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Purpose: Although 18 F-FDG-PET/CT is helpful in defining many types of cancer, localized prostate cancer should not be treated with this technique. This study describes the use of multi-parametric MRI (mpMRI) to characterize incidental 18 F-FDG uptake in the prostate., Methods and Materials: While 18 F-FDG-PET/CT is useful for characterizing a variety of cancers, it is not advised for prostate cancer that is localized. This work investigates the use of mpMRI to describe incidental 18 F-FDG uptake in the prostate.mpMRI included T2-weighted (T2W), dynamic contrast enhancement (DCE), and apparent diffusion coefficient (ADC) sequences. Patients were classified according to PI-RADS (Prostate Imaging Reporting and Data System) version 2.1 by an experienced uroradiologist, and 18 F-FDG-PET was evaluated to determine whether the area of involvement on CT had a counterpart in mpMRI. A biopsy was performed on 30 of the 92 patients. These patients' maximum standardized uptake values (SUVmax) 6 < and ≥ 6, PS(PSA) density 0.15 < and ≥ 0.15, PSA level, uptake pattern (focal involvement/diffuse involvement), and PI-RADS scores were compared. P < .05 was considered statistically significant. Logistic regression was used to analyze PI-RADS score groups age, PSA, PSA density and SUVmax., Results: In the study, 92 patients with incidental 18 F-FDG-PET/CT prostate uptake were examined. Median age was 66, PSA median was 3.6 ng/ml (range: 0-3198 ng/ml). Notably, in 70.6% of cases, PET/CT uptake didn't correlate with mp-MRI findings. Among PI-RADS 3-4-5 patients (29.3%), there was a correlation. Biopsies in 30 patients revealed 43.3% benign, 56.7% malignant. Significant differences between benign and malignant cases were observed in PSA density, PI-RADS scores, and PSA levels (p < .05), while SUVmax and uptake pattern were not significant. In multivariate logistic regression analysis, PI-RADS score groups were found to be independent risk factors for predicting malignancy., Conclusions: Our study showed that incidental 18 F-FDG-PET/CT prostate uptake was detected and that high PSA density values, PI-RADS scores, and PSA values, such as in routine patients, and not PET-CT findings such as SUVmax and uptake pattern, were more predictive of malignancy., Competing Interests: Declarations. Ethics approval and consent to participate: Our study, which included human participants, was reviewed and approved by the ethics committee of Basaksehir Cam and Sakura Hospital. The ethics committee approval is attached. Our study was conducted retrospectively by scanning patients through the PACS system. Our patients sign informed consent documents stating that their information can be used when undergoing MRI scans, but a new informed consent form has not been signed with the information of the ethics committee. The ethics committee decision was uploaded to the system as an additional file. Ethical approval of the present single-center study was granted by the local ethics committee (E-96317027-514.10-232789128; decision date: 29/12/2023) and the necessity for written informed consent was waived due to its retrospective design (Ethics committee approval was sent in the file named ethics). The study adhered to the principles of the Helsinki Declaration. Consent for publication: The materials described in the article, including all relevant raw data, are freely available to any scientist who wishes to use them for non-commercial purposes, without violating the privacy of participants. Added at the end of the main document. For manuscripts containing data of any individual in any form (including individual details, images or videos), permission to publish has been obtained from the individual in question or, in the case of children, from their parents or legal guardians. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background: Insall-Salvati index (ISI) is widely used to evaluate patella position, the specific relationship between quadriceps patellar tendon angle (QPA) and patellofemoral measurements remains unclear. Understanding this relationship could provide valuable insights into diagnosing and treating knee pain, instability, and patellofemoral pathologies more effectively. In this study, we aimed to assess whether there was a significant difference between the patients with patella alta and baja in terms of many patellofemoral measurements and pathologies. Furthermore, we evaluated a newly described QPA., Methods: A retrospective cross-sectional study including 446 patients who underwent knee magnetic resonance imaging (MRI) between 2019 and 2021 in Basaksehir City Hospital was conducted. Two hundred and five patients were divided into two groups according to their ISI (ISI >1.3 and ISI <0.8). The patellar tendon length, patellar height, patella angle, lateral patellar tilt angle (LPTA), patella-patellar tendon angle (PPTA), QPA, medial and lateral trochlear inclination, patella