WFUMB position paper. Incidental findings of the salivary glands.

A salivary incidentaloma (SI) stands for any focal salivary lesion, independent of size, discovered by any imaging method including ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), multimodal positron emis-sion tomography (PET) combined with CT or MRI, or X-ray imaging, performed for another reason, in the absence of known salivary glands' disease. The article presents a detailed analysis of salivary gland diseases with the emphasis on neoplasms. It describes frequency of SIs found on imaging, their prevalence, epidemiology and clinical significance.

Gallbladder-duodenal fistula detected by ultrasound - a case report.

Gallbladder-duodenal (cholecystoduodenal) fistula is an uncommon bilioenteric fistula between the gallbladder and the duodenum. It usually occurs following a chronic case of cholecystitis upon which the gallbladder adheres to the adjacent duodenum, and a stone penetrates through the wall. The case presented herein is that of a gallbladder-duodenal fistula detected primarily with the use of ultrasound imaging, and subsequently confirmed by computed tomography.

Is the level of diffusion restriction in celiac and cervico-thoracic sympathetic ganglia helpful in their proper recognition on PSMA ligand PET/MR?

Aim:  To check if diffusion weighted imaging (DWI) might be helpful in proper recognition of celiac (CG) and cervicothoracic (CTG) sympathetic ganglia on the whole-body multimodal PSMA-ligand PET/MR imaging, in the view of their common misleading avidity on PET potentially suggestive of malignant lesions, including metastatic lymph nodes.

Methods:  The thickness and the level of diffusion restriction was assessed qualitatively and quantitatively in 406 sympathetic ganglia (189 CTG in 101 males and 217 CG in 116 males) on DWI maps (b-value 0 and 800 s/mm) and apparent diffusion coefficient (ADC) maps (mean ADC) of the whole-body PET/MR 68Ga-PSMA-11 PET/MR. To form a reference group of a matching ganglia size, the smallest lymph node was chosen from each patient with metastases and underwent the same procedure.

The "question-mark" MR anatomy of the cervico-thoracic ganglia complex: can it help to avoid mistaking it for a malignant lesion on 68Ga-PSMA-11 PET/MR?

Background Detectable uptake of 68Ga-PSMA-ligands in sympathetic ganglia may potentially lead to mistaking them for malignant lesions. Our aim was to investigate the anatomy of cervico-thoracic-ganglia-complex (CTG-C) in the MR part of multimodal 68Ga-PSMA-11 PET/MR imaging, in view of PET factors hindering its proper identification. Patients and methods In 106 patients, 212 sites of the CTG-C were retrospectively reviewed to assess the radiotracer uptake (SUVmax), size, shape, position, symmetry of location and visual uptake intensity.

Are superior cervical sympathetic ganglia avid on whole body 68Ga-PSMA-11 PET/magnetic resonance?: a comprehensive morphologic and molecular assessment in patients with prostate cancer.

Objectives: Recent reports warn against erroneous mistaking of celiac and stellate sympathetic ganglia for metastatic lymph nodes on multimodal prostate-specific membrane antigen (PSMA)-ligand PET imaging. The aim was to check the intensity of Ga-PSMA-11 uptake and magnetic resonance (MR) features of superior cervical ganglia (SCG) on PET/MR imaging.

Methods: In 89 patients 106 SCG were reliably identified on Ga-PSMA-11 PET/MR.

Unusual Drainage of the Bifurcated Left Renal Vein Into a Dilated Lumbar Azygos Vein and Inferior Vena Cava.

We report a unique case of unusual drainage of the bifurcated retroaortic left renal vein, with the cranial wider branch draining into a dilated lumbar azygos vein and caudal thinner branch connecting with the inferior vena cava. The right renal vein was duplicated. The anomaly was discovered on multimodal F-labeled fluorodeoxyglucose positron emission tomography/computed tomography performed for oncological purposes.

Celiac ganglia: can they be misinterpreted on multimodal 68Ga-PSMA-11 PET/MR?

Objective: The objective of this study was to investigate the morphologic features and Ga-prostate-specific membrane antigen (PSMA)-11 avidity of celiac ganglia (CG) on multimodal PET/MRI.

Materials And Methods: Ga-PSMA-11 whole-body PET/MR examinations in 120 patients, referred for staging or follow-up of prostate cancer, were retrospectively reviewed to investigate the radiotracer uptake [maximum standardized uptake value (SUVmax)] and morphologic features (size, shape, location) of CG. Nodular, oval and longitudinal nodular, thick or with oval parts shapes of CG were regarded as mistakable with lymph nodes, whereas linear and longitudinal shapes were considered as not mistakable.

Mistakes in ultrasound diagnosis of superficial lymph nodes.

The article discusses basic mistakes that can occur during ultrasound imaging of superficial lymph nodes. Ultrasound is the first imaging method used in the diseases of superficial organs and tissues, including lymph nodes. The causes of mistakes can be either dependent or independent of the performing physician.

Mistakes in ultrasound examination of salivary glands.

Ultrasonography is the first imaging method applied in the case of diseases of the salivary glands. The article discusses basic mistakes that can be made during an ultrasound examination of these structures. The reasons for these mistakes may be examiner-dependent or may be beyond their control.

The role of ultrasound and lymphoscintigraphy in the assessment of axillary lymph nodes in patients with breast cancer.

Breast cancer is the most common malignancy and the leading cause of death due to cancer in European women. Mammography screening programs aimed to increase the detection of early cancer stages were implemented in numerous European countries. Recent data show a decrease in mortality due to breast cancer in many countries, particularly among young women.

Radiotherapy of liver metastases. Comparison of target volumes and dose-volume histograms employing CT- or MRI-based treatment planning.

Purpose: To assess differences in delineated target volumes of liver metastases using contrast-enhanced CT and different MRI sequences for radiation treatment planning.

Patients And Methods: 25 patients with 43 colorectal liver metastases were recruited. Tumor margins were defined by two experienced radiologists.

[Ultrasound imaging in laryngology].

Modern ultrasound with high resolution transducers, and sensitive power Doppler and color Doppler modes, and other options, such as panoramic and 3D imaging, allows for detailed imaging of many anatomical structures and pathologic lesions of the head and neck. Only the structures situated in the sonographic acoustic shadow: behind bones, calcified cartilages, stones, and behind organs containing gas (f.e.

US of the major salivary glands: anatomy and spatial relationships, pathologic conditions, and pitfalls.

Ultrasonography (US) is useful for differential diagnosis of diseases of the salivary glands. In acute inflammation, salivary glands are enlarged and hypoechoic with increased blood flow; they may contain multiple small, oval, hypoechoic areas. In chronic inflammation, salivary glands are normal sized or smaller, hypoechoic, and inhomogeneous.

[Kuttner tumour--review of the literature and report of 3 cases].

We present 3 cases of Kuttner tumour (or chronic sclerosing sialadenitis of submandibular gland) all treated by surgery. In one case we report bilateral involvement. The disease was first described by Kuttner more than 100 years ago.

Role of ultrasonography in diagnosis and differentiation of pleomorphic adenomas: work in progress.

Objective: To estimate the utility of ultrasonography in diagnosis and differentiation of pleomorphic adenomas.

Design: From the group of 88 patients examined by ultrasound, who were referred because of the tumor in the preauricular area, submandibular area, or cheek, pleomorphic adenoma was finally diagnosed in 24 (with multiple recurrent tumors in 2 patients).

Results: Ultrasound was able to differentiate between benign and malignant lesions with 96% accuracy in this study.