E-Book Description
Cancer Imaging Lung and Breast Carcinomas Volume 1 PDF Free Download
The primary objective of this series, CANCER IMAGING, is to present the readers with the most up-to-date instrumentation, general applications, as well as specific applications of imaging technology to diagnose various cancers. The present work concentrates on the application of this technology to the diagnosis of lung and breast carcinomas, the two major worldwide cancers. In this work we discuss strategies for imaging cancer and clinical applications of this technology and explain the role of molecular imaging in early therapy monitoring. In addition, we cover the following topics: synthesis and use of different contrast agents, especially the most commonly used tracer, 18F-fluorodeoxyglucose (FDG), in conjunction with imaging modalities (e.g., magnetic resonance imaging [MRI]); the advantages and limitations of the tracers; and rational and protocol details of whole-body screening with computed tomography (CT), positron emission tomography (PET), and PET/CT. We also describe the role of imaging in drug development, gene therapy, and therapy with monoclonal antibodies; for example, we describe the advantages of preclinical immuno-PET. The advantages of hybrid modalities, such as PET/CT (e.g., in lung cancer), are also presented. The importance of the use of imaging for clinical diagnosis is presented in detail, and the relationship between radiation dose and image quality is discussed. In addition, we present detailed methods for absorbed X-ray dose measurement in mammography to avoid the risk of radiation-induced carcinogenesis. We also detail lung cancer screening, staging, and diagnosing, applying different imaging modalities and point out false-negative and false-positive images potentially encountered in various body parts when imaged. Imaging modalities, including high-resolution CT, thinsection CT, computer-aided diagnosis with CT, low-dose helical CT, and FDG-PET/CT, used for staging and diagnosing lung cancer (e.g., non-small cell lung carcinoma), are discussed. Details of a large number of imaging modalities, including optical mammography, digital mammography, contrast-enhanced MRI, SPECT, color-Doppler sonography, and sonography, used for diagnosing breast cancer are presented. Other topics include use of imaging for diagnosing invasive lobular carcinoma, density of breast carcinoma, axillary lymph node status in breast cancer, small-size primary breast cancer, and microcalcification in breast lesions.
E-Book Details
Сategories: Free Medical Books|Oncology
Language : English
Hardcover : 1584 pages
ISBN-10 : 0123742129
ISBN-13 : 978-0123742124
Language : English
Hardcover : 1584 pages
ISBN-10 : 0123742129
ISBN-13 : 978-0123742124
Table of Contents
Contents of Volume 2 xxiii
Contributors xxix
Preface xxxix
Selected Glossary xli
Introduction xlix
Part I Instrumentation
1.1 Strategies for Imaging Biology in
Cancer and Other Diseases 3
Philipp Mayer-Kuckuk and Debabrata Banerjee
Introduction 3
Imaging Strategies 4
Conferring Imaging Visibility 4
Peptides, Proteins, and Probes 4
Imaging Reporter Genes 5
Imaging Modalities 7
Preclinical Applications 7
Gene Transcription 7
Ribonucleic Acid Biology 8
Protein Biology 8
Imaging Strategies for
Clinical Applications 10
Receptors and Cell-Surface
Targets 10
Enzyme Activities 11
Transporters 11
Cell Death 11
Acknowledgments 12
References 12
1.2 Synthesis of 18F-fluoromisonidazole
Tracer for Positron Emission
Tomography 15
Ganghua Tang
Introduction 15
Methods 16
Results and Discussion 19
References 21
1.3 Radiation Hormesis 23
Rekha D. Jhamnani and Mannudeep K. Kalra
Introduction 23
Hormesis 23
Mechanisms 24
Animal Studies 24
Human Studies 24
Controversy 25
References 26
Part II General Imaging
Applications
2.1 Molecular Imaging in Early
Therapy Monitoring 29
Susanne Klutmann and Alexander Stahl
Introduction 29
The Place of Early Therapy Monitoring
in the Management of Cancer 29
vii
What Can be Expected from Positron
Emission Tomography Imaging? 30
F-18-FDG in Therapy Monitoring 30
Monitoring Neoadjuvant Therapy 31
Therapy Monitoring in Non-Small Cell
Lung Cancer (NSCLC) 31
Therapy Monitoring in Non-Hodgkin’s
Lymphoma (NHL) 32
Therapy Monitoring in Carcinomas of the
Esophagus, Esophagogastric Junction,
and Stomach 33
General Aspects of Early Therapy
Monitoring with FDG-Positron
Emission Tomography 33
Specific Aspects 34
Procedural Aspects 35
Colorectal Cancer 35
References 36
2.2 Positron Emission Tomography in
Medicine: An Overview 39
Abbas Alavi and Steve S. Huang
Introduction 39
Positron Emission Tomography
in Oncology 39
Positron Emission Tomography in
Lung and Breast Cancer 41
Positron Emission Tomography
in Brain Imaging 42
Positron Emission Tomography
in Cardiac Imaging 43
Positron Emission Tomography in
Infection and Inflammation 43
Cell Proliferation Agents 43
Hypoxia Positron Emission
Tomography Imaging 44
Peptide and Protein Positron Emission
Tomography Tracers 44
References 44
2.3 Radiation Dose and Image
Quality 45
Colin J. Martin and David G. Sutton
Introduction 45
Radiation Dose 46
Image Quality 48
X-ray Beam Interactions 49
Radiographic Imaging 50
Fluoroscopy 53
Radiation Quality 54
Tube Potential 54
Filtration 54
Scattered Radiation 55
Optimization of Technique
in Fluoroscopy 56
Computed Tomography 56
Computed Tomography
Scanners 56
Radiation Dose and Image
Quality 57
Computed Tomography Dose
Assessment 58
Radionuclide Imaging 58
Imaging Technique 59
Radiation Dose and Image
Quality 59
Conclusions 60
References 61
2.4 Contrast Agents for Magnetic
Resonance Imaging:
An Overview 63
Alan Jasanoff
Introduction 63
Relaxation Agents 64
Basic Principles of Relaxation
Contrast 64
Determinants of Inner Sphere
Relaxivity 65
Determinants of Outer Sphere
Relaxivity 66
Characteristics of T1 Agents 67
Characteristics of T2 Agents 67
Advances in the Design
of Relaxation Agents 69
Chemical Exchange-dependent
Saturation Transfer Agents 70
The CEST Effect 70
CEST Agents and Applications 72
Nonproton Contrast Agents 73
Direct Detection of Nuclei Other
Than Protons 73
19F and 13C Imaging Agents 73
Hyperpolarization Techniques 75
Conclusions 75
References 76
viii Contents of Volume 1
2.5 Whole-body Computed Tomography
Screening 79
Lincoln L. Berland and Nancy W. Berland
Introduction 79
What Is Whole-body Computed Tomography
Screening? 79
How Is it Done? Standards, Protocols,
and Informed Consent 80
What Is Found on Whole-body
Computed Tomography Screening? 80
Renal Cell Carcinoma 80
Abdominal Aortic Aneurysm 81
Ovarian Carcinoma 81
Other Findings on Whole-body
Computed Tomography Screening 81
Liver Lesions 81
Adrenal Lesions 81
Other Miscellaneous Conditions 82
Risks and Costs of Positive Results 82
Risks of Positive Results 82
Radiation 82
Costs of Positive Results 83
Analyzing the Rationale of Whole-body
Computed Tomography Screening 83
Analogies to Existing Screening
Practices 83
Distrust of Authority and
Self-empowerment 84
Is Proof of Value Necessary? 84
Is Whole-body Computed Tomography
Screening Truly Screening? 85
Psychological Implications 86
Variability of Rate of Positive Results 86
Enhancement of Radiology’s
Role in Medicine 87
Entrepreneurial Value of Screening 87
References 88
2.6 Whole-body 18F-fluorodeoxyglucose-
Positron Emission Tomography:
Is It Valuable for Health
Screening? 89
Matthias Weckesser and Otmar Schober
Introduction 89
Current Positron Emission Tomography
Screening Programs 91
Considerations on Screening
Programs 91
18F-fluorodeoxyglucose-Positron
Emission Tomography 92
Negative Tumors 92
Radiation Protection 92
References 93
2.7 Staging Solid Tumors with
18F-fluorodeoxyglucose-Positron
Emission Tomography/Computed
Tomography 95
Gerald Antoch and Andreas Bockisch
Introduction 95
PET/CT Imaging Protocols for Staging
Solid Tumors 96
Staging Solid Tumors with
FDG-PET/CT 96
T-stage 97
N-stage 98
M-stage 100
References 102
2.8 Laser Doppler Perfusion Imaging:
Clinical Diagnosis 103
E. Y-K Ng, S. C. Fok, and Julie Richardson
Introduction 103
Review of Laser Doppler
Perfusion Imaging 104
Some Past and Recent LDPI
Applications 106
Potential Integration of LDPI
in Cancer Diagnosis 110
Conclusions 112
Acknowledgment 112
References 112
2.9 Dynamic Sonographic Tissue
Perfusion Measurement
with the PixelFlux Method 115
Thomas Scholbach, Jakob Scholbach,
and Ercole Di Martino
Introduction 115
Tumor Perfusion Evaluation—State
of the Art 115
Contents of Volume 1 ix
Dynamic Tissue Perfusion Measurement
(PixelFlux) 116
Preconditions 117
Workflow 117
Procedure 117
Output 117
Use of Contrast Enhancers 118
Application 118
PixelFlux Application in
Oncology 118
Evaluation of PixelFlux Results 119
Comparison of Results with Other
Techniques 123
Conclusions and Outlook 123
References 124
2.10 Immuno-Positron Emission
Tomography 127
Lars R. Perk, Gerard W. M. Visser, and
Guus A. M. S. van Dongen
Introduction 127
Diagnostic and Therapeutic Applications of
Monoclonal Antibodies 128
Therapy Planning with
Monoclonal Antibodies 128
Immuno-PET: Imaging and
Quantification 129
Clinical PET Imaging Systems 130
Positron Emitters for Immuno-Pet 130
Experience with Preclinical
Immuno-Pet 131
Experience with Clinical
Immuno-Pet 133
Acknowledgments 136
References 136
2.11 Role of Imaging Biomarkers
in Drug Development 139
Janet C. Miller, A. Gregory Sorensen,
and Homer H. Pien
Introduction 139
Biomarkers and Surrogate
Markers 140
Imaging Biomarkers 140
Anatomic Imaging 142
Physiological Imaging 144
Molecular Imaging 148
Conclusions 156
References 156
Part III Lung Carcinoma
3.1 The Role of Imaging
in Lung Cancer 163
Clifton F. Mountain and Kay E. Hermes
Introduction 163
The International System for Staging
Lung Cancer 163
Stage Groups and Survival
Patterns 164
The Role of Imaging in Lung
Cancer Staging 165
Imaging for Primary Tumor
Evaluation 165
Imaging for Evaluation of Regional
Lymph Nodes 167
Imaging for Evaluation of
Distant Metastasis 167
Restaging 168
Implications of Imaging for Lung
Cancer Screening 168
Conclusions 169
References 169
3.2 Lung Cancer Staging: Integrated
18F-fluorodeoxyglucose-Positron
Emission Tomography/Computed
Tomography and Computed
Tomography Alone 171
Kyung Soo Lee
Introduction 171
Results Obtained by Previous
Studies 172
T-Staging 172
N-Staging 172
M-Staging 173
Problems and Their Solutions 174
Potential Advancements 175
References 175
x Contents of Volume 1
Contents of Volume 1 xi
3.3 Computed Tomography Screening
for Lung Cancer 177
Claudia I. Henschke, Rowena Yip, Matthew D.
