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Barat M, Guegan-Bart S, Cottereau AS, Guillo E, Hoeffel C, Barret M, Gaujoux S, Dohan A, Soyer P. CT, MRI and PET/CT features of abdominal manifestations of cutaneous melanoma: a review of current concepts in the era of tumor-specific therapies. Abdom Radiol (NY) 2021; 46:2219-2235. [PMID: 33135115 DOI: 10.1007/s00261-020-02837-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/15/2020] [Accepted: 10/20/2020] [Indexed: 12/12/2022]
Abstract
Abdominal manifestations in patients with cutaneous melanoma include involvement due to metastatic spread and immune checkpoint inhibitor induced adverse events. The purpose of this review is to provide a critical overview of abdominal manifestations in patients with cutaneous melanoma and highlight the current imaging challenges in the era of tumor-specific therapies. Immune checkpoint inhibitors represent a treatment with demonstrated efficacy in the treatment of advanced cutaneous melanoma but are associated with several abdominal adverse events that must be recognized. CT has a role in the identification of colitis, enteritis and pancreatitis, whereas MRI has an important role in the diagnosis of autoimmune pancreatitis. Current evidence demonstrates that MRI should be the preferred imaging technique for the detection and characterization of hepatic and splenic metastases from cutaneous melanoma. The role of 18F-FDG-PET/CT should be further evaluated but current literature suggests an efficacy in the detection of pancreatic metastases not seen on CT and MRI.
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Affiliation(s)
- Maxime Barat
- Department of Abdominal & Interventional Radiology, Hôpital Cochin, AP-HP, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
- Université de Paris, Descartes-Paris 5, rue de l'Ecole de Médecine, F-75006, Paris, France
| | - Sarah Guegan-Bart
- Université de Paris, Descartes-Paris 5, rue de l'Ecole de Médecine, F-75006, Paris, France
- Department of Dermatology, Hôpital Cochin, AP-HP, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Anne-Ségolène Cottereau
- Université de Paris, Descartes-Paris 5, rue de l'Ecole de Médecine, F-75006, Paris, France
- Department of Nuclear Medicine, Hôpital Cochin, AP-HP, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Enora Guillo
- Department of Abdominal & Interventional Radiology, Hôpital Cochin, AP-HP, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Christine Hoeffel
- Department of Radiology, Hôpital Robert Debré, 11 Boulevard Pasteur, 51092, Reims, France
| | - Maximilien Barret
- Université de Paris, Descartes-Paris 5, rue de l'Ecole de Médecine, F-75006, Paris, France
- Department of Gastroenterology, Hôpital Cochin, AP-HP, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Sébastien Gaujoux
- Université de Paris, Descartes-Paris 5, rue de l'Ecole de Médecine, F-75006, Paris, France
- Department of Abdominal Surgery, Hôpital Cochin, AP-HP, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Anthony Dohan
- Department of Abdominal & Interventional Radiology, Hôpital Cochin, AP-HP, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
- Université de Paris, Descartes-Paris 5, rue de l'Ecole de Médecine, F-75006, Paris, France
| | - Philippe Soyer
- Department of Abdominal & Interventional Radiology, Hôpital Cochin, AP-HP, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France.
- Université de Paris, Descartes-Paris 5, rue de l'Ecole de Médecine, F-75006, Paris, France.
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Magnetic resonance imaging of the gut: a primer for the luminal gastroenterologist. Am J Gastroenterol 2014; 109:497-509; quiz 510. [PMID: 24394750 DOI: 10.1038/ajg.2013.452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Accepted: 11/24/2013] [Indexed: 12/11/2022]
Abstract
Magnetic resonance imaging (MRI) is well established for imaging the solid organs of the abdomen and pelvis. In recent years it has been having an increasingly important role in the evaluation of the gastrointestinal (GI) tract. Fluoroscopy and abdominal computed tomography, the traditional mainstays of bowel imaging, remain valuable; however, the contemporary emphasis on decreasing patient radiation exposure is driving practice toward non-ionizing modalities such as MRI. The inherent dynamic properties of MRI, its superior tissue contrast, and cross-sectional capabilities offer additional advantages. Here we review, from esophagus to anus, techniques and indications for MRI of the GI lumen with an emphasis on the normal MRI appearance of the GI tract and commonly encountered pathology.
