Single-centre evaluation and staging of rectal carcinoma on a 3-Tesla magnetic resonance imaging and correlation with histological profile

Purpose: To assess magnetic resonance imaging (MRI) features of rectal carcinoma in correlation with pathology, and to evaluate the diagnostic accuracy of 3-Tesla MRI. Material and methods: A total of 86 patients were included. 3T MR imaging was conducted pre-operatively, with imaging data correlated to pathology results. High-resolution, 2-dimensional, T2-weighted fast-spin echo sequences in the sagittal, axial, and coronal planes used to tumour staging. Diffusion-weighted images were used to increase the accuracy of tumour evaluation. Results: Rectal carcinoma was staged as T3 in 45.3% of all patients (n = 39), without involvement of the mesorectal fascia in 31.4% (n = 27), and with a possible or obvious invasion in 14% of patients (n = 12). The diagnostic accuracy of 3T MRI was 97.6% for the T1 stage, 92.1% for T2, 89% for T3, and 90% for T4 tumours. MR-derived extramural vascular invasion (EMVI) was found in 16.2% (n = 14), with an estimated diagnostic accuracy of 95%. Diffusion-weighted images and apparent diffusion coefficient were estimated for the different histology types of rectal carcinoma. The average apparent diffusion coefficient for adenocarcinoma was 0.846 ± 0.17, for mucinous adenocarcinoma it was 1.17 ± 0.08, and for signet cell and squamous carcinomas it was 0.91 ± 0.11 and 0.796 ± 0.21 mm2/s, respectively. Conclusions: 3T MRI enables high levels of diagnostic accuracy in local rectal carcinoma staging, including assessment of mesorectal fascia infiltration and EMVI-status with high accuracy

Impact of COPD on clinical and CT characteristics of COVID-19-associated pneumonia: single tertiary center experience

Abstract Background The severe acute respiratory syndrome-related coronavirus 2 pandemic continues to this day worldwide. Individuals with COPD are at increased risk of contracting SARS-CoV-2. Most of the conducted studies are based on the clinical assessment of COVID-19 infection with different comorbidities. The specific contribution of COPD to the severity of the disease and outcome still remains the point of investigation. The main goals of our study are to assess COPD’s influence on the severity of clinical and CT characteristics of COVID-19 pneumonia and associated in-hospital mortality. Results This is a retrospective study on 281 patients with RT-PCR-confirmed COVID-19 infection and CT spectrum of COVID-19 pneumonia. Fifty patients have COPD based on CT criteria. No significant difference was observed in the mean hospital length of stay, arterial oxygen saturation on admission or in-hospital mortality between COPD and non-COPD groups. Patients with COPD were two times less likely to have fever less than 37.9 °C (RR = 2.037; 95% CI 1.114–3.724, p = 0.016), but higher absolute neutrophil count (p = 0.033) and median level of neutrophil/lymphocyte ratio (p = 0.029). The COPD group was presented with milder CT severity score (especially CT1, less than 25% of lung involvement) (p = 0.022), less likely to have bilateral (RR = 2.601; 95% CI: 1.341–5.044, p = 0.023) or central (RR = 1.754; 95% CI 1.024–3.003, p = 0.046) distribution of ground-glass opacities, right lower lobe (RR = 2.887; 95% CI 1.574–5.293, p = 0.008) or left lung (RR = 2.627; 95% CI 1.448–4.765, p = 0.009) involvement, and “crazy-paving” pattern (RR = 2.208; 95% CI 1.292–3.774, p = 0.003). Both moderate positive and negative relationship was observed between CT1, CT4, hypoxia and in-hospital mortality in the COPD group (r = − 0.383, p = 0.033; r = 0.486, p = 0.007; r = − 0,354, p = 0,022, respectively). Conclusion The presence of COPD by imaging criteria in the settings of COVID-19-associated pneumonia did not significantly influence the clinical or imaging performance of the patients, nor was it linked to the increased in-hospital mortality

CT volume analysis in living donor liver transplantation: accuracy of three different approaches

Abstract Objectives The aim of this retrospective study is to compare and evaluate accuracy of three different approaches of liver volume quantification in living donor transplantations. Methods This is a single-center, retrospective study of 60 donors. The total and right lobe liver volumes were analyzed in the portal-venous phase by two independent radiologists who estimated the volumes using manual, semi-automated and automated segmentation methods. The measured right lobe liver volume was compared to the real weight of the graft after back-table examinations. Results The mean estimated overall liver volume was 1164.4 ± 137.0 mL for manual, 1277.4 ± 190.4 mL for semi-automated and 1240.1 ± 108.5 mL for automated segmentation. The mean estimated right lobe volume was 762.0 ± 122.4 mL for manual, 792.9 ± 139.9 mL for semi-automated and 765.4 ± 132.7 mL for automated segmentation. The mean graft weight was 711.2 ± 142.9 g. The manual method better correlated with the graft weight (r = 0.730) in comparison with the semi-automated (r = 0.685) and the automated (r = 0.699) methods (p < 0.001). The mean error ratio in volume estimation by each application was 12.7 ± 16.6% for manual, 17.1 ± 17.3% for semi-automated, 14.7 ± 16.8% for automated methods. There was a statistically significant difference between the mean error ratio of the manual and the semi-automated segmentations (p = 0.017), and no statistically significant difference between the manual and the automated applications (p = 0.199). Conclusion Volume analysis application better correlates with graft weight, but there is no obvious difference between correlation coefficients of all three methods. All three modalities had an error ratio, of which the semi-automated method showed the highest value. Critical relevance statement Volume analysis application was more accurate, but there is no drastic difference between correlation coefficients of all three methods. Graphical abstrac

Cystic Echinococcosis of the Bone in Kazakhstan

Cystic echinococcosis (CE) is a parasitic zoonosis caused by E. granulosus primarily affecting the liver and lungs. CE of the bone is by far the most debilitating form of the disease and is very difficult to manage as it mimics malignant tumors. We reviewed bone CE cases admitted to a reference oncological hospital in Kazakhstan from January 2010 to February 2017. Among eight patients, the mean age was 33.5 years, and the male/female ratio was 1 : 3. Patients were examined by X-ray (8/8), CT (7/8), and MRI (3/8). CE was in the spine (2 cases), pelvis (3 cases), and long bones (humerus, tibia, and femur; one case for each). All patients were treated surgically. No perioperative albendazole was administered. No patient received albendazole afterwards. The mean hospital stay was 25 days. Interventions are urgently needed to assess the burden of CE in Kazakhstan and to inform clinicians of the existence of the disease