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Background International Federation of Gynaecology and Obstetrics (FIGO) staging of carcinoma cervix, although essentially clinical, acknowledges the benefits of MRI. The impact of incorporating MRI in staging of cervical cancer and the discordance between clinical-and MRI-based FIGO staging is not well studied, especially in low- and middle-income countries. Aim We aim to study the role and accuracy of MRI in staging carcinoma cervix, its correlation with clinical FIGO and histopathological staging with emphasis on how it can change treatment plan. Methods Retrospective observational cohort study (n = 193) where MRI details of different staging parameters of the study subjects were compared with clinical FIGO staging and histopathology to assess correlation and agreement between them. Change of clinical FIGO stage and hence treatment plan brought about by incorporating MRI was assessed. Results MRI had a tumor detection rate of 94.3%, overall staging accuracy of 78.3% and very strong correlation with histopathology (Spearman's coefficient of rank correlation, r = 0.886). Clinical FIGO and MRI had agreement only in 52.8% cases (r = 0.61). Incorporating MRI changed the clinical stage in 47.2% patients and subsequently modified primary treatment plan in 23.3%. Conclusion MRI is highly accurate in evaluating carcinoma cervix and has good correlation with histopathology. Our data shows low agreement between MRI and clinical FIGO staging. Thus, incorporating MRI in FIGO staging has considerable impact in altering treatment decisions and should be offered to all patients for staging carcinoma cervix.

The association of mediastinal germ cell tumor (GCT) and hematological malignancy is a well-documented but extremely rare phenomenon. This syndrome is characterized by the occurrence of nonseminomatous mediastinal germ cell tumor and an associated hematological neoplasm that usually involve the megakaryocytic lineage. The hematopoietic malignancies can involve the mediastinum or present as infiltration of bone marrow or lymphoid organs. In majority of cases, the hematological malignancy was detected in the bone marrow simultaneously or within 6 months after the detection of mediastinal germ cell tumor. There are very few limited case reports on the presence of hematopoietic or leukemic cells within the germ cell tumor itself and mass formation due to myeloid sarcoma is exceptionally rare. Herein we report the case of a 36-year-old male patient with a large mediastinal mass, excision biopsy of which showed areas of yolk sac tumor, immature teratoma and a separate round cell component. On immunohistochemical examination, the round cell component showed positivity for CD45 (dim), CD43, MPO, CD11c, and CD68 and were negative for CD117, CD20, CD5, CD34, Tdt, CD30, CD123, and CD61. A diagnosis of mediastinal germ cell tumor with yolk sac tumor and immature teratoma components and associated myeloid sarcoma was given. Peripheral smear and bone marrow examination showed no evidence of leukemic involvement.

The study aims at the prediction of optimal cytoreduction (OCR) in patients undergoing interval cytoreduction (ICR) in advanced epithelial ovarian cancer (AEOC) based on CT imaging and CA 125 values and assessing the survival pattern of these patients after ICR. This is a prospective observational study of patients with stage III C ovarian cancer who underwent ICR in our institution after neoadjuvant chemotherapy (NACT). All consecutive patients operated from April 2016 to October 2017 were included in the study. From their medical records, their demographic details and clinical variables were recorded. The CA 125 value and CT scan findings before and after chemotherapy were documented. A Bristow’s predictive score (BS) was calculated based on the radiological parameters. After ICR, the outcome of the surgery was documented. Optimal cytoreduction (OCR) was defined as no gross residual disease after surgery. The surgical outcome was correlated with the CA 125 difference pre and post chemotherapy and Bristow’s predictive score pre and post chemotherapy. The patients were followed up and their survival at 6 and 12 months was assessed. Univariate and multivariate analysis was done to identify factors predicting OCR. 51 patients were included in the study. Age group of the women ranged from 31 to 74 years with a mean of 52 years. Majority of the patients (70.6%) were postmenopausal. Of the 51 women, OCR could be achieved in 31 patients (60.8%). Post-chemotherapy, 36 patients had elevated CA125 above baseline of which 50% attained OCR. Forty six patients had CA 125 response post chemotherapy of which 67.4% attained OCR. Forty five patients had reduction in Bristow Score compared to the pre chemo values of which 64.4% attained OCR which was not found to be statistically significant. Overall survival was 100% survival at 6 months and 92.8% at 12 months in those who achieved OCR. Those with residual disease 0.1–1 cm had survival of 74.1% at 6 and 12 months. Those with residual disease > 1 cm had a survival of 50% at 6 and 12 months. CA125 response has a significant role in predicting OCR while CT evaluation using the BS was not useful in predicting OCR during ICR for AEOC.

Atypical features of Posterior reversible encephalopathy syndrome (PRES) (diffusion restriction, involvement of corpus callosum & white matter tracts along posterior limbs of internal capsule) were seen in a patient after oxaliplatin administration (FOLFOX- 4 regimen). Findings were most obvious on diffusion weighted images, similar to acute methotrexate neurotoxicity, and resolved completely on follow up.

Lung cancer is one of the death threatening diseases among human beings. Early and accurate detection of lung cancer can increase the survival rate from lung cancer. Computed Tomography (CT) images are commonly used for detecting the lung cancer. Nowadays the lung cancer is staged according to the TNM staging method where T means Tumor, N means Nodule and M means Metastates. The existing lung cancer detection algorithms cannot stage cancer according to the TNM staging method. The proposed system can identify the T stage of the cancer accurately. The proposed system includes different stages such as preprocessing, segmentation, feature extraction, tumor detection and tumor stage identification. The proposed system promises better result than the existing systems, which would be beneficial for the radiologist for the accurate and early detection of cancer. The method has been tested on 200 slices of CT images of various stages of cancer obtained from Regional Cancer Centre Trivandrum and is found to give good results. The accuracy of the proposed method in this dataset is 94.4% General Terms Algorithms, Classification, Staging

Osmotic myelinolysis is an acute, rare, demyelinating process. After the initial description of the condition by Adam and colleagues in 1959, many case series have been published describing the central and extrapontine myelinolysis. Imaging has a definitive role in establishing the diagnosis of osmotic myelinolysis in vivo and diffusion-weighted imaging reveals earliest changes in affected brain parenchyma. We report two cases of patients with proven malignancy who developed extrapontine myelinolysis after treatment for hyponatremia and progressed to central pontine myelinolysis within a week. This was confirmed with magnetic resonance (MR) imaging and clinical assessment. This temporal progression of MR features, especially on diffusion-weighted imaging, from extrapontine to central pontine myelinolysis in osmotic injury has not been described in literature to the best of our knowledge. An early MRI of the brain in suspected/high-risk cases of osmotic myelinolysis may show features of extrapontine myelinolysis in the form of restricted diffusion in bilateral basal ganglia and may serve as a guide for predicting progression, prognosticating and deciding further treatment of pontine myelinolysis. We propose that in a significant number of cases, central pontine myelinolysis may be predicted by doing an early MRI of the brain with diffusion-weighted imaging, when extrapontine symptoms start to develop. This can potentially increase the window period and possibilities for therapeutic intervention and may even help in prevention.

Purpose Ultrasound (US) imaging is widely used for diagnosis these days due to its advantages such as no-radiation, portability and low cost. But the two inherent drawbacks of US imaging are low contrast and speckle noise. The objective of the proposed algorithm is to simultaneously enhance the contrast and suppress the speckle noise thereby improving the visual quality of the US image.

Primary testicular lymphoma (PTL) is an uncommon neoplasm (