Sarcoidosis presenting as orbital pseudotumor.

Sarcoidosis is a systemic multiorgan disorder of unknown etiology characterized by a non-caseating granuloma reaction. Ocular involvement has been reported in 25-60% of the patients. Seven percent of the patients with sarcoidosis may first see an ophthalmologist due to ocular complaints. This report aims to present our diagnostic and treatment approach to a female patient with significant unilateral lacrimal gland swelling and musculoskeletal involvement, who was diagnosed with sarcoidosis on the basis of tests and histological studies.

The effectiveness of whole body magnetic resonance imaging (diffusion-weighted imaging and fat saturated T2-weighted imaging) in the evaluation of patients with newly diagnosed malignancies in comparison with positron emission tomography-computed tomography.

PURPOSE: To evaluate the effectiveness of WB-MRI for the detection of primary and metastatic lesions in comparison to PET-CT in patients with newly diagnosed malignancies MATERIAL AND METHODS: In this prospective study, 36 patients were evaluated between August 2008 and October 2012. The findings of WB-MRI (DWI and fat saturated T2 weighted images) were compared to the findings of PET-CT re- garding the primary lesions and metastasis. Sensitivity, specificity, positive and negative predictive values were calculated. To assess the aggreement between PET-CT and WB-MRI, kappa analysis was performed. RESULTS: The sensitivity, specificity, positive and negative predictive values for WB-DWI for the detection of primary and metastatic lesions in comparison to PET-CT were 96%, 89%, 97% and 84%, respectively. These are calculated as 96%, 56%, 90% and 77%, for fat-saturated T2W images. According to kappa analysis, the agreement between PET-CT and WB-DWI was excellent (χ = 0.83), but between PET-CT and fat-saturated T2 weighted images, it was moderate (χ = 0.58). CONCLUSION: Providing both morphogical and functional data, WB-MRI with DWI is emerging as a promising alternative imaging tool in the evaluation of cancer patients and may become complementary to PET-CT in several clinical applications.

Demonstrating disease activity in patients with rheumatoid arthritis. Is 18F FDG PET a sensitive method?

AIM: We aimed to investigate the relationship of fluor-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F FDG PET/CT) with clinical, laboratory parameters and conventional radiographs in patients with rheumatoid arthritis (RA). PATIENTS, MATERIAL, METHODS: 25 patients with RA diagnosis were evaluated by sociodemographic, clinical [duration of disease (year), the joints in which the complaints started, most recent joint involvement]; other parameters used in RA-specific clinical assessment [Steinbocker functional staging, disease activity score 28 (DAS 28 score), health assessment questionnaire score (HAQ score), general RA assessment (patients' and physicians' global assessment), patients' assessments of pain and general health condition (visual analog scale)], laboratory, radiological [conventional radiology of hand and foot joints], positron emission tomography [18F FDG PET visual total score and maximum standardized uptake value (SUVmax) total score] parameters. RESULTS: No significant correlation was detected between the 18F FDG PET total score and SUVmax total score of the patients and clinical, laboratory, and radiological parameters (p > 0.05). There was no relationship between the cut-off values determined according to the disease activity and 18F FDG PET/SUVmax total values (p > 0.05). CONCLUSIONS: In our study, no relationship was found between disease activity demonstrated by 18F FDG PET/CT in RA patients and clinical, laboratory, and radiological parameters. 18F FDG PET/CT appears to be a more sensitive method in demonstrating disease activity compared to other evaluated methods.

Evaluation of coronary bypass graft occlusion and stenosis with 64-detector-row computed tomography angiography.

BACKGROUND: A noninvasive imaging modality is desirable for the evaluation of coronary bypass graft stenosis and occlusion. PURPOSE: To prospectively evaluate the effectiveness of 64-detector-row computed tomography (DCT) for the assessment of coronary bypass grafts. MATERIAL AND METHODS: Forty-two patients (35 male, seven female, mean age 66.3 years) with 103 bypass grafts (32 arterial, 71 venous) were examined with 64-DCT. The evaluations were done by two radiologists blinded to the results of quantitative coronary angiography (QCA), used as the reference standard. RESULTS: All of the 26 occluded grafts, nine of the 10 stenosed grafts, and 66 of the 67 patent grafts were correctly diagnosed with 64-DCT angiography. The sensitivity, specificity, and positive and negative predictive values for 64-DCT in detecting graft stenosis were 90%, 99%, 90%, and 99%, respectively. For graft occlusion, all were 100%. No statistically significant difference was found between 64-DCT and QCA for the evaluation of bypass grafts. Intermodality and interobserver agreement were excellent. CONCLUSION: 64-DCT angiography is a reliable, noninvasive diagnostic method for the assessment of coronary bypass grafts. It can be considered as a useful tool for follow-up purposes and may function as a gatekeeper before invasive procedures.