Cham, and David F. Yankelevitz
Introduction 177
Prior Screening Studies 177
Memorial Sloan-Kettering Cancer Center
(MSKCC) and Johns Hopkins Medical
Institution (JHMI) Studies 178
Mayo Lung Project (MLP) 178
Czechoslovakia Study 178
Recommendations and Controversy Resulting
from Prior Studies 178
The Early Lung Cancer Action
Project Paradigm for Evalution
of Screening 179
The Early Lung Cancer Action
Project 180
Computed Tomography Screening
in Japan 181
The New York Early Lung
Cancer Action Project 181
International Conferences on Screening
for Lung Cancer 181
International Early Lung Cancer
Action Program 182
National Cancer Institute
Conferences 182
Performance of Computed Tomography
Screening for Lung Cancer 182
Updated Recommendations
Regarding Screening 185
Problems Identified in Performing Randomized
Screening Trials 185
References 188
3.4 Lung Cancer: Role of Multislice
Computed Tomography 191
Suzanne Matthews and Sameh K. Morcos
Introduction 191
Multislice Computed Tomography Technique
for Diagnosis and Staging
of Bronchogenic Carcinoma 192
Scanning Protocol 192
Imaging Protocol 192
Multislice Computed Tomography
Staging of Bronchogenic
Carcinoma 192
T-staging 192
Chest Wall Invasion 193
Invasion of Fissures and
Diaphragm 194
Invasion of Mediastinum 194
N-staging 194
M-staging 195
Assessment of Response to Treatment
and Tumor Recurrence 195
Virtual Bronchoscopy 196
Conclusions 196
References 196
3.5 Surgically Resected Pleomorphic
Lung Carcinoma: Computed
Tomography 199
Tae Sung Kim
Intoduction 199
Pleomorphic Carcinoma
of the Lung 199
References 202
3.6 Lung Cancer: Low-dose Helical
Computed Tomography 203
Yoshiyuki Abe, Masato Nakamura, Yuichi Ozeki,
Kikuo Machida, and Toshiro Ogata
Introduction 203
Materials and Methods 204
Results 204
Discussion 205
References 206
3.7 Lung Cancer: Computer-aided
Diagnosis with Computed
Tomography 209
Yoshiyuki Abe, Katsumi Tamura, Ikuko Sakata, Jiro
Ishida, Masayoshi Nagata, Masato Nakamura,
Kikuo Machida, and Toshiro Ogata
Intoduction 209
Materials and Methods 210
Results 211
Discussion 212
Conclusions 213
References 213
3.8 Stereotactic Radiotherapy for
Non-small Cell Lung Carcinoma:
Computed Tomography 215
Hiroshi Onishi, Atsushi Nambu, Tomoki Kimura,
and Yasushi Nagata
Introduction 215
Definition of Stereotactic
Radiotherapy 216
Clinical Status of Stereotactic Radiotherapy for
Early-Stage Lung Carcinoma 216
The Significance of Computed
Tomography Imaging for Stereotactic
Radiotherapy 216
Utility of Computed Tomography for
Radiotherapy Treatment Planning of
Stereotactic Radiotherapy for
Lung Carcinoma 217
Definition of Target Volumes with Computed
Tomography Images 217
Radiologic-Pathologic Correlation of Stage I
Lung Carcinoma 218
Usefulness of Thin-section Computed
Tomography in the Evaluation
of Lung Carcinoma 218
Attenuation of Lung Carcinoma 218
Solid Attenuation 218
Ground-glass Opacity 218
Borders Characteristics 219
Spicula and Pleural Indentation 219
Growth Patterns of Lung
Carcinoma 219
Limits of Computed Tomography
for Evaluating Lung Tumors 220
Management of Respiratory Motion
of the Target during Irradiation 220
Simulation Using Slow-scan Computed
Tomography for Free or Suppressed
Breathing Technique 220
Three-dimensional Stereotactic
Repositioning of the Isocenter
during Irradiation 221
Computed Tomography-Linear Accelerator
(Linac) Unit 221
Cone Beam Computed
Tomography 221
Evaluation of the Treatment Effect and
Differentiation between Inflammatory Change
and a Recurrent Mass 222
Peculiarity of Radiation Injury of the Lung
after Stereotactic Radiotherapy 222
Appearance Time of Radiation Injury
of the Lung after Stereotactic
Radiotherapy 223
Summary of Computed Tomography
Findings of Radiation Injury of the Lung after
Stereotactic Radiotherapy 224
Computed Tomography Evaluation of the
Tumor Response and Progression 225
Tumor Response 225
Local Recurrence 225
Cases of Computed Tomography Findings
after Stereotactic Radiotherapy 226
Guidelines for Quality Control of Computed
Tomography Images 226
Future Direction 227
Image Quality of Cone Beam
Computed Tomography 227
Megavoltage Computed
Tomography 227
Helical Tomotherapy 227
Imaging Supplement for Computed
Tomography for Evaluating Tumor
Malignancy and Extension 228
References 229
3.9 Thin-section Computed Tomography
Correlates with Clinical Outcome
in Patients with Mucin-producing
Adenocarcinoma of the Lung 231
Ukihide Tateishi, Testuo Maeda, and Yasuaki Arai
Introduction 231
Materials and Methods 232
Results 233
Discussion 234
Acknowledgments 235
References 235
3.10 Non-small Cell Lung Carcinoma:
18F-fluorodeoxyglucose-Positron
Emission Tomography 237
Rodney J. Hicks and Robert E. Ware
Introduction 237
Role of FDG-PET on Diagnosing
Lung Cancer 238
xii Contents of Volume 1
Preoperative PET Staging of
Non-small Cell Lung Cancer 239
Evaluation of Distant Metastasis (M)
Stage 240
Evaluation of Intrathoracic Lymph
Node (N) Stage 240
Evaluation of Tumor (T) Stage 241
Impact of Staging FDG-PET
on Patient Management 241
Role of PET in Therapeutic Response
Assessment in NSCLC 243
Use of FDG-PET for Restaging
Following Definitive Treatment
of NSCLC 244
A Philosophical Perspective on
the Quantitative Analysis of FDG
Uptake in NSCLC 244
Use of Hybrid PET-CT Images in
Staging 246
Conclusions 246
References 246
3.11 Evaluating Positron Emission
Tomography in Non-small Cell Lung
Cancer: Moving Beyond Accuracy
to Outcome 249
Harm van Tinteren, Otto S. Hoekstra,
Carin A. Uyl-de Groot, and Maarten Boers
Introduction 249
Diagnostic Accuracy of Positron Emission
Tomography in Non-small Cell
Lung Cancer 250
The Framework 251
Literature Analysis 251
Exploiting Clinical Data Obtained Prior
to Introducing a New Test 251
Decision Modeling 252
Clinical-Value Studies 252
Randomized Controlled
Trials 253
Economic Evaluation 254
Before and After
Implementation 254
Conclusions 255
References 255
3.12 Non-small Cell Lung Cancer:
False-positive Results with
18F-fluorodeoxyglucose-Positron
Emission Tomography 257
Siroos Mirzaei, Helmut Prosch, Peter Knoll,
and Gerhard Mostbeck
Introduction 257
Physiological High Uptake of 18F-FDG
in Different Tissues 258
Head and Central Nervous
System 258
Neck 258
Chest 258
Abdomen 258
Urinary Tract 258
Breast 259
Skeletal Muscle 259
Focal Uptake of FDG Due to
Benign Disease 259
High Metabolic Activity after
Treatment 261
Focal Uptake of FDG
Due to Artifacts 262
Focal Uptake of FDG Due to Artifacts
by New PET Devices 262
Conclusions 263
References 263
3.13 Oxygen-enhanced Proton Magnetic
Resonance Imaging of the Human
Lung 267
Eberhard D. Pracht, Johannes F. T. Arnold, Nicole
Seiberlich, Markus Kotas, Michael Flentje, and
Peter M. Jakob
Introduction 267
Respiratory Physiology 268
Theory of Oxygen-enhanced
Imaging 269
T1-Relaxation in the Human
Lung 269
Influence of Oxygen and the Oxygen
Transfer Function (OTF) 270
T2*Relaxation in the Human
Lung 274
Oxygen-enhanced Imaging in Volunteers
and Patients 276
Contents of Volume 1 xiii
Improvement of Imaging
Technique 276
Studies in Patients and Correlation with
Physiologic Parameters 277
Conclusions 277
References 278
3.14 Detection of Pulmonary Gene Transfer
Using Iodide-124/Positron Emission
Tomogrpahy 281
Frederick E. Domann and Gang Niu
Introduction 281
Pulmonary Applications of Gene
Therapy 281
Gene Therapy for Inherited
Lung Diseases 282
Cystic Fibrosis 282
Alpha-1 Anitrypsin Deficiency 283
Gene Therapy for Lung Cancer 283
Gene Delivery Vehicles and Vectors 283
Retroviruses 284
Adenoviruses 284
Adeno-associated Viruses (AAV) 284
Nonviral Liposomal Vectors 284
Molecular Imaging of Pulmonary
Gene Transfer 284
Reporter Gene Systems 285
Herpes Simplex Virus-1 Thymidine
Kinase (HSV1-TK) 286
Sodium Iodide Symporter 287
Considerations in PET Imaging of Pulmonary
Gene Transfer 288
