Imaging of Oncologic Emergencies

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification for enrollments starting after May 25, 2023:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Computed Tomography: 2.75
Procedures: 2.75
Head, Spine, and Musculoskeletal: 0.75
Neck and Chest: 1.00
Abdomen and Pelvis: 1.00

Magnetic Resonance Imaging: 4.25
Patient Care: 1.50
Patient Interactions and Management: 1.50
Procedures: 2.75
Neurological: 1.00
Body: 1.75

Radiography: 4.25
Patient Care: 1.50
Patient Interactions and Management: 1.50
Procedures: 2.75
Head, Spine and Pelvis Procedures: 1.00
Thorax and Abdomen Procedures: 1.75

Registered Radiologist Assistant: 4.25
Procedures: 4.25
Abdominal Section: 1.50
Thoracic Section: 1.25
Neurological, Vascular, and Lymphatic Sections: 1.50

Radiation Therapy: 4.25
Patient Care: 2.00
Patient and Medical Record Management: 2.00
Procedures: 2.25
Treatment Sites and Tumors: 2.25

Outline

1. Introduction
2. Imaging Approach
3. Central Nervous System Emergencies
   1. Cerebral Herniation
   2. Carcinomatous Meningitis
   3. Spinal Cord Compression
4. Thoracic Emergencies
   1. Central Airway Obstruction
   2. Esophagorespiratory Fistula
   3. Massive Hemoptysis
   4. Pulmonary Embolism
   5. Superior Vena Cava Syndrome
   6. Pericardial Tamponade
5. Abdominal Emergencies
   1. Uncontrolled Intraabdominal Hemorrhage
   2. Intestinal Emergencies
   3. Urinary Tract Obstruction
6. Treatment-related Emergencies
7. Conclusions

Objectives

Upon completion of this course, students will:

1. list the classifications of oncologic emergencies
2. specify the reasons cancer patients visit the emergency room
3. explain which oncologic emergencies require imaging studies
4. state what tumors are associated with ATLS
5. differentiate between the percentage of primary and metastatic brain tumors
6. list the types of brain herniation associated with increased intracranial pressure
7. list the symptoms of intracranial pressure
8. articulate the reasons for increased detection of metastatic involvement of the leptomeninges
9. select the most common mechanism of spread in carcinomatous meningitis
10. name the symptoms of carcinomatous meningitis
11. understand the best imaging modality for diagnosis of leptomeningeal carcinomatosis in the absence of malignant cells in fluid samples
12. rank the areas of the spine affected by malignant compression
13. state the most common symptom of malignant SCC
14. verbalize which cancer is the most common cause of central airway obstruction
15. list the types of malignancies that can cause central airway obstruction
16. understand how obstruction of the upper airway can cause severe acute respiratory failure
17. summarize the symptoms of central airway obstruction
18. recognize the clinical signs of malignant central airway obstruction
19. state the treatment options for malignant central airway obstruction
20. indicate the two types of radiation therapy used to treat malignant central airway obstruction
21. discuss the use of tracheal stent placement
22. list the common malignant causes of esophagorespiratory fistula
23. explain what area of the esophagus is most highly affected by esophagorespiratory fistula
24. name the clinical features of esophagorespiratory fistula
25. indicate the causes for hemoptysis due to lung metastases
26. list the common malignancies that may cause tumor embolism
27. express the clinical presentation in patients with pulmonary embolism
28. categorize catheter-based interventions for acute pulmonary embolism
29. match the percentage and types of cancers causing superior vena cava syndrome
30. distinguish between the types of SVC syndrome onset
31. specify the cause of pericardial tamponade in oncology patients
32. name the most common clinical finding in patients with cardiac tamponade
33. state the medical signs associated with Beck’s triad
34. discuss the imaging options available to guide pericardial fluid drainage
35. list the risk factors for intramural hemorrhage and subsequent spontaneous rupture
36. express the common bowel-related emergencies in cancer patients
37. distinguish between the percentages of ovarian and colorectal cancer patients that may develop acute intestinal obstruction
38. explain the pathophysiologic events related to acute bowel obstruction
39. name the categories of intussusceptions
40. list the cancers associated with bladder outlet obstruction