Cover
Oncologic Imaging: A Multidisciplinary Approach
Copyright
Dedication
Contributors
Foreword
Acknowledgments
Table of Contents
1 A Multidisciplinary
Approach
to Cancer: A Radiologist’s
View
Introduction
Multidisciplinary Cancer Imaging: The Role Of The Radiologist
The Value Of Communication
Participation
Summary
References
2 A Multidisciplinary
Approach
to Cancer: A Surgeon’s View
Introduction
Diagnosis
Staging
Surgical Planning
Surgical Treatment
Definitive Resection of Primary Tumors
Definitive Resection of Metastatic Tumors
Debulking Surgery
Palliative and Emergency Surgery
Reconstructive Surgery
Conclusions
Summary
References
3 A Multidisciplinary
Approach
to Cancer: A Medical
Oncologist’s View
Introduction
Epidemiology
The Rationale For Chemotherapy
Indications For Chemotherapy
Adjuvant Chemotherapy
Neoadjuvant Chemotherapy
Chemotherapy for Metastatic Cancer
Chemotherapy Schedules
Dose Intensity
Combination Chemotherapy
Intermittent Chemotherapy
Continuous Therapy
Targeted Therapy
Route of Administration
Drug Development
Clinical Development
Summary
References
4 A Multidisciplinary
Approach
to Cancer: A Radiation
Oncologist’s View
Radiation Biology
Normal Tissue Effects Of Radiation
Therapeutic Gain
Surgery And Radiation Therapy
Chemotherapy And Radiation Therapy
Radiation Techniques
External Beam Radiation Therapy
Photons
Electrons and Protons
Treatment Planning
Brachytherapy
Role Of Imaging In Radiation Therapy
References
5
Assessing Response to Therapy
Introduction
General Imaging Strategies
Why Do We Need To Monitor Tumor Response?
History of an Evolving Imaging-Based Response Assessment
RECIST 1.1: The Current Standard
Highlighting Sources of Errors in Response Evaluation
Possible Problems Related to Image Acquisition
Errors Resulting From Target Selection
Errors in Tumor Measurement
Errors Related to Nontumor Conditions
How Is Response Determined on Positron Emission Tomography?
Qualitative Technique.
Quantitative Technique.
Immune-Related Response Criteria
References
6
Head and Neck Cancer
Introduction
Epidemiology And Clinical Presentation
Pathology And Risk Factors
Mucosal Squamous Cell Carcinoma
Skin Cancers
Lymphoma
Salivary Gland Tumors
Miscellaneous
Anatomy
Mucosal Surfaces
Parapharyngeal and Retropharyngeal Spaces
Salivary glands
Lymphatics
Imaging
Computed Tomography
Positron Emission Tomography
Magnetic Resonance Imaging
Ultrasound
Patterns Of Nodal Metastases And Workup Of The “Unknown Primary”
Patterns Of Tumor Spread And Staging Of Disease
Direct Invasion by Primary Tumor (T Stage)
Cervical Lymphadenopathy (N Stage)
Hematogenous Dissemination, Distant Metastases (M stage)
Perineural Tumor Spread
Treatment
Surveillance
Monitoring Tumor Response and Detecting Recurrence
Complications of Therapy
Summary
References
7 Lung Cancer
Introduction
Epidemiology and Risk Factors
Pathology
Adenocarcinoma
Squamous Cell Carcinoma
Large Cell Carcinoma
Small Cell Lung Cancer
Clinical Manifestations
Patterns of Tumor Spread
Imaging Evaluation
Nonsmall Cell Lung Cancer Tumor-Node-Metastasis Staging
Primary Tumor (T Descriptor)
Regional Lymph Nodes (N Status)
Metastatic Disease (M Status)
Small Cell Lung Cancer Staging
Imaging
Nonsmall Cell Lung Cancer
Small Cell Lung Cancer
Treatment
Nonsmall Cell Lung Cancer
Small Cell Lung Cancer
Surveillance
Conclusion
References
Abbreviated References
8 Primary Mediastinal Neoplasms
Introduction
Epidemiology And Risk Factors
Anatomy And Pathology
Clinical Presentation
Staging
Patterns Of Spread
Imaging
Thymic Neoplasms
Germ Cell Tumors
Neurogenic Tumors
Treatment
Thymic Tumors
Germ Cell Tumors
Neurogenic Tumors
