CT and MRI in Oncology

ISBN-13: 9783642468445 / Angielski / Miękka / 2012 / 413 str.

Didier Buthiau; David Khayat; S. Buthiau

Opis

Imaging techniques are often called upon in oncology in virtue of their essential role in tumor diagnosis, extension work up to various organs and detection of relapse. They are also indispensable in research and in clinical practice, allowing an objective assessment of tumoral regression in patients undergoing treatment. It is currently impossible to establish the management plan of a cancer patient or to obtain follow-up of such a patient under treatment without clinical and imaging confrontation.

Spis treści

Introduction: Cancer, internal medicine and new imaging.- 1 Principles and performance of CT and MRI.- CT: performance and techniques.- Performance of a CT examination.- Patient explanation and details.- Contraindications.- Patient preparation.- Performance of the examination.- Viewing of the images.- Acquisition techniques and parameters.- Scanogram or scout view.- Thickness and spacing of the slices.- Interstice delays.- Field of view.- Matrix.- Filters.- Continuous rotation and helical mode.- Image reconstructions.- MRI: performance and techniques.- Performance of MRI.- Types of magnet.- Resistive.- Superconducting.- Permanent.- Field strength.- Coils.- Types of sequence.- Spin echo.- Inversion recovery.- Gradient echo.- Opposed phase sequence (Dixon method or chemical shift).- Echoplanar imaging.- Other acquisition parameters.- Orientation of the scan plane.- Number of acquisitions.- Field of view.- Acquisition matrix (NX x NY).- Slice thickness.- Number of slices.- Acquisition time.- Gating.- 2 Contrast agents.- Iodinated contrast agents in CT.- Current data and applications in imaging.- General pharmacokinetics of uro-angiographic contrast agents.- Pharmacokinetics applicable to CT.- Bolus injection.- Injection by slow infusion.- Bolus infusion.- Intra-arterial injection.- Other applications.- Future prospects.- Safety and tolerance.- Iodine concentration imaging.- Contrast agents in MRI.- Current data and applications in imaging.- Classification of MRI contrast agents.- Paramagnetic agents.- Superparamagnetic agents or magnetic susceptibility agents.- Products containing few or no protons, such as perfluorooctylbromide.- Products currently available for diagnostic clinical use.- The chelates of gadolinium, markers of the extracellular space.- Superparamagnetic agents.- Future prospects.- Tissue specific agents.- Fast bolus tracking.- 3 Malignant intracerebral tumors.- Classification of intracranial tumors.- Presenting signs.- Imaging of intracranial tumors: general points.- CT.- Findings.- Differences between intra-axial and extra-axial tumors.- MRI.- Normal appearances.- MRI contrast agents.- Performance of MRI for intracranial tumors.- Findings specific to MRI.- Tumor localization.- Supratentorial tumors.- Intra-axial tumors.- Gliomas.- Cerebral metastases.- Lymphoma.- Pinealoma.- Extra-axial tumors.- Meningioma.- Dural metastases.- Congenital intracranial tumors.- Tumors of the sellar region.- Bony tumors.- Tumors of otorhinolaryngological origin.- Infratentorial tumors.- Infratentorial tumors in children.- Infratentorial tumors in adults.- Pretreatment assessment and management.- Follow-up and post-treatment appearances of intra-axial tumors.- 4 Tumors associated with the neurodermatoses.- Neurofibromatosis.- Neurofibromas.- Neurinomas.- Glial tumors.- Hemispheric gliomas.