• Title/Summary/Keyword: Atypical

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Differentiating Uterine Sarcoma From Atypical Leiomyoma on Preoperative Magnetic Resonance Imaging Using Logistic Regression Classifier: Added Value of Diffusion-Weighted Imaging-Based Quantitative Parameters

  • Hokun Kim;Sung Eun Rha;Yu Ri Shin;Eu Hyun Kim;Soo Youn Park;Su-Lim Lee;Ahwon Lee;Mee-Ran Kim
    • Korean Journal of Radiology
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    • v.25 no.1
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    • pp.43-54
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    • 2024
  • Objective: To evaluate the added value of diffusion-weighted imaging (DWI)-based quantitative parameters to distinguish uterine sarcomas from atypical leiomyomas on preoperative magnetic resonance imaging (MRI). Materials and Methods: A total of 138 patients (age, 43.7 ± 10.3 years) with uterine sarcoma (n = 44) and atypical leiomyoma (n = 94) were retrospectively collected from four institutions. The cohort was randomly divided into training (84/138, 60.0%) and validation (54/138, 40.0%) sets. Two independent readers evaluated six qualitative MRI features and two DWI-based quantitative parameters for each index tumor. Multivariable logistic regression was used to identify the relevant qualitative MRI features. Diagnostic classifiers based on qualitative MRI features alone and in combination with DWI-based quantitative parameters were developed using a logistic regression algorithm. The diagnostic performance of the classifiers was evaluated using a cross-table analysis and calculation of the area under the receiver operating characteristic curve (AUC). Results: Mean apparent diffusion coefficient value of uterine sarcoma was lower than that of atypical leiomyoma (mean ± standard deviation, 0.94 ± 0.30 10-3 mm2/s vs. 1.23 ± 0.25 10-3 mm2/s; P < 0.001), and the relative contrast ratio was higher in the uterine sarcoma (8.16 ± 2.94 vs. 4.19 ± 2.66; P < 0.001). Selected qualitative MRI features included ill-defined margin (adjusted odds ratio [aOR], 17.9; 95% confidence interval [CI], 1.41-503, P = 0.040), intratumoral hemorrhage (aOR, 27.3; 95% CI, 3.74-596, P = 0.006), and absence of T2 dark area (aOR, 83.5; 95% CI, 12.4-1916, P < 0.001). The classifier that combined qualitative MRI features and DWI-based quantitative parameters showed significantly better performance than without DWI-based parameters in the validation set (AUC, 0.92 vs. 0.78; P < 0.001). Conclusion: The addition of DWI-based quantitative parameters to qualitative MRI features improved the diagnostic performance of the logistic regression classifier in differentiating uterine sarcomas from atypical leiomyomas on preoperative MRI.

Outlier Detection Diagnostic based on Interpolation Method in Autoregressive Models

  • Cho, Sin-Sup;Ryu, Gui-Yeol;Park, Byeong-Uk;Lee, Jae-June
    • Journal of the Korean Statistical Society
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    • v.22 no.2
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    • pp.283-306
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    • 1993
  • An outlier detection diagnostic for the detection of k-consecutive atypical observations is considered. The proposed diagnostic is based on the innovational variance estimate utilizing both the interpolated and the predicted residuals. We adopt the interpolation method to construct the proposed diagnostic by replacing atypical observations. The perfomance of the proposed diagnositc is investigated by simulation. A real example is presented.

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Massive Hemoptysis Caused by Atypical Behcet's Disease

  • Lee, Won-Young;Hoon, Choi Se;Kim, Hyeong Ryul
    • Journal of Chest Surgery
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    • v.47 no.2
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    • pp.178-180
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    • 2014
  • Pulmonary and/or bronchial aneurysm with systemic thrombophlebitis can be seen in the case of both Behcet's disease and Hughes-Stovin syndrome. These two diseases may be indistinguishable since the clinical, radiological, and histopathological findings are similar in both cases. In particular, from the perspective of pulmonary involvement, hemoptysis is the leading cause of death in both conditions and is followed by aneurysmal rupture. Here, we report a case in which surgical resection was performed for a patient presenting recurrent hemoptysis as an atypical presentation of Behcet's disease.

