Jacqueline Sitt - Academia.edu (original) (raw)

Papers by Jacqueline Sitt

Poster: "ECR 2013 / C-0592 / Approach to ultrasound of paediatric scrotal masses" by: &... more Poster: "ECR 2013 / C-0592 / Approach to ultrasound of paediatric scrotal masses" by: "J. C. M. Sitt, J. Abrigo, J. W. L. Yu, J. M. W. Mou, A. W. H. Chan, W. C. W. Chu; Hong Kong/CN"

Hong Kong Journal of Radiology, 2016

This pictorial review aimed to present the sonographic appearances of common scrotal masses in ch... more This pictorial review aimed to present the sonographic appearances of common scrotal masses in children, supplemented with pathological findings in operative cases. This review also provides a diagnostic algorithm to summarise the imaging features of common testicular and paratesticular mass lesions classified into painful and non-painful scrotal masses according to the clinical presentation.

Hong Kong Journal of Radiology, Jun 23, 2016

Objectives: To investigate the diagnostic performance of ultrasound-guided pleural biopsy, and di... more Objectives: To investigate the diagnostic performance of ultrasound-guided pleural biopsy, and discuss its clinical applications, limitations, and pitfalls. Methods: Clinical notes, pathological and microbiological reports, ultrasound and other imaging studies of 111 patients who underwent ultrasound-guided pleural biopsy from 1 January to 31 December 2014 were reviewed. The technique of the procedures was reviewed and correlated with the pathological yield of the specimens; any minor or major complications were identified. The application and usefulness of the biopsies in directing patient management were studied in view of the final patient outcome, which was determined by clinical and radiological follow-up of patients (range, 1-30 months). Results: A total of 127 biopsies were performed (left: 64, right: 63) in 111 patients (59 male and 52 female). The mean age of patients was 69 (range, 23-101) years. Overall 89% (n = 113) of biopsies were performed with an 18G Temno needle, with a mean number of 1.4 cores; 75% (n = 83) of biopsies yielded a histologically conclusive specimen. When combined with the results of pleural aspirate cytology (n = 21) and microbiological assessment of both the pleural biopsy and pleural aspirate (n = 11), which were all obtained at the same procedure, a definitive diagnosis was made in up to 90% of cases (n = 115). The final diagnosis of these patients included primary lung carcinoma (n = 23, majority adenocarcinoma), tuberculosis (n = 18), pleural metastases (n = 10), lymphoma (n = 1), chylothorax (n = 1), pyogenic infection (n = 6), undifferentiated inflammation (n = 20), and 'no significant abnormality / pathology detected' (n = 28). A minority of cases remained inconclusive (7%) and the diagnosis was made upon further clinical assessment, including bronchoscopy (bronchoalveolar lavage) [n = 1] and fineneedle aspiration of cervical lymph node (n = 2). For those with a diagnosis made by pleural aspirate cytology or culture, the provision of a pleural biopsy allowed further molecular tests (e.g. tuberculosis-polymerase chain reaction, tumour marker staining, or immunohistochemical tests / mutation detection) to be made to guide further patient management. Major complications (3.9%) included pneumothorax and hydropneumothorax requiring chest drain insertion (n = 3), transfusion (n = 1), and localised infection (n = 1). Conclusion: Ultrasound-guided pleural biopsy is a safe and useful procedure to help diagnose the aetiology of pleural effusions, in particular to obtain histological diagnoses for suspected tuberculosis and tumours, and to provide tissue for immunohistochemical testing in confirmed malignant conditions. Combination with pleural aspirate analysis and microbiological assessment is suggested to maximise its utility.

Hong Kong Journal of Radiology

We report on a young female renal transplant recipient on long-term cyclosporine A therapy who de... more We report on a young female renal transplant recipient on long-term cyclosporine A therapy who developed a giant fibroadenoma presenting as a rapidly enlarging solitary left axillary mass, with a background history of recurrent smaller fibroadenomas. A brief discussion of the clinical and imaging features, pathology, and treatment approaches follows with a short review of the literature. The importance of a multidisciplinary approach is also demonstrated.

