Publications by authors named "Lyburn I"

Rationale And Objectives: The potential of breast microcalcification chemistry to provide clinically valuable intelligence is being increasingly studied. However, acquisition of crystallographic details has, to date, been limited to high brightness, synchrotron radiation sources. This study, for the first time, evaluates a laboratory-based system that interrogates histological sections containing microcalcifications.

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Marginal zone lymphoma (MZL) is a group of low-grade, indolent, non-Hodgkin lymphomas rarely manifesting in the lungs. A 46-year-old man presenting with shortness of breath and cough was investigated and treated over 10 months for an atypical pattern of lung disease in keeping with cryptogenic organizing pneumonia (COP). Initial lung biopsies were nondiagnostic - repeat sampling eventually showed MZL.

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Langerhans cell histiocytosis (LCH) is a rare hematological disease, more common in pediatric populations. A 26-year-old man with biopsy-proven cutaneous LCH underwent 18 F-FDG PET/CT systemic staging. 18 F-FDG PET/CT highlighted multiple sites of avid cutaneous disease within the natal cleft.

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A case involving a 64-year-old woman with ovarian carcinoma on maintenance therapy who underwent 18-fluorodeoxyglucose positron emission tomography with computed tomography ([18F]FDG PET/CT) restaging due to rapid cancer antigen 125 (Ca-125) rise. This revealed recurrent disease within the pelvis and large volume, peritoneal carcinomatosis including an avid umbilical deposit, consistent with the rarely seen Sister Mary Joseph nodule (SMJN). This case elegantly demonstrates not only the anatomy of the peritoneal surfaces through avid disease deposition but also highlights the sensitive depiction of disease burden in peritoneal carcinomatosis, including the detection of rare manifestations such as SMJN.

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Introduction: Staging of oesophagogastric (OG) cancers usually involves endoscopy (OGD), and separate visits for contrast enhanced computed tomography (CeCT) and positron emission tomography (PET/CT). At the height of the COVID-19 pandemic, some of our patients underwent single-visit combined staging with PET/CeCT. We compare this novel pathway with standard separate imaging in time to completion of staging, to start of treatment, and cost.

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Ductal carcinoma in-situ (DCIS) accounts for 20-25% of all new breast cancer diagnoses. DCIS has an uncertain risk of progression to invasive breast cancer and a lack of predictive biomarkers may result in relatively high levels (~ 75%) of overtreatment. To identify unique prognostic biomarkers of invasive progression, crystallographic and chemical features of DCIS microcalcifications have been explored.

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Microcalcifications play an important role in cancer detection. They are evaluated by their radiological and histological characteristics but it is challenging to find a link between their morphology, their composition and the nature of a specific type of breast lesion. Whilst there are some mammographic features that are either typically benign or typically malignant often the appearances are indeterminate.

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Objective: To pilot a process for the independent external validation of an artificial intelligence (AI) tool to detect breast cancer using data from the NHS breast screening programme (NHSBSP).

Methods: A representative data set of mammography images from 26,000 women attending 2 NHS screening centres, and an enriched data set of 2054 positive cases were used from the OPTIMAM image database. The use case of the AI tool was the replacement of the first or second human reader.

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Adult-onset Still's disease (AOSD) is an inflammatory disease of unknown aetiology, with no specific diagnostic tests. A 17-year-old female presented with fevers, night sweats and weight loss. Markedly FDG avid lymphadenopathy, and diffuse marrow and splenic uptake were demonstrated on [18F]FDG-PET/CT, most suggestive of lymphoma.

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Aim: To investigate the impact of the COVID-19 pandemic on core and higher breast radiology training in the UK from the perspective of trainees and new consultants.

Materials And Methods: A survey comprising 25 questions was distributed to UK radiology trainees via the regional Junior Radiologists Forum representatives under the auspices of the British Society of Breast Radiology (BSBR).

Results: Sixty-nine eligible responses were received representing all UK training regions.

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Objectives: The importance of consistent terminology in describing the appearance of breast calcifications in mammography is well recognised. Imaging of calcifications using electron microscopy is a globally growing field of research. We therefore suggest that the time is ripe to develop a lexicon of terms for classifying the micromorphology of breast calcifications.

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In an attempt to protect the high-risk demographic and reduce burden on health care systems, concomitant administration of COVID-19 and influenza vaccines has been recommended by health bodies. The ComFluCOV trial indicates this is well tolerated with no reduction in immune response to either vaccine. A 48-year-old woman with right oropharyngeal squamous cell carcinoma underwent postradiotherapy FDG PET/CT, which demonstrated complete metabolic response.