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Savoye-Collet C, Roset JB, Koning E, Charpentier C, Hommel S, Lerebours E, Dacher JN, Savoye G. Magnetic resonance colonography in severe attacks of ulcerative colitis. Eur Radiol 2012; 22:1963-71. [DOI: 10.1007/s00330-012-2456-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Revised: 02/21/2012] [Accepted: 02/24/2012] [Indexed: 12/12/2022]
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5
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Zijta F, Florie J, Jensch S, Bipat S, Nievelstein R, Poulus M, Thomassen-de Graaf M, Montauban van Swijndregt A, Stoker J. Diagnostic performance of radiographers as compared to radiologists in magnetic resonance colonography. Eur J Radiol 2010; 75:e12-7. [DOI: 10.1016/j.ejrad.2009.10.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Accepted: 10/14/2009] [Indexed: 11/26/2022]
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Abstract
The bowel is a common site for pathologic processes, including malignancies and inflammatory disease. Colorectal cancer accounts for 10% of all new cancers and 9% of cancer deaths. A significant decrease in the incidence of colorectal cancer and cancer death rates has been attributed to screening measures, earlier detection, and improved therapies. Virtual colonoscopy (VC), also known as computed tomography colonography, is an effective method for detecting polyps. However, in light of increasing concerns about ionizing radiation exposure from medical imaging and potential increased risk of future radiation-induced malignancies, magnetic resonance imaging (MRI) is seen as an increasingly attractive alternative. Improvements in MRI technology now permit three-dimensional volumetric imaging of the entire colon in a single breath hold at high spatial resolution, making VC with MRI possible.
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Affiliation(s)
- Lewis K Shin
- Department of Radiology, Stanford University School of Medicine, 300 Pasteur Drive, Room H-1307, Stanford, CA 94305-5105, USA.
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Noninvasive radiologic imaging of the large intestine: a valuable complement to optical colonoscopy. Curr Opin Gastroenterol 2010; 26:61-8. [PMID: 19786870 DOI: 10.1097/mog.0b013e328332b835] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Radiologic imaging of the large intestine continues to evolve and expand the potential for noninvasive diagnosis. The aim of this review is to provide an update on current and emerging clinical capabilities for a variety of radiologic diagnostic imaging tools for evaluating the colon and rectum. RECENT FINDINGS The utility of computed tomography for the evaluation of symptomatic inflammatory and neoplastic conditions of the colon is well established, but the clinical role of computed tomography colonography is rapidly evolving. In addition to a number of diagnostic indications, computed tomography colonography is emerging as a potential frontline colorectal screening test for cancer prevention. MRI has become increasingly valuable for rectal cancer staging and inflammatory bowel disease but has yet to gain momentum for polyp evaluation. PET imaging has been primarily utilized for oncologic indications, but also holds considerable potential for inflammatory conditions. Other imaging modalities, such as the barium enema, conventional radiography, and ultrasound, play a much more limited role. SUMMARY Advances in radiologic imaging of the colorectum will continue to expand the capabilities and clinical indications for noninvasive diagnosis, allowing for a greater emphasis on the complementary roles of tissue sampling and therapy with optical colonoscopy.
