1
|
Hariharan N, Rao TS, Rajappa S, Naidu C, Raju K, Koppula V, Sannapareddy K, Sudhir R, Kodandapani S, Fonseca D, Murthy S. Accuracy of Tumor Bed Biopsy for Predicting Pathologic Complete Response After Chemotherapy Among Women With Breast Cancer: Complete Responders in the Breast Study. JCO Glob Oncol 2023; 9:e2300014. [PMID: 37656945 PMCID: PMC10581657 DOI: 10.1200/go.23.00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 07/01/2023] [Accepted: 07/21/2023] [Indexed: 09/03/2023] Open
Abstract
PURPOSE With the advent of taxanes and targeted agents in neoadjuvant chemotherapy (NACT) for breast cancer, the rates for pathologic complete response (pCR) have been steadily increasing. Surgery in these women serves as a biopsy to confirm or negate a pCR. METHODS All newly diagnosed patients with nonmetastatic breast cancer, planned for NACT, were screened. Eligible patients with a complete or near-complete response to NACT as seen on a mammogram and ultrasound (US) were recruited. A magnetic resonance imaging was performed for these patients for documentation. US-guided core biopsies of the tumor bed (Core Bx) using a 14G needle was performed (minimum four in number), and the results were compared with the final histopathology report after surgery for standard performance parameters. RESULTS This study recruited 65 women of whom 94% were node-positive, and 60% were hormone receptor-negative. The pCR rate was 41.5% and 53.8% for the whole cohort and the hormone receptor-negative subgroup, respectively. The false-negative rate (FNR) for Core Bx was 42.1% (95% CI, 26.3 to 59.2), with a negative predictive value of 59.0% (95% CI, 42.1 to 74.4). Among the hormone receptor-negative tumors, the FNR was 44.4% (95% CI, 21.5 to 69.2) with a negative predictive value of 70.4% (95% CI, 49.8 to 86.2). CONCLUSION The Complete Responders in the Breast study results suggest that ultrasound-guided 14G core needle biopsy of the tumor bed may not be a reliable predictor of pCR in the breast. These results highlight the importance of further research into the omission of surgery in the breast after chemotherapy. This study is registered with Clinical Trials Registry of India (CTRI/2018/01/011122).
Collapse
Affiliation(s)
- Nisha Hariharan
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
| | - T. Subramanyeshwar Rao
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
| | - Senthil Rajappa
- Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
| | - C.C.K. Naidu
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
| | - K.V.V.N. Raju
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
| | - Veeraiah Koppula
- Department of Radiology, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
| | - Kamala Sannapareddy
- Department of Radiology, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
| | - Rashmi Sudhir
- Department of Radiology, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
| | - Suseela Kodandapani
- Department of Pathology, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
| | - Daphne Fonseca
- Department of Pathology, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
| | - Sudha Murthy
- Department of Pathology, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
| |
Collapse
|
2
|
Nusrath S, Thammineedi SR, Raju KVVN, Patnaik SC, Saksena AR, Karthik J, Basude M, Kumar J P, Shukla S, Rao VB, Kumar C K, Gujjuru S, Tewani R, Rushdie T, Sudhir R, Smith LM, Are C. Factors associated with pathologic complete response following neoadjuvant chemoradiation and esophagectomy for carcinoma of esophagus and gastroesophageal junction. J Surg Oncol 2022; 127:48-55. [PMID: 36129433 PMCID: PMC10087616 DOI: 10.1002/jso.27103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/05/2022] [Accepted: 09/12/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND AND OBJECTIVES The aim of this study was to analyze factors associated with pathologic complete response (pCR) following neoadjuvant chemoradiation (NCRT) and esophagectomy for carcinoma of the esophagus (EC) and gastroesophageal junction (GEJ). METHODS Patients with EC and GEJ tumors who received NCRT and underwent esophagectomy between January 2010 to March 2021 were included. Univariate and multivariate analyses were performed to evaluate the factors associated with pCR by comparing the patients who achieved pCR (pCR group) with those who did not achieve pCR (non-pCR group). RESULTS A total of 321 patients were included in the study, with squamous cell carcinoma (SCC) accounting for the majority of cases (76%). One hundred and sixty (49.8%) patients had pCR. SCC histology and pretreatment radiographic node-negative status (cN0) were associated with pCR. Patients in the pCR group had significantly better overall and disease-free survival compared with patients in the non-pCR group. CONCLUSIONS SCC histology and pretreatment radiographic node-negative status were associated with pCR. For patients with tumors of EC and GEJ who received NCRT and underwent esophagectomy, pCR was associated with improved prognosis compared with those not achieving pCR.
