Search

Purpose: we aimed to investigate the value of magnetic resonance imaging (MRI)- based parameters in differentiating between progressive massive fibrosis (PMF) and lung cancer. Methods: this retrospective study included 60 male patients (mean age, 67.0 +/- 9.0 years) with a history of more than 10 years working in underground coal mines who underwent 1.5 T MRI of thorax due to a lung nodule/mass suspicious for lung cancer on computed tomography. Thirty patients had PMF, and the remaining ones had lung cancer diagnosed histopathologically. The sequences were as follows: coronal single-shot turbo spin echo (SSH-TSE), axial T1- and T2-weighted spin-echo (SE), balanced turbo field echo, T1-weighted high- resolution isotropic volume excitation, free-breathing and respiratory triggered diffusion-weighted imaging (DWI). The patients' demographics, lesion sizes, and MRI-derived parameters were compared between the patients with PMF and lung cancer. Results: Apparent diffusion coefficient (ADC) values of DWI and respiratory triggered DWI, signal intensities on T1-weighted SE, T2-weighted SE, and SSH-TSE imaging were found to be significantly different between the groups (p < 0.001, for all comparisons). Median ADC values of free-breathing DWI in patients with PMF and cancer were 1.25 (0.93-2.60) and 0.76 (0.53-1.00) (x 10(-3) mm(2)/s), respectively. Most PMF lesions were predominantly iso- or hypointense on T1- weighted SE, T2-weighted SE, and SSH-TSE, while most malignant ones predominantly showed high signal intensity on these sequences. Conclusion: MRI study including SE imaging, specially T1-weighted SE imaging and ADC values of DWI can help to distinguish PMF from lung cancer., NA

Background There is no consensus on the imaging modality to be used in the diagnosis and management of Coronavirus disease 2019 (COVID-19) pneumonia. The purpose of this study was to make a comparison between computed tomography (CT) and chest X-ray (CXR) through a scoring system that can be beneficial to the clinicians in making the triage of patients diagnosed with COVID-19 pneumonia at their initial presentation to the hospital. Results Patients with a negative CXR (30.1%) had significantly lower computed tomography score (CTS) (p < 0.001). Among the lung zones where the only infiltration pattern was ground glass opacity (GGO) on CT images, the ratio of abnormality seen on CXRs was 21.6%. The cut-off value of X-ray score (XRS) to distinguish the patients who needed intensive care at follow-up (n = 12) was 6 (AUC = 0.933, 95% CI = 0.886–0.979, 100% sensitivity, 81% specificity). Conclusions Computed tomography is more effective in the diagnosis of COVID-19 pneumonia at the initial presentation due to the ease detection of GGOs. However, a baseline CXR taken after admission to the hospital can be valuable in predicting patients to be monitored in the intensive care units.

Birt Hogg Dube syndrome is a rare disease characterized by autosomal dominant inherited multiple cysts in the lungs, renal tumors and skin fibrofolliculomas. It was first described in 1977 by Birt et al. In this case report, a patient who was diagnosed with symptoms and his first degree relative is presented. Diseases that should be considered in differential diagnosis are discussed. The diagnosis of this disease is usually made after recurrent pneumothorax. Since it is a genetic disease, the importance of follow-up and screening needs of patients and their relatives is emphasized.

OBJECTIVE: In this study, we aimed to determine the prevalence of gynecomastia by evaluating computed tomography (CT) images of male patients who were admitted to our hospital during the coronavirus disease-2019 (COVID-19) pandemic. MATERIALS AND METHODS: This study included a total of 1,877 patients who underwent chest CT for prediagnosis of COVID-19 pneumonia between March 15(th) and May 15(th), 2020. All images were evaluated for the presence of gynecomastia. Gynecomastia patterns were evaluated according to morphological features, and diagnoses were made by measuring the largest glandular tissue diameter. Statistical analysis was performed with IBM SPSS software version 25.0. RESULTS: The prevalence of gynecomastia was 32.3%. In terms of pattern, 22% were nodular, 57% were dendritic, and 21% were diffuse glandular gynecomastia. A significant correlation was found between age and gynecomastia pattern (p

[No Abstract Available], NIHR Southampton Biomedical Research Centre; Wellcome Trust [209553/Z/17/Z]; NIHR UCLH Biomedical Research Centre, UK, J.M. Wallis receives a research fellowship from the NIHR Southampton Biomedical Research Centre. This research was funded in whole or in part by the Wellcome Trust (209553/Z/17/Z). For this project, J. Jacob and E. Gudmundsson were also supported by the NIHR UCLH Biomedical Research Centre, UK. Funding information for this article has been deposited with the Crossref Funder Registry.

