VMAT Planning With Xe-CT Functional Images Enables Radiotherapy Planning With Consideration of Lung Function.

Background/aim: The most severe adverse event of radiotherapy in lung cancer is radiation pneumonitis (RP). Some indices commonly used to prevent RP are evaluated based on the anatomical lung volume. The irradiation dose may be more accurately assessed by using functional lung volume.

Computed tomography pulmonary angiography and venography with a low dose of contrast medium.

The authors developed a method to ensure sufficient opacification of pulmonary vasculature for separate depiction of arteries and veins in three-dimensional form with a small dose of contrast medium utilizing a test injection to determine optimal timing of computed tomography (CT) scanning. The dose was determined by a simulation based on a pharmacokinetic model. The contrast medium was administered at a rate of 5.

Generation of ventilation/perfusion ratio map in surgical patients by dual-energy CT after xenon inhalation and intravenous contrast media.

Background: While many studies have evaluated the change in lung volume before and after lung resection and correlated this with pulmonary function test results, there is very little evidence on the changes in ventilation perfusion ratio (V/Q) before versus after lung resection. In the present pilot study, we evaluated if V/Q mapping can be constructed using dual energy CT images.

Methods: Thirty-one lung cancer patients planned for pulmonary resection were included in this study.

Evaluation of pulmonary function using single-breath-hold dual-energy computed tomography with xenon: Results of a preliminary study.

Xenon-enhanced dual-energy computed tomography (xenon-enhanced CT) can provide lung ventilation maps that may be useful for assessing structural and functional abnormalities of the lung. Xenon-enhanced CT has been performed using a multiple-breath-hold technique during xenon washout. We recently developed xenon-enhanced CT using a single-breath-hold technique to assess ventilation.

Prediction of postoperative pulmonary function: preliminary comparison of single-breath dual-energy xenon CT with three conventional methods.

Purpose: To assess the use of xenon ventilation maps (Xe-images) for predicting postoperative pulmonary function.

Materials And Methods: After study approval by the institutional review board, written informed consent was obtained from 30 patients with lung tumors who underwent pre- and postoperative spirometry, pulmonary perfusion SPECT and dual-energy CT (80 kV and 140 kV/Sn) after single-breath inspiration of 35 % xenon. Xe-images were calculated by three-material decomposition.

Multidetector CT appearance of adhesion-induced small bowel obstructions: matted adhesions versus single adhesive bands.

Adhesive small bowel obstruction (SBO) is a common cause of abdominal pain after surgery or peritonitis. The role of computed tomography (CT) in the evaluation of SBO has expanded. Diagnosis of adhesive SBO, however, remains challenging.

Appendiceal diverticulitis: multidetector CT features.

Purpose: Appendiceal diverticulitis has been difficult to distinguish from acute appendicitis clinically and radiologically. The purpose of this study was to describe multidetector computed tomography (MDCT) features of cases of pathologically proved appendiceal diverticulitis at our institution over a 36-month period.

Materials And Methods: Seven of 156 patients who underwent appendectomy with the preoperative diagnosis of acute appendicitis were pathologically diagnosed with appendiceal diverticulitis.

Imaging of ventilation with dual-energy CT during breath hold after single vital-capacity inspiration of stable xenon.

Purpose: To assess single-breath-hold technique for ventilation mapping by using dual-energy computed tomography (CT) in phantom experiments and volunteers.

Materials And Methods: Institutional review board approved this study, and written informed consent was obtained from all volunteers. A rubber bag filled with a mixture of xenon (0%-35.

Cystic artery bleeding due to blunt gallbladder injury: computed tomography findings and treatment with transcatheter arterial embolization.

Blunt gallbladder injury is rare, and bleeding from the cystic artery due to blunt trauma is even rarer. We report herein a case of extraluminal bleeding of the gallbladder in a patient following blunt abdominal trauma. Contrast-enhanced computed tomography revealed pericholecystic fluid and extravasation of contrast material in the subcapsular liver space adjacent to the gallbladder.

Relation between pulmonary embolus volume quantified by multidetector computed tomography and clinical status and outcome for patients with acute pulmonary embolism.

Purpose: The aim of this study was to determine whether pulmonary embolus volume (PEV) obtained with multi-detector row computed tomography is related to clinical status and outcomes.

Materials And Methods: Subjects comprised 48 patients with acute pulmonary embolism (PTE). PEV was measured by tracing the contours manually and compared between sets of two groups divided by clinical status.

Correlation of left ventricular dyssynchrony with myocardial stunning using dual single photon emission computed tomography of (123)iodine-beta-methyl iodophenyl pentadecanoic acid and (201)thallium scintigraphy after reperfusion therapy.

