Radiologic Clinics of North America RSS feed: Current Issue. Radiologic Clinics of North America brings you comprehensive, clinical information that can be applied directly to your practice. Each bimonthly issue covers one current topic in radiology under the guidance of a guest editor specializing in the field. You'll find detailed articles written by leading experts, along with high-quality reproductions of radiographs, MR images, CT scans and sonograms. In addition, you can earn valuable CME credits - up to 90 per year - with your subscription. http://www.radiologic.theclinics.com/?rss=yesElsevier Inc.en © 2012 Published by Elsevier Inc. All rights reserved. Radiologic Clinics of North America0033-8389503May 2012 © 2012 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.radiologic.theclinics.com/article/PIIS003383891200070X/abstract?rss=yesContributors10.1016/S0033-8389(12)00070-XRadiologic Clinics of North America 50, 3 (2012)2012-05-01Radiologic Clinics of North America2012-05-01503S0033-8389(11)X0009-Xiiiivhttp://www.radiologic.theclinics.com/article/PIIS0033838912000711/abstract?rss=yesContents10.1016/S0033-8389(12)00071-1Radiologic Clinics of North America 50, 3 (2012)2012-05-01Radiologic Clinics of North America2012-05-01503S0033-8389(11)X0009-Xvviihttp://www.radiologic.theclinics.com/article/PIIS0033838912000796/abstract?rss=yesCME Accreditation Page and Author Disclosure10.1016/j.rcl.2012.04.016Radiologic Clinics of North America 50, 3 (2012)2012-05-01Radiologic Clinics of North America2012-05-01503S0033-8389(11)X0009-Xviiiviiihttp://www.radiologic.theclinics.com/article/PIIS0033838912000735/abstract?rss=yesForthcoming Issues10.1016/S0033-8389(12)00073-5Radiologic Clinics of North America 50, 3 (2012)2012-05-01Radiologic Clinics of North America2012-05-01503S0033-8389(11)X0009-Xixixhttp://www.radiologic.theclinics.com/article/PIIS0033838912000243/abstract?rss=yesImaging of the pancreas continues to evolve with both advances in diagnostic capabilities as well as improvement in image-guided therapeutic techniques for a variety of pancreatic diseases. Progressive understanding of the pathogenesis of common pancreatic diseases, such as acute pancreatitis, and discovery or enhanced recognition of pancreatic pathologies due to both broader applications of imaging strategies as well as improvements in imaging techniques requires a practicing radiologist to keep abreast of the latest information from the literature. This issue of Radiologic Clinics North America is devoted to the practice of Pancreatic Imaging. A fantastic group of internationally recognized pancreas imaging experts has been tapped to succinctly convey state-of-the-art imaging approaches for a vast array of pancreatic diseases. These categories of pancreatic disorders will be presented to the readers in familiar divisions, with some overlap of technical issues pertinent to the disease process being discussed. Articles on imaging as it relates to pancreatic surgery and endoscopic interventions are also included to enhance understanding of the complex interdisciplinary issues often required in caring for patients with pancreatic disorders. In addition to articles devoted specifically to the “nuts and bolts” of state-of-the-art pancreas diagnostic techniques, an emphasis on more advanced imaging applications, such as microbubble contrast-enhanced sonography, diffusion and perfusion magnetic resonance imaging, and low kVp and dual energy MDCT, are introduced. The latter allow practicing radiologists to familiarize themselves with these further advances in pancreatic imaging that will become mainstream and widely available to clinicians in the not too distant future.PrefaceDesiree E. Morgan, Koenraad J. Mortele10.1016/j.rcl.2012.03.013Radiologic Clinics of North America 50, 3 (2012)2012-05-01Radiologic Clinics of North America2012-05-01503S0033-8389(11)X0009-Xxixihttp://www.radiologic.theclinics.com/article/PIIS0033838912000231/abstract?rss=yesMultidetector-row CT (MDCT) imaging of the pancreas has important roles in diagnosis, staging, and treatment monitoring of a vast array of pancreatic diseases. Optimizing MDCT protocols not only requires an understanding of expected pathologies but also must take into account cumulative radiation dose considerations.MDCT Evaluation of the Pancreas: Nuts and BoltsMustafa R. Bashir, Rajan T. Gupta10.1016/j.rcl.2012.03.012Radiologic Clinics of North America 50, 3 (2012)2012-05-01Radiologic Clinics of North America2012-05-01503S0033-8389(11)X0009-X365377http://www.radiologic.theclinics.com/article/PIIS0033838912000140/abstract?rss=yesPancreatic magnetic resonance (MR) imaging has become a useful tool in evaluating pancreatic disorders. Technical innovations in MR imaging have evolved over the last decade, with most sequences being performed in one or a few breath-holds. Three-dimensional sequences with thin, contiguous slices allow for improved spatial resolution on the postgadolinium images and MR