Aim: Assessing the diagnostic role of multiparametric MRI (mpMRI) in indeterminate mammographic breast lesions and postulated a diagnostic model for MRI interpretation integrating the morphological, and functional parameters. Material and Methods: Two hundred forty patients included in a self-control retrospective study in a tertiary center. All patients examined with 1.5T MR unit using multiparametric studies including morphological analysis followed by functional evaluation via MR diffusion (MR-DWI), spectroscopy(MRS), and kinetic enhanced curves (DCE-MRI). Diagnostic performance of each parameter was evaluated alone and in combination. The histopathological results were the standard of reference. Results: Combined mpMRI parameters possess a moderate agreement (κ=0.435) with 23.5% false discovery rate (FDR) and an overall accuracy of 78%.On the other hand, combined mpMRI data after omitting MRS data show almost perfect agreement (κ=0.923)with histopathological data and recorded 100% specificity, 90% specificity, 5% FDR and zero% for both false omission rate (FOR) and false-negative rate (FNR). The Quantitative analysis of DWI with ADC map shows a significant statistical value for mean ADC (m-ADC) value and relative ADC (r-ADC) value. The former has cutoff value 1.1x10-3 mm2/sec with higher specificity 97.5% while r-ADC has cutoff value 0.42x10-3 mm2/sec with quite lower specificity 85%. Perfect agreement in the interpretation of DCE-MRI curves, MR-DWI, and MRS with κ =0.92,0.9 and 0.84 respectively. Conclusion: Tailored combined multiparametric MRI is a potent diagnostic tool in the …

Aim: Assessing the diagnostic role of multiparametric MRI (mpMRI) in indeterminate mammographic breast lesions and postulated a diagnostic model for MRI interpretation integrating the morphological, and functional parameters. Material and Methods: Two hundred forty patients included in a self-control retrospective study in a tertiary center. All patients examined with 1.5T MR unit using multiparametric studies including morphological analysis followed by functional evaluation via MR diffusion (MR-DWI), spectroscopy(MRS), and kinetic enhanced curves (DCE-MRI). Diagnostic performance of each parameter was evaluated alone and in combination. The histopathological results were the standard of reference. Results: Combined mpMRI parameters possess a moderate agreement (κ=0.435) with 23.5% false discovery rate (FDR) and an overall accuracy of 78%.On the other hand, combined mpMRI data after omitting MRS data show almost perfect agreement (κ=0.923)with histopathological data and recorded 100% specificity, 90% specificity, 5% FDR and zero% for both false omission rate (FOR) and false-negative rate (FNR). The Quantitative analysis of DWI with ADC map shows a significant statistical value for mean ADC (m-ADC) value and relative ADC (r-ADC) value. The former has cutoff value 1.1x10-3 mm2/sec with higher specificity 97.5% while r-ADC has cutoff value 0.42x10-3 mm2/sec with quite lower specificity 85%. Perfect agreement in the interpretation of DCE-MRI curves, MR-DWI, and MRS with κ =0.92,0.9 and 0.84 respectively. Conclusion: Tailored combined multiparametric MRI is a potent diagnostic tool in the …

Aim: Assessing the diagnostic role of multiparametric MRI (mpMRI) in indeterminate mammographic breast lesions and postulated a diagnostic model for MRI interpretation integrating the morphological, and functional parameters. Material and Methods: Two hundred forty patients included in a self-control retrospective study in a tertiary center. All patients examined with 1.5T MR unit using multiparametric studies including morphological analysis followed by functional evaluation via MR diffusion (MR-DWI), spectroscopy(MRS), and kinetic enhanced curves (DCE-MRI). Diagnostic performance of each parameter was evaluated alone and in combination. The histopathological results were the standard of reference. Results: Combined mpMRI parameters possess a moderate agreement (κ=0.435) with 23.5% false discovery rate (FDR) and an overall accuracy of 78%.On the other hand, combined mpMRI data after omitting MRS data show almost perfect agreement (κ=0.923)with histopathological data and recorded 100% specificity, 90% specificity, 5% FDR and zero% for both false omission rate (FOR) and false-negative rate (FNR). The Quantitative analysis of DWI with ADC map shows a significant statistical value for mean ADC (m-ADC) value and relative ADC (r-ADC) value. The former has cutoff value 1.1x10-3 mm2/sec with higher specificity 97.5% while r-ADC has cutoff value 0.42x10-3 mm2/sec with quite lower specificity 85%. Perfect agreement in the interpretation of DCE-MRI curves, MR-DWI, and MRS with κ =0.92,0.9 and 0.84 respectively. Conclusion: Tailored combined multiparametric MRI is a potent diagnostic tool in the …

