129 results on '"Bharwani N"'
Search Results
2. Pre-operative MRI staging of endometrial cancer in a multicentre cancer network: can we match single centre study results?
- Author
-
Soneji, N. D., Bharwani, N., Ferri, A., Stewart, V., and Rockall, A.
- Published
- 2018
- Full Text
- View/download PDF
3. European society of urogenital radiology (ESUR) guidelines: MR imaging of pelvic endometriosis
- Author
-
Bazot, M., Bharwani, N., Huchon, C., Kinkel, K., Cunha, T. M., Guerra, A., Manganaro, L., Buñesch, L., Kido, A., Togashi, K., Thomassin-Naggara, I., and Rockall, A. G.
- Published
- 2017
- Full Text
- View/download PDF
4. The prevalence of incidentally detected adrenal enlargement on CT
- Author
-
Tang, Y.Z., Bharwani, N., Micco, M., Akker, S., Rockall, A.G., and Sahdev, A.
- Published
- 2014
- Full Text
- View/download PDF
5. Peritoneal pseudocysts: aetiology, imaging appearances, and natural history
- Author
-
Bharwani, N. and Crofton, M.E.
- Published
- 2013
- Full Text
- View/download PDF
6. OC05.01: *Prospective validation of an end‐to‐end machine learning‐based model for the classification of adnexal masses using ultrasonography.
- Author
-
Barcroft, J., Linton‐Reid, K., Munaretto, M., Fantauzzi, M., Kim, J., Murugesu, S., Parker, N., Kyriacou, C., Novak, A.M., Pikovsky, M., Cooper, N., Lee, S., Savelli, L., Thomson, A.R., Yazbek, J., Stalder, C., Bharwani, N., Posma, J., Timmerman, D., and Al‐Memar, M.
- Subjects
TRANSVAGINAL ultrasonography ,PEARSON correlation (Statistics) ,SENSITIVITY & specificity (Statistics) ,DEEP learning ,RECEIVER operating characteristic curves - Abstract
This article discusses the validation of a machine learning model for classifying adnexal masses using ultrasonography. The model was tested on two cohorts of women with adnexal masses, one in London and one in Seoul. The model's performance was compared to the Assessment of Different NEoplasia's in the adneXa (ADNEX) model. The results showed that the machine learning model had comparable performance to the ADNEX model in both cohorts. However, further validation is needed before the model can be integrated into clinical practice. [Extracted from the article]
- Published
- 2024
- Full Text
- View/download PDF
7. Radiological predictors of cytoreductive outcomes in patients with advanced ovarian cancer
- Author
-
Borley, J, Wilhelm-Benartzi, C, Yazbek, J, Williamson, R, Bharwani, N, Stewart, V, Carson, I, Hird, E, McIndoe, A, Farthing, A, Blagden, S, and Ghaem-Maghami, S
- Published
- 2015
- Full Text
- View/download PDF
8. FDG-PET/CT pitfalls in gynecological and genitourinary oncological imaging
- Author
-
Lakhani, A, Khan, S, Bharwani, N, Stewart, V, Rockall, A, Barwick, T, and Khan, S
- Published
- 2015
- Full Text
- View/download PDF
9. Fertility preservation in gynaecologic malignancy: imaging role in treatment planning
- Author
-
Papadopoulou, I, Qureshi, M, Butterfield, N, Bharwani, N, and Rockall, A
- Published
- 2015
- Full Text
- View/download PDF
10. Detection of gynaecological cancer in pregnancy
- Author
-
Cuthbert, F, Bharwani, N, and Rockall, A
- Published
- 2015
- Full Text
- View/download PDF
11. Is Internal Iliac Artery Embolization Essential Prior to Endovascular Repair of Aortoiliac Aneurysms?
- Author
-
Bharwani, N., Raja, J., Choke, E., Belli, A. M., Thompson, M. M., Morgan, R. A., and Munneke, G.
- Published
- 2008
- Full Text
- View/download PDF
12. Society of Abdominal Radiology (SAR) and European Society of Urogenital Radiology (ESUR) joint consensus statement for MR imaging of placenta accreta spectrum disorders
- Author
-
Jha, P. Pōder, L. Bourgioti, C. Bharwani, N. Lewis, S. Kamath, A. Nougaret, S. Soyer, P. Weston, M. Castillo, R.P. Kido, A. Forstner, R. Masselli, G.
- Abstract
Objectives: This study was conducted in order to establish the joint Society of Abdominal Radiology (SAR) and European Society of Urogenital Radiology (ESUR) guidelines on placenta accreta spectrum (PAS) disorders and propose strategies to standardize image acquisition, interpretation, and reporting for this condition with MRI. Methods: The published evidence-based data and the opinion of experts were combined using the RAND–UCLA Appropriateness Method and formed the basis for these consensus guidelines. The responses of the experts to questions regarding the details of patient preparation, MRI protocol, image interpretation, and reporting were collected, analyzed, and classified as “recommended” versus “not recommended” (if at least 80% consensus among experts) or uncertain (if less than 80% consensus among experts). Results: Consensus regarding image acquisition, interpretation, and reporting was determined using the RAND–UCLA Appropriateness Method. The use of a tailored MRI protocol and standardized report was recommended. Conclusions: A standardized imaging protocol and reporting system ensures recognition of the salient features of PAS disorders. These consensus recommendations should be used as a guide for the evaluation of PAS disorders with MRI. Key Points: • MRI is a powerful adjunct to ultrasound and provides valuable information on the topography and depth of placental invasion. • Consensus statement proposed a common lexicon to allow for uniformity in MRI acquisition, interpretation, and reporting of PAS disorders. • Seven MRI features, namely intraplacental dark T2 bands, uterine/placental bulge, loss of low T2 retroplacental line, myometrial thinning/disruption, bladder wall interruption, focal exophytic placental mass, and abnormal vasculature of the placental bed, reached consensus and are categorized as “recommended” for diagnosing PAS disorders. © 2020, European Society of Radiology.
- Published
- 2020
13. Intra-abdominal fibrosis in a recent cohort of patients with neuroendocrine (‘carcinoid’) tumours of the small bowel
- Author
-
Druce, M.R., Bharwani, N., Akker, S.A., Drake, W.M., Rockall, A., and Grossman, A.B.
- Published
- 2010
14. Intra-abdominal fibrosis in a modern cohort of patients with mid-gut carcinoid tumours - a cross-sectional survey from one centre: 208
- Author
-
Druce, M. R., Bharwani, N., Akker, S. A., Chew, S. L., Drake, W. M., Rockall, A., and Grossman, A. B.
- Published
- 2009
15. O-RADS MRI score: analysis of misclassified cases in a prospective multicentric European cohort.
- Author
-
Thomassin-Naggara, I., Belghitti, M., Milon, A., Abdel Wahab, C., Sadowski, E., Rockall, A. G., on behalf of EURAD study group, Poncelet, E., Jalaguier-Coudray, A., Guerra, A., Fournier, L. S., Stojanovic, S., Millet, I., Bharwani, N., Juhan, V., Cunha, T. M., Masselli, G., Balleyguier, C., Malhaire, C., and Perrot, N.
