Multiple myeloma (MM) is a hematologic cancer characterized by clonal proliferation of plasma cells within the bone marrow. It is the most serious form of plasma cell dyscrasias, whose complications—hypercalcemia, renal failure, anemia, and lytic bone lesions—are severe and justify the therapeutic management. Imaging of bone lesions is a cardinal element in the diagnosis, staging, study of response to therapy, and prognostic evaluation of patients with MM. Historically, the skeletal radiographic workup (SRW), covering the entire axial skeleton, has been used to detect bone lesions. Over time, new imaging techniques that are more powerful than SRW have been evaluated. Low-dose and whole-body computed tomography (CT) supplants SRW for the detection of bone involvement, but is of limited value in assessing therapeutic response. Bone marrow MRI, initially studying the axial pelvic-spinal skeleton and more recently the whole body, is an attractive alternative. Beyond its non-irradiating character, its sensitivity for the detection of marrow damage, its capacity to evaluate the therapeutic response and its prognostic value has been demonstrated. This well-established technique has been incorporated into disease staging systems by many health systems and scientific authorities. Along with positron emission tomography (PET)-18 fluorodeoxyglucose CT, it constitutes the current imaging of choice for MM. This article illustrates the progress of the MRI technique over the past three decades and situates its role in the management of patients with MM.

Objective: To evaluate the ponticulus posticus according to the skeletal relationship found in strict lateral radiographs at the Centro Dental Docente of the Universidad Peruana Cayetano Heredia during the period 2015–2017, using the classification according to the degree of mineralization described by Selby and Steiner’s skeletal relationship classification. Material and methods: It was performed on digital strict lateral radiographs using a 20-inch screen using the SIDEXIS XG program, observing the degree of mineralization of the ponticulus posticus: without evidence of the bony spicule over the vertebral artery = absent bridge, when spicule formation and/or calcification was noted or evident in the middle of the bridge or incompletely = partial bridge, when the bony arch was evident finished visualizing = complete bridge and the classification of the skeletal relationship by measuring the ANB angle: Class I = 0–4°; Class II = >4° and Class III = <0°: the statistical analysis was done with the SPSS V program.22.0 for Windows using the Chi-square tests. Results: Of the 925 digital strict lateral radiographs evaluated, 283 radiographs were found to present ponticulus posticus and the highest frequency was found in the absent type (69.4%), the partial type (17.1%) and the complete type (13.5%). The ponticulus posticus was present in 25.1% of the female and 38.4% of the male. The skeletal relationship associated with ponticulus posticus was present in Class II (19.1%), Class I (10.4%) and Class III (1.1%). Conclusions: The ponticulus posticus is an anatomical variant present in 30.6% of cases. No statistically significant difference was found between the presence of ponticulus posticus and skeletal relationship or sex.

Objective: To evaluate the imaging features of spondyloarthritis on magnetic resonance imaging (MRI) of the sacroiliac (SI) joints in terms of topography (in thirds) and affected margin, since this aspect is rarely addressed in the literature. Methods: Cross-sectional study with MRI (1.5 T) evaluation of the SI in 16 patients with diagnosis of axial spondyloarthritis regarding the presence of acute (subchondral bone edema, enthesitis, synovitis and capsulitis) and chronic changes (erosions, subchondral bone sclerosis, bone bridging and fatty replacement), performed by two radiologists, blinded to clinical data. MRI findings were correlated with clinical data including age, disease duration, medications, HLA-B27, BASDAI, ASDAS-VHS and ASDAS-PCR, BASMI, BASFI, and mSASSS. Results: Bone edema pattern and erosions showed predominance in the upper third of SI (p = 0.050, p = 0.0014, respectively). There was a correlation between the time of disease and structural changes by affected third (p = 0.028-0.037), as well as the presence of bone bridges with BASMI (p = 0.028) and mSASSS (p = 0.014). Patients with osteitis of the lower third had higher ASDAS values (ESRV: p = 0.011 and CRP: p = 0.017). Conclusion: Chronic inflammatory changes and the pattern of bone edema predominated in the upper third of the SI, but there was also concomitant involvement of the middle or lower thirds of the joint. The localization of involvement in the upper third of the SI was insufficient to differentiate between degeneration and inflammation.

The optimized methodology and results of the new characterization in terms of dose and image quality of the X-ray system used in the main pediatric hemodynamics service in Chile are presented. In addition, scattered dose rate values at the operator’s eye level are reported for all acquisition modes available in different thicknesses of absorbent media and angiography. The characterization was performed according to the European DIMOND and SENTINEL protocols adapted to pediatric procedures. The air kerma at the entrance surface (ESAK) was measured and the image quality parameters signal-to-noise ratio (SNR) and a figure of merit (FOM) were calculated. The scattered dose rate was measured in personal dose equivalent units. The ESAK for fluoroscopic modes ranged from 0.2 to 35.6 μGy/image when passing from 4 to 20 cm of polymethyl methacrylate (PMMA). For the cine mode, these values ranged from 2.8 to 160.1 μGy/image. The values of the image quality parameters showed a correct system configuration, although abnormal values were observed in the medium fluoroscopic mode. As for the scattered dose rate at the level of the cardiologist’s eyes, the highest value is PMMA with a thickness of 20 cm, where the cine mode reached 9.41 mSv·h-1. The differences found from previous evaluations can be explained by the deterioration of the system and the change of one of the X-ray tubes.

Introduction: the presence of anti-CCP is an important prognostic tool for rheumatoid arthritis (RA), but its relationship with the activity of the disease and functional capacity is still being investigated. Objectives: to study the relationship between anti-CCP and the indices of disease activity, functional capacity and structural damage, by means of conventional radiography (CR) and magnetic resonance imaging (MRI), in stabilized RA. Methods: cross-sectional study of RA patients with one to 10 years of disease. The participants were subjected to clinical evaluation with anti-CCP screening. Disease activity was assessed by means of the Clinical Disease Activity Index (CDAI) and functional capacity by means of the Health Assessment Questionnaire (HAQ). CR was analyzed by the Sharp van der Heijde index (SmvH) and MRI by the Rheumatoid Arthritis Magnetic Resonance Image Scoring System (RAMRIS). Results: 56 patients were evaluated, with median (IIq) of 55 (47.5–60.0) years, 50 (89.3%) were female among whom 37 (66.1%) were positive for anti-CCP. The median (IIq) of CDAI, HAQ, SmvH and RAMRIS were 14.75 (5.42–24.97), 1.06 (0.28–1.75), 2 (0–8) and 15 (7–35), respectively. There was no association between anti-CCP and CDAI, HAQ, SmvH and RAMRIS. Conclusion: our results did not establish the association of anti-CCP with the severity of the disease. So far, we cannot corroborate the anti-CCP as a prognostic tool in RA established.

Colorectal cancer is the fourth leading cause of death worldwide and the fifth leading cause of cancer death in Colombia. Magnetic resonance imaging is the ideal modality for the evaluation of colorectal cancer, since it allows staging by determining invasion beyond the muscularis propria, extension towards adjacent organs, identification of patients who are candidates for chemotherapy or pre-surgical radiotherapy and planning of the surgical procedure. The key point is based on the differentiation between T2 and T3 stages through the use of sequences with high-resolution T2 information. In addition to this, it allows the assessment of the size and morphology of the lymph nodes, and considerably increases the specificity for the detection of lymph node involvement. MRI is a technique with high specificity and high reproducibility.