ChatGPT, which can automatically generate written responses to queries using internet sources, soon went viral after its release at the end of 2022. The performance of ChatGPT on medical exams shows results near the passing threshold, making it comparable to third-year medical students. It can also write academic abstracts or reviews at an acceptable level. However, it is not clear how ChatGPT deals with harmful content, misinformation or plagiarism; therefore, authors using ChatGPT professionally for academic writing should be cautious. ChatGPT also has the potential to facilitate the interaction between healthcare providers and patients in various ways. However, sophisticated tasks such as understanding the human anatomy are still a limitation of ChatGPT. ChatGPT can simplify radiological reports, but the possibility of incorrect statements and missing medical information remain. Although ChatGPT has the potential to change medical practice, education and research, further improvements of this application are needed for regular use in medicine.
Purpose To analyze the appearance of primary and recurrent aggressive fibromatosis (AF) on MRI with a focus on configuration and to determine potential risk factors for recurrences detected on MRI follow-up scans. Methods From 79 consecutive patients with histologically proven diagnosis of AF, 39 patients underwent a minimum of four 1.5 T MRI follow-up scans after resection of primary AF between 2008 and 2018. The primary and recurrent tumors were radiographically examined for configuration, limitation and extent on MRI. Epidemiological data and loco-regional subcutaneous edema, muscle edema and post-operative seroma were included. Results The mean age of the patients was 39 ± 2.6 years. Primary and recurrent AF most often occurred in the thigh. The main appearance of primary AF was significantly most often fascicular (p = 0.001–0.01) with heterogeneous and marked contrast enhancement. 21 % (n = 8) of the patients developed recurrences of AF. A fascicular configuration with homogeneous/heterogeneous contrast enhancement was the main appearance of recurrent AF, but recurrent AF appeared nodular, polycyclic, ovoid or streaky/flat as well. Recurrent AF significantly most often occurred within the first 9 months after primary tumor resection (p = 0.009), especially in patients up to 25 years of age (RR = 6.1; 95 % CI: 1.8–20.9; p = 0.004). The cases of recurrent AF were altogether significantly smaller than the primary tumors (p = 0.001). Post-treatment subcutaneous and muscle edema were present in 77 % and 56 %, respectively. Patients with muscle edema after primary tumor resection had a significantly higher risk for AF recurrences (relative risk ratio (RR) = 1.8; 95 % CI: 1.16–2.8; p = 0.0096). There was no significant difference detected in patients with complete or incomplete resection of the primary tumor. Conclusion Primary and recurrent aggressive fibromatosis has a mostly fascicular configuration, but may appear ovoid, nodular, streaky/flat or polycyclic as well. High risks for tumor recurrences are detected for patients up to 25 years of age, patients within the first 9 post-operative months and patients with muscle edema after primary tumor resection. Key points: Citation Format
Purpose: To analyse the appearance of primary and recurrent malignant peripheral nerve sheath tumours (MPNSTs) in magnetic resonance imaging (MRI) with a focus on configuration, and to assess the occurrence of loco-regional post-treatment changes and metastases during post-treatment follow-up. Material and methods:Twenty patients with histologically proven MPNST underwent post-treatment 1.5 T MRI. Primary and recurrent MPNSTs were examined for configuration, contrast enhancement, extent, and signal intensity in MRI. Loco-regional post-treatment changes and information on metastases were extracted from the follow-up.Results: MPNSTs occurred most often in the extremities (p = 0.006). Twenty per cent (n = 4) of the patients developed recurrences, with a total of 24 lesions. Recurrent MPNSTs were significantly smaller than primary MPNSTs (p = 0.003). Primary MPNSTs mostly occurred unifocally as multilobulated or ovoid and heterogeneous lesions with mostly well-defined borders. Recurrent MPNSTs purely occurred multifocally as mostly nodular (p < 0.001), multilobulated, or ovoid lesions. 80%, 65% and 30% of the patients showed post-treatment subcutaneous oedema (p = 0.002 to 0.03), muscle oedema (p = 0.02), and seroma, respectively. Twenty-five per cent (n = 5) of patients presented metastases during follow-up. The relative risk in patients with recurrences to develop lung or lymph node metastases is eightfold (p = 0.056).Conclusions: While primary MPNSTs mostly appear unifocally as multilobulated or ovoid lesions, recurrent MPNSTs purely occur multifocally as mostly nodular lesions. Subcutaneous and muscle oedema are very common locoregional post-treatment changes. Patients with recurrences have a higher risk for lung and lymph node metastases.
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