Could Breast Tomosynthesis With Synthetic View Mammography Aid Standard Two-Dimensional Mammography in Evaluation at Symptomatic Triple Assessment Breast Clinics?

Background This study aimed to determine whether breast tomosynthesis and synthetic view mammography (SM) can aid standard two-dimensional mammography (S2DM) in the evaluation of symptomatic women at triple assessment clinics (TACs). Methodology Digital breast tomosynthesis (DBT), SM, and S2DM were performed on 400 patients at symptomatic breast TACs between September 2020 and November 2020. Diagnostic findings on mammography and ultrasound were retrospectively recorded and analyzed by a breast-trained radiologist with 13 years of clinical experience.

Hallmarks of Cancer in the Reading Room: A Guide for Radiologists.

Objective: The hallmarks of cancer are mechanisms that cells develop to undergo malignant transformation. The targeting of these hallmarks by newer cancer therapies results in new mechanisms of response, toxicity, and resistance. The purpose of this article is to review these hallmarks, their associated targeted therapies, imaging features of responses, and toxicities.

Can the synthetic C view images be used in isolation for diagnosing breast malignancy without reviewing the entire digital breast tomosynthesis data set?

Aims And Objectives: The aim of this study was to determine if the synthetic C view acquired at digital breast tomosynthesis (DBT) would give adequate information to confirm a malignancy and could obviate the need to review all the tomosynthesis image data set.

Methods: All patients with biopsy-proven breast cancer recalled from screening mammograms between May and September 2016 were included for review. For each patient, the screening 2D mammogram, the synthetic C view, and the DBT images were reviewed by three breast radiologists and each assigned a BIRADS code.

Hepatobiliary phase MRI: impact on planning image-guided liver tumor ablations.

Purpose: To assess the impact of hepatobiliary phase images obtained during intravenous gadoxetate disodium-enhanced liver MRI in the planning of image-guided liver tumor ablations.

Methods: This institutional review board-approved retrospective study included 34 patients (21 men, 13 women, ages 25-80) who underwent 36 liver MRI examinations with gadoxetate disodium within 12 weeks prior to image-guided thermal ablation of 62 liver tumors during 36 procedures. Visibility of bile ducts, subdivided by branch order, on hepatobiliary phase images was compared to standard MRI sequence images by an attending abdominal radiologist and fellow.

Current Concepts in Non-Gastrointestinal Stromal Tumor Soft Tissue Sarcomas: A Primer for Radiologists.

Non-gastrointestinal stromal tumor (GIST) soft tissue sarcomas (STSs) are a heterogeneous group of neoplasms whose classification and management continues to evolve with better understanding of their biologic behavior. The 2013 World Health Organization (WHO) has revised their classification based on new immunohistochemical and cytogenetic data. In this article, we will provide a brief overview of the revised WHO classification of soft tissue tumors, discuss in detail the radiology and management of the two most common adult non-GIST STS, namely liposarcoma and leiomyosarcoma, and review some of the emerging histology-driven targeted therapies in non-GIST STS, focusing on the role of the radiologist.

Update on Gastrointestinal Stromal Tumors for Radiologists.

The management of gastrointestinal stromal tumors (GISTs) has evolved significantly in the last two decades due to better understanding of their biologic behavior as well as development of molecular targeted therapies. GISTs with exon 11 mutation respond to imatinib whereas GISTs with exon 9 or succinate dehydrogenase subunit mutations do not. Risk stratification models have enabled stratifying GISTs according to risk of recurrence and choosing patients who may benefit from adjuvant therapy.

Evolving Cancer Classification in the Era of Personalized Medicine: A Primer for Radiologists.

Traditionally tumors were classified based on anatomic location but now specific genetic mutations in cancers are leading to treatment of tumors with molecular targeted therapies. This has led to a paradigm shift in the classification and treatment of cancer. Tumors treated with molecular targeted therapies often show morphological changes rather than change in size and are associated with class specific and drug specific toxicities, different from those encountered with conventional chemotherapeutic agents.

