A picture is worth a thousand words: a history of diagnostic imaging for lymphoma.

The journey from early drawings of Thomas Hodgkin's patients to deep learning with radiomics in lymphoma has taken nearly 200 years, and in many ways, it parallels the journey of medicine. By tracing the history of imaging in clinical lymphoma practice, we can better understand the motivations for current imaging practices. The earliest imaging modalities of the 2D era each had varied, site-dependent sensitivity, and the improved accuracy of imaging studies allowed new diagnostic and therapeutic techniques.

Fentanyl Iontophoretic Transdermal System (IONSYS(®)) can be Safely used in the Hospital Environment with X-Rays, Computerized Tomography and Radiofrequency Identification Devices.

Introduction: Fentanyl iontophoretic transdermal system (fentanyl ITS, IONSYS(®)) is a patient-controlled analgesia system used for the management of acute postoperative pain, designed to be utilized in a hospital setting. The objective of the two studies was to determine if fentanyl ITS could be safely used with X-rays, computerized tomography (CT) scans and radiofrequency identification (RFID) devices.

Methods: The ITS system has two components: controller and drug unit; the studies utilized ITS systems without fentanyl, referred to as the ITS Placebo system.

Phase II trial of saracatinib (AZD0530), an oral SRC-inhibitor for the treatment of patients with hormone receptor-negative metastatic breast cancer.

Background: SRC activation is associated with cell migration, proliferation, and metastasis. Saracatinib is an oral tyrosine kinase inhibitor (TKI) selective for SRC. We performed this trial to evaluate the efficacy and safety of saracatinib monotherapy in patients with estrogen receptor (ER)(-) and progesterone receptor (PR)(-) metastatic breast cancer (MBC).

Risk-adapted dose-dense immunochemotherapy determined by interim FDG-PET in Advanced-stage diffuse large B-Cell lymphoma.

PURPOSE In studies of diffuse large B-cell lymphoma, positron emission tomography with [(18)F]fluorodeoxyglucose (FDG-PET) performed after two to four cycles of chemotherapy has demonstrated prognostic significance. However, some patients treated with immunochemotherapy experience a favorable long-term outcome despite a positive interim FDG-PET scan. To clarify the significance of interim FDG-PET scans, we prospectively studied interim FDG-positive disease within a risk-adapted sequential immunochemotherapy program.

Feasibility trial of letrozole in combination with bevacizumab in patients with metastatic breast cancer.

Purpose: Preclinical models suggest that the use of anti-vascular endothelial growth factor (anti-VEGF) therapy with antiestrogens may prevent or delay the development of endocrine therapy resistance. We therefore performed a feasibility study to evaluate the safety of letrozole plus bevacizumab in patients with hormone receptor-positive metastatic breast cancer (MBC).

Methods: Patients with locally advanced breast cancer or MBC were treated with the aromatase inhibitor (AI) letrozole (2.

A phase II trial of erlotinib in combination with bevacizumab in patients with metastatic breast cancer.

Purpose: To evaluate the efficacy and toxicity of erlotinib plus bevacizumab in patients with metastatic breast cancer (MBC), targeting the epidermal growth factor receptor (EGFR/HER1) and the vascular endothelial growth factor (VEGF) pathway.

Experimental Design: Thirty-eight patients with MBC were enrolled and treated at two institutions with erlotinib, a small molecule EGFR tyrosine kinase inhibitor (150 mg p.o.

False-positive findings on 18F-FDG PET/CT: differentiation of hibernoma and malignant fatty tumor on the basis of fluctuating standardized uptake values.

Objective: Hibernoma is a benign tumor of brown fat that has imaging features similar to those of malignant fat-containing soft-tissue tumors. Hibernoma is metabolically active on (18)F-FDG PET/CT, and its presence can lead to false-positive interpretations. We present three cases in which fatty lesions with increased radiotracer uptake identified on FDG PET/CT turned out to be hibernomas.

Pharmacokinetics and toxicity of weekly docetaxel in older patients.

Purpose: To evaluate the pharmacokinetics of weekly docetaxel in a cohort of older patients with metastatic cancer and to explore the relationship of pharmacokinetic variables, Erythromycin Breath Test results, age, geriatric assessment variables, and toxicity to therapy.

Experimental Design: Twenty patients ages > or = 65 years with metastatic breast, prostate, or lung cancer entered an Institutional Review Board-approved protocol to evaluate the pharmacokinetics of weekly docetaxel administered at 35 mg/m2 i.v.

