Biomedical subjects

Kaname Tomoda

Publications and source records attributed to Kaname Tomoda.

At least 19 recordsLinked to original sources

PubMed2006

Hepatic metastases: detection with multi-detector row CT, SPIO-enhanced MR imaging, and both techniques combined.

PURPOSE: To retrospectively compare the accuracy in detection of hepatic metastases among contrast material-enhanced multi-detector row computed tomography (CT) alone, superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance (MR) imaging alone, and a combination of contrast-enhanced CT and SPIO-enhanced MR imaging. MATERIALS AND METHODS: The ethics committee did not require its approval or informed consent for this retrospective study, which was compliant with Declaration of Helsinki principles. Data in 38 patients (22 men, 16 women; mean age, 64.5 years; range, 35-78 years) suspected of having hepatic metastases who underwent both contrast-enhanced CT and SPIO-enhanced MR imaging were retrospectively analyzed. Twenty-one of the 38 patients had 61 metastases. Seventeen of the 61 metastases were confirmed histologically; the remaining 44 metastases were defined with imaging follow-up. At MR imaging, SPIO-enhanced heavily T1-weighted images, T2*-weighted gradient echo images, and T2-weighted fast spin-echo images were evaluated. Contrast-enhanced multi-detector row CT images obtained in the portal phase were evaluated. Four blinded observers independently reviewed CT images, MR images, and the combination of CT and MR images. Diagnostic accuracy was evaluated by using the alternative free-response receiver operating characteristic (AFROC) method. Sensitivities and positive predictive values were also analyzed with the Fisher protected least significant difference test and generalized estimating equations. RESULTS: The mean area under the AFROC curve for the combined approach (0.70) was significantly higher than that for SPIO-enhanced MR imaging alone (0.58, P < .05, Fisher protected least significant difference test), and there was no significant difference between each of them and that for contrast-enhanced CT alone (0.66). For all lesions, the mean sensitivity of combined imaging (0.59) was significantly higher than that of CT (0.48) or MR imaging (0.43) alone (P < .05, Fisher protected least significant difference test and generalized estimating equations). For all lesions, the mean positive predictive values were 0.82, 0.89, and 0.81, for combined MR and CT, CT alone, and MR alone, respectively. CONCLUSION: The addition of SPIO-enhanced MR imaging to contrast-enhanced multi-detector row CT (ie, combined analysis of SPIO-enhanced MR images and contrast-enhanced CT images) can improve sensitivity in the detection of hepatic metastases, although this improvement in sensitivity was not significant at AFROC analysis.

Adult↗

PubMed2006

Hemodynamic characterization of focal hepatic lesions: role of ferucarbotran-enhanced dynamic MR imaging using T2-weighted multishot spin-echo echo-planar sequence.

PURPOSE: To investigate the role of ferucarbotran-enhanced dynamic MR imaging using multishot spin-echo echo-planar sequence in the evaluation of hemodynamics of focal hepatic lesions. MATERIALS AND METHODS: Sixty-three focal hepatic lesions (24 benign and 39 malignant) from 53 consecutive patients who underwent both ferucarbotran-enhanced MR imaging and dynamic computed tomography (CT) were included in this study. MR imaging was performed with a 1.5-T scanner with a phased-array coil. T2-weighted multishot spin-echo echo-planar sequences (TR/TE = 1714-2813/80 msec) were obtained during a single breathhold before and 15, 60, 120, 180, and 600 seconds after intravenous injection of ferucarbotran. The enhancement patterns of lesions were classified into three categories by a study coordinator on the basis of dynamic CT images as hypervascular, hypovascular, and hemangioma type. The study coordinator created mean contrast-to-noise ratio of lesions vs. time curves for each enhancement pattern for quantitative analyses. Moreover, three radiologists separately and blindly reviewed MR images, and then assigned three confidence scores for the three enhancement patterns to each lesion. Sensitivity, specificity, and receiver operating characteristic analyses were performed. RESULTS: Quantitative analyses showed characteristic enhancement curves for each enhancement pattern. Mean sensitivities/specificities were 0.816/0.882, 0.897/0.863, and 0.800/0.989 for hypervascular, hypovascular, and hemangioma types, respectively. Mean areas under the receiver operating characteristic curve were 0.886 for hypervascular type and 0.913 for hypovascular type. CONCLUSION: Ferucarbotran-enhanced dynamic MR imaging can be used to successfully characterize the hemodynamics of focal hepatic lesions.

