[Importance of conventional pancreas imaging: ultrasound, CT, and MRI. Facts and possibilities]. / Hasnyálmirigy-daganatok hagyományos képalkotása napjainkban, az UH, CT és MR jelentosége ­ Tények és lehetoségek.

Modern imaging procedures, including CT and MR diagnostics, play a significant role in recognizing, characterizing, determining the extent of pancreatic tumor lesions, assessing their operability, and evaluating response to treatment and patient follow-up. This article reviews the conventional imaging modalities used in the modern diagnosis of pancreatic tumors, conventional and contrast-enhanced abdominal ultrasound, standard protocols using the latest research results from CT and MRI scans, and their location and diagnostic value in the treatment of solid and cystic neoplasia. In addition, it briefly discusses the additional possibilities of artificial intelligence-based processing of digital imaging data, which is under strong development and is expected to be incorporated into clinical practice in the future.

[Stereotactic body radiotherapy of liver metastasis: early experience]. / Májáttétes betegek sztereotaxiás ablatív sugárkezelésével (SABRT) elért elsõ eredményeink.

Recently the prevalence of oligometastatic patients is increasing. A common site of distant spread is the liver. The standard of care is curative surgical resection, however, the resecability rate is only 10-20%. Alternatively, radiofrequency ablation (RFA) or transarterial chemoembolization (TACE) may be used. Stereotactic ablative body radiotherapy (SABRT) makes it possible to deliver curative radiation dose without radiation injury to the healthy liver tissue. We delivered SABRT to three patients with inoperable hepatic metastases. The primary tumors were rectal (2) and lung (1). The dose was 3x20 Gy every other day. We observed one grade 1 side effect. All the metastases showed complete remission and no local recurrence or late side effect occurred during the one year of follow-up. One patient is tumor-free, one has stable disease, in one patient two new hepatic metastases appeared and receives chemo-biological therapy. SABRT of liver metastases is safe and highly effective. It can be expected that in the near future it will become one of the standard treatments of hepatic tumors.

[Technical novelties, latest diagnostic options in the MRI and CT diagnostics of colorectal cancer]. / Technikai újdonságok, legújabb diagnosztikus lehetoségek a colorectalis daganatok MR- és CT-diagnosztikájában.

Diagnostic and therapeutic options of colorectal cancer (CRC) have changed over the past decade. Imaging plays a major role, thus the use of scanning methods is recommended by guidelines. Accurate staging, evaluation of treatment efficacy and identification of residual and recurrent tumors are required for the modern management of colorectal cancer. If adequate technical background is provided, magnetic resonance imaging (MRI) gives the information upon which therapeutic options may be determined. High-resolution MRI scans can be interpreted as maps providing functional and molecular information. Diffusion-weighted MRI (DW-MRI) has shown promising results regarding the determination of tumor volume and evaluation of treatment efficacy. Perfusion dynamic contrast-enhanced MRI (P-DCE-MRI) is the subject of research in the early assessment of treatment efficacy. Magnetic resonance spectroscopic imaging (MRSI) is a procedure utilizing biochemical analysis. Its application in CRC is under investigation. Clinical effectiveness of PET-MRI (hardware-based combination of MRI and positron emission tomography) is also being studied. Diagnostic value of computed tomographic colonography (CTC) has been proven in the detection of CRC as well as of polyps.

[Comparison of CT- and MRI-based clinical target volumes for 3-dimensional conformal external-beam radiotherapy of prostate cancer]. / CT és MRI alapján meghatározott céltérfogatok összehasonlítása prosztatarákos betegek 3 dimenziós konformális külso sugárkezelésében.

The aim of the study was to compare clinical target volumes defined by CT and MRI for 3 dimensional conformal external beam radiotherapy of prostate cancer. CT and T2-weighed MRI images with 3 mm slice thickness were acquired for 13 patients with clinically organ-confined prostate cancer. Target volumes were contoured by two clinicians ("AP" and "SZ") experienced in prostate radiotherapy. Two clinical target volumes were defined: prostate (CTVpros) and prostate with a margin including the proximal 1 cm of the seminal vesicles (CTVpvs). Eight clinical target volumes were outlined for all patients: CTVprosAPCT, CTVprosAPMR, CTVpvsAPCT, CTVpvsAPMR, CTVprosSZCT, CTVprosSZMR, CTVpvsSZCT, CTVpvsSZMR. Volumes were measured in cm3. The volumes of different PTVs were compared using the Student's t-test. Mean CTVpros and CTVpvs using CT vs. MRI were 36.9 (range:13.8-121) vs. 32.0 (9.7-120.1) (p=0.0002), and 77.2 (30.5-209.5) vs. 67.6 (29.8-191.1) (p=0.0001), respectively. Mean CTVprosAPCT vs. CTVprosAPMR were 39.2 vs. 32.0 (p<0.00005), respectively. Mean CTVprosSZCT vs. CTVprosSZMR were 34.6 vs. 31.9 (p=0.15). Mean CTVpvsAPCT vs. CTVpvsAPMR were 85.8 vs. 70.9 (p<0.00006). Mean CTVpvsSZCT vs. CTVpvsSZMR were 68.6 vs. 64.4 (p=0.14). Interobserver difference for CTVpros defined by CT images was significant (39.2 vs. 34.6; p=0,0058). However, the difference was not significant using MRI images (32.0 vs. 31.9; p=0.93). Interobserver differences for CTVpvs were significant using either CT (85.8 vs. 68.6; p=0.0001) or MRI (70.9 vs. 64.4; p=0.004). Ratio of mean volumes contoured by the two observers were 1,12 (CT) vs. 1 (MRI) for CTVpros and 1,2 (CT) vs. 1,09 (MRI) for CTVpvs. Clinical target volumes defined for prostate cancer external beam radiotherapy by MRI images are significantly smaller compared to CT image based contouring. The magnitudes of differences are observer dependent. The use of MRI decreases the interobserver difference of mean volumes with 11% and 12% for CTVpvs and CTVpros.

[Role of MRI in determining the therapy of rectal cancer]. / Az MR-vizsgálat szerepe a rectumcarcinomák terápiájának meghatározásában.

Over the past decade, significant progress has been made in the management of rectal cancer. Advances in surgical technique and adjuvant therapies have led to significant improvements in outcome for some patients. The advances in preoperative therapies have led to the need for an accurate preoperative staging technique to select those patients who are expected to benefit from these interventions without subjecting others to unnecessary treatment. Performing neoadjuvant therapy knowledge of the relationship of the tumor to the circumferential resection margin is of importance. In Hungary, respecting European guidelines, the high resolution magnetic resonance imaging is mandatory in the staging of rectal cancer, and in early rectal cancer transrectal endosonography has a complementary role. The current role of multidetector computer tomography is for detecting distant metastasis and in local tumor staging of advanced cancers.