Noninvasive Diagnostic Imaging Techniques Research Articles

Noninvasive diagnostic imaging of pelvic venous disorders.

It is estimated that chronic pelvic pain (CPP) may affect up to 24% of women. Unfortunately, very often, despite extensive diagnostics, the cause of CPP remains unknown. The pathophysiology of CPP could be explained to a large extent by the occurrence of pelvic venous disorders (PVD). Although pelvic venography is still considered the gold standard for the diagnosis of PVD, noninvasive diagnostic imaging techniques seem to be instrumental in the initial identification of patients with PVD. This literature review aimed to analyze and evaluate the usefulness of noninvasive diagnostic imaging techniques like transvaginal ultrasonography, transabdominal ultrasonography, magnetic resonance, and computed tomography in the diagnosis and identification of patients with PVD. Forty-one articles published between 1984 and 2023 were included in this literature review. Based on this literature review, we conclude that the clinical application of noninvasive diagnostic techniques in the diagnosis of PVD seems to be very promising. Future studies investigating the role of noninvasive diagnostic imaging techniques in the diagnosis of PVD are required.

The emerging topic of injected cosmetic fillers in the perinasal region of dromedary camels: ultrasonographic and radiographic verification.

Dermal cosmetic fillers have been commonly used in camels in the last few years in Gulf countries. This study aimed to describe the radiographic as well as sonographic findings of injected cosmetic fillers in Arabian camel perinasal region in beauty shows. A total number of (n = 11,626) Arabian camels (Camelus dromedarius) were thoroughly investigated for injection of cosmetic fillers in the perinasal area. The age of the camels was 6 months to 10 years, and their weights were 400-650 kg. In parallel, a control group consisting of 30 age/weight-matched non-injected camels was used. Of the 11,626 examined camels, 25 animals (0.0.002%) were injected with cosmetic fillers in the perinasal region. Of the 25 camels, 19 (76%) were females and 6 (24%) were males. Radiographic examinations were carried out for the 25 injected camel perinasal regions. Ultrasonographic examination of the injected perinasal regions revealed precise discrimination of the filler material, which appeared hypo-echogenic in 17 camels (68%) and with anechoic spots in the remaining 8 camels (32%). Variable degrees of swelling caused by the injection of moderate and large quantities of fillers were noted by radiographic assessment, the injected cosmetic filler was precisely diagnosed in the perinasal region as grey in color having soft tissue density in obtained radiographs. In conclusion, radiographic and ultrasonographic examinations are reliable, accurate, and non-invasive diagnostic imaging techniques that can precisely discriminate a filler agent in the soft tissues and determine the situ and size of cutaneous deposits in dromedary camels (C. dromedarius).

Thermographic Examination of the Horse

Abstract Thermography is a noninvasive diagnostic imaging technique that detects regions of the body surface with increased (or decreased) temperature by measuring infrared radiation. It reveals physiological and pathophysiological changes primarily related to blood flow and metabolic rate in the examined body regions, as well as altered heat production. These include physical stress, various physical injuries, medical conditions, and environmental factors. In equine medicine, thermography can be used for early detection of tissue temperature changes, allowing intervention at an early stage of a medical deterioration. Thermographic examination can be used to detect tissue abnormalities in all regions of the body. It is particularly useful for the detection of musculoskeletal disorders. Inflammatory processes are present in many diseases and injuries, which can be successfully detected with thermography. Thermography makes it possible to monitor the success of treatment. Often, thermographically visible disease changes are detected before clinical signs or other imaging techniques become visible in the animal. In physical therapy, it helps locate regions of the body in need of treatment and plays an important role in detecting illegal procedures (such as local analgesics) to improve competitive performance in horses. Thermography serves as a complementary diagnostic tool. However, in practice, it has some limitations. The method is not specific and cannot determine the etiology of pathological changes. Therefore, it is usually used together with other diagnostic methods (such as X-ray, ultrasound, computed tomography and magnetic resonance imaging) and can not replace them.

