The content of Fundamentals in Oncologic Ultrasound goes far beyond a narrow interpretation of the title, in that a wide range of non-tumour conditions is included and illustrated – in fact, wherever a non-tumour mass should be considered as part of the differential diagnosis, it is covered in detail here. This means that it will be indispensable to all clinics using ultrasound in general imaging. A wide-ranging introductory section covers the basics of ultrasound interpretation, including grey scale and Doppler, as well as microbubble contrast agents. In addition, unusually, there is a detailed discussion of the pros and cons of ultrasound compared with other imaging techniques, and a discussion of the benefits and dangers of screening, a topic that is often short-changed. There is also an important discussion of the use of imaging in evaluating response to treatment. As well as sections on the abdomen and superficial structures such as the head and neck, and the breast, there are sections on the genitourinarytract and one on the use of ultrasound to guide interventional procedures, including ablation techniques.
The volume is therefore structured in seven broad chapters. Chapter 1. An analysis is made of the general relations between diagnostic imaging modalities, with particular reference to ultrasound, and the principal fields of oncology. An initial presentation is made of the advantages and limitations of US, the knowledge of which is essential for any clinical application of the technique, and therefore also for the study of cancer. The focus then shifts to the different phases in which US and the oncologic disease interact: secondary prevention, intrinsic characteristics of the cancer (with particular reference to neoangiogenesis), cancer staging, the evaluation of response to different types of anticancer treatments, short- and longterm monitoring, and the identification of disease recurrence. Only with an adequate understanding of these features of malignant disease can diagnostic imaging make a truly effective contribution. Chapter 1 also takes into consideration the examination techniques of US, spectral Doppler, color Doppler, power Doppler and contrastenhanced US (CEUS), with particular reference to the study of neoplastic diseases in their superficial and deep locations. The presentation especially focuses on the current possibility of optimizing the US instrumentation and exploration technique, with the aim of maximizing the detection and morphofunctional analysis of neoplastic lesions. The sections dealing with the examination technique alternate with a presentation of the principal imaging characteristics: although tumors arising in different organs may display different features, the discussion aims to underline the common imaging characteristics so they can be applied from time to time to the various anatomic regions and clinical problems.
Chapters 2–6. The clinical problems connected either directly or indirectly to neoplastic disease of the different body regions are many and varied and can be included in a single volume only in part. Instead of an encyclopedic approach, with systematic discussion of the epidemiologic, clinical, diagnostic and imaging characteristics of the different neoplasms in different body regions, we preferred to begin with the basic clinical problem, which is how the disease is presented to the diagnostic imaging specialist. This approach involves, first of all, an illustration of the general appearance and then the imaging characteristics, first and foremost US, but also CD, spectral Doppler and CEUS.
Chapter 7. The current range of extravascular interventional procedures is extremely broad and constantly on the increase. This chapter describes the main USguided procedures used in the cancer patient: diagnostic sampling of superficial and deep lesions (both cytologic – FNAC, and histologic – core biopsy), vacuum-assisted biopsy in breast cancer, placement of presurgical markers, drainage of collections, cysts and liquefactive masses, percutaneous ablation (with special reference to percutaneous ethanol injection and radiofrequency thermal ablation, and especially with regard to focal hepatic lesions). It should, nonetheless, be borne in mind that the number of US-guided interventional procedures is much greater, ranging from biliary drainage to nephrostomy and nerve block for anesthesia or pain management to venous catheterization. US guidance, either alone or in combination with other modalities; this allows all of these procedures to be performed more effectively and with greater safety for the patient than with a “blind” approach”. An increasingly widespread diffusion of the technique can therefore be reasonably expected. In this text the term color Doppler and its abbreviation CD are used, except where specifically stated, in reference to the Doppler techniques in general and therefore including power Doppler. In all cases where the description refers specifically to power Doppler this term will be expressly stated.
The term contrast-enhanced US (CEUS) is always used to refer specifically to gray-scale study with injection of sonographic contrast medium. When the intention is to indicate CD with contrast medium this is always expressly stated and should not be considered associated with the idea of US contrast enhancement.
Throughout the volume the term “US-guided” is a general reference to all procedures performed with US guidance, regardless of the type of transducer used, whether dedicated to the intervention or not. The specific meaning attributed to the terms “freehand”, “US-assisted” and “US-guided” is discussed at the beginning of Chapter 7.
Lastly, throughout the text, the term “biopsy” is used as a general indication of diagnostic sampling, both cytologic and microhistologic, where not otherwise specified. The difference between the former (aspirated with a fine needle, with the abbreviation FNAC) and true biopsy (indicated as “core biopsy”) is also thoroughly illustrated in Chapter 7. We preferred not to use the well-known abbreviation FNAB at all to avoid confusion in terms.
