Total Neoadjuvant Therapy Significantly Increases Complete Clinical Response.

Background: Increased experience with total neoadjuvant therapy for rectal cancer suggests significantly more tumor regression and increased rates of complete clinical response as measured by pathological complete response and clinical complete response.

Objective: This study aimed to assess outcomes after total neoadjuvant therapy versus standard neoadjuvant chemoradiotherapy for patients with locally advanced rectal cancer.

Design: This is a retrospective cohort study.

Multifunctionality of prostatic acid phosphatase in prostate cancer pathogenesis.

The role of human prostatic acid phosphatase (PAcP, P15309|PPAP_HUMAN) in prostate cancer was investigated using a new proteomics tool termed signal sequence swapping (replacement of domains from the native cleaved amino terminal signal sequence of secretory/membrane proteins with corresponding regions of functionally distinct signal sequence subtypes). This manipulation preferentially redirects proteins to different pathways of biogenesis at the endoplasmic reticulum (ER), magnifying normally difficult to detect subsets of the protein of interest. For PAcP, this technique reveals three forms identical in amino acid sequence but profoundly different in physiological functions, subcellular location, and biochemical properties.

Multifunctionality of Prostatic Acid Phosphatase in Prostate Cancer Pathogenesis.

The role of human prostatic acid phosphatase (PAcP, P15309|PPAP_HUMAN) in prostate cancer was investigated using a new proteomic tool termed signal sequence swapping (replacement of domains from the native cleaved amino terminal signal sequence of secretory/membrane proteins with corresponding regions of functionally distinct signal sequence subtypes). This manipulation preferentially redirects proteins to different pathways of biogenesis at the endoplasmic reticulum, magnifying normally difficult to detect subsets of the protein of interest. For PAcP this technique reveals three forms identical in amino acid sequence but profoundly different in physiological functions, subcellular location, and biochemical properties.

Quantitative magnetic resonance imaging (q-MRI) for the assessment of soft-tissue sarcoma treatment response: a narrative case review of technique development.

Soft-tissue sarcomas are a heterogeneous class of tumors that exhibit varying degrees of cellularity and cystic degeneration in response to neoadjuvant chemotherapy. This creates unique challenges in the radiographic assessment of treatment response when relying on conventional markers such as tumor diameter (RECIST criteria). In this case series, we provide a narrative discussion of technique development for whole tumor volume quantitative magnetic resonance imaging (q-MRI), highlighting cases from a small pilot study of 8 patients (9 tumors) pre- and post-neoadjuvant chemotherapy.

Peripheral Thyroid Nodule Calcifications on Sonography: Evaluation of Malignant Potential.

The purpose of this study is to assess the association of thyroid cancer with sonographic features of peripheral calcifications. We retrospectively reviewed patients who had a total of 97 thyroid nodules with peripheral calcifications who underwent ultrasound-guided fine-needle aspiration from 2008 to 2018. Three board-certified radiologists evaluated the nodules for features of peripheral calcifications: the percentage of the nodule involved by peripheral calcifications, whether the calcifications were continuous or discontinuous, the visibility of internal components of the nodule, and the presence of extrusion of soft tissue beyond the calcifications.

Contrast-Enhanced Transrectal Ultrasound in Focal Therapy for Prostate Cancer.

Purpose Of Review: Contrast-enhanced transrectal ultrasound (CeTRUS) is an emerging imaging technique in prostate cancer (PCa) diagnosis and treatment. We review the utility and implications of CeTRUS in PCa focal therapy (FT).

Recent Findings: CeTRUS utilizes intravenous injection of ultrasound-enhancing agents followed by high-resolution ultrasound to evaluate tissue microvasculature and differentiate between benign tissue and PCa, with the latter demonstrating increased enhancement.

Contrast-Enhanced Transrectal Ultrasound for Follow-up After Focal HIFU Ablation for Prostate Cancer.

