Women at very high risk of breast cancer due to mutations in breast cancer susceptibility genes or a strong family history are recommended to undertake enhanced surveillance. Annual MRI, in addition to mammography, is the current recommendation, as mammography alone is considered insufficiently sensitive.    ...

Cancer is the leading cause of death worldwide and accounted for 7.6 million deaths in 2008 with primary lung cancer responsible for 1.37 million deaths alone [ 1 ]. There are an estimated 226,160 new cases of lung cancer in 2012 in the United States with approximately 160,340 deaths [ 2 ]....

Although evidence continues to mount that human papillomavirus (HPV)–associated squamous cell carcinoma of the head and neck represents a unique entity, with distinct clinical and molecular characteristics, the optimal management for the increasing proportion of patients diagnosed with this disease...

Molecular imaging of disease biomarkers, especially cancer biomarkers, could potentially improve our understanding of the disease and drug activity during preclinical and clinical drug treatment and patient stratification.1–4 For the preclinical setting, applications of molecular imaging are useful...

The preoperative diagnostic evaluation and staging of rectal cancer are important in terms of planning therapy and determining prognosis because therapeutic approaches and clinical outcomes in rectal cancer are strongly influenced by preoperative staging. In recent years, there has been an increase in...

Anatomical variations occurring during irradiation, including tumor shrinkage and shape deformation, can be significant and can result in suboptimal treatment of patients, especially when highly conformal treatment techniques, such as intensity modulated photon or proton therapy, are used [ ,]. Repeat...

In breast cancer treatment, the use of neoadjuvant systemic therapy is increasing with more effective chemotherapeutic regimes expanding therapeutic indications. Approximately 5%–10% of newly diagnosed breast cancer patients present with locally advanced ...

Recently, several studies have confirmed the advantages of delivering high doses of external beam radiotherapy (EBRT) to achieve optimal tumor-control outcomes in patients with localized prostate cancer. It is now clear that conventional EBRT doses in the range of 70 Gy are not sufficient to eradicate...

With 58.000 newly diagnosed cases every year in Germany, prostate cancer is the most common cancer of men in Germany. As the proportion of men older than 60 years is estimated to rise with the demographic shift up to 37% in 2050, prostate cancer will gain more and more epidemiological and economical...

Malignancies of the hepato-pancreatico-biliary (HPB) system are relatively common and generally characterized by a dismal prognosis. Positron emission tomography (PET) is a functional imaging technique that has emerged as an important modality in oncological decision-making. The principal radiopharmaceutical...

Abnormal spinal curvature may be idiopathic or secondary to dystrophic etiologies, such as congenital, traumatic, and malignant causes. Initial assessment and followup of patients with an abnormal spinal curvature have routinely been performed using plain radiographs . To evaluate dystrophic features,...

Renal cell carcinoma is a heterogeneous disease with a highly variable prognosis. Although numerous prognostic factors have been described, no single factor has been shown as a perfect indicator of prognosis. Outcome prediction models also known as prognostic...

Pain secondary to osseous metastases is a serious problem in many patients with stage IV cancer. There are several options for the treatment of painful bone metastases. Radiation therapy is an effective treatment, providing pain relief and reducing the need for narcotics and other analgesics to manage...

Surgery is the only potentially curative modality for patients with clinically localized and operable pancreatic cancer . Combined modality therapy compared to surgery alone has shown an advantage in terms of overall survival and should be considered for adjuvant treatment of resectable cancer...

Lynch syndrome is defined as the presence of a germline mutation in a DNA mismatch repair gene . Mutation carriers have increased risk for various malignancies, including carcinomas of the colorectum (CRC), endometrium, ovary, small bowel, stomach, biliary tract, bladder, ureter and renal pelvis ....

Malignant pleural mesothelioma (MPM) is an uncommon tumor characterized by locally aggressive behavior which leads to a fatal prognosis, but its incidence has increased in recent times within industrialized nations including Japan [–]. The optimal management of resectable MPM...

Cervical metastases from an unknown primary site (CUP) are an uncommon presentation of head and neck squamous cell carcinoma accounting for 2% to 4% of all cases. In the traditional diagnostic paradigm, when a primary tumor site is not readily identified on physical exam, computed tomography (CT) scan,...

