Keyword: Ultrasonography
3 results found.
Congress Abstract
Oncology, Nuclear Medicine and Transplantology, 2(3, Suppl. 1), 2026, onmt_A10, https://doi.org/10.63946/onmt/19327
ABSTRACT:
Introduction: Catheter-associated thrombosis can lead to dysfunction and unplanned removal of the central venous catheter, as well as to re-catheterization. After hematopoietic stem cell transplantation, its development may be determined by the combined action of the components of Virchow's triad: endothelial injury, venous blood flow disturbance, and hypercoagulability. Objective: To assess the incidence of catheter-associated thrombosis and to interpret the associated clinical factors from the perspective of Virchow's triad in patients after hematopoietic stem cell transplantation.
Materials and Methods: A retrospective single-center study was conducted on 91 episodes of central venous catheter placement in 78 patients at the Department of Bone Transplantation. Risk factors were analyzed in 58 completed primary episodes. Transplant type, conditioning regimen, infectious and mechanical complications, number of puncture attempts, parenteral nutrition, and anticoagulant use were assessed. Fisher's exact test was used; differences were considered statistically significant at p < 0.05.
Results: Catheter-associated thrombosis occurred in both episodes with catheter-associated bloodstream infection (2 of 2, 100%), compared with 9 of 56 episodes without such infection (16.1%; p = 0.033). Thrombosis occurred in 2 of 5 episodes with early mechanical complications (40.0%) and in 9 of 53 episodes without such complications (17.0%; p = 0.237). With prophylactic enoxaparin use, no thrombosis was observed in 12 episodes; without prophylaxis, thrombosis occurred in 11 of 46 episodes (23.9%; p = 0.097). In the Virchow's triad model, infection and mechanical complications corresponded to endothelial injury and local inflammation; the presence of the catheter created conditions for blood flow disturbance; differences by transplant type and enoxaparin use may reflect the contribution of hypercoagulability.
Conclusions: Catheter-associated thrombosis after hematopoietic stem cell transplantation can be viewed as a result of the interaction of all components of Virchow's triad. The association with catheter-associated bloodstream infection supports the role of endothelial injury and local inflammation; the central venous catheter creates conditions for blood flow disturbance; the observed differences by transplant type may reflect differing degrees of systemic prothrombotic factors. Virchow's triad unifies the identified factors into a single mechanism of thrombosis; however, the contribution of individual components requires clarification in a larger sample.
Materials and Methods: A retrospective single-center study was conducted on 91 episodes of central venous catheter placement in 78 patients at the Department of Bone Transplantation. Risk factors were analyzed in 58 completed primary episodes. Transplant type, conditioning regimen, infectious and mechanical complications, number of puncture attempts, parenteral nutrition, and anticoagulant use were assessed. Fisher's exact test was used; differences were considered statistically significant at p < 0.05.
Results: Catheter-associated thrombosis occurred in both episodes with catheter-associated bloodstream infection (2 of 2, 100%), compared with 9 of 56 episodes without such infection (16.1%; p = 0.033). Thrombosis occurred in 2 of 5 episodes with early mechanical complications (40.0%) and in 9 of 53 episodes without such complications (17.0%; p = 0.237). With prophylactic enoxaparin use, no thrombosis was observed in 12 episodes; without prophylaxis, thrombosis occurred in 11 of 46 episodes (23.9%; p = 0.097). In the Virchow's triad model, infection and mechanical complications corresponded to endothelial injury and local inflammation; the presence of the catheter created conditions for blood flow disturbance; differences by transplant type and enoxaparin use may reflect the contribution of hypercoagulability.
Conclusions: Catheter-associated thrombosis after hematopoietic stem cell transplantation can be viewed as a result of the interaction of all components of Virchow's triad. The association with catheter-associated bloodstream infection supports the role of endothelial injury and local inflammation; the central venous catheter creates conditions for blood flow disturbance; the observed differences by transplant type may reflect differing degrees of systemic prothrombotic factors. Virchow's triad unifies the identified factors into a single mechanism of thrombosis; however, the contribution of individual components requires clarification in a larger sample.
Congress Abstract
Oncology, Nuclear Medicine and Transplantology, 2(3, Suppl. 1), 2026, onmt_A24, https://doi.org/10.63946/onmt/19313
ABSTRACT:
Background: Dense breast tissue reduces mammographic sensitivity and raises breast cancer risk. Supplemental imaging and artificial intelligence supported mammography reading have been tested prospectively. The European Society of Breast Imaging recommends supplemental magnetic resonance imaging for extremely dense breasts, whereas the American College of Physicians in 2026 advised against it for average risk women with dense breasts. This review summarises what the principal studies measured and found.
Objective: To review the published evidence on both strategies in dense breasts, reporting each study's endpoints and results.
