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Objectives: The aim of this study is to present novel diagnostic ultrasonography (USG)-based classification of inflammatory granulomatous mastitis (IGM) and to assess and compare dosage responses of locoregional steroid therapy. Methods: From January 2017 through March 2023, total of 230 biopsy-proven IGM patients were reclassified (grades I, II, and III) according to USG-based morphological features. The injection applications were grouped in Group1 (40 mg/mL between years 2017 and 2019) versus Group2 (80 mg/mL between years 2019 and 2023), and effectiveness was analysed for each grade in between groups. Results: The mean age was 31 years old (range: 19-60) with median follow-up period of 7 months. The most common clinical presentation was breast mass accompanying draining skin sinuses of the affected skin and hypoechogenic mass with tubular extensions was the most prevalent feature on USG examination. As per USG-based features, 79 (34.3%) patients were redefined as grade I, 64 (27.8%) as grade II, and 87 (37.8%) as grade III. All patients underwent locoregional steroid injection only. The average number of treatments in the first group was 6 (±3 SD) with an effective dose of 40 mg/mL in the first group, and 4 (±2 SD) with an effective dose of 80 mg/mL in the second group. The generalized linear mixed model was used to investigate effects between groups (P < .05). Conclusions: High-dose steroid treatment was effective in burnout lesions (grades II and III), and it was found to be statistically significant in lowering number of treatments irrespective of grade. Advances in knowledge: This novel classification could be a convenient tool in terms of common language between radiologists and clinicians. In addition, our study is a pioneer in comparing steroid dosage with no relapse in IGM patients. [ABSTRACT FROM AUTHOR]

Inflammatory granulomatous mastitis is a benign inflammatory disease of the breast mostly presenting in puerperal women. The disease is characterized by recurrent bouts of mastitis with clinical picture of hyperemia, breast mass, and swelling of the breast with or without purulent discharge depending on the severity of the underlying inflammatory process. Although no true prevalence and incidence have been reported in the literature, there are several reported studies setting forth a predilection in specific ethnic groups and/ or geographical areas. Due to the intricate nature of the disease, quite often inflammatory granulomatous mastitis may be mistaken for malignant processes of the breast and even so, there are no pathognomonic imaging appearances to differentiate one from another. The histopathological analysis is a definite way of diagnosis. In this article, we review the imaging manifestations and clinical and histopathological findings along with current trends of available treatment options in the literature and briefly discussed our institutional perspective regarding grading of inflammatory granulomatous mastitis based on ultrasonographic appearances. [ABSTRACT FROM AUTHOR]

In adenocarcinomas presenting with nodular pattern, nodule size (>=6 mm) represents an important parameter for predicting malignant progression in lung cancer screening.[1] On the other hand, lung nodules <6 mm despite being relatively not of utmost importance in clinical standpoint still bear a clinical impact to be further delineated with other hybrid imaging modalities including PET/CT, MRI, and PET/MRI. This study is a preliminary contribution to our understanding of clinical utility of hybrid PET/MRI in smaller lung nodules and its potential effectiveness in assessing pleural invasion, which may go unnoticed with other imaging modalities. Editorial for "Predictive Value of 18F-FDG PET/MRI for Pleural Invasion in Solid and Subsolid Lung Adenocarcinomas Smaller Than 3 cm". [Extracted from the article]