Articles

Articles are a collaborative effort to provide a single canonical page on all topics relevant to the practice of radiology. As such, articles are written and edited by countless contributing members over a period of time. A global group of dedicated editors oversee accuracy, consulting with expert advisers, and constantly reviewing additions.

74 results found
Article

Anal cancer (staging)

The most recent version of TNM staging of anal cancer is as follows: Primary tumour (T) TX: primary tumour cannot be assessed T0: no evidence of primary tumour Tis: carcinoma in situ (Bowen disease, high-grade squamous intraepithelial lesion [HSIL], anal intraepithelial neoplasia II-III (AIN...
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Binet staging system for chronic lymphocytic leukaemia

The Binet staging system is one of the two staging systems currently adopted in assessment of chronic lymphocytic leukaemia (CLL). It classifies CLL according to the number of lymphoid tissues that are involved (i.e. the spleen and the lymph nodes of the neck, groin, and underarms), as well as ...
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Breast cancer (staging)

Breast cancer staging uses the TNM staging system and then into stage groupings. Classification TNM staging Primary tumour (T) Tx: primary tumour cannot be assessed T0: no evidence of primary tumour Tis: carcinoma in situ T1 T1a: 0.1-0.5 cm T1b: 0.5-1.0 cm T1c: 1.0- 2.0 cm T2: 2-5 cm ...
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Cancer staging list

Cancer staging using a number of systems to help direct treatment and aid prognosis.  Staging systems TNM FIGO (in gynaecological cancer) Dukes staging system Examples Breast breast cancer staging Chest lung cancer staging malignant pleural mesothelioma staging Gastrointestinal oesop...
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Cervical cancer (staging)

Staging of cervical cancer can either be based on the TNM or FIGO system. Revised FIGO staging of cervical carcinoma 2009 8 stage 0: cervical intraepithelial neoplasia (HSIL or CIN III)  stage I: confined to cervix stage Ia: invasive carcinoma only diagnosed by microscopy. Ia1: stromal inva...
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Cervical intraepithelial neoplasia (staging)

Cervical intraepithelial neoplasia (CIN) (also known as cervical dysplasia) is the potentailly premalignant stage in the dysplastic changes in the squamous epithelium of the cervix.  Grading of CIN is based on the degree of dysplasia seen in a sample of cervical tissue: CIN I similar to condy...
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Cervical lymph node (staging)

Cervical lymph node staging is important in a variety of tumours, especially squamous cell carcinoma of the head and neck. TNM nodal staging Nodal staging is the same for squamous cell carcinomas of most regions of the upper aerodigestive tract of the head and neck, including those of the of t...
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Choi response criteria

Use only the size of the tumor during evaluation of response to chemotherapy has some pitfalls and limitations, especially when the estimated response for specific tumors such as gastrointestinal stromal tumour (GIST). The Choi response criteria for GIST proposed that tumour attenuation could p...
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Cholangiocarcinoma (staging)

Cholangiocarcinoma staging is dependant on whether the tumour is primarily intrahepatic (ICC), hilar/perihilar (Klatskin), or extrahepatic. Tumour resection is currently the most optimal treatment and the ability of the tumour to infiltrate longitudinally and radially along the biliary tree nec...
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Choriocarcinoma (staging)

The staging system for choriocarcinoma (usually refers to uterine choriocarcinoma) is the FIGO staging system and is as follows 1: stage I:  disease limited to the uterus stage II: disease out of the uterus but limited to the female genital tract stage III: metastasis in the lung with or with...
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Colorectal cancer (staging)

Colorectal carcinoma staging can be performed using two systems. The traditional Dukes staging system has largely been replaced by the TNM system, but is nonetheless often used clinically. Staging Dukes (Astler-Coller modification) stage A: confined to mucosa stage B: through muscularis prop...
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Deauville five-point scale

