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Query: UMLS:C0677930 (primary tumor)
 20,210 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Both CT and MRI address the pertinent clinical issues in the management of patients with squamous cell carcinoma of the upper aerodigestive tract and neck, and are crucial to staging, treatment, and follow-up. By combining the clinical assessment of primary mucosal extent with the objective information provided by CT or MRI about deep tissue extension of the primary tumor and any nodal metastases, accurate assessment of the actual pretreatment primary tumor and nodal stages is possible. With this objective picture of tumor extent, decisions about surgery and radiotherapy can be made for primary and recurrent tumors, as well as for nodal metastases.
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PMID:Imaging tumors of the central nervous system and extracranial head and neck. 311 51

For the early diagnosis of metastatic brain tumor, careful and long-term follow-up is important when the primary tumor has already been found. Metastatic brain tumor should be suspected whenever neurological symptoms develop in such a patient. In the cases of lung cancer or lung metastases, CT scan of brain should be taken even if the patients have no neurological symptoms, because lung cancer frequently metastasizes to the brain and other cancers metastasize to the brain via the lung. When the primary sites are unknown, primary brain tumors should be distinguished. Relatively rapid progression of symptoms including mental disturbance, multiple lesions on CT scan, lesions on chest X ray film, careful cerebral angiogram and MRI are helpful for the differential diagnosis.
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PMID:[Early diagnosis of metastatic brain tumor]. 317 5

Meticulous pretreatment evaluation is basic to the successful management of suspected ovarian masses. Among currently available imaging techniques, sonography and computerized tomography are the most important diagnostic modalities. The purpose of our study was to determine whether magnetic resonance imaging provided additional information on masses in the true pelvis. 73 patients with masses in the true pelvis underwent preoperative magnetic resonance imaging. MRI was done with a 1.0 T supraconductive magnet (Magnetom Impact, Siemens). The results obtained were compared with sonographic (transabdominal and transvaginal), intraoperative and histopathologic findings. MR images were evaluated for their information on differentiation between benign and malignant neoplasm, tumor staging, lymph node involvement, peritoneal spread, local extension and organ relation. MRI correctly characterized malignant and benign tumors in 97% of cases versus 81% on ultrasound. The site of the primary tumor was correctly diagnosed in 94% of cases on MRI images versus 86% on ultrasound images. Invasion of adjacent intestinal segments as well as peritoneal carcinomatosis and omental metastases (metastasis > 1 cm) were also detected in the majority of cases. Based on our results MRI performs well at lesion detection and characterization in the evaluation of suspected ovarian masses. MRI should be considered in the investigation of patients with complicated findings on ultrasound.
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PMID:Magnetic resonance imaging in the preoperative evaluation of suspected ovarian masses. 764 35

MRI provides additional information about tumor location, extent, and margins. MRI was used in 158 patients with CNS tumors for treatment planning from 1985-89 and they were studied in a prospective manner. The most common site was cerebrum (73 pts), then extradural spinal axis (21 pts) posterior fossa (17 pts), brain stem (14 pts) and pituitary (13 pts), etc. The most common histological primary tumor was glioblastoma multiform (25 pts), then low grade astrocytoma (22 pts), anaplastic astrocytoma (14 pts), pituitary tumor (13 pts), medulloblastoma (9 pts), ependymoma (7 pts), and germ cell tumors (6 pts). Twenty-nine patients had metastasis to the brain. A majority of the patients with CNS tumors had the studies using Gadolinium-DTPA. Of the patients with CNS tumors, 120 (76%) had better information based on the MRI, which improved the treatment planning (using the three dimensional images) and field arrangement. In 89 patients (56%) the MRI was very decisive in the treatment volume and field arrangement. In 31 patients (20%) the MRI was beneficial and confirmed the treatment plan. MRI provides important additional information for radiation therapy planning.
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PMID:Use of magnetic resonance imaging in central nervous system tumors. 773 Jul 30

A 34-year-old housewife presented to a hospital because of dry cough. Her chest radiograph showed bilateral multiple nodular lesions. Smaller but similar lesions had been seen on the chest radiograph 2 years earlier. Because the tissue taken during a trans bronchial biopsy was non-diagnostic, open lung biopsy was done and the diagnosis was pulmonary metastasis of alveolar soft part sarcoma. The primary tumor was found in her left calf by MRI. Malignant tumors are important for differential diagnosis of slow-growing multiple pulmonary nodules, and in some cases MRI is useful for finding the primary site.
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PMID:[A case of alveolar soft part sarcoma found by pulmonary metastasis]. 773 Nov 26

Neuroendocrine tumors of the gastroenteropancreatic system represent a group of tumors with various diagnostic problems. Especially detection of primary tumor lesions is often difficult. Endoscopic ultrasonography is a relatively new imaging procedure localizing insulinomas preoperatively in about 90% of cases. Thus, previously used invasive preoperative imaging methods are usually unnecessary. The combination of endoscopic ultrasonography and somatostatin receptor scintigraphy allows visualization of gastrinomas in 90% of cases. Somatostatin receptor scintigraphy can also visualize metastatic lesions of gastrinomas and carcinoids in the whole body with high accuracy. In surgical management of a gastrinoma, duodenal transillumination and intraoperative ultrasound should be performed in all cases to exclude small duodenal or periduodenal, extrapancreatic tumors. US, CT, and MRI should be mainly used to exclude local and distant metastases. Angiography is helpful in detecting anatomical variations of abdominal vessels preoperatively. Due to the excellent results of endoscopic ultrasonography and somatostatin receptor scintigraphy in localizing insulinomas and gastrinomas, transhepatic portal venous sampling appears to be obsolete.
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PMID:[Imaging methods in diagnosis of neuroendocrine tumors of the gastrointestinal tract]. 775 24