- Gliomas of the optic pathways.- Meningo-encephalic gliosis.- Gliomas of the spinal cord.- Hamartomas.- Meningiomas.- Other lesions.- Tuberous sclerosis of Bourneville.- Intracerebral tumors.- Subependymal nodules.- Pigmented neurodermatoses.- Basal cell nevomatoses (Gorlin’s syndrome).- Angiomatous neurodermatoses.- von Hippel-Lindau syndrome.- Intracranial hemangioblastomas.- Hemangioblastomas of the spinal cord.- 5 Tumors of the optic nerve, eye and orbit.- Clinical signs.- Techniques of investigation.- Classification of orbital tumors.- Orbital tumors in children.- Rhabdomyosarcoma.- Optic nerve glioma.- Teratoma.- Meningioma.- Dermoid cyst.- Meningoencephalocele.- Retinoblastoma.- Rare orbital tumors of childhood.- Orbital tumors of adults.- Vascular tumors.- Cavernous hemangioma.- Orbital varices.- Orbital arterio-venous fistulae.- Rare vascular tumors.- Meningeal or nerve tumors.- Meningioma.- Tumors of hematological origin.- Tumors of the lacrymal gland.- Rare primary orbital tumors.- Secondary orbital tumors by direct spread.- Secondary metastatic orbital tumors.- 6 Malignant sellar, parasellar and skull base tumors.- Diagnosis of an anterior pituitary tumor.- Pituitary adenomas.- Diagnosis of microadenomas.- Diagnosis of macroadenomas.- Other lesions.- Metastases.- Multiple endocrine neoplasia.- Lymphoma.- Granulomas and infiltrative lesions.- Pseudotumors and hypophyseal hyperplasia.- Diagnosis of a tumor of the pituitary stalk and/or posterior pituitary.- Tumors of the hypothalamo-hypophyseal axis.- Primary tumors of the neurohypophysis and infundibulum.- Diagnosis of a juxtasellar tumor: supra-, latero-, infra- and/or retrosellar.- Lesions of the cavernous sinuses.- Parasellar tumors.- Craniopharyngiomas.- Meningiomas of the sellar region.- Meningoangiomatosis.- Gliomas of the sellar region.- Hypothalamic hamartomas, lipomas of the tuber cinereum, epidermoid cysts.- Other parasellar tumors.- Cystic lesions.- Mucocele of the sphenoid sinus.- Diagnosis of a skull base tumor.- Assessment of extent.- Assessment of etiology.- Chordomas.- Cartilaginous tumors.- Invasive pituitary adenomas.- Meningiomas.- Metastases.- Nasopharyngeal tumors.- Benign sino-nasal tumors.- Other tumors.- Fibrous dysplasia.- 7 Malignant tumors of the spine and spinal cord.- Spinal tumors.- Benign vertebral tumors.- Primary malignant tumors.- Osteosarcoma.- Chondrosarcoma.- Ewing’s sarcoma.- Clear cell sarcomas, fibrosarcomas.- Tumors of embryonic origin.- Neuroblastomas.- Chordomas.- Sacrococcygeal teratoma.- Secondary vertebral tumors.- Spinal metastases.- Myeloma.- Lymphoma and leukemia.- Intraspinal tumors.- Epidural tumors, carcinomatous epiduritis.- Intradural extramedullary tumors.- Meningiomas.- Neurinomas.- Intradural metastases or “drop metastases”.- Lipomas.- Other intradural extramedullary tumors.- Intramedullary tumors.- Ependymomas.- Astrocytomas.- Hemangioblastoma.- Intramedullary metastases.- Post-treatment appearances.- 8 Imaging of malignant head and neck tumors (cervico-facial).- Ultrasound.- CT.- MRI.- 9 Cancer of the pharynx and larynx.- Review of anatomy.- Techniques for examination of the pharyngo-larynx.- CT.- MRI.- Cancers of the endolarynx.- Pathological anatomy.- Supraglottic lesions.- Glottic tumors.- Subglottic lesions.- Lesions of the hypopharynx.- 10 Cancer of the oropharynx and buccal cavity.- Review of anatomy.- Clinical features.- Oropharynx.- Buccal cavity.- Imaging techniques.- CT.- MRI.