RESUMEN
Oncologic patients are treated with a combination of chemotherapy, radiation therapy, and surgery. Advances in therapeutic options have greatly improved the survival of patients with cancer. Examples of these advances are newer chemotherapeutic agents that target the cell receptors and advanced radiation therapy delivery systems. It is imperative that radiologists be aware of the variety of imaging findings seen after therapy in patients with cancer. Complications may occur with classic cytotoxic therapies (eg, 5-fluorouracil), usually at higher or prolonged doses or when administered to radiosensitive areas. Newer targeted systemic agents, such as bevacizumab and imatinib, have associated characteristic toxicities because their effects on cells do not depend on dose. Radiation may induce early and late effects in local normal tissues that may be seen at imaging. Imaging findings after chemotherapy include fatty liver, pseudocirrhosis, hepatic veno-occlusive disease, and splenic rupture. Complications of radiation therapy include large and small bowel strictures and radiation-induced hepatitis and tumors. Awareness of the various therapeutic options and knowledge of the spectrum of posttherapeutic complications allows radiologists to provide a comprehensive report that may impact patient management.
Asunto(s)
Antineoplásicos/efectos adversos , Neoplasias/tratamiento farmacológico , Neoplasias/radioterapia , Abdomen , Adulto , Anciano , Preescolar , Femenino , Humanos , Enfermedades Intestinales/diagnóstico por imagen , Enfermedades Intestinales/etiología , Hepatopatías/diagnóstico por imagen , Hepatopatías/etiología , Masculino , Persona de Mediana Edad , Pelvis , Traumatismos por Radiación/diagnóstico por imagen , Traumatismos por Radiación/etiología , Radioterapia/efectos adversos , Enfermedades del Bazo/diagnóstico por imagen , Enfermedades del Bazo/etiología , Tomografía Computarizada por Rayos X , Enfermedades Vasculares/diagnóstico por imagen , Enfermedades Vasculares/etiologíaRESUMEN
Masses can involve the kidney unilaterally or bilaterally. The purpose of this article is to review common and uncommon adult renal masses that present bilaterally. Clinical and imaging findings are described. Renal masses that present in a bilateral fashion can have particular clinical and imaging characteristics and knowledge of their presentation enables appropriate diagnosis and management, especially in a multidisciplinary care setting. More commonly found bilateral renal masses that are discussed include metastasis, lymphoproliferative disorders, adult polycystic kidney disease, angiomyolipomas, renal infracts and renal abscesses. Less common bilateral renal masses include transitional cell carcinoma, oncocytoma, and hematomas.
Asunto(s)
Neoplasias Renales/diagnóstico por imagen , Riñón/patología , Adulto , Anciano , Diagnóstico Diferencial , Humanos , Enfermedades Renales/diagnóstico por imagen , Enfermedades Renales/patología , Neoplasias Renales/patología , Persona de Mediana Edad , Tomografía Computarizada por Rayos X/métodosRESUMEN
Many different masses can involve the kidney other than the commonly encountered renal cell carcinoma (RCC). The purpose of this article is to review the characteristic clinical and imaging findings of common and uncommon masses that predominantly present unilaterally in the adult patient, other than RCC. Awareness of such lesions and knowing the clinical scenario is important for appropriate diagnosis and management, especially in a multidisciplinary care setting.
Asunto(s)
Carcinoma de Células Renales/diagnóstico por imagen , Neoplasias Renales/diagnóstico por imagen , Riñón/patología , Adulto , Anciano , Carcinoma de Células Renales/patología , Diagnóstico Diferencial , Femenino , Humanos , Neoplasias Renales/patología , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVE: This educational review focuses on the staging and radiologic evaluation of renal cell carcinoma. It includes discussion of the epidemiology, pathology, and therapeutic options of renal cell carcinoma and the implications for radiologic follow-up. CONCLUSION: The incidence of renal cell carcinoma has been increasing. Imaging plays a central role in its detection, staging, and treatment evaluation and follow-up.
