This presentation was held by dr. Antonio Pio Masciotra - italian radiologist - on Novembre 2012 at Prato.
It concerns about neoplastic tissue's elasticity and breast elastography.
This document provides an overview of elastography, a medical imaging technique that detects differences in tissue stiffness. It discusses various elastography methods including quasi-static ultrasound elastography, which images strain from externally applied stress, and dynamic methods like transient elastography that image shear waves to quantify tissue stiffness. The document outlines early developments in elastography research and commercial applications, limitations of different techniques, and potential future advances.
Elastography is a noninvasive imaging technique that uses ultrasound to image the elasticity or stiffness of tissues. It works by applying slight pressure and tracking how tissues deform. Stiffer tissues will deform less than softer tissues. There are different elastography techniques that vary by how tissue excitation is achieved and measured. Elastography provides objective quantification of tissue stiffness and has applications in imaging the breast, thyroid, prostate, liver and lymph nodes to help distinguish between benign and malignant lesions. It provides quantitative measurements of tissue elasticity in kilopascals and qualitative color maps of relative stiffness.
Presentation1, radiological imaging of gastro intestinal stromal tumour(gist).Abdellah Nazeer
This document summarizes radiological imaging of gastrointestinal stromal tumors (GISTs). It describes GISTs as the most common mesenchymal tumors of the GI tract, occurring most often in older adults. Imaging findings are discussed for various modalities including CT, MRI, US, and PET. Characteristic features include soft tissue masses arising from the GI tract wall. Larger tumors may show necrosis, hemorrhage, or cystic changes. Imaging can also detect metastatic lesions or tumor response to chemotherapy.
Tissue harmonic imaging is an ultrasound technique that provides higher quality images compared to conventional ultrasound by collecting harmonic signals generated in tissues and filtering out transducer-generated fundamental echo signals, resulting in clearer images with improved contrast resolution, reduced artifacts, and better visualization of deeper structures and vessels. While tissue harmonic imaging improves image quality in many clinical applications, it can decrease axial resolution compared to fundamental frequency imaging due to the narrowed signal bandwidth.
Presentation1.pptx, radiological imaging of beign breast diseasesAbdellah Nazeer
This document summarizes radiological imaging findings of various benign breast diseases. It describes imaging modalities used and findings for conditions such as ductal ectasia with inspissated secretion, fibroadenoma, cystosarcoma phyllodes, fibrocystic disease, idiopathic granulomatous mastitis, lupus mastitis, epidermal inclusion cyst, perilobular hemangioma, and hydatid cyst. Dynamic contrast MRI, diffusion MRI, MR spectroscopy, and ultrasound findings are presented for some conditions like fibroadenoma. Cyst morphology and characteristics are also detailed.
presentation on ultrasound elastography-introduction ,techniques,physics,application, interpretation and future prospects.sourced from multiple articles.
MR imaging is useful for staging prostate cancer once diagnosis is established through biopsy. It allows for identification of extracapsular extension, seminal vesicle invasion, and lymph node involvement. The departmental cases demonstrated various MRI findings of prostate cancer, including low T2 signal in the peripheral zone, restricted diffusion, and increased choline on MR spectroscopy. MRI is more sensitive and specific than other imaging modalities for local staging of prostate cancer when combined with MR spectroscopy.
This document provides an overview of elastography, a medical imaging technique that detects differences in tissue stiffness. It discusses various elastography methods including quasi-static ultrasound elastography, which images strain from externally applied stress, and dynamic methods like transient elastography that image shear waves to quantify tissue stiffness. The document outlines early developments in elastography research and commercial applications, limitations of different techniques, and potential future advances.
Elastography is a noninvasive imaging technique that uses ultrasound to image the elasticity or stiffness of tissues. It works by applying slight pressure and tracking how tissues deform. Stiffer tissues will deform less than softer tissues. There are different elastography techniques that vary by how tissue excitation is achieved and measured. Elastography provides objective quantification of tissue stiffness and has applications in imaging the breast, thyroid, prostate, liver and lymph nodes to help distinguish between benign and malignant lesions. It provides quantitative measurements of tissue elasticity in kilopascals and qualitative color maps of relative stiffness.
Presentation1, radiological imaging of gastro intestinal stromal tumour(gist).Abdellah Nazeer
This document summarizes radiological imaging of gastrointestinal stromal tumors (GISTs). It describes GISTs as the most common mesenchymal tumors of the GI tract, occurring most often in older adults. Imaging findings are discussed for various modalities including CT, MRI, US, and PET. Characteristic features include soft tissue masses arising from the GI tract wall. Larger tumors may show necrosis, hemorrhage, or cystic changes. Imaging can also detect metastatic lesions or tumor response to chemotherapy.
Tissue harmonic imaging is an ultrasound technique that provides higher quality images compared to conventional ultrasound by collecting harmonic signals generated in tissues and filtering out transducer-generated fundamental echo signals, resulting in clearer images with improved contrast resolution, reduced artifacts, and better visualization of deeper structures and vessels. While tissue harmonic imaging improves image quality in many clinical applications, it can decrease axial resolution compared to fundamental frequency imaging due to the narrowed signal bandwidth.
Presentation1.pptx, radiological imaging of beign breast diseasesAbdellah Nazeer
This document summarizes radiological imaging findings of various benign breast diseases. It describes imaging modalities used and findings for conditions such as ductal ectasia with inspissated secretion, fibroadenoma, cystosarcoma phyllodes, fibrocystic disease, idiopathic granulomatous mastitis, lupus mastitis, epidermal inclusion cyst, perilobular hemangioma, and hydatid cyst. Dynamic contrast MRI, diffusion MRI, MR spectroscopy, and ultrasound findings are presented for some conditions like fibroadenoma. Cyst morphology and characteristics are also detailed.
presentation on ultrasound elastography-introduction ,techniques,physics,application, interpretation and future prospects.sourced from multiple articles.
MR imaging is useful for staging prostate cancer once diagnosis is established through biopsy. It allows for identification of extracapsular extension, seminal vesicle invasion, and lymph node involvement. The departmental cases demonstrated various MRI findings of prostate cancer, including low T2 signal in the peripheral zone, restricted diffusion, and increased choline on MR spectroscopy. MRI is more sensitive and specific than other imaging modalities for local staging of prostate cancer when combined with MR spectroscopy.
Ultrasound elastography is a relatively advanced technique used to know the stiffness of the tissue. It is a non-invasive technique. Broadly classified into Quasistatic and Dynamic elastography.
