Abstract Introduction Dysphagia is a frequent and clinically relevant complication after intracerebral haemorrhage (ICH) and is associated with increased morbidity and mortality. While radiologic severity and lesion characteristics are known to influence neurological outcome, their relationship with objectively measured dysphagia severity (DS) and swallowing management remains insufficiently defined. This study investigated the association between radiologic ICH burden and DS assessed by flexible endoscopic evaluation of swallowing (FEES), and examined the clinical impact of FEES-guided swallowing management in an neuro intensive care unit (ICU) cohort. Methods We conducted a retrospective analysis of consecutive ICH patients treated in neurological ICU who underwent standardized bedside dysphagia assessment, with FEES performed when clinically indicated and feasible. DS and functional oral intake were quantified using the Fiberoptic Endoscopic Dysphagia Severity Scale (FEDSS) and the Functional Oral Intake Scale (FOIS-G). Multivariable regression models adjusted for age and clinical severity were used to examine associations between radiologic parameters (hematoma volume, location, ICH score, intraventricular and subarachnoid haemorrhage) and dysphagia outcomes. Results Of 241 patients 120 (49.8%) were diagnosed with relevant dysphagia FEES was performed in 68 patients (28.2%) at a median of 13 days after admission. After FEES, the diet was modified in 67% of patients and the oral intake score improved from a median of one to four. Radiologic severity was independently associated with dysphagia outcomes: higher ICH score predicted lower odds of of favourable FOIS-G and FEDSS scores. Deep intracerebral haemorrhage, intraventricular haemorrhage and subarachnoid haemorrhage were associated with worse functional oral intake. FEES led to a modification of swallowing management in 67% of examined patients, most frequently allowing safer and more liberal oral intake compared with bedside assessment alone. Conclusion In ICU-treated patients with ICH, dysphagia is common and closely linked to radiologic severity and lesion characteristics. FEES frequently reveals clinically relevant discrepancies between bedside assessment and actual swallowing function and substantially influences swallowing management. Integrating radiologic risk stratification with FEES-guided decision-making may improve safety, nutrition, and rehabilitation planning in this high-risk population.
Structured reporting in knee MRI represents a transformative advancement in musculoskeletal radiology, promising enhanced clarity and consistency in evaluating the knee’s complex anatomy—menisci, ligaments, cartilage, and bone. This review article explores the foundations, evolution, and clinical applications of structured reporting, with a special focus on its role in knee MRI. Furthermore, we examine different studies highlighting the benefits of structured reporting, like improved clinician communication and support for emerging artificial intelligence (AI) tools, while also addressing challenges like balancing structure and a certain amount of narrative flexibility. Frameworks such as anatomical versus tissue-based approaches are explored, and insights into possible best practices are offered. The outlook is promising with AI-driven automation, natural language processing, and patient-centric innovations, driven by global standardization efforts from radiological societies. Structured reporting in knee MRI invites further exploration to unlock its full potential, ultimately leading to improved patient care.
Postmastectomy radiotherapy (PMRT) reduces locoregional recurrence and improves survival in high-risk breast cancer (BC), yet its real-world use remains variable. Population-based data on PMRT utilization and guideline adherence in Switzerland are lacking. We evaluated PMRT patterns, determinants, and adherence to ASCO-ASTRO-SSO recommendations among women with stage I–III BC over two time periods and interpreted findings in the context of the 2025 guideline. This retrospective, population-based study analyzed data from seven Swiss cancer registries, including Eastern Switzerland (2003–2005; n = 4,246), and from Eastern Switzerland alone (2015–2017; n = 976). Eligible patients were women aged ≥ 18 years with stage I–III invasive BC treated by simple mastectomy. PMRT use was examined across original ASCO-ASTRO-SSO-defined risk groups: low-risk (T1–2N0), intermediate-risk (T1–2N1, T3N0), and high-risk (T4 or N2–3). Multivariable regression identified clinicopathologic determinants of PMRT use. Trends in PMRT guideline adherence and regional nodal irradiation (RNI) were evaluated within the framework of evolving clinicobiologic risk paradigms. Overall survival (OS) was analyzed using Kaplan–Meier and Cox regression methods. Overall PMRT utilization remained low (25–30
Die arthroskopische Versorgung von TFCC-Läsionen bzw. die Stabilisierung des DRUG bietet ein differenziertes Spektrum von befundorientierten Verfahren. Diese umfassen zentrale Glättungen/Teilresektionen über periphere Kapselnähte bis zur fovealen Refixation und, bei irreparabler Schädigung, die anatomische Rekonstruktion der DRUG-stabilisierenden radioulnaren Bänder. Die Klassifikationen nach Palmer und Atzei sind im klinischen Alltag weit verbreitet und bieten eine strukturierende Diagnostik und Indikationsstellung, wobei die foveale Integrität als zentrales Kriterium für die DRUG-Stabilität gilt. Anamnese, klinische Untersuchung, Bildgebung und insbesondere die diagnostische Arthroskopie gewährleisten eine präzise Zuordnung, während standardisierte Nachbehandlungskonzepte und realistische Erwartungen das funktionelle Ergebnis sichern. Die Wahl des konkreten Verfahrens sollte verletzungsspezifisch, patientenbezogen und erfahrungsgeleitet erfolgen.
Pancreatic amphicrine-like carcinoma (ALC) is an exceptionally rare neoplasm characterized by simultaneous exocrine and endocrine differentiation within the same tumour cells. These tumours represent a diagnostic challenge because they must be distinguished from mixed neuroendocrine-non-neuroendocrine neoplasms (MiNENs), which consist of morphologically distinct tumour components. We report a case of pancreatic ALC with acinar differentiation harboring a KANK4::RAF1 fusion identified by comprehensive genomic profiling. Histologically, the tumour demonstrated acinar differentiation with expression of trypsin and BCL10 together with neuroendocrine differentiation characterized by synaptophysin and INSM1 expression within the same neoplastic population. Molecular analysis revealed a RAF1 rearrangement, a potentially actionable alteration previously described in a subset of pancreatic acinar carcinomas. The patient showed rapid disease progression despite systemic chemotherapy. Treatment with the MEK inhibitor trametinib was initiated based on the presence of a RAF1 fusion but was discontinued after 1 month because of toxicity, preventing assessment of therapeutic efficacy. This case expands the molecular spectrum of pancreatic ALC with acinar differentiation and highlights the importance of comprehensive molecular profiling in rare pancreatic neoplasms to identify potentially actionable genomic alterations.