Surveillance
New Therapies
Summary
Acknowledgment
References
9 Pleural Tumors
Introduction
Epidemiology And Risk Factors
Anatomy and Pathology
Clinical Presentation
Patterns of Tumor Spread
Staging Evaluation
T Staging
N Staging
M Staging
Imaging
Chest Radiography
Computed Tomography
Magnetic Resonance Imaging
Positron Emission Tomography
Differential Diagnosis
Treatment
Treatment Response and Prognosis
Surveillance
Complications of Therapy
Summary
References
10 Liver Cancer:
Hepatocellular
and Fibrolamellar
Carcinoma
Hepatocellular Carcinoma
Introduction
Epidemiology
Anatomy
Pathology
Clinical Presentation
Staging Classification
Patterns of Tumor Spread
Imaging
Liver Imaging Reporting and Data System
Primary Tumor
Ultrasound
Computed Tomography
Magnetic Resonance Imaging
Positron Emission Tomography
Lymph Nodes
Metastatic Disease
Treatment
Liver Resection
Liver Transplant
Transarterial Chemoembolization
Ablation
Systemic Therapy
Radioembolization
Stereotactic Body Radiotherapy
Posttreatment Imaging
Liver Imaging Reporting and Data System Assessment
Imaging Following Radiofrequency Ablation
Imaging Following Transarterial Chemoembolization
Imaging Following Transarterial Radioembolization
The Radiology Report
Summary
Fibrolamellar Hepatocellular Carcinoma
Introduction
Epidemiology
Pathology
Clinical Presentation
Staging
Patterns of Tumor Spread
Imaging
Treatment
Surgery
Transarterial Chemoembolization/Chemotherapy Agents
Radiation Therapy
Surveillance
The Radiology Report
Summary
References
11 Cholangiocarcinoma
Introduction
Intra- And Extrahepatic Cholangiocarcinoma
Epidemiology And Risk Factors
Anatomy
Pathology
Clinical Presentation
Staging Classification
Perihilar Extrahepatic Cholangiocarcinoma
Distal Extrahepatic Cholangiocarcinoma
Intrahepatic Cholangiocarcinoma
Patterns of Tumor Spread
Imaging
Primary Tumor
Ultrasound
Computed Tomography
Positron Emission Tomography
Magnetic Resonance Imaging
Percutaneous Transhepatic Cholangiography and Endoscopic Retrograde Cholangiopancreatography
Lymph Nodes
Metastatic Disease
The Radiology Report
Treatment
Surgery
Transarterial Chemoembolization
Radiofrequency Ablation
Chemotherapy
Radiotherapy
Surveillance
Summary
Gallbladder Cancer
Introduction
Epidemiology
Anatomy
Clinical Presentation
Pathology
Staging
Pattern of Tumor Spread
Imaging
The Radiology Report
Therapy
Surgery
Chemotherapy/Radiation Therapy
Surveillance
Summary
References
12 Pancreatic Ductal Adenocarcinoma
Introduction
Epidemiology and Risk Factors
Molecular Biomarkers
Anatomy and Pathology
Clinical Presentation
Classification
Primary Tumor (T)
Nodal Disease (N)
Metastatic Disease (M)
Stage Grouping
Patterns of Tumor Spread
Imaging
Primary Tumor
Nodal Disease
Metastatic Disease
Clinician’s Perspective on Imaging
Treatment
General Considerations
Surgery
Adjuvant and Neoadjuvant Chemotherapy and Radiation Therapy
Image-Guided Locoregional Therapies
Surveillance
Monitoring Tumor Response
Detection of Recurrence
Screening in Pancreatic Ductal Adenocarcinoma
Future Directions
Positron Emission Tomography/Magnetic Resonance
Imaging-Based Biomarkers
Deep Learning
Conclusion
References
13 Cystic Pancreatic Lesions
Introduction
Pancreatic Pseudocysts
Epidemiology and Risk Factors
Clinical Presentation
Imaging
Treatment
Surveillance
Simple Cysts
Epidemiology and Risk Factors
Clinical Presentation
Imaging
Treatment
Surveillance
Mucinous Nonneoplastic Cyst
Epidemiology and Risk Factors
Pathology
Clinical Presentation
Imaging
Treatment
Surveillance
Mucinous Cystadenomas
Epidemiology and Risk Factors
Anatomy and Pathology
Clinical Presentation
Imaging
