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Ultrasound in Obstetrics & Gynecology :... Jan 2021To describe the ultrasound features of different endometrial and other intracavitary pathologies inpre- and postmenopausal women presenting with abnormal uterine... (Observational Study)
Observational Study
Typical ultrasound features of various endometrial pathologies described using International Endometrial Tumor Analysis (IETA) terminology in women with abnormal uterine bleeding.
OBJECTIVE
To describe the ultrasound features of different endometrial and other intracavitary pathologies inpre- and postmenopausal women presenting with abnormal uterine bleeding, using the International Endometrial Tumor Analysis (IETA) terminology.
METHODS
This was a prospective observational multicenter study of consecutive women presenting with abnormal uterine bleeding. Unenhanced sonography with color Doppler and fluid-instillation sonography were performed. Endometrial sampling was performed according to each center's local protocol. The histological endpoints were cancer, atypical endometrial hyperplasia/endometrioid intraepithelial neoplasia (EIN), endometrial atrophy, proliferative or secretory endometrium, endometrial hyperplasia without atypia, endometrial polyp, intracavitary leiomyoma and other. For fluid-instillation sonography, the histological endpoints were endometrial polyp, intracavitary leiomyoma and cancer. For each histological endpoint, we report typical ultrasound features using the IETA terminology.
RESULTS
The database consisted of 2856 consecutive women presenting with abnormal uterine bleeding. Unenhanced sonography with color Doppler was performed in all cases and fluid-instillation sonography in 1857. In 2216 women, endometrial histology was available, and these comprised the study population. Median age was 49 years (range, 19-92 years), median parity was 2 (range, 0-10) and median body mass index was 24.9 kg/m (range, 16.0-72.1 kg/m ). Of the study population, 843 (38.0%) women were postmenopausal. Endometrial polyps were diagnosed in 751 (33.9%) women, intracavitary leiomyomas in 223 (10.1%) and endometrial cancer in 137 (6.2%). None (0% (95% CI, 0.0-5.5%)) of the 66 women with endometrial thickness < 3 mm had endometrial cancer or atypical hyperplasia/EIN. Endometrial cancer or atypical hyperplasia/EIN was found in three of 283 (1.1% (95% CI, 0.4-3.1%)) endometria with a three-layer pattern, in three of 459 (0.7% (95% CI, 0.2-1.9%)) endometria with a linear endometrial midline and in five of 337 (1.5% (95% CI, 0.6-3.4%)) cases with a single vessel without branching on unenhanced ultrasound.
CONCLUSIONS
The typical ultrasound features of endometrial cancer, polyps, hyperplasia and atrophy and intracavitary leiomyomas, are described using the IETA terminology. The detection of some easy-to-assess IETA features (i.e. endometrial thickness < 3 mm, three-layer pattern, linear midline and single vessel without branching) makes endometrial cancer unlikely. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.
Topics: Adult; Endometrium; Female; Humans; Middle Aged; Prospective Studies; Ultrasonography; Uterine Diseases; Uterine Hemorrhage
PubMed: 32484286
DOI: 10.1002/uog.22109 -
Frontiers in Oncology 2021High-dose-rate brachytherapy by remote afterloading is now performed under three-dimensional image guidance by CT or MRI. Three-dimensional image-guided brachytherapy in... (Review)
Review
High-dose-rate brachytherapy by remote afterloading is now performed under three-dimensional image guidance by CT or MRI. Three-dimensional image-guided brachytherapy in cervical cancer disclosed that the traditional intracavitary brachytherapy by Manchester method cannot deliver an adequate dose to the large tumor with resulting local recurrence. To improve the local control rate, combined interstitial and intracavitary (hybrid) brachytherapy can increase the dose to the large parametrial involvement without increasing the dose to the rectum and bladder. Whether hybrid brachytherapy can be performed safely on a multi-institutional basis remains to be studied. From 2015, phase I/II study of hybrid brachytherapy was launched in Japan, and it was revealed that hybrid brachytherapy can be performed safely and with a high quality of radiation dose distribution in a multi-institutional study. In Japan, the number of patients undergoing hybrid brachytherapy in cervical cancer is rapidly rising. Education and clinical trial are very important to establish hybrid brachytherapy in the management of cervical cancer.
PubMed: 35096614
DOI: 10.3389/fonc.2021.809825 -
Computational and Mathematical Methods... 2022[This retracts the article DOI: 10.1155/2021/9508838.].
[This retracts the article DOI: 10.1155/2021/9508838.].