Materials and Methods: Narrative review of primary publications, published online 2019 to 2025, quoted verbatim. Four large prospective multicentre studies reporting on dense breasts were selected, two per strategy: the randomised trials DENSE (Netherlands, magnetic resonance imaging) and BRAID (United Kingdom, abbreviated magnetic resonance imaging, automated ultrasound and contrast-enhanced mammography), and the observational studies PRAIM (Germany, artificial intelligence supported double reading) and ASSURE (United States, artificial intelligence supported single reading with safeguard review).
Results: DENSE randomised 40,373 women with extremely dense breasts and normal mammography to invitation for supplemental magnetic resonance imaging or to mammography alone: interval cancers 2.5 versus 5.0 per 1000; among the 59% accepting, detection was 16.5 and false positives 79.8 per 1000. BRAID randomised 9361 women with dense breasts and a negative mammogram: detection was 17.4 per 1000 examinations with abbreviated magnetic resonance imaging, 19.2 with contrast-enhanced mammography and 4.2 with automated ultrasound, the contrast-based modalities not differing significantly; recall 9.7%, 9.7% and 4.0%, median invasive size 10, 11 and 22 millimetres. In PRAIM (463,094 women), artificial intelligence supported double reading was associated with detection of 6.7 versus 5.7 per 1000 (17.6% higher) and non-inferior recall; in dense breasts the 18.7% increase was not statistically significant. In ASSURE (579,583 tomosynthesis examinations, single reading), detection with the artificial intelligence workflow was 5.6 versus 4.6 per 1000 (21.6% higher), recall 11.1% versus 10.6%, and detection in dense breasts 22.7% higher.
Conclusions: In BRAID, abbreviated magnetic resonance imaging and contrast-enhanced mammography detected three times as many invasive cancers as automated ultrasound, at half the size with more than twice the recall, and did not differ significantly from each other. In DENSE, invitation to supplemental magnetic resonance imaging halved the interval cancer rate. Artificial intelligence support was associated with higher detection in PRAIM without higher recall and in ASSURE with slightly higher recall; neither was randomised. No included study measured breast cancer mortality; survival benefit remains undemonstrated and overdiagnosis unquantified.
Objective: To review the published evidence on both strategies in dense breasts, reporting each study's endpoints and results.
Materials and Methods: Narrative review of primary publications, published online 2019 to 2025, quoted verbatim. Four large prospective multicentre studies reporting on dense breasts were selected, two per strategy: the randomised trials DENSE (Netherlands, magnetic resonance imaging) and BRAID (United Kingdom, abbreviated magnetic resonance imaging, automated ultrasound and contrast-enhanced mammography), and the observational studies PRAIM (Germany, artificial intelligence supported double reading) and ASSURE (United States, artificial intelligence supported single reading with safeguard review).
Results: DENSE randomised 40,373 women with extremely dense breasts and normal mammography to invitation for supplemental magnetic resonance imaging or to mammography alone: interval cancers 2.5 versus 5.0 per 1000; among the 59% accepting, detection was 16.5 and false positives 79.8 per 1000. BRAID randomised 9361 women with dense breasts and a negative mammogram: detection was 17.4 per 1000 examinations with abbreviated magnetic resonance imaging, 19.2 with contrast-enhanced mammography and 4.2 with automated ultrasound, the contrast-based modalities not differing significantly; recall 9.7%, 9.7% and 4.0%, median invasive size 10, 11 and 22 millimetres. In PRAIM (463,094 women), artificial intelligence supported double reading was associated with detection of 6.7 versus 5.7 per 1000 (17.6% higher) and non-inferior recall; in dense breasts the 18.7% increase was not statistically significant. In ASSURE (579,583 tomosynthesis examinations, single reading), detection with the artificial intelligence workflow was 5.6 versus 4.6 per 1000 (21.6% higher), recall 11.1% versus 10.6%, and detection in dense breasts 22.7% higher.
Conclusions: In BRAID, abbreviated magnetic resonance imaging and contrast-enhanced mammography detected three times as many invasive cancers as automated ultrasound, at half the size with more than twice the recall, and did not differ significantly from each other. In DENSE, invitation to supplemental magnetic resonance imaging halved the interval cancer rate. Artificial intelligence support was associated with higher detection in PRAIM without higher recall and in ASSURE with slightly higher recall; neither was randomised. No included study measured breast cancer mortality; survival benefit remains undemonstrated and overdiagnosis unquantified.
Congress Abstract
Oncology, Nuclear Medicine and Transplantology, 2(3, Suppl. 1), 2026, onmt_A26, https://doi.org/10.63946/onmt/19281
ABSTRACT:
Introduction: Pediatric nodular thyroid disease is associated with an elevated probability of malignant transformation (20% to 26%), necessitating precise preoperative diagnostic triage (1). International consensus guidelines establish ultrasound-based risk stratification using the Thyroid Imaging Reporting and Data System (TI-RADS) alongside fine-needle aspiration biopsy (FNAB) with cytopathological evaluation under the Bethesda System as pivotal clinical instruments guiding the choice between observation and surgical intervention (1,2). This study aimed to evaluate the impact of TI-RADS and cytopathological classification on the selection of surgical versus observational management strategies in pediatric patients with thyroid nodules.
