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...

An estimated 70 530 new cases of bladder cancer were diagnosed in the USA in 2010, resulting in 14 680 deaths . Initially, 70% of patients present with non‐muscle invasive bladder cancer (NMIBC), and 30% with muscle‐invasive bladder cancer (MIBC) . Despite transurethral resection...

Despite the widespread use of total mesorectal excision and neoadjuvant therapy, between 2.6 % and 32 % of patients with rectal cancer will develop pelvic recurrence after initial curative surgery . In addition, local recurrence (LR) is seen in up to 20 % of patients who had...

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.