value of three-dimensional helical ct image-guided planning for made-to-order lumpectomy in breast...
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technique, and the limitations of diffusion tensor imaging and anisotropic
diffusion-weighted MRI are presented and their applications in various
neurological and neurosurgical diseases are discussed with special emphasis
on the visual system. A special focus is laid on the combination of fiber tract
imaging, anatomical imaging, and functional MRI for presurgical planning
and intraoperative neuronavigation of lesions near the visual system.
Orbital pathology
Muller-Forell W, Pitz S. (Institute for Neuroradiology, Medical School
University of Mainz, Langenbeckstrasse 1, D-55101 Mainz, Germany). Eur
J Radiol 2004;49:105–142.
This overview of orbital pathology deals with different kinds of tumors,
inflammatory, vascular, and traumatic diseases, which may involve the
orbit. Depending on the respective orbital compartment of the globe, the
intrakonal, extrakonal, and optic nerve, the most important and most
frequent lesions are presented with their specific clinical symptoms. Their
specific presentation on CT and MR imaging is discussed in detail,
including the most important differential diagnosis.
Intracranial pathology of the visual pathway
Muller-Forell W. (Institute of Neuroradiology, Medical School University of
Mainz, Langenbeckstrasse 1, D-55101 Mainz, Germany). Eur J Radiol
2004;49:143–178.
Intracranial pathologies involving the visual pathway are manifold. Align-
ing to anatomy, the most frequent and/or most important extrinsic and
intrinsic intracranial lesions are presented. Clinical symptoms and imaging
characteristics of lesions of the sellar region are demonstrated in different
imaging modalities. The extrinsic lesions mainly consist of pituitary
adenomas, meningiomas, craniopharyngiomas, and chordomas. In (asymp-
tomatic and symptomatic) aneurysms, different neurological symptoms
depend on the location of aneurysms of the circle of Willis. Intrinsic tumors
as astrocytoma of any grade, ependymoma, and primary CNS lymphoma
require the main pathology in the course of the visual pathway. Vascular
and demyelinating diseases complete this overview of intracranial lesions.
Mammographic features of breast cancer in young symptomatic
women
Zadelis S, Houssami N. (N.H.: Screening and Test Evaluation Program
(STEP), School of Public Health, A27, University of Sydney, New South
Wales 2006, Australia). Australas Radiol 2003;47:404–408.
The present study provides a descriptive analysis of the mammographic
appearance of breast cancer in women aged 30–39 years presenting with
symptoms, based on 65 cancers confirmed with histology. We correlate the
findings with clinical presentation and histological findings. We describe,
categorize and illustrate the different lesions seen on mammography. Our
study shows that microcalcification, with or without associated masses, is a
dominant feature of breast cancer visualized on mammography in women in
this age group.
Value of three-dimensional helical CT image-guided planning for
made-to-order lumpectomy in breast cancer patients
Uematsu T, Sano M, Homma K, Sato N. (Division of Diagnostic Radiology,
Shizuoka Cancer Center Hospital, Naga-izumi, Shizuoka 411-8777, Japan).
Breast J 2004;10:33–37.
The authors reviewed Niigita Cancer Center Hospital’s experience treating
patients with lumpectomy to evaluate the utility of three-dimensional
helical computed tomography (3D-CT) image-guided made-to-order lum-
pectomy and determine a positive margin rate. From April 1993 to
September 2000, 251 breasts in 248 patients were treated with lumpectomy
with a 1-cm macroscopic free margin. In 213 breast (85%), 3D-CT image-
guided made-to-order lumpectomy was performed. Thirty-eight breasts
(15%) underwent a lumpectomy without 3D-CT. The lumpectomy spe-
cimen was sectioned at 5-mm intervals. Margin status was classified as
negative (no invasive or ductal carcinoma in situ (DCIS) within 2 mm from
the cut surface) or positive. Positive margins were classified as focally
positive (invasive or DCIS transected at the margin within 5 mm or one
slide) or massively positive. With 3D-CT image-guided lumpectomy, 21%
(45/213) of lesions had a positive margin and 42% (16/38) of lesions
without 3D-CT image-guided lumpectomy had a positive margin
( P= .0055). For lesions with massively positive margins, the rates were
9% (4/45) for 3D-CT image-guided lumpectomy and 38% (6/16) for
lumpectomy without ( P= .0152). 3D-CT image-guided made-to-order
lumpectomy decreased the positive surgical margin rate. Among patients
with positive margins, those with 3D-CT image-guided lumpectomy have
less residual cancer than those without 3D-CT.
Comparison of MRI and renal cortical scintigraphy findings in
childhood acute pyelonephritis: preliminary experience
Kovanlikaya A, Okkay N, Cakmakci H, Ozdogan O, Degirmenci B,
Kavukcu S. (H. C.: Department of Radiology, Dokuz Eylul University
School of Medicine, Inciralti, Izmir, Turkey). Eur J Radiol 2004;49:76–80.
Objective: The diagnosis of acute pyelonephritis in children remains a
clinical challenge. It may cause permanent renal scar formation and results
in the chronic renal failure if prompt diagnosis and treatment are delayed.
The purpose of this study is to compare magnetic resonance imaging (MRI)
and renal cortical scintigraphy (RCS) findings in childhood acute pyelo-
nephritis and to determine pyelonephritic foci in the acute phase.
Materials and methods: Twenty children (15 females and 5 males) with
symptoms dysuria, enuresis, costovertebral pain, fever of 37.5 �C or more,
and/or positive urine culture were imaged by unenhanced turbo spin echo
T2, spin echo T1-weighted, and pre- and postgadolinium inversion recovery
MRI and RCS. Both imaging techniques were read independently by two
radiologists and nuclear medicine specialists. Sensitivity and specifity of
MRI in detecting in detecting acute pyelonephritic foci and scar lesions
were calculated. Furthermore, in order to calculate the reliability of MRI
over RCS in differentiating scar tissue and acute pyelonephritic foci,
follow-up MRI studies were done in six patients after treatment of acute
pyelonephritis.
Results: Sensitivity and specificity of MRI in the detection of pyeloneph-
ritic lesions were found to be 90.9 and 88.8%, respectively. There is no
statistically significant difference in lesion detection between the two
diagnostic modalities ( P > .05).
Conclusion: Postgadolinium MR images show significant correlation with
RCS in the determination of renal pathology. Moreover, the ability of
discriminating acute pyelonephritic foci and renal scar in early stages of
disease is the superiority of MRI.
T2-weighted MR imaging of prostate cancer: multishot echo-planar
imaging vs. fast spin-echo imaging
Tamada T, Sone T, Nagai K, Jo Y, Gyoten M, Imai S, Kajihara Y,
Fukunaga M. (Department of Radiology, Kawasaki Medical School, 577
Matsushima, 701-0192 Kurashiki City, Okayama, Japan). Eur Radiol 2004;
14:318–325.
The aim of the present study was to assess the performance of prebiopsy
T2-weighted MR imaging using multishot echo-planar imaging (EPI)
sequence for visualization of prostate cancer and to compare image quality
with that of fast spin-echo (FSE) sequence. Thirty-nine patients with
Abstracts / Journal of Clinical Imaging 28 (2004) 231–233232