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Chapter 9 - The anterior abdominal wall and peritoneum
- from Section 2 - Thorax, Abdomen and Pelvis
- Edited by Paul Butler, Adam Mitchell, Jeremiah C. Healy
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- Book:
- Applied Radiological Anatomy
- Published online:
- 05 November 2012
- Print publication:
- 05 July 2012, pp 134-149
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Summary
Radiographic anatomy
Anterior abdominal wall
Plain film radiography (Fig. 9.1) is not used to evaluate the anterior abdominal wall.
Peritoneum
Plain radiography (Fig. 9.1) has been superseded by cross-sectional imaging techniques and the peritoneal cavity is visualized only via contrast herniography (Fig. 9.2).
Cross-sectional anatomy
Cross-sectional imaging techniques optimally assess the anterior abdominal wall and peritoneum.
Anterior abdominal wall
US
Ultrasound is useful in evaluating focal masses in the anterior abdominal wall but does not demonstrate the anatomical relations as well as computed tomography (CT) or magnetic resonance imaging (MRI).
CT/MRI
CT and MRI provide excellent anatomical detail of the anterior abdominal wall in the axial plane.
MRI has superior soft-tissue contrast resolution but images can be degraded by respiratory artefact.
Peritoneum
US
Ultrasound is widely used to detect intraperitoneal collections, but is limited by bowel gas and body habitus.
CT/MRI
Contrast-enhanced CT (with or without oral contrast medium) is the method of choice to evaluate the peritoneal spaces, reflections and their contents.
MRI provides good visualization of the peritoneal spaces and reflections; however, bowel peristalsis and respiratory movement can degrade the images.
Series Foreword
-
- By Rodney H. Reznek, London
- Edited by Michael J. Michell
-
- Book:
- Breast Cancer
- Published online:
- 06 July 2010
- Print publication:
- 25 February 2010, pp ix-x
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Summary
Imaging has become pivotal in all aspects of the management of patients with cancer. At the same time it is acknowledged that optimal patient care is best achieved by a multidisciplinary team approach. The explosion of technological developments in imaging over the past years has meant that all members of the multidisciplinary team should understand the potential applications, limitations, and advantages of all the evolving and exciting imaging techniques. Equally, to understand the significance of the imaging findings and to contribute actively to management decisions and to the development of new clinical applications for imaging, it is critical that the radiologist should have sufficient background knowledge of different tumors. Thus the radiologist should understand the pathology, the clinical background, the therapeutic options, and prognostic indicators of malignancy.
Contemporary Issues in Cancer Imaging aims to meet the growing requirement for radiologists to have detailed knowledge of the individual tumors in which they are involved in making management decisions. A series of single subject issues, each of which will be dedicated to a single tumor site, edited by recognized expert guest editors, will include contributions from basic scientists, pathologists, surgeons, oncologists, radiologists, and others.
While the series is written predominantly for the radiologist, it is hoped that individual issues will contain sufficient, varied information so as to be of interest to all medical disciplines and to other health professionals managing patients with cancer.
Series foreword
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- By Rodney H. Reznek, London
- Edited by Hero K. Hussain, Isaac R. Francis
-
- Book:
- Primary Carcinomas of the Liver
- Published online:
- 04 August 2010
- Print publication:
- 26 November 2009, pp ix-x
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Summary
Imaging has become pivotal in all aspects of the management of patients with cancer. At the same time, it is acknowledged that optimal patient care is best achieved by a multidisciplinary team approach. The explosion of technological developments in imaging over the past years has meant that all members of the multidisciplinary team should understand the potential applications, limitations, and advantages of all the evolving and exciting imaging techniques. Equally, to understand the significance of the imaging findings and to contribute actively to management decisions and to the development of new clinical applications for imaging, it is critical that the radiologist should have sufficient background knowledge of different tumors. Thus the radiologist should understand the pathology, the clinical background, the therapeutic options, and the prognostic indicators of malignancy.
