This study aims to investigate the ability of ultrasound strain elastography as an adjunct to predict malignancy in soft tissue tumors suspect of sarcoma or metastasis in a tertiary reference center for sarcoma. A total of 137 patients were included prospectively. Patients were referred on the basis of clinical or radiological suspicion of malignant soft tissue tumor. All patients had previously undergone diagnostic imaging (MRI, CT or PET-CT). After recording strain elastography cine loops, ultrasound guided biopsy was performed. Three investigators, who were blinded to final diagnosis, reviewed all elastograms retrospectively. For each elastogram, a qualitative, visual 5-point score was decided in consensus and a strain ratio was calculated. Final pathology obtained from biopsy or tumor resection served as gold standard. Eighty-one tumors were benign, and 56 were malignant. t-tests showed a significant difference in mean visual score between benign and malignant tumors. There was no significant difference in mean strain ratio between the two groups. Strain elastography may be a valuable adjunct to conventional B-mode ultrasound, perhaps primarily in primary care, when considering whether to refer to a sarcoma center or to biopsy, although biopsies cannot reliably be ruled out based on the current data.

Surgery is the primary treatment for tongue cancer. The goal is a complete resection of the tumor with an adequate margin of healthy tissue around the tumor.Inadequate margins lead to a high risk of local cancer recurrence and the need for adjuvant therapies. Ex vivo imaging of the resected surgical specimen has been suggested for margin assessment and improved surgical results. Therefore, we have developed a novel three-dimensional (3D) ultrasound imaging technique to improve the assessment of resection margins during surgery. In this research protocol, we describe a study comparing the accuracy of 3D ultrasound, magnetic resonance imaging (MRI), and clinical examination of the surgical specimen to assess the resection margins during cancer surgery. Tumor segmentation and margin measurement will be performed using 3D ultrasound and MRI of the ex vivo specimen. We will determine the accuracy of each method by comparing the margin measurements and the proportion of correctly classified margins (positive, close, and free) obtained by each technique with respect to the gold standard histopathology.

The margin of the removed tumor in cancer surgery has an important influence on survival. Adjuvant treatments, prognostic complications, and financial costs are required when the pathologist observes a close/positive surgical margin. Ex vivo imaging of resected cancer tissue has been suggested for margin assessment, but traditional cross-sectional imaging is not optimal in a surgical setting. Instead, three-dimensional (3D) ultrasound is a portable, high-resolution, and low-cost method to use in the operation room. In this study, we aimed to investigate the accuracy of 3D ultrasound versus computed tomography (CT) to measure the tumor volume in an animal model compared to gross pathology assessment. The specimen was formalin fixated before systematic slicing. A slice-by-slice area measurement was performed to compare the accuracy of the 3D ultrasound and CT techniques. The tumor volume measured by pathological assessment was 980.2 mm³. The measured volume using CT was 890.4 ± 90 mm³, and the volume using 3D ultrasound was 924.2 ± 96 mm³. The correlation coefficient for CT was 0.91 and that for 3D ultrasound was 0.96. Three-dimensional ultrasound is a feasible and accurate modality to measure the tumor volume in an animal model. The accuracy of tumor delineation on CT depends on the soft tissue contrast.

Background: Focal pancreatitis constitutes a classic mimicker of pancreatic ductal adenocarcinoma (PDAC). Knowledge of characteristic findings in chronic and autoimmune pancreatitis (AIP) is important to avoid unnecessary surgery. Purpose: To retrospectively investigate CT (computed tomography) imaging features of AIP and chronic pancreatitis (CP) mimicking PDAC in surgically resected patients. Material and Methods: A search in the pancreatic database in our tertiary reference center was performed, and all patients undergoing pancreatic resection during the past 10 years with a final diagnosis of AIP were initially identified. Matched groups of patients with focal CP and PDAC were extracted from the same database. A control group of patients with diffuse AIP was identified from the local benign multidisciplinary team meetings. Two experienced abdominal radiologists reviewed all patients’ imaging and reached a consensus decision blinded to the diagnoses. Characteristic imaging features and attenuation values were recorded. Results: A total cohort of 41 patients (14 PDAC, 15 CP, and 12 focal AIP) who underwent surgery were included, along with 15 controls with diffuse AIP and no surgery. Both benign conditions showed contrast enhancement patterns and imaging features similar to PDAC. All groups were hypoattenuating without any significant differences in enhancement patterns. Conclusion: Differentiating focal autoimmune and CP from PDAC may be challenging despite knowledge of the characteristic CT imaging findings. Further diagnostic tests such as magnetic resonance imaging, IgG4 testing, and endoscopic ultrasound with biopsy should be performed in equivocal cases.

Objective : We present the first clinical experience with the BIOGRAPH One next-generation PET/MRI system scanner, evaluating its performance for body and brain imaging in patients across multiple tracers. Methods: A total of 59 patients were scanned on the BIOGRAPH One PET/MRI following standard clinical PET/CT (n = 52) or first-generation PET/MRI (Biograph mMR, n = 7). Scans comprised 30 total body (TB), whole body (WB), or regional scans with [¹⁸F]FDG, and 29 brain scans with either [¹⁸F]FDG (n = 5), [¹⁸F]FE-PE2I (n = 10), [¹⁸F]FET (n = 4), or [⁶⁸Ga]Ga-DOTATOC (n = 10). The PET image quality was visually assessed using a 5-point Likert scale (1 = very good to 5 = very bad) and compared with clinical scans acquired on either a current-generation digital PET/CT or a first-generation PET/MRI system, including evaluation of diagnostic concordance. PET quantification and image noise was compared in brain and WB/TB [¹⁸F]FDG PET scans. Results: PET image quality was rated as good or very good in 93% of scans with a median [inter-quartile range] score of 1.5 [1.5;2]. In 99% of cases, image quality was judged equal to or better than the clinical reference scan (median score 3 [2.5;3]). Diagnostic concordance was observed in 99% of readings. Imaging metrics revealed the anticipated regional bias in brain imaging, while no significant bias was observed in body imaging. Image noise was comparable to that observed with digital PET/CT and demonstrated superiority over first-generation PET/MRI despite potential degradation related to isotope decay in BIOGRAPH One PET/MRI acquisitions scans performed at the end of the imaging workflow. Conclusions: Within the study limitations related to sequential imaging, the BIOGRAPH One PET/MRI scanner demonstrated improved PET sensitivity and workflow potential over its first-generation predecessor, which may allow for broader clinical and research applications.