Diagnostic accuracy of diffusion-weighted imaging- magnetic resonance imaging compared to positron emission tomography/computed tomography in evaluating and assessing pathological response to treatment in adult patients with lymphoma: A systematic review.

The use of Positron emission tomography/computerised tomography (PET/CT) is well established in the staging and assessment of treatment response of lymphoma. Recent studies have suggested that whole body diffusion-weighted imaging -magnetic resonance imaging (WB-DW-MRI) may be an alternative to PET/CT in both staging and assessment of treatment response. A systematic review was performed to assess the ability of DW-MRI in the assessment of treatment response in lymphoma.

Overdiagnosis of Pulmonary Embolism by Pulmonary CT Angiography.

Objective: The purpose of this study is to evaluate the rate of overdiagnosis of pulmonary embolism (PE) by pulmonary CT angiography (CTA) in a tertiary-care university hospital.

Materials And Methods: This study is a retrospective review of all pulmonary CTA examinations performed in a tertiary-care university hospital over a 12-month period. Studies originally reported as positive for PE were retrospectively reinterpreted by three subspecialty chest radiologists with more than 10 years' experience.

Update in the evaluation of the solitary pulmonary nodule.

A solitary pulmonary nodule (SPN) is defined as a round opacity that is smaller than 3 cm. It may be solid or subsolid in attenuation. Semisolid nodules may have purely ground-glass attenuation or be partly solid (mixed solid and ground-glass attenuation).

Multimodality imaging evaluation of esophageal cancer: staging, therapy assessment, and complications.

Esophageal cancer is among the leading causes of cancer-related deaths worldwide. The management of patients with esophageal cancer is determined to a large extent by patient performance status, location of the primary cancer, and stage of disease at presentation. Multimodality regimens combining neoadjuvant chemotherapy and/or radiotherapy followed by surgery have been increasingly used in suitable candidates with locally advanced cancer.

Unsuspected pulmonary emboli in oncology patients undergoing routine computed tomography imaging.

Introduction: Clinically unsuspected pulmonary embolism (PE) can be detected in oncology patients undergoing computed tomography (CT) imaging for reasons other than for PE diagnosis, but there is little prospective data on its true prevalence, clinical importance, or on methods to improve detection.

Methods: In consecutive oncology patients undergoing CT imaging of the chest for indications other than PE detection, CT pulmonary angiography (CTPA) was systematically included as part of the imaging protocol. Each imaging study was prospectively analyzed for the presence of PE.

Clinical utility of PET/CT in lymphoma.

Objective: The purpose of this review is to assist interpreting radiologists in becoming familiar with the role of PET/CT in baseline staging and therapeutic response assessment in the management of lymphoma, in becoming aware of imaging pitfalls, and in understanding the natural behavior of lymphoma and the therapeutic options.

Conclusion: Therapeutic strategies for the management of lymphoma are constantly being refined to improve long-term survival with the lowest risk of toxicity to the patient. PET/CT is accurate for baseline staging and yields important prognostic information for determining the most appropriate initial treatment.

Imaging of pulmonary fusariosis in patients with hematologic malignancies.

Objective: The purpose of this study was to assess the radiographic features of pulmonary fusariosis, an increasingly encountered cause of severe opportunistic mold pneumonia.

Conclusion: Pulmonary fusariosis has radiographic manifestations that are suggestive of an angioinvasive mold. Nodules or masses were the most common findings at CT, seen in 82% of patients compared with only 45% on chest radiography.

Imaging of non-small cell lung cancer of the superior sulcus: part 2: initial staging and assessment of resectability and therapeutic response.

Imaging plays a crucial role in the diagnosis and staging of superior sulcus tumors, assessment of their resectability, determination of the optimal approach to disease management, and evaluation of the response to therapy. Computed tomography (CT), magnetic resonance (MR) imaging, and positron emission tomography (PET)/CT contribute important and complementary information. Whereas CT is optimal for depicting bone erosion and for staging of intrathoracic disease, MR imaging is superior for evaluating tumor extension to the intervertebral neural foramina, the spinal cord, and the brachial plexus, primarily because of the higher contrast resolution and multiplanar capability available with MR imaging technology.

Imaging of non-small cell lung cancer of the superior sulcus: part 1: anatomy, clinical manifestations, and management.

Non-small cell carcinomas of the superior pulmonary sulcus represent 3% of all lung cancers and are associated in most cases with a poor clinical outcome. Multimodality therapy with irradiation, chemotherapy, and surgery offers the best possibility for long-term survival and cure in most cases. For patients with pulmonary sulcus tumors that are not surgically resectable, chemoradiotherapy may help prolong survival and provide long-term pain relief.

PET/CT and hepatic radiation injury in esophageal cancer patients.