- Subjects
ADNEXAL diseases ,PELVIC inflammatory disease ,MAGNETIC resonance imaging ,HISTOLOGY - Abstract
Objective: To retrospectively review the causes of categorization errors using O-RADS-MRI score and to determine the presumptive causes of these misclassifications. Methods: EURAD database was retrospectively queried to identify misclassified lesions. In this cohort, 1194 evaluable patients with 1502 pelvic masses (277 malignant / 1225 benign lesions) underwent standardized MRI to characterize adnexal masses with histology or 2 years' follow-up as a reference standard. An expert radiologist reviewed cases with two junior radiologists and lesions termed misclassified if malignant lesion was scored ≤ 3, a benign lesion was scored ≥ 4, the site of origin was incorrect, or a non-adnexal mass was incorrectly categorized as benign or malignant. Results: There were 139 / 1502 (9.2%) misclassified masses in 116 women including 109 adnexal and 30 non-adnexal masses. False-negative cases corresponded to 16 borderline or invasive malignant adnexal masses rated score ≤ 3 (16 / 139, 11.5%). False-positive cases corresponded to 88 benign masses were rated score 4 (67 / 139, 48.2%) or 5 (18 / 139,12.9%) or considered suspicious non-adnexal lesions (3 / 139, 2.2%). Misclassifications were only due to origin error in 12 adnexal masses (8 benign, 4 malignant) (8.6%, 12 / 139) and 23 non-adnexal masses (18 benign, 5 malignant,16.5%, 23 / 139) perceived respectively as non-adnexal and adnexal masses. Interpretive error (n = 104), failure to recognize technical insufficient exams (n = 9), and perceptual errors (n = 4) were found. Most interpretive was due to misinterpretation of solid tissue or incorrect assignment of mass origin. Eighty-four out of 139 cases were correctly reclassified by the readers with strict adherence to the score rules. Conclusion: Most errors were due to misinterpretation of solid tissue or incorrect assignment of mass origin. Key Points: • Prospective assignment of O-RADS-MRI score resulted in misclassification of 9.25% of sonographically indeterminate pelvic masses. • Most errors were interpretive (74.8%) due to misinterpretation of solid tissue as defined by the lexicon or incorrect assignment of mass origin. • Pelvic inflammatory disease is a common source of misclassification (8.9%) (12 / 139). [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
16. Patient preferences for whole-body MRI or conventional staging pathways in lung and colorectal cancer: a discrete choice experiment
- Author
-
Miles, A, Taylor, SA, Evans, REC, Halligan, S, Beare, S, Bridgewater, J, Goh, V, Janes, S, Navani, N, Oliver, A, Morton, A, Rockall, A, Clarke, CS, Morris, S, Aboagye, A, Agoramoorthy, L, Ahmed, S, Amadi, A, Anand, G, Atkin, G, Austria, A, Ball, S, Bazari, F, Beable, R, Beedham, H, Beeston, T, Bharwani, N, Bhatnagar, G, Bhowmik, A, Blakeway, L, Blunt, D, Boavida, P, Boisfer, D, Breen, D, Burke, S, Butawan, R, Campbell, Y, Chang, E, Chao, D, Chukundah, S, Collins, B, Collins, C, Conteh, V, Couture, J, Crosbie, J, Curtis, H, Daniel, A, Davis, L, Desai, K, Duggan, M, Ellis, S, Elton, C, Engledow, A, Everitt, C, Ferdous, S, Frow, A, Furneaux, M, Gibbons, N, Glynne-Jones, R, Gogbashian, A, Gourtsoyianni, S, Green, A, Green, L, Groves, A, Guthrie, A, Hadley, E, Hameeduddin, A, Hanid, G, Hans, S, Hans, B, Higginson, A, Honeyfield, L, Hughes, H, Hughes, J, Hurl, L, Isaac, E, Jackson, M, Jalloh, A, Jannapureddy, R, Jayme, A, Johnson, A, Johnson, E, Julka, P, Kalasthry, J, Karapanagiotou, E, Karp, S, Kay, C, Kellaway, J, Khan, S, Koh, D-M, Light, T, Limbu, P, Lock, S, Locke, I, Loke, T, Lowe, A, Lucas, N, Maheswaran, S, Mallett, S, Marwood, E, McGowan, J, Mckirdy, F, Mills-Baldock, T, Moon, T, Morgan, V, Nasseri, S, Nichols, P, Norman, C, Ntala, E, Nunes, A, Obichere, A, O'Donohue, J, Olaleye, I, Onajobi, A, O'Shaughnessy, T, Padhani, A, Pardoe, H, Partridge, W, Patel, U, Perry, K, Piga, W, Prezzi, D, Prior, K, Punwani, S, Pyers, J, Rafiee, H, Rahman, F, Rajanpandian, I, Ramesh, S, Raouf, S, Reczko, K, Reinhardt, A, Robinson, D, Russell, P, Sargus, K, Scurr, E, Shahabuddin, K, Sharp, A, Shepherd, B, Shiu, K, Sidhu, H, Simcock, I, Simeon, C, Smith, A, Smith, D, Snell, D, Spence, J, Srirajaskanthan, R, Stachini, V, Stegner, S, Stirling, J, Strickland, N, Tarver, K, Teague, J, Thaha, M, Train, M, Tulmuntaha, S, Tunariu, N, Van Ree, K, Verjee, A, Wanstall, C, Weir, S, Wijeyekoon, S, Wilson, J, Wilson, S, Win, T, Woodrow, L, Yu, D, Imperial College Healthcare NHS Trust- BRC Funding, and Department of Health
- Subjects
Adult ,Male ,Positron emission tomography ,Lung Neoplasms ,Social Sciences ,X-ray computed ,Magnetic resonance imaging ,Psychology, Multidisciplinary ,Positron Emission Tomography Computed Tomography ,Surveys and Questionnaires ,Psychology ,Humans ,Whole Body Imaging ,Patient preference ,Prospective Studies ,Tomography ,Cancer ,Aged ,Neoplasm Staging ,Science & Technology ,Radiology, Nuclear Medicine & Medical Imaging ,Tomography, X-ray computed ,1103 Clinical Sciences ,CARE ,Middle Aged ,NEGATIVE AFFECT ,Biomedical Social Sciences ,Social Sciences, Biomedical ,Nuclear Medicine & Medical Imaging ,PANAS ,Oncology ,Positron-Emission Tomography ,Regression Analysis ,CLAUSTROPHOBIA ,Female ,STREAMLINE investigators ,Colorectal Neoplasms ,Life Sciences & Biomedicine - Abstract
Objectives To determine the importance placed by patients on attributes associated with whole-body MRI (WB-MRI) and standard cancer staging pathways and ascertain drivers of preference. Methods Patients recruited to two multi-centre diagnostic accuracy trials comparing WB-MRI with standard staging pathways in lung and colorectal cancer were invited to complete a discrete choice experiment (DCE), choosing between a series of alternate pathways in which 6 attributes (accuracy, time to diagnosis, scan duration, whole-body enclosure, radiation exposure, total scan number) were varied systematically. Data were analysed using a conditional logit regression model and marginal rates of substitution computed. The relative importance of each attribute and probabilities of choosing WB-MRI-based pathways were estimated. Results A total of 138 patients (mean age 65, 61% male, lung n = 72, colorectal n = 66) participated (May 2015 to September 2016). Lung cancer patients valued time to diagnosis most highly, followed by accuracy, radiation exposure, number of scans, and time in the scanner. Colorectal cancer patients valued accuracy most highly, followed by time to diagnosis, radiation exposure, and number of scans. Patients were willing to wait 0.29 (lung) and 0.45 (colorectal) weeks for a 1% increase in pathway accuracy. Patients preferred WB-MRI-based pathways (probability 0.64 [lung], 0.66 [colorectal]) if they were equivalent in accuracy, total scan number, and time to diagnosis compared with a standard staging pathway. Conclusions Staging pathways based on first-line WB-MRI are preferred by the majority of patients if they at least match standard pathways for diagnostic accuracy, time to diagnosis, and total scan number.
- Published
- 2019
17. OP03.08: Imaging characteristics of unicornuate uterus: an 11‐year retrospective study.
- Author
-
Murugesu, S., Kakar, G., Fotopoulou, C., Bharwani, N., and Al‐Memar, M.
- Abstract
To determine the clinical features, and management of women presenting with differing subtypes of unicornuate uterus at a London tertiary centre. Results 33 patients identified with a unicornuate uterus on MRI. Of the 6/19 cases with a functioning rudimentary horn, 2 were communicating (incidental findings, median diagnosis age 51.5) and 4 were non-communicating (presenting with significant symptoms, median diagnosis age 29). [Extracted from the article]
- Published
- 2022
- Full Text
- View/download PDF
18. Vagina and Vulva: Imaging Techniques, Normal Anatomy and Anatomical Variants.
- Author
-
Soo, M. J., Bharwani, N., and Rockall, Andrea G.
