Evaluation of relative abundance of lymphedema after reverse axillary mapping in patients with breast cancer

Breast ultrasound imaging systems performance evaluation using novel Contrast-Detail (C-D) and Anechoic-Target (A-T) phantoms

Ultrasound imaging plays an important role in the early detection and management of breast cancer. This study aimed to evaluate the imaging performance of a range of clinically-used breast ultrasound systems using a set of novel spherical lesion contrast-detail (C-D) and anechoic-target (A-T) phantoms.

METHODS

C-D and A-T phantoms were imaged using a range of clinical breast ultrasound systems and imaging modes. A novel sensitive imaging performance metric, the Detectability Score (DS), was proposed which encompasses the Lesion Contrast to Noise Ratio (LCNR) weighted by the lesion depth and diameter. A geometry-based theoretical model comparing LCNR measured using spherical and cylindrical phantom anechoic/lesion targets was developed to investigate the influence of slice thickness on focal lesion detectability.

RESULTS

LCNR and DS metrics derived from phantom image measurments were capable of differentiating the imaging performance of a range of ultrasound systems and advanced imaging modes, with the -2 dB contrast lesion targets offered as the most challenging to resolve. The geometry-based theoretical model, validated against phantom measurements, demonstrated the significant influence of slice thickness on focal lesion detectability, highlighting the need for increased availability of low contrast resolution spherical target phantoms for clinically realistic performance evaluation.

CONCLUSIONS

The performance metrics coupled with the -1 dB contrast targets provide scope for evaluating future technological improvements in ultrasound systems. Given the high dependence of breast cancer care on high quality ultrasound imaging techniques, there is a need for evaluating imaging performance using clinically relevant test objects.

Diagnostic value of total serum/free prostate specific antigen and prostate cancer antigen-3 levels in prostate cancer

BACKGROUND

The purpose of this study was to compare serum total and free prostate specific antigen (PSA) levels and serum prostate cancer antigen-3 (PCA3) levels in patients with prostate cancer in 2018 and 2019.

METHODS

This research was a prospective case-control study. The case group included all patients with suspected prostate cancer, and the control group included individuals without prostate disease who were referred to Ali Asghar and Nour Hospital in Isfahan, Iran, from October 2018 to October 2020. The serum total PSA, free PSA, and PCA3 levels in both groups were measured using the ELISA method with standard kits and compared between the groups.

RESULTS

The two groups were matched in terms of age and body mass index (BMI). The results showed that the mean free PSA level in the control group was significantly higher than that in the case group (P<0.05). Conversely, the mean total PSA level in the case group was significantly higher than that in the control group (P<0.05). However, no significant difference was observed in the mean PCA3 levels between the case and control groups. In addition, the total PSA variable with a cutoff of ≤3.14 exhibited 93% sensitivity and 82% specificity, demonstrating the highest diagnostic accuracy in distinguishing between prostate cancer and healthy individuals. Similarly, the PCA3 value with a cutoff of ≤3.5 had a sensitivity and specificity of 70% and 72%, respectively.

CONCLUSION

Overall, the study results indicated that total PSA and PCA3 levels have higher diagnostic accuracy in distinguishing patients with suspected prostate cancer from healthy individuals.

Comparison of the Effects of Special Care Enhanced Recovery and Conventional Recovery Methods after Mini Omega Gastric Bypass

Background

Bariatric surgery is a surgical procedure for patients with extreme obesity. Enhanced Recovery after Surgery (ERAS) is a method that provides special peri- and post-operation care. Here, we aimed to compare the effects of ERAS and standard recovery cares.

Materials and Methods

This is a randomized clinical trial that was performed in 2020-2021 in Isfahan on 108 candidates for mini gastric bypass. Patients were then randomly divided into two equal groups receiving ERAS and standard recovery protocols. Patients were examined and visited after one month regarding the average number of hospitalization days, the average days required to return to normal activity or work, occurrence of pulmonary thromboemboli (PTE) and the rate of readmission.