Melanoma and Nevi Subtype Histopathological Characterization with Optical Coherence Tomography.

Melanoma incidence has continued to rise in the latest decades, and the forecast is not optimistic. Non-invasive diagnostic imaging techniques such as optical coherence tomography (OCT) are largely studied; however, there is still no agreement on its use for the diagnosis of melanoma. For dermatologists, the differentiation of non-invasive (junctional nevus, compound nevus, intradermal nevus, and melanoma in-situ) versus invasive (superficial spreading melanoma and nodular melanoma) lesions is the key issue in their daily routine. This work performs a comparative analysis of OCT images using haematoxylin-eosin (HE) and anatomopathological features identified by a pathologist. Then, optical and textural properties are extracted from OCT images with the aim to identify subtle features that could potentially maximize the usefulness of the imaging technique in the identification of the lesion's potential invasiveness. Preliminary features reveal differences discriminating melanoma in-situ from superficial spreading melanoma and also between melanoma and nevus subtypes that pose a promising baseline for further research. Answering the final goal of diagnosing non-invasive versus invasive lesions with OCT does not seem feasible in the short term, but the obtained results demonstrate a step forward to achieve this.

Spectral Optical Properties of Gray Matter in Human Male Brain Tissue Measured at 400–1100 nm

Gray matter, in the outermost layer of the cerebral cortex, plays a significant role in processing important information, such as when reasoning and planning, in addition to influencing intelligence, emotion, memory, and language. In this paper, measurements of the optical properties, such as the attenuation coefficients, scattering coefficients, scattering efficiency, and penetration depth of gray matter in the cerebral cortex were measured in the fresh brain tissue of a healthy human male at a spectral range of 400–1100 nm. Determining the optical properties of gray matter is important for developing NIR noninvasive diagnostic imaging techniques and therapy. The absorption spectra of the gray matter tissues obtained here showed clear peaks at 550 and 580 nm due to HBO2 and 970 nm due to water. The attenuation coefficient, transport length, and penetration depth for the gray matter were measured at 800 nm. The possible NIR optical imaging depth was roughly 3.8 mm, determined by the theoretical limit resulting from ballistic and snake photons. Using Beer’s law and the Mie model, the structural properties, such as the density of neurons, in the gray matter of human brain tissue, were investigated for the first time. The density of neurons in the examined gray matter tissue sample was estimated as roughly 40,000 neurons/mg.

Pulmonary Artery Remodeling and Advanced Hemodynamics: Magnetic Resonance Imaging Biomarkers of Pulmonary Hypertension

Poorly characterized by non-invasive diagnostic imaging techniques, pulmonary hypertension (PHT) is commonly associated with changes in vascular hemodynamics and remodeling of pulmonary artery architecture. These disease phenotypes represent potential biomarkers of interest in clinical environment. In this retrospective clinical study, 33 patients with pulmonary hypertension and seventeen controls were recruited. Architectural remodeling was characterized using 3D-contrast enhanced angiogram via the measurement of pulmonary artery diameters, bifurcation distances, and angles. Hemodynamics were characterized using 4D-flow magnetic resonance imaging (MRI) via wall shear stress, kinetic energy, vorticity, and directional flow dynamics. Parameters were compared using independent samples student’s t-tests. Correlational analysis was performed using Pearson’s correlation. PHT patients demonstrated dilation in the main and right branch of the pulmonary artery (p < 0.05). Furthermore, these patients also exhibited increases in bifurcation distances in the left and right pulmonary arteries (p < 0.05). Wall shear stress, maximum kinetic energy, and energy loss were decreased in the pulmonary artery (p < 0.001). Correlations were observed between peak velocities and right ventricle ejection fraction (r = 0.527, p < 0.05). These findings suggest that pulmonary artery remodeling and hemodynamic changes may possess clinical utility as MRI biomarkers for PHT.