Adult↗

PubMed2006

Principles and techniques of transcatheter embolotherapy for peripheral vascular lesions.

Transcatheter embolotherapy (TCE), a common procedure for interventional radiologists, comprises transcatheter delivery of embolic agents into target vessels in order to eliminate lesions or lesion-associated symptoms. Good knowledge of delivery catheters and embolic agents is essential to optimize embolization techniques and to obtain the desired therapeutic outcomes. In this review, we describe the principles and techniques of TCE for peripheral arterial and venous lesions featuring visceral aneurysms, peripheral and pulmonary arteriovenous malformations (AVMs), and varicoceles.

Catheterization↗

PubMed2006

[The progress of hepatic arterial infusion chemotherapy for hepatocellular carcinoma].

Hepatic arterial infusion (HAI) chemotherapy has been selected as a therapeutic option for highly advanced hepatocellular carcinoma (HCC) with tumor thrombi in major portal branches or intrahepatic metastases. Conventional therapies have no clinical effect on highly advanced HCC. Recent advances of an implanted portcatheter system have facilitated repeated arterial infusion of chemotherapeutic agents, and HAI chemotherapy with several anticancer drugs provides a useful choice for advanced HCC. In various regimens of HAI chemotherapy, low-dose cisplatin and 5-fluorouracil (5-FU) therapy or combination therapy of interferon (IFN)-alpha/5-FU have been reported to improve the response rates for advanced HCC. However, the survival benefit of HAI chemotherapy may be affected by liver function. None of these regimens have been proved to be the standard for HAI chemotherapy. We previously reported that the beneficial effects of combination therapy of IFN-alpha/5-FU for advanced HCC. IFN-alpha/5-FU combination therapy may be a promising treatment modality for advanced HCC.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed2006

[A successful case of hepatocellular carcinoma with portal venous tumor thrombus (Vp2) treated by transcatheter arterial chemoembolization].

We reported a case of hepatocellular carcinoma (HCC) with portal venous tumor thrombus (PVTT) (Vp2) successfully treated by transcatheter arterial chemoembolization (TACE), and the tumor showed complete response and the patient survived for 28 months. A 67-year-old male was diagnosed with HCC in the area of subsegment 5 with PVTT from the P5 to the posterior branch. He was treated by segmental TACE. The tumor markers decreased within normal limits, and localized hepatic infraction in the subsegment 5 and atrophy of the PVTT were recognized. He survived for 28 months with no tumor recurrence after the first TACE. This case suggested that embolization might play a part of treatment to HCC with PVTT, if the liver function was preserved and the lesion of liver infraction was limited.

Aged↗

PubMed2005

T staging of gastric cancer: role of multi-detector row CT.

PURPOSE: To evaluate retrospectively the accuracy of multi-detector row computed tomography (CT) in the assessment of serosal invasion in patients with gastric cancer. MATERIALS AND METHODS: The Ethics Committee does not require approval or informed consent for retrospective studies. Forty-one consecutive patients (24 men, 17 women; mean age, 68 years) with gastric cancer were included in this study. All patients were given 600 mL of tap water to drink and were positioned prone or supine on the scanning table. The detector row configuration included four detector rows, a section thickness of 1.25 mm, a pitch of 6, and a reconstruction interval of 0.63 mm. Transverse and multiplanar reconstruction images were simultaneously evaluated by two independent observers to assess the depth of tumor invasion in the gastric wall (ie, T stage). T staging at multi-detector row CT was compared with T staging at histologic evaluation (reference standard), which was performed by means of surgical or histologic examination of the resected specimen. We also calculated the sensitivity, specificity, and accuracy of multi-detector row CT for each observer in the assessment of serosal invasion. RESULTS: Analysis of interobserver agreement showed substantial or almost perfect agreement (nonweighted kappa value of 0.78 and weighted kappa value of 0.85). Correct assessment of gastric wall invasion was 80% and 85% for observers 1 and 2, respectively. The sensitivity, specificity, and accuracy of multi-detector row CT in the assessment of serosal invasion were 90%, 95%, and 93%, respectively, for observer 1 and 80%, 97%, and 93%, respectively, for observer 2. Overstaging occurred in six patients, and understaging occurred in five patients. All understaged tumors were scirrhous subtype gastric cancer. CONCLUSION: Multi-detector row CT scanning of patients with gastric cancer gave 93% accuracy in the assessment of serosal invasion in patients with gastric cancer.