Asunto(s)
Carcinoma de Células Renales/diagnóstico , Diagnóstico por Imagen , Neoplasias Renales/diagnóstico , Carcinoma de Células Renales/epidemiología , Carcinoma de Células Renales/patología , Carcinoma de Células Renales/terapia , Humanos , Neoplasias Renales/epidemiología , Neoplasias Renales/patología , Neoplasias Renales/terapia , Estadificación de Neoplasias , Vigilancia de la Población , Análisis de SupervivenciaRESUMEN
OBJECTIVE: The purpose of this article is to discuss the epidemiology, risk factors, and presentation of prostate cancer. After reviewing the prostate anatomy, the article will show how imaging plays an important role in establishing the diagnosis, staging, and monitoring the therapeutic response in prostate cancer, with a focus on adenocarcinomas. CONCLUSION: Imaging studies, in the appropriate laboratory and clinical context, contribute essential information that enhances the capacity to provide individualized risk stratification, a suitable treatment strategy, and monitoring for the patient with prostate cancer.
Asunto(s)
Diagnóstico por Imagen/métodos , Estadificación de Neoplasias/métodos , Vigilancia de la Población/métodos , Neoplasias de la Próstata/diagnóstico , Neoplasias de la Próstata/epidemiología , Medición de Riesgo/métodos , Centros Médicos Académicos , Humanos , Masculino , Oncología Médica/métodos , Prevalencia , Factores de Riesgo , Texas/epidemiologíaRESUMEN
Conventional, single-slice helical computed tomography (SSCT) allowed for scanning the majority of the liver during the critical portal venous phase. This was often referred to as the 'optimal temporal window'. The introduction of current day multislice CT (MSCT) now allows us to acquire images in a much shorter time and more precisely than ever before. This yields increased conspicuity between low attenuation lesions and the enhanced normal liver parenchyma and optimal imaging for the vast majority of hepatic hypovascular metastases. Most importantly, these scanners, when compared to conventional non-helical scanners, avoid impinging upon the 'equilibrium' phase when tumors can become isodense/invisible. MSCT also allows for true multiphase scanning during the arterial and late arterial phases for detection of hypervascular metastases. The MSCT imaging speed has increased significantly over the past years with the introduction of 32- and 64-detector systems and will continue to increase in the future volumetric CT. This provides a number of important gains that are discussed in detail.
Asunto(s)
Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Hepáticas/secundario , Tomografía Computarizada por Rayos X , Medios de Contraste , Humanos , Tomografía Computarizada por Rayos X/instrumentaciónRESUMEN
OBJECTIVE: The objective of this article is to describe the imaging appearances of radiation injury to normal tissues in the abdomen that may be seen during imaging surveillance of oncology patients. CONCLUSION: Therapeutic radiation is used to treat various malignant conditions in the abdomen. Radiation damages normal surrounding tissues as well as the intended tumor. Radiation changes vary based on the target organ and the time from completion of therapy. Familiarity with the spectrum of changes that may be seen on follow-up imaging studies should help in the differentiation of radiation injury from other causes such as recurrent malignancy.
Asunto(s)
Traumatismos por Radiación/diagnóstico por imagen , Radiografía Abdominal , Neoplasias Abdominales/radioterapia , Adolescente , Adulto , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sistema Musculoesquelético/diagnóstico por imagen , Sistema Musculoesquelético/lesiones , Traumatismos por Radiación/etiología , Radioterapia/efectos adversos , Tomografía Computarizada por Rayos X , Vísceras/diagnóstico por imagen , Vísceras/lesionesRESUMEN
Advances in cross-sectional imaging, including conventional and helical (spiral) CT and multidetector (MDCT) and MR imaging, now allow detailed evaluation of the anatomy and pathology of the neck and thoracic inlet. The major structures are identified by their appearance and that of contrasting fatty tissue planes surrounding the soft tissues. These structures include the larynx, trachea, thyroid, and parathyroid glands as well as the vessels, lymph node chains, nerves, and supporting muscles. A thorough understanding of the normal cross-sectional anatomy is fundamental to properly interpret pathologic processes. Pathologic processes include both solid and cystic masses. Most solid masses are enlarged lymph nodes. In contrast, cystic masses are of variable pathology, and their characteristic appearances and locations with respect to normal neck anatomy allow a confident diagnosis to be made from a brief differential diagnostic spectrum.
Asunto(s)
Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Metástasis Linfática/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Neoplasias de Cabeza y Cuello/clasificación , Humanos , Ganglios Linfáticos/anatomía & histología , Cuello/anatomía & histología , Estadificación de NeoplasiasRESUMEN
Primary hepatocellular carcinoma (HCC) is a significant tumor worldwide and represents the most common primary hepatic neoplasm. Staging criteria are important for appreciation of timely work up of these neoplasms in contradiction with surgical colleagues. This article demonstrates the appearance of HCC on multiphasic, multidetector CT (MDCT) and relates these findings to current staging criteria. The variable appearance on different planes of contrast is critical to appreciate in staging this neoplasm. The hypervascular nature of the primary tumor makes MDCT and three-phase imaging a critical feature in the detection and characterization of this tumor. This is especially critical in the patients who are candidates for surgical resection. Additionally, MDCT has allowed arterial phase imaging to define the vascular supply of the tumor. An accurate representation of the size and number of lesions is critical in not only the initial staging but also the follow-up of hepatocellular carcinoma. The post-treatment features including the appearance post-surgically and after radiofrequency ablation can be well appreciated on MDCT.
