Radiology Pathology Research Articles

Perthes disease-diagnosis, classification and treatment based on Aachen-Dortmund treatment algorithm

Legg-Calvé-Perthes disease is amultifactorial idiopathic necrosis of the hip that typically occurs in childhood between the ages of 3 and 12. Treatment adapted to the stadium of the disease and to the clinical findings is medical art. The treatment is focused on the preservation or recovery of the arthrogenic containment of the femoral head. Multiple treatment options are available. The indications for treatment can be derived from clinical and radiological pathology. Structuring of the therapy options is the aim of this publication. For this purpose, aclear and concise overview of relevant clinical findings and useful radiographic classifications as well as reasonable therapy is presented.

Heterotopic Gastrointestinal Cyst of the Oral Cavity Radiology–Pathology Correlation

Heterotopic gastrointestinal cyst of the oral cavity is a rare congenital lesion that may arise from ectopic undifferentiated endodermal cells. Imaging, particularly MRI, is useful for surgical planning. On MRI, the cysts typically demonstrate high signal on T2-weighted sequences and variable signal on T1-weighted sequences, which can resemble other conditions, such as dermoids. On histology, the appearance of these lesions can be variable, and may include stratified squamous, simple and ciliated columnar, as well as foveolar and intestinal-type epithelia, often surrounding by smooth muscle. Complete surgical excision is the treatment of choice.

The AWOL Business Card

I recently had the pleasure of participating as a young physician faculty member at the inaugural Radiology Leadership Institute “Kickstart Your Career” symposium. With a target audience of radiology residents enrolled at the concurrent Armed Institute for Radiology Pathology course, the purpose of the symposium was to introduce younger members of the ACR to early career topics, including how to perform an effective job search, how to evaluate a job offer, and how to interview effectively.

FDG-PET diagnoses of sporadic Creutzfeldt-Jakob disease: radiology-pathology correlation.

FDG-PET diagnoses of sporadic Creutzfeldt-Jakob disease: radiology-pathology correlation.

STUDY OF SERUM NEOPTERIN, INTERLEUKIN-10 AND NEUTROPHIL TO LYMPHOCYTE RATIO IN CONTRAST INDUCED NEPHROPATHY

Background: Recent improvements in radio-diagnostic procedures and in cardiovascular percutaneous interventions, together with increased life expectancy, have resulted in the subjection of an increasing number of patients to contrast medium-enhanced examinations or cardiac and angiographic procedure requiring iodinated contrast medium injection.  Subjects and methods: This study was carried out at Internal Medicine, Cardiology, Radiology and Clinical Pathology departments, Zagazig University Hospitals. The study was approved by Institutional Review Board (IRB) and included a total of 60 patients.  Based on the development of contrast induced nephropathy after IV administration of high osmolar contrast agent, Patients were classified into CIN and NO CIN groups. We measured serum neopterin and IL-10 and calculating neutrophil to lymphocyte ratio before contrast administration, 24 and 48 hours after in 45 patients underwent coronary angiography for diagnostic and therapeutic purposes and 15 patients underwent renal angiography.  Results : About 25 % of the present studied patients (14 patients) fulfilled the criteria of contrast nephropathy with more cases in the percutaneous coronary angiography group (11 patients).This study revealed that serum neopterin, IL 10 and neutrophil to lymphocyte ratio were higher in patients with CIN following IV contrast media at 24 & 48 hours compared to patients without CIN. In our study; we found increased pre procedural and post-procedural CRP, ESR and uric acid levels at 48 hours in patients with CIN. We found a decreased basal serum total bilirubin level in patients with CIN following IV contrast media compared to patients without CIN.  Conclusion: Serum neopterin, IL 10 and neutrophil to lymphocyte ratio proved that they can be used as early biomarkers of contrast induced nephropathy instead of serum creatinine as they rise 24 hours before any change in the serum creatinine. Decreased serum total bilirubin levels had a higher incidence of CIN after the use of contrast media. Measuring ESR & CRP levels at admission may offer additional assistance in predicting the development of CIN. Elevated serum uric acid level is independently associated with an increased risk of CIN.  Abbreviations: CIN = Contrast induced nephropathy , AKI = Acute kidney injury, CRP = C-reactive protein, NLR = Neutrophil to lymphocyte ratio, ESR = Erythrocyte sedimentation rate, UA = Uric acid, eGFR = estimated glomerular filtration rate.  Keywords: Contrast induced nephropathy; Neopterin; IL-10; Neutrophil to lymphocyte ratio.