Breast ultrasound uses high-frequency sound waves to detect breast abnormalities. It has high sensitivity in detecting breast lesions. Modern ultrasound equipment with high-frequency transducers can detect malignancy associated with microcalcifications. Breast ultrasound is useful for differentiating between cystic and solid breast lesions. Simple cysts appear anechoic with thin walls and increased sound transmission, while complex cysts have thick walls, septations, or solid components. Malignant solid masses tend to have an irregular shape, angular margins, heterogeneity, and ductal extension, compared to benign masses which are often oval with smooth margins and uniform internal echoes.
Ultrasound Elastography is a new imaging technique that allows a noninvasive estimation and imaging of tissue elasticity distribution within biological tissues using conventional, Real Time Ultrasound equipment with modified software. It can be viewed as an electronic palpation of tissues. Introduced by Ophir et al in 1991, it subsequently evolved into a Real Time Imaging tool.
MRI of the breast has certain contraindications including the presence of metallic implants, those unable to lie prone, or with large body habitus. Normal breast tissue may enhance asymmetrically, so scheduling during days 7-20 of the menstrual cycle can provide less enhancement. Dedicated breast coils are used with patients lying prone, and protocols involve unilateral or bilateral imaging with pre-and post-contrast sequences to analyze enhancement kinetics. Morphological features like irregular shapes and enhancement kinetics help identify lesions, with Type I curves associated with benign lesions and Type III with malignancy. MRI is useful for screening, determining tumor extent, assessing recurrence or residual disease, and providing information not available from other imaging methods.
The document describes the anatomy of the larynx based on a radiology report. It discusses the boundaries and divisions of the larynx and describes the cartilages that make up the laryngeal framework, including the thyroid, cricoid, and arytenoid cartilages. It also summarizes the imaging appearance of the larynx on computed tomography (CT) and magnetic resonance imaging (MRI).
Presentation1.pptx, radiological imaging of uterine cervix diseases.Abdellah Nazeer
This document discusses radiological imaging techniques for evaluating diseases of the uterine cervix. It begins by describing the anatomy of the cervix and then discusses various imaging modalities like CT, MRI, ultrasound and PET scans. It explains how these modalities are used to diagnose and stage cervical cancers as well as other cervical conditions like infections, polyps and endometriosis. The document concludes that while MRI is essential for evaluating cervical lesions, the findings must be interpreted in the clinical context to make an accurate diagnosis.
Multiplanar reformatted images in CT scans of the chest allow radiologists to view the scans in different planes and orientations beyond just axial sections. This helps identify patterns of diffuse lung disease, distributions of lesions, and other findings more quickly. Techniques like longitudinal reformation, minimum intensity projection (mIP), maximum intensity projection (MIP), multiplanar virtual reality (VR) averaging, and three-dimensional VR and volume intensity projection (VIP) generate reformatted images that provide additional clinical information about characteristics and locations of abnormalities in a more efficient manner compared to just reviewing numerous axial images.
Presentation1, radiological imaging of endometrial carcinoma.Abdellah Nazeer
MRI is a valuable tool for assessing endometrial cancer by depicting tumor size, extension into the myometrium or parametrium, cervical invasion, and lymphadenopathy. It plays an important role in pre-operative planning by identifying high-risk features that may require lymph node dissection or adjuvant therapy. While endometrial cancer is surgically staged, MRI can accurately assess key features to guide treatment. It can also differentiate endometrial cancer from benign conditions like hyperplasia, adenomyosis, or fibroids.
Sonoelastography, also known as ultrasound elastography, is a non-invasive medical imaging technique that maps the stiffness or elasticity of tissues. It uses ultrasound to capture how tissue deforms under an applied force. There are various elastography techniques including compression elastography, acoustic radiation force imaging (ARFI), and shear wave elastography. Shear wave elastography utilizes focused ultrasound beams to generate shear waves in tissue and can provide a quantitative measure of tissue stiffness in kilopascals. Elastography can help differentiate between benign and malignant lesions and may help reduce unnecessary breast biopsies.
Ultrasound is useful for evaluating breast lesions. It can differentiate between solid and cystic masses. Elastography further helps characterize lesions by assessing tissue stiffness. Benign lesions tend to be softer and more homogeneous while malignant lesions are typically stiffer and heterogeneous. Elastography can potentially upgrade or downgrade BI-RADS assessments. For example, a BI-RADS 3 lesion may be upgraded to 4 if seen as stiff on elastography, or a BI-RADS 4a lesion may be downgraded to 3 if appearing soft and homogeneous. Elastography provides additional information to ultrasound for more accurate characterization of breast abnormalities.
Contrast-enhanced ultrasound uses microbubbles and ultrasound to improve visualization of blood vessels and assessment of vascular perfusion. Microbubbles are spherical gas-filled shells approximately 1-4 micrometers in size composed of materials such as albumin or lipids. When combined with ultrasound imaging, they enhance the contrast between blood pools and surrounding tissues. This technique is useful for evaluation of organ perfusion and differentiation of benign and malignant lesions. Targeted microbubbles also show promise for molecular imaging applications.
This document provides information on endometrial carcinoma, cervical cancer, and uterine sarcomas as assessed by MRI. It begins with an overview of endometrial carcinoma histology and prognosis factors. It then details the MRI protocol for evaluating these cancers, including sequences used. The document describes the typical MRI appearances of these cancers and their stages according to FIGO classification. It concludes with sections on the MRI features of various uterine sarcomas, including leiomyosarcoma, endometrial stromal sarcoma, undifferentiated endometrial sarcoma, and adenosarcoma.
This document discusses using ultrasound guidance for breast procedures like cyst aspiration and biopsy. It describes how cyst aspiration is performed by inserting a needle under ultrasound guidance to drain fluid from cysts. It also outlines how to perform core biopsies on superficial and deep breast lesions using ultrasound to guide placement of the biopsy needle. Ultrasound is noted as an accurate and reliable method for guiding breast biopsies and cyst aspirations.
Presentation1.pptx, radiological imaging of malignant breast diseases.Abdellah Nazeer
The document discusses various types of breast cancers and their radiological appearances. It begins by describing breast cancer in general, noting that it usually occurs in women and can begin in the ducts or lobules. It then summarizes the main types of breast cancers like ductal carcinoma in situ, invasive ductal carcinoma, invasive lobular carcinoma, inflammatory breast carcinoma, and rare types like mucinous carcinoma and phyllodes tumor. For each type, it provides details on their clinical and radiological features like mammography and MRI appearances to aid in diagnosis.
This document contains 23 cases of gastrointestinal and hepatobiliary findings from imaging studies. Each case includes a description of findings and differential diagnoses. The cases cover a wide range of conditions affecting the esophagus, stomach, small bowel, colon, liver and bile ducts.
Introduction to mammography and its equipment.
Different views on mammography & supplementary views.
Birads mammographic lexicon
Birads ultrasound lexicon
Imaging of suspicious mammary lymph nodes
Categories in BIRADS 2013.
