Benign Lesions Research Articles

Evaluation of the diagnostic role of radial probe endobronchial ultrasound for peripheral pulmonary lesions.

To evaluate the predictive value of echo features of radial probe endobronchial ultrasound (RP-EBUS) in the differential diagnosis of malignant and benign 1esions. The clinical data of 336 patients with peripheral pulmonary lesions (PPLs) undergoing RP-EBUS were analyzed in order to evaluate the predictive value of the three EBUS echo features including continuous margin, absence of a linear-discrete air bronchogram, and heterogeneous in pulmonary lesions. The sensitivity and specificity for each echoic feature or in combination in diagnosing malignancy or benignity were determined. 336 cases of PPLs including 216 cases of malignant lesions and 120 cases of benign lesions. The sensitivity and specificity of the continuous margin to the diagnosis of malignant lesions were 86.11% and 17.50%. The sensitivity and specificity of the absence of a linear-discrete air bronchogram to the diagnosis of malignant lesions were 66.67% and 57.50%, and the positive predictive value was 73.85%. The sensitivity and specificity of heterogeneity to the diagnosis of malignant lesions were 65.28% and 72.50%, and the positive predictive value was 81.03%. The combination of heterogeneous and absence of a linear-discrete air bronchogram could improve the diagnostic specificity to 87.50%, and the positive predictive value to 80.77%. The two EBUS echo features of heterogeneous and absence of a linear-discrete air bronchogram have predictive value for PPLs, especially in the presence of two features the pulmonary lesions should be highly suspected malignant tumors.

A contrast-enhanced computed tomography-based radiomics nomogram for preoperative differentiation between benign and malignant cystic renal lesions.

There is lack of discrimination as to traditional imaging diagnostic methods of cystic renal lesions (CRLs). This study aimed to evaluate the value of machine learning models based on clinical data and contrast-enhanced computed tomography (CECT) radiomics features in the differential diagnosis of benign and malignant CRL. There were 192 patients with CRL (Bosniak class ≥ II) enrolled through histopathological examination, including 144 benign cystic renal lesions (BCRLs) and 48 malignant cystic renal lesions (MCRLs). Radiomics features were extracted from CECT images taken during the medullary phase. Using the light gradient boosting machine (LightGBM) algorithm, the clinical, radiomics and combined models were constructed. A comprehensive nomogram was developed by integrating the radiomics score (Rad-score) with independent clinical factors. Receiver operating characteristic (ROC) curves were plotted. The corresponding area under the curve (AUC) value was worked out to quantify the discrimination performance of the three models in training and validation cohorts. Calibration curves were worked out to assess the accuracy of the probability values predicted by the models. Decision curve analysis (DCA) was worked out to assess the performance of models at different thresholds. Maximum diameter and Bosniak class were independent risk factors of patients with MCRL in the clinical model. Twenty-one radiomics features were extracted to work out a Rad-score. The performance of the clinical model in the training cohort was AUC =0.948, 95% confidence interval (CI): 0.917-0.980, and the performance in the validation cohort was AUC =0.936, 95% CI: 0.859-1.000 (P<0.05). The performance of the radiomics model in the training cohort was AUC =0.990, 95% CI: 0.979-1.000, and the performance in the validation cohort was AUC =0.959, 95% CI: 0.903-1.000 (P<0.05). Compared with the above models, the combined radiomics nomogram had an AUC of 0.989 (95% CI: 0.977-1.000) in the training cohort and an AUC of 0.962 (95% CI: 0.905-1.000) in the validation cohort (P<0.05), showing the best diagnostic efficacy. The radiomics nomogram integrating clinical independent risk factors and radiomics signature improved the diagnostic accuracy in differentiating between BCRL and MCRL, which can provide a reference for clinical decision-making and help clinicians develop individualized treatment strategies for patients.

Spinal aneurysmal bone cysts - case series.

