Utility of three dimensional (3-D) ultrasound and power Doppler in identification of high risk endometrial cancer at a tertiary care hospital in southern India: A preliminary study

Objective: The study was conducted to find the utility of three dimensional (3-D) ultrasound and Doppler sonography in differentiating benign and malignant endometrial lesions and to ascertain the association of sonology parameters with type, grade and stage of endometrial cancer. Materials and methods: Women attending the gynaecology department of a tertiary care hospital, with a provisional diagnosis of carcinoma endometrium were subjected to three dimensional power Doppler ultrasound evaluation and assessment of vascular patterns. VOCAL (Virtual Organ Computer-aided Analysis) software was used to assess volume, Vascularisation Index (VI), Flow Index (FI) and Vascularisation Flow Index (VFI). Ultrasound parameters were compared with histologic diagnosis to evaluate the diagnostic performance using Receiver Operating Characteristic (ROC) Curve. Results: Sixty-four women were included in the study, 33 with benign and 31 with malignant endometrial lesions. Larger endometrial volume and higher Doppler indices correlated with malignant lesions. The variables with good discriminatory potential between benign and malignant status were VI and VFI, having a sensitivity of 90.3% and specificity of around 80%. VFI (adjusted odds ratio of 40.4; (95% CI – 8.46–192.88), p value < 0.001) was the only significant variable identified by multivariate logistic regression, when adjusted for age and post-menopausal status. Multiple global and focal vessel pattern was seen predominantly in malignant cases (specificity 93.9%), although the sensitivity was low (61.2%). Higher stages and grades of tumour and non-endometrioid types had higher Doppler indices, and requires further evaluation. Conclusions: 3-D ultrasound has good discrimination potential between benign and malignant endometrial lesions and could be useful as a screening tool. However, utility of 3-D tool for differentiation between tumour characteristics needs further validation. Keywords: Endometrial cancer, Three dimensional ultrasound, Power Doppler, Vessel patterns, Vascularisation flow inde

Association between Physical Activity Levels and Brain Volumes in Adults Visiting Radio-Imaging Center of Tertiary Care Hospital

Background and aim: There is evidence to support the favorable impact of physical activity (PA) on brain volume. However, the empirical evidence exploring the relationship between physical and sedentary behavior remains mixed. We aimed to explore the relationship between PA and sedentary behavior and brain volume. Methods: The study sample (n = 150, mean age = 39.7 years) included patients interviewed with the International Physical Activity Questionnaire (IPAQ) who underwent an MRI brain scan. From the images obtained, we measured total intracranial, gray matter, and white matter volume along with the hippocampus, amygdala, parahippocampal gyrus, and posterior cingulate cortex (PCC). Multivariable linear regression analysis was done. Results and discussion: Left hippocampus and overall PA were positively and significantly associated (&beta; = 0.71, p = 0.021) whereas time spent on vigorous physical activity showed a negative association (&beta; = &minus;0.328, p = 0.049) with left hippocampal volume. Conclusion: We found a positive association between total PA and the left hippocampus, whereas vigorous PA showed a negative association with the left hippocampus