美国放射学院(American College of Radiology,ACR)偶发病变委员会(Incidental Findings Committee,IFC)发布了CT或MR偶发胰腺囊肿的管理建议。该建议是对美国放射学院杂志(JACR)2010年发布的肾上腺、肾脏、肝脏以及胰腺偶发病变管理白...美国放射学院(American College of Radiology,ACR)偶发病变委员会(Incidental Findings Committee,IFC)发布了CT或MR偶发胰腺囊肿的管理建议。该建议是对美国放射学院杂志(JACR)2010年发布的肾上腺、肾脏、肝脏以及胰腺偶发病变管理白皮书中胰腺部分的更新。该管理方案由多位腹部影像医师、1位胃肠道学医师以及1位胰腺外科医师所组成的胰腺亚组委员会制定。该方案参考已发表的文献和专家意见,经反复协商,最终达成共识。该方案的分支成功地根据患者的临床特点及影像特征将胰腺囊肿进行分类,评估终点为良性和/或进展缓慢病变的诊断(足以结束随访)或具体的管理建议。该方案适用于大多数但非全部的病理及临床情况。该方案旨在通过提供胰腺偶发囊肿的管理指导,来提高患者的管理质量。展开更多
One of the most common cancers worldwide, colorectal cancer (CRC) has been associated with significant morbidity and mortality and therefore represents an enormous burden to the health care system. Recent advances in ...One of the most common cancers worldwide, colorectal cancer (CRC) has been associated with significant morbidity and mortality and therefore represents an enormous burden to the health care system. Recent advances in CRC treatments have provided patients with primary and metastatic CRC a better long-term prognosis. The presence of synchronous or metachronous metastasis has been associated, however, with worse survival. The most common site of metastatic disease is the liver. A variety of treatment modalities aimed at targeting colorectal liver metastases (CRLM) has been demonstrated to improve the prognosis of these patients. Loco-regional approaches such as surgical resection and tumor ablation (operative and percutaneous) can provide patients with a chance at long-term disease control and even cure in select populations. Patient selection is important in defining the most suitable treatment option for CRLM in order to provide the best possible survival benefit while avoiding unnecessary interventions and adverse events. Medical imaging plays a crucial role in evaluating the characteristics of CRLMs and disease resectability. Size of tumors, proximity to adjacent anatomical structures, and volume of the unaffected liver are among the most important imaging parameters to determine the suitability of patients for surgical management or other appropriate treatment approaches. We herein provide a comprehensive overview of current-state-of-the-art imaging in the management of CRLM, including staging, treatment planning, response and survival assessment, and post-treatment surveillance. Computed tomography (CT) scan and magnetic resonance imaging (MRI) are two most commonly used techniques, which can be used solely or in combination with functional imaging modalities such as positron emission tomography (PET) and diffusion weighted imaging (DWI). Providing up-to-date evidence on advantages and disadvantages of imaging modalities and tumor assessment criteria, the current review offers a practice guide to assist providers in choosing the most suitable imaging approach for patients with CRLM.展开更多
文摘美国放射学院(American College of Radiology,ACR)偶发病变委员会(Incidental Findings Committee,IFC)发布了CT或MR偶发胰腺囊肿的管理建议。该建议是对美国放射学院杂志(JACR)2010年发布的肾上腺、肾脏、肝脏以及胰腺偶发病变管理白皮书中胰腺部分的更新。该管理方案由多位腹部影像医师、1位胃肠道学医师以及1位胰腺外科医师所组成的胰腺亚组委员会制定。该方案参考已发表的文献和专家意见,经反复协商,最终达成共识。该方案的分支成功地根据患者的临床特点及影像特征将胰腺囊肿进行分类,评估终点为良性和/或进展缓慢病变的诊断(足以结束随访)或具体的管理建议。该方案适用于大多数但非全部的病理及临床情况。该方案旨在通过提供胰腺偶发囊肿的管理指导,来提高患者的管理质量。
文摘One of the most common cancers worldwide, colorectal cancer (CRC) has been associated with significant morbidity and mortality and therefore represents an enormous burden to the health care system. Recent advances in CRC treatments have provided patients with primary and metastatic CRC a better long-term prognosis. The presence of synchronous or metachronous metastasis has been associated, however, with worse survival. The most common site of metastatic disease is the liver. A variety of treatment modalities aimed at targeting colorectal liver metastases (CRLM) has been demonstrated to improve the prognosis of these patients. Loco-regional approaches such as surgical resection and tumor ablation (operative and percutaneous) can provide patients with a chance at long-term disease control and even cure in select populations. Patient selection is important in defining the most suitable treatment option for CRLM in order to provide the best possible survival benefit while avoiding unnecessary interventions and adverse events. Medical imaging plays a crucial role in evaluating the characteristics of CRLMs and disease resectability. Size of tumors, proximity to adjacent anatomical structures, and volume of the unaffected liver are among the most important imaging parameters to determine the suitability of patients for surgical management or other appropriate treatment approaches. We herein provide a comprehensive overview of current-state-of-the-art imaging in the management of CRLM, including staging, treatment planning, response and survival assessment, and post-treatment surveillance. Computed tomography (CT) scan and magnetic resonance imaging (MRI) are two most commonly used techniques, which can be used solely or in combination with functional imaging modalities such as positron emission tomography (PET) and diffusion weighted imaging (DWI). Providing up-to-date evidence on advantages and disadvantages of imaging modalities and tumor assessment criteria, the current review offers a practice guide to assist providers in choosing the most suitable imaging approach for patients with CRLM.