Treatment
Surveillance
Mucinous Cystadenocarcinomas
Epidemiology and Risk Factors
Anatomy and Pathology
Clinical Presentation
Staging Evaluation
Imaging
Treatment
Surveillance
Intraductal Papillary Mucinous Neoplasm
Introduction
Epidemiology and Risk Factors
Anatomy and Pathology
Clinical Presentation
Main Duct-Type Intraductal Papillary Mucinous Neoplasm
Anatomy and Pathology
Clinical Presentation
Patterns of Tumor Spread
Staging
Imaging
Branch-Duct Intraductal Papillary Mucinous Neoplasms
Anatomy and Pathology
Clinical Presentation
Patterns of Tumor Spread
Imaging
Combined Intraductal Papillary Mucinous Neoplasms
Treatment
Surveillance
Serous Cystadenoma
Introduction
Epidemiology and Risk Factors
Microcystic Serous Cystadenomas
Anatomy and Pathology
Clinical Presentation
Treatment
Oligocystic Serous Cystadenoma
Anatomy and Pathology
Imaging
Treatment
Surveillance
Solid Pseudopapillary Tumor
Introduction
Epidemiology and Risk Factors
Anatomy and Pathology
Clinical Presentation
Staging
Patterns of Tumor Spread
Imaging
Treatment
Surveillance
Guidelines For Imaging Surveillance
Summary
References
14 Pancreatic
Neuroendocrine
Tumors
Introduction
Epidemiology and Risk Factors
Anatomy
Tumor Types and Clinical Presentation
Pathology
Staging
Imaging
Anatomic Imaging
Ultrasound
Endoscopic Ultrasound
Multidetector Row Computed Tomography and Magnetic Resonance Imaging
Multidetector Row Computed Tomography
Magnetic Resonance Imaging
Functional Imaging
Angiography
Treatment
Systemic Therapy
Somatostatin Analogs
Targeted Drugs
Cytotoxic Chemotherapy
Peptide Receptor Radionuclide Therapy
Treatment Sequencing
Specific Tumor Types
Insulinoma
Clinical Presentation
Primary Tumor and Patterns of Tumor Spread
Surgical Treatment
Gastrinoma
Clinical Presentation
Primary Tumor and Patterns of Tumor Spread
Surgical Treatment
Vasoactive Intestinal Polypeptidoma
Clinical Presentation
Primary Tumor and Patterns of Tumor Spread
Surgical Treatment
Glucagonoma
Clinical Presentation
Primary Tumor and Patterns of Tumor Spread
Surgical Treatment
Nonfunctional Pancreatic Neuroendocrine Tumors
Clinical Presentation
Primary Tumor and Patterns of Tumor Spread
Surgical Treatment
Radiation Therapy
Imaging Metastatic Disease
Tumor Response
Objective Criteria Based on Tumor Size
Morphologic Changes Unrelated to Size
Response by Functional Imaging
Summary
References
15 Esophageal Cancer
Introduction
Epidemiology and Risk Factors
Anatomy and Pathology
Clinical Presentation
Staging Evaluation
Patterns Of Tumor Spread
Local Extension
Lymphatic Dissemination
Hematogenous Dissemination
Imaging
Primary Tumor
Computed Tomography and Endoscopic Ultrasound
Positron Emission Tomography/Computed Tomography
Nodal Disease
Computed Tomography
Positron Emission Tomography/Computed Tomography
Metastases
Computed Tomography
Positron Emission Tomography/Computed Tomography
Treatment
Neoadjuvant Chemoradiation Therapy
Radiation Therapy
Surgery
Therapeutic Response Evaluation
Surveillance
New Therapies
Conclusion
References
16 Gastric Carcinoma
Introduction
Epidemiology and Risk Factors
Epidemiology
Etiology and Risk Factors
Clinical Presentation
Anatomy and Pathology
Anatomy
Pathology
Patterns of Tumor Spread
Staging
Imaging Evaluation
Tumor Detection and Staging
Lymph Node Staging
Metastatic Gastric Carcinoma
Treatment
Surgery
Chemotherapy and Radiation Therapy
Advanced or Metastatic Gastric Carcinoma
Surveillance and Recurrence
References
17 Small Bowel Malignant Tumors
Introduction
I Carcinoid
Introduction
Epidemiology
Anatomy and Pathology
Clinical Presentation
Patterns of Tumor Spread
Staging Evaluation
Imaging
