Purpose: To evaluate the correlation of the mean and minimal apparent diffusion coefficient values (ADC mean , ADC minimal ) and dynamic magnetic resonance imaging (MRI) findings with prognostic factors in invasive ductal carcinoma. Materials and Methods:A total of 107 women with invasive ductal cancer underwent breast MRI. The ADC mean and ADC minimal of the cancers were computed. MRI findings were retrospectively evaluated according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon: mass or nonmass type, mass shape, mass margin, nonmass distribution, and enhancement pattern. Histological records were reviewed for tumor size, lymph node metastasis, histologic grade, and expression of estrogen receptors (ER), progesterone receptors (PR), c-erbB-2(HER2), Ki-67, and epidermal growth factor receptors (EGFR). Correlations of ADC values and MR findings with prognostic factors were determined using the Mann-Whitney U-test and the Kruskal-Wallis test.Results: The mean ADC minimal was 0.78 6 0.24 (Â10 À3 mm 2 /s), and the mean ADC mean was 1.01 6 0.23 (Â10 À3 mm 2 /s). There was a significant correlation of the ADCmean value with ER expression (P ¼ 0.027) and HER2 expression (P ¼ 0.018). There was no significant relationship between ADC minimal and prognostic factors or between ADC mean and traditional prognostic factors, PR, Ki-67 and EGFR. The majority of the mass type lesions were less than 5 cm in size and the majority of nonmass type lesions were more than 2 cm in size (P ¼ 0.022). The margin of mass was significantly associated with lymph node metastasis (P ¼ 0.031), ER expression (P ¼ 0.013), PR expression (P ¼ 0.036), HER2 expression (P ¼ 0.019), and EGRF expression (P ¼ 0.041). The rim internal enhancement was significantly correlated with Ki-67 expression (P ¼ 0.008). Conclusion:The low ADC mean value was related to positive expression of ER and negative expression of HER2. A spiculated margin was related to a good prognosis, but rim enhancement was associated with a poor prognosis.

Various ADC parameters were correlated with prognostic factors and subtype, except for ADCmin . HER2 positivity showed high ADC values and high Ki-67 index revealed low ADC values.

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The results of this study suggest that incidentally found thyroid lesions by FDG-PET/CT, especially a focal FDG uptake and a high SUV, have a high risk of thyroid malignancy. Further diagnostic work-up is needed in these cases.

After breast conservation therapy in women 50 years or younger, the addition of MRI to annual mammography screening improves detection of early-stage but biologically aggressive breast cancers at acceptable specificity. Results from this study can inform patient decision making on screening methods after breast conservation therapy.

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Robotic thyroidectomy was lengthier in duration than endoscopic thyroidectomy, more costly, and associated with increased postoperative drainage with no improvement in oncologic outcomes or complication rates. Therefore our data do not support any advantage of robotic surgery over endoscopic surgery.

xillary lymph node status is the most important prognostic factor in breast cancer. 1 The presence of nodal metastases decreases 5-year survival by approximately 40% compared to node-negative patients. 2 Sentinel lymph node biopsy has replaced axillary lymph node dissection in patients with a low risk of axillary nodal metastases because of decreased morbidity. [3][4][5][6][7] Sentinel lymph node status is a representative indicator for the entire lymph node basin. However, false-negative results of sentinel lymph node biopsy have been found. 4,8,9 Noninvasive imaging techniques have been used to predict the preoperative axillary lymph node status. Sonography has higher diagnostic accuracy than mammography, computed tomography, magnetic resonance imaging, and positron emission tomographyJae Jeong Choi, MD, Bong Joo Kang, MD, PhD, Sung Hun Kim, MD, Ji Hye Lee, MD, Seung Hee Jeong, MPH, Hyun Woo Yim, MD, PhD, Byung Joo Song, MD, Sang Seol Jung, MD Received September 20, 2010, ORIGINAL RESEARCHObjectives-The purpose of this study was to evaluate the diagnostic utility of sonographic elastography in differentiating reactive and metastatic axillary lymph nodes in breast cancer.Methods-A total of 64 lymph nodes (reactive, n = 33; metastatic, n = 31) from 62 patients with breast cancer were examined by both B-mode sonography and elastography from April to July 2009. Two experienced radiologists retrospectively assessed B-mode sonograms by the sum of scores for 4 criteria: short diameter, shape, hilum, and cortical thickening. Elastographic images were given scores of 1 to 4 according to the percentage of high-elasticity areas in the lymph nodes. We compared the diagnostic performance of B-mode sonography, elastography, and combined examinations. We also calculated the strain ratio of the lymph node and subcutaneous fat tissue.Results-The elasticity score for malignant lymph nodes (mean, 3.1) was higher than the score for benign lymph nodes (mean, 2.2; P < .0001). With a cutoff between elasticity scores of 2 and 3, elastography showed 80.7% sensitivity, 66.7% specificity, and 73.4% accuracy. With a cutoff between B-mode sonographic scores of 1 and 2, B-mode sonography showed 74.2% sensitivity and 78.8% specificity. Combined B-mode and elastographic sonography showed higher sensitivity (87.1%) than B-mode sonography alone. With a strain ratio cutoff point of 2.3, sensitivity was 82.8%, and specificity was 56.3%.Conclusions-Sonographic elastography may increase the sensitivity of B-mode sonography in the detection of metastatic axillary lymph nodes.