Metastatic Patterns of Solitary Fibrous Tumors: A Single-Institution Experience.

Objective: The objective of our study was to evaluate the metastatic patterns and imaging features of solitary fibrous tumors (SFTs).

Materials And Methods: This retrospective study included 139 patients with pathologically proven SFT, 49 of whom developed metastases. Electronic medical records and all available images were reviewed to record the pattern and imaging appearances of metastatic disease, and comparisons of thoracic SFTs and extrathoracic SFTs were also performed.

Patterns and Prognostic Importance of Hepatic Involvement in Patients with Serous Ovarian Cancer: A Single-Institution Experience with 244 Patients.

Purpose To evaluate the frequency, patterns, and prognostic importance of metastatic hepatic involvement in serous ovarian cancer. Materials and Methods This institutional review board-approved retrospective study, with waived informed consent, included 244 patients with pathologically proven serous ovarian cancer (mean age ± standard deviation, 59 years ± 10.7; range 19-93 years).

Comparison of performance of various tumor response criteria in assessment of sunitinib activity in advanced gastrointestinal stromal tumors.

Purpose: To compare the performance of various tumor response criteria (TRC) in the assessment of patients with advanced gastrointestinal stromal tumor (GIST) treated with sunitinib after failure of imatinib.

Methods: Sixty-two participants with advanced GIST in two clinical trials received oral sunitinib after prior failure of imatinib (median duration 24 weeks; interquartile range 14-56) and were followed with contrast-enhanced computed tomography at baseline and thereafter at median intervals of 6 weeks (IRQ 6-9). Tumor response was prospectively determined using Response Evaluation Criteria in Solid Tumors (RECIST) 1.

Anastomosing hemangiomas: locations of occurrence, imaging features, and diagnosis with percutaneous biopsy.

Purpose: To describe a series of anastomosing hemangiomas and report its locations, imaging features, and the use of image-guided percutaneous biopsy to establish the diagnosis.

Methods: In this institutional review board-approved, HIPAA compliant, retrospective study, an electronic pathology database was searched for all cases of anastomosing hemangioma from January 2009 to January 2015, yielding 32 cases (18 men, mean age 62 years). Tumor locations were recorded, and in a subgroup of patients with imaging, image characteristics (contour, attenuation, enhancement after intravenous contrast injection, the presence of hemorrhage or fat attenuation, and non-enhancing component) were evaluated.

Advanced High-Grade Serous Ovarian Cancer: Frequency and Timing of Thoracic Metastases and the Implications for Chest Imaging Follow-up.

Purpose: To study the frequency, timing, and associations of thoracic metastases in advanced (stage III and IV) high-grade serous ovarian cancer (HGSC) to help optimize the use of cross-sectional chest imaging.

Materials And Methods: This institutional review board-approved retrospective study with waived informed consent included 186 consecutive patients with pathologically proven advanced HGSC after primary cytoreduction (mean age ± standard deviation, 60 years ± 9.7) who underwent imaging at our tertiary cancer institution from January 2012 to December 2012 with at least 1 year of follow-up, unless there was thoracic metastasis or death.

Accuracy and feasibility of estimated tumour volumetry in primary gastric gastrointestinal stromal tumours: validation using semiautomated technique in 127 patients.

Objectives: To validate estimated tumour volumetry in primary gastric gastrointestinal stromal tumours (GISTs) using semiautomated volumetry.

Methods: In this IRB-approved retrospective study, we measured the three longest diameters in x, y, z axes on CTs of primary gastric GISTs in 127 consecutive patients (52 women, 75 men, mean age 61 years) at our institute between 2000 and 2013. Segmented volumes (Vsegmented) were obtained using commercial software by two radiologists.

Hermansky-pudlak syndrome complicated by pulmonary fibrosis: radiologic-pathologic correlation and review of pulmonary complications.

