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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 and Purpose: Given their overlapping features, pituitary metastases frequently imitate pituitary neuroendocrine tumors in neuroimaging studies. This study aimed to distinguish pituitary metastases from pituitary neuroendocrine tumors on the basis of conventional MR imaging and clinical features as a practical approach., Materials and Methods: In this 2-center retrospective study, backward from January 2024, preoperative pituitary MR imaging examinations of 22 pituitary metastases and 74 pituitary neuroendocrine tumors were analyzed. Exclusion criteria were as follows: absence of a definitive histopathologic diagnosis, history of pituitary surgery or radiation therapy before MR imaging, and pituitary neuroendocrine tumors treated with medical therapy. Two radiologists systematically evaluated 13 conventional MR imaging features that have been reported more commonly as indicative of pituitary metastases and pituitary neuroendocrine tumors in the literature. Age, sex, history of cancer, and maximum tumor size constituted the clinical/epidemiologic features. The primary cancer origin for this study was also noted. Univariable and multivariable logistic regression was used for the selection of variables, determining independent predictors, and modeling. Interobserver agreement was evaluated for all imaging parameters using the Cohen κ statistic or intraclass correlation coefficient., Results: A total of 22 patients with pituitary metastases (8 women; mean age, 49.5 [SD, 13] years) and 74 patients with pituitary neuroendocrine tumors (36 women; mean age, 50.1 [SD, 11] years) were enrolled. There was no statistically significant distributional difference in age, sex, or maximum tumor size between the 2 groups. Lung cancer (9/22; 41%) was the most commonly reported primary tumor, followed by breast (3/22; 13.6%) and unknown cancer (3/22; 13.6%). Logistic regression revealed 3 independent predictors: rapid growth on control MR imaging, masslike or nodular expansion of the pituitary stalk, and a history of cancer. The model based on these 3 features achieved an area under the curve, accuracy, sensitivity, specificity, and Brier score of 0.987 (95% CI, 0.964-1), 97.9% (95% CI, 92.7%-99.8%), 95.5% (95% CI, 77.2%-99.9%), 98.6% (95% CI, 92.7%-100%), and 0.025, respectively., Conclusions: Two conventional features based on pituitary MR imaging with the clinical variable of history of cancer had satisfying predictive performance, making them potential discriminators between pituitary metastases and pituitary neuroendocrine tumors. In cases in which differentiation between pituitary metastases and pituitary neuroendocrine tumors poses a challenge, the results of this study may help with the diagnosis., (© 2024 by American Journal of Neuroradiology.)

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.)

The purpose of this study was to reveal the anatomical risk factors for anterior and posterior cruciate ligament (ACL and PCL) injuries and menisci injury. We aim to investigate whether there are significant relationships between tibial tubercle-trochlear groove (TT-TG) distance, patella angle, trochlear sulcus angle (TSA), trochlear groove depth (TGD), medial and lateral trochlea length (MT and LT), MT/LT ratio, lateral patellar tilt angle (LPTA), patella-patellar tendon angle (P-PTA), quadriceps-patellar tendon angle (QPA), Insall-Salvati index (ISI), medial and lateral trochlear inclination (MTI and LTI) measurements and important common pathologies such as ACL, PCL, medial and lateral meniscal injuries (MM and LM), peripatellar fat pad edema, chondromalacia, and effusion. Thus, the mechanisms of injury will be better understood by revealing important anatomical variations for meniscus and ligament damage. Three hundred eighty patients with knee magnetic resonance imaging examination were included in this study. Our patients who underwent knee magnetic resonance imaging were divided into groups according to the presence of MM tear, LM tear, ACL tear, PCL tear, peripatellar fat pad edema, chondromalacia and effusion. TT-TG distance, patella angle, TSA, TGD, MT, LT, MT/LT ratio, LPTA, P-PTA, QPA, ISI, MTI, and LTI were measured. In patients with ACL tear, age, LT, ML/LT ratio, and QPA measurements were found to be significantly higher. There was no significant difference between the participants' LPTA value and the presence of ACL tear, MM and LM injury. MT and ML/LT ratio were found to be significantly lower in the group with MM tear ( p <0.001). The TT-TG distance was found to be significantly lower in the group with LM tear. Increased age, LT, ML/LT ratio, and QPA are predisposed risk for ACL tear. Decreased MT and ML/LT ratio are among the risk factors for MM tear. The anatomical variations are associated with ligament and meniscal injury., Competing Interests: None declared., (Thieme. 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).)

