Imaging prostate cancer

In the detection of prostate cancer, the most important role of imaging is ultrasound-guided prostatic biopsy. In the staging evaluation of prostate cancer, each presently used modality--transrectal US (TRUS), MR imaging, CT, nuclear medicine, and positron emission tomography--has advantages and disadvantages. Evidence-based guidelines on the use of CT and nuclear medicine bone scan, in assessing the risk of distant spread of prostate cancer, are available. There is no consensus and there are no guidelines, however, for the use of imaging in the evaluation of prostate cancer local tumor extent. Results on the value of TRUS vary widely, and prospective multicenter studies suggest that TRUS is no better than digital rectal examination in predicting extracapsular extension. MR imaging offers the most promise for local staging of prostate cancer, but it must resolve problems of reproducible image quality and interobserver variability, and it should prove its efficacy in multicenter trials before it can be recommended for general clinical use. The introduction of MR spectroscopic imaging further expands the value of MR imaging, offering anatomic and metabolic evaluation of prostate cancer.     

Imaging of pediatric lymphomas

Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) represent 10% to 15% of all malignancies occurring in children younger than 20 years of age. Advances in cross-sectional imaging and the availability of positron emission tomography (PET) and PET-CT have had a major impact on imaging and management of pediatric patients. This article reviews the clinical features of lymphoma, focusing on the spectrum of imaging findings seen in diagnosis, staging, and follow-up of HL and NHL. Pediatric NHL has four major histologic subtypes: Burkitt lymphoma, diffuse large B-cell lymphoma, anaplastic large cell lymphoma, and lymphoblastic lymphoma. The most important subtype of HL is nodular sclerosis.     

Imaging pediatric bone sarcomas

Primary malignant bone tumors are rare and account for about 6% of all new pediatric cancer cases per year in the United States. Identification of the lesion not uncommonly occurs as a result of imaging performed for trauma. Clinical and standard imaging characteristics of the various tumor types are evolving in concert with treatment advancements and clinical trial regimens. This article reviews the 3 most common pediatric bone sarcomas-osteosarcoma, Ewing sarcoma, and chondrosarcoma-and their imaging as applicable to contemporary disease staging and monitoring, and explores the roles of evolving imaging techniques.     

Imaging and radiotherapy of the prostate

Prostate cancer is the most common malignancy diagnosed in men. Over the past 10 to 20 years, advances in screening and diagnostic and management paradigms have led to improved treatment outcomes. This article offers an overview of the evolution of the role and nature of diagnostic imaging techniques in the management of prostate cancer.     

Imaging of prostate cancer

The role of imaging in the diagnosis and management of prostate is reviewed. Transrectal ultrasonography, which can be used to guide biopsy, is most frequently used imaging technique in cancer detection. For determining the extent of disease, CT and MR imaging are the most commonly used modalities; bone scintigraphy and positron emission tomography have roles only in advanced disease. Currently, the role of imaging in prostate cancer is evolving to improve disease detection and staging, to determine the aggressiveness of disease, and to predict outcomes in different patient populations     

Imaging of the pediatric eye and orbit

The spectrum of ocular and orbital pathology in the pediatric age group is quite different from that of adults. Imaging studies serve an important role in the diagnosis and management of many of these abnormalities. This review outlines the various abnormalities of the pediatric eye and orbit for which imaging studies are often required, including: infection, neoplasm, inflammation and infiltration, developmental anomalies, and trauma. The computed tomographic appearances of these abnormalities are emphasized. Additionally, the pertinent findings recorded with magnetic resonance imaging, scintigraphy, and radiography are described. Correlation of the results of imaging studies with pertinent clinical information allows the determination of specific diagnoses in most instances of pediatric orbital pathology.     

Imaging of pediatric neurovascular emergencies

Pediatric strokes are rare but critical diagnoses to make in the emergency setting. They are associated with a set of pathologies that are not frequently encountered in the adult population. Some of these diseases have variable clinical presentations and imaging appearance depending on the age of onset and severity of the underlying pathologies. This article reviews the differential diagnoses and noninvasive imaging evaluation of pediatric cerebral ischemic and hemorrhagic diseases.     

Imaging of pediatric neck masses

Palpable neck masses are a common indication for pediatric imaging. Such lesions may be caused by infectious, inflammatory, tumoral, traumatic, lymphovascular, immunologic, or congenital etiologies. Radiological assessment of neck masses in young children should be tailored based on patient presentation and physical examination, as well as clinical suspicion. The goal of imaging should be to help arrive at a diagnosis or limited differential in an efficient manner while minimizing radiation exposure.     

Imaging of pediatric pelvic neoplasms

Pediatric pelvic neoplasms, although relatively uncommon, are often difficult to evaluate and characterize with imaging, due to their overlapping appearances. This article discusses key clinical features and imaging findings that help limit the differential diagnosis of pediatric pelvic neoplasms. Testicular, ovarian, uterine, and bladder masses are included in addition to sacrococcygeal teratoma.     

Imaging modalities in pediatric oncology

This article reviews the roles of specific imaging modalities in the diagnosis and management of noncentral nervous system childhood cancer. Imaging modalities to be discussed include conventional radiography, ultrasound, computed tomography, magnetic resonance imaging, and nuclear medicine, including positron emission tomography. Emerging imaging techniques will also be discussed. Current literature will be referenced for more in-depth review.     

Imaging of pediatric hip disorders

Developmental and acquired abnormalities of the hips are common in childhood. Radiographs, MR imaging, CT, and nuclear medicine play an important role in the diagnosis and management of these disorders. Knowledge of the surgical and clinical treatments of these disorders is important to interpret accurately the radiology studies and impact treatment of the children.     

Imaging of pediatric foot disorders

Imaging pediatric foot disorders is a challenging task. Optimally exposed and well-positioned radiographs can answer many questions. Because many bones may not be completely ossified, however, CT or MR imaging is often needed to provide additional information to assist in the management of congenital and acquired lesions in the foot.