Aneurysmal bone cysts are benign neoplastic lesions that are extensively vascularized and can occasionally exhibit destructive and expanding activity. They typically affect young people, with a small predilection toward females, and most frequently arise during the second decade of life. Aneurysmal bone cysts account for about 1% of all bone tumors and usually develop in long tubular bones, with the spine being much less commonly affected.

Mastite xantogranulomatosa em fêmea canina

Xanthogranulomatous mastitis (MXG) is a rare chronic inflammatory condition of the breast. In women, it raises concern and requires a biopsy due to the clinical-radiological similarity with breast neoplasia. The definitive diagnosis is given through histopathological examination. In canine females, chronic benign non-neoplastic lesions in the mammary glands are not frequently described, such as MXG. The objective of this work is to describe the clinicopathological findings of a case of xanthogranulomatous mastitis in a female canine. The case occurred in a female Pinscher breed, 8 years old, not castrated, who presented irregular heat, in addition to a history of galactorrhea and treatment with antigalactogenic drugs. The physical examination revealed the presence of a nodule in the left mammary chain, affecting the caudal thoracic mammary gland (M2E). Due to the fear that it was a malignant neoplasm, the treatment was a radical mastectomy of the left mammary chain, followed by an anatomopathological examination of all glands. Histologically, the M2E nodule was made up of cracks and cholesterol crystals associated with the presence of numerous lipid-laden macrophages and multinucleated giant cells, characterizing it as xanthogranulomatous mastitis.

The diagnostic accuracy of conventional breast ultrasound in Diagnosing Malignant Breast Lesions Taking Histopathology as Gold Standard

Breast cancer is a prominent worldwide health issue, with difficulties in detection worsened by the presence of dense breast tissue. Ultrasound and other alternative diagnostic methods have demonstrated potential to enhance detection rates, especially in situations involving thick breast tissue. Objective: To evaluate how well conventional breast ultrasonography can accurately differentiate between benign and malignant tumors, using histopathology as the most reliable method of comparison. Methods: A cross-sectional study was conducted at a tertiary care hospital to evaluate 185 female patients with breast lesions using sonographic examination. Demographic information, ultrasonography results and histopathological data were gathered and examined using SPSS version 26.0. Calculations were performed to determine the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy. Results: The study demonstrated that conventional breast ultrasound has a high diagnostic accuracy rate, with ratings of 91.07%, 83.57%, 89.47%, 85.92%, and 88.11% for sensitivity, specificity, positive predictive value and negative predictive value, respectively. Statistically significant differences in diagnostic accuracy were observed when stratification was performed based on age, duration of disease, parity, and history of breastfeeding. Conclusions: The findings indicated that ultrasound is highly effective in differentiating between benign and malignant breast lesions, with substantial diagnostic precision. However, false positives remain a concern, necessitating ongoing research for optimizing ultrasound efficacy, especially in high-risk cohorts.

Management strategies in benign eyelid lesions

Eyelid tumors are a common discovery during an ophthalmological or dermatological examination. According to available knowledge, they constitute about 5–10% of skin tumors. The majority of them are benign and can be classified as inflammatory, infectious, traumatic or neoplastic lesions. Depending on the lesion type, there are different approaches to management that include: observation, topical application of steroids or antibiotics, injection of steroids, application of warm compresses, biopsy, excision, curettage, various types of laser therapy or plasma-based therapies, cryosurgery and electrocautery. Malignant eyelid tumors are not rare, therefore, an accurate diagnosis is crucial to provide best suited type of treatment. In many cases, an experienced physician is able to distinguish a benign lesion basing on clinical examination, however, it is often difficult to differentiate benign tumors from malignant and premalignant lesions. In case of any uncertainty, a biopsy followed by histopathological examination should always be taken into consideration.