cholangiopancreatography (MRCP). The diagnostic potential of MRCP is equivalent to endoscopic retrograde pancreatography, particularly when intravenous secretin is used to enhance the pancreatic duct assessment. This article highlights the advantages and disadvantages of state-of-the-art and emerging pulse sequences and their application to imaging pancreatic diseases.MR Imaging Techniques for PancreasTemel Tirkes, Christine O. Menias, Kumaresan Sandrasegaran10.1016/j.rcl.2012.03.003Radiologic Clinics of North America 50, 3 (2012)2012-05-01Radiologic Clinics of North America2012-05-01503S0033-8389(11)X0009-X379393http://www.radiologic.theclinics.com/article/PIIS0033838912000218/abstract?rss=yesAlthough the pancreas is often thought of as an organ that is difficult to explore using ultrasound (US), because of its deep retroperitoneal location, with the appropriate technique it can be studied successfully in most patients. In this article, the authors discuss the use of available US techniques in the diagnosis of the most common pancreatic diseases, the use of US intraoperatively, and the use of sonographic guidance for diagnostic and therapeutic procedures. The authors also briefly discuss the potential use of elastosonography techniques in the evaluation of pancreatic disease.Ultrasonography of the PancreasGiulia A. Zamboni, Maria Chiara Ambrosetti, Mirko D'Onofrio, Roberto Pozzi Mucelli10.1016/j.rcl.2012.03.010Radiologic Clinics of North America 50, 3 (2012)2012-05-01Radiologic Clinics of North America2012-05-01503S0033-8389(11)X0009-X395406http://www.radiologic.theclinics.com/article/PIIS003383891200019X/abstract?rss=yesBecause of the evolution of treatment strategies staging criteria for pancreatic cancer now emphasize arterial involvement for determining unresectable disease. Preoperative therapy may improve the likelihood of margin negative resections of borderline resectable tumors. Cross-sectional imaging is crucial for correctly staging patients. Magnetic resonance (MR) imaging and computed tomography (CT) are probably comparable, with MR imaging probably offering an advantage for identifying liver metastases. Positron emission tomography/CT and endoscopic ultrasound may be helpful for problem solving. Clear and concise reporting of imaging findings is important. Several national organizations are developing templates to standardize the reporting of imaging findings.Imaging of Pancreatic Adenocarcinoma: Update on Staging/ResectabilityEric P. Tamm, Aparna Balachandran, Priya R. Bhosale, Matthew H. Katz, Jason B. Fleming, Jeffrey H. Lee, Gauri R. Varadhachary10.1016/j.rcl.2012.03.008Radiologic Clinics of North America 50, 3 (2012)2012-05-01Radiologic Clinics of North America2012-05-01503S0033-8389(11)X0009-X407428http://www.radiologic.theclinics.com/article/PIIS0033838912000498/abstract?rss=yesAcute pancreatitis is an acute inflammatory process of the pancreatic gland with increasing incidence worldwide. Usually the clinical presentation and course are mild, with an uneventful recovery. In 10% to 20% of patients, however, local and systemic complications develop, resulting in significant morbidity and mortality. In 1992, the Atlanta symposium provided definitions for acute pancreatitis and its severity. Insights into the pathophysiology of the disease, improved diagnostic imaging, and implementation of minimally invasive techniques have led to classification updates. This article reviews the cross-sectional imaging features of acute pancreatitis and presents proposed definitions of the revised Atlanta classification.Imaging of Acute Pancreatitis: Update of the Revised Atlanta ClassificationThomas L. Bollen10.1016/j.rcl.2012.03.015Radiologic Clinics of North America 50, 3 (2012)2012-05-01Radiologic Clinics of North America2012-05-01503S0033-8389(11)X0009-X429445http://www.radiologic.theclinics.com/article/PIIS0033838912000164/abstract?rss=yesMultiple disorders may cause chronic pancreatitis (CP) through recurrent inflammation of the pancreatic parenchyma. Chronic calcifying pancreatitis caused by excessive alcohol intake accounts for most cases of CP. However, there are multiple other causes of CP, including obstructive chronic pancreatitis, autoimmune pancreatitis, groove pancreatitis, tropical, and hereditary pancreatitis. This article reviews the multiple imaging techniques, some of which are accepted as first-line modalities in patients with suspected CP, and the imaging features associated with the different causes of CP.Imaging of Chronic Pancreatitis (Including Groove and Autoimmune Pancreatitis)Rocio Perez-Johnston, Nisha I. Sainani, Dushyant V. Sahani10.1016/j.rcl.2012.03.005Radiologic Clinics of North America 50, 3 (2012)2012-05-01Radiologic Clinics of North America2012-05-01503S0033-8389(11)X0009-X447466http://www.radiologic.theclinics.com/article/PIIS0033838912000127/abstract?rss=yesCystic tumors of the pancreas are a subset of rare pancreatic tumors that vary from benign to malignant. Many have