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Chung M, Ton L, Lee AY. Forget Me Not: Incidental Findings on Breast MRI. JOURNAL OF BREAST IMAGING 2024:wbae023. [PMID: 38758984 DOI: 10.1093/jbi/wbae023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Indexed: 05/19/2024]
Abstract
With the growing utilization and expanding role of breast MRI, breast imaging radiologists may encounter an increasing number of incidental findings beyond the breast and axilla. Breast MRI encompasses a large area of anatomic coverage extending from the lower neck to the upper abdomen. While most incidental findings on breast MRI are benign, identifying metastatic disease can have a substantial impact on staging, prognosis, and treatment. Breast imaging radiologists should be familiar with common sites, MRI features, and breast cancer subtypes associated with metastatic disease to assist in differentiating malignant from benign findings. Furthermore, detection of malignancies of nonbreast origin as well as nonmalignant, but clinically relevant, incidental findings can significantly impact clinical management and patient outcomes. Breast imaging radiologists should consistently follow a comprehensive search pattern and employ techniques to improve the detection of these important incidental findings.
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Affiliation(s)
- Maggie Chung
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Lauren Ton
- School of Medicine, University of California, San Francisco, CA, USA
| | - Amie Y Lee
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
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Caserta S, Gangemi S, Murdaca G, Allegra A. Gender Differences and miRNAs Expression in Cancer: Implications on Prognosis and Susceptibility. Int J Mol Sci 2023; 24:11544. [PMID: 37511303 PMCID: PMC10380791 DOI: 10.3390/ijms241411544] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
MicroRNAs are small, noncoding molecules of about twenty-two nucleotides with crucial roles in both healthy and pathological cells. Their expression depends not only on genetic factors, but also on epigenetic mechanisms like genomic imprinting and inactivation of X chromosome in females that influence in a sex-dependent manner onset, progression, and response to therapy of different diseases like cancer. There is evidence of a correlation between miRNAs, sex, and cancer both in solid tumors and in hematological malignancies; as an example, in lymphomas, with a prevalence rate higher in men than women, miR-142 is "silenced" because of its hypermethylation by DNA methyltransferase-1 and it is blocked in its normal activity of regulating the migration of the cell. This condition corresponds in clinical practice with a more aggressive tumor. In addition, cancer treatment can have advantages from the evaluation of miRNAs expression; in fact, therapy with estrogens in hepatocellular carcinoma determines an upregulation of the oncosuppressors miR-26a, miR-92, and miR-122 and, consequently, apoptosis. The aim of this review is to present an exhaustive collection of scientific data about the possible role of sex differences on the expression of miRNAs and the mechanisms through which miRNAs influence cancerogenesis, autophagy, and apoptosis of cells from diverse types of tumors.
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Affiliation(s)
- Santino Caserta
- Division of Hematology, Department of Human Pathology in Adulthood and Childhood "Gaetano Barresi", University of Messina, Via Consolare Valeria, 98125 Messina, Italy
| | - Sebastiano Gangemi
- Allergy and Clinical Immunology Unit, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria, 98125 Messina, Italy
| | - Giuseppe Murdaca
- Department of Internal Medicine, University of Genova, Viale Benedetto XV, 16132 Genova, Italy
- IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Alessandro Allegra
- Division of Hematology, Department of Human Pathology in Adulthood and Childhood "Gaetano Barresi", University of Messina, Via Consolare Valeria, 98125 Messina, Italy
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Jen A, Kochkodan-Self J, Mandell JC. A Retrospective Analysis of Sternal Lesions Detected on Breast MRI in Patients Without History of Cancer. JOURNAL OF BREAST IMAGING 2023; 5:48-55. [PMID: 38416958 DOI: 10.1093/jbi/wbac078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Indexed: 03/01/2024]
Abstract
OBJECTIVE To determine the imaging characteristics and stability over time of sternal lesions identified on breast MRI in patients without history of cancer. METHODS An IRB-approved retrospective analysis of all breast MRIs performed at our institution from September 1, 2017 to December 1, 2021 that included one of several key words related to the sternum. Studies with history of non-dermatologic malignancy including breast cancer, absence of a true sternal lesion, or presence of symptoms during the examination were excluded. Imaging was reviewed for size, distribution, signal characteristics, and presence of contrast enhancement, perilesional edema, periosteal edema, or intralesional fat. Available comparison imaging, clinical history, and follow-up recommendations were reviewed. Descriptive statistics were used to summarize lesion data. RESULTS Of 60 lesions included from 60 patients, 40 lesions with more than two years of comparison imaging were either stable or decreased in size and none demonstrated change in signal characteristics. The majority of these presumed benign lesions demonstrated hypointense signal on T1-weighted sequences (21/40, 52.5%), hyperintense signal on fluid-sensitive sequences (33/40, 82.5%), contrast enhancement (32/40, 80.0%), and absence of clear intralesional fat (29/40, 72.5%). One patient who did not have comparison imaging was diagnosed with malignancy (multiple myeloma) eight months following their MRI. This lesion demonstrated uniquely diffuse and heterogeneous enhancement but did not undergo biopsy. CONCLUSION Sternal lesions in women without history of non-dermatologic malignancy have a very low likelihood of malignancy. Common imaging characteristics of the presumed benign lesions can inform imaging recommendations when incidental sternal lesions are discovered.