Radiologist Accuracy in Predicting Pathology in Breast Imaging

Introduction: Breast cancer, the most prevalent cancer in women and second only to lung cancer in female mortality, has seen rising incidence, especially during the 1980s and 1990s due to increased mammography screening. Screening’s primary goal is early tumor detection, reducing mortality by over 40%. Yet, it has downsides, including false-positive cases of benign biopsies and potential increased patient anxiety and stress. The average recall rate from screening mammograms is 5-10%. Among women requiring biopsy, the anticipated rate of malignant findings range between 30-50%. With the evolution of image-guided breast biopsy techniques, concerns have risen regarding the escalating frequency of breast biopsies. The possible causes are overlapping imaging characteristics of benign and malignant pathologies, patients’ anxiety, litigation risk and radiologist years of experience. A radiologists’ ability to predict breast histology from imaging findings remains an understudied domain. This study’s core purpose is to comprehensively analyze the ability of a radiologist to predict benign versus malignant results to provide guidance in reducing the number of benign biopsies. Methods: This prospective study involved radiologists completing survey sheets when recommending biopsies and when performing the biopsy, predicting benign vs malignant, specific pathology, with confidence interval. Predictions were compared to the final biopsy results to determine accuracy. All patients who underwent biopsy at our institutions were included in the data. Data was categorized as either concordant or discordant when comparing predicted pathology results to actual. Results: The accuracy of radiologist prediction from initial diagnostic imaging when compared to actual pathology results in the study population is 71% (95% CI,61.8%-79.37%) with a sensitivity of 75 % (95% CI, 60.4%-86.36%). The accuracy of radiologist prediction at biopsy when compared to actual pathology results is 80.79% (95% CI, 75.89%-85.08%) with sensitivity of 79.77% (95% CI, 73%-85.49%). The accuracy of less to moderately experienced radiologists to highly experienced radiologists is similar, 78.2% vs 81.0%. Further analysis of specific pathology prediction reveals that fibroadenoma is the most common benign pathology encountered, the prediction of which by imaging alone/at biopsy is 65%/68%. In the malignant category, invasive ductal carcinoma is the most common pathology encountered where the prediction is 68%/85%. Conclusions: This data will potentially help radiologists gain confidence in watching likely benign lesions based on imaging features (assigned as BIRADS 3) to reduce benign biopsies.

Contrast-Enhanced Ultrasound in the Diagnosis of Solid Renal Lesions.

The availability of imaging methods has enabled increased detection of kidney lesions, which are a common clinical problem. It is estimated that more than half of patients over the age of 50 have at least one undetermined mass in the kidney. The appropriate characterization and diagnosis of lesions imaged in the kidney allows for proper therapeutic management. Previously, contrast-enhanced computed tomography (CT) and contrast-enhanced magnetic resonance imaging (MRI) have been used in their extended diagnosis. However, the limitations of these techniques, such as radiation exposure, renal toxicity, and allergies to contrast agents, must be considered. Contrast-enhanced ultrasound (CEUS) is increasingly being used as an examination to resolve interpretive doubts that arise with other diagnostic methods. Indeed, it can be considered both as a problem-solving technique for diagnosing and distinguishing lesions and as a technique used for observation in preservative treatment. Evaluation of the enhancement curve over time on CEUS examination can help to differentiate malignant renal cell carcinoma (RCC) subtypes that should be resected from benign lesions, such as oncocytoma or angiomyolipoma (AML), in which surgery can be avoided. It allows for distinguishing between benign and malignant tumors, renal and pseudotumors, and solid and cystic tumors. Therefore, with recent advances in ultrasound technology, CEUS has emerged as a fast, reliable, and cost-effective imaging tool in the preoperative evaluation and diagnosis of solid renal masses.

Ultrasound as a standalone tool for the management of pediatric calvarial dermoid cysts.

