[A Case of Mediastinal Lymph Node Metastasis from Liver Metastasis of Colon Cancer].

A 64-year-old woman underwent partial colectomy with partial resection ofthe retroperitoneum and D3 lymphadenectomy for descending colon cancer(tub2, pSS, ly0, v0, pN1, sH0, sP0, sM0, fStage III b). Three years and 6 months later, she underwent resection ofsegment 4 ofthe liver because ofliver metastasis. One year and 2 months later, her serum carcinoembryonic antigen level increased, and computed tomography showed an inferior mediastinal mass of 18mm in diameter.

[A case of advanced colon cancer with atrial fibrillation and the use of dabigatran for safe chemotherapy using fluoropyrimidine-based antitumor agents].

A 77-year-old man with colon cancer and multiple metastases to the liver and lungs underwent resection of the primary tumor and D3 lymph node dissection. He presented with chronic atrial fibrillation; therefore, warfarin was used initially as an anticoagulant. Because of the need to administer a fluoropyrimidine-based antineoplastic agent[5-fluorouracil(5-FU)] during chemotherapy, we changed the anticoagulant from warfarin to dabigatran etexilate(dabigatran)before initiating chemotherapy.

[A case of complete response treated by gastrectomy with lymphadenectomy and combined chemotherapy of peroral S-1 and CDDP by arterial infusion for gastric cancer with multiple liver metastasis].

A 70-year-old female was admitted to our hospital with high fever about 5 days before this writing, along with anemia and hyperglycemia. Upper gastrointestinal series and endoscopy revealed type 1 gastric cancer in the greater curvature. CT and MRI showed multiple liver metastasis in the right lobe.

Gallbladder disease: appearance of associated transient increased attenuation in the liver at biphasic, contrast-enhanced dynamic CT.

Purpose: To evaluate the frequency, location, and appearance of transient increased attenuation in the liver during arterial-phase helical or incremental computed tomography (CT) in patients with gallbladder disease without hepatic extension.

Materials And Methods: Findings in dynamic CT examinations in 31 patients with surgically proved gallbladder disease not extending into the liver and in 31 control patients without gallbladder disease were retrospectively reviewed and correlated with findings in other imaging examinations.

Results: Areas of transient increased hepatic attenuation (n = 27) were identified in 22 of 31 patients with gallbladder disease and in only one of 31 control patients.

Thin-section oblique CT with 25 degrees cranially tilted images. Evaluation of pulmonary tumors adjacent to the interlobar fissures.

Purpose: Thin-section oblique CT with cranially tilted axial scans can provide better visualization of the interlobar fissures than thin-section CT with conventional axial scans. The purpose of this study was to evaluate the usefulness of oblique CT scans for pulmonary tumors adjacent to the interlobar fissures.

Material And Methods: Cranially tilted and conventional axial images were obtained by thin-section CT in 10 patients with solitary pulmonary tumors adjacent to the interlobar fissures.

High resolution CT findings in community-acquired pneumonia.

Purpose: Our goal was to clarify the high resolution CT (HRCT) findings of community-acquired pneumonia based on pathologic findings and to make a differential diagnosis between bacterial and atypical pneumonias.

Method: This study evaluated 32 cases with community-acquired pneumonia, including 18 cases with bacterial pneumonia and 14 cases with atypical pneumonia [mycoplasma pneumonia (n = 12), chlamydia pneumonia (n = 1), and influenza viral pneumonia (n = 1)]. HRCT images in these cases were space consolidation, ground-glass attenuation, thickening of the bronchovascular bundle, and distribution of abnormal attenuation.

Abnormal extrapulmonary accumulation of 99mTc-MAA during lung perfusion scanning.

We present fourteen patients with an abnormal extrapulmonary accumulation on lung perfusion scintigraphy with 99mTc-macroaggregated albumin (MAA), who were examined during the last decade. These included six patients with lung cancer, four with pulmonary arterio-venous fistula, two with congenital heart disease, one with inferior vena cava (IVC) syndrome and one with congenital bronchogenic cyst. All six patients with lung cancer had superior vena cava (SVC) syndrome, and the tumor invaded the thoracic wall.

[Evaluation of pancreatic cancers using thallium-201 single photon emission computed tomography].