Anatomical and molecular imaging tests have an integral role in clinical cancer management as they are used to accurately assess the phenotype of a given cancer based on the morphology and biological properties of the malignancies. Indeed, imaging tests are important tools in all facets of the cancer...

Thyroid carcinoma is the most common endocrine malignancy in the United States, with an estimated incidence of 56,460 in 2012 . Most cases are comprised of differentiated subtypes, specifically papillary and follicular thyroid cancer. Surgical resection by way of thyroidectomy is the mainstay of treatment...

To investigate the feasibility and safety of endoscopic submucosal dissection (ESD) of esophageal or gastric carcinomas under general anesthesia.
Subjects and Methods ESD removal of esophageal or gastric carcinomas was performed in 59 patients under midazolam sedation (control group), and in 46...

The development of three-dimensional conformal radiotherapy (3D-RT) has enabled the restriction of the dose to normal lung, limiting radiation-induced lung injury.
This study was designed to describe the time course of lung function until 7.5 months after 3D-RT in patients with lung cancer, and...

Among currently used cancer imaging methods, nuclear medicine modalities provide metabolic information, whereas modalities in radiology provide anatomical information. However, different modalities, having different acquisition times in separate machines, decrease the specificity and accuracy of images....

Of the nearly 300,000 cases of invasive and in situ breast cancers diagnosed in 2010 alone, 20–40% of these patients will experience a local recurrence (LR) and approximately half of those will have isolated recurrences . Optimal local control is noted to be important for patient outcomes. Local...

Colorectal cancer is the third most common malignancy in Europe, and the lung is the second most common site for metastatic disease, after the liver. Surgical resection is offered to patients with limited pulmonary metastases and no extrapulmonary disease with a reported...

Early gastric cancer (EGC) is defined as a cancer that does not invade beyond the submucosa regardless of lymph node involvement (T1, any N). Initiation of national cancer screening programs in Japan and Korea had increased the number of EGC cases dramatically, which accounts for up to 50% of all gastric...

Medical imaging is used routinely in oncology for diagnosis, staging and assessment of treatment response, but is less reliable for predicting response or for inferring prognosis before therapy has been instigated, such that the ability to stratify patients to different...

Colon cancer remains the third most common cancer diagnosis and is the second leading cause of cancer-related death in the US annually . Early detection through evidence-based screening protocols can lead to the identification of early disease . Initial screening for colon cancer can be grouped...

The utility of PET-computed tomography (CT) using F-fluoro-2-deoxy-D-glucose (FDG) has increasingly been studied during the last decades. Nowadays, FDG PET-CT has a major clinical impact not only for diagnosis but also for staging, response assessment, and relapse detection in cancer patients. However,...

Despite advances in treatment, lung cancer remains incurable in many patients because of its advanced stage at the time of diagnosis. Banning smoking would have the largest impact on lung cancer mortality, but even then the problem would persist for several decades,...

For women who have been treated for sporadic early stage breast cancer (BC), basic surveillance consisting of history, physical examination and mammography is supported by the American Society for Clinical Oncology.  In Australia, similar guidelines have been produced by the National Health and...

During the last three decades, PET imaging has developed into a valuable clinical procedure. Widespread availability and increased affordability of F-fluorodeoxyglucose (FDG) have played an important part in this process. FDG-PET is now an important tool in oncology patient management and drug development....

Although the potential anti-cancer effects of acquired bacterial infection have been evident for over 120 years and the presence of bacteria in excised tumors has been noted for over 60 years, it is only in more recent times that the tumor-specific growth of bacteria has been considered for therapeutic...

Positron emission tomography (PET) is a functional image modality that characterizes the different tissues of the body according to perfusion and metabolic activity. 18 F-fluoro-2-deoxy-D-glucose (FDG), a radioactively labeled glucose analogue, is utilized due to its capacity to emit positrons...

Nasopharyngeal carcinoma (NPC) is the most commonly diagnosed head and neck cancer in Southeast Asia. Most NPC patients present with nonmetastatic disease; however, 6% of cases are metastatic at initial diagnosis. The most common regions for distant metastasis in NPC include bone, lung, and liver. Although...

Neoadjuvant chemotherapy (NAC), also called preoperative or primary chemotherapy, is the administration of (combination of) anti-neoplastic drug(s) to treat non-metastasised invasive breast cancer before local treatment. When first introduced, NAC was mainly used for treatment...

