With pleural or peripheral lung lesions, US guidance is comparable to CT guidance in terms of sample accuracy, while allowing for a significant reduction in procedure time and postprocedural pneumothorax and being free from ionizing radiation.

Objectives To evaluate ultrasound (US)-guided treatment of capsular contracture (CC) in patients with reconstructed/ augmented breast. Methods Twenty-five patients with grade IV CC were treated with peri-implant US-guided injection of triamcinolone acetonide. Before/after treatment, maximum capsular thickness (MCT) was measured by ultrasound and pain assessed with visual analogue score (pain-VAS). Patients with pain relief at 1 month were considered early responders (ERs). Another injection was performed in patients without pain relief at 1 month (late responders, LRs).Results One patient (treated with chemo-radiotherapy) experienced severe pain and local reaction after the second injection, requiring surgery. Twenty-four patients had baseline MCT of 1.8±0.3 mm and pain-VAS of 4.9±0.5, the baseline MCT of 19 ERs (1.7±0.2 mm) being significantly lower than that of 5 LRs (2.1±0.2 mm) (p=0.030). ERs had significantly reduced MCT and pain-VAS at one (1.1±0.3 mm; 1.5±0.5) and 6 months (1.1±0.2 mm; 0.9±0.7, respectively) (p< 0.001). At 1 month, LRs had a significantly reduced MCT (1.6±0.1 mm, p=0.042) but non-significantly changed pain-VAS (4.7±0.2); 5 months later, MCT reached 1.0±0.1 mm, pain-VAS reached 0.8±0.5 (p<0.044). Significant correla- Radiol (2011) 21:575-581 DOI 10.1007/s00330-010-1921 tion between the relative variation of MCT and pain-VAS (1 month/baseline) was found. Conclusions US-guided injection of triamcinolone acetonide is effective in treating grade IV CC.

The aim of our study was to establish whether ultrasonography can be proposed as the main diagnostic technique for the follow-up of soft tissue sarcoma (STS). In 26 patients with previous history of STS, a sonographic examination was carried out using a 5 MHz linear transducer to identify early local recurrences. Sonography was performed every 3 months and a computed tomographic (CT) control was made when the sonogram showed findings strongly suggestive of recurrence. STS recurrences were detected by sonography in 20 of 26 patients (77%) and were confirmed by histologic examination. In six cases, sonographic results were uncertain and in three of these the recurrence was ascertained by biopsy. CT scan provided a correct diagnosis in 16 patients (61.5%) and only in cases with lesions greater than 5 cm in diameter. From our experience we conclude that high frequency sonography is a most accurate noninvasive approach in early detection of STS recurrences. CT plays an important role in the cases amenable to surgery treatment and is recommended to obtain a better assessment of anatomic connection between tumor and adjacent structures.

KEYWORDSAdnexal masses; Contrast-enhanced ultrasound; Ovarian cancer.Abstract Introduction: Vascularity influences the characteristics of gynecologic tumors observed with direct imaging techniques that reveal the macrovascular component of these lesions (color and power Doppler) and with indirect imaging involving the administration of contrast agents to examine the microcirculation and interstitial perfusion (contrast-enhanced computed tomography [CT] and magnetic resonance [MR] imaging). The purpose of this study was to determine whether contrast-enhanced ultrasonography (CEUS) of ovarian lesions provides useful information that cannot be obtained with conventional US. Materials and methods: We used CEUS to assess 72 nonspecific adnexal lesions in 61 patients. CEUS was performed with a 4.8-ml bolus of a second-generation ultrasonographic contrast agent and dedicated imaging algorithms. For each lesion, B-mode morphology, CEUS morphology, and time/intensity curves were evaluated. Results: In 8/61 cases (13.1%) CEUS offered no additional morphovascular information. In 38/61 cases (62.3%), it provided additional information that did not modify the management of the lesion, and in 15/61 cases (24.6%) it gave additional information that modified the management of the lesion. Malignant lesions were characterized by significantly shorter times to peak enhancement (11.9 AE 3.1 s vs 19.8 AE 4.0 s p < 0.01) and significantly higher peak intensity (24.7 AE 4.2 dB vs 17.8 AE 3.3 dB p < 0.01) compared with benign lesions. Conclusions: CEUS improves diagnostic confidence in the characterization of liquid-corpuscular lesions where conventional US is inconclusive. CEUS can be proposed as a valid alternative to CT and MR. However, information obtained by CEUS influences the therapy in a limited percentage of cases (24.6%). Sommario Introduzione: La ricchezza della componente vascolare dei tumori ginecologici influenza le caratteristiche dell'imaging diretto, utilizzando metodiche che evidenziano la componente macrovascolare delle lesioni (color e power Doppler), e di quello indiretto, mediante somministrazione di mezzi di contrasto (MdC) per lo studio del microcircolo e della perfusione interstiziale. Lo scopo di questo lavoro è di valutare l'aggiunta di informazioni diagnostiche fornite dalla valutazione ecografica con MdC nello studio delle lesioni ovariche. Materiali e metodi: Abbiamo valutato 72 lesioni annessiali in 61 pazienti con lesioni ovariche di incerta interpretazione mediante somministrazione di 4,8 ml di MdC ecoamplificatore di II generazione. Per ogni lesione, abbiamo valutato la morfologia basale, quella contrastografica e le curve intensità/tempo. Risultati: La valutazione post-contrasto confrontata con la basale non ha apportato informazioni aggiuntive morfovascolari in 8 pazienti (13,1%); in 38 pazienti (62,3%) ha apportato informazioni senza modifiche del comportamento clinico; in 15 soggetti (24,6%) ha apportato elementi che hanno modificato il comportamento clinico. Le lesioni maligne presentavano valori...

Although NSCLC is not known as an immunogenic-mediated malignancy, in the past few years, the authors have observed an increasing interest in the development of therapies able to modulate the immune response including vaccines and non-specific immunoregulatory drugs (such as ipilimumab). Ipilimumab may become a new, powerful strategy for the management of NSCLC patients. Further investigation is needed to confirm the optimal treatment schedule and determine the potential predictors of response to the CTLA-4 blockade.