Overview of epidemiological clinical aspects

Incidence and prevalence morbidity and mortality Worldwide, breast cancer is the most commonly occurring cancer in women, and the leading cause of cancer-related deaths among women. In the year 1990, there were an estimated 795 600 newly diagnosed cases of breast cancer worldwide 1 . Breast cancer rates vary greatly worldwide, with the highest rates in North America and Europe about one-fifth to one-tenth the occurrence is seen in Asia 2 . Within the U.S. the incidence rates are increasing the...

View to early detection screening

19.1.1 Challenges entailed in cancer screening As emphasized by Rimer et al. 18 , while the aim of cancer screening is very practical, i.e. the detection of cancer at an early and treatable stage, the reality is quite complex (p. 627). Most challenging is to ensure that outcome is truly improved, and that harm does not occur. This, of course, is the basic principle of all medicine Primam non nocere--above all, do no harm. However, since screening is performed on asymptomatic persons, a special...

Breast cancer screening with mammography

The currently recommended method for reducing breast cancer mortality is through a clinical breast examination and mammogram. The American Cancer Society recommends that these begin at age 40 for women at average risk 13 . Mortality reduction associated with screening mammography Regular screening with mammography has been consistently shown in randomized controlled trials to provide long-term reduction in breast cancer mortality 13 . In order to achieve a 30 reduction in breast cancer...

Potential biological effects of exposure to magnetic fields

The potential biological effects of MRS and MRSI are related to exposure to static, gradient and radiofrequency electromagnetic fields. Each of these can represent a possible health risk at high levels of exposure, although there is much uncertainty and controversy about the extent to which low-level exposures are harmful 1 . It has been argued that there is a small value of magnetic susceptibility of human tissues. However, there have been no replicated studies demonstrating a health hazard...

Appropriateness of the FPT for tumor diagnostics within magnetic resonance

We have reviewed extensively how dilemmas surrounding assignment, the non-uniqueness of fitting and quantification represent major obstacles for clinical MRS and MRSI with respect to tumor identification, histological classification, tumor grading, assessment of response to therapy and early detection of tumor recurrence. In short, the fast Pade Transform fulfills the most stringent requirements for tumor diagnostics within magnetic resonance Markedly enhanced resolution and SNR compared to the...

Small number of observable compounds on MRS revealed with FFT

Using the FFT, only a few compounds (low molecular weight, high concentration) are observable on a clinical scanner, and these may not be the most critical for timely diagnosis of malignant processes. Limitations of the new neuro-chemistry in brain tumor diagnostics Danielsen and Ross 14 state that in vivo MRS has introduced a new neuro-chemistry, providing the clinician with the possibility of non-invasively accessing neuro-physiologic and neuro-chemical information. This, together with the...

Comparisons with nonneoplastic brain lesions

The reader is directed to column five of Table 8.1 for a summary of the empirical data on how well individual metabolites detected using 'H-MRS distinguish brain tumors with non-malignant brain lesions. Column 3 of Table 8.2 provides for a summary for metabolic ratios. Choline is found to be elevated not only in brain tumors, but can also be increased in many other conditions 17 . These include Sub-acute and chronic ischemia, Infiltrative processes, Encephalitis, Demyelinization (acute and in...

Cancer of the Uterine Cervix

10.2.1 Overview of epidemiological and clinical aspects Carcinoma of the cervix was previously the most common cause of cancer death among women. Over the past 30 years due to widespread screening using the Papanicolaou6 smear, deaths rates have fallen by 50 . Incidence and prevalence morbidity and mortality Cancer of the uterine cervix is the third most frequently occurring malignancy among women worldwide. Nearly 80 of cases occur in the developing countries, where this is one of the most...

Acetate Succinate Valine Leucine in Brain Abscesses vs Tumors

In-vitro analysis by Grand et al. 108 demonstrated that acetate and succinate were present, respectively, in 12 and 8 of 13 brain abscesses, whereas these substances were much lower or barely detectible in necrotic brain tumors. Thus, these findings corroborate the observations from in vivo MRS, that the presence of acetate and succinate are suggestive of brain abscess rather than neoplasia. Furthermore, in vitro 2D J-resolved MRS showed much higher concentrations of valine and leucine in the...

MRS in the assessment of sarcomas 1331 Primary detection

Studies using in vivo proton MRS to assess sarcomas are sparse, and fairly inconclusive. Schick et al. 16 performed proton MRS and MRSI1 in 37 examinations of 27 patients with bone tumors (various sarcomas plus 14 benign tumors). Resonances from fat were found in osteochondromas but not in the malignant tumors. Resonances with J coupling were found in 7 of the 13 malignant tumors. Oya 17 et al. performed 49 proton MRS studies2 of bone and soft tissue tumors of various types. These authors...

Ovarian Cancer

10.1.1 Overview of epidemiological and clinical aspects There are three major clinical pathological entities epithelial carcinomas, germ cell tumors and stromal carcinomas. Approximately 90 of ovarian cancers in the U.S. are of the epithelial type 1 . Incidence and prevalence morbidity and mortality An estimated 191 000 new cases of ovarian cancer are diagnosed each year worldwide 2 . It is the most common cause of death from gynecologic cancer in the U.S., accounting for about 5 of all cancer...

General Approach to Diagnosis and Differential Diagnosis

After appropriate clinical evaluation of the patient, imaging with MRI and CT has become the hallmark for diagnosing a large number of neurological disorders. MRI is preferred for the detection of brain tumors for reasons that will be discussed in section 8.2. Actual tumor diagnosis and grading, however, has depended upon histopathologic analysis of the surgical material 14 . Increasingly, MRS and MRSI are being incorporated into various aspects of tumor diagnostics (including differential...

Early results in 1 breast cancer diagnosis

With a number of recent advances, contrast-enhanced MRI has emerged as a method with sensitivity approaching 100 for detection of invasive breast cancer 28, 29 . MRI is particularly valuable for detecting malignant lesions in mammographically dense breasts 30 . Studies are currently on going in the U.S., Canada, Germany, Netherlands, U.K., France and Italy to evaluate MRI as a possible screening method for women at high risk for breast cancer 13 . Since most invasive breast cancers are...

Endometrial Cancer

10.3.1 Overview of epidemiological and clinical aspects Incidence and prevalence morbidity and mortality Endometrial cancer accounts for about 3.8 of all cancers in women worldwide. The highest rates are reported in North America and Eastern Europe, with lower incidence seen in Asia. There are approximately 34 000 cases diagnosed annually and 6 000 women die each year from endometrial cancer in the U.S. 3, 40 . Incidence rates rise steadily 5 to 10 years prior to menopause and peak at age...

Comment on difference in approach to genderspecific cancers using MRS and MRSI

This author is struck by the wealth of studies using in vivo MRS and MRSI for prostate cancer with noteworthy improvements in diagnostic accuracy (see Chapter 9), and the dearth, and in the case of endometrial cancer total absence, of publications applying MRS and particularly MRSI to gynecological cancers, as reviewed in the present chapter. We are hopeful that the benefits of molecular imaging through magnetic resonance will soon be made available with the aim of further improving diagnostics...