Elastography is a noninvasive imaging technique that uses ultrasound to image the elasticity or stiffness of tissues. It works by applying slight pressure and measuring how tissues deform. Hard tissues appear stiffer on elastograms. Elastography has many medical applications including differentiating benign from malignant breast lesions, assessing liver fibrosis, and evaluating prostate lesions. Shear wave elastography provides quantitative stiffness measurements and is the most accurate method. While useful, elastography has limitations such as difficulty imaging large or painful lesions and certain anatomical areas. Overall, elastography provides important clinical information about tissue composition when used along with other imaging tests.
Breast ultrasound uses high-frequency sound waves to map the internal structures of the breast. Though it should not be used alone for screening, ultrasound can detect cancers not seen on mammography when used together with mammography. With new transducers, ultrasound can also detect malignancy associated with clustered microcalcifications seen on mammograms. Ultrasound provides high quality images of the normal and abnormal breast and can help differentiate between cystic and solid lesions.
WHY IS THIS topic important
It is because prostate cancer is very common and but a good proportion of these cancers are considered clinically insignificant
And then there are more aggressive ones which are clinically significant which need to be treated
Our goal is to improve detection of these before they spread So that they can be treated
Comparison between mammogram and mri in detecting breast cancernordin1808
MRI mammography is more accurate than mammography in detecting breast diseases. A study compared MRI and mammography on 15 patients and found MRI detected 12 cases of ductal carcinoma in situ (DCIS) in the right breast that mammography missed, and 10 cases of DCIS in the left breast that mammography also missed. MRI mammography had a sensitivity of 100% while mammography's sensitivity was only 18% in detecting breast cancers. MRI is better able to detect lesions obscured by dense breast tissue and can find additional, missed tumors in the other breast of cancer patients. However, further large-scale studies are still needed to continue validating MRI mammography.
Physicians have used palpation to detect differences in tissue stiffness as an aid to diagnosis based on the fact that the mechanical properties of tissues are often dramatically affected by the presence of disease processes such as cancer, inflammation, and fibrosis. Elastography depends on the same differences in mechanical properties between healthy and abnormal tissues using imaging to detect these differences at depths not reachable by manual palpation and presents data in color-coded display, can be performed with ultrasound, using manual pressure or low frequency sonic waves, or by MR Elastography imaging.
Ultrasound elastography is a relatively advanced technique used to know the stiffness of the tissue. It is a non-invasive technique. Broadly classified into Quasistatic and Dynamic elastography.
Breast ultrasound uses high-frequency sound waves to detect breast abnormalities. It has high sensitivity in detecting breast lesions. Modern ultrasound equipment with high-frequency transducers can detect malignancy associated with microcalcifications. Breast ultrasound is useful for differentiating between cystic and solid breast lesions. Simple cysts appear anechoic with thin walls and increased sound transmission, while complex cysts have thick walls, septations, or solid components. Malignant solid masses tend to have an irregular shape, angular margins, heterogeneity, and ductal extension, compared to benign masses which are often oval with smooth margins and uniform internal echoes.
Ultrasound Elastography is a new imaging technique that allows a noninvasive estimation and imaging of tissue elasticity distribution within biological tissues using conventional, Real Time Ultrasound equipment with modified software. It can be viewed as an electronic palpation of tissues. Introduced by Ophir et al in 1991, it subsequently evolved into a Real Time Imaging tool.
MRI of the breast has certain contraindications including the presence of metallic implants, those unable to lie prone, or with large body habitus. Normal breast tissue may enhance asymmetrically, so scheduling during days 7-20 of the menstrual cycle can provide less enhancement. Dedicated breast coils are used with patients lying prone, and protocols involve unilateral or bilateral imaging with pre-and post-contrast sequences to analyze enhancement kinetics. Morphological features like irregular shapes and enhancement kinetics help identify lesions, with Type I curves associated with benign lesions and Type III with malignancy. MRI is useful for screening, determining tumor extent, assessing recurrence or residual disease, and providing information not available from other imaging methods.
The document describes the anatomy of the larynx based on a radiology report. It discusses the boundaries and divisions of the larynx and describes the cartilages that make up the laryngeal framework, including the thyroid, cricoid, and arytenoid cartilages. It also summarizes the imaging appearance of the larynx on computed tomography (CT) and magnetic resonance imaging (MRI).
Presentation1.pptx, radiological imaging of uterine cervix diseases.Abdellah Nazeer
This document discusses radiological imaging techniques for evaluating diseases of the uterine cervix. It begins by describing the anatomy of the cervix and then discusses various imaging modalities like CT, MRI, ultrasound and PET scans. It explains how these modalities are used to diagnose and stage cervical cancers as well as other cervical conditions like infections, polyps and endometriosis. The document concludes that while MRI is essential for evaluating cervical lesions, the findings must be interpreted in the clinical context to make an accurate diagnosis.
Multiplanar reformatted images in CT scans of the chest allow radiologists to view the scans in different planes and orientations beyond just axial sections. This helps identify patterns of diffuse lung disease, distributions of lesions, and other findings more quickly. Techniques like longitudinal reformation, minimum intensity projection (mIP), maximum intensity projection (MIP), multiplanar virtual reality (VR) averaging, and three-dimensional VR and volume intensity projection (VIP) generate reformatted images that provide additional clinical information about characteristics and locations of abnormalities in a more efficient manner compared to just reviewing numerous axial images.
Presentation1, radiological imaging of endometrial carcinoma.Abdellah Nazeer
MRI is a valuable tool for assessing endometrial cancer by depicting tumor size, extension into the myometrium or parametrium, cervical invasion, and lymphadenopathy. It plays an important role in pre-operative planning by identifying high-risk features that may require lymph node dissection or adjuvant therapy. While endometrial cancer is surgically staged, MRI can accurately assess key features to guide treatment. It can also differentiate endometrial cancer from benign conditions like hyperplasia, adenomyosis, or fibroids.
Sonoelastography, also known as ultrasound elastography, is a non-invasive medical imaging technique that maps the stiffness or elasticity of tissues. It uses ultrasound to capture how tissue deforms under an applied force. There are various elastography techniques including compression elastography, acoustic radiation force imaging (ARFI), and shear wave elastography. Shear wave elastography utilizes focused ultrasound beams to generate shear waves in tissue and can provide a quantitative measure of tissue stiffness in kilopascals. Elastography can help differentiate between benign and malignant lesions and may help reduce unnecessary breast biopsies.
Ultrasound is useful for evaluating breast lesions. It can differentiate between solid and cystic masses. Elastography further helps characterize lesions by assessing tissue stiffness. Benign lesions tend to be softer and more homogeneous while malignant lesions are typically stiffer and heterogeneous. Elastography can potentially upgrade or downgrade BI-RADS assessments. For example, a BI-RADS 3 lesion may be upgraded to 4 if seen as stiff on elastography, or a BI-RADS 4a lesion may be downgraded to 3 if appearing soft and homogeneous. Elastography provides additional information to ultrasound for more accurate characterization of breast abnormalities.