The optimal strategy for imaging after focal therapy for prostate cancer is evolving. This series is an initial report on the use of contrast-enhanced transrectal ultrasound (TRUS) in follow-up of patients after high-intensity focused ultrasound (HIFU) hemiablation for prostate cancer. In 7 patients who underwent HIFU hemiablation, contrast-enhanced TRUS findings were as follows: (1) contrast-enhanced TRUS clearly showed the HIFU ablation defect as a sharply marginated nonenhancing zone in all patients; (2) contrast-enhanced TRUS identified suspicious foci of recurrent enhancement within the ablation zone in 2 patients, facilitating image-guided prostate biopsy, which showed prostate cancer; and (3) contrast-enhanced TRUS findings correlated with multiparametric magnetic resonance imaging and biopsy histologic findings.

Contrast-Enhanced Ultrasound of Spermatic Cord and Retroperitoneal Liposarcoma.

Liposarcoma is the most common paratesticular scrotal malignancy. Ultrasound is the conventional imaging modality for evaluating scrotal masses. Contrast-enhanced ultrasound (CEUS) can provide complementary information by identifying distinct enhancement patterns.

Pictorial review: Renal ultrasound.

Ultrasound (US) is the first-line imaging modality for evaluating azotemic patients for urinary obstruction and renal size. US is also valuable for distinguishing congenital variants and simple cystic lesions from renal masses. Doppler US is effective in detection of renal calculi and evaluation of vascular pathology.

Intra-arterial contrast-enhanced ultrasound (IA CEUS) for localization of hepatocellular carcinoma (HCC) supply during transarterial chemoembolization (TACE): a case series.

Transarterial chemoembolization (TACE) is a proven catheter-based locoregional therapy for treatment of hepatocellular carcinoma (HCC). Drug-eluting bead TACE involves delivering micrometer-sized particles preloaded with doxorubicin directly to the tumor via its arterial blood supply and results in vascular embolization with intra-tumoral drug release. Effective therapy requires mapping of the tumor arterial supply, which in some cases cannot be accomplished with conventional angiographic techniques alone.

Hepatic Kaposi Sarcoma Revisited: An Important but Less Commonly Seen Neoplasm in Patients With Acquired Immunodeficiency Syndrome.

Hepatic Kaposi sarcoma (KS) is the most commonly seen hepatic neoplasm in patients with acquired immunodeficiency syndrome (AIDS), found in 34% of patients in an autopsy series. However, the incidence of hepatic KS has significantly declined since the advent of highly active antiretroviral therapy and is not as commonly seen on imaging. We present a case of hepatic KS in a patient with AIDS, which was initially mistaken for hepatic abscesses on computed tomography.

Duplex Doppler sonography: is there clinical relevance to elevated renal vein velocity in kidney transplants?

Purpose: This study aims to determine a velocity threshold in the main renal vein (MRV) of renal transplants and evaluate the cause and clinical significance of elevated velocity.

Methods: Maximum MRV velocity from 331 consecutive renal transplant Doppler ultrasounds in 170 patients was recorded. A priori, twice the median MRV velocity was selected as the threshold for elevation.

Voxel-based whole-lesion enhancement parameters: a study of its clinical value in differentiating clear cell renal cell carcinoma from renal oncocytoma.

Purpose: The purpose of this study was to compare whole-lesion (WL) enhancement parameters to single region of interest (ROI)-based enhancement in discriminating clear cell renal cell carcinoma (ccRCC) from renal oncocytoma.

Materials And Methods: In this IRB-approved retrospective study, the surgical database was queried to derive a cohort of 94 postnephrectomy patients with ccRCC or oncocytoma (68 ccRCC, 26 oncocytoma), who underwent preoperative multiphase contrast-enhanced computed tomography (CECT) between June 2009 and August 2013. CT acquisitions were transferred to a three-dimensional workstation, and WL ROIs were manually segmented.

Abdominal radiograph pearls and pitfalls for the emergency department radiologist: a pictorial review.

Abdominal plain films are often the first imaging examination performed on a patient with abdominal pain in the emergency department. Radiograph findings can help guide clinical management and the need for advanced imaging. A pictorial review of a range of abdominal radiograph findings is presented, including bowel gas patterns, abdominal organ evaluation, pathologic gas, calcifications, implanted devices, and foreign bodies.

3.0Tesla magnetic resonance angiography (MRA) for comprehensive renal evaluation of living renal donors: pilot study with computerized tomography angiography (CTA) comparison.

