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A E, Prakash A, Ashta A, Garg A, Verma A, Padaliya P. Pediatric presacral tumors with intraspinal extension: a rare entity with diagnostic challenges. Acta Radiol 2023; 64:3056-3073. [PMID: 37753549 DOI: 10.1177/02841851231202688] [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] [Indexed: 09/28/2023]
Abstract
The presacral space is a potential space located between the rectum and the lumbosacral spine. It contains various primitive germ cell types that serve as the origin for a range of tumors. Imaging is crucial in characterizing, assessing the extent of and evaluating the treatment response to these tumors. We report a series of six cases of pediatric presacral tumors with intraspinal extension, including an immature sacrococcygeal teratoma (Altman type II), a malignant sacrococcygeal teratoma (Altman type IV), a neuroblastoma, a rhabdomyosarcoma, a clear cell sarcoma and an Ewing's sarcoma of the ilium. These tumors can be broadly categorized as tumors of germ cell, neuroblastic, mesenchymal and osteogenic origin. Despite overlapping imaging features, a review of the existing literature and careful retrospective observation revealed several distinctive features that aid in the optimal characterization of tumors. These include the tumor's epicenter, the pattern and degree of bone involvement, the status of sacral foramina and neural elements, and internal tumor characteristics such as the presence of fat, calcification, hemorrhage and necrosis.
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Affiliation(s)
- Ebinesh A
- Department of Radiodiagnosis, Maulana Azad Medical College and associated Lok Nayak Hospital, Jawahar Lal Nehru Marg, New Delhi, India
| | - Anjali Prakash
- Department of Radiodiagnosis, Maulana Azad Medical College and associated Lok Nayak Hospital, Jawahar Lal Nehru Marg, New Delhi, India
| | - Aanchal Ashta
- Department of Radiodiagnosis, Maulana Azad Medical College and associated Lok Nayak Hospital, Jawahar Lal Nehru Marg, New Delhi, India
| | - Anju Garg
- Department of Radiodiagnosis, Maulana Azad Medical College and associated Lok Nayak Hospital, Jawahar Lal Nehru Marg, New Delhi, India
| | - Abhishek Verma
- Department of Radiodiagnosis, Maulana Azad Medical College and associated Lok Nayak Hospital, Jawahar Lal Nehru Marg, New Delhi, India
| | - Prerna Padaliya
- Department of Radiodiagnosis, Maulana Azad Medical College and associated Lok Nayak Hospital, Jawahar Lal Nehru Marg, New Delhi, India
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Abd elsalam SM, ELbadawi MA, Diab WA, Said AHM, Gomaa MI. Diagnostic value of whole -body diffusion weighted imaging added to bone scan in early diagnosis of bone metastases in breast cancer patients. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2023; 54:102. [DOI: 10.1186/s43055-023-01050-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 05/25/2023] [Indexed: 09/01/2023] Open
Abstract
Abstract
Background
Metastases to the bones are a frequent location of metastasis in advanced breast cancer and are responsible for substantial morbidity and healthcare expenses. Imaging has been crucial in directing patient therapy for decades, contributing to the staging and response evaluation of the skeleton. This research aimed to assess the diagnostic value of whole-body magnetic resonance imaging with diffusion-weighted imaging added to radionuclide bone scans for early diagnosis of bone metastases in breast cancer patients.
Results
The study was a prospective observational cohort study performed on 20 patients with breast cancer and suspected bone metastases. The patients were evaluated first by obtaining a detailed personal history. Laboratory tests, including CBC, liver, and kidney function tests were assessed. All patients were examined by diffusion-weighted whole-body MRI (DWIBS; diffusion-weighted imaging with background body signal suppression) images and bone scintigraphy after intravenous injection of 20 mci of technetium-99m (99mTc) methylene diphosphonate using a dual head gamma camera. The total number of lesions detected by bone scan was 74, and 75 lesions were seen by DWIBS. Twenty-four lesions were missed by bone scan and detected by DWIBS. Fourteen lesions were detected by bone scan and found free by DWIBS examination in the spine and pelvic bones.
Conclusions
Whole body DWIBS seems to be a promising method of imaging in detecting bone metastases from breast cancer that could be used complementary to the traditional bone scan for more accurate diagnosis and staging of the tumor, helping to determine the most appropriate protocol of management.