Imaging Algorithm for Carcinoid
Treatment
Surveillance
Conclusion
II Adenocarcinoma
Introduction
Epidemiology and Risk Factors
Anatomy and Pathology
Clinical Presentation
Patterns of Tumor Spread
Imaging
Tumor Detection
Primary Tumor (T)
Nodal Disease (N)
Metastatic Disease (M)
Treatment
Surveillance
III Lymphoma
Introduction
Epidemiology
Anatomy and Pathology
Patterns of Tumor Spread
Staging Evaluation
Imaging
Imaging Algorithm for Lymphoma
Treatment
Surveillance
Conclusion
IV Gastrointestinal Stromal Tumor
Introduction
Epidemiology and Risk Factors
Anatomy and Pathology
Clinical Presentation
Patterns of Tumor Spread
Staging Evaluation
Epidemiology and Risk Factors
Imaging
Treatment
Surveillance
V Metastases to the Small Bowel
Anatomy and Pathology
Clinical Presentation
Patterns of Tumor Spread
Staging Evaluation
Imaging
Treatment
Conclusion
References
18 Colorectal Cancer
Introduction
Epidemiology and Risk Factors
Anatomy and Pathology
Patterns of Tumor Spread
Local Spread
Nodal
Peritoneal
Hematogenous
Staging
T Stage
N Stage
M Stage
Surgical Resection Margin
Lymphovascular Invasion
Imaging
Screening
Computed Tomography Colonography
Cancer Staging
Endoscopic Ultrasound
Computed Tomography
Magnetic Resonance Imaging
Positron Emission Tomography
Therapies and Clinical Perspectives
Surgery
Role of Radiation Therapy in the Treatment of Colorectal Cancer
Chemotherapy
Surveillance
Monitoring Tumor Response
Detection of Recurrence
Conclusion
References
19 Renal Tumors
Introduction
Epidemiology and Risk Factors
Anatomy
Pathology
Staging
Imaging Evaluation
Computed Tomography Evaluation
Preoperative Computed Tomography Evaluation
Magnetic Resonance Imaging Evaluation
Ultrasound Evaluation
Percutaneous Biopsy
Patterns of Metastasis
Therapy
Surgical Therapy
Radical Nephrectomy
Laparoscopic Radical Nephrectomy
Management of Metastatic Renal Cell Carcinoma: Role of Cytoreductive Nephrectomy
Nephron-Sparing Surgery: Open, Laparoscopic, and Robotic Partial Nephrectomy
Cryoablation and Radiofrequency Ablation
Medical Therapy
Other Renal Tumors
Wilms Tumor
Mesenchymal Tumors
Angiomyolipoma
Other Rare Renal Mesenchymal Tumors
Lymphoma
Solid Tumor Metastases
Acknowledgements
References
20 Urothelial Carcinoma (Bladder Cancer and Upper Tracts)
Introduction
Epidemiology
Risk Factors
Anatomy and Pathology
Bladder
Upper Tracts
Clinical Presentation
Patterns of Tumor Spread
Bladder Cancer
Upper Tracts
Staging Evaluation
Bladder
Upper Tracts
Imaging
Primary Tumor (T)
Bladder
Computed Tomography
Technique.
Findings.
Magnetic Resonance Imaging.
Technique.
Findings.
Ultrasonography.
Upper Tracts
Intravenous Urography.
Technique.
Imaging Findings.
Direct Pyelography.
Technique.
Computed Tomography Urography.
Technique.
Findings.
Magnetic Resonance Urography.
Technique.
Ultrasonography.
Nodal Disease (N)
Computed Tomography
Magnetic Resonance Imaging
2-[18F] Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography
Metastatic Disease (M)
Computed Tomography
Magnetic Resonance Imaging
Nuclear Medicine
Plain Film Radiography
Percutaneous Biopsy
Treatment
Surgery
Intravesical Therapy
Chemotherapy
Radiation Therapy
Upper Tract Therapies
Surveillance
Monitoring Tumor Response
Detection of Recurrence
Non–Muscle-Invasive Disease
Urothelial Surveillance
Muscle-Invasive Disease
Metastatic Disease
Complications of Therapy
New Therapies
Conclusion
References
21 Testicular Germ Cell Tumors
Introduction
Epidemiology
Risk Factors
Anatomy and Pathology of the Scrotum and Testes
Anatomy
Pathology
Tumor Types
Gross and Microscopic Features
Seminoma.
Nonseminomatous Germ Cell Tumors.
Tumor Markers.