Asunto(s)
Carcinoma Hepatocelular/diagnóstico por imagen , Neoplasias Hepáticas/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Carcinoma Hepatocelular/patología , Humanos , Neoplasias Hepáticas/patología , Estadificación de Neoplasias , Tomografía Computarizada por Rayos X/métodosRESUMEN
The increased speed, greater coverage, and thinner slices of MSCT are exciting developments in radiology, and these feature should only improve with newer generation multislice scanners. The impact of this technology on abdominal imaging has just begun.
Asunto(s)
Abdomen Agudo/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Abdomen Agudo/etiología , Traumatismos Abdominales/diagnóstico por imagen , Humanos , Procesamiento de Imagen Asistido por Computador , Imagenología Tridimensional , Dosis de Radiación , Radiografía Torácica , Tomografía Computarizada por Rayos X/instrumentaciónAsunto(s)
Carcinoma/diagnóstico por imagen , Carcinoma/patología , Neoplasias Esofágicas/diagnóstico por imagen , Neoplasias Esofágicas/patología , Anciano , Carcinoma/terapia , Neoplasias Esofágicas/terapia , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Evaluación de Resultado en la Atención de Salud , Tomografía Computarizada por Rayos XRESUMEN
Flank pain due to urolithiasis is a common problem in patients presenting to emergency departments. Radiology plays a vital role in the work-up of these patients. Many modalities can be used, including ultrasonography, nuclear medicine, and the traditionally used techniques of intravenous urography and conventional radiography. The development of nonenhanced computed tomography (CT) (single- or multi-detector row helical) has provided a means to enable detection and characterization of urolithiasis with unprecedented sensitivity, specificity, and accuracy while yielding important information for treatment planning, including the size and location of calculi. This technique can also help detect causes for flank pain outside the genitourinary tract. However, close attention must be paid to all aspects of the CT study to prevent misdiagnoses.
Asunto(s)
Dolor en el Flanco/etiología , Tomografía Computarizada por Rayos X/métodos , Cálculos Urinarios/complicaciones , Cálculos Urinarios/diagnóstico por imagen , Diagnóstico por Imagen/tendencias , Humanos , Sensibilidad y Especificidad , Cálculos Urinarios/diagnósticoAsunto(s)
Carcinoma/diagnóstico , Estadificación de Neoplasias , Vigilancia de la Población , Neoplasias del Cuello Uterino/diagnóstico , Adulto , Anciano , Carcinoma/etiología , Carcinoma/terapia , Femenino , Humanos , Persona de Mediana Edad , Factores de Riesgo , Neoplasias del Cuello Uterino/etiología , Neoplasias del Cuello Uterino/terapiaAsunto(s)
Carcinoma de Células Transicionales/diagnóstico , Diagnóstico por Imagen , Neoplasias de la Vejiga Urinaria/diagnóstico , Adenocarcinoma/diagnóstico , Adenocarcinoma/patología , Anciano , Biopsia , Instituciones Oncológicas , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patología , Carcinoma de Células Transicionales/patología , Femenino , Hospitales Universitarios , Humanos , Masculino , Persona de Mediana Edad , Invasividad Neoplásica , Estadificación de Neoplasias , Texas , Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/patologíaAsunto(s)
Carcinoma Hepatocelular/diagnóstico , Neoplasias Hepáticas/diagnóstico , Anciano , Carcinoma Hepatocelular/diagnóstico por imagen , Carcinoma Hepatocelular/patología , Carcinoma Hepatocelular/terapia , Femenino , Humanos , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Hepáticas/patología , Neoplasias Hepáticas/terapia , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
The subperitoneal space consists of fatty tissue, blood vessels, lymphatics, and lymph nodes enveloped by a serosal lining. This provides a complex interconnecting space which is an important conduit for pathology within the peritoneal cavity. The anatomy and pathology of the subperitoneal space and the surrounding cavity is discussed in its relationship to tumor spread.