Contemporary Issues in Cancer Imaging–A Multidisciplinary Approach aims to meet the growing requirement for radiologists to have detailed knowledge of the individual tumors about which they are involved in making management decisions. A series of single subject issues, each of which is dedicated to a single tumor site, edited by recognized expert guest editors, include contributions from basic scientists, pathologists, surgeons, oncologists, radiologists, and others.
Although the series is written predominantly for the radiologist, it is hoped that individual issues will contain sufficient varied information so as to be of interest to all medical disciplines and to other health professionals managing patients with cancer.
Series Foreword
- Edited by Richard M. Gore, Northwestern University Medical School, Illinois
-
- Book:
- Gastric Cancer
- Published online:
- 31 March 2010
- Print publication:
- 19 November 2009, pp viii-viii
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Summary
Imaging has become pivotal in all aspects of the management of patients with cancer. At the same time it is acknowledged that optimal patient care is best achieved by a multidisciplinary team approach. The explosion of technological developments in imaging over the past years has meant that all members of the multidisciplinary team should understand the potential applications, limitations and advantages of all the evolving and exciting imaging techniques. Equally, to understand the significance of the imaging findings and to contribute actively to management decisions and to the development of new clinical applications for imaging, it is critical that the radiologist should have sufficient background knowledge of different tumors. Thus the radiologist should understand the pathology, the clinical background, the therapeutic options, and prognostic indicators of malignancy.
Contemporary Issues in Cancer Imaging – A Multidisciplinary Approach aims to meet the growing requirement for radiologists to have detailed knowledge of the individual tumors in which they are involved in making management decisions. A series of single subject issues, each of which will be dedicated to a single tumor site and edited by recognized expert guest editors, will include contributions from basic scientists, pathologists, surgeons, oncologists, radiologists, and others.
While the series is written predominantly for the radiologist, it is hoped that individual issues will contain sufficient varied information so as to be of interest to all medical disciplines and to other health professionals managing patients with cancer.
Series Foreword
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- By Rodney H. Reznek, London
- Edited by Jay Heiken
-
- Book:
- Pancreatic Cancer
- Published online:
- 23 December 2009
- Print publication:
- 11 December 2008, pp ix-ix
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Summary
Imaging has become pivotal in all aspects of the management of patients with cancer. At the same time it is acknowledged that optimal patient care is best achieved by a multidisciplinary team approach. The explosion of technological developments in imaging over the past years has meant that all members of the multidisciplinary team should understand the potential applications, limitations and advantages of all the evolving and exciting imaging techniques. Equally, to understand the significance of the imaging findings and to contribute actively to management decisions and to the development of new clinical applications for imaging, it is critical that the radiologist should have sufficient background knowledge of different tumors. Thus the radiologist should understand the pathology, the clinical background, the therapeutic options and prognostic indicators of malignancy.
Contemporary Issues in Cancer Imaging – A Multidisciplinary Approach aims to meet the growing requirement for radiologists to have detailed knowledge of the individual tumors in which they are involved in making management decisions. A series of single subject issues, each of which will be dedicated to a single tumor site, edited by recognized expert guest editors, will include contributions from basic scientists, pathologists, surgeons, oncologists, radiologists and others.
While the series is written predominantly for the radiologist, it is hoped that individual issues will contain sufficient varied information so as to be of interest to all medical disciplines and to other health professionals managing patients with cancer.
Series foreword
- Edited by Andy Adam, University of London, Peter R. Mueller
-
- Book:
- Interventional Radiological Treatment of Liver Tumors
- Published online:
- 23 December 2009
- Print publication:
- 11 December 2008, pp xi-xii
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Summary
Imaging has become pivotal in all aspects of the management of patients with cancer. At the same time, it is acknowledged that optimal patient care is best achieved by a multidisciplinary team approach. The explosion of technological developments in imaging over the past years has meant that all members of the multidisciplinary team should understand the potential applications, limitations, and advantages of all the evolving and exciting imaging techniques. Equally, to understand the significance of the imaging findings and to contribute actively to management decisions and to the development of new clinical applications for imaging, it is critical that the radiologist should have sufficient background knowledge of different tumors. Thus the radiologist should understand the pathology, the clinical background, the therapeutic options, and prognostic indicators of malignancy.
