Risk Stratification for Oropharyngeal Squamous Cell Carcinoma Using Texture Analysis on CT - A Step Beyond HPV Status.

Human papillomavirus-associated oropharyngeal squamous cell carcinoma (OPSCC) is increasingly prevalent. Despite the overall more favorable outcome, the observed heterogeneous treatment response within this patient group highlights the need for additional means to prognosticate and guide clinical decision-making. Promising prediction models using radiomics from primary OPSCC have been derived.

Association of Primary Tumor Volume With Survival in Patients With T3 Glottic Cancer Treated With Radiotherapy: A Study of the Canadian Head & Neck Collaborative Research Initiative.

Importance: The association of primary tumor volume with outcomes in T3 glottic cancers treated with radiotherapy with concurrent chemotherapy remains unclear, with some evidence suggesting worse locoregional control in larger tumors.

Objective: To evaluate the association of primary tumor volume with oncologic outcomes in patients with T3 N0-N3 M0 glottic cancer treated with primary (chemo)radiotherapy in a large multi-institutional study.

Design, Setting, And Participants: This multi-institutional retrospective cohort study involved 7 Canadian cancer centers from 2002 to 2018.

TRK Inhibition with Entrectinib in Metastatic Salivary Secretory Carcinoma (SC): A Case Report.

NTRK gene fusions are rare oncogenic driver mutations that can be found in a broad range of neoplasms. In secretory carcinoma (SC), gene fusion is seen in a majority of the cases and represents a druggable target for patients with advanced disease in the absence of a currently accepted standard of care. In our case, we describe a patient with recurrent, metastatic SC treated with first line entrectinib with clinically meaningful, durable ongoing response after 49 months.

Novel imaging classification system of nodal disease in human papillomavirus-mediated oropharyngeal squamous cell carcinoma prognostic of patient outcomes.

Background: Matted nodes in human papillomavirus (HPV)-mediated oropharyngeal squamous cell carcinoma (OPC) is an independent predictor of distant metastases and decreased overall survival. We aimed to classify imaging patterns of metastatic lymphadenopathy, analyze our classification system for reproducibility, and assess its prognostic value.

Methods: The metastatic lymphadenopathy was classified based on radiological characteristics for 216 patients with HPV-mediated OPC.

Volumetric changes in pharyngeal structures following head and neck cancer chemoradiation therapy.

Objectives/hypothesis: To determine the volumetric changes in pharyngeal structures in patients with head and neck squamous cell carcinoma (HNSCC) treated with curative chemoradiation therapy (CRT). Patients treated with CRT for esophageal carcinoma (EC), where pharyngeal structures were not part of the radiation treatment fields, were controlled for dysphagia-associated weight loss. We hypothesize that tissue volume alteration is a contributing factor of post-CRT dysphagia.

Case series of mild behavioral impairment: toward an understanding of the early stages of neurodegenerative diseases affecting behavior and cognition.

Mild behavioral impairment (MBI) is characterized by later life acquired, sustained, and impactful neuropsychiatric symptoms (NPS) of any severity that cannot be better accounted for by other formal medical and psychiatric nosology. MBI is an "at risk" state for incident cognitive decline and dementia, and for some, MBI is the index manifestation of neurodegeneration, observed in advance of cognitive impairment. Initially described in Frontotemporal Dementia (FTD), MBI evolved to describe a preclinical stage of all cause dementia, and has been operationalized in the International Society to Advance Alzheimer's Research and Treatment-Alzheimer's Association (ISTAART-AA) proposed research diagnostic criteria.

Secondary Neuroendocrine Carcinoma Following High-Dose Radiotherapy for Head and Neck Cancer: Report of Two Cases.

Patients treated with radiation have an increased risk of developing second cancers, of which carcinomas, sarcomas, and hematological malignancies have most commonly been reported. Neuroendocrine carcinomas (NEC) are rarely reported in patients previously treated with radiation. Two patients, who had successfully undergone chemoradiotherapy for head and neck cancers at our institution, developed secondary NEC within the radiation field more than five years after the treatment.

Improved transoral surgical tool design by CT measurements of the oral cavity and pharynx.

The majority of head and neck cancers arise from the oral cavity and oropharynx. Many of these lesions will be amenable to surgical resection using transoral approaches including transoral robotic surgery (TORS). To develop and control TORS tools, precise dimensions of the oral cavity and pharynx are desirable.

Neuroradiology Using Secure Mobile Device Review.

Background: Image review on computer-based workstations has made film-based review outdated. Despite advances in technology, the lack of portability of digital workstations creates an inherent disadvantage. As such, we sought to determine if the quality of image review on a handheld device is adequate for routine clinical use.