- Advantages and disadvantages of the two techniques.- Follow-up and detection of recurrences.- 11 Cancer of the nasopharynx.- Review of anatomy.- Clinical features.- Imaging techniques.- CT.- MRI.- 12 Cancer of the paranasal sinuses.- Clinical features.- Carcinomas.- Imaging techniques.- 13 Malignant tumors of the salivary glands.- Clinical and anatamopathological review.- Parotid gland.- Submandibular glands.- Accessory salivary glands.- Imaging techniques.- Ultrasound.- Sialography.- CT.- MRI.- 14 Cancer of the thyroid and parathyroid glands.- Cancer of the thyroid.- Indications for CT and MRI.- Signs.- Cancer of the parathyroid glands.- Indications for CT and MRI.- Signs.- 15 Breast cancer.- Applications of CT and MRI.- CT.- MRI.- Signs.- CT.- MRI.- 16 Bronchopulmonary cancer.- Diagnosis and pretherapeutic assessment of bronchial cancers.- Indications for CT and MRI.- Signs.- Small-cell cancers.- Other tumors.- Post-therapeutic appearances.- Post-operative.- Post-radiotherapy.- 17 Pulmonary metastases.- Indications for CT and MRI.- CT.- MRI.- Signs.- Pulmonary nodules.- Cavitating lesions.- 18 Mediastinal tumors.- 19 Malignant tumors of the pleura,..- Focal pleural thickening.- Focal fibrous tumor.- Liposarcoma.- Spread of a bronchial carcinoma.- Diffuse pleural thickening.- Malignant mesothelioma.- Pleural metastases.- Lymphoma.- 20 Malignant tumors of the chest wall.- Primary tumors of the sternum and ribs.- Malignant sternal tumors.- Rib tumors.- Soft tissue tumors.- Secondary and hematological tumors.- Chest wall metastases.- Hematological tumors.- Myeloma.- Hodgkin’s and non-Hodgkin’s lymphoma.- Chest wall invasion by an adjacent malignant lesion.- Bronchial cancer.- Breast cancer.- Pleural tumors.- Tumors of the diaphragm.- 21 Tumors of the trachea.- CT.- MRI.- Specific properties of each tumor.- Carcinomas.- Adenomas.- Other malignant tumors.- Secondary tumors.- Tracheal spread from an adjacent tumor.- 22 Tumors of the heart and great vessels.- Indications for CT and MRI.- Signs.- Technique.- CT and MRI.- Heart.- Great vessels.- 23 Tumors of the liver.- Review of anatomy.- Malignant hepatic tumors.- Hepatic metastases.- The role of imaging in the investigation of hepatic metastases.- Signs.- Primary cancer of the liver.- Hepatocellular carcinoma.- Other types of primary liver cancer.- Indications and signs.- Hepatic lymphoma.- Future prospects of helical CT.- 24 Tumors of the biliary system.- Cancer of the gallbladder.- Indications for CT and MRI.- Signs.- Gallbladder metastases.- Cholangiocarcinoma of the extrahepatic bile duct.- Indications for CT and MRI.- Signs.- Cholangiocellular carcinoma.- Indications for CT and MRI.- Signs.- 25 Cancer of the esophagus.- Indications for CT and MRI.- CT.- MRI.- Signs.- CT.- MRI.- 26 Tumors of the gastrointestinal tract (excluding esophagus): cancer of the stomach, duodenum, small bowel, colon, rectum and anus.- Indications for CT and MRI.- CT.- MRI.- Other investigations.- Anatomy of the digestive tract on CT.- Radiological signs according to the pathology.- Adenocarcinomas of the GIT.- Stomach.- Duodenum and small intestine.- Colon and rectum.- Anus.- Bowel wall tumors.- Lymphomas.- Involvement of the GIT in other malignant hematological conditions.- Kaposi’s sarcoma.- Connective tissue tumors.- Carcinoid tumors.- Mucocele of the appendix.- Iatrogenic complications.- 27 Primary retroperitoneal tumors.- Indications and signs for CT and MRI.- CT.- Positive diagnosis.- Diagnosis of spread.