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Rashid RJ, Tahir SH, Kakamad FH, Omar SS, Salih AM, Ahmed SF, Abdalla SH, Naqar S, Salih RQ, Kakamad SH, Mohammed KK, Mustafa SM, Hassan MN, Mohammed SH. Whole‑body MRI for metastatic workup in patients diagnosed with cancer. Mol Clin Oncol 2023; 18:33. [PMID: 36925744 PMCID: PMC10011947 DOI: 10.3892/mco.2023.2629] [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: 09/14/2022] [Accepted: 01/17/2023] [Indexed: 03/05/2023] Open
Abstract
Early diagnosis and appropriate staging workup are crucial for cancer patients. Whole-body magnetic resonance imaging (WB-MRI) has been proposed as another practical whole-body approach for assessing local invasiveness and distant metastases in patients newly diagnosed with cancer. The current study aimed to evaluate the efficacy of WB-MRI in assessing metastasis in patients newly diagnosed with cancer using histopathologic data as the reference method. A prospective observational study was performed from April 2018 to July 2020. MRI sequences were utilized to acquire anatomical and functional images in three orthogonal planes. The discovery was classified as nodal, skeletal and visceral metastases. Patient-based analysis was used for visceral metastasis and region-based for skeletal, systemic and lymph node metastases. A total of 43 consecutive patients (mean age, 56±15.2 years) were assessed successively. In 41 patients, there was a concordance between the WB-MRI and histological confirmation. The most prevalent site of metastasis was the skeletal system (18 patients). There were 12 individuals with liver metastasis, 10 with lung metastasis and 4 with peritoneal metastasis, with just one brain metastatic lesion found. On WB-MRI, 38 lymph node groups were deemed positive. Out of the total, 66 skeletal locations contained metastases. The accuracy of WB-MRI for nodal, skeletal and visceral metastases was (98.45, 100 and 100%, respectively). In conclusion, WB-MRI in three orthogonal planes, including the diffusion-weighted MRI with background body signal suppression sequence, may be utilized efficiently and accurately for assessing metastasis staging and may thus be utilized in patients with newly diagnosed cancer.
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Affiliation(s)
- Rezheen J Rashid
- Department of Oncology, Hiwa Cancer Hospital Centre, Sulaimani Directorate of Health, Sulaimani, Kurdistan 46000, Iraq.,Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq
| | - Soran H Tahir
- Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq.,Department of Surgery, College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46000, Iraq
| | - Fahmi H Kakamad
- Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq.,Department of Surgery, College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46000, Iraq.,Kscien Organization, Sulaimani, Kurdistan 46000, Iraq
| | - Sami S Omar
- Kscien Organization, Sulaimani, Kurdistan 46000, Iraq.,Rizgary Oncology Center, Erbil, Kurdistan 44000, Iraq
| | - Abdulwahid M Salih
- Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq.,Department of Surgery, College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46000, Iraq
| | - Shaho F Ahmed
- Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq
| | - Shalaw H Abdalla
- Department of Oncology, Hiwa Cancer Hospital Centre, Sulaimani Directorate of Health, Sulaimani, Kurdistan 46000, Iraq
| | - Sharo Naqar
- Department of Oncology, Hiwa Cancer Hospital Centre, Sulaimani Directorate of Health, Sulaimani, Kurdistan 46000, Iraq.,Department of Surgery, College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46000, Iraq
| | - Rawezh Q Salih
- Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq.,Kscien Organization, Sulaimani, Kurdistan 46000, Iraq
| | | | | | - Shevan M Mustafa
- Kscien Organization, Sulaimani, Kurdistan 46000, Iraq.,Rizgary Oncology Center, Erbil, Kurdistan 44000, Iraq.,Medical Laboratory Technician Department, Al Qalam University College, Kirkuk, Kurdistan 46000, Iraq
| | - Marwan N Hassan
- Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq.,Department of Surgery, College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46000, Iraq.,Kscien Organization, Sulaimani, Kurdistan 46000, Iraq
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Diffusion-weighted imaging of the abdomen using echo planar imaging with compressed SENSE: Feasibility, image quality, and ADC value evaluation. Eur J Radiol 2021; 142:109889. [PMID: 34388627 DOI: 10.1016/j.ejrad.2021.109889] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 07/25/2021] [Accepted: 07/27/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To evaluate the feasibility, image quality, and apparent diffusion coefficient (ADC) values of diffusion-weighted imaging (DWI) using echo planar imaging (EPI) with Compressed SENSE (EPICS-DWI) of the abdomen and to compare them with conventional single-shot EPI with parallel imaging (PI) technique (PI-DWI). MATERIALS AND METHODS This prospective study included 46 participants with known or suspected upper abdominal diseases (19 men and 27 women, mean age, 68 years) who underwent MRI. DWI acquisition was performed using free-breathing two-dimensional fat-suppressed PI-DWI and EPICS-DWI with SENSE or compressed sensing (CS) factor, 3.0. Moreover, image noise and contour of liver and pancreas were qualitatively evaluated using a five-point scale. The mean ADC value and standard deviation (SD) of the liver, pancreas, and spleen were measured, and the coefficient of variation (CV) was calculated. Qualitative and quantitative parameters were compared between PI-DWI and EPICS-DWI using the Wilcoxon test. RESULTS The mean image quality scores for image noise and contour of liver and pancreas were higher in EPICS-DWI compared with PI-DWI (P < 0.0001). Moreover, the mean ADC values of the liver and pancreas were higher in EPICS-DWI compared with PI-DWI (P < 0.0001), but that of spleen was not significantly different. The mean SD and CV of the liver, pancreas, and spleen were lower in EPICS-DWI compared with PI-DWI (P < 0.0001-0.032). CONCLUSION EPICS-DWI could be feasible in MRI of the abdomen and significantly improve image quality compared with PI-DWI in aggressive setting. ADC value measurements were higher in EPICS-DWI compared with PI-DWI.
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