Collapse
Affiliation(s)
- Syed Nusrath
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, India
| | - Subramanyeshwar R Thammineedi
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, India
| | | | - Sujith C Patnaik
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, India
| | - Ajesh R Saksena
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, India
| | - Jaya Karthik
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, India
| | - Madhunarayana Basude
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, India
| | - Pavan Kumar J
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, India
| | - Srijan Shukla
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, India
| | - Vishal B Rao
- Department of Pathology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, India
| | - Kishore Kumar C
- Department of Clinical Trials and Research, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, India
| | - Swathi Gujjuru
- Department of Clinical Trials and Research, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, India
| | - Rohan Tewani
- Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, India
| | - Tasneem Rushdie
- Department of Radiation Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, India
| | - Rashmi Sudhir
- Department of Radiology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, India
| | - Lynette M Smith
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Chandrakanth Are
- Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska, USA
| |
Collapse
|
3
|
Li D, Parvez W, Tiwari M, Jones M, Tufail M, Agrawal S, Bennett J, Sudhir R. EP13.01-001 The Burden of Incidental Extra-thoracic Positron Emission Tomography-CT (PET-CT) Findings in Thoracic Malignancies. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
4
|
Herkar PP, Anantharaj A, Praveen P, Shankarappa PR, Sudhir R. A comparative study of conventional and Hall techniques of crown placement using finite element stress analysis. J Indian Soc Pedod Prev Dent 2022; 40:302-310. [PMID: 36260472 DOI: 10.4103/jisppd.jisppd_173_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Hall technique of crown placement causes the changes in vertical occlusal dimension; the mode of settlement of which needs to be explored. AIM To assess and compare the changing patterns of stress distribution following placement of stainless steel crowns on primary teeth by Hall and conventional techniques using a finite element model analysis. MATERIALS AND METHODS The clinical crown heights of primary molars restored with Hall and conventional techniques and opposing teeth in contact, vertical dimension changes in the primary canine area were measured using intraoral digital scan. T-scan was used to measure the changes in bite force while the finite element analysis was used to assess deformative changes on the 2nd, 5th, 10th, and 15th days. RESULTS The Hall technique of crown placement caused more stress distribution in the tooth supporting tissues that settled in 2 weeks as compared with conventional technique of crown placement in which settlement occurred in 2 days. CONCLUSION The settling of vertical occlusal dimension as well as stress distribution in Hall technique probably takes place by intrusion of crowned tooth and opposing teeth in contact.
Collapse
Affiliation(s)
- Pawan Pramodrao Herkar
- Department of Paediatric and Preventive Dentistry, D. A. Pandu Memorial R. V. Dental College, Bengaluru, Karnataka, India
| | - A Anantharaj
- Department of Paediatric and Preventive Dentistry, D. A. Pandu Memorial R. V. Dental College, Bengaluru, Karnataka, India
| | - P Praveen
- Department of Paediatric and Preventive Dentistry, D. A. Pandu Memorial R. V. Dental College, Bengaluru, Karnataka, India
| | - Prathibha Rani Shankarappa
- Department of Paediatric and Preventive Dentistry, D. A. Pandu Memorial R. V. Dental College, Bengaluru, Karnataka, India
| | - R Sudhir
- Department of Paediatric and Preventive Dentistry, D. A. Pandu Memorial R. V. Dental College, Bengaluru, Karnataka, India
| |
Collapse
|
5
|
Kim JW, Vella C, Parvez W, Verma R, Majid M, Woltmann G, Pareek M, Bennett J, Agrawal S, Sudhir R, Ahyow L, Tufail M, Haldar P. Impact of COVID-19 on the diagnosis and management of lung cancer and TB. Int J Tuberc Lung Dis 2022; 26:372-374. [PMID: 35351244 DOI: 10.5588/ijtld.22.0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- J W Kim
