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Seminars in Ultrasound, CT, and MR

Brett W Carter
Lung cancer is the leading cause of cancer-related mortality and accounts for more deaths than breast, prostate, and colon cancers combined. Traditionally, treatment options have included surgery, chemotherapy, and radiation therapy. Continual advances in the characterization of lung cancer have resulted in the development of effective immunotherapies. These agents help the immune system recognize tumors as foreign, stimulate the immune system, and relieve the inhibition that allows the growth and spread of cancer...
June 2018: Seminars in Ultrasound, CT, and MR
Girish S Shroff, Marcelo F Benveniste, Patricia M de Groot, Brett W Carter, Carol C Wu, Chitra Viswanathan, Mylene T Truong
The identification of genetic mutations known as oncogenic driver mutations that lead to the growth and survival of cancer cells has been an important advance in the field of oncology. Treatment in advanced non-small-cell lung cancer (NSCLC) has transitioned from a more general approach to a more personalized approach based on genetic mutations of the cancer itself. Common mutations detected in patients with advanced NSCLC include mutations of epidermal growth factor receptor and anaplastic lymphoma kinase (ALK)...
June 2018: Seminars in Ultrasound, CT, and MR
Marcelo F Benveniste, Sonia L Betancourt Cuellar, Daniel Gomez, Girish S Shroff, Brett W Carter, Ana Paula A Benveniste, Edith M Marom
Radiation therapy is an important modality in the treatment of patients with lung cancer. Recent advances in delivering radiotherapy were designed to improve loco-regional tumor control by focusing higher doses on the tumor. More sophisticated techniques in treatment planning include 3-dimensional conformal radiation therapy, intensity-modulated radiotherapy, stereotactic body radiotherapy, and proton therapy. These methods may result in nontraditional patterns of radiation injury and various radiologic appearances that can be mistaken for recurrence, infection and other lung diseases...
June 2018: Seminars in Ultrasound, CT, and MR
Patricia M de Groot, Mylene T Truong, Myrna C B Godoy
Surgical resection offers the best hope of cure for patients with operable early-stage lung cancer. Wedge resection, segmentectomy, lobectomy, or pneumonectomy may be performed depending on the size and location of the tumor. Radiologists must be familiar with the types of surgical resection utilized in the treatment of lung carcinoma and with their normal and abnormal postsurgical appearance on imaging studies. Prompt identification of postoperative complications on imaging is essential to appropriate patient management and helps to determine when additional intervention is warranted...
June 2018: Seminars in Ultrasound, CT, and MR
Girish S Shroff, Bradley S Sabloff, Mylene T Truong, Brett W Carter, Chitra Viswanathan
Applications of positron emission tomography/computed tomography (PET/CT) in the thorax include the evaluation of solitary pulmonary nodules, staging and restaging of oncologic patients, assessment of therapeutic response, and detection of residual or recurrent disease. Accurate interpretation of PET/CT requires knowledge of the physiological distribution of [18F]-fluoro-2-deoxy-D-glucose, as well as artifacts and quantitative errors due to the use of CT for attenuation correction of the PET scan. Potential pitfalls include malignancies that are PET negative and benign conditions that are PET positive...
June 2018: Seminars in Ultrasound, CT, and MR
Emily B Tsai, Caroline Chiles, Brett W Carter, Myrna C B Godoy, Girish S Shroff, Reginald F Munden, Mylene T Truong, Carol C Wu
Incidental findings are commonly detected by computed tomography, but distinguishing which findings have little or no clinical consequence and which are significant enough to require further evaluation is not always clear. This distinction is important for patient care and to ensure appropriate use of health care resources. This article aims to highlight some of the incidental findings detected by low-dose CT (LDCT) performed for lung cancer screening and to present an overview of currently accepted management recommendations...