Contrast-enhanced ultrasound uses microbubbles and ultrasound to improve visualization of blood vessels and assessment of vascular perfusion. Microbubbles are spherical gas-filled shells approximately 1-4 micrometers in size composed of materials such as albumin or lipids. When combined with ultrasound imaging, they enhance the contrast between blood pools and surrounding tissues. This technique is useful for evaluation of organ perfusion and differentiation of benign and malignant lesions. Targeted microbubbles also show promise for molecular imaging applications.
This document provides information on endometrial carcinoma, cervical cancer, and uterine sarcomas as assessed by MRI. It begins with an overview of endometrial carcinoma histology and prognosis factors. It then details the MRI protocol for evaluating these cancers, including sequences used. The document describes the typical MRI appearances of these cancers and their stages according to FIGO classification. It concludes with sections on the MRI features of various uterine sarcomas, including leiomyosarcoma, endometrial stromal sarcoma, undifferentiated endometrial sarcoma, and adenosarcoma.
This document discusses using ultrasound guidance for breast procedures like cyst aspiration and biopsy. It describes how cyst aspiration is performed by inserting a needle under ultrasound guidance to drain fluid from cysts. It also outlines how to perform core biopsies on superficial and deep breast lesions using ultrasound to guide placement of the biopsy needle. Ultrasound is noted as an accurate and reliable method for guiding breast biopsies and cyst aspirations.
Presentation1.pptx, radiological imaging of malignant breast diseases.Abdellah Nazeer
The document discusses various types of breast cancers and their radiological appearances. It begins by describing breast cancer in general, noting that it usually occurs in women and can begin in the ducts or lobules. It then summarizes the main types of breast cancers like ductal carcinoma in situ, invasive ductal carcinoma, invasive lobular carcinoma, inflammatory breast carcinoma, and rare types like mucinous carcinoma and phyllodes tumor. For each type, it provides details on their clinical and radiological features like mammography and MRI appearances to aid in diagnosis.
This document contains 23 cases of gastrointestinal and hepatobiliary findings from imaging studies. Each case includes a description of findings and differential diagnoses. The cases cover a wide range of conditions affecting the esophagus, stomach, small bowel, colon, liver and bile ducts.
Introduction to mammography and its equipment.
Different views on mammography & supplementary views.
Birads mammographic lexicon
Birads ultrasound lexicon
Imaging of suspicious mammary lymph nodes
Categories in BIRADS 2013.
Elastography is a noninvasive imaging technique that uses ultrasound to image the elasticity or stiffness of tissues. It works by applying slight pressure and measuring how tissues deform. Hard tissues appear stiffer on elastograms. Elastography has many medical applications including differentiating benign from malignant breast lesions, assessing liver fibrosis, and evaluating prostate lesions. Shear wave elastography provides quantitative stiffness measurements and is the most accurate method. While useful, elastography has limitations such as difficulty imaging large or painful lesions and certain anatomical areas. Overall, elastography provides important clinical information about tissue composition when used along with other imaging tests.
Breast ultrasound uses high-frequency sound waves to map the internal structures of the breast. Though it should not be used alone for screening, ultrasound can detect cancers not seen on mammography when used together with mammography. With new transducers, ultrasound can also detect malignancy associated with clustered microcalcifications seen on mammograms. Ultrasound provides high quality images of the normal and abnormal breast and can help differentiate between cystic and solid lesions.
WHY IS THIS topic important
It is because prostate cancer is very common and but a good proportion of these cancers are considered clinically insignificant
And then there are more aggressive ones which are clinically significant which need to be treated
Our goal is to improve detection of these before they spread So that they can be treated
Comparison between mammogram and mri in detecting breast cancernordin1808
MRI mammography is more accurate than mammography in detecting breast diseases. A study compared MRI and mammography on 15 patients and found MRI detected 12 cases of ductal carcinoma in situ (DCIS) in the right breast that mammography missed, and 10 cases of DCIS in the left breast that mammography also missed. MRI mammography had a sensitivity of 100% while mammography's sensitivity was only 18% in detecting breast cancers. MRI is better able to detect lesions obscured by dense breast tissue and can find additional, missed tumors in the other breast of cancer patients. However, further large-scale studies are still needed to continue validating MRI mammography.
Physicians have used palpation to detect differences in tissue stiffness as an aid to diagnosis based on the fact that the mechanical properties of tissues are often dramatically affected by the presence of disease processes such as cancer, inflammation, and fibrosis. Elastography depends on the same differences in mechanical properties between healthy and abnormal tissues using imaging to detect these differences at depths not reachable by manual palpation and presents data in color-coded display, can be performed with ultrasound, using manual pressure or low frequency sonic waves, or by MR Elastography imaging.
MRI can detect breast lesions with high sensitivity but has variable specificity in differentiating benign from malignant lesions. MR spectroscopy provides additional metabolic information that can improve specificity by detecting elevated choline levels associated with malignant tumors. Response to chemotherapy can also be assessed non-invasively with MR spectroscopy by monitoring changes in choline levels within 24 hours of treatment. Limitations include difficulty with small lesions, dense breasts, and lactating breasts.
This document discusses various imaging modalities used for breast and gynecologic imaging. For breast imaging, it describes mammography technique including breast compression and views obtained. It also discusses ultrasound, MRI, and other modalities. Common benign and malignant breast lesions are shown. For gynecologic imaging, it describes ultrasound technique and anatomy seen, hysterosalpingography technique and findings, and the roles of CT and MRI.
Breast imaging techniques have advanced significantly since the 1950s. Mammography was introduced in the 1960s and digital mammography in the 2000s improved image quality and reduced radiation exposure. Tomosynthesis was developed in the 2010s to reduce tissue superimposition by creating 1mm slices. Ultrasound is used as an adjunct to mammography to differentiate cysts from solid masses and guide biopsies. The BI-RADS classification system standardizes how breast imaging findings are reported and communicated. While mammography remains the primary breast cancer screening tool, tomosynthesis and ultrasound have improved cancer detection rates by reducing false negatives, especially for women with dense breasts.
1. Breast cancer develops from mutations in genes controlling cell growth and health. Abnormal cells divide uncontrollably, forming tumors that can be benign or malignant.
2. Malignant tumors are cancerous and can spread via the lymphatic system to other parts of the body. Breast cancer refers specifically to malignant tumors in the breast.
3. Treatment plans consider cancer type, stage, hormone sensitivity, and patient history. Early detection through education and screening as well as primary and adjuvant therapies can help improve outcomes for breast cancer.
