Prospective assessment of VI-RADS score in multiparametric MRI in bladder cancer: accuracy and the factors affecting the results

PURPOSEWe aimed to investigate the accuracy of Vesical Imaging - Reporting and Data System (VI-RADS) in the detection of muscle-invasive bladder cancer (MIBC) and to determine which factors affect the results of this scoring system.METHODSA prospective data analysis of 80 patients who were detected to have bladder tumor was performed between March 2019 and October 2020. VI-RADS scoring was used to determine the probability of muscle invasion. The scores were compared with pathological results to evaluate the accuracy of the VI-RADS scoring system. Interobserver agreement was assessed by VI-RADS scoring of 20 randomly chosen patients by a different experienced radiologist.RESULTSUsing the VI-RADS scoring system, the sensitivity, specificity, positive predictive value, and negative predictive value of multiparametric magnetic resonance imaging (mpMRI) were 87.5%, 87.5%, 63.6%, and 96.6%, respectively. The interobserver agreement expressed as the interclass correlation coefficient (ICC) was 0.72 (95% CI: 0.44-0.84, P < .001). In addition, the flat appearance of the tumor was an important factor affecting the accuracy of the VI-RADS score (odds ratio: 5.3 [95% CI: 1.1-27.0] and relative risk: 1.87 [95% CI: 1.24-2.82]).CONCLUSIONThe mpMRI, used in conjunction with VI-RADS, has proven to be an effective imaging method for detecting muscle invasion in cases of bladder cancer. VI-RADS scoring system can distinguish whether there is a muscle-invasive and non-muscle invasive bladder cancer with acceptable accuracy. In addition, the flat appearance of the tumor is an important entity that can affect the accuracy of the VI-RADS scoring system

Ultrasonography evaluation of small bowel bezoars with suspicious findings on CT in the elderly

Aim: Our aim was to evaluate the feasibility of using ultrasonography (US) in the detection and management of small bowel bezoarsin elderly patients ( 65 y).Material and Methods: This study included 15 elderly patients ( 65 y) with small bowel obstruction and initial diagnosis of smallbowel bezoar using abdominal computed tomography (CT) from among 182 patients with small bowel obstruction. The diagnosticperformance of US was prospectively evaluated and compared with the surgical or clinical diagnoses.Results: Among the 15 patients, ten of them were diagnosed via ultrasonography as having small bowel bezoar. Eight patientswere also surgically diagnosed with phytobezoars, and the remaining two patients who showed bezoars on US showed completesymptomatic improvement with ultrasonographic follow-up showing the bezoar passing through the cecum. The other five patientswere surgically diagnosed with brid ileus. US correctly diagnosed small bowel bezoars in all patients. The sonographic follow-up ofthe bezoars in the two patients who showed symptomatic improvement was also successful.Conclusion: US is a feasible imaging modality for the diagnosis and follow-up of small bowel bezoars. Timely diagnosis andmanagement of bezoars is especially important in elderly patients. US can help both, radiologists and clinicians in easy diagnosisand timely management of small bowel bezoars in elderly patients

Efficacy of ultrasound and shear wave elastography for the diagnosis of breast cancer-related lymphedema

Kamali Polat, Ayfer/0000-0001-6414-9435; Ozturk, Mesut/0000-0003-4059-2656; Polat, Ahmet Veysel/0000-0002-9740-3580WOS: 000495228800001PubMed: 31705687Objectives To assess the feasibility of ultrasound and shear wave elastography (SWE) in the diagnosis of breast cancer-related lymphedema. Methods Forty-one patients with a history of unilateral breast surgery and axillary dissection or sentinel lymph node excision were included in this prospective study. The patients were classified as having normal findings, latent lymphedema, and clinical lymphedema on the basis of a physical examination, lymphedema index scores, and limb circumference measurements. The thickness and stiffness of the cutaneous and subcutaneous tissue of the forearm and arm were measured by ultrasound and SWE. The thickness and stiffness of the cutaneous and subcutaneous tissue of the affected limb and contralateral limbs of the normal, latent lymphedema, and clinical lymphedema groups were compared. Results The mean age +/- SD of the 41 patients was 55.42 +/- 10.12 years. There were 15 patients with normal findings, 10 with latent lymphedema, and 16 with clinical lymphedema. In the latent lymphedema group, the thickness measurements of the cutaneous tissue of the affected forearm and the cutaneous and subcutaneous tissue of the affected arm were significantly greater than those of the contralateral forearm and arm (P = .034; P = .022; and P = .002, respectively), and the stiffness measurements of the cutaneous and subcutaneous tissue of the affected forearm were significantly greater than those of the contralateral forearm (P = .011; and P = .002). In the clinical lymphedema group, the thickness and stiffness measurements of the cutaneous and subcutaneous tissue of the affected forearm and arm were significantly greater than those of the contralateral limb (P < .001-P = .032). Conclusions Ultrasound and SWE are effective for diagnosing breast cancer-related lymphedema even at a latent stage