Identifying research priorities in newborn medicine: a Delphi study of parents' views.

Objective: Neonatal conditions can have lifelong implications for the health and well-being of children and families. Traditionally, parents and patients have not been included in shaping the agenda for research and yet they are profoundly affected by the neonatal experience and its consequences. This study aimed to identify consensus research priorities among parents/patients of newborn medicine in Australia and New Zealand.

Breast MRI Does Not Help Differentiating Radial Scar With and Without Associated Atypia or Malignancy.

Purpose: To review breast magnetic resonance imaging (MRI) features of radial scar (RS) with and without associated atypia/malignancy.

Methods: Twenty-eight (mean age 56.8) patients diagnosed with 30 biopsy-proven RS (n = 25, ultrasound-guided 14-gauge, n = 5, stereotactically guided 9-gauge) subsequently underwent breast MRI followed by surgery.

Value of Shear Wave Elastography for the Differentiation of Benign and Malignant Microcalcifications of the Breast.

The objective of our study was to evaluate whether shear wave elastography (SWE) can differentiate benign from malignant microcalcifications of the breast when detected on ultrasound (US). Between February 9, and June 23, 2016, 74 patients with mammographically detected suspicious microcalcifications underwent breast US. When microcalcifications were identified on US, stiffness was assessed using SWE.

Can strain elastography improve the characterization of breast lesions identified during second-look MRI-directed sonographic examination?

Purpose: To evaluate strain elastography as a complementary tool for characterization of lesions identified during second-look MRI-directed sonographic examination.

Methods: We reviewed 83 breast lesions evaluated with MRI, secondlook ultrasound (US) and strain elastography in 75 consecutive patients (median age, 56 years). US-guided biopsies were performed in all cases.

Enhancement of breast cancer on pre-treatment dynamic contrast-enhanced MRI using computer-aided detection is associated with response to neo-adjuvant chemotherapy.

Purpose: To evaluate whether enhancement of breast cancer on pre-treatment dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) as evaluated semi-quantitatively using computer-aided detection (CAD) is associated with response to neo-adjuvant chemotherapy.

Materials And Methods: A total of 84 women, (mean age, 51±10 [SD] years; range: 30-73 years) with 84 breast cancers who underwent MRI before neo-adjuvant chemotherapy were included in this retrospective study. The proportion of each type of signal intensity-time curve (SITC) (type 1: persistent; type 2: plateau; Type 3: washout) within the tumor volume was quantified semi-automatically using a CAD system (Aegis, Sentinelle medical, Toronto, Canada) and was compared to histological features of the tumors and to pathological response to neo-adjuvant chemotherapy.

Evaluating the Impact of Breast Density on Preoperative MRI in Invasive Lobular Carcinoma.

Background: The focus of this study was to assess the accuracy of breast MRI in predicting pathologic tumor size in invasive lobular carcinoma (ILC) and to evaluate the incidence and factors associated with the detection of additional MRI lesions in ILC patients.

Study Design: We retrospectively reviewed data from patients with stage I to III ILC diagnosed between 2010 and 2016 at our institution. Univariable and multivariable logistic regression were used to determine factors associated with detection of additional suspicious lesions on MRI.

The Positive Outcome of MRI-Guided Vacuum Assisted Core Needle Breast Biopsies Is Not Influenced by a Prior Negative Targeted Second-Look Ultrasound.

Purpose: The study sought to investigate the outcome of breast magnetic resonance-guided biopsies as a function of the indication for magnetic resonance imaging (MRI), the MRI features of the lesions, and the performance or not of a targeted second-look ultrasound (SLUS) prior breast MRI-guided biopsy.

Methods: We identified 158 women with MRI-detected breast lesions scheduled for MRI-guided biopsy (2007-2013). Patient demographics, performance of targeted SLUS, imaging characteristics, and subsequent pathology results were reviewed.

Imaging features and conspicuity of invasive lobular carcinomas on digital breast tomosynthesis.

Objective: To review the imaging features of invasive lobular carcinoma (ILC) seen on digital breast tomosynthesis (DBT) in comparison with invasive ductal carcinoma (IDC), and to evaluate whether DBT could improve conspicuity and tumour size assessment of ILC in comparison with digital mammography (DM).

Methods: Institutional review board with waiver of informed consent was obtained for this retrospective study. Patients with ILC or IDC who underwent DBT and DM at the time of diagnosis were included.

Retroareolar Carcinomas in Breast Ultrasound: Pearls and Pitfalls.

Breast Ultrasound (US) is an important tool for both screening and diagnostic examinations. Although breast US has benefitted from significant recent technical improvements, its use for the retroareolar region is known to be more challenging than for other locations. The retroareolar location was defined by Giess et al.