- Published
- 2013
- Full Text
- View/download PDF
19. Diffusion-weighted and multiphase contrast-enhanced MRI as surrogate markers of response to neoadjuvant sunitinib in metastatic renal cell carcinoma.
- Author
-
Bharwani, N, Miquel, M E, Powles, T, Dilks, P, Shawyer, A, Sahdev, A, Wilson, P D, Chowdhury, S, Berney, D M, and Rockall, A G
- Subjects
- *
IMAGING of cancer , *DIFFUSION magnetic resonance imaging , *RENAL cell carcinoma , *CONTRAST-enhanced magnetic resonance imaging , *TUMOR markers , *ADJUVANT treatment of cancer , *METASTASIS - Abstract
Background:Current imaging criteria for categorising disease response in metastatic renal cell carcinoma (mRCC) correlate poorly with overall survival (OS) in patients on anti-angiogenic therapies. We prospectively assess diffusion-weighted and multiphase contrast-enhanced (MCE) MR imaging (MRI) as markers of outcome.Methods:Treatment-naive mRCC patients on a phase II trial using sunitinib completed an MRI substudy. Whole-tumour apparent diffusion coefficient (ADC) maps and histograms were generated, and mean ADC and AUClow (proportion of the tumour with ADC values lying below the 25th percentile of the ADC histogram) recorded. On MCE-MRI, regions of interest were drawn around the most avidly enhancing components to analyse enhancement parameters. Baseline (n=26) and treatment-related changes in surviving patients (n=20) were correlated with OS. Imaged metastases were also analysed.Results:Forty-seven per cent of the patients showed significant changes in whole-tumour mean ADC following therapy, but there was no correlation with outcome. Patients with a high baseline AUClow and greater-than-median AUClow increase had reduced OS (HR=3.67 (95% confidence interval (CI)=1.23-10.9), P=0.012 and HR=3.72 (95% CI=0.98-14.21), P=0.038, respectively). There was no correlation between MCE-MRI parameters and OS. Twenty-eight metastases were analysed and showed positive correlation with primary tumour mean ADC for individual patients (r=0.607; P<0.001).Conclusion:Primary RCC ADC histogram analysis shows dynamic changes with sunitinib. Patients in whom the tumour ADC histogram demonstrated high baseline AUClow or a greater-than-median increase in AUClow with treatment had reduced OS. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
20. Diffusion-weighted imaging of the liver: an update.
- Author
-
Bharwani, N. and Koh, D. M.
- Published
- 2013
- Full Text
- View/download PDF
21. In vitro and in vivo repeatability of abdominal diffusion-weighted MRI.
- Author
-
MIQUEL, M., SCOTT, A. D., MACDOUGALL, N. D., BOUBERTAKH, R., BHARWANI, N., and ROCKALL, A. G.
- Published
- 2012
- Full Text
- View/download PDF
22. In vitro and in vivo repeatability of abdominal diffusion-weighted MRI.
- Author
-
MIQUEL, M. E., SCOTT, A. D., MACDOUGALL, N. D., BOUBERTAKH, R., BHARWANI, N., and ROCKALL, A. G.
- Subjects
DIFFUSION ,MAGNETIC resonance imaging ,PLANAR graphs ,GALLBLADDER ,MEDICAL imaging systems - Abstract
Objective: To study the in vitro and in vivo (abdomen) variability of apparent diffusion coefficient (ADC) measurements at 1.51 using a free-breathing multislice diffusion-weighted (DW) MRI sequence. Methods: DW MRI images were obtained using a multislice spin-echo echo-planar imaging sequence with b-values=0, 100, 200, 500, 750 and l000 s mm
-2 . A flood-field phantom was imaged at regular intervals over 100 days, and 10 times on the same day on 2 occasions. 10 healthy volunteers were imaged on two separate occasions. Mono- exponential ADC maps were fitted excluding b=0. Paired analysis was carried out on the liver, spleen, kidney and gallbladder using multiple regions of interest (ROIs) and volumes of interest (VOIs). Results: The in vitro coefficient of variation was 1.3% over 100 days, and 0.5% and 1.0% for both the daily experiments. In vivo, there was no statistical difference in the group mean ADC value between visits for any organ. Using ROIs, the coefficient of reproducibility was 20.0% for the kidney, 21.0% for the gallbladder, 24.7% for the liver and 28.0% for the spleen. For VOIs, values fall to 7.7%, 6.4%, 8.6% and 9.6%, respectively. Conclusion: Good in vitro repeatability of ADC measurements provided a sound basis for in vivo measurement. In vivo variability is higher and when considering single measurements in the abdomen as a whole, only changes in ADC value greater than 23.1% would be statistically significant using a two-dimensional ROI. This value is substantially lower (7.9%) if large three-dimensional VOIs are considered. [ABSTRACT FROM AUTHOR]- Published
- 2012
- Full Text
- View/download PDF
23. Diffusion-weighted imaging in the assessment of tumour grade in endometrial cancer.
- Author
-
Bharwani, N., Miquel, M. E., Sahdev, A., Narayanan, P., Malietzis, G., Reznek, R. H., and Rockall, A. G.
- Subjects
- *
ENDOMETRIAL cancer , *BIOPSY , *CANCER patients , *MEDICAL imaging systems , *CANCER diagnosis , *PREVENTIVE medicine , *CLINICAL pathology - Abstract
Objective: Endometrial cancer is the most common gynaecological malignancy in developed countries. Histological grade and subtype are important prognostic factors obtained by pipelle biopsy. However, pipelle biopsy "samples" tissue and a high grade component that requires more aggressive treatment may be missed. The purpose of the study was to assess the use of diffusion-weighted MRI (DW-MRI) in the assessment of tumour grade in endometrial lesions. Method: 42 endometrial lesions including 23 endometrial cancers and 19 benign lesions were evaluated with DW-MRI (1.5T with multiple b-values between 0 and 750 s mm-2). Visual evaluation and the calculation of mean and minimum apparent diffusion coefficient (ADC) value were performed and correlated with histology. Results: The mean and minimum ADC values (×10-3 mm-2 s-1) for each histological grade were 1.02 ± 0.29 and 0.74 ± 0.24 (Grade 1), 0.88 ± 0.39 and 0.64 ± 0.36 (Grade 2), and 0.94 ± 0.32 and 0.72 ± 0.36 (Grade 3), respectively. There was no statistically significant difference between tumour grades. However, the mean ADC value for endometrial carcinoma was 0.97 ± 0.31, which was significantly lower (p < 0.0001) than that of benign endometrial pathology (1.50 ± 0.14). Applying a cut-off mean ADC value of less than 1.28 × 10-3 mm2 s-1 we obtained a sensitivity, specificity, positive predictive value and negative predictive value for malignancy of 87%, 100%, 100% and 85.7%, respectively. Conclusion: Tumour mean and minimum ADC values are not useful in differentiating histological tumour grade in endometrial carcinoma. However, mean ADC measurement can provide useful information in differentiating benign from malignant endometrial lesions. This information could be clinically relevant in those patients where pre-operative endometrial sampling is not possible. [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
24. Epithelioid angiomyolipoma: imaging appearances.
- Author
-
Bharwani, N., Christmas, T. J., Jameson, C., Moat, N., and Sohaib, S. A.
- Subjects
- *
SOFT tissue tumors , *TUBEROUS sclerosis , *MEDICAL imaging systems , *VENA cava inferior , *HYPERTENSIVE encephalopathy - Abstract
Epithelioid angiomyolipoma is a recently described rare variant of renal angiomyolipoma. It can occur in patients with or without tuberous sclerosis, and may potentially be malignant. We report the imaging findings from two cases of epithelioid angiomyolipoma: the first in a patient with tuberous sclerosis complex, arising in a horse-shoe kidney and growing into the inferior vena cava and right atrium; the second in a 62-year-old hypertensive man. [ABSTRACT FROM AUTHOR]
- Published
- 2009
- Full Text
- View/download PDF
25. Re: Can MRI predict the diagnosis of endometrial carcinosarcoma?
- Author
-
Bharwani, N., Newland, A., Tunariu, N., Babar, S., Sahdev, A., Rockall, A., and Reznek, R.