PURPOSE: We aimed to demonstrate the computed tomography (CT) findings observed at the initial presentation of coronavirus disease 2019 (COVID-19) pneumonia and reveal the most frequent infiltration and distribution patterns of the disease. METHODS: One hundred and eighty-five patients (87 men, 98 women; mean age, 48.7 years), who underwent RT-PCR sampling and high-resolution CT examination in our hospital between March 15, 2020, and April 15, 2020, and got a definitive diagnosis of COVID-19 disease via initial or follow-up RT-PCR test, were included in the study. We comprehensively analyzed the most common and relatively rare CT imaging features (e.g., distribution pattern, density of the lesions, additional CT signs) in patients diagnosed with COVID-19 pneumonia. RESULTS: Thirty-eight patients (20.6%) had no evidence of pneumonia on their initial high-resolution CT images. Among 147 patients (79.4%) who had parenchymal infiltration consistent with pneumonia, 10 (6.8%) had a negative baseline RT-PCR test, and positivity was detected as a result of repeated tests. Most of the patients had multifocal (89.1%) and bilateral (86.4%) lesions. The most common location, right lower lobe, was affected in 87.8% of the patients. Lesions were distributed predominantly at peripheral (87.1%) and posterior (46.3%) areas of lung parenchyma. Most of the patients had pure ground glass opacity (GGO) (82.3%) followed by GGO with consolidation (32.7%) and crazy paving pattern (21.8%). Pure consolidation, solid nodules, halo sign, reverse halo sign, vascular enlargement, subpleural line, air-bronchogram, and bronchiectasis were the other findings observed in at least 15% of the cases. Halo sign, acinar nodules, air-bubble sign, pleural thickening and effusion, mediastinal and/or hilar lymphadenopathy were seen rarely (2%-12.9%). Pericardial effusion, pneumothorax, cavitation, and tree-in-bud pattern were not detected in our study group. CONCLUSION: Multifocal and bilateral GGO infiltration predominantly distributed in peripheral, posterior, and lower lung areas was the most common infiltration pattern.

Aims: The aim of our study was to assess the correlations between apparent diffusion coefficient (ADC) values and standardized uptake values (SUVs) and their correlations with tumor size, tumor stage and histological grade in patients with head and neck squamous cell carcinomas (HNSSCs). Methods: This retrospective study included 36 patients with histologically confirmed HNSSCs visible on diffusion weighted imaging (DWI) and fluorodeoxyglucose (FDG) positron emission tomography (PET/CT). Correlations of minimum ADC (ADCmin), mean ADC (ADCmean), and minimum-mean ADC ratio (ADCmin/mean) with maximum SUV (SUVmax) and lean body mass SUVlbm (SUVlbm) were analyzed using the Spearman's correlation test. The Kruskal-Wallis one-way ANOVA test and Mann-Whitney U test were used to assess the correlations of ADC values and SUVs with tumor size, tumor stage and histological grade. Two experienced readers measured the ADC and SUVs independently, and intraclass correlation coefficient (ICC) was used to analyze the inter-observer agreement. Results: The mean ADCmin, ADCmean, and ADCmin/mean for HNSSCs were 0.68±0.17x10-3 mm2/s, 0.82±0.17x10-3 mm2/s, and 0.83±0.10, respectively. The mean SUVmax and SUVlbm were 14.65±5.5 and 10.96±5.1, respectively. The correlations between ADC values and SUVs did not reach statistical significance. There were no significant correlations of ADC values and SUVs with tumor size, tumor stage or histological grade. There was a tendency of SUVs to increase and ADC values to decrease with tumor dedifferentiation; however, the changes were not significant. Inter-observer agreement for tumor ADC values and SUVs was almost perfect (ICC>0.81). Conclusions: Pretreatment ADC values and SUVs in HNSSCs are reproducible and independent biomarkers. © 2020 Galenos Publishing House., received no financial support.