Objective: Left ventricular (LV) dyssynchrony after reperfusion therapy has been closely examined as a cause of chronic remodeling, but the details have not been clarified. The present study measured LV dyssynchrony appearing immediately after reperfusion therapy using real-time three-dimensional echocardiography (RT-3DE), and assessed the significance of this phenomenon in relation to dual single photon emission computed tomography (SPECT) of (123)iodine beta methyliodophenyl pentadecanoic acid ((123)I-BMIPP) and (201)thallium ((201)Tl).

Methods: Subjects comprised 58 patients with first-time acute myocardial infarction who received reperfusion therapy and underwent RT-3DE and dual SPECT of (123)I-BMIPP and (201)Tl within two weeks of onset.

Multidetector computed tomography diagnosis of primary and secondary epiploic appendagitis.

Purpose: The aim of this study was to evaluate the epiploic appendages in patients with acute abdomen using multidetector computed tomography (MDCT) and to determine the incidence of primary and secondary epiploic appendagitis (EA).

Materials And Methods: A radiologist reviewed MDCT images from 1338 patients with acute abdomen for visible epiploic appendages. Two radiologists then reviewed the MDCT images showing inflamed epiploic appendages and diagnosed primary EA, secondary EA, or other conditions by consensus.

Evaluation of quality of life and psychological response in cancer patients treated with radiotherapy.

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.

Materials And Methods: The subjects were 170 patients who had undergone radiotherapy.

Three-dimensional assessment of urinary stone on non-contrast helical computed tomography as the predictor of stonestreet formation after extracorporeal shock wave lithotripsy for stones smaller than 20 mm.

The incidence of stonestreet formation after extracorporeal shock wave lithotripsy (ESWL) rises with increasing stone burden. However, stonestreet after ESWL is often experienced even in stones smaller than 20 mm. To examine whether the non-contrast helical computed tomography (CT) data could predict stonestreet formation in these stones, 53 radiopaque stones of 5-20 mm treated with ESWL were evaluated.

Relationship between (99m)Tc-GSA scintigraphic indices of liver function reserve and portal circulation in patients with chronic liver disease.

Objectives: In order to predict the prognosis or complications of portal hypertension in patients with chronic liver disease, it is important to evaluate both hepatic functional reserve and portal circulation. On (99m)Tc-galactosyl human serum albumin ((99m)Tc-GSA) scintigraphy, the index of blood clearance (HH15) and receptor index (LHL15) have been widely used to evaluate the hepatic functional reserve. However, the relationship between these indices and portal circulation is unknown.

Arteriovenous malformation of the gallbladder: CT and angiographic findings.

We encountered a case of arteriovenous malformation (AVM) of the gallbladder in a patient with hepatocellular carcinoma (HCC). Contrast-enhanced computed tomography (CT) showed serpentine vessels around and within the gallbladder wall. Angiography showed dilated and tortuous cystic arteries, a racemose vascular network, and early-filling cystic veins.

Discrimination between ureteral stent and stone by non-contrast helical computed tomography in the clinical setting.

Objective: In urolithiasis with indwelling ureteral stent, an adequate visualization of retained stone is often obscured by the stent. In functional solitary kidney, it is essential to detect retained fragments before stent removal. We examined the capability of non-contrast helical computed tomography (NCHCT) in discriminating stone from stent.

Role of volume and attenuation value histogram of urinary stone on noncontrast helical computed tomography as predictor of fragility by extracorporeal shock wave lithotripsy.

Objectives: To test, for the first time, the predictive capability of the total stone volume (TSV) and the attenuation value histogram. Recently, the mean attenuation value (MAV) of urinary stones has been recognized as a predictor of fragility by extracorporeal shock wave lithotripsy. However, properties other than MAV, including the TSV and the heterogeneity of attenuation value histogram, may also be related to fragility.

Extraosseous accumulation of 99mTc-MDP in lymph node metastases of small cell carcinoma of the esophagus.

We report a case of esophageal carcinoma that showed extraosseous accumulation of 99mTc-MDP in lymph node metastases to the cervical and paracardial lymph nodes. There are few cases showing abnormal extraosseous accumulation of 99mTc-MDP in esophageal cancer lesion. The patient was a 53-year-old man with advanced esophageal cancer.

Three-dimensional stereotactic surface projection of brain perfusion SPECT improves diagnosis of Alzheimer's disease.

Objectives: Alzheimer's disease (AD) is diagnosed by either inspection of the brain perfusion SPECT, or three-dimensional stereotactic surface display (3D-SSP). The purpose was to compare diagnostic performances of these methods.

Methods: Sixteen nuclear medicine physicians independently interpreted 99mTc-ECD SPECT in one session and SPECT with 3D-SSP in another session without clinical information for 50 studies of AD patients and 40 studies of healthy volunteers.

Adult embryonal rhabdomyosarcoma in axilla.

A case of embryonal rhabdomyosarcoma (RMS) arising from an axillary space is described. RMS is one of the most common soft-tissue neoplasms in children, but adult embryonal RMS is rare. The patient was a 55-year-old man with a tumor of the left axillary area.