This document provides an overview of breast cancer, including risk factors, signs and symptoms, causes, diagnosis, treatment options and prevention strategies. It notes that breast cancer is the second leading cause of cancer deaths in women. While the chances of developing breast cancer increase with age, early detection through screening and awareness of changes to the breasts can help lead to successful treatment if cancer is found early. A variety of treatment options exist depending on the type and stage of cancer diagnosed. Lifestyle factors may also impact risk.
Magnetic Resonance Elastography is an advanced imaging technique in MRI. This method is a method of "virtual palpation" of internal organs with the help of MRI.
Compressive behavior of soft muscle tissuesVivek Kumar
The group studied the mechanical properties of soft muscle tissues. They performed compression testing of ovine muscle tissue samples on a universal testing machine (UTM). The stress-strain curve was nonlinear and time-dependent, showing different behavior for different strain rates. True stress-strain values had to be used instead of nominal values due to changes in cross-sectional area during testing. The experiment provided data on the stress-strain behavior of soft muscle tissues and added to research in this area.
The document discusses the mechanical properties of dental materials. It defines mechanical properties as those defined by the laws of mechanics, including forces and their effects on materials. Mechanical properties need to be considered collectively based on the intended application of the material. The success of any dental restoration depends on the mechanical properties of the material used. Key mechanical properties discussed include stress, strain, strength, elastic modulus, resilience, toughness, ductility and hardness. Various testing methods are used to evaluate these properties.
This document discusses bone and soft-tissue tumors. It provides information on different types of bone tumors like osteosarcoma, chondrosarcoma, and Ewing's sarcoma. It also discusses approaches to musculoskeletal tumors including history, imaging, biopsy, and differential diagnosis. Surgical treatment options for bone cancers include resection, reconstruction, and prosthesis replacement. Limb salvage is preferred over amputation when possible. Follow-up care after treatment is also covered.
1) The document discusses the evolution of concepts in understanding biomechanics related to fractures of the craniofacial maxillomandibular (CMF) region. Early concepts viewed the mandible as a simple beam under tension and compression.
2) More recent concepts recognize the mandible's behavior is influenced by soft tissues like muscles and that tension and compression zones change dynamically based on bite location. Forces are transmitted through both bone and soft tissues.
3) There has also been evolution in osteosynthesis techniques from wire loops and splints to rigid plates and screws, and now semi-rigid miniplates that provide stability while allowing function and healing. The goal is load-sharing constructs that avoid stress concentrations
This is the slideshow of the presentation held at 3d International Meeting on Sono-Elastography in Pavia on Oct. 1st 2013 concerning both elastography of the testis and general considerations on elastography.
Queste sono le slides presentate al Terzo Meeting Internazionale di Sonoelastografia tenutosi a Pavia il 01/10/2013.
Vengono trattati sia l'elastografia del testicolo che gli aspetti più generali dell'elastografia con le sue prospettive di sviluppo.
The document discusses soft tissue mechanics, specifically pseudoelasticity, collagen, ligaments, tendons, and viscoelasticity. It defines pseudoelasticity as large, recoverable strains without a temperature change. Collagen is the main structural protein, with 28 types identified, though type I composes 90% of the human body. Ligaments and tendons are composed of crimped collagen fibers within a ground substance. Both ligaments and tendons exhibit nonlinear, viscoelastic stress-strain behavior and hysteresis.
This study used a custom-built horizontal atomic force microscope to compress individual chondrocytes under varying conditions in order to determine whether the cell's mechanical response is controlled by its cortex or internal mechanics. The researchers found that changing the compression rate, force, or pipette pressure that controls the cell's cortical tension drastically altered the chondrocyte's behavior. Specifically, tests where the pipette pressure was varied at a constant compression rate revealed that the cell's elastic response depended strongly on its cortical tension. This supports the cortical shell model of cellular mechanics for chondrocytes.
1) The document discusses various mechanical properties of dental materials including elastic properties like elastic modulus and plastic properties like yield strength.
2) Mechanical properties are quantified using concepts of stress and strain, and different tests are used to measure properties like hardness, tensile strength, and impact resistance.
3) Key mechanical properties discussed include elastic modulus, proportional limit, yield strength, ductility, toughness, and hardness. Different tests for measuring these properties are also described.
" we want to share with other interested colleagues,our adventure into
surprises of rotator cuff tendinopathy; obviously a cooperative effort could
give more consistent data "
Manuel Branes
This document summarizes research on rotator cuff tendinopathy (SRCT). It discusses histopathological classifications of SRCT and findings from examining tissue samples from 65 patients. Key findings include:
1. Samples showed degeneration ranging from mild (Grade II) to severe (Grade IV) based on the Riley classification scale.
2. Neoangiogenesis and vascular responses play an important role in repair capabilities. Normal neoangiogenesis was observed but also abnormal forms with microhemorrhages.
3. Nodular neoangiogenesis clusters near tendon areas showed organized architecture and collagen synthesis, while diffuse neoangiogenesis was infiltrative with more microhemorrhages.
4.
This document summarizes research on rotator cuff tendinopathy (SRCT). It discusses histopathological classifications of SRCT and findings from examining tissue samples from 65 patients. Key findings include:
1. Samples showed degeneration ranging from mild (Grade II) to severe (Grade IV) based on the Riley classification scale.
2. Neoangiogenesis and vascular responses play an important role in repair capabilities. Normal neoangiogenesis was observed but also abnormal forms with microhemorrhages.
3. Nodular neoangiogenesis clusters near tendon areas showed organized architecture and collagen synthesis, while diffuse neoangiogenesis infiltrating tendon tissue was disorganized with inactive vessels.
4
This document summarizes research on rotator cuff tendinopathy (SRCT). It discusses histopathological classifications of SRCT and findings from examining tissue samples from 65 patients. Key findings include:
1. Samples showed degeneration ranging from mild (Grade II) to severe (Grade IV) based on the Riley classification scale.
2. Neoangiogenesis and vascular responses play an important role in repair capabilities. Normal neoangiogenesis was observed but also abnormal forms with microhemorrhages.
3. Nodular neoangiogenesis clusters near tendon areas showed organized architecture and collagen synthesis, while diffuse neoangiogenesis was infiltrative with more microhemorrhages, indicating unsuccessful angiogenesis.
This document discusses the structure and biomechanics of connective tissue. It describes connective tissue as containing widely dispersed cells and a large extracellular matrix. The main components of connective tissue are fibers (mostly collagen and elastin) which provide strength and elasticity, and ground substance which aids development. Biomechanics analyzes how biomaterials like bone and cartilage respond mechanically. Bone is a hard tissue analyzed using theories of elasticity, while soft tissues like muscle are analyzed using stress and strain theories. Properties like Young's modulus describe the stiffness of tissues, while load-deformation curves illustrate the toe, elastic, and plastic regions of mechanical response.
