New advance in breast cancer pathology and imaging

Radiopharmaceuticals: A New Vista for Diagnosis and Treatment of Thyroid Cancer

Radiopharmaceuticals are in the diagnosis and treatment of cancerous and noncancerous diseases, and a hope for optimistic effort in the field of nuclear medicine. They play a crucial role in clinical nuclear medicine by providing a tool to comprehend human disease and create efficient treatments. A detailed analysis is provided regarding the crux of molecular imaging including PET and SPECT overview for the detection of cancers. For a specified understanding of radiation therapy, topics include ranging from the selection of radionuclide to its development and manufacture, and dosage requirements to establishing the importance of I- 131 Radiotherapy in thyroid cancer. In this review, we also discussed the current state of the art of nuclear medicine in thyroid cancer, including the role of radioiodine (RAI) therapeutic scans in the diagnosis of differentiated thyroid cancer. In addition, we established a brief outlook into the current status of the research in thyroid cancer and discussed the future directions in this field.

The Contribution of a Solid Breast Mass Gray-Scale Histographic Analysis in Ascertaining a Benign-Malignant Differentiation

Objective:

The aim of this study was to determine the efficiency of a fat-lesion histographic analysis (FLHA) to make a benign-malignant differentiation, for patients with a breast mass. In addition, it was important to examine the relationship between FLHA rates and Breast Imaging–Reporting and Data System (BI-RADS) scoring.

Materials and Methods:

This was a retrospective study conducted by examining the breast ultrasonograms (BUS) and histopathologic data of 76 women, having at least one solid breast mass. The patients were grouped according to their histopathologic diagnoses and BUS BI-RADS scores. The recorded digital gray-scale images were transferred to a workstation to quantitatively measure tissue echogenicity. The breast masses and adjacent adipose tissue were evaluated using the ImageJ analysis program, and gray-scale histographic analysis values were generated. The FLHA rate was determined by dividing the fat tissue histographic value by the mass-lesion histographic value. Statistical analysis was performed using this value as well as the patients’ histopathologic data and BUS BI-RADS score.

Results:

A complementary effect was noted using FLHA rates with the BUS BI-RADS criteria, and a statistically significant difference was detected between benign and malignant histopathology groups ( P < .001). Similarly, the malignant histopathologic diagnosis with BI-RADS 4 and benign histopathologic diagnosis with BI-RADS 4 groups were related ( P < .001). The correlation between BI-RADS criteria and FLHA rates demonstrated a significant difference between BI-RADS 3 and BI-RADS 5 ( P < .001), and BI-RADS 4 and BI-RADS 5 for FLHA rates ( P = .002).

Conclusion:

It was determined that using the FLHA rate was a complement to the BUS BI-RADS criteria. In this cohort, there was a statistically significant difference in predicting possible malignancy in all BI-RADS classes.

18F-FDG-PET/CT analysis in hospitalized patients affected by pulmonary disease: The experience of the Nuclear Medicine Unit of "Policlinico Tor Vegata"

OBJECTIVE

The main aim of this study was to retrospectively evaluate the clinical data and outcomes of a cohort of 492 hospitalized patients who underwent fluorine-18-fluorodeoxyglucose (F-FDG)-PET/CT analysis at the nuclear medicine unit of 'Policlinico Tor Vergata' in Rome during the years 2017 and 2018 with particular emphasis for patients affected by pulmonary diseases.

METHODS

Anamnestic data (age and gender), main pathologic conditions, results of F-FDG-PET/CT examination, appropriateness of the request, and medical records of 492 consecutive hospitalized patients who underwent F-FDG-PET/CT analysis (55.38 ± 3.78 years; range 33-81 years) from January 2017 to December 2018 were obtained.

RESULTS

Considering all examinations, positive results were observed in 66.9% of cases whereas it was not possible to perform a diagnosis in 12.7% of cases (doubt results). About 20-fold increase in the percentage of doubt results was observed in F-FDG-PET/CT analysis with no appropriateness as compared to those with double appropriateness (both the request and clinical). Noteworthy, our data showed a 95% higher concordance between the positive results of the F-FDG-PET/CT examination and the histologic diagnosis. Conversely, the concordance between the analysis of the bronchoalveolar lavages and the PET analysis was very low.

CONCLUSION

Data here reported showed the high accuracy of the F-FDG-PET/CT performed in our department, mainly for pulmonary diseases, also highlighting the importance of continuously updating the selection criteria for patients who need PET examinations.

Breast cancer metastasis to bone: From epithelial to mesenchymal transition to breast osteoblast-like cells

In this review we highlighted the newest aspects concerning the physiopathology of breast cancer metastatization into the bone including: a) in situ biomarkers of breast cancer metastatic diseases, b) biological processes related to the origin of metastatic cells (epithelial to mesenchymal transition), c) the nature and the possible role of Breast Osteoblast-Like Cells in the formation of bone lesions and d) the prognostic value of breast microcalcifications for the bone metastatic disease. In addition, the more recent data about the biology of breast cancer metastatic process and the origin and function of Breast Osteoblast-Like Cells have been analyzed to propose the use of molecular imaging investigations able to identify early neoplastic lesions with high propensity to form bone metastasis in vivo.