New quantitative elastography technique of shear-wave elastography (SWE; Supersonic Imagine, Aix-en-Provence, France) is based on the combination of a radiation force induced in a tissue by an ultrasonic beam and an ultrafast (5,000 frames per s) acquisition sequence capable...

PROSTATE CANCER IS the fifth most common cancer in the world and the second most common in men . Numerous studies indicated approximately 65%–75% prostate cancer cases occur in the peripheral zone . Magnetic resonance (MR) imaging as a noninvasive tool plays an increasingly important role in the...

The most important determinant in reducing mortality from breast cancer is early detection through appropriate screening. However, less than half of women worldwide comply with screening guidelines at present, and the usual presentation of breast cancer is still a painless...

Histologic grading of breast cancer is liable to inter- and intra-observer variability and it has suboptimal reproducibility because of the subjective nature of the three components that constitute the grading system: nuclear pleomorphism, tubule formation and mitotic count. The usefulness of nuclear...

Real-time elastography (RTE), which is based on the principle that softer tissue structures can be compressed more than hard ones, is a new technique that can be used to visualize the tissue stiffness. Consistent with other cancers, it has been reported that carcinomas from...

Gastroenteropancreatic neuroendocrine tumours (GP-NETs), a heterogeneous family of tumours arising in variety of anatomic sites, are generally well differentiated and often metastatic at diagnosis. Morphologic and functional imaging modalities have vastly improved the understanding and diagnosis of NETs....

The meshwork of blood vessels within the tumour microenvironment is constituted in part by endothelial cells that proliferate as part of the recruitment of new vessels to the tumour. These cells are critical in response to both intracellular and extracellular signals that initiate neovascularization....

It is known that brown tumors can have increased FDG activity. Focal osseous FDG activity in patients with hyperthyroidism should raise the suspicion of brown tumor. In addition, SPECT images should be acquired along with planar image when hyperparathyroidism is accompanied with functional thyroid nodules....

Ovarian cancer is the leading cause of death from gynecologic malignancies. In 75% to 80% of cases, the diagnosis is late, and the surveillance is very low: when diagnosed, most patients is already at stage III to IV (according to the International Federation of Gynecology and Obstetrics), and despite...

Liver lesions are any abnormalities found in the liver, which is vital to human life . Among the many causes of liver lesions are malignant tumours or benign causes such as cysts, hepatic adenoma, infectious causes, haemangiomas or focal nodular hyperplasia. The majority of liver tumours...

Neoadjuvant chemoradiotherapy (CRT) has become an important component of the treatment for patients with locally advanced rectal cancer [, ]. A long-course of CRT followed by total mesorectal excision (TME) has been shown to reduce the prevalence for local tumour recurrence...

Several meta-analyses and randomized trials have demonstrated survival benefits of concurrent chemoradiotherapy for limited-stage small cell lung cancer (LS-SCLC) (–). One of the controversies among radiation oncologists is how to treat regional lymph nodes (LNs). Historically,...

Radial probe endobronchial ultrasound (EBUS) employs a flexible catheter housing an ultrasound transducer which produces a 360-degree ultrasound image, and was first applied to guide transbronchial biopsy (TBB) by Herth et al. in 2002. EBUS-guided TBB has an advantage over conventional bronchoscopic...

Computer-assisted quantification of biomarkers in biological tissue samples is becoming increasingly utilized , due to objectivity, repeatability and savings in human labor. Meanwhile, the use of whole slide scanning of pathological tissue glass slides is producing large image files up to hundreds of...

The dramatic improvement in the survival of patients with Ewing’s sarcoma during the past 2 decades can be attributed to the use of aggressive chemotherapy. In the absence of chemotherapy, this highly malignant tumor quickly metastasizes, even when adequate local control has been achieved. In patients...

Treatment of pain in patients with advanced pancreatic cancer is one of the most important goals of palliative care. It is estimated that pain occurs in 80–85% of patients with unresectable pancreatic tumors [, ]. Despite the improved effectiveness of pharmacotherapy, treatment of severe pain from...

F-fluorodeoxyglucose (FDG) positron emission tomography (PET) is now used for the imaging of various human cancers. This noninvasive technique that recognizes alterations in cellular glucose metabolism detects the presence of cancer cells by their increased glucose metabolism...

In radiotherapy (RT), target soft tissues are best defined on MR images. In several cases, CT imaging is needed only for dose calculation and generation of digitally reconstructed radiographs (DRRs). Image co-registration errors between MRI and CT can be avoided by using MRI-only based treatment planning,...