- Department of Respiratory Sciences, University of Leicester, Leicester, Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester
| | - C Vella
- Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester
| | - W Parvez
- Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester
| | - R Verma
- Department of Respiratory Sciences, University of Leicester, Leicester, Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester
| | - M Majid
- Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester
| | - G Woltmann
- Department of Respiratory Sciences, University of Leicester, Leicester, Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester
| | - M Pareek
- Department of Respiratory Sciences, University of Leicester, Leicester
| | - J Bennett
- Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester
| | - S Agrawal
- Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester
| | - R Sudhir
- Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester
| | - L Ahyow
- UK Health Security Agency, London, UK
| | - M Tufail
- Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester
| | - P Haldar
- Department of Respiratory Sciences, University of Leicester, Leicester, Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester
| |
Collapse
|
6
|
Prabhu D, Anantharaj A, Praveen P, Rani SP, Sudhir R. A clinical and radiographic comparative evaluation of custom-made zirconia crowns using CAD-CAM and stainless steel crowns in primary molars. J Indian Soc Pedod Prev Dent 2022; 40:34-42. [PMID: 35439881 DOI: 10.4103/jisppd.jisppd_269_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND AND AIM OF STUDY Early childhood caries is a multifactorial disease process affecting children below 71 months of age and continues to be a global health problem. Stainless steel crowns (SSCs) are widely used and are very popular in pediatric dentistry due to its superiority and durability when compared with multisurface amalgam restorations. However, one of the major disadvantages with these crowns is the poor esthetics. Parents often request for a more esthetic alternative to the SSC. Zirconia crowns are one of the tooth-colored full crown restorations currently available for use in primary teeth. These are available as both preformed and custom-made crowns and show excellent esthetics. However, these require extensive tooth preparation with a subgingival finish lines, which would cause gingival trauma and bleeding during the preparation. The present study uses intraoral scanners for making the custom-made zirconia crowns, which will avoid the conventional impressions. Currently, there are no studies available in pediatric dentistry regarding CAD-CAM crowns. Hence, there is a need for the study. AIM The aim of this study is to clinically evaluate the performance of preformed SSCs and custom-made zirconia crowns in primary molars. To elicit parental and patient satisfaction with respect to preformed SSCs and custom made zirconia crowns and to radiographically compare the interproximal bone height for 1 year. METHODS The patients were selected with purposive sampling. The tooth of interest was prepared according to the crown it would receive. The upper and the lower arch of the tooth receiving custom-made zirconia crown was scanned using an intraoral scanner. The crowns were cemented using Type 1 glass ionomer cement (GIC) (SSC) and resin modified GIC (custom-made zirconia crown). After the crown placement, the patient and the parent's satisfaction was scaled regarding the time taken, comfort, cost of crown, appearance of crown, etc., using a 5-point Likert scale. A baseline radiograph was taken after crown placement. The patient was recalled every 3 months till 1 year for evaluation (loss of retention, loss of proximal contact, gingival inflammation, opposing tooth wear, and marginal integrity). At the end of 1 year, radiographs were taken to check the interproximal bone. RESULTS After 1 year evaluation of custom-made zirconia crowns and preformed SSCs in primary molars, it was shown that both SSC and zirconia crowns showed good gingival scores but zirconia crown was better than SSC in improving the gingival health. SSCs showed better results with respect to the opposing tooth wear and marginal adaptability. Parents as well as patients preferred a tooth-colored crown as a treatment option. CONCLUSION Custom-made zirconia crowns are comparable to the preformed SSCs and they show better gingival scores and excellent color match.
