The purpose of our study was to perform a meta-analysis comparing the performance of double-contrast barium enema (DCBE) with CT colonography (CTC) for the detection of colorectal polyps > or = 6 mm ...using endoscopy as the gold standard.
Prospective DCBE and CTC studies were identified. Percentages of polyps and of patients with polyps > or = 10 mm and 6-9 mm were abstracted. The performance of DCBE versus CTC was determined by separately evaluating each technique's performance versus that of endoscopy, and contrasting the techniques. The I-squared statistic and Fisher's exact test were used for heterogeneity, the Cochran-Mantel-Haenszel and the Kruskal-Wallis tests for correlation, and the A(z) test for comparing pooled weighted estimates of performance.
Eleven studies of DCBE (5,995 patients, 1,548 polyps) and 30 studies of CTC (6,573 patients, 2,348 polyps) fulfilled inclusion criteria. For polyps > or = 10 mm, a 0.121-per-patient sensitivity difference favored CTC (p < 0.0001; DCBE, 0.702 95% CI, 0.687-0.715; CTC, 0.823 0.809-0.836). For polyps > or = 10 mm, a 0.031-per-polyp sensitivity difference favored CTC (p < 0.0001; DCBE, 0.715 0.703-0.726; CTC, 0.746 0.735-0.757). For polyps > or = 10 mm, a specificity difference of 0.104 favored CTC (p = 0.001; DCBE, 0.850 0.847-0.855; CTC, 0.954 0.952-0.955). DCBE was also significantly less sensitive for 6- to 9-mm polyps (p < 0.001).
DCBE has statistically lower sensitivity and specificity than CTC for detecting colorectal polyps > or = 6 mm.
Gas in the kidney: CT findings Portnoy, Orith; Apter, Sara; Koukoui, Olga ...
Emergency radiology
14, Številka:
2
Journal Article
Recenzirano
Gas in the renal parenchyma is a rare finding seen best with computed tomography (CT). It can be encountered in a wide range of clinical conditions, some of them life-threatening like emphysematous ...pyelonephritis, whereas in others, it may represent a postoperative or procedure outcome. The latter are not usually a clinical emergency (for example, after nephrostomy insertion or in a urinary intestinal connection). Due to the increasing use of abdominal CT examinations, radiologists, especially in emergency setting, should be aware of this rare finding and be familiar with its differential diagnosis.
High breast density is associated with an increased risk of breast cancer development. Little is known concerning ethnic variations in breast density and its relevant contributing factors. We aimed ...to study breast density among Ethiopian immigrants to Israel in comparison with Israeli‐born women and to determine any effect on breast density of the length of residency in the immigrant population. Mammographic breast density using the BI‐RADS system was estimated and compared between 77 women of Ethiopian origin who live in Israel and 177 Israeli‐born controls. Logistic regression analysis was performed to estimate the odds ratios (OR) for high density (BI‐RADS score ≥ 3) vs low density (BI‐RADS score < 3) cases, comparing the 2 origin groups. Ethiopian‐born women had a crude OR of 0.15 (95% CI: 0.08‐0.26) for high breast density compared with Israeli‐born women. Adjustments for various cofounders did not affect the results. Time since immigration to Israel seemed to modify the relationship, with a stronger association for women who immigrated within 2 years prior to mammography (OR:0.07, 95% CI: 0.03‐0.17) as opposed to women with a longer residency stay in Israel (OR:0.23, 95% CI:0.10‐0.50). Adjustments of various confounders did not alter these findings. Breast density in Ethiopian immigrants to Israel is significantly lower than that of Israeli‐born controls. Our study suggests a positive association between time since immigration and breast density. Future studies are required to define the possible effects of dietary change on mammographic density following immigration.
Objective
We evaluated a functional three-dimensional (3D) infrared imaging system (3DIRI) coupled with multiparametric computer analysis for risk assessment of breast cancer. The technique provides ...objective risk assessment for the presence of a malignant tumour based on automated parameters derived from a clinically known training set.
Methods
Following institutional review board approval, we recruited 434 women for this prospective multicentre trial, including 256 healthy woman undergoing routine screening mammography with BI-RADS-1 results and 178 women with newly diagnosed breast cancer. This was a two-phase study: an initial training and calibration phase, followed by a two-armed blinded evaluation phase (52 healthy and 66 with breast cancer). 3DIRI data sets were acquired using a non-contact, no radiation system.