Results

Patients that received ERAS had significantly lower frequencies of nausea and vomiting (P = 0.032). Patients that received ERAS had significantly lower hospitalization duration (P < 0.001) compared to controls. No other significant differences were observed between two groups regarding surgery complication, re-admission rate and occurrence of PTE (P > 0.99 for all).

Conclusion

Patients that received ERAS protocol after gastric bypass had significantly lower hospitalization duration and lower incidence of nausea and vomiting. They also had similar post-operative outcomes compared to the standard protocol.

Evaluation of PD-L1 antigen expression using immunohistochemistry technique in medullary thyroid carcinoma samples

BACKGROUND

Markers related to the mechanism of tumoral cell escape from the immune system have received more attention. The PD-L1 molecule encoded by the "CD274" gene binds to T lymphocytes and can inhibit these cells. Therefore, increasing the expression of this marker on inflammatory or tumor cells can indicate tumor progression invasiveness and long-term consequences. The present study aimed to determine the expression of the PD-L1 marker in thyroid medullary tumors and to evaluate its role in predicting long-term outcomes after cancer.

METHODS

This retrospective longitudinal study was performed on pathology samples of patients with medullary thyroid carcinoma referred to the Cancer Institute of Imam Khomeini Hospital from 2015 to 2020. Slides related to medullary thyroid tumors were examined. A tissue microarray was used to evaluate the immunohistochemistry of PD-L1. Patients were followed up to assess the occurrence of recurrence. Out of 207 patients evaluated in the present study, histopathological information of 144 patients was available.

RESULTS

The expression rate of PD-L1 in our community was 14.6% in lymphocyte cells, 35.4% in tumor cells, and 12.5% in both cells. The presence of metastasis at the time of diagnosis was reported in 35 cases (72.9%), and the occurrence of tumor recurrence was reported in 38 cases (79.2%). There was no relationship between the expression of this marker and the sex and age of patients. In addition, PD-L1 expression was unrelated to the two main characteristics of this cancer, namely tumor size and its focality. The presentation of tumor PD (L1) (but not lymphocytic) was a prognostic marker for synchronous metastasis at cancer diagnosis but could not predict tumor recurrence.

CONCLUSION

PD-L1 tumor marker expression is predictable in 14.6% of lymphocyte cells, 35.4% of tumor cells, and 12.5% in the selected Iranian population with medullary thyroid cancer. The expression of this marker is not related to the morphological characteristics of the tumor, such as tumor size or focality.

Comparing the effect of cup placement between true and false acetabula in total hip arthroplasty in patients with Crowe type 3 dysplastic hip: A randomized clinical trial

BACKGROUND

Hip dysplasia is one of the most widespread hip disorders. Total hip arthroplasty (THA) is the preferred treatment in patients with cup placement choices in true or false acetabulum. The objective of this research was to compare the effectiveness of the two mentioned procedures.

MATERIALS AND METHODS

This study was a randomized, open-label, parallel-group clinical trial, in which 46 patients/51 hips with Crowe type 3 dysplastic hip having THA were assigned to two groups: Group 1 - patients who had cup placement in the true acetabulum and Group 2 - patients who underwent cup placement in the false acetabulum. The variables that were evaluated and analyzed included severity of pain using the visual analog scale (VAS), range of motion (ROM), gait ability, the need for repeated joint replacement, and the Harris Hip Score (HHS).

RESULTS

Forty-six patients/51 hips were included in the present study. The patients who were evaluated included 30 (65.2%) males and 16 (34.8%) females. The mean age in the population under study was 71.0 ± 10.22, and the mean body mass index of participants was 26.34 ± 2.22 kg/m². The basic parameters in the two research groups were similar (P > 0.05). There were no significant differences between the two groups in terms of the mean values of VAS and ROM (P > 0.05); however, the mean HHS was significantly higher in the true acetabulum group, 57.90 ± 18.47 versus 48.29 ± 13.80 (P = 0.04).