- Published
- 2012
- Full Text
- View/download PDF
26. Prostate cancer staging.
- Author
-
STEPHENS, N. J., BHARWANI, N., and HEENAN, S. D.
- Subjects
- *
PROSTATE cancer , *PROSTATE diseases , *ANTIGENS , *HISTOPATHOLOGY , *MEDICAL imaging systems , *BIOPSY - Abstract
The diagnosis of prostate cancer is suggested by elevated prostate-specific antigen but is confirmed by histopathological examination of ultrasound-guided transrectal biopsies. Recent NICE guidelines have made specific recommendations regarding imaging, and this review focuses on the value of existing imaging modalities in the staging of prostate cancer. [ABSTRACT FROM AUTHOR]
- Published
- 2008
- Full Text
- View/download PDF
27. Imaging of bladder cancer.
- Author
-
BHARWANI, N., STEPHENS, N. J., and HEENAN, S. D.
- Subjects
- *
BLADDER cancer , *BLADDER radiography , *DIAGNOSIS , *MEDICAL imaging systems , *CANCER , *BLADDER diseases - Abstract
Bladder cancer is a relatively common cancer and, while imaging is rarely required to make the diagnosis, it plays an important role in the staging and follow-up of patients with this malignancy. This review discusses the indications and limitations of currently available imaging modalities. [ABSTRACT FROM AUTHOR]
- Published
- 2008
- Full Text
- View/download PDF
28. Picture Quiz.
- Author
-
EDEY, A. J., SIDHU, P. S., AMAECHI, I., BHARWANI, N., STEPHENS, N. J., HEENAN, S. D., LEE, L., and PILCHER, J.
- Subjects
PAIN ,TESTICULAR diseases - Abstract
A quiz concerning the diagnosis of a 14-year-old boy presented with acute pain in the left testis is presented.
- Published
- 2008
- Full Text
- View/download PDF
29. OC16.06: A 10‐year review of the magnetic resonance imaging and clinical features of Mayer‐Rokitansky‐Küster‐Hauser syndrome.
- Author
-
Cooper, N.C., Al‐Memar, M., Edmonds, K., Rose, G., Dixon, N., McNamara, C., Van Ree, K., and Bharwani, N.
- Subjects
MAGNETIC resonance imaging ,FUNCTIONAL magnetic resonance imaging - Abstract
Magnetic resonance imaging (MRI) is the gold standard for diagnosis. Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital disorder characterised by uterine and vaginal hypoplasia. Methods Women referred to a specialist service with a diagnosis of MRKH who had an MRI pelvis between 1st January 2011 - 31st April 2021 were included. [Extracted from the article]
- Published
- 2021
- Full Text
- View/download PDF
30. Circulating Immune Complexes in Malignant Melanoma: Serial Studies in 130 Patients.
- Author
-
Bharwani, N., Campbell, L., Ashley, P., Queen, W.D., Phillips, T.M., and Jerry, L.M.
- Published
- 1986
- Full Text
- View/download PDF
31. Bizarre presentation of abdominal lymphangioma in children
- Author
-
Bharwani, N.
- Subjects
Letter - Published
- 1983
32. P9 Is there a size threshold for the visualisation of parathyroid adenomas by Tc99m-sestamibi parathyroid scintigraphy?
- Author
-
Crawshaw, J.W., Bharwani, N., Mansfield, L., Sharma, A., Allan, R., Heenan, S., and Beharry, N.
- Published
- 2007
- Full Text
- View/download PDF
33. Magnetic resonance imaging and clinical features of Mayer-Rokitansky-Küster-Hauser syndrome: A 10-year review from a dedicated specialist centre.
- Author
-
Cooper N, Al-Memar M, Linton-Reid K, Edmonds K, Rose G, Dixon N, McNamara C, Fotopoulou C, Ree KV, and Bharwani N
- Abstract
Objective: To correlate the clinical history with imaging findings of women with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome., Design: Retrospective cohort study., Setting: A UK IOTA and ESGO-certified tertiary referral centre for disorders of reproductive development., Population: All patients with a diagnosis of MRKH and who had undergone an MRI pelvis between 1 January 2011 and 31 April 2021 were included., Methods: MRI images were analysed by specialist gynaecological radiologists. Clinical data was extracted from an electronic patient record system. Statistical analysis was computed in R (version 4.1.2), R base stats package and ggstatsplot (v0.5.0)., Main Outcome Measures: Clinical history and predefined imaging features., Results: One hundred and thirty-four patients were included. Median age at MRI was 18 years (10-64 years). Half (48.2%) of women presenting had a history of pain, most often abdominal (84.6%) or vaginal (9.2%). Remnants were identified in 91.8% of women (n = 123). 4.5% of women had imaging features of endometriosis (n = 6). Women with a functional remnants were significantly more likely to experience pain (p < 0.001). Pain history was not strongly associated with ectopic ovarian position. Common gynaecological pathology such as endometriosis, ovarian cysts and fibroids were also identified., Conclusions: We identify that majority of women with MRKH will have uterine remnants with a connecting fibrous band, and an ectopic ovarian position 44.0% of cases. Abdominal pain was significantly associated with functional remnants on MRI. Further work is required to identify how other gynaecological pathology impacts women with MRKH., (© 2024 The Author(s). BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.)
- Published
- 2024
- Full Text
- View/download PDF
34. Weibull parametric model for survival analysis in women with endometrial cancer using clinical and T2-weighted MRI radiomic features.
- Author
-
Li X, Marcus D, Russell J, Aboagye EO, Ellis LB, Sheeka A, Park WE, Bharwani N, Ghaem-Maghami S, and Rockall AG
- Subjects
- Humans, Female, Middle Aged, Retrospective Studies, Survival Analysis, Aged, ROC Curve, Adult, Models, Statistical, Radiomics, Endometrial Neoplasms mortality, Endometrial Neoplasms diagnostic imaging, Magnetic Resonance Imaging methods, Proportional Hazards Models
- Abstract
Background: Semiparametric survival analysis such as the Cox proportional hazards (CPH) regression model is commonly employed in endometrial cancer (EC) study. Although this method does not need to know the baseline hazard function, it cannot estimate event time ratio (ETR) which measures relative increase or decrease in survival time. To estimate ETR, the Weibull parametric model needs to be applied. The objective of this study is to develop and evaluate the Weibull parametric model for EC patients' survival analysis., Methods: Training (n = 411) and testing (n = 80) datasets from EC patients were retrospectively collected to investigate this problem. To determine the optimal CPH model from the training dataset, a bi-level model selection with minimax concave penalty was applied to select clinical and radiomic features which were obtained from T2-weighted MRI images. After the CPH model was built, model diagnostic was carried out to evaluate the proportional hazard assumption with Schoenfeld test. Survival data were fitted into a Weibull model and hazard ratio (HR) and ETR were calculated from the model. Brier score and time-dependent area under the receiver operating characteristic curve (AUC) were compared between CPH and Weibull models. Goodness of the fit was measured with Kolmogorov-Smirnov (KS) statistic., Results: Although the proportional hazard assumption holds for fitting EC survival data, the linearity of the model assumption is suspicious as there are trends in the age and cancer grade predictors. The result also showed that there was a significant relation between the EC survival data and the Weibull distribution. Finally, it showed that Weibull model has a larger AUC value than CPH model in general, and it also has smaller Brier score value for EC survival prediction using both training and testing datasets, suggesting that it is more accurate to use the Weibull model for EC survival analysis., Conclusions: The Weibull parametric model for EC survival analysis allows simultaneous characterization of the treatment effect in terms of the hazard ratio and the event time ratio (ETR), which is likely to be better understood. This method can be extended to study progression free survival and disease specific survival., Trial Registration: ClinicalTrials.gov NCT03543215, https://clinicaltrials.gov/ , date of registration: 30th June 2017., (© 2024. The Author(s).)