Plevral lipomlar, parietal plevranın submezotelyal tabakasından köken alan, benign, yavaş büyüme gösteren ve genellikle soliter yumuşak doku tümörleridir. Sıklıkla asemptomatik olup radyografide insidental olarak saptanırlar. Akciğer grafisinde yumuşak doku dansitesinde görülürler. Burada akciğer grafisinde insidental saptanan plevral lipom olgusu tanısal radyolojik özellikleriyle sunulmakta, ayırıcı tanıda düşünülmesi gereken hastalıklar tartışılmaktadır. Tanı genellikle radyolojik olarak konmaktadır. Şüpheli olgularda transtorasik ya da cerrahi biyopsi uygulanabilir.

[No Abstract Available]

[No Abstract Available], Wellcome Trust [209553/Z/17/Z]; UCLH Biomedical Research Centre, This study was supported by Wellcome Trust grant 209553/Z/17/Z and the UCLH Biomedical Research Centre. Funding information for this article has been deposited with the Crossref Funder Registry.

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first reported in Wuhan, China. The infection rapidly spread to more than 200 countries around the world. The clinical presentation of the disease may vary from mild illness to severe pneumonia such as acute respiratory distress syndrome (ARDS). The chest computed tomography (CT) has an important complementary role in diagnosis of the disease. The predominant CT findings of the disease are ground glass opacities and consolidations located in subpleural areas of lower lobes. Widespread ground-glass opacities, consolidation, air bronchograms, central involvement of lung parenchyma, mediastinal lymphadenopathy are more common in patients with the severe form of the disease. CT imaging also guides in differentiation of alternative diagnosis or in assessment of associated pulmonary embolism during the course of the disease. In this pictorial review we aim to review the CT features of COVID-19 pneumonia and mention the changes throughout the disease process.

Degerli Meslektaslarimiz, Plevra hastaliklari, gunumuzde insidansi giderek artan ve hem gogus hastaliklari hem de gogus cerrahisi kliniklerinin pratiginde yaygin bir is yuku olusturan sorun halinde karsimiza cikmaktadir. Cok genis sebeplere dayali bir dagilim gosteren plevra patolojilerinin tani ve tedavi yontemi multidisipliner yaklasim gerekmektedir. Bu konuyla ilgili cikarilan eserler oldukca degerli teorik bilgiler icermekle birlikte pratik ve vaka noktasinda bilgi birikimini gerektigi olcude yansitmadigi gozlenmektedir. Bu dusunceden yola cikarak, plevral hastaliklari ve cerrahi tedavi yaklasimini olgu sunumlari esliginde ozetleyen alaninda bu yonuyle ilk eser olan bu kitabi degerli okuyucularimiza sunmaktan gurur duyuyoruz. Bu eserde gunumuzdeki plevra patolojilerine yaklasim, guncel tani rehberleri ve cerrahi tedavideki yenilikler, gogus hastaliklari ve gogus cerrahisi alanlarinda kursu sahibi olan degerli hocalarimiz tarafindan olgular esliginde islenmistir. Klinik tecrubelerin kanita dayali yontemlerle aktarildigi, vakalarin guncel pratigimizde rehberlik edecegi bir kaynak olarak titizlikle hazirlanmistir. Eserin tum bolumlerinin hazirlik asamasinda emegi gecen kiymetli hocalarimiza ayri ayri sukranlarimizi sunariz. Kiymetli meslektaslarimiza faydali olmasi temennisiyle…. Kizlarimiz Zulal, Elif, Defne, Gokcen ve tum saglik calisanlarinin cocuklarina armagan olmasi dilegiyle

