Differential Diagnosis Of Benign Research Articles

Evaluation of image-pro plus assisted superb microvascular imaging for differential diagnosis of renal masses

ObjectivePrevious research on diagnostic assessment by superb microvascular imaging (SMI) were based on qualitative or semi-quantitative assessments of vascularity, which may be subjective and unrepeatable by different sonographers. This study aimed to evaluate diagnostic performance of SMI Image-pro Plus (IPP) based vascular index (VI) for malignant renal masses. MethodWe retrospectively reviewed 222 masses in 214 patients who underwent SMI between August 2019 and August 2022 in our study. We evaluated the diagnostic performance of blood flow via Alder grade, VI based on both IPP and SMI. ResultsThe kappa consistency of the Adler grade and VI for renal masses was classified among different observers were 0.765 and 0.824. The intra-observers correlation ecoefficiency (ICC) were 0.727 and 0.874. Benign renal masses were mainly Adler grade 0, grade I, and grade II, VI was 4.30 ± 4.27 (Range 0.98–16.42); while malignant masses were mainly Adler grade III, VI was 14.95 ± 10.94 (Range 0.79–56.89). VI was higher in malignant than benign masses (t = 15.638, P < 0.01). Among the malignant masses, the mean VI in clear cell renal cell carcinoma was higher than that in papillary renal cell carcinoma and chromophobe renal cell carcinoma (F = 30.659, P < 0.01). The sensitivity, specificity and accuracy of SMI were 80.00%, 71.15%, and 78.64%, respectively. The sensitivity, specificity, and accuracy were 60.59%, 88.46%, and 80.18% by using a VI of 7.95 as the cutoff value to identify malignant lesions from benign masses yielded. VI had better diagnostic efficiency than ultrasonic characteristics and Adler grade in benign and malignant differential diagnosis (Z = 4.851, P < 0.01; Z = 2.732, P < 0.01). ConclusionVI was higher in malignant than benign in renal masses. In malignant masses, VI in CCRCC was higher than that in papillary renal cell carcinoma and ChRCC. As a noninvasive examination, it had important clinical significance in the differential diagnosis of renal masses. VI from IPP may assist sonographer in distinguish renal malignances as a quantitative tool for vascularity.

The Application Value of Ultrasound Imaging in the Differential Diagnosis of Benign and Malignant Breast Nodules of BI-RADS 3 and Above

Objective: To explore the diagnostic value of ultrasound imaging for breast nodules of breast imaging-reporting and data system (BI-RADS) category 3 and above. Methods: From June 2021 to July 2022, 163 patients with breast nodules of BI-RADS 3 or above were selected as the research subjects. After pathological diagnosis, 24 cases were malignant breast nodules of BI-RADS 3 or above, while 139 cases were benign breast nodules of BI-RADS 3 or above. The diagnosis rate of malignant and benign breast nodules of BI-RADS 3 or above, including 95% CI, was observed and analyzed. Results: The malignant and benign detection rates of conventional ultrasound were 88.63% and 75.00%, respectively, and the malignant and benign detection rates of ultrasound imaging were 93.18% and 87.50%, respectively, with 95% CIs greater than 0.7. Conclusion: Ultrasound imaging can help improve the diagnostic accuracy of benign and malignant breast nodules of BI-RADS 3 and above and reduce the misdiagnosis rate.

Differential Diagnosis of Benign and Malignant Pulmonary Nodules in CT Images Based on Multitask Learning.