Collapse
Affiliation(s)
- Deepika Prabhu
- Department of Pediatric and Preventive Dentistry, D.A.P.M.R.V. Dental College, Bengaluru, Karnataka, India
| | - A Anantharaj
- Department of Pediatric and Preventive Dentistry, D.A.P.M.R.V. Dental College, Bengaluru, Karnataka, India
| | - P Praveen
- Department of Pediatric and Preventive Dentistry, D.A.P.M.R.V. Dental College, Bengaluru, Karnataka, India
| | - S Prathibha Rani
- Department of Pediatric and Preventive Dentistry, D.A.P.M.R.V. Dental College, Bengaluru, Karnataka, India
| | - R Sudhir
- Department of Pediatric and Preventive Dentistry, D.A.P.M.R.V. Dental College, Bengaluru, Karnataka, India
| |
Collapse
|
7
|
Sudhir R, Sannapareddy K, Potlapalli A, Penmetsa V. Clinico-radio-pathological Features and Biological Behavior of Breast Cancer in Young Indian Women: A Prospective Study. Indian J Radiol Imaging 2021; 31:323-332. [PMID: 34556915 PMCID: PMC8448222 DOI: 10.1055/s-0041-1734342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Aims The aim of the study is to evaluate the characteristic imaging features of breast cancer on mammogram, ultrasound, and magnetic resonance imaging (MRI) in women less than 40 years of age and to assess the degree of correlation between clinico-radio-pathological features and biological behavior. Methods and Materials A prospective observational study on consecutive women under 40 years of age evaluated with ultrasound of breast, digital mammogram, or contrast-enhanced breast MRI, diagnosed with breast cancer on histopathology and molecular analysis done at our center between January and December 2019 were included. Patient demographics, clinical presentation, family history, BRCA mutation status, imaging, pathological findings, and molecular status were determined. Results Out of 2,470 women diagnosed with breast cancer, 354 (14.3%) were less than 40 years of age who were included in this study. Mammography showed positive findings in 85%, ultrasonography in 94.3%, and MRI in 96.4% of women. Majority of the women (69.6%) presented in the late stage (Stage III and IV) with high-grade carcinoma in 39.5% and triple-negative breast cancer (TNBC) in 45.7%. Tumors with human epidermal growth factor-2neu expression were associated with the presence of microcalcifications ( p -value = 0.006), and TNBC with circumscribed margins or BI-RADS 3/4a category on imaging ( p -value = 0.007) and high-grade invasive carcinoma compared with others ( p -value <0.0001). Conclusion The incidence of breast cancer in Indian women less than 40 years of age is relatively high as compared with the West. The detection of breast cancer in young women remains challenging due to dense breast tissue, lower incidence rate, and lack of regular breast screening. While ultrasound is the recommended imaging method for evaluation of breast under the age of 40 years, we found a better characterization of lesions and higher cancer detection rates when they were also evaluated with mammography and MRI.
Collapse
Affiliation(s)
- Rashmi Sudhir
- Department of Radio-Diagnosis, Basavatarkam Indo-American Cancer Hospital and Research Centre, Hyderabad, Telangana, India
| | - Kamala Sannapareddy
- Department of Radio-Diagnosis, Basavatarkam Indo-American Cancer Hospital and Research Centre, Hyderabad, Telangana, India
| | - Alekya Potlapalli
- Department of Radio-Diagnosis, Basavatarkam Indo-American Cancer Hospital and Research Centre, Hyderabad, Telangana, India
| | - Vidhatri Penmetsa
- Department of Radio-Diagnosis, Basavatarkam Indo-American Cancer Hospital and Research Centre, Hyderabad, Telangana, India
| |
Collapse
|
8
|
Thammineedi SR, Raju KVVN, Patnaik SC, Saksena AR, Iyer RR, Sudhir R, Rayani BK, Smith LM, Are C, Nusrath S. Laparoscopic Repair of Acute Post-Esophagectomy Diaphragmatic Herniation Following Minimal Access Esophagectomy. Indian J Surg Oncol 2021; 12:729-736. [DOI: 10.1007/s13193-021-01415-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 08/09/2021] [Indexed: 10/20/2022] Open
|
9
|
Sudhir R, Sannapareddy K, Potlapalli A, Krishnamurthy PB, Buddha S, Koppula V. Diagnostic accuracy of contrast-enhanced digital mammography in breast cancer detection in comparison to tomosynthesis, synthetic 2D mammography and tomosynthesis combined with ultrasound in women with dense breast. Br J Radiol 2021; 94:20201046. [PMID: 33242249 DOI: 10.1259/bjr.20201046] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To assess the diagnostic efficacy of contrast-enhanced digital mammography (CEDM) in breast cancer detection in comparison to synthetic two-dimensional mammography (s2D MG), digital breast tomosynthesis (DBT) alone and DBT supplemented with ultrasound examination in females with dense breast