Adult↗

PubMed2005

Double phase CT during hepatic arteriography for diagnosis of hepatocellular carcinoma.

RATIONALE AND OBJECTIVES: The purpose of this study is to assess the diagnostic impact of double phase computed tomography during hepatic arteriography for hepatocellular carcinoma. MATERIALS AND METHODS: 118 hepatocellular carcinomas in 73 cirrhotic patients who underwent double phase computed tomography during hepatic arteriography were enrolled in this study. Double phase computed tomography during hepatic arteriography consisted of computed tomography images obtained at 5-10 s (first phase) and 40-50 s (second phase) after the initiation of an intraarterial administration of 40-60 ml of contrast medium through the hepatic artery. Diagnostic accuracy of the first phase computed tomography during hepatic arteriography alone and double phase computed tomography during hepatic arteriography images for hepatocellular carcinoma were separately analyzed by three blinded readers independently. Alternative-free response receiver operating characteristic curves were constructed to compare each set of computed tomography during hepatic arteriography images. RESULTS: The detection sensitivity of the double phase CTHA for HCC (mean, 83.1%) was significantly higher than that of the first phase CTHA alone (mean, 73.4%) (P < 0.01). Moreover, the positive predictive value of the double phase CTHA (mean, 93.7%) was higher than that of the first phase CTHA alone (87.4%). The area under the AFROC curve (Az value) of the double phase CTHA (mean, 0.88) was significantly higher than that of the first phase CTHA alone (mean, 0.77) (P < 0.05). CONCLUSIONS: Double phase computed tomography during hepatic arteriography can improve the diagnostic accuracy of hepatocellular carcinoma.

Adult↗

PubMed2005

Quantitative tissue blood flow evaluation of pancreatic tumor: comparison between xenon CT technique and perfusion CT technique based on deconvolution analysis.

PURPOSE: There has been one report that tissue blood flow (TBF) quantification with xenon CT was effective in predicting the therapeutic response to an anticancer drug in pancreatic cancer. The purpose of this study was to evaluate the correlation between the TBF of pancreatic tumors calculated with xenon CT and those with perfusion CT, in order to evaluate whether perfusion CT could replace xenon CT. MATERIALS AND METHODS: Nine patients with pathologically proved pancreatic tumors who underwent both xenon CT and perfusion CT were included. RESULTS: Quantitative TBF of pancreatic tumors measured by perfusion CT ranged from 22.1 to 196.2 ml/min/100 g (mean+/-SD, 52.6+/-54.8 ml/min/100 g). In contrast, those obtained by xenon CT ranged from 10.3 to 173.6 ml/min/100 g (mean+/-SD, 47.4+/-49.4 ml/min/100 g). There was a good linear correlation between xenon CT and perfusion CT (y=0.8537x+2.48, R2=0.895: p<0.05). CONCLUSION: The TBF of pancreatic tumors measured by xenon CT and perfusion CT techniques showed a close linear correlation. We can expect that perfusion CT based on the deconvolution algorithm may replace xenon CT to predict the effect of pancreatic tumor treatment with anticancer drugs.

Adenocarcinoma↗

PubMed2005

Prospective respiratory-triggered multidetector row CT (MDCT) for abdominal examinations: initial experience with a prototype.

PURPOSE: To develop a prototype for prospective respiratory-triggered multidetector row computed tomography (MDCT) for abdominal examinations and to assess its feasibility. MATERIALS AND METHODS: The prototype consisted of the following components: an MDCT unit, personal computer (PC), and a respiratory motion detector in the form of a wearable belt with sensors to measure differences in pressure caused by breathing excursions. The registered signals were processed by the PC. The abdominal MDCT images of 10 healthy volunteers were obtained with an incremental axial technique in the expiration phase during normal breathing. Multiplanar reformations (MPR) were then performed. On the basis of the precision of these reconstructions, two radiologists then assessed the accuracy and applicability of the system. RESULTS: Coronal and sagittal MPR images from these prospective respiratory-gated examinations were found to be accurate. In particular, the continuity of borders and surfaces of scanned organs proved the exactness of the previously acquired respiration-correlated axial source images. CONCLUSION: This prototype is feasible to perform prospective respiratory-triggered abdominal MDCT examinations during normal respiration without breathhold. This system may be useful for patients with reduced compliance in holding their breath.