PROSTATE CANCER (PCA) is emerging as one of the most common forms of malignancy and one of the leading causes of cancer‐related deaths in men. There are two pressing needs that need to be addressed in the clinical management of PCA, namely, early detection of the cancer and identification of prognostic...

Lung cancer, with 80–85% being non-small-cell lung cancer (NSCLC), is the leading cause of cancer-related death in both men and women in the western world . In 2008, 215,020 new cases are expected and 161,840 persons are projected to die from the disease in the United States . Adequate therapeutic...

It is estimated that 20–40% of patients with systemic cancer will develop metastases. The incidence of metastatic tumour to the central nervous system is about 10 times that of primary brain tumours . Lung cancer is the most common malignancy in the world. Brain metastases...

Gastric cancer is the most common cancer in Korea . Although 5-year survival rates for gastric cancer have markedly increased recently, possibly due to an early diagnosis, advanced gastric cancer still carries a poor prognosis with high mortality rate . The only available curative therapy...

Over the past 6 decades, radiotherapy technology has advanced dramatically with significant improvements in clinical efficacy. These advancements have included the introduction of megavoltage beams, isocentric delivery techniques, customized cerrobend blocking, computerized tomography (CT)‐guided...

Lung cancer is the leading cause of cancer deaths worldwide. Despite the new advances in treatment and diagnosis the overall 5‐year survival rate is only 15%. This poor survival is related to the fact that most lung cancers are detected at advanced non‐surgical stages, when therapeutic options...

Pancreatic cancer is the fourth leading cause of cancer‐related death in the United States and is widely recognized as one of the most painful malignancies.   At time of diagnosis, the resectability rate is only 34%. Despite recent advances in medical and surgical therapies for pancreatic...

Indicators of breast cancer prognosis and response to therapy include patient age, tumour type, grade, size, lymph node status, oestrogen receptor (ER) status, and progesterone receptor (PR) status.   Hormone receptor status, which is particularly important for the selection of patients who...

Between 15 and 75% of patients with primary hyperparathyroidism (PHPT) have coexisting thyroid disease., It has been suggested that there is an association between PHPT and thyroid cancer, with an overall incidence of thyroid malignancy in patients with PHPT ranging 2-6%.,- It is controversial...

The development of modern imaging techniques has significantly altered the treatment and management of head and neck malignancies. Important treatment decisions that were once made intra-operatively are now made preoperatively by means of advanced imaging, i.e. computed tomography (CT) and magnetic resonance...

Changes in maximum standard uptake values (SUV) and computed tomography (CT) tumour size in FDG positron emission tomography (PET)/CT follow-up studies in oncologic patients are often assessed in tandem to determine disease progression or regression. RECIST criteria based on CT are most frequently...

Since 2005, combined positron emission tomography with computed tomography (PET-CT) has become an essential investigation for patients with potentially resectable esophageal cancer . Unlike staging investigations such as computed tomography (CT) alone and endoscopic ultrasound, PET-CT...

Interest in boosting the dose to the tumour during neo-adjuvant radiochemotherapy for rectal cancer is ever increasing, especially within the frame of adaptive radiotherapy. Rectal motion remains a potentially important obstacle to the full exploitation of this approach and needs to be carefully investigated....

Primary gastrointestinal (GI) lymphoma is very rare, constituting 1–4% of all malignancies that affect the GI tract. Stomach is the most common site to be involved (>50%) in GI lymphoma followed by small bowel (20–50%) and colon (4–6%). The majority of primary GI lymphomas are non‐Hodgkin...

Neoadjuvant chemotherapy (NAC) has been established as the standard-of-care treatment for locally advanced inoperable breast cancer, but it is increasingly being used for patients with operable cancer [, ]. It has been established that when patients can achieve pathologic complete response...

Leiomyosarcoma, or malignant smooth muscle tumor, is a common histology among retroperitoneal sarcomas. However, most of these are intramuscular in origin. Only about 5% of leiomyosarcomas arise directly from large blood vessels ; the vast majority of these from the inferior vena cava (IVC)...

Radiotherapy plays a major role in the treatment of non‐small cell lung cancer (NSCLC). Curative radiotherapy requires delivery of high doses of radiation to the lung cancer while limiting radiation dose to surrounding normal structures. To maximise the therapeutic ratio, accurate delineation of...

