Related items
Showing items related by title, author, creator and subject.
-
Magnetic resonance imaging of the pulsing brain: a systematic reviewObjective: To perform a systematic review of the literature exploring magnetic resonance imaging (MRI) methods for measuring natural brain tissue pulsations (BTPs) in humans. Methods: A prospective systematic search of MEDLINE, SCOPUS and OpenGrey databases was conducted by two independent reviewers using a pre-determined strategy. The search focused on identifying reported measurements of naturally occurring BTP motion in humans. Studies involving non-human participants, MRI in combination with other modalities, MRI during invasive procedures and MRI studies involving externally applied tests were excluded. Data from the retrieved records were combined to create Forest plots comparing brain tissue displacement between Chiari-malformation type 1 (CM-I) patients and healthy controls using an independent samples t-test. Results: The search retrieved 22 eligible articles. Articles described 5 main MRI techniques for visualisation or quantification of intrinsic brain motion. MRI techniques generally agreed that the amplitude of BTPs varies regionally from 0.04 mm to ~ 0.80 mm, with larger tissue displacements occurring closer to the centre and base of the brain compared to peripheral regions. Studies of brain pathology using MRI BTP measurements are currently limited to tumour characterisation, idiopathic intracranial hypertension (IIH), and CM-I. A pooled analysis confirmed that displacement of tissue in the cerebellar tonsillar region of CM-I patients was + 0.31 mm [95% CI 0.23, 0.38, p < 0.0001] higher than in healthy controls. Discussion: MRI techniques used for measurements of brain motion are at an early stage of development with high heterogeneity across the methods used. Further work is required to provide normative data to support systematic BTPs characterisation in health and disease.
-
Invasive lobular carcinoma arising in accessory breast tissue.BACKGROUND: Lobular carcinoma in accessory breast tissue is a rare occurrence. We present such a case in a 61-year-old woman. CASE PRESENTATION: A skin nodule in the axillary skin on excision biopsy revealed invasive lobular carcinoma. CONCLUSIONS: Carcinoma in accessory breast tissue is uncommon especially invasive lobular type. A high index of suspicion may avoid late diagnosis.
-
Accuracy of GE digital breast tomosynthesis vs supplementary mammographic views for diagnosis of screen-detected soft-tissue breast lesions.OBJECTIVE: To compare the accuracy of standard supplementary views and GE digital breast tomosynthesis (DBT) for assessment of soft-tissue mammographic abnormalities. METHODS: Women recalled for further assessment of soft-tissue abnormalities were recruited and received standard supplementary views (typically spot compression views) and two-view GE DBT. The added value of DBT in the assessment process was determined by analysing data collected prospectively by radiologists working up the cases. Following anonymization of cases, there was also a retrospective multireader review. The readers first read bilateral standard two-view digital mammography (DM) together with the supplementary mammographic views and gave a combined score for suspicion of malignancy on a five-point scale. The same readers then read bilateral standard two-view DM together with two-view DBT. Pathology data were obtained. Differences were assessed using receiver operating characteristic analysis. RESULTS: The study population was 342 lesions in 322 patients. The final diagnosis was malignant in 113 cases (33%) and benign/normal in 229 cases (67%). In the prospective analysis, the performance of two-view DM plus DBT was at least equivalent to the performance of two-view DM and standard mammographic supplementary views-the area under the curve (AUC) was 0.946 and 0.922, respectively, which did not reach statistical significance. Similar results were obtained for the retrospective review-AUC was 0.900 (DBT) and 0.873 (supplementary views), which did not reach statistical significance. CONCLUSION: The accuracy of GE DBT in the assessment of screen detected soft-tissue abnormalities is equivalent to the use of standard supplementary mammographic views. ADVANCES IN KNOWLEDGE: The vast majority of evidence relating to the use of DBT has been gathered from research using Hologic equipment. This study provides evidence for the use of the commercially available GE DBT system demonstrating that it is at least equivalent to supplementary mammographic views in the assessment of soft-tissue screen-detected abnormalities.
