Predicting breast cancer response to neoadjuvant treatment using multi-feature MRI: results from the I-SPY 2 TRIAL.

Dynamic contrast-enhanced (DCE) MRI provides both morphological and functional information regarding breast tumor response to neoadjuvant chemotherapy (NAC). The purpose of this retrospective study is to test if prediction models combining multiple MRI features outperform models with single features. Four features were quantitatively calculated in each MRI exam: functional tumor volume, longest diameter, sphericity, and contralateral background parenchymal enhancement.

Neoadjuvant Chemotherapy for Breast Cancer: Functional Tumor Volume by MR Imaging Predicts Recurrence-free Survival-Results from the ACRIN 6657/CALGB 150007 I-SPY 1 TRIAL.

Purpose: To evaluate volumetric magnetic resonance (MR) imaging for predicting recurrence-free survival (RFS) after neoadjuvant chemotherapy (NACT) of breast cancer and to consider its predictive performance relative to pathologic complete response (PCR).

Materials And Methods: This HIPAA-compliant prospective multicenter study was approved by institutional review boards with written informed consent. Women with breast tumors 3 cm or larger scheduled for NACT underwent dynamic contrast-enhanced MR imaging before treatment (examination 1), after one cycle (examination 2), midtherapy (examination 3), and before surgery (examination 4).

Locally advanced breast cancer: MR imaging for prediction of response to neoadjuvant chemotherapy--results from ACRIN 6657/I-SPY TRIAL.

Purpose: To compare magnetic resonance (MR) imaging findings and clinical assessment for prediction of pathologic response to neoadjuvant chemotherapy (NACT) in patients with stage II or III breast cancer.

Materials And Methods: The HIPAA-compliant protocol and the informed consent process were approved by the American College of Radiology Institutional Review Board and local-site institutional review boards. Women with invasive breast cancer of 3 cm or greater undergoing NACT with an anthracycline-based regimen, with or without a taxane, were enrolled between May 2002 and March 2006.

Accuracy of breast magnetic resonance imaging in predicting pathologic response in patients treated with neoadjuvant chemotherapy.

Background: Prior studies of the ability of magnetic resonance imaging (MRI) to predict pathologic response to neoadjuvant chemotherapy have shown conflicting results that vary depending on baseline molecular characteristics. This study examines the ability of MRI to predict pathologic complete response (pCR) and explores the influence of tumor molecular profiles on MRI sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).

Methods: Eighty-one patients with invasive breast cancer treated with neoadjuvantsystemic therapy between 2002 and 2009 who were imaged with breast MRI pre- and post-treatment were reviewed.

Pilot trial of preoperative (neoadjuvant) letrozole in combination with bevacizumab in postmenopausal women with newly diagnosed estrogen receptor- or progesterone receptor-positive breast cancer.

Introduction: Tumor content or expression of vascular endothelial growth factor (VEGF) is associated with impaired efficacy of antiestrogen adjuvant therapy. We designed a pilot study to assess the feasibility and short-term efficacy of neoadjuvant letrozole and bevacizumab (anti-VEGF) in postmenopausal women with stage II and III estrogen receptor/progesterone receptor-positive breast cancer.

Patients And Methods: Patients were treated with a neoadjuvant regimen of letrozole orally 2.

Specimen radiographs assist in identifying and assessing resection margins of occult breast carcinomas.

For carcinoma specimens with non-grossly identifiable lesions such as microcalcifications, difficulties may be encountered in locating these abnormalities and sampling the margins that are at risk. This is magnified in the case of skin-sparing procedures where the margin is a much greater surface area and is the operation of choice in patients with diffuse microcalcifications and/or multifocal in situ disease. The objective of this study was to determine the efficacy of specimen radiographs of mastectomy in identifying occult carcinoma associated with microcalcifications and assessing the resection margins.

Three-dimensional changes in upper airways of patients with obstructive sleep apnea following maxillomandibular advancement.

Purpose: The purpose of this study was to analyze the morphologic changes of the airway in obstructive sleep apnea (OSA) patients by helical computed tomography (CT) scanning following maxillomandibular advancement (MMA) surgery.

Materials And Methods: Twenty consecutive OSA patients treated with MMA from 2000 to 2003 at the University of Alabama at Birmingham Hospital and diagnosed by polysomnography (PSG) were included in this study. The criteria for this study were MMA surgery, pre- and postoperative helical CT scan, and PSG.

Incidence of hip osteonecrosis among renal transplantation recipients: a prospective study.

Aim: To investigate whether a lessened glucocorticoid cumulative dose would lead to a decreased incidence of femoral head osteonecrosis.

Methods: Newly transplanted in-patients (n = 49) underwent hip radiographs and magnetic resonance imaging (MRI) a mean of 17.0+/-4.

Ultrasound detection of bone erosions in rheumatoid arthritis: a comparison to routine radiographs of the hands and feet.

Purpose: To determine if ultrasound (US) of selected joints in the hands and feet can detect more erosions than radiography and establish the presence of erosive disease in patients with rheumatoid arthritis (RA).

Methods: Eighty joints in ten patients with RA and 40 joints in five healthy control subjects, who were age, gender and ethnicity-matched to the patients with arthritis, were prospectively studied with radiographs and sonography. Conventional radiographs of the hands and feet were obtained.

MTX affects inflammation and tissue destruction differently in the rat AA model.

Objective: To investigate the dose response relationships of methotrexate (MTX) therapy in rat adjuvant arthritis (AA), an animal model of rheumatoid arthritis (RA).