Ultrasonography is considered useful to distinguish between solid and cystic thyroid nodules and to stratify a nodule’s risk of cancer as low, medium, or high. Ultrasound (US) elastography has been applied to study the hardness/elasticity of nodules to differentiate malignant from benign lesions....

Use of magnetic resonance imaging (MRI) for investigation of breast disease is increasing. In certain scenarios MRI has been confirmed as superior to other diagnostic imaging modalities used in breast disease, mainly for screening in high risk (>20-30 % risk) young women....

FDG-PET may be considered in patients with colorectal cancer who have stage IV disease to assess the resectability of known metastasis and to identify additional sites of metastatic disease that may preclude operative management. In addition, FDG-PET has been used in patients with colorectal cancer concerning...

Lung cancer is the leading cause of cancer deaths in the United States, with more than 190,000 deaths per year. Nearly 60% of patients diagnosed with lung cancer die within 1 year of their diagnosis; nearly 75% die within 2 years with a 5-year survival less than 16%. Poor survival is largely because...

Medullary thyroid carcinoma (MTC) accounts for 5% to 10% of all thyroid carcinoma and occurs both as a familial and a sporadic disease [, ]. Total thyroidectomy with lymph node dissection is the primary treatment of both hereditary and sporadic MTC. After surgery, many patients...

Multidisciplinary treatment of locally advanced rectal cancer includes preoperative radiotherapy followed by radical rectal resection. In the United States, long-course radiotherapy with concurrent chemotherapy is a treatment standard that is associated with improved local control and significant effects...

Increasing doses for prostate cancer have been shown to be associated with improved biochemical control rates in several prospective randomized studies . However, rectal toxicity has also increased significantly. Rectal toxicity is known to be the dose-limiting toxicity in prostate cancer radiotherapy...

There might be some heterogeneity between trials. The risk for the low risk population (of patients with follicular lymphoma) was taken from the trial with the highest rates of survival at 5 years (GELF94 trial). The high risk rate is approximately the risk in the CUP-trial, for relapsed patients. No...

The use of radiotherapy (RT) in the treatment of head and neck (H&N) cancer has significantly improved over the last decade. Two-dimensional, conventional large fields have been extensively replaced by more sophisticated techniques, such as 3D conformal radiotherapy...

Breast physical examination, mammography and B-mode ultrasonography (USB) are the triad commonly used for characterization of breast masses and assessment of their risk for malignancy. The diagnostic confirmation of suspicious lesions is established by histopathological...

Gastric adenomas are benign epithelial neoplastic tumors with a glandular organization that are characterized by localized proliferation of adenomatous epithelium with tubular and/or papillary structures.   Non‐invasive carcinomas occasionally coexist within gastric adenomas and demonstrate...

The peritoneal cancer index (PCI) provides a measurement of the volume and extent of peritoneal tumor found at laparotomy. The PCI score combines the distribution of peritoneal tumor at 13 abdominal and pelvic regions with the tumor size. The PCI is the most widely validated and precise quantitative...

Colorectal cancer has been recognized as the second most common cause of cancer-related death in the United States, and it is known to progress through stages of low-grade dysplasia (both polypoid and flat) to high grade and ultimately to invasive carcinoma . Small, distal hyperplastic polyps traditionally...

Abstract  

The aim of this study is to clarify the prognostic value of the pathological overall tumor cellularity after neoadjuvant chemotherapy for locally advanced hypopharyngeal cancer.

Enhanced glycolysis is a common characteristic of many malignancies1 and has been studied in animals and humans with PET using fluorine‐18 (18F)‐fluoro‐deoxyglucose (18F‐FDG‐PET). As a glucose analogue, FDG travels via the blood stream, is transported into cells via specific...

The pooled 2-year clinical experience using three tomotherapy units installed in France in 2007 is presented. Treatment indications and protocols were devised for each disease site and were the result of a consensus. A total of 642 patients were treated for central nervous system, head and neck, thoracic,...

Imaging cervical cancer is largely restricted to morphological datasets with computerized tomography (CT) and magnetic resonance imaging (MRI). The 2010 guidelines from the European Society of Urogenital Radiologists currently recommend T2-weighted MRI for cervical cancer staging and follow-up with images...