Aim: Assessing the diagnostic role of multiparametric MRI (mpMRI) in indeterminate mammographic breast lesions and postulated a diagnostic model for MRI interpretation integrating the morphological, and functional parameters. Material and Methods: Two hundred forty patients included in a self-control retrospective study in a tertiary center. All patients examined with 1.5T MR unit using multiparametric studies including morphological analysis followed by functional evaluation via MR diffusion (MR-DWI), spectroscopy(MRS), and kinetic enhanced curves (DCE-MRI). Diagnostic performance of each parameter was evaluated alone and in combination. The histopathological results were the standard of reference. Results: Combined mpMRI parameters possess a moderate agreement (κ=0.435) with 23.5% false discovery rate (FDR) and an overall accuracy of 78%.On the other hand, combined mpMRI data after omitting MRS data show almost perfect agreement (κ=0.923)with histopathological data and recorded 100% specificity, 90% specificity, 5% FDR and zero% for both false omission rate (FOR) and false-negative rate (FNR). The Quantitative analysis of DWI with ADC map shows a significant statistical value for mean ADC (m-ADC) value and relative ADC (r-ADC) value. The former has cutoff value 1.1x10-3 mm2/sec with higher specificity 97.5% while r-ADC has cutoff value 0.42x10-3 mm2/sec with quite lower specificity 85%. Perfect agreement in the interpretation of DCE-MRI curves, MR-DWI, and MRS with κ =0.92,0.9 and 0.84 respectively. Conclusion: Tailored combined multiparametric MRI is a potent diagnostic tool in the …

Objective To investigate the correlation between quantitative computed tomography (CT) perfusion findings in patients with colorectal thickening discovered at various imaging studies and histopathological examination. Patients and methods CT protocol included a precontrast scan. A region of 2 cm (four cuts) was selected based on the precontrast series. A dynamic study of the selected area was performed after contrast injection. Statistical analysis of the data was done. Results The current study enrolled 43 patients with suspected colorectal cancer; out of them, 39 patients were confirmed to have colorectal cancer based on the pathological evaluation. Blood flow of the thickened colon had 92% sensitivity and 50% specificity for diagnosing the malignant lesions, whereas blood volume had 97.4% sensitivity and 75% specificity. Permeability surface of the thickened part had 82% sensitivity and 75% specificity. Moreover, mean transit time had 44% sensitivity and 75% specificity. Conclusion Quantitative perfusion CT measurements enable differentiation and better discrimination between malignant and benign nature of colorectal thickening; however, the need for histopathological correlation cannot be omitted.

Objective To investigate the correlation between quantitative computed tomography (CT) perfusion findings in patients with colorectal thickening discovered at various imaging studies and histopathological examination. Patients and methods CT protocol included a precontrast scan. A region of 2 cm (four cuts) was selected based on the precontrast series. A dynamic study of the selected area was performed after contrast injection. Statistical analysis of the data was done. Results The current study enrolled 43 patients with suspected colorectal cancer; out of them, 39 patients were confirmed to have colorectal cancer based on the pathological evaluation. Blood flow of the thickened colon had 92% sensitivity and 50% specificity for diagnosing the malignant lesions, whereas blood volume had 97.4% sensitivity and 75% specificity. Permeability surface of the thickened part had 82% sensitivity and 75% specificity. Moreover, mean transit time had 44% sensitivity and 75% specificity. Conclusion Quantitative perfusion CT measurements enable differentiation and better discrimination between malignant and benign nature of colorectal thickening; however, the need for histopathological correlation cannot be omitted.