Calvarial dermoid and epidermoid cysts are benign lesions common in pediatric neurosurgery. Diagnosis is primarily clinical, with frequent but inconsistent use of imaging. Dermoids have been shown to possess distinct sonographic features, but ultrasound (US) remains underutilized in their management. The purpose of this study is to investigate the independent reliability of US in managing pediatric calvarial dermoids and distinguishing them from other calvarial lesions. A retrospective review of consecutive patients ≤ 21years of age with surgically resected calvarial masses between 2017-2024 was performed. Demographic, clinical, and imaging data were analyzed. Pearson chi-squared tests were used for comparison of categorical variables and a binomial linear model was generated controlling for age, lesion tenderness, growth, and suture location. Fifty-nine patients with 61 lesions (31 in females; median age 13months) were included. Dermoids were more common in younger patients (median age 12months), along suture lines, and were less likely to present with tenderness (p < 0.001) or rapid growth (p = 0.003). Ultrasound was used in 83% of cases and was the sole imaging modality in 33%. On multivariate analysis, suture location was a significant positive predictor of a dermoid diagnosis (OR = 8.08, 95% CI = 1.67-44.18), while rapid growth was a significant negative predictor (OR = 0.08, 95% CI = 0.003-0.80). Ultrasound presents a sensitive and reliable method for the evaluation of most pediatric calvarial lesions, especially dermoid cysts, and warrants being part of standard workup. With appropriate patient selection, US obviates the need for additional imaging in pediatric patients.

Microwave ablation of synovial hypertrophy in recurrent monoarthritis: the results of extended cohort and long-term follow-up

Abstract Objectives Recurrent monoarthritis (RM) is a major challenge of many rheumatic diseases. Ablation is a well-known technique in the treatment of benign or malign lesions of different aetiologies. We aimed to investigate the success and safety of microwave ablation (MWA) as an adjunctive therapy in a cohort of medical treatment-resistant RM. Methods Patients with RM associated with different inflammatory diseases were included. MWA was performed after measuring the size of synovial hypertrophy with 15 or 20 W power and different durations until microbubbles were shown, indicating necrosis. Both clinical and radiologic data were recorded. Results We applied MWA in total of 24 knee joints of 10 female and 12 male patients aged between 22 and 71 years. Median IA aspiration (IAA) need in the last 6 months before MWA was 5 (0–15). The median follow-up was 10 (3–16) months. Overall IAA count in the last 6 months before MWA in total of 144 months was 129, and decreased to 7 in post-MWA in total of 226 months (0.89 vs 0.03 per month, P &amp;lt; 0.001). The second MWA session was needed for three patients and a third session for one. Functional disability and pain scores were improved significantly (median score from 9 to 1, P &amp;lt; 0.00001, in both). In MRI, follow-up significant regression in synovial hypertrophy size was shown especially after the 6th month. No complication was observed during the procedure or follow-up. Conclusion As a less invasive technique compared with the surgical approach, MWA of synovial hypertrophy showed significant clinical improvement in RM safely. MWA seems promising as a treatment option candidate in the management of RM.

Multimodal breast cancer risk classifier based on biomaterial impedance analysis

Purpose of the research. Breast cancer is the most common malignant tumor among women in Europe and its early detection plays a leading role in reducing mortality rates. Currently, X-ray mammography is the standard screening method for detecting breast cancer. However, due to the morphological similarities between benign and malignant lesions, many of the positive screening mammograms are false positive (up to 40%). Therefore, automation and intellectualization of this process is an urgent task.Methods. The presented studies examine the problems of finding new, highly sensitive, prompt and non-invasive methods for detecting malignant tumors, based on the use of modern computer and telecommunication technologies, which make it possible not only to identify early manifestations of a pathological focus, but also to monitor the process of the effectiveness of therapy without significant harm to the patient’s health.Results. The presented model of a multi-channel classifier integrates the capabilities of multi-frequency bioimpedance measurements and matrix acquisition of information from the surface of human skin through multi-electrode matrix systems. To do this, based on a matrix of electrodes, 3D mapping of the skin surface in problem areas is carried out. Through multi-frequency scanning, we obtain a three-dimensional bioimpedance image, which is analyzed by a convolutional neural network and/or by a decision maker. The proposed solution allows simultaneous analysis of data by an expert (bioimpedance image) and a convolutional neural network (trained classifier), which leads to a reduction in false positive results.Conclusion. The possibilities of multichannel monitoring open up prospects for constructing impedance multidimensional "portraits" of malignant tumors. To classify “portraits” (diagnostics and preclinical diagnostics), methods and algorithms for image recognition and classification are used.