CONCLUSION

The effectiveness of cup placements both in the true and false acetabula was similar in all of the evaluated variables in terms of clinical outcomes except for HHS which was higher in the true acetabulum group. To further support the results of this research, it is recommended that more research be done on a greater population.

Investigating the role of susceptibility weighted imaging for assessment of ischemic penumbra with respect to Venus blood flow in ischemic stroke patients

INTRODUCTION

Susceptibility weighted imaging can be used to study intracranial venous blood arteries based on the paramagnetic sensitivity of blood discharged by oxygen (SWI). Significant hypotensive drainage channels have been discovered in the ischemic tissue of the brain, which have been recognized by SWI. The compliance or non-compliance between the variation in venous drainage of ischemic brain tissue by SWI and diffusion limitation.

MATERIAL AND METHODS

This cross-sectional study was conducted in 2019 on 20 patients (15 men and 5 females) who were assigned to the Ghaem Hospital MRI Institute in Rasht, Iran.

RESULTS

Infarction has been detected in a total of 20 vascular regions. The caliber of the sulcal and intramedullary veins, on the other hand, was increased in 80 percent and 65 percent of the infarcted regions, respectively. In 45 percent of the vascular regions, a match between SWI and diffusion-weighted magnetic resonance imaging (DWI) was detected, mismatch was detected in two; follow-up revealed infarct progression.

CONCLUSIONS

Significant data on critically perfused cerebral cortex with possibility of infarction growth was focused on in elevated SWI investigations, contributing to SWI as a worthy MR implies that could be attached as complementary protocols to neuroimaging techniques for acute ischemia, according to the findings of this study.

Comparison of diagnostic values of two magnetic resonance imaging (MRI) protocols for diagnosis of breast lesions

BACKGROUND

Magnetic resonance imaging (MRI) has a pivotal role in diagnosing breast lesions. Here we aimed to compare the diagnostic values of Abbreviated and Full Breast MRI for breast lesions.

METHODS

This is a cross-sectional study performed in 2017-2021 on 80 women with breast lesions. Using the available MRI analysis software, the necessary sequences for the Abbreviated MRI were extracted from standard breast MRI protocol. First, a Full Breast MRI was examined by a radiologist giving Breast imaging-reporting and data system (BI-RADS). Then, from this Full Breast MRI, the necessary sequences for Abbreviated Breast MRI were prepared. The second expert radiologist read them in this field and BIRADS was reported. The data relating to each patient were recorded in the patient-specific profile and then the pathology results were followed for each patient.

RESULTS

Modified breast MRI had 84% sensitivity and 58.18% specificity, while full Breast MRI had 100% sensitivity and 38.18% specificity. Comparing the results of pathology (benign or malignant) for breast tumors and BIRADS reported by modified breast MRI indicated that these results were similar in 53 cases (66.3%) and different in 27 patients (33.8%). On the other hand, similar assessments for Full Breast MRI and pathology reports showed that the results were the same in 46 patients (57.5%) and different in 34 patients (42.5%).

CONCLUSION

Abbreviated breast MRI has lower sensitivity and higher specificity than full breast MRI.

A literature review on the imaging methods for breast cancer

Breast cancer will be easier and more effective to treat if detected early. Breast cancer is assessed and detected using imaging as a primary approach. The capacity to diagnose breast cancers is continually improving thanks to developments in imaging technologies. However, some of these enhancements have been linked to delays in the initiation of treatment procedures of breast cancer. Overall, cancer management relies heavily on imaging procedures such as screening and symptomatic disease management. Mammography, which is considered the gold standard, and breast ultrasonography are employed as routine imaging modalities. Previous research has shown that, despite recent developments, no single imaging modality can detect and characterizing majority of breast lesions. Various imaging methods and their uses in diagnosing and caring the breast cancer are discussed in this study.