Contemporary Issues in Cancer Imaging – A Multidisciplinary Approach aims to meet the growing requirement for radiologists to have detailed knowledge of the individual tumors in which they are involved in making management decisions. A series of single-subject issues, each of which will be dedicated to a single tumor site, edited by recognized expert guest editors, will include contributions from basic scientists, pathologists, surgeons, oncologists, radiologists, and others.
While the series is written predominantly for the radiologist, it is hoped that individual issues will contain sufficiently varied information so as to be of interest to all medical disciplines and to other health professionals managing patients with cancer.
Series Foreword
- Edited by Hedvig Hricak, Peter Scardino
-
- Book:
- Prostate Cancer
- Published online:
- 23 December 2009
- Print publication:
- 20 November 2008, pp ix-x
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Summary
Imaging has become pivotal in all aspects of the management of patients with cancer. At the same time it is acknowledged that optimal patient care is best achieved by a multidisciplinary team approach. The explosion of technological developments in imaging over the past years has meant that all members of the multidisciplinary team should understand the potential applications, limitations and advantages of all the evolving and exciting imaging techniques. Equally, to understand the significance of the imaging findings and to contribute actively to management decisions and to the development of new clinical applications for imaging, it is critical that the radiologist should have sufficient background knowledge of different tumors. Thus the radiologist should understand the pathology, the clinical background, the therapeutic options, and prognostic indicators of malignancy.
Contemporary Issues in Cancer Imaging – A Multidisciplinary Approach aims to meet the growing requirement for radiologists to have detailed knowledge of the individual tumors in which they are involved in making management decisions. A series of single subject issues, each of which will be dedicated to a single tumor site and edited by recognized expert guest editors, will include contributions from basic scientists, pathologists, surgeons, oncologists, radiologists, and others.
While the series is written predominantly for the radiologist, it is hoped that individual issues will contain sufficient varied information so as to be of interest to all medical disciplines and to other health professionals managing patients with cancer.
Series Foreword
- Edited by Robert Hermans
-
- Book:
- Squamous Cell Cancer of the Neck
- Published online:
- 24 August 2009
- Print publication:
- 09 October 2008, pp vii-viii
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Summary
Imaging has become pivotal in all aspects of the management of patients with cancer. At the same time, it is acknowledged that optimal patient care is best achieved by a multidisciplinary team approach. The explosion of technological developments in imaging over the past years has meant that all members of the multidisciplinary team should understand the potential applications, limitations and advantages of all the evolving and exciting imaging techniques. Equally, to understand the significance of the imaging findings and to contribute actively to management decisions and to the development of new clinical applications for imaging, it is critical that the radiologist should have sufficient background knowledge of different tumors. Thus, the radiologist should understand the pathology, the clinical background, the therapeutic options and the prognostic indicators of malignancy.
Contemporary Issues in Cancer Imaging – A Multidisciplinary Approach aims to meet the growing requirement for radiologists to have detailed knowledge of the individual tumors in which they are involved in making management decisions. A series of single subject issues, each of which will be dedicated to a single tumor site, edited by recognized expert guest editors, will include contributions from basic scientists, pathologists, surgeons, oncologists, radiologists and others.
While the series is written predominantly for the radiologist, it is hoped that individual issues will contain sufficient varied information so as to be of interest to all medical disciplines and to other health professionals managing patients with cancer.
Series foreword
-
- By Rodney H. Reznek, London
- Edited by David MacVicar
-
- Book:
- Carcinoma of the Bladder
- Published online:
- 25 August 2009
- Print publication:
- 22 May 2008, pp ix-x
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Summary
Imaging has become pivotal in all aspects of the management of patients with cancer. At the same time it is acknowledged that optimal patient care is best achieved by a multidisciplinary team approach. The explosion of technological developments in imaging over the past years has meant that all members of the multidisciplinary team should understand the potential applications, limitations and advantages of all the evolving and exciting imaging techniques. Equally, to understand the significance of the imaging findings and to contribute actively to management decisions and to the development of new clinical applications for imaging, it is critical that the radiologist should have sufficient background knowledge of different tumors. Thus the radiologist should understand the pathology, the clinical background, the therapeutic options and prognostic indicators of malignancy.