June 2018: Seminars in Ultrasound, CT, and MR
Myrna C B Godoy, Erika G L C Odisio, Jeremy J Erasmus, Rodrigo C Chate, Ricardo S Dos Santos, Mylene T Truong
Lung cancer is the leading cause of cancer death in both men and women in the United States. The National Lung Screening Trial (NLST) demonstrated that low-dose computed tomography (CT) screening reduces lung cancer mortality by 20% compared to screening with chest radiography. Currently, many institutions in the US are implementing lung cancer screening programs. The use of lung-RADS as a quality assurance tool allows standardization of lung cancer screening CT lexicon, reporting and management recommendations, and reduces confusion in lung cancer screening CT interpretations...
June 2018: Seminars in Ultrasound, CT, and MR
Jane P Ko, Lea Azour
The incidental pulmonary nodule is commonly encountered when interpreting chest CTs. The management of pulmonary nodules requires a multidisciplinary approach entailing integration of nodule size and features, clinical risk factors, and patient preference and comorbidities. Guidelines have been issued for the management of both solid and subsolid nodules, with the Fleischner Society issuing revised guidelines in 2017. This article focuses on the CT imaging characteristics and clinical behavior of pulmonary nodules, with review of the current management guidelines that reflect this knowledge...
June 2018: Seminars in Ultrasound, CT, and MR
Gabriela Gayer
No abstract text is available yet for this article.
June 2018: Seminars in Ultrasound, CT, and MR
Gabriela Gayer, Christian Park
The abdominal wall does not comprise a distinct organ, and is often cursorily evaluated on CT. However, it is affected by many different pathological processes. These may be categorized according to their underlying etiology-trauma, infection or inflammation, iatrogenic and neoplastic process-or according to the abdominal wall layer they affect. We chose instead to group these lesions into 6 distinct categories based on their CT characteristic density: solid, infiltrative, hypervascular, fluid, fat, and bone density lesions...
April 2018: Seminars in Ultrasound, CT, and MR
Ulysses S Torres, Carlos Matsumoto, Dalila R Maia, Luis Ronan M F de Souza, Giuseppe D'Ippolito
The group of inflammatory pseudotumors (IPTs) encompasses a variety of rare neoplastic and nonneoplastic entities described to occur in almost every location in the body and whose clinical features and aggressive imaging findings (varying from infiltrative to mass-forming lesions), frequently mimic those of malignant tumors. The radiologic features of IPTs are variable and nonspecific, the imaging findings depending on the body location and involved organ. Abdominopelvic IPTs are rare and the purposes of this review, therefore, are to familiarize the radiologist with the wide spectrum of computed tomography and magnetic resonance imaging findings of IPTs in various locations throughout the abdomen and pelvis, discussing the imaging features that allow consideration of IPTs in the differential diagnosis of soft-tissue masses within the pertinent clinical setting...
April 2018: Seminars in Ultrasound, CT, and MR
Ulysses S Torres, Carlos Matsumoto, Augusto Cesar de Macedo Neto, Rogério Pedreschi Caldana, Ângela Hissae Motoyama Caiado, Dario Ariel Tiferes, Gisele Warmbrand, Laiz Laura de Godoy, Giuseppe D'Ippolito
There is a broad range of inflammatory, pseudotumoral, and benign lesions that may masquerade as pancreatic malignancies, often representing a challenge to the radiologist. Unawareness of these entities can lead to inadequate differential diagnoses or misdiagnosis, with important prognostic and therapeutic consequences. The purpose of this article is to revisit a spectrum of lesions, varying from common to exceedingly rare nonmalignant, that may mimic malignant pancreatic neoplasms on imaging, identifying relevant features that may contribute to reaching the correct diagnosis...
April 2018: Seminars in Ultrasound, CT, and MR
Adele Taibbi, Dario Picone, Massimo Midiri, Ludovico La Grutta, Tommaso Vincenzo Bartolotta
Nowadays, the most common imaging techniques allow to study focal liver lesions with high diagnostic accuracy but a relatively recent emerging field of interest is represented by diffuse liver disease. They include a variegated series of storage and metabolic pathologies (ie, iron overload disorders and steatosis) requiring a precise diagnosis not always possible at imaging due to the overlapping of findings at conventional ultrasound, CT, or MR studies. In recent years, several imaging tecniques and specific softwares have been developed, especially for ultrasound and MR imaging, in order to identify different parameters useful in the noninvasive recognition and follow-up of these diffuse processes involving the liver...