Background: Idiopathic pulmonary fibrosis (IPF) and pleuroparenchymal fibroelastosis (PPFE) are known to have poor outcomes but detailed examinations of prognostic significance of an association between these morphologic processes are lacking. Methods: Retrospective observational study of independent derivation and validation cohorts of IPF populations. Upper-lobe PPFE extent was scored visually (vPPFE) as categories of absent, moderate, marked. Computerised upper-zone PPFE extent (cPPFE) was examined continuously and using a threshold of 2.5% pleural surface area. vPPFE and cPPFE were evaluated against 1-year FVC decline (estimated using mixed-effects models) and mortality. Multivariable models were adjusted for age, gender, smoking history, antifibrotic treatment and diffusion capacity for carbon monoxide. Findings: PPFE prevalence was 49% (derivation cohort, n = 142) and 72% (validation cohort, n = 145). vPPFE marginally contributed 3-14% to variance in interstitial lung disease (ILD) severity across both cohorts. In multivariable models, marked vPPFE was independently associated with 1-year FVC decline (derivation: regression coefficient 18.3, 95 CI 8.47-28.2%; validation: 7.51, 1.85-13.2%) and mortality (derivation: hazard ratio [HR] 7.70, 95% CI 3.50-16.9; validation: HR 3.01, 1.33-6.81). Similarly, continuous and dichotomised cPPFE were associated with 1-year FVC decline and mortality (cPPFE > 2.5% derivation: HR 5.26, 3.00-9.22; validation: HR 2.06, 1.28-3.31). Individuals with cPPFE > 2.5% or marked vPPFE had the lowest median survival, the cPPFE threshold demonstrated greater discrimination of poor outcomes at two and three years than marked vPPFE. Interpretation: PPFE quantification supports distinction of IPF patients with a worse outcome independent of established ILD severity measures. This has the potential to improve prognostic management and elucidate separate pathways of disease progression. Funding: This research was funded in whole or in part by the Wellcome Trust [209,553/Z/17/Z] and the NIHR UCLH Biomedical Research Centre, UK. (c) 2021 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/), Wellcome Trust [209553/Z/17/Z]; NIHR UCLH Biomedical Research Centre, UK; NIHR South-ampton Biomedical Research Centre; EPSRC [EP/M020533/1], This research was funded in whole or in part by the Wellcome Trust [209553/Z/17/Z]. For the purpose of open access, the author has applied a CC-BY public copyright licence to any author accepted manuscript version arising from this submission. This project, JJ, EG and SMJ were also supported by the NIHR UCLH Biomedical Research Centre, UK. MGJ and CB acknowledge the support of the NIHR South-ampton Biomedical Research Centre. EPSRC grant EP/M020533/1 helped support this work.

Shortly after being identified in China, 2019 coronavirus disease (COVID-19) caused by SARS-CoV-2 has spread rapidly and millions of people were infected as of May 2020; the outbreak resulting in more than 250,000 deaths was declared a pandemic. In this critical stage of the ongoing pandemic of COVID-19, information regarding the long term effects of the disease remains limited. While most of the patients recover completely, some patients may develop complications. In this report, we aimed to present the serial chest high-resolution computed tomography (HRCT) findings in a patient who developed pulmonary fibrosis (PF) similar to usual interstitial pneumonia (UIP) pattern during recovery from severe novel coronavirus pneumonia.

Coronavirus disease 2019 (COVID-19) first emerged in China and rapidly spread in the world causing a pandemic. Chest computed tomography (CT) continues to play an important role in the diagnosis and follow-up of the disease due to shortcomings of the real-time reverse transcription-polymerase chain reaction test, which is the gold standard in the diagnosis of this disease. Typical chest CT findings of COVID-19 pneumonia have been widely reported in the literature. However, atypical findings such as central involvement, peribronchovascular involvement, isolated upper lobe involvement, nodular involvement, lobar consolidation, solitary involvement, pleural and pericardial fluid, and subpleural sparing can also be seen. Knowing these atypical findings is important to avoid misdiagnosis. This review summarizes the atypical findings that can be seen in the course of the disease and may be confused with other diseases.

[Abstract Not Available]

Background: Pulmonary thromboembolism (PTE) is an important cause of morbidity and mortality in hospitalized patients and computed tomographic angiography (CTA) has become the gold standard diagnostic examination for suspected PTE. Dual energy computed tomography (DECT) not only detects thromboembolic filling defects but also provides functional perfusion information by generating iodine distribution maps. Objectives: The objective of the study is to determine the value of perfusion defect score (P score) in detection of the severity of acute PTE and to correlate it with pulmonary obstruction score (Qanadli score), other CTA parameters and clinical findings. Patients and Methods: Fifty five patients, with acute PTE who underwent DECT were reviewed. We calculated P score, Qanadli score, ratio of the right ventricle diameter to the left ventricle (RV/LV ratio) and the main pulmonary artery (PA) diameter by using the dual energy CTA images. The correlation between CTA parameters and clinical- echocardiographic data was investigated. Results: Correlation analysis showed a significant positive correlation between the P score and Qanadli score (r = 0.748, P < 0.001). There was also a significant positive correlation between P score and RV/LV ratio (r = 0.432, P = 0.001) and between Qanadli score and RV/LV ratio (r = 0.424 P = 0.001). Echocardiographic data was present in 39 patients (70.9 %). P score was significantly higher in patients with RV dilatation (P = 0.022) and RV dysfunction (P = 0.001) on echocardiography. Likewise, similar interaction was present between Qanadli score and RV dilatation (P = 0.023) and RV dysfunction (P = 0.003). No correlation was present between P score and blood gas analysis [partial pressure of oxygen in arterial blood (PaO2), partial pressure of arterial carbon dioxide (PaCO2),(PaO2)/fraction of inspired oxygen (FiO2), oxygen saturation] and hemodynamic data (blood pressure and pulse). Conclusion: P score is seen as a good adjunctive tool to other CTA parameters and echocardiography in detection of PTE severity. Addition of perfusion changes to clinical risk assessment will help in the management of patients.