European Radiology, 2016

To investigate the diagnostic performance of ultrasound-guided synovial biopsy. Clinical notes, p... more To investigate the diagnostic performance of ultrasound-guided synovial biopsy. Clinical notes, pathology and microbiology reports, ultrasound and other imaging studies of 100 patients who underwent 111 ultrasound-guided synovial biopsies were reviewed. Biopsies were compared with the final clinical diagnosis established after synovectomy (n = 43) or clinical/imaging follow-up (n = 57) (mean 30 months). Other than a single vasovagal episode, no complication of synovial biopsy was encountered. One hundred and seven (96 %) of the 111 biopsies yielded synovium histologically. Pathology ± microbiology findings for these 107 conclusive biopsies comprised synovial tumour (n = 30, 28 %), synovial infection (n = 18, 17 %), synovial inflammation (n = 45, 42 %), including gouty arthritis (n = 3), and no abnormality (n = 14, 13 %). The accuracy, sensitivity, and specificity of synovial biopsy was 99 %, 97 %, and 100 % for synovial tumour; 100 %, 100 %, and 100 % for native joint infection; and 78 %, 45 %, and 100 % for prosthetic joint infection. False-negative synovial biopsy did not seem to be related to antibiotic therapy. Ultrasound-guided Tru-cut synovial biopsy is a safe and reliable technique with a high diagnostic yield for diagnosing synovial tumour and also, most likely, for joint infection. Regarding joint infection, synovial biopsy of native joints seems to have a higher diagnostic yield than that for infected prosthetic joints. • Ultrasound-guided Tru-cut synovial biopsy has high accuracy (99 %) for diagnosing synovial tumour. • It has good accuracy, sensitivity, and high specificity for diagnosis of joint infection. • Synovial biopsy of native joints works better than biopsy of prosthetic joints. • A negative synovial biopsy culture from a native joint largely excludes septic arthritis. • Ultrasound-guided Tru-cut synovial biopsy is a safe and well-tolerated procedure.

The British journal of radiology, Jan 19, 2015

Ultrasound-guided needle biopsy of synovium is an increasingly performed procedure with a high di... more Ultrasound-guided needle biopsy of synovium is an increasingly performed procedure with a high diagnostic yield. In this review, we discuss the normal synovium, as well as the indications, technique, tissue handling and clinical applications of ultrasound-guided synovial biopsy.

Journal of Clinical Ultrasound, 2015

Ultrasound (US) is increasingly being used as the first-line imaging modality for investigating t... more Ultrasound (US) is increasingly being used as the first-line imaging modality for investigating the chest wall for soft tissue and bony lesions. This article describes the technique used for the US examination, the relevant chest-wall anatomy, and the appearances on US scanning of pathologic entities either unique to or common in the region of the chest wall. © 2015 Wiley Periodicals, Inc. J Clin Ultrasound, 2015.

This article provides an up-to-date overview of breast cancer mammography screening and briefly d... more This article provides an up-to-date overview of breast cancer mammography screening and briefly discusses its history, controversies, current guidelines, practices across Asia, and future directions. An emphasis is made on shared decision-making--instead of giving just a 'yes' or 'no' answer to patients, the focus should be on providing sufficient information about the pros and cons of screening to help women make a personal, informed choice. Frontline experts, including breast surgeons, oncologists, breast radiologists, and their representative professional associations should all participate in guideline panels, with the goal of improving cancer detection, reducing mortality, and improving patient outcome.

Stroke, 2015

Aneurysmal subarachnoid hemorrhage is a serious disease with high case fatality and morbidity. De... more Aneurysmal subarachnoid hemorrhage is a serious disease with high case fatality and morbidity. Delayed cerebral infarction (DCI) is an important surrogate marker. How location and infarct load affected outcomes was unclear. We aimed to assess the effects of load and location of DCI on outcomes of aneurysmal subarachnoid hemorrhage at 3 months. We prospectively enrolled patients with subarachnoid hemorrhage presenting to an academic neurosurgical unit in Hong Kong during a 3-year period. DCI was defined by new hypoattenuation on computed tomography at 4 to 6 weeks, which was not present in the postaneurysm-treatment computed tomography at 24 to 48 hours. DCI was assessed for location according to cerebral artery territories and load semiquantitatively. Cognitive and functional outcome assessments were carried out 3 months after ictus. One hundred twenty-six patients with subarachnoid hemorrhage consented for this study. DCI occurred in 56 (44%) patients and was associated with poorer cognitive and functional outcomes (Montreal Cognitive Assessment, Mini-Mental State Examination, modified Rankin Scale, and Lawton Instrumental Activity of Daily Living) at 3 months. In patients with DCI, the presence of perforator zone infarct was associated with poorer cognitive and functional outcomes, and cortical middle cerebral artery infarct was associated with poorer modified Rankin Scale. After adjustment for age, admission World Federation of Neurosurgical Societies Grade and mode of aneurysm treatment, both middle cerebral artery cortical infarct load and perforator infarct load were independently associated with poor cognitive outcomes (Montreal Cognitive Assessment and Mini-Mental State Examination) and modified Rankin Scale. Middle cerebral artery cortical and perforator zone infarct loads are potential surrogate marker to assess the severity of delayed cerebral ischemia.