Abstract: In this prospective study, the diagnostic performance of MicroV Doppler ultrasonography (US) and Q-pack application in distinguishing malignant thyroid nodules from benign nodules will be examined. Given the emerging irregular vascular structures in malignant nodules, it is thought that MicroV Doppler US and Q-pack application can help in diagnosis. One hundred sixteen nodules that were suggested a biopsy by a clinician were examined with B-mode US, color, X-flow, and MicroV Doppler US, respectively. In addition, during MicroV Doppler US examination, thyroid nodule and its adjacent thyroid parenchyma were evaluated with Q-pack application. After US examinations, biopsy was performed on the nodules and histopathological results were obtained. Eighty-nine nodules were histopathologically proven as benign, and the rest of them were malignant. In Doppler types, the thyroid findings in score 1, 2, and 3 nodule blood supply type were benign, whereas the thyroid findings in the score 4 have a possibility of malignancy between 63% and 66.7%. It was found that MicroV Doppler was significantly superior to X-flow and color Doppler ( P = 0.037 and P = 0.042, respectively). Nodule/parenchyma Q-pack mean values were statistically significantly higher in malignant findings compared with benign findings ( P < 0.001). Nodule/parenchyma Q-pack peak values were also statistically significantly higher in malignant findings compared with benign findings ( P < 0.001).As a result, although Q-pack application enables us to obtain quantitative values about vascularity, due to its ability to demonstrate slow blood flow, microvascular vessel structure, and distribution, MicroV Doppler US has promises to detect malignant thyroid nodules., Competing Interests: The authors declare no conflict of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

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.)

Background: To evaluate the hysterosalpingography (HSG) findings of women with infertility in a tertiary center located in central Turkey., Methods: A total of 1,996 patients undergoing the HSG procedure for the investigation of infertility from April 2012 to 2017 were retrospectively evaluated using the archives of the reproductive endocrinology and radiology departments. Demographic and clinical characteristics of patients with normal HSG findings (n = 1,549) and patients with abnormal HSG findings (n = 447) were compared, and the distribution of pathologies on the HSG examinations was evaluated as well., Results: There were statistically significant differences between patients with normal and abnormal HSG findings in terms of age (25.68 ± 4.54 vs. 35.87 ± 2.65, p < 0.001), type (for secondary) and duration of infertility [43.1% vs. 50.6% (p = 0.006); 7 (1-22) vs. 2 (1-12) (p < 0.001), respectively], and baseline follicle stimulating hormone and estradiol levels [7.22 ± 1.38 vs. 7.55 ± 1.42 (p < 0.001); 45.54 ± 9.92 vs. 44.40 ± 9.99 (p < 0.001), respectively]. Among a total of 1,996 HSG examinations, 447 (22.39%) showed abnormalities, of which 237 (11.87%) were associated with tubal pathologies, 163 (8.17%) with uterine pathologies, and 47 (2.35%) with a combination of both. While the most common tubal pathology was one-sided distal tubal occlusion (2.91%), the most common uterine pathology was filling defects (4.16%)., Conclusion: HSG is the most commonly used, well-tolerated, low-cost, and safe radiological procedure to use for the investigation of the causes of female infertility., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Aim: We aimed to investigate the effectiveness of shear wave elastography (SWE) in the diagnosis of acute pancreatitis (AP)., Material and Methods: The pancreatic parenchyma of 50 patients whose clinical and laboratory findings were indicative of AP and of 70 healthy, asymptomatic volunteer participants with normal laboratory values was examined using SWE.Computed tomography was performed in all patients with AP on admission. Elastographic measurements were performed by manually drawing the contours of the pancreatic parenchyma using the free region of interest. The quantitative SWE values (meters/second [m/s], kilopascal [kPa]) of the patients and asymptomatic volunteers group were compared., Results: The mean SWE value of the pancreatic parenchyma was 2.60 ± 1.63 m/s in the asymptomatic volunteers and 3.48 ± 0.52 m/s in patients with AP, with a statistically significant difference (p<0.001, t=-3.685). The mean SWE value of the pancreatic parenchyma was 23.77±6.72 kPa in the asymptomatic volunteers and 45.71 ± 10.72 kPa in patients with AP, indicating a significant difference (p<0.001, t=-3.685). AP can be diagnosed with a sensitivity and specificity of 98.0% when 29.45 kPa was designated as cut-off value and with a 96.0% sensitivity and 98.3% specificity when 2.77 m/s was designated as the cut-off value. The superiority of SWE was found over B-mode US and CECT in the diagnosis of AP on admission. Conclusion: SWE can be used as an effective imaging method with high sensitivity and specificity for the diagnosis of AP. It may be used as an important imaging method to assist in the diagnosis of AP especially when B-mode US and CECT findings are normal.