By Perry J. Pickhardt MD, David H. Kim MD
In CT Colonography, Perry Pickhardt and David Kim current thoughts for speedier assessment and analysis of colon melanoma during the pioneering, specialty-changing imaging means of digital colonoscopy (VC). this mixture of refined X-rays and CT scans of the stomach bargains sufferers a substitute for colonoscopy that's within your means and decreases the necessity for pointless polyp removing. Abundantly illustrated in complete colour, this pioneering ebook describes CT colonography from pathogenesis, staging and therapy via symptoms, strategy, and interpretation for the most typical pathologies. you should have the complete spectrum of VC process and be capable to see techniques played via videos at the incorporated DVD.Covers ideas, ideas, and interpretations for the most typical pathologies in a logical, sensible organization.Presents counsel from the authors on developing a VC perform to supply a private, instructive guide.Provides over a thousand full-color, high-resolution anatomic photos all through for the clearest, such a lot actual photo of colorectal melanoma, its typical historical past, and its prognosis by way of VC.Focuses on photographs, with the textual content serving as context for the right kind use and realizing of VC.Features a DVD with videos of VC methods that make clear the textual content and complement the photographs which are incorporated for obtain.
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Extra resources for CT Colonography: Principles and Practice of Virtual Colonoscopy
Example text
A minority of cancers from this pathway are MSI low or stable. ” This phenomenon is related to inactivation of DNA repair genes such as hMLH1 or MGMT. 24 Although most errors are of little significance in noncoding regions, mutations introduced into genes regulating cell growth can ultimately result in the progression of a serrated lesion to cancer. 22 The major pathway accounting for 75% of these cancers results in MSI-H carcinomas, whereas the minor pathway results in MSI-L or MSI-S cancers. In the major pathway, a defining genetic marker is activation of the BRAF on- 26 COLORECTAL POLYPS AND CANCER Serrated polyp-carcinoma pathway* BRAF CpG island methylation hMLH1 Colorectal cancer (MSI-H) Normal Hyperplastic polyp **SSA, TSA, mixed polyp Serrated polyp with marked dysplasia *Major pathway (MSI-H).
This is not surprising, as stated previously, because all modalities use similar size and morphologic criteria to make this assessment. One situation in which CTC is clearly helpful is in the assessment of synchronous polyps and cancers proximal to a distal cancer. In cases where optical colonoscopy cannot pass a stenotic cancer, CTC allows evaluation of these proximal areas (Fig. 16 It is important to note that besides initial clinical staging, imaging plays an ongoing role in the evaluation for recurrent disease.
O’Brien MJ. Hyperplastic and serrated polyps of the colorectum. Gastroenterol Clin N Am. 2007;36:947-968. 24. Shibata D, Peinado MA, Ionov Y, Malkhosyan S, Perucho M. Genomic instability in repeated sequences is an early somatic event in colorectal tumorigenesis that persists after transformation. Nat Genet. 1994;6(3):273-281. 25. Tateyama H, Li WX, Takahashi E, Miura Y, Sugiura H, Eimoto T. Apoptosis index and apoptosis-related antigen expression in serrated adenoma of the colorectum—The saw-toothed structure may be related to inhibition of apoptosis.