- Published
- 2024
- Full Text
- View/download PDF
35. Distal Ulna Giant Cell Tumor treated by Resection without Reconstruction: What were the functional outcomes and review of literature.
- Author
-
Banala TR, Salunke AA, Bharwani N, Patel K, Maharjan D, Patel S, Warikoo V, Sharma M, and Pandya S
- Abstract
Introduction: Giant Cell Tumours (GCT) are benign tumours with aggressive potential that disrupt the local bony architecture, which can be especially problematic in peri-articular locations. Our aim was to assess the outcomes of patients with GCT of the distal ulna who were treated by resection without reconstruction., Methods: The study included 21 patients with distal ulna GCT that were treated with resection without reconstruction. There were 12 males and 9 females, with a mean age of 30.4years (range 14-45 years). The patients mean follow-up period was 4.4 years, with a two-year minimum follow-up., Results: Painful swelling was the presenting symtom in all cases. Nineteen patients had Campanacci grade 3 and two had Campanacci grade 2. The mean resected length of the distal ulna was 6.8 cm (range 4-10) cm. The Musculoskeletal Tumor Society score (MSTS) was 26.1. (range 22-28). Grip strength of the affected hand was reduced by 10.5% on average. (range 0%-16%). Two patients were having multi-centric disease on presentation and none of the cases had pathological fracture on presentation. One case had a local recurrence which was treated with surgery., Conclusion: Based on current study, GCT of the distal ulna, en bloc resection without reconstruction can be recommended as a valuable treatment option for Campanacci grades 2 and 3 tumours. Resection of the distal end of the ulna without reconstruction results in excellent functional outcomes, with forearm rotational movement and hand function preserved. According to review of literature this is the largest series of GCT Ulna and we recommend a multicentre and comparitive studies on this topic., (© 2024 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.)
- Published
- 2024
- Full Text
- View/download PDF
36. The surgical management and oncologic outcomes of patients with fungating soft tissue sarcoma treated at a tertiary cancer centre and review of literature.
- Author
-
Sadangi S, Saraiya H, Salunke AA, Bharwani N, Patel K, Pandya S, Warikoo V, and Pandya S
- Abstract
Background: Currently there is limited literature available on fungating soft tissue sarcoma and its effect of outcomes. In the current study we evaluated the surgical management and oncologic outcomes of patient with fungating soft tissue sarcoma., Materials and Methods: This was a retrospective observational study of patients with fungating sarcoma between January 2015 till January 2019 at a tertiary cancer care centre. A total of 59 patients were considered of which 16 had metastasis at presentation. The duration of symptoms prior to presentation averaged 10.2 months (median, 7.2months; range, 1-57 months). Median tumor length was 10 cm., Results: 56% patients underwent amputation and 44% were treated with limb salvage. Following limb salvage surgery in10 cases primary closure of defect was performed and 6 cases required skin grafting for closure of defect. In 6 patients local flap was used for coverage of defect and 4 patients required free flap surgery. Two-year overall survival (OS) of the study cohort were 52.2% and 58% respectively. Two-year disease free survival (DFS) and OS in 43 non metastatic patients at presentation was seen in 58%(95% CI,38%-74%) and 66.5%(95% CI,42%-81%) respectively. The two-year disease OS in 16 patients with metastasis at presentation was 33.2 %. On univariate analysis, tumor size and metastatic at presentation had significant effect on survival., Conclusion: Tumor size and metastatic at presentation has significant impact on survival in these patients. The oncologic outcomes including Disease free survival, overall survival and local recurrence rates similar amongst the two surgical modalities (amputation versus limb salvage). Amputation rates are more amongst fungating soft tissue sarcoma but limb salvage can be attempted whenever feasible keeping tumor free surgical margins under consideration., Competing Interests: The authors declare no conflict of interest., (© 2024 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.)
- Published
- 2024
- Full Text
- View/download PDF
37. Metallosis: A Rare Complication to Common Procedure with Its Imaging Finding.
- Author
-
Suthar RR, Bharwani N, and Salunke AA
- Abstract
Metallosis is a medical condition that shows local and systemic clinical symptoms due to the deposition of heavy metal debris in soft tissues and bones due to metallic prostheses. The estimated incidence of Metallosis is around 5%. Clinical presentation and imaging findings can mimic tumor likely situation, However local reactions of Metallosis shows some peculiar features on cross-sectional imaging, and here we present two such cases of Metallosis with its imaging findings., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Indian Journal of Nuclear Medicine.)
- Published
- 2024
- Full Text
- View/download PDF
38. Machine learning and radiomics for segmentation and classification of adnexal masses on ultrasound.
- Author
-
Barcroft JF, Linton-Reid K, Landolfo C, Al-Memar M, Parker N, Kyriacou C, Munaretto M, Fantauzzi M, Cooper N, Yazbek J, Bharwani N, Lee SR, Kim JH, Timmerman D, Posma J, Savelli L, Saso S, Aboagye EO, and Bourne T
- Abstract
Ultrasound-based models exist to support the classification of adnexal masses but are subjective and rely upon ultrasound expertise. We aimed to develop an end-to-end machine learning (ML) model capable of automating the classification of adnexal masses. In this retrospective study, transvaginal ultrasound scan images with linked diagnoses (ultrasound subjective assessment or histology) were extracted and segmented from Imperial College Healthcare, UK (ICH development dataset; n = 577 masses; 1444 images) and Morgagni-Pierantoni Hospital, Italy (MPH external dataset; n = 184 masses; 476 images). A segmentation and classification model was developed using convolutional neural networks and traditional radiomics features. Dice surface coefficient (DICE) was used to measure segmentation performance and area under the ROC curve (AUC), F1-score and recall for classification performance. The ICH and MPH datasets had a median age of 45 (IQR 35-60) and 48 (IQR 38-57) years old and consisted of 23.1% and 31.5% malignant cases, respectively. The best segmentation model achieved a DICE score of 0.85 ± 0.01, 0.88 ± 0.01 and 0.85 ± 0.01 in the ICH training, ICH validation and MPH test sets. The best classification model achieved a recall of 1.00 and F1-score of 0.88 (AUC:0.93), 0.94 (AUC:0.89) and 0.83 (AUC:0.90) in the ICH training, ICH validation and MPH test sets, respectively. We have developed an end-to-end radiomics-based model capable of adnexal mass segmentation and classification, with a comparable predictive performance (AUC 0.90) to the published performance of expert subjective assessment (gold standard), and current risk models. Further prospective evaluation of the classification performance of this ML model against existing methods is required., (© 2024. The Author(s).)
- Published
- 2024
- Full Text
- View/download PDF
39. Is polypropylene mesh reconstruction functionally superior to non reconstructive group following total scapular resection? A retrospective analysis of 16 patients and a systematic review of the literature.
- Author
-
Salunke AA, Nandy K, Kamani M, Parmar R, Bharwani N, Pathak S, Patel K, and Pandya S
- Abstract
Background: Various reconstruction methods have been described in medical literature on scapular tumor resection depending on the type of resection and other factors. However the ideal method of reconstructions has been still debatable. The purpose of the current study was to assess whether polypropylene mesh reconstruction is superior as compared to non reconstructive group following total scapular resection.We also evaluated how our method of reconstruction fare as compared to reported reconstruction methods in the published literature., Methods: During 2014 to 2019; Total scapulectomy (Type III scapular resection) was performed in 16 patients for malignant tumor involving scapula bone. Reconstruction with polyprolene mesh(Group I) was performed in 56 % patient and non reconstruction technique (Group II) was observed in 44 % patient. The mean follow-up duration of current study was 28.3 months (range 13-67 months). The search method of PubMed and Cochrane databases provided 121 articles; of which 5 studies having 144 cases were utilised for final analysis. The reconstruction method used were dynamic humeral suspension (39.5%), non reconstruction method (35 %), scapular prosthesis (18 %) and static humeral suspension (5.5%)., Results: The mean Musculoskeletal tumor society score (MSTS) of the study cohort was 19.8(0-23); and that in polyprolene mesh or static suspension method (Group I) and non reconstructive technique (Group II) was 67 % and 61% respectively. The emotional acceptance score in group I was 4.5 and that in group II was 4.2 points. There was no difference in the shoulder movements in both the groups. The mean surgical durations in group I and group II was was 186 min and 140 min respectively. The systematic review showed the mean Musculoskeletal tumor society score (MSTS) of dynamic suspension and non reconstruction method were 63 % and 63.5% respectively. The mean Musculoskeletal tumor society score (MSTS) of scapula prosthesis tended to be higher than those with dynamic suspension (77 % vs 65 %)., Conclusions: The reconstruction with polypropylene mesh had better functional outcome and emotional acceptance as compared to non-reconstructive group in patients with total scapular resection surgery. The findings of systematic review suggest that; patients treated by reconstruction with polypropylene mesh and non-reconstructive group as compared to scapular prosthesis had limited shoulder movements with no difference in hand position, manual dexterity and lifting ability., Competing Interests: There is no conflict of interest in this paper.:NIL., (© 2024 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.)
