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PubMedDate not supplied

"Hot" spots in hybrid positron emission tomography/computed tomography scanning of the abdomen: protocols, indications, interpretation, responsibilities, and reimbursements.

Although introduction of hybrid positron emission tomography/computed tomography (PET/CT) scanners represents an important development in field of radiology, the alliance of functional imaging with structural imaging has raised many controversial issues. The present review describes some of the important issues in hybrid PET/CT such as specific indications, protocols that deliver diagnostic quality CT scans while ensuring radiation dose associated with hybrid PET/CT examination are minimized, and the feasibility, desirability, and timing of oral and intravenous contrast administration. The issues of clinical indications for hybrid PET/CT versus PET alone will be discussed as well as the role of the CT component (ie, for diagnosis or transmission source alone) are discussed. The logistics of hybrid PET/CT scan interpretation, including the roles of radiologists and nuclear medicine physicians, will be discussed. This review describes the pertinent medical literature and discusses our experience with suitable examples.

Abdomen↗
PubMed2006

Spectrum of imaging findings in the abdomen after radiotherapy.

OBJECTIVE: The objective of this article is to describe the imaging appearances of radiation injury to normal tissues in the abdomen that may be seen during imaging surveillance of oncology patients. CONCLUSION: Therapeutic radiation is used to treat various malignant conditions in the abdomen. Radiation damages normal surrounding tissues as well as the intended tumor. Radiation changes vary based on the target organ and the time from completion of therapy. Familiarity with the spectrum of changes that may be seen on follow-up imaging studies should help in the differentiation of radiation injury from other causes such as recurrent malignancy.

Abdominal Neoplasms↗
PubMed1993

Primary extrauterine endometrial stromal neoplasms: a clinicopathologic study of 20 cases and a review of the literature.

We present the results of a clinicopathologic study of 20 patients with primary extrauterine endometrial stromal sarcoma (ESS). The sites of the primary neoplasm and the number of patients with sufficient follow-up for survival analysis are as follows: ovary (three of four), fallopian tube (one of one), pelvic cavity (six of eight), abdominal cavity (five of six), and retroperitoneum (one of one). Evaluation of all patients included the mitotic index (MI) and cytologic atypia. Thirteen of the sixteen patients eligible for survival analysis had tumors with an MI < 10 and would be classified as low-grade stromal sarcomas in the Norris and Taylor scheme. Eight (62%) of the 13 had one or more relapses; of these, three died of disease at 35, 108, and 120 months, respectively, and another patient was alive with disease at 96 months. The other four patients who were treated after a relapse showed no evidence of disease after relapse at 36, 57, 63, and 146 months, respectively. Two of the 13 patients had tumor considered unresectable at the time of diagnosis; both died of disease at 5 and 10 months, respectively. Neither MI nor cytologic atypia were predictive of tumor recurrence or death from tumor. We also extracted clinical and morphologic data from all previous reports of primary extrauterine ESS, combined them with our 20 patients, and then compared the combined group with 17 cases of primary high-stage uterine ESS we presented in an earlier report. Not surprisingly, the behavior of the primary extrauterine ESS was more reminiscent of high-stage primary uterine ESS than low-stage primary uterine ESS.

Abdominal Neoplasms↗
PubMed1980

[Electron microscopic diagnostic problems in human fibroblastic tumors].

The ultrastructure of 17 fibroblastic tumors in man has been studied. As a result, there was revealed a complex of features which might aid the electron-microscopic differential diagnosis of the neoplasms concerned: large cells with heavy cytoplasmatic processes; wide intercellular spaces which contain a specific fibrillar and granular fibrillar material; cellular nuclei sections show a typical irregular pattern represented in two variants. The intercellular fibrillar apparatus is specific enough with respect to the filaments structure, their aggregation and localization; also typical is the presence of an extensive system of granular endoplasmatic reticulum in cytoplasm. It is emphasized that the absence of some structures characteristic of other neoplasms: basal membrane, desmosomes, specific secretory granules etc. is of great importance for diagnosing such kind of tumors.