[Abstract Not Available]

Background: Multidetector computed tomography (MDCT) angiography is considered as the gold standard imaging modality in the evaluation of acute pulmonary embolism. Optimum vascular enhancement is critical for MDCT studies. The suboptimal opacification in pulmonary artery could be salvaged using low-energy virtual monoenergetic images (VMI) at rapid kVp switch dual energy CT. Objectives: To explore the potential improvement in pulmonary artery opacification and to assess the change in image quality parameters in VMI using fast switch kVp dual energy CT. Patients and Methods: The CT images of 877 patients who were referred with a preliminary diagnosis of pulmonary embolism were reviewed. Sixty patients with suboptimal enhancement (< 200 Hounsfeld Unit [HU]) were involved. Standard images (140 kVp) and VMI from 40 to 120 keV were generated. Attenuation, noise, signal to noise ratio (SNR) and contrast to noise ratio (CNR) were measured in the pulmonary artery. Using VMIs, the best image was determined as the image with the main pulmonary artery opacification greater than 200 HU and image quality ≥ 3. Fifty six studies that met these criteria were considered as salvaged. At this best energy level, quantitative parameters were compared with standard images. Results: The mean attenuation of pulmonary arteries was 169.80 HU in standard images in patients with suboptimal enhancement. The attenuations of VMIs at 40, 45, 50, 55, 60, 65, and 70 keV were significantly higher than standard images (P < 0.001). Similar findings were observed with SNR and CNR. In the salvaged patients, the average increase in mean pulmonary artery attenuation was 62% (from 172.61 ± 23.4 to 280.55 ± 40.7), the average increase in SNR was 38% (from 12.1 ± 5.3 to 16.7 ± 7.1) and the average increase in CNR was 48% (9.2 ± 4.3 to 13.7 ± 6) (P < 0.001). Conclusions: Low keV VMI reconstructions significantly increase pulmonary artery attenuation, CNR and SNR compared to standard image reconstructions. Suboptimal CT studies could be salvaged using low keV VMIs.

[No Abstract Available]

A new type of coronavirus 2019-nCoV is rapidly spreading worldwide and causes pneumonia, respiratory distress, thromboembolic events, and death. Chest computed tomography CT plays an essential role in the diagnosis of viral pneumonia, monitoring disease progression, determination of disease severity, and evaluating therapeutic efficacy. Chest CT can show important clues of 2019-nCoV disease also known as COVID-19 in patients with an appropriate clinic. Prompt diagnosis of COVID-19 is essential to prevent disease transmission and provides close clinical observation of patients with clinically severe disease. Therefore, radiologists and clinicians should be familiar with the CT imaging findings of COVID-19 pneumonia. Herein, we aimed to review the imaging findings of COVID-19 pneumonia and examine the critical points to be considered for imaging in cases with COVID-19 suspicion.

OBJECTIVETo determine the prognostic and/or predictive role of 18F-FDG PET/CT parameters, such as SUVmax, SUVmean, Metabolic Tumor Volume (MTV) and Total Lesion Glycolysis (TLG=MTVxSUVmean), for the patients with locally advanced rectal cancer (LARC) treated with neoadjuvant radiotherapy±chemotherapy.METHODSBetween January 2005 and December 2016, a total of 106 patients with clinical T3-4 and/or N+ rectal cancer without distant metastasis were included in this study. Correlation between metabolic and volumetric parameters and tumor characteristics was evaluated. Prognostic factors for overall sur-vival (OS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were analyzed.RESULTSThe median follow-up duration for all patients was 39.0 months (range, 6–103 months). Pathologic complete response (pCR) was defined as the absence of viable cancer cells in the resected specimen (ypT0N0). pCR was achieved in 17% of all cases (18/106). There was a weak correlation between SUV-max of primary tumor and MTV ([r]=0.238; p