- Published
- 2024
- Full Text
- View/download PDF
40. Living donor uterus transplant in the UK: A case report.
- Author
-
Jones BP, Vali S, Saso S, Devaney A, Bracewell-Milnes T, Nicopoullos J, Thum MY, Kaur B, Roufosse C, Stewart V, Bharwani N, Ogbemudia A, Barnardo M, Dimitrov P, Klucniks A, Katz R, Johannesson L, Diaz Garcia C, Udupa V, Friend P, Quiroga I, and Smith JR
- Subjects
- Female, Humans, Living Donors, Uterus surgery, United Kingdom, Organ Transplantation, Transplants
- Published
- 2024
- Full Text
- View/download PDF
41. Clinicopathological and oncological outcomes in upper extremity Ewing's sarcoma: A single institutional experience.
- Author
-
Shukla S, Salunke AA, Trivedi M, Patel K, Pandya S, Suthar R, Reddy T, Kapoor K, Yala P, Krishna G, Bharwani N, and Pandya S
- Abstract
Background: Ewing's sarcoma is highly aggressive bone tumor having predilection for younger age groups with t (11,22) translocation, recombines the FLI-1 and EWS genes on chromosome 22. This disease requires multi-disciplinary treatment withneo-adjuvant chemotherapy followed by surgery or radiotherapy and adjuvant chemotherapy. This study was aimed to assess the demographic distribution, clinical behaviour and oncological outcome of Ewings Sarcoma involving upper extremity., Methods: From 2015 to 2022, 45 patients of upper extremity Ewing's sarcoma underwent treatment at a territory cancer centre. A total of 26 patients treated with surgical management were included in the study comprising 15 males (57.7 %) and 11 females (42.3 %). Mean age of presentation was 26 years (3-43 years). The most common site for Ewings sarcoma of upper extremity was Humerus(42 %) followed by Scapula(27 %), Radius(15 %), Ulna(8 %), Metacarpals(4 %) and Clavicle(4 %). Out of 26 cases, 19 (73%) underwent limb salvage surgery and 7 (27%) underwent ampuation surgery., Results: In limb salvage group reconstruction with Extra-corporeal radiotherapy (ECRT), Ulna centralization, Megaprosthesis and 3D printed scapula was performed following wide resection of tumor. In Amputation group ray resection in one case and forequarter amputation was performed in six cases. Mean serum LDH value was 335 IU/L (2.3X Normal value) and serum albumin was 4.04 gm/dl. Mean tumour necrosis after neo-adjuvant chemotherapy was 68 %. Out of 26 cases, 19(73 %) cases underwent limb salvage and 7 patients underwent amputation surgery. Out of 26, 13 (50 %) patients developed metastasis on follow up. The Event free survival (EFS) in current study was 70 % at 12 months and 40 % at 24 months. Mean Event free survival (EFS) in current study was 33.5 months (22.3-44.6) and Median Event free survival (EFS) in current study was 25 months (19.7-30.2)., Conclusion: This study characterises demographic and oncologic outcomes of upper extremity ewings sarcoma in Indian subpopulation. Pain and swelling were prominent clinical findings at presentation in patients with upper extremity Ewing's sarcoma. The survival rate following limb salvage surgery in Ewings sarcoma of upper extremity was comparable to that of patients with amputation surgery. Ewings sarcoma of upper extremity was associated with higher LDH level which was raised more than twice the normal range and can led to worse oncologic outcomes. A comparative study on upper extremity and lower extremity ewings sarcoma will be of help to improve literature on this rare disease., Competing Interests: None., (© 2023 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.)
- Published
- 2023
- Full Text
- View/download PDF
42. Development and Evaluation of Machine Learning in Whole-Body Magnetic Resonance Imaging for Detecting Metastases in Patients With Lung or Colon Cancer: A Diagnostic Test Accuracy Study.
- Author
-
Rockall AG, Li X, Johnson N, Lavdas I, Santhakumaran S, Prevost AT, Punwani S, Goh V, Barwick TD, Bharwani N, Sandhu A, Sidhu H, Plumb A, Burn J, Fagan A, Wengert GJ, Koh DM, Reczko K, Dou Q, Warwick J, Liu X, Messiou C, Tunariu N, Boavida P, Soneji N, Johnston EW, Kelly-Morland C, De Paepe KN, Sokhi H, Wallitt K, Lakhani A, Russell J, Salib M, Vinnicombe S, Haq A, Aboagye EO, Taylor S, and Glocker B
- Subjects
- Humans, Magnetic Resonance Imaging methods, Retrospective Studies, Whole Body Imaging methods, Lung, Sensitivity and Specificity, Diagnostic Tests, Routine, Lung Neoplasms diagnostic imaging, Colonic Neoplasms diagnostic imaging
- Abstract
Objectives: Whole-body magnetic resonance imaging (WB-MRI) has been demonstrated to be efficient and cost-effective for cancer staging. The study aim was to develop a machine learning (ML) algorithm to improve radiologists' sensitivity and specificity for metastasis detection and reduce reading times., Materials and Methods: A retrospective analysis of 438 prospectively collected WB-MRI scans from multicenter Streamline studies (February 2013-September 2016) was undertaken. Disease sites were manually labeled using Streamline reference standard. Whole-body MRI scans were randomly allocated to training and testing sets. A model for malignant lesion detection was developed based on convolutional neural networks and a 2-stage training strategy. The final algorithm generated lesion probability heat maps. Using a concurrent reader paradigm, 25 radiologists (18 experienced, 7 inexperienced in WB-/MRI) were randomly allocated WB-MRI scans with or without ML support to detect malignant lesions over 2 or 3 reading rounds. Reads were undertaken in the setting of a diagnostic radiology reading room between November 2019 and March 2020. Reading times were recorded by a scribe. Prespecified analysis included sensitivity, specificity, interobserver agreement, and reading time of radiology readers to detect metastases with or without ML support. Reader performance for detection of the primary tumor was also evaluated., Results: Four hundred thirty-three evaluable WB-MRI scans were allocated to algorithm training (245) or radiology testing (50 patients with metastases, from primary 117 colon [n = 117] or lung [n = 71] cancer). Among a total 562 reads by experienced radiologists over 2 reading rounds, per-patient specificity was 86.2% (ML) and 87.7% (non-ML) (-1.5% difference; 95% confidence interval [CI], -6.4%, 3.5%; P = 0.39). Sensitivity was 66.0% (ML) and 70.0% (non-ML) (-4.0% difference; 95% CI, -13.5%, 5.5%; P = 0.344). Among 161 reads by inexperienced readers, per-patient specificity in both groups was 76.3% (0% difference; 95% CI, -15.0%, 15.0%; P = 0.613), with sensitivity of 73.3% (ML) and 60.0% (non-ML) (13.3% difference; 95% CI, -7.9%, 34.5%; P = 0.313). Per-site specificity was high (>90%) for all metastatic sites and experience levels. There was high sensitivity for the detection of primary tumors (lung cancer detection rate of 98.6% with and without ML [0.0% difference; 95% CI, -2.0%, 2.0%; P = 1.00], colon cancer detection rate of 89.0% with and 90.6% without ML [-1.7% difference; 95% CI, -5.6%, 2.2%; P = 0.65]). When combining all reads from rounds 1 and 2, reading times fell by 6.2% (95% CI, -22.8%, 10.0%) when using ML. Round 2 read-times fell by 32% (95% CI, 20.8%, 42.8%) compared with round 1. Within round 2, there was a significant decrease in read-time when using ML support, estimated as 286 seconds (or 11%) quicker ( P = 0.0281), using regression analysis to account for reader experience, read round, and tumor type. Interobserver variance suggests moderate agreement, Cohen κ = 0.64; 95% CI, 0.47, 0.81 (with ML), and Cohen κ = 0.66; 95% CI, 0.47, 0.81 (without ML)., Conclusions: There was no evidence of a significant difference in per-patient sensitivity and specificity for detecting metastases or the primary tumor using concurrent ML compared with standard WB-MRI. Radiology read-times with or without ML support fell for round 2 reads compared with round 1, suggesting that readers familiarized themselves with the study reading method. During the second reading round, there was a significant reduction in reading time when using ML support., Competing Interests: Conflicts of interest and sources of funding: A.G.R. is part of the advisory board of RoClub. This study was funded by the National Institute of Health Research Efficacy and Mechanism Evaluation Programme (trial registration: ISRCTN 23068310). The project is supported by the Imperial College London National Institute for Health Research Biomedical Research Centre, CRUK Imperial Centre, National Institute for Health Research University College London Hospitals Biomedical Research Centre, NIHR Biomedical Research Centre, and the NIHR Clinical Research Facilities and the Royal Marsden Hospital and Institute of Cancer Research. S.T. is an NIHR senior investigator. This research has been conducted using the UK Biobank Resource., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2023
- Full Text
- View/download PDF
43. Role of bone scintigraphy (bone scan) in skeletal osteosarcoma: A retrospective audit and review from tertiary oncology centre.