Artifacts↗

PubMed2004

MR appearances of radiofrequency thermal ablation region: histopathologic correlation with dog liver models and an autopsy case.

RATIONALE AND OBJECTIVES: The purpose of this study was to evaluate the utility of magnetic resonance (MR) imaging for indicating the extent of true tissue necrosis of the liver after radiofrequency (RF) ablation in comparison with histopathologic findings in dog models and an autopsy case. MATERIALS AND METHODS: RF ablation of the liver parenchyma was performed on three dogs under general anesthesia. MR appearances of the RF-ablated regions on T1-weighted fast-low angle shot (FLASH; repetition time/echo time [TR/TE]/flip angle: 120/3.8/70),T2-weighted turbo spin echo (3000/80/echo train = 25) and contrast-enhanced T1-weighted images were compared with histopathologic findings. An autopsy case with hepatocellular carcinoma was also enrolled in this study. RESULTS: All ablated regions showed three zones on T1-weighted FLASH images: a central zone with low intensity, a broad hyperintense middle zone, and a surrounding hypointense band. The central and middle zones corresponded to the degrees of coagulation necrosis observed during histopathologic examination, whereas no viable cells were seen in these zones during the microscopic examination using nicotinamide adenine dinucleotide diaphorase stain. The surrounding hypointense band corresponded to sinusoidal congestion in the acute phase and to fibrotic change in the subacute phase. CONCLUSION: MR imaging using the FLASH sequence can accurately determine the extent of the necrotic area after RF ablation.

Aged↗

PubMed2004

Laparoscopic correction of congenital portosystemic shunt in children.

Congenital portosystemic shunt is a rare clinical entity that may progress to jaundice, severe encephalopathy, and pulmonary hypertension and require surgical correction or coil embolization. We present a novel approach to the management of children with congenital portosystemic shunt by means of a minimally invasive surgical technique. Congenital portosystemic shunts were identified between the superior mesenteric vein and inferior vena cava in case 1 and between the splenic vein and left renal vein in case 2. Both of them were successfully ligated by laparoscopic approach, and catheters were subsequently replaced to monitor portal venous pressure. The patients tolerated the procedure well, and short-term results were excellent. Laparoscopic ligation of congenital portosystemic shunt is technically feasible and less invasive to the management of patients with congenital portosystemic shunts, preventing late onset, life-threatening complications.

Child↗

PubMed2004

CT Scan and MRI in the Differentiation of Liver Tumors.

Computed tomography (CT) and magnetic resonance imaging (MRI) are useful for detection and characterization of liver tumors, and widely used in clinical practice. By using dynamic CT and MRI with extracellular contrast material or MRI with liver-specific contrast material, we can investigate the morphological, hemodynamical and functional nature of focal hepatic lesions. Tumors often show characteristic findings on CT and MRI. Thus, we can correctly establish a diagnosis of liver tumors based on those findings. In this article, we describe the role of CT scan and MRI in the differentiation of liver tumors as well as presenting some typical CT and MR images.

Contrast Media↗

PubMed2004

[PACS for multi-slice CT--seamless integration implementing 3D and 4D workstations].

A PACS system for data management in multi-slice CT examination was upgraded using interactive 3D and 4D workstations and network computing technology. We categorized the original PACS (CT-PACS) as follows: (1) a fault-tolerant system linked with the hospital information system (HIS) and radiology information system (RIS); (2) an interactive network system using a workstation with real-time 3D and 4D reconstruction; (3) a system for research and development of software for 3D image analysis on the CT-PACS system. Because of the use of cooperative diagnostic supporting tools, no major problems occurred in daily clinical practice or research and education. In conclusion, CT-PACS with real-time 3D and 4D workstations was found to be helpful to radiologists and researchers in reading and analyzing large volumetric data.

Computer Communication Networks↗

PubMed2004

[Hepatic arterial infusion chemotherapy (HAIC)--hepatocellular carcinoma].

