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Focusing On The Abdomen And Pelvis

May 14, 2010
Written by: , Filed in: Abdominal Imaging
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We’ve been rounding up some of the studies introduced in San Diego last week at the American Roentgen Ray Society’s annual meeting. Let’s wrap up our miniseries by focusing on the abdomen and pelvic area:

  • FDG-PET/CT can help confirm a suspected recurrence of colorectal cancer at an early stage, say researchers at The Christie NHS Foundation Trust, a cancer center in Manchester, England. They studied 71 patients with suspected—because of either conventional CT or MR scans or a carcinoembryonic antigen (CEA) test—colorectal cancer recurrence. All 71 received a PET/CT scan. “PET/CT accurately confirmed a recurrence in 40/71 patients,” said Rohit Kochhar, MD, lead author of the study. “This shows that PET/CT has a definite role in the management of patients with recurrent colorectal cancer in addition to conventional imaging and the CEA test.”
  • For prostate cancer patients, preoperative MRI may help surgeons preserve continence and erectile function during a robotic assisted laparoscopic prostatectomy (RALP), concludes a study from UCLA. The study included 104 men with prostate cancer (proven through biopsies) who underwent MRI before RALP. This increasingly common surgical technique has the disadvantage of not allowing doctors to judge by feel whether it might be possible to preserve the neurovascular bundle (NVB), which controls erectile function and continence. Pre-op MRIs influenced surgeons to change their minds about nerve-sparing techniques for 29 of the 104 patients. “MRI before RALP appears to help surgeons make a more informed decision with regards to the aggressiveness of nerve-sparing surgical technique without compromising the oncological outcome,” said lead author Timothy McClure, MD.
  • CT scans do better at detecting pelvic fractures than standard X-rays, according to a retrospective study at Allegheny General Hospital in Pittsburgh. Researchers examined data for 132 pelvic-fracture patients who had received both standard X-rays and CT. “Pelvic X-rays, especially special views, failed to identify 48 percent of pelvic injuries and also failed to add any significant value to patient care,” said lead author Zulfiqar Ali, MD. He added:

Most orthopedic surgeons order special, additional X-ray views after a CT scan has been performed and a diagnosis confirmed. We recommend that these additional views be eliminated since pelvic CT, with multiplanar and three-dimensional reconstructed images, is sufficient for complete evaluation of suspected pelvic injuries.

  • Conventional MRI may be a good alternative to MR arthrography for diagnosing hip labral tears, suggests a University of Wisconsin study. Tears in the labrum (the cartilage that surrounds the hip socket) are a common cause of hip pain. MR arthrography, often used to diagnose such tears, includes the injection of contrast material into the hip joint. It’s only minimally invasive—but conventional MRI isn’t invasive at all. The study involved 30 patients who had undergone imaging with both techniques before surgery. “Conventional hip MRI and MR arthrogram studies revealed no significant difference between the two imaging techniques in the detection of labral tears,” said lead author Colin Strickland, MD. He said further study is needed, especially regarding how well conventional MRI can evaluate nonspecific hip pain.

Related seminar: CT/MRI of the Abdomen and Pelvis (just released)

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