ABSTRACT
The value of Magnetic Resonance Imaging (MRI) in the diagnosis, staging and treatment evaluation of retroperitoneal lymph node metastases of non-seminomatous germ cell tumours of the testis (NSGCT) was prospectively studied in 41 consecutive patients before, during and after cisplatin-based chemotherapy. MRI is a non-invasive method, with results equivalent to laparotomy in determining the anatomical localization and size of retroperitoneal lymph node metastases of non-seminomatous germ cell tumours of the testis and residual mass after chemotherapy. Components responding differently can be observed with MRI within the retroperitoneal lymph node metastases on the basis of the tumour signal intensity or homogeneity in the T1- and T2-weighted images; MRI cannot warrant any conclusion about viability of the residual mass or other effects of chemotherapy.
Subject(s)
Germinoma/pathology , Germinoma/secondary , Lymphatic Metastasis/diagnosis , Testicular Neoplasms/pathology , Adolescent , Adult , Cisplatin/therapeutic use , Germinoma/drug therapy , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Neoplasm Staging , Prospective Studies , Retroperitoneal Space , Testicular Neoplasms/drug therapyABSTRACT
The value of magnetic resonance imaging (MRI) and computed tomography (CT) in the diagnosis of bone tumours was investigated in a prospective study of 25 patients. MRI is superior to CT because it permits multidirectional exposures. Moreover, the tumour can be readily distinguished from the neurovascular structures without injection of contrast medium. MRI gives better contrast than CT, making it possible to study the relationship to the soft tissues, bone marrow and joints more accurately. On the other hand, CT gives a better picture of the destruction of cortical bone. With neither MRI nor CT can the exact tumour length be measured. Neither MRI nor CT permits an exact, reliable diagnosis. Owing to the relatively slow exposure technique in combination with respiratory movements, depiction of the thoracic wall is less satisfactory with MRI than with CT. If both techniques are available, MRI is preferred. In view of the fact that MRI apparatus is still less widely available, it should be borne in mind that CT also allows an adequate investigation of skeletal lesions.
Subject(s)
Bone Neoplasms/diagnosis , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Adolescent , Adult , Aged , Aged, 80 and over , Bone Neoplasms/surgery , Child , Female , Humans , Male , Middle Aged , Neoplasm Invasiveness , Prospective Studies , Sarcoma/diagnosisABSTRACT
The role of Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) in the treatment evaluation of retroperitoneal lymph-node metastases of non-seminomatous testicular tumors (NSTT) was prospectively studied in 10 consecutive patients before, during and after chemotherapy. The results thus obtained were compared with laparotomy findings before and after chemotherapy, the histology of the primary testicular tumor, and that of retroperitoneal residual lesions after chemotherapy. MRI and CT proved to be equivalent in detection and in determining the anatomical localization and size of the retroperitoneal lymph node metastases. Unlike CT, MRI revealed unmistakable changes in the structure of the retroperitoneal lymph-node metastases during chemotherapy, for which no histological cause was found except in mature teratoma. In mature teratoma a high T2 signal was found within the metastases, corresponding with a high water content. On the basis of tumor consistency and signal intensity in the T1- and T2-weighted images, MRI cannot yet warrant any conclusion about the ultimate effect of chemotherapy.
Subject(s)
Lymphatic Metastasis , Magnetic Resonance Imaging , Teratoma/secondary , Testicular Neoplasms/secondary , Tomography, X-Ray Computed , Adolescent , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bleomycin/administration & dosage , Cisplatin/administration & dosage , Etoposide/administration & dosage , Humans , Ifosfamide/administration & dosage , Laparotomy , Lymph Node Excision , Lymphatic Metastasis/diagnosis , Lymphatic Metastasis/diagnostic imaging , Lymphatic Metastasis/pathology , Magnetic Resonance Imaging/methods , Male , Neoplasm Staging , Prospective Studies , Retroperitoneal Space , Teratoma/drug therapy , Teratoma/pathology , Teratoma/surgery , Testicular Neoplasms/drug therapy , Testicular Neoplasms/surgery , Tomography, X-Ray Computed/methodsABSTRACT
The value of MRI and CT in the diagnosis of soft-tissue tumors was investigated in a prospective study of 25 patients. MRI and CT give a true reflection of the tumor dimensions. It is impossible, however, to make a reliable diagnosis with either technique. If both techniques are available, then MRI is to be preferred in view of the better spatial orientation and sharper contrast it offers between the tumor and adjacent structures. If only CT is available, then an adequate image can generally be obtained with this technique too.
Subject(s)
Magnetic Resonance Imaging , Soft Tissue Neoplasms/diagnosis , Tomography, X-Ray Computed , Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Prospective Studies , Soft Tissue Neoplasms/diagnostic imaging , Soft Tissue Neoplasms/pathology , Soft Tissue Neoplasms/surgeryABSTRACT
Limb-saving procedures for patients with osteosarcomas of the extremities are based on the anatomical localization and extent of the tumor. The effectiveness of neoadjuvant chemotherapy, high-dose methotrexate (HD MTX), was prospectively analyzed in patients using magnetic resonance imaging (MRI) and histologic evaluation of bone biopsies. Evaluation of in vivo response to neoadjuvant chemotherapy for osteosarcomas with MRI is a method which seems promising in predicting the histologic tumor reaction.