The Deauville five-point scale (Deauville 5ps) is an internationally-recommended scale for routine clinical reporting and clinical trials using FDG-PET/CT in the initial staging and assessment of treatment response in Hodgkin lymphoma (HL) and certain types of non-Hodgkin lymphomas (NHL).  Incl...
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Dukes staging system for colorectal cancer

The Dukes staging system is a classification system for colorectal cancer. This system is now mainly of historical interest as it has largely been replaced by the TNM staging system. It is not recommended for clinical practice. Dukes A: invasion into but not through the bowel wall (90% 5 year s...
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ECOG performance status

The Eastern Cooperative Oncology Group (ECOG) is one of the largest clinical cancer research organizations in the United States and conducts clinical trials in all types of adult cancers. The ECOG performance status is a scale used to assess how a patient's disease is progressing, assess how th...
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Endometrial carcinoma (staging)

Endometrial carcinoma staging allows appropriate treatment options to be considered and enables greater prognostic accuracy for endometrial carcinoma.  Staging Staging can be based on the TNM or FIGO system.  MR imaging is the modality of choice for staging with CT having relatively low speci...
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Enneking surgical staging system

The Enneking surgical staging system (also known as the MSTS system) is based on tumour grade, local spread and metastatic disease of malignant musculoskeletal tumours. It does not classify skull tumours or marrow-originating tumours (e.g. lymphoma, plasmacytoma / multiple myeloma, Ewing sarcom...
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FIGO staging system

The FIGO staging systems are determined by the International Federation of Gynecology and Obstetrics (Fédération Internationale de Gynécologie et d’Obstétrique). In general, there are five stages: stage 0: carcinoma in situ (common in cervical, vaginal, and vulval cancer) stage I: confined to...
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Gleason score

The Gleason score determines the histological grading of prostate cancer. A score of 1 to 5 is assigned to each of the two largest areas of tumour involvement in the samples obtained, based on the worst feature. 1: least aggressive 5: most aggressive These two scores are then added together t...
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Head and neck cancer therapy response interpretation (Hopkins criteria)

The head and neck cancer therapy response interpretation (Hopkins criteria) is a qualitative system of interpretation for therapy response assessment using PET-CT. Background Widely used options for therapy response assessment are clinical examination, histopathology, CT  and MR imaging, howev...
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Hepatoblastoma (staging)

As expected there are a number of different staging systems for hepatoblastoma. Staging PRETEXT grouping system of paediatric liver tumours not specific to hepatoblastoma; used in all paediatric liver tumours Intergroup staging system specific for hepatoblastoma (see below) Intergroup stag...
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Hepatocellular carcinoma (staging)

Hepatocellular carcinoma staging classifications supersede the typical TNM staging system seen in most other epithelial cancers, as the TNM staging system has been found to not be as prognostically useful for stratification of patients with hepatocellular carcinoma. Several substitute staging sy...
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Hypopharyngeal squamous cell carcinoma (staging)

Staging of hypopharyngeal squamous cell carcinoma is performed using the TNM staging system. TNM staging Primary tumour staging (T) T1: limited to 1 subsite AND tumour size ≤ 2 cm in greatest dimension T2: extends into adjacent subsite or area (larynx, oropharynx) and/or tumour size betw...
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Hypopharyngeal tumours (T staging)

T staging of hypopharyngeal tumours is as follows: Definition The hypopharynx includes the pyriform sinuses, the lateral and posterior hypopharyngeal walls, and the postcricoid region. T1: tumour is limited to one subsite of the hypopharynx and 2 cm or less in greatest dimension T2: tumour i...
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iRANO criteria

The immunotherapy response assessment for neuro-oncology (iRANO) criteria have been developed as a modification of RANO criteria to address the challenges of emerging novel immunotherapy for high-grade gliomas 1. Although these criteria have been primarily for the purposes of standardising asses...
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Juvenile nasopharyngeal angiofibromas (staging)