angle, trochlear sulcus angle (TSA), trochlear groove depth (TGD), medial and lateral trochlea length (LT), medial trochlea length (MT) and LT ratio and tibial tubercle-trochlear groove distance, fat-pad edema, chondromalacia and effusion were evaluated. Whether the measurement or presence of pathology differed significantly according to ISI were investigated. The difference between two arithmetic means were analyzed with T -test. The Mann-Whitney U test were used for assessing the difference between two independent groups and to determine difference or equality between groups., Results: When the groups with ISI >1.3 and <0.8 were compared with each other in terms of measurements, patellar tendon length, tibial tubercle-trochlear groove distance, LPTA, PPTA, QPA were found to be significantly higher in the group with ISI >1.3 (P<0.05). Patellar height and TGD were significantly greater in the group with ISI <0.8 (P<0.001, P=0.007). Patellar tendon length, patellar tendon height, tibial tubercle-trochlear groove distance, patella angle, TGD, MT and LT, PPTA, QPA, medial trochlear inclination values and frequency of fat-pad edema were significantly higher in men (P<0.001). The ISI, TSA and frequency of chondromalacia was found to be significantly higher in women (P<0.001)., Conclusions: Major angles such as LPTA, PPTA, patellar tendon length, tibial tubercle-trochlear groove distance and QPA were increased in the group with patella alta. The patients with patella baja have higher patellar height and TGD., Competing Interests: Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-23-1722/coif). The authors have no conflicts of interest to declare., (2024 AME Publishing Company. All rights reserved.)

Background: The newly defined angle, quadriceps-patella angle (QPA), reflects the combined force transmitted to the patella by the quadriceps muscles and patellar tendon. An increase in QPA may correlate with an increased force on the patella, which is significant in diagnosing patellofemoral instability and pain syndrome. In our study, we examined how various angles and pathologies vary depending on lateral patellar tilt angle (LPTA). QPA and patellar malalignment was investigated. Thus, the importance of understanding patellar malalignment and the research gap., Methods: Three hundred and fifty patients who underwent knee magnetic resonance imaging (MRI) examinations were included. The cross-sectional study conducted retrospectively between the years of 2018-2020 in a tertiary care outpatient clinic. Shapiro-Wilk normality, Chi-square, Mann-Whitney- U , Spearman correlation and receiver operating characteristic (ROC) curve analysis, statistical tests used for analysis. The patellar tendon length, patellar height, tibial tubercle-trochlear groove distance (TT-TG), patella angle, trochlear sulcus angle, trochlear groove depth (TGD), medial trochlea length (MT), lateral trochlea length (LT), medial trochlear/lateral trochlear length ratio (MT/LT), LPTA, patella-patellar tendon angle (PPTA), QPA, Insall-Salvati index (ISI), medial trochlear inclination (MTI), lateral trochlear inclination (LTI) were among these measurements. In addition, we aim to reveal whether there is a significant relationship between two important angles LPTA and QPA. Whether there is a significant increase in the development of chondromalacia for the patient group with LPTA >5°. We examined how the frequency of chondromalacia changes in the patient group with LPTA >5°., Results: Two hundred and seventy seven patients included in the study and many measurements were performed on MRI. Fad-pad edema was found to be significantly higher in the group with LPTA <5° (P=0.046). TT-TG distance was significantly higher, TGD and MT were significantly lower in patients with higher LPTA (P=0.001, P=0.002 and P=0.017, respectively). A low level of significant positive correlation was found between QPA and patellar tendon length. There is no significant difference between QPA and PPTA angles between the groups with LPTA <5° and >5° (P=0.503, P=0.188). In the ROC analysis performed to determine the cut-off value, the LPTA value ≤14.2° which significantly predicted the presence of fad-pad edema, had the highest sensitivity and specificity [sensitivity: 76.71%, specificity: 39.90%, area under the curve (AUC): 0.588, P=0.024]., Conclusions: QPA is independent from many angles of the knee and does not change significantly. As the patellar tendon length increases, QPA angle also increases. In patients with abnormal LPTA, the frequency of TT-TG distance and chondromalacia increased, while TGD and MT decreased. Patients with a low LPTA can be more carefully examined for chondromalacia and fad-pad edema in clinical and MRI examination., Competing Interests: Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-23-1592/coif). The authors have no conflicts of interest to declare., (2024 Quantitative Imaging in Medicine and Surgery. All rights reserved.)

