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Showing papers in "Radiation Medicine in 2008"


Journal ArticleDOI
TL;DR: The mean ADC values for breast cancer were significantly different from that of normal breasts, and the mean ADC value did not significantly correlate with cancer cellularity but did correlate with histological types.
Abstract: Purpose The purpose of this study was to examine the relation between cancer cellularity and the apparent diffusion coefficient (ADC) value using diffusion-weighted magnetic resonance imaging in breast cancer.

145 citations


Journal ArticleDOI
TL;DR: The ADC value might be useful for diagnosing the malignancy of nonmyxoid soft tissue tumors.
Abstract: Purpose We evaluated the efficacy of using the apparent diffusion coefficient (ADC) to differentiate soft tissue tumors.

136 citations


Journal ArticleDOI
TL;DR: Small cancers were more clearly visible on DWI at 3.0 T than 1.5 T and had better image scores at 3-0-T than at 1-1-5 T.
Abstract: Purpose The aim of this study was to compare diffusion-weighted imaging (DWI) at 3.0 T and 1.5 T by evaluating the apparent diffusion coefficient (ADC) value and visibility of breast cancer in the same patients.

115 citations


Journal ArticleDOI
TL;DR: The number of radiologists in Japan is the lowest among the 26 countries, and the workload is the highest, and it showed that for Japan to provide sustainable and quality health care 8614 diagnostic radiologists—2.5 times the present number—would be required.
Abstract: The aim of this study was to compare radiology statistics and procedures across the world with an eye to lightening the workload of radiologists in Japan. Literature and data in the public domain were obtained for Organization for Economic Cooperation and Development (OECD) member countries. This study collected and analyzed the number of (diagnostic) radiologists and physicians, computed tomography/magnetic resonance (CT/MR) units, CT/MR examinations, and workload of radiologists. Data for the number of radiologists and CT/MR units were obtained from 26 countries and, among them, data for the number of CT/MR examinations for 17 countries. The study found that in 2004 Japan had only 36 radiologists per million population, which is one-third the national average of the 26 countries surveyed, making Japan one of the lowest ranked countries. The workload of a radiologist (CT/MR examinations/year) in Japan was calculated at 6130. This is 4.3 times the global average (1440 for the 17 countries). This comparison showed that the number of radiologists in Japan is the lowest among the 26 countries, and the workload is the highest. The study also showed that for Japan to provide sustainable and quality health care 8614 diagnostic radiologists—2.5 times the present number—would be required.

84 citations


Journal ArticleDOI
TL;DR: The authors could treat cancer patients by radiotherapy without reducing their QOL, and improvement in QOL was significant in the palliative radiotherapy group, and mental condition was also improved after radiotherapy.
Abstract: Purpose The importance of the quality of life (QOL) and mental condition of patients being treated for cancer is now recognized. In this study, we evaluated QOL and mental condition in patients with cancer before and after radiotherapy.

76 citations


Journal ArticleDOI
TL;DR: A 70-year-old lung cancer patient with slight focal pulmonary honeycombing in whom subclinical idiopathic pulmonary fibrosis was exacerbated by SBRT is reported, which has important implications for the development of selection criteria prior to S BRT for pulmonary lesions.
Abstract: Hypofractionated stereotactic body radiotherapy (SBRT) for pulmonary lesions provides a high local control rate, allows completely painless ambulatory treatment, and is not associated with adverse reactions in most cases. Here we report a 70-year-old lung cancer patient with slight focal pulmonary honeycombing in whom subclinical idiopathic pulmonary fibrosis was exacerbated by SBRT. This experience has important implications for the development of selection criteria prior to SBRT for pulmonary lesions. For SBRT candidates with lung tumors, attention must be paid to the presence of co-morbid interstitial pneumonia even if findings are minimal. Such patients must be informed of potential risks, and careful decision-making must take place when SBRT is being considered.