Gene Transfer Barriers 288
Iodine-124 as Imaging Agent 288
Relationship between PET Signal and
Reporter Gene Expression 289
Resolution and Sensitivity of PET 290
Acknowledgements 290
References 290
3.15 Lung Cancer with Idiopathic
Pulmonary Fibrosis: High-resolution
Computed Tomography 295
Kazuma Kishi and Atsuko Kurosaki
Introduction 295
Prevalence of Lung Cancer
in Idiopathic Pulmonary Fibrosis 295
Pathogenesis of Lung Cancer
in Idiopathic Pulmonary Fibrosis 296
Clinical Features 296
Chest Radiograph 296
Computed Tomography
and High-resolution Computed Tomography
Findings 296
References 298
Part IV Breast Carcinoma
4.1 Categorization of Mammographic
Density for Breast Cancer: Clinical
Significance 301
Mariko Morishita, Akira Ohtsuru, Ichiro Isomoto,
and Shunichi Yamashita
Introduction 301
Breast Density by Mammography 301
Clinical Applications of Breastdensity
Category 303
Analysis of Patient Characteristics
by Breast-density Category 303
Steroid Receptor Status and
Breast-density Category 303
Comparison of Nottingham Prognostic
Index Scores in Breast-density
Categories 304
Patient Prognosis and
Breast-density Category 304
Analytic Considerations 304
References 305
4.2 Breast Tumor Classification
and Visualization with
Machine-learning
Approaches 309
Tim W. Nattkemper, Andreas Degenhard,
and Thorsten Twellmann
Introduction 309
The Contribution of Machine Learning
and Artificial Neural
Networks 310
State-of-the-Art Approaches to Dynamic
Contrast-enhanced Magnetic
Resonance Visualization 311
Learning Algorithms 312
Learning Clusters 312
xiv Contents of Volume 1
Human Experts versus Computer
Algorithms 314
Monitoring Tumor Development 317
Supervised Learning Algorithms 318
Supervised Detection and
Segmentation of Lesions 319
Supervised Classification
of Lesions 319
Summary and Outlook 321
Acknowledgements 321
References 321
4.3 Mass Detection Scheme for Digitized
Mammography 325
Bin Zheng
Introduction 325
Basic Architecture of Mass
Detection Schemes 325
Computer-aided Detection Schemes
Based on a Single Image 325
Computer-aided Detection Schemes
Based on multi-image 329
Evaluation and Application of Commercial
Computer-aided Detection Systems 331
New Developments in Mass
Detection Schemes 332
Improvement of Computer-aided Detection
Performance 333
Improvement of Reproducibility of Computeraided
Detection Schemes 333
Interactive Computer-aided
Detection Systems 334
References 336
4.4 Full-field Digital Phase-contrast
Mammography 339
Toyohiko Tanaka, Chika Honda, Satoru Matsuo,
and Tomonori Gido
Introduction 339
Historical Background of the Phase-contrast
Technique 340
Absorption Contrast and Phase
Contrast 340
Edge Effect Due to Phase
Contrast 341
Realization of the Phase-contrast Technique in
Mammography 341
Design of Digital Image Acquisition
and Output 341
Magnification-demagnification Effect
in Digital Mammography 342
Sharpness 342
Image Noise 343
Improvement of Image Quality by the
Magnification-demagnification
Effect 343
Improvement of Image Sharpness
in Digital Full-field PCM 343
Clinical Images 344
Clinical Experience 345
Future Development 345
Acknowledgements 347
References 347
4.5 Full-field Digital Mammography
versus Film-screen
Mammography 349
Arne Fischmann
Introduction and Historical
Perspective 349
Physical Performance of Digital
Compared to Film-screen
Mammography 350
Phantom Studies Comparing Full-field
Digital Mammography and
Film-screen Mammography 350
Simulated Microcalcifications 351
Clinical or Diagnostic
Digital Mammography 353
Full-field Digital Mammography and
Film-screen Mammography in
Screening 354
Oslo I and II Studies 355
Digital Mammography Imaging
Screening Trial 355
Financial Considerations
of Digital Mammography 356
Radiation Dose Considerations 356
References 357
Contents of Volume 1 xv
4.6 Use of Contrast-enhanced Magnetic
Resonance Imaging for Detecting
Invasive Lobular Carcinoma 359
Carla Boetes and Ritse M. Mann
Introduction 359
Incidence 359
Presentation 359
Pathology 360
Mammography 360
Ultrasound 360
Goal of MRI in the Assessment of Invasive
Lobular Carcinoma 361
Magnetic Resonance
Imaging 361
Dynamic Sequences in Breast Magnetic
Resonance Imaging 362
False-Negative Imaging on Magnetic
Resonance Imaging 363
Conclusions 364
References 364
4.7 Axillary Lymph Node Status in Breast
Cancer: Pinhole Collimator Single–
Photon Emission Computed
Tomography 367
Giuseppe Madeddu, Orazio Schillaci, and Angela
Spanu
Introduction 367
99mTc-tetrofosmin Pinhole–Single Photon
Emission Computed
Tomography 369
Method 369
Results and Discussion 369
Conclusions 371
References 372
4.8 Detection of Small-size Primary Breast
Cancer: 99mTc-tetrofosmin Single
Photon Emission Computed
Tomography 375
Angela Spanu, Orazio Schillaci, and Giuseppe
Madeddu
Introduction 375
The Planar and SPECT Scintimammography
Method 376
Results and Discussion 377
Conclusions 380
References 381
4.9 Microcalcification in Breast
Lesions: Radiography and
Histopathology 383
Arne Fischmann
Introduction 383
Histopathology 383
Detection 384
Classification of Breast
Calcifications 385
Systematic Classification 385
Breast Imaging-Reporting
and Data System 386
Work-up of Breast
Calcifications 389
Summary 391
References 391
4.10 Benign and Malignant
Breast Lesions: Doppler
Sonography 393
José Luís del Cura
Introduction 393
Doppler Ultrasound Technique
in Breast Diseases 394
Breast Doppler Limitations 394
Differentiation of Benign and Malignant
Solid Breast Lesions 395
Tumor Vessel Identification 395
Quantitative Criteria 395
Semiquantitative Criteria 396
Breast Cancer Prognosis 397
Assessment of Lymph Node
Involvement 397
Recurrence versus Scar
in Operated Patients 398
Treatment Monitoring 398
Conclusions 398
References 399
xvi Contents of Volume 1
4.11 Response to Neoadjuvant Treatment
in Patients with Locally Advanced
Breast Cancer: Color-Doppler
Ultrasound Contrast
Medium (Levovist) 401
Paolo Vallone
Introduction 401
Materials and Methods 401
Results 402
Discussion 402
References 406
4.12 Magnetic Resonance Spectroscopy of
Breast Cancer: Current Techniques
and Clinical Applications 407
Sina Meisamy, Patrick J. Bolan, and Michael
Garwood
Introduction 407
Background 407
The “Choline Peak” 407
Why Is tCho Elevated
in Cancer? 408
Technique 408
Tumor Localization 408
Technical Issues 408
Respiratory Artifact 409
Quantification 409
How Reliable Is the tCho
Measurement? 410
Clinical Applications 410
Diagnosis 410
Sample Diagnostic Cases 411
Therapeutic Monitoring with
Early Feedback 412
Sample Therapeutic Monitoring
Cases 413
Acknowledgement 414
References 414
4.13 Breast Scintigraphy 417
Orazio Schillaci, Angela Spanu, and Giuseppe
Madeddu
Introduction 417
Breast Scintigraphy 417
Planar Method 417
Planar Results 418
Single Photon Emission Computed
Tomography Method 418
Single Photon Emission Computed
Tomography Results 419
Dedicated Imaging Systems 419
Methods 419
Results 420
Clinical Indications of Breast Scintigraphy
or Scintimammography 421
References 421
4.14 Primary Breast Cancer: False-negative
and False-positive Bone
Scintigraphy 423
Hatice Mirac Binnaz Demirkan and Hatice Durak
Introduction 423
Search Strategy and Selection
Criteria 423
Procedures and Technical Aspects
of Bone Scan 423
Clinical Applications in Breast
Cancer 427
Pitfalls of Bone Scan Encountered in Breast
Cancer Patients and their Solutions with
Potential Advances 429
References 431
4.15 Improved Sensitivity and Specificity
of Breast Cancer Thermography
435
E. Y-K. Ng
Introduction 435
Image Analysis Tools 436
Thermography 436
Artificial Neural Networks 437
Backpropagation 437
Radial Basis Function Network 438
Biostatistical Methods 438
Data Acqusition 439
Procedures for Thermal
Imaging 439
Designed Integrated Approach 440
Step 1: Linear Regression 440
Step 2: ANN RBFN/BFN 440
