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Radiologic Clinics of North America

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https://www.readbyqxmd.com/read/29622081/imaging-of-lung-cancer-update-on-screening-staging-and-therapy
#1
EDITORIAL
Jeremy J Erasmus, Mylene T Truong
No abstract text is available yet for this article.
May 2018: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/29622080/targeted-therapy-and-immunotherapy-in-the-treatment-of-non-small-cell-lung-cancer
#2
REVIEW
Girish S Shroff, Patricia M de Groot, Vassiliki A Papadimitrakopoulou, Mylene T Truong, Brett W Carter
The treatment strategy in advanced non-small cell lung cancer (NSCLC) has evolved from empirical chemotherapy to a personalized approach based on histology and molecular markers of primary tumors. Targeted therapies are directed at the products of oncogenic driver mutations. Immunotherapy facilitates the recognition of cancer as foreign by the host immune system, stimulates the immune system, and alleviates the inhibition that allows the growth and spread of cancer cells. The authors describes the role of targeted therapy and immunotherapy in the treatment of NSCLC, patterns of disease present on imaging studies, and immune-related adverse events encountered with immunotherapy...
May 2018: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/29622079/lung-cancer-posttreatment-imaging-radiation-therapy-and-imaging-findings
#3
REVIEW
Marcelo F Benveniste, James Welsh, Chitra Viswanathan, Girish S Shroff, Sonia L Betancourt Cuellar, Brett W Carter, Edith M Marom
In this review, we discuss the different radiation delivery techniques available to treat non-small cell lung cancer, typical radiologic manifestations of conventional radiotherapy, and different patterns of lung injury and temporal evolution of the newer radiotherapy techniques. More sophisticated techniques include intensity-modulated radiotherapy, stereotactic body radiotherapy, proton therapy, and respiration-correlated computed tomography or 4-dimensional computed tomography for radiotherapy planning. Knowledge of the radiation treatment plan and technique, the completion date of radiotherapy, and the temporal evolution of radiation-induced lung injury is important to identify expected manifestations of radiation-induced lung injury and differentiate them from tumor recurrence or infection...
May 2018: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/29622078/update-of-mr-imaging-for-evaluation-of-lung-cancer
#4
REVIEW
Mario Ciliberto, Yuji Kishida, Shinichiro Seki, Takeshi Yoshikawa, Yoshiharu Ohno
Since MR imaging was introduced for the assessment of thoracic and lung diseases, various limitations have hindered its widespread adoption in clinical practice. Since 2000, various techniques have been developed that have demonstrated the usefulness of MR imaging for lung cancer evaluation, and it is now reimbursed by health insurance companies in many countries. This article reviews recent advances in lung MR imaging, focusing on its use for lung cancer evaluation, especially with regard to pulmonary nodule detection, pulmonary nodule and mass assessment, lung cancer staging and detection of recurrence, postoperative lung function prediction, and therapeutic response evaluation and prediction...
May 2018: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/29622077/dilemmas-in-lung-cancer-staging
#5
REVIEW
Ioannis Vlahos
The advent of the 8th edition of the lung cancer staging system reflects a further meticulous evidence-based advance in the stratification of the survival of patients with lung cancer. Although addressing many limitations of earlier staging systems, several limitations in staging remain. This article reviews from a radiological perspective the limitations of the current staging system, highlighting the process of TNM restructuring, the residual issues with regards to the assignment of T, N, M descriptors, and their associated stage groupings and how these dilemmas impact guidance of multidisciplinary teams taking care of patients with lung cancer...
May 2018: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/29622076/staging-lung-cancer-metastasis
#6
REVIEW
Girish S Shroff, Chitra Viswanathan, Brett W Carter, Marcelo F Benveniste, Mylene T Truong, Bradley S Sabloff
The updated eighth edition of the tumor, node, metastasis (TNM) classification for lung cancer includes revisions to T and M descriptors. In terms of the M descriptor, the classification of intrathoracic metastatic disease as M1a is unchanged from TNM-7. Extrathoracic metastatic disease, which was classified as M1b in TNM-7, is now subdivided into M1b (single metastasis, single organ) and M1c (multiple metastases in one or multiple organs) descriptors. In this article, the rationale for changes in the M descriptors, the utility of preoperative staging with PET/computed tomography, and the treatment options available for patients with oligometastatic disease are discussed...