A pithy but thorough discussion on ultrasound elastography. An understanding of basic physics, principles and techniques and most importantly its use in clinical settings.
The document discusses vertebral implants and the materials used to create them. It notes that back pain is common and often due to spinal instability from injury, disease, or degeneration. Vertebral instrumentation is used to stabilize the spine and prevent excessive motion while the bones fuse during surgery. Traditionally, implants were made from biocompatible metal alloys like titanium and stainless steel. However, metals have limitations like obscuring imaging and stress shielding bone. Newer materials like PEEK polymers are being used which are less stiff and may improve outcomes. The document also discusses 3D printed vertebrae and coating implants with bioactive ceramics to enhance integration with bone.
Biomechanics of dental implants/dental implant courses by Indian dental academyIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
A 60-year-old male patient presented with persistent lumbar pain and was known to have prostatic carcinoma. MRI images showed a hypointense osteolytic lesion in the L2 vertebral body extending into the epidural space, consistent with spinal metastasis. Modern imaging such as MRI is indispensable for diagnosing and managing spinal metastases, clearly depicting bone destruction and soft tissue involvement to guide treatment.
This document provides an overview of elastography, a medical imaging technique that maps the elastic properties and stiffness of tissues. It discusses various elastography methods including quasi-static ultrasound elastography, dynamic ultrasound elastography using shear waves, and magnetic resonance elastography. For dynamic ultrasound elastography, it describes techniques such as transient elastography using acoustic radiation force impulse imaging, supersonic shear imaging, and vibro-acoustography. It also discusses the basic principles of elasticity, generation and measurement of shear waves, and quantitative analysis of tissue stiffness from shear wave propagation speeds.
This document provides an overview of the various physical properties of dental materials, including rheological properties like viscosity and viscoelasticity, thermal properties such as thermal conductivity and coefficient of thermal expansion, mechanical properties like modulus of elasticity and hardness, electrical properties like galvanism, and chemical properties such as corrosion and tarnish. It discusses these properties in the context of how they impact dental materials during storage, mixing, setting and as a set material. The properties are important to consider when selecting materials to ensure their successful performance for the intended dental application.
A 50-year-old woman undergoing an abdominal ultrasound for breast cancer staging was found to have a renal mass. Computer tomography and magnetic resonance imaging confirmed features consistent with renal angiomyolipoma. Biopsy of the mass showed the classic microscopic pathology of angiomyolipoma, with myoid cells and mature fat tissue surrounding large vessels. Elastography found the mean stiffness of the angiomyolipoma to be similar to renal cortex but less than the renal medulla.
Dr. masciotra sonoelastography and us in the diagnosis of small thyroid pap...antonio pio masciotra
Three small thyroid papillary cancers were detected in two asymptomatic women. Shear wave elastography proved reliable in identifying stiff nodules, correctly characterizing the single benign nodule as soft. While papillary cancers are usually stiff, follicular cancers can be soft. Small nodules can be cancerous, while large nodules may be benign. Ultrasonography offers multiple parameters including stiffness, standard deviation, and elasticity ratios, providing a multiparametric approach rather than relying on a single mode.
Dr. masciotra new emerging tools in us technology in a case of thyroid fol...antonio pio masciotra
A 51-year-old woman underwent ultrasound examination of her thyroid which revealed two nodules - a mixed 25mm nodule in the right lobe and a solid 6mm nodule in the left lobe. Various ultrasound techniques were used to analyze the nodules, including color Doppler, power Doppler, and shear wave elastography. While TIRADS analysis only slightly differed between the nodules, shear wave elastography showed the right nodule to be significantly stiffer, correctly indicating it was a follicular carcinoma based on areas of capsular invasion. Advanced ultrasound tools like shear wave elastography provide important additional information beyond traditional ultrasound in evaluating thyroid nodules.
A 50-year-old woman felt a slightly painful nodule in her left breast. Comparison of mammograms from 1 year and 2 months ago showed an increase in density and volume of the nodule. Ultrasound, MRI and shear wave elastography of the breast and axilla revealed a 3 cm cancer close to the pectoral fascia and metastatic involvement of at least two axillary lymph nodes. High breast density can obscure cancers on mammography. Multiple modalities including ultrasound and MRI may be needed for screening in dense breasts. Shear wave elastography provides information on size and stiffness of cancers and lymph nodes beyond conventional ultrasound.
This document describes a case of intrahepatic cholelithiasis (gallstones within the liver) in a 29-year-old woman who had no symptoms. Ultrasound images showed multiple small (<1mm) hyperechoic foci distributed along the intrahepatic biliary tree in segments 6 and 7, consistent with lipid deposits. The distribution and appearance indicated it was not caused by air in the bile ducts. In young women, this condition can be caused by low phospholipid content in the bile due to genetic mutations affecting bile acid transport.
Dr. masciotra swe in a selection of primitive and secondary lymphnodes mali...antonio pio masciotra
This is a collection of clinical cases of primary and secondary lymphodes malignancies with analysis of the information that Shear Wave Elastography can add to diagnostic workup.
Dr. masciotra shear wave elastography and more in a clinical case of multip...antonio pio masciotra
This is the presentation of a clinical case of Multiple Myeloma with a thorough discussion on many aspects of the disease and on applications of Shear Wave Elastography.
Ultrasound gives today more informations both in morphology (through speed of sound optimisation and 3D acquisition) and in mechanical properties evaluations (it gives mean, maximum and minimum stiffness as well standard deviation in the ROI). Furthermore it's possible to draw freehand ROI, very useful to differentiate the tumor and the stiff surrounding stroma also in the C plane with 3D SWE. Here some clinical cases are presented.
In this presentation dr. Masciotra shows how the speed of sound selection in US imaging does change the informations of US data, both qualitative (morphology, echogenicity, spatial and contrast resolution) and quantitative (density of vessels, stiffness map) of the tissues examined.
In questa presentazione il dr. Masciotra analizza sulle immagini di casi clinici gli effetti della scelta della velocità del suono sulla qualità delle informazioni dei dati ecografici.
Come si può vedere il parametro della velocità del suono condiziona in maniera sensibile le informazioni sia qualitative (morfologia, ecostruttura, risoluzione spaziale e di contrasto) che quantitative (densità dei vasi e proprietà meccaniche come l'elasticità) dei tessuti esaminati.
Swe on breast cancer in dense breast with considerations on tnm stagingantonio pio masciotra
This case shows how dense breast can hinder cancer at mammography and the important role of US and SWE elastography in situation like this.
SWE could be the most reliable tool for the measurement of the 'T' parameter of TNM staging of breast cancer, especially if performed with 3D probe.