Staging of juvenile nasopharyngeal angiofibromas is performed with cross-sectional imaging and relies on the identification of local tumour extent, and invasion of adjacent spaces. For a discussion of this entity please refer to the parent article: juvenile nasopharyngeal angiofibroma.  The sta...
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Laryngeal squamous cell carcinoma (staging)

Laryngeal squamous cell carcinoma staging uses the TNM staging system and actual staging is subsite (see laryngeal subsites) specific for T1-3. A rough approximation for all subsites is T1: limited to one subsite and normal cord mobility T2: more than one subsite and impaired cord mobility (bu...
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Legg-Calvé-Perthes disease (staging)

Staging of Legg-Calve-Perthes syndrome refers to x-ray abnormalities, and represents 4 phases of the disease: stage I: early asymmetric femoral epiphyseal size (smaller on the affected side) apparent increased density of the femoral head epiphysis widening of the medial joint space blurring...
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Liver cancer (BCLC staging)

Barcelona clinic liver cancer (BCLC) staging uses a set of criteria to guide management of patients with hepatocellular carcinoma (HCC). The classification takes the following variables into account 1,2: performance status (PS)  Child-Pugh score radiologic tumour extent tumour size multipl...
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Lugano classification: response evaluation criteria for CT and PET/CT

The Lugano classification recommends two methods of visualization for standing lymphoma: Computer tomography (CT) Positron emission tomography–computed tomography (PET/CT) Response Assessment on CT   CT uses for the standing of all types of lymphoma (if CT is performed for tumor size measure...
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Lung cancer (staging - IASLC 7th edition - superseded)

The IASLC (International Association for the Study of Lung Cancer) 7th edition lung cancer staging system was proposed in 2010 and has now been updated and superseded by the 8th edition, published in 2016. Small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) used to be staged di...
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Lung cancer (staging - IASLC 8th edition)

The IASLC (International Association for the Study of Lung Cancer) 8th edition lung cancer staging system was introduced in 2016 and supersedes the IASLC 7th edition.  TNM system T: primary tumour Tx: primary tumour cannot be assessed or tumour proven by the presence of malignant cells in spu...
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Lymphoma (staging)

There are a number of lymphoma staging systems for both Hodgkin lymphoma and non-Hodgkin lymphoma including the Ann Arbor classification, Cotswolds-modified Ann Arbor classification, and the most current, Lugano classification.  Evolution of lymphoma staging and treatment response evaluation cr...
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Malignant pleural mesothelioma (staging)

A number of staging systems have been described for staging of malignant pleural mesothelioma. Below is the International Mesothelioma Interest Group TNM staging system. TNM T - Tumour Tx: primary tumour cannot be assessed T0: no evidence of primary tumour T1a potentially resectable only ...
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Masaoka staging system of thymoma

The Masaoka staging system is commonly adopted for thymomas 1-3, and is the most important determinant of survival following surgical resection 4: stage I: intact thymic capsule stage II: capsular invasion into adjacent mediastinal fat or pleura stage III: macroscopic invasion into adjacent o...
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Modified Ringertz grading system for diffuse astrocytomas

The modified Ringertz grading system has historically been one of the more frequently used grading systems for diffuse astrocytomas, but has not essentially been replaced by the WHO grading system. Unlike the WHO grading system and St Anne-Mayo grading system (also known as the Dumas-Duport gra...
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Nasopharyngeal carcinoma (staging)

Nasopharyngeal carcinoma staging uses the TNM staging system with derived stage groupings.  TNM staging Primary tumour (T) Tx: primary tumour cannot be assessed T0: no evidence of primary tumour Tis: carcinoma in situ T1: tumour is confined to the nasopharynx T2: tumour extends to soft ti...
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Necrotising enterocolitis (staging)

Necrotising enterocolitis (NEC) can be staged into three groups, helping to guide appropriate treatment. In general, stage I and II are managed medically whereas stage III is managed surgically. stage I clinical signs lethargy, temperature instability, apnoea, bradycardia emesis, abdominal d...
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Neuroblastoma (staging)