Currently, resection is the only curative option available for patients with gastric cancer [1-4]. Accurate assessment of local tumor depth invasion (T), regional lymph node invasion (N), and distant metastases (M) is crucial to appropriate surgical and treatment planning [1, 2, 5]. Understaging...

Purpose of review To present the recent advances in imaging for diagnosis, staging, and follow-up of bladder cancer.Recent findings The use of multidetector 64-slice computed tomography (CT) and diffusion-weighted imaging has enabled higher-resolution imaging of bladder cancer on CT and MRI, respectively,...

What do the latest data show about the effectiveness of screening for breast and lung cancers?

 Laparoscopic gastrectomy with lymph node dissection, such as laparoscopy-assisted distal gastrectomy (LADG), has been widely accepted as the treatment for early gastric cancer with the risk of lymph node metastasis, especially in Asia since 1991.

A round-up of recently published studies on how imaging techniques can contribute to the management of hepatocellular carcinoma.

Listen to Dr Nick Perry of the London Breast Institute report on 11 years of experience with digital mammography in this audio interview conducted exclusively for GetInsideHealth on 23 March 2011.

Background and Objective The current standard for diagnosis of skin cancers is visual inspection followed by biopsy and histopathology. This process can be invasive, subjective, time consuming, and costly. Optical techniques, including Optical Coherence Tomography (OCT) and Raman Spectroscopy (RS), have been developed to perform non-invasive characterization of skin lesions based on either morphological or biochemical features of disease. The objective of this work is to report a clinical instrument capable of both morphological and biochemical characterization of skin cancers with RS-OCT.

Purpose   The ability of PET to aid in the diagnosis and management of recurrent and/or disseminated metastatic prostate cancer may be enhanced by the development of novel prognostic imaging probes. Accumulating experimental evidence indicates that overexpression of integrin α₂β₁ may correlate with progression in human prostate cancer. In this study, ⁶⁴Cu-labeled integrin α₂β₁-targeted PET probes were designed and evaluated for the imaging of prostate cancer.

Abstract

Purpose To demonstrate dynamic imaging of a diffusible perfusion tracer, hyperpolarized [¹³C]urea, for regional measurement of blood flow in preclinical cancer models.

Abstarct

Background Cervical carcinoma is the only gynecological tumor still being staged mainly by clinical examination and only a limited use of diagnostic radiology. Cross sectional imaging is increasingly used as an aid in the staging procedure. We wanted to assess the impact of magnetic resonance imaging (MRI) in addition to the clinical staging of patients with carcinoma of the uterine cervix.

Abstarct

Background   Primary malignant neoplasms of the small bowel comprise only 1-3% of all gastrointestinal malignancies. Small bowel cancers pose a significant diagnostic challenge. The recent development of video capsule endoscopy (VCE) and device-assisted enteroscopy (DAE) have greatly facilitated evaluation of the small bowel.

Abstract

Background The purpose of this study was to compare 5-field and 7-field intensity-modulated radiation therapy (IMRT) techniques in terms of xerostomia and related quality of life in patients with nasopharyngeal cancer.

Abstract

Background The prognostic and predictive value of magnetic resonance (MR) investigations in clinical oncology may be improved by implementing strategies for discriminating between viable and necrotic tissue in tumors. The purpose of this preclinical study was to investigate whether the extent of necrosis in tumors can be assessed by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and/or T₂-weighted MR imaging.

Over one-third of patients with low-risk prostate cancer patients are getting radiographic imaging scans that are not recommended by treatment guidelines, while nearly 40% of high-risk patients who should be receiving the tests aren't getting them, according to a study of 30,183 patients reported here at the Genitourinary Cancers Symposium.

Is "a small revolution in screening for colon cancer" underway, as some specialists recently concluded? To mark National Colorectal Cancer Awareness Month in the USA, we look at the latest published clinical data on colorectal cancer screening.

In a review paper published at the end of 2010, specialists from the Unit Of Medical Oncology at the Ospedali Riuniti di Bergamo, Italy, wrote that "a small revolution in screening for colon cancer is in the making".

In this audio interview conducted exclusively for GetInsideHealth on 23 February 2011, Dr William G Bradley, Jr, discusses how MR-guided focused ultrasound (MRgFUS) is currently being used in clinical practice, and provides insights into likely future uses of the technique based on the findings of cutting-edge research.