The document discusses shear wave propagation in different mediums like isotropic phantoms, the liver, and brain. It shows images from ultrasound and MR elastography experiments visualizing the propagation of shear waves through these tissues at different driving frequencies, as well as the resulting elastograms estimating tissue stiffness.
Carotid and vertebral arteries cd, pd, ultrafast doppler, cimt and pulsed wav...antonio pio masciotra
Ultrasound is currently the only mean to determine non-invasively:
•the elastic properties of the arterial wall material (Young's elastic modulus)
•the relationship between intima-media thickness (IMT) and elastic properties or the influence of inward or outward remodeling on arterial distensibility.
Here you find also a demonstration of UltraFast doppler technology in the study of the carotids and vertebral arteries.
UltraFast doppler acquisition lasts only a few seconds and then in postprocessing it is possible to do spectral analysis in up to 3 different vessels (or 3 different sites in the same vessel).
It automatically identifies the frames with :
1) Maximum velocities
2) Mean velocities
3) Peak sistolic velocity.
It's very fast and reliable.
1) A 74-year-old woman underwent an unenhanced CT scan of the chest for cough and dyspnea that incidentally found a 3 cm solid mass in her right breast. Further imaging with mammography, ultrasound, and shear wave elastography provided details of the mass's irregular margins, infiltrating growth, and stiff mechanical properties.
2) A follow-up CT scan with contrast found the mass had a contrast enhancement pattern between Type 1 and Type 2 curves on MR, which is not highly indicative of malignancy based on kinetics. Density increments were also relatively low.
3) The CT scan also incidentally found endometrial cancer, and total body CT was done for staging. Incidental breast
The document discusses liver shear wave elastography and presents several clinical cases. It provides a table comparing the liver fibrosis classification using liver biopsy and Metavir scores to the corresponding ranges measured by shear wave elastography in kilopascals and meters/second. Several images show shear wave elastography measurements of livers with conditions like steatosis, cirrhosis, and hepatocellular carcinoma. The document demonstrates using shear wave elastography to evaluate liver fibrosis in patients with hepatitis C at different stages of disease.
This document discusses the use of breast and thyroid sonoelastography and shear wave elastography in evaluating various clinical cases. It presents case studies demonstrating how elastography can help characterize nodules, cysts, lymph nodes and tissue changes after radiation therapy. Quantitative shear wave elastography provides stiffness measurements that can help differentiate benign from malignant lesions and identify tissue abnormalities. The goal of elastography is to correctly quantify tissue elasticity and identify elasticity cut-off values to aid the diagnostic evaluation of diffuse and focal diseases.
The document discusses the transition from morphological imaging to physiopathological imaging. It notes that in ancient Egypt, hard masses in the body were linked to disease, and in Hippocratic medicine, palpation was an essential part of examination. It states that in the 21st century, remote palpation through elastographic imaging is becoming a reality. The document also provides examples of elasticity imaging techniques for breast lesions and lymph nodes and discusses aims of quantifying tissue elasticity and identifying disease states.
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
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The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)MuskanShingari
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
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- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
Discover the benefits of homeopathic medicine for irregular periods with our guide on 5 common remedies. Learn how these natural treatments can help regulate menstrual cycles and improve overall menstrual health.
Visit Us: https://drdeepikashomeopathy.com/service/irregular-periods-treatment/
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdf
Breast elastography
1. Elasticità e tessuto neoplastico
Considerazioni di fisiopatologia
Antonio Pio Masciotra
Campobasso-Molise-Italia
Email : antoniomasciotra@yahoo.it
Skype : antonio.masciotra
2. Mechanical (elastic) properties
of neoplastic tissue
Physiopathology
Antonio Pio Masciotra
Campobasso-Molise-Italy
Email : antoniomasciotra@yahoo.it
Skype : antonio.masciotra
3. Elastografia mammaria :
quantitativa o qualitativa?
Antonio Pio Masciotra
Campobasso
Email : antoniomasciotra@yahoo.it
Skype : antonio.masciotra
4. Breast sonoelastography :
quantitative or qualitative?
Antonio Pio Masciotra
Campobasso-Molise-Italy
Email : antoniomasciotra@yahoo.it
Skype : antonio.masciotra
5. PRINCIPAL MECHANICAL PROPERTIES
Those characteristics of the materials which describe their behaviour under external loads are known as
Mechanical Properties.
The most important and useful mechanical properties are:
Strength
It is the resistance offered by a material when subjected to external loading.
So, stronger the material the greater the load it can withstand.
Depending upon the type of load applied the strength can be tensile, compressive, shear or torsional.
The maximum stress that any material will withstand before destruction is called its ultimate strength.
Elasticity
Elasticity of a material is its power of coming back to its original position after deformation when the stress
or load is removed.
Elasticity is a tensile property of its material.
The greatest stress that a material can endure without taking up some permanent set is called elastic limit.
Stiffness (Rigidity)
The resistance of a material to deflection is called stiffness or rigidity.
Steel is stiffer or more rigid than aluminium.
Stiffness is measured by Young‟s modulus E.
The higher the value of the Young‟s modulus, the stiffer the material.
Hardness
It is the ability of a material to resist scratching, abrasion, indentation or penetration.
6. PRINCIPALI PROPRIETA’ MECCANICHE
Le caratteristiche dei materiali che descrivono il loro comportamento quando vengono sottoposti a carichi
esterni vengono definite PROPRIETA’ MECCANICHE.
Le più importanti di esse sono:
FORZA
E‟ la resistenza offerta da un materiale quando viene sottoposto ad un carico esterno.
Pertanto, quanto più forte è un materiale tanto maggiore sarà il carico che esso può sorreggere.
ELASTICITA’
E‟ la capacità di un materiale a recuperare le sue posizione e forma iniziali dopo la rimozione di un carico od una
forza, la cui applicazione ne aveva indotto la deformazione.
STIFFNESS (RIGIDITA’)
E‟ la resistenza che un materiale oppone al suo „piegamento‟.
L‟acciaio è più rigido dell‟alluminio.
La stiffness viene misurata dal Modulo di Young E.
Quanto maggiore è il valore del modulo di Young tanto maggiore è la stiffness del materiale.
DUREZZA
E‟ la capacità di un materiale a resistere al graffio, all‟abrasione, alla scalfittura od alla penetrazione
9. Stiffness distribution of cells and results of
migration and invasion test
Citation: Xu W, Mezencev R, Kim B, Wang L, McDonald J, et al. (2012)
Cell Stiffness Is a Biomarker of the Metastatic Potential of Ovarian Cancer Cells.
PLoS ONE 7(10): e46609. doi:10.1371/journal.pone.0046609
10. The distribution of the actin network plays an important role in
determining the mechanical properties of single cells.
As cells transform from non-malignant to cancerous states, their
cytoskeletal structure changes from an organized to an irregular
network, and this change subsequently reduces the stiffness of single
cells.
