Although MRI is the most efficient method of detecting breast cancer, its standard protocol is time-consuming and expensive. The objective of this study was to compare the diagnostic accuracy of the ...modified innovative abbreviated MRI protocol (AMRP) and the standard magnetic resonance protocol (SMRP) when detecting breast cancer.
The research involved 477 patients referred for breast MRI due to suspected lesions. They were randomly assigned to the AMRP group (N = 232) or the SMRP group (N = 245). The AMRP comprised one native (contrast-free) and four post-contrast dynamic sequences of T1-weighted volume imaging for breast assessment (VIBRANT) and 3d MIP (maximum intensity projection) lasting for eight minutes. All the patients underwent a core biopsy of their lesions and histopathological analysis.
The groups were comparable regarding the pre-screening and post-diagnostic characteristics and were of average (±SD) age at breast cancer diagnosis of 53.6 ± 12.7 years. There was no significant difference between the two protocols in terms of specificity or sensitivity of breast cancer diagnosis. The sensitivity (95% Cis) of the AMRP was 99.05% (96.6-99.9%), and its specificity was 59.09% (36.4-79.3%), whereas the sensitivity of the SMRP was 98.12% (95.3-99.5%) and its specificity was 68.75% (50.0-83.9%). Most of the tumors comprised one solid lesion in one of the breasts (77.3%), followed by multicentric tumors (16%), bilateral tumors (4.3%), and multifocal tumors (1.7%). The average size of tumors was approximately 14 mm (ranging from 3 mm to 72 mm).
Our innovative AMR protocol showed comparable specificity and sensitivity for the diagnosis of breast cancer when compared to SMRP, which is the "gold standard" for histopathological diagnosis. This can lead to great savings in terms of the time and cost of imaging and interpretation.
Two cases with lethal complications are reported among 1750 ultrasound (US)-guided percutaneous fine-needle liver biopsies performed in our department. The first patient had angiosarcoma of the liver ...which was not suspected after computed tomography (CT) and US studies had been performed. The other patient had hepatocellular carcinoma in advanced hepatic cirrhosis. Death was due to bleeding in both cases. Pre-procedure laboratory tests did not reveal the existence of major bleeding disorders in either case. Normal liver tissue was interposed in the needle track between the liver capsule and the lesions which were targeted.
Breast cancer is the most common cancer in women. It can be diagnosed in early stage through screening, early detection and educational programs, and when diagnosed early it can be efficiently ...treated. Treatment modalities include surgery, chemotherapy, radiotherapy, hormonal therapy and targeted biologic therapy, according to the stage of the disease and patient condition. Treatment decisions should be made after multidisciplinary team discussion. Due to the significance of this disease it is important to define and implement standardized approach for diagnostic, treatment and monitoring algorithm as well. The following text presents the clinical guidelines in order to standardize the procedures and criteria for diagnosis, management, treatment and monitoring of patients with breast cancer in the Republic of Croatia.
Abdominalni ultrazvuk rabi transmisiju i refleksiju ultrazvučnih valova za prikaz unutarnjih organa kroz trbušnu stijenku. Opisali smo klinički značaj i sonografske karakteristike različitih oblika ...žarišnih i difuznih jetrenih lezija te upalnih stanja žučnog sustava, gušteraće i slezene kao i diferencijalno dijagnostičke mogućnosti. Izuzevši jednostavne ciste i tipične hemangiome, definitivna karakterizacija jetrenih lezija nije uvijek moguća konvencionalnim ultrazvukom. Ovaj pregledni rad također opisuje karakteristike transabdominalnog ultrazvuka tankog i debelog crijeva kod različitih infektivnih bolesti i upalnih stanja.
Breast cancer is the most common malignancy in women. Early diagnosis and more effective treatment of invasive breast cancer resulted in significant mortality reduction, improvement of survival and ...the quality of life of the patients. The management od non-invasive breast cancer, on the contrary, is still controversial and the problem of overdiagnosis and overtreatment of patients come to evidence. In the following text a multidisciplinary team of experts brings the first consensus guidelines aimed to standardize and optimize the criteria and management in diagnosis, treatment and monitoring of non-invasive breast cancer patients in the Republic of Croatia.
Breast cancer is the most common malignancy in women. Preventive measures, early diagnosis and development of all treatment modalities (surgery, radiotherapy, chemotherapy, hormonal and targeted ...biologic therapy) led to improvement in survival and quality of life of the patient. In order to standardize and optimize the approach, following good clinical practice standards, we bring consensus guidelines for diagnosis, treatment and monitoring of breast cancer patients as a result of consensus of a multidisciplinary team of experts for breast cancer.
To evaluate duplex Doppler sonography to assess renal vascular resistance (RVR) in diabetic patients.
Resistive indexes (RIs) and pulsatility indexes (PIs) were measured in intrarenal arteries of 144 ...patients with diabetes mellitus and 61 control subjects. RIs and PIs were compared for control subjects and patients with diabetic nephropathy and correlated with laboratory and clinical findings.
In control subjects, the mean RI was 0.595 +/- 0.033 (standard deviation) and mean PI was 1.001 +/- 0.105. Elevated RIs and PIs accompanied progression of nephropathy. Statistically significant (P < .001) correlations were observed between both RI and PI and serum creatinine level, creatinine clearance rate, systolic and diastolic blood pressure measurements, and patient age.
Doppler indexes reflect increased RVR in diabetic nephropathy and correlate with laboratory and clinical parameters, but RI and PI measurements offer no advantages over these parameters to predict disease progress or in patient care.