Litrature Review Trauma Vascular

Vascular traumatic is trauma to the blood vessels caused by blunt injuries such as a hard impact or penetrating injuries such as sharp object injuries, penetrating bullet shots. Massive haemorrhage is the main cause of vascular trauma, resulting in death. Therefore, prompt treatment is needed to avoid other complications or even death due to uncontrolled bleeding. Vascular surgeons are the key to trauma injury patients, by controlling bleeding and vascular reconstruction, using aspects of open and endovascular surgical techniques. Diagnostic protocols are needed to identify injuries and consider the best tactics for surgical treatment of vascular injuries. Accurate, non-invasive diagnostic imaging techniques are key to this strategy. The aim of this review is to determine the optimal diagnostic imaging in patients with suspected vascular injury in the anatomic region and the method of treatment with retrospective or prospective data collection which is preferable to CT angiography compared to other methods. CT angiography can be declared the gold standard for diagnosing vascular injury in patients.

INFLUENCE OF RENAL FUNCTION ON RETINAL VASCULAR DENSITY ASSESSED BY OCT ANGIOGRAPHY IN HYPERTENSIVE PATIENTS

Objective: It is well known that the retinal vasculature may be considered as a window through which the body microcirculation can be easily, safely and repeatedly, observed. Alterations of the renal microcirculation have been documented in animal models with hypertensive renal damage and microvasculature changes have been suggested to play a mayor etiological role in a large proportion of subjects with chronic CKD. Angio OCT is a recently developed noninvasive diagnostic imaging technique that employs motion contrast extracted from high-speed OCT images to produce depth-resolved, high-resolution images of retinal and choroidal vasculature without dye injection. Aim: Our study was aimed to assess in hypertensive patients the influence of renal function on retinal vascular density assessed by Angio-OCT. Design and method: We enrolled 120 consecutive hypertensive subjects (age: 51 ± 13 years; males 68%) attending our Hypertension Centre. All the patients underwent routine biochemical evaluation and angio-OCT. The retinal angiograms obtained allowed to assess vascular density of both superficial (DRS) and deep (DRP) network in the parafoveal area. Only one eye of each subject was randomly selected for analysis. Glomerular filtration rate was estimated by CKD-EPI equation. Results: 26 subjects showed a GFR value < 60 ml/min/ 1.73 m2. These patients, when compared to those with higher GFR, showed significantly lower values of DRS (36.48 ± 1.23 vs 37.29 ± 0.78 %; p < 0.001) and of DRP (37.69 ± 1.23 vs 38.34 ± 0.97 %; p = 0.005). Moreover, the GFR correlated directly with DRP (r = 0.385; p < 0.001) and with DRS (r = 0.247; p < 0.01). These associations remain statistically significant even after adjustment for age, BP and other confounders in multiple linear regression analyses (respectively, beta = 0.265; p < 0.05 e beta 0.211; p < 0.05). Conclusions: Our study, showing a significant association between reduced retinal vascular density and renal function impairment, confirms the close link relating CKD with retinal vascular abnormalities.

Survey on Recent Works in Computed Tomography based Computer ‑ Aided Diagnosis of Liver using Deep Learning Techniques

Computed tomography (CT) scanning is a non-invasive diagnostic imaging technique that provides more detailed information about the liver than standard X-rays. Unlike ultrasound (US) examination, the quality of the CT image is not highly operator dependent. Plenty of works has been done using computer-aided diagnosis (CAD) for liver using conventional machine learning algorithms with better results. Recent advances especially in deep learning technology, can detect, classify, segment patterns in medical images where the advancements in deep learning has been shifted to medical domain also. One of the core abilities of deep learning is that they could learn feature representations automatically from data instead of feeding hand crafted features based on application. In this review, the basics of deep learning is introduced and their success in liver segmentation and lesion detection, classification using CT imaging modality is reviewed and their different network architectures is also discussed. Transfer learning is an interesting approach in deep learning which is also discussed. So, deep learning and CAD system has made a huge impact and has produced enhanced performance in healthcare industry.

The role of non-invasive imaging techniques in detecting intra-abdominal adhesions: a systematic review.