Radionuclide study has not been frequently applied to pancreatic cancers because of the absence of suitable radiopharmaceuticals for their positive depiction. We evaluated thallium-201 chloride (201T1) SPECT for the investigation of pancreatic cancers. The subjects included 24 patients with pancreatic cancer, seven with benign disorders and 10 controls.

Bone scintigraphy in growth hormone-secreting pulmonary cancer and hypertrophic osteoarthropathy.

Hypertrophic osteoarthropathy was detected in a 55-yr-old man with pulmonary squamous-cell cancer by bone scintigraphy using 99mTc-hydroxy methylene diphosphonate (HMDP). Intense symmetrical uptake was demonstrated in the distal portions of the long bones as was the parallel tract sign, accompanied by markedly elevated serum growth hormone levels. After chemoradiotherapy for pulmonary cancer, the arthralgia disappeared and scintigraphic findings and serum growth hormone levels improved, suggesting that ectopic production of growth hormone in the pulmonary tumor had been associated with hypertrophic osteoarthropathy.

[Regional pulmonary Xenon-133 washout study using dynamic SPECT images obtained by a triple-headed SPECT system].

We investigated preliminary the clinical utility of dynamic SPECT in studying pulmonary Xenon-133 gas washout, using the continuous repetitive rotating acquisition method with a triple-headed SPECT system. The subjects included one healthy volunteer and 16 various lung diseases. After obtaining the equilibrium images, the sequential washout images were acquired every 60 sec for 6 min.

MR imaging of the uterus: findings from high-resolution multisection dynamic imaging with a surface coil.

MR imaging of the female pelvis with a local coil (multiple phased array coils) has been reported. With this method, the signal-to-noise ratio (S/N) is improved so that high-resolution images can be obtained. Dynamic contrast-enhanced MR imaging has been reported to be useful in diagnosing uterine neoplasms.

Technetium-99m-HMPAO as a marker of chemical and irradiation lung injury: experimental and clinical investigations.

Unlabelled: We evaluated the ability of 99mTc-hexamethylpropyleneamine oxime (99mTc-HMPAO) to serve as a sensitive marker of lung injury.

Methods: Two experimental rabbit models of minimal lung injury were designed using injections of a low dose (0.05 ml/kg) of oleic acid or 50 Gy of irradiation.

[Experimental and clinical evaluation of 99mTc-HMPAO as a sensitive marker for chemical lung injury].

To investigate whether 99mTc-hexamethylpropyleneamine oxime (99mTc-HMPAO) can be a sensitive marker of lung injury, an animal model of lung injury was designed in the rabbits using the injection of a low dose (0.05 ml/kg) of oleic acid. In the injured rabbit lungs, electron microscope revealed morphologic changes localized in the microvascular endothelium (edematous change), although their chest radiographies and light microscope did not show any significant changes compared to the controls.

I-123 IMP scintigraphy in two patients with primary pulmonary malignant lymphoma.

123I-IMP lung scintigraphy was performed in two patients with primary malignant lymphoma, whose radiographic features were difficult to differentiate from inflammatory or atelectatic lesions. 123I-IMP scans revealed a defect in the lesions on the delayed (24 hr) image, suggesting a tumorous lesion. 123I-IMP scan may contribute to differential diagnosis of this rare tumorous entity from benign disorders having a different appearance.

[Difference of thallium-201 kinetics between VX-2 tumors and inflammatory lesions in rabbits].

To evaluate the difference of thallium-201 chloride (201Tl) kinetics between malignant tumors and inflammatory lesions, 201Tl scintigraphy was performed in the 30 rabbits with variable sized VX-2 tumors; and in the 27 rabbits with variable sized inflammatory lesions induced by turpentine oil and the solution of auto-feces. The degree of 201Tl uptake was expressed as the count ratios of the lesions over the contralateral normal muscle tissue, and the early uptake ratio (1 min after the injection) and the delayed uptake ratio (30 min) were acquired. The retention index derived from these ratios was used to assess the degree of 201Tl washout from the lesions.

Difference in 201Tl accumulation on single photon emission computed tomography in benign and malignant thoracic lesions.

