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In osteopetrosis, refractory jawbone osteomyelitis often occurs because of the progression of bone sclerosis, which makes the bone brittle. Herein, we report a case of refractory osteopetrosis-related maxillary osteomyelitis for which conservative therapy and surgical intervention were performed along with imaging evaluation. A 58-year-old woman had maxillary gingivitis for 2 years, for which her tooth was recently extracted. Subsequently, she developed sequestration and oroantral fistula and visited our department. Panoramic radiography, computed tomography, and magnetic resonance imaging (MRI) scans revealed left maxillary osteomyelitis, sinusitis, and sequestration. She had been diagnosed with osteopetrosis in childhood and exhibited sclerotic changes, which were likely caused by osteopetrosis. Bone scintigraphy using Tc-99m-HMDP revealed no increase in tracer uptake in the jawbone. Finally, the patient was diagnosed with osteopetrosis-related left maxillary osteomyelitis and sinusitis; hence, she underwent hyperbaric oxygen therapy, multiple surgeries, and antibiotic therapy. Hepatic dysfunction occurred during the treatment, and a mediastinal tumor was suspected. Thus, fluorodeoxyglucose-positron emission tomography was performed. Further, the patient was diagnosed with extramedullary hematopoietic foci associated with osteopetrosis and hepatic dysfunction due to hepatitis B, there was no Tc-99m accumulation in the maxilla, and hepatitis was treated concurrently. Six months after the final surgery for osteomyelitis, antibiotic therapy was discontinued. Notably, 2 years have passed without exacerbation of osteomyelitis. Moreover, bone scintigraphy using Tc-99m-HMDP did not reveal increased Tc-99m accumulation in the jawbone. In cases of osteopetrosis-related osteomyelitis, interpretation of findings should be done cautiously because Tc-99m may accumulate in an area with active bone metabolism and osteomyelitis may be masked. Refractory osteomyelitis with osteopetrosis requires careful interpretation of MRI and bone scintigraphy scans, and long-term follow-up is required. [ABSTRACT FROM AUTHOR]

To date, there is little consensus on the role of pelvic imaging in assessing local disease extent during initial staging in patients with endometrial carcinoma, with practices differing widely across centers. However, when pretreatment assessment of local tumor extent is indicated, MRI is the preferred imaging modality. Preoperative imaging of endometrial carcinoma can define the extent of disease and indicate the need for subspecialist referral in the presence of deep myometrial invasion, cervical extension, or suspected lymphadenopathy. If distant metastatic disease is clinically suspected, preoperative assessment with cross-sectional imaging or PET/CT may be performed. However, most patients with low-grade disease are at low risk of lymph node and distant metastases. Thus, this group may not require a routine pretreatment evaluation for distant metastases. Recurrence rates in patients with endometrial carcinoma are infrequent. Therefore, radiologic evaluation is typically used only to investigate suspicion of recurrent disease due to symptoms or physical examination and not for routine surveillance after treatment. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. [ABSTRACT FROM AUTHOR]

To date, there is little consensus on the role of pelvic imaging in assessing local disease extent during initial staging in patients with endometrial carcinoma, with practices differing widely across centers. However, when pretreatment assessment of local tumor extent is indicated, MRI is the preferred imaging modality. Preoperative imaging of endometrial carcinoma can define the extent of disease and indicate the need for subspecialist referral in the presence of deep myometrial invasion, cervical extension, or suspected lymphadenopathy. If distant metastatic disease is clinically suspected, preoperative assessment with cross-sectional imaging or PET/CT may be performed. However, most patients with low-grade disease are at low risk of lymph node and distant metastases. Thus, this group may not require a routine pretreatment evaluation for distant metastases. Recurrence rates in patients with endometrial carcinoma are infrequent. Therefore, radiologic evaluation is typically used only to investigate suspicion of recurrent disease due to symptoms or physical examination and not for routine surveillance after treatment. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. [ABSTRACT FROM AUTHOR]

Highlights • Electrical resistance tomography (ERT) method is proposed to visually detect the defect in cementitious materials. • A similarity calculation based on color histogram is introduced to evaluate the image from ERT measurement. • The factors effecting on the image quality of ERT is analyzed and discussed. Abstract Electrical resistance tomography (ERT) method is proposed to visually investigated of the defect in cementitious materials. Specimens with one precast defect are made with different water-cement (w/c) ratio and detected using the embedded electrodes. The experimental images are assessed with a similarity evaluation method based on color histogram. In addition, the electrical resistivity and moisture content of the specimens are measured simultaneously to explore its effects on the quality of the imaging results. The results show that the moisture content is the main factor influencing the resistivity of the specimens in the early hydration reaction while the w/c ratio becomes the main factor effecting the resistivity after the early hydration reaction. For the multi-defect detecting, the influence of electrical soft field effect cannot be neglected. The experiment results imply that ERT technique has potential in defect detection and in-situ monitoring in cement mortar. [ABSTRACT FROM AUTHOR]

