Imaging

Staging rectal cancer with MRI

With the advent of powerful gradient coil systems and high-resolution surface coils, magnetic resonance imaging (MRI) has come into tis own in being able to assess the relationship of a rectal tumor to surrounding organs and tissues. MRI is currently the only imaging modality that is highly accurate in predicting whether or not it is likely that a tumor can be resected without leaving cells behind and, therefore,  provides important information

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FDG PET for neuroendocrine cancer

PET that uses FDG (a type of tagged sugar) is not all that sensitive in neuroendocrine cancers(NET). This means that it may not pick up some neuroendocrine cancers. Specificity means that what it does pick up is really cancer and not some other false positive. However, other imaging modalities also had disadvantages as well as advantages.  One study revealed that for neuroendocrine tumors, PET that used 18F-FDOPA was more accurate (sensitivity,

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MRI for back pain

Back pain is very common.  It widely acknowledged that there should be definitive standar5ds on when and how frequently MRI scans should be performed to assess back pain. The American College of Physicians (ACP) and the American Pain Society (APS) have issued a comprehensive joint clinical practice guideline for the diagnosis and treatment of low back pain, which is published in the October 2, 2007 issue of the Annals of Internal Medicine. For patients

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PET for cholangiocarcinoma – pro

Cholangiocarcinomas are not simple to image because they are located in an area of multiple other organs and there is often associated inflammation and anatomic variation. There are also only a few studies of PET for cholangiocarcinomas and conclusions vary. In a study by Kim et al, FDG PET was not found to be specific enough in detecting hilar cholangiocarcinomas, an observation ascribed to small tumor size or to fibrous or mucinous components of

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Posttreatment surveillance after hepatic metastases resection for colorectal cancer

Since the appearance of effective new drugs for colorectal cancer and more aggressive surgical approaches to resecting isolated metastases, many patients who had metastatic cancer are now free of disease for an extended period of time. There are few guidelines on how to follow such patients it is fairly new situation and there are no mature studies. For high risk non-metastatic colon cancer, NCCN guidelines recommend annual CT of chest, abdomen

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PET for glioblastoma

PET is more and more frequently used to visualize brain cancers. However, PET is not medically appropriate to follow glioblastoma because it not supported by credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community.  PET for brain cancer is not included in the NCCN guidelines and CMS does not cover PET for this diagnosis. Occasionally, PET can provide information to differentiate

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Breast tomosynthesis: a new mammography

Breast tomosynthesis is a 3-dimensional (3-D) imaging technology that involves acquiring images of a compressed breast at multiple angles during a short scan. It is more comfortable than standard mammography. The individual images are then reconstructed into a series of thin high-resolution slices that displayed individually or in a dynamic movie-like mode. Tomosynthesis can reduce or eliminate the tissue overlap effect. While holding the breast

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PET for salivary gland cancers

The clinical utility of 18F-FDG PET in evaluating salivary gland malignancies has not been well defined. First we need to know how sensitive and specific PET can be and then a variety of issues regarding its role in staging, restaging and surveillance have to be resolved. The largest study by Hong-Lyel was only in 34 patients. He found that the sensitivity of 18F-FDG PET and CT for detecting primary tumors was 31 of 34 (91.2%) and 27 of 34 (79.4%),

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PET for neuroendocrine cancer

FDG PET is not all that sensitive in neuroendocrine cancers(NET). This may relate to how neuroendocrine cancer takes up FDG in comparison to other radio-labels used for PET scanning. One study revealed that for neuroendocrine tumors, 18F-FDOPA scanning was more sensitive and accurate (sensitivity, 100%; specificity, 91%) in the detection of skeletal lesions than octreotide scintigraphy or CT but was not sensitive (sensitivity, 20%; specificity, 94%)

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MRI to Assess Bone Marrow Blood Flow

Among the new spinoffs of MRI technology is the recently developed method of assessing bone marrow flow, which can provide valuable information on the abnormal cells in the marrow in conditions such as leukemia or multiple myeloma. IT is also being studies in conditions such as prostate cancer that can involve the marrow. The most common method to measure perfusion in the body using MRI is T1-weighted dynamic contrast enhancement (DCE-MRI). The analysis

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