Contents
Chapter 1 General Considerations
1.1 Advantages of Ultrasound in Oncology
1.2 Limitations of Ultrasound in Oncology
1.3 Ultrasound and Cancer Screening
1.4 Ultrasound and Neoangiogenesis
1.5 Cancer Staging
1.6 Ultrasound and Response to Treatment
1.7 Ultrasound, Follow-up and Recurrence
1.8 Gray-Scale Ultrasound: Examination Technique
1.9 Gray-Scale Ultrasound: Imaging Characteristics
1.10 Spectral Doppler: Examination Technique and Imaging
1.10 Characteristics
1.11 Color Doppler and Power Doppler: Examination Technique
1.12 Color Doppler and Power Doppler: Imaging Characteristics
1.13 Contrast-Enhanced Ultrasound: Examination Technique
1.14 Contrast-Enhanced Ultrasound: Imaging Characteristics
Chapter 2 Superficial Soft Tissues
2.1 Skin Tumors
2.2 Superficial Lymphadenopathy
2.3 Palpable Superficial Masses
2.4 Soft-Tissue Sarcomas
Chapter 3 The Neck
3.1 Neck Masses
3.2 Salivary Tumors
3.3 Thyroid Nodules
3.4 Staging and Follow-up of Thyroid Cancer
Chapter 4 The Breast
4.1 Breast Nodules
4.2 Locally Advanced Breast Cancer
4.3 Lymph Node Metastasis
4.4 Locoregional Recurrence of Breast Cancer
Chapter 5 The Abdomen
5.1 Abdominal Masses
5.2 Focal Lesions in Patients without Chronic Liver Disease
5.3 Focal Lesions in Patients with Chronic Liver Disease
5.4 Gallbladder Wall Lesions
5.5 Malignant Obstructive Jaundice
5.6 Pancreatic Tumors
5.7 Focal Splenic Lesions
5.8 Abdominal Lymphadenopathies
5.9 Peritoneal Carcinomatosis
5.10 Gastrointestinal Tract Tumors
Chapter 6 The Urogenital Tract
6.1 Adrenal Masses
6.2 Small Renal Tumors
6.3 Renal Masses
6.4 Atypical Renal Cysts
6.5 Ovarian Masses
6.6 Endometrial Thickening
6.7 Bladder Wall Lesions
6.8 Prostate Nodules
6.9 Testicular Tumors
Chapter 7 US-Guided Intervention
7.1 US Guidance for Interventional Procedures
7.2 Needle Aspiration – Superficial Structures
7.3 Needle Aspiration – Internal Structures
7.4 Core Biopsy – Superficial Structures
7.5 Core Biopsy – Internal Structures
7.6 Vacuum-Assisted Biopsy
7.7 Placement of Presurgical Markers
7.8 Drainages
7.9 Percutaneous Ethanol Injection
7.10 Radiofrequency Ablation and other Ablation Therapies
7.11 Assessment of Liver Lesions Treated with Ablation Therapies
Subject Index
The volume is therefore structured in seven broad chapters. Chapter 1. An analysis is made of the general relations between diagnostic imaging modalities, with particular reference to ultrasound, and the principal fields of oncology. An initial presentation is made of the advantages and limitations of US, the knowledge of which is essential for any clinical application of the technique, and therefore also for the study of cancer. The focus then shifts to the different phases in which US and the oncologic disease interact: secondary prevention, intrinsic characteristics of the cancer (with particular reference to neoangiogenesis), cancer staging, the evaluation of response to different types of anticancer treatments, short- and longterm monitoring, and the identification of disease recurrence. Only with an adequate understanding of these features of malignant disease can diagnostic imaging make a truly effective contribution. Chapter 1 also takes into consideration the examination techniques of US, spectral Doppler, color Doppler, power Doppler and contrastenhanced US (CEUS), with particular reference to the study of neoplastic diseases in their superficial and deep locations. The presentation especially focuses on the current possibility of optimizing the US instrumentation and exploration technique, with the aim of maximizing the detection and morphofunctional analysis of neoplastic lesions. The sections dealing with the examination technique alternate with a presentation of the principal imaging characteristics: although tumors arising in different organs may display different features, the discussion aims to underline the common imaging characteristics so they can be applied from time to time to the various anatomic regions and clinical problems.
Chapters 2–6. The clinical problems connected either directly or indirectly to neoplastic disease of the different body regions are many and varied and can be included in a single volume only in part. Instead of an encyclopedic approach, with systematic discussion of the epidemiologic, clinical, diagnostic and imaging characteristics of the different neoplasms in different body regions, we preferred to begin with the basic clinical problem, which is how the disease is presented to the diagnostic imaging specialist. This approach involves, first of all, an illustration of the general appearance and then the imaging characteristics, first and foremost US, but also CD, spectral Doppler and CEUS.