- Diagnosis of the nature of the tumor.- MRI.- 28 Malignant retroperitoneal fibrosis.- Indications for CT and MRI.- CT.- MRI.- Signs.- CT.- MRI.- 29 Cancer of the pancreas.- Indications and signs of CT and MRI.- Ductal or canalicular adenocarcinoma.- CT.- MRI.- Cystic tumors.- Endocrine tumors.- Other rare tumors.- Lymphoma.- Solid papillary epithelial tumor.- Others.- 30 Cancer of the kidney.- Review of anatomopathology and prognostic factors.- Malignant tumors.- Renal adenocarcinoma or renal cell carcinoma.- Histopathology and prognostic factors.- Other malignant tumors.- Benign tumors.- Clinical features.- Imaging.- Indications for CT, MRI and other imaging techniques.- Intravenous urography.- Abdominal ultrasound.- CT.- MRI.- Angiography.- Bone scintigraphy.- Signs.- Characterization of renal tumors (renal adenocarcinoma).- Tumor spread.- Follow-up.- Other primary tumors of the kidney.- 31 Malignant tumors of the adrenal glands.- Hypersecreting lesions.- Bilateral adrenal hypertrophy of extrapituitary origin.- Malignant cortical adrenalomas.- Indications for CT and MRI.- Signs.- Malignant pheochromocytomas.- Indications for CT and MRI.- Signs.- Non-secreting lesions.- Adrenal metastases and the diagnostic problem of differentiation from a benign non-secreting adenoma.- Adrenal lymphoma.- Non-secreting pheochromocytoma.- Neuroblastoma.- 32 Cancer of the bladder.- Diagnosis and staging of bladder cancers.- Indications for CT and MRI.- Signs.- CT.- MRI.- Bladder involvement by other pelvic tumors.- Post-treatment follow-up.- Indications.- Signs.- CT.- MRI.- 33 Cancer of the uterine cervix.- Pre-invasive stage of cancer of the cervix.- Invasive cancer of the cervix.- Role of CT and MRI.- Signs.- Clinical investigations.- Diagnostic surgical investigations.- Positive diagnosis and staging.- 34 Cancer of the endometrium.- Positive diagnosis;The importance of early detection.- Diagnosis of spread.- Myometrial invasion.- Spread to the uterine cervix.- Applications of CT and MRI.- Conventional radiography.- Ultrasound.- CT.- MRI.- Signs.- CT.- MRI.- Patient management in practice.- Role of imaging in the diagnosis.- Role of imaging in treatment management.- 35 Cancer of the ovary.- Diagnosis of ovarian cancers.- Applications of CT and MRI.- Specific CT and MRI features of the different types of ovarian tumors.- Epithelial tumors.- Tumors of the mesenchyme and sexual cords.- Germinal tumors.- Secondary tumors of the ovary.- Differential diagnosis.- Value of the new techniques.- Assessment and follow-up of ovarian cancers.- Applications of CT and MRI.- CT and MRI signs.- Other methods of investigation.- Investigations to be performed.- 36 Cancer of the prostate.- Indications for CT and MRI.- CT.- MRI.- Signs.- CT.- MRI.- 37 Testicular tumors.- Indications for CT and MRI.- Initial staging.- Follow-up.- Evaluation of residual masses post-chemotherapy.- Signs.- 38 Hodgkin’s disease and non-Hodgkin’s lymphomas.- Lymphoma of lymph nodes and spleen.- Assessment of abdominal lymph node involvement.- Diagnosis.- Initial staging.- Assessment of splenic involvement.- CT.- MRI.- Assessment of mediastinal lymph node involvement.- CT.- MRI.- Assessment of cervical and peripheral lymph node involvement.- CT.- MRI.- Extranodal lymphomatous involvement.- Assessment of lesions of the central nervous system.- Intracranial lesions.- Meningeal involvement.- Hepatic involvement.- CT.- MRI.- Thoracic involvement.- CT.- MRI.- Other extranodal sites.