Extraocular muscle Diffusion Weighted Imaging as a quantitative metric of posterior orbital involvement in thyroid associated orbitopathy.

Objectives: The clinical activity score (CAS) and European severity scale (ESS) are established clinical tools to assess thyroid eye disease (TED) but are limited in terms of subjectivity and their reliability in non-Caucasian individuals, and can underestimate significant disease in the posterior orbit. Preliminary data from pilot studies have shown that diffusion-weighted imaging (DWI) using extraocular muscle (EOM) apparent diffusion coefficient (ADC) measurements may provide complementary information in TED. This study expands on previous research to assess for correlations between clinical scores and EOM-ADCs in stratifying disease activity and severity in a large patient cohort from an ethnically diverse population.

Discriminating between benign and malignant salivary gland tumors using diffusion-weighted imaging and intravoxel incoherent motion at 3 Tesla.

Purpose: The purpose of this study was to retrospectively evaluate the diagnostic performances of diffusion-weighted imaging (DWI) and intravoxel incoherent motion (IVIM) for discriminating between benign and malignant salivary gland tumors (SGTs).

Materials And Methods: Sixty-seven patients with 71 SGTs who underwent MRI examination at 3 Tesla were included. There were 34 men and 37 women with a mean age of 57 ± 17 (SD) years (age range: 20-90 years).

Imaging of head and neck mucosa-associated lymphoid tissue lymphoma (MALToma).

Marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALToma) arises in extranodal sites in the head and neck. Chronic inflammatory, infectious or autoimmune conditions are implicated in its pathogenesis. Within the head and neck, MALToma is often multifocal and indolent and the imaging appearances may be mistaken for non-malignant disease in the head and neck.

Clinical practice guidelines on ultrasound-guided fine needle aspiration biopsy of thyroid nodules: a critical appraisal using AGREE II.

Purpose: To appraise the quality of current guidelines on fine needle aspiration biopsy (FNAB) of thyroid nodules for adults using the AGREE II quality assessment tool.

Methods: We conducted an online search for guidelines on FNAB of thyroid nodules published between 2013 and October 2018. They were evaluated by four independent reviewers previously trained to apply the AGREE II instrument, which is organized into items and domains.

Amide proton transfer MRI detects early changes in nasopharyngeal carcinoma: providing a potential imaging marker for treatment response.

Purpose: To determine if treatment of nasopharyngeal carcinoma (NPC) induces early changes in amide proton transfer-weighted (APTw) magnetic resonance imaging (MRI), and to perform a preliminary evaluation of APTw imaging in response assessment.

Methods: Sixteen patients with NPC planned for treatment with radiotherapy and/or chemotherapy underwent APTw imaging of the primary tumour pre-treatment and 2-week intra-treatment. Difference in pre- and intra-treatment APT mean (APT) was compared using the Wilcoxon signed rank test.

Head and Neck Tumors: Amide Proton Transfer MRI.

Purpose To evaluate the utility of amide proton transfer (APT) imaging in the characterization of head and neck tumors. Materials and Methods This retrospective study of APT imaging included 117 patients with 70 nasopharyngeal undifferentiated carcinomas (NUCs), 26 squamous cell carcinomas (SCCs), eight non-Hodgkin lymphomas (NHLs), and 13 benign salivary gland tumors (BSGTs). Normal tissues were examined in 25 patients.

Routine and Advanced Ultrasound of Major Salivary Glands.

Ultrasound is the preferred initial imaging modality in Europe and Asia for assessing the major salivary glands. In experienced hands, it is sensitive for a range of salivary pathologies, often diagnostic, and also a safe, cost-effective gatekeeper for further investigations as well as image-guided diagnostic biopsies and aspirations. This article reviews the scanning technique and normal sonographic anatomy of major salivary glands and overviews typical sonographic appearances of salivary pathologies, including infective and inflammatory conditions, sialolithiasis, and neoplasms.

Nasopharyngeal carcinoma: relationship between invasion of the prevertebral space and distant metastases.