57 citations


Journal ArticleDOI
TL;DR: A 34-year-old woman with a past history of a carcinoid tumor in the right ovary presented with a right breast mass found on contrast-enhanced computed tomography (CT) of the chest, and a primary breast neuroendocrine tumor and peritoneal dissemination of the ovarian carcinoids tumor were diagnosed.
Abstract: A 34-year-old woman with a past history of a carcinoid tumor in the right ovary presented with a right breast mass found on contrast-enhanced computed tomography (CT) of the chest. She was asymptomatic, and her blood tests were normal. The mass measured about 2 cm. Mammography showed a lobular, circumscribed, high-density mass without microcalcifications in the upper outer quadrant of the right breast. Ultrasonography showed an irregular mass with both hypoechoic and hyperechoic components with increased vascularity. The mass was well enhanced on contrast-enhanced CT and dynamic magnetic resonance imaging. At the same time, a well-enhanced small nodule was detected in the pouch of Douglas. Both of the tumors were resected, and a primary breast neuroendocrine tumor (solid neuroendocrine carcinoma) and peritoneal dissemination of the ovarian carcinoid tumor were diagnosed.

56 citations


Journal ArticleDOI
TL;DR: MRIgFUS ablation is a safe, effective treatment for nonobese patients with symptomatic fibroids that show low signal intensity on T2-weighted images and may be needed with a short-term follow-up.
Abstract: Purpose The aim of this study was to assess the feasibility and effectiveness of magnetic resonance (MRI)-guided focused ultrasound (MRIgFUS) ablation for uterine fibroids and to identify the candidates for this treatment.

55 citations


Journal ArticleDOI
TL;DR: TACE is more likely to induce HAD in cirrhotic patients with impaired liver function and when a high dose of the chemotherapeutic agent was used.
Abstract: Purpose The aim of this study was to assess the incidence, degree, and predictors of hepatic arterial damage (HAD) after transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).

49 citations


Journal ArticleDOI
TL;DR: Radiation-induced changes in NAWM can be detected at 3 months after RT, with changes in FA, CL, and CS values seen at a thresh-old dose of 45–50 Gy, thus providing an objective measure of radiation effect on NAWM.
Abstract: Purpose The aim of this study was to ascertain whether diffusion tensor imaging (DTI) metrics—fractional anisotropy (FA), mean diffusivity (MD), linear case (CL), planar case (CP), spherical case (CS)—can characterize a threshold dose and temporal evolution of changes in normal-appearing white matter (NAWM) of adults with low-grade gliomas (LGGs) treated with radiation therapy (RT).

43 citations


Journal ArticleDOI
TL;DR: It is found that simultaneous microwave ablation using multiple microwave antennas creates large ablative zones without indentations when multiple antennas are activated with an antenna spacing of 2.0 cm or less.
Abstract: Our purpose was to determine the optimal antenna spacing to achieve large ablative zones without indentations when microwave ablation is performed with simultaneous activation of two or three antennas. Microwave ablation was performed with single-antenna activation and simultaneous activation of two or three antennas with a spacing of 1.5, 2.0, 2.5, or 3.0 cm in explanted bovine livers. Microwave energy was applied for 10 min with a power of 45 W. The shapes and sizes of the ablative zones created were recorded and compared. The shape of the ablative zone was ellipsoid in the axial plane (along the antenna axis) and spherical in the transverse plane (perpendicular to the antenna axis) in single-antenna ablation. The ablative zones were spherical or ellipsoid in both the axial and transverse planes in two-and three-antenna ablation with an antenna spacing of 2.0 cm or less. Indentations were observed between the ablative zones created by the antennas when the spacing was 2.5 cm or more, reducing the minimum transverse diameter. When two-or three-antenna ablation was performed with a spacing of 2.0 cm or less, the axial and minimum transverse diameters were significantly larger than in single-antenna ablation. The largest volume (almost two or three times the single-activation volume) was achieved in two-or three-antenna ablation with an antenna spacing of 2.0 cm. We found that simultaneous microwave ablation using multiple microwave antennas creates large ablative zones without indentations when multiple antennas are activated with an antenna spacing of 2.0 cm or less.