Poster: "ECR 2013 / C-0592 / Approach to ultrasound of paediatric scrotal masses" by: &... more Poster: "ECR 2013 / C-0592 / Approach to ultrasound of paediatric scrotal masses" by: "J. C. M. Sitt, J. Abrigo, J. W. L. Yu, J. M. W. Mou, A. W. H. Chan, W. C. W. Chu; Hong Kong/CN"

Hong Kong Journal of Radiology, 2016

This pictorial review aimed to present the sonographic appearances of common scrotal masses in ch... more This pictorial review aimed to present the sonographic appearances of common scrotal masses in children, supplemented with pathological findings in operative cases. This review also provides a diagnostic algorithm to summarise the imaging features of common testicular and paratesticular mass lesions classified into painful and non-painful scrotal masses according to the clinical presentation.

Hong Kong Journal of Radiology, Jun 23, 2016

Objectives: To investigate the diagnostic performance of ultrasound-guided pleural biopsy, and di... more Objectives: To investigate the diagnostic performance of ultrasound-guided pleural biopsy, and discuss its clinical applications, limitations, and pitfalls. Methods: Clinical notes, pathological and microbiological reports, ultrasound and other imaging studies of 111 patients who underwent ultrasound-guided pleural biopsy from 1 January to 31 December 2014 were reviewed. The technique of the procedures was reviewed and correlated with the pathological yield of the specimens; any minor or major complications were identified. The application and usefulness of the biopsies in directing patient management were studied in view of the final patient outcome, which was determined by clinical and radiological follow-up of patients (range, 1-30 months). Results: A total of 127 biopsies were performed (left: 64, right: 63) in 111 patients (59 male and 52 female). The mean age of patients was 69 (range, 23-101) years. Overall 89% (n = 113) of biopsies were performed with an 18G Temno needle, with a mean number of 1.4 cores; 75% (n = 83) of biopsies yielded a histologically conclusive specimen. When combined with the results of pleural aspirate cytology (n = 21) and microbiological assessment of both the pleural biopsy and pleural aspirate (n = 11), which were all obtained at the same procedure, a definitive diagnosis was made in up to 90% of cases (n = 115). The final diagnosis of these patients included primary lung carcinoma (n = 23, majority adenocarcinoma), tuberculosis (n = 18), pleural metastases (n = 10), lymphoma (n = 1), chylothorax (n = 1), pyogenic infection (n = 6), undifferentiated inflammation (n = 20), and 'no significant abnormality / pathology detected' (n = 28). A minority of cases remained inconclusive (7%) and the diagnosis was made upon further clinical assessment, including bronchoscopy (bronchoalveolar lavage) [n = 1] and fineneedle aspiration of cervical lymph node (n = 2). For those with a diagnosis made by pleural aspirate cytology or culture, the provision of a pleural biopsy allowed further molecular tests (e.g. tuberculosis-polymerase chain reaction, tumour marker staining, or immunohistochemical tests / mutation detection) to be made to guide further patient management. Major complications (3.9%) included pneumothorax and hydropneumothorax requiring chest drain insertion (n = 3), transfusion (n = 1), and localised infection (n = 1). Conclusion: Ultrasound-guided pleural biopsy is a safe and useful procedure to help diagnose the aetiology of pleural effusions, in particular to obtain histological diagnoses for suspected tuberculosis and tumours, and to provide tissue for immunohistochemical testing in confirmed malignant conditions. Combination with pleural aspirate analysis and microbiological assessment is suggested to maximise its utility.

Hong Kong Journal of Radiology

We report on a young female renal transplant recipient on long-term cyclosporine A therapy who de... more We report on a young female renal transplant recipient on long-term cyclosporine A therapy who developed a giant fibroadenoma presenting as a rapidly enlarging solitary left axillary mass, with a background history of recurrent smaller fibroadenomas. A brief discussion of the clinical and imaging features, pathology, and treatment approaches follows with a short review of the literature. The importance of a multidisciplinary approach is also demonstrated.