Artificial intelligence-based aided diagnostic systems for pulmonary nodules can be divided into subtasks such as nodule detection, segmentation, and benign and malignant differentiation. Most current studies are limited to single-target tasks. However, aided diagnosis aims to distinguish benign from malignant pulmonary nodules, which requires the fusion of multiple-scale features and comprehensive discrimination based on the results of multiple learning tasks. This study focuses on the aspects of model design, network structure, and constraints and proposes a novel model that integrates the learning tasks of pulmonary nodule detection, segmentation, and classification under weakly supervised conditions. The main innovations include the following three aspects: (1) a two-dimensional sequence detection model based on a ConvLSTM (Convolutional Long Short-Term Memory) network and U-shaped structure network is proposed to obtain the context space features of image slices fully; (2) a differential diagnosis of benign and malignant pulmonary nodules based on multitask learning is proposed, which uses the annotated data of different types of tasks to mine the potential common features among tasks; and (3) an optimization strategy incorporating prior knowledge of computed tomography images and dynamic weight adjustment of multiple tasks is proposed to ensure that each task can efficiently complete training and learning. Experiments on the LIDC-IDRI and LUNA16 datasets showed that our proposed method achieved a final competition performance metric score of 87.80% for nodule detection and a Dice similarity coefficient score of 83.95% for pulmonary nodule segmentation. The cross-validation results of the LIDC-IDRI and LUNA16 datasets show that our model achieved 87.80% of the final competition performance metric score for nodule detection and 83.95% of the DSC score for pulmonary nodule segmentation, representing the optimal result for that dataset.

Retracted: The Application Value of SMI Technology and Contrast-Enhanced Ultrasound in the Differential Diagnosis of Benign and Malignant Thyroid Nodules.

[This retracts the article DOI: 10.1155/2022/6157026.].

Retracted: Application of CT Postprocessing Reconstruction Technique in Differential Diagnosis of Benign and Malignant Solitary Pulmonary Nodules and Analysis of Risk Factors.

[This retracts the article DOI: 10.1155/2022/9739047.].

Intercalated Duct Adenoma of the Parotid Gland

&#x0D; &#x0D; &#x0D; &#x0D; A 56-year-old man presented with a 10-year history of gradually enlarging left pre-auricular mass. No biopsies were done. He underwent superficial parotidectomy which showed an enlarged parotid gland measuring 6 x 5.5 x 2 cm with a 0.5 x 0.2 x 0.2 cm discrete, cream-brown, ovoid intraparenchymal solid nodule. The latter was the lesion of interest.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Microscopic examination of the nodule shows a well-circumscribed, encapsulated proliferation of closely packed tubular ducts surrounded by non-neoplastic, otherwise histologically unremarkable lobules of serous acini with an intact ductal system. (Figure 1) The tubules within the nodule are lined by simple cuboidal cells having bland, uniform, round nuclei and moderate amounts of eosinophilic cytoplasm. (Figure 2) In some of these tubules, serous acinar cells containing coarse basophilic granules partly line the lumina, adjacent to or around the cuboidal cells. (Figure 3) Based on the morphological features, a diagnosis of intercalated duct adenoma (IDA) was rendered, occurring in a background that is suggestive of sialadenosis.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Intercalated duct adenomas are mostly asymptomatic, benign neoplasms identified incidentally in salivary glands removed for diverse lesions of either benign or malignant etiology.1-4 They are most often found in the parotid gland of adults ranging from 41 to 73 years (mean 57 years) with a female-to-male ratio of 3:2.1,2&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; They belong to a group of ductal proliferations known as intercalated duct lesions (IDL) which are composed of compact proliferation of tubular ducts that are lined by cuboidal ductal cells. Scattered tubules have serous acinar cells complexed with the ductal cells, while others have inconspicuous myoepithelial cells that surround them. Intercalated duct lesions are arbitrarily divided into IDA – if encapsulated and discretely separated from adjacent acinar units, and intercalated duct hyperplasia (IDH) - if unencapsulated and blending into the adjacent acinar units.3-5&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; The ductal cells of IDA resemble those of non-neoplastic intercalated ducts on immunohistochemistry, staining diffusely with CK7 and S100, and focally for ER and lysozyme while CK14 and Calponin highlight the thin myoepithelial cells surrounding the ductal cells.1,3,4 Immunohistochemical stains for myoepithelial cells were not requested as we felt that the participation of acinar cells in a characteristic manner was sufficiently diagnostic of the entity.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Important benign differential diagnoses of IDA include striated duct adenoma, canalicular adenoma and basal cell adenoma.2,3 Striated duct adenoma and canalicular adenoma can both be distinguished from IDA due to lack of myoepithelial and acinar cells; the latter is also more commonly found in the minor salivary glands.2,3 Basal cell adenoma and adenocarcinoma on the other hand are challenging differential diagnoses due to significant overlaps in morphology. They tend to be larger (usually &gt;10 mm) with prominent bilayering of luminal cells and distinct basaloid abluminal cells that show palisading. Basal cell adenocarcinoma importantly demonstrates an invasive growth pattern.3,5 IDA on the other hand are small and infrequently seen macroscopically, most often measuring less than 5 mm in diameter.2&#x0D; Both IDA and IDL in general have an excellent prognosis upon complete surgical excision and recurrences are not reported. However, IDA’s frequent co-occurrence with other salivary gland tumors has led to it being hypothesized as a potential precursor of salivary gland tumors, particularly of epithelial-myoepithelial carcinomas.1-2 Its coexistence with sialadenosis has not been previously reported. The diagnosis of IDA in conjunction with other salivary gland pathologies is therefore important to further elucidate the clinical, histopathological, and possible molecular nature and relationships of this lesion.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D;