Purpose: To identify primary sites of nasopharyngeal carcinoma (NPC) invasion on the staging head and neck magnetic resonance imaging (MRI) that correlate with distant metastases (DM).

Materials And Methods: Staging head and neck MRI examinations of 579 NPC patients were assessed for primary tumour invasion into 16 individual sites, primary stage (T) and nodal stage (N). Results were correlated with distant metastasis-free survival (DMFS) using the Cox regression, and the diagnostic performance of significant independent markers for DM was calculated.

Prediction of distant metastases from nasopharyngeal carcinoma: Improved diagnostic performance of MRI using nodal volume in N1 and N2 stage disease.

Purpose: To determine if the magnetic resonance imaging (MRI) of the head and neck can predict distant metastases (DM) from nasopharyngeal carcinoma (NPC).

Methods And Materials: MRI examinations of 763 NPC patients were assessed for primary tumour stage (T), nodal stage (N), primary tumour volume (PTV) and total nodal volume (NV). The association between MRI and clinical parameters were examined in DM+ and DM- patients using logistic regression and for distant metastases free survival (DMFS) using cox regression.

Acute diffuse thyroid swelling: A rare complication of fine-needle aspiration.

We present a case illustrating the rare complication of acute generalized thyroid swelling shortly after sonographic-guided fine needle aspiration of a thyroid nodule. Ultrasound revealed the presence of characteristic linear hypoechoic avascular areas interspersed throughout the gland suggestive of edema. The patient was treated conservatively, with near complete normalization of the thyroid within 24 hours.

Contemporary solutions for patients with microtia and congenital aural atresia - Hong Kong experience.

Managing microtia patients is always a challenge. Multidisciplinary approach, good family support, well established doctor-patient relationship and well organised patient-support groups are the essential elements for success. With the advancement of implantable hearing devices, more options will be available for the microtia patients.

MRI of diffuse large B-cell non-Hodgkin's lymphoma of the head and neck: comparison of Waldeyer's ring and sinonasal lymphoma.

To document the magnetic resonance imaging (MRI) features of diffuse large B-cell lymphoma (DLBCL) in Waldeyer's ring (WR) and the sinonasal (SN) region, and to identify any differences between lymphatic and extra-lymphatic DLBCLs, and predictors of disease beyond the neck. Primary, nodal, and multifocal sites on head and neck MRI were compared between 31 WR and 15 SN DLBCL, and between 27 patients with disease confined to the head and neck and 16 patients with disease beyond the neck, using logistic regression. Compared to SN, WR DLBCLs had significantly smaller primary tumour volumes (p = 0.

Diffusion-weighted imaging of nasopharyngeal carcinoma to predict distant metastases.

Our study aimed to identify diffusion-weighted imaging (DWI) parameters obtained from primary nasopharyngeal carcinoma (NPC) at initial presentation, that can predict patients at risk of distant metastases. One hundred and sixty-four patients underwent pretreatment magnetic resonance imaging and DWI. The apparent diffusion coefficient (ADC), ADC, and ADC were obtained by histogram analysis.

Feasibility Study of Texture Analysis Using Ultrasound Shear Wave Elastography to Predict Malignancy in Thyroid Nodules.

Textural analysis of ultrasound shear wave elastography (SWE) was evaluated to discriminate benign and malignant thyroid nodules. Sixteen papillary thyroid cancers and 89 benign hyperplastic nodules in 105 patients underwent SWE using four static pre-compression levels. Fifteen gray level co-occurrence matrix textural features and six absolute SWE indices were computed from SWE images.

Cervical nodal metastases from head and neck squamous cell carcinoma: MRI criteria for treatment assessment.

Background: The purpose of this study was to assess MRI criteria for detecting residual malignant head and neck squamous cell carcinoma (HNSCC) nodes after chemoradiotherapy (CRT).

Methods: One hundred and six metastatic nodes were assessed 6 weeks posttreatment by MRI for necrosis, extranodal neoplastic spread (ENS), size, and percentage of size change. Size measurements were reanalyzed after dividing posttreatment nodes into "discrete solid," "discrete necrotic," and "indiscrete" groups.