European Radiology, 2016

To investigate the diagnostic performance of ultrasound-guided synovial biopsy. Clinical notes, p... more To investigate the diagnostic performance of ultrasound-guided synovial biopsy. Clinical notes, pathology and microbiology reports, ultrasound and other imaging studies of 100 patients who underwent 111 ultrasound-guided synovial biopsies were reviewed. Biopsies were compared with the final clinical diagnosis established after synovectomy (n = 43) or clinical/imaging follow-up (n = 57) (mean 30 months). Other than a single vasovagal episode, no complication of synovial biopsy was encountered. One hundred and seven (96 %) of the 111 biopsies yielded synovium histologically. Pathology ± microbiology findings for these 107 conclusive biopsies comprised synovial tumour (n = 30, 28 %), synovial infection (n = 18, 17 %), synovial inflammation (n = 45, 42 %), including gouty arthritis (n = 3), and no abnormality (n = 14, 13 %). The accuracy, sensitivity, and specificity of synovial biopsy was 99 %, 97 %, and 100 % for synovial tumour; 100 %, 100 %, and 100 % for native joint infection; and 78 %, 45 %, and 100 % for prosthetic joint infection. False-negative synovial biopsy did not seem to be related to antibiotic therapy. Ultrasound-guided Tru-cut synovial biopsy is a safe and reliable technique with a high diagnostic yield for diagnosing synovial tumour and also, most likely, for joint infection. Regarding joint infection, synovial biopsy of native joints seems to have a higher diagnostic yield than that for infected prosthetic joints. • Ultrasound-guided Tru-cut synovial biopsy has high accuracy (99 %) for diagnosing synovial tumour. • It has good accuracy, sensitivity, and high specificity for diagnosis of joint infection. • Synovial biopsy of native joints works better than biopsy of prosthetic joints. • A negative synovial biopsy culture from a native joint largely excludes septic arthritis. • Ultrasound-guided Tru-cut synovial biopsy is a safe and well-tolerated procedure.

The British journal of radiology, Jan 19, 2015

Ultrasound-guided needle biopsy of synovium is an increasingly performed procedure with a high di... more Ultrasound-guided needle biopsy of synovium is an increasingly performed procedure with a high diagnostic yield. In this review, we discuss the normal synovium, as well as the indications, technique, tissue handling and clinical applications of ultrasound-guided synovial biopsy.

Journal of Clinical Ultrasound, 2015

Ultrasound (US) is increasingly being used as the first-line imaging modality for investigating t... more Ultrasound (US) is increasingly being used as the first-line imaging modality for investigating the chest wall for soft tissue and bony lesions. This article describes the technique used for the US examination, the relevant chest-wall anatomy, and the appearances on US scanning of pathologic entities either unique to or common in the region of the chest wall. © 2015 Wiley Periodicals, Inc. J Clin Ultrasound, 2015.

This article provides an up-to-date overview of breast cancer mammography screening and briefly d... more This article provides an up-to-date overview of breast cancer mammography screening and briefly discusses its history, controversies, current guidelines, practices across Asia, and future directions. An emphasis is made on shared decision-making--instead of giving just a 'yes' or 'no' answer to patients, the focus should be on providing sufficient information about the pros and cons of screening to help women make a personal, informed choice. Frontline experts, including breast surgeons, oncologists, breast radiologists, and their representative professional associations should all participate in guideline panels, with the goal of improving cancer detection, reducing mortality, and improving patient outcome.

Stroke, 2015

Aneurysmal subarachnoid hemorrhage is a serious disease with high case fatality and morbidity. De... more Aneurysmal subarachnoid hemorrhage is a serious disease with high case fatality and morbidity. Delayed cerebral infarction (DCI) is an important surrogate marker. How location and infarct load affected outcomes was unclear. We aimed to assess the effects of load and location of DCI on outcomes of aneurysmal subarachnoid hemorrhage at 3 months. We prospectively enrolled patients with subarachnoid hemorrhage presenting to an academic neurosurgical unit in Hong Kong during a 3-year period. DCI was defined by new hypoattenuation on computed tomography at 4 to 6 weeks, which was not present in the postaneurysm-treatment computed tomography at 24 to 48 hours. DCI was assessed for location according to cerebral artery territories and load semiquantitatively. Cognitive and functional outcome assessments were carried out 3 months after ictus. One hundred twenty-six patients with subarachnoid hemorrhage consented for this study. DCI occurred in 56 (44%) patients and was associated with poorer cognitive and functional outcomes (Montreal Cognitive Assessment, Mini-Mental State Examination, modified Rankin Scale, and Lawton Instrumental Activity of Daily Living) at 3 months. In patients with DCI, the presence of perforator zone infarct was associated with poorer cognitive and functional outcomes, and cortical middle cerebral artery infarct was associated with poorer modified Rankin Scale. After adjustment for age, admission World Federation of Neurosurgical Societies Grade and mode of aneurysm treatment, both middle cerebral artery cortical infarct load and perforator infarct load were independently associated with poor cognitive outcomes (Montreal Cognitive Assessment and Mini-Mental State Examination) and modified Rankin Scale. Middle cerebral artery cortical and perforator zone infarct loads are potential surrogate marker to assess the severity of delayed cerebral ischemia.