Preoperative imaging of colorectal liver metastases: what the radiologist and the multidisciplinary team need to know.

The management of patients with colorectal liver metastases (CRLM) has transformed over the past 2 decades. Advances in surgical techniques, systemic therapies, and local treatments have resulted in a paradigm shift. Disease that would once have been considered terminal is now frequently treated aggressively with both a disease-free and overall survival benefit.

What is the optimum post treatment surveillance imaging protocol for low-grade appendiceal mucinous neoplasms and pseudomyxoma peritoneii?

Appendiceal mucinous neoplasms are rare and can be associated with the development of disseminated peritoneal disease known as pseudomyxoma peritonei (PMP). Mucinous tumours identified on appendicectomy are therefore followed up to assess for recurrence and the development of PMP. In addition, individuals who initially present with PMP and are treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) are followed up to assess for recurrence.

The role of radiology in addressing the challenge of lung cancer after lung transplantation.

The importance of lung cancer as a complication of lung transplantation is increasingly recognised. It may become an important survival-limiting factor in lung transplant patients as management of other complications continues to improve and utilisation of extended criteria donors grows. Radiology can play a key role in tackling this issue at multiple stages in the transplantation pathway and follow-up process.

Peritoneal malignancy: anatomy, pathophysiology and an update on modern day imaging.

With increasing subspecialised experience in radical cytoreductive surgery and intra-abdominal chemotherapy for peritoneal malignancy, outcomes have improved significantly in selected patients. The surgery and the treatment regimens are radical and therefore correct patient selection is critical. The radiologist plays a central role in this process by estimating, as precisely as possible, the pre-treatment disease burden.

An abbreviated MRI protocol for surveillance of cystic pancreatic lesions.

Purpose: Cystic pancreatic lesions (CPLs) are common and increasingly encountered in clinical radiology practice. The appropriate imaging surveillance strategy for lower-risk CPLs (branch duct-intraductal papillary mucinous neoplasms and indeterminant small cystic lesions) has been a topic of intense study and debate in recent years. MRI is considered the investigation of choice for initial characterisation and follow-up of CPLs.

What the Radiologist Should Know About Treatment of Peritoneal Malignancy.

Objective: The purpose of this article is to discuss the role of the radiologist in the treatment of peritoneal cancer, with focus placed on advanced treatment options and selection of patients with resectable disease for whom complete cytoreduction can be achieved.

Conclusion: Peritoneal cancers traditionally have been associated with significant morbidity and universal mortality; however, the management of such cancers has evolved substantially. Advanced treatment options, including cytoreductive surgery and intraperitoneal chemotherapy, are associated with significantly improved long-term patient survival.

Advanced multimodality imaging of inflammatory bowel disease in 2015: An update.

The diagnosis and effective management of inflammatory bowel disease (IBD) requires a combination clinical, endoscopic, histological, biological, and imaging data. While endoscopy and biopsy remains the gold standard for diagnosis of IBD, imaging plays a central role in the assessment of extra mural disease, in disease surveillance and in the assessment of response to medical treatments, which are often expensive. Imaging is also vital in the detection and diagnosis of disease related complications, both acute and chronic.

Renal Cell Carcinoma: Accuracy of Multidetector Computed Tomography in the Assessment of Renal Sinus Fat Invasion.

Purpose: The purpose of this study was to evaluate the accuracy of multidetector computed tomography (MDCT) in the preoperative assessment of renal sinus fat invasion (RSFI) in patients with renal cell carcinoma (RCC) and to assess imaging features that improve detection of RSFI on CT.

Methods: This is a single-institution retrospective review of 53 consecutive patients with histologically proven RCC who underwent triple-phase preoperative contrast MDCT prior to partial or radical nephrectomy. Two experienced radiologists (R1 and R2), blinded to the final histology result, independently reviewed the preoperative MDCT studies to assess for RSFI.

Imaging of bone metastasis: An update.

Early detection of skeletal metastasis is critical for accurate staging and optimal treatment. This paper briefly reviews our current understanding of the biological mechanisms through which tumours metastasise to bone and describes the available imaging methods to diagnose bone metastasis and monitor response to treatment. Among the various imaging modalities currently available for imaging skeletal metastasis, hybrid techniques which fuse morphological and functional data are the most sensitive and specific, and positron emission tomography (PET)/computed tomography and PET/magnetic resonance imaging will almost certainly continue to evolve and become increasingly important in this regard.

Evaluation of imaging quality of pulmonary 64-MDCT angiography in pregnancy and puerperium.

Objective: The aim of this study was to quantitatively and qualitatively evaluate pulmonary 64-MDCT angiography image quality in pregnancy and puerperium, compared with female nonpregnant control subjects.

Materials And Methods: The study group comprised 124 consecutive pregnant and postpartum women and 124 female nonpregnant control subjects who presented with suspected pulmonary embolism. The individual studies were evaluated for subjective and objective diagnostic quality.

PET/CT in the imaging of ovarian Cancer.