The difference in 201Tl-chloride (201Tl) accumulation on single photon emission computed tomography (SPECT) between 58 benign (58 cases) and 48 malignant (46 cases) thoracic lesions, each of more than 20 mm in diameter was investigated. In the 34 benign and 48 malignant lesions depicted in both early (15 min) and delayed (3 h) images there was no significant difference in the mean early and delayed uptake ratios of lesion to normal contralateral lung between benign and malignant. However, the retention index in the lesion derived from (delayed ratio--early ratio)/(early ratio) x 100% showed a significant difference (benign -4.

[Evaluation of radionuclide studies in the 8 patients with Takayasu's arteritis].

We evaluated various radionuclide studies performed in the 8 patients with Takayasu's arteritis over the past six years. Radionuclide angiography was performed in 5 patients to investigate the lesions of the branches of the aortic arch, and it demonstrated abnormalities of the affected arteries in 4 patients. Pulmonary perfusion scan demonstrated single or multiple reduced perfusion sites in all the 5 patients examined, while chest radiographies of these patients did not show any abnormalities in the reduced perfusion sites except one case.

Lobar primary pulmonary lymphoma: iodine-123-iodoamphetamine and thallium-201-chloride scintigraphic findings.

A case of primary pulmonary malignant lymphoma (PML) was evaluated by 123I-IMP scintigraphy and 201TlCl SPECT. Radiography and CT showed a so-called lobar consolidation on the chest that was difficult to differentiate from other benign conditions. However, 123I-IMP scintigraphy showed a defect corresponding to the lesion both in the early and delayed images, and 201TlCl SPECT showed a higher retention index than that of benign disorders.

Preliminary Tl-201 SPECT for assessment of treatment efficacy in three patients with pancreatic cancer.

To evaluate treatment efficacy, Tl-201 SPECT was performed in three patients with pancreatic cancer. In all of the patients, the degree of Tl-201 uptake by tumor, evaluated from the tumor-liver uptake ratio of Tl-201 activity, correlated well with alterations in serum level of a tumor marker (CA 19-9, DUPAN-2) after treatment. One of the patients showed no tumor shrinkage on CT after treatment; however, Tl-201 SPECT demonstrated reduced uptake in the tumor coupled with a decreased level of CA 19-9.

Evaluation of 99mTc-HMPAO scintigraphy for irradiated lung in rabbits: detection of pulmonary microvascular injury.

The pulmonary microvascular endothelium manifests structural and functional alterations following irradiation. It is important to determine a suitable method for detecting the endothelial damage. For the assessment of the initial phase of this pulmonary injury, 99mTc-hexamethylpropylene amine oxime (99mTc-HMPAO) scintigraphy as an indicator of early endothelial injury induced by irradiation was employed.

[Usefulness of 2D FLASH multislice dynamic MR imaging for evaluation of parametrial invasion in cervical carcinoma].

Twenty seconds and 3 minutes after starting rapid injection of Gd-DTPA, multislice dynamic (MD) images were obtained with the 2 dimension fast low-angle shot (2D FLASH) technique. Four of 5 cervical carcinomas showed high signal intensity in the early dynamic phase (20 seconds), so they were readily distinguished from the myometrium that were not enhanced in the same phase. For evaluation of parametrial invasion, MD study showed better contrast between the tumor and the parametrium than did T2-weighted images because the tumor demonstrated a high signal intensity similar to that of the parameterium on T2-weighted images.

[Evaluation of early MR imaging of the liver in rabbits after ethanol injection].

Seven days after ethanol injection, MR images of the liver in 5 rabbits were evaluated by T1, T2-weighted SE and TURBO-FLASH dynamic images. Necrotic area was visualized as low-intensity on T1-weighted images and high-intensity on T2-weighted images. These findings were similar to the tumor that was not treated, so it is necessary to be careful for evaluation of therapeutic efficacy.

[Changes of pulmonary perfusion in the lung area unaffected by embolism].

Observation of serial pulmonary scintigraphies after the treatment in the patients with pulmonary thromboembolism revealed altered perfusion in the lung area unaffected by embolism in 2 cases. Also, showed that recovered perfusion of the embolized lung area influenced the perfusion of contralateral embolic lung area in 1 patient. These findings were detected and confirmed by comparison of the serial scintigraphies mutually.