Oncologic Imaging - Stritch School of Medicine
Transcript of Oncologic Imaging - Stritch School of Medicine
![Page 1: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/1.jpg)
1
Oncologic Imaging
Kenneth L. Piece, M.D.Stritch School of Medicine
GOALS OF PRESENTATION
• Familiarize participant with Pathology commonly seen in Oncology patients using CT
• Investigate other imaging modalities useful in Oncological Dx
• Discuss practical issues in radiological imaging
OVERVIEW
• Anatomy most readily displayed in CT modality
• MR to supplement• Occassionally US/ plain film/
mammography
![Page 2: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/2.jpg)
2
BREAST CA
• CT shows advanced disease, mammography and MR for local
• Axillary, int mamm LN seen on CT• Post RT changes of lung, bones, soft tissue
• skin thickening, pulm fibrosis, bone sclerosis• recurrence can be local - focal mass in
axilla or chest wall
![Page 3: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/3.jpg)
3
![Page 4: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/4.jpg)
4
![Page 5: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/5.jpg)
5
![Page 6: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/6.jpg)
6
![Page 7: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/7.jpg)
7
BRONCHOGENIC CA
• CT modality of choice• 60% are central- hilar mass, pneumonia• 40% are peripheral- spiculated, cavitate• Evaluate nodes for staging >1-1.5cm
significant
![Page 8: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/8.jpg)
8
![Page 9: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/9.jpg)
9
![Page 10: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/10.jpg)
10
![Page 11: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/11.jpg)
11
![Page 12: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/12.jpg)
12
![Page 13: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/13.jpg)
13
![Page 14: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/14.jpg)
14
![Page 15: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/15.jpg)
15
LYMPHOMA
• CT modality of choice• Mediastinal lymphadenopathy common• CT helpful in Hodgkin’s - determines stage
and treatment• CT good for follow-up in both• Can affect lungs less commonly
![Page 16: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/16.jpg)
16
![Page 17: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/17.jpg)
17
HEPATOCELLULAR CARCINOMA
• More common in Asia, Africa• Usually due to EtOH in US• Can be mass, nodular or diffuse• Non-necrotic areas enhance, necrotic areas
lower density• Can invade portal/hepatic vein
![Page 18: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/18.jpg)
18
![Page 19: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/19.jpg)
19
![Page 20: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/20.jpg)
20
PANCREATIC CANCER
• Advanced at time of Dx• Poor prognosis• 65% in pancreatic head• Findings include mass, hypodensity, dilated
duct, biliary obstruction, local invasion of vessels
![Page 21: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/21.jpg)
21
![Page 22: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/22.jpg)
22
![Page 23: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/23.jpg)
23
![Page 24: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/24.jpg)
24
LYMPHOMA
• CT modality of choice• CT good for follow-up in both• With or without splenomegaly• Follows vessels
![Page 25: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/25.jpg)
25
![Page 26: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/26.jpg)
26
RENAL CELL CARCINOMA
• Common, can present as painless hematuria• CT for Dx and staging• Findings
• pre - hypo to hyperdense• post - most enhance, but less than kidney• invasion of renal v, IVC, nodes
![Page 27: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/27.jpg)
27
![Page 28: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/28.jpg)
28
ADRENAL GLANDS
• Adenomas• unilateral, round, low density, 2-5 cm• most not functional
• Metastases• >5 cm, higher density, bilateral• lung most common
• Carcinoma -rare
![Page 29: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/29.jpg)
29
PROSTATE CARCINOMA
• CT planning very useful for better targeting• CT predicts local extent 65%, 70% for
lymph nodes• Prostate usually enlarged, but can be NL• Can invade bladder base,seminal vesicles,
rectum
![Page 30: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/30.jpg)
30
![Page 31: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/31.jpg)
31
CERVICAL CARCINOMA
• Most common gyne ca in world• 5 yr survival rate 71%, 10% for distant
spread• Findings
• soft tissue mass lower uterus• nodes• local invasion
![Page 32: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/32.jpg)
32
BONE DISEASE
• Useful for evaluation of mets in prostate CA• Pathologic fracture
• metastatic disease destroys bone, non-traumatic fx
• dx’d on plain films, but CT and MR helpful• Primary bone tumors in the pelvis
![Page 33: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/33.jpg)
33
![Page 34: Oncologic Imaging - Stritch School of Medicine](https://reader031.fdocuments.in/reader031/viewer/2022020706/61fc9b459d50e757a5219532/html5/thumbnails/34.jpg)
34