We aimed to search the contribution of diffusion-weighted imaging (DWI) in follow-up of patients with acute appendicitis associated inflammatory appendiceal mass (IAM). DWI was used as a monitoring imaging method to assess the response of medical treatment. 19 patients (mean age, 37+-13.1; age range, 19-69; M/F: 10/9), presented with clinical, laboratory and computed tomography (CT) findings suggestive of IAM were enrolled prospectively in this study. CT and DWI images were evaluated by two radiologists in consensus. b values 0, 500 and 1000 s/mm(2) were used, and DWI images were analysed both qualitatively and quantitatively. Laboratory parameters were C-reactive protein value and white blood cell count. During follow-up changes in the diameter of IMA and laboratory parameters were correlated with ADC values. Conservative treatment with interval appendectomy and a total conservative approach without surgery were the treatment options during follow-up. We found statistically significant correlation between the ADC values, maximum IAM diameter and laboratory parameters. During follow-up five surgical procedures were performed: one patient underwent surgery for cecal adenocarcinoma and four underwent interval appendectomy. One patient developed acute relapse of IAM at the sixth month of follow-up. DWI may be used with a significant success for follow-up of patients with IAM. As a monitoring imaging method, DWI may also aid in determining of most appropriate timing for interval appendectomy as well as may help in diagnosing alternative diagnoses (e.g. malignancy and inflammatory bowel disease) that can mimic IAM.

Breast Ultrasound and Dynamic Contrast-Enhanced Magnetic Resonance Imaging Findings of Idiopathic Granulomatous Mastitis: A Retrospective Single-Center Clinical Study - Hamidiye Medical Journal

The present study aimed to compare the effectiveness of two abbreviated magnetic resonance imaging (MRI) protocols in assessing the response to neoadjuvant chemoradiotherapy (CRT) in patients with rectal cancer. Data from the examinations of 62 patients with rectal cancer who underwent neoadjuvant CRT and standard contrast‑enhanced rectal MRI were retrospectively evaluated. Standard contrast‑enhanced T2‑weighted imaging (T2‑WI), post‑contrast T1‑weighted imaging (T1‑WI) and diffusion‑weighted imaging (DWI) MRI, as well as two abbreviated protocols derived from these images, namely protocol AB1 (T2‑WI and DWI) and protocol AB2 (post‑contrast fat‑suppressed (FS) T1‑WI and DWI), were assessed.Measurements of lesion length and width, lymph node short‑axis length, tumor staging, circumferential resection margin (CRM), presence of extramural venous invasion (EMVI), luminal mucin accumulation (MAIN), mucinous response, mesorectal fascia (MRF) involvement, and MRI‑based tumor regression grade (mrTRG) were obtained. The reliability and compatibility of the AB1 and AB2 protocols in the evaluation of tumor response were analyzed. The imaging performed according to the AB1 and AB2 protocols revealed significant decreases in lesion length, width and lymph node size after CRT. These protocols also showed reductions in lymph node positivity, CRM, MRF, EMVI.Furthermore, both protocols were found to be reliable in determining lesion length and width. Additionally, compliance was observed between the protocols in determining lymph node size and positivity, CRM involvement, and EMVI after CRT. In conclusion, the use of abbreviated MRI protocols, specifically T2‑WI with DWI sequences or post‑contrast FS T1‑WI with DWI sequences, is effective for evaluating tumor response in patients with rectal cancer following neoadjuvant CRT.The AB protocols examined in this study yielded similar results in terms of lesion length and width, lymph node positivity, CRM involvement, EMVI, MAIN, and MRF involvement.

Background/Objectives: Pathological complete response (pCR) is an important early endpoint in HER2-positive breast cancer treated with neoadjuvant therapy. Although tumor biology is a major determinant of response, the potential contribution of host-related factors such as body composition and systemic inflammatory-nutritional status remains uncertain. This study evaluated the associations of pretreatment skeletal muscle index (SMI), myosteatosis, an imaging-defined low-SMI obesity phenotype, and hemoglobin-albumin-lymphocyte-platelet (HALP) score with pCR. Methods: This retrospective single-center study included 114 patients with HER2-positive disease documented on pretreatment biopsy who received neoadjuvant systemic therapy followed by definitive surgery. CT-based body-composition measurements at the L3 level were available in 88 patients. SMI, skeletal muscle radiodensity, myosteatosis, an imaging-defined low-SMI obesity phenotype, and pretreatment HALP score were assessed. Factors associated with pCR were evaluated using Firth penalized logistic regression. Two multivariable models incorporated body-composition variables, HALP, hormone receptor status, simplified clinical T and N categories, HER2-treatment group, age, and Ki-67. Final multivariable analyses included 80 complete cases. Results: pCR was achieved in 59 of 114 patients (51.8%). Hormone receptor-negative tumors had a higher pCR rate than hormone receptor-positive tumors (74.4% vs. 40.0%; p < 0.001). Pretreatment SMI, myosteatosis, the imaging-defined low-SMI obesity phenotype, and HALP were not significantly associated with pCR in univariable analyses. In multivariable analyses, SMI and myosteatosis were not independently associated with pCR, whereas hormone receptor positivity remained associated with lower pCR odds. The treatment-group coefficient indicated lower adjusted pCR odds with trastuzumab alone than with dual HER2 blockade; however, this estimate was based on sparse complete-case subgroup data and should not be interpreted as a comparative treatment-effect estimate. Muscle attenuation and myosteatosis classification differed significantly by CT acquisition type, whereas SMI did not. Conclusions: Pretreatment SMI, myosteatosis, the imaging-defined low-SMI obesity phenotype, and HALP were not significantly associated with pCR in this cohort. Hormone receptor status remained strongly associated with response. Treatment-related estimates and attenuation-based body-composition measures should be interpreted cautiously because of sparse subgroup data, treatment-era confounding, and imaging heterogeneity. Larger prospective studies with standardized imaging are warranted.