BACKGROUND: Occult nodal disease (OND) during clinically-N0 salvage total laryngectomy (TL) can be detected with the Neck-Imaging-Reporting-and-Data-Systems (NI-RADS). However, some patients will still have OND revealed on final pathology.
METHODS: A retrospective study on all patients who had OND during salvage TL with elective neck dissection (END) between 2009 and 2021 was performed. Repeat CT and PET scan interpretation was performed to evaluate their preoperative imaging for suspicious features.
RESULTS: Among 81 salvage TL patients undergoing END, 12 (16%) had OND and a total of 26 occult nodes were identified. On pathology, the average node length [SD] was 0.6 cm [0.3]. On CT, 31% (8 of 26) had rounded morphology. On PET, most had SUVmax below blood pool. One patient scored NI-RADS 2; the rest scored 1.
CONCLUSIONS: On re-review of preoperative imaging, occult nodes were subtle and challenging to identify. Despite no clear impact on survival, performing an END may provide prognostic information.

Multiple Myeloma (MM) is a hematological malignancy affecting bone marrow, most frequently in elderly men. Imaging has a crucial role in this disease. Recently, whole-body MRI has been introduced and it has gained growing interest due to is high sensitivity and specificity in evaluating bone marrow involvement in MM. Diffusion-weighted sequences (DWI) with apparent diffusion coefficient (ADC) maps have emerged as the most sensitive technique to evaluate patients with MM, both in the pre- and post-treatment setting. Aim of this review is to provide an overview of the role and main imaging findings of whole-body MRI in MM.

While functional imaging with [18F]Fluoro-deoxy-glucose positron emission tomography (PET)/computed tomography is a well-established imaging modality in most lymphoma entities, novel tracers addressing cell surface receptors, tumor biology, and the microenvironment are being developed. Especially, with the emergence of immuno-PET targeting surface markers of lymphoma cells, a new imaging modality of immunotherapies is evolving, which might especially aid in relapsed and refractory disease stages. This review highlights different new PET tracers in indolent and aggressive lymphoma subtypes and summarizes the current state of immuno-PET imaging in lymphoma.

Increased survivorship, improvements in cancer treatments, and the potential for cardiac side effects from cancer treatments have resulted in increased collaboration between oncologists and cardiologists and the development of cardio-oncology clinics. This collaboration is important given its role in ensuring greater patient satisfaction, aiding teams of clinicians in making complex treatment decision, and ensuring cardiac complications are diagnosed at an early stage. The particularities of implementing this collaboration in the field of radiation oncology and how this setting is different from other areas of cardio-oncology have not been well detailed in the literature. This paper will discuss what is currently understood about the need for and role of cardio-oncology and what a cardio-oncology services involves, with a particular emphasis on patient and clinician needs in the field of radiation oncology. The literature and recent guidelines do advocate for a detailed baseline assessment of cancer patients undergoing radiotherapy, especially patients with treatment or patient risk factors that increase their risk of cancer-therapy related cardiotoxicity. Advancements in cardiac imaging techniques will be discussed as these may help to diagnose cardiac side effects of certain cancer treatments, including radiotherapy, at an early stage. A multi-disciplinary and collaborative approach is well received by patients and such an approach, guided by the aim of maintaining a patient\'s cancer treatment wherever possible, should be the cornerstone of cardio-oncology clinics regardless of the patient\'s treatment regime.

Primary aortic angiosarcomas (PAA) are rare angiosarcomas, frequently diagnosed in advanced stages due to initial misdiagnosis. This case describes a 66-year-old woman, initially presenting with a distal thoracic aorta thrombus and symptomatic bilateral popliteal emboli. Despite initial management and therapeutic anticoagulation, she experienced progressive lower limb claudication and 12 months following initial presentation she re-presented with an obstructing distal thoracic aorta mass and metastatic disease. Histopathology confirmed metastatic epithelioid angiosarcoma. Despite urgent palliative radiotherapy, she died 6 weeks after diagnosis from complications of tumour thromboembolism. Suspicion for PAA should be raised in the case of thrombus in atypical segments (e.g. thoracic aorta) or progressive course despite anticoagulation. Multimodal imaging including MRI and FDG-PET is useful to distinguish from benign aetiologies.

