Radiological evidence to changes in the olfactory bulb volume depending on body mass index in the childhood.

OBJECTIVE: Energy balance is preserved through the exchange between body weight and adipose tissue across the multi-faceted complex network that is composed of the sensorial, metabolic, and neuro-endocrine circuits. The olfactory control of energy homeostasis is maintained through the interplay between the olfactory bulb (OB) and adipose tissue. While extremely studied, most researches still report controversial results and sensorial regulation of obesity is not fully understood. This study aims to investigate the interplay between olfactory bulb volume (OBV) as a radiological clue of sensorial control and obesity in children. SUBJECTS AND METHOD: Children (n = 195) were classified into four groups based on body mass index (BMI) percentiles: normal weight (n = 89), overweight (n = 31), obese (n = 32) and morbidly obese (n = 43). OBV were calculated using MRI. RESULTS: Mean OBV was higher in children with obesity than in those of normal weights. The means of OBV are found higher in the overweight and obese children (43.76 ± 9.50-49.29 ± 8.61 mm3) than in those of morbidly obese (38.23 ± 11.52 mm3) (p < 0.001). In overweight and obese children, a positive correlation were found between the BMI and OBV (roverweigh = 0.275-robese = 0.377), while in the morbidly obese group, there was a negative correlation (rseverelyobese = -0.445). CONCLUSION: This study reveals that OBV is higher in obese children. Also, it shows that there is a positive correlation between OBV and BMI in overweight and obese children and a negative correlation in the morbidly obese group. These radiological bimodal changes in OBV indicate that olfactory control acts to provide energy balance, mediated by positive in the overweight and obese children, negative feedback in the morbidly obese group.

Is temporal muscle thickness a survival predictor in newly diagnosed glioblastoma multiforme?

AIM: Glioblastoma multiforme (GBM) is the most common primary malignant brain tumor in adults. In this study, we aimed to show the relationship between temporal muscle thickness (TMT) measurement and survival in newly diagnosed patients with GBM. METHODS: Forty-seven patients with newly diagnosed GBM were evaluated, retrospectively. TMT at diagnosis of GBM before any surgical procedure was measured on the contrast-enhanced axial longitudinal relaxation time (T1)-weighted magnetic resonance images. Overall survival (OS) was analyzed by the Kaplan-Meier method and log-rank test was used to determine the differences between the groups. The median TMT was used to determine the cutoff point. RESULTS: The median TMT was 4.7 mm (range, 2.8-6.6) in females and 5.4 mm (range, 2.9-8.1) in males. Median survival for TMT < 4.9 mm was 12.9 ± 3.5 (95% CI, 6.0-19.8) months, and 39.4 ± 11.9 (95% CI, 16.0-62.8) months for TMT ≥ 4.9 (P = .023). In the multivariate Cox regression model, the TMT group (Hazard ratio [HR] = 2.07, 95% CI, 0.92-4.61, P = .032) and age group (HR = 2.18, 95% CI, 1.01-4.67, P = .014) showed statistically significant difference. CONCLUSION: TMT is not an independent predictor of response but a predictor of sarcopenia and survival in newly diagnosed GBM. TMT measurement is an easy and practical method. Survival prediction will provide useful information in GBM patients having poor prognosis.

The relationship between the olfactory bulb and precocious puberty: from the nose to the pituitary.

Background/objective The olfactory bulb (OB) and pubertal development have a close relationship as they share a common ontogenetic origin. The aim of this study was to analyze the potential relationship between precocious puberty (PP) in girls as a sign of early pubertal timing and their OB volume as an indicator of its functional activity. Design In the study group (n = 125), OB volume, pituitary height (PH), body mass index (BMI) and body surface (S) variables were retrospectively investigated in 49 girls included in the PP group and 76 healthy girls constituting the control group. Volumetric and length measurements were performed on a magnetic resonance imaging (MRI) scan by using manual segmentation of slices. Results The mean OB volume (73.41 ± 17.21 mm3) and PH (4.96 ± 1.01 mm) were significantly higher in the PP group (p = 0.001 and p = 0.001, respectively). The mean volume difference between the right and left bulbs (1.52 ± 1.87) was higher in the PP group (p = 0.03). The body surface (1.05 ± 0.16 m2) was larger in the PP group (p = 0.09). There was a high correlation between the OB volume and PH (r125 = 0.716). There was a moderate correlation between the body surface and OB volume (r125 = 654), and a weak correlation between the former (S) and the PH (r125 = 452). Conclusions This study showed that there is a strong correlation between increased OB volume and PH in cases with PP. It indicates that increased OB volume may be a strong clue that olfactory functions play a role in pubertal timing in humans, although it does not show definitive proof of a causal relationship.

Virtual touch tissue imaging quantification shear wave elastography for determining benign versus malignant cervical lymph nodes: a comparison with conventional ultrasound.

