Differentiating Benign from Malignant Sinonasal Lesions: Feasibility of Diffusion Weighted MRI

Abstract Introduction Appearance of nasal masses on routine CT and MRI are not pathognomonic. We utilized the apparent diffusion coefficient (ADC) value obtained from diffusion weighted image (DWI) to detect the differences in the microstructures of tumor and non-tumor tissues. Objective The objective of our study was to evaluate the diagnostic role of DWI and ADC values in differentiating between malignant and benign sinonasal lesions and its correlation with histopathological results as the reference standard. Methods Patients with nasal and / or paranasal mass underwent CT, MRI, and DWI before any surgical intervention.We used diagnostic sinonasal endoscopy and biopsy to confirm the diagnosis after MRI. Results When we used ADC value of (1.2 x 10 3 mm2/s) as a cut-off value for differentiating benign from malignant sinonasal lesions, we achieved 90% accuracy, 100% sensitivity, 88.4% specificity, 77.8% positive predictive value, and 100% negative predictive value. At this cut-off, benign lesions show statistically significant higher ADC value than malignant tumors. Conclusion DW MRI and ADC value calculation are promising quantitative methods helping to differentiate betweenmalignant and benign sinonasal lesions. Thus, they are effective methods compared with other conventionalmethods with short imaging time thus it is recommended to be incorporated into routine evaluations.

Possible Relationship between Matrix Metalloproteinases Genotyping and Risk of Hepatocellular Carcinoma in HCV Infected Patients.

Background: The annual number of new cases of hepatocellular carcinoma (HCC) worldwide is over 1 million. In developing countries, the major cause of HCC is chronic hepatitis C virus (HCV) infection. Various studies have reported an association between functional gene polymorphism of matrix metalloproteinases (MMP) promoters and different cancers. Rationale: This study examined the association between MMP1 -1607, MMP9-1562, MMP14-6727 and MMP14-6767 gene polymorphisms and risk of HCC in HCV infected patients. Methods: The study enrolled 160 HCC patients, 91 with & 69 without chronic HCV infection, and 140 healthy subjects as control group. Genomic DNA was analysed for MMPs gene polymorphism using restriction fragment length polymorphism polymerase chain reaction (RFLP-PCR) for MMP1 and MMP9 but real time PCR was used for MMP14 genotyping. Results: MMP1-2G allele carriers had higher susceptibility of developing HCC in HCV infected patients. MMP9-1562 T/T genotype had high risk of developing HCC in HCV and non HCV related patients when compared to healthy controls. A significant lower risk for HCC was shown in individuals with MMP14-6767 G/A. The distribution frequency of MMP14-6767 G and MMP14-6727 C allele and homozygote genotype was significantly higher in HCC patients. Conclusion: MMP-1 -1607 2G allele carriers would alter the risk of HCC under specific conditions such as chronic infection with HCV. People with MMP9-1562 T/T genotype are at risk of developing HCC. MMP14-6767 G and MMP14-6727 C allele carriers and homozygote genotype might contribute to the prediction of susceptibility and pathological development of HCC in HCV infected patients.