Purpose: Most living related donor (LRD) kidneys are harvested laparoscopically. Renal vascular anatomy helps determine donor suitability for laparoscopic nephrectomy. Computed tomography angiography (CTA) is the current gold standard for preoperative imaging; magnetic resonance angiography (MRA) offers advantages including lack of ionizing radiation and lower incidence of contrast reactions.

Role of contrast-enhanced ultrasound (CEUS) in evaluation of thermal ablation zone.

Purpose: Thermal ablation has emerged as a mainstay therapy for primary and metastatic liver malignancy. Percutaneous thermal ablation is usually performed under CT and/or ultrasound guidance. CT guidance frequently utilizes iodinated contrast for tumor targeting, with additional radiation and contrast required at the end of the procedure to ensure satisfactory ablation margins.

Versatile utilization of real-time intraoperative contrast-enhanced ultrasound in cranial neurosurgery: technical note and retrospective case series.

Objective: Intraoperative contrast-enhanced ultrasound (iCEUS) offers dynamic imaging and provides functional data in real time. However, no standardized protocols or validated quantitative data exist to guide its routine use in neurosurgery. The authors aimed to provide further clinical data on the versatile application of iCEUS through a technical note and illustrative case series.

Contrast-enhanced ultrasound findings of post-transplant lymphoproliferative disorder in a transplanted kidney: A case report and literature review.

Post-transplant lymphoproliferative disorder occurs in approximately one percent of kidney transplant recipients. We evaluated a seventy-seven year-old man with a solid mass in his transplant kidney. On contrast enhanced ultrasound, the mass enhanced but remained persistently hypovascular throughout exam.

Contrast-Enhanced Sonography for Monitoring Neoadjuvant Chemotherapy in Soft Tissue Sarcomas.

Neoadjuvant chemotherapy is a mainstay in treating soft tissue sarcomas. Soft tissue sarcomas can show an increase in size and central necrosis, with a decrease in the viable tumor, as an initial response to neoadjuvant chemotherapy. Thus, the maximum tumor diameter may not reliably assess the response to this therapy.

Quantitative assessment of solid renal masses by contrast-enhanced ultrasound with time-intensity curves: how we do it.

Purpose: To discuss the evaluation of the enhancement curve over time of the major renal cell carcinoma (RCC) subtypes, oncocytoma, and lipid-poor angiomyolipoma, to aid in the preoperative differentiation of these entities. Differentiation of these lesions is important, given the different prognoses of the subtypes, as well as the desire to avoid resecting benign lesions.

Methods: We discuss findings from CT, MR, and US, but with a special emphasis on contrast-enhanced ultrasound (CEUS).

Contrast-enhanced ultrasound (CEUS) of cystic and solid renal lesions: a review.

Incidentally detected renal lesions have traditionally undergone imaging characterization by contrast-enhanced computer tomography (CECT) or magnetic resonance imaging. Contrast-enhanced ultrasound (CEUS) of renal lesions is a relatively novel, but increasingly utilized, diagnostic modality. CEUS has advantages over CECT and MRI including unmatched temporal resolution due to continuous real-time imaging, lack of nephrotoxicity, and potential cost savings.

Pre-embolization evaluation of high-flow priapism: magnetic resonance angiography of the penis.

Purpose: High-flow priapism is often a sequela of perineal trauma resulting in an arteriocavernosal fistula (ACF) between a cavernosal artery and lacunar spaces of the penis. We report our experience utilizing magnetic resonance angiography (MRA) in addition to color Doppler Sonography (CDS) in the workup and treatment planning of 4 patients with high-flow priapism.

Methods: All patients had suspected high-flow priapism diagnosed by clinical exam and CDS and underwent MRA of the penis prior to sub-selective arterial embolization (SSAE) of the feeding vessel(s).

Use of MR imaging to determine preservation of the neurovascular bundles at robotic-assisted laparoscopic prostatectomy.

Purpose: To determine whether findings at preoperative endorectal coil magnetic resonance (MR) imaging influence the decision to preserve neurovascular bundles and the extent of surgical margins in robotic-assisted laparoscopic prostatectomy (RALP).

Materials And Methods: This study was approved by the investigational review board and was compliant with the HIPAA; the requirement to obtain informed consent was waived. The authors prospectively evaluated 104 consecutive men with biopsy-proved prostate cancer who underwent preoperative endorectal coil MR imaging of the prostate and subsequent RALP.