PURPOSE: We aimed to prospectively examine virtual touch tissue imaging quantification (VTIQ) shear wave elastography (SWE) and conventional (B-mode and Doppler) ultrasonography (US), individually and combined, for their ability to differentiate benign and malignant cervical lymph nodes (CLNs). METHODS: One hundred enlarged lymph nodes (LNs) from 72 patients, confirmed by histopathologic diagnoses, were included in the present study. B-mode US, Doppler US, and SWE were performed before histopathologic sampling of the LNs. The LN shear wave velocity (SWV, m/s) was assessed by VTIQ. RESULTS: Using a 3.03 m/s cutoff value, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of SWVmax for differentiating benign and malignant CLNs were 93%, 59%, 68%, 91%, and 75%, respectively. B-mode and Doppler had a sensitivity, specificity, PPV, NPV, and accuracy of 79.2%, 71.2%, 71.6%, 78.7%, and 75%, respectively. B-mode, Doppler, and VTIQ SWE combined had 87.5%, 75%, 76.3%, 86.6%, and 81% for the same parameters, respectively. CONCLUSION: VTIQ SWE is a promising noninvasive diagnostic imaging technique for differentiating benign and malignant CLNs. VTIQ SWV can improve the diagnostic performance of conventional US for differentiating benign and malignant CLNs.

Rectal cancer confined to the bowel wall: the role of 3 Tesla phased-array MR imaging in T categorization.

OBJECTIVE: To determine the diagnostic value of 3 Tesla MR imaging in detection of mucosal (Tis), submucosal (T1) and muscularis propria (T2) invasion in patients with early rectal cancer. METHODS: A total of 50 consecutive patients who underwent 3 Tesla MR imaging and curative-intent intervention for MRI-staged Tis/T1/T2 rectal cancer from March 2012 to December 2016 were included. The radiological T category of each rectal tumour was compared retrospectively with histopathological results assessed according to the tumor, node, metastasis (TNM) classification. The sensitivities, specificities, and overall accuracy rates of 3 Tesla MR imaging for Tis, T1, and T2 cases were calculated using MedCalc statistical software v. 16. RESULTS: The sensitivity, specificity, PPV, NPV of 3 Tesla MR imaging in T categorization for T2 were: 93.7% [95% CI (0.79-0.99)], 77.7% [95% CI (0.52-0.93)], 88.2% [95% CI (0.75-0.94)] and 87.5% [95% CI (0.64-0.96)]; for T1 were 92% [95% CI (0.63-0.99)], 91.8% [95% CI (0.78-0.98)], 80% [95% CI (0.57-0.92)] and 97.1% [95% CI (0.83-0.99)]; for Tis were: 20% [95% CI (0.51-0.71)], 100% [95% CI (0.92-1)], 100%, 91.8% [95% CI (0.87-0.94)], respectively. MR categorization accuracy rates for T2, T1 and Tis were calculated as 88, 92 and 92%, respectively. CONCLUSION: 3 Tesla MR imaging seems to be useful for accurate categorization of T-stage in early rectal cancer, especially for T1 cancers. The method is not a reliable tool to detect Tis cases. The potential for overstaging and understaging of the technique should be realized and taken into consideration when tailoring the treatment protocol for each patient. Advances in knowledge: High-resolution MR with phased-array coil is being increasingly used in the pre-operative assessment of rectal cancer. 3 Tesla high-resolution MR imaging allows improved definition of bowel wall and tumour infiltration.

Mean ADC values discriminate rectal mucinous carcinomafrom rectal nonmucinous adenocarcinoma

Background/aim: This study aimed to differentiate rectal mucinous carcinoma (MC) from nonmucinous rectal adenocarcinoma (AC) using mean apparent diffusion coefficient (mADC) values obtained with diffusion-weighted imaging.Materials and methods: Sixty-two pathologically confirmed rectal AC (n = 44) and MC (n = 18) patients were included in this study. The two groups underwent pelvic MRI to determine the local staging baseline for rectal tumors. Once the region of interest (ROI) was determined, a border was drawn around each hyperintense tumor (b = 1000 s/mm2 images). Following a repeat of this procedure for each patient, the ROIs were recorded to apparent diffusion coefficient (ADC) maps, and mADC values were measured. The mADC was determined per slice, followed by a calculation of whole tumor volume ADC mean using the individual mADC values. The Mann?Whitney test was performed to compare mADCs for the two groups. A receiver operating characteristic (ROC) curve was generated to determine the differentiating capacity of ADCs from MC to AC. Results: The mADC was higher in MC (1.631 ± 0.375 x 10-3 mm2/s) (range: 0.95-2.36 x 10-3 mm2/s) than in AC (0.921 ± 0.157 x 10-3 mm2/s) (range: 0.6-1.48 x 10-3 mm2/s) (P < 0.001). mADCs were effective in distinguishing MC from AC (area under the ROC curve, 0.972 (95% CI : 0.928-1.00)). A threshold of 1.27 x 10-3 mm2/s was set that corresponded with high sensitivity (94.4%) and specificity (97.7%). Twelve MCs (67%) were predominantly hypointense, and 6 MCs (33%) were seen as mixed signal intensity lesions. Forty ACs (91%) were observed as hyperintense lesions, and 4 ACs (9%) had mixed signal intensity. There was a significant difference in the signal intensities between MC and AC (c2 = 54.7, P < 0.001).Conclusion: MCs and ACs show different diffusion characteristics, which can be distinguished with high sensitivity and specificity and can help to improve prognostic treatment options.