Cadaveric Study: Sign of Leser-Trélat Associated with Breast Cancer

INTRODUCTION: Seborrheic keratoses (SK) is considered the most common benign skin lesions found in individuals that are middle aged and older. In dermatology practice, these lesions pose no threat to the individual but can be concerning for cosmetic and underlying malignancy reasons when they cover most of the skin surface. Of specific concern is the sign of Leser-Trélat, which has been documented as a cutaneous harbinger of underlying malignancy associated with proliferation of the size and/or number seborrheic keratoses. The rare sign is usually caused by malignancies such as gastrointestinal adenocarcinoma, but also lung, kidney, liver, or pancreatic cancer. This case report will describe the histology of the skin lesions in Lesar Trélat and analyze the current literature regarding its association with breast cancer, which is quite rare. RESOURCES: For this case study, a cadaver from the body donor program in Philadelphia College of Osteopathic Medicine (PCOM), South Georgia was used. Skin samples were sent to Colquitt Regional Center for processing, where sections were embedded in paraffin and were stained with H&amp;E stain. A pathologist reported histopathological findings of the skin lesions and the breast tissue samples. DESCRIPTION: Multiple SK lesions covering the face, abdomen, back, as well as both upper and lower extremities were observed in one of the cadavers in the gross anatomy laboratory. Due to the significant number of pigmented, verrucous lesions, the sign of Leser-Trélat was clinically postulated, later confirmed during routine laboratory dissection of the breast tissue. Histology sections confirmed not only multiple SK lesions in the skin, but also revealed an associated breast cancer in the form of an infiltrative ductal carcinoma. SIGNIFICANCE: The sign of Leser-Trélat is rare by itself and its association with breast cancer is even more uncommon. Once a clinician recognizes the multiple SK eruptions, the patient should be meticulously investigated for not only for an underlying GI malignancy, but also for other cancers like breast cancer. Additionally, a case report confirmed malignant melanoma that mimicked sign of Leser-Trélat, warranting the importance of further analyzing the pathology diagnosis when there is a proliferation of multiple seborrheic keratoses.Therefore, biopsy and histology diagnosis is crucial for ruling out both cutaneous as well as underlying malignancies and should be encouraged when patients present in clinic rather than assuming the typical benign characteristics of seborrheic keratosis.

Cutaneous Ciliated Cysts: 2 Case Reports and Review of Literature.

Cutaneous ciliated cysts are rare benign lesions most commonly seen in the lower extremities of young female patients. There is still ongoing debate about the origin of these cysts, with the most common theories being Mullerian heterotopia and eccrine gland metaplasia. To further increase the data pool, we present 2 new cutaneous ciliated cyst cases and gathered data about all 67 cases of literature. We want to highlight that immunohistochemistry and demographic information may play a key role in distinguishing between the 2 possible origins of this cyst, namely estrogen receptor, progesterone receptor, and carcinoembryonic antigen immunohistochemistry. Estrogen receptor and progesterone receptor nuclear positivity is proof of Mullerian origin, but when they are negative with a positive carcinoembryonic antigen, the most likely origin is eccrine gland metaplasia. We advocate using the terms "Cutaneous Mullerian Cyst" and "Ciliated Cutaneous Eccrine Cyst" instead of "Cutaneous Ciliated Cyst" to accurately indicate their distinct origins.

Diagnostic yield and complication rates of percutaneous transthoracic CT-guided coaxial needle biopsy in persistent pulmonary consolidation.