There are two methods of neuroblastoma staging, one that is based on post-operative patients (INSS) and one developed for pre-treatment patients (INRGSS). Staging International Neuroblastoma Staging System (INSS) This staging system is for post-operative patients and mainly for prognosis 1: ...
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Oesophageal cancer (staging)

Oesophageal cancer staging can depend slightly on whether the tumour is squamous cell or adenocarcinoma subtype. Due to the lack of a serosal layer, oesophageal cancer often tends to have mediastinal spread at the time of diagnosis. Staging TNM staging T staging Tx: primary tumour cannot be...
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Okuda staging system

The Okuda staging system was an advance on earlier hepatocellular (HCC) staging classifications, in that it incorporated both cancer-related variables and liver function related variables to determine prognosis 1: disease involving >50% of hepatic parenchyma ascites albumin ≤3 mg/dL bilirubi...
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Olfactory neuroblastoma (staging)

Olfactory neuroblastomas (or esthesioneuroblastomas) are most frequently staged using a system proposed by Kadish et al. in 1976 1. group a: limited to the nasal cavity group b: limited to the nasal cavity and paranasal sinuses group c: extends beyond the nasal cavity and paranasal sinuses: ...
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Oral cavity tumours (T staging)

T staging of oral cavity tumours is as follows: Oral cavity The anterior border of the oral cavity is the junction of the skin and vermilionborder of the lip. The posterior border is formed by the junction of the hard and soft palates superiorly, the circumvallate papillae inferiorly, and the ...
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Oropharyngeal tumours (T staging)

T staging of oropharyngeal tumours is as follows: Definition The oropharynx includes the base of the tongue, the inferior surface of the soft palate and uvula, the anterior and posterior tonsillar pillars, the glossotonsillar sulci, the pharyngeal tonsils, and the lateral and posterior pharyng...
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Osteochondritis dissecans (surgical staging)

Osteochondritis dissecans can be classified at surgery into 4 stages: stage I stable lesion in continuity with the host bone covered by intact cartilage stage II stable on probing partial discontinuity of the lesion from the host bone stage III unstable on probing fragment not dislocat...
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Ovarian cancer (staging)

The most commonly adopted ovarian cancer staging system is the FIGO staging system. The most recent staging system is from 2014 1: CT is considered the best imaging modality for staging ovarian cancer. 4. stage I:  tumour limited to the ovary or fallopian tube stage Ia:  ​tumour limited to o...
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Paediatric liver tumour (PRETEXT grouping system)

The PRETEXT system proposed by the International Childhood Liver Tumours Strategy Group (previously called Société Internationale d’Oncologie Pédiatrique - Epithelial Liver Tumour Study Group - SIOPEL) aims for staging and risk stratification of liver tumours at diagnosis.  It is used to descri...
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Pancreatic ductal adenocarcinoma (staging)

Staging of pancreatic ductal adenocarcinoma is traditionally done according to American Joint Committee on Cancer (AJCC) / Union for International Cancer Control (IUCC) TNM system.  In 2017 new edition (8th edition) AJCC published with some major changes; now exocrine and endocrine tumours of th...
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PERCIST

Positron Emission Tomography Response Criteria in Solid Tumors (PERCIST) make use of positron emission tomography (PET) to provide functional information to help determine tumour viability. The criteria consist of four categories: complete metabolic response (CMR), partial metabolic response (P...
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Primary fallopian tube carcinoma (staging)

The staging used for primary fallopian tubal carcinoma is the FIGO system and is as follows: stage I: limited to fallopian tubes stage Ia: limited to lining of one fallopian tube (intraluminal) stage Ib: limited to inner linings of both tubes (intraluminal) stage Ic: invasion beyond the inne...
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Primary urethral cancer (staging)