Journal ArticleDOI
TL;DR: Most (60%) of the patients with unilateral SNHL showed a significant difference in the diameters of the bony canals of the cochlear nerve between the affected and unaffected sides; moreover, the mean value was significantly smaller in affected ears.
Abstract: Purpose The aim of this study was to evaluate the diameters of the various bony canals of the inner ear in patients with sensorineural hearing loss (SNHL) and establish criteria for detecting hypoplasia of the bony canal of the cochlear nerve

Journal ArticleDOI
TL;DR: IH following TAE with a mixture of ferucarbotran and lipiodol was capable of inducing selective hyperthermia with the authors' device, however, further investigation is needed to confirm its safety and effectiveness in the treatment of malignant neoplasms in humans.
Abstract: Purpose To evaluate the possibility of selective hyperthermia following transcatheter arterial embolization (TAE) with ferucarbotran using a newly developed inductive heating (IH) device.

Journal ArticleDOI
TL;DR: Data indicate that dental panoramic radiography may not induce chromosomal damage, but it is able to promote cytotoxicity, and cellular death is considered a prime mechanism in nongenotoxic mechanisms of carcinogenesis.
Abstract: Although it has been clearly demonstrated that X-rays play a key role in diagnosing medical and dental problems, this type of ionizing radiation is also able to induce noxious activities, such as genetic damage. The aim of the present study was to evaluate DNA damage (micronucleus) and cellular death in exfoliated buccal mucosa cells from healthy individuals (smokers and nonsmokers) following dental X-ray exposure. A total of 39 healthy people who had submitted to panoramic dental radiography were included in the study: 9 smokers and 30 nonsmokers. The results indicated no significant statistically differences (P > 0.05) in micronucleated oral mucosa cells before and after dental X-ray exposure. On the other hand, X-ray exposure did increase other nuclear alterations closely related to cytotoxicity, such as karyorrhexis, pyknosis, and karyolysis. It seems that cigarette smoke did not affect X-ray outcomes induced in buccal cells. These data indicate that dental panoramic radiography may not induce chromosomal damage, but it is able to promote cytotoxicity. Because cellular death is considered a prime mechanism in nongenotoxic mechanisms of carcinogenesis, dental X-ray should be used only when necessary.

Journal ArticleDOI
TL;DR: The results suggest that MD and FA reflect progression of AD-related histopathological changes in the PCFTs and may represent a useful biological index for monitoring AD.
Abstract: The aim of this study was to determine diffusion abnormalities in the posterior cingulate fiber tracts (PCFTs) in patients with Alzheimer’s disease (AD) by diffusion tensor tractography (DTT). We studied 23 AD patients and 18 age-matched normal controls who underwent magnetic resonance imaging using diffusion tensor imaging (DTI). DTT of PCFTs was generated from DTI. Mean diffusivity (MD) and fractional anisotropy (FA) were measured in co-registered voxels along with DTT of PCFTs. Student’s t-test was used to compare results between the AD patients and normal controls. The MD in PCFTs was significantly higher in AD patients than in normal controls (P = 0.019). The FA in PCFTs was significantly lower in AD patients than in normal controls (P = 0.007). The abnormal MD increase and FA decrease, which is considered to indicate a net loss of barriers that restrict water molecular motion and tissue anisotropy of white matter, is consistent with neuropathological data that demonstrate partial loss of myelin, axons, and oligodendrial cells in white matter of AD brains. Our results suggest that MD and FA reflect progression of AD-related histopathological changes in the PCFTs and may represent a useful biological index for monitoring AD.

Journal ArticleDOI
TL;DR: A case of multiple rice body formation that accompanied chronic nonspecific tenosynovitis of the flexor tendons of the wrist is presented.
Abstract: Rice body formation is generally a rare disorder related to rheumatoid arthritis. It can also be observed in cases of systemic lupus erythematosus, seronegative arthritis, infectious arthritis (tuberculosis, atypical mycobacterial infection), nonspecific arthritis, and osteoarthritis. It is generally located within joints or bursae. Multiple rice bodies of tendon sheaths are rarely encountered. Rice body formation may also be encountered without underlying systemic disorders. We present a case of multiple rice body formation that accompanied chronic nonspecific tenosynovitis of the flexor tendons of the wrist.