Clinical Presentation
Patterns of Tumor Spread
Lymphatic Drainage of Testes
Blood Supply of Testes
Lymphatic Spread
Hematogenous Spread
Staging
Imaging
Ultrasound
Computed Tomography
Plain Chest Radiographs
Magnetic Resonance Imaging
Magnetic Resonance Imaging Sequences
Magnetic Resonance Imaging of the Scrotum
Positron Emission Tomography/Computed Tomography
Bone Scan
Treatment
Retroperitoneal Lymph Node Dissection
Chemotherapy
Surveillance
Monitoring Tumor Response
Detection of Recurrence
Complications of Therapy
New Therapies
Conclusion
References
22 Primary Adrenal Malignancy
Introduction
I Adrenal Cortical Carcinoma
Epidemiology and Risk Factors
Anatomy and Pathology
Anatomy
Pathology
Clinical Presentation
Staging Classification
Patterns of Tumor Spread
Imaging
Tumor
Computed Tomography
Magnetic Resonance Imaging
Ultrasound
Positron Emission Tomography/Computed Tomography
Radionuclide Imaging
Nodal Disease
Metastatic Disease
Treatment
Surveillance
Malignant Pheochromocytoma
Epidemiology and Risk Factors
Anatomy and Pathology
Patterns of Tumor Spread
Clinical Presentation
Staging Classification
Imaging
Tumor
Computed Tomography
Magnetic Resonance Imaging
Radionuclide Imaging
Nodal and Distant Metastases in Malignant Pheochromocytoma
Treatment
Surveillance
References
23 Prostate Cancer
Introduction
Epidemiology and Risk Factors
Anatomy and Histology
Clinical Presentation
Patterns of Tumor Spread
Staging
Local Staging (T)
Metastatic Disease (N and M Staging)
Imaging
Imaging in Local Staging
Transrectal Ultrasound
Magnetic Resonance Imaging
Detection
Local Staging
Imaging Advanced Disease and Lymphatic and Hematogenous Metastases
Computed Tomography
Bone Scan, Magnetic Resonance Imaging, Computed Tomography, and Radiographs
Treatment
Active Surveillance
Surgery
Cryotherapy
High-Intensity Focused Ultrasound
Radiation Therapy
External Beam Therapy
Outcome Studies for Primary Radiation Therapy
Brachytherapy
Hormone Therapy/Chemotherapy
Recurrence
Complications of Therapy
Conclusion
References
24 Primary
Retroperitoneal
Tumors
Introduction
Epidemiology and Risk Factors
Anatomy and Pathology
Anatomy
Pathology
Clinical Presentation
Staging Evaluation
T Definition: Tumor Size
N Definition
M Definition
Pathologic Criteria: Grading
Limitations of American Joint Committee on Cancer Classification
Site of Origin
Size of Primary Tumor
Margin Status of Resected Tumor
Tumor Recurrence
Other Staging Systems
Patterns of Tumor Spread
Local Spread
Hematogenous, Lymphatic, and Peritoneal Spread
Imaging
Primary Tumor Detection and Characterization
Liposarcoma
Leiomyosarcoma
Sarcomas Related to Genetic Syndromes
Lymph Node Metastases (N)
Distant Metastases (M)
Therapy
Surgical Therapy
Radiation Therapy
Chemotherapy
Surveillance
Monitoring Tumor Response
Detection of Recurrence
Complications of Therapy
Surgical Therapy
Radiation Therapy
Chemotherapy
New Therapies
Conclusion
References
25 Tumors of the Uterine Corpus
I. Endometrial Cancer
Introduction
Epidemiology and Risk Factors
Anatomy and Pathology
Clinical Presentation
Patterns of Tumor Spread
Staging Evaluation
Imaging Evaluation
Primary Tumor
Ultrasound
Magnetic Resonance Imaging
Computed Tomography
Positron-Emission Tomography/Computer Tomography
Positron-Emission Tomography/Magnetic Resonance Imaging
Treatment
Surveillance, Posttherapy Complications, and Recurrent Disease
New Therapies
Conclusion
II. Malignant Mesenchymal Tumors of the Uterine Corpus
Introduction
Epidemiology and Risk Factors
Clinical Presentation
Staging Evaluation
Imaging
Metastatic Disease
Treatment
Leiomyosarcoma
Endometrial Stromal Sarcomas
Undifferentiated Endometrial Sarcoma
Adenosarcoma
Prognosis
Surveillance
New Therapies
Conclusion
References
26 Cervical Cancer
Introduction
Epidemiology and Risk Factors
Anatomy and Pathology
Cervix
Pelvic Anatomy
Pelvic Nodal Anatomy
Clinical Presentation
Patterns of Tumor Spread
Staging
Imaging
Primary Tumor
Magnetic Resonance Imaging
Technique.
Evaluation of Images.
Stage I.
Stage II.
Stage III.
Stage IV.
Computed Tomography
Lymph Node Involvement
Computed Tomography and Magnetic Resonance Imaging in Evaluation of Nodal Involvement
Positron Emission Tomography/Computed Tomography
Treatment
Concurrent Chemoradiation
Chemotherapy Considerations
Neoadjuvant Chemotherapy Followed by Surgery
Neoadjuvant Chemotherapy Followed by Radiotherapy
Role of Adjuvant Chemotherapy After Completion of Primary Treatment
Treatment of Stage IV Disease
Treatment of Recurrence
New Therapies
Surveillance
References
27 Ovarian Cancer
Introduction
Epidemiology
Anatomy
Classification
Epithelial Tumors
Serous Tumors
Mucinous Tumors
Endometrioid Tumors
Clear-Cell Tumors
Transitional Cell Epithelial Tumors or “Brenner Tumors”
Germ Cell Tumors
Benign Tumors
Monodermal Teratomas.