A phase I study of cetuximab/paclitaxel in patients with advanced-stage breast cancer.

Background: The epidermal growth factor receptor (EGFR) is part of the ErbB family of receptor tyrosine kinases and is known to be variably expressed in breast cancers. Cetuximab is a humanized monoclonal antibody directed against the EGFR that works by blocking the downstream signaling function of this protein and thereby interfering with cancer cell proliferation. Preclinical studies have indicated a synergistic effect for the combination of anti-EGFR therapy plus paclitaxel in breast cancer models.

18F-2-fluoro-2-deoxy-D-glucose positron emission tomography scanning affects surgical management in selected patients with high-risk, operable breast carcinoma.

Background: The role of positron emission tomography (PET) scanning in determining the extent of disease in patients with breast cancer has not been defined. We investigated the utility of (18)F-2-fluoro-2-deoxy-D: -glucose (FDG)-PET scanning compared with conventional imaging with computed tomographic scanning and bone scanning in determining the extent of disease in patients with high-risk, operable breast cancer.

Methods: This was a prospective study of patients who presented to Memorial Sloan-Kettering Cancer Center for operative treatment of breast cancer.

Metastatic lobular carcinoma of the breast: patterns of spread in the chest, abdomen, and pelvis on CT.

Objective: We determined the pattern of spread of metastatic lobular carcinoma in the chest, abdomen, and pelvis on CT.

Materials And Methods: We identified 57 women (age range, 30-79 years; mean age, 57 years) with metastatic lobular carcinoma of the breast who underwent CT of the chest, abdomen, or pelvis between 1995 and 1998. Then two experienced oncology radiologists retrospectively reviewed 78 CT examinations of those patients to identify sites of metastatic disease and to identify complications caused by metastases.

Staging of malignant pleural mesothelioma: comparison of CT and MR imaging.

Objective: This article compares the accuracy of CT with that of MR imaging in staging of malignant pleural mesothelioma.

Subjects And Methods: Ninety-five patients were enrolled in a prospective staging protocol based on the International Mesothelioma Interest Group staging system. Sixty-five patients underwent CT and MR imaging and a surgical procedure (excluding percutaneous needle biopsy) to stage and resect the tumor.

Magnetic resonance imaging of the postpneumonectomy chest: normal and abnormal findings.

To determine the normal findings at magnetic resonance imaging (MRI) of the postpneumonectomy space (PPS), and to evaluate the utility of MRI in detection of recurrent tumor in the postpneumonectomy chest, 32 MRI scans were performed in 31 patients at varying time intervals after pneumonectomy. Eleven patients also had 12 computed tomography (CT) scans performed at the same time to evaluate possible tumor recurrence. Of the 32 scans, 5 demonstrated complete obliteration of the fluid containing PPS, and 4 showed gas in the PPS; the remainder (n = 23) demonstrated persistence of fluid-filled spaces of varying size.

Non-neoplastic causes of high signal intensity at T2-weighted MR imaging after treatment for musculoskeletal neoplasm.

Objective: The objective of this study was to describe a variety of non-neoplastic causes of high-signal-intensity areas seen on T2-weighted magnetic resonance (MR) images obtained after treatment for malignant musculoskeletal neoplasm.

Design: MR examinations obtained after treatment for malignant musculoskeletal neoplasm in 11 patients were reviewed. The examinations of these patients were selected because at least one MR study of each patient showed high-signal-intensity areas on T2-weighted images at or near the site of the original tumor.

Low-density supradiaphragmatic band artifact on advanced multiple-beam equalization radiography of the chest.

Rationale And Objectives: A low-density dark band artifact was found above the diaphragm on advanced multiple-beam equalization radiography (AMBER) of the chest and was evaluated.

Methods: Fifty consecutive chest radiographs were evaluated for the presence of the artifact. AMBER radiographs of a phantom were scanned with a microdensitometer.

Four cycles of chemotherapy and regional radiation therapy for clinical early-stage and intermediate-stage Hodgkin's disease.

To achieve a high percentage of durable complete remissions (CR) and prolonged survivals and reduce toxicity in patients with early-stage and intermediate-stage Hodgkin's disease, a randomized trial of four cycles of mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) versus four cycles of thiotepa, bleomycin, and vinblastine (TBV) combined with regional radiation therapy (RT) was conducted. For MOPP and RT, the CR percentage was 98% (60 of 61), and at 5 years, the percentage of patients in CR was 90%, with freedom from progression of 89% and overall survival of 91%. For TBV and RT, the CR percentage was 93% (55 of 59), with a 5-year duration of CR of 83%, freedom from progression of 81%, and overall survival of 91% (P greater than 0.