PubMed: 36540289
DOI: 10.1155/2022/9896052 -
Respiratory Medicine Apr 2020Aspergilloma, also known as mycetoma or fungus ball, is the most common manifestation of pulmonary involvement by Aspergillus species. The fungal ball typically forms... (Review)
Review
Aspergilloma, also known as mycetoma or fungus ball, is the most common manifestation of pulmonary involvement by Aspergillus species. The fungal ball typically forms within preexisting cavities of the lungs. Diagnosis requires both radiographic evidence along with serologic or microbiologic evidence of Aspergillus species involvement. While clinical features such as hemoptysis, chest pain, shortness of breath, cough, and fever are helpful in diagnosis, they are non-specific symptoms. Surgery is currently the mainstay of treatment for aspergilloma but is associated with considerable mortality and morbidity. Alternative options exist for patients who are poor surgical candidates and for those who prefer a less invasive treatment modality. Systemic treatment with amphotericin B is ineffective and is not recommended as a monotherapy, but systemic azoles is effective in approximately 50-80% of patients. Potential alternatives to surgery include intracavitary instillation or endobronchial administration of antifungal medication, as well as direct transbronchial aspergilloma removal. Bronchial artery embolization and radiotherapy are options to manage hemoptysis until definite eradication of the aspergilloma. More rigorous studies are needed to better establish non-surgical treatment paradigm for inoperable patients.
Topics: Amphotericin B; Antifungal Agents; Azoles; Bronchial Arteries; Conservative Treatment; Embolization, Therapeutic; Female; Hemoptysis; Humans; Instillation, Drug; Male; Pulmonary Aspergillosis
PubMed: 32217289
DOI: 10.1016/j.rmed.2020.105903 -
Fertility and Sterility Aug 2019For humans, the uterus is their first home. Accurate evaluation and effective therapy are central to optimizing the conditions for implantation and sustained pregnancy.... (Review)
Review
For humans, the uterus is their first home. Accurate evaluation and effective therapy are central to optimizing the conditions for implantation and sustained pregnancy. For macroscopic intracavitary disease, hysteroscopy remains the gold standard for diagnosis and treatment. We review the role of hysteroscopy before fertility therapies. We also address intracavitary pathologies and their relevance to procreative outcomes. Controversies in the literature are noted and clarified, and trends in the field of hysteroscopy are identified regarding how they will influence the future of reproductive care and women's health.
Topics: Female; Humans; Hysteroscopy; Infertility, Female; Pregnancy; Risk Factors; Uterine Diseases; Uterus
PubMed: 31352959
DOI: 10.1016/j.fertnstert.2019.06.031 -
Computational and Mathematical Methods... 2021In order to explore the effective diagnosis method of gynecological acute abdomen, this paper takes hospital gynecological acute abdomen patients as samples and selects...
In order to explore the effective diagnosis method of gynecological acute abdomen, this paper takes hospital gynecological acute abdomen patients as samples and selects gynecological acute abdomen patients admitted to the hospital to be included in this study. They are divided into transabdominal ultrasound group, intracavitary ultrasound group, and combined group. Moreover, this paper uses mathematical statistics to carry out sample statistics. The statistical data mainly include ectopic pregnancy, torsion of ovarian tumor pedicle, acute suppurative salpingitis, torsion of fallopian tube, hemorrhagic salpingitis, acute pelvic inflammatory disease, rupture of corpus luteum cyst, and diagnosis accuracy rate. In addition, this paper compares the diagnostic accuracy of the abdominal ultrasound group, the intracavitary ultrasound group, and the combined group. The experimental research shows that the combined ultrasound diagnosis method can effectively improve the accuracy of the diagnosis of gynecological acute abdomen.
Topics: Abdomen, Acute; Computational Biology; Diagnosis, Differential; Female; Genital Diseases, Female; Humans; Pregnancy; Pregnancy Complications; Pregnancy, Ectopic; Ultrasonography
PubMed: 35003327
DOI: 10.1155/2021/9508838 -
Jornal Brasileiro de Pneumologia :... 2016
Topics: Adult; Humans; Male; Pulmonary Aspergillosis; Solitary Pulmonary Nodule; Tomography, X-Ray Computed
PubMed: 27812627
DOI: 10.1590/S1806-37562016000000223 -
Journal of Contemporary Brachytherapy Dec 2018Cervical cancer (CC) is a neoplasm with great potential for prevention, but it is still an important public health problem in most developing countries. No significant... (Review)
Review
Cervical cancer (CC) is a neoplasm with great potential for prevention, but it is still an important public health problem in most developing countries. No significant difference is found in the literature between intracavitary high-dose-rate (HDR) and low-dose-rate (LDR) brachytherapy, when considering overall, disease specific, and recurrence-free survivals. Cervical dilatation is mandatory for the insertion of intra-uterine tandems for CC intracavitary brachytherapy. Pain and discomfort may eventually be the limiting factors of the procedure, sometimes leading to unsatisfactory results in terms of adequate position of the applicator set. In this paper, we critically reviewed the current sedation and anesthetic options for comfort and safety procedures when performing intracavitary brachytherapy.
PubMed: 30662480
DOI: 10.5114/jcb.2018.81027