DCE-MRI for Pre-Treatment Prediction and Post-Treatment Assessment of Treatment Response in Sites of Squamous Cell Carcinoma in the Head and Neck.

Background And Purpose: It is important to identify patients with head and neck squamous cell carcinoma (SCC) who fail to respond to chemoradiotherapy so that they can undergo post-treatment salvage surgery while the disease is still operable. This study aimed to determine the diagnostic performance of dynamic contrast enhanced (DCE)-MRI using a pharmacokinetic model for pre-treatment predictive imaging, as well as post-treatment diagnosis, of residual SCC at primary and nodal sites in the head and neck.

Material And Methods: Forty-nine patients with 83 SCC sites (primary and/or nodal) underwent pre-treatment DCE-MRI, and 43 patients underwent post-treatment DCE-MRI, of which 33 SCC sites had a residual mass amenable to analysis.

CT pre-operative planning of a new semi-implantable bone conduction hearing device.

Purpose: Accommodating a novel semi-implantable bone conduction hearing device within the temporal bone presents challenges for surgical planning. This study describes the utility of CT in pre-operative assessment of such an implant.

Methods: Retrospective review of pre-operative CT, clinical and surgical records of 16 adults considered for device implantation.

Thyroid nodule ultrasound: technical advances and future horizons.

Unlabelled: Thyroid nodules are extremely common and the vast majority are non-malignant; therefore the accurate discrimination of a benign lesion from malignancy is challenging. Ultrasound (US) characterisation has become the key component of many thyroid nodule guidelines and is primarily based on the detection of key features by high-resolution US. The thyroid imager should be familiar with the strengths and limitations of this modality and understand the technical factors that create and alter the imaging characteristics.

Amide proton transfer-weighted imaging of the head and neck at 3 T: a feasibility study on healthy human subjects and patients with head and neck cancer.

The aim of this study was to explore the feasibility and repeatability of amide proton transfer-weighted (APTw) MRI for the head and neck on clinical MRI scanners. Six healthy volunteers and four patients with head and neck tumors underwent APTw MRI scanning at 3 T. The APTw signal was quantified by the asymmetric magnetization transfer ratio (MTRasym) at 3.

Non-Gaussian analysis of diffusion weighted imaging in head and neck at 3T: a pilot study in patients with nasopharyngeal carcinoma.

Purpose: To technically investigate the non-Gaussian diffusion of head and neck diffusion weighted imaging (DWI) at 3 Tesla and compare advanced non-Gaussian diffusion models, including diffusion kurtosis imaging (DKI), stretched-exponential model (SEM), intravoxel incoherent motion (IVIM) and statistical model in the patients with nasopharyngeal carcinoma (NPC).

Materials And Methods: After ethics approval was granted, 16 patients with NPC were examined using DWI performed at 3T employing an extended b-value range from 0 to 1500 s/mm(2). DWI signals were fitted to the mono-exponential and non-Gaussian diffusion models on primary tumor, metastatic node, spinal cord and muscle.

Ultrasound elastography in the head and neck. Part II. Accuracy for malignancy.

Ultrasound elastography (USE) describes a variety of ultrasound-based imaging techniques that measure tissue stiffness properties, and is currently under intense investigation for tissue characterization in several anatomic sites. This article summarizes the evidence regarding the accuracy of USE for malignancy in the head and neck. Currently, most published data pertains to small pilot studies with varied methodologies.

Ultrasound elastography in the head and neck. Part I. Basic principles and practical aspects.

Ultrasound elastography (USE) is a rapidly developing field of imaging that measures and displays tissue elasticity or stiffness properties using ultrasound. In recent years, real-time USE modes have appeared on commercially available clinical ultrasound machines, stimulating an explosion of research into potential oncologic and non-oncologic clinical applications of USE. Preliminary evidence suggests that USE can differentiate benign and malignant conditions accurately in several different tissues.