To investigate the diagnostic performance and complication rates of percutaneous transthoracic CT-guided coaxial core needle biopsy (PTCNB) in persistent consolidations and evaluate its safety in routine clinical practice. A total of 685 patients (404 males, 281 females) underwent PTCNB with coaxial core technique for persisted consolidation were reviewed in this study. According to histopathological and microbiological analysis, the results of biopsy specimens were categorized as follows: malignant, specific benign, non-specific benign and non-diagnostic. The final diagnosis was established through surgical resection or clinicoradiological follow-up for at least 12months following biopsy. Diagnostic yield of PTCNB was defined as the percentage of the true diagnosis from biopsy as malignant and specific benign lesions. With respect to the final diagnosis, 54 (54/685; 7.88%) cases were obtained by surgery and the remaining were by follow-up. The total accuracy, sensitivity, specificity of PTCNB for malignancy diagnosis was 94.45%, 84.87%, 100%, respectively. Diagnostic yield of PTCNB was 66.28%. Compared to lesions smaller than 3cm, higher diagnostic yield (70.89%), lower complication incidence (38.22%) and shorter procedure time (8.78min) were observed in lesions ≥ 3cm group. PTCNB in persistent consolidation is a safe and effective procedure, which provide relatively high diagnostic yield and acceptable complication, especially in size over 3cm lesions. CT-guided coaxial needle biopsy for pulmonary consolidation is a safe and effective procedure. The coaxial needle biopsy yielded high diagnostic rates and low complication rates (including pneumothorax and intrapulmonary hemorrhage), especially in larger lesions.

A nomogram combining CT-based radiomic features with clinical features for the differentiation of benign and malignant cystic pulmonary nodules

BackgroundCurrently, the differentiation between benign and malignant cystic pulmonary nodules poses a significant challenge for clinicians. The objective of this retrospective study was to construct a predictive model for determining the likelihood of malignancy in patients with cystic pulmonary nodules.MethodsThe current study involved 129 patients diagnosed with cystic pulmonary nodules between January 2017 and June 2023 at the Neijiang First People’s Hospital. The study gathered the clinical data, preoperative imaging features of chest CT, and postoperative histopathological results for both cohorts. Univariate and multivariate logistic regression analyses were employed to identify independent risk factors, from which a prediction model and nomogram were developed. In addition, The model's performance was assessed through receiver operating characteristic (ROC) curve analysis, calibration curve analysis, and decision curve analysis (DCA).ResultsA cohort of 129 patients presenting with cystic pulmonary nodules, consisting of 92 malignant and 37 benign lesions, was examined. Logistic data analysis identified a cystic airspace with a mural nodule, spiculation, mural morphology, and the number of cystic cavities as significant independent predictors for discriminating between benign and malignant cystic lung nodules. The nomogram prediction model demonstrated a high level of predictive accuracy, as evidenced by an area under the ROC curve (AUC) of 0.874 (95% CI: 0.804–0.944). Furthermore, the calibration curve of the model displayed satisfactory calibration. DCA proved that the prediction model was useful for clinical application.ConclusionIn summary, the risk prediction model for benign and malignant cystic pulmonary nodules has the potential to assist clinicians in the diagnosis of such nodules and enhance clinical decision-making processes.

Artificial intelligence and skin melanoma

Melanoma is the deadliest skin cancer, presenting typically with changing pigmented areas and usually treated with surgical removal. As benign cutaneous pigmented lesions are very common in all populations, it can be challenging to identify which areas should be cut out or left untreated. Delayed treatment in melanoma increases the risk of death, but it is not possible to remove all lesions. Dermatoscopy uses polarized light and can be used to help distinguish melanomas from benign lesions. Dermatoscopy images with a confirmed diagnosis can be used to develop artificial intelligence (AI) as a medical device (AIaMD) tool. This contribution discusses the utilization of AI in melanoma management and describes an AIaMD tool used in current UK clinical practice on more than 80,000 patients. This is a springboard for discussing the scope, risks, and mitigations for future AI use by all clinicians involved in managing people with melanoma.