Primary urethral cancer staging often uses the TNM system and is as follows: TNM staging Primary tumour staging (T) Tx: primary tumour cannot be assessed T0: no evidence of primary tumour Tis: carcinoma in situ Ta: non-invasive papillary, polypoid, or verrucous carcinoma T1: invasion of s...
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Prostate cancer (staging)

Prostate cancer staging can be thought of in terms of physical location or grading histologically. The TNM classification is used to determine spread, and the Gleason score is used to determine the histological type. Another staging system is the Jewett-Whitmore staging system. Additionally, th...
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Rai staging system for chronic lymphoid leukaemia

The Rai staging system is one of the two staging systems currently adopted in assessment of chronic lymphocytic leukaemia (CLL). It comprises of stages 0 to IV and classifies chronic lymphocytic leukemia into low, intermediate and high-risk categories, which correspond with stages 0, I & II, an...
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Rectal cancer (staging)

Staging strongly influences the success of and rate of local recurrence following rectal cancer resection. MRI is the modality of choice for the staging of rectal cancer, to guide surgical and non-surgical management options. MRI is used at diagnosis, following downstaging chemoradiotherapy, and...
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Renal cell carcinoma (TNM staging)

Renal cell carcinoma staging using the TNM staging system for renal cell carcinoma. Older but still widely used system in some practices is the Robson staging system. TNM staging (7th edition) T T1 T1a: tumour confined to kidney, <4 cm T1b: ltumour confined to kidney, >4 cm but <7 cm T2: l...
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Retinoblastoma (staging)

Retinoblastoma staging can be via a number of systems with various end-points and multiple systems are often used concurrently. Staging Reese Ellsworth classification The Reese Ellsworth classification is assessed with fundoscopy and aims at predicting the chance of preserving the eye with ex...
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Rhabdomyosarcoma (staging)

Staging of rhabdomyosarcoma is based on the Lawrence/Gehan Staging System which comprises of a combination of pretreatment staging and postoperative clinical grouping. Stage stage I: orbit, eyelid, head and neck (excluding parameningeal), genitourinary (non-bladder, non-prostate), N0 or 1, M0 ...
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Robson staging system of renal cell carcinoma

Robson staging of renal cell carcinoma (RCC) is simple but has largely been replaced by the TNM system (see renal cell cancer staging article). Robson staging revolves around the relationship to Gerota's fascia, involvement of renal vein and regional nodes. stage I: limited to kidney stage II:...
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Siltzbach sarcoidosis chest radiographic staging system

Siltzbach system is a chest radiographic staging method for sarcoidosis. stage 0: normal chest radigraph: 10% at time of diagnosis stage I: lymph node enlargement: 50% at time of diagnosis stage II: lymph node enlargement and pulmonary opacities: 30% at time of diagnosis stage III: pulmonary...
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Small cell lung cancer (staging - superseded)

Previously, small cell lung cancer (SCLC) was not staged in the same manner as non-small cell lung cancer (NSCLC), but since 2013 both are staged using the IASLC (International Association for the Study of Lung Cancer) lung cancer staging system (currently in its 8th edition, published in 2016)....
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Squamous cell carcinoma of the oral cavity (staging)

Staging of oral cavity squamous cell carcinoma uses the TNM staging system. Primary tumour staging (T) Tx - tumour cannot be assessed T0 - no evidence of primary tumour Tis - carcinoma in situ T1 - tumour 2 cm or less in greatest dimension T2 - tumour greater than 2 cm and less than 4 cm i...
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Squamous cell carcinoma of the penis (staging)

Squamous cell carcinoma of the penis arises most commonly at the distal end of the penile urethra with local invasion of the glans. In addition to TNM classification, the following staging is used: Staging stage I: confined to the glans or foreskin stage II: invasion of penile shaft stage I...
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Suzuki staging system for Moyamoya