The Application Value of SMI Technology and Contrast-Enhanced Ultrasound in the Differential Diagnosis of Benign and Malignant Thyroid Nodules.

Thyroid disease has always been a common and frequent disease in clinical medicine, and its disease detection rate has been increasing year by year. Thyroid diseases are mainly divided into two categories: thyroid diseases treated by medical treatment and thyroid diseases treated by surgery. Thyroid cancer has also become one of the most common malignant secretory tumor diseases today. Ultrasound examination is a commonly used method for diagnosing thyroid diseases. During the diagnosis process, doctors need to observe the characteristics of ultrasound images and combine professional knowledge and clinical experience to give the patient's disease status. With the improvement of people's living standards and health awareness, thyroid disease has become an important issue that plagues the health of Chinese residents. Therefore, people and medical workers are paying more attention to thyroid disease. In recent years, various ultrasound technologies have been applied in the differential diagnosis of benign and malignant thyroid nodules and have played an important role in the diagnosis. This article aims to study the application value of SMI technology (ultra-microvascular imaging technology) and contrast-enhanced ultrasound in the differential diagnosis of thyroid benign and malignant nodules. It conducts diagnostic experiments and analysis on some cases of benign and malignant thyroid nodules through the use of SMI diagnostic methods and contrast-enhanced ultrasound examination methods. And the ROC curve was used to calculate the sensitivity of SMI technology and ultrasound for the identification and diagnosis of thyroid benign and malignant nodules, and the results were 0.83 and 0.81, respectively. It is concluded that SMI technology and contrast-enhanced ultrasound examination have good diagnostic efficiency and application value for the identification and diagnosis of thyroid benign and malignant nodules.

Value and Safety Analysis of Color Doppler Ultrasound in Differential Diagnosis of Benign and Malignant Thyroid Nodules

Value and Safety Analysis of Color Doppler Ultrasound in Differential Diagnosis of Benign and Malignant Thyroid Nodules

Search for New Target Genes of MicroRNA for Differential Diagnosis of Benign and Malignant Neoplasms of the Thyroid Gland by In Silico Methods.

Differential diagnosis of thyroid gland neoplasms is an urgent problem in modern oncothyroidology. This is especially true for the diagnosis of follicular thyroid cancer and follicular thyroid adenoma at the preoperative stage. In this study, in silico methods were used to search for potential markers that are microRNA target genes. A list of 19 microRNAs was compiled, the expression of which varies depending on the type of thyroid neoplasms. For these microRNAs, the target genes were selected considering tissue specificity and association with thyroid diseases. We selected 9 target genes (MCM2, RASSF2, SPAG9, SSTR2, TP53BP1, INPP4B, CCDC80, GNAS, and PLK1), which can be considered as promising markers according to published data. Also, 6 new potential markers (CDK4, FGFR1, ERBB3, EGR1, MYLK, and SRC) were found, which make it possible to distinguish between follicular thyroid cancer and follicular thyroid adenoma. The proposed algorithm using various bioinformatics tools allows us to identify potential markers for the differential diagnosis of thyroid neoplasms.