Objective To investigate the correlation between quantitative computed tomography (CT) perfusion findings in patients with colorectal thickening discovered at various imaging studies and histopathological examination. Patients and methods CT protocol included a precontrast scan. A region of 2 cm (four cuts) was selected based on the precontrast series. A dynamic study of the selected area was performed after contrast injection. Statistical analysis of the data was done. Results The current study enrolled 43 patients with suspected colorectal cancer; out of them, 39 patients were confirmed to have colorectal cancer based on the pathological evaluation. Blood flow of the thickened colon had 92% sensitivity and 50% specificity for diagnosing the malignant lesions, whereas blood volume had 97.4% sensitivity and 75% specificity. Permeability surface of the thickened part had 82% sensitivity and 75% specificity. Moreover, mean transit time had 44% sensitivity and 75% specificity. Conclusion Quantitative perfusion CT measurements enable differentiation and better discrimination between malignant and benign nature of colorectal thickening; however, the need for histopathological correlation cannot be omitted.

Objective To investigate the correlation between quantitative computed tomography (CT) perfusion findings in patients with colorectal thickening discovered at various imaging studies and histopathological examination. Patients and methods CT protocol included a precontrast scan. A region of 2 cm (four cuts) was selected based on the precontrast series. A dynamic study of the selected area was performed after contrast injection. Statistical analysis of the data was done. Results The current study enrolled 43 patients with suspected colorectal cancer; out of them, 39 patients were confirmed to have colorectal cancer based on the pathological evaluation. Blood flow of the thickened colon had 92% sensitivity and 50% specificity for diagnosing the malignant lesions, whereas blood volume had 97.4% sensitivity and 75% specificity. Permeability surface of the thickened part had 82% sensitivity and 75% specificity. Moreover, mean transit time had 44% sensitivity and 75% specificity. Conclusion Quantitative perfusion CT measurements enable differentiation and better discrimination between malignant and benign nature of colorectal thickening; however, the need for histopathological correlation cannot be omitted.

Background and Objectives. The use of complete mesocolic excision (CME) technique seems to be gaining popularity in the management of cancer colon. We aim to compare the laparoscopic approach for CME with the open approach in right colon cancer treatment with regard to the feasibility, safety, and perioperative and oncologic outcomes. Patients and Methods. A prospective study which included all patients that underwent radical right hemicolectomy for pathologic confirmed stage II or stage III tumor with CME at South Egypt Cancer Institute, Assiut University, from January 2012 to December 2019. Patients were grouped according to the surgical approach into the laparoscopic colectomy (LCME) group (n = 48) or open colectomy (OCME) group (n = 48). Results. The mean operative time was significantly longer in the LCME group than that in the OCME group with less mean intraoperative blood loss. Conversion was required in 4 patients (8.3%) in the LCME group. The use of laparoscopy increased the number of harvested lymph nodes compared to the open approach (39.81 ± 16.74 vs. 32.65 ± 12.28, respectively, ). The laparoscopic approach was associated with a shorter time interval to first flatus as well as shorter time interval to liquid and normal diet after surgery. The postoperative hospital stay was significantly shorter in the LCME group. The complication rate was slightly lower in the LCME (14.7%) than in the OCME group (27.2%) (). The 3-year OS in the LCME group was similar to that in OCME (78.2% vs. 63.2%, respectively, value = 0.423). The three-year DFS in the laparoscopic group was higher (74.5%) than the …

Background and Objectives. The use of complete mesocolic excision (CME) technique seems to be gaining popularity in the management of cancer colon. We aim to compare the laparoscopic approach for CME with the open approach in right colon cancer treatment with regard to the feasibility, safety, and perioperative and oncologic outcomes. Patients and Methods. A prospective study which included all patients that underwent radical right hemicolectomy for pathologic confirmed stage II or stage III tumor with CME at South Egypt Cancer Institute, Assiut University, from January 2012 to December 2019. Patients were grouped according to the surgical approach into the laparoscopic colectomy (LCME) group (n = 48) or open colectomy (OCME) group (n = 48). Results. The mean operative time was significantly longer in the LCME group than that in the OCME group with less mean intraoperative blood loss. Conversion was required in 4 patients (8.3%) in the LCME group. The use of laparoscopy increased the number of harvested lymph nodes compared to the open approach (39.81 ± 16.74 vs. 32.65 ± 12.28, respectively, ). The laparoscopic approach was associated with a shorter time interval to first flatus as well as shorter time interval to liquid and normal diet after surgery. The postoperative hospital stay was significantly shorter in the LCME group. The complication rate was slightly lower in the LCME (14.7%) than in the OCME group (27.2%) (). The 3-year OS in the LCME group was similar to that in OCME (78.2% vs. 63.2%, respectively, value = 0.423). The three-year DFS in the laparoscopic group was higher (74.5%) than the …