Endodontic Management of Maxillary First Molar With Five Canals: A Case Report

For root canal treatment success, complete root canal cleaning is essential. However, the detection of morphological changes in the teeth and the cleaning of all canal influence the success of root canal treatment. The finding of canals within the root canal system enhances the success of treatment. The aim of this case report is to present a rare five-channel successful root canal treatment of maxillary first molar teeth.A 34-year-old male patient was referred to the endodontic clinic with a chief complaint of dull pain. Clinical examination revealed deep dentine carious lesion, the teeth was tender to percussion. After radiological examination, no radiolucency and pathology was detected around the related teeth. While root canal treatment, in addition to the expected canals second canal was found at distobuccal root. After the biomechanic preparation of the canals, the root canals were obturated using gutta-percha and sealer. The teeth was restored with composite resin. Following 6 months, he had no tenderness to percussion or palpation and no pathological evidence was determined in radiographic images

Cadaveric versus Radiology Anatomy: Do we have the right balance to prepare medical students to be physicians?

BackgroundRadiology is one of the cornerstones of modern medicine, playing an important role in patient diagnosis and management. All physicians, regardless of their speciality, are now expected to provide preliminary interpretations of radiological studies throughout their careers. Many medical undergraduate anatomy programs are beginning to teach radiological concepts through their anatomy curricula to improve the clinical relevance of teaching and to better prepare students for clinical practice. However, there has been no research to date assessing the optimal balance between cadaveric and radiological anatomy. The purpose of this study is to assess medical students' comfort level in identifying normal cadaveric and radiological anatomy and to identify areas where curricula can be renewed.MethodsAn anonymous online survey was administered to the second, third and fourth year undergraduate medical students at a large distributed medical school which teaches both cadaveric and radiologic anatomy (N = 850). The survey collected respondents' demographic information as well as prior radiology exposure. Students were asked to rank their comfort level in identifying anatomy in cadavers and on radiology studies on a 4‐point Likert scale. Statistical analysis was carried out to determine if there was any difference in student responses based on year of training (i.e. pre‐clinical vs clinical) and the Copeland score method was used to generate a rank order list of student comfort level across all variables.Results153 students completed the survey yielding a response rate of 18%. 50.3% of respondents were female and most respondents were between 18–24 years old. 51.6% of respondents were in their clinical years (i.e. year 3 and 4) and 48.4% were in their pre‐clinical years. Most (90.8%) students reported receiving no radiology teaching prior to medical school. Most students (65.4%) reported their overall anatomy knowledge as “average.” When Likert data was used to generate a rank‐order list, students reported feeling most comfortable when identifying cadaveric organ anatomy, cadaveric bony anatomy and recognizing spatial relationships in cadavers and least comfortable when identifying radiological pathology, radiological neuroanatomy, and recognizing spatial relationships on imaging studies. There was no statistical difference in response when considering students' level of training.ConclusionsOverall, medical students reported feeling less comfortable when identifying normal anatomy on radiological studies when compared to identifying the same structures in the cadaver. This study suggests medical students would benefit from increased exposure to radiology anatomy during medical school, especially given that most physicians will be primarily examining radiology images throughout their careers.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

