Академический Документы
Профессиональный Документы
Культура Документы
APPROACH TO
DIAGNOSIS
MARIAEM M. ANDRES, MD
Institute of Radiology
St. Luke’s Medical Center, Quezon City and Global City
OBJECTIVES
Fatal Battlefield Injuries Incas first performed craniectomy in 19th century Meningioma in
Ancient Egyptian skull
1904
• Calcifications
• Oligodendroglioma
• Astrocytoma
• Meningioma
• Choroid plexus neoplasia
• Pituitary tumors
■ INDICATIONS:
– Tumor profiling
– Differentiating post-radiation scar tissue from tumor recurrence
– Metabolic white matter diseases or adrenoleukodystrophy
– Non-inherited metabolic disorders i.e.HIE
Brain Tumor Imaging:
PET/CT
■ FLUORINE-18-DEOXUGLUCOSE (FDG)
■ Measures metabolic activity of tumors
■ Establishes a diagnosis
■ Assesses response to therapy
■ Prognosticates
Department of Neurosurgery
Alder Hey Children’s Hospital
Liverpool, England
Multimodal display of
intraoperative MRI with BrainLAB
sotware for neuronavigation.
Neurosurgeon's view of a large
cerebral tumour through the
operating microscope is displayed
with corresponding
axial
sagittal
coronal
SKULLBASE AND NECK
H&N Tumor Imaging: CT and MRI
■ In descending head and neck structures, the advantages of MRI decrease and
those of CT increase
■ CHONDROSARCOMA
– Most common primary malignant bone tumor of the chest wall
– Accounts for 33% all primary rib tumors
– 2nd most common rib tumor: myeloma
■ CHONDROSARCOMA
– Matrix is nodular, peripheral
■ OSTEOSARCOMA
– Matrix is dense, cloudy
– Greatest at the center
Chest Wall Tumor Imaging
■ LIPOMA
– Most common benign soft tissue tumor of the chest wall
■ MALIGNANT FIBROUS HISTIOCYTOMA
– Most common malignant soft tissue tumor of chest wall
■ RHABDOMYOSARCOMA
– Most common malignant soft tissue
tumor in children
LUNG TUMORS
Lung Tumor Imaging
■ Leading cause of cancer-related deaths for both men and women across the
developed world
■ Overall survival for all stages at 15%
■ Majority present with cough, hemoptysis, chest pain and even pneumonia
■ IMAGING:
– CHEST RADIOGRAPH –first line of investigation
– CHEST CT –cornerstone of lung cancer imaging
Common CT Presentation of Lung
Tumors
Atypical CT Presentation of Lung
Tumors
TNM CLASSIFICATION OF LUNG TUMOR
Based on recommendations by
the International
Association for Study
of Lung Cancer (IASLC)
TNM CLASSIFICATION OF LUNG TUMOR
■ VIRTUAL COLONOGRAPHY
– Non invasive, no sedation
– Just like CT scan but air is pumped into the colon
– Structural examination of ENTIRE COLON
■ No limitation of not being able to advance due to stricture or tortuosity of colon
– 2D and 3D evaluation of multiple planes
– Minimal risk for bleeding and perforation
VIRTUAL COLONOSCOPY
NUCLEAR ULTRASOUND
MEDICINE
PETCT CT/MRI
THANK YOU FOR LISTENING.