May 2018: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/29622075/staging-lung-cancer-regional-lymph-node-classification
#7
REVIEW
Ahmed H El-Sherief, Charles T Lau, Brett W Carter, Carol C Wu
This article reviews regional lymph node assessment in lung cancer. In the absence of a distant metastasis, the absence or location of lung cancer spread to a regional mediastinal lymph node affects treatment options and prognosis. Regional lymph node maps have been created to standardize assessment of the N descriptor. The International Association for the Study of Lung Cancer lymph node map is used for the standardization of N descriptor assessment. CT, PET/CT with fluorodeoxyglucose, endobronchial ultrasound-guided and/or esophageal ultrasound-guided biopsy, and mediastinoscopy are common modalities used to determine the N descriptor...
May 2018: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/29622074/tumor-staging-of-lung-cancer-essential-concepts-for-the-radiologist
#8
REVIEW
Constantine A Raptis, Caroline L Robb, Sanjeev Bhalla
Several important modifications have been proposed for the tumor (T) descriptor for lung cancers. New size cutoffs have been determined and there are new T descriptors for adenocarcinoma in situ, minimally invasive adenocarcinoma, and part-solid adenocarcinomas with a solid component > 0.5 cm to 3 cm (T1a, T1b, T1c). There are also recommendations for multifocal adenocarcinoma, which are classified by the lesion with the highest level T descriptor, and the number of lesions is indicated. Knowledge of these changes is important in the appropriate clinical staging of patients with lung cancer...
May 2018: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/29622073/lung-cancer-biopsies
#9
REVIEW
Amita Sharma, Jo-Anne O Shepard
Image-guided percutaneous transthoracic needle biopsy (PTNB) is a well-established and minimally invasive technique for evaluating pulmonary nodules. Implementation of a national lung screening program and increased use of chest computed tomography have contributed to the frequent identification of indeterminate pulmonary nodules that may require tissue sampling. The advent of biomarker-driven lung cancer therapy has led to increased use of repeat PTNB after diagnosis. Percutaneous insertion of markers for preoperative localization of small nodules can aid in minimally invasive surgery and radiation treatment planning...
May 2018: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/29622072/missed-lung-cancer
#10
REVIEW
Rydhwana Hossain, Carol C Wu, Patricia M de Groot, Brett W Carter, Matthew D Gilman, Gerald F Abbott
The chest radiograph is one of the most commonly used imaging studies and is the modality of choice for initial evaluation of many common clinical scenarios. Over the last two decades, chest computed tomography has been increasingly used for a wide variety of indications, including respiratory illnesses, trauma, oncologic staging, and more recently lung cancer screening. Diagnostic radiologists should be familiar with the common causes of missed lung cancers on imaging studies in order to avoid detection and interpretation errors...
May 2018: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/29622071/pulmonary-nodule-management-in-lung-cancer-screening-a-pictorial-review-of-lung-rads-version-1-0
#11
REVIEW
Myrna C B Godoy, Erika G L C Odisio, Mylene T Truong, Patricia M de Groot, Girish S Shroff, Jeremy J Erasmus
The number of screening-detected lung nodules is expected to increase as low-dose computed tomography screening is implemented nationally. Standardized guidelines for image acquisition, interpretation, and screen-detected nodule workup are essential to ensure a high standard of medical care and that lung cancer screening is implemented safely and cost effectively. In this article, we review the current guidelines for pulmonary nodule management in the lung cancer screening setting.
May 2018: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/29622070/management-of-incidental-lung-nodules-current-strategy-and-rationale
#12
REVIEW
Jeffrey B Alpert, Jane P Ko
Incidentally detected lung nodules are increasingly common in routine diagnostic computed tomography (CT) imaging. Formal management recommendations for incidental nodules, such as those outlined by the Fleischner Society, must therefore reflect a balance of malignancy risk and the clinical context in which nodules are discovered. Nodule size, attenuation, morphology, and location all influence the likelihood of malignancy and, thus, the necessity and timing of follow-up according to current Fleischner recommendations...
May 2018: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/29420987/prostate-mr-imaging
#13
EDITORIAL
Aytekin Oto
No abstract text is available yet for this article.