Hermansky-Pudlak syndrome (HPS) is a rare autosomal recessive disorder characterized by oculocutaneous hypopigmentation, platelet dysfunction, and in many cases, life-threatening pulmonary fibrosis. We report the clinical course, imaging, and postmortem findings of a 38-year-old female with HPS-related progressive pulmonary fibrosis, highlighting the role of imaging in assessment of disease severity and prognosis.

"EcoRadiology"--pulling the plug on wasted energy in the radiology department.

Rationale And Objectives: We sought to evaluate the power consumption of various devices around the radiology department, audit our use of recycling, and review efforts by vendors to reduce the environmental impact of their products.

Materials And Methods: Using a readily available power monitor, we calculated the power consumption of different devices around our department. In particular, we calculated the financial and environmental cost of leaving equipment on overnight and/or at weekends.

Practical tips and tricks for assessing prosthetic valves and detecting paravalvular regurgitation using cardiac CT.

Paravalvular leaks are an uncommon but serious complication of prosthetic valves. Transthoracic echocardiography is used in the assessment of prosthetic valves but can be limited by acoustic shadowing from the prosthesis and poor acoustic windowing. Small case series have previously shown cardiac CT to have promising results in detecting paravalvular leaks.

Thyroid lymphoma on a background of Hashimoto's thyroiditis: PET/CT appearances.

Primary thyroid lymphoma is a rare thyroid tumor accounting for only 5% of all thyroid malignancies. It is more common in patients with a background history of chronic thyroiditis. PET/CT is helpful in the initial staging and for follow up to assess treatment response.

Magnetic resonance imaging appearances in primary and secondary angiosarcoma of the breast.

Angiosarcomas are malignant tumours of endovascular origin. They are rare tumours accounting for 0.04-1% of all breast malignancies.

Staging of gastroenteropancreatic neuroendocrine tumors: how we do it based on an evidence-based approach.

In contrast to other common types of malignant tumors, the vast majority of gastroenteropancreatic neuroendocrine tumors are well differentiated and slowly growing with only a minority showing aggressive behavior. It is important to accurately stage patients radiologically so the correct treatment can be implemented and to improve prognosis. In this article, we critically appraise the current literature in an effort to establish the current role of radiologic imaging in the staging of neuroendocrine tumors.

Poststernotomy lymphadenopathy: prevalence, size, and location on chest CT.

Purpose: We aimed to determine the prevalence of enlarged lymph nodes (LNs) in chest computed tomography (CT) scans of patients with a history of sternotomy.

Materials And Methods: The chest CT scans of 271 patients with a history of sternotomy (mean age, 68.3±14.

Thrombosed prosthetic valve in Ebstein's anomaly: Evaluation with echocardiography and 64-slice cardiac computed tomography.

Ebstein's anomaly (EA) is a rare cardiac congenital malformation with displacement of septal and posterior tricuspid leaflets, resulting in atrialization of the right ventricle. We report a case of EA in which the etiology of a malfunctioning prosthetic tricuspid valve is depicted on cardiac computed tomography to be as a result of thrombus lodged in the valve.

Investigation of cardiomyopathy using cardiac magnetic resonance imaging part 2: Rare phenotypes.

Cardiac magnetic resonance imaging (CMRI) has emerged as a useful tertiary imaging tool in the investigation of patients suspected of many different types of cardiomyopathies. CMRI images are now of a sufficiently robust quality to enable high spatial and temporal resolution image acquisition. This has led to CMRI becoming an effective non-invasive imaging tool for many cardiomyopathies.

Investigation of cardiomyopathy using cardiac magnetic resonance imaging part 1: Common phenotypes.

Cardiac magnetic resonance imaging (CMRI) has emerged as a useful tertiary imaging tool in the investigation of patients suspected of many different types of cardiomyopathies. CMRI sequences are now of a sufficiently robust quality to enable high spatial and temporal resolution image acquisition. This has led to CMRI becoming an effective non-invasive imaging gold standard for many cardiomyopathies.