Accuracy of diffusion-weighted magnetic resonance imaging in diagnosing malignant musculoskeletal tumours

Background: Conventional magnetic resonance imaging (MRI) lacks specificity for differentiating several tumours. Combining advanced techniques like diffusion-weighted imaging (DW-MRI) with conventional MRI may enhance diagnostic accuracy. However, we do not have such data for Bangladeshi patients. This study aimed to examine the diagnostic accuracy of apparent diffusion coefficient values obtained by DW-MRI. Methods: A cross-sectional study was conducted from July 2022 to June 2023 in the Department of Radiology and Imaging, Bangabandhu Sheikh Mujib Medical University (BSMMU).  After collecting their baseline data, thirty-five patients with musculoskeletal tumours underwent DW-MRI and histopathology tests or fine needle aspiration cytology (FNAC). The apparent diffusion coefficient (ADC) values obtained by DW-MRI were examined for diagnostic accuracy against a standard of histopathology/FNAC. Results: According to the gold standard (histopathology/FNAC), there were 28 patients with malignancy, and 7 had benign tumours. Their mean age was 33 (standard deviation, 17) years (range, 4 to 74 years). The mean ADC value was 0.86 ± 0.30×10-3 mm2/s. The malignant musculoskeletal tumour group had significantly lower ADC (0.79 ± 0.24 ×10-3 mm2/s) compared to the benign tumour group (1.15 ± 0.37×10-3 mm2/s.) (P = 0.04). The DW-MRI ADC categories correctly diagnosed 27 malignant and five benign tumours using a cut-off value of ≤ 1.1×10−3 mm2/s. DW-MRI had a sensitivity of 96.4% and a specificity of 71.4%. Diagnostic accuracy was 91.4% for detecting malignant musculoskeletal tumours. Conclusions: Malignant musculoskeletal tumours have lower DW-MRI-derived ADC levels, demonstrating good diagnostic accuracy. However, a larger and more representative sample is needed before it is recommended for clinical practice

Digital breast tomosynthesis for early detection of malignant breast microcalcification: A hospital-based cross-sectional study

Background: Breast cancer is the leading cause of cancer-related deaths in women. Early detection by screening is crucial for improved survival. Digital breast tomosynthesis (DBT) may offer better visibility than conventional screening. This study aims to assess the diagnostic accuracy of DBT in detecting malignant breast microcalcifications compared to histopathological findings. Methods: This cross-sectional study was done at the Department of Radiology and Imaging, Bangabandhu Sheikh Mujib Medical University, Dhaka, from July 2022 to June 2023 and enrolled 35 women suspected of having breast cancer. Each patient underwent DBT and histopathology tests. The diagnostic accuracy of DBT in detecting malignant breast microcalcifications was assessed compared to the gold standard of histopathology. Results: The average age of the participants was 48.6 years. Palpable breast lumps (91.4%) were the most common clinical presentation. Among them, 80% had malignant microcalcifications diagnosed by DBT, primarily with linear (40.0%) and segmental (28.6%) distribution. Histopathology identified 80% of cases as malignant, with ductal carcinoma in situ (34.3%) being the most prevalent type. DBT demonstrated high sensitivity (100%) and specificity (85.7%) in detecting malignant microcalcifications, resulting in an overall accuracy of 97.1%. Conclusions: DBT has high diagnostic accuracy for detecting malignant breast microcalcifications and can be considered a valid tool for the early detection of breast microcalcifications, particularly in the context of diagnosing breast cancer

Radiological features of pygopagus conjoined twins: A case report

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Early Prediction and HRCT Evaluation of Post Covid-19 Related Lung Fibrosis

Background: Early detection of post-COVID-19-related lung fibrosis is very important for the early introduction of treatment and to minimize morbidity and mortality. The aim of this study is the early detection and evaluation of post-COVID-19 fibrosis by high-resolution computed tomography (HRCT). Methods: This prospective study included 115 patients irrespective of age and sex, who tested positive for the SARS-CoV-2 by nasopharyngeal swab (RT PCR), admitted to the Dhaka North City Corporation (DNCC) dedicated COVID-19 hospital, Dhaka, and discharged after recovery. Patients went through a chest HRCT scan at least once during their hospital stay and another scan during follow-up after hospital discharge and 8 to 12 weeks of negative RT-PCR report. Result: Among 100 patients 23 patients had >50% of total lung involvement by visual assessment. Thirty-three patients had 25% to 50% of total lung volume involvement. Twenty-seven patients had less than 25% of total lung involvement, whereas 17 patients had no visual fibrotic change on the follow-up HRCT scan. A statistical association was found between age, gender, smoking, and severe form of lung fibrosis ( P  < .05). Patients with mild CT severity score (⩽8) had a very good prognosis. Patients who were admitted to the hospital for more than 15 days were more prone to developing moderate and severe forms of fibrosis. Patients who received at least 2 doses of the COVID-19 vaccine had less severe forms of fibrosis as well as more cases of complete radiological recovery. On the HRCT scan, most of the patients had bilateral, peripheral (68%), and predominant mid & lower lobar parenchymal involvement. Conclusion: Early detection and HRCT evaluation of post-COVID-19 related lung fibrosis is very crucial for early management and introduction of anti-fibrotic drugs