Purpose Given the lack of information about abdominal imaging findings and correlation with clinical features of COVID-19, we aimed to evaluate the changes in hepatic attenuation during the course of disease. Our aim was to correlate the liver-to-spleen ratio (L/S), clinical, laboratory findings, and lung CT scores of patients with COVID-19 who had two consecutive chest CTs. Methods A retrospective search was performed between March 1, 2020 and April 26, 2020 to identify patients who had positive RT-PCR tests and two unenhanced chest CTs. Scans that were obtained at hospital admission and follow-up were reviewed to assess L/S and lung CT scores. Patients were divided into two groups based on lung CT scores (non-progressive vs progressive). Patient demographics, laboratory findings, length of hospital stay, and survival were noted from electronic medical records. Results Twenty patients in the progressive group and 7 patients in the non-progressive group were identified. the mean L/S of the progressive group (1.13 +/- 0.3) was lower than that of the non-progressive group (1.21 +/- 0.29) at hospital admission but there was no significant difference between the two groups (p = 0.547). L/S at follow-up was significantly different between the groups as the mean L/S values of the progressive and non-progressive groups were 1.02 +/- 0.23 and 1.25 +/- 0.29, respectively (p = 0.009). L/S was negatively correlated with AST and ALT (r = - 0.46,p = 0.016 andr = - 0.534,p = 0.004, respectively). There were significant differences between the two groups in terms of WBC, neutrophil, lymphocyte, monocyte, and platelet counts that were obtained at hospital admission. Length of hospital stay was significantly longer in patients in the progressive group (p = 0.035). Conclusions Decrease in L/S may be observed in patients with elevated lung CT scores at follow-up. WBC, neutrophil, lymphocyte, monocyte, and platelet counts at hospital admission may predict the progression of COVID-19.

[Abstract Not Available]

Aims Patients with idiopathic pulmonary fibrosis (IPF) receiving antifibrotic medication and patients with non-IPF fibrosing lung disease often demonstrate rates of annualised forced vital capacity (FVC) decline within the range of measurement variation (5.0%-9.9%). We examined whether change in visual CT variables could help confirm whether marginal FVC declines represented genuine clinical deterioration rather than measurement noise. Methods in two IPF cohorts (cohort 1: n=103, cohort 2: n=108), separate pairs of radiologists scored paired volumetric CTs (acquired between 6 and 24 months from baseline). Change in interstitial lung disease, honeycombing, reticulation, ground-glass opacity extents and traction bronchiectasis severity was evaluated using a 5-point scale, with mortality prediction analysed using univariable and multivariable Cox regression analyses. Both IPF populations were then combined to determine whether change in CT variables could predict mortality in patients with marginal FVC declines. Results on univariate analysis, change in all CT variables except ground-glass opacity predicted mortality in both cohorts. on multivariate analysis adjusted for patient age, gender, antifibrotic use and baseline disease severity (diffusing capacity for carbon monoxide), change in traction bronchiectasis severity predicted mortality independent of FVC decline. Change in traction bronchiectasis severity demonstrated good interobserver agreement among both scorer pairs. Across all study patients with marginal FVC declines, change in traction bronchiectasis severity independently predicted mortality and identified more patients with deterioration than change in honeycombing extent. Conclusions Change in traction bronchiectasis severity is a measure of disease progression that could be used to help resolve the clinical importance of marginal FVC declines., Wellcome Trust Clinical Research Career Development FellowshipWellcome Trust [209553/Z/17/Z]; MRC eMedLab Medical Bioinformatics Career Development Fellowship; Medical Research CouncilMedical Research Council UK (MRC) [MR/L016311/1]; European Union's Horizon 2020 research and innovation program [666992]; National Institute for Health Research Biomedical Research Centre at the University of Southampton, JJ was supported by a Wellcome Trust Clinical Research Career Development Fellowship (209553/Z/17/Z). AA holds an MRC eMedLab Medical Bioinformatics Career Development Fellowship. This work was supported by the Medical Research Council (grant number MR/L016311/1). This project has received funding from the European Union's Horizon 2020 research and innovation program (grant agreement number 666992). CJB and MGJ were supported by the National Institute for Health Research Biomedical Research Centre at the University of Southampton.

