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Background: DWI and ADC values are noninvasive MRI techniques, which provide quantitative information about tumor heterogeneity. Aim: To determine the minimum and mean ADC values in breast carcinoma and to correlate ADC values with various prognostic factors. Settings and Design: Prospective observational study. Materials and Methods: Fifty-five patients with biopsy-proven breast carcinoma were included in this study. MRI with DWI was performed with Siemens 3T Skyra scanner. ADC values were measured by placing regions of interest (ROIs) within the targeted lesions on ADC maps manually. The histopathological and immunohistochemical analysis of surgical specimen was done to determine the prognostic factors. Statistical Analysis: Students T test and ANOVA were used to study the difference in ADC between two groups. Pearson correlation coefficient was used to quantify the correlation between ADC values and prognostic factors. Results: Lower grade (grade I) breast carcinoma had a significantly high ADC value as compared to higher grade carcinoma (grade II and III). For differentiating Grade I tumors from grade II and III, a minimum ADC cut-off value was 0.79 × 10−3 mm2/sec (83% sensitivity and 84% specificity) and a mean ADC cut-off value was 0.82 × 10-3 mm2/sec (83% sensitivity and 71% specificity) was derived. There was no significant correlation between ADC and other prognostic factors. Conclusion: ADC values can be used to differentiate lower grade breast carcinoma (grade I) from higher grades (grade II and III). Minimum ADC values are more accurate in predicting the grade of the breast tumor than mean ADC value.

Objective : To study the effectiveness and safety of USG-guided ethanol sclerotherapy in cystic thyroid nodules. Materials and Methods : USG of the thyroid gland was performed in 54 patients suspected to have a thyroid nodule on clinical examination. All patients with a predominantly cystic nodule (i.e., when >2/3 rd of the nodule was cystic) were included in the study. Ethanol was injected into the cyst under USG guidance. The amount of ethanol injected was about 50% of the amount of aspirated fluid. Follow-up USG was done every month for 3 months; ethanol was re-injected when there was no significant reduction in the cyst volume. The initial cyst volume was compared with the final volume; statistical significance was assessed using the paired t-test. Results : USG revealed predominant cystic nodules in 16 of the 54 patients. Fifteen patients were selected for the study. Following ethanol sclerotherapy, four out of the 15 patients (26.6%) showed complete disappearance of the cyst and nine (60%) showed significant reduction in the cyst volume (i.e., reduction of cyst volume by ≥50% of initial volume). Only two patients did not show significant reduction in cyst volume; both these patients had nodules with an initial volume of ≥20 cc. There were no complications attributable to ethanol injection during follow-up. Conclusion: Ethanol sclerotherapy is an effective and safe treatment for benign cystic thyroid nodules with volumes of < 20 cc. Cystic nodules with volume >20 cc may need more number of alcohol injections and longer follow-up.

Bronchial artery embolization may be the only life-saving procedure available in a patient presenting with massive hemoptysis. Rarely, selective catheterization of these vessels may be rendered difficult due to a stenotic ostium. This may result in closure of the vessel or absence of forward flow after the stenotic segment is crossed with a diagnostic catheter or a microcatheter. Further, it may also lead to recurrence of hemoptysis if the distal vessel and the prearteriolar bed are inadequately embolized. We describe a technique of selective cannulation of the stenotic vessel, dilatation of the stenosis and then successful embolization.

Several angiographic techniques have been developed to image the arterial system, the commonest using iodinated contrast media. Useful as they may be, they are not without disadvantages. One other modality is angiography using CO 2 . Although CO 2 can be used as an alternative contrast medium, delivery systems are expensive to procure. We describe an indigenous and effective delivery system developed at our institute.