specific imaging findings that allow them to be differentiated from each other. This article (1) reviews the imaging features of the common cystic pancreatic lesions, including serous microcystic adenoma, mucinous cystic tumor, intraductal papillary mucinous tumor, and solid pseudopapillary tumor, and including the less common lesions such as cystic endocrine tumors, cystic metastases, cystic teratomas, and lymphangiomas; and (2) provides comprehensive algorithms on how to manage the individual lesions, with recommendations on when to reimage patients.Cystic Tumors of the Pancreas: Imaging and ManagementCatherine E. Dewhurst, Koenraad J. Mortele10.1016/j.rcl.2012.03.001Radiologic Clinics of North America 50, 3 (2012)2012-05-01Radiologic Clinics of North America2012-05-01503S0033-8389(11)X0009-X467486http://www.radiologic.theclinics.com/article/PIIS0033838912000176/abstract?rss=yesUnderstanding pancreatic development and the congenital anomalies and variants that result from alterations in normal development allows for better recognition of these anomalies at diagnostic imaging. This article reviews normal pancreatic embryology and anatomy, and the appearance of the more common developmental anomalies and ductal variants, with emphasis on computed tomography and magnetic resonance imaging. Common mimics of masses are also covered.Congenital Pancreatic Anomalies, Variants, and ConditionsLauren F. Alexander10.1016/j.rcl.2012.03.006Radiologic Clinics of North America 50, 3 (2012)2012-05-01Radiologic Clinics of North America2012-05-01503S0033-8389(11)X0009-X487498http://www.radiologic.theclinics.com/article/PIIS0033838912000206/abstract?rss=yesThe vast array of possible histologies for a given pancreatic mass makes the specific diagnosis of a solid pancreatic mass in an individual patient challenging. This article discusses and reviews the imaging findings of those entities that are likely to be encountered in clinical practice, specifically pancreatic endocrine tumors, solid pseudopapillary tumor, secondary pancreatic masses, and heterotopic spleen.Unusual Solid Pancreatic TumorsAlec J. Megibow10.1016/j.rcl.2012.03.009Radiologic Clinics of North America 50, 3 (2012)2012-05-01Radiologic Clinics of North America2012-05-01503S0033-8389(11)X0009-X499513http://www.radiologic.theclinics.com/article/PIIS003383891200022X/abstract?rss=yesIn this article's coverage of miscellaneous pancreatic topics, a brief review of pancreatic trauma; pancreatic transplantation; rare infections, such as tuberculosis; deposition disorders, including fatty replacement and hemochromatosis; cystic fibrosis; and others are discussed with pertinent case examples.Imaging of Miscellaneous Pancreatic Pathology (Trauma, Transplant, Infections, and Deposition)Nagaraj-Setty Holalkere, Jorge Soto10.1016/j.rcl.2012.03.011Radiologic Clinics of North America 50, 3 (2012)2012-05-01Radiologic Clinics of North America2012-05-01503S0033-8389(11)X0009-X515528http://www.radiologic.theclinics.com/article/PIIS0033838912000152/abstract?rss=yesPancreatic surgery, until the Whipple era in the early 1900s, was once regarded as calamitous by most surgeons. With advances in surgical techniques, operative mortality has been greatly reduced, although morbidity remains a significant problem. Knowledge of the surgical options for treatment of pancreatic neoplastic and inflammatory disease is important for the practicing radiologist, to anticipate and identify complications commonly sought and well depicted with imaging.Imaging After Pancreatic SurgeryDesiree E. Morgan10.1016/j.rcl.2012.03.004Radiologic Clinics of North America 50, 3 (2012)2012-05-01Radiologic Clinics of North America2012-05-01503S0033-8389(11)X0009-X529545http://www.radiologic.theclinics.com/article/PIIS0033838912000139/abstract?rss=yesBoth endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) play critical roles in the diagnosis and management of a wide variety of pancreatic disorders from pancreatitis to pancreatic cancer. ERCP has become primarily a therapeutic procedure for managing both acute and chronic pancreatitis and their complications, whereas EUS mainly provides diagnosis of chronic pancreatitis, pancreatic cysts, and pancreatic masses. EUS has begun to enter therapeutics with endoscopic cystgastrostomy, necrosectomy, celiac plexus neurolysis/block, and as an adjunct to ERCP to gain access to the pancreatic duct.Update on Advanced Endoscopic Techniques for the Pancreas: Endoscopic Retrograde Cholangiopancreatography, Drainage and Biopsy, and Endoscopic UltrasoundLinda S. Lee, Darwin L. Conwell10.1016/j.rcl.2012.03.002Radiologic Clinics of North America 50, 3 (2012)2012-05-01Radiologic Clinics of North America2012-05-01503S0033-8389(11)X0009-X547561http://www.radiologic.theclinics.com/article/PIIS0033838912000784/abstract?rss=yesIndex10.1016/S0033-8389(12)00078-4Radiologic Clinics of North America 50, 3 (2012)2012-05-01Radiologic Clinics of North America2012-05-01503S0033-8389(11)X0009-X563568