Ovarian cancer is responsible for the largest proportion of deaths among patients with gynecologic cancer. This paper discusses fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in the imaging of ovarian cancer. We discuss and demonstrate how FDG PET/CT can be used to appropriately guide clinical management decisions in patients with ovarian cancer.

Incidental pulmonary nodules detected on abdominal computed tomography.

Objectives: To review the characteristics and outcome of incidental pulmonary nodules reported on abdominal computed tomography (CT).

Methods: A database search of abdominal CTs from January 1, 2004, to December 31, 2006, revealed 413 patients with incidental pulmonary nodules and at least one follow-up chest CT. Demographic information, nodule characteristics, and eventual outcome of the nodules were analyzed.

Brown fat at PET/CT: correlation with patient characteristics.

Purposes: To assess the prevalence of brown fat in patients with cancer, compare demographic characteristics of those with and those without brown fat, and correlate these characteristics with the mean and maximum standardized uptake values of brown fat.

Materials And Methods: This case-control study was institutional review board approved and HIPAA compliant. Informed consent was waived.

Imaging of preoperative liver transplantation in adults: what radiologists should know.

Therapeutic strategies for treating patients with liver failure, particularly optimization of liver transplantation, are constantly being refined, with the goal of improving long-term survival with the lowest risk for toxicity in donors and recipients. Optimal planning for liver transplantation requires a multidisciplinary collaboration between the radiologist, hepatologist, clinical oncologist, and transplant surgeon. Radiologists play an essential role in identifying normal and abnormal variant anatomy and other conditions that may be present, a task that is critical for accurate surgical planning.

Interventional radiology in the management of abdominal collections after distal pancreatectomy: a retrospective review.

Objective: The purpose of this study was to assess the technical and clinical success and complications of imaging-guided percutaneous catheter drainage of peripancreatic fluid collections after distal pancreatectomy.

Materials And Methods: Between January 2001 and February 2009, the cases of patients who underwent distal pancreatectomy were selected from a surgical database, and the cases of those who underwent subsequent interventional radiologic percutaneous drainage were identified. Details of percutaneous catheter drainage were recorded, and technical and clinical success was determined.

Treatment of deep intramuscular and musculoskeletal abscess: experience with 99 CT-guided percutaneous catheter drainage procedures.

Objective: The purpose of this article is to describe our experience draining deep muscular and musculoskeletal abscess collections with CT guidance, emphasizing clinicopathologic factors associated with drain failure, and to further analyze patient outcomes according to whether the process involves muscle alone or also involves adjacent bone or joint (skeletal involvement).

Materials And Methods: The details of percutaneous catheter drainage were retrospectively recorded for all drainages performed over a 9-year period. The technical and clinical successes of percutaneous catheter drainage were determined.

Percutaneous lung biopsy after pneumonectomy: factors for improving success in the care of patients at high risk.

Objective: The purpose of this study was to assess the risks and complications of CT-guided needle biopsy of lung nodules in patients with a single lung after pneumonectomy.

Materials And Methods: A database search for the records of patients who had undergone lung biopsy over a 9-year period revealed that 1771 patients had done so. Fourteen (0.

Imaging-guided suprapubic bladder tube insertion: experience in the care of 549 patients.

Objective: Symptomatic bladder outlet obstruction and neurogenic bladder are common conditions that frequently necessitate suprapubic insertion of a bladder tube. The purpose of this study was to describe an experience with minimally invasive imaging-guided percutaneous suprapubic bladder tube placement and the clinical and technical success and complications encountered.

Materials And Methods: A total of 585 primary suprapubic bladder tube insertions and 439 exchanges of suprapubic bladder tubes were performed on 549 patients (469 men, 80 women; mean age, 66 years; range, 15-106 years).

Multitechnique imaging findings of Prolene plug hernia repair.

Objective: The objective of this article is to illustrate the spectrum of imaging findings of polypropylene (Prolene) plug hernia repair.

Conclusion: Knowledge of patient history and awareness of postsurgical imaging appearances are of importance because Prolene plugs are often incidentally encountered and if misdiagnosed may lead to erroneous patient disease staging and management.

Incidental adrenal lesions: accuracy of characterization with contrast-enhanced washout multidetector CT--10-minute delayed imaging protocol revisited in a large patient cohort.

Purpose: To reassess the accuracy of the 10-minute delayed scan to differentiate both lipid-rich and lipid-poor lesions in a large cohort of patients.

Materials And Methods: This HIPAA-compliant retrospective study had institutional review board approval; the need for informed consent was waived. A multidetector computed tomography (CT) adrenal protocol (unenhanced, dynamic contrast material-enhanced, and 10-minute delayed CT) was used in 314 consecutive patients (201 women, 113 men; mean age, 63.

Adrenal imaging.

Objective: Adrenal nodules are frequently encountered on current high-resolution imaging, and accurate characterization of such lesions is critical for appropriate patient care. Our article highlights how imaging techniques such as CT densitometry, CT washout characteristics, chemical shift MRI, PET, and PET/CT help characterize most adrenal lesions. We focus on these techniques as well as specifically, because of space constraints, the varied imaging appearances of adrenocortical carcinoma, pheochromocytoma, and lymphoma on these techniques.