Positron emission tomography (PET) is now primarily used in oncological indication owing to the successful application of fluorine-18 fluorodeoxyglucose (FDG) in an increasing number of clinical indications at different stages of diagnosis, and for staging and follow-up. This review first considers the biological characteristics of FDG and then discusses methodological considerations regarding its use. Clinical indications are considered, and the results achieved in respect of various organs and tumour types are reviewed in depth. The review concludes with a brief consideration of the ways in which clinical PET might be improved.

/pdf/oncological-applications-of-positron-emission-tomography-1qoet8uhon.pdf

Oncological applications of positron emission tomography with fluorine-18 fluorodeoxyglucose.

Learning the basic concepts required to understand magnetic resonance (MR) imaging is a straightforward process. Although the individual concepts are simple, there are many concepts to learn and re...

AAPM/RSNA physics tutorial for residents: fundamental physics of MR imaging.

Evaluating human breast ductal carcinomas with high-resolution magic-angle spinning proton magnetic resonance spectroscopy.

Introduction: Occult primary breast cancer, i.e., isolated axillary adenocarcinoma without detectable tumor in the breast by either physical exam or mammography, represents up to 1% of operable breast cancer. Modified radical mastectomy (MRM) is generally the accepted treatment for this condition although tumor is identified in only two-thirds of mastectomy specimens. Breast magnetic resonance imaging (MRI) can identify occult breast carcinoma and may direct therapy. This study examined the ability of breast MRI to detect occult breast cancer and to facilitate breast conservation therapy.

Magnetic resonance imaging facilitates breast conservation for occult breast cancer.

Purpose. To investigate the safety, efficacy and feasibility of using high-intensity focused ultrasound (HIFU) as a non-invasive treatment for patients with breast cancer. Patients and Methods. Twenty-two patients with breast cancer were enrolled into this non-randomized prospective trial. Disease TNM stage was classified as stage I in 4 patients, stage IIA in 9 patients, stage IIB in 8 patients, and stage IV in 1 patient. Tumor size ranged from 2 to 4.8 cm in diameter (mean 3.4 cm). All patients received chemotherapy, radiation and tamoxifen, following HIFU for the primary lesions. Outcome measures included radiological and pathologic assessment of the treated tumor, cosmesis, and local recurrence. A cumulative survival rate is calculated by using the Kaplan–Meier method. Results. No severe complications were encountered after HIFU. Post-operative imaging demonstrated positive response and regression of all treated lesions. Follow-up biopsy revealed coagulation necrosis of target tumor and subsequent replacement by fibroblastic tissue. After a median follow-up of 54.8 months, 1 patient died, 1 was lost to follow-up, and 20 were still alive. Two of 22 patients developed local recurrence. Five-year disease-free survival and recurrence-free survival were 95% and 89%, respectively. Cosmetic result was judged as good to excellent in 94% of patients. Conclusions. HIFU treatment is safe, effective, and feasible for patients with breast cancer. But, large-scale, multiple-center clinical trials will be needed to determine the future role of this novel modality.

Extracorporeal high intensity focused ultrasound treatment for patients with breast cancer

Mammography is currently the best imaging technique for the early detection and diagnosis of breast cancer. Although numerous advances and improvements in mammography in the past decades have greatly improved image quality, the technique is not without shortcomings that limit its sensitivity and specificity. Multiple areas of research have therefore been sought not only to improve film/screen mammography, but also to consider entirely new techniques in the study of breast cancer. Although this review is not intended to include all methods currently under investigation, those chosen for discussion represent areas where major efforts have provided data that suggest exciting future applications. These include MR imaging, digital mammography, computer-aided diagnosis (CAD), positron-emission tomography (PET), and single-photon emission planar CT imaging (SPECT).

R L Wahl

Papers

New methods for imaging the breast: techniques, findings, and potential.