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.

79 results found
Article

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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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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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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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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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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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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Non small cell lung cancer (IASLC 8th edition staging)

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.  It is as follows: TNM system T: primary tumour Tx: primary tumour cannot be assessed or tumour proven by presence of maligna...
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Lung cancer (IASLC 7th edition staging)

The International Association for the Study of Lung cancer (IASLC) 7th edition for lung cancer staging is as follows. This has now been updated and superseded by the 8th edition in 2016. T staging descriptor The parameters assessed on the T stage include size, endobronchial location, local inv...
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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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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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Traumatic abruption placenta scale

The traumatic abruption placenta scale (TAPS) was devised to stratify placental injury findings on CT. Since placental abruption is a concern in a pregnant patient who has undergone traumatic injury, CT is occasionally the first imaging modality used to evaluate the placenta. 0: normal homogene...
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Small cell lung cancer (staging)

Previously, small cell lung cancer was not staged in the same manner as non small cell lung cancer, on account of its being almost never resectable at the time of diagnosis, except in rare cases where it appears as a solitary pulmonary nodule. limited disease confined to one hemithorax inclus...
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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 papi...
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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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Osteoarthritis of the hip (grading)

Osteoarthritis of the hip can be graded according to severity on imaging. Conventional radiograph grading grade 0: normal grade 1: possible joint space narrowing and subtle osteophytes grade 2: definite joint space narrowing, defined osteophytes and some sclerosis, especially in the acetabul...
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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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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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Non small cell lung cancer (staging) - 7th edition

Non-small cell lung cancer (NSCLC) staging can be accomplished both by the TNM system or by the AJCC staging system. This staging has since been revised. See IASLC 8th edition staging. For a general discussion of these tumours please refer to the article on non-small cell lung cancer (NSCLC). ...
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Pancreatic ductal adenocarcinoma (staging)

Both endocrine and exocrine tumours of the pancreas are now staged by a single pancreatic staging system. Staging of pancreatic ductal adenocarcinoma is with the TNM system, and as a majority of tumours are not-resectable, this is mostly achieved with imaging (typically CT scan) although laparo...
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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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ACR Thyroid Imaging Reporting and Data System (ACR TI-RADS)

ACR TI-RADS is a reporting system for thyroid nodules on ultrasound proposed by the American College of Radiology (ACR) 1. This uses a standardised scoring system for reports providing users with recommendations for when to use fine needle aspiration (FNA) or ultrasound follow-up of suspicious ...
Article

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...
Article

Anterior cruciate ligament tear

Anterior cruciate ligament (ACL) tears are the most common knee ligament injury encountered in radiology practice. Pathology The ACL is the most commonly disrupted ligament of the knee, especially in athletes who participate in sports that involve rapid starting, stopping, and pivoting (e.g. s...
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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 number of Ts Ns and Ms depend on the tumour/site but in general: TNM T: Tumour Tx: primary tumour cannot be assessed T0: no evidence of primary tumour Tis: carcinoma in situ...
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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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Cervical degenerative spondylosis (grading)

Cervical degenerative changes can be graded using a very old but reliable classification given by Kellgren et al. It is based on findings on a lateral cervical spine radiograph although it can also be applied to MRI evaluation of spine. The key parameters are osteophyte formation, intervertebra...
Article

Deauville five-point scale

The Deauville five-point scale (Deauville 5ps) is an internationally recommended scale for clinical routine 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).  Inclusions FD...
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Hypopharyngeal tumours (T staging)

T staging of hypopharyngeal tumours is as follows: Definition The hypopharynx includes the pyriform sinuses, the lateraland 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 in...
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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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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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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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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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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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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...
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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...
Article

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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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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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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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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Rectal cancer (staging)

Staging strongly influences the success of, and rate of local recurrence following rectal cancer resection. In rectal cancer, pre-treatment MRI is the evaluation of choice, guiding surgical and non-surgical management options.  TNM staging See: TNM staging system for a general description. Pr...
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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...
Article

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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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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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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Mueller Weiss syndrome (staging)

Mueller Weiss syndrome refers to a spontaneous adult onset osteonecrosis of the tarsal navicular. This syndrome is multifactorial and related to chronic loading on a suboptimally ossified navicular bone which is susceptible to central osteonecrosis due to its centripetal blood supply. It is dist...
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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...
Article

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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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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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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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 Child-Pugh score tumour size multiple tumours vascular invasion no...
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Varicocele (grading on colour Doppler)

Varicocele grading can be done variably. The most elaborate and accepted grading was given by Sarteschi, which is briefed below.  For a general discussion of this condition refer to the article: varicocele. Evaluation first do a baseline grey scale study in supine position and measure the dia...
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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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Diffuse axonal injury (grading)

Grading of diffuse axonal injury has been described histologically according to the anatomic distribution of injury, which correlated with outcome 1-3. The classification was first proposed by Adams in 1989 4 and divides diffuse axonal injury (DAI) into three grades: grade I: involves grey-whit...
Article

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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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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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...
Article

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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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 ...
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Chondromalacia (grading)

Chondromalacia can be divided into 4 grades by MRI, typically using fat saturated proton density sequences. This grading system is the modified Outerbridge grading system, which was devised for arthroscopy initially for assessment of chondromalacia patella, but then modified and extended for all...
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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...
Article

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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Anal cancer (staging)

The accepted TNM staging of anal cancer is as follows 1: Primary tumour (T) TX: primary 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 >2 cm but <5 cm in greatest dimension T3: tumour >5 cm in gre...
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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:...
Article

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 ...
Article

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...
Article

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...
Article

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 t...
Article

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...
Article

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...
Article

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...
Article

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 ...
Article

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...
Article

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 non-small cell lung cancer staging small cell lung cancer staging malignant pleura...
Article

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...
Article

Modified Noyes grading of the chondral injury

Chondromalacia can be divided into 4 grades by MRI, typically using fat saturated proton density sequences. The original Noyes grading system was based on arthroscopic findings. The modified Noyes system was published in 2009. Grade 0: normal cartilage Grade 1: increased T2 signal intensity of...
Article

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...
Article

Silzbach sarcoidosis chest radiographic staging system

Silzbach 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 ...
Article

Olfactory neuroblastoma (staging)

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

PRETEXT grouping system of paediatric liver tumours

The PRETEXT system propsed 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 diagnoisis.  It's used to descr...

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