Breast magnetic resonance imaging: are those who need it getting it?

Preoperative Staging Diagnosis of Colorectal Cancer Based on Multi-Row Spiral CT

Colorectal cancer is a common malignant tumor of digestive tract, and its incidence has increased significantly in recent years. The 5-year survival rate of patients with early local colorectal cancer is more than 90%, with local invasion of about 68%, and distant metastasis of less than 10%. Therefore, early diagnosis and early treatment is an effective means for the prevention and treatment of colorectal cancer. At present, X-ray air-barium double contrast radiography and fiberoptic endoscope are most commonly used in the examination of colorectal tumors in the world. These two methods have the advantages of simple operation, intuition and low cost. However, it is limited to judge the depth of tumor invasion, whether to break through the serosa, lymphatic metastasis, and distant metastasis. In this work, it can be confirmed that the measurement of preoperative tumor vascular volume reconstruction density is feasible in the preoperative evaluation of colorectal cancer, it will provide clinicians with more valuable information about preoperative tumor staging. Besides, multi-slice spiral CT has the advantages of less trauma, high speed, and clear image. It can not only judge the location of the tumor, the depth, and extent of tumor invasion, and show distant organ metastasis, but also has good application value in tumor staging. In this paper, the clinical data and MSCT imaging data of patients with colorectal cancer were analyzed retrospectively, and the value of MSCT in the diagnosis of colorectal cancer was discussed.

Utilization of breast MRI and breast MRI-guided biopsy in clinical practice: results of a survey in Québec and France

Background

To investigate the practice regarding breast MRI exams and breast MRI-guided biopsies in two countries with different health care systems, France and Québec. A 12-item questionnaire was distributed online among radiologists from France and Québec, attempting to determine: demographic characteristics and breast MRI diagnostic and MRI-guided practices (indications, workload, availability, and waiting time assessment).

Results

One hundred and seventy radiologists (France, 132 respondents (28.5%); Quebec, 38 respondents (35.2%)) participated in the survey, most of them based in non-academic centers. Thirty-eight percent of Quebec and 2.3% of French radiologists did not perform breast MRI in their daily practice. Nearly 50% of French and Quebec respondents interpreted 1–10 breast MRI exams per week. Decision-making factors of preoperative MRI were similar in both countries (pathology, age, and breast density), with a heavier emphasis placed on the surgeon’s opinion in Quebec (47.8% versus 21.8% (p = 0.009)). Quebec demonstrated a higher waiting time than France (1–2 weeks in 40% versus less than 1 week in 40%). MRI-guided breast biopsies (less than 5 MRI-guided biopsies per week) were being performed by a minority of the respondents (36% in France and 43% in Québec).

Conclusion

Most of radiologists performing breast MRIs work in non-academic institutions in both countries. Waiting time is higher in Quebec, but most of preoperative breast MRIs are performed within 3 weeks in both countries. The surgeon plays an important role in recommending preoperative MRI in Quebec. MRI-guided breast biopsies are not widely available in both countries.

Protocole d’IRM abrégée pour le diagnostic et le dépistage du cancer du sein

Le cancer du sein est le premier cancer féminin en France, et sa détection précoce est indispensable. L’IRM mammaire est un élément de choix dans son diagnostic mais présente des coûts directs et indirects élevés, notamment du fait de sa durée qui ralentit son utilisation plus large. Compte tenu de ses éléments, l’utilisation d’un protocole abrégé se développe pour pallier ces inconvénients. Les premières données de la littérature tendent à penser que cet examen plus rapide permet également une durée d’interprétation plus courte. De plus, la sensibilité et la spécificité de l’examen ne sont pas inférieures à celles du protocole complet. Cet article explique ce nouveau concept et son intérêt, le compare au protocole complet et évoque les perspectives futures et notamment à l’adjonction de séquences à haute résolution temporelle.