Methods: Female Lewis rats were fed a defined diet and were treated with 0, 0.3, 1, 2, 3, 5, and 10 mg MTX per week beginning 3 days after adjuvant injection and lasting 6 weeks.

Reducing the cost of diagnosis of breast carcinoma: impact of ultrasound and imaging-guided biopsies on a clinical breast practice.

Background: The objective of this study was to determine whether the use of ultrasound and percutaneous breast biopsies in patients with screen-detected nonpalpable abnormalities can reduce benign open surgical biopsies of the breast without increasing cost or sacrificing detection of potentially curable breast carcinomas.

Method: Using a computerized mammography database and consecutive logs of needle localization procedures and fine- and large core needle biopsies of a single university-based breast imaging practice, the authors determined the breast carcinoma yield and cost of diagnosis over a 14-year period and the changes that occurred over time with the sequential introduction of ultrasound, ultrasound-guided biopsies, and stereotactic biopsies.

Results: The overall breast carcinoma yield for needle localization biopsies of nonpalpable lesions increased from 21% in 1984 to 68% in 1998 (P < 0.

Three-dimensional reconstruction system for imaging of the temporomandibular joint using magnetic resonance imaging.

This study was undertaken to develop a three-dimensional reconstruction system using magnetic resonance (MR) images in order to visualize three-dimensional images of the temporomandibular joint (TMJ) including the disk. The computerized reconstruction program (written using Visual Basic for Windows, Microsoft Corp.) could reliably generate three-dimensional images of the TMJ.

PACS and CR implementation in a level I trauma center emergency department.

Implementation of a picture archive and communication system (PACS) at a large teaching hospital is an expensive and daunting endeavor. The approach taken at the University of Alabama Hospitals has been to assemble an institution-wide system through focused integration of smaller mini-PACS. Recently a mini-PACS using Computed Radiography (CR) has been placed in the Emergency Department (ED) of a Level I Trauma Center completely replacing conventional screen-film radiography.

Mammography of breasts in which catheter cuffs have been retained: normal, infected, and postoperative appearances.

Objective: The purpose of this report is to show that Dacron (DuPont, Wilmington, DE) cuffs retained in breasts after the removal of Hickman catheters may result in complications requiring radiographic evaluation for subsequent management. We also describe potential complications, including infection, associated with a retained cuff and changes after the removal of a retained cuff.

Conclusion: Because of the increased use of Hickman catheters for central vein access, Dacron cuffs more frequently are retained in breasts and are likely to be seen on mammograms.

Cartilage imaging in osteoarthritis.

Osteoarthritis (OA) is the most common articular disorder encountered worldwide. Its successful evaluation (and eventual treatment) depends on establishing a set of criteria for measuring disease progression. An ideal measurement would evaluate changes in articular cartilage, where the primary pathology of the disease takes place.

Needle-localization biopsy of the breast: impact of a selective core needle biopsy program on yield.

Purpose: To determine the effect of a selective core biopsy program on the yield at needle-localization biopsy (NLB) of nonpalpable lesions.

Materials And Methods: Two hundred consecutive core biopsy samples of the breast were evaluated in an ongoing consecutive series of 1,172 NLB samples.

Results: Before implementation of the core biopsy program, the yield at NLB improved from 21% at 100 cases to 35% just before the introduction of core biopsy.

Successful delivery of mature twins after a ruptured interstitial heterotopic pregnancy. A case report.

A 31-year-old primigravida had a combined pregnancy consisting of intrauterine twins and an interstitial ectopic after in vitro fertilization/embryo transfer. The patient underwent repair of the ectopic pregnancy at 15 weeks of gestation, with subsequent delivery of mature twins close to term.

Arthroscopic evaluation of knee articular cartilage: a comparison with plain radiographs and magnetic resonance imaging.

Objective: To compare radiographic, magnetic resonance imaging (MRI), and outpatient direct arthroscopic evaluation of cartilage in patients with osteoarthritis (OA) of the knee.

Methods: Thirty-three patients with OA of the knee were evaluated by plain weight bearing radiographs and arthroscopy using a 1.9 mm arthroscope under local anesthesia.

MR imaging of anatomy and tears of wrist ligaments.

Numerous intrinsic and extrinsic wrist ligaments are visible at magnetic resonance (MR) imaging. Because the previously published descriptions of these ligaments were often conflicting, the authors derived a classification system based on a functional perspective and their experience with MR imaging, arthroscopy, and surgical dissection. This system was used to evaluate MR images of 23 cadaveric wrists for the presence and integrity of 16 wrist ligaments.

Functional magnetic resonance imaging should be included in the evaluation the cervical spine in patients with rheumatoid arthritis.

Objective: To determine the value of functional (flexion) magnetic resonance imaging (MRI) studies in patients with rheumatoid arthritis (RA) suspected of having cervical (C)-spine involvement.

Methods: Four patients with RA suspected of having C spine involvement, with neurological symptoms and/or signs, and who had normal MRI in neutral position, underwent functional MRI.

Results: In all 4 patients functional MRI provided additional information.

MR imaging of the hands in early rheumatoid arthritis: preliminary results.

Several magnetic resonance (MR) imaging pulse sequences (unenhanced T1 weighted spin echo, with and without fat suppression; unenhanced T2 weighted with fat suppression; and spoiled gradient-recalled acquisition in the steady state [GRASS], with fat suppression, before and after gadolinium enhancement) were analyzed in 30 patients with early rheumatoid arthritis to determine which sequences were best for imaging various aspects of the disease as manifested in the hands and wrists. A single hand was imaged in all patients. Inflammation and erosions were best seen on spoiled GRASS images with fat suppression and gadolinium enhancement, with the latter also being well seen on T1-weighted images.