Journal ArticleDOI
TL;DR: Low-grade fibromyxoid sarcoma (LGFMS) is a rare tumor that commonly arises in the lower extremities but rarely in the mesentery, suggesting that the tumor contained myxoid tissue.
Abstract: Low-grade fibromyxoid sarcoma (LGFMS) is a rare tumor that commonly arises in the lower extremities but rarely in the mesentery. We report computed tomography (CT) and magnetic resonance imaging (MRI) findings of LGFMS of the small bowel mesentery. On CT, the mass was composed of two components. One component, on its right side, appeared to have isointense attenuation relative to muscle, whereas the other component, on its left side, appeared to have low attenuation. On MRI the mass on the right side showed hypointensity similar to muscle on both T1-and T2-weighted images as well as mostly slight enhancement on contrast-enhanced T1-weighted images. On the other hand, the mass on the left side showed relative hypointensity on T1-weighted images and hyperintensity on T2-weighted images as well as intense enhancement on contrast-enhanced T1-weighted images, suggesting that the tumor contained myxoid tissue. The myxoid area of LGFMS may have a tendency to reveal intense enhancement on contrast-enhanced images.

Journal ArticleDOI
TL;DR: Investigation of the frequency of breast tumors and breast cancers with noncontrast spiral chest computed tomography found four breast cancer patients were over 70 years old, and the characteristics of the tumor margins corresponded to mammography and ultrasonography findings.
Abstract: The aim of this study was to investigate the frequency of breast tumors and breast cancers with noncontrast spiral chest computed tomography (CT). A clinical study was conducted to evaluate findings in the mammary region of 1008 consecutive patients with no mammary symptoms or signs who underwent noncontrast spiral CT of the chest from April 2003 to March 2006. Six cases of breast abnormality were detected among the 1008 women. Three were primary breast cancers, one was metastatic breast cancer, and two were benign tumors. All four breast cancer patients were over 70 years old. The characteristics of the tumor margins on CT scans corresponded to the mammography and ultrasonography findings. The mammographic background density ranged from inhomogeneous high-density breast to fatty breast. The detection rate of primary breast cancer by noncontrast spiral CT was 0.30%. Noncontrast spiral chest CT occasionally detects nonsymptomatic breast cancers, especially in elderly patients.

Journal ArticleDOI
TL;DR: Investigation of the diagnostic reliability of multidetector-row computed tomography for preoperative assessment of local tumoral spread in hilar cholangiocarcinoma found it likely to play an important role in evaluation of focal lesion spread especially in intrapancreatic tumor invasion.
Abstract: Purpose Our aim was to investigate the diagnostic reliability of multidetector-row computed tomography (MDCT) for preoperative assessment of local tumoral spread in hilar cholangiocarcinoma.

Journal ArticleDOI
TL;DR: This study showed that the increase in dose rate and lower out-of-field dose can be possible advantages for an unflattened 18-MV beam.
Abstract: Purpose Several studies on the dosimetric properties of unflattened photon beams have shown some advantages for radiotherapy. In this study, the effect of removing the flattening filter from an 18-MV photon beam was investigated using the Monte Carlo method.

Journal ArticleDOI
Sharad Goyal1, Alan Cohler1, Jayne M Camporeale1, Venkat Narra1, Ning J. Yue1 
TL;DR: IMRT is feasible when treating orbital lymphoma and reduces dose to critical structures while providing excellent dose coverage of target volumes, similar to conventional RT, with no increased toxicity.
Abstract: Purpose Orbital manifestations of non-Hodgkin’s lymphoma (NHL) are rare and accounts for only 1% of all cases of NHL. There have been no reports of treating orbital lymphoma using intensity-modulated radiotherapy (IMRT).