Malignant Tumors
Dysgerminoma.
Nondysgerminomas.
Immature Teratomas.
Yolk Sac Tumor (Endodermal Sinus Tumor).
Choriocarcinoma.
Sex Cord–Stromal Tumors
Granulosa Cell Tumor
Sertoli–Leydig Cell Tumors
Fibromas
Thecomas
Metastatic Ovarian Tumors
Patterns of Ovarian Tumor Spread
Staging
Stage I
Stage II
Stage III
Stage IV
Imaging
Role of Imaging in Diagnosing Primary Ovarian Neoplasms
Primary Tumor
Dysgerminomas
Immature Teratomas
Monodermal Teratomas
Choriocarcinomas
Imaging of Lymphadenopathy and Peritoneal Disease
Lymphadenopathy
Peritoneal Disease
Computed Tomography.
Ultrasound.
Magnetic Resonance Imaging.
Positron Emission Tomography/Computed Tomography.
Recurrent Disease
Computed Tomography
Magnetic Resonance Imaging
Positron Emission Tomography Alone and Positron Emission Tomography Computed Tomography
Surveillance
Treatment
Surgery
Chemotherapy
Radiation Therapy
Investigational Therapy
The Radiology Report
Conclusion
References
28 Breast Cancer
Introduction
Epidemiology
Screening
Mammography
Magnetic Resonance Imaging
Anatomy and Pathology
Anatomy
Pathology
Clinical Presentation
Staging Classification
Patterns of Tumor Spread
Imaging
Primary Tumor
Mammography
Ultrasound
Magnetic Resonance Imaging
Unconventional Breast Imaging
Nodal Disease
Metastatic Disease
Bone Metastases
Liver Metastasis
Intrathoracic Metastasis
Brain Metastasis
Abdominal Metastasis
Treatment
Surgical Treatment
Chemotherapy
Radiation Therapy
Conclusion
References
29 Myeloma and Leukemia
Introduction
Myeloma
Epidemiology and Risk Factors
Pathology
Clinical Presentation
Staging
Imaging
Goals
Techniques
Conventional Radiography
Computed Tomography
Magnetic Resonance Imaging
Positron Emission Tomography
Treatment
Surveillance
Promising Therapies
Leukemia
Epidemiology and Risk Factors
Acute Lymphoblastic Leukemia
Acute Myeloid Leukemia
Chronic Lymphocytic Leukemia
Chronic Myeloid (or Myelogenous) Leukemia
Staging
Acute Lymphoblastic Leukemia
Chronic Lymphocytic Leukemia
Acute Myeloid Leukemia
Chronic Myeloid (or Myelogenous) Leukemia
Imaging of the Disease and its Relapse after Treatment
Acute Lymphoblastic Leukemia
Chronic Lymphocytic Leukemia
Acute Myeloid Leukemia
Chronic Myeloid (or Myelogenous) Leukemia
Imaging of Complications
Treatment
Promising Therapies
Conclusion
References
30 Hematologic
Malignancy:
The Lymphomas
Introduction
Epidemiology
Incidence
Etiology
Pathology
Non-Hodgkin Lymphoma
Hodgkin Lymphoma
Clinical Features
Hodgkin Lymphoma
Non-Hodgkin Lymphomas
Staging Systems and Prognostication
Patterns of Tumor Spread
Imaging Techniques
Nodal Disease
Cross-sectional Imaging
Functional Imaging With Positron Emission Tomography and Positron Emission Tomography/Computed Tomography
Neck
Thorax
Abdomen and Pelvis
Extranodal Disease
Thorax
Abdomen
Spleen and Liver.