Abdominal Neoplasms↗
PubMed2003

Accuracy of image fusion of normal upper abdominal organs visualized with PET/CT.

Although PET/CT scanners have the potential for precise fused registration of structures visualized on both PET and CT, physiological motion during the acquisition of both studies may alter the appearance of organ shape, size or location. The degree of possible mismatch in abdominal organ size and position between PET and CT has not been evaluated. The aim of this study was to assess the consistency in location and measured size of upper abdominal organs with PET and CT using a combined PET/CT system. Forty-six consecutive inpatients who underwent clinical PET/CT scans for suspected cancer were evaluated. CT and PET images attenuation corrected by both CT and germanium-68 transmission scans were obtained, and we separately determined the location of the top and bottom (height), anterior and posterior margins (thickness), and right and left margins (width) for each organ, including liver, spleen, and bilateral kidneys, using CT and both sets of PET images. Differences between the two modalities in terms of location and measured organ size were investigated. In the upper margin of the liver and lower margin of the spleen, more than 10% of the cases showed a larger discrepancy (>20 mm) between CT-based and Ge-corrected PET-based measurements, although the differences in the positions of the edges were less than 10 mm in most cases. The center of the liver tended to be located cephalad and to the right of the body, and that of the spleen tended to be cephalad and posterior on PET, as compared with CT. Moreover, the center of both kidneys tended to be seen cephalad, posterior, and to the right on PET. The liver appeared slightly larger on PET than CT in thickness (CT vs CT-corrected PET vs Ge-corrected PET = 156 mm vs 162 mm vs 162 mm) and width (186 mm vs 189 mm vs 188 mm). By contrast, the spleen appeared slightly smaller on PET than CT in height (84 mm vs 77 mm vs 80 mm) and width (85 mm vs 81 mm vs 80 mm). A similar tendency was observed in the left kidney (105 mm vs 100 mm vs 99 mm in height, and 64 mm vs 59 mm vs 58 mm in width) and the right kidney (99 mm vs 93 mm vs 93 mm in height, and 64 mm vs 59 mm vs 60 mm in width). These differences between the two modalities were statistically significant ( P<0.05). In conclusion, minor mismatches in location and organ size were found to exist between CT and PET images, in part due to physiological motion. Although these differences could potentially affect the quality of the image registrations, they were generally of a modest nature.

Abdomen↗
PubMed1982

Role of abdominal computed tomography in evaluating left upper quadrant masses.

The etiology of abdominal masses in the left upper quadrant may be confusing because of the anatomic relationships of the organs involved. In three representative cases presented, computed tomography (CT) clearly defined masses as being nonurologic in origin, although conventional radiologic diagnostic techniques originally yielded results that suggested a renal or adrenal origin. In two other cases, masses thought to originate from the spleen or retroperitoneum were shown by CT to be renal tumors. In a sixth case, a large mass thought to be of renal origin but not evaluated by CT was found at surgery to be a pancreatic cyst. Abdominal CT is more sensitive than other imaging modalities in clarifying organ relationships and the origin of masses in the left upper quadrant.

Abdominal Neoplasms↗
PubMed1978

Ultrasonic evaluation of ventral hernias disguised as intra-abcominal neoplasms.

Most cases of ventral hernias are easily diagnosed by palpation, but palpation is a subjective examination that may be difficult or even misleading, especially in obese patients. In cases of diagnostic uncertainty, ultrasonic examinations offer an objective means of distinguishing between a mass in the abdominal wall and one actually deep to the peritoneum. In addition, if such a mass is detected, these studies provide information that can characterize its physical nature.

Abdominal Muscles↗
PubMed1994

Abdominal lymphadenopathy in children with AIDS.