Step 3: ROC Analysis 441
Contents of Volume 1 xvii
Results and Discussion 441
Summarized Results for Step 1:
Linear Regression 441
Selected Results for Step 2:
ANN RBFN/BPN 441
Selected Results (with Area > 0.85)
for Step 3: ROC Analysis 441
Conclusions and Future
Trends 442
Acknowledgements 443
References 443
4.16 Optical Mammography 445
Sergio Fantini and Paola Taroni
Introduction 445
Sources of Intrinsic Optical
Contrast in Breast Tissue 446
Principles of Optical
Mammography 447
Continuous-wave Approaches:
Dynamic Measurements and Spectral
Information 448
Time-resolved Approaches 448
Interpretation of Optical
Mammograms 450
Prospects of Optical
Mammography 452
Acknowledgements 453
References 453
4.17 Digital Mammography 455
John M. Lewin
Introduction 455
Technical Advantages of Digital
Mammography 455
Technologies Used for Digital
Mammography 456
Clinical Advantages of Digital
Mammography 456
Advanced Applications
of Digital Mammography 457
Tomosynthesis 457
Contrast-enhanced Digital
Mammography 458
References 458
4.18 Screening for Breast Cancer
in Women with a Familial or
Genetic Predisposition: Magnetic
Resonance Imaging versus
Mammography 459
Mieke Kriege, Cecile T. M. Brekelmans,
and Jan G. M. Klijn
Introduction 459
Magnetic Resonance Imaging
Screening Studies 461
Results 461
Discussion 462
References 463
4.19 Mammographic Screening:
Impact on Survival 465
James S. Michaelson
Introduction 465
Why Screening Works 465
Screening Effectiveness 465
Cancers Become More Lethal
as they Increase in Size 466
Present and Future Life-saving Impact
of Screening 466
Life-saving Potential of Screening 467
Tumor Size and Survival 467
False-positives 468
How is Screening Actually Used 468
Present Status of Breast Cancer
Screening 469
References 470
4.20 False-positive Mammography
Examinations 473
Pamela S. Ganschow and Joann G. Elmore
Introduction 473
Definitions 473
Current Estimates of False-positive
Rates in the United States and
International Guidelines 474
Cumulative False-positive Rates 475
Predictors of False-positive
Mammograms 475
Patients factors 476
Radiologist Factors 478
xviii Contents of Volume 1
Facility and System Factors 479
Predicting the Cumulative Risk
of False-positive Mammograms 480
Significance of False-positive
Mammography Examination 480
Recall Rates in the United States
versus Other Countries 481
Efforts to Reduce False-positive
Mammograms and to Better
Deal with Expected False-Positive
Screenings 483
Acknowledgment 483
References 483
4.21 Breast Dose in Thoracic Computed
Tomography 487
Eric N. C. Milne
Introduction 487
Methodology 488
Results 488
Discussion 489
Cancer Risks 489
Computed Tomography of
the Breast 490
Reducing Radiation Dose 490
Imaging without Using Ionizing
Radiation 490
Optical Imaging 491
Ultrasound 491
Magnetic Resonance Imaging 491
References 492
4.22 Absorbed Dose Measurement in
Mammography 493
Marianne C. Aznar and Bengt Å. Hemdal
Introduction 493
Estimation of Absorbed Dose
to the Breast 494
Concepts and Quantities Used 494
From Measurement to
Dose Estimate 496
Dose Limits and Diagnostic
Reference Levels 497
Dosimeters for Indirect Measurements 498
Ionization chambers 498
Semiconductors 498
Dosimeters for Direct in vivo
Measurements 498
Thermoluminescence Detectors 499
Novel in vivo Techniques 499
Summary and Conclusions 500
References 500
4.23 Metastatic Choriocarcinoma to the
Breast: Mammography and Color
Doppler Ultrasound 503
Naveen Kalra and Vijaynadh Ojili
Introduction 503
Mammography 504
Ultrasonography and
Color Doppler 504
Tissue Diagnosis 506
References 507
4.24 Detection and Characterization
of Breast Lesions: Color-coded
Signal Intensity Curve Software
for Magnetic Resonance–based
Breast Imaging 509
Federica Pediconi, Fiorella Altomari, Luigi
Carotenuto, Simona Padula, Carlo Catalano,
and Roberto Passariello
Introduction 509
Computer-aided Diagnosis: Features
and Applications 511
Computer-aided Detection for Breast Magnetic
Resonance Imaging 512
Characterization Algorithm 514
Registration Algorithm 514
Conclusions 515
References 517
4.25 Detection of Breast Malignancy:
Different Magnetic Resonance
Imaging Modalities 519
Wei Huang and Luminita A. Tudorica
Introduction 519
Major Breast Imaging
Modalities 519
Breast Dynamic Contrast-enhanced Magnetic
Resonance Imaging 520
Contents of Volume 1 xix
Subjective Assessment 520
Empirical Quantitative
Characterization 521
Analytical Pharmacokinetic
Modeling 522
Breast 1H Magnetic
Resonance Spectroscopy 523
Breast T2*-Weighted Perfusion Magnetic
Resonance Imaging 525
References 526
4.26 Breast Lesions: Computerized
Analysis of Magnetic Resonance
Imaging 529
Kenneth G. A. Gilhuijs
Introduction 529
Mechanisms of Functional Imaging using
Magnetic Resonance Imaging 530
Interpretation of Contrast-enhanced Magnetic
Resonance Imaging 531
Reduction of Motion Artifacts 532
Computerized Extraction of
Temporal Features 533
Computerized Extraction of
the Region of Interest 534
Computerized Extraction
of Morphological Features 535
Computerized Classification
of Features of Enhancement 536
Current Status and Future Role
of Computerized Analysis of Breast
Magnetic Resonance Imaging 537
References 538
4.27 Optical Imaging Techniques
for Breast Cancer 539
Alexander Wall and Christoph Bremer
Introduction 539
Tomographic Imaging 540
Nonspecific Contrast Agents (Perfusion-type
Contrast Agents) 540
Fluorochromes with Molecular
Specificity 542
Smart Probes 542
Targeted Probes 542
Multimodality Probes 543
Outlook 544
References 544
4.28 Magnetic Resonance Imaging:
Measurements of Breast Tumor
Volume and Vascularity for
Monitoring Response to
Treatment 547
Savannah C. Partridge
Introduction 547
Magnetic Resonance Imaging
of the Breast 547
Neoadjuvant Treatment 547
Magnetic Resonance Imaging to
Monitor Treatment Response 548
Measuring Changes in Tumor
Size with Treatment 548
Measuring Changes in Tumor
Vascularity with Treatment 548
Imaging Considerations 548
Magnetic Resonance Imaging
Acquisition 548
Imaging Postprocessing 549
Assessing Treatment Response 550
Changes in Tumor Volume Predict
Recurrence-free Survival (RFS) 550
Vascular Changes with
Treatment 550
Conclusions 551
Acknowledgements 552
References 552
4.29 Defining Advanced Breast Cancer:
18F-fluorodeoxyglucose-Positron
Emission Tomography 555
William B. Eubank
Introduction 555
Positron Emission Tomography
Principles 556
Positron Emission Tomography
Instrumentation 556
Fluorodeoxyglucose (FDG) 556
Axillary Node Staging 557
Detection of Locoregional
and Distant Recurrences 557
xx Contents of Volume 1
Contents of Volume 1 xxi
Locoregional Recurrences 557
Intrathoracic Lymphatic
Recurrences 558
Distant Metastases 559
Response to Therapy 560
Impact of FDG-PET on
Patient Management 561
Beyond FDG: Future Applications of
PET to Breast Cancer 562
Estrogen Receptor Imaging 562
References 563
4.30 Leiomyoma of the Breast Parenchyma:
Mammographic, Sonographic, and
Histopathologic Features 567
Aysin Pourbagher and M. Ali Pourbagher
Introduction 567
Mammographic Appearance 568
Sonographic Appearance 568
References 570
4.31 Detection of Breast Cancer: Dynamic
Infrared Imaging 571
Terry M. Button
Introduction: Infrared and
its Detection 571
History of Infrared for Breast
Cancer Detection 572
Dynamic Infrared Imaging 573
Mechanism for Breast Cancer
Detection with Dynamic Infrared 575
Applications of Dynamic Infrared
Imaging 576
Pitfalls of Dynamic Infrared
Imaging 577
Conclusion: The Future of Infrared
and Dynamic Infrared Imaging
for Breast Cancer Detection 578
Acknowledgements 579
References 579
4.32 Phyllodes Breast Tumors: Magnetic
Resonance Imaging 581
Aimée B. Herzog and Susanne Wurdinger
Introduction 581
Magnetic Resonance Imaging 582
Morphology 582
Signal Intensity 582
Contrast-enhancement
Characteristics 583
Guidelines 583