This paper evaluates the imaging appearance of radiation injury in the liver on positron emission tomography (PET)/computed tomography (CT) in patients with distal esophageal cancer who underwent pre-operative chemoradiation therapy. Twenty-six patients with distal esophageal cancer who received chemoradiotherapy before esophagectomy were included. All patients had baseline and follow-up PET/CT.

PET/CT of esophageal cancer: its role in clinical management.

Positron emission tomography (PET)/computed tomography (CT) has important utility and limitations in the initial staging of esophageal cancer, evaluation of response to neoadjuvant therapy, and detection of recurrent malignancy. Esophageal cancer is often treated by using a combined modality approach (chemotherapy, radiation therapy, and esophagectomy); correct integration of PET/CT into the conventional work-up of esophageal cancer requires a multidisciplinary approach that combines the information from PET/CT with results of clinical assessment, diagnostic CT, endoscopic gastroduodenoscopy, and endoscopic ultrasonography. PET/CT has limited utility in T staging of esophageal cancer and relatively limited utility in detection of dissemination to locoregional lymph nodes.

Development of pulmonary arteriovenous communications within pulmonary metastases after chemotherapy.

The development of acquired pulmonary arteriovenous communications within pulmonary metastases from an extrathoracic malignancy is a rare phenomenon, but it has potentially serious clinical consequences for the patient. We describe two such patients, both of whom developed intrametastatic pulmonary arteriovenous communications after chemotherapy of the pulmonary metastases, and one of whom required coil embolization for control of symptoms related to the right-to-left shunt. In both cases, computed tomographic angiography was useful for the detection and pre-therapeutic evaluation of the arteriovenous malformations.

Preoperative chemo-radiation-induced ulceration in patients with esophageal cancer: a confounding factor in tumor response assessment in integrated computed tomographic-positron emission tomographic imaging.

Hypothesis: Positron emission tomography can be useful in predicting response of esophageal cancer after preoperative chemo-radiation therapy (CRT). We evaluated the use of integrated computed tomography (CT)-PET among patients with esophageal cancer being considered for resection after CRT.

Methods: Three reviewers blinded to clinical and pathologic staging retrospectively reviewed the CT-PET scans of patients with esophageal cancer after preoperative CRT who underwent esophagectomy.

Short-term restaging of patients with non-small cell lung cancer receiving chemotherapy.

Objective: To determine whether computed tomography (CT) performed within a month of receiving chemotherapy is useful in assessing response among patients with non-small cell lung cancer (NSCLC).

Patients And Methods: Consecutive patients receiving chemotherapy for NSCLC who underwent short-term CT restaging between April 2001 and June 2005 were included in the study. Serial CT scans were performed within 31 days (mean, 24 days; range, 9-31 days) after receiving chemotherapy for all patients.

Integrated CT-PET imaging of esophageal cancer: unexpected and unusual distribution of distant organ metastases.

CT-PET imaging is being increasingly used for the initial staging, assessment of treatment response, and follow-up of patients with esophageal carcinoma, primarily because of its superior detection of distant metastases compared to conventional methods. Our recent experience has shown that metastases from esophageal cancer can occur in unusual locations and have an unexpected presentation. Recognition of the distribution and appearance of esophageal metastases is important for optimal image interpretation in order to avoid confusion with more benign disease.

Sonography of pediatric small-bowel intussusception: differentiating surgical from nonsurgical cases.

Objective: The purpose of this study was to determine whether there are clinical or sonographic findings that can be used to differentiate benign self-limited small-bowel intussusception from pathologic small-bowel intussusception that necessitates surgical intervention.

Materials And Methods: A retrospective search was performed of abdominal sonograms obtained at two institutions between January 1996 and June 2005. Sonographic findings were correlated with medical and surgical records.

Detection of interval distant metastases: clinical utility of integrated CT-PET imaging in patients with esophageal carcinoma after neoadjuvant therapy.

Background: The objective of the study was to determine the utility of integrated computed tomography / positron emission tomography (CT-PET) imaging for detecting interval distant metastases and assessing therapeutic response in patients with locally advanced, potentially resectable esophageal carcinoma after neoadjuvant therapy.

Methods: A retrospective study was performed of 88 patients with potentially resectable esophageal carcinoma who received neoadjuvant therapy before planned surgical resection. CT-PET before and after completion of neoadjuvant was used for evaluating therapeutic response; response criteria were based on qualitative and semiquantitative analyses.

Incidental findings on integrated PET/CT that do not accumulate 18F-FDG.

Objective: The purpose of this study was to report the prevalence of abnormalities that do not show increased 18F-FDG uptake on the CT component of integrated PET/CT in patients with non-small cell lung cancer.

Materials And Methods: Images from all PET/CT studies performed consecutively between April and October 2003 on patients with non-small cell lung cancer were retrospectively reviewed. All abnormalities present on the CT component of the PET/CT scans that did not show abnormally increased 18F-FDG uptake were documented.