Diffusion-weighted MRI findings of caudate nucleus and putamen in patients with obsessive-compulsive disorder

Objective The purpose of this study was to establish the diffusion-weighted magnetic resonance imaging (DW-MRI) findings of the caudate nucleus and putamen in patients with obsessive-compulsive disorder (OCD) and to obtain new information on the etiopathogenesis of OCD, which is still unclear. Methods The study comprised 20 patients with OCDs and 20 healthy volunteers. In these cases, DW-MRI and diffusion-weighted echo-planar images (DW-EPI) at b600 and b1000 gradient values were taken and the measurements were made using the apparent diffusion coefficient (ADC) maps of each group at b600 and b1000 values from the caudate nucleus and putamen. Results When the DW-MRI examination in patients with OCD was compared with the control group, the mean ADC values in the caudate nucleus and putamen were not found to have statistically significantly changed. In addition, there were no significant differences regarding the right and left caudate nuclei and putamen ADC values at the b600 and b1000 in the patients with OCD or the control group. Conclusion There are still many unknowns about the neurobiology of OCD. When the DW-MRI examination of the patients with OCD was compared with the control group in our study, no significant difference was found between the ADC values of the caudate nucleus and putamen. Further studies are required for this present study on DW-MRI in patients with OCD to be meaningful

Outcomes of high-risk breast lesions diagnosed using image-guided core needle biopsy: results from a multicenter retrospective study

PURPOSEThe clinical management of high-risk lesions using image-guided biopsy is challenging. This study aimed to evaluate the rates at which such lesions were upgraded to malignancy and identify possible predictive factors for upgrading high-risk lesions.METHODSThis retrospective multicenter analysis included 1.343 patients diagnosed with high-risk lesions using an image-guided core needle or vacuum-assisted biopsy (VAB). Only patients managed using an excisional biopsy or with at least one year of documented radiological follow-up were included. For each, the Breast Imaging Reporting and Data System (BI-RADS) category, number of samples, needle thickness, and lesion size were correlated with malignancy upgrade rates in different histologic subtypes. Pearson’s chi-squared test, the Fisher–Freeman–Halton test, and Fisher’s exact test were used for the statistical analyses.RESULTSThe overall upgrade rate was 20.6%, with the highest rates in the subtypes of intraductal papilloma (IP) with atypia (44.7%; 55/123), followed by atypical ductal hyperplasia (ADH) (38.4%; 144/375), lobular neoplasia (LN) (12.7%; 7/55), papilloma without atypia (9.4%; 58/611), flat epithelial atypia (FEA) (8.7%; 10/114), and radial scars (RSs) (4.6%; 3/65). There was a significant relationship between the upgrade rate and BI-RADS category, number of samples, and lesion size Lesion size was the most predictive factor for an upgrade in all subtypes.CONCLUSIONADH and atypical IP showed considerable upgrade rates to malignancy, requiring surgical excision. The LN, IP without atypia, pure FEA, and RS subtypes showed lower malignancy rates when the BI-RADS category was lower and in smaller lesions that had been adequately sampled using VAB. After being discussed in a multidisciplinary meeting, these cases could be managed with follow-up instead of excision