Genitourinary Tract
Central Nervous System
Bone and Bone Marrow
Lymphoma in the Immunocompromised
Acquired Immunodeficiency Syndrome–Related Lymphomas
Posttransplant Lymphoproliferative Disorders
The Radiologist’s Report
Lymph Nodes
Extranodal Disease
Local Complications of Disease
Conclusion
Treatment
Hodgkin Lymphoma
Second Malignancies After Treatment for Hodgkin Lymphoma
Non-Hodgkin Lymphoma
Experimental Therapies
Surveillance
Monitoring Response to Therapy
Radiographic Predictors of Outcome
Residual Masses and Functional Imaging
Functional Imaging and Response Criteria
The Lugano Classification
International Workshop on Chronic Lymphocytic Leukemia
Detection of Recurrence
Complications of Therapy
Conclusion
References
31 Thoracic Metastatic Disease
Introduction
Technique
Patterns of Metastatic Disease
Simple Nodules
Nodules With a Ground Glass “Halo”
Cavitary Nodules
Calcified Nodules
Airspace Nodules, Airspace Disease
Branching Metastatic Disease
Reticular and Nodular Opacities (Lymphangitic Carcinomatosis)
Endovascular Metastases
Endobronchial Metastases
Adenopathy
Metastatic Intrathoracic Adenopathy
Pleural Manifestations of Metastatic Disease
Pleural Metastases
Pneumothorax Associated With Metastatic Disease
Cardiac Metastases
Differential Diagnosis
Conclusion
References
32 Metastases to Abdominal-Pelvic Organs
Introduction
Epidemiology
Clinical Presentation
Diagnosis
Treatment
Patterns of Tumor Spread
Liver
Spleen
Gallbladder
Pancreas
Adrenal Glands
Kidneys
Urinary Bladder
Female Genital Tract
Male Genital Tract
Prostate
Testicles
References
33 Peritoneal Cavity
and
Gastrointestinal Tract
Introduction
Anatomy
Embryology
Visceral and Parietal Peritoneum
Supramesocolic and Inframesocolic Space
Paravesicular Spaces
Spread of Disease
Direct Spread
Intraperitoneal Seeding
Lymphatic Spread
Hematogenous Spread
Imaging Techniques
Computed Tomography
Magnetic Resonance Imaging
Positron Emission Tomography/Computed Tomography
Sonography
Approach to and Classifying of Peritoneal Disease
Conclusion
References
34 Bone Metastases
Introduction
Distribution and Pathophysiology
Detection
Conventional Radiography
Computed Tomography
Nuclear Medicine
Magnetic Resonance Imaging
Future Imaging
Response to Therapy
Treatment of Bone Metastases
Medical/Systemic Therapy
Radiation Therapy
Surgical/Interventional Therapy
Summary
References
35 Cancer of Unknown Primary
Introduction
Epidemiology and Risk Factors
Pathologic Classification and Assessment
Role of Molecular Profiling to Determine the Tissue of Origin
Natural History, Clinical Presentation and Prognosis
Patterns of Tumor Spread
Staging Evaluation
Imaging
General Considerations for Management
Prognostically Favorable Subsets of Cancer of Unknown Primary
Prognostically Unfavorable Subsets of Cancer of Unknown Primary
Treatment Highlights
Surveillance
Conclusion
References
36 Imaging in Thyroid Cancer
Introduction
Epidemiology and Risk Factors
Anatomy
Pathology
Papillary Thyroid Carcinoma
Follicular Thyroid Carcinoma
Hurthle Cell Carcinoma
Medullary Thyroid Carcinoma
Anaplastic Thyroid Carcinoma
Lymphoma of the Thyroid Gland
Other Cancers of the Thyroid
Gross and Microscopic Features
Clinical Presentation
Patterns of Tumor Spread
Staging Evaluation
Imaging
Ultrasonography
Isotope Scanning
2-[18F] Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography Scanning
Additional Diagnostic Imaging (Computed Tomography and Magnetic Resonance Imaging)
Treatment
Surgery
Radioiodine Ablation Therapy and Chemotherapy
Radiation
Surveillance
Serum Thyroglobulin Measurement
Surveillance Imaging
References
37 Melanoma
Introduction
Epidemiology and Risk Factors
Epidemiology
Risk Factors
Anatomy and Pathology
Anatomy
Clinical Presentation
Patterns of Tumor Spread
Staging and Prognosis
Primary Tumor Classification
Lymph Node
Metastatic Subgroups
Clinical Stage Groups
Pathological Stage Groups
Prognosis
Imaging
Primary Tumor
Nodal Disease and Distant Metastatic Disease
Imaging Modalities
Lymphoscintigraphy.
Ultrasound.
Computed Tomography and Magnetic Resonance Imaging.
Positron Emission Tomography/Computed Tomography.
Whole-Body Magnetic Resonance Imaging and Positron Emission Tomography/Magnetic Resonance Imaging.
General Features
Metastatic Sites
Lung.
Skin and Soft Tissues.
Liver.
Brain.
Head and Neck.
Musculoskeletal System.
Gastrointestinal Tract.
Genitourinary Tract.
Gallbladder, Pancreas, and Spleen.
Mesentery.
Thorax.