In recent months several important new papers have been published relating to the diagnosis and management of ductal carcinoma in situ (DCIS) – the pathology that accounts for about one in five of all screen-detected breast cancers. Here we present a round-up of some of the main findings and the implications for clinical practice and future research.

Should low-dose helical CT now be the method of choice for lung cancer screening? In November 2010 the USA’s National Cancer Institute (NCI) released early findings from the National Lung Screening Trial (NLST) showing that screening with low-dose helical CT was associated with a significant mortality benefit compared with chest X-ray screening, in older current and former heavy smokers. Overall, there were 20% fewer lung cancer deaths in the population screened using CT than in the population screened using X-ray.

The importance of considering quality of life in women with gynecologic cancer.

Recent developments have highlighted the continuing and growing importance of considering quality of life (QoL) in women with cancer, and gynaecologic cancer in particular.

Abstract

Purpose of the Report This study tested the feasibility of C11-acetate (acetate) positron emission tomography (PET) imaging to assess response to therapy in men with bone metastatic prostate cancer and compared results for disease detection and response evaluation with F-18 fluorodeoxyglucose (FDG) PET.

Abstract

A key aspect for the postoperative prognosis of patients with head and neck cancer is complete tumor resection. In current practice, the intraoperative assessment of the tumor-free margin is dependent on visual appearance and palpation of the tumor. Optical imaging has the potential of traversing the gap between radiology and surgery by providing real-time visualization of the tumor, thereby allowing for image-guided surgery. The use of the near-infrared light spectrum offers 2 essential advantages: increased tissue penetration of light and an increased signal-to-background ratio of contrast agents.

Abstract

Background No universal consensus of optimal radiation target coverage for oral tongue cancer exists, and there is wide variability in practice. Some centers use intensity-modulated radiotherapy (IMRT) to selectively target only certain regions at risk while sparing others; however, patterns of failure after such selective targeting are rarely reported.

Abstract

Background Tumor grade, age, extent of resection, and performance status are established prognostic factors for survival in primary brain tumor (PBT) patients. Development of disease-related symptoms is predictive of tumor recurrence in other cancers but has not been reported in the PBT population.

Abstract

Objective To evaluate the accuracy of ¹⁸F-fluoride PET/computed tomography (CT) to detect bone metastases (BMs) in a breast and prostate cancer population, using magnetic resonance imaging (MRI) or thin-slice CT as a gold standard.

Abstract

Introduction To determine the best imaging modality for preoperative detection, characterization and measurement of colorectal liver metastases (CRLM) after neoadjuvant chemotherapy (NAC).

Abstract

Purpose To assess the correlations between parameters measured on dynamic contrast-enhanced magnetic resonance imaging and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in rectal cancer.

Purpose Gastro-entero-pancreatic (GEP) endocrine tumours are a heterogenous group of tumours of variable localization and prognosis. It has been suggested that positron emission tomography (PET) using 2-[¹⁸F]fluoro-2-deoxy-D-glucose (¹⁸F-FDG) may have a prognostic value and help to identify patients at risk of progression. [¹⁸F]fluoro-3′-deoxy-3′-L-fluorothymidine (¹⁸F-FLT) has been recently developed as a PET proliferation tracer. At present, there are no studies investigating its role in GEP. The aim of this prospective study was to assess the value of ¹⁸F-FLT-PET for the evaluation of GEP.

Purpose To evaluate the correlation of the mean and minimal apparent diffusion coefficient values (ADC_mean, ADC_minimal) and dynamic magnetic resonance imaging (MRI) findings with prognostic factors in invasive ductal carcinoma.

Purpose   Positron emission tomography (PET)/CT has become a widely used technology for preoperative staging of non-small cell lung cancer (NSCLC). Two recent randomized controlled trials (RCT) have established its efficacy over conventional staging, but no studies have assessed its cost-effectiveness. The objective of this study was to assess the cost-effectiveness of PET/CT as an adjunct to conventional workup for preoperative staging of NSCLC.

Although PET was found to be useful for the functional visualisation of anatomical structures, the accurate localization of structures remained problematic, due to patient movement, and particularly when dealing with the more flexible parts of the body which are prone to involuntary movement. Initially, PET images were aligned with computed tomography (CT) images using sophisticated software, but a major advance in accuracy was achieved with the introduction of combined modality PET/CT scanners.² 

Background   Sentinel lymph node (SLN) mapping in colorectal cancer may have prognostic and therapeutic significance; however, currently available techniques are not optimal. We hypothesized that the combination of invisible near-infrared (NIR) fluorescent light and ex vivo injection could solve remaining problems of SLN mapping in colorectal cancer.

