Late Stage Complicated Atheroma in Low-Grade Stenotic Carotid Disease: MR Imaging Depiction—Prevalence and Risk Factors

Radiology ◽  
2011 ◽  
Vol 260 (3) ◽  
pp. 841-847 ◽  
Author(s):  
Helen M. C. Cheung ◽  
Alan R. Moody ◽  
Navneet Singh ◽  
Richard Bitar ◽  
James Zhan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mr Imaging ◽  
Late Stage ◽  
Low Grade ◽  
Carotid Disease

scholarly journals Radiation necrosis after a combination of external beam radiotherapy and iodine-125 brachytherapy in gliomas

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Indrawati Hadi ◽  
Daniel Reitz ◽  
Raphael Bodensohn ◽  
Olarn Roengvoraphoj ◽  
Stefanie Lietke ◽  
...  
Keyword(s):  
Risk Factors ◽  
Radiation Necrosis ◽  
Irradiation Time ◽  
External Beam Radiotherapy ◽  
High Grade Glioma ◽  
Metabolic Imaging ◽  
Time Interval ◽  
Low Grade ◽  
External Beam ◽  
Iodine 125

Abstract Purpose Frequency and risk profile of radiation necrosis (RN) in patients with glioma undergoing either upfront stereotactic brachytherapy (SBT) and additional salvage external beam radiotherapy (EBRT) after tumor recurrence or vice versa remains unknown. Methods Patients with glioma treated with low-activity temporary iodine-125 SBT at the University of Munich between 1999 and 2016 who had either additional upfront or salvage EBRT were included. Biologically effective doses (BED) were calculated. RN was diagnosed using stereotactic biopsy and/or metabolic imaging. The rate of RN was estimated with the Kaplan Meier method. Risk factors were obtained from logistic regression models. Results Eighty-six patients (49 male, 37 female, median age 47 years) were included. 38 patients suffered from low-grade and 48 from high-grade glioma. Median follow-up was 15 months after second treatment. Fifty-eight patients received upfront EBRT (median total dose: 60 Gy), and 28 upfront SBT (median reference dose: 54 Gy, median dose rate: 10.0 cGy/h). Median time interval between treatments was 19 months. RN was diagnosed in 8/75 patients. The 1- and 2-year risk of RN was 5.1% and 11.7%, respectively. Tumor volume and irradiation time of SBT, number of implanted seeds, and salvage EBRT were risk factors for RN. Neither of the BED values nor the time interval between both treatments gained prognostic influence. Conclusion The combination of upfront EBRT and salvage SBT or vice versa is feasible for glioma patients. The risk of RN is mainly determined by the treatment volume but not by the interval between therapies.

A non-resolving splenic ‘abscess’ in an elderly male – An unusual manifestation of splenic lymphoma

2020 ◽  
pp. 004947552098130
Author(s):  
Raj K Nagarajan ◽  
Balasubramanian Gopal ◽  
Muhamed Tajudeen ◽  
Sarath C Sistla ◽  
K Balamourougan
Keyword(s):  
Risk Factors ◽  
Splenic Abscess ◽  
Low Grade ◽  
Surgical Drainage ◽  
Elderly Male ◽  
Unusual Manifestation ◽  
Splenic Lymphoma ◽  
Haematogenous Spread ◽  
Uncommon Condition ◽  
Abscess Wall

Splenic abscess is a relatively uncommon condition, posing a diagnostic and therapeutic challenge for the treating physician. It occurs due to haematogenous spread from endocarditis or other septic foci, especially in immune-compromised individuals and diabetics. We describe an elderly male who presented with splenomegaly and low-grade fever with no predisposing factors. Examination revealed a tender splenomegaly. Ultrasonography (US) showed a hypoechoic area within the spleen from which guided aspiration of pus grew Staphylococcus aureus and Klebsiella pneumoniae. Percutaneous drainage and culture-based antibiotics failed to resolve the abscess, obligating surgical drainage. Intraoperative biopsy from the abscess wall was reported as splenic marginal lymphoma. This unusual presentation of lymphoma needs to be considered in splenic abscess without known risk factors.