References 584
Index 585
Cancer Imaging Lung and Breast Carcinomas Volume 1 PDF Ebook
Contributors xxix
Preface xxxix
Selected Glossary xli
Introduction xlix
Part I Instrumentation
1.1 Strategies for Imaging Biology in
Cancer and Other Diseases 3
Philipp Mayer-Kuckuk and Debabrata Banerjee
Introduction 3
Imaging Strategies 4
Conferring Imaging Visibility 4
Peptides, Proteins, and Probes 4
Imaging Reporter Genes 5
Imaging Modalities 7
Preclinical Applications 7
Gene Transcription 7
Ribonucleic Acid Biology 8
Protein Biology 8
Imaging Strategies for
Clinical Applications 10
Receptors and Cell-Surface
Targets 10
Enzyme Activities 11
Transporters 11
Cell Death 11
Acknowledgments 12
References 12
1.2 Synthesis of 18F-fluoromisonidazole
Tracer for Positron Emission
Tomography 15
Ganghua Tang
Introduction 15
Methods 16
Results and Discussion 19
References 21
1.3 Radiation Hormesis 23
Rekha D. Jhamnani and Mannudeep K. Kalra
Introduction 23
Hormesis 23
Mechanisms 24
Animal Studies 24
Human Studies 24
Controversy 25
References 26
Part II General Imaging
Applications
2.1 Molecular Imaging in Early
Therapy Monitoring 29
Susanne Klutmann and Alexander Stahl
Introduction 29
The Place of Early Therapy Monitoring
in the Management of Cancer 29
vii
What Can be Expected from Positron
Emission Tomography Imaging? 30
F-18-FDG in Therapy Monitoring 30
Monitoring Neoadjuvant Therapy 31
Therapy Monitoring in Non-Small Cell
Lung Cancer (NSCLC) 31
Therapy Monitoring in Non-Hodgkin’s
Lymphoma (NHL) 32
Therapy Monitoring in Carcinomas of the
Esophagus, Esophagogastric Junction,
and Stomach 33
General Aspects of Early Therapy
Monitoring with FDG-Positron
Emission Tomography 33
Specific Aspects 34
Procedural Aspects 35
Colorectal Cancer 35
References 36
2.2 Positron Emission Tomography in
Medicine: An Overview 39
Abbas Alavi and Steve S. Huang
Introduction 39
Positron Emission Tomography
in Oncology 39
Positron Emission Tomography in
Lung and Breast Cancer 41
Positron Emission Tomography
in Brain Imaging 42
Positron Emission Tomography
in Cardiac Imaging 43
Positron Emission Tomography in
Infection and Inflammation 43
Cell Proliferation Agents 43
Hypoxia Positron Emission
Tomography Imaging 44
Peptide and Protein Positron Emission
Tomography Tracers 44
References 44
2.3 Radiation Dose and Image
Quality 45
Colin J. Martin and David G. Sutton
Introduction 45
Radiation Dose 46
Image Quality 48
X-ray Beam Interactions 49
Radiographic Imaging 50
Fluoroscopy 53
Radiation Quality 54
Tube Potential 54
Filtration 54
Scattered Radiation 55
Optimization of Technique
in Fluoroscopy 56
Computed Tomography 56
Computed Tomography
Scanners 56
Radiation Dose and Image
Quality 57
Computed Tomography Dose
Assessment 58
Radionuclide Imaging 58
Imaging Technique 59
Radiation Dose and Image
Quality 59
Conclusions 60
References 61
2.4 Contrast Agents for Magnetic
Resonance Imaging:
An Overview 63
Alan Jasanoff
Introduction 63
Relaxation Agents 64
Basic Principles of Relaxation
Contrast 64
Determinants of Inner Sphere
Relaxivity 65
Determinants of Outer Sphere
Relaxivity 66
Characteristics of T1 Agents 67
Characteristics of T2 Agents 67
Advances in the Design
of Relaxation Agents 69
Chemical Exchange-dependent
Saturation Transfer Agents 70
The CEST Effect 70
CEST Agents and Applications 72
Nonproton Contrast Agents 73
Direct Detection of Nuclei Other
Than Protons 73
19F and 13C Imaging Agents 73
Hyperpolarization Techniques 75
Conclusions 75
References 76
viii Contents of Volume 1
2.5 Whole-body Computed Tomography
Screening 79
Lincoln L. Berland and Nancy W. Berland
Introduction 79
What Is Whole-body Computed Tomography
Screening? 79
How Is it Done? Standards, Protocols,
and Informed Consent 80
What Is Found on Whole-body
Computed Tomography Screening? 80
Renal Cell Carcinoma 80
Abdominal Aortic Aneurysm 81
Ovarian Carcinoma 81
Other Findings on Whole-body
Computed Tomography Screening 81
Liver Lesions 81
Adrenal Lesions 81
Other Miscellaneous Conditions 82
Risks and Costs of Positive Results 82
Risks of Positive Results 82
Radiation 82
Costs of Positive Results 83
Analyzing the Rationale of Whole-body
Computed Tomography Screening 83
Analogies to Existing Screening
Practices 83
Distrust of Authority and
Self-empowerment 84
Is Proof of Value Necessary? 84
Is Whole-body Computed Tomography
Screening Truly Screening? 85
Psychological Implications 86
Variability of Rate of Positive Results 86
Enhancement of Radiology’s
Role in Medicine 87
Entrepreneurial Value of Screening 87
References 88
2.6 Whole-body 18F-fluorodeoxyglucose-
Positron Emission Tomography:
Is It Valuable for Health
Screening? 89
Matthias Weckesser and Otmar Schober
Introduction 89
Current Positron Emission Tomography
Screening Programs 91
Considerations on Screening
Programs 91
18F-fluorodeoxyglucose-Positron
Emission Tomography 92
Negative Tumors 92
Radiation Protection 92
References 93
2.7 Staging Solid Tumors with
18F-fluorodeoxyglucose-Positron
Emission Tomography/Computed
Tomography 95
Gerald Antoch and Andreas Bockisch
Introduction 95
PET/CT Imaging Protocols for Staging
Solid Tumors 96
Staging Solid Tumors with
FDG-PET/CT 96
T-stage 97
N-stage 98
M-stage 100
References 102
2.8 Laser Doppler Perfusion Imaging:
Clinical Diagnosis 103
E. Y-K Ng, S. C. Fok, and Julie Richardson
Introduction 103
Review of Laser Doppler
Perfusion Imaging 104
Some Past and Recent LDPI
Applications 106
Potential Integration of LDPI
in Cancer Diagnosis 110
Conclusions 112
Acknowledgment 112
References 112
2.9 Dynamic Sonographic Tissue
Perfusion Measurement
with the PixelFlux Method 115
Thomas Scholbach, Jakob Scholbach,
and Ercole Di Martino
Introduction 115
Tumor Perfusion Evaluation—State
of the Art 115
Contents of Volume 1 ix
Dynamic Tissue Perfusion Measurement
(PixelFlux) 116
Preconditions 117
Workflow 117
Procedure 117
Output 117
Use of Contrast Enhancers 118
Application 118
PixelFlux Application in
Oncology 118
Evaluation of PixelFlux Results 119
Comparison of Results with Other
Techniques 123
Conclusions and Outlook 123
References 124
2.10 Immuno-Positron Emission
Tomography 127
Lars R. Perk, Gerard W. M. Visser, and
Guus A. M. S. van Dongen
Introduction 127
Diagnostic and Therapeutic Applications of
Monoclonal Antibodies 128
Therapy Planning with
Monoclonal Antibodies 128
Immuno-PET: Imaging and
Quantification 129
Clinical PET Imaging Systems 130
Positron Emitters for Immuno-Pet 130
Experience with Preclinical
Immuno-Pet 131
Experience with Clinical
Immuno-Pet 133
Acknowledgments 136
References 136
2.11 Role of Imaging Biomarkers
in Drug Development 139
Janet C. Miller, A. Gregory Sorensen,
and Homer H. Pien
Introduction 139
Biomarkers and Surrogate
Markers 140
Imaging Biomarkers 140
Anatomic Imaging 142
Physiological Imaging 144
Molecular Imaging 148
Conclusions 156
References 156
Part III Lung Carcinoma
3.1 The Role of Imaging
in Lung Cancer 163
Clifton F. Mountain and Kay E. Hermes
Introduction 163
The International System for Staging
Lung Cancer 163
Stage Groups and Survival
Patterns 164
The Role of Imaging in Lung
Cancer Staging 165
Imaging for Primary Tumor
Evaluation 165
Imaging for Evaluation of Regional
Lymph Nodes 167
Imaging for Evaluation of
Distant Metastasis 167
Restaging 168
Implications of Imaging for Lung
Cancer Screening 168
Conclusions 169
References 169
3.2 Lung Cancer Staging: Integrated
18F-fluorodeoxyglucose-Positron
Emission Tomography/Computed
Tomography and Computed
Tomography Alone 171
Kyung Soo Lee
Introduction 171
Results Obtained by Previous
Studies 172
T-Staging 172
N-Staging 172
M-Staging 173
Problems and Their Solutions 174
Potential Advancements 175
References 175
x Contents of Volume 1
Contents of Volume 1 xi
3.3 Computed Tomography Screening
for Lung Cancer 177
Claudia I. Henschke, Rowena Yip, Matthew D.
