The aim of this study was to evaluate CT imaging in the post-operative follow-up and in the detection of recurrence after radical prostatectomy in cases of prostatic carcinoma. In over 500 patients undergoing radical prostatectomy for prostatic carcinoma, 22 cases with local recurrence were found. CT examinations of the pelvis were retrospectively evaluated in these patients. Local recurrence was detected by PSA uptake and confirmed by transrectal ultrasound (TRUS) in combination with guided biopsy. In 22 cases of confirmed local recurrence, positive results on CT were found in eight patients (36%) and negative results in nine patients (41%). In the remaining five cases (23%), no distinction could be made between scar and local recurrence. All cases definitively classified as recurrent tumour disease showed a soft tissue mass of 2 cm or more. CT sensitivity in local recurrence of prostatic carcinoma after surgery is low. Even in a very careful follow-up, the understaging would be up to 41%. In comparison, PSA, TRUS and needle biopsy are the methods of choice and are superior to CT imaging. Based on these results, there would be no reason for including pelvic CT examinations in the follow-up of prostatic carcinoma after radical prostatectomy.

Disparity in prognosis and management between primary and secondary pancreatic tumours makes recognition of metastases to the pancreas on CT and MRI an important goal. Three different patterns of secondary pancreatic tumours may be seen: localized, multifocal, or diffuse enlargement. CT findings include hypodense lesions, which show rim enhancement following intravenous contrast medium. On MR examination, the lesions are usually hypointense on T1 weighted and hyperintense on T2 weighted images.

Ultrasound remains the most readily available and least expensive of the imaging techniques used in assessment of the upper abdomen. Ultrasound is very useful in the detection of pancreatic tumors as well as in the evaluation of the extent of the disease. If ultrasound fails technically or is inconclusive, CT is recommended. Determination of CA 19-9 may help to decide whether ultrasound should be followed by CT or other examinations (51). Patients with any equivocal or inconclusive abnormality on ultrasound or CT should undergo ERCP. Even when ultrasound and CT of the pancreas appear normal there may be an indication for performing ERCP if the clinical suspicion of pancreatic cancer is still strong (52). Angiography is a reliable method of assessing major vascular tumor involvement, which to most surgeons would be a sign of unresectability. Although for some investigators CT is superior to angiography in assessing vascular involvement, angiography is performed preoperatively in many cases because it delineates the vascular anatomy, which can be abnormal in up to one third of patients. Percutaneous biopsy is an important technique for confirming the radiologic diagnosis of unresectable pancreatic carcinoma, particularly for differentiating pancreas carcinoma from other focal pancreatic lesions such as islet cell tumor, lymphoma, and chronic pancreatitis.

fMRI's efficacy in the preoperative localization of language and motor areas is high. The method should become a routine adjunct for preoperative evaluation of brain tumors in the near future.

The purpose of the study was to simulate cystoscopy based on three-dimensional helical CT scan datasets in real-time in patients with tumours of the urinary bladder. A helical CT scan with double detector technology was carried out pre-operatively in 11 patients with histologically confirmed carcinoma of the urinary bladder and one patient with chronic cystitis. A non-enhanced scan was first performed, followed by an examination in the early phase of contrast medium enhancement. Further images were acquired after adequate filling of the bladder with contrast medium, approximately 30 min after injection. These data were transferred to a separate graphic computer workstation and reconstructed. The results were then compared with the cystoscopic and histopathological findings. All tumours of the urinary bladder identified at fibreoptic cystoscopy were shown on virtual cystoscopy. The best reconstruction results were obtained from data acquired 30 min after injection of contrast medium. The ureteric orifices were not visualized at virtual cystoscopy. These data lead us to conclude that, at present, virtual cystoscopy has not reached the quality of fibreoptic examination and remains restricted to use in specific cases, for example patients with urethral strictures.