Comparison of the Value of Color Doppler Ultrasound and Multislice Spiral CT in the Differential Diagnosis of Benign and Malignant Nodules in the Liver.

Objective This study aimed to explore the value of color Doppler ultrasound and multislice spiral CT (MSCT) in the differential diagnosis of benign and malignant nodules in the liver. Methods The clinical imaging data of 102 patients with nodular hepatocellular carcinoma (hepatocellular carcinoma group) and 50 patients with focal nodular hyperplasia (FNH) of the liver (FNH group) admitted to our hospital were collected, and their color Doppler ultrasound and MSCT imaging features were retrospectively analyzed to explore the value of their clinical application in the differential diagnosis of benign and malignant nodules in the liver. Results The sensitivity, accuracy, and negative predictive value of MSCT in the diagnosis of nodular liver cancer were 94.12%, 92.76%, and 88.24%, respectively, which were significantly higher than those of color Doppler ultrasound 79.41%, 84.21%, and 69.12%, and the difference was statistically significant (P < 0.05). Conclusion In conclusion, the value of MSCT in the differential diagnosis of benign and malignant liver nodules was significantly better than color Doppler ultrasound.

A large and invasive pleomorphic adenoma of nasal cavity: a rare case report and review of literatures

BackgroundPleomorphic adenomas are common tumors of major salivary glands. However, the localization in nasal cavity originating from the lateral wall is exceptional.This work is a presentation of a very rare case that presents the diagnostic challenge, considering the multitude of malignant and benign differential diagnosis. A discussion of surgical approach, and the possible complications associated with it.Case presentationThis is the case of an invasive nasal pleomorphic adenoma in a 48-year-old patient; the patient underwent complete excision through combined left lateral rhinotomy and functional endoscopic sinus surgery.ConclusionPleomorphic adenoma is a very rare benign tumor of the nasal cavity. Clinical diagnosis is generally difficult regarding the multitude of differential diagnosis. Confirmation is established upon histological aspect.This is a case of a very rare large pleomorphic adenoma of nasal cavity originating from the lateral wall, associated with differential diagnosis, and surgical approaches, as well as perceivable complications.The strength of this work is to point out the importance of complete surgical extirpation and thorough follow-up to prevent recurrences and malignant transformation.

Differential Diagnosis of Benign and Malignant Gallbladder Lesions Using CT Based Machine Learning

Introduction: Gallbladder cancer is a tumor of extremely high malignancy. However, in most cases, patients with gallbladder cancer are detected at a late stage and miss the opportunity for radical resection. Therefore, early and correct diagnosis of gallbladder cancer is the key to provide the best treatment for patients.

Differential Diagnosis of Benign and Malignant Breast Tumors Based on DCE-MRI

Breast cancer is a malignant tumor mostly found in the female population, and it is important to improve the survival rate of patients by determining its benignity and malignancy at the early stage of the disease through non-invasive imaging, so that appropriate treatment can be adopted. In this paper, we tested the application of the deep learning model of residual network (Resnet) in the diagnosis of breast tumors by Dynamic Contrast-Enhanced MRI (DCE-MRI), and compared three network models of different depths, Resnet50, Resnet34, and Resnet18, to find the best way to achieve the diagnosis of breast tumors. With the number of network layers increasing the depth of the network increases, and the phenomenon of overfitting occurs. The results showed that Resnet18 was the most accurate method to classify benign and malignant tumor images. The experimental results showed that the accuracy of Resnet18 network was higher, reaching 96.4%.