Cham, and David F. Yankelevitz
Introduction 177
Prior Screening Studies 177
Memorial Sloan-Kettering Cancer Center
(MSKCC) and Johns Hopkins Medical
Institution (JHMI) Studies 178
Mayo Lung Project (MLP) 178
Czechoslovakia Study 178
Recommendations and Controversy Resulting
from Prior Studies 178
The Early Lung Cancer Action
Project Paradigm for Evalution
of Screening 179
The Early Lung Cancer Action
Project 180
Computed Tomography Screening
in Japan 181
The New York Early Lung
Cancer Action Project 181
International Conferences on Screening
for Lung Cancer 181
International Early Lung Cancer
Action Program 182
National Cancer Institute
Conferences 182
Performance of Computed Tomography
Screening for Lung Cancer 182
Updated Recommendations
Regarding Screening 185
Problems Identified in Performing Randomized
Screening Trials 185
References 188
3.4 Lung Cancer: Role of Multislice
Computed Tomography 191
Suzanne Matthews and Sameh K. Morcos
Introduction 191
Multislice Computed Tomography Technique
for Diagnosis and Staging
of Bronchogenic Carcinoma 192
Scanning Protocol 192
Imaging Protocol 192
Multislice Computed Tomography
Staging of Bronchogenic
Carcinoma 192
T-staging 192
Chest Wall Invasion 193
Invasion of Fissures and
Diaphragm 194
Invasion of Mediastinum 194
N-staging 194
M-staging 195
Assessment of Response to Treatment
and Tumor Recurrence 195
Virtual Bronchoscopy 196
Conclusions 196
References 196
3.5 Surgically Resected Pleomorphic
Lung Carcinoma: Computed
Tomography 199
Tae Sung Kim
Intoduction 199
Pleomorphic Carcinoma
of the Lung 199
References 202
3.6 Lung Cancer: Low-dose Helical
Computed Tomography 203
Yoshiyuki Abe, Masato Nakamura, Yuichi Ozeki,
Kikuo Machida, and Toshiro Ogata
Introduction 203
Materials and Methods 204
Results 204
Discussion 205
References 206
3.7 Lung Cancer: Computer-aided
Diagnosis with Computed
Tomography 209
Yoshiyuki Abe, Katsumi Tamura, Ikuko Sakata, Jiro
Ishida, Masayoshi Nagata, Masato Nakamura,
Kikuo Machida, and Toshiro Ogata
Intoduction 209
Materials and Methods 210
Results 211
Discussion 212
Conclusions 213
References 213
3.8 Stereotactic Radiotherapy for
Non-small Cell Lung Carcinoma:
Computed Tomography 215
Hiroshi Onishi, Atsushi Nambu, Tomoki Kimura,
and Yasushi Nagata
Introduction 215
Definition of Stereotactic
Radiotherapy 216
Clinical Status of Stereotactic Radiotherapy for
Early-Stage Lung Carcinoma 216
The Significance of Computed
Tomography Imaging for Stereotactic
Radiotherapy 216
Utility of Computed Tomography for
Radiotherapy Treatment Planning of
Stereotactic Radiotherapy for
Lung Carcinoma 217
Definition of Target Volumes with Computed
Tomography Images 217
Radiologic-Pathologic Correlation of Stage I
Lung Carcinoma 218
Usefulness of Thin-section Computed
Tomography in the Evaluation
of Lung Carcinoma 218
Attenuation of Lung Carcinoma 218
Solid Attenuation 218
Ground-glass Opacity 218
Borders Characteristics 219
Spicula and Pleural Indentation 219
Growth Patterns of Lung
Carcinoma 219
Limits of Computed Tomography
for Evaluating Lung Tumors 220
Management of Respiratory Motion
of the Target during Irradiation 220
Simulation Using Slow-scan Computed
Tomography for Free or Suppressed
Breathing Technique 220
Three-dimensional Stereotactic
Repositioning of the Isocenter
during Irradiation 221
Computed Tomography-Linear Accelerator
(Linac) Unit 221
Cone Beam Computed
Tomography 221
Evaluation of the Treatment Effect and
Differentiation between Inflammatory Change
and a Recurrent Mass 222
Peculiarity of Radiation Injury of the Lung
after Stereotactic Radiotherapy 222
Appearance Time of Radiation Injury
of the Lung after Stereotactic
Radiotherapy 223
Summary of Computed Tomography
Findings of Radiation Injury of the Lung after
Stereotactic Radiotherapy 224
Computed Tomography Evaluation of the
Tumor Response and Progression 225
Tumor Response 225
Local Recurrence 225
Cases of Computed Tomography Findings
after Stereotactic Radiotherapy 226
Guidelines for Quality Control of Computed
Tomography Images 226
Future Direction 227
Image Quality of Cone Beam
Computed Tomography 227
Megavoltage Computed
Tomography 227
Helical Tomotherapy 227
Imaging Supplement for Computed
Tomography for Evaluating Tumor
Malignancy and Extension 228
References 229
3.9 Thin-section Computed Tomography
Correlates with Clinical Outcome
in Patients with Mucin-producing
Adenocarcinoma of the Lung 231
Ukihide Tateishi, Testuo Maeda, and Yasuaki Arai
Introduction 231
Materials and Methods 232
Results 233
Discussion 234
Acknowledgments 235
References 235
3.10 Non-small Cell Lung Carcinoma:
18F-fluorodeoxyglucose-Positron
Emission Tomography 237
Rodney J. Hicks and Robert E. Ware
Introduction 237
Role of FDG-PET on Diagnosing
Lung Cancer 238
xii Contents of Volume 1
Preoperative PET Staging of
Non-small Cell Lung Cancer 239
Evaluation of Distant Metastasis (M)
Stage 240
Evaluation of Intrathoracic Lymph
Node (N) Stage 240
Evaluation of Tumor (T) Stage 241
Impact of Staging FDG-PET
on Patient Management 241
Role of PET in Therapeutic Response
Assessment in NSCLC 243
Use of FDG-PET for Restaging
Following Definitive Treatment
of NSCLC 244
A Philosophical Perspective on
the Quantitative Analysis of FDG
Uptake in NSCLC 244
Use of Hybrid PET-CT Images in
Staging 246
Conclusions 246
References 246
3.11 Evaluating Positron Emission
Tomography in Non-small Cell Lung
Cancer: Moving Beyond Accuracy
to Outcome 249
Harm van Tinteren, Otto S. Hoekstra,
Carin A. Uyl-de Groot, and Maarten Boers
Introduction 249
Diagnostic Accuracy of Positron Emission
Tomography in Non-small Cell
Lung Cancer 250
The Framework 251
Literature Analysis 251
Exploiting Clinical Data Obtained Prior
to Introducing a New Test 251
Decision Modeling 252
Clinical-Value Studies 252
Randomized Controlled
Trials 253
Economic Evaluation 254
Before and After
Implementation 254
Conclusions 255
References 255
3.12 Non-small Cell Lung Cancer:
False-positive Results with
18F-fluorodeoxyglucose-Positron
Emission Tomography 257
Siroos Mirzaei, Helmut Prosch, Peter Knoll,
and Gerhard Mostbeck
Introduction 257
Physiological High Uptake of 18F-FDG
in Different Tissues 258
Head and Central Nervous
System 258
Neck 258
Chest 258
Abdomen 258
Urinary Tract 258
Breast 259
Skeletal Muscle 259
Focal Uptake of FDG Due to
Benign Disease 259
High Metabolic Activity after
Treatment 261
Focal Uptake of FDG
Due to Artifacts 262
Focal Uptake of FDG Due to Artifacts
by New PET Devices 262
Conclusions 263
References 263
3.13 Oxygen-enhanced Proton Magnetic
Resonance Imaging of the Human
Lung 267
Eberhard D. Pracht, Johannes F. T. Arnold, Nicole
Seiberlich, Markus Kotas, Michael Flentje, and
Peter M. Jakob
Introduction 267
Respiratory Physiology 268
Theory of Oxygen-enhanced
Imaging 269
T1-Relaxation in the Human
Lung 269
Influence of Oxygen and the Oxygen
Transfer Function (OTF) 270
T2*Relaxation in the Human
Lung 274
Oxygen-enhanced Imaging in Volunteers
and Patients 276
Contents of Volume 1 xiii
Improvement of Imaging
Technique 276
Studies in Patients and Correlation with
Physiologic Parameters 277
Conclusions 277
References 278
3.14 Detection of Pulmonary Gene Transfer
Using Iodide-124/Positron Emission
Tomogrpahy 281
Frederick E. Domann and Gang Niu
Introduction 281
Pulmonary Applications of Gene
Therapy 281
Gene Therapy for Inherited
Lung Diseases 282
Cystic Fibrosis 282
Alpha-1 Anitrypsin Deficiency 283
Gene Therapy for Lung Cancer 283
Gene Delivery Vehicles and Vectors 283
Retroviruses 284
Adenoviruses 284
Adeno-associated Viruses (AAV) 284
Nonviral Liposomal Vectors 284
Molecular Imaging of Pulmonary
Gene Transfer 284
Reporter Gene Systems 285
Herpes Simplex Virus-1 Thymidine
Kinase (HSV1-TK) 286
Sodium Iodide Symporter 287
Considerations in PET Imaging of Pulmonary
Gene Transfer 288
Gene Transfer Barriers 288