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Monitoring of tumor promotion and progression in a mouse model of inflammation-induced colon cancer with magnetic resonance colonography. Neoplasia 2009; 11:237-46, 1p following 246. [PMID: 19242605 DOI: 10.1593/neo.81326] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2008] [Revised: 11/30/2008] [Accepted: 12/08/2008] [Indexed: 01/17/2023] Open
Abstract
Early detection of precancerous tissue has significantly improved survival of most cancers including colorectal cancer (CRC). Animal models designed to study the early stages of cancer are valuable for identifying molecular events and response indicators that correlate with the onset of disease. The goal of this work was to investigate magnetic resonance (MR) colonography in a mouse model of CRC on a clinical MR imager. Mice treated with azoxymethane and dextran sulfate sodium were imaged by serial MR colonography (MRC) from initiation to euthanasia. Magnetic resonance colonography was obtained with both T1- and T2-weighted images after administration of a Fluorinert enema to remove residual luminal signal and intravenous contrast to enhance the colon wall. Individual tumor volumes were calculated and validated ex vivo. The Fluorinert enema provided a clear differentiation of the lumen of the colon from the mucosal lining. Inflammation was detected 3 days after dextran sulfate sodium exposure and subsided during the next week. Tumors as small as 1.2 mm(3) were detected and as early as 29 days after initiation. Individual tumor growths were followed over time, and tumor volumes were measured by MR imaging correlated with volumes measured ex vivo. The use of a Fluorinert enema during MRC in mice is critical for differentiating mural processes from intraluminal debris. Magnetic resonance colonography with Fluorinert enema and intravenous contrast enhancement will be useful in the study of the initial stages of colon cancer and will reduce the number of animals needed for preclinical trials of prevention or intervention.
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Farraye FA, Adler DG, Chand B, Conway JD, Diehl DL, Kantsevoy SV, Kwon RS, Mamula P, Rodriguez SA, Shah RJ, Wong Kee Song LM, Tierney WM. Update on CT colonography. Gastrointest Endosc 2009; 69:393-8. [PMID: 19231482 DOI: 10.1016/j.gie.2008.10.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2008] [Accepted: 10/09/2008] [Indexed: 02/08/2023]
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Advances in radiological imaging of gastrointestinal tumors. Crit Rev Oncol Hematol 2008; 69:153-67. [PMID: 18674926 DOI: 10.1016/j.critrevonc.2008.06.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2008] [Revised: 05/02/2008] [Accepted: 06/26/2008] [Indexed: 02/06/2023] Open
Abstract
This article summarizes the recent advances in radiological imaging in the hepatogastrointestinal field in terms of detection, characterization and staging of tumors. Introduction of multidetector row computed tomography technology has helped computed tomography to excel in its already established indications, and has expanded its capabilities by adding new clinical applications, such as computed tomography angiography, liver perfusion, computed tomography enterography or enteroclysis, and virtual colonoscopy. Contrast-enhanced ultrasound has dramatically changed the role of ultrasound in liver tumor characterization, detection, and other applications. Combining the advantages of unsurpassed soft tissue contrast and lack of ionizing radiation, magnetic resonance imaging of the gastrointestinal tract has become increasingly used clinically. Moreover, substantial progress in molecular and cellular magnetic resonance imaging has been achieved in the past few years. Particularly, the increasing number of available specific contrast agents dedicated to the evaluation of the liver and lymph nodes shows promises in the area of oncologic abdominal imaging.
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Sun L, Wu H, Guan YS. Colonography by CT, MRI and PET/CT combined with conventional colonoscopy in colorectal cancer screening and staging. World J Gastroenterol 2008; 14:853-63. [PMID: 18240342 PMCID: PMC2687052 DOI: 10.3748/wjg.14.853] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Colorectal cancer (CRC) remains a leading cancer killer worldwide. But the disease is both curable and preventable at an early stage. Regular CRC cancer screening has been shown to reduce the risk of dying from CRC. However, the importance of large-scale screening is only now starting to be appreciated. This article reviews a variety of imaging procedures available for detecting ulcerative colitis (UC) and Crohn’s disease (CD), polyps and CRC in their early stage and also presents details on various screening options. Detecting, staging and re-staging of patients with CRC also require multimodality, multistep imaging approaches. Staging and re-staging with conventional colonoscopy (CC), computer tomography colonography (CTC), magnetic resonance colonography (MRC) and positron emission tomography/computer tomography colonography (PET/CTC) are of paramount importance in determining the most appropriate therapeutic method and in predicting the risk of tumor recurrence and overall prognosis. The advantages and limitations of these modalities are also discussed.
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