Correlation between the maximum standard uptake value and mean Hounsfield unit on single-photon emission computed tomography-computed tomography to discriminate benign and metastatic lesions among patients with breast cancer.

Retrospective study. To compare and correlate technetium-99m methylene diphosphonate uptake between benign and metastatic bone lesions using semiquantitative analysis of maximum standard uptake value (SUVmax) and mean Hounsfield unit (HU) in single-photon emission computed tomography-computed tomography (SPECT-CT). Qualitative interpretation of metastatic bone lesions in breast cancer on bone scintigraphy is often complicated by coexisting benign lesions. In total, 185 lesions were identified on bone and SPECT-CT scans from 32 patients. Lesions were classified as metastatic (109 sclerotic lesions) and benign (76 lesions) morphologically on low-dose CT. Semiquantitative analysis using SUVmax and mean HU was performed on the lesions and compared. To discriminate benign and metastatic lesions, the correlation between SUVmax and mean HU was determined using the intraclass correlation coefficients. The SUVmax was higher in metastatic lesions (20.66±14.36) but lower in benign lesions (10.18±12.79) (p<0.001). The mean HU was lower in metastatic lesions (166.62±202.02) but higher in benign lesions (517.65±192.8) (p<0.001). A weak negative correlation was found between the SUVmax and the mean HU for benign lesions, and a weak positive correlation was noted between the SUVmax and the mean HU on malignant lesions with no statistical significance (p=0.394 and 0.312, respectively). The cutoff values obtained were 10.8 for SUVmax (82.6% sensitivity and 84.2% specificity) and 240.86 for the mean HU (98.7% sensitivity and 88.1% specificity) in differentiating benign from malignant bone lesions. Semiquantitative assessment using SUVmax and HU can complement qualitative analysis. Metastatic lesions had higher SUVmax but lower mean HU than benign lesions, whereas benign lesions demonstrated higher mean HU but lower SUVmax. A weak correlation was found between the SUVmax and the mean HU on malignant and benign lesions. Cutoff values of 10.8 for the SUVmax and 240.86 for the mean HU may differentiate bone metastases from benign lesions.

The diagnostic performance of T1 mapping in the assessment of breast lesions: A preliminary study

PurposeTo assess T1 mapping performance in distinguishing between benign and malignant breast lesions and to explore its correlation with histopathologic features in breast cancer. MethodsThis study prospectively enrolled 103 participants with a total of 108 lesions, including 25 benign and 83 malignant lesions. T1 mapping, diffusion-weighted imaging (DWI), and dynamic contrast-enhanced (DCE) were performed. Two radiologists independently outlined the ROIs and analyzed T1 and apparent diffusion coefficient (ADC) values for each lesion, assessing interobserver reliability with the intraclass correlation coefficient (ICC). T1 and ADC values were compared between benign and malignant lesions, across different histopathological characteristics (histological grades, estrogen, progesterone and HER2 receptors expression, Ki67, N status). Receiver operating characteristic (ROC) analysis and Pearson correlation coefficient (ρ) were performed. ResultsT1 values showed statistically significant differences between benign and malignant groups (P < 0.001), with higher values in the malignant (1817.08 ms ± 126.64) compared to the benign group (1429.31 ms ± 167.66). In addition, T1 values significantly increased in the ER (−) group (P = 0.001). No significant differences were found in T1 values among HER2, Ki67, N status, and histological grades groups. Furthermore, T1 values exhibited a significant correlation (ρ) with ER (P < 0.01) and PR (P = 0.03). The AUC for T1 value in distinguishing benign from malignant lesions was 0.69 (95 % CI: 0.55 – 0.82, P = 0.005), and for evaluating ER status, it was 0.75 (95 % CI: 0.62 – 0.87, P = 0.002). ConclusionsT1 mapping holds the potential as an imaging biomarker to assist in the discrimination of benign and malignant breast lesions and assessing the ER expression status in breast cancer.