Intra-abdominal adhesions after surgery are highly prevalent. Adhesions implicate complications during subsequent surgery and can cause chronic abdominal pain. The objective of this review was to investigate the usefulness of non-invasive diagnostic methods for detection of adhesions. We searched the electronic databases: MEDLINE, Embase, and The Cochrane Central Register of Controlled Trials for studies investigating the use of non-invasive diagnostic imaging techniques for detecting adhesions. Main outcome was the sensitivity and specificity of each technique. We used the Quality Assessment of Diagnostic Accuracy studies tool to assess bias. In total, 25 studies were included: 18 using ultrasound (US), 5 using magnetic resonance imaging (MRI), 1 using computed tomography (CT), and 1 using both US and MRI. A total of 2195 patients were included. Overall accuracy ranged between 76 and 100% for US studies and between 79 and 90% for MRI and was 66% for CT. Sensitivity ranged between 21 and 100% for US and between 22 and 93% for MRI and was 61% for CT. Specificity was 32-100% for US, 25-93% for MRI, and 63% for CT. Bias analysis revealed that in most studies, investigators were blinded to the reference standard but not to the index test and 11 of 25 studies had a high risk of selection bias. Currently, abdominal US can be used to determine the presence of adhesions between bowel and the abdominal wall. MRI is also an accurate diagnostic modality and can in addition visualize adhesions between viscera, however, with a tendency to over diagnose adhesions. There is insufficient evidence to support CT as a diagnostic modality for adhesions.

Development of the MRI Flow Phantom System Focused on Low Speed Flows in Fluid Machinery

At present, magnetic resonance imaging (MRI), which is one of the noninvasive diagnostic imaging techniques for medical use, has been applied to industrial product inspection. In this study, a hydraulic model test system, called the “flow phantom system,” which can generate steady flow and oscillating flow for time-resolved MRI, was developed to aid optimum design of fluid machinery. Simple flow phantoms are tested under laminar flow or oscillating flow to evaluate the validity and effectiveness of the proposed system. In this article, the test results of double cylindrical pipe flow, elbow pipe flow, cylindrical valve flow, and jet pump flow, which are often seen in fluid machines, are tested using the 2D time-spatial labeling inversion pulse (Time-SLIP) method, which can track a labeled water mass and visualize it using two-dimensional images. MRI-detected flow patterns were compared with particle image velocimetry (PIV) or numerical simulation.

Contrast Radiography in Zarudni’s Spur-Thighed Tortoises (Testudo graeca zarudnyi) by Gastrografin®

Objective- In this study, the general anatomical features of the digestive tube and the transit time of the digestive tube of the Zarudni’s spur-thighed tortoises were examined by contrast radiology.Design - Experimental study.Animals - 4 adult female Zarudni’s spur-thighed tortoises (Testudo graeca zarudnyi).Procedures- At a temperature of 25-27°c a set of dorsoventral radiograph was taken to locate the Gastrografin position.Results- The normal gastric, small intestine and large intestine anatomy were obtained and the mean gastric, small intestine and large intestine transit times were 0.2 hr, 2.1 hr, and 27 hr, respectively. Our results showed some differences in the gastrointestinal transit time with that of other species.Conclusion and Clinical Relevance- The noninvasive diagnostic imaging techniques provide detailed information concerning gastrointestinal tract. Since there have not been any anatomical and radiological studies on this species in Iran, results of this study can use as a reference in this species.

SERS Signal Enhancement of Methylene Blue‐embedded Agglomerated Gold Nanorod@SiO2 Core@Shell Composites

In medical science, Raman spectroscopy has received considerable attention as the next noninvasive diagnostic imaging technique. However, its clinical applications are limited by the weak signal intensities of Raman active molecules. Previously, we showed that a methylene‐blue‐loaded gold nanorod@silica (MB‐GNR@SiO2) core@shell nanostructure is promising for the development of a cancer theranostic agent due to its excellent surface‐enhanced Raman scattering (SERS) performance and synergistic cancer‐destroying efficacy. In this study, we successfully synthesized MB‐embedded agglomerated gold nanorod@SiO2 (MB‐A.GNR@SiO2) composites, in which the many interparticle junctions created by the agglomerated GNRs were able to enhance the SERS signal of the loaded MB by a factor of five compared to MB‐GNR@SiO2. This high SERS performance of the present MB‐A.GNR@SiO2 could provide us with an approach to explore a rapid and ultra‐sensitive SERS detection method for various biological molecules.

