Among 17 women with newly diagnosed breast cancer who underwent contrast-enhanced mammography (CEM) and MRI, both modalities were concordant for the index cancer in all women. In 6/17, CEM ...demonstrated an additional lesion that was confirmed by MRI (2 multifocal, 1 multicentric, 2 contralateral); two were malignant. MRI did not identify any additional cancers not identified on CEM. CEM may have a role in women with breast augmentation and contraindication or limited access to MRI.
Purpose
Acquired cystic kidney disease (ACKD) is commonly seen in patients with end-stage renal disease (ESRD), and patients with ACKD have an increased risk of renal cell carcinoma (RCC). Acquired ...cystic disease-associated RCC (ACD-RCC) was incorporated into the 2016 World Health Organization Classification. This study aims to describe the imaging features of ACD-RCC, which are not well reported previously.
Methods
Retrospective review of patients with ACKD who underwent total nephrectomy for concern of a renal mass between 2016 and 2021 yielded 122 nephrectomies in 107 patients. Pathology reports were searched for type and subtype of mass. In ACD-RCC subtypes, imaging studies were evaluated for modality and contrast enhancement (CE). Imaging findings assessed included cystic/solid nature, unenhanced CT (NECT) attenuation, enhancement characteristics non-enhancing (< 10 HU difference), equivocal (10–20 HU), enhancing (> 20 HU), subjective MRI enhancement, T1 and T2 signal intensity, restricted diffusion, ultrasound (US) echogenicity, and subjective CEUS enhancement.
Results
148 masses were identified, 122 (82%) of which were malignant and 26 (18%) benign. The three most common tumors were clear cell RCC (
n
= 47), papillary RCC (
n
= 35), and ACD-RCC (
n
= 21). Of the 21 cases of ACD-RCC, 16 had preoperative imaging: CT (15: 6 NECT only, 2 CECT only, 7 combined NECT and CECT), MRI (4), CEUS (5). Ten of these tumors were solid/mostly solid and 6 mixed cystic/solid. On NECT, the average attenuation was 35 HU (range 13–52). Of those with multiphasic CTs, 1 was non-enhancing, 3 were equivocal, and 3 enhanced. All 3 masses imaged with CE-MRI showed enhancement. All 4 tumors evaluated by MRI demonstrated T2 hypointensity and restricted diffusion. All five masses enhanced on CEUS.
Conclusion
ACD-RCC subtype was the third most common renal neoplasm in ACKD patients. Our findings found that no single imaging feature is pathognomonic for ACD-RCC. However, ACD-RCCs are typically solid masses with most demonstrating equivocal or mild enhancement on CT. T2 hypointensity and restricted diffusion were the most common MRI features.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, VSZLJ, ZAGLJ
PURPOSE Contrast-enhanced mammography (CEM) and magnetic resonance imaging (MRI) have shown similar diagnostic performance in detection of breast cancer. Limited CEM data are available for high-risk ...breast cancer screening. The purpose of the study was to prospectively investigate the efficacy of supplemental screening CEM in elevated risk patients. MATERIALS AND METHODS A prospective, single-institution, institutional review board–approved observational study was conducted in asymptomatic elevated risk women age 35 years or older who had a negative conventional two-dimensional digital breast tomosynthesis screening mammography (MG) and no additional supplemental screening within the prior 12 months. RESULTS Four hundred sixty women were enrolled from February 2019 to April 2021. The median age was 56.8 (range, 35.0-79.2) years; 408 of 460 (88.7%) were mammographically dense. Biopsy revealed benign changes in 22 women (22/37, 59%), high-risk lesions in four women (4/37, 11%), and breast cancer in 11 women (11/37, 30%). Fourteen cancers (10 invasive, tumor size range 4-15 mm, median 9 mm) were diagnosed in 11 women. The overall supplemental cancer detection rate was 23.9 per 1,000 patients, 95% CI (12.0 to 42.4). All cancers were grade 1 or 2, ER+ ERBB2–, and node negative. CEM imaging screening offered high specificity (0.875 95% CI, 0.844 to 0.906), high NPV (0.998 95% CI, 0.993 to 1.000), moderate PPV1 (0.164 95% CI, 0.076 to 0.253), moderate PPV3 (0.275 95% CI, 0.137 to 0.413), and high sensitivity (0.917 95% CI, 0.760 to 1.000). At least 1 year of imaging follow-up was available on all patients, and one interval cancer was detected on breast MRI 4 months after negative screening CEM. CONCLUSION A pilot trial demonstrates a supplemental cancer detection rate of 23.9 per 1,000 in women at an elevated risk for breast cancer. Larger, multi-institutional, multiyear CEM trials in patients at elevated risk are needed for validation.
