Richard C. Semelka

Radiologic features of cystic, endocrine and other pancreatic neoplasms

This article presents imaging features of cystic, endocrine and other pancreatic neoplasms. Microcystic adenoma which is composed of small cysts (<2 cm), its macrocystic subgroup contains solitary cyst. Multiple cysts larger than 2 cm are associated with mucinous cystic neoplasm. Swiss cheese appearence with central calcification is characteristic for microcystic adenomas. Septal and mural enhancement as well as larger size (>2 cm) are accounted for mucinous cystic neoplasms, its variant along pancreatic duct is ductectatic mucinous cystic neolasm. Endocrine tumors of pancreas are hypervascular and can be depicted on early dynamic enhanced crosssectional imaging modalities or on angiography when they are <1 cm. Pancreatic metastases and lymphomas are rare neoplasms which should also be included in differential diagnosis for pancreatic masses.

Radiologic diagnosis and staging of pancreatic ductal adenocarcinoma

This article presents imaging modalities in the diagnosis and staging of pancreatic ductal adenocarcinoma. Magnetic resonance imaging (MRI) and endoscopic ultrasonography (EUS) have the highest accuracy in detection of pancreatic cancer. MRI and EUS have similar accuracy in determining the local extent of pancreatic cancer. Angiography, computed tomography (CT) angiography and EUS are similarly accurate in evaluating peripancreatic vascular involvement. MRI is the superior method for detecting liver metastases and peritoneal implants of pancreatic ductal adenocarcinoma. Endoscopic retrograde cholangiopancreatography (ERCP) and magnetic resonance cholangiopancreatography (MRCP) are used to assess the biliary tract of patients with pancreatic cancer. Positron emission tomography (PET) is useful in distinguishing pancreatic cancer from focal pancreatic inflammation.

Chapter 30 – Tumors of the Bladder and Urethra

IMAGING HIGHLIGHTS □ Bladder cancer is the most common genitourinary (GU) malignancy; more than 90% of bladder cancers are epithelial; the majority are transitional cell cancer.