Differentiation of Fibroadenomas and Pure Mucinous Carcinomas on Dynamic Contrast-Enhanced MRI of the Breast Using Volume Segmentation for Kinetic Analysis: A Feasibility Study.

Objective: The objective of this study was to retrospectively evaluate the diagnostic performance of volume-based kinetic analysis in dynamic contrast-enhanced MRI (DCE-MRI) of the breast for the differentiation of fibroadenomas (FAs) with high T2 signal intensity from pure mucinous carcinomas (PMCs).

Materials And Methods: A review of records from 2007 to 2013 that were stored in the pathology department database at our institution identified nine patients with PMCs (defined as tumor cells with a mucinous component ≥ 90%) who underwent preoperative breast MRI. The PMCs were compared with 15 biopsy-proven FAs from 13 patients.

Value of pre-operative breast MRI for the size assessment of ductal carcinoma in situ.

Objective: To retrospectively evaluate the accuracy of pre-operative breast MRI and mammography in determining the size of ductal carcinoma in situ (DCIS) compared with the histopathological results.

Methods: 79 patients [mean age: 56.5 (standard deviation 10.

Atypical ductal hyperplasia diagnosed at sonographically guided core needle biopsy: frequency, final surgical outcome, and factors associated with underestimation.

Objective: The purposes of this article were to review the mammographic and sonographic features of breast masses yielding atypical ductal hyperplasia (ADH) at sonographically guided biopsy, evaluate the surgical pathology outcome of these lesions, and determine whether clinical or imaging features can be used to predict upgrade to malignancy.

Materials And Methods: Among 6325 sonographically guided biopsies (2003- 2010) (14-gauge cores), 56 yielded the diagnosis of ADH (0.9%).

Values of pathological analysis of lost tissue fragments in the vacuum canister during a vacuum-assisted stereotactic biopsy of the breast.

Objective: Determine values of pathological analysis of the canister content during a vacuum-assisted breast biopsy (VABB).

Methods: Approval was obtained from the ethical committee. Prospective radiological and pathological analyses of the canister content collected during 231 VABBs performed on 231 patients were carried out.

Flat epithelial atypia of the breast: pathological-radiological correlation.

Objective: This study was undertaken to determine the prevalence of flat epithelial atypia at ultrasound-guided and stereotactically guided needle biopsies, to describe the mammographic and sonographic features of flat epithelial atypia, and to determine the significance of lesions diagnosed as flat epithelial atypia at imaging-guided needle biopsies.

Materials And Methods: Retrospective review of a database of 1369 consecutive sonographically and stereotactically guided needle biopsies performed during a 12-month period yielded 33 lesions with flat epithelial atypia as the most severe pathologic entity (32 patients). Two radiologists retrospectively reviewed the imaging presentation, by combined consensus, according to the BI-RADS lexicon.

Cavernous hemangioma of the breast: mammographic and sonographic findings and follow-up in a patient receiving hormone-replacement therapy.

We report the case of a 78-year-old woman who had been receiving hormone-replacement therapy (HRT) for 6 years and had a 4-month history of a painless nodule in the 9 o'clock position in her right breast. Mammography performed 4 years previously had shown a 4-mm bilobed, ovoid, well-defined nodule in that location; mammography performed 1 year previously had shown that the nodule had increased to 6 mm. We performed mammographic and sonographic examinations, which revealed a 10-mm ovoid nodule in the same 9 o'clock position in the right breast.

Expectant treatment of ectopic pregnancies: clinical and sonographic predictors.

Objective: We identified the potential clinical and sonographic predictors of the spontaneous resolution of ectopic pregnancies.

Subjects And Methods: We performed a prospective study of 78 consecutive patients with a transvaginal sonographic diagnosis of ectopic pregnancy who had either two consecutive quantitative measurements of their beta subunit of human chorionic gonadotropin (beta-hCG) more than 24 hrs apart or an embryo with a heart beat. We evaluated the patient's age, time from the last menstrual period, beta-hCG level, size of ectopic pregnancy, presence of a gestational sac or embryonic elements, vascularity on color Doppler sonography, peak systolic velocity, and resistive index of ectopic pregnancy at the time of presentation as potential independent predictors of the final outcome.

Sonographic appearance of benign and malignant conditions of the colon.

Objective: The objective of this study was to compare the sonographic appearance of different abnormalities of the colon to evaluate the role of sonography in their differential diagnosis.

