both MDCTA and US-ECD for the study of carotid arteries, were evaluated (33 males, 12 females; age range 43–70 years; mean age of 59.6 years). For all subjects the following parameters were analyzed: stenosis degree by using the NASCET method, plaque morphology (regular versus irregular), type of the plaque (fatty, mixed and calcified) and presence of ulcerations. Statistical analysis was performed to calculate concordance between the two techniques employed. Results: The agreement observed in the quantification of carotid artery stenosis was 94.4% with a kappa value of 0.9306 (95% confidence interval of 0.8612–1.0). In the definition of the type of plaque, the observed agreements were 91.1% and the kappa value was 0.8815 (95% confidence interval: 0.7920–0.9709). In the definition of plaque ulceration, the observed agreements were 88.4% but the kappa value was only 0.325 (95% confidence interval: 0.201–0.449). Agreement observed in the evaluation of plaque morphology was 78.3% with a kappa value of 0.513 (95% confidence interval: 0.452–0.574). Conclusion: We observed a good agreement between US-ECD and MDCTA in the quantification of carotid artery stenosis and the assessment of plaque type. There was, however, a poor agreement in the evaluation of plaque ulceration. The use of US-ECD and MDCTA provides different results in the evaluation of plaque. Our results suggest that information derived from US-ECD should be always critically compared with other diagnostic techniques

Potential role of quantitative MRI assessment in differentiating high from low-grade gliomas

Background: It is crucial to accurately differentiate HGGs from LGGs, as treatment strategies vary. Our study aims to assess the sensitivity and specificity of fractional anisotropy (FA) values derived from diffusion tensor imaging (DTI) and dynamic contrast enhanced perfusion-weighted imaging (PWI) in differentiating HGGs from LGGs. Materials: 15 patients with HGGs and 9 LGGs were examined. Mean, Minimal and Maximal FA fractional anisotropy in tumour, necrotic area and in surrounding oedema, as well as (rCBV) ratio of the lesions were measured and compared between LGG and HGG. The efficacy of the above parameters in grading gliomas was evaluated. In perfusion MRI, we measure rCBV ratio as parameter of neovascularity of tumour. Results: The use of MR DTI had an important role in the grading of brain gliomas as it was accurate in grading 24 cases. There was significant correlation between histopathological grade and FA values measured in tumour and necrotic areas. No positive correlation in perifocal areas could be established. Our results show significant difference between HGG and LGG with mean rCBV ratio as 2.62 & 0.79 with best cut-off value (1.2). Combined use of MR DTI and MR perfusion added to the accuracy of grading of glioma

Computed tomography enterography in assessment of Crohn’s disease activity

AbstractBackgroundMonitoring the disease activity in Crohn’s disease (CD) may be challenging with endoscopic manoeuvers due to difficulties in reaching the affected areas and being restricted to mucosal lesions, so the existence of a more tolerable and reliable technique will be highly warranted.ObjectivesThis study aims at detection of CD’s activity by computed tomography enterography (CTE) in correlation with ileocolonoscopy evaluation as well as detection of extra-enteric manifestations and complications of the disease.Materials and methodsTwenty-four patients who were clinically and histopathologically proven as CD patients were retrospectively included in this study. Patients were divided into active and inactive groups according to ileocolonoscopic evaluation. All patients underwent CTE as clinically indicated within 1 week of ileocolonoscopy. Radiological parameters suggestive of Crohn’s disease activity at CTE were interpreted at the terminal ileum and correlated to the corresponding ileocolonoscopy reports for signs of CD activity. Extra-enteric findings and complications of CD were also reported if present.ResultsCTE was accurate in detecting CD activity in 15 out of 18 active cases (active group) and in detecting disease inactivity in 5 out of 6 inactive cases (inactive group) with sensitivity and specificity of 83.3%. Mural hyperenhancement was the most distinguished sign of CD activity in CTE.ConclusionCTE is a non invasive and reliable technique that has a significant value in assessment of CD activity in correlation with endoscopy, hence, it is useful in follow up and preoperative guidance

Role of tomosynthesis and ultrasound in the assessment of asymmetric breast densities: a comparative prospective study

Abstract Background Tomosynthesis is a recent advancement of full-field digital mammography involves transforming two-dimensional (2D) breast images into three dimensions (3D) images. It reduces the adverse effect of tissue superimposition on conventional 2D- mammography, therefore having high potential enhancing identification and assessment of asymmetric breast densities. The aim of the study was to assess and compare the diagnostic performance of breast ultrasound and 3D digital breast tomosynthesis in the assessment of asymmetric breast densities. Results In the current study, 80 patients with 80 mammographically and/or tomosynthesized breast asymmetries were included. The patients' ages ranged from 30 to 70 years old, with a mean age of 47.2 ± 9.2 SD. Breast ultrasound outperformed digital breast tomosynthesis in terms of diagnostic performance. Tomosynthesis had a sensitivity of 86.4%, specificity of 93.1%, positive predictive value of 82.6%, negative predictive value of 94.7%, and accuracy of 91.3% compared to ultrasounds' sensitivity of 100.00%, specificity of 93.1%, positive predictive value of 84.6%, negative predictive value of 100.00%, and accuracy of 95%. Conclusions Incorporating ultrasonography in the assessment of asymmetric breast densities outperformed tomosynthesis and shown to be more precise in characterisation of lesions underlying asymmetric breast density