A Diagnostic Imaging Method – Shear Wave Elastography

Shear Wave Elastography (SWE) is a non-invasive diagnostic imaging technique, that maps the elastic properties of tissues. Nowadays this modality develops increasingly in medicine across its disciplines and opens a new era of high-quality ultrasound examination because it increases the specificity and thus improves diagnostic assurance. This method is similar to manual palpation, shows elastic properties of biological tissues and provides a kind of reconstruction of the internal structure of soft tissues based on measurement of the response of tissue compression. Results: This method is already used routinely in the detection and diagnosis of breast cancer and thyroid cancer, prostate cancer, in hepatology, cardiology, view of the carotid arteries and lymphatic nodules. Standards of elasticity values for human tissues such as the mammary gland, liver, prostate or thyroid gland are progressively being created across the medical fields. Finally, the article examines its unquestioned benefit in ophthalmology. In ophthalmology, it already appears as an up-and-coming method in diagnostics and in evaluating the changes in oculomotor muscles and orbital tissues in patients with endocrine orbitopathy. Conclusion: Shear wave elastography offers three main innovations: the quantitative aspect, dimensional resolution, and real-time imaging ability. Determination of the utilization rate of this method and its inclusion into the diagnostics of endocrine orbitopathy is still a question and the subject of presently conducted clinical studies.

The Role of Laparoscopy in Diagnosis of Ascites of Obscure Etiology

Background: The role of diagnostic laparoscopy was markedly decreased with the advent of major developments in noninvasive imaging modalities such as ultrasonography, computed tomography, and magnetic resonance imaging. However, many reports suggest that imaging has a limited role in the diagnosis of exudative ascites. The aim of the present study was to answer the question if there still a place of laparoscopy in the diagnosis of ascites of obscure etiology?. Methods: We prospectively evaluated patients with undiagnosed exudative ascites seen in the internal medicine and general surgery departments in Sohag university hospital, Sohag, Egypt in the period from September 2014 till November 2016. Results: 32 patients were included in our study; 30 females(93.75%) and 2 males (6.25%) with a mean age of (range from 16 to 68 years. All patients were referred to surgery department due to ascites of obscure origin. No mortality was registered in this study; all patients were discharged from hospital the 2nd day after laparoscopy andreturned to their home activity. The final pathological diagnosis after examination of ascetic fluid and biopsies that weretaken by laparoscopy were carcinomatosis peritoneii in 24 (75%), tuberculous peritonitis in 6 (18.75%) and liver cirrhosis in 2 cases (6.25%). Conclusion: Despite great advances in noninvasive diagnostic imaging techniques; diagnostic laparoscopy is stilla valuable option for diagnosis of ascites of obscure etiology.

工業製品内部の流れの可視化を目指したMRI用流動ファントムシステムの開発

Today, magnetic resonance imaging (MRI) technique which is one of noninvasive diagnostic imaging techniques for medical use has been applied to industrial product inspection. In this study, hydraulic model test system "flow phantom system" for time-resolved MRI was developed to aim optimum designing of fluid machinery. Steady flow and pulsating flow are given to the attachable test flow phantoms. As the evaluation test, flow passing cylindrical valve with low Re condition and periodic pulsating flow condition were tested using Time-SLIP MRI method which can track the tagged fluid mass.