Papilledema as a sign of intracranial hypertension

Papilledema (choked disk) is a sign of intracranial hypertension (ICH) - condition that presents danger not only for patient's vision, but also for their life. Despite the fact that ICH is usually a neurosurgical pathology, sometimes an ophthalmologist is the first doctor such patients visit, most often in a primary healthcare clinic. At the same time, as practice shows, not all ophthalmologists are well aware about in this pathology; difficulties occur in differential diagnosis of papilledema against similar changes of the optic nerve head seen during ophthalmoscopic examination. This article reviews scientific literature on ICH, including benign ICH, diagnosis and differential diagnosis of papilledema. The authors also share their decades-long experience of working in a neurosurgical facility.

The Value of Chinese Thyroid Imaging Report and Data System Combined With Contrast-Enhanced Ultrasound Scoring in Differential Diagnosis of Benign and Malignant Thyroid Nodules.

To explore the diagnostic value of contrast-enhanced ultrasound (CEUS) combined with the Chinese Thyroid Imaging Reporting and Data System (C-TIRADS) for differentiation of benign and malignant thyroid nodules. A retrospective analysis of the conventional ultrasound and CEUS data of 388 nodules in 355 patients who had undergone thyroid nodule resection was conducted. All nodules had clear pathological results. The CEUS observation indexes included the enhancement degree in the arterial phase (no enhancement, scant punctate-linear enhancement, mild enhancement, moderate enhancement, and high enhancement) and wash-out patterns (rapid wash-out, slow wash-out, and isochronous wash-out). Chi-square test between groups and receiver operating characteristic curves (ROC) were used to determine the malignant (+1 point) and benign (-1 point) observation indexes that were statistically significant for the differentiation between benign and malignant thyroid nodules. The CEUS and C-TIRADS malignant and benign indexes were combined to score and draw the ROC curve, which was compared with the ROC curve scored by C-TIRADS alone to compare the diagnostic efficacy of the two methods for differentiating between benign and malignant thyroid nodules. Among the CEUS observation indexes, mild enhancement and rapid wash-out were malignant indexes, while isochronous wash-out was a benign index. The best diagnostic cut-off value for the differentiation of benign and malignant thyroid nodules using the C-TIRADS score and the C-TIRADS and CEUS combined score (C-TIRADS + CEUS score) was 2. The sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV) of the two methods were 79.97, 75.48, 82.9, 70.5%, and 89.7, 72.9, 83.3, 82.5%, respectively. The area under the curve values were 0.840 and 0.877 (P < .001), respectively. The CEUS feature of mild enhancement in the arterial phase and rapid wash-out pattern are suggestive of malignancy and isochronous wash-out pattern is suggestive of benignity. The C-TIRADS + CEUS score has a higher value for distinguishing benign from malignant thyroid nodules than the C-TIRADS score alone.

Application of Contrast-enhanced Ultrasound in Differential Diagnosis of Benign and Malignant Thyroid Nodule

Application of Contrast-enhanced Ultrasound in Differential Diagnosis of Benign and Malignant Thyroid Nodule

Ultrasonographic Features of Presumed Renal Telangiectasia in Three Pembroke Welsh Corgis.

Renal telangiectasia has been reported in Pembroke Welsh corgis with chronic hematuria; however, the sonographic features of these lesions have never been described. Two dogs with confirmed renal telangiectasia and one dog with presumptive renal telangiectasia were identified in a medical record search. All dogs had one or more variably sized renal nodules identified on abdominal ultrasound. The nodules in two of the three dogs were similar, appearing hyperechoic with numerous punctate hypoechoic to anechoic foci throughout. None of the nodules showed evidence of hemodynamic flow on Doppler ultrasound. Renal telangiectasia should be considered as a benign differential diagnosis, particularly in Pembroke Welsh corgis.