MP63-16 PROSPECTIVE RANDOMIZED COMPARISON OF CONVENTIONAL AND TRIPLE BOLUS COMPUTED TOMOGRAPHY FOR HEMATURIA EVALUATION

You have accessJournal of UrologyImaging/Radiology: Uroradiology IV1 Apr 2018MP63-16 PROSPECTIVE RANDOMIZED COMPARISON OF CONVENTIONAL AND TRIPLE BOLUS COMPUTED TOMOGRAPHY FOR HEMATURIA EVALUATION Daniel Lama, Egor Parkhomenko, Chandana Lall, Roshan Patel, Kamaljot Kaler, Ralph Clayman, and Jaime Landman Daniel LamaDaniel Lama More articles by this author , Egor ParkhomenkoEgor Parkhomenko More articles by this author , Chandana LallChandana Lall More articles by this author , Roshan PatelRoshan Patel More articles by this author , Kamaljot KalerKamaljot Kaler More articles by this author , Ralph ClaymanRalph Clayman More articles by this author , and Jaime LandmanJaime Landman More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2039AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Hematuria is a common urological complaint requiring computed tomography (CT) imaging. While conventional CT with and without the use of intravenous contrast (CCT) is the gold standard for complete imaging of the upper and lower urinary tract, it is also associated with inherent ionizing radiation exposure. Alternatively, the triple bolus computed tomography (TBCT) protocol has previously been shown to expose patients to 20-40% less ionizing radiation compared to CCT. Herein, we present our preliminary findings of a prospective comparison of TBCT and CCT for the evaluation of hematuria. METHODS We prospectively randomized 52 patients at our institution with a chief complaint of macroscopic or microscopic hematuria to either CCT (n=35) or TBCT (n=17). Patient demographics, pre- and post-imaging creatinine, and urological pathology detection rate were recorded. Radiation exposure was quantified using two metrics; the volumetric computed tomography dose index (CTDIvol) and dose length product (DLP). In addition, a single experienced abdominal CT radiologist, blinded to the CT protocol used, completed an imaging quality questionnaire (rating system ranging from 1 (poor) to 5 (excellent)) for each imaging study. RESULTS There were no differences in patient age, gender, body mass index, Charlson-comorbidity index, change in creatinine, or CTDIvol between those who underwent CCT or TBCT. Patients with CCT imaging received twice the radiation dose compared to patients with TBCT (DLP: 1606 vs. 883 mGy*cm, respectively, p<0.01) (Table 1). CCT scores for imaging quality of the renal vasculature, renal parenchyma, and the collecting system were significantly higher than TBCT (4.94 vs. 4.71, 4.97 vs. 4.59, 4.71 vs. 4.29, respectively, p <0.05). The urological pathology detection rates were similar between CCT and TBCT (68% vs. 59%, respectively, p=0.49). CONCLUSIONS The TBCT protocol for hematuria evaluation exposes patients to a decreased dose of ionizing radiation and demonstrates a comparable radiological pathology detection rate to gold standard CT imaging despite a degradation in overall imaging quality. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e847 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Daniel Lama More articles by this author Egor Parkhomenko More articles by this author Chandana Lall More articles by this author Roshan Patel More articles by this author Kamaljot Kaler More articles by this author Ralph Clayman More articles by this author Jaime Landman More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

FDG-PET diagnoses of sporadic Creutzfeldt-Jakob disease: radiology-pathology correlation.

FDG-PET diagnoses of sporadic Creutzfeldt-Jakob disease: radiology-pathology correlation.

Stromal fibrosis: imaging features with diagnostic contribution of diffusion-weighted MRI.

To describe magnetic resonance imaging (MRI) and ultrasonography findings of breast stromal fibrosis (SF) and compare apparent diffusion coefficient (ADC) stromal fibrosis values with breast cancer and normal parenchyma. 45 patients (ages 22‒74) with histopathologically proven SF who underwent MRI were included in this study. Their MRI and ultrasonography features were examined and categorized. The mean ADC values for SF, contralateral normal parenchyma, and breast malignancy of the control group values were calculated and compared among each other. The vast majority of SF on sonography showed features suggestive of malignancy: (1) irregular in shape 25/45 (55%); (2) indistinct in margin 27/45 (60%); and (3) hypoechoic 39/45 (87%) with posterior acoustic shadowing 11/45 (24%). An SF MRI showed a mass in 12/45 (26%) and non-mass enhancement in 33/45 (74%), mostly with irregular (8/12; 67%) shape. Non-mass lesions showed heterogeneous (12/33), clumped (9/33), and homogenous (9/33) enhancement. The initial SF contrast uptake rate varied between slow (57%), rapid (22%), and medium (21%). Delayed SF enhancement may be persistent (66%) or plateau (34%). Small cysts were located around/near 21 (47%) of lesions. Ductal ectasia was found in 14 (31%) of all patients. Mean ADCs of parenchyma, SF, and malignancy were 1.32 ± 0.32, 1.23 ± 0.25, and 0.99 ± 0.24 × 10-3 mm2 sec-1, respectively. SF often mimics breast carcinoma on imaging and leads the radiology‒pathology disagreement. In terms of distinguishing SF from malignancy, ADC could be a significant and promising value in diffusion-weighted MRI along with conventional sequences. Slow initial uptake with delayed persistent contrast enhancement in a non-mass lesion with relatively higher ADC values are very helpful for differentiating SF from malignancy. The presence of small cysts and ductal ectasia were common findings around/near the SF. Advances in knowledge: A quantitative analysis for measuring ADC values along with additional MRI features can be very helpful in distinguishing SF from malignant lesions.

