Imaging bone tumors in the 1990s

Article Abstract:

In the past two decades, great improvements have been made in the treatment of bone tumors, particularly osteosarcoma. Not only has survival improved, but it has become possible to avoid amputation in a greater percentage of cases. Since the discovery of X-rays by Wilhelm Roentgen in 1895, the radiography has been the best method for the diagnosis of bone cancer, and this remains true even today. However, newer techniques of imaging have made contributions to the staging of bone cancer and the precise determination of the extent of the tumor. Magnetic resonance imaging and computed tomography contribute to determining the extent of the primary tumor, although magnetic resonance imaging seems to be superior in this regard. Computed tomography, however, is better in the identification of metastatic spread to the lungs. Metastatic spread to other parts of the body may be determined by the technique of radionuclide scintigraphy, which is regarded as sensitive, complete, and cost-effective. Radioactive tracer substances are injected and preferentially accumulated by cancerous cells. A detector system then scans the body, and metastatic deposits of tumor are detected as localized radioactive ''hot spots'' within the body. Similar techniques may be used to monitor the response of bone cancer to chemotherapy. However, in this case it becomes critical to be able to distinguish between necrotic tumor and tumors that remain healthy. Neither computed tomography nor magnetic resonance imaging provide completely unambiguous information in this regard, but evidence is accumulating the magnetic resonance images enhanced with gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA) may be useful. MRI enhanced with Gd-DTPA reflects the vascular supply of tissues, and therefore healthy tumors appear different on the MR images than do necrotic tissues. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Usage, Innovations, History, CT imaging, CAT scans, Magnetic resonance imaging, Medical imaging equipment, Radionuclide imaging, Radioisotope scanning, Bone tumors

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Carcinoma of the female reproductive system: value of cross-sectional imaging

Article Abstract:

Cancers of the female reproductive organs are quite common. Cancer of the uterus is the fourth most common cancer among women, following only breast, lung, and colorectal cancer. In the United States each year, roughly 34,000 new cases of uterine cancer are diagnosed. In addition, there are 20,000 new cases of ovarian cancer each year and 13,000 cases of cancer of the cervix. The newer imaging techniques of computed tomography (CT) and magnetic resonance imaging (MRI) have not influenced the diagnoses of these cancers, which are still based on clinical examination, patient history, and histopathological examination of specimens. Neither CT nor MRI is particularly effective in distinguishing benign from cancerous disease. However, after the diagnosis of cancer is made, these techniques may then contribute greatly to the determination of the exact location and extent of the cancer. Of the two imaging techniques, MRI is the newer and therefore the one with which less experience has been accumulated. However, the excellent soft tissue contrast that can be achieved with MRI produces images that are superior to those attainable with CT. Computed tomography cannot distinguish relatively small tumors from the background of healthy tissues, and thus CT is useful for larger and more extensive tumors. A second-look laparotomy, in which the abdomen is again surgically opened to look for developing metastatic tumors long after the original ovarian cancer has been removed, continues to be a standard part of the treatment for this cancer. Despite the improvements in imaging techniques, the presence of metastatic ovarian tumors is still best accomplished by the direct vision of the surgeon. (Consumer Summary produced by Reliance Medical Information, Inc.)

Tumor staging, Cancer staging, Genital cancer, Urogenital cancer

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