-
Webster Holden posted an update 3 weeks, 2 days ago
otein level and some imaging features at MRI helped to differentiate progressed HCC from lower grade nodules. © RSNA, 2020 Online supplemental material is available for this article. check details See also the editorial by Motosugi in this issue.Background In heart failure with preserved ejection fraction (HFpEF), echocardiographic studies suggest that global longitudinal strain (GLS) has an impact on survival. Feature-tracking cardiovascular MRI also allows for strain analysis; however, to the knowledge of the authors, little is known about its prognostic value and whether it reflects severity of diffuse fibrosis, as assessed by cardiovascular MRI T1 mapping. Purpose To investigate the association between myocardial strain at cardiovascular MRI with extracellular volume by T1 mapping and outcome in participants with HFpEF. Materials and Methods In this secondary analysis of a prospective study (NCT03405987), consecutive participants with HFpEF underwent cardiovascular MRI between July 2012 and March 2018, including T1 mapping and three-dimensional strain analysis. Extracellular volume and strain results were assessed to determine if there was a correlation between these two factors. Cox regression was performed to determine the prognostic relevance al longitudinal strain at cardiovascular MRI was correlated with extracellular volume by T1 mapping and was associated with cardiovascular events. © RSNA, 2020 Online supplemental material is available for this article.Tracheal metastasis from papillary thyroid carcinoma (PTC) is an unprecedented and rare entity. We present the case of a 65 year-old lady who suffered from dyspnea and a thyroid goiter that turned out to be PTC. A magnetic resonance imaging (MRI) scan of the lungs revealed a huge tracheal mass causing obstruction of the tracheal lumen. She underwent a surgical tracheostomy and diode laser debulking of the tumor. Following this, she had a total thyroidectomy and postoperative radioiodine ablation and radiotherapy. She remains well under close and regular follow-up. A secondary tracheal tumor usually comes from a lymphatic spread of the primary tumor, whereas the vascular route is rarely reported. Endoscopic minimally invasive laser tracheal surgery with adjuvant radiotherapy appears to be equally effective to more aggressive tracheal resections.Ameloblastoma (AM) is a slow growing and aggressive benign tumor with an odontogenic epithelial origin arising from the mandible or maxilla. The odontogenic neoplasm invades local tissues asymptomatically and accounts for 1% of oral tumors and over 10% of odontogenic tumors. A 64-year-old man with a history of allergic fungal rhinosinusitis (AFRS) undergoing a revision image-guided endoscopic sinus surgery was found to have a fibrous mass suspicious of malignancy projecting inferolaterally and attached to the floor of the left maxillary sinus. Diagnostic biopsies were taken, and additional surgery was required to successfully resect the tumor via a transnasal endoscopic dissection. Multiple permanent pathology samples concluded the diagnosis of an AM. Endoscopic investigations led to the incidental discovery and ultimate complete endoscopic resection of the AM. The utilization of an endoscopic resection compared to the traditional maxillectomy with reconstruction results in significant less short and long-term morbidity for the patient.Objective To study the potential changes of health-related quality of life (HRQL), voice quality, and communicative function up to 24 months following radiotherapy for patients with laryngeal cancer. Methods A total of 28 patients with laryngeal cancer, treated by curatively intended radiotherapy were included in this prospective longitudinal descriptive study. Patients were followed pre-radiotherapy, 12 months, and 24 months post-radiotherapy. At each time point, voice recordings and patient-reported outcome instruments (European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire Core30, Head and Neck35, Swedish Self-Evaluation of Communication Experiences after Laryngeal Cancer) were completed. Perceptual analysis using the Grade-Roughness-Breathiness-Asthenia-Strain was performed using the voice recordings. Results Voice quality remains inferior to the voices of healthy controls both before and up to 24 months post-radiotherapy, demonstrating no statistically significant changes during the study period. Self-perceived communicative function revealed a trend toward improvement. Health-related quality of life remains mostly at stable levels, however, with statistically significant deterioration regarding dry mouth and sticky saliva. Generally, patients reported inferior scores compared to a normal population. Conclusion This study demonstrated no statistically significant changes over time in HRQL and perceptual voice quality at pre-radiotherapy compared to 24 months post-radiotherapy. However, the values remain inferior to the voices of healthy controls or a normal population.Objectives With tympanostomy tube insertion remaining the most common procedure performed in children to date, growing interests in minimizing both procedural costs and anesthetic exposure in the pediatric population have inspired innovation with respect to tympanostomy tubes. As such, we aim to discuss the current state of tympanostomy tube innovation including insertion devices, tube material, and design. Methods Computerized literature review. Results (1) Numerous single-use devices consisting of a myringotomy knife and preloaded tympanostomy tube offer potential advantages of decreasing or eliminating operating room time and may be performed under moderate instead of a general anesthetic. (2) Innovation with respect to tympanostomy tube material and design may offer enhanced ototopical drug delivery, decreased rates of tube occlusion, and/or the ability to dissolve “on-command” with application of a novel ototopical material. (3) These technologies currently remain in various phases of preclinical and clinical testing. Conclusions While clinical testing for a number of new technologies is preliminary and ongoing, tympanostomy tube-related innovations hold exciting promise to supplement or potentially replace the present-day armamentarium of tympanostomy tube design and insertion moving forward.