with histopathology as the gold-standard. METHODS It was a prospective study, where consecutive females presenting to symptomatic breast clinic between April 2019 and June 2020 were evaluated with DBT. Females who were found to have heterogeneously dense (ACR type C) or extremely dense (ACR type D) breast composition detected on s2D MG were further evaluated with high-resolution breast ultrasound and thereafter with CEDM, but before the core biopsy or surgical excision, were included in the study. s2D MG was derived from post-processing reconstruction of DBT data set. Females with pregnancy, renal insufficiency or prior allergic reaction to iodinated contrast agent were excluded from the study. Image interpretation was done by two experienced breast radiologists and both were blinded to histological diagnosis. RESULTS This study included 166 breast lesions in130 patients with mean age of 45 ± 12 years (age range 24-72 years). There were 87 (52.4%) malignant and 79 (47.6%) benign lesions. The sensitivity of CEDM was 96.5%, significantly higher than synthetic 2D MG (75.6%, p < 0.0001), DBT alone (82.8%, p < 0.0001) and DBT + ultrasound (88.5%, p = 0.0057); specificity of CEDM was 81%, significantly higher than s2D MG (63.3%, p = 0.0002) and comparable to DBT alone (84.4%, p = 0.3586) and DBT + ultrasound (79.7%, p = 0.4135). In receiver operating characteristic curve analysis, the area under the curve was of 0.896 for CEDM, 0.841 for DBT + ultrasound, 0.769 for DBT alone and 0.729 for s2D MG. CONCLUSION CEDM is an accurate diagnostic technique for cancer detection in dense breast. CEDM allowed a significantly higher number of breast cancer detection than the s2D MG, DBT alone and DBT supplemented with ultrasonography in females with dense breast. ADVANCES IN KNOWLEDGE CEDM is a promising novel technology with higher sensitivity and negative predictive value for breast cancer detection in females with dense breast in comparison to DBT alone or DBT supplemented with ultrasound.
Collapse
Affiliation(s)
- Rashmi Sudhir
- Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, India
| | - Kamala Sannapareddy
- Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, India
| | - Alekya Potlapalli
- Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, India
| | | | - Suryakala Buddha
- Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, India
| | - Veeraiah Koppula
- Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, India
| |
Collapse
|
10
|
Sudhir R, Koppula VC, Rao TS, Sannapareddy K, Rajappa SJ, Murthy SS. Accuracy of digital mammography, ultrasound and MRI in predicting the pathological complete response and residual tumor size of breast cancer after completion of neoadjuvant chemotherapy. Indian J Cancer 2021; 59:345-353. [PMID: 33753611 DOI: 10.4103/ijc.ijc_795_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Neoadjuvant chemotherapy (NACT) is the standard of care for the treatment of locally advanced or non-metastatic breast cancer, which may increase the chances of breast conservative surgery (BCS) in place of radical mastectomy without compromising on the overall survival. The aim of this study was to evaluate the accuracy of mammography (MG), ultrasound (US), and magnetic resonance imaging (MRI) in predicting the complete response and to assess the extent of residual breast cancer in women treated with NACT. Materials and Methods Fifty-six consecutive patients with stage II or III breast cancer, who underwent imaging evaluation of breast with digital mammogram, US, and MRI after NACT and before the breast surgery, were included in the study. For each patient, pathologic complete response (pCR) or residual tumor (non-pCR) was predicted and the maximum extent of the residual tumor was measured on each imaging modality. These measurements were subsequently compared with the final histopathology results. Results Of 56 patients, 22 showed pCR with MRI having better accuracy for predicting complete response than the MG and US (area under the receiver operating characteristic curve: 0.86, 0.68, and 0.65, respectively; p = 0.0001 for MRI; p = 0.06 for MG, and p = 0.02 for US). The sensitivity of MRI for detecting pCR was 72.7%; specificity and positive predictive value were 100%. For pathological residual tumor, the size measured on MRI showed significantly higher correlation with the pathologic size (correlation coefficient, r = 0.786), than the MG (r = 0.293) and US (r = 0.508) with P < 0.05. Conclusions Accuracy of MRI for predicting pathological complete response was significantly higher than the MG and US. Pathologic residual tumor size was also more precisely reflected by the longest tumor dimension on MRI with the strong positive correlation coefficient.