scholarly journals NCMP-14. SKULL BASE OSTEOMYELITIS DUE TO COMMUNITY-ACQUIRED ASPERGILLUS FUMIGATUS MIMICKING RECURRENT CHONDROSARCOMA

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii125-ii126
Author(s):  
Kevin Lillehei ◽  
B K Kleinschmidt-Demasters
Keyword(s):  
Risk Factors ◽  
Aspergillus Fumigatus ◽  
Skull Base ◽  
Replacement Therapy ◽  
Perceived Risk ◽  
Opportunistic Infections ◽  
Low Grade ◽  
Recurrent Tumor ◽  
Her Family ◽  
Patient Use

Abstract Skull base chondrosarcomas are often low grade tumors that do not metastasize, but are locally invasive and often recur locally. Thus, when patients with these tumors re-present with new onset symptoms, even decades later, recurrent tumor is presumed. A 50 year old woman with skull base chondrosarcoma initially diagnosed 30 years prior developed the subacute onset of worsening confusion and vision, with progressive blindness. Imaging disclosed a bony-erosive skull base mass without associated sinusitis/sinus opacification; additional small cerebral infarcts were identified. She had been on physiologic replacement therapy for panhypopituitarism since the original surgery, but had not received recent radiation therapy or chemotherapy and did not have neutropenia. RESULTS: Biopsy disclosed a chronic inflammation and necrotic debris; only on permanent sections were septated, 45-degree angle-branching fungi identified in one area. These had morphological features of, and were polymerase chain reaction-proven, Aspergillus fumigatus. No recurrent tumor was present. Given the lack of perceived risk factors, further questioning of the patient and her mother disclosed that precisely 1 year prior to surgery she and her family had participated in “cleaning out an old very dirty and dusty barn” in southern Colorado without the use of face masks; only the proband experienced sequelae. Anti-fungal therapy (voriconazole) was recommended although patient use was intermittent and symptoms have progressed. CONCLUSION: Community-acquired Aspergillus infections due to exposure to silage or barn detritus contaminated by fungal hyphae is almost never seen today, in comparison to opportunistic infections due to known risk factors of neutropenia and/or steroid usage. Replacement therapy may have added to this patient’s risk. Infections all too often mimic recurrent tumor.

scholarly journals Development and External Validation of Deep-Learning-Based Tumor Grading Models in Soft-Tissue Sarcoma Patients Using MR Imaging

Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2866
Author(s):  
Fernando Navarro ◽  
Hendrik Dapper ◽  
Rebecca Asadpour ◽  
Carolin Knebel ◽  
Matthew B. Spraker ◽  
...  
Keyword(s):  
Deep Learning ◽  
Soft Tissue ◽  
Mr Imaging ◽  
Characteristic Curve ◽  
External Validation ◽  
Soft Tissue Sarcomas ◽  
Treatment Decision ◽  
Receiver Operator Characteristic Curve ◽  
Low Grade ◽  
Tumor Grading

Background: In patients with soft-tissue sarcomas, tumor grading constitutes a decisive factor to determine the best treatment decision. Tumor grading is obtained by pathological work-up after focal biopsies. Deep learning (DL)-based imaging analysis may pose an alternative way to characterize STS tissue. In this work, we sought to non-invasively differentiate tumor grading into low-grade (G1) and high-grade (G2/G3) STS using DL techniques based on MR-imaging. Methods: Contrast-enhanced T1-weighted fat-saturated (T1FSGd) MRI sequences and fat-saturated T2-weighted (T2FS) sequences were collected from two independent retrospective cohorts (training: 148 patients, testing: 158 patients). Tumor grading was determined following the French Federation of Cancer Centers Sarcoma Group in pre-therapeutic biopsies. DL models were developed using transfer learning based on the DenseNet 161 architecture. Results: The T1FSGd and T2FS-based DL models achieved area under the receiver operator characteristic curve (AUC) values of 0.75 and 0.76 on the test cohort, respectively. T1FSGd achieved the best F1-score of all models (0.90). The T2FS-based DL model was able to significantly risk-stratify for overall survival. Attention maps revealed relevant features within the tumor volume and in border regions. Conclusions: MRI-based DL models are capable of predicting tumor grading with good reproducibility in external validation.