The staging system for moyamoya disease first described by Suzuki and Takaku in their seminal 1969 article1 is still in use today. Formally, the staging refers to findings on conventional angiography, although there are efforts to apply similar systems to MR angiography.2 Suzuki stage appears t...
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Testicular cancer (staging)

The staging for testicular tumours is performed according to the TNM system with staging groupings. It can be remembered in its abbreviated form as:  stage I: confined to testis, epididymis, spermatic cord, scrotum stage II: lymph nodes involved but no distant metastases and serum tumour marke...
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Thyroid cancer (staging)

Successful treatment of thyroid cancer highly depends on accurate preoperative staging. Ultrasound and ultrasound-guided FNA or core biopsy remain the investigation of choice for diagnosing primary thyroid malignancies. CT and MRI are inferior to ultrasound for characterising thyroid nodules, h...
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TNM staging system

The TNM system has been widely adopted in many areas as a replacement for idiosyncratic disease specific systems. The precise details depend on the primary tumour site and/or histology but in general: TNM T: Tumour Tx: primary tumour cannot be assessed T0: no evidence of primary tumour Tis:...
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Transitional cell carcinoma of the bladder (staging)

Transitional cell carcinoma of the bladder staging uses the TNM system which has replaced the previously widely used Jewett-Scott-Marshall tumour staging system. It is very similar to the staging of TCC of the renal pelvis and staging of TCC of the ureter. TNM staging T Ta: non-invasive papil...
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Transitional cell carcinoma of the renal pelvis (staging)

Transitional cell carcinoma of the renal pelvis staging uses the TNM system and is very similar to staging of TCC of the bladder and to staging of TCC of the ureter. TNM staging T Ta: noninvasive papillary tumour Tis: in situ (noninvasive flat) T1: through lamina propria into sub-epithelial...
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Transitional cell carcinoma of the ureter (staging)

Transitional cell carcinoma of the ureter staging uses the TNM system and is very similar to staging of TCC of the bladder and to staging of TCC of the renal pelvis.  TNM staging T Ta: noninvasive papillary tumour Tis: in situ (noninvasive flat) T1: through lamina propria into sub-epithelia...
Article

Transitional cell carcinoma (staging)

Staging of transitional cell carcinomas of the urinary tract vary according to the location of the tumour, and are staged using the TNM staging system.  transitional cell carcinoma of the renal pelvis transitional cell carcinoma of the ureter transitional cell carcinoma of the bladder  
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Vaginal cancer (staging)

The staging of primary vaginal cancer covers for all histological sub types and is as follows FIGO staging system stage 0: carcinoma in situ stage I: tumour confined to vagina stage II: invasion of paravaginal tissues but no extension beyond pelvic side walls stage III: extension to pelvic ...
Article

Visceral pleural invasion

Visceral pleural invasion is a feature that can be seen in lung cancers. It is defined as tumour extension beyond the elastic layer of the visceral pleura. It is considered an aggressive sign and one of the most important adverse prognostic factors in non-small cell lung cancers 1. Pathology G...
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Vulval cancer (staging)

Staging of vulval cancer is the FIGO staging system and is as follows: stage 0: carcinoma in situ (pre-invasive); corresponds to Tis stage I: tumour <2cm (greatest dimension) and confined to vulva/perineum; corresponds to T1 stage Ia: stromal invasion by <1mm Stage Ib: stromal invasion by >1...
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WHO criteria in tumour response

The WHO criteria have been developed in the 1980s to standardised reporting of cancers in clinical trial.​ These criteria Nowadays, newer criteria often based on the WHO criteria (such as RECIST, mRECIST, Choi criteria, Lugano response criteria), have widely replaced the WHO criteria in clinical...
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Wilms tumour (staging)

Wilms' tumour staging is largely anatomical and relates to the invasion and spread of the tumour. Where there is invasion or metastasises, prognosis is poorer. Wilms tumour, is one of the more common childhood malignancies. stage I confined to kidney complete resection possible stage II loc...

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