Although there are no reliable pathognomonic imaging features for GPA, the present article attempts to identify patterns of disease that are suggestive of the disease. The diagnosis ultimately relies on a constellation of radiographic findings, laboratory values, and accurate clinical history.
Purpose:To investigate if changes in tumor angiogenesis associated with complete pathologic response (pCR) or partial pathologic response (pPR) to treatment can be demonstrated by using diffuse optical spectroscopic (DOS) tomography.
Materials and Methods:All participants in this prospective, HIPAA-compliant, institutional review board-approved study provided written informed consent. Eleven women with invasive breast carcinoma were imaged with DOS tomography prior to, during, and at completion of neoadjuvant chemotherapeutic regimens. By using region of interest (ROI) analysis, the DOS measure of total tissue hemoglobin (Hb T ) was temporally correlated with quantitative measures of existing (CD31-expressing) and tumor-induced (CD105-expressing) vessels, in pretreatment and posttreatment tissue specimens, to assess change.
Results:Quantifi ed angiogenesis alone in pretreatment core biopsy specimens did not predict treatment response, but mean vessel density (MVD) and mean vessel area (MVA) of CD105-expressing vessels were signifi cantly decreased in women with pCR ( n = 7) ( P , .001 and P = .003, respectively). MVA of CD105-expressing vessels was also signifi cantly reduced at comparison of pre-and posttreatment residual tumor for women with pPR ( n = 4) ( P = .033). A longitudinal analysis showed signifi cant decreases ( P = .001) in mean Hb T levels during neoadjuvant chemotherapy in breast abnormality ROIs for women with pCR but not women with pPR. For women with pCR, but not women with pPR, pretreatment MVD of CD105-expressing vessels correlated with pretreatment Hb T ( P Յ .001).
Conclusion:DOS tomographic examinations in women with breast cancer who are receiving neoadjuvant chemotherapy show a mean decrease in Hb T with time in patients with pCR only. Observed pretreatment and posttreatment correlates with quantifi ed angiogenesis markers confi rm the likely biologic origin for this DOS signature and support its potential to predict angiogenic tissue response early in the treatment cycle.q RSNA, 2011Supplemental material : http://radiology.rsna.org/lookup /suppl
ObjectivesThe purpose of this pictorial review is to present the imaging spectrum of renal oncocytomas with radiological-pathological correlation.ConclusionThe differences in tumour cellularity (high cellularity or low cellularity with abundant stroma) and haemorrhagic/cystic change contribute to a wide spectrum of imaging findings of renal oncocytomas. Imaging findings substantially overlap those of common subtypes of clear cell and non-clear cell renal cell carcinomas. Multifocal renal oncocytomas are not rare, and making the diagnosis of oncocytoma with concomitant renal cell carcinoma is difficult. In addition, renal oncocytomas that demonstrate interval growth or develop in the setting of end-stage renal disease may be mistaken for malignancy.Teaching Points• High cellular components demonstrate avid arterial enhancement and subsequent washout.• Low cellular components demonstrate gradual subsequent enhancement owing to abundant stroma.• Cystic and hemorrhagic changes may account for lesion heterogeneity in the delayed phase.• Multifocal oncocytomas and oncocytomas coexisting with renal cell carcinoma are not rare.• Renal oncocytomas may demonstrate interval growth.
The purpose of this study was to clarify the association between CT findings and Fuhrman grade of clear cell renal cell carcinoma (ccRCC). The study group consisted of 214 surgically proven ccRCC in 214 patients. Contrast-enhanced CT studies were retrospectively assessed for tumor size, cystic versus solid, calcification, heterogeneity of lesions, percentage of non-enhancing (necrotic) areas, and growth pattern. CT findings and Fuhrman grade were compared. Nineteen of 22 (86.4%) cystic ccRCC were low grade (Fuhrman grades 1-2). There was no significant correlation between tumor size and grade in cystic ccRCC (P = 0.43). In predominantly solid ccRCC, there was significant correlation between tumor size and grade (P < 0.0001). Thirty-eight of 43 (88.4%) infiltrative ccRCC were high grade (Fuhrman grades 3-4). Logistic regression showed tumor size and infiltrative growth were significantly associated with grades 3-4 (P = 0.00083 and P = 0.0059). Cystic ccRCC tends to be low grade. Infiltrative growth and larger tumor size may increase the likelihood of high grade ccRCC.
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