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Affiliation(s)
- Aaron Jen
- Brigham and Women's Hospital and Harvard Medical School, Department of Radiology, Boston, MA, USA
| | - Jeanne Kochkodan-Self
- Brigham and Women's Hospital and Harvard Medical School, Department of Radiology, Boston, MA, USA
| | - Jacob C Mandell
- Brigham and Women's Hospital and Harvard Medical School, Department of Radiology, Boston, MA, USA
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Ryoo JA, Kim SY. Incidental Extramammary Findings on Preoperative Breast MRI in Breast Cancer Patients: A Pictorial Essay. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2023; 84:372-385. [PMID: 37051390 PMCID: PMC10083632 DOI: 10.3348/jksr.2022.0076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/21/2022] [Accepted: 08/12/2022] [Indexed: 04/03/2023]
Abstract
Breast cancer is one of the most common cancers and causes several complications in females. Currently, MRI is a necessary method for preoperative studies in patients with breast cancer. A high frequency of breast MRI can lead to an increase in the number of incidental extramammary findings. Moreover, it can provide accurate preoperative workup; therefore, the prognosis of patients can be improved. Herein, we provide several extramammary findings, including the mediastinum, lung, upper abdomen, bone, and soft tissue, correlating with US, chest CT, liver MRI, PET-CT, and bone scan.
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Corines MJ, Coffey K, Dou E, Lobaugh S, Zheng J, Hwang S, Feigin K. Bone Lesions Detected on Breast MRI: Clinical Outcomes and Features Associated with Metastatic Breast Cancer. JOURNAL OF BREAST IMAGING 2022; 4:600-611. [PMID: 37744182 PMCID: PMC10516530 DOI: 10.1093/jbi/wbac053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Objective To determine prevalence and frequency of malignancy among bone lesions detected on breast MRI and to identify clinical and imaging features associated with bone metastases from breast cancer (BC), as bone lesions are suboptimally evaluated on breast imaging protocols and can present a diagnostic challenge. Methods This IRB-approved retrospective review of breast MRIs performed from June 2009 to June 2018 identified patients with bone lesions. Demographic, clinical, and MRI features were reviewed. Clinical outcome of bone lesions was determined based on pathology and/or additional diagnostic imaging. All benign lesions had ≥ 2 years of imaging follow-up. Statistics were computed with Fisher's exact and Wilcoxon rank sum tests. Results Among all patients with breast MRI, 1.2% (340/29 461) had bone lesions. Of these, 224 were confirmed benign or metastatic BC by pathology or imaging follow-up, with 70.1% (157/224) be- nign and 29.9% (67/224) metastatic. Bone metastases were associated with BC history (P < 0.001), with metastases occurring in 58.2% (53/91) of patients with current BC, 17.9% (14/78) patients with prior BC, and 0.0% (0/55) without BC. Bone metastases were associated with invasive and ad- vanced stage BC and, on MRI, with location in sternum, ribs, or clavicles, larger size, multiplicity, andT1 hypointensity (all P < 0.01 in tests of overall association). Conclusion Of clinically confirmed breast MRI-detected bone lesions, 30% were bone metastases; all were detected in patients with current or prior BC. Metastases were associated with advanced stage, invasive carcinoma, larger lesion size, multiplicity, low T1 signal, and non-spine location.
