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Background: US-based thyroid imaging lexicons have been widely used in clinical practice for identification of FNAC-eligible thyroid nodules. A “U”-classification (BTA) was introduced in 2014 with intense researches conducted in last five years trying to test its feasibility and reliability in stratification of US thyroid nodules. Material and Methods: Prospective single-center uni-departmental study aimed at selection of only “solitary” nodules with image-analysis of US features of suspicious and non-suspicious nodules and ascribing each nodule a “U”-class in view of lexicon-provided user-friendly graphic references. Results: A small cohort, of 37 solitary nodules, was selected out of a total of 150 with comparison to FNAC aspiration cytology result according to pathology Bethesda staging. The correlation of each “U” class was compared to pathology (fine needle aspirates) and revealed very good statistical significance. Conclusion: The study suggests that a BTA (The “U”- classification) is a simple reliable test that can be feasibly practiced to select FNAC-eligible nodule amongst multi-nodular glands.

Background: Pancreatic cancer is the fourth leading cause of cancer related deaths worldwide. It has poor prognosis especially in locally advanced tumours. Treatment of pancreatic tumours remains a challenge regarding their growth into the adjacent anatomical and vascular structures. Multidetector computed tomography (MDCT) plays an important role in diagnosing of patients with resectable and borderline resectable tumours. Evaluation of borderline resectable tumours should involve the accurate identification of the relationship between the tumour and the surrounding vessels and other vital struc-tures. Aim of Study: Evaluation of the role of CT angiography in the assessment of tumor vascular relationship in patients with pancreatic tumors in order to choose the proper treatment decision. Material and Methods: This study is a prospective study which was conducted in the Radiology Department of Man-soura University Hospital over the period from August 2016 to September 2019. This study included 79 patients, their ages ranged from 45 to 74 years old with mean age 58.3 years old. All patients were referred from oncology Center of Mansoura University and outpatient surgery clinics. The study was approved by our institution's ethics committee, and all patients gave their informed consent before inclusion in the study. CT scans were obtained with a MDCT scanner (Aquilion 64, Toshiba Medical Systems). CT protocols for pancreatic imaging vary at different institutions but typically include a multiphasic technique with a very thin section imaging and multiplanar reconstruction. Contrast enhanced images include: A late arterial or pancreatic phase and a portal or venous phase after injection of 100-120mL of intravenous non-ionic water soluble contrast material usually at rate of 4-5mL/sec. Results: This study included 79 patients, their ages ranged from 45 to 74 years old with mean age was 58.3 years. The most common affected site in the pancreas was the pancreatic head (47 lesions). All the lesions in our study were histopatho-logical proven malignant. The most common histopathological type in our study was pancreatic adenocarcinoma representing 61 lesions (77.21%). As regards the CT appearance of the pancreatic masses, most of the lesions were hypodense (71lesions). Detailed evaluation by CT angiography showed that the hepatic artery was involved in 35 cases, the SMA in 49 cases, the celiac trunk in 29 cases and the gartroduodenal artery in 47 cases. There was no arterial vascular involvement in 25 cases. Finally as regards the anatomical variations; accessory right hepatic artery was detected in 11 cases, Accessory left hepatic artery in 12 cases, replaced left hepatic artery in 14 cases, replaced right hepatic artery in 10 cases, replaced common hepatic artery in 9 cases and 23 cases showed no anatomical variants. Conclusion: Multidetector CT with CT angiography plays a major role in the diagnosis and staging of pancreatic carci-noma. The use of standardized technique and radiologic reporting method can improve the evaluation of the tumor-vessel relationship and precisely evaluate the arterial anatom-ical variants.

Background: Breast cancer is one of the major causes of death among females, its early diagnosis allow better prognosis and prolonged survival rates of the patients. Post contrast dynamic MRI is the most sensitive method for breast cancer detection which has also good diagnostic performance for evaluation of different breast pathological lesions. Magnetic Resonance (MR) spectroscopy is a functional MRI technique which is used to study the metabolic profile of different breast lesions to improve the diagnostic accuracy of MRI especially in BIRADS 4 breast lesions in order to reduce the unnecessary biopsies.Aim of Study: Evaluation of the role of multi-voxel MR spectroscopy in the recategorization of BIRADS 4 breast lesions when combined with Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI).Material and Methods: This study included 63 patients, their ages ranged from 28 to 73 years old with mean age 46.7 years old. All the patients included in this study were subjected to history, clinical examination, MRI examination and his-topathology. Initially the included breast lesions were catego-rized as BIRADS 4 by conventional post contrast dynamic MRI techniques, and then we added the results of the magnetic resonance spectroscopic imaging to detect whether the spec-troscopic data can improve the diagnostic accuracy of the MRI study. Finally the reported diagnosis was confirmed by histopathological specimens obtained after excision biopsy and core needle biopsy. We used 1.5 T MRI system and the sequences performed included T1 & T2 pulse sequences, STIR and dynamic contrast enhanced MRI followed by MRS for the suspected lesions. For statistical analysis we used T-test and ROC curve.Results: This study included 63 female patients, their ages ranged from 28 to 73 years old with mean age 46.7 years old. All the breast lesion were categorized as BI-RADS 4 breast lesions based on the Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) then after magnetic resonance spectroscopy the breast lesions were re-categorized into BIRADS 3, 4 and 5 categories. Finally the results were compared to the histopathological results. The most common clinical presentation is palpable mass. We had 33 pathologically proven benign lesions and 30 pathologically proven malignant lesions. The diagnosis was downgraded into BIRADS 3 in 29 cases and upgraded into BIRADS 5 in 28 cases and in 6 cases there was no change in the BIRADS 4 categorization after MRS. During MRS examination the choline resonance peak was detected at a frequency of 3.23ppm, and the choline SNR was measured at cut off value of 2. There were statistically significant differences between malignant and benign breast lesions, the choline SNR measured 6.31±0.99 (mean ± SD) in the malignant lesions and it measured 1.902±0.47 (mean ± SD) in the benign lesions. The sensitivity, specificity, PPV, NPV and accuracy measured 81.3%, 62.6%, 76.5%, 67.1% and 73.4% for the DCE-MRI and measured 87.9%, 89.1%, 85.2%, 88.9% and 94.8% for combined assessment by MRS and DCE-MRI.Conclusion: Magnetic resonance spectroscopic imaging can be problem solving method for BIRADS 4 breast lesions when combined with dynamic contrast enhanced MRI to improve its diagnostic accuracy.