Hepatic arterial infusion chemotherapy (HAIC) has been often selected as a therapeutic option for advanced hepatocellular carcinoma (HCC) with intrahepatic metastases or portal vein thrombosis, which is not eligible for hepatic resection, tumor ablation, or embolization. Among various regimens, HAIC, consisting of 5-fluorouracil (5-FU) in combination with either low-doses of cisplatin (CDDP) or interferon-alpha has been reported to improve the response rates for advanced HCC. As both regimens require the use of an implanted port-catheter system, maintaining the patency of hepatic arteries is an important factor for the intrahepatic drug distribution and the efficacy of HAIC. Recently, a new product, CDDP powder has been also developed for intraarterial use, which adds a new option to HAIC. However, the long-term outcome or the survival benefit remains unclear with HAIC, and it may be significantly affected by liver function and cirrhosis. None of the regimens have been proved to be the standard for HAIC, and prospective multi-center clinical studies with standardized protocol are needed in the future.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed2003

Evaluation of optimal timing of arterial phase imaging for the detection of hypervascular hepatocellular carcinoma by using triple arterial phase imaging with multidetector-row helical computed tomography.

PURPOSE: We evaluated the optimal timing of arterial phase imaging for detection of hypervascular hepatocellular carcinoma by using triple arterial phase imaging with multidetector-row helical computed tomography. MATERIALS AND METHODS: Forty-nine patients with 90 hypervascular hepatocellular carcinomas (3 to 50 mm in diameter; mean, 18.7 mm) underwent triple arterial phase imaging of the whole liver using a multidetector-row helical computed tomography. At 20 seconds, 30 seconds, and 40 seconds after intravenous administration of 100 mL of 300 mgI/mL of nonionic contrast medium at a rate of 4 mL/s, early, middle, and late arterial phase images were obtained serially during a single breath-hold with an interscan delay of 5 seconds. Detector-row configurations of 4 mm x 4, scan pitch of 5.5, and scan time of 5 seconds for each phase were used. Forty prospective reconstruction images of 5-mm thickness for each phase were obtained. The images from each phase were interpreted separately for detection of hypervascular hepatocellular carcinoma by 3 observers independently who were unaware of tumor burden in the liver. Sensitivity, positive predictive value, and area under the receiver operating characteristic curve values for each arterial phase were calculated and compared statistically. RESULTS: The mean sensitivity and positive predictive values for hypervascular hepatocellular carcinoma diagnosis of blind readers were 37% and 87% for the early arterial phase, 73% and 85% for the middle arterial phase, and 49% and 81% for the late arterial phase, respectively. The middle arterial phase imaging showed significantly superior sensitivity compared with the early and late arterial phase for detecting hepatocellular carcinoma (P < 0.05). Mean area under the receiver operating characteristic curve value of the middle arterial phase imaging (0.84) was significantly higher that that of the early (0.56) or late arterial phase (0.62; P < 0.05). CONCLUSION: If a single arterial phase is used for diagnosis of hypervascular hepatocellular carcinoma, the middle phase (delay time of 30 seconds) is optimal.

Adult↗

PubMed2003

Using superparamagnetic iron oxide-enhanced MRI to differentiate metastatic hepatic tumors and nonsolid benign lesions.

OBJECTIVE: We evaluated the ability of superparamagnetic iron oxide (SPIO)-enhanced MRI to differentiate solid metastatic tumors and nonsolid benign lesions by clarifying the characteristic signal-intensity pattern of each lesion on SPIO-enhanced T2-weighted and heavily T1-weighted gradient-echo images. MATERIALS AND METHODS: SPIO-enhanced MRI was performed using a 1.5-T system in 33 consecutive patients without cirrhosis who had 81 focal hepatic lesions (42 cysts, 13 hemangiomas, 26 metastatic tumors). The relative signal intensity of lesions on SPIO-enhanced heavily T1- and T2-weighted gradient-echo images was classified into one of the following three categories: high intensity, isointensity, or low intensity relative to the surrounding liver parenchyma. The diagnostic accuracy for differentiating solid metastatic tumors from nonsolid benign lesions (cysts or hemangiomas) was determined. RESULTS: A combination of the relative signal intensity of the lesion on T2- and heavily T1-weighted gradient-echo images could be classified into the following five categories: high intensity and high intensity (category 1), high intensity and isointensity (category 2), high intensity and low intensity (category 3), isointensity and isointensity (category 4), and isointensity and low intensity (category 5). According to these categories, category 1 contained two hemangiomas, category 2 had 11 hemangiomas, category 3 had 25 metastatic tumors and two cysts, category 4 had three cysts, and category 5 had 37 cysts and one metastatic tumor. When a tumor with a relative signal intensity of categories 1 or 2 was considered to be a hemangioma (category 3 metastatic tumors and categories 4 and 5 cysts), diagnostic accuracy for characterizing such hepatic lesions was 96% (78/81). CONCLUSION: When evaluating metastatic liver tumors on SPIO-enhanced MRI, we recommend that heavily T1- and T2-weighted gradient-echo images be obtained with our parameters to exclude hemangiomas or cysts.

