Cisterna chyli in patients with malignancy--is there a correlation between changes in cisterna volume and progression or regression of the tumor?

UNLABELLED: The purpose of this study was to investigate the potential correlation between the size of the cisterna chyli (CC) and the tumor size in patients with malignancies on computed tomography (CT). MATERIALS AND METHODS: Out of a 3000 patient cohort 138 patients with histologically confirmed malignant disease, a detectable CC on CT and at least two CT scans within a 6 month period were included in this retrospective study. Out of 525 scans a total of 711 lesion intervals were evaluated. The volume of the CC and all target lesions (up to three per scan) were recorded. The Pearson correlation coefficient for the two parameters of changes in lesion size and CC size was calculated for the whole cohort and for a 33 patient subgroup that included only patients with tumors that showed the closest association with large CC in a previous study. RESULTS: The mean difference in lesion size for all 711 intervals was -1165µl. The mean difference in CC size for all 711 intervals was -46.6µl. The respective Pearson correlation coefficient was .05 with a non-significant p-value of .1823 (subgroup: r=.04, p=.6358). CONCLUSION: No significant correlation between the progression or regression of malignant disease and the size of the cisterna chyli could be found.

Pitfalls in abdominal diffusion-weighted imaging: how predictive is restricted water diffusion for malignancy.

OBJECTIVE: As diffusion-weighted imaging is increasingly implemented into routine protocols of abdominal MRI, abnormal findings in expected and unexpected locations become more common. The aim of our retrospective study was to investigate the specificity of restricted diffusion in differentiation of benign from malignant abdominal disease. MATERIALS AND METHODS: Two hundred thirty consecutively registered patients underwent abdominal MRI including diffusion-weighted imaging (single-shot spin-echo echo-planar sequence) with b values of 0, 150, 500, and 1,000 s/mm(2). Lesions were detected by two blinded readers using only the images with a b value of 1,000 s/mm(2), and representative apparent diffusion coefficients were measured. Lymph nodes were not documented. RESULTS: Fifty-two of the 230 patients had a total of 55 lesions with restricted diffusion (23.9%). The mean apparent diffusion coefficient was 809 mm(2)/s. Forty-three lesions (78.2%) were malignant. The 12 benign lesions were liver hemangioma, liver adenoma, autoimmune pancreatitis, pancreatic teratoma, two abscesses, three cases of inflammatory bowel wall thickening due to Crohn's disease, Bartholin cyst, hemorrhagic ovarian cyst, and renal Rosai-Dorfman disease. CONCLUSION: Restricted diffusion is generally considered to be associated with malignant tumors because of the high cellularity of these tumors. However, in interpretation of diffusion-weighted images, it should be kept in mind that a number of benign lesions, as many as 22% in our cohort, can exhibit restricted diffusion on images with high b values, thus mimicking malignant lesions.

Computer-aided detection in computer tomography colonography: a review.

BACKGROUND: Colorectal cancer is one of the most common causes of death from cancer. Computer tomography colonography (CTC) - also known as 'virtual colonoscopy' - is a minimally invasive, CT-based procedure that can simulate conventional colonoscopy using three-dimensional computerized reconstructions. In an attempt to improve the method further, a lot of research emphasis has been put on computer-aided detection (CAD) to overcome potential limitations of this examination. OBJECTIVE: This review recapitulates basic principles of CTC and CAD and highlights the importance of this method as a tool for screening for colorectal cancer. METHODS: This article reviews the current literature on CAD used with CT colonography. RESULTS/CONCLUSION: CAD potentially helps to improve the detection rate for adenomas, decrease interobserver variability and data set interpretation time.

Monitoring gastric filling, satiety and gastric emptying in a patient with gastric balloon using functional magnetic resonance imaging-a feasibility report.

BACKGROUND: Intragastric balloons are used for short term weight loss therapy in obese. It is possible to monitor the ballon with sonography, however this method is sometimes insufficient in obese patients. Therefore MRI seems to be a potential therapy-monitoring option. PURPOSE: In this feasibility report we want to demonstrate the potential use of functional MRI in monitoring gastric filling, patient satiation and gastric emptying in a obese patient who previously received intragastric balloon placement. MATERIAL AND METHODS: We selected one patient (male, 178 cm, 127 kg, BMI = 40,5 kg/m(2)) who recently received a gastric balloon and visualized gastric motility in presence of the gastric balloon before and after food intake. Fast cross-sectional images in one breathhold spin echo or gradient echo sequences were aquired. Real-time gastric motion was performed with cine mode. RESULTS: MRI offers perfect visualisation of gastric balloons in obese patients. Gastric filling and emptying can be monitored in correlation to patient satiety sensation. MRI can visualize the gastric balloon with degree of filling and possible leakages. Cine mode sequences demonstrate gastric motility and gastric wall peristalsis. CONCLUSION: MR is a valuable imaging alternative for patients with intragastric balloons.

CT colonography: an update.

Computed tomographic (CT) colonography (CTC)--also known as "virtual colonoscopy"--was first described more than a decade ago. As advancements in scanner technology and three-dimensional (3D) postprocessing helped develop this method to mature into a potential option in screening for colorectal cancer, the fundamentals of the examination remained the same. It is a minimally invasive, CT-based procedure that simulates conventional colonoscopy using 2D and 3D computerized reconstructions. The primary aim of CTC is the detection of colorectal polyps and carcinomas. However, studies reveal a wide performance variety in regard to polyp detection, especially for smaller polyps. This article reviews the available literature, discusses established indications as well as open issues and highlights potential future developments of CTC.