ABSTRACT
Purpose@#To evaluate the diagnostic utility of the stalk and the inchworm sign on preoperative MRI for detecting superficial bladder cancers, and to compare the diagnostic performance between the stalk and the inchworm sign. @*Materials and Methods@#We retrospectively reviewed 240 patients (505 tumors) who had undergone radical cystectomy. The tumors were classified as follows: superficial or invasive tumors indicated by the stalk or inchworm sign on 3.0 Tesla MRI. We evaluated the diagnostic accuracy of the stalk and inchworm signs, by comparing each finding with the postoperative pathologic T stage. We compared diagnostic performance between them statistically. @*Results@#The stalk and inchworm signs showed high specificity (93% and 91%, respectively), positive predictive values (89% and 90%, respectively), and acceptable accuracy (70% and 74%, respectively), but low sensitivity (54% and 61%, respectively) and negative predictive values (60% and 63%, respectively). There was no statistically significant difference between the two signs (p > 0.05). @*Conclusion@#Superficial bladder cancers could be differentiated from invasive tumors using the stalk or inchworm sign on MRI.
ABSTRACT
Purpose@#The purpose of our study was to evaluate digital breast tomosynthesis as a breast cancer screening modality for women with gynecologic cancer. @*Materials and Methods@#This retrospective study included patients with underlying gynecologic malignancies who underwent screening digital breast tomosynthesis for breast cancer. The cancer detection rate, recall rate, sensitivity, specificity, and positive predictive value (PPV) were calculated. PPV1 was defined as the percentage of all positive screening exams that have a tissue diagnosis of cancer within a year. PPV2 was defined as the percentage of all diagnostic exams (and Breast Imaging Reporting and Data System category 4, 5 from screening setting) with a recommendation for tissue diagnosis that have cancer within a year. PPV3 was defined as the percentage of all known biopsies actually performed that resulted in a tissue diagnosis of cancer within the year. For each case of screen-detected cancer, we analyzed the age, type of underlying gynecologic malignancy, breast density, imaging features, final Breast Imaging Reporting and Data System assessment, histologic type, T and N stages, molecular subtype, and Ki-67 index. @*Results@#Among 508 patients, 7 with breast cancer were identified after a positive result. The cancer detection rate was 13.8 per 1000 screening exams, and the recall rate was 17.9%. The sensitivity was 100%, and the specificity was 83.2%. The false negative rate was 0 per 1000 exams. The PPV1, PPV2, and PPV3 were 7.7, 31.8, and 31.8, respectively. @*Conclusion@#Digital breast tomosynthesis may be a promising breast cancer screening modality for women with gynecologic cancer, based on the high cancer detection rate, high sensitivity, high PPV, and high detection rate of early-stage cancer observed in our study.
ABSTRACT
Purpose@#To evaluate the diagnostic utility of the stalk and the inchworm sign on preoperative MRI for detecting superficial bladder cancers, and to compare the diagnostic performance between the stalk and the inchworm sign. @*Materials and Methods@#We retrospectively reviewed 240 patients (505 tumors) who had undergone radical cystectomy. The tumors were classified as follows: superficial or invasive tumors indicated by the stalk or inchworm sign on 3.0 Tesla MRI. We evaluated the diagnostic accuracy of the stalk and inchworm signs, by comparing each finding with the postoperative pathologic T stage. We compared diagnostic performance between them statistically. @*Results@#The stalk and inchworm signs showed high specificity (93% and 91%, respectively), positive predictive values (89% and 90%, respectively), and acceptable accuracy (70% and 74%, respectively), but low sensitivity (54% and 61%, respectively) and negative predictive values (60% and 63%, respectively). There was no statistically significant difference between the two signs (p > 0.05). @*Conclusion@#Superficial bladder cancers could be differentiated from invasive tumors using the stalk or inchworm sign on MRI.
ABSTRACT
PURPOSE@#To evaluate the magnetic resonance imaging (MRI) findings to improve the diagnostic accuracy for transverse process fractures and sacral fractures.@*MATERIALS AND METHODS@#The lumbosacral MRI scans of 214 patients (mean age, 60 years; male-to-female ratio, 85:129), who had spine trauma between January and November 2015 were included. Two radiologists evaluated the presence, number, level, and anatomic site of the fractures on MRI with computed tomography as reference standard. Imaging findings were described as cortical disruption, marrow edema, or soft tissue edema on T1-, T2-, and fat-suppressed T2-weighted images. A statistical analysis was performed to compare the diagnostic accuracy of the MRI pulse sequences for the transverse process and sacral fractures.@*RESULTS@#Of 168 fractures, 26 (15.5%) and 13 (4.9%) were in the transverse processes and sacra, respectively. A paravertebral soft tissue edema occurred in the transverse process fractures (80.8%) and presacral soft tissue and marrow edemas occurred in the sacral fractures (46.1%). The sensitivity for the transverse process fractures was 88% on the T2-weighted image. It was 92% on fat-suppressed T2- and T1-weighted images for sacral fractures.@*CONCLUSION@#Bone marrow and soft tissue edemas on the MRI could potentially improve the diagnostic accuracy of an MRI for fractures in the transverse process and sacrum.