Spiradenocarcinoma is a rare dermal adnexal malignancy often arising from a pre-existing benign spiradenoma and may occur sporadically or in the setting of the autosomal dominant genodermatosis Brooke–Spiegler Syndrome (BSS). Imaging descriptions of spiradenoma and spiradenocarcinoma are scant, with no literature to date describing comparative imaging features of benign and malignant tumors to the best of our knowledge. We report a case of a 64-year-old patient with a rapidly enlarging right frontal scalp mass and a relatively indolent left parietal scalp mass in addition to innumerable small head and neck nodules. MRI for preoperative planning demonstrated heterogeneous enhancement and markedly reduced diffusion in both lesions, while 18F-FDG PET-CT showed marked FDG avidity (SUVmax = 16.3) in the frontal mass but mild uptake in the parietal mass (SUVmax = 2.1). Histopathology confirmed the frontal mass to be a low-grade spiradenocarcinoma and the left parietal lesion a benign spiradenoma. Genetic testing confirmed BSS. This case illustrates the clinical-radiologic-pathologic correlation of spiradenocarcinoma in the context of BSS, a rare clinical and radiologic mimic of NF1, and highlights that rapid growth and FDG avidity may help the reporting radiologist to differentiate spiradenocarcinoma from spiradenoma in patients with BSS.
GE has recently developed Sonic DL MRI acceleration technology. We wished to (1) quantify scanner time reduction compared to the AIR Recon DL already in clinical use at our institution and (2) preliminarily evaluate any change in diagnostic findings between these methods. A total of 30 outpatients undergoing routine shoulder MRI for shoulder pain were recruited. Each underwent routine AIR Recon DL and Sonic DL exams containing the same sequences. Three subspecialized musculoskeletal radiologists assessed image quality, graded pathology, and reported diagnostic confidence in a blinded fashion. Differences in image quality and confidence were compared using Wilcoxon signed-rank tests. Sonic DL reduced nominal acquisition time 38.7
To quantify documentation of predefined, conspicuous sacroiliac joint (SIJ) structural abnormalities on routine abdominal CT in patients with established axial spondyloarthritis (axSpA) and identify associated factors. This retrospective longitudinal study evaluated 516 abdominal CT examinations from 188 patients with established SpA. Two readers applied a predefined hierarchical SIJ classification, with adjudication of disagreements. The primary analysis included 226 Moderate or Major examinations; all had fusion-based patterns. Patient-clustered logistic generalized estimating equations included workflow, request-level context, structural severity, prior recognition, and scan year. SIJ findings were absent from 152 of 226 reports (67.3
Standard osteoporosis assessment using dual-energy X-ray absorptiometry (DXA) provides limited 2D measures (BMD, T-score), potentially missing localized bone density differences relevant to fracture risk. Opportunistic CT allows comprehensive 3D volumetric bone density analysis. This study presents a detailed 3D statistical model of CT-derived apparent volumetric bone mineral density (CT-vBMD) covering the L4 and L5 vertebrae, pelvic bones, sacrum, and proximal femur and examines spatial distributions and associations with age and sex. Retrospective analysis included 330 routine abdominal CT scans (ages 20–91; approximately balanced by sex). Bones were segmented with a semi-automated workflow, internally calibrated, registered to bone-specific population templates, and projected onto corresponding tetrahedral meshes. Whole-bone averages were compared across age groups and between sexes. For each element, we calculated mean vBMD, variability, correlations with age and sex, and cluster-defined low-density and age-sensitive subregions. The global spatial pattern was similar in females and males. The highest CT-vBMD values were localized mainly to cortical load-bearing zones, whereas the lowest values were concentrated in trabecular spongiosa. Older age was associated with lower whole-bone CT-vBMD in all bones and with stronger negative associations in trabecular-rich regions, such as the subchondral acetabulum, femoral neck, sacral ala, and vertebral bodies. Cortical-dominant load-bearing regions showed weaker negative associations with age. This framework maps anatomically localized associations between age and CT-vBMD beyond the regions routinely assessed by DXA. Opportunistic CT mapping may complement standard osteoporosis assessment by providing spatial information for the pelvis, sacrum, lower lumbar spine, and proximal femur.
Spinal osteosarcoma is rare and highly aggressive malignancy associated with poor clinical outcomes. To our knowledge, the perfusion MRI features of spinal osteosarcoma using T1-weighted DCE MRI, including plasma volume, permeability, and time-intensity analysis, have not previously been studied. In addition, changes in these features following radiation treatment have not yet been evaluated. We hypothesize that highly malignant spinal osteosarcoma demonstrates hypervascularity based on its pharmacokinetic perfusion parameters. We analyzed 27 patients (mean age 44.5, SD 21.8) of untreated metastatic Spinal osteosarcoma who underwent DCE-MRI. Perfusion parameters, including Ktrans and plasma volume (Vp) as an indicator of permeability and tumor vascularity respectively, were measured using the extended Tofts model. A subset of 12 patients underwent preradiation therapy (RT), 18F-FDG PET, and 7 patients had post-RT DCE-MRI for assessment of treatment effects. Additionally, time intensity curve analysis was conducted to evaluate post-treatment changes. Thirty-five lesions in 27 patients were evaluated. Perfusion characteristics including mean Ktrans and Vp were 0.323 and 3.54, respectively, indicating that metastatic Spinal osteosarcoma is hypervascular. In the 7 patients with post-RT DCE-MRI, the mean post-RT Vp decreased to 1.77 from a pre-RT mean of 3.28, reflecting a 46.04
