Semi-quantitative DCE-MRI threshold criteria are effective for predicting ovarian malignancy. The surgical approach may be altered depending on DCE-MRI threshold criteria analysis. Borderline tumours demonstrate significant overlap with benign lesions using DCE-MRI threshold criteria.

Threshold criteria established in this preliminary study using quantitative DCE-MRI provide an accurate method for the prediction of malignancy, particularly in preoperative indeterminate cases.

Background:Current imaging criteria for categorising disease response in metastatic renal cell carcinoma (mRCC) correlate poorly with overall survival (OS) in patients on anti-angiogenic therapies. We prospectively assess diffusion-weighted and multiphase contrast-enhanced (MCE) MR imaging (MRI) as markers of outcome.Methods:Treatment-naive mRCC patients on a phase II trial using sunitinib completed an MRI substudy. Whole-tumour apparent diffusion coefficient (ADC) maps and histograms were generated, and mean ADC and AUClow (proportion of the tumour with ADC values lying below the 25th percentile of the ADC histogram) recorded. On MCE-MRI, regions of interest were drawn around the most avidly enhancing components to analyse enhancement parameters. Baseline (n=26) and treatment-related changes in surviving patients (n=20) were correlated with OS. Imaged metastases were also analysed.Results:Forty-seven per cent of the patients showed significant changes in whole-tumour mean ADC following therapy, but there was no correlation with outcome. Patients with a high baseline AUClow and greater-than-median AUClow increase had reduced OS (HR=3.67 (95% confidence interval (CI)=1.23–10.9), P=0.012 and HR=3.72 (95% CI=0.98–14.21), P=0.038, respectively). There was no correlation between MCE-MRI parameters and OS. Twenty-eight metastases were analysed and showed positive correlation with primary tumour mean ADC for individual patients (r=0.607; P<0.001).Conclusion:Primary RCC ADC histogram analysis shows dynamic changes with sunitinib. Patients in whom the tumour ADC histogram demonstrated high baseline AUClow or a greater-than-median increase in AUClow with treatment had reduced OS.

Objectives: The imaging features of Mucoepidermoid carcinoma (MEC) of the breast are unfamiliar to the breast radiologists due to its rarity. In this paper, we aimed to review the literature, do an analysis and find a common pattern of those lesions that could potentially give a better understanding of this entity. Methods: A review is performed with searching keywords “mucoepidermoid carcinoma breast”, without limitations in the dates or the article types, in the PubMed database. Information about the number of cases, the age of the patients, the presenting symptom, the time-interval between the onset of the symptoms and the time of diagnosis, the diagnostic approach, the imaging, the treatment and the outcome have been reviewed and tabulated. Results: We identified 40 cases. The mean age of the patients was 57. The commonest symptom was a palpable mass, few months to up to 37 years, prior to the diagnosis, with the size ranging 5-82 mm. On US, the lesions appeared as irregular masses or had cystic benign features. The majority underwent a radical/modified radical mastectomy with a form of axillary lymph node procedure. 15 cases were Highgrade, 3 Intermediate-grade, and 19 Low-grade MEC. No chemotherapy was administered in most cases and in a mean follow-up time of 30 months, 5 died because of metastasis. Conclusion: Due to its rarity, the diagnostic and therapeutic approach of MEC in the breast is not welldocumented, causing challenges in daily practice, even at experienced Breast Centers. Review of the published cases is essential for multidisciplinary team meetings to plan treatment strategies.