OBJECTIVE: To describe the structure of a dedicated body oncologic imaging fellowship program. To summarize the numbers and types of cross-sectional imaging examinations reported by fellows.
METHODS: The curriculum, training methods, and assessment measures utilized in the program were reviewed and described. An educational retrospective analysis was conducted. Data on the number of examinations interpreted by fellows, breakdown of modalities, and examinations by disease management team (DMT) were collected.
RESULTS: A total of 38 fellows completed the fellowship program during the study period. The median number of examinations reported per fellow was 2296 [interquartile range: 2148 - 2534], encompassing all oncology-relevant imaging modalities: CT 721 [646-786], MRI 1158 [1016-1309], ultrasound 256 [209-320] and PET/CT 176 [130-202]. The breakdown of examinations by DMT revealed variations in imaging patterns, with MRIs most frequently interpreted for genitourinary, musculoskeletal, and hepatobiliary cancers, and CTs most commonly for general staging or assessment of nonspecific symptoms.
CONCLUSIONS: This descriptive analysis may serve as a foundation for the development of similar fellowship programs and the advancement of body oncologic imaging. The volume and diversity of examinations reported by fellows highlights the comprehensive nature of body oncologic imaging.

Radiomics and artificial intelligence carry the promise of increased precision in oncologic imaging assessments due to the ability of harnessing thousands of occult digital imaging features embedded in conventional medical imaging data. While powerful, these technologies suffer from a number of sources of variability that currently impede clinical translation. In order to overcome this impediment, there is a need to control for these sources of variability through harmonization of imaging data acquisition across institutions, construction of standardized imaging protocols that maximize the acquisition of these features, harmonization of post-processing techniques, and big data resources to properly power studies for hypothesis testing. For this to be accomplished, it will be critical to have multidisciplinary and multi-institutional collaboration.

The field of oncology has undergone rapid changes following the introduction of immunotherapies and biologics. However, these changes have also created new roles for radiology in both diagnosis and treatment. Our article addresses the evolving role of radiology in the immune checkpoint inhibitor era of oncology. With the progression of new immunotherapies for cancer, imaging paradigms and image guided therapy options have changed. Multidisciplinary oncology teams should be aware of these opportunities for collaboration.

The practice of interventional oncology (IO) embodies all the qualities that one would expect to find in a modern, value-based healthcare system. A dynamic, cutting-edge specialty like IO uses highly-targeted, minimally-invasive, image-guided techniques to deliver cost-effective, personalised medicine for cancer patients. Unfortunately, the technical and clinical sophistication of IO is not matched by the reimbursement models and funding arrangements in Australia to fully support this critical component of patient care. Differences between state and federal funding lead to inequity of access to \'standard of care\' interventions for patients across public and private hospitals. IO procedures are poorly represented in the Medicare Benefits Schedule and often inadequately funded to cover the true costs of providing care. Complex private health fund reimbursements and inconsistent rebates for prostheses and essential equipment result in inconsistent access to important services and widely variable out-of-pocket costs for patients. IO techniques must be supported by fair, consistent and equitable funding arrangements at all levels to allow for integrated contemporary patient care; only then will the full clinical and economic benefits of IO  be realised.

Histiocytoses are rare multi-system disorders marked by abnormal histiocyte cell proliferation, affecting children with diverse clinical presentations. Classified into five groups in 2016, including Langerhans-related (L), cutaneous (C), malignant (M), Rosai-Dorfman disease (R) and haemophagocytic lymphohistiocytosis (H), newer entities such as ALK-positive histiocytosis have also emerged, heralding the era of molecular (sub)classification. Common entities include Langerhans cell histiocytosis (LCH), Erdheim-Chester disease (ECD), Rosai-Dorfman disease (RDD) and haemophagocytic lymphohistiocytosis (HLH). This pictorial essay aids radiologists in recognising and differentiating paediatric histiocytoses based on unique neuroimaging features.