Objectives

Appreciate the basic histological findings of mucinous colorectal cancer.

Understand the natural history of mucinous colorectal cancer versus conventional adenocarcinoma.

Review the imaging features of mucinous colorectal cancer versus conventional colorectal adenocarcinoma.

Avoid common pitfalls in reporting studies with mucinous colorectal cancers

Background

Mucinous colorectal cancer is a subtype of colorectal cancer, it is essential for an abdominal radiologist to be aware of the implications of a diagnosis of the mucinous colorectal cancer as it can alter the imaging characteristics of the primary and metastases. Mucinous colorectal cancer can be more aggressive in comparison to the conventional adenocarcinoma and accurate local staging is paramount. The mucinous components can make reporting metastatic disease challenging.

Imaging findings OR Procedure findings

A variety of cases demonstrating the key imaging features of local and metastatic mucinous colorectal cancer on CT and MRI including the signal characteristics on MRI.

Conclusion

An awareness of the behaviour and imaging features of mucinous colorectal cancer can help abdominal radiologist accurately detect and stage mucinous colorectal cancer.

Objectives

The purpose of this exhibit is to:

1. Illustrate motility, functional and structural disorders of upper GI tract on barium studies.

2. Correlation of these findings with CT and/or endoscopy

Background

Barium studies are invaluable in demonstrating functional anomalies in addition to structural abnormalities. There has however been a decline in the number of oral barium studies over the past few decades due to use of other common techniques like endoscopy. Currently, it is only indicated in cases where patients are unable to tolerate endoscopy, or where cross-sectional imaging cannot provide the definitive answer. The expertise in this field is declining and the skills required in interpreting barium studies are decreasing among radiology trainees.

Imaging findings OR Procedure findings

We aim to illustrate barium studies of:

*Oesophageal functional abnormalities e.g. reflux esophagitis, feline oesophagus

*Motility disorders e.g. achalasia, diffuse esophageal spasm, presbyesophagus

*Benign and malignant disorders of oesophagus and stomach

-Benign: pharyngeal web, Zenker’s diverticulum, Schatzki’s ring

-Malignant: Malignant neoplasm of oesophagus and stomach

We will aim to show endoscopic and/or CT correlation where possible.

Conclusion

Barium swallow and meal are still important diagnostic modalities in patients where endoscopy has failed and when other imaging modalities do not provide adequate information or when functional information is required. Hence it is important even in this era for radiologists to be aware of findings on these studies and its implications on patient management. We hope to add value to interpretation of this dying art through this illustration.

Objectives

To understand the indications and limitations of the key gastrointestinal (GI) related nuclear medicine investigations.

To understand the key pathologies that GI nuclear medicine investigations can detect

We will present multiple nuclear medicine case studies discussing their role in the diagnostic pathway.

Background

Nuclear medicine investigations of the GI tract can be overlooked in favour CT and MR imaging to solve a problem or reach a diagnosis. An understanding of the key GI related nuclear medicine investigation can allow a target approach to solving diagnostic conundrums or confirm the findings from cross sectional imaging.

Imaging findings OR Procedure findings

A range of cases where nuclear medicine investigations aided the diagnostic process.
Gastric emptying, small bowel and colonic transit studies
HIDA studies including for sphincter of Oddi dysfunction and bile leak
Bile acid malabsorption studies
Meckels scan
Somatostatin receptor imaging
FDG PET-CT for a range of GI tract malignancies

Conclusion

GI Nuclear medicine studies can be underutilised for the diagnosis of GI pathologies. Knowledge of the indications and limitations can be a useful tool in the armoury of an abdominal radiologist.