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Ductal carcinoma (DCIS) is frequently associated with breast calcification. This study combines multiple analytical techniques to investigate the heterogeneity of these calcifications at the micrometre scale. X-ray diffraction, scanning electron microscopy and Raman and Fourier-transform infrared spectroscopy were used to determine the physicochemical and crystallographic properties of type II breast calcifications located in formalin fixed paraffin embedded DCIS breast tissue samples.

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A 46-year-old woman with previous history of breast cancer had follow-up 18F-FDG PET/CT 5 days after COVID-19 vaccination. In addition to avid axillary nodes, a well-documented feature, the scan demonstrated diffuse splenic and marrow uptake. Clinical history, laboratory, and scan findings were in keeping with SIRS (systemic inflammatory response).

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When interpreting an [18F]prostate specific membrane antigen (PSMA)-1007 PET/CT, it is important to understand the normal biodistribution of the tracer. A 73-year-old man with prostate cancer underwent [18F]PSMA-1007 PET/CT for biochemical recurrence. There was no abnormal uptake in the prostatectomy bed, but PSMA-avid pelvic nodal disease was found.

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The rapid rollout of COVID-19 vaccination is accompanied by incidental findings on 18F-FDG PET/CT. Most cases describe reactive axillary lymphadenopathy. A 46-year-old woman with previous history of stage 3A breast cancer underwent follow-up 18F-FDG PET/CT, which demonstrated avid left axillary nodes and intense diffuse splenic uptake and moderate diffuse bone marrow uptake.

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Artificial intelligence (AI) algorithms are used in an increasing range of aspects of our lives. In particular, medical applications of AI are being developed and deployed, including many in image analysis. Deep learning methods, which have recently proved successful in image classification, rely on large volumes of clinical data generated by healthcare institutions.

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A 70-year-old man with newly diagnosed prostate cancer underwent 18F-PSMA-1007 PET/CT for staging. PSMA-avid primary prostatic malignancy was identified. Incidental intense patchy peripheral lung uptake was also noted.

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World-wide mass COVID-19 vaccination has been deployed starting with those most vulnerable, including the elderly and cancer patients. A 70-year-old man with right lung cancer underwent staging FDG PET/CT, which demonstrated an avid right lung mass with avid hilar and mediastinal nodes. Avid left axillary nodes of benign configuration were also noted.

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According to published guidelines and routine procedures, patients are instructed to avoid strenuous exercise for 6 to 24 hours before FDG imaging, avoiding unfavorable muscular uptake. A 40-year-old man with esophageal carcinoma underwent FDG PET/CT for response assessment. Intense uptake was noted in the muscles of the right upper limb and chest.

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Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an uncommon T cell Non-Hodgkin Lymphoma (NHL) associated with breast implants. Raising awareness of the possibility of BIA-ALCL in anyone with breast implants and new breast symptoms is crucial to early diagnosis. The tumour begins on the inner aspect of the peri-implant capsule causing an effusion, or less commonly a tissue mass to form within the capsule, which may spread locally or to more distant sites in the body.

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Article Synopsis
  • - Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare type of Non-Hodgkin lymphoma linked to breast implants, emphasizing the need for awareness among individuals with implants and new breast symptoms for early detection.
  • - Diagnosis involves analyzing fluid from the area around the implant, looking for specific cell types; most cases are slow-growing but can be aggressive in some patients.
  • - Treatment usually involves surgically removing the implant and its capsule, which is often effective; however, late detection may lead to more extensive surgeries and reduced survival rates, highlighting the importance of timely diagnosis.
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In accordance with published international COVID-19 pandemic guidance (American College of Nuclear Medicine, British Nuclear Medicine Society, and European Association of Nuclear Medicine), the use of face masks has become an essential part of infection control for both patients and staff. A 56-year-old man with mantle cell lymphoma underwent staging FDG PET/CT, which demonstrated avid lymphadenopathy below the diaphragm and an unusual diffuse FDG uptake projected over the face, raising the suspicion of cutaneous lymphomatous involvement. On reflection of the clinical scenario and scanning conditions, cutaneous involvement was discounted; the pattern of uptake and lack of CT correlate were supportive of a cutaneous artifact related to the presence of the patient's mask.

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