Contemporary Issues in Cancer Imaging – A Multidisciplinary Approach aims to meet the growing requirement for radiologists to have detailed knowledge of the individual tumors in which they are involved in making management decisions. A series of single subject issues, each of which will be dedicated to a single tumor site, edited by recognised expert guest editors, will include contributions from basic scientists, pathologists, surgeons, oncologists, radiologists and others.
While the series is written predominantly for the radiologist, it is hoped that individual issues will contain sufficient varied information so as to be of interest to all medical disciplines and to other health professionals managing patients with cancer.
7 - Imaging characteristics of unusual renal cancers
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- By Anju Sahdev, Consultant, Radiologist, Department of Diagnostic Imaging, St. Bartholomew's Hospital, West Smithfield, London, UK, Rodney H. Reznek, Professor of Diagnostic Imaging, Cancer Imaging, Institute of Cancer, St Bartholomew's Hospital, West Smithfield, London, UK
- Edited by Uday Patel, St George's Hospital, London
-
- Book:
- Carcinoma of the Kidney
- Published online:
- 08 August 2009
- Print publication:
- 06 December 2007, pp 126-154
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Summary
Introduction
A wide variety of malignant neoplasms have been described in the kidney, but 90% of primary renal cancers are classified as renal cell carcinomas (RCC). Transitional cell carcinomas (TCC) account for about 5%–8% of renal cancers; and nephroblastomas, sarcomas, lymphoma, and metastases commonly from breast, bronchus, and malignant melanoma account for a further 5% of renal cancers.
The increased use of ever-evolving cross-sectional imaging has resulted in early and incidental diagnosis of renal cancers. Up to 40% of renal tumors are now incidentally detected and at an earlier stage. For example, 82% of incidentally detected tumors are below stage pT3 compared with only 35% of symptomatic tumors and the disease-free and 5-year survival time is significantly better in lower stage tumors. These favorable prognostic features allow recent developments in localized lesion therapies such as ablation techniques, embolization and nephron-sparing surgery to be offered as practical treatment options to conventional nephrectomy. However, histological subtypes with a poor prognosis such as collecting duct carcinomas, sarcomas and TCCs are not suitable for these nephron-sparing treatment options. Lymphoma and metastatic lesions require systemic chemotherapy. Furthermore, although localized treatment may be offered to patients with locally advanced renal cancer and intractable hematuria in a palliative setting, recent developments in targeted chemotherapy may alter the approach to these patients (as discussed in Chapter 1). It is also important to know the histological subtype of the renal cancer prior to embarking on localized treatment options.
Series foreword
-
- By Rodney H. Reznek, London, Janet E. Husband, London
- Edited by Gina Brown
-
- Book:
- Colorectal Cancer
- Published online:
- 07 September 2010
- Print publication:
- 06 December 2007, pp ix-x
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Series foreword
-
- By Rodney H. Reznek, London, Janet E. Husband, London
- Edited by Sheila C. Rankin
-
- Book:
- Carcinoma of the Esophagus
- Published online:
- 08 August 2009
- Print publication:
- 06 December 2007, pp ix-x
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- Chapter
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Summary
Imaging has become pivotal in all aspects of the management of patients with cancer. At the same time, it is acknowledged that optimal patient care is best achieved by a multidisciplinary team approach. The explosion of technological developments in imaging over the past years has meant that all members of the multidisciplinary team should understand the potential applications, limitations, and advantages of all the evolving and exciting imaging techniques. Equally, to understand the significance of the imaging findings and to contribute actively to management decisions and to the development of new clinical applications for imaging, it is critical that the radiologist should have sufficient background knowledge of different tumors. Thus the radiologist should understand the pathology, the clinical background, the therapeutic options, and prognostic indicators of malignancy.