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Affiliation(s)
- Marina J. Corines
- Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY, USA
| | - Kristen Coffey
- Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY, USA
| | - Eda Dou
- University of California San Francisco, Department of Radiology and Biomedical Imagery, San Francisco, CA, USA
| | - Stephanie Lobaugh
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Junting Zheng
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sinchun Hwang
- Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY, USA
| | - Kimberly Feigin
- Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY, USA
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Xiang L, Sun LH, Liu B, Wang LS, Gong XJ, Qiu J, Ge YQ, Yao WJ, Gu KC. Quantitative Dynamic Contrast-Enhanced Magnetic Resonance Imaging for the Analysis of Microvascular Permeability in Peritumor Brain Edema of Fibrous Meningiomas. Eur Neurol 2021; 84:361-367. [PMID: 34315157 DOI: 10.1159/000516921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/26/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION This study aims to analyze the permeability of intra- and peri-meningiomas regions and compare the microvascular permeability between peritumoral brain edema (PTBE) and non-PTBE using DCE-MRI. METHODS This was a retrospective of patients with meningioma who underwent surgery. The patients were grouped as PTBE and non-PTBE. The DCE-MRI quantitative parameters, including volume transfer constant (Ktrans), rate constant (Kep), extracellular volume (Ve), and mean plasma volume (Vp), obtained using the extended Tofts-Kety 2-compartment model. Logistic regression analysis was conducted to explore the risk factor of PTBE. RESULTS Sixty-three patients, diagnosed as fibrous meningioma, were included in this study. They were 17 males and 46 females, aged from 32 to 88 years old. Kep and Vp were significantly lower in patients with PTBE compared with those without (Kep: 0.1852 ± 0.0369 vs. 0.5087 ± 0.1590, p = 0.010; Vp: 0.0090 ± 0.0020 vs. 0.0521 ± 0.0262, p = 0.007), while there were no differences regarding Ktrans and Ve (both p > 0.05). The multivariable analysis showed that tumor size ≥10 cm3 (OR = 4.457, 95% CI: 1.322-15.031, p = 0.016) and Vp (OR = 0.572, 95%CI: 0.333-0.981, p = 0.044) were independently associated with PTBE in patients with meningiomas. CONCLUSION DCE-magnetic resonance imaging·Meningioma·Blood vessel MRI can be used to quantify the microvascular permeability of PTBE in patients with meningioma.
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Affiliation(s)
- Li Xiang
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Department of Radiology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Li-Hua Sun
- Department of Radiology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Bin Liu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Long-Sheng Wang
- Department of Radiology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xi-Jun Gong
- Department of Radiology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ju Qiu
- Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | | | - Wen-Jun Yao
- Department of Radiology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Kang-Chen Gu
- Department of Radiology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
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Diffusion-Weighted Imaging Can Differentiate between Malignant and Benign Pleural Diseases. Cancers (Basel) 2019; 11:cancers11060811. [PMID: 31212757 PMCID: PMC6627409 DOI: 10.3390/cancers11060811] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 06/01/2019] [Accepted: 06/03/2019] [Indexed: 12/12/2022] Open
Abstract
It is not clear whether magnetic resonance imaging (MRI) is useful for the assessment of pleural diseases. The aim of this study is to determine whether diffusion-weighted magnetic resonance imaging (DWI) can differentiate malignant pleural mesothelioma (MPM) from pleural dissemination of lung cancer, empyema or pleural effusion. The DWI was calibrated with the b value of 0 and 800 s/mm2. There were 11 MPMs (8 epithelioid and 3 biphasic), 10 pleural disseminations of lung cancer, 10 empyemas, and 12 pleural effusions. The apparent diffusion coefficient (ADC) of the pleural diseases was 1.22 ± 0.25 × 10−3 mm2/s in the MPMs, 1.31 ± 0.49 × 10−3 mm2/s in the pleural disseminations, 2.01 ± 0.45 × 10−3 mm2/s in the empyemas and 3.76 ± 0.62 × 10−3 mm2/s in the pleural effusions. The ADC of the MPMs and the pleural disseminations were significantly lower than the ADC of the empyemas and the pleural effusions. Concerning the diffusion pattern of DWI, all 11 MPMs showed strong continuous diffusion, 9 of 10 pleural disseminations showed strong scattered diffusion and 1 pleural dissemination showed strong continuous diffusion, all 10 empyemas showed weak continuous diffusion, and all 12 pleural effusions showed no decreased diffusion. DWI can evaluate pleural diseases morphologically and qualitatively, and thus differentiate between malignant and benign pleural diseases.
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Golse N, Adam R. Liver Metastases From Breast Cancer: What Role for Surgery? Indications and Results. Clin Breast Cancer 2017; 17:256-265. [DOI: 10.1016/j.clbc.2016.12.012] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 12/26/2016] [Indexed: 12/30/2022]
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