Contemporary imaging in surgical oncology:
Saved in:
| Format: | Book |
|---|---|
| Language: | English |
| Published: |
Philadelphia [u.a.]
Saunders
1999
|
| Series: | Surgical oncology clinics of North America
8,1 |
| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Physical Description: | XVI, 230 S. Ill. |
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MARC
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I I ON 11 MI ORAK V IMAC iIN(, IN SUKUC AI ONO )I IX .Y
CONTENTS
Foreword xi
Blake Cady
Preface xiii
Scott H. Kurtzman
Breast Cancer Imaging 1
Thelma C. Hurd and Stephen B. Edge
The role of the surgeon in the diagnosis and management of breast
cancer continues to evolve as office based diagnostic procedures
gain more prominence. This article outlines the basic clinical and
technical aspects of mammography and ultrasound. The evalua¬
tion and management of several challenging breast problems are
discussed.
The Difficult Breast 17
John T. Ziewacz, David P. Neumann, and Ronald E. Weiner
Mammography is used to screen the population for breast cancer
but often is inconclusive. There are several developing techniques
to further assess the breast before biopsy that may decrease the
number of benign biopsies. These include ultrasound, nuclear
medicine, and MR imaging. When a biopsy is deemed necessary,
there are several methods used to obtain tissue that are less inva¬
sive and less costly than open biopsy. This evolving area of breast
evaluation is now filled with great expectation and uncertain future.
Pancreatic Imaging 35
Paul L. Baron, Clive Kay, and Brenda Hoffman
Pancreatic cancer has traditionally been difficult to diagnose. There
I are now numerous diagnostic tests that can visualize these tumors
I SJRGICALONCOLOC^CXlNlCSOt NORTH1 AMERICA
L
VOLUME 8 • NUMBER 1 • JANUARY 1999 vii
early when they are small and determinine which cases are the
most likely to be unresectable. The principal tests, including spiral
CT, MR imaging, endoscopic ultrasound, and laparoscopy, have
advantages and disadvantages. The purpose of this article is to
review each technique, and try to come up with a recommended
approach to evaluating the patient with pancreatic malignancy.
Imaging of Hepatobiliary Neoplasms 59
Ronald P. DeMatteo and Yuman Fong
Improvements in imaging have markedly improved the ability to
detect hepatobiliary masses. The radiologic features of a lesion
when considered in the context of the medical history, physical
findings, and laboratory data can often provide a diagnosis. Inves¬
tigative modalities can accurately stage hepatobiliary tumors and
determine their resectability so that the patient may be offered ap¬
propriate therapeutic interventions. This article summarizes the es¬
sential imaging techniques and their application to common he¬
patobiliary neoplasms.
Imaging of Soft Tissue Sarcomas 91
Martin J. Heslin and J. Kevin Smith
Imaging of soft tissue sarcomas is critically important in the man¬
agement of these patients. Whether CT scanning or MR imaging is
the best test remains controversial; studies to support either mo¬
dality exist and are reviewed. An integrated approach using clini¬
cal algorithms and radiologic studies to preoperatively stage and
follow these patients seems to provide optimal care.
Imaging of the Adrenal Gland 109
Julie Ann Sosa and Robert Udelsman
CT scanning remains the principal imaging technique for deline¬
ating adrenal gland lesions. Additional modalities complement CT
by providing information about functional status and tissue spe¬
cific characteristics of adrenal pathology. They include MR imag¬
ing, radionuclide scintigraphy, selective venous sampling, angi
ography, ultrasound, percutaneous adrenal biopsy, and positive
emission tomography.
The Radioimmunoguided Surgery (RIGS) System
as a Diagnostic Tool 129
Efthimios A. Bakalakos and William E. Burak, Jr
Radioimmunoguided surgery (RIGS) was developed to improve
on the intraoperative detection of malignancy. The RIGS system
uses a hand held gamma radiation detection probe to identify ra¬
dioactive tissues targeted by a preadministered tumor associated
Viii CONTENTS
radiolabeled targeting antibody or peptide. Clinical experience
with RIGS in colorectal cancer has been favorable; better intra
operative staging has provided the surgeon more information re¬
garding the pattern of disease and individual patients. Pancreatic,
breast, ovarian, and prostate cancer have also been studied in clini¬
cal trials using RIGS and early results are encouraging. In the fu¬
ture, marked improvements with the RIGS system will be realized
with the development of better targeting agents.
The Use of Imaging Studies in the Diagnosis and
Management of Thyroid Cancer and Hyperparathyroidism 145
Charles James, Michael Starks, Dougald C. MacGillivray,
and Jonathan White
With the variety of radiopharmaceutical agents and refined imag¬
ing techniques, thyroid and parathyroid imaging provides much
valuable clinical information. The use of imaging is most important
in the follow up of differentiated (DTC) and medullary thyroid
cancer (MTC). Patients with DTC are followed with serum thy
roidglobulin and 131I whole body scintigraphy when the serum thy
roglobulin level is elevated. When the 131I scintigram is negative,
201Tl scintigraphy may best identify the site of recurrent DTC. Al¬
ternative radioisotopes, ultrasound, CT, and FDG PET are also use¬
ful in localizing the site of DTC metastases. MTC recurrences and
metastases are more difficult to image. Selective venous catheteri
zation is the most sensitive and specific method for detecting areas
of recurrent MTC. High resolution ultrasound, CT, MR imaging,
and scintigraphy are all capable of, and useful in, detecting mac¬
roscopic foci of metastatic tumor. Somatostatin receptor scnintig
raphy and Tc DMSA have been the most frequently used nuclear
imaging agents in patients with recurrent MTC. Imaging for hyper¬
parathyroidism remains controversial. Sestambi has become the
preferred isotope for parathyroid scintigrapghy; whereas high
resolution ultrasound is also frequently used. Preoperative imag¬
ing is being used as a method to allow a unilateral neck exploration,
more recently, in conjunction with intraoperative 1 84 PTH assay
and with intraoperative use of the gamma probe. Most often, para¬
thyroid imaging is performed before reoperation for persistent hy¬
perparathyroidism.