Canadian Expert Panel Recommendations for MRI Use in MS Diagnosis and Monitoring.

Background: A definitive diagnosis of multiple sclerosis (MS), as distinct from a clinically isolated syndrome, requires one of two conditions: a second clinical attack or particular magnetic resonance imaging (MRI) findings as defined by the McDonald criteria. MRI is also important after a diagnosis is made as a means of monitoring subclinical disease activity. While a standardized protocol for diagnostic and follow-up MRI has been developed by the Consortium of Multiple Sclerosis Centres, acceptance and implementation in Canada have been suboptimal.

Diagnostic utility of central node necrosis in predicting extracapsular spread among oral cavity squamous cell carcinoma.

Background: Oral cavity squamous cell carcinoma (SCC) represents the most common SCC affecting the head and neck region. Long-term survival of patients with oral cavity SCC is adversely affected by lymph node metastasis and further decreased by the presence of lymph node extracapsular spread (ECS).

Methods: Using a case-control design, preoperative CT scans from patients with oral cavity SCC and metastatic lymphadenopathy were evaluated by 2 independent neuroradiologists, blinded to the study, for a number of radiologic parameters, including central node necrosis.

Impact of neuroradiologist second opinion on staging and management of head and neck cancer.

Objective: Patients with head and neck cancer frequently present to academic tertiary referral centers with imaging studies that have been performed and interpreted elsewhere. At our institution, these outside head and neck imaging studies undergo formal second opinion reporting by a fellowship-trained academic neuroradiologist with expertise in head and neck imaging. The purpose of this study was to determine the impact of this practice on cancer staging and patient management.

Radiologic reporting for paranasal sinus computed tomography: a multi-institutional review of content and consistency.

Objectives/hypothesis: To optimize clinical care, radiologic reporting should consistently include clinically pertinent information. The purpose of this study was to: 1) determine the current satisfaction of otolaryngologists with paranasal sinus computed tomography (CT) radiologic reporting and 2) evaluate the comprehensiveness of paranasal sinus CT radiologic reporting.

Study Design: Two parts: 1) A national survey of all practicing otolaryngologists in Canada and 2) a retrospective review of paranasal sinus CT scan radiologic reporting.

Impact of newer generation multidetector computed tomography on the diagnosis of abscesses in the head and neck.

Objective: To understand how newer generation multidetector computed tomographic (NGCT) scanner technology (≥ 16 slices) has affected the imaging characteristics of head and neck abscesses.

Design: Retrospective chart review.

Setting: Tertiary referral centre.

Asymptomatic unruptured intracranial aneurysms: approach to screening and treatment.

ABSTRACTOBJECTIVETo review the current knowledge of screening and treatment of asymptomatic unruptured intracranial aneurysms (AUIAs) using a case-based approach.SOURCES OF INFORMATIONPubMed was searched from January 1995 to January 2008 using the phrase unruptured intracranial aneurysm. Scientific statements of the Stroke Council of the American Heart Association pertaining to intracranial aneurysms were also reviewed.

Correlation of CT scan versus plain radiography for measuring urinary stone dimensions.

Objectives: To correlate the measured dimensions of urinary stones from spiral non-contrast computerized tomography (CT) with that of plain radiography (KUB).

Methods: The transverse diameter as reported on CT was compared to the measured transverse diameter on KUB for 61 stones. The transverse and craniocaudal dimensions on CT were then re-measured for 30 urinary stones and again compared to the re-measured values for KUB.

Variations in calcaneonavicular morphology demonstrated with radiography.

Purpose: To determine and classify radiographically demonstrated variations in calcaneonavicular morphology and to estimate prevalence in a clinically relevant patient population.

Materials And Methods: Retrospective review was performed of foot radiographs obtained during diagnostic evaluation of 460 consecutive patients who presented to the emergency department with acute foot pain. Variations in calcaneonavicular morphology depicted on the medial oblique view (obtained at a 45 degrees angle) were classified into four groups according to morphologic type (types 1-4), and the prevalence of each type was calculated.

Classic metaphyseal lesion following external cephalic version and cesarean section.

We report a case of an otherwise healthy neonate diagnosed at birth with a classic metaphyseal lesion of the proximal tibia following external cephalic version for frank breech presentation and a subsequent urgent cesarean section. Although the classic metaphyseal lesion is considered highly specific for infant abuse, this case demonstrates the importance of obtaining a history of obstetric trauma for neonates presenting to the imaging department for suspected non-accidental injury.