Collapse
Affiliation(s)
- Rashmi Sudhir
- Department of Radiodiagnosis, Basavatarakam Indo-American Cancer Hospital and Research Centre, Hyderabad, India
| | - Veeraiah Chaudhary Koppula
- Department of Radiodiagnosis, Basavatarakam Indo-American Cancer Hospital and Research Centre, Hyderabad, India
| | - T Subramanyeshwar Rao
- Department of Surgical oncology, Basavatarakam Indo-American Cancer Hospital and Research Centre, Hyderabad, India
| | - Kamala Sannapareddy
- Department of Radiodiagnosis, Basavatarakam Indo-American Cancer Hospital and Research Centre, Hyderabad, India
| | - Senthil J Rajappa
- Department of Medical oncology, Basavatarakam Indo-American Cancer Hospital and Research Centre, Hyderabad, India
| | - Sudha S Murthy
- Department of Pathology and Lab medicine, Basavatarakam Indo-American Cancer Hospital and Research Centre, Hyderabad, India
| |
Collapse
|
11
|
Sudhir R, Koppula V, Mandava A, Kamala S, Potlapalli A. Technique and clinical applications of dual-energy contrast-enhanced digital mammography (CEDM) in breast cancer evaluation: a pictorial essay. ACTA ACUST UNITED AC 2020; 27:28-36. [PMID: 33252334 DOI: 10.5152/dir.2020.19573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This pictorial essay illustrates an overview of the basic technique used in acquiring dual-energy contrast-enhanced digital mammography (CEDM) images and its potential clinical applications in regular practice. CEDM may be used as a low-cost alternative to magnetic resonance imaging (MRI), as a problem-solving tool in clinical practice and for therapeutic planning of breast cancer, which may include high-risk screening, dense breast evaluation, mammographically equivocal lesions, local staging, treatment response evaluation, and post treatment follow-up. We share our experience of CEDM at a tertiary care cancer hospital.
Collapse
Affiliation(s)
- Rashmi Sudhir
- Basavatarakam Indo-American Cancer Hospital and Research Centre, Hyderabad, India
| | - Veeraiah Koppula
- Basavatarakam Indo-American Cancer Hospital and Research Centre, Hyderabad, India
| | - Anitha Mandava
- Basavatarakam Indo-American Cancer Hospital and Research Centre, Hyderabad, India
| | - Sannapareddy Kamala
- Basavatarakam Indo-American Cancer Hospital and Research Centre, Hyderabad, India
| | - Alekya Potlapalli
- Basavatarakam Indo-American Cancer Hospital and Research Centre, Hyderabad, India
| |
Collapse
|
12
|
Stockbridge A, Agarwal S, Sudhir R, Perkins T, Savory S, Pinglay P, Rao P, Das I, Brozik J, Machin R, Deshpande A, Bajaj A, Barnes D, Agrawal S, Bennett J, Tufail M. Optimal lung cancer pathway implementation in a tertiary care centre and its impact on reducing emergency presentations. Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30046-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
13
|
Hariharan N, Rao T, Rajappa S, Naidu C, Raju K, Koppula V, Sudhir R, Murthy S, Kodandapani S, Fonseca D. Accuracy of core biopsy in predicting pathologic complete response in the breast in patients with complete/near complete clinical and radiological response (Complete Responders in the Breast – CRBr): A feasibility study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz417.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
14
|
Sudhir R, Chaudhary VK, Ahmed F, Raju KV. Breast metastasis as initial presentation of asymptomatic gastroesophageal carcinoma: A case report. Indian J Cancer 2019; 56:370-371. [PMID: 31607711 DOI: 10.4103/ijc.ijc_159_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Rashmi Sudhir
- Department of Radiodiagnosis, Basavatarakam Indo-American Cancer Hospital and Research Centre, Hyderabad, Telangana, India
| | - Veeriah K Chaudhary
- Department of Radiodiagnosis, Basavatarakam Indo-American Cancer Hospital and Research Centre, Hyderabad, Telangana, India
| | - Faiq Ahmed
- Department of Pathology and Lab Medicine, Basavatarakam Indo-American Cancer Hospital and Research Centre, Hyderabad, Telangana, India
| | - K Vvn Raju
- Department of Surgical Oncology, Basavatarakam Indo-American Cancer Hospital and Research Centre, Hyderabad, Telangana, India
| |
Collapse
|
15
|
Sudhir R, Mohan MVTK, Shilpa B, Chaudhary VK. Efficacy of acoustic radiation force impulse elastography in differentiation of benign and malignant lymph nodes. Asian Journal of Oncology 2019. [DOI: 10.4103/asjo.asjo_48_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Abstract
Aims and Objectives: Aim of this study was to assess the clinical usefulness of Acoustic Radiation Force Impulse (ARFI) elastography imaging in differentiating benign and malignant/metastatic superficial nodes.
