Cabozantinib monotherapy for advanced adrenocortical carcinoma: a single-arm, phase 2 trial.

Background: Adrenocortical carcinoma is a rare malignancy with poor response to systemic chemotherapy. Mitotane is the only approved therapy for adrenocortical carcinoma. Cabozantinib is a multikinase inhibitor approved in multiple malignancies.

Mesenchymal Neoplasms of the Prostate and Seminal Vesicles: Spectrum of Disease with Radiologic-Pathologic Correlation.

There is a wide spectrum of benign and malignant mesenchymal neoplasms of the prostate, which account for less than 1% of all prostatic tumors. These include distinctive tumors that arise from the specialized prostatic stroma and site-agnostic neoplasms such as smooth muscle tumors, fibrous or myofibroblastic neoplasms, neurogenic tumors, vascular tumors, and a plethora of sarcomas. Select tumors show classic sites of origin within the prostate.

Temporal evolution of metastatic disease: part I-an in-depth review of the evolution of metastatic disease across diverse spectrum of non-neural solid tumors on serial oncologic imaging studies and relevant practical applications.

With improved survival rates of patients with metastatic disease due to continuously evolving multimodality treatment options, radiologists are increasingly interpreting imaging studies from patients with protracted metastatic disease. It is thus crucial for radiologists to have an in-depth understanding of the temporal evolution of metastatic spread and the accompanying findings on imaging studies, to provide accurate interpretation that supports optimal management. A general overview of the evolution of cancer spread on serial imaging studies and common pathways of tumor spread across multiple tumor types and tumor locations is not readily available in radiology literature.

Temporal evolution of metastatic disease: part II-a novel proposal for subcategorization of metastatic disease from non-neural solid tumors with diverse histologies and locations.

Tumor spread is a continuous process and metastases can further disseminate. Currently, metastatic disease from most primary tumors is subcategorized as M0 if absent and M1 if present. However, metastatic disease in different locations may have different prognostic implications, even if it is from the same primary tumor.

Second Malignancies after Radiation Therapy: Update on Pathogenesis and Cross-sectional Imaging Findings.

A wide spectrum of second cancers occur as late complications of radiation therapy (RT) used to treat various malignancies. In addition to the type and dose of radiation, lifestyle, environmental, and genetic factors are important to the development of second malignancies in cancer survivors. Typically, RT-induced malignancies (RTIMs) are biologically aggressive cancers with a variable period of 5-10 years for hematologic malignancies and 10-60 years for solid tumors between RT and the development of the second cancer.

Nivolumab-Induced Subcutaneous Fat Necrosis: Another FDG-Avid Immune-Related Adverse Event.

A 59-year-old woman with history of metastatic melanoma, currently on nivolumab, presents for a restaging FDG PET/CT scan. New subcutaneous hypermetabolic foci are seen in bilateral lower extremities, suggestive of recurrent melanoma. She is referred for percutaneous image-guided biopsy for definitive diagnosis of progressive disease.

Imaging of acute abdomen in cancer patients.

The pattern of disease causing acute abdominal pain has changed over last few decades, some of this has been attributed to intraabdominal cancers. The most common acute abdominal complaints in cancer patients are related to the gastrointestinal system. Abdominal emergencies in cancer patients can result from the underlying malignancy itself, cancer therapy and/or result from the standard pathologies causing acute abdomen in otherwise healthy population.

Imaging and Staging of Cervical Cancer.

Cervical carcinoma remains a common gynecologic malignancy. Physical examination has historically served as the predominant tool for staging and assessment, in part due to lack of availability of additional diagnostic resources in many parts of the world. Cross-sectional imaging in the evaluation of cervical cancer has become standard of care in developed countries, and has recently been incorporated into the official staging classification of the International Federation of Gynecology and Obstetrics.

Tumor thrombus in the venous drainage pathways of primary, recurrent and metastatic disease on routine oncologic imaging studies: beyond hepatocellular and renal cell carcinomas.

Radiologists routinely evaluate for tumor thrombus in the portal and hepatic veins in patients with hepatocellular carcinoma and in the renal vein and inferior vena cava in patients with renal cell carcinoma. However, tumor thrombus occurs in association with numerous other tumor types, . colorectal carcinoma and pancreatic neuroendocrine tumor.

Long-Term Survival According to Histology and Radiologic Response to Preoperative Chemotherapy in 126 Patients Undergoing Resection of Non-GIST Sarcoma Liver Metastases.

Background: Non-gastrointestinal stromal tumor sarcomas (NGSs) have heterogeneous histology, and this heterogeneity may lead to uncertainty regarding the prognosis of patients with liver metastases from NGS (NGSLM) and decision regarding their surgical management. Furthermore, the role of preoperative chemotherapy in treatment of NGSLM remains poorly defined. We investigated long-term survival and its correlation to response to preoperative chemotherapy in patients with NGSLM.

Free-breathing radial volumetric interpolated breath-hold examination vs breath-hold cartesian volumetric interpolated breath-hold examination magnetic resonance imaging of the liver at 1.5T.

Aim: To compare breath-hold cartesian volumetric interpolated breath-hold examination (cVIBE) and free-breathing radial VIBE (rVIBE) and determine whether rVIBE could replace cVIBE in routine liver magnetic resonance imaging (MRI).

Methods: In this prospective study, 15 consecutive patients scheduled for routine MRI of the abdomen underwent pre- and post-contrast breath-hold cVIBE imaging (19 s acquisition time) and free-breathing rVIBE imaging (111 s acquisition time) on a 1.5T Siemens scanner.