DL-3-123I-iodo-alpha-methyltyrosine (123I-IMT) is a radiopharmacon which concentrates in brain tumors and can be employed in SPECT. We performed 20 studies in 16 patients after neurosurgery for malignant brain tumors (localization of the primary tumor by CT/MRI). Tumor/non-tumor ratios (T/NT) were calculated in ROI-technique. In 17 cases there was a recurrence or tumor remnant. 14/17 were detectable by increased uptake (T/NT 1.43-2.25). The scans were correlated with CT/MRI studies and validated by biopsy (6/14) or follow-up. All 3 patients without recurrence (neuroradiological follow-up over 6-24 months) had a negative scan. 123I-IMT scintigraphy provides complementary information to CT and MRI. In equivocal neuroradiological or clinical cases it may be valuable in the detection of tumor recurrences and allows an earlier onset of therapy.
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PMID:[Uptake of DL-3-123I-iodo-alpha-methyltyrosine in recurrent brain tumors]. 776 Dec 77

Because of the high tendency of breast cancer to develop metastatic deposits in the skeleton, space-occupying processes in the sternal region are mostly attributed to osseous metastases and not to parasternal lymph node involvement, even in case of solitary lesions, primary tumor localizations in the inner quadrants, positive axillary nodes and negative X-ray or bone scan findings. The sonographic examinations of 115 patients with breast cancer and clinical and/or scintigraphic suspicion of sternal metastasis, however, revealed the typical bone metastases of the sternum with a small soft tissue tumors in only 27.8 %, whereas 59.1 % of the cases showed parasternal recurrences; 5.2 % had both. Non-tumorous changes were seen in 6.1 %, equivocal results in 1.7 %. Solitary osseous metastasis of the sternum was rare; multiple skeletal lesions were found in the majority of this group in contrast to the patients in the parasternal relapse group, which moreover showed strong overrepresentation of the primary tumor localization in the inner quadrants. X-rays of the chest or the sternum were often false-negative and not reliable, the bone scans positive only in cases of secondary sternal invasion or skeletal metastases. Concerning reliability and cost, sonography was the imaging method of first choice for diagnosis, therapy planning and follow-up for space-occupying processes in the sternal region, with CT or MRI as adjuncts in cases of extended tumors invading the mediastinum.
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PMID:[Metastasis to the sternum or parasternal recurrence of breast carcinoma? Value of sonography]. 882 Mar 68

Knowledge of the extent of primary colorectal carcinoma at initial diagnosis is critical for proper management of disease. Currently, CT does not have a role in screening for colorectal carcinoma, though promising work on virtual colonoscopy is on the horizon. In patients with proven colorectal carcinoma, accurate prospective noninvasive assessment can identify those who may benefit from preoperative local radiotherapy, hepatic resection or cryoablation, or intra-arterial chemotherapy. CT should be considered complementary to the clinical assessment of colorectal carcinoma and to other modalities, such as barium enema, endorectal ultrasonography, MRI, and immunoscintigraphy. Although limited in evaluation of the primary tumor and local spread, CT has proven useful in assessing patients thought to harbor extensive local or metastatic disease. CT is generally the modality of choice for imaging the postoperative patient. The cross-sectional display of CT clearly depicts the operative bed, particularly after abdominoperineal resection. Baseline examinations should be obtained 2 to 4 months after surgery, with follow-up examinations every 6 to 9 months for 2 years, and yearly studies thereafter. CT-guided biopsies should be performed when findings suggest recurrent carcinoma.
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PMID:Computed tomography evaluation of colorectal carcinoma. 884 30

Because SRS identifies 90% of hepatic metastatic disease and the addition of other studies (ultrasonography, C.T. MRI, and selective mesenteric angiography) identities only 4% more, the identification of a primary lesion with SRS obviates for the most part the use of further investigations. If SRS is negative, additional studies should only be undertaken if surgery is contemplated. Because SRS may only localize 60%-70% of primary gut NETs, an additional 10%-15% may be identified by undertaking additional studies. The most sensitive test, STIR-MRI, should be undertaken next, but because it is not widely available, pancreatic protocol CT scan is almost as effective in identification of a primary lesion. If a primary gastrinoma cannot be identified by SRS or STIR-MRI, endoscopic ultrasonography should be undertaken because duodenal gastrinomas are often minute and multicentric. A similar strategy applies for insulinomas because up to 40% cannot be located by SRS and the majority are located in the pancreatic head. Thus, STIR-MRI followed by endoscopic ultrasonography is the most appropriate course. Although calcium provocation-angiography is highly effective in the identification of insulinomas, it is significantly more invasive and should be used only as a last resort. Of particular interest is the observation that in the study of gastrinomas, SRS altered clinical management in almost 50% of patients. This reflected the ability of SRS not only to identify the primary tumor location but clarify equivocal localization results generated by conventional imaging studies. It thus seems that the simplicity, superior sensitivity, high specificity, and cost-effectiveness of SRS mandate that it be the imaging modality in patients with gastrinomas. Because the cost of an SRS is $1800 and may obviate the need for multiple other topographic studies that are at least as expensive, the fiscal dictates further warrant the use of this study as the initial topographic investigation. These observations are probably applicable to all gut NETs, although the likelihood of primary identification in the instance of insulinoma patients may be somewhat less. The timely and cost-effective establishment of the type of NET, its primary site, and the detection metastatic spread will enable determination of the appropriate management strategy.
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PMID:Approaches to the diagnosis of gut neuroendocrine tumors: the last word (today). 902 13


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