Outcomes of high-risk breast lesions diagnosed using image-guided core needle biopsy: results from a multicenter retrospective study.

PURPOSE: The clinical management of high-risk lesions using image-guided biopsy is challenging. This study aimed to evaluate the rates at which such lesions were upgraded to malignancy and identify possible predictive factors for upgrading high-risk lesions. METHODS: This retrospective multicenter analysis included 1.343 patients diagnosed with high-risk lesions using an image-guided core needle or vacuum-assisted biopsy (VAB). Only patients managed using an excisional biopsy or with at least one year of documented radiological follow-up were included. For each, the Breast Imaging Reporting and Data System (BI-RADS) category, number of samples, needle thickness, and lesion size were correlated with malignancy upgrade rates in different histologic subtypes. Pearson's chi-squared test, the Fisher-Freeman-Halton test, and Fisher's exact test were used for the statistical analyses. RESULTS: The overall upgrade rate was 20.6%, with the highest rates in the subtypes of intraductal papilloma (IP) with atypia (44.7%; 55/123), followed by atypical ductal hyperplasia (ADH) (38.4%; 144/375), lobular neoplasia (LN) (12.7%; 7/55), papilloma without atypia (9.4%; 58/611), flat epithelial atypia (FEA) (8.7%; 10/114), and radial scars (RSs) (4.6%; 3/65). There was a significant relationship between the upgrade rate and BI-RADS category, number of samples, and lesion size Lesion size was the most predictive factor for an upgrade in all subtypes. CONCLUSION: ADH and atypical IP showed considerable upgrade rates to malignancy, requiring surgical excision. The LN, IP without atypia, pure FEA, and RS subtypes showed lower malignancy rates when the BI-RADS category was lower and in smaller lesions that had been adequately sampled using VAB. After being discussed in a multidisciplinary meeting, these cases could be managed with follow-up instead of excision.

The effect of radiological distribution on the COVID-19 disease.

INTRODUCTION: The aim of the study was to investigate the effects of radiological distribution on COVID-19 clinic and prognosis and to determine the relationship between laboratory parameters and thorax CT findings. MATERIALS AND METHODS: Patients with COVID-19 were evaluated retrospectively. Laboratory parameters were obtained from medical records. Ground-glass opacities (GGO) and consolidation were evaluated on thorax CT. The presence of a single lobe lesion was considered as limited while multiple lobe lesions were considered as diffuse involvement for both GGO and consolidation. RESULT: A total 200 patients with COVID-19 were evaluated. 178 of them (89%) were discharged, 17 patients (8.5%) were transferred to the ICU and five patients died (2.5%). The ratios of mortality and transfer to the ICU in patients with diffused GGO were significantly higher compared to patients with limited GGOs. It was observed that troponin ≥0.06 µg/L, platelet <140 and fibrinogen ≥350 mg/dl were independent predictors of the presences of diffused GGOs in thorax CT. CONCLUSIONS: Diffused GGOs on thorax CT are correlated with the rate of mortality and transfer to the ICU in patients with COVID-19. Also, troponin, fibrinogen, and platelet levels can be used while predicting extensive parenchymal disease on thorax CT.

The efficacy of CT for detection of right ventricular dysfunction in acute pulmonary embolism, and comparison with cardiac biomarkers.

PURPOSE: The purpose of this study was to evaluate results from computed tomography pulmonary angiography (CTPA) indicative of right ventricular dysfunction (RVD), and to assess the relationship of these results with cardiac biomarkers and mortality among patients with acute PE. MATERIALS AND METHODS: This retrospective study involved 118 patients with acute PE proved by CTPA. CTPA variables were analyzed and compared with cardiac biomarkers and echocardiography (ECHO) findings. RESULTS: Compared with ECHO, the sensitivity, specificity, positive predictive value, and negative predictive value of CTPA for detection of RVD were 85.7, 91.7, 93.7, and 81.5 %, respectively. ROC curve analysis for prediction of RVD resulted in areas under the curve of 0.925 for RV dimension (95 % CI 0.879-0.971, p < 0.001) and 0.913 for main pulmonary artery (MPA) diameter (95 % CI 0.863-0.963, p < 0.001). The optimum cut-off values for prediction of RVD were 37.5 mm for RV dimension and 29.1 mm for MPA diameter. These values were also statistically significantly greater for non-survivors than for survivors (p = 0.001, p < 0.001, respectively) and significantly associated with cardiac biomarkers. CONCLUSION: It was found that CTPA findings were significantly associated with the presence of RVD in ECHO, cardiac biomarkers, and mortality of patients with acute PE.

