Oncologic Imaging

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Oncologic Imaging

• Kenneth L. Piece, M.D.
• Stritch School of Medicine

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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

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OVERVIEW

• Anatomy most readily displayed in CT modality
• MR to supplement
• Occassionally US/ plain film/ mammography

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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

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BRONCHOGENIC CA

• CT modality of choice
• 60 are central- hilar mass, pneumonia
• 40 are peripheral- spiculated, cavitate
• Evaluate nodes for staging gt1-1.5cm significant

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LYMPHOMA

• CT modality of choice
• Mediastinal lymphadenopathy common
• CT helpful in Hodgkins - determines stage and
  treatment
• CT good for follow-up in both
• Can affect lungs less commonly

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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

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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

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LYMPHOMA

• CT modality of choice
• CT good for follow-up in both
• With or without splenomegaly
• Follows vessels

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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

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ADRENAL GLANDS

• Adenomas
• unilateral, round, low density, 2-5 cm
• most not functional
• Metastases
• gt5 cm, higher density, bilateral
• lung most common
• Carcinoma -rare

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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

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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

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BONE DISEASE

• Useful for evaluation of mets in prostate CA
• Pathologic fracture
• metastatic disease destroys bone, non-traumatic
  fx
• dxd on plain films, but CT and MR helpful
• Primary bone tumors in the pelvis

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