scholarly journals Emerging Role of Epigenetics in Explaining Relationship of Periodontitis and Cardiovascular Diseases

Diseases ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 48
Author(s):  
Syed Ameer Hamza ◽  
Saba Asif ◽  
Zohaib Khurshid ◽  
Muhammad Sohail Zafar ◽  
Syed Akhtar Hussain Bokhari
Keyword(s):  
Risk Factors ◽  
Cardiovascular Diseases ◽  
Heart Diseases ◽  
Periodontal Diseases ◽  
Protein Translation ◽  
Epigenetic Modifications ◽  
Human Diseases ◽  
Low Grade ◽  
Oral Diseases ◽  
Mirna Regulation

Cardiovascular diseases such as ischemic heart diseases or stroke are among the leading cause of deaths globally, and evidence suggests that these diseases are modulated by a multifactorial and complex interplay of genetic, environmental, and lifestyle factors. Genetic predisposition and chronic exposure to modifiable risk factors have been explored to be involved in the pathophysiology of CVD. Environmental factors contribute to an individual’s propensity to develop major cardiovascular risk factors through epigenetic modifications of DNA and histones via miRNA regulation of protein translation that are types of epigenetic mechanisms and participate in disease development. Periodontal disease (PD) is one of the most common oral diseases in humans that is characterized by low-grade inflammation and has been shown to increase the risk of CVDs. Risk factors involved in PD and CVD are determined both genetically and behaviorally. Periodontal diseases such as chronic inflammation promote DNA methylation. Epigenetic modifications involved in the initiation and progression of atherosclerosis play an essential role in plaque development and vulnerability. Epigenetics has opened a new world to understand and manage human diseases, including CVDs and periodontal diseases. Genetic medicine has started a new era of epigenetics to overcome human diseases with various new methodology. Epigenetic profiling may aid in better diagnosis and stratification of patients showing potential predisposed states for disease. A better understanding of the exact regulatory mechanisms of epigenetic pathways driving inflammation is slowly emerging and will aid in developing novel tools for the treatment of disease.

Relationship between Anatomical Risk Factors, Articular Cartilage Lesions, and Patient Outcomes Following Medial Patellofemoral Ligament Reconstruction

Cartilage ◽  
2019 ◽  
pp. 194760351989472 ◽  
Author(s):  
Charles L. Holliday ◽  
Laurie A. Hiemstra ◽  
Sarah Kerslake ◽  
John A. Grant
Keyword(s):  
Risk Factors ◽  
Odds Ratio ◽  
Patellar Instability ◽  
Ligament Reconstruction ◽  
Medial Patellofemoral Ligament ◽  
Trochlear Dysplasia ◽  
Cartilage Lesion ◽  
Low Grade ◽  
Medial Patellofemoral Ligament Reconstruction ◽  
Cartilage Lesions

