Introduction: Neoadjuvant chemotherapy (NAC) is widely used to treat breast cancer. Sentinel lymph node biopsy has replaced axillary lymph node dissection in patients who convert to node-negative status, after NAC. However, few studies have evaluated the diagnostic performance of ultrasonography (US) and magnetic resonance imaging (MRI) in determining axillary lymph node status after NAC. The aim of this study was to evaluate the diagnostic performance of breast US and MRI in predicting a response to NAC, for breast cancer. Methods: A systematic search, in PubMed, the Cochrane Library, and Web of Science, for original studies was performed. The Quality Assessment of Diagnostic Accuracy Studies 2 tool was used to assess the methodological quality of the included studies. Patient, study, and imaging characteristics were extracted, and sufficient data were used to reconstruct 2 × 2 tables. Data pooling, heterogeneity testing, forest plot construction, meta-regression analysis, and sensitivity analysis were performed using Meta-DiSc and Stata version 14.0 (StataCorp LP, College Station, TX, USA). Results: Nine studies met all the eligibility criteria and were included. The pooled sensitivity and specificity of MRI were 0.78 and 0.92, while the corresponding values for US were 0.80 and 0.90, respectively. The prevalence of pathologic complete response (pCR), among breast cancer patients, after neoadjuvant therapy was 26%. The prevalence of patients with estrogen receptor (ER)-, human epidermal growth factor receptor (HER)-, and progesterone receptor (PR)-positive tumors were 65%, 22%, and 37%, respectively. Conclusion: These results showed that MRI and US have almost the same accuracy in predicting pCR in patients with breast cancer undergoing neoadjuvant surgery. There is still a need for further investigations to prove that US is not inferior to MRI for this diagnosis.
BACKGROUND:The nasal septum deviation is the most common deformity of the nasal, and that can be congenital or acquired. Despite many studies exist about the impact of nasal septum deviation on chronic sinusitis and also association between chronic otitis and mastoid pneumatization; few studies exist about the impact of nasal septum deviation on chronic otitis and mastoid pneumatization.AIM:The aim of this study was to evaluate the associations of nasal septum deviation and mastoid pneumatization and chronic otitis.METHODS:In this study review, all CT scans of PNS and Mastoid View in the imaging section from Imam Ali hospital in 2016-2017 years and cases of nasal septum deviation were enrolled. The nasal septum deviation was recorded, and the degree of nasal septum deviation in the coronal plane that showed the maximum deviation of the nasal septum was recorded. The volume of the mastoid cells automatically and directly was calculated using three diameter measurements (2 coronal diameters and 1 axial diameter) by the program. The software of SPSS 22 was used for statistical analysis.RESULTS:There was no relationship between nasal septum deviation severity and incidence of mastoid pneumatization in patients with nasal septum deviation (P > 0.05). There was relationship between nasal septum deviation severity and chronic otitis in patients with nasal septum deviation (P < 0.05). In patients with moderate and severe intensity of nasal septum deviation, the volume of mastoid air cells in deviation side was lower than the front side (P < 0.05).CONCLUSION:Based on the results of the CT scan, in patients with moderate and severe nasal septum deviation intensity, the volume of mastoid air cells in deviation side was lower than the front side. Also, there was a relationship between nasal septum deviation severity and chronic otitis.
Objective. The aim of this meta-analysis was to compare the diagnostic accuracy of 18F-FDG-PET/CT and MRI in predicting the tumor response in locally advanced cervical carcinoma (LACC) treated by chemoradiotherapy (CRT). Method. This meta-analysis has been performed according to PRISMA guidelines. Systematic searches were conducted using PubMed and Embase databases for articles published from January 1, 2010, to January 1, 2020. By using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool, the reviewers assessed the methodological quality scores of the selected studies. We analyzed the sensitivity, specificity, and accuracy of two diagnostic methods using Meta-DiSc 1.4 and Stata 15. Results. An overall of 15 studies including 1132 patients were included. Sensitivities of PET/CT and MRI were 83.5% and 82.7%, while the corresponding rates for specificities were 77.8% and 68.4%, respectively. The DOR, PLR, and NLR for MRI were 15.140, 2.92, and 22.6. PET/CT had a DOR of 25.21. The PLR and NLR for PET/CT were 4.13 and 0.215, respectively. The diagnostic sensitivity and specificity of PET/CT for the detection of residual tumor were 86% and 95%, respectively. The corresponding rates for MRI were 73% and 96%, respectively. The diagnostic sensitivity and specificity of PET/CT for the detection of tumor metastases were 97% and 99%, while the corresponding rates for MRI were 31% and 98%, respectively. Conclusion. 18F-FDG PET/CT seemed to have a better overall diagnostic accuracy in the evaluation of treatment response to chemoradiotherapy in LACC patients. MRI showed a really poor sensitivity in the detection of metastases, and PET/CT performed significantly better. However, the difference between these two methods in the detection of residual disease was not significant. More studies are needed to be conducted in order to approve that 18F-FDG PET/CT can be a standard option to assess the treatment response.
An increasing body of evidence suggests that low vitamin D (25-[OH]-D) concentrations is linked to increased activity in multiple sclerosis (MS) patients and MS relapse. Therefore, the current study was aimed to evaluate vitamin D serum concentrations and its possible seasonal variations among MS patients with relapse. This prospective, descriptive study was conducted on patients with MS relapse who referred to the neurology center of Ali ibn Abi Talib Hospital in Zahedan during one year. Magnetic Resonance Imaging (MRI)-Spine was performed for 90 patients and serum samples were collected from patient to measure serum vitamin D levels using RIA KIT. Furthermore, the Plaques in each patient's MRI were counted and then recorded. Descriptive and inductive statistics were conducted using statistical software. Our findings indicated a significant correlation between serum vitamin D level and cervical spinal cord plaques (p = 0.007, r=0.28), while no association was revealed between serum vitamin D level and number of brain plaque. Furthermore, a significant association was also observed between number of cervical spinal cord plaques and serum vitamin D levels. In addition, a reverse correlation was observed between number of cervical spinal cord plaques and serum vitamin D levels in spring. In autumn, there was a statistically significant relationship between number of brain plaque and serum vitamin D level. Additionally, a statistically significant relationship was found between serum vitamin D levels and number of plaques in winter. Our findings are in agreement with some previous studies that reported conflicting result, where the association of season with the prevalence of relapse cases cannot be verified. Although the mean serum levels of vitamin D are inversely correlated with the incidence of relapses in winter. However, the values obtained in the spring do not confirm such an inverse relationship.
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