- Author
-
Suthar R, Bharwani N, Pareek P, Salunke AA, Patel K, Shukla S, Aron J, Kapoor K, Yalla P, Rathod P, Pandya S, and Pandya S
- Abstract
Introduction: Bone scan is a investigation which uses radionuclide phosphonate compound for whole skeletal survey. In this current study we have done the analysis of the role of bone scan in skeletal osteosarcoma at tertiary oncology care centre., Material & Methods: This is a retrospective study conducted in a tertiary oncology centre from January 2022 to February 2023. A total of 92 patients with skeletal OGS were included in our study undergone 99 mTCcMDP whole body bone scan. 99 mTc MDP was prepared freshly every morning and dose for each patient were calculated as per EANM guidelines. Images were acquired 2-3 h of post injection. All images were acquired at GE infinia dual head machine with peak setting at 140Kev and LEAP collimator. Suspicious lesions on planer bone scan were correlated with SPECT fused with CT. All the bone scans were reviewed retrospectively by two independent nuclear medicine physicians., Results: In this study group, 86 patients with biopsy proven skeletal OGS underwent 99 mTCcMDP bone scan of which 63 were males and 23 were females (2.7:1) with age of study group ranging from 7years to 48years. Patients referred for bone scan were retrospectively categorized in two groups, first group patients (52) were referred for initial staging of disease and second group of patients (34) were referred for follow-up or re-staging of the disease. Total 09 patients showed distant skeletal metastases on bone scan, out of which 05 were in initial staging group and 04 in follow up group., Conclusion: Osteosarcoma has propensity to metastasize to many sites in the body however most common site being lung followed by skeletal, nodal and rarely soft tissue metastasis. Bone scan enjoys a optimal sensitivity in case of osteosarcoma to detect skeletal metastasis but have low specificity. However being a cost effective and faster investigation makes it a wise investigation of choice in case of osteosarcoma for skeletal metastasis evaluation., (© 2023 Published by Elsevier B.V. on behalf of Professor P K Surendran Memorial Education Foundation.)
- Published
- 2023
- Full Text
- View/download PDF
44. Does an excision of needle bone biopsy tract affect the prognosis in patients with primary bone tumor?
- Author
-
Gami A, Shah A, Shankaralingappa S, Salunke AA, Gandhi J, Patel K, Bharwani N, Trivedi P, and Pandya S
- Abstract
Background: Opinion remains divided as to whether excision of needle biopsy tract is beneficial and affect the prognosis. The aim of the study was to compare the outcomes in patients of primary malignant bone tumor who had undergone surgery with or without biopsy tract excision., Methods: From January 2017 to June 2020, 240 patients with primary malignant bone tumors who underwent percutaneous needle biopsy followed by surgery were included. We categorized patients into Biopsy tract excision (Group1:185 patients) and Non Biopsy tract excision (Group 2:55 patients). Median follow-up of patients was 58.6 months (range; 12-61.8months)., Results: Demographics, histopathological type, tumor location, type of surgery were similar in biopsy tract excision and non excision group. We found biopsy tract seeding in two cases out of 185 (1.1 %). Local recurrence in biopsy tract excision and non excision group was observed in 3.2 % and 1.8 % respectively with p value 0.58. The mean local recurrence free survival rate in group 1 and 2 was 60 and 44 months respectively. Limb salvage was performed in 71.6 % and in amputation in 28.3 % cases. The local recurrence in limb-salvage and amputation group was observed in 3.4 % (6/172) and 1.4 % (1/68) respectively., Conclusion: There was no significant difference in the rate of local recurrence between patients who were treated by biopsy tract excision or non tract excision. Percutenous needle bone biopsy tract leads to minimal risk of tumor seeding during surgical resection of primary bone tumors.We recommend the further multi centre studies with more number of patients to reach a consensus on resection of needle biopsy tract during surgical management of primary bone tumors., Competing Interests: NIL., (© 2023 Published by Elsevier B.V. on behalf of Professor P K Surendran Memorial Education Foundation.)
- Published
- 2023
- Full Text
- View/download PDF
45. An Integrated Clinical-MR Radiomics Model to Estimate Survival Time in Patients With Endometrial Cancer.
- Author
-
Li X, Marcus D, Russell J, Aboagye EO, Ellis LB, Sheeka A, Park WE, Bharwani N, Ghaem-Maghami S, and Rockall AG
- Subjects
- Humans, Female, Retrospective Studies, Magnetic Resonance Imaging, Area Under Curve, ROC Curve, Endometrial Neoplasms diagnostic imaging
- Abstract
Background: Determination of survival time in women with endometrial cancer using clinical features remains imprecise. Features from MRI may improve the survival estimation allowing improved treatment planning., Purpose: To identify clinical features and imaging signatures on T2-weighted MRI that can be used in an integrated model to estimate survival time for endometrial cancer subjects., Study Type: Retrospective., Population: Four hundred thirteen patients with endometrial cancer as training (N = 330, 66.41 ± 11.42 years) and validation (N = 83, 67.60 ± 11.89 years) data and an independent set of 82 subjects as testing data (63.26 ± 12.38 years)., Field Strength/sequence: 1.5-T and 3-T scanners with sagittal T2-weighted spin echo sequence., Assessment: Tumor regions were manually segmented on T2-weighted images. Features were extracted from segmented masks, and clinical variables including age, cancer histologic grade and risk score were included in a Cox proportional hazards (CPH) model. A group least absolute shrinkage and selection operator method was implemented to determine the model from the training and validation datasets., Statistical Tests: A likelihood-ratio test and decision curve analysis were applied to compare the models. Concordance index (CI) and area under the receiver operating characteristic curves (AUCs) were calculated to assess the model., Results: Three radiomic features (two image intensity and volume features) and two clinical variables (age and cancer grade) were selected as predictors in the integrated model. The CI was 0.797 for the clinical model (includes clinical variables only) and 0.818 for the integrated model using training and validation datasets, the associated mean AUC value was 0.805 and 0.853. Using the testing dataset, the CI was 0.792 and 0.882, significantly different and the mean AUC was 0.624 and 0.727 for the clinical model and integrated model, respectively., Data Conclusion: The proposed CPH model with radiomic signatures may serve as a tool to improve estimated survival time in women with endometrial cancer., Evidence Level: 4 TECHNICAL EFFICACY: Stage 2., (© 2022 The Authors. Journal of Magnetic Resonance Imaging published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.)