Contemporary Issues in Cancer Imaging: A Multidisciplinary Approach aims to meet the growing requirement for radiologists to have detailed knowledge of the individual tumors in which they are involved in making management decisions. A series of single subject issues, each of which will be dedicated to a single tumor site, edited by recognized expert guest editors, will include contributions from basic scientists, pathologists, surgeons, oncologists, radiologists, and others.
While the series is written predominantly for the radiologist, it is hoped that individual issues will contain sufficient varied information so as to be of interest to all medical disciplines and to other health professionals managing patients with cancer.
Series foreword
-
- By Rodney H. Reznek, London, Janet E. Husband, London
- Edited by Uday Patel, St George's Hospital, London
-
- Book:
- Carcinoma of the Kidney
- Published online:
- 08 August 2009
- Print publication:
- 06 December 2007, pp ix-x
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- Chapter
- Export citation
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Summary
Imaging has become pivotal in all aspects of the management of patients with cancer. At the same time it is acknowledged that optimal patient care is best achieved by a multidisciplinary team approach. The explosion of technological developments in imaging over the past years has meant that all members of the multidisciplinary team should understand the potential applications, limitations, and advantages of all the evolving and exciting imaging techniques. Equally, to understand the significance of the imaging findings and to contribute actively to management decisions and to the development of new clinical applications for imaging, it is critical that the radiologist should have sufficient background knowledge of different tumors. Thus the radiologist should understand the pathology, the clinical background, the therapeutic options, and the prognostic indicators of malignancy.
Contemporary Issues in Cancer Imaging: A Multidisciplinary Approach aims to meet the growing requirement for radiologists to have detailed knowledge of the individual tumors in which they are involved in making management decisions. A series of single subject issues, each of which will be dedicated to a single tumor site, edited by recognized expert guest editors, will include contributions from basic scientists, pathologists, surgeons, oncologists, radiologists, and others.
While the series is written predominantly for the radiologist, it is hoped that individual issues will contain sufficient varied information so as to be of interest to all medical disciplines and to other health professionals managing patients with cancer.
Series Foreword
-
- By Rodney Reznek, London, Janet Husband, London
- Edited by Sujal R. Desai
-
- Book:
- Lung Cancer
- Published online:
- 12 August 2009
- Print publication:
- 21 December 2006, pp ix-x
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Summary
Imaging has become pivotal in all aspects of the management of patients with cancer. At the same time it is acknowledged that optimal patient care is best achieved by a multidisciplinary team approach. The explosion of technological developments in imaging over the past years has meant that all members of the multidisciplinary team should understand the potential applications, limitations and advantages of all the evolving and exciting imaging techniques. Equally, to understand the significance of the imaging findings and to contribute actively to management decisions and to the development of new clinical applications for imaging, it is critical that the radiologist should have sufficient background knowledge of different tumours. Thus the radiologist should understand the pathology, the clinical background, the therapeutic options and prognostic indicators of malignancy.
Contemporary Issues in Cancer Imaging – A Multidisciplinary Approach aims to meet the growing requirement for radiologists to have detailed knowledge of the individual tumours in which they are involved in making management decisions. A series of single subject issues, each of which will be dedicated to a single tumour site, edited by recognized expert guest editors, will include contributions from basic scientists, pathologists, surgeons, oncologists, radiologists and others.
While the series is written predominantly for the radiologist, it is hoped that individual issues will contain sufficient varied information to be of interest to all medical disciplines and to other health professionals managing patients with cancer.
7 - MR Imaging in Ovarian Cancer
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- By Aslam Sohaib, Department of Radiology, Royal Marsden Hospital, London, UK, Rodney Reznek, Department of Radiology, Royal Marsden Hospital, London, UK
- Edited by Rodney Reznek
-
- Book:
- Cancer of the Ovary
- Published online:
- 11 September 2009
- Print publication:
- 14 December 2006, pp 112-131
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Summary
Introduction
MR imaging is increasingly being used in gynaecological and pelvic imaging due to its high contrast resolution compared to CT and ultrasound. As MR imaging techniques continue to improve, its role continues to evolve. Consequently, MRI is proving useful in characterising adnexal masses and may have a role in defining the extent of disease in ovarian cancer.