Adult↗

PubMed2002

[Technical application of three-dimensional visualization and measurement for breast cancer using multidetector-row CT scanner].

This paper describes an integrated methodology that addresses the operation of 3D imaging and measurement for the diagnosis and surgical operation of breast cancer. The main system for breast CT imaging used a multi-slice CT scanner and 3D-workstation. The clinical sequence was performed in three phases with non-contrast and biphasic contrast-enhanced studies that were performed with multi-slice helical CT scanning. Acquired DICOM images were directly sent to the 3D workstation that implemented our developed functions. Four types of transfer functions (mammary skin, vessel, lymph node, and tumor) were set based on region-of-interest (ROI) measurements. After that, two types of segmentation were prepared with volumetry and measurement of the size of breast cancer. Batch processing for 3D visualization and the measurement of breast tumors was helpful for diagnosis and surgical planning.

Breast Neoplasms↗

PubMedDate not supplied

Detection of hypervascular hepatocellular carcinoma by dynamic magnetic resonance imaging with double-echo chemical shift in-phase and opposed-phase gradient echo technique: comparison with dynamic helical computed tomography imaging with double arterial phase.

PURPOSE: The technique of double-echo chemical shift gradient echo magnetic resonance imaging (MRI) with the fast low-angle shot (double-echo FLASH) sequence provides in-phase and opposed-phase images in a single breath hold. The purpose of this study was to evaluate the efficacy of dynamic MRI with double-echo FLASH imaging for the detection of hypervascular hepatocellular carcinoma by comparing it with dynamic helical computed tomography (CT) imaging with double arterial phase. MATERIALS AND METHODS: Twenty-nine patients with 67 hypervascular hepatocellular carcinoma nodules who underwent both dynamic MRI with double-echo FLASH imaging (repetition time/echo time/flip angle: 160/3.6, 7.0/80 degrees ) and dynamic helical CT imaging with double arterial phase were enrolled in the study. For dynamic MRI, precontrast, arterial, portal venous, and equilibrium phase images were obtained before and approximately 19, 60, and 120 seconds, respectively, after intravenous injection of 0.1 mmol/kg of gadopentetate dimeglumine at a rate of 2 ml/s. For dynamic CT imaging, quadraphase images, including early arterial, late arterial, portal venous, and equilibrium phases, were obtained serially approximately 20, 30, 70, and 180 seconds, respectively, after intravenous administration of 2 ml/kg of 300 mgI/ml of nonionic contrast medium at a rate of 5 ml/s. Three masked observers independently interpreted images obtained with each technique in random order, separately and without patient identifiers. Sensitivity and positive predictive values as well as the area below the alternative-free response receiver operating characteristic curve (Az) for each imaging technique were calculated and compared statistically. RESULTS: Mean sensitivity and positive predictive values of MRI for hypervascular hepatocellular carcinoma were 48% and 94%, respectively, and those of CT imaging were 47% and 91%, respectively. In 11 (38%) of the 29 patients, at least one observer judged dynamic MRI to be superior, whereas in 5 patients (17%), dynamic CT was judged to be superior. There was no significant difference in the sensitivity and positive predictive values between these techniques (p > 0.05). There was no significant difference either in mean Az values between CT (0.55) and MRI (0.57) (p = 0.61). CONCLUSION: Dynamic MRI with double-echo FLASH imaging can detect hypervascular hepatocellular carcinoma as well as dynamic helical CT imaging with double arterial phase.

Adult↗