The impact of lung and bone metastases on prognosis in advanced PDAC.

494 Background: Pancreatic ductal adenocarcinoma (PDAC) remains a highly fatal disease inherently resistant to cytotoxic treatment. Despite the prevalence of liver and peritoneal metastases, subsets of patients also develop lung and bone metastases highlighting phenotypic heterogeneity. We reviewed the prognostic implications of metastatic sites on survival. Methods: This retrospective cohort study included all patients with PDAC who received surgical or oncological treatment at the University Health Network from September 2012 until December 2016. Clinical and pathological variables were obtained from patient electronic records. Radiological images and pathology reports were reviewed to ascertain sites of metastatic disease. The Kaplan-Meier method for survival and multivariable cox regression analysis identified prognostic factors. Results: 1153 patients were reviewed and 985 were included. 55% were male and the median age at diagnosis was 67 years. 287 (29%) completed curative surgery and 698 (71%) had locally advanced or metastatic disease; the median survival was 22 months and 9 months respectively. Lung and bone metastases were present in 18% (N = 180) and 6% (N = 58) of patients. In multivariable analysis increasing age and stage at diagnosis correlated with inferior survival (p &lt; 0.0001) and the presence of any lung (HR 0.77; 95% CI 0.63-0.94, p = 0.01) or bone metastases (HR 0.74; 95% CI 0.54-1.0, p = 0.05) resulted in improved outcomes. Liver and peritoneal disease were not prognostic. Sex and family history of PDAC did not associate with survival. There was no association between site of metastases and sex however patients with bone metastases were significantly younger at first diagnosis (median age 63yrs, p &lt; 0.01). Conclusions: Patients with advanced PDAC and metastases to lung or bone may represent distinct biological subtypes of PDAC. Molecular profiling of available tissue is ongoing.

99 A Wave of Innovation in Pathology Teaching With Incorporation of Advanced Radiology and Ultramodern Pathology Techniques

99 A Wave of Innovation in Pathology Teaching With Incorporation of Advanced Radiology and Ultramodern Pathology Techniques

Contrast enhanced ultrasound guided biopsies of liver lesions not visualized on standard B-mode ultrasound-preliminary experience.

To assess the technical success of contrast enhanced ultrasound (CEUS) guided biopsies of liver lesions poorly visualized on B-mode ultrasound. Patients were selected during the procedure based on the real-time clinical scenario of unsatisfactory B-mode ultrasound lesion visualization and all patients would have otherwise undergone CT guided liver lesion biopsy. A total of 26 patients underwent CEUS guided biopsy and were included in this retrospective analysis. The review of the patients' files included demographic information, lesion characteristics on imaging, procedural details and pathology outcome. Technical success was defined as concordance between the radiological findings, pathology report and clinical follow-up-demonstrating lack of need for re-biopsy or re-biopsy with identical pathological results. Patients with less than 2 months follow-up were excluded from the study. CEUS guided liver biopsy was successful in 23 out of 26 patients (88.5%). The average procedure time was 30.7±12.3 minutes and the average lesion size was 2.2±1.7 cm. The majority of lesions (80.8%) were hypoenhancing on the delayed phase of CEUS. The mean number of samples taken from each lesion per procedure was 3.2 (±1.7). CEUS guidance biopsies of focal liver lesions (FLL) that were difficult to visualize on B-mode ultrasound demonstrated high success rate and may be an evolving image guidance modality in selected patients to avoid CT guided procedures.