ABSTRACTWe report a large mobile bladder calculus with intense Tc-MDP uptake demonstrated on both whole-body bone scintigraphy and SPECT/CT images in a patient with complicated chronic history of ...urolithiasis and urinary tract infection. Bone tracer uptake in bladder calculus is a rare phenomenon and might be related to the composition and matrix of calculus, direct exposure to excreted radiotracer, and bacterial colonization on the surface of calculus.
ABSTRACTExtramedullary multiple myeloma (EMM) is a subset of multiple myeloma with a poor prognosis. We report a rare case with biopsy-proven concurrent liver and mesentery primary EMM at the time of ...initial staging after serologic diagnosis of multiple myeloma. F-FDG PET/CT is valuable in detection of EMM when the patient has no osseous lesions and a negative bone marrow biopsy.
Abstract
Objective
Evaluate women’s anxiety and experience undergoing screening mammography during the COVID-19 pandemic.
Methods
An IRB-approved anonymous survey was administered to women receiving ...screening mammography across six sites in the U.S. and Singapore from October 7, 2020, to March 11, 2021. Using a 1–5 Likert scale, women rated their pre- and post-visit anxiety regarding having their mammogram during the COVID-19 pandemic, importance of observed COVID-19 precautions, and personal risk factors for breast cancer and severe COVID-19 illness. Post-visit change in anxiety was evaluated. Multivariable logistic regression was used to test associations of pre-visit anxiety with breast cancer and COVID-19 risk factors.
Results
In total, 1086 women completed the survey. Of these, 59% (630/1061) had >1 breast cancer risk factor; 27% (282/1060) had >1 COVID-19 risk factors. Forty-two percent (445/1065) experienced pre-visit anxiety. Pre-visit anxiety was independently associated with risk factors for severe COVID-19 (OR for >2 vs 0 risk factors: 2.04, 95% confidence interval CI: 1.11–3.76) and breast cancer (OR for >2 vs 0 risk factors: 1.71, 95% CI: 1.17–2.50), after adjusting for age and site. Twenty-six percent (272/1065) of women reported post-visit anxiety, an absolute 16% decrease from pre-visit anxiety (95% CI: 14%–19%, P < 0.001). Provider masking (941/1075, 88%) and physical distancing (861/1085, 79%) were rated as the most important precautions.
Conclusion
Pre-visit anxiety was associated with COVID-19 or breast cancer risk factors and declined significantly after screening mammography. Provider masking and physical distancing were rated the most important precautions implemented by imaging clinics.
Job rotation is one method that is sometimes used to reduce exposure to strenuous materials handling; however, developing effective rotation schedules can be complex in even moderate sized ...facilities. The purpose of this research is to develop methods of incorporating safety criteria into scheduling algorithms to produce job rotation schedules that reduce the potential for injury. Integer programming and a genetic algorithm were used to construct job rotation schedules. Schedules were comprised of lifting tasks whose potential for causing injury was assessed with the Job Severity Index. Each method was used to design four job rotation schedules that met specified safety criteria in a working environment where the object weight, horizontal distance and repetition rate varied over time. Each rotation was assigned to a specific gender/lifting capacity group. Five versions of the integer programming search method were applied to this problem. Each version generated one job rotation schedule. The genetic algorithm model was able to create a population of 437 feasible solutions to the rotation problem. Utilizing cluster analysis, a rule set was derived from the genetic algorithm generated solutions. These rules provided guidelines for designing safe job rotation schedules without the use of a computer. The advantages and limitations of these approaches in developing administrative controls for the prevention of back injury are discussed.
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BFBNIB, GIS, IJS, KISLJ, NUK, PNG, UL, UM, UPUK
This research explored social work licensure board members' decision-making about alleged violations by social workers and subsequent sanctioning. Participants served within the last five years on a ...jurisdictional board regulating social workers in the US. The survey included factors related to board member decision-making, rank ordering the seriousness of listed allegations, and four vignettes where participants rated the seriousness of the allegations and the importance for a board to discipline the social worker. Persons serving on twelve US boards that license social workers (n=21) read four vignettes of hypothetical social worker violations and rated the seriousness of the violations and the importance of disciplining the social workers. The violations, in order from most (7) to least severe (1) were fraudulent record keeping (5.63), professional boundaries (non-sexual) (5.37), impairment (5.1), and improper termination (2.63). The importance to discipline, in order from most (7) to least important (1), were: professional boundaries (non-sexual) (6.1), fraudulent reporting (5.68), impairment (4.4), and improper termination (2.47). Having an MSW degree, as opposed to BSW, was the only variable increasing the seriousness of the offense in all four vignettes. Results may help with understanding how licensing boards review alleged violations and determine sanctions.
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