Pleural Metastasis of Atypical Bronchial Carcinoid

  • Zinchenko, Eugeniy Igorevich;Maslak, Olga Sergeevna;Pischik, Vadim Grigorievich;Obornev, Aleksandr Dmitrievich;Kovalenko, Aleksandr Igorevich
    • Journal of Chest Surgery
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    • v.53 no.5
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    • pp.317-320
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    • 2020
  • Pulmonary carcinoids are relatively rare tumors with low metastatic potential. Pleural carcinomatosis of a bronchial carcinoid has only been reported in 4 cases. Due to the rarity of this condition, there are no guidelines for its treatment or management. We report a case of atypical carcinoid with local recurrence and pleural metastases treated by video-assisted thoracoscopic surgery lobectomy and total pleurectomy with photodynamic therapy after non-radical wedge resection.

Malignant Brain Tumours in Children : Present and Future Perspectives

  • Rutka, James T.
    • Journal of Korean Neurosurgical Society
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    • v.61 no.3
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    • pp.402-406
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    • 2018
  • In contrast to many of the malignant tumors that occur in the central nervous system in adults, the management, responses to therapy, and future perspectives of children with malignant lesions of the brain hold considerable promise. Within the past 5 years, remarkable progress has been made with our understanding of the basic biology of the molecular genetics of several pediatric malignant brain tumors including medulloblastoma, ependymoma, atypical teratoid rhabdoid tumour, and high grade glioma/diffuse intrinsic pontine glioma. The recent literature in pediatric neuro-oncology was reviewed, and a summary of the major findings are presented. Meaningful sub-classifications of these tumors have arisen, placing children into discrete categories of disease with requirements for targeted therapy. While the mainstay of therapy these past 30 years has been a combination of central nervous system irradiation and conventional chemotherapy, now with the advent of high resolution genetic mapping, targeted therapies have emerged, and less emphasis is being placed on craniospinal irradiation. In this article, the present and future perspective of pediatric brain malignancy are reviewed in detail. The progress that has been made offers significant hope for the future for patients with these tumours.

Atypical Teratoid Rhabdoid Tumour : From Tumours to Therapies

  • Richardson, Elizabeth Anne;Ho, Ben;Huang, Annie
    • Journal of Korean Neurosurgical Society
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    • v.61 no.3
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    • pp.302-311
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    • 2018
  • Atypical teratoid rhabdoid tumours (ATRTs) are the most common malignant central nervous system tumours in children ${\leq}1year$ of age and represent approximately 1-2% of all pediatric brain tumours. ATRT is a primarily monogenic disease characterized by the bi-allelic loss of the SMARCB1 gene, which encodes the hSNF5 subunit of the SWI/SNF chromatin remodeling complex. Though conventional dose chemotherapy is not effective in most ATRT patients, high dose chemotherapy with autologous stem cell transplant, radiotherapy and/or intrathecal chemotherapy all show significant potential to improve patient survival. Recent epigenetic and transcriptional studies highlight three subgroups of ATRT, each with distinct clinical and molecular characteristics with corresponding therapeutic sensitivities, including epigenetic targeting, and inhibition of tyrosine kinases or growth/lineage specific pathways.

Traumatic Carotid-cavernous Fistula Bringing about Intracerebral Hemorrhage

  • Lee, Chang-Ju;Choi, Seung-Won;Kim, Seon-Hwan;Youm, Jin-Young
    • Journal of Korean Neurosurgical Society
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    • v.38 no.2
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    • pp.155-157
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    • 2005
  • Spontaneous intracerebral hemorrhage associated with traumatic carotid-cavernous fistula is rare. The cardinal symptoms of traumatic carotid-cavernous fistula are confined to ocular manifestations. This article describes a case of traumatic carotid-cavernous fistula which was initially diagnosed as an intracerebral hemorrhage, after ocular symptoms were overlooked. Because some cases of carotid-cavernous fistula have an atypical drainage which can result in intracerebral hemorrhage, early diagnosis and intervention are vital to prevent this unwanted intracerebral hemorrhage.

Atypical Facial Filler Granuloma: Comparative Histologic Analysis with Paraffinoma

  • Park, Kang Gyun;Dhong, Eun Sang;Goong, Sik Nam;Han, Jung Kyu;Han, Seung Kyu;Kim, Woo Kyung
    • Archives of Craniofacial Surgery
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    • v.17 no.3
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    • pp.169-172
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    • 2016
  • Dermal fillers are generally accepted as safe and well-tolerable cosmetic tools. However, adverse reactions have been reported in the literature. Here, we present a case of atypical facial filler granuloma and compare its histologic features with those of the classic paraffinoma.