CT-guided Hookwire localization before video-assisted thoracoscopic surgery for solitary ground-glass opacity dominant pulmonary nodules: radiologic-pathologic analysis.

The optimal screening or treatment strategies of solitary pulmonary nodules especially ground-glass opacities (GGOs) remain controversial. With CT-guided Hookwire localization, it is accurate to find the small lesions during video-assisted thoracoscopic surgery (VATS). In this study, we evaluate the efficiency and safety of CT-guided Hookwire localization of GGO-dominant (GGO component > 50%) pulmonary nodules before VATS and investigate the correlation between the radiologic features and pathology. From April 2008 to April 2014, a total of 273 patients with solitary GGO-dominant pulmonary nodules were included. Tumor size was 12.4 ± 5.7 mm in diameter, including 208 pulmonary adenocarcinomas and 65 benign nodules. Dislodgement occurred in six patients (2.20%) during surgery. Postoperative complications included asymptomatic needle track hemorrhage (27.1%), minimal pneumothorax (5.9%) and hemoptysis (0.4%). In 208 (76.2%) pulmonary adenocarcinomas, 82 nodules showed ≥90% GGO and 126 showed 50%≤GGO<90%, while 84 nodules staged as T1aN0M0, 96 staged as T1bN0M0, and 28 staged as T1cN0M0. The multivariable analysis demonstrated that 50%≤GGO<90% (HR=2.459, 95% CI: 1.246-4.853, P=0.010), speculation (HR=3.911, 95% CI: 1.966-7.663, P<0.001), lobulation (HR=4.582, 95% CI: 2.149-9.767, P<0.001) and vascular convergence (HR=4.096, 95% CI: 1.132-14.824, P=0.032) were the independent risk factors to identification of the malignant GGO-dominant pulmonary nodules. In conclusions,CT-guided Hookwire localizati for GGO-dominant pulmonary nodules before VATS is a safe and effective procedure for accurate diagnosis and resection of indeterminate solitary pulmonary nodules.

Prognostic Value of Lordosis Decrease in Radiographic Adjacent Segment Pathology After Anterior Cervical Corpectomy and Fusion

While cervical lordosis alteration is not uncommon after anterior cervical arthrodesis, its influence on radiological adjacent segment pathology (RASP) is still unclear. Biomechanical changes induced by arthrodesis may contribute to ASP onset. To investigate the correlation between cervical lordosis decrease and RASP onset after anterior cervical corpectomy and fusion (ACCF) and to determine its biomechanical effect on adjacent segments after surgery, 80 CSM patients treated with ACCF were retrospectively studied, and a baseline finite element model of the cervical spine as well as post-operation models with normal and decreased lordosis were established and validated. We found that post-operative lordosis decrease was prognostic in predicting RASP onset, with the hazard ratio of 0.45. In the FE models, ROM at the adjacent segment increased after surgery, and the increase was greater in the model with decreased lordosis. Thus, post-operative cervical lordosis change significantly correlated with RASP occurrence, and it may be of prognostic value. The biomechanical changes induced by lordosis change at the adjacent segments after corpectomy may be one of the mechanisms for this phenomenon. Restoring a well lordotic cervical spine after corpectomy may reduce RASP occurrence and be beneficial to long-term surgical outcomes.

Clinical breast concerns in low-risk pediatric patients: practice review with proposed recommendations.