March 2018: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/29420986/future-perspectives-and-challenges-of-prostate-mr-imaging
#14
REVIEW
Baris Turkbey, Peter L Choyke
MR imaging is an important part of prostate cancer diagnosis. Variations in quality and skill in general practice mean results are not as impressive as they were in academic centers. This observation provides an impetus to improve the method. Improved quality assurance will likely result in better outcomes. Improved characterization of clinically significant prostate cancer may assist in making MR imaging more useful. Improved methods of registering MR imaging with transrectal ultrasound imaging and robotic arms controlling the biopsy can reduce the impact of inexperienced operators and make the entire system of MR imaging-guided biopsies more robust...
March 2018: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/29420985/role-of-prostate-mr-imaging-in-radiation-oncology
#15
REVIEW
Cynthia Ménard, Eric Paulson, Tufve Nyholm, Patrick McLaughlin, Gary Liney, Piet Dirix, Uulke A van der Heide
The use of prostate MR imaging in radiotherapy continues to evolve. This article describes its current application in the selection of treatment regimens, integration in treatment planning or simulation, and assessment of response. An expert consensus statement from the annual MR in RT symposium is presented, as a list of 21 key quality indicators for the practice of MR imaging simulation in prostate cancer. Although imaging requirements generally follow PIRADSv2 guidelines, additional requirements specific to radiotherapy planning are described...
March 2018: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/29420984/mr-imaging-guided-focal-treatment-of-prostate-cancer-an-update
#16
REVIEW
Sherif G Nour
Focal treatment of prostate cancer has evolved from a concept to a practice in the recent few years and is projected to fill an existing need, bridging the gap between conservative and radical traditional treatment options. With its low morbidity and rapid recovery time compared with whole-gland treatment alternatives, focal therapy is poised to gain more acceptance among patients and health care providers. As our experience with focal treatment matures and evidence continues to accrue, the landscape of this practice might look quite different in the future...
March 2018: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/29420983/mr-imaging-targeted-prostate-biopsies
#17
REVIEW
Saradwata Sarkar, Sadhna Verma
Conventional ultrasound-guided prostate biopsies have multiple limitations leading to underdetection of clinically significant prostate cancer (PCa) and overdetection of clinically insignificant PCa. Multiparametric MR imaging of the prostate offers better localization of prostatic tumors in comparison with ultrasound imaging and can help address these limitations. MR imaging-identified lesions can be targeted for biopsy directly in-gantry or indirectly using a fusion of MR imaging and ultrasound imaging. The fusion may be performed by the operator visually or using a software fusion device...
March 2018: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/29420982/multiparametric-mr-imaging-of-the-prostate-pitfalls-in-interpretation
#18
REVIEW
Stephen Thomas, Aytekin Oto
Multiparametric MR imaging is widely embraced for the diagnosis, staging, and surveillance of prostate cancer. However, normal anatomic structures and many benign entities have overlapping imaging features with prostate cancer. Although some of these entities require biopsy and histopathologic diagnosis, some have characteristic imaging features that are suggestive of their diagnosis. Knowledge of these pitfalls is important in establishing a correct diagnosis and avoiding unnecessary biopsies, as these entities are encountered routinely in clinical practice...
March 2018: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/29420981/prostate-mr-imaging-for-posttreatment-evaluation-and-recurrence
#19
REVIEW
Sonia Gaur, Baris Turkbey
Prostate multiparametric MR imaging (mpMRI) plays an important role in local evaluation after treatment of prostate cancer. After radical prostatectomy, radiation therapy, and focal therapy, mpMRI can be used to visualize normal post-treatment changes and to diagnose locally recurrent disease. An understanding of the various treatments and expected changes is essential for complete and accurate post-treatment mpMRI interpretation.
March 2018: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/29420980/mr-imaging-for-prostate-cancer-screening-and-active-surveillance
#20
REVIEW
Sasha C Druskin, Katarzyna J Macura
The current prostate cancer management paradigm has been criticized in recent years for contributing to the overdiagnosis and overtreatment of the disease. Active surveillance is an avenue by which to reduce overtreatment, but patient selection and monitoring remain a challenge. The use of prostate MR imaging has been growing in recent years and has been incorporated into prostate cancer screening and patient selection and monitoring for active surveillance. This review article discusses the current evidence for the use of MR imaging in each of those settings...
March 2018: Radiologic Clinics of North America
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