Methods and Materials: ARFI elastography (Siemens Medical Solutions, Mountain View, CA) using Virtual touch Tissue Imaging (VTI) technique was performed and Shear wave velocity (m/sec) was measured in 85 patients (mean age, 49 years; range, 16–72 years) with 126 lymph nodes (96 axillary, 21 cervical and 9 inguinal nodes) which were biopsied and histo-pathologically correlated.
Results: Of 126 nodes, 71 were benign (64 reactive and 7 koch's) and 55 were malignant (40 metastases and 15 lymphoma). The mean ARFI value of malignant nodes ±SD (4.42 ± 2.60) were significantly higher than the benign nodes (1.76 ± 0.44), with P <0.001. With the use of Receiver Operating Characteristic (ROC) curve, the cut off SWV was estimated to be 2.45m/s with sensitivity of 83.6%, specificity of 91%, and accuracy of 93.7 % while the conventional US based short axis diameter (SAD) measurement with cut off value of 10mm, showed the sensitivity of 62 %, specificity of 87% and accuracy of 87%.
Conclusion: Acoustic radiation force impulse elastography is feasible for superficial lymph nodes and provides quantitative elasticity measurements, which may complement B-mode ultrasound and potentially improve the differentiation of benign and malignant/metastatic lymph nodes.
Collapse
Affiliation(s)
- Rashmi Sudhir
- Department of Radiodiagnosis, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - M. V. T. Krishna Mohan
- Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - Bogala Shilpa
- Department of Radiodiagnosis, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - Veeraiah K. Chaudhary
- Department of Radiodiagnosis, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| |
Collapse
|
16
|
Akepati NKR, Sudhir R, Murthy S, Abubakar ZA. Torsion Ovary, an Unusual Presentation of Carcinoma Appendix Detected in Whole-Body F-18 2-Fluoro 2-deoxy Glucose Positron Emission Tomography/Computed Tomography Scan. Indian J Nucl Med 2018; 33:331-333. [PMID: 30386056 PMCID: PMC6194758 DOI: 10.4103/ijnm.ijnm_97_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Torsion ovary is one of the common emergencies in gynecology requiring surgery. Torsion ovary is generally caused by cystic lesions of ovary and benign tumors. Malignant tumors rarely present as torsion ovary. Krukenberg tumor presenting as torsion ovary is very rare with only a few case reports described in literature. Stomach is the most common primary site (70%) followed by colorectal, breast, lung, contralateral ovary, pancreatic, cholangiocarcinoma, and gallbladder carcinomas. Krukenberg tumor with primary in appendix is relatively rare. Here, we are presenting an unusual case of mucinous carcinoma appendix with Krukenberg tumor presenting as unilateral torsion ovary, demonstrating the role of whole-body F18 2-Fluoro 2-deoxyglucose positron emission tomography/computed tomography scan in identifying the primary.
Collapse
Affiliation(s)
- Naveen Kumar Reddy Akepati
- Department of Nuclear Medicine, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - Rashmi Sudhir
- Department of Radiology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - Sudha Murthy
- Department of Pathology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - Zakir Ali Abubakar
- Department of Nuclear Medicine, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| |
Collapse
|
17
|
Shilpa B, Sudhir R, Mohan MVTK, Koppula V. Spontaneous pneumomediastinum, pneumothorax, pneumorrhachis, pneumoretroperitoneum, surgical emphysema. Indian J Radiol Imaging 2018; 28:132-133. [PMID: 29692541 PMCID: PMC5894309 DOI: 10.4103/ijri.ijri_168_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Bogala Shilpa
- Department of Radiodiagnosis, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India E-mail:
| | - Rashmi Sudhir
- Department of Radiodiagnosis, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India E-mail:
| | - M V T Krishna Mohan
- Department of Radiodiagnosis, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India E-mail:
| | - Veeraiah Koppula
- Department of Radiodiagnosis, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India E-mail:
| |
Collapse
|
18
|
Sudhir R, Praveen P, Anantharaj A, Venkataraghavan K. Assessment of the effect of probiotic curd consumption on salivary pH and streptococcus mutans counts. Niger Med J 2013; 53:135-9. [PMID: 23293413 PMCID: PMC3531032 DOI: 10.4103/0300-1652.104382] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Antimicrobial methods of controlling dental caries that include probiotic agents can play a valuable role in establishing caries control in children at moderate to high risk for developing dental caries. Several studies have demonstrated the beneficial effects of use of various Probiotic products including curd. The objective of this study was to compare the effect of short-term consumption of probiotic curd containing Lactobacillus acidophilus and normal curd on salivary Streptococcus Mutans counts, as well as salivary pH. MATERIALS AND METHODS Forty, caries-free, 10-12 years old children were selected and randomly allocated to two groups. Test Group consisted of 20 children who consumed 200ml of probiotic curd daily for 30 days. Control Group consisted of 20 children who were given 200ml of regular curd for 30 days. Salivary pH and salivary Streptococcus Mutans counts were recorded at baseline and after 30 days and statistically compared using the Student's t-test. RESULTS Consumption of probiotic curd resulted in a statistically significant reduction in S. Mutans colony counts (P<0.001) as compared to regular curd. However, there was a slight reduction in pH (P>0.05) in both the groups. CONCLUSION Short-term consumption of probiotic curds can reduce oral S. Mutans counts. However, this caused a slight reduction in salivary pH.