Journal ArticleDOI
TL;DR: Two patients of ureteroarterial fistula who underwent successful endovascular treatment by stent-grafts were reported, and the hematuria disappeared immediately after stent -graft deployment.
Abstract: Ureteroarterial fistula is a rare condition with life-threatening hematuria that should be diagnosed and treated immediately. We reported two patients of ureteroarterial fistula who underwent successful endovascular treatment by stent-grafts. They had undergone pelvic surgery followed by placement of an indwelling ureteral stent for stricture of the ureter before sudden hematuria occurred. Routine contrast-enhanced computed tomography did not reveal extravasation or a pseudo-aneurysm. Angiograms with multiple oblique views demonstrated small pseudoaneurysms of the iliac artery overriding the ipsilateral ureter. The endovascular treatment of ureteroarterial fistula using stent-grafts was successful, and the hematuria disappeared immediately after stent-graft deployment. The hematuria did not recur up to the last follow-up visits of 3 and 19 months, respectively.

Journal ArticleDOI
TL;DR: PMCT can detect or presume fatal trauma when diagnosing the cause of death after traffic accidents, and findings of damage to the head, neck, thorax, abdomen, and pelvis were classified according to the Abbreviated Injury Scale (AIS).
Abstract: Most traumatic deaths in Japan are due to nonpenetrating injuries, especially those that result from traffic accidents; however, the autopsy rate of traffic accident-related deaths is only about 5%. We investigated the diagnostic ability of postmortem computed tomography (PMCT) in cases of fatal trauma after traffic accidents. Our subjects were 78 subjects (59 males, 19 females; mean age 50 years, range 15–87 years) who were brought to our institution in cardiopulmonary arrest on arrival after traffic accidents and died despite resuscitation attempts. PMCT findings of damage to the head, neck, thorax, abdomen, and pelvis were classified into three grades according to the Abbreviated Injury Scale (AIS) severity: A: 1 (minor), 2 (moderate); B: 3 (serious), 4 (severe), 5 (critical); C: 6 (maximum). The percentage ratio of A/B/C in 78 head injuries was 32/60/8, in 41 neck injuries 83/5/12, in 76 thorax injuries 5/38/57, in 76 abdominal injuries 70/24/7, and in 76 pelvic injuries 79/21/0, respectively. PMCT can detect or presume fatal trauma when diagnosing the cause of death after traffic accidents

Journal ArticleDOI
TL;DR: Mediastinal fluid collections or free gas bubbles are not specific during the early postoperative period, however, after 2 21 days, these observations could be indicative of mediastinitis.
Abstract: Purpose The aim of this study was to evaluate the effectiveness of computed tomography (CT) findings in the diagnosis of mediastinitis after cardiovascular surgery with median sternotomy.

Journal ArticleDOI
TL;DR: The carbon fiber tabletop significantly decreases the skin-sparing effect and the dosimetric effect of the tabletop may be higher, especially for the intensity-modulated radiation therapy depending on the beam orientation.
Abstract: Purpose The dose changes in the buildup region and beam attenuation by a carbon fiber tabletop were investigated for 6-and 18-MV photon beams.

Journal ArticleDOI
TL;DR: A case of internal oblique hematoma caused by rupture of the subcostal artery in a 57-year-old woman, showing a large soft tissue mass with extravasation of contrast medium located in the rightinternal oblique muscle is reported.
Abstract: Abdominal wall hematoma is an uncommon cause of acute abdominal pain. We report a case of internal oblique hematoma caused by rupture of the subcostal artery in a 57-year-old woman. Ultrasonography (US) showed a hypoechoic mass in the right lateral abdominal wall. Contrast-enhanced computed tomography (CT) showed a large soft tissue mass with extravasation of contrast medium located in the right internal oblique muscle. Angiography showed contrast extravasation from the subcostal artery, and transcatheter arterial embolization was performed successfully.

