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Bachtiar Murtala

The role of radiologic imaging in


oncology
 To find out tumor
 To demonstrate more detail of tumor: site, shape,
size, extension to adjacent tissue / regional or
distant metastases.
 Staging
 Assessment of resectability or management
 Predictive/prognostic
 Follow up
 Guide biopsy
 Therapy---interventional, radiotherapy
We will discuss radiological aspect of some most
popular tumors in the daily practice
Intracranial tumor
Modalities
 Plain radiography of skull
 CT-scan
 MRI
 Cerebral angiography
Plain radiography
 Sensitifity and spesifisity are low
 It might be seen just as increase of intracranial
pressure signs
Radiological signs of increasing of
intracranial pressure
CT-Scan
 Very useful in presenting nodul/mass
 Tumor of brain usually hypodense . Sometimes
hyperdense or isodense (need contrast
administration)
 Perifocal edema
 Mass effect as obliteration or narrowing of
ventricle systems,
 and midline shift
 Can produce obstruction – hydrocephalus
 Erosion/destruction of bone
ASTROCYTOMA

Low grade astrocytoma

Hypodensity nodul ,
High grade astrocytoma
 craniopharyngioma
MENINGIOMA

 Hyperdensity mass,
well-defined,
perifocal edema,
 Convexity of brain or
where the meninges
layer is.
 Mass effect
Spinal cord tumor

 MRI is the modality


of choise
 It can identify
intradural or
extradural tumors
Nasopharyngeal tumor (NPC)

 CT and MRI
 Mass fill nasopharyngeal
space, usually start from
Rosenmullery fossa
 Extension to adjacent
tissue and bone

Normal nasopharyng
NPC
AXIAL CT SCAN
MRI
Pulmonary tumors

Chest X-Ray
 Opacification mass,
irregular
border/spiculated margin
 Enlargement of limph
node
 Pleural effusion
 Bone erosion
CT SCAN
 To evaluate extension of
tumor especially to limph
node
 More detail of tumor; size,
shape,etc
Mediastinal Tumors

 The site of tumor is the most


important
 Such as : Thymoma,
lymphoma, thyroid tumor.
Chest X-ray
 solid mass. Well defined,
convex toward lung
 Arise from mediastinum
 Rountinely by PA/lateral views
HODGKIN’S LYMPHOMA
CT SCAN

HODGKIN’S LYMPHOMA
GI Tract
 From esophagus to colon
 Barium study
 Esofagus  esophagography
 Maag-Duodenum MD foto (gastroduodenography)
 Colon  colon inloop (Barium enema)
General appearances

 Filling defect
Malignant---irregular margin
Benign---smooth margin
 Dilatation of proximal segmen of the tumor
Esophageal tumor

Carcinoma of
esophagus
Gastric tumor
Colon tumor

Filling defect “shoulder


sign”
Hepatic tumor / HEPATOMA

USG & CT SCAN  most


useful
Liver
metastases
Hepatoma
Renal Tumor

 WILM’S Tumor ( pediatric


patient )
 GRAWITZ tumor/Renal
cell carcinoma in adult
Imaging modalities :
 Plain abd. radiography
 IVP/IVU
 USG
 CT Scan / MRI
Urinanry bladder tumor

Imaging modalities :
 Cystography
 USG
 CT Scan
Prostate hypertrophy/cancer

Imaging :
- IVP - CT
- Cystography - MRI
Gynecologic tumors
 Uterus : leiomyoma, choriocarcinoma, ca cervix
 Adnexa : Ovarial cyst/tumor

Imagings :
USG - CT Scan - MRI
Urin bladd

Uterus

cyst
Bone Tumor

 Benign : osteochondroma,
aneurysmal bone cyst,
osteoma, osteoid osteoma, etc
 Malignant: Osteosarcoma,
Ewing sarcoma,
chondrosarcoma

Osteochondroma
Osteosarcoma

OSTEOSARCOMA
- Most frequent in teenager
- Predilection site :
Metaphysis of long
bones.
Radiological signs :
- Osteolytic
- Osteoblastic
- Codman’s triangle
- Sunburst appearance
- Soft tissue swelling
 Metas
Pathologic fracture
Lung metastases of osteosarcoma
TUMOR METASTASIS

Lung metastases

- Multiple nodules
- Pleural effusion
- Comes from other site :
breast, GI tract, bone,
testis, etc
TUMOR METASTASE

Bone metastases
- Commonly affecting axial
bones
- Can produce bone
seperti : cranium, tulang
belakang, costa dsb.
- Initial lesion in pedicle (
if occur in spine )
- Osteolytic ( most
common ) or osteoblastic
type ( usually from
METASTASES FROM CARCINOMA OF prostat cancer )
THE BREAST TO THE LEFT PEDICLE
TUMOR METASTASEs

BLASTIC METASTASES IN CARCINOMA OF THE PROSTAT


mammography
US of fibroadenoma mammae
Mammogram of breast carcinoma
Thank you