Beyond Anatomy: MR Imaging as a Molecular
Diagnostic Tool 171
Benjamin F. Calvo and Richard C. Semelka
Technical advances in software and hardware make MR imaging
competitive with CAT scanning as an anatomic imaging tool. Al¬
though anatomic relationships remain important, increased under¬
standing of cell structure and function is rapidly moving us toward
diagnosis and treatment at the cellular level. By virtue of its reli¬
ance on nuclear magnetic spin moment, MR imaging is responsive
to real time physico chemical characteristics of cells and tissues
CONTENTS ix
being imaged. This intrinsic advantage of MR imaging is being
rapidly developed through the use of targeted imaging agents and
magnetic resonance spectroscopy. Imaging agents that target spe¬
cific cell populations have been prepared by using monoclonal
antibodies, liposomes, and short peptides bound to chelates con¬
taining paramagnetic atoms. Using magnetic resonance spectros¬
copy, the chemical composition of tumors can be analyzed and
compared with normal tissues in vivo and in vitro. Areas of pos¬
sible clinical usefulness for magnetic spectral analysis include: (1)
in vitro or in vivo characterization of lesions as benign or malig¬
nant, (2) differentiation between in situ and invasive carcinomas,
(3) determination of responsiveness to specific chemotherapeutic
regimens before their institution, (4) study of in vivo drug metab¬
olism by neoplasms, and (5) assessment of response to therapy and
of residual disease at the completion of therapy. Early experiences
in these parallel fields show great promise, with widespread clini¬
cal applications expected in the near future.
What is New in Nuclear Medicine Imaging? 185
Susan K. Ferrand, Clara C. Chen, Vasken Dilsizian,
and Ronald D. Neumann
Modern nuclear medicine tests can be of great help to today s sur¬
gical oncologists. The new techniques of positron emission tomog¬
raphy (PET) and single photon emission computed tomography
(SPECT), and the availability of new radiopharmaceuticals for lo¬
calization of tumors and assessment of organ function provide in¬
formation vital to the management of oncology patients.
Intraoperative and Laparoscopic Ultrasound 205
Junji Machi
The instruments, techniques, clinical applications and results, ad¬
vantages and limitations of intraoperative ultrasound (IOUS) and
laparoscopic ultrasound (LUS) in general surgical oncology are
presented based on our experiences and review of publications.
IOUS provides remarkable benefits in acquisition of accurate di¬
agnostic information, particularly in tumor staging and resect
ability, and thereby in intraoperative decision making during he
patobiliary, pancreatic, and endocrine surgery. In addition, various
surgical procedures are guided or assisted by IOUS. A latest mo¬
dality of IOUS is LUS, which can provide similar valuable infor¬
mation and compensate for the limitation of laparoscopy. LUS will
demonstrate great promise as an adjunct to laparoscopic explora¬
tion or surgery.
Index 227
Subscription Information Inside back cover
X CONTENTS
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| series | Surgical oncology clinics of North America |
| series2 | Surgical oncology clinics of North America |
| spelling | Contemporary imaging in surgical oncology Scott H. Kurtzman, guest ed. Philadelphia [u.a.] Saunders 1999 XVI, 230 S. Ill. txt rdacontent n rdamedia nc rdacarrier Surgical oncology clinics of North America 8,1 Bildgebendes Verfahren (DE-588)4006617-4 gnd rswk-swf Krebs Medizin (DE-588)4073781-0 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Krebs Medizin (DE-588)4073781-0 s Bildgebendes Verfahren (DE-588)4006617-4 s DE-604 Kurtman, Scott H. Sonstige oth Surgical oncology clinics of North America 8,1 (DE-604)BV007071205 8,1 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008444278&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Contemporary imaging in surgical oncology Surgical oncology clinics of North America Bildgebendes Verfahren (DE-588)4006617-4 gnd Krebs Medizin (DE-588)4073781-0 gnd |
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| title | Contemporary imaging in surgical oncology |
| title_auth | Contemporary imaging in surgical oncology |
| title_exact_search | Contemporary imaging in surgical oncology |
| title_full | Contemporary imaging in surgical oncology Scott H. Kurtzman, guest ed. |
| title_fullStr | Contemporary imaging in surgical oncology Scott H. Kurtzman, guest ed. |
| title_full_unstemmed | Contemporary imaging in surgical oncology Scott H. Kurtzman, guest ed. |
| title_short | Contemporary imaging in surgical oncology |
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