Feasibility of single-voxel MRS measurement of apparent diffusion coefficient of water in breast tumors

We report initial results with single voxel spectroscopy (SVS) using diffusion weighting and localization by adiabatic selective refocusing (LASER) in breast tumors to measure the apparent diffusion coefficient of water (ADCw). This is a quick (30 s) and relatively easy method to implement compared with image-based diffusion measurements, and is insensitive to lipid signal contamination. The ADCw and concentration of total choline containing compounds [tCho] were evaluated for associations with each other and final pathologic diagnosis in 25 subjects. The average (+/- SD) ADCw in benign and malignant lesions was 1.96 +/- 0.47 mm(2)/s and 1.26 +/- 0.29 x 10(-3) mm(2)/s, respectively, P< 0.001. Receiver operating characteristic curve analysis showed an area under the curve of 0.92. Analysis of the single voxel (SV) ADCw and [tCho] showed significant correlation with a R(2) of 0.56, P< 0.001. Compared with more commonly used image-based methods of measuring water ADC, SV-ADCw is faster, more robust, insensitive to fat, and potentially easier to implement on standard clinical systems.

Occult testicular interstitial-cell tumor in a patient with gynecomastia: ultrasonic detection

A locally asymptomatic interstitial (Leydig) cell testicular tumor was detected by high-resolution ultrasonography in a 25-year-old man with gynecomastia. The utility of ultrasound in the detection of occult testicular tumors is illustrated.

Use of CT to reduce understaging in prostatic cancer: comparison with conventional staging techniques

Thirty prostatic cancer patients were evaluated for staging purposes with both CT (18-sec scan speed) and certain commonly used "conventional" diagnostic tests, namely: radionuclide bone scan with correlative plain films, the prostatic fraction of the serum acid phosphatase, excretory urogram, and chest radiograph. All patients included in the study had histopathologic proof of diagnosis. CT correctly identified extracapsular prostatic cancer spread locally or in pelvic lymph nodes in 14% of patients with completely negative conventional studies. Sensitivity of extracapsular tumor spread detection increased from 41% to 59% by adding CT to the conventional studies. CT confirmed the presence of tumor spread and localized it in 43% of patients with positive conventional studies. Conventional studies were positive when tumor spread was present in 32% of patients with negative CT. CT reduces understaging when conventional tests are negative, localizes and confirms tumor spread when conventional tests are positive, but cannot demonstrate tumor spread in some patients whose conventional tests are positive and who are subsequently shown to have tumor spread histopathologically.