Analysis of free-form radiology dictations for completeness and clarity for pancreatic cancer staging.

Purpose: To assess the completeness and clarity of current free-form radiology reports for pancreatic cancer staging by evaluating them against the elements of the RSNA CT oncology primary pancreas mass dictation template.

Methods: This retrospective study was approved by our Institutional Review Board (IRB). 295 free-form computed tomography (CT) reports for baseline staging of pancreatic cancer (PC) generated between August 2008 and December 2010 were evaluated by one of two radiologists with expertise in pancreatic cancer imaging.

Nosocomial rapidly growing mycobacterial infections following laparoscopic surgery: CT imaging findings.

Objective: To identify the distribution and frequency of computed tomography (CT) findings in patients with nosocomial rapidly growing mycobacterial (RGM) infection after laparoscopic surgery.

Method: A descriptive retrospective study in patients with RGM infection after laparoscopic surgery who underwent CT imaging prior to initiation of therapy. The images were analyzed by two radiologists in consensus, who evaluated the skin/subcutaneous tissues, the abdominal wall, and intraperitoneal region separately.

Optimization of MR imaging for pretreatment evaluation of patients with endometrial and cervical cancer.

Endometrial and cervical cancer are the most common gynecologic malignancies in the world. Accurate staging of cervical and endometrial cancer is essential to determine the correct treatment approach. The current International Federation of Gynecology and Obstetrics (FIGO) staging system does not include modern imaging modalities.

Ewing sarcoma of the kidney: a rare entity.

Ewing sarcoma and primitive peripheral neuroectodermal tumor (PNET) are high-grade malignant tumors typically found in children and adolescents. These tumors belong to the family of small round cell tumors and are of neuroectodermal origin. Primary Ewing sarcoma of the kidney is rare and because of that is an infrequent differential diagnosis in urologic malignancies.

Intrabiliary growth of colorectal liver metastasis: spectrum of imaging findings and implications for surgical management.

Objective: The propensity for colorectal liver metastasis to invade the biliary tree is increasingly recognized, placing particular emphasis on the risk of postoperative recurrence. This article illustrates the spectrum of imaging findings when colorectal metastasis invades the biliary tree.

Conclusion: Knowledge of the imaging features of intrabiliary invasion by colorectal liver metastasis improves the quality of preoperative staging and is crucial in an era in which nonanatomic wedge resection and radiofrequency ablation are routinely performed.

Sonohysterography: Principles, technique and role in diagnosis of endometrial pathology.

Sonohysterography (SHG), which provides enhanced endometrial visualization during standard transvaginal ultrasonography, is a relatively safe procedure for the evaluation of endometrial pathology. It can be used to evaluate patients with abnormal vaginal bleeding or infertility. This modality offers real time imaging of the endometrium without exposure to ionizing radiation.

Intraoperative abdominal ultrasound in oncologic imaging.

Significant advances in ultrasound technology have created new opportunities for its use in oncologic imaging. The advent of new transducers with focal beam technology and higher frequency has solidified the role of intraoperative sonography (IOUS) as an invaluable imaging modality in oncologic surgery of the liver, kidneys and pancreas. The ability to detect and characterize small lesions and the precise intraoperative localization of such tumors is essential for adequate surgical planning in segmental or lobar hepatic resections, metastasectomy, nephron-sparing surgery, and partial pancreatectomy.

Imaging features of hematogenous metastases to the pancreas: pictorial essay.

This pictorial essay illustrates the imaging appearances of a wide variety of metastases to the pancreas as seen on computed tomography (CT), magnetic resonance imaging and positron emission tomography/CT. Key clinical and radiologic features (lesion distribution, non-contrast imaging appearance, enhancement pattern and pattern of spread) that may aid differentiation of primary from solitary secondary pancreatic malignancies are discussed.

Mullerian duct anomalies: MR imaging.

Mullerian duct anomalies (MDAs) are rare, affecting approximately 1% of all women and about 3% of women with poor reproductive outcomes. These congenital anomalies usually result from one of the following categories of abnormalities of the mullerian ducts: failure of formation (no development or underdevelopment) or failure of fusion of the mullerian ducts. The American Fertility Society (AFS) classification of uterine anomalies is widely accepted and includes seven distinct categories.

Extramural venous invasion by gastrointestinal malignancies: CT appearances.

The purpose of this article is to describe and demonstrate the appearances of extramural vascular invasion on computed tomography in gastrointestinal malignancies as one of the pathways of disease spread. In this article, we demonstrate the imaging features with pathologically proven examples, along with a brief description of relevant vascular anatomy. We shall also discuss the clinical significance and prognostic implications of extramural vascular invasion in gastrointestinal malignancies.

Multidisciplinary management strategy for incidental cystic lesions of the pancreas.

Background: At our institution, incidental pancreatic cysts are frequently identified in asymptomatic patients undergoing routine imaging for staging of nonpancreatic malignancies. Management of these patients is unclear because a small but significant number of incidental pancreatic cysts are malignant.

Study Design: Our institutional database was reviewed for patients with ICD-9 codes for pancreatic cysts from 1980 to 2005.

Pictorial essay: multimodality imaging of metastases from pancreatic ductal adenocarcinoma.

Surgical resection is the only curative therapy available for pancreatic ductal adenocarcinoma. Unfortunately, metastatic disease constitutes an absolute contraindication for surgery. Therefore, the detection of metastatic disease is a critical component of preoperative imaging of pancreatic adenocarcinoma.