• The changes in the tumor blood supply represented by the CT enhancement rate is a new evaluation method of the chemotherapy effect on osteosarcoma. • The blood supply changes based on CT evaluation are related with tumor necrosis rate. • The evaluation based on CT enhancement rate can be a reference for evaluating the chemotherapy effect of osteosarcoma. Analysis of the tumour necrosis rate is an important method to evaluate the effect of neoadjuvant chemotherapy for osteosarcoma. However, at present, there is no specific imaging method to evaluate this effect. The purpose of this study was to evaluate the changes in blood supply after chemotherapy by measuring the CT enhancement rate and to analyse the correlation between the CT enhancement rate and the tumour necrosis rate. Patients with primary osteosarcoma of the extremities treated in our institute from 2016 to 2017 were analysed retrospectively. In total, 103 eligible patients were enrolled in the study, including 67 males and 36 females, with an average age of 17.7 (6–54) years. Sixty cases had tumour sites in the femur, 25 in the tibia, 10 in the humerus, and eight in other sites. All patients received neoadjuvant chemotherapy including methotrexate, cisplatin + doxorubicin and ifosfamide before surgical treatment. All patients underwent enhanced CT examination of the same tumour site before and after the neoadjuvant chemotherapy protocol. The CT value before and after chemotherapy was measured and the enhancement rate was calculated. The change in the CT enhancement rate after chemotherapy was analysed. Changes in the CT enhancement rate were compared between patients with a tumour necrosis rate greater than 90% and those with one <90%. The average CT enhancement rates before and after chemotherapy were 1.68 (median 1.63, range 1.00–2.51) and 1.39 (median 1.28, range 1.00–2.83), respectively (P < 0.01). The average CT enhancement rate after chemotherapy decreased by 15.0% (median 16.7%, range −27.5–53%): 75 cases exhibited a decrease, three cases remained unchanged, and 25 cases exhibited an increase. The average enhancement rate before chemotherapy was 1.75 (median 1.68, range 1.18–2.51) in the group with a necrosis rate >90% and 1.62 (median 1.52, range 1.00–2.41) in the group with a necrosis rate < 90% (P = 0.068). The average CT enhancement rate after chemotherapy was 1.20 (median 1.21, range 1.00–1.53) in the group with a necrosis rate > 90% and 1.53 (median 1.43, range 1.00–2.83) in the group with a necrosis rate < 90% (P < 0.01). The enhancement rate of the group with a necrosis rate > 90% decreased by 29.0% (median 28%, range −2.3–53%) (P < 0.01); the enhancement rate of the group with a necrosis rate < 90% decreased by 3.8% on average (median 0.7%, range −27.5–44.5%) (P = 0.225). After receiving neoadjuvant chemotherapy, most patients with osteosarcoma of the extremities exhibited reductions in the CT enhancement rate. In cases where the tumour necrosis rate was greater than 90%, the tumour blood supply was significantly reduced. This suggests that imaging evaluations based on the CT enhancement rate can be used as a reference for evaluating the preoperative effect of chemotherapy for osteosarcoma. [ABSTRACT FROM AUTHOR]

Background Immune checkpoint inhibitors are an important tool in the therapeutic strategy against metastatic non–small cell lung cancer (NSCLC); however, radiological evaluation is challenging due to the emergence of atypical patterns of responses. Several evaluation criteria have been proposed, such as the Response Evaluation Criteria in Solid Tumours (RECIST), version 1.1, immune -related RECIST (irRECIST) and iRECIST, but have not been systematically compared in a homogeneous population. Patients and methods We conducted a monocentric retrospective analysis of consecutive advanced NSCLC patients treated with an anti–programmed cell death-1 or anti–program death-ligand 1. Response patterns and the discordance between RECIST 1.1, irRECIST and iRECIST guidelines were described, and associations of response patterns and clinical outcome were explored. Results Overall, 160 patients treated between February 2013 and October 2016 were included. Atypical responses were observed in 20 patients (13%), including eight pseudoprogressions (PsPDs) (5%) and 12 dissociated responses (8%). Thirteen of the 20 patients demonstrated clinical benefit. Per the RECIST 1.1, 37 patients (23%) showed an objective response or stable disease, and 123 patients (77%) exhibited progression. Eighty progressive patients were assessable for irRECIST and iRECIST: 15 patients were assessed differently; however, only three (3.8%) mismatches with a theoretical impact on the therapeutic decision were identified. Patients with PsPD or dissociated response had higher overall survival than patients with true progression. Conclusion Atypical responses (PsPD/dissociated response) occurred in 13% of NSCLC patients under immune checkpoint inhibitors. Based on survival analyses, the RECIST 1.1 evaluation underestimated the benefit of immune checkpoint inhibitors in 11% of the progressive patients. Immune-related RECIST and iRECIST identified these unconventional responses, with a 3.8% discrepancy rate. [ABSTRACT FROM AUTHOR]

In the management of epithelial ovarian cancers, imaging is used for cancer detection and staging, both before and after initial treatment. The decision of whether to pursue initial cytoreductive surgery for ovarian cancer depends in part on accurate staging. Contrast-enhanced CT of the abdomen and pelvis (and chest where indicated) is the current imaging modality of choice for the initial staging evaluation of ovarian cancer. Fluorine-18-2-fluoro-2-deoxy-d-glucose PET/CT and MRI may be appropriate for problem-solving purposes, particularly when lesions are present on CT but considered indeterminate. In patients who achieve remission, clinical suspicion for relapse after treatment prompts imaging evaluation for recurrence. Contrast-enhanced CT is the modality of choice to assess the extent of recurrent disease, and fluorine-18-2-fluoro-2-deoxy-d-glucose PET/CT is also usually appropriate, as small metastatic foci may be identified. If imaging or clinical examination confirms a recurrence, the extent of disease and timing of disease recurrence then determines the choice of treatments, including surgery, chemotherapy, and radiation therapy. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. [ABSTRACT FROM AUTHOR]