The relationship between coronary artery disease and pericoronary epicardial adipose tissue thickness.

OBJECTIVES: A retrospective study to investigate the relationship between epicardial adipose tissue thickness (EATT) and presence of coronary artery plaque, coronary artery disease (CAD) and CAD risk factors. METHODS: Multidetector computed tomography (MDCT) coronary angiography images were reviewed. Left anterior decending artery, right coronary artery and left circumflex artery pericoronary EATT were measured. Demographic, clinical and CAD risk factor data were obtained from medical records. RESULTS: Patients with CAD (n = 49) had significantly larger mean EATT than those without CAD (n = 101). Pericoronary EATT was significantly correlated with body mass index, total cholesterol level, coronary artery calcium score, hypertension and diabetes mellitus history. CONCLUSIONS: There is an association between pericoronary EATT and CAD, as well as CAD risk factors. Pericoronary EATT measurement may become a widely used, easy-to-perform method for determining CAD risk.

The role of apparent diffusion coefficient values in differentiation between adrenal masses.

The aim of this study was to evaluate the utility of apparent diffusion coefficient (ADC) values in differentiation between solid adrenal masses. The ADC values of 73 adrenal lesions (54 benign, 19 malignant) in 69 patients were measured at b 100, 600 and 1000 gradients on diffusion-weighted magnetic resonance imaging (DW-MRI). No statistically significant difference was found between ADC values of benign and malignant adrenal masses, nonadenomatous benign adrenal masses and malignant adrenal masses, adrenal adenomas and nonadenomatous lesions, adenomas and metastases, adenomas and pheochromocytomas, metastases and pheochromocytomas. ADC values are not helpful in the differentiation between solid adrenal masses.

A case of intraorbital hemangioma diagnosed with tc 99m labeled erythrocyte scintigraphy and magnetic resonance imaging.

UNLABELLED: We present a 20 year-old male patient who had prominent positional proptosis of the right eye and admitted to the hospital for tonsillectomy operation. After conventional ophthalmological examination, magnetic resonance imaging (MRI) and Tc 99m labeled erythrocyte scintigraphy were performed to confirm the diagnosis. Although it is rare to perform scintigraphy for this pathology, the visualization of intraorbital hemangioma was very obvious and we would like to present the visualization of the intraorbital hemangioma both with scintigraphy and MRI. CONFLICT OF INTEREST: None declared.

Congenital hemihypertrophy with hemihypertrichosis.

The rare condition in which one side of the body seems to grow faster than the other is called hemihypertrophy. This may be accepted as normal, but there are certain serious conditions that may be associated with this type of growth pattern. Congenital hypertrichosis is believed to be a genetic disorder that is inherited or occurs as a result of spontaneous mutation. The incidence of generalised congenital hypertrichosis is about one in a billion. A seven-month-old female case was brought to the hospital with growth and hairiness complaints, which were more apparent in the right side of the face, the right arm and the right leg. Physical examination showed more apparent hypertrophy and hypertrichosis, which covered the entire right side of the body beginning from the face and including the lower extremities and the genitalia. Hypertrichosis was more evident above the right scapula and on the right leg. The diameter of the right upper extremity and the right lower extremity were measured at 13 mm and 14 mm thicker than the left side, respectively. The infant did not have teeth yet and had totally normal nail growth. Skeletal structure, cardiovascular, respiratory, urogenital, central nervous system and eye examinations were all normal. Results of all laboratory analyses, including genetic examination, and those of the imaging techniques were found to be normal. We hereby present the rare co-presence of hemihypertrophy and hemihypertrichosis, for which we could not identify an etiological cause and which is the third such case in the literature.