Aim: Congenital cardiovascular (CV) anomalies and aortic dilatation are common in patients with Turner syndrome. the aim of this study was to compare echocardiography (ECHO) findings with CV anomalies and aortic dilatation identified using magnetic resonance imaging (MRI) in children and young adults with Turner syndrome. Materials and Methods: Twenty-six girls with Turner syndrome aged 11-20 years were recruited through tertiary centers. CV anomalies and aortic diameter were evaluated using CV-MRI. Auxological measurements, karyotype analyses, medical therapies (growth hormone, estrogen, and thyroid replacement therapy) and transthoracic ECHO findings were recorded for all participants. Results: Normal cardiac anatomy was identified in 16 (61.5%) of our 26 cases, with no cardiac pathology being identified via either CV-MRI or ECHO. CV anomalies were identified in 5 of the 26 (19.2%) patients via CV-MRI. Aortic dilatation was determined in four patients (one with descending and ascending aorta, one with ascending aorta, and two with descending aorta). Aortic size index was

Purpose To evaluate the predictive value of adaptive threshold-based metabolic tumor volume (MTV), maximum standardized uptake value (SUVmax) and maximum lean body mass corrected SUV (SULmax) measured on pretreatment positron emission tomography and computed tomography (PET/CT) imaging in head and neck cancer patients treated with definitive radiotherapy/chemoradiotherapy. Materials and methods Pretreatment PET/CT of the 62 patients with locally advanced head and neck cancer who were treated consecutively between May 2010 and February 2013 were reviewed retrospectively. The maximum FDG uptake of the primary tumor was defined according to SUVmax and SULmax. Multiple threshold levels between 60% and 10% of the SUVmax and SULmax were tested with intervals of 5% to 10% in order to define the most suitable threshold value for the metabolic activity of each patient's tumor (adaptive threshold). MTV was calculated according to this value. We evaluted the relationship of mean values of MTV, SUVmax and SULmax with treatment response, local recurrence, distant metastasis and disease-related death. Receiver-operating characteristic (ROC) curve analysis was done to obtain optimal predictive cut-off values for MTV and SULmax which were found to have a predictive value. Local recurrence-free (LRFS), disease-free (DFS) and overall survival (OS) were examined according to these cut-offs. Results Forty six patients had complete response, 15 had partial response, and 1 had stable disease 6 weeks after the completion of treatment. Median follow-up of the entire cohort was 18 months. Of 46 complete responders 10 had local recurrence, and of 16 partial or no responders 10 had local progression. Eighteen patients died. Adaptive threshold-based MTV had significant predictive value for treatment response (p = 0.011), local recurrence/progression (p = 0.050), and disease-related death (p = 0.024). SULmax had a predictive value for local recurrence/progression (p = 0.030). ROC curves analysis revealed a cut-off value of 14.00 mL for MTV and 10.15 for SULmax. Three-year LRFS and DFS rates were significantly lower in patients with MTV ≥ 14.00 mL (p = 0.026, p = 0.018 respectively), and SULmax ≥ 10.15 (p = 0.017, p = 0.022 respectively). SULmax did not have a significant predictive value for OS whereas MTV had (p = 0.025). Conclusion Adaptive threshold-based MTV and SULmax could have a role in predicting local control and survival in head and neck cancer patients.

WOS: 000430070100001, Objective: Bone marrow (BM) involvement is one of the most important prognostic factors in lymphoma patients. Therefore, it is important to determine the presence of BM involvement in lymphoma patients at the time of diagnosis. Bone marrow biopsy (BMB) is still accepted as the gold standard for evaluating the marrow but it is painful and invasive. In this retrospective study, we aimed to evaluate the role of positron emission tomography combined with computed tomography (PET/CT) in evaluating the BM involvement in lymphoma patients at the initial staging. Patients and Methods: The patients who were evaluated by PET/CT and bone marrow biopsy at time of diagnosis were enrolled in the study. Results: The overall sensitivity of PET/CT in demonstrating BM involvement was 65.8%, and the specificity was 89.4%. In the subgroup analysis of 176 Hodgkin lymphoma (HL) patients, the sensitivity and specificity of the PET/CT were 81% and 84% respectively. Negative predictive value was 98%. In 201 diffuse large B cell lymphoma (DLBCL) patients, the sensitivity and specificity of the test were 91.3% and 94.3%, respectively. Negative predictive value was 98.8%. Conclusion: PET/CT is an accurate and complementary modality with high specificity and sensitivity in detecting BM infiltration in HL and DLBCL patients.

