Multidetector computed tomography in the study of pancreatic metastases.

PURPOSE: The aim of this study was to explore the diagnostic performance of multidetector computed tomography (MDCT) in characterising pancreatic metastases. MATERIALS AND METHODS: CT examinations of 17 patients affected by pancreatic metastases were retrospectively reviewed. The primary malignancy was renal cell carcinoma (RCC) in eight cases, uterine leiomyosarcoma in two, lung carcinoma in four and breast carcinoma in three. CT images were assessed for lesion number, size and morphology. RESULTS: Pancreatic lesions were solitary in seven cases and multiple in ten. Lesion size ranged between 8 and 40 mm. Metastases from RCC were hyperattenuating in the arterial phase, metastases from breast cancer and lung cancer were hypoattenuating and metastases from uterine leiomyosarcoma were inhomogeneous. Precise lesion characterisation was obtained by using CT examination in 12 cases. In the remaining five patients, all with solitary metastases from RCC, a precise diagnosis was not possible because the lesions could not be differentiated from a neuroendocrine tumour. CONCLUSIONS: MDCT allowed pancreatic metastases characterisation in 70.5% of cases. The lesions were the manifestation of widely disseminated neoplastic disease, with the exception of metastases from RCC, which were exclusively located in the pancreas.

Preoperative local staging of colosigmoideal cancer: air versus water multidetector-row CT colonography.

PURPOSE: The authors sought to evaluate the diagnostic accuracy of multidetector-row computed tomography (MDCT) performed with two different hypodense endoluminal contrast agents for the preoperative staging of colosigmoideal cancer. MATERIALS AND METHODS: Seventy consecutive patients with an endoscopically and histologically proven diagnosis of colosigmoideal cancer underwent MDCT examination. Thirty-five patients were evaluated with water MDCT colonography and the remaining 35 with air MDCT colonography. Patients were randomly assigned to the air or water groups for staging. Transverse images and multiplanar reconstructions (MPR) were retrospectively examined by two blinded expert radiologists in order to assess T and N parameters, and the results were compared with histological findings. RESULTS: The overall diagnostic accuracy of MDCT was 68.6% for water and 62.8% for air colonography. In the evaluation of the T parameter, the accuracy values were 88.6% for water and 80% for air colonography. In staging of the N parameter, the accuracy values were 77.1% and 74.3% for water and air MDCT colonography, respectively. CONCLUSIONS: MDCT examination can be proposed for the local staging of colosigmoideal cancer. Water is more accurate than air in evaluation of the T parameter, whereas the kind of endoluminal contrast material does not influence the definition of the N parameter.

Facial approximation for identification purposes: soft tissue thickness in a Caucasian population. Sex and age-related variations.

The aim of this study was to collect soft tissue thickness (STT) values of an Italian population from 12 bone landmarks, to improve the facial approximation process for identification purposes. 100 Italian adults (50 males and 50 females), who had undergone head CT for clinical purposes, were analysed in order to expand the database of the Italian population. Average values, standard deviation and range were collected according to gender and age and the obtained values were statistically analysed in order to evaluate any possible significant difference. Only one landmark was statistically significant associated with sex, females showed significantly higher values for para-zygomaxillary. Two landmarks were statistically significant associated with age, upper incisor and pogonion. The obtained results were compared with the existing literature. Such information can be useful in the forensic craniofacial reconstruction process and can facilitate choosing the most suitable STT values according to osteological analysis of the human remains.

CT-guided needle biopsy performed with modified coaxial technique in the diagnosis of malignant lymphomas.

PURPOSE: The aim of was study was to evaluate the accuracy of computed tomography (CT)-guided core needle biopsy (CNB) performed by modified coaxial technique as an alternative tool to surgical biopsy in patients with suspected malignant lymphoma. MATERIALS AND METHODS: Between May 2005 and December 2008, 67 CT-guided CNB of deep lesions were performed on 64 patients with suspected malignant lymphoma. In 19 out of 64 patients (29.7%), recurrent lymphoma was suspected. A modified coaxial technique was used in all cases, and multiple samples were obtained for histological and immunohistochemical studies. RESULTS: A diagnosis of malignant lymphomas with specification of subtype according to the World Health Organization (WHO) classification was established in 41/67 cases. Other malignant neoplasms were found in 13/67, lymphoma without subtype specification was diagnosed in 7/67, whereas no conclusive diagnosis could be established in 6/67 cases. Overall diagnostic accuracy was 80.1%. In patients with a final diagnosis of malignant lymphoma, accuracy was 75.9%. No complications occurred. CONCLUSIONS: Percutaneous CT-guided CNB is a safe, effective and reliable tool in the management of lymphomas in patients without superficial lymphadenopathy and can be considered an alternative approach to surgical sampling. The modified coaxial technique represents an effective tool that has a good diagnostic accuracy value with a low complication rate.

Prognostic value of multidetector computed tomography in bowel infarction.

PURPOSE: This study aimed to correlate computed tomography (CT) findings and outcomes in patients affected by bowel infarction. MATERIALS AND METHODS: Twenty-seven patients with bowel infarction due to vascular obstruction were evaluated with multidetector CT (MDCT) to establish the prognostic value of CT findings and their correlation with the origin of the ischaemia. The chi-square test was used to analyse the results (p

Role of computerized tomography in the staging of gastrointestinal neoplasms.

Gastrointestinal neoplasms are very common diseases, and the first challenge for clinicians is to define the extent of the tumor in order to plan the best treatment. The role of computerized tomography in assessing this kind of patient is well established worldwide. This article reviews the capabilities and the limits of this imaging technique in the staging of the tumors of the digestive tract (liver, gallbladder, biliary tract, pancreas, esophagus, stomach, small bowel, and colon).