Objective The purpose of this study was (1) to determine which risk factors for patellar instability were associated with the presence of patellofemoral cartilage lesions and (2) to determine how cartilage lesion presence, size, and grade affect postoperative disease-specific quality of life. Design Preoperative, intraoperative, and postoperative demographic, anthropometric (body mass index, Beighton score, hip rotation), radiographic (crossover sign, trochlear bump), cartilage lesion morphology (presence, size, location, grade), and outcomes data (Banff Patella Instability Instrument 2.0 [BPII 2.0]) were prospectively collected from patients undergoing isolated medial patellofemoral ligament reconstruction. For all knees ( n = 264), single and multivariable logistic regression was used to determine if any patellar instability risk factors affected the odds of having a cartilage lesion. In patients with unilateral symptoms ( n = 121), single variable linear regression was used to determine if the presence, size, or ICRS (International Cartilage Regeneration & Joint Preservation Society) grade of cartilage lesions could predict the 12 or 24+ month postoperative BPII 2.0 score. Results A total of 84.5% of knees had patellofemoral cartilage lesions (88.3% involved the distal-medial patella). Trochlear dysplasia (high grade: odds ratio = 15.7, P < 0.001; low grade: odds ratio = 2.9, P = 0.015) was associated with the presence of a cartilage lesion. The presence, size, and grade of cartilage lesions were not associated with 12 or 24+ month postoperative BPII 2.0 scores. Conclusions Trochlear dysplasia was a risk factor for the development of patellofemoral cartilage lesions in this patient population. Cartilage lesions most commonly involve the distal-medial patella. There was no significant relationship between patellofemoral cartilage lesion presence, size, or grade and postoperative BPII 2.0 scores in short-term follow-up.

Low-Grade and Anaplastic Gliomas: Differences in Architecture Evaluated with Diffusion-Tensor MR Imaging

Radiology ◽  
2006 ◽  
Vol 239 (1) ◽  
pp. 217-222 ◽  
Author(s):  
Einar Goebell ◽  
Susanne Paustenbach ◽  
Ole Vaeterlein ◽  
Xiao-Qi Ding ◽  
Oliver Heese ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Diffusion Tensor ◽  
Low Grade ◽  
Anaplastic Gliomas ◽  
Diffusion Tensor Mr Imaging

Predictors of tumor progression among children with gangliogliomas

2009 ◽  
Vol 3 (6) ◽  
pp. 461-466 ◽  
Author(s):  
Mostafa El Khashab ◽  
Lynn Gargan ◽  
Linda Margraf ◽  
Korgun Koral ◽  
Farideh Nejat ◽  
...  
Keyword(s):  
Risk Factors ◽  
Tumor Progression ◽  
Cox Regression ◽  
Tumor Resection ◽  
Progression Free Survival ◽  
Initial Presentation ◽  
Subtotal Resection ◽  
Low Grade ◽  
Cox Regression Analysis ◽  
Presenting Symptoms

Object Few reports describe the outcome and prognostic factors for children with gangliogliomas. The objective of this report was to describe the progression-free survival (PFS) for children with low-grade gangliogliomas and identify risk factors for tumor progression. Methods A retrospective study was performed in children with low-grade gangliogliomas who were evaluated and treated in the neuro-oncology department between 1986 and 2006 to determine risk factors for subsequent tumor progression. Results A total of 38 children with newly diagnosed gangliogliomas were included in this report. Thirty-four children were treated with surgery alone, 3 with subtotal resection and radiation therapy, and 1 with subtotal resection and chemotherapy. The follow-up ranged from 4 months to 15.8 years (mean 5.7 ± 4.2 years [± SD]). Seven children have experienced tumor progression, and 1 child died after his tumor subsequently underwent malignant transformation. The 5-year PFS was calculated to be 81.2% using Kaplan-Meier survival analysis. Initial presentation with seizures (p = 0.004), tumor location in the cerebral hemisphere (p = 0.020), and complete tumor resection (p = 0.035) were associated with prolonged PFS. Further analysis of the above significant variables by a Cox regression model identified initial presentation with seizures as being associated with prolonged PFS (p = 0.028). Conclusions The PFS and overall survival of children with gangliogliomas are good. Tumors located in the cerebral hemispheres, the achievement of total resection, and seizures at presentation were associated with prolonged PFS. Cox regression analysis identified presenting symptoms including seizures as significant predictive factors of PFS. Prospective studies with larger numbers of children are needed to define the significant factors of tumor progression.

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