Faculty of Medicine
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Item type:Publication, THE ROLE OF МR SPECTROSCOPY AND CONTRAST ENHANCED MRI IN PROSTATE CANCER DIAGNOSIS(Macedonian Association of Anatomists and Morphologists, 2025-11-25); ; ; Bozhinovska, BiljanaIn patients with increased prostate-specific antigen, the next diagnostics tool is transrectal ultrasound-guided biopsy. The biopsy can cause pain, bleeding and infection. Multiparametric magnetic resonance imaging (mp MRI) as non-invasive diagnostics tool is used as a triage test to avoid biopsy, as well as to improve the diagnostics. The aim of this study was to examine the value of MR spectroscopy and dynamic post-contrast series in the diagnosis of prostate cancer. This cohort prospective study included 100 patients from CGH “September 8th” with increased levels of PSA. The MRI equipment used was Siemens Essenza 1,5T with body coil. The results obtained by MR spectroscopy analysis were correlated with the post-contrast series, whereby by mapping suspicious areas, patients underwent biopsy according to the PIRADS (prostate imaging and reporting data system) classification. Of the 100 patients, 96 were biopsied according to the PIRADS (prostate imaging and reporting data system) classification. The MRI results and pathohistological findings were then compared. On MR postcontrast series, a malignant lesion was detected in 52% of patients, in 33% of patients the lesion was suspicious for malignancy. On MR spectroscopy, a choline+creatinine/citrate ratio of 0.8 to 2 indicating a possible malignant lesion was confirmed in 33% of patients, this ratio was greater than 2 in 33% of patients, indicating a lesion highly suspicious for malignancy. MR spectroscopy combined with contrast enhanced MRI is a powerful tool for non-invasive differentiation of benign prostatic hyperplastic nodule and prostatitis from a malignant nodule. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Bone metastases – 10 years clinicopathologic experience(Springer, 2018-09); ; ; Background & Objective: Bones are the third most frequent site of metastases which are radiologically characterized as osteolytic, osteosclerotic and mixed. The aim of this study was to make clinicopathologic characterization of the patients with bone metastasis (BM) and to correlate osteoblastic and osteoclastic activity with the metastasis type. Method: We analyzed 80 patients with BM who underwent surgical therapy, for demographic data, radiological types, primary tumour, localization, pathological fracture and survival. Microscopically, we analyzed 10 high power fields of the densest metastatic deposition areas. We used semi-quantitative method to determine the density of bony trabeculae osteoblast rimming and the osteoclasts’ density in Howship’s lacunae, categorizing it as mild, moderate and high. Similarly, we determined the thickness of the trabeculae and osteoid. Results: There were 55 osteolytic, 11 osteosclerotic and 14 mixed metastases. The commonest primary site for osteolytic metastases was the mammary gland and for osteosclerotic was the prostate gland. The most affected bone was the femur. Pathological fracture was present in 49 patients. The mean survival time was 16,42 months. The density of osteoclasts was significantly higher in osteolytic metastases (p<0,01), the density of osteoblastic rimming was non-significantly higher in osteosclerotic metastases, and the bony trabeculae and osteoid were non-significantly thicker in osteosclerotic metastases. Mixed MS showed prevalence of one or other type of activity without significant difference. There was significant correlation between the radiological and histological findings (p<0,05). Conclusion: We found that the histological pattern of bone reaction correlates to the radiographical findings and the osteoclastic was the main activity in BM.