Fibroadenoma is overwhelmingly the most common pediatric breast lesion. Breast malignancy is quite uncommon in children, most frequently metastatic or hematological malignancy. Core biopsy has largely replaced excision for diagnosis of breast masses in adults. The purpose of this study is two-fold: (1) compare utilization at our institution of interventional procedures vs. surgery for breast mass diagnosis in patients ≤18years and (2) propose guidelines for breast imaging and biopsy in this population. We extracted data for all patients ≤18 who, between 2004 and 2016, underwent either (a) imaging and/or intervention procedure, or (b) breast surgery, from the Radiology Information System and Pathology Data System, respectively. We recorded age, gender, imaging, procedure, lesion size and histopathology. We found 1,050 pediatric patients ≤18years who underwent diagnostic breast ultrasound between 2004 and 2016. Of these, 168 patients underwent 199 interventional procedures. One hundred thirty patients underwent 160 core biopsies of solid lesions. Core biopsy pathology diagnosed benign lesions in 99%, of which 84.3% were fibroadenomas (n=135). One malignancy was diagnosed, B cell lymphoma. Two hundred three patients underwent surgical excision for 266 discrete lesions, and 89% were fibroadenomas. Seven benign phyllodes tumors were surgically diagnosed. No malignancies were diagnosed. Core biopsy in patients 18years and younger is well-tolerated, has few risks, and is preferable to surgery in developing breasts, but the goal is to avoid any breast procedure whenever possible. We propose guidelines for pediatric breast imaging, follow-up, core biopsy and excisions.

Discriminative Scale Learning (DiScrn): Applications to Prostate Cancer Detection from MRI and Needle Biopsies

There has been recent substantial interest in extracting sub-visual features from medical images for improved disease characterization compared to what might be achievable via visual inspection alone. Features such as Haralick and Gabor can provide a multi-scale representation of the original image by extracting measurements across differently sized neighborhoods. While these multi-scale features are effective, on large-scale digital pathological images, the process of extracting these features is computationally expensive. Moreover for different problems, different scales and neighborhood sizes may be more or less important and thus a large number of features extracted might end up being redundant. In this paper, we present a Discriminative Scale learning (DiScrn) approach that attempts to automatically identify the distinctive scales at which features are able to best separate cancerous from non-cancerous regions on both radiologic and digital pathology tissue images. To evaluate the efficacy of our approach, our approach was employed to detect presence and extent of prostate cancer on a total of 60 MRI and digitized histopathology images. Compared to a multi-scale feature analysis approach invoking features across all scales, DiScrn achieved 66% computational efficiency while also achieving comparable or even better classifier performance.

Ex vivo tissue imaging for radiology-pathology correlation: a pilot study with a small bore 7-T MRI in a rare pigmented ganglioglioma exhibiting complex MR signal characteristics associated with melanin and hemosiderin.

.To advance magnetic resonance imaging (MRI) technologies further for in vivo tissue characterization with histopathologic validation, we investigated the feasibility of ex vivo tissue imaging of a surgically removed human brain tumor as a comprehensive approach for radiology–pathology correlation in histoanatomically identical fashion in a rare case of pigmented ganglioglioma with complex paramagnetic properties. Pieces of surgically removed ganglioglioma, containing melanin and hemosiderin pigments, were imaged with a small bore 7-T MRI scanner to obtain T1-, T2-, and T2*-weighted image and diffusion tensor imaging (DTI). Corresponding histopathological slides were prepared for routine hematoxylin and eosin stain and special stains for melanin and iron/hemosiderin to correlate with MRI signal characteristics. Furthermore, mean diffusivity (MD) maps were generated from DTI data and correlated with cellularity using image analysis. While the presence of melanin was difficult to interpret in in vivo MRI with certainty due to concomitant hemosiderin pigments and calcium depositions, ex vivo tissue imaging clearly demonstrated pieces of tissue exhibiting the characteristic MR signal pattern for melanin with pathologic confirmation in a histoanatomically identical location. There was also concordant correlation between MD and cellularity. Although it is still in an initial phase of development, ex vivo tissue imaging is a promising approach, which offers radiology–pathology correlation in a straightforward and comprehensive manner.