In this study, 304 patients undergoing screening mammography also underwent automated 3D US examination. The conventional mammography images were assessed by one independent examiner and the 3D images were assessed by two additional independent examiners. Conventional mammography was employed as the reference standard in order to calculate the sensitivity and specificity of the automated 3D technique.

“This work is quite a novel approach in that success of screening is usually measured in terms of reduction in mortality from breast cancer,” said Nicholas Perry, MD, of The London Breast Institute, London, UK. “We are not aware of any other studies in this age group comparing success in terms of breast preservation,” he added.

In their study, Dr. Perry and colleagues compared mastectomy rates following breast cancer diagnosis at a UK center in women aged 40-50 with a prior mammogram within the previous year to those with longer interval or no previous mammography.

Multi-phasic CT examinations of the liver can be used to detect malignant liver lesions; however, they can deliver doses of radiation that may increase a patient’s lifetime cancer risk.

To investigate whether it is possible to reduce the level of exposure while maintaining diagnostic accuracy, specialists at Royal Brisbane & Women's Hospital, Moorooka, Australia, performed a study using a CT liver lesion phantom consisting of a soft-tissue-equivalent disk with spherical lesions (9.5mm and 4.8mm diameter, each with a density 10 HU below background).

Specialists at the Department of Radiology, Seoul National University Hospital, Seoul, Korea, have been able to identify key lesion characteristics revealed by CT examination that can enable clinicians to predict very accurately whether PSNs would be transient or persistent on follow-up CTs.

“Part-solid nodules have been reported to indicate a high probability of early lung cancer in many previous studies,” said Yong Sub Song, MD, who presented the research. “However, we observed that a substantial proportion of PSNs detected at screening CT could be transient because of inflammation or hemorrhage,” Dr. Song noted.

“PTLD is a rare, but serious and potentially lethal complication of solid organ transplantation,” said Homeira Zahiri, MD, University of Nebraska Medical Center, Omaha, Nebraska, who presented the study. “FDG-PET has proven useful for staging high and intermediate-grade lymphoma. However, the accuracy of FDG-PET for staging PTLD is unknown,” she added.

To investigate the usefulness of FDG-PET in the early detection, staging, and treatment of PTLD after solid organ transplantation, Dr. Zahiri’s team performed a study involving 16 transplant recipients with histologically confirmed PTLD.

“RFA is a safe and effective nonsurgical treatment for symptomatic benign thyroid nodules,” said Jung-Yin Huh, MD, Gangnam CHA General Hospital, Seoul, Korea, who presented the results.

Dr. Huh’s team evaluated the efficacy of single- vs. dual-session RFA treatment in patients with BTN in a prospective randomized trial. 30 outpatients were randomly assigned to one session of RFA (RFA-1, n=15) or two sessions of RFA (RFA-2, n=15) and were subsequently followed for a period of at least 6 months.

RFA was performed under continuous ultrasound- (US) guidance with an 18-gauge internally cooled electrode. Dependent variables included nodule volume, cosmetic score and symptom score.

Lead investigator Antonella Filippone, MD, and colleagues used diffusion-weighted imaging (DWI) to assess response to CRT in patients with LARC. A total of 28 patients underwent magnetic resonance imaging (MRI) prior to and 8 weeks after treatment, including T2-weighted and an echo-planar DWI-sequence with 6 b-values (0 to 1000 mm2/sec), from which the apparent diffusion coefficient (ADC) was calculated.

The study was conducted by researchers at Stanford University, Stanford, California, and involved a review of Medicare claims submitted between 1998 and 2005 for over 10 million people, focusing on the well-characterized patient group of older adults, who are most frequently imaged. The data were analyzed in two temporally differentiated cohorts: 1998-2001 (N = 5,267,230) and 2002-2005 (N = 5,555,345).

The study by Dr. Callstrom and colleagues enrolled 62 adult patients with painful bone metastases who had either failed or were poor candidates for conventional radiation treatment or chemotherapy. All patients were treated with CT-guided cryoablation using one or more cryoprobes under general anesthesia or conscious sedation. Osteolytic metastases involving or abutting bone were treated.