Iodine-124 as Imaging Agent 288
Relationship between PET Signal and
Reporter Gene Expression 289
Resolution and Sensitivity of PET 290
Acknowledgements 290
References 290
3.15 Lung Cancer with Idiopathic
Pulmonary Fibrosis: High-resolution
Computed Tomography 295
Kazuma Kishi and Atsuko Kurosaki
Introduction 295
Prevalence of Lung Cancer
in Idiopathic Pulmonary Fibrosis 295
Pathogenesis of Lung Cancer
in Idiopathic Pulmonary Fibrosis 296
Clinical Features 296
Chest Radiograph 296
Computed Tomography
and High-resolution Computed Tomography
Findings 296
References 298
Part IV Breast Carcinoma
4.1 Categorization of Mammographic
Density for Breast Cancer: Clinical
Significance 301
Mariko Morishita, Akira Ohtsuru, Ichiro Isomoto,
and Shunichi Yamashita
Introduction 301
Breast Density by Mammography 301
Clinical Applications of Breastdensity
Category 303
Analysis of Patient Characteristics
by Breast-density Category 303
Steroid Receptor Status and
Breast-density Category 303
Comparison of Nottingham Prognostic
Index Scores in Breast-density
Categories 304
Patient Prognosis and
Breast-density Category 304
Analytic Considerations 304
References 305
4.2 Breast Tumor Classification
and Visualization with
Machine-learning
Approaches 309
Tim W. Nattkemper, Andreas Degenhard,
and Thorsten Twellmann
Introduction 309
The Contribution of Machine Learning
and Artificial Neural
Networks 310
State-of-the-Art Approaches to Dynamic
Contrast-enhanced Magnetic
Resonance Visualization 311
Learning Algorithms 312
Learning Clusters 312
xiv Contents of Volume 1
Human Experts versus Computer
Algorithms 314
Monitoring Tumor Development 317
Supervised Learning Algorithms 318
Supervised Detection and
Segmentation of Lesions 319
Supervised Classification
of Lesions 319
Summary and Outlook 321
Acknowledgements 321
References 321
4.3 Mass Detection Scheme for Digitized
Mammography 325
Bin Zheng
Introduction 325
Basic Architecture of Mass
Detection Schemes 325
Computer-aided Detection Schemes
Based on a Single Image 325
Computer-aided Detection Schemes
Based on multi-image 329
Evaluation and Application of Commercial
Computer-aided Detection Systems 331
New Developments in Mass
Detection Schemes 332
Improvement of Computer-aided Detection
Performance 333
Improvement of Reproducibility of Computeraided
Detection Schemes 333
Interactive Computer-aided
Detection Systems 334
References 336
4.4 Full-field Digital Phase-contrast
Mammography 339
Toyohiko Tanaka, Chika Honda, Satoru Matsuo,
and Tomonori Gido
Introduction 339
Historical Background of the Phase-contrast
Technique 340
Absorption Contrast and Phase
Contrast 340
Edge Effect Due to Phase
Contrast 341
Realization of the Phase-contrast Technique in
Mammography 341
Design of Digital Image Acquisition
and Output 341
Magnification-demagnification Effect
in Digital Mammography 342
Sharpness 342
Image Noise 343
Improvement of Image Quality by the
Magnification-demagnification
Effect 343
Improvement of Image Sharpness
in Digital Full-field PCM 343
Clinical Images 344
Clinical Experience 345
Future Development 345
Acknowledgements 347
References 347
4.5 Full-field Digital Mammography
versus Film-screen
Mammography 349
Arne Fischmann
Introduction and Historical
Perspective 349
Physical Performance of Digital
Compared to Film-screen
Mammography 350
Phantom Studies Comparing Full-field
Digital Mammography and
Film-screen Mammography 350
Simulated Microcalcifications 351
Clinical or Diagnostic
Digital Mammography 353
Full-field Digital Mammography and
Film-screen Mammography in
Screening 354
Oslo I and II Studies 355
Digital Mammography Imaging
Screening Trial 355
Financial Considerations
of Digital Mammography 356
Radiation Dose Considerations 356
References 357
Contents of Volume 1 xv
4.6 Use of Contrast-enhanced Magnetic
Resonance Imaging for Detecting
Invasive Lobular Carcinoma 359
Carla Boetes and Ritse M. Mann
Introduction 359
Incidence 359
Presentation 359
Pathology 360
Mammography 360
Ultrasound 360
Goal of MRI in the Assessment of Invasive
Lobular Carcinoma 361
Magnetic Resonance
Imaging 361
Dynamic Sequences in Breast Magnetic
Resonance Imaging 362
False-Negative Imaging on Magnetic
Resonance Imaging 363
Conclusions 364
References 364
4.7 Axillary Lymph Node Status in Breast
Cancer: Pinhole Collimator Single–
Photon Emission Computed
Tomography 367
Giuseppe Madeddu, Orazio Schillaci, and Angela
Spanu
Introduction 367
99mTc-tetrofosmin Pinhole–Single Photon
Emission Computed
Tomography 369
Method 369
Results and Discussion 369
Conclusions 371
References 372
4.8 Detection of Small-size Primary Breast
Cancer: 99mTc-tetrofosmin Single
Photon Emission Computed
Tomography 375
Angela Spanu, Orazio Schillaci, and Giuseppe
Madeddu
Introduction 375
The Planar and SPECT Scintimammography
Method 376
Results and Discussion 377
Conclusions 380
References 381
4.9 Microcalcification in Breast
Lesions: Radiography and
Histopathology 383
Arne Fischmann
Introduction 383
Histopathology 383
Detection 384
Classification of Breast
Calcifications 385
Systematic Classification 385
Breast Imaging-Reporting
and Data System 386
Work-up of Breast
Calcifications 389
Summary 391
References 391
4.10 Benign and Malignant
Breast Lesions: Doppler
Sonography 393
José Luís del Cura
Introduction 393
Doppler Ultrasound Technique
in Breast Diseases 394
Breast Doppler Limitations 394
Differentiation of Benign and Malignant
Solid Breast Lesions 395
Tumor Vessel Identification 395
Quantitative Criteria 395
Semiquantitative Criteria 396
Breast Cancer Prognosis 397
Assessment of Lymph Node
Involvement 397
Recurrence versus Scar
in Operated Patients 398
Treatment Monitoring 398
Conclusions 398
References 399
xvi Contents of Volume 1
4.11 Response to Neoadjuvant Treatment
in Patients with Locally Advanced
Breast Cancer: Color-Doppler
Ultrasound Contrast
Medium (Levovist) 401
Paolo Vallone
Introduction 401
Materials and Methods 401
Results 402
Discussion 402
References 406
4.12 Magnetic Resonance Spectroscopy of
Breast Cancer: Current Techniques
and Clinical Applications 407
Sina Meisamy, Patrick J. Bolan, and Michael
Garwood
Introduction 407
Background 407
The “Choline Peak” 407
Why Is tCho Elevated
in Cancer? 408
Technique 408
Tumor Localization 408
Technical Issues 408
Respiratory Artifact 409
Quantification 409
How Reliable Is the tCho
Measurement? 410
Clinical Applications 410
Diagnosis 410
Sample Diagnostic Cases 411
Therapeutic Monitoring with
Early Feedback 412
Sample Therapeutic Monitoring
Cases 413
Acknowledgement 414
References 414
4.13 Breast Scintigraphy 417
Orazio Schillaci, Angela Spanu, and Giuseppe
Madeddu
Introduction 417
Breast Scintigraphy 417
Planar Method 417
Planar Results 418
Single Photon Emission Computed
Tomography Method 418
Single Photon Emission Computed
Tomography Results 419
Dedicated Imaging Systems 419
Methods 419
Results 420
Clinical Indications of Breast Scintigraphy
or Scintimammography 421
References 421
4.14 Primary Breast Cancer: False-negative
and False-positive Bone
Scintigraphy 423
Hatice Mirac Binnaz Demirkan and Hatice Durak
Introduction 423
Search Strategy and Selection
Criteria 423
Procedures and Technical Aspects
of Bone Scan 423
Clinical Applications in Breast
Cancer 427
Pitfalls of Bone Scan Encountered in Breast
Cancer Patients and their Solutions with
Potential Advances 429
References 431
4.15 Improved Sensitivity and Specificity
of Breast Cancer Thermography
435
E. Y-K. Ng
Introduction 435
Image Analysis Tools 436
Thermography 436
Artificial Neural Networks 437
Backpropagation 437
Radial Basis Function Network 438
Biostatistical Methods 438
Data Acqusition 439
Procedures for Thermal
Imaging 439
Designed Integrated Approach 440
Step 1: Linear Regression 440
Step 2: ANN RBFN/BFN 440
Step 3: ROC Analysis 441
Contents of Volume 1 xvii