Journal ArticleDOI
TL;DR: The radiological features and the important issues necessary in the diagnostic approach of subpubic cartilaginous cysts were discussed and definitive diagnosis of all the cases was confirmed by excisional biopsy.
Abstract: Subpubic cartilaginous cysts are rare cystic lesions that have been radiologically identified only in recent years, and the our understanding of the cautions to be observed in the diagnostic approach and the radiologic characteristics is still incomplete. The medical literature search revealed three reported cases of a subpubic cartilaginous cyst diagnosed histopathologically and one case that was suggested by radiological findings. Definitive diagnosis of all the cases was confirmed by excisional biopsy. This report discusses the radiological features and the important issues necessary in the diagnostic approach of subpubic cartilaginous cysts.

Journal ArticleDOI
TL;DR: An 82-year-old man with an asymptomatic left high-grade carotid stenosis was treated with carotID artery stenting (CAS) under distal protection, and it was suggested that an embolus had been liberated from the in-stent lesion, reaching the left MCA and obliterating it.
Abstract: An 82-year-old man with an asymptomatic left high-grade carotid stenosis was treated with carotid artery stenting (CAS) under distal protection. The procedure consisted with predilation with a 5 × 40 mm percutaneous transluminal angioplasty (PTA) balloon, deployment of a 10 × 20 mm self-expandable stent, post-dilation with a 7 × 20 mm PTA balloon, and aspiration of debris with 60 ml of blood. The cervical carotid angiogram immediately after deflation of the distal blocking balloon demonstrated a small in-stent filling defect of the contrast medium that protruded from the anterior wall of the carotid artery. The following cranial carotid angiogram showed abrupt occlusion of the left middle cerebral artery (MCA). Because the in-stent lesion had vanished in the repeat study after recognition of this embolic event, it was suggested that an embolus had been liberated from the in-stent lesion, reaching the left MCA and obliterating it. In this case, the embolus was speculated to originate in the ruptured plaque, which protruded into the stent through the cells of the device and became liberated into the bloodstream. Attention should be paid so as not to overlook any plaque protrusion, which may be seen subsequently as a cerebral embolism on the angiogram obtained immediately after CAS.

Journal ArticleDOI
TL;DR: It is speculated that the delayed enhancement could be attributed to the abundant fibrous tissue, which was the main structural material of the tumor, which has been described in previous reports of IMT in other organs.
Abstract: We report two cases of inflammatory myofibroblastic tumor (IMT) of the lung in a 4-year-old boy and a 7-year-old girl. We performed dynamic contrastenhancement computed tomography in both of our cases and dynamic contrast enhancement magnetic resonance imaging (MRI) in one case. These dynamic studies showed a demarcated mass with delayed enhancement in both cases. A T1-weighted MR image shows a mass with homogeneous low signal intensity, and a T2- weighted image shows a mass with slightly high signal intensity. A post-contrast-enhanced T1-weighted image demonstrates homogeneous enhancement. We speculate that the delayed enhancement could be attributed to the abundant fibrous tissue, which was the main structural material of the tumor. This same finding has been described in previous reports of IMT in other organs.

Journal ArticleDOI
TL;DR: Technetium-99m human serum albumindiethylenetriaminepentaacetic acid (HSA-DTPA) lymphoscintigraphy with single photon emission computed tomographic combined with integrated low-dose computed tomography (SPECT/CT) is useful for evaluating chylothorax.
Abstract: Technetium-99m human serum albumindiethylenetriaminepentaacetic acid (HSA-DTPA) lymphoscintigraphy with single photon emission computed tomography combined with integrated low-dose computed tomography (SPECT/CT) is useful for evaluating chylothorax. We report a case of chylothorax that occurred 2 months after childbirth in a 24-year-old woman. Lymphoscintigraphy with SPECT/CT showed abnormal tracer accumulation in the right plural effusion, and chylothorax was diagnosed. Collateral branches of the thoracic duct were found to be ruptured during video-assisted thoracoscopic surgery performed for ligation.