Further progressive reduction of stiffness corresponds to an increase
in invasive and migratory capacity of malignant cells.
Less invasive
Normal cell toward cancer cell
Single cell stiffness reduction
More invasive
11. Mammary epithelial growth and morphogenesis is
regulated by matrix stiffness.
(A) 3D cultures of normal mammary epithelial cells
within collagen gels of different concentration.
Stiffening the ECM through an incremental increase in
collagen concentration (soft gels: 1 mg/ml Collagen I,
140 Pa; stiff gels 3.6 mg/ml Collagen I, 1200 Pa) results
in the progressive perturbation of morphogenesis, and
the increased growth and modulated survival of MECs.
Altered mammary acini morphology is illustrated by the
destabilization of cell–cell adherens junctions and
disruption of basal tissue polarity indicated by the
gradual loss of cell–cell localized β-catenin (green) and
disorganized β4 integrin (red) visualized through
immunofluorescence and confocal imaging.
Kass et al. Page 9
Int J Biochem Cell Biol. Author manuscript; available in
PMC 2009 March 19.
NIH-PA
22. Transizione da un ‘imaging’ ‘morfologico’ ad
un’imaging fisiopatologico?
23. Going from a morphologic to a
physiopathologic ‘imaging’?
24. Transizione da un ‘imaging’ ‘morfologico’
ad un’imaging fisiopatologico?
25. Going from a morphologic to a
physiopathologic ‘imaging’?
26. Nell‟Antico Egitto il riscontro di una massa dura
nel corpo veniva correlata ad uno stato di
malattia.
Nella Medicina Ippocratica la palpazione era
parte essenziale dell‟esame fisico del paziente.
Nel Terzo Millennio la «Palpazione Remota»
sta diventando realtà grazie all‟ Imaging
Elastografico.
27. In ancient Egypt, a link was established between
a hard mass within the human body & pathology.
In Hippocratic medicine, palpation was
an essential part of a physical examination.
In the 21st century, «remote palpation» by means
of elastographic imaging is becoming a reality.
28. Many R& D techniques have emerged since the 1990s, based on the
Ultrasound and Magnetic Resonance imaging modalities.
Sonoelasticity: KJ Parker et al, 1990
Ultrasound Strain Elastography: J Ophir et al, 1991
MR Elastography: R Sinkus et al, 2000
Shear Wave Elastography: J Bercoff et al, 2004
All techniques are based on the same principle:
Generate a stress, and then use an imaging technique to map the
tissue response to this stress in every point of the image.
but differ substantially in terms of their performance
characteristics:
Qualitative / quantitative nature, absolute / relative quantification.
Accuracy / precision / reproducibility, …
Spatial / temporal resolution, sensitivity / penetration, …
28
29. Initially introduced by Hitachi, and later on
Siemens, in the early 2000s.
More manufacturers have followed in the last
year(s).
The basic principle used is the one proposed
by Ophir‟s group in the early 1990s:
1. Tissue compression (Stress) is induced
manually by the user.
2. Multiple images are recorded using
conventional imaging at standard frame rates.
3. The relative deformation (Strain) is estimated
using Tissue Doppler techniques.
4. The derived strains are displayed as
29
a qualitative elasticity image.
30. Strain Elastography Summary
Stress Source Manual Compression (user-dependent).
Stress Frequency Static (user-induced vibration < 2 Hz).
Result Type Qualitative image (E=Stress/Strain, but Stress is
unknown).
Relative quantification (Background-to-Lesion-Ratio).
Straightforward implementation on
current scanners (standard acquisition
architecture, plus Tissue-Doppler-like processing)..
Stress penetration / uniformity issues.
User-applied compression is attenuated by
soft objects & depth and cannot penetrate hard-shelled lesions.
User-dependence.
User-applied compression is attenuated by soft objects & depth, and
cannot penetrate hard-shelled lesions.
30
31. External Natural
Mechanical force Heart
SuperSonic Imagine has developed a novel method called
SonicTouch,
which is based on focused ultrasound, and can remotely generate
Shear Wave-fronts providing uniform coverage of a 2D area interest.
32. Esempio di viscosità
La sostanza in basso ha maggior viscosità
della sostanza acquosa in alto
34. Strain vs. Shear Wave Elastography
Strain Elastography tends to
produce a
binary classification, where the
whole lesion is either hard or soft.
Shear Wave Elastography provides
richer & more complex information with
many cases of hard borders plus soft
centers.
The differences between Strain and Shear Wave Elastography are not
34 surprising, given the very different principles on which they are based.
35. Shear Wave Elastography
Phantom with liquid center inside hard lesion
Highly-localized estimation
of tissue elasticity
• Especially, inside hard lesions
Shear Wave Elastography can “see” inside
the hard lesion, because the shear waves
can propagate through the hard shell.
Strain Elastography interprets the whole
lesion as hard, because the applied manual
35
compression cannot penetrate the hard shell.
36. Tipo di tessuto/organo Young‟s modulus Densità
E (kPa) (kg/L)
Mammella Tessuto adiposo normale 18-24
Tessuto ghiandolare normale 28-66
Tessuto fibroso 96-244
Carcinoma 22-560
Prostata Parte anteriore normale 55-63 1.0 10%
~ Acqua
Parte posteriore normale 62-71
Iperplasia benigna 36-41
Carcinoma 96-241
Muscolo 6-7
Fegato Parenchima sano 0.4-6
Rene Tessuto fibroso 10-55
68. Lymphnodes in different sites in the same patient
Bidimensional US
B cell Lymphoma inguinal B cell Lymphoma ext. iliac
69. Lymphnodes in different sites in the same patient
SW Elastography
B cell Lymphoma inguinal B cell Lymphoma ext. iliac
70. Lymphnodes SWE
Different stiffness depending on histology
• B cell Lymphoma - 21 kPa • Breast cancer metastasis – 16 kPa
• NET metastasis -209 kPa
71.
72. Aims of elastography
Correct tissue elasticity quantification
Identification of „cut off‟ elasticity values
for the right diagnostic workup of
diffuse and focal diseases
73. Breast lipomas
SW Elastography precision and repeatibility
Fat 19.9 kPa Lipoma 20.5 kPa Fat 8.0 kPa Lipoma 7.8 kPa
SW Ratio 1.03 SW Ratio 1.03
Ore 10:07:09 Ore 10:07:34
74. Breast sonoelastography :
Question n. 1 :
quantitative or qualitative?
Answer n. 1 Quantitative!
Question n. 2 :
SW or Strain Elastography?
Answer n. 2 SW Elastography
Antonio Pio Masciotra
Campobasso-Molise-Italy
Email : antoniomasciotra@yahoo.it
Skype : antonio.masciotra