Results and Discussion 441
Summarized Results for Step 1:
Linear Regression 441
Selected Results for Step 2:
ANN RBFN/BPN 441
Selected Results (with Area > 0.85)
for Step 3: ROC Analysis 441
Conclusions and Future
Trends 442
Acknowledgements 443
References 443
4.16 Optical Mammography 445
Sergio Fantini and Paola Taroni
Introduction 445
Sources of Intrinsic Optical
Contrast in Breast Tissue 446
Principles of Optical
Mammography 447
Continuous-wave Approaches:
Dynamic Measurements and Spectral
Information 448
Time-resolved Approaches 448
Interpretation of Optical
Mammograms 450
Prospects of Optical
Mammography 452
Acknowledgements 453
References 453
4.17 Digital Mammography 455
John M. Lewin
Introduction 455
Technical Advantages of Digital
Mammography 455
Technologies Used for Digital
Mammography 456
Clinical Advantages of Digital
Mammography 456
Advanced Applications
of Digital Mammography 457
Tomosynthesis 457
Contrast-enhanced Digital
Mammography 458
References 458
4.18 Screening for Breast Cancer
in Women with a Familial or
Genetic Predisposition: Magnetic
Resonance Imaging versus
Mammography 459
Mieke Kriege, Cecile T. M. Brekelmans,
and Jan G. M. Klijn
Introduction 459
Magnetic Resonance Imaging
Screening Studies 461
Results 461
Discussion 462
References 463
4.19 Mammographic Screening:
Impact on Survival 465
James S. Michaelson
Introduction 465
Why Screening Works 465
Screening Effectiveness 465
Cancers Become More Lethal
as they Increase in Size 466
Present and Future Life-saving Impact
of Screening 466
Life-saving Potential of Screening 467
Tumor Size and Survival 467
False-positives 468
How is Screening Actually Used 468
Present Status of Breast Cancer
Screening 469
References 470
4.20 False-positive Mammography
Examinations 473
Pamela S. Ganschow and Joann G. Elmore
Introduction 473
Definitions 473
Current Estimates of False-positive
Rates in the United States and
International Guidelines 474
Cumulative False-positive Rates 475
Predictors of False-positive
Mammograms 475
Patients factors 476
Radiologist Factors 478
xviii Contents of Volume 1
Facility and System Factors 479
Predicting the Cumulative Risk
of False-positive Mammograms 480
Significance of False-positive
Mammography Examination 480
Recall Rates in the United States
versus Other Countries 481
Efforts to Reduce False-positive
Mammograms and to Better
Deal with Expected False-Positive
Screenings 483
Acknowledgment 483
References 483
4.21 Breast Dose in Thoracic Computed
Tomography 487
Eric N. C. Milne
Introduction 487
Methodology 488
Results 488
Discussion 489
Cancer Risks 489
Computed Tomography of
the Breast 490
Reducing Radiation Dose 490
Imaging without Using Ionizing
Radiation 490
Optical Imaging 491
Ultrasound 491
Magnetic Resonance Imaging 491
References 492
4.22 Absorbed Dose Measurement in
Mammography 493
Marianne C. Aznar and Bengt Å. Hemdal
Introduction 493
Estimation of Absorbed Dose
to the Breast 494
Concepts and Quantities Used 494
From Measurement to
Dose Estimate 496
Dose Limits and Diagnostic
Reference Levels 497
Dosimeters for Indirect Measurements 498
Ionization chambers 498
Semiconductors 498
Dosimeters for Direct in vivo
Measurements 498
Thermoluminescence Detectors 499
Novel in vivo Techniques 499
Summary and Conclusions 500
References 500
4.23 Metastatic Choriocarcinoma to the
Breast: Mammography and Color
Doppler Ultrasound 503
Naveen Kalra and Vijaynadh Ojili
Introduction 503
Mammography 504
Ultrasonography and
Color Doppler 504
Tissue Diagnosis 506
References 507
4.24 Detection and Characterization
of Breast Lesions: Color-coded
Signal Intensity Curve Software
for Magnetic Resonance–based
Breast Imaging 509
Federica Pediconi, Fiorella Altomari, Luigi
Carotenuto, Simona Padula, Carlo Catalano,
and Roberto Passariello
Introduction 509
Computer-aided Diagnosis: Features
and Applications 511
Computer-aided Detection for Breast Magnetic
Resonance Imaging 512
Characterization Algorithm 514
Registration Algorithm 514
Conclusions 515
References 517
4.25 Detection of Breast Malignancy:
Different Magnetic Resonance
Imaging Modalities 519
Wei Huang and Luminita A. Tudorica
Introduction 519
Major Breast Imaging
Modalities 519
Breast Dynamic Contrast-enhanced Magnetic
Resonance Imaging 520
Contents of Volume 1 xix
Subjective Assessment 520
Empirical Quantitative
Characterization 521
Analytical Pharmacokinetic
Modeling 522
Breast 1H Magnetic
Resonance Spectroscopy 523
Breast T2*-Weighted Perfusion Magnetic
Resonance Imaging 525
References 526
4.26 Breast Lesions: Computerized
Analysis of Magnetic Resonance
Imaging 529
Kenneth G. A. Gilhuijs
Introduction 529
Mechanisms of Functional Imaging using
Magnetic Resonance Imaging 530
Interpretation of Contrast-enhanced Magnetic
Resonance Imaging 531
Reduction of Motion Artifacts 532
Computerized Extraction of
Temporal Features 533
Computerized Extraction of
the Region of Interest 534
Computerized Extraction
of Morphological Features 535
Computerized Classification
of Features of Enhancement 536
Current Status and Future Role
of Computerized Analysis of Breast
Magnetic Resonance Imaging 537
References 538
4.27 Optical Imaging Techniques
for Breast Cancer 539
Alexander Wall and Christoph Bremer
Introduction 539
Tomographic Imaging 540
Nonspecific Contrast Agents (Perfusion-type
Contrast Agents) 540
Fluorochromes with Molecular
Specificity 542
Smart Probes 542
Targeted Probes 542
Multimodality Probes 543
Outlook 544
References 544
4.28 Magnetic Resonance Imaging:
Measurements of Breast Tumor
Volume and Vascularity for
Monitoring Response to
Treatment 547
Savannah C. Partridge
Introduction 547
Magnetic Resonance Imaging
of the Breast 547
Neoadjuvant Treatment 547
Magnetic Resonance Imaging to
Monitor Treatment Response 548
Measuring Changes in Tumor
Size with Treatment 548
Measuring Changes in Tumor
Vascularity with Treatment 548
Imaging Considerations 548
Magnetic Resonance Imaging
Acquisition 548
Imaging Postprocessing 549
Assessing Treatment Response 550
Changes in Tumor Volume Predict
Recurrence-free Survival (RFS) 550
Vascular Changes with
Treatment 550
Conclusions 551
Acknowledgements 552
References 552
4.29 Defining Advanced Breast Cancer:
18F-fluorodeoxyglucose-Positron
Emission Tomography 555
William B. Eubank
Introduction 555
Positron Emission Tomography
Principles 556
Positron Emission Tomography
Instrumentation 556
Fluorodeoxyglucose (FDG) 556
Axillary Node Staging 557
Detection of Locoregional
and Distant Recurrences 557
xx Contents of Volume 1
Contents of Volume 1 xxi
Locoregional Recurrences 557
Intrathoracic Lymphatic
Recurrences 558
Distant Metastases 559
Response to Therapy 560
Impact of FDG-PET on
Patient Management 561
Beyond FDG: Future Applications of
PET to Breast Cancer 562
Estrogen Receptor Imaging 562
References 563
4.30 Leiomyoma of the Breast Parenchyma:
Mammographic, Sonographic, and
Histopathologic Features 567
Aysin Pourbagher and M. Ali Pourbagher
Introduction 567
Mammographic Appearance 568
Sonographic Appearance 568
References 570
4.31 Detection of Breast Cancer: Dynamic
Infrared Imaging 571
Terry M. Button
Introduction: Infrared and
its Detection 571
History of Infrared for Breast
Cancer Detection 572
Dynamic Infrared Imaging 573
Mechanism for Breast Cancer
Detection with Dynamic Infrared 575
Applications of Dynamic Infrared
Imaging 576
Pitfalls of Dynamic Infrared
Imaging 577
Conclusion: The Future of Infrared
and Dynamic Infrared Imaging
for Breast Cancer Detection 578
Acknowledgements 579
References 579
4.32 Phyllodes Breast Tumors: Magnetic
Resonance Imaging 581
Aimée B. Herzog and Susanne Wurdinger
Introduction 581
Magnetic Resonance Imaging 582
Morphology 582
Signal Intensity 582
Contrast-enhancement
Characteristics 583
Guidelines 583
References 584
Index 585
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