Comparative Assessment of miR-185-5p and miR-191-5p Expression: From Normal Endometrium to High-Grade Endometrial Cancer.

Endometrial cancer (EC) is a significant cause of cancer-related deaths in women. MicroRNAs (miRs) play a role in cancer development, acting as oncogenes or tumor suppressors. This study evaluated the diagnostic potential of hsa-miR-185-5p and hsa-miR-191-5p in EC and their correlation with clinical and histopathological features. A cross-sectional study analyzed formalin-fixed, paraffin-embedded tissue samples from 59 patients: 18 with EC, 21 with endometrial hyperplasia (EH), 17 with normal endometrium (NE), and 3 with endometrial polyps (EPs). Quantitative reverse transcription-polymerase chain reaction and TaqMan probes were used for miR expression analysis. The Shapiro-Wilk test was used to analyze the normal distribution of the data. Subsequently, parametric or non-parametric tests were used to evaluate the associations between the expression levels of each miR and clinical parameters. Both miRs were underexpressed in some precursor and malignant lesions compared to certain NE subtypes and benign lesions. Specifically, hsa-miR-185-5p showed underexpression in grade 3 EC compared to some NE and EH subtypes (FC: -57.9 to -8.5, p < 0.05), and hsa-miR-191-5p was underexpressed in EH and EC compared to secretory endometrium and EPs (FC: -4.2 to -32.8, p < 0.05). SETD1B, TJP1, and MSI1 were common predicted target genes. In conclusion, hsa-miR-185-5p and hsa-miR-191-5p are underexpressed in EC tissues, correlating with histopathological grades, highlighting their potential as diagnostic biomarkers and their role as tumor suppressors in EC.

Role of Endoscopic Ultrasound in Diagnosis of Submucosal Lesions of Gastrointestinal Tract

The study aimed to understand the magnitude of submucosal lesions as part of the referral to the endoscopic ultrasound (EUS) unit in one year and know the percent of the different types and sites of submucosal lesions of GIT in Theodore Bilharz Research Institute as tertiary referral center draining Egyptian community. Within one year, all patients referred to the EUS unit at Theodore Bilharz Research Institute (TBRI) for assessment to assess the percent of submucosal lesions cases as part of the total referral and know the different types seen and their common sites as compared to the international literature. Patients diagnosed to have submucosal lesion will be subjected to; full clinical history, thorough physical examination, laboratory investigations, BUS for more characterization (site, size, location, echo pattern, etc.) and BUS-guided fine-needle aspiration (FNA) for histopathological examination. The work comprised 36 patients; 16 females and 20 males. Their ages ranged from 21 to 75 years. All patients had preliminary upper endoscopy or colonoscopy. According to the indication of upper preliminary endoscopy or colonoscopy, 12 (33.3%) were complaining of melena, 5 (13.8%) hematemesis, 1 (2.7%) bleeding per rectum, 7 (19.4%) upper abdominal pain, 2 (5.5%) dysphagia, finally, 8 (22.2%) vomiting. According to the site of the submucosal lesion, 24 (66.6%) were gastric, 6 (16.6%) esophageal, 4 (11.1%) duodenal, 1 gastro-esophageal (2.8%), and 1 (2.8%) rectal. 34 cases (94%) were covered by normal overlying mucosa while 2 cases (6%) had superficial ulcerations. It was concluded that EUS criteria, can be used without FNA and histopathologic examination to reduce the cost of differentiation between malignant and benign lesions. All homogenous lesions were benign. Lesion size of 4.5 cm is a cut off; &gt; 4.5 cm were malignant whereas &lt; 4.5 cm were benign. All submucosal lesions without areas of breakdown were benign. Those infiltrating all layers are malignant. EUS guided fine needle aspiration (FNA) and histopathological examination should be done for some submucosal masses to put a definite diagnosis. EUS with colored Doppler is necessary in differentiating cystic from vascular lesions.