Impact of adjuvant radiation on the patterns and rate of relapse in advanced-stage Hodgkin's disease treated with alternating chemotherapy combinations.

The role of adjuvant radiation therapy (RT) in the management of advanced-stage Hodgkin's disease (HD) was analyzed in 222 patients who attained a complete remission (CR) with alternating chemotherapy combinations. Mechlorethamine, vincristine, procarbazine, and prednisone/doxorubicin, bleomycin, vinblastine, and dacarbazine (MOPP/ABVD) or MOPP/ABV alternating with the lomustine, melphalan, and vindesine combination (MOPP/ABV/CAD) were similarly effective in inducing a CR in 222 of 270 (83%) patients. These patients were scheduled to receive consolidative RT to bulky disease or other critical sites of initial nodal involvement to a total dose of 2,000 cGy, with an optional additional boost of 1,000 cGy.

Prognostic factors among 185 adults with newly diagnosed advanced Hodgkin's disease treated with alternating potentially noncross-resistant chemotherapy and intermediate-dose radiation therapy.

The initial promising results with alternating chemotherapy regimens (mechlorethamine, vincristine, procarbazine, and prednisone/doxorubicin, bleomycin, vinblastine, and dacarbazine [MOPP/ABVD]; lomustine, melphalan, and vindesine [CAD] plus MOPP plus ABV) combined with intermediate-dose radiation therapy (RT) have been sustained with further follow-up; 82.2% of patients (152 of 185) achieved a complete remission (CR), and overall survival is 71.7% +/- 4.

A prospective study of the accuracy of preoperative computed tomographic staging of patients with biopsy-proven rectal carcinoma.

From June 1983 to January 1986, 91 patients with biopsy-proven adenocarcinoma of the rectum had computed tomographic scans of the pelvis performed before treatment as part of a "sandwich" radiotherapy-surgery regimen. Two experienced diagnostic radiologists performed locoregional staging of all scans according to the University of California at San Francisco criteria; one of these radiologists repeated this staging at a later time to test the reproducibility of a single observer. Staging was performed without the use of any other radiographic studies or of any clinical information except the patients' age, sex, and the diagnosis of rectal carcinoma, to test the value of computed tomographic scans alone for staging.

The chief residency in radiology. Results of a survey of A3CR2 members.

Detailed questionnaires were sent to the 192 members of the American Association of Academic Chief Residents in Radiology (A3CR2) to learn about the logistics of chief resident selection, the responsibilities of the chief resident, the attitudes and perceptions of the chief resident about his or her position, and suggestions for improving the chief residency. Completed questionnaires were returned by 149 (78%) chief residents from 111 different residency programs. The results show that radiology residents have a greater voice in selecting their chief residents than in the past.

Superior sulcus tumors: CT and MR imaging.

Thirty-one patients with superior pulmonary sulcus tumors underwent a total of 32 sets of computed tomographic (CT) and magnetic resonance (MR) imaging examinations before receiving therapy. Prospective, independent, and blinded interpretations of the studies were compared with both the surgical findings (15 patients) and the patient's clinical symptoms (17 patients). Thin-section (5-mm) coronal and sagittal MR images proved more accurate than CT scans (.

Lung tumors: percutaneous implantation of I-125 sources with CT treatment planning.

Seven patients with lung tumors underwent percutaneous implantation of iodine-125 sources into the tumor. Needle placement and seed implantation were effected with biplane fluoroscopy and a computer planning model based on computed tomography. No complications were encountered.

Abnormal gallium scintigraphy in pulmonary alveolar proteinosis (PAP).

A patient with medulloblastoma of the cerebellum developed dyspnea and hypoxemia. Pulmonary function tests showed decreased lung volume and diffusing capacity, while the chest radiographs initially showed only mild interstitial infiltrates. Repeated gallium scans showed diffuse lung uptake and diagnosis of pulmonary alveolar proteinosis was made by open lung biopsy.

Pulmonary Kaposi's sarcoma in the acquired immune deficiency syndrome. Clinical, radiographic, and pathologic manifestations.

Pulmonary Kaposi's sarcoma related to the acquired immune deficiency syndrome (AIDS) has not been well characterized. To define the clinical, radiographic, and pathologic features of this entity, 11 autopsy-proved cases of pulmonary Kaposi's sarcoma were reviewed. The most common clinical symptoms were dyspnea and cough, but hemoptysis and stridor were also found.