Chapter 7. The current range of extravascular interventional procedures is extremely broad and constantly on the increase. This chapter describes the main USguided procedures used in the cancer patient: diagnostic sampling of superficial and deep lesions (both cytologic – FNAC, and histologic – core biopsy), vacuum-assisted biopsy in breast cancer, placement of presurgical markers, drainage of collections, cysts and liquefactive masses, percutaneous ablation (with special reference to percutaneous ethanol injection and radiofrequency thermal ablation, and especially with regard to focal hepatic lesions). It should, nonetheless, be borne in mind that the number of US-guided interventional procedures is much greater, ranging from biliary drainage to nephrostomy and nerve block for anesthesia or pain management to venous catheterization. US guidance, either alone or in combination with other modalities; this allows all of these procedures to be performed more effectively and with greater safety for the patient than with a “blind” approach”. An increasingly widespread diffusion of the technique can therefore be reasonably expected. In this text the term color Doppler and its abbreviation CD are used, except where specifically stated, in reference to the Doppler techniques in general and therefore including power Doppler. In all cases where the description refers specifically to power Doppler this term will be expressly stated.
The term contrast-enhanced US (CEUS) is always used to refer specifically to gray-scale study with injection of sonographic contrast medium. When the intention is to indicate CD with contrast medium this is always expressly stated and should not be considered associated with the idea of US contrast enhancement.
Throughout the volume the term “US-guided” is a general reference to all procedures performed with US guidance, regardless of the type of transducer used, whether dedicated to the intervention or not. The specific meaning attributed to the terms “freehand”, “US-assisted” and “US-guided” is discussed at the beginning of Chapter 7.
Lastly, throughout the text, the term “biopsy” is used as a general indication of diagnostic sampling, both cytologic and microhistologic, where not otherwise specified. The difference between the former (aspirated with a fine needle, with the abbreviation FNAC) and true biopsy (indicated as “core biopsy”) is also thoroughly illustrated in Chapter 7. We preferred not to use the well-known abbreviation FNAB at all to avoid confusion in terms.
Contents
Chapter 1 General Considerations
1.1 Advantages of Ultrasound in Oncology
1.2 Limitations of Ultrasound in Oncology
1.3 Ultrasound and Cancer Screening
1.4 Ultrasound and Neoangiogenesis
1.5 Cancer Staging
1.6 Ultrasound and Response to Treatment
1.7 Ultrasound, Follow-up and Recurrence
1.8 Gray-Scale Ultrasound: Examination Technique
1.9 Gray-Scale Ultrasound: Imaging Characteristics
1.10 Spectral Doppler: Examination Technique and Imaging
1.10 Characteristics
1.11 Color Doppler and Power Doppler: Examination Technique
1.12 Color Doppler and Power Doppler: Imaging Characteristics
1.13 Contrast-Enhanced Ultrasound: Examination Technique
1.14 Contrast-Enhanced Ultrasound: Imaging Characteristics
Chapter 2 Superficial Soft Tissues
2.1 Skin Tumors
2.2 Superficial Lymphadenopathy
2.3 Palpable Superficial Masses
2.4 Soft-Tissue Sarcomas
Chapter 3 The Neck
3.1 Neck Masses
3.2 Salivary Tumors
3.3 Thyroid Nodules
3.4 Staging and Follow-up of Thyroid Cancer
Chapter 4 The Breast
4.1 Breast Nodules
4.2 Locally Advanced Breast Cancer
4.3 Lymph Node Metastasis
4.4 Locoregional Recurrence of Breast Cancer
Chapter 5 The Abdomen
5.1 Abdominal Masses
5.2 Focal Lesions in Patients without Chronic Liver Disease
5.3 Focal Lesions in Patients with Chronic Liver Disease
5.4 Gallbladder Wall Lesions
5.5 Malignant Obstructive Jaundice
5.6 Pancreatic Tumors
5.7 Focal Splenic Lesions
5.8 Abdominal Lymphadenopathies
5.9 Peritoneal Carcinomatosis
5.10 Gastrointestinal Tract Tumors
Chapter 6 The Urogenital Tract
6.1 Adrenal Masses
6.2 Small Renal Tumors
6.3 Renal Masses
6.4 Atypical Renal Cysts
6.5 Ovarian Masses
6.6 Endometrial Thickening
6.7 Bladder Wall Lesions
6.8 Prostate Nodules
6.9 Testicular Tumors
Chapter 7 US-Guided Intervention
7.1 US Guidance for Interventional Procedures
7.2 Needle Aspiration – Superficial Structures
7.3 Needle Aspiration – Internal Structures
7.4 Core Biopsy – Superficial Structures
7.5 Core Biopsy – Internal Structures
7.6 Vacuum-Assisted Biopsy
7.7 Placement of Presurgical Markers
7.8 Drainages
7.9 Percutaneous Ethanol Injection
7.10 Radiofrequency Ablation and other Ablation Therapies
7.11 Assessment of Liver Lesions Treated with Ablation Therapies
Subject Index
Book Details
- Hardcover: 375 pages
- Publisher: Springer; 1 edition (May 4, 2009)
- Language: English
- ISBN-10: 8847013542
- ISBN-13: 978-8847013544
- Product Dimensions: 10.3 x 7.5 x 1 inches