- Published
- 2023
- Full Text
- View/download PDF
46. Prediction of Deep Myometrial Infiltration, Clinical Risk Category, Histological Type, and Lymphovascular Space Invasion in Women with Endometrial Cancer Based on Clinical and T2-Weighted MRI Radiomic Features.
- Author
-
Li X, Dessi M, Marcus D, Russell J, Aboagye EO, Ellis LB, Sheeka A, Park WE, Bharwani N, Ghaem-Maghami S, and Rockall AG
- Abstract
Purpose: To predict deep myometrial infiltration (DMI), clinical risk category, histological type, and lymphovascular space invasion (LVSI) in women with endometrial cancer using machine learning classification methods based on clinical and image signatures from T2-weighted MR images., Methods: A training dataset containing 413 patients and an independent testing dataset consisting of 82 cases were employed in this retrospective study. Manual segmentation of the whole tumor volume on sagittal T2-weighted MRI was performed. Clinical and radiomic features were extracted to predict: (i) DMI of endometrial cancer patients, (ii) endometrial cancer clinical high-risk level, (iii) histological subtype of tumor, and (iv) presence of LVSI. A classification model with different automatically selected hyperparameter values was created. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve, F1 score, average recall, and average precision were calculated to evaluate different models., Results: Based on the independent external testing dataset, the AUCs for DMI, high-risk endometrial cancer, endometrial histological type, and LVSI classification were 0.79, 0.82, 0.91, and 0.85, respectively. The corresponding 95% confidence intervals (CI) of the AUCs were [0.69, 0.89], [0.75, 0.91], [0.83, 0.97], and [0.77, 0.93], respectively., Conclusion: It is possible to classify endometrial cancer DMI, risk, histology type, and LVSI using different machine learning methods.
- Published
- 2023
- Full Text
- View/download PDF
47. Deep pelvic infiltrating endometriosis: MRI consensus lexicon and compartment-based approach from the ENDOVALIRM group.
- Author
-
Rousset P, Florin M, Bharwani N, Touboul C, Monroc M, Golfier F, Nougaret S, and Thomassin-Naggara I
- Subjects
- Female, Humans, Magnetic Resonance Imaging methods, Pelvis diagnostic imaging, Uterus, Consensus, Endometriosis diagnostic imaging
- Abstract
Purpose: The purpose of this consensus article was to develop guidelines by a focused panel of experts to elaborate a lexicon of image interpretation, and a standardized region-based reporting of deep infiltrating endometriosis (DIE) with magnetic resonance imaging (MRI)., Materials and Methods: Evidence-based data and expert opinion were combined using the RAND-UCLA Appropriateness Method to attain consensus guidelines. Experts scoring of pelvic compartment delineation and reporting template were collected; responses were analyzed and classified as "RECOMMENDED" versus "NOT RECOMMENDED" (when ≥ 80% consensus among experts) or uncertain (when < 80% consensus among experts)., Results: Consensus regarding pelvic compartment delineation and DIE reporting was attained using the RAND-UCLA Appropriateness Method. The pelvis was divided in nine compartments and extrapelvic lesions were assigned to an additional (tenth) compartment. A consensus was also reached for each structure attributed to a compartment and each reporting template item among the experts. No consensus was reached for a normal aspect of uterosacral ligament, but a consensus was reached for an unequivocal involvement leading to a positive diagnosis and an equivocal involvement leading to uncertain diagnosis. Tailored MRI lexicon and standardized region-based report were proposed., Conclusion: These consensus recommendations should be used as a guide for DIE reporting and staging with MRI. Standardized MRI compartment-based structured reporting is recommended to enable consistent accuracy and help select the best therapeutic approach., Competing Interests: Declaration of Competing Interest Pascal Rousset declares consultancies for ZIWIG and EDAP TMS France. François Golfier declares consultancies for ZIWIG. The other authors have no competing interests to disclose., (Copyright © 2022 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)
- Published
- 2023
- Full Text
- View/download PDF
48. Atypical Lumbar Scheuermann's Disease: A Rare Entity and Literature Review.
- Author
-
Singh M, Bansal M, Singh A, Bharwani N, and Bhati M
- Abstract
Introduction: Atypical Scheuermann disease involves one or two vertebral bodies which result in kyphosis., Case Report: An 18-year-old male presented in OPD with a complaint of chronic lower back pain without any lower limb pain and neurological deficit. Radiological imaging and blood parameters were in favor of atypical Scheuermann disease., Conclusion: Radiological and blood investigations are required to rule out other possible causes of chronic back pain to make a diagnosis of atypical Scheuermann disease which should be treated conservatively initially., Competing Interests: Conflict of Interest: Nil, (Copyright: © Indian Orthopaedic Research Group.)
- Published
- 2023
- Full Text
- View/download PDF
49. An unusual presentation of mycetoma around knee joint as a subcutaneous mass - A case report.
- Author
-
Singh B, Gehlot R, Saxena M, Bharwani N, Raichandani K, and Bhati M
- Abstract
Introduction: Mycetoma is a form of chronic granulomatous disease which involves subcutaneous tissues and causes bone destruction in advanced stages. The characteristic features are sinus formation, granules formation, and mass in subcutaneous region., Case Report: A 19-year-old male presented to our out-patient clinic with complaint of a painless swelling around the medial aspect of the right knee joint for 8 months with no sinus or discharge of granules. Pes anserinus bursitis was thought of as differential diagnosis for the present condition. "Staging-classification of mycetoma" is commonly used for classifying mycetoma and as per classification, the present case had Stage-A., Conclusion: Single-stage local excision was performed and supplemented with anti-fungal agent for 6 months, which showed good outcome at the final follow-up of 13 months., Competing Interests: Conflict of Interest: Nil, (Copyright: © Indian Orthopaedic Research Group.)
- Published
- 2022
- Full Text
- View/download PDF
50. Synovial Hemangioma Presenting as Anterior Knee Pain - A Case Series.
- Author
-
Rishita, Singh D, Singhvi A, Bharwani N, Jain H, and Bhati M
- Abstract
Introduction: Synovial hemangioma is a benign soft-tissue tumor of vascular origin. The knee joint is most common joint affected and with highest incidence noted till date. For diagnosis, of such rare presentation radiological investigations such as digital radiograph and magnetic resonance imaging are of utmost importance, and magnetic resonance imaging being considered as investigation of choice. The gold standard treatment being complete excision of the growth., Case 1: A 13-year-old boy presented in out-patient clinic with chief complaint of right sided anterior knee pain since 10 months and patient had history of trauma in past. Magnetic resonance imaging of knee joint showed well circumscribed lesion in infra-patellar area (Hoffa's fat pad), with internal septations present within lesion., Case 2: A 25-year-old female presented to out-patient clinic with chief complaint of left sided anterior knee pain since 2 year, with no history of prior injury. The magnetic resonance imaging of knee joint showed ill-defined lesion around anterior patella-femoral articulation adherent to quadriceps tendon, internal septations present within lesion. For both cases, en bloc excision was performed and good functional outcome was achieved., Conclusion: Knee joint synovial hemangioma is rare presentation to orthopedic outdoors, has slight female predominance with pre-existing history of trauma. In the present study, both cases were of patella-femoral type (anterior and infra-patellar fat pad). For such lesions, en bloc excision is gold standard procedure to prevent recurrence, same procedure was followed in our study, and good functional outcome was achieved., Competing Interests: Conflict of Interest: Nil, (Copyright: © Indian Orthopaedic Research Group.)
- Published
- 2022
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.