Flow visualization of simple pipe and channel flows obtained by MRI time-slip method

Herein, time-resolved magnetic resonance imaging, a noninvasive medical diagnostic imaging technique, was evaluated as a noncontact measurement tool for intuitively understanding fluid machineries. Simple pipe flows and channel flows are investigated by the 2D time–spatial labeling inversion pulse (2D time–SLIP) method, which can track a labeled water mass and visualize it using two-dimensional images. In this article, moving water masses of steady and pulsating pipe flows in a straight single pipe and a double cylindrical pipe (which are often seen in fluid machines and heat exchangers) are described. Then, abruptly contracting and expanding channels were tested and compared with particle image velocimetry (PIV) measurements or numerical simulations to evaluate their validity. In addition, as a feasibility test, a rotating water wheel and a fluidic diode with a strong swirling flow were tested to estimate this method’s applicability to fluid machines. The results suggest that the time-SLIP method of tracking a labeled water mass is sufficiently accurate for use in simple fluid machinery under low Re number conditions.

Sedation Effect of Acepromazine and Butorphanol in Dopplervelocimetric Parameters in Great Abdominal Arteries and Femoral Artery in Dogs

Background: Doppler ultrasound is a non-invasive diagnostic imaging technique that allows vascular anatomical and dynamics evaluation. Each artery has flow velocity profiles and different Doppler spectrum. The purpose of this study was to determine if sedation with acepromazine and butorphanol in dogs alters Doppler velocimetric values and diameter from abdominal aorta, celiac, mesenteric cranial, renal, external iliac and femoral arteries of healthy dogs.Materials, Methods & Results: Twenty healthy female dogs, aged 1 to 5 years, with body weight ranging from 10 to 25 kg, were evaluated with Doppler ultrasound in order to obtain: peak systolic velocity, end diastolic velocity, time average medium velocity, time average maximum velocity, resistive index, pulsatility index, and diameter from abdominal aorta, celiac, mesenteric cranial, renal, external iliac and femoral arteries. The same animals were sedated with acepromazine (0.02 mg/kg) and buthorphanol (0.4 mg/kg) and the same parameters were reevaluated. The heart rate was also measured. The study was approved by the Animal Ethics Committee of UFRGS, under the 25552 protocol, and the owners signed an informed consent form. Statistical analysis was performed with pared t test.The heart rate was statistically significant different, 98 ± 20.13 bpm before and 79 ± 17.74 after sedation. The exam was done before and after sedation in all selected vessels, except the celiac and cranial mesenteric artery, which were possible only in 35% and 45% respectively. All measured arteries exhibit difference in at least two of the analyzed parameters, except femoral artery, that only diameter was different.Discussion: Each vessel was selected because of its importance, and each of them has its own characteristic waveform. Changes in patterns of flow velocity of the celiac artery and mesenteric can help to determine the physiological condition of the gastrointestinal tract; in the case of renal arteries are associated with diseases involving parenchyma and; thrombosis in the aorta and the iliac and femoral arteries may be difficult to evaluate without the Doppler image. Examination of the AC and AMC before and after sedation not could be performed in all animals, maybe because the present work was carried out with only fasting requirement, without using dimethicone, and one of the difficulties encountered was the presence of gas in the gastrointestinal tract. Another factor that may have contributed to these findings is that the acute stress of containment and other environmental factors can cause release of vasopressin and leads to vasoconstriction of the splanchnic vascular bed. The dopplervelocimetric data found in celiac, mesenteric cranial, renal and femoral arteries in non-sedated animals was similar to what was described by other authors. Although all dogs demonstrated relaxation during the exam, this sedation protocol alters the values found with Doppler ultrasound in the selected vessels, except femoral artery, which caused only increase of diameter. The Doppler differences found can be a consequence of a decrease in heart rate associated with longer cycle length, and therefore, larger diastolic volume with vessels that stayed with same diameter, or in case of caudal abdominal aorta, that reduced the diameter. This study compared the dopplervelocimetric values to the ones described by other authors in non-sedated animals and demonstrated that although acepromazine and buthorphanol are a good option to sedate dogs to perform ultrasound exam, they alter the Doppler values from aorta abdominal, celiac, cranial mesenteric, renal, external iliac arteries and the femoral artery diameter.