Materials And Methods: We retrospectively reviewed videotaped sonographic examinations of 99 patients with proven diagnoses that included diverticulitis (n = 35), malignancy (n = 20), Crohn's disease (n = 16), pseudomembranous colitis (n = 14), ischemic colitis (n = 9), and ulcerative colitis (n = 5). Data were collected with regard to gut features, including the site of colonic involvement, associated small-bowel involvement, length of diseased segment, stratification, luminal contents, pneumatosis, and diverticula.

Pelvic fluid collections by sonography and febrile morbidity after abdominal hysterectomy.

Objective: To assess the range of normal findings at endovaginal sonography after abdominal hysterectomy and to assess the relationship these findings and febrile morbidity.

Methods: Fifty-eight women had endovaginal ultrasound at a median of 4 days after abdominal hysterectomy. The volume of fluid in the cul-de-sac and its sonographic characteristics were assessed.

Role of endovaginal sonography in the diagnosis and management of ectopic pregnancy.

Although diagnostic laparoscopy is still considered the standard reference in the diagnosis of ectopic pregnancy (EP), use of high-resolution endovaginal sonography, in conjunction with qualitative serum assays of the beta subunit of human chorionic gonadotropin (beta-hCG), allows detection of earlier and smaller EPs. The most common endovaginal sonographic finding of EP (89%-100% of cases) is an extraovarian, round or elongated, solid tubal mass. A tubal ring (an extrauterine saclike structure) is the second most common finding (40%-68% of cases).

Diffuse uterine adenomyosis: morphologic criteria and diagnostic accuracy of endovaginal sonography.

Purpose: To determine the accuracy of endovaginal ultrasound (US) in the diagnosis of uterine adenomyosis and to evaluate the frequency of observed sonographic criteria.

Materials And Methods: Endovaginal US was performed in 100 consecutive women undergoing hysterectomy for a variety of benign and malignant conditions. Adenomyosis was diagnosed when a poorly defined area of abnormal echotexture (decreased or increased echogenicity, heterogeneous echotexture, myometrial cysts) was present in the myometrium.

Endovaginal sonographic appearance of benign ovarian masses.

This article illustrates the different appearances of benign ovarian and paraovarian masses at endovaginal sonography. A retrospective study was performed of the records for 118 patients with 140 surgically proved benign adnexal masses, including dermoid cysts (n = 27), endometriomas (n = 40), epithelial inclusion cysts (n = 14), serous cystadenomas (n = 11), mucinous cystadenomas (n = 14), fibromas (n = 11), cystadenofibromas (n = 12), paratubal cysts (n = 5), hydrosalpinges (n = 3), and tubo-ovarian abscesses (n = 3). Preoperative diagnosis was made in 96% of the dermoid cysts on the basis of a hyperechoic attenuating component or multiple small horizontal interfaces and in 100% of uncomplicated fibromas on the basis of a hypoechoic attenuating mass.

Accuracy of endovaginal sonography for the detection of fallopian tube blockage.

The patency of 814 fallopian tubes in 414 patients was evaluated by endovaginal sonography immediately prior to hysterosalpingography. In the 659 fallopian tubes that were normal with free spillage, endovaginal sonography did not reveal any tubal or peritubal abnormality (specificity 100%). Of the 64 fallopian tubes with definite hydrosalpinx on hysterosalpingography, only 22 were detected on endovaginal sonography (sensitivity 34%).

Transvaginal US appearance of endometrial abnormalities.

A retrospective study was performed on a series of 44 patients who had undergone transvaginal ultrasound (US) before hysterectomy. The surgically proved endometrial abnormalities included cystic atrophy, cystic and adenomatous hyperplasia, polyps, and malignancy. The following endometrial findings were evaluated: endometrial thickness, echogenicity, smoothness or irregularity of the contour, definition of the contour, and the presence of cystic areas.

Gas bubble emboli detected by transcranial Doppler sonography in patients with prosthetic heart valves: a preliminary report.

After observing spikes in the Doppler signal of cerebral arteries of patients with neurologic symptoms and prosthetic heart valves, we then studied two groups of patients with prosthetic heart valves: seven patients with neurologic symptoms and 65 asymptomatic patients. Using transcranial Doppler sonography of the middle cerebral artery, we found Doppler spikes in six symptomatic and 24 asymptomatic patients with mechanical heart valves. No spikes were found in one symptomatic and 21 asymptomatic patients with biological valves or in 20 asymptomatic patients with mechanical valves.

Accuracy of ultrasound in counting and measuring gallstones.

A prospective study of accuracy of ultrasound in measuring and counting gallstones was undertaken in 30 patients undergoing cholecystectomy. Stones were correctly counted (up to five) in 27 of 30 patients. Ninety-three of 106 stones (88%) examined were measured accurately (with a 2 mm error margin).