Differential Diagnosis of Benign and Malignant Level Tumors in Children by Quantitative MRI with Intracellular Contrast Agent

Purpose: Тo determine the possibilities of quantitative assessment of mpMRI with EOB-DTPA in the differential diagnosis of benign and malignant tumors in children.Material and methods: 30 patients (male — 17, female — 13) with 83 tumors underwent MRI. Age ranged from 5 months to 20 years. All children underwent MRI on 3T or 1.5T MR-scanners using body coil. Fat saturated T1WI were performed before and after hepatotropic MR-contrast agent (gadoxetic acid) injection in arterial, portal, venous and delayed phases (1, 5, 20, 40 min). Tumors were divided into 2 groups: benign (52) and malignant (31). In this work we use only pre- and postcontrast T1WI. Diagnosis was confirmed histologically (all malignant and a part of benign FLL) and long-term MRI follow-up studies (for benign). To eliminate influence of external factors we used coefficients for each MR-program, the signal was normalized to intact liver parenchyma, spleen, abdominal aorta and v. cava inferior, also normalization to native series has been performed. Coefficients were compared for malignant and benign tumors using Student’s t-test, significantly different parameters were further used to build mathematical model by constructing a logistic regression with step-by-step selection of the most informative values.Results: Regression model is presented by formula. The model is informative and statistically significant (p &lt; 0.001). If A&gt;0.5 tumors has a malignant nature if А ≤ 0.5–benign. Model sensitivity and specificity are 0.862 and 0.925, respectively.Conclusion: Our model could be an excellent assistance in differentiation of benign and malignant focal liver lesions and reduces diagnostic path, effects the proper patients management.

Diagnostic Challenges of an Extremely Large Testicular Adrenal Rest Tumor - a Case Report

Background: Congenital adrenal hyperplasia (CAH) is an autosomal recessive genetic disorder characterized by elevated levels of adrenocorticotropic hormone (ACTH) and overproduction of adrenal sex steroids. It is speculated that the correlation between CAH and testicular adrenal rest tumors (TARTs) is caused through ACTH-triggered progression of aberrant adrenal cells in testes. Case Presentation: Here, we present a case of a nine-year-old boy with bilateral testicular masses referred to Ghaem hospital (Mashhad, Iran), in the summer of 2019. Laboratory studies revealed elevated ACTH and 17-hydroxyprogesterone confirming the diagnosis of CAH. Radiologic assessment showed bilateral multiple heterogeneous masses that had replaced the normal testicular tissue. Conclusions: Due to the rare nature of TARTs and their manifestations, many of these patients, like ours don’t get prompt detection. It seems crucial for urologists and radiologists to be familiar with this condition as a benign differential diagnosis of bilateral testicular tumors

Application of Contrast-Enhanced Ultrasound in the Differential Diagnosis of Benign and Malignant Subpleural Pulmonary Lesions.

To explore the clinical value of contrast-enhanced ultrasound (CEUS) in the differential diagnosis of benign and malignant subpleural pulmonary lesions (SPLs). Among 959 patients with SPLs who were scheduled to undergo ultrasound-guided puncture in our department between January 2019 and June 2019, 506 patients were included and their B-mode ultrasound and CEUS features, including the lesion's location, size, margin, echo, perfusion pattern of ultrasound contrast agent, degree of enhancement, homogeneity, vascular signs, and necrosis, were retrospectively investigated. All malignant cases were diagnosed by pathology, while benign cases were diagnosed by two respiratory physicians after comprehensive analysis of pathology, etiology, imaging, and clinical symptoms. Statistical differences in these features between the benign and malignant groups were then analyzed. There were 506 cases in this study, including 219 benign cases and 287 malignant cases. Among them, 351 were males and 155 were females, with an average age of 59 ± 16 years. There were statistically significant differences between benign and malignant groups in the perfusion pattern, the degree of enhancement, and vascular signs. The features of the malignant group included local-to-whole perfusion pattern, hypo-enhancement, and curly hair sign, while those of the benign group included a centrifugal perfusion pattern, iso-enhancement and hyper-enhancement, and dendritic sign. There was no statistically significant difference between the two groups in homogeneity and necrosis. CEUS enhancement mode is different between benign and malignant SPLs, which can provide supplementary information for the differential diagnosis of SPLs in the existing imaging diagnosis.