Diagnostic radiology and nuclear medicine

Abstract

The diagnosis and accurate staging of esophageal adenocarcinoma remains one of the greatest challenges for non-invasive imaging techniques. All modalities have limitations and require a rational application of combined tools in order to assess the extent of loco-regional tumor and distant metastatic disease. The fundamental role remains defining organ-confined disease and mapping non-organ confined disease. Endoscopic ultrasound combined with multislice computed tomography (CT) is the mainstay of morphologic loco-regional staging. In recent years, functional metabolic 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography (PET) has emerged as a particularly useful adjunct to detect occult metastatic disease, to predict response to neoadjuvant therapy and to document recurrent disease. The current imaging algorithm and new developments in imaging assessment will be reviewed.

Selection of Response Criteria for Clinical Trials of Sarcoma Treatment

“…Automated collection and analysis of CT data are vital but not widely available, and manual data collection and analysis are expensive and time-consuming [34]. Another important limitation of CT methods is that heterogeneity of tumors (e.g., hypoxic regions) can confound volumetric measurements [35]. 18 FDG-PET can assess tumor glucose use with high reproducibility.…”

Case Report: Fusion of positron emission tomography (PET) and computed tomography (CT) images for image-guided endoscopic navigation in maxillofacial surgery: Clinical application of a new technique

“…These techniques, however, lack the ability to show crucial differences in physiology. To distinguish tumour tissue from fibrosis or inflammation with CT or MRI alone is difficult (Castillo and Lawler, 2005). Moreover, a differentiation between benign and malignant lesions is also not possible.…”

Lugol’s Iodine Chromoendoscopy Versus Narrow Band Image Enhanced Endoscopy for the Detection of Esophageal Cancer in Patients With Stenosis Secondary to Caustic/Corrosive Agent Ingestion

“…The technique known as "Narrow Band Imaging" (NBI), uses narrow light spectrum, which penetrates in the superficial tissues, allowing the identification of small blood vessels and details of the mucosal pattern (2) . With the NBI technique the normal mucosa appears light blue/green and the vessels brown, lighting up suspicious lesions, similarly to Lugol's chromoscopy (5,16) . This allows for demarcation of suspicious areas and hence targeted biopsy (2,18) .…”