A systemic review on ultrasonographic applications in camels

Ultrasound is widely accepted as a safe noninvasive diagnostic imaging technique in animals and human. This review aims to shed light on the current applications and future prospect of ultrasonography in camels. To date, ultrasonography has been used efficiently to study the ovarian status in she camels such as; follicular wave, spontaneous ovulation, optimum time for mating, ovarian vasculature, superovulatory response, ovarian follicular dynamics, ovarian follicular wave synchronisation and follicular deviation. Moreover, it has been applied for collection of cumulus oocyte complexes, pregnancy diagnosis, foetometry, foetal sexing, embryo transfer programmes, assessment of somatic cell nuclear transfer and evaluation of the quality and developmental ability of dromedary embryos. Uterine involution and various reproductive disorders such as; early embryonic death, endometritis, vaginal adhesions, ovarian cysts and ovarian hydrobursitis have been diagnosed by ultrasound. In male camels, ultrasonography is a useful tool in studying the developmental changes of testes and pelvic genitalia including; bulbourethral gland, prostate, and pelvic urethra and predicting puberty and future fertility. Normal pleura, heart, fore stomach, liver, small and large intestines, kidney, eye, udder and teat, foot, carpal and tarsal joints have been successfully imaged. However, very limited affections of these structures including; infectious pleuropneumonia, peritonitis, trypanosomiasis, John's disease, intestinal obstruction and ruptured urinary bladder have been diagnosed ultrasonographically in camels. Therefore, ultrasonographic application in camels, compared to other farm animals, is still limited. In conclusion, ultrasonography is untapped in camel practice however, it can offer veterinarians the opportunity for more precise diagnosis and treatment of numerous disorders.

Role of sonoelastography and MR spectroscopy in diagnosis of solid breast lesions with histopathological correlation

ObjectiveTo demonstrate the role of ultrasound elastography and magnetic resonance spectroscopy in diagnosis of solid breast lesions with histopathological correlation. Patients and methodsThis study included 40 female patients, and their ages ranged from 17 to 73years with mean age of 43.18years. Patients were referred on the basis of suspected breast lesion and/or nipple discharge. All patients underwent elastography in addition to conventional ultrasonography and MR spectroscopy and the radiological results were correlated with histopathological examination for achieving confirmed final diagnosis. ResultsAll benign lesions were 17 on the basis of elastography, while the malignant lesions were 18. Fifteen malignant lesions (93.7%, 15/21) had an elastography score 5, while Thirteen benign lesions (86.7%, 13/19) had an elastography score 3. On the basis of DCE-MRI, benign lesions were 16, while the malignant lesions were 19. Sixteen malignant lesions (94.1%) were diagnosed as BI-RADS 5, while fourteen benign lesions (93.3%) were diagnosed as BI-RADS 3. On the basis of MR spectroscopy, benign lesions were 17, while the malignant lesions were 19. Nineteen malignant lesions (90.5) had positive choline peak while seventeen benign lesions (89.5%) had negative choline peak. The study showed conventional ultrasound sensitivity, specificity, PPV, NPV and accuracy as 85%, 80%, 80.9%, 84.2% and 82.5% respectively, and sono-elastography sensitivity, specificity, PPV, NPV and accuracy as 90%, 85%, 85.7%, 89.4% and 87.5% respectively. Dynamic contrast enhanced MRI sensitivity, specificity, PPV, NPV and accuracy were 85.7%, 84.2%, 85.7%, 84.2% and 85% respectively, while MR spectroscopy sensitivity, specificity, PPV, NPV and accuracy were 90.4%, 89.4%, 90.4%, 89.5% and 80.5% respectively. ConclusionThe study showed that sono-elastography and MR spectroscopy are valuable noninvasive diagnostic imaging techniques in diagnosis of early breast malignancy than any other diagnostic tools, consequently help to avoid nondesirable invasive surgical biopsy of the breast lesions.