Treatment
Surgery and Lymph Node Dissection
Nonsurgical Therapy
Chemotherapy
Cytokine Therapy
Radiation Therapy
Oncolytic Virus Therapy
Immunotherapy for Stage III and IV Melanoma
Adjuvant Immunotherapy
Immunotherapy for Metastatic Melanoma
Combination Immunotherapy
Targeted Therapy
Targeted Therapy in the Adjuvant Setting
Targeted Therapy in the Metastatic Setting
Combination BRAF/MEK Inhibition
Immune-Related Adverse Events
Monitoring Tumor Response/Treatment Response
Biomarkers
Surveillance and Recurrence
Conclusion
References
38 Soft Tissue Sarcomas
Introduction
Epidemiology and Etiologic Considerations
Histopathologic Considerations
Clinical Evaluation
Classification and Staging
Tumor Characteristics
Histologic grade (G): FNCLCC histologic grade
Primary tumor (T)
Regional lymph nodes (N)
Distant metastases (M)
Spectrum of Soft Tissue Sarcomas
Imaging
Radiography
Magnetic Resonance Imaging
Technique
Magnetic Resonance Imaging Characteristics of Soft Tissue Tumors
Computed Tomography
Positron Emission Tomography
Ultrasonography
Bone Scintigraphy
Treatment and Prognosis
Surveillance
New Therapies
Conclusion
References
39 Interventional
Imaging
in the Oncologic Patient
Introduction
Image-Guided Tissue Ablation
Technical Background
Radiofrequency and Microwave Ablation
Cryoablation
Clinical Applications
Liver Tumors
Renal Tumors
Lung Tumors
Transcatheter Arterial Hepatic Embolization And Chemoembolization
Technical Background
Clinical Applications
Radioembolotherapy
Technical Background
Clinical Applications
Portal Vein Embolization
Technical Background
Clinical Applications
References
40 Complications
in the
Oncologic Patient: Chest
Introduction
Chemotherapy-Induced Noninfectious Lung Disease
Chemotherapy-Induced Infectious Lung Disease
Bacterial Pneumonia
Viral Pneumonia
Fungal Pneumonia
Tuberculosis
Stem Cell Complications
Early Complications
Preengraftment Period (Days 1–30)
Early Phase (Days 30–100)
Late Complications
Radiation-Induced Lung Disease
Treatment-Associated Malignancy
Conclusion
References
41 Complications
in the Oncologic
Patient: Abdomen and Pelvis
Introduction
Hepatobiliary, Spleen, and Pancreas
Liver
Chemotherapy Change
Radiation Change
Surgical Change
Gallbladder
Chemotherapy Change
Spleen
Chemotherapy Change
Radiation Change
Surgical Change
Pancreas
Chemotherapy Change
Radiation Change
Surgical Change
Digestive System
Chemotherapy Change
Radiation Change
Esophagus
Stomach and Duodenum
Small and Large Bowel
Surgical Change
Genitourinary System
Chemotherapy Change
Kidney
Bladder
Reproductive System
Radiation Change
Kidney
Bladder
Ureter/Urethra
Prostate and Seminal Vesicles
Testes
Uterus, Cervix, Vagina, and Vulva
Ovaries
Surgical Change
Kidney/Proximal Ureter
Bladder/Distal Ureter
Prostate
Ovaries/Testes
Musculoskeletal System and Vessels
Bone
Chemotherapy Change
Radiation Change
Muscle
Chemotherapy Change
Radiation Change
Nerves
Vessels
Chemotherapy Change
Radiation Change
Fat
Secondary Tumors
Conclusion and Important Points
References
42 Pulmonary Embolic Disease and Cardiac Masses and Tumors
Pulmonary Embolism
Epidemiology and Risk Factors
Anatomy
Clinical Presentation
Severity Assessment
Imaging
Chest Radiography
Ventilation-Perfusion Scanning
Computed Tomography
Treatment
Cardiac Masses and Tumors
Epidemiology and Risk Factors
Anatomic Distribution of Cardiac Tumors
Clinical Presentation
Imaging Evaluation
Magnetic Resonance Imaging
Computed Tomography
Cardiac Mass Assessment
Treatment
Conclusion
References
43 Protocols for Imaging Studies in the Oncologic Patient
Multidetector Computed Tomography: Computed Tomography Imaging
Chest Protocols (MDCT 64 Slice)
Abdomen/Pelvis Protocols (MDCT 64 Slice)
Musculoskeletal (MSK) Protocols (MDCT 64 Slice)
Magnetic Resonance Imaging Protocols
Chest Protocols (1.5 T)
Body Protocols (1.5 T)
Musculoskeletal Protocols (1.5 T)
References
Index
Conf idence is ClinicalKey