Materials and Methods: A consecutive retrospective analysis was conducted on 15 patients aged 10 to 17 years with thyroid nodules evaluated between October 2024 and July 2026 at an ambulatory surgical center. Inclusion criteria encompassed age under 18 years, ultrasonographic confirmation of a nodular lesion, and completion of fine-needle aspiration biopsy. No exclusion criteria were applied. The diagnostic workup incorporated sonography with TI-RADS categorization, ultrasound-guided biopsy with cytopathological reporting according to the Bethesda System (2,3), and serological assessment of thyroid-stimulating hormone (TSH), free thyroxine, antithyroid antibodies, and calcitonin. Data analysis relied on the calculation of relative frequencies and proportions. The study was conducted in accordance with the principles of the Helsinki Declaration; retrospective analysis of anonymized data did not require informed consent.
Results: Female adolescents constituted the majority of the cohort (86.7%; 13/15), with an overall mean age of 14.8 ± 2.3 years, consistent with the age distribution of thyroid pathology in adolescents (1). Ultrasound stratification revealed TI-RADS 2–3 in 73.3% (11/15) and TI-RADS 4 in 26.7% (4/15). Initial cytopathological classification yielded category I in 40.0% (6/15), category III in 26.7% (4/15), category IV in 26.7% (4/15), and category V in 6.7% (1/15). The proportion of non-diagnostic aspirates was related to the presence of cystic elements within this cohort (4). Hormonal profiling demonstrated euthyroidism in all evaluated cases with a median thyroid-stimulating hormone concentration of 2.1 mIU/L. Conservative dynamic surveillance at three- to six-month intervals was chosen for 93.3% of children (14/15). In one adolescent (6.7%; 1/15) presenting concordant TI-RADS 4 and category IV cytology, total thyroidectomy with regional lymph node clearance was performed; postoperative histopathology confirmed metastatic papillary thyroid carcinoma (1,5). The overall confirmed malignancy rate was 6.7%, which aligns with literature data for pediatric populations (5% to 26%) (1,5).
Conclusions: Combined application of TI-RADS sonographic stratification and Bethesda-based biopsy enables reliable triage of pediatric patients. The substantial proportion of category I aspirates (40.0%) mandates repeat aspiration for cystic lesions, whereas concordance between TI-RADS 4 sonographic criteria and neoplastic cytology constitutes a direct indication for surgical intervention.
Materials and Methods: A consecutive retrospective analysis was conducted on 15 patients aged 10 to 17 years with thyroid nodules evaluated between October 2024 and July 2026 at an ambulatory surgical center. Inclusion criteria encompassed age under 18 years, ultrasonographic confirmation of a nodular lesion, and completion of fine-needle aspiration biopsy. No exclusion criteria were applied. The diagnostic workup incorporated sonography with TI-RADS categorization, ultrasound-guided biopsy with cytopathological reporting according to the Bethesda System (2,3), and serological assessment of thyroid-stimulating hormone (TSH), free thyroxine, antithyroid antibodies, and calcitonin. Data analysis relied on the calculation of relative frequencies and proportions. The study was conducted in accordance with the principles of the Helsinki Declaration; retrospective analysis of anonymized data did not require informed consent.
Results: Female adolescents constituted the majority of the cohort (86.7%; 13/15), with an overall mean age of 14.8 ± 2.3 years, consistent with the age distribution of thyroid pathology in adolescents (1). Ultrasound stratification revealed TI-RADS 2–3 in 73.3% (11/15) and TI-RADS 4 in 26.7% (4/15). Initial cytopathological classification yielded category I in 40.0% (6/15), category III in 26.7% (4/15), category IV in 26.7% (4/15), and category V in 6.7% (1/15). The proportion of non-diagnostic aspirates was related to the presence of cystic elements within this cohort (4). Hormonal profiling demonstrated euthyroidism in all evaluated cases with a median thyroid-stimulating hormone concentration of 2.1 mIU/L. Conservative dynamic surveillance at three- to six-month intervals was chosen for 93.3% of children (14/15). In one adolescent (6.7%; 1/15) presenting concordant TI-RADS 4 and category IV cytology, total thyroidectomy with regional lymph node clearance was performed; postoperative histopathology confirmed metastatic papillary thyroid carcinoma (1,5). The overall confirmed malignancy rate was 6.7%, which aligns with literature data for pediatric populations (5% to 26%) (1,5).
Conclusions: Combined application of TI-RADS sonographic stratification and Bethesda-based biopsy enables reliable triage of pediatric patients. The substantial proportion of category I aspirates (40.0%) mandates repeat aspiration for cystic lesions, whereas concordance between TI-RADS 4 sonographic criteria and neoplastic cytology constitutes a direct indication for surgical intervention.