April 2018: Seminars in Ultrasound, CT, and MR
Arthur H Baghdanian, Armonde A Baghdanian, Shilpa Puppala, Michele Tana, Michael A Ohliger
Although the overall prevalence of peptic ulcer disease (PUD) has decreased in modern times, its actual incidence may be underestimated owing to the nonspecific clinical presentations patients' manifest. The potential lethal complications that can result from PUD include life-threatening abdominal hemorrhage and bowel perforation that result in significant morbidity and mortality. Computed tomography (CT) imaging historically lacks specificity in detecting PUD-related pathology in the stomach and proximal small bowel segments...
April 2018: Seminars in Ultrasound, CT, and MR
Ulysses S Torres, Camila D F M Fortes, Priscila S Salvadori, Dario A Tiferes, Giuseppe D Ippolito
Pneumatosis of the alimentary tract may occur from the esophagus to rectum as a result of a wide spectrum of conditions that range from benign to life-threatening. Although distinguishing between these 2 groups is of paramount importance for an appropriate clinical management, it still remains a challenge for the radiologist in the daily practice. In the light of the current literature, we provide in the present article a comprehensive review focusing on the clinical, laboratory, and radiological findings that most consistently may allow such a differentiation...
April 2018: Seminars in Ultrasound, CT, and MR
Francesca Iacobellis, Alessandra Perillo, Isabella Iadevito, Michela Tanga, Luigia Romano, Roberto Grassi, Refky Nicola, Mariano Scaglione
Oncologic emergencies can be either the result of the primary tumor, its metastasis, a paraneoplastic syndrome or reaction to the chemotherapy. Imaging plays a crucial role in ensuring a prompt diagnosis as well as assisting in the therapeutic management. In this article, we discuss the common thoracic and abdominal oncological emergencies that may be encountered in an emergency department.
April 2018: Seminars in Ultrasound, CT, and MR
Yoan K Kagoma, Gabriela Gayer
Internal hernia in the postoperative laparoscopic Roux-en-Y patient is a diagnosis associated with significant morbidity and risk of death. The radiologist plays an instrumental role in workup of this patient group; however, the imaging assessment of these patients is not straightforward given their complex postsurgical anatomy. Multiple radiologic signs of internal hernia have been studied in the literature. This review article presents these signs with representative cases as well as a summary of their diagnostic accuracy...
April 2018: Seminars in Ultrasound, CT, and MR
Kunal Kothari, John J Hines
The kidneys are paired intra-abdominal organs which provide essential functions and maintain homeostasis throughout the human body. Numerous disease processes affect the kidneys and cause acute renal dysfunction or other potentially catastrophic complications. These conditions can be broadly categorized into obstructive, infectious, hemorrhagic, traumatic, and vascular diseases. Imaging plays a vital role in the work-up and diagnosis of acute and emergent renal conditions. Evaluation of emergent renal conditions with a focus on CT imaging is discussed...
April 2018: Seminars in Ultrasound, CT, and MR
Gabriela Gayer
No abstract text is available yet for this article.
April 2018: Seminars in Ultrasound, CT, and MR
Richard G Barr
There is a large body of published material that supports the use of elastography, both strain and shear wave, for characterization of breast lesions. To a lesser extent, elastography can be used in the detection of breast abnormalities. This article reviews the principles of elastography regarding breast imaging, reviews the techniques to perform both strain and shear wave elastography, and reviews the literature and discusses how elastography can be used to improve the characterization of breast lesions to allow for decrease in the number of short-term follow-up examinations and benign biopsies...
February 2018: Seminars in Ultrasound, CT, and MR
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