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Biomedical subjects

H Czembirek

Publications and source records attributed to H Czembirek.

133 records · Page 8Linked to original sources
PubMedDate not supplied

Locally advanced breast carcinoma: evaluation of mammography in the prediction of residual disease after induction chemotherapy.

BACKGROUND: We aimed to assess the mammographic features of locally advanced breast carcinoma treated with neoadjuvant chemotherapy and to evaluate morphological criteria that determine the value of mammography in therapy monitoring. MATERIALS AND METHODS: We reviewed the pre- and post-therapeutic mammograms of 44 patients with stage III-breast carcinoma with regard to tumor characteristics and malignant calcifications and compared to histopathological results. RESULTS: Delineation of the tumor proved to be the most significant criterion. In 34 tumors more than 50% of the lesion was defined; these showed a high correlation between the mammographically determined tumor diameter and that determined on histopathological examination (r = 0.77). Less than 50% of the mass was definable in 14 tumors; here the correlation between mammographically and histopathologically determined tumor diameter was low (r = -0.19). CONCLUSIONS: The diagnostic value of mammography in the evaluation of tumor response to induction chemotherapy depends primarily on the extent to which the tumor can be delineated from the adjacent breast tissue. For tumors whose margins can be defined by more than 50% on the baseline mammogram, the diagnostic reliability of mammography is high. Ill-defined masses should preferably be assessed with other imaging procedures such as ultrasonography or magnetic resonance imaging.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Osseous metastases in breast cancer: radiographic monitoring of therapeutic response.

BACKGROUND: Standard radiographs are primary means of evaluation of therapy-induced changes of the skeletal structure in patients with breast cancer metastatic to the bone, but objective quantitation has been difficult to standardize. MATERIALS AND METHODS: Serial radiographs of therapy-induced changes in the structure of bone metastases secondary to breast cancer were analyzed in 274 patients over a period of 10 years and roentgenologic signs of tumor response evaluated with regard to a defined principal metastasis. RESULTS: Indicators of regression were recalcification/reossification of primary osteolysis (11.6%), the formation of marginal sclerosis around the defect (13.5%) and lack of progression over a period of up to at least 12 months (10.5%). Reduction of sclerosis or structural loosening in primary osteosclerotic metastases (2.5%) may also be evidence of regression. Recurrence or progression of tumor was manifested by new metastases and/or increase in lesion size (56.9%) as well as development of lytic areas in primarily sclerotic or mixed metastases (2.5%). One hundred and one out of 157 patients with initially sclerotic or mixed metastases stayed stable or showed a response which lasted 12 months or longer. The duration of response in osteolytic lesions was less favourable. Irradiation and complex treatment (chemotherapy or hormonal therapy plus irradiation) was most often associated with a favourable objective response, 75%, which in 8 cases reflected nonprogression of disease, recalcification of primary osteolysis in 11 cases, the formation of marginal sclerosis around the defect in 8 lesions and disappearance of metastases in 1 case. CONCLUSION: Standard radiographs are useful in the serial evaluation of the effectiveness of therapy for osseous metastases in that anatomic quantitation of lesions as well as the dynamic evolution of lytic lesions to blastic healing may be observed

Adult↗
PubMedDate not supplied

Magnetic resonance imaging in the preoperative evaluation of suspected ovarian masses.

Meticulous pretreatment evaluation is basic to the successful management of suspected ovarian masses. Among currently available imaging techniques, sonography and computerized tomography are the most important diagnostic modalities. The purpose of our study was to determine whether magnetic resonance imaging provided additional information on masses in the true pelvis. 73 patients with masses in the true pelvis underwent preoperative magnetic resonance imaging. MRI was done with a 1.0 T supraconductive magnet (Magnetom Impact, Siemens). The results obtained were compared with sonographic (transabdominal and transvaginal), intraoperative and histopathologic findings. MR images were evaluated for their information on differentiation between benign and malignant neoplasm, tumor staging, lymph node involvement, peritoneal spread, local extension and organ relation. MRI correctly characterized malignant and benign tumors in 97% of cases versus 81% on ultrasound. The site of the primary tumor was correctly diagnosed in 94% of cases on MRI images versus 86% on ultrasound images. Invasion of adjacent intestinal segments as well as peritoneal carcinomatosis and omental metastases (metastasis > 1 cm) were also detected in the majority of cases. Based on our results MRI performs well at lesion detection and characterization in the evaluation of suspected ovarian masses. MRI should be considered in the investigation of patients with complicated findings on ultrasound.

Diagnosis, Differential↗
PubMedDate not supplied

Chronic lower back pain due to sarcoma.

We describe a 74-year-old woman with extensive pelvic leiomyosarcoma presenting with uncharacteristic musculoskeletal pain of the lumbosacral region and left lower extremity. Hemipelvectomy was considered the treatment of choice, and a model for a pelvic prosthesis was constructed based on imaging analysis. However, the tumour (and the complaints) responded surprisingly well to a combined treatment regimen including superselective arterial catheter embolization, which led to tumour regression to such a degree that aggressive surgical treatment became unnecessary.

Aged↗