Collapse
Affiliation(s)
- R Sudhir
- Department of Pediatric and Preventive Dentistry, D.A.P.M.R.V Dental College, Bangalore, Karnataka, India
| | | | | | | |
Collapse
|
19
|
Rajasekhar G, Vura NG, Sudhir R, Dhanala S, Alwala AM. Versatility of Dieffenbach's Modification of Weber Fergusson's Approach for Treatment of Maxillary Pathologies. J Maxillofac Oral Surg 2012; 11:416-9. [PMID: 24293933 DOI: 10.1007/s12663-011-0331-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Accepted: 12/08/2011] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The aim of the study is to evaluate the usage of Dieffenbach's modification of Weber-Fergusons approach in the treatment of lesions involving maxilla. STUDY In this study five different maxillary pathologies were approached through Dieffenbach's modification of Weber-Fergusons approach. Partial and subtotal procedures were performed depending on the type of pathology and the extent of the lesion which was assessed both clinically and radiologically. The study evaluates the easy exposure of the site, post operative complications like scar formation and infra orbital nerve parasthesia. RESULTS There were two subtotal maxillectomy procedures and three partial maxillectomy procedures approached through Dieffenbach's modification of Weber-Fergusson's approach. All the cases recovered well in the post operative healing period without noticeable scarring. There was parasthesia in three cases which subsided in 3 months. CONCLUSION The approach through Dieffenbach's modification of Weber-Fergusons incision gave better visibility and accessibility to the lesions of maxilla. Because there is direct access to the pathology, the inadvertent resection of the un-involved structures is prevented thus minimizing the morbidity.
Collapse
Affiliation(s)
- G Rajasekhar
- Mamata Dental College and Hospital, Khammam, Andhra Pradesh India
| | | | | | | | | |
Collapse
|
20
|
Venkataraghavan K, Anantharaj A, Prasanna P, Sudhir R. Oligodontia in the primary dentition: report of a case. J Dent Child (Chic) 2007; 74:154-156. [PMID: 18477440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Congenital absence of primary teeth is relatively rare. The prevalence, possible etiological factors and management of oligodontia was briefly reviewed. This paper reports a rare case of multiple missing (n=18) primary teeth in a 4-year-old male of Asian origin.
Collapse
|
21
|
Vidhya K, Sudhir R, Mohan V. Continuous glucose monitoring system--useful but expensive tool in management of diabetes. J Assoc Physicians India 2004; 52:587-90. [PMID: 15645991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Until recently, self monitoring of blood glucose (SMBG) was the only tool used for monitoring blood glucose levels. The limitation of SMBG is that it cannot continuously monitor blood glucose levels. In this paper, we present our initial experience with the continuous glucose monitoring system (CGMS) in three different clinical situations. With reduction in cost and further refinement in technology, CGMS could become a valuable tool for clinical practice and research studies in diabetes.
Collapse
Affiliation(s)
- K Vidhya
- M.V. Diabetes Specialities Centre and Madras Diabetes Research Foundation Gopalapuram, Chennai, India
| | | | | |
Collapse
|