Diagnosis in oncology


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The incidences of cancer are continually increasing worldwide. There are also development of radiological diagnostic methods and their widespread use in the diagnosis of cancer in the early stages. The survival rate for cancer depends on the severity of the disease.

In oncology, the following basic methods of radiation diagnostics are used:

  • Ultrasound – (a visual technique based on the use of ultrasonic waves to produce an image)
  • X-ray diagnostics (X-ray method) – The principle of imaging is based on the characteristics of the absorption of X-rays by various tissues of the body.
  • Computed Tomography (CT) is an X-ray method based on the receipt of layered images in a transverse plane and their computer reconstruction.
  • Magnetic Resonance Imaging (MRI) is a method based on the receipt of layered images of organs and tissues using the magnetic resonance phenomenon.
  • Radionuclide diagnosis or nuclear medicine is a method of radiation diagnostics based on the registration of radiation from artificial radiopharmaceutous drugs introduced into the body.
  • Appropriate additional research and biopsy should be performed in respect of any localizations suspected of a malignant process, as the exact location of the stage of the disease determines the treatment and outcome of the underlying disease.

The use of radiation diagnostics in oncology is aimed at solving the main problems:

  1. Early (preclinical) diagnosis of tumours. Recently, radiation diagnostic methods have been used effectively such as a screening, which allows the detection of tumours less than 1 cm in size.
  2. Staging, assessment of localization, prevalence, metastasis, differential diagnosis. At this stage, radionuclide methods are the most informative, based on the decision on treatment tactics.
  3. Evaluation of the results of treatment and the dynamics of the disease. Antitumor treatment includes radiation therapy, chemotherapy, surgical intervention as independent methods and their combinations in different sequences. A system of criteria known as RECIST (Response Evaluation Criteria in Solid Tumours) is used to assess the effectiveness of the therapy, as well as to objectively compare the results in various clinics around the world. These criteria determine the parameters of full, partial responses, stabilization and progression of the disease. The basis of the classification defines the tumour size using radiation diagnostic methods and endoscopic methods. Thus, re-diagnosis using radiation methods is actively used in the postoperative period and after treatment, as it gives a clear understanding of the effectiveness of therapy and allows planning of further tactics of patient management
  4. Dynamic observation. Modern cancer treatment algorithms provide observation and periodic research using radiological methods to detect relapses.
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Types of cancer and methods of its diagnosis

Ovarian tumours

Imaging techniques such as magnetic resonance imaging (MRI), can provide additional information but may not be necessary in preoperative assessment in routine practice. After getting ultrasound results, MRI techniques can be used to specify the imaging method and this will reduce the risks of misdiagnosis.

CT is not necessarily used to diagnose ovarian cancer but is used in place of MRI and in the assessment of lymph nodes.

Cervical cancer

Magnetic resonance imagine (MRI) is used as an additional method and it is better than CT scans when it comes to assessing the prevalence of a tumour. However, both methods are effective in assessing lymph node damage. MRI of the pelvic and abdominal activity can also be done to look for metastases. Computer tomography can also be used in the detection of metastatic chest lesions.

Endometrial cancer

MRI is recommended when there is cervical condition. Chest and abdominal CT scans can be done to identify metastases.

Oesophageal tumours

Chest and abdominal CT scans can be performed to determine the prevalence of oesophageal tumours.

Stomach tumours

MRI and CT scans which are radiation diagnostic methods can be used to search for metastases in the abdominal cavity and the peritoneal space, in the small pelvis, lungs as well as the brain. It is ideal that MRI of the abdominal cavity is performed and that of the pelvic region and brain as well as CT scan of the lungs.

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Pancreatic tumours

The optimal and diagnostic methods that can be used are CT scans and MRI. MRI will provide more accurate results when it comes to identifying invasive growth, that is important for surgical volume.

All organs of the abdominal cavity usually metastasize to the lungs, brain and small pelvis.

Liver tumours

Liver tumours can be best diagnosed using MRI with contrasting amplification and the use of hepatospecific contrast drugs which have an advantage in this pathology. The stage of the tumour can be determined by performing CT scans of the chest organs and the abdominal organs.

Cancer of the gallbladder and bile ducts

The diagnosis is based on the data of radiological study of MRI and pathomorphological confirmation of the diagnosis.

Colon cancer

The location of the tumour can be visualized using virtual colonoscopy which is a non-invasive method based on radiation diagnosis. It involves a combination with the endoscopic method in planning of the volume of surgery.

Colorectal cancer

MRI of the rectum can provides exhaustive information to the surgeon regarding the stage of the process, determining features of the blood supply, it helps in understanding the volume of the surgery as well as the surgical access. Computed Tomography will be carried out so as to detect metastases in the abdominal cavity, lungs and brain.

Colon tumours

The diagnostic method used is virtual colonoscopy which is a non-invasive method based on radiation. CT scan will be used to search for metastases.

Lung tumours and mediatisation

The main method of diagnosis is chest CT. Lung cancer usually metastasizes in the abdominal cavity and the brain and for this reason, it is ideal that a CT and MRI of the abdominal cavity is conducted.

Kidney tumours

This disease is diagnosed using CT, connection with renal arteries, the degree of germination in the cup-lohan system and extra organic spread and exposure. MRI is also widely used when identifying kidney tumours.

Tumors of the bladder

An MRI of the pelvic floor with contrast will be performed. The metastases in the lungs and abdominal cavity will be identified using a CT scan.

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Prostate and testicular cancer

This is identified using MRI of the pelvic floor as it allows the assessment of a detailed structure of the prostate gland, any pathological processes in the surrounding tissues and the lymph nodes. Prostate cancer often metastasizes in the bones and therefore osteoscinthigraphy is performed in the later stages of the disease.

Lymphoproliferive diseases / lymphomas

The presence of tumours is identified using radiation diagnostics such as computer and MRI imaging with contrast. It reveals the formation of various anatomical areas that may not be visible to the doctor during the external examination.

Brain tumours

MRI is the main method of diagnosis so as to clarify the location of the tumour and to determine the extent of the tumour. MR-tractography will be able to identify the degree of the involvement of the conducive pathways of the brain. Computer tomography is used as an additional method when bone structures are involved in the process. Moreover, CT is done in the presence of absolute contraindications to MRI examination.

Spinal cord tumors

The location of the tumour, its level and position (intramedullary or extra medullary tumours, whether it is in the spinal cord or outside.) is determined by magnetic resonance imaging. If there are contraindications to MRI conduct a CT scan.

Melanoma

Melanoma is not detected by radiation diagnosis but due to active metastsis, CT and MRI scans should be done.

Bone tumours

MRI and CT scans are used depending on the location of the tumour. Apart from the local information in the affected area, CT and MRI diagnosis of other areas can also reveal tumours located in other organs, lymph node lesion. MRI of soft tissues will make the doctor understand the spread of bone tumours on them. An entire MRI can be used to evaluate the stage and examine the effectiveness of the treatment.


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