Amaç: Kemik iliği (Kİ) tutulumu, lenfoma hastalarında en önemli prognostik faktörlerden biridir. Bu nedenle, tanı anında Kİ tutulumunun gösterilmesi önemlidir.Kemik iliği biyopsisi (KİB) tutulumu göstermede altın standart kabul edilmesine rağmen invaziv ve ağrılı bir yöntemdir. Bu retrospektif çalışmada, tanı anında evreleme amacıyla çekilen PET/CT'nin Kİ tutulumunu göstermedeki yerini araştırdık.Hastalar ve Yöntemler : Tanı anında PET/CT ve KİB yapılan hastalar çalışmaya alındı.Bulgular: PET/CT'nin lenfoma hastalarının Kİ tutulumunu göstermedeki sensitivitesi %65.8, spesifisitesi ise %89.4 idi. Altgrup analizi yapıldığında; 176 Hodgkin lenfoma hastasında sensitivite %81 ve spesifisite %84 olarak bulundu. Negatif prediktif değer %98 idi. 201 diffüz büyük B hücreli lenfoma hastasında ise, sensitivite ve spesifisite sırasıyla %91.3 ve %94.3 idi. Negatif prediktif değer %98.8 olarak hesaplandı.Sonuç: PET/CT özellikle Hodgkin lenfoma ve difüz büyük B hücreli lenfoma hastalarında yüksek sensitivite ve spesifisitesi ile tamamlayıcı ve değerlendirilmesi gereken bir yöntemdir., Objective: Bone marrow (BM) involvement is one of the most important prognostic factors in lymphoma patients. Therefore, it is important to determine the presence of BM involvement in lymphoma patients at the time of diagnosis. Bone marrow biopsy (BMB) is still accepted as the gold standard for evaluating the marrow but it is painful and invasive. In this retrospective study, we aimed to evaluate the role of positron emission tomography combined with computed tomography (PET/CT) in evaluating the BM involvement in lymphoma patients at the initial staging.Patients and Methods: The patients who were evaluated by PET/CT and bone marrow biopsy at time of diagnosis were enrolled in the study.Results: The overall sensitivity of PET/CT in demonstrating BM involvement was 65.8%, and the specificity was 89.4%. In the subgroup analysis of 176 Hodgkin lymphoma (HL) patients, the sensitivity and specificity of the PET/CT were 81% and 84% respectively. Negative predictive value was 98%. In 201 diffuse large B cell lymphoma (DLBCL) patients, the sensitivity and specificity of the test were 91.3% and 94.3%, respectively. Negative predictive value was 98.8%.Conclusion: PET/CT is an accurate and complementary modality with high specificity and sensitivity in detecting BM infiltration in HL and DLBCL patients.

Background: In this study, we aimed to determine the correlation between supraclavicular lymph node involvement (SLNI) and metastatic potential, frequency, and metastases predilection sites in patients diagnosed with various head and neck tumors (HNT) and staged via positron emission tomography/computed tomography (PET/CT) imaging. We also investigated the impact of different variables on SLNI. Patients and Methods: 270 patients diagnosed with HNT were enrolled in the study (194 males and 96 females, mean age 54.9 ± 14.7 years (range 18-89 years)). Results: Nasopharyngeal carcinoma demonstrated significant SLNI (p < 0.01); however, other subtypes of HNT did not. In all HNT studied, no apparent metastatic predilection tendency for the supraclavicular region was observed, as opposed to the well-described Virchow's node. Age, gender, tumor size, and systemic metastases were not identified as statistically significant variables contributing to SLNI. Multivariate regression analysis revealed an increased cervical (p < 0.01) and thoracic (p = 0.001) lymph node involvement in patients with SLNI. Conclusion: SLNI with the possibility of metastasis was more frequently observed in nasopharyngeal carcinoma, advancing the nodal status without significantly influencing the T and M stages. A careful evaluation of this very small region is of critical importance for proper nodal staging in nasopharyngeal cancer patients.