Role of magnetic resonance imaging in early detection of nasopharyngeal carcinoma

The aim of the study was to determine whether MR imaging has the potential to replace invasive Endoscopic guided biopsy [EGB] in patients with suspected nasopharyngeal carcinoma [NPC]. Data from 2 groups of patients was reviewed, group 1 with proved NPC for MR staging [n = 465] and group 2 with suspected NPC [n = 77]. In group 1, which included 118 of 456 [26%] with stage 1 disease, cancer was detected in all patients. In group 2, MR imaging was negative for NPC in 70 [91%] patients, MR imaging was positive for NPC in 7 [9%] patients and NPC was confirmed by biopsy in 3 [4%]. Two of these 3 patients had undergone negative endoscopy and biopsy before the MR imaging. NPC was not present in the remaining 4 patients, 2 of whom were found to have lymphoid hyperplasia. MR imaging has the potential to screen healthy patients who do not require EGB and direct the site of biopsy in small cancers that may be missed by endoscopy

Radiological approach for pineal region masses

Thirty-two pineal and related tumors were diagnosed by computed tomography [CT] and magnetic resonance imaging [MRI]. Pineal region tumors were classified as germ-cell tumors, glial tumors, pineal parenchymal tumors and cysts. They demonstrated different MR signal characteristics on pre-contrast scans and nodular or ring type enhancement with occasional central lucencies, except for benign cysts which have not shown any enhancement. MR images were useful in defining the relationship of the tumor to the posterior third ventricle, Sylvian aqueduct, vein of Galen and tentorium. Although CT can demonstrate more evident fashion displacement of the original pineal calcification as well as tumor calcifications, MR imaging demonstrates different signal characteristics in germinomas and pineoblastomas which can be a useful adjunct in the evaluation and differential diagnosis of these tumors. There were eight germinomas, four primary pineal tumors, two embryonal cell carcinomas and choriocarcinoma, five teratoma, two primitive neuroectodermal tumor, four astrocytomas, two lipomas, four meningiomas and one pineal cyst