Technique
Optimal imaging in ovarian cancer requires a high-field system with good gradients in order to obtain rapid and high-resolution images. Imaging acquisition is further enhanced by the use of phased-array coils that are compatible with parallel imaging techniques. These techniques use some of the spatial information contained in the individual elements of a radiofrequency (RF) receiver coil array to increase imaging speed [1].
For characterisation of adnexal masses, images should be obtained in at least two planes to assist in determining the organ of origin of the mass. Both T1- and T2-weighted images are important for pelvic anatomy and in tissue characterisation. The use of small field of view high-resolution images improves the delineation of small structures such as papillary projections. Fat-suppression sequences help to distinguish fatty from haemorrhagic masses. Fat-saturated chemical shift techniques are preferable to STIR sequences. This is to avoid confusion between fat and haemorrhagic lesions, as haemorrhagic lesions may have the same T1 relaxation time as fat on the STIR sequence. Gadolinium-enhanced fat-suppressed T1-weighted images improve lesion characterisation by increasing the conspicuity of nodules and septa in complex adnexal masses [2–5].
Index
- Edited by Rodney Reznek
-
- Book:
- Cancer of the Ovary
- Published online:
- 11 September 2009
- Print publication:
- 14 December 2006, pp 173-176
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Preface to Cancer of the Ovary
-
- By Rodney Reznek, London
- Edited by Rodney Reznek
-
- Book:
- Cancer of the Ovary
- Published online:
- 11 September 2009
- Print publication:
- 14 December 2006, pp xi-xii
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Summary
Ovarian cancer is not only the commonest but also the most lethal gynaecological malignancy, partly because the majority of patients present with advanced disease. Nevertheless, as is true for so many cancers, the management of patients with ovarian neoplasms has changed substantially over the years. Several factors have contributed to this: for example, major advances in chemotherapy have resulted in improved survival; the role of surgery is constantly evolving and being refined. Many challenges are being addressed in order to lessen the devastating effects of advanced disease: screening strategies are being introduced and detection of early stage disease may offer an opportunity to reduce mortality. Also, a better understanding of the interactions between environmental and molecular biological events that cause or protect against ovarian cancer may lead to clear clinical benefits in prevention, early detection and treatment of the disease.
There is little doubt, however, that central to these advances has been the development and application of modern imaging, whether it be in diagnosis, staging or follow-up. All forms of imaging, including ultrasound, MRI and CT, play a critical role not only in the day-to-day management of the patient but also in the development of future strategies. Position emission tomography may also in future play a role.
This issue of Contemporary Issues in Cancer Imaging – A Multidisciplinary Approach deals with all these important developments. Increasingly, there is a need for the radiologist to understand the clinical issues that prompt the need for imaging.
Contributors
- Edited by Rodney Reznek
-
- Book:
- Cancer of the Ovary
- Published online:
- 11 September 2009
- Print publication:
- 14 December 2006, pp vii-viii
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Cancer of the Ovary
- Edited by Rodney Reznek
-
- Published online:
- 11 September 2009
- Print publication:
- 14 December 2006
-
Ovarian cancer is not only the commonest but also the most lethal gynaecological malignancy, partly because the majority of patients present with advanced disease. Nevertheless, the management of patients with ovarian neoplasms has changed substantially recently, with improved survival due to better screening strategies, major advances in chemotherapy and the constantly evolving role of surgery. Optimal patient care is best achieved by a multidisciplinary team, with imaging playing a pivotal role. The explosion of technological developments in imaging in recent years has meant that all members of the team should understand the potential applications, limitations and advantages of evolving imaging techniques. Each volume in Contemporary Issues in Cancer Imaging - A Multidisciplinary Approach is edited by an expert guest editor with contributions from all members of the multidisciplinary team, thus bringing together expertise from many specialties to promote the understanding and application of modern imaging in overall patient management.
Contents
- Edited by Rodney Reznek
-
- Book:
- Cancer of the Ovary
- Published online:
- 11 September 2009
- Print publication:
- 14 December 2006, pp v-vi
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