Relationship between background parenchymal enhancement on breast MRI and pathological tumor response in breast cancer patients receiving neoadjuvant chemotherapy.

OBJECTIVE: To evaluate the impact of background parenchymal enhancement (BPE) on breast MRI and pathological tumor responses to neoadjuvant chemotherapy (NAC) in breast cancer patients. METHODS: A panel of 372 MRI from 186 pathologically confirmed breast cancer patients who underwent breast MRI before and after NAC were selected. BPE was classified into four categories before and after NAC. The association between BPE and the pathological tumor response to NAC, recurrence-free survival (RFS) and molecular subtypes were analyzed. We also evaluated the associations between the baseline BPE before NAC and menopausal status or mammographic parenchymal density. RESULTS: Baseline BPE did not differ significantly according to the pathological tumor response to NAC (p = 0.2019). However, changes in BPE after NAC were significantly greater in the pathological complete remission (pCR) group than in the non-pCR group (p = 0.0008). There was no statistically significant association between BPE and RFS or molecular subtypes. The baseline BPE of pre-menopausal females (2.77 ± 0.86) were greater than those of post-menopausal females (2.05 ± 0.69), with statistical significance (p < 0.0001). Baseline BPE showed no significant difference according to mammographic parenchymal density. CONCLUSION: The degree of BPE reduction in breast MRI correlates with the pathological tumor response to NAC in breast cancer patients. No significant difference in BPE was observed according to RFS or molecular subtypes of tumors. Advances in knowledge: This study suggests that the change in BPE may have potential as a biomarker of tumor response in breast cancer patients receiving NAC.

Localized pulmonary alveolar proteinosis: two case reports.

BACKGROUND: Pulmonary alveolar proteinosis (PAP) is a relatively rare disease characterized by abnormal accumulation of surfactant-like material in the alveolar spaces. The classic radiologic findings of PAP include bilateral, symmetric, diffuse ground-glass opacity (GGO) or consolidation. The most common computed tomography (CT) feature of PAP is widespread GGO with thickened interlobular septa, the so-called crazy-paving pattern, which strongly suggests the diagnosis. CASE REPORT: Here, we report the cases of two young male patients with unusual presentations of PAP. One patient showed localized PAP in the left lower lobe on CT images and the other patient presented with unilateral PAP involving the right lower lung field and recurrence in the same area with the same pattern as the initial manifestation. CONCLUSION: In conclusion, it is important for radiologists to be aware of potential atypical imaging findings of PAP in order to provide a correct diagnosis. Along these lines, PAP can present as a solitary nodular lesion or unilateral focal lesion, and can recur in the same pattern and location.

Korean Version of the ABILOCO Questionnaire in the Assessment of Locomotion in Hemiplegic Stroke Patients.

OBJECTIVE: To investigate the intra- and inter-rater reliability of the Korean version of the ABILOCO questionnaire (K-ABILOCO). METHODS: The original ABILOCO questionnaire was translated into Korean and back-translated into English. Stroke patients (n=30) with hemiplegia were evaluated using the K-ABILOCO at one week interval. At each visit, the physiatrist also evaluated patient performance of the activities described in the K-ABILOCO, and the total logit scores were recorded. The total scores were used to evaluate intraclass correlation (ICC). Test-retest scores and each test scores were compared to obtain the intra- and inter-rater reliability. RESULTS: The K-ABILOCO showed good intra-rater correlation at one week interval in both patient and physiatrist evaluations (ICC=0.81, 0.91), respectively. It also showed a high inter-rater correlation between the patient and physiatrist at both the first and second visits (ICC=0.76, 0.84), respectively. CONCLUSION: The K-ABILOCO is a useful tool that may reliably evaluate the locomotion ability in hemiplegic stroke patients.

Azygos vein aneurysm mimicking paratracheal mass: dynamic magnetic resonance imaging findings.

Aneurysms of the azygos vein are rare and can sometimes mimic a paratracheal or posterior mediastinal mass. It is important to confirm the diagnosis with radiologic tools before performing invasive procedures, which carry the risk of hemorrhage. Here, we present a case in a 79-year-old asymptomatic patient of an increasing azygos vein aneurysm that mimicked a growing paratracheal mass. Review of images obtained using various modalities, including dynamic magnetic resonance image (MRI), revealed that the image findings were suggestive of azygos vein aneurysm. Using this method, an exact diagnosis can be reached without resorting to invasive procedures.

Painful os peroneum syndrome presenting as lateral plantar foot pain.

Lateral plantar foot pain can be caused by various entities, and the painful os peroneum syndrome should be considered in the differential diagnosis. Recent developments in musculoskeletal ultrasonography are very useful for initial diagnosis. We discuss a 69-year-old female who experienced lateral plantar foot pain for over one month. Through physical examination, radiography, ultrasound and magnetic resonance imaging, she was diagnosed with the painful os peroneum syndrome with a chronic fatigue fracture of multipartite os peroneum and peroneus longus tenosynovitis, for which she underwent surgery. We herein report this rare condition and reviewed the relevant literature.