PURPOSE: To identify conditions associated with abdominal lymphadenopathy in children with vertically-transmitted human immunodeficiency virus (HIV) infection. METHODS: Abdominal computed tomography (CT) scans were performed on 29 children over an eight-year period. The presence or absence of abdominal lymphadenopathy (> 10 mm in diameter) was prospectively evaluated at the time of CT. Clinical and histopathologic data in these children was reviewed. RESULTS: Abdominal lymphadenopathy was noted in eight (28%) children. The lymphadenopathy was isoattenuating relative to adjacent muscle in all cases. The most common specific associated diagnosis was systemic infection with Mycobacterium avium intracellulare (three children). One child had disseminated Kaposi sarcoma while four children had no known associated systemic infection or neoplasm. CONCLUSIONS: Abdominal lymphadenopathy was noted at CT in 28% of all HIV-infected children studied with CT and represented a nonspecific finding. The presence of lymphadenopathy should raise the suspicion of disseminated mycobacterial infection; however, it may also be observed in the absence of known systemic infection or neoplasm.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Placental-like alkaline phosphatase. Re-evaluation of the tumor marker with exclusion of smokers.

This report demonstrates that smoking is a major factor of nonspecific elevation of the tumor marker placental-like alkaline phosphatase (PLAP). In 98 healthy nonsmokers the mean of the enzyme activity was determined as 0.068 U/L (range, +/- 2 SD 0-0.144 U/L) compared to a mean of 0.378 U/L (range, +/- 2 SD 0-1.02 U/L) in 65 smokers. In view of this finding the usefulness of PLAP as a tumor marker was re-evaluated in 286 patients with various neoplasms and a negative smoking history. Of these patients, 23% and 50% had elevated values for PLAP and carcinoembryonic antigen, respectively. When compared to the range of PLAP in normal smokers only 4.1% of the patients showed elevated values. An increased incidence of elevated PLAP was found in patients with tumors of the lung, pancreas, stomach, colon/rectum, ovaries, and in 2 of 3 seminomas. It was concluded from the data that PLAP is a useful tumor marker for selected neoplasms provided its use is confined to nonsmokers.

Abdominal Neoplasms↗
PubMed1986

New concepts in the non-Hodgkin lymphomas: radiologic implications.

Non-Hodgkin lymphomas are a heterogeneous group of neoplasms believed to be derived in the majority of cases from a common ancestor, the lymphocyte. The clinical and radiologic implications of the newer concepts in the classification, staging, and treatment of these neoplasms form the basis for this review. The disease course, staging requirements, and treatment strategies are determined by histologic classification, prognostic grade of the tumor, disease presentation in a nodal or extranodal site, and clinical stage. The unique and common radiologic features of these neoplasms are reviewed in each of the major anatomic regions of the body.

Abdominal Neoplasms↗
PubMedDate not supplied

[Acute leukemia as secondary neoplasms in children with advanced lymphomas].

In 1985 a new treatment regimen for advanced non-Hodgkin's lymphoma was started in the "Instituto da Criança-HC-FMUSP". The final results are remarkably better than those achieved with former programs. Two cases of children who developed a second neoplasm after the therapy was completed are described and discussed.

Abdominal Neoplasms↗
PubMed1984

Computed tomography in 101 patients with a palpable abdominal mass.

A total of 101 patients with a palpable or suspected abdominal mass of unknown origin were examined by computed tomography (CT). In 69 patients an abnormality was demonstrated at the site of the palpable mass; only in one patient was this finding erroneous (false positive). In 32 patients no lesion was demonstrated (one false negative). Such high positive and negative predictive values (99% and 97%) indicate the value of CT in determining the presence or absence of a lesion to account for a clinically apparent mass, especially when there is doubt as to its presence or organ of origin. As to the cause of the mass, CT correctly identified the responsible organ or structure in 64 out of 69 patients with a lesion (93%) and suggested the likely nature in 61 (88%).

Abdominal Neoplasms↗