Results
The sensitivity and specificity of functional infrared imaging in providing the correct risk for the presence of breast cancer were 90.9 % and 72.5 %, respectively. The area under the ROC curve was 86 %. Forty-two of the 60 (70 %) cancers in women correctly classified by the system as suspicious were smaller than 20 mm in size.
Conclusion
The preliminary blinded results of this novel technology show sufficient performance of functional infrared imaging in providing risk assessment for breast cancer to warrant further clinical studies.
Key Points
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3D functional infrared imaging
(
3DIRI
)
provides new metabolic signatures from breast lesions
.
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3DIRI offers high sensitivity for risk assessment of breast cancer
.
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It also has reasonable specificity
.
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This initial experience warrants further evaluation in larger clinical trials
.
Changes after radical prostatectomy (RP) may present potential pitfalls in the interpretation of pelvic MRI studies in post-RP patients. One such change is retained seminal vesicles (SVs). The ...purpose of this study was to characterize the MRI features and evaluate the frequency of retained SV remnants in patients after RP.
Retained SV remnants are a common finding after RP. Most are fibrotic distal tips. Recognition of SV remnants may prevent their misinterpretation as local recurrences.
The CT appearance of the normal and abnormal thymus and its age-related changes have been described. However, there is no information regarding the change in thymus CT attenuation values in children.
...The aim of the present study was to evaluate the normal CT attenuation of the thymus in infants and children and discover when the decline begins.
CT attenuation values of the thymus were retrospectively evaluated in 152 children between ages of 1 day and up to 14 years. For each patient the mean value of the CT thymus attenuation was calculated and compared to CT attenuation of the chest wall and cardiac muscles. We also examined the correlation between thymic attenuation, gender, and disease. The statistical analysis used was multivariate linear regression.
CT attenuation of the thymus declines with age, beginning only after the 1st year of life. The thymus is more hyperdense than the chest wall and cardiac muscles in infants less than 1 year. The thymus is denser in males than females. In malignant conditions, in infants less than 1 year, thymus CT attenuation is decreased. In older children thymus attenuation was similar to that for the chest wall and cardiac muscles.
The decline in thymic CT attenuation with age is consistent with fatty infiltration of the gland. The measurements given in this report can serve as a basis for comparison to determine whether the thymus of a young child is normal or pathological.
A limited number of chemotherapeutic agents have been found to be active against advanced soft-tissue sarcomas (STSs), particularly sarcomas that have progressed following doxorubicin treatment. The ...aim of this retrospective study was to determine the response to treatment with gemcitabine plus paclitaxel in patients with STSs. Data were collected on all patients with advanced non-resectable STS who were treated with a fixed dose 700 mg/m2 gemcitabine in combination with 70 mg/m2 paclitaxel on days 1 and 8 every 3 weeks. A total of 30 patients were included, with a median age of 56.4 years (range, 40-70 years). The gemcitabine/paclitaxel combination was well tolerated, with an overall response in 27% and a clinical benefit in 57% of the patients. The median progression-free survival was 6.1 months and the overall survival was 14.3 months. In conclusion, gemcitabine plus paclitaxel was found to be tolerable and effective in patients with advanced STSs.
On September 11, 2001, the world changed. The vicious giant of terrorism that was dormant until that date had arisen. After the horrific mass-casualty terror attack on the United States, any and all ...forms of assault seem possible. Owing to the complexity of injuries encountered in terror attack victims, fast and accurate imaging plays an essential role in triage and identification of abnormalities associated with injuries. The radiologist becomes a crucial part of the first-line team of doctors treating these patients. Knowledge that the best available treatment is given to terror attack victims can enhance the strength and endurance of society against terror. On the basis of the authors' experience with terror events in Israel, the steps involved in imaging of terror attack patients include conventional radiography, focused abdominal sonography in trauma, computed tomography, and angiography, with the judicious use of supplemental imaging.
Lateral ovarian transposition is a surgical procedure performed in premenopausal women with pelvic malignancies in which the ovaries are surgically displaced from the pelvis, before radiation ...therapy. In this article, we present the imaging features of normal transposed ovaries as well as the spectrum of abnormalities associated with lateral ovarian transposition.
After lateral ovarian transposition, it is important to recognize the ovaries to avoid confusing them with peritoneal implants. In addition, benign ovarian lesions must be distinguished from primary and secondary malignancies.
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