- Assessment of the therapeutic response, follow-up and detection of recurrence.- Follow-up of lymphatic involvement.- Residual mediastinal masses.- 39 Malignant melanoma.- 40 Investigation of metastases from an unknown primary.- Diagnosis of metastatic disease.- Search for the primary tumor.- Cervical lymph node involvement (excluding the supraclavicular nodes).- Axillary lymph node involvement.- Inguinal lymph node involvement.- Supraclavicular lymph node involvement.- Involvement of the midline lymph nodes (mediastinal and/or retroperitoneal).- Intrathoracic metastases.- Solitary pulmonary nodule.- Multiple pulmonary nodules.- Lymphangitis carcinomatosa.- Pleural effusion.- Abdominal metastases.- Hepatic metastases.- Peritoneal carcinomatosis.- Bone metastases.- Cerebral metastases.- Cutaneous metastases.- 41 CT and MRI in radiotherapy.- CT and radiotherapy.- Techniques used.- Treatment assessment.- Simulation.- CT planning.- Data acquisition.- Transfer of data.- Number and position of slices.- Calculation of density.- MRI and radiotherapy.- 42 Interventional CT in oncology.- CT guided percutaneous biopsies.- Indications.- Contraindications.- Technique.- Results.- Complications.- Percutaneous neurolysis of the celiac plexus and splanchnic nerves.- Indications.- Technique.- Results.- Complications.- Other interventional procedures.- 43 Primary malignant tumors of bone and soft tissues.- Primary malignant bone tumors.- CT.- Osteomedullary involvement.- Soft tissue lesions.- Pitfalls and limitations.- MRI.- Osteomedullary tumor spread.- Soft tissue lesions.- Pitfalls and limitations.- Histological types.- Osteosarcoma.- Ewing’s sarcoma.- Chondrosarcoma.- Miscellaneous forms: Fibrosarcoma, malignant fibrous histiocytoma, giant cell sarcoma.- Chordoma.- Adamantinoma.- Preoperative management.- In bone sarcomas of high grade malignancy.- In bone sarcomas of low grade malignancy.- Follow-up.- CT.- MRI.- Strategy.- Malignant tumors of the soft tissues.- CT.- MRI.- Respective roles of the two examinations.- Findings specific to histological type.- Malignant fibrous histiocytoma.- Liposarcoma.- Synovial sarcoma (malignant synovioma).- Fibrosarcoma.- Rhabdomyosarcoma.- Leiomyosarcoma.- Myositis ossificans circumscripta.- Desmoid fibroma.- Management strategy.- Small volume tumors.- Large subaponeurotic tumors.- 44 Progress in helical CT in oncology.- Virtual endoscopy in oncology.- Methods.- Potential clinical applications.- Pulmonary disease.- Virtual tracheobronchial endoscopy.- Endothoracic virtual imaging.- ENT virtual endoscopy.- Digestive virtual endoscopy.- Urological virtual endoscopy.- Clinical measurement of volumes with the helical scanner.- Acquisition techniques.- Reconstruction technique.- Results.- Discussion.- 45 Progress in MR imaging in oncology.- MR angiography in oncologic patients: clinical uses.- Neoplasm of the central nervous system.- Extradural tumors - Dural sinus involvement and meningiomas.- Brain tumors.- Glomus tumors.- Lung neoplasms.- Vascular involvement.- Dynamic MR assessment of mediastinal lymph node involvement.- Hepatic neoplasm.- Characterization of hepatic lesions.- CT vs MR arterial portography (CTAP vs MRAP).- Venous involvement in kidney neoplasms.- Uterine masses.- Musculoskeletal neoplasms.- Other applications.- MR cholangio-pancreatography.- MR cholangiography.- Artefacts and limitations.- Value of MR cholangiography in cases of neoplastic pancreatico-biliary obstruction.