The objective of this study was to assess the value of contrast-enhanced dynamic breast imaging in patients with carcinoma of unknown primary (CUP). Fourteen patients presenting with metastatic disease compatible with breast cancer (axillary lymph node metastasis: n = 6; supraclavicular lymph node metastasis: n = 1; bone metastasis: n = 3; liver metastasis: n = 3; lung metastasis: n = 1), who had no evidence of tumor in X-ray mammograms and ultrasound, underwent bilateral dynamic breast MR imaging. Suspicious lesions were localized preoperatively using a stereotactic device for MR-guided localization procedures. Magnetic resonance imaging revealed suspicious lesions in 9 of 14 patients. Histopathology revealed invasive carcinoma of the breast in 6 of these patients. Two enhancing lesions were fibroadenomas; one proved to be sclerosing adenosis. In 5 patients MR imaging showed no abnormality. Follow-ups performed up to 1 year after initial treatment revealed no breast cancers in these 5 patients. In patients with metastatic disease of unknown primary, MRI of the breast depicts the primary in a considerable number of cases with normal conventional evaluation.
Conventional radiography is still regarded the gold standard for imaging techniques in rheumatoid arthritis (RA). It is a very important tool for the diagnosis, the differential diagnosis, and the evaluation of the course and prognosis of the disease. Special advantages of conventional radiography are the worldwide availability and experience with the method over decades and the relatively low costs. Moreover, x-rays can be stored and re-evaluated over long periods of time. Joint damage caused by RA can be quantified by means of scoring methods. The amount of destruction correlates well with functional disability over time. The inhibition of damage progression seen on radiographs is the most important characteristic of a DMARD. Typical radiographic changes are part of the ACR classification criteria of RA. Technically, bone structure can be demonstrated with a high local resolution better than with all other imaging techniques, whereas only indirect conclusions can be drawn concerning soft tissue and cartilage lesions. This review includes recommendations given by the "Commission on Imaging Techniques" of the German Society of Rheumatology regarding technical and personal preconditions, costs, indication as well as practical performance of radiography in RA. In addition, radiographic changes that can be expected in RA including destruction and repair are discussed briefly.
Multi-slice CT provides superior z-resolution and higher volume coverage speed. These qualities fulfill one of the prerequisites for improvement of 3D postprocessing.
The results suggest that FFDM is at least equivalent to or--as far as spot views are concerned--superior to conventional SFM concerning the detectability of simulated lesions. Thus, a potential of dose reduction is suggested.
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