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INTRODUCTION

RADIOLOGICAL EXAMINATION ASSISTED CLINICAL DIAGNOSIS OF CANCER (PLAIN PHOTO, CONTRAST PHOTO, ULTRASONOGRAPHY, MAMMOGRAPHY CT, MRI AND NUCLEAR MEDICINE). Disampaikan leh : Wigati Dhamiyati Radiology Department Faculty of medicine Gadjah Mada University. INTRODUCTION.

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INTRODUCTION

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  1. RADIOLOGICAL EXAMINATIONASSISTED CLINICAL DIAGNOSIS OF CANCER(PLAIN PHOTO, CONTRAST PHOTO, ULTRASONOGRAPHY, MAMMOGRAPHY CT, MRI AND NUCLEAR MEDICINE) Disampaikanleh: WigatiDhamiyatiRadiology Department Faculty of medicine GadjahMada University

  2. INTRODUCTION • Plain photo, contrast photo, ultrasound, CT,MRI and nuclear medicine are modalities on radiology imaging. • Mammography is a special examination for the breast using x-rays, usually combined with ultrasound . • All of these examination depend of the interest organ have an important role to make an accurate diagnosis of neoplasm  

  3. Tumors of the lung in plain chest film

  4. A solitary lung lesion • The questions that have to be answered are : is it a primary or secondary malignant lesions or is it benign?

  5. Radiographic signs • The character of the edge • Internal calcification • Growth of a lesion

  6. CT Scan

  7. PANCOST TUMOR Pancoasttumour ,Chest X-ray shows asymmetrical right apical pleural thickening

  8. Mediastinal Mass

  9. Metastatic tumors • Most pulmonary metastases  genitourinary and gastrointestinal system. • Hematogenous metastasis Discrete and circumscribed Miliary or snow strom appearance indicated rapid growth. • Lymphatic permeation Mediastinum and its nodes are the first line with this type of spread. • Massive pleural effusion.

  10. Tumors of the bone in plain photo • Three important question requere to answered : • Neoplastic or infective • Benign or malignannt • Primary or secondary neoplasm.

  11. General principles of radiological diagnosis of bone tumors : • consider the age of the patient and the clinical hystory. • Lesion soliter or multiple • Type of bone involved • Position of the lesion within the bone : cortex, disphysis, metaphysis • Plain film features : radioluscent focus, radioopaq, ground glass • Margins of the lesion look like

  12. Secondary neoplasm. • Bone Scintigraphy (Nuclear Medine examination) • Gamma camera images using Tc 99m labelled diphosphonate compounds • After injection 3 hours later the skeleton is imaged when the radiopharmaceutical has localized in bone. Scintigraphy may used to asses the primary presenting lesion and also to detect whether it is monoostotic or accompanied by other skeletal lesions such as metastasis.t

  13. GASTROINTESTINAL AND UROGENITAL TRACT TUMOR • CONTRAST EXAMINATION • ULTRASONOGRAPHY • CT • MRI

  14. COLON TUMOR BENIGN  POLIP MALIGNANT TUMOR

  15. SESSILE POLYP

  16. PEDUNCULATED POLIP

  17. VILLOUS TYPE

  18. ANNULARE TYPE

  19. Carsinomacolon

  20. UTERINE FIBROID (leiomyoma)

  21. UTERINE FIBROID (leiomyoma)

  22. URINARY BLADDER TUMOR

  23. Renal tumor CT Scan

  24. Both pictures (different cases) show metastases in the liver shown in red circles

  25. MRI • .

  26. LIVER TUMOR

  27. LIVER METASIS

  28. PANCREATIC TUMOR

  29. BRAIN TUMOR • CT • MRI

  30. BRAIN TUMOR CT

  31. GLIOBLASTOMA MULTIFORME AND MENINGIOMA

  32. BRAIN TUMOR MRI

  33. ORBITAL TUMOUR A B • Haemangiomas. Multilobate mass right which does not fill the tip of the orbit and displays • distinct enhancement of 37HU after administration of contrast medium (In). • Glioma of the optic nerve. Spindle-shaped enlargement retrobulbar in the region of the • optic nerve with dilatation of the tip of the orbit including the optic canal (Su);Meningioma • of the optic nerve sheath with calcification in the region of the optic sheath. No enlargement • of the optic nerve is visible in this slice

  34. MALIGNANT LYMPHOMAS • Medial lesion, medial extraocular muscles and almost exclusively extraconal location • determined in the horizontal slice. • Intraconal malignant lymphoma with enlargement of the muscle cone extending into • the tip of orbit. Homogenous tissue density lesion.

  35. MALIGNANT LYMPHOMAS • Lateral malignant lymphoma (polymorphic immunocytoma) situated within and outside • the muscle cone and masking the musculus rectus lateralis • Plasmocytoma with infiltration of the retrobulbar fatty tissue and destruction of the • osseous orbit

  36. MAMMOGRAPHIC SIGNSOF BREAST CA • DIRECT SIGN OF FOCALLY GROWING INVASIVE CARCINOMA 1.increase density in comparison with the parenchym. 2.equal in density in comparison with the parenchym with outline :. • Spiculated or irregular • Similar to parenchyma, lobulated,geographically ill-definded (=indeterminate mass) • Round or rarely entirely smooth. 3.Microcalsification 4.Distorted architecture. 5.Asymmetry in comparison with the contralateral side.

  37. INDIRECT SIGN/secondary sign OF A FOCALLY GROWING INVASIVE CA • Nipple retraction • Local retraction of the skin or the parenchyma overlying the lession • Thickening of cooper’s ligaments in the vicinity of the lesion Local thickening of skin overlying the lesion. • Trabecular thickening in the subcutaneous space or in the prepectoral muscle • Retraction or fixation on the pectoral muscle • Enlarged, multiple,homogenously dense,smoothly or unsharply outlined lymph nodes in the axillary extention.

  38. Malignant tumor

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