Aim: CT-guided radiofrequency ablation (RFA) is among the thermal ablative procedures and provides great benefits with a minimally invasive procedure. In this prospective study, we aimed to reveal the significance of a multidisciplinary method in reducing the recurrence and complications in osteoid osteoma patients with CT-guided RFA performed by a team of experts in the field., Materials and Methods: A total of consecutive 40 patients with osteoid osteoma were prospectively evaluated and treated with CT-guided RFA. Before and the post ablation the visual analog scale (VAS) and use of nonsteroidal anti-inflammatory drugs (NSAIDS) were compared., Results: Post-ablation VAS of the patients at the 1st week and 3rd month after the procedure decreased significantly (p < 0.01) compared to the pre-ablation. The frequency of NSAID use after the ablation decreased significantly (p < 0.01) compared to the pre-ablation time. The pre-procedure NSAID use of our patients included in the study was average 6.93 per week, the NSAID use in the 3rd month post-procedure controls was average 0.53 per week. Recurrence was detected in 4 of our patients, 36 patients had complete recovery., Conclusion: Radiofrequency ablation is an effective treatment method in the management of osteoid osteomas. Radiofrequency ablation has low recurrence rates and provides rapid regression in patients' pain after treatment., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Aim: We aimed to evaluate the effectiveness of combining 2-dimensional shear wave elastography (2D-SWE) with ultrasonography (US) in diagnosing acute appendicitis in patients with suspected acute appendicitis., Methods: Clinical and laboratory findings, gray-scale US and 2D-SWE imaging features, operation information, and pathology results of 48 patients diagnosed with acute appendicitis who presented with right lower quadrant pain were prospectively evaluated. We compared the findings to the US and SWE imaging features of 79 asymptomatic patients., Results: Mean Alvarado score and appendix diameter were statistically significantly higher for acute appendicitis (p < 0.001). In patients with acute appendicitis, mesenteric lymphadenopathy and fat stranding were also more frequent (p < 0.001). The mean velocity and kPa values for appendix and mesenteric fat were statistically significantly higher in acute appendicitis (p < 0.001)., Conclusion: In the diagnosis of acute appendicitis, 2D-SWE increases the diagnostic performance of gray-scale US in the differentiation of inflamed and normal appendixes., (© 2022. Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).)

Objective: In this prospective study, the diagnostic performance of the new version of superb microvascular imaging (SMI) in differentiating malignant from benign lesions was evaluated., Material and Methods: Ninety breast lesions were included. During color SMI examination, both free-hand region of interest (ROI) and box ROI were used. Vascular index (VI) values were obtained from the lesion using both types of ROI and from normal breast tissue via box ROI. VI values, monochrome SMI grading and histopathological results were compared. The efficacy of color SMI and monochrome SMI was investigated in differentiating between benign and malignant breast lesions., Results: The cut-off value, in the differentiation of benign and malignant lesions with color SMI was 0.50 for box ROI, while it was 0.30 for free-hand ROI. The specificity of VI values obtained with box ROI was higher than that of free-hand ROI when differentiating malignant lesions from benign. Comparison of VI values from a lesion and from normal breast tissue showed that VI values in malignant lesions were significantly higher (p<0.05). The VI values of benign lesions and VI values of normal breast tissue were similar. There was a statistically significant relationship between monochrome SMI grading and the malignancy or benign status of the lesion (p<0.001)., Conclusion: Drawing the lesion circumference free-hand using a free-shape ROI did not enhance the sensitivity and specificity. Contrary to popular belief, a more easy and practical measurement method may be more suitable for SMI examination. It is hoped that this will be one of the earliest studies to assess the clinical performance of the latest version of SMI., Competing Interests: Conflict of Interest: No conflict of interest declared by the authors., (©Copyright 2022 by Turkish Federation of Breast Diseases Associations.)