Biomedical subjects

Kenji Yutani

Publications and source records attributed to Kenji Yutani.

4 recordsLinked to original sources

PubMed2004

Preoperative evaluation of prognosis in breast cancer patients by [(18)F]2-Deoxy-2-fluoro-D-glucose-positron emission tomography.

PURPOSE: [18F]2-Deoxy-2-fluoro-D-glucose (FDG)-positron emission tomography (PET) was applied to breast cancer patients for the purpose of preoperative evaluation of patient prognosis with more accuracy than conventional TNM staging. METHODS: FDG-PET was performed preoperatively in 81 patients with breast cancer, and the maximum standardized uptake value (SUVmax) of tumors as well as the focal accumulation of FDG in the axillary region (PET-N status) were investigated in their association with patient prognosis. RESULTS: The SUVmax high group (n=40) showed a significantly (P=0.011) poorer prognosis than the SUVmax low group (n=41) (5-year disease-free survival (DFS) rates; 75.0% vs 95.1%). FDG-PET was more accurate in the diagnosis of axillary lymph node status than physical examination, i.e., diagnostic accuracy was 80% and 70% for FDG-PET and physical examination, respectively. The combination of high SUVmax and positive PET-N (+) was shown to be a highly significant risk factor being independent of the clinical T and N factors, i.e., patients with high SUVmax and positive PET-N (+) showed a significantly (P<0.001) poorer prognosis than the other patients (5-year DFS rates; 44.4% vs 96.8%). CONCLUSIONS: These results suggest that FDG-PET is useful in the preoperative evaluation of prognosis in breast cancer patients with more accuracy than conventional TNM staging. It is expected that the indication of neoadjuvant chemotherapy can be decided more precisely by the preoperative evaluation of patient prognosis with FDG-PET due to a possible elimination of overtreatment for those who have good prognosis and, thus, need not to be treated with chemotherapy.

Adult↗

PubMed2004

[Visualization of pancreaticobiliary reflux in patients with elevated amylase activity in bile with dynamic secretin-stimulated MR cholangiopancreatography].

Seven patients who had elevated amylase activity in the bile at cholecystectomy and seven normal volunteers were prospectively examined by secretin-stimulated dynamic MRCP. Thirty-five consecutive MR cholangiopancreatograms were acquired at intervals of approximately 10 sec after secretin injection; the acquisition time was 4 sec per image. In all normal volunteers, no apparent signal intensity (SI) changes were noted in the intra- and extrahepatic ducts. Of the 7 patients, the extrahepatic duct showed a sequential SI increase from downstream to upstream in 6; its caliber increased subsequent to pancreatic fluid secretion in 5; and duodenal filling grade tended to be lower in the patients (p < 0.01). These findings were thought to be suggestive of pancreaticobiliary reflux.

Adult↗

PubMed2003

Quantitative mapping of cerebral deoxyhemoglobin content using MR imaging.

In this study, we present a magnetic resonance imaging (MRI) method for quantifying cerebral deoxyhemoglobin content that is based on a measurement of the reversible contribution (R'2) of the transverse relaxation rate under the assumption of a quantitative relationship between R'2 and deoxyhemoglobin content. A numerical simulation was performed assuming a specific pulse sequence conventionally employed for R'2 measurement. The results showed a near linear relationship between R'2 and deoxyhemoglobin content in the physiological range of oxygen extraction for almost all sized vessels, although a large diffusion effect for capillary sized vessels compromised the relationship. Concerning the methodology for R'2 measurement, a theoretical analysis showed that multiexponential transverse signal decay of brain parenchyma may result in a considerable underestimation or overestimation of R'2, if a conventional method is employed for R'2 quantification. A modified method for correcting the effect of multiexponential signal decay was employed for R'2 measurement of the brain in normal volunteers. The results showed a high level of agreement between the R'2 values measured in our study and those estimated from physiological parameters obtained using other modalities such as PET. In the context of BOLD contrast-based functional MRI, the method proposed provides a quantitative mapping of baseline cerebral deoxyhemoglobin content, which is the essential physiological parameter for calibrating the stimulation-induced BOLD signal change and mapping neuronal activity in a quantitative manner by functional MRI.

Adult↗

PubMed2002

Correction of nonuniform attenuation and image fusion in SPECT imaging by means of separate X-ray CT.

Improvements in image quality and quantitation measurement, and the addition of detailed anatomical structures are important topics for single-photon emission tomography (SPECT). The goal of this study was to develop a practical system enabling both nonuniform attenuation correction and image fusion of SPECT images by means of high-performance X-ray computed tomography (CT). A SPECT system and a helical X-ray CT system were placed next to each other and linked with Ethernet. To avoid positional differences between the SPECT and X-ray CT studies, identical flat patient tables were used for both scans; body distortion was minimized with laser beams from the upper and lateral directions to detect the position of the skin surface. For the raw projection data of SPECT, a scatter correction was performed with the triple energy window method. Image fusion of the X-ray CT and SPECT images was performed automatically by auto-registration of fiducial markers attached to the skin surface. After registration of the X-ray CT and SPECT images, an X-ray CT-derived attenuation map was created with the calibration curve for 99mTc. The SPECT images were then reconstructed with scatter and attenuation correction by means of a maximum likelihood expectation maximization algorithm. This system was evaluated in torso and cylindlical phantoms and in 4 patients referred for myocardial SPECT imaging with Tc-99m tetrofosmin. In the torso phantom study, the SPECT and X-ray CT images overlapped exactly on the computer display. After scatter and attenuation correction, the artifactual activity reduction in the inferior wall of the myocardium improved. Conversely, the incresed activity around the torso surface and the lungs was reduced. In the abdomen, the liver activity, which was originally uniform, had recovered after scatter and attenuation correction processing. The clinical study also showed good overlapping of cardiac and skin surface outlines on the fused SPECT and X-ray CT images. The effectiveness of the scatter and attenuation correction process was similar to that observed in the phantom study. Because the total time required for computer processing was less than 10 minutes, this method of attenuation correction and image fusion for SPECT images is expected to become popular in clinical practice.

Algorithms↗