Topographic Pain Mapping versus Radiological Inter-observer Variation in Ankle Arthritis

Category: Ankle, Ankle Arthritis Introduction/Purpose: Topographic pain mapping has gained popularity during 20th century, providing opportunities for patients to demonstrate spatial distribution of pain. Despite this, evidence of clinical application in orthopaedics remains largely limited to spinal pathologies. We investigate how clinician interpretation of routine radiological studies compares to patient pain mapping in ankle arthritis. Methods: Between 2014 and 2016 we identified 21 patients ultimately diagnosed with ankle arthritis, who underwent comprehensive gait analysis (including topographic pain mapping) on referral to our institution. Patients were requested to map up to three pain areas, assigning a visual analogue score (VAS) of 0-10, to signify severity of pain in each area. A consultant orthopaedic foot and ankle surgeon, and orthopaedic trainees undertook blinded evaluation of relevant radiological studies, estimating patients’ mapping and VAS scores on the basis of radiological pathology. For the purpose of analysis findings were applied to five distinct regions around the ankle: three anterior (antero-medial; central; and antero-lateral), lateral and medial. Results were correlated between the different assessors, as well as to the patients’ pain mapping, using Spearman’s Rho &amp; Kendall Tau correlation statistics, significance taken as p=&lt;0.05. Results: There is a strong radiological inter-observer correlation for anterior ankle pain in ankle arthritis [Antero-lateral 0.751(p=0.012); Central 0.912(p=&lt;0.001)]. These findings also correlate well with patient pain mapping [Central consultant-patient 0.920(p=&lt;0.001); trainee-patient 0.982(p=&lt;0.001)]. Assessment of medial (tibialis posterior) and lateral (subtalar/peroneal) pathology demonstrates poorer inter-observer correlations (p&gt;0.05). Correlation to patient pain mapping was even poorer, with radiological assessment consistently over- estimating symptom severity (p=&gt;0.05). Conclusion: There is a statistically strong correlation between topographic pain mapping and radiological evaluation of ankle arthritis. We strongly recommend that additional pathology around the ankle is excluded by use of pre-operative MRI imaging prior to surgery for ankle arthritis. Pain from ankle arthritis appears to mask additional soft tissue pathology surrounding the ankle noted on MRI scan.

Distinctive Features of Testicular Neoplasms: Seminoma versus Mixed Germ Cell Tumor

HomeRadioGraphicsVol. 37, No. 4 Previous IlluminationsDistinctive Features of Testicular Neoplasms: Seminoma versus Mixed Germ Cell TumorAletta Ann Frazier Aletta Ann Frazier Author AffiliationsAmerican Institute for Radiologic Pathology, Silver Spring, Maryland, and University of Maryland School of Medicine, Baltimore, Maryland ([email protected]).Aletta Ann Frazier Published Online:Jul 11 2017https://doi.org/10.1148/rg.2017174007MoreSectionsFull textPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In Article HistoryPublished online: July 11 2017Published in print: July 2017 FiguresReferencesRelatedDetailsRecommended Articles Testicular Seminoma and Its Mimics: From the Radiologic Pathology ArchivesRadioGraphics2017Volume: 37Issue: 4pp. 1085-1098Testicular Germ Cell Tumors: Classification, Pathologic Features, Imaging Findings, and ManagementRadioGraphics2021Volume: 41Issue: 6pp. 1698-1716Spectrum of Extratesticular and Testicular Pathologic Conditions at Scrotal MR ImagingRadioGraphics2018Volume: 38Issue: 3pp. 806-830Association between Testicular Microlithiasis and Testicular Neoplasia: Large Multicenter Study in a Pediatric PopulationRadiology2017Volume: 285Issue: 2pp. 576-583Multimodality Imaging Approach to Ovarian Neoplasms with Pathologic CorrelationRadioGraphics2020Volume: 41Issue: 1pp. 289-315See More RSNA Education Exhibits Testicular Germ Cell Tumors: Current Update on Classification, Pathology, Imaging Findings, and Management Digital Posters2020Radiologic-Pathologic Correlation of Intratesticular and Extratesticular Lesions: US, MR and CTDigital Posters2020Sizing up the Scrotum: Multimodality Approach to Scrotal Neoplasms with Pathology CorrelationDigital Posters2019 RSNA Case Collection Testicular SeminomaRSNA Case Collection2020Pineal Germinoma RSNA Case Collection2021Left breast hamartomaRSNA Case Collection2020 Vol. 37, No. 4 Metrics Altmetric Score PDF download