The utility of gadolinium-enhanced magnetic resonance (MR) imaging in assessing the response of spinal metastases to therapy was evaluated. Fifteen patients (62 affected vertebral bodies) with spinal metastases were evaluated with gadopentetate dimeglumine-enhanced imaging before and after irradiation or chemotherapy. Signal intensities of the lesions and of adjacent normal vertebral bodies were compared. Before therapy, metastatic foci enhanced significantly more than did normal vertebral bodies. After therapy, the lesions were divided into 37 responding lesions (group 1) and 25 nonresponding lesions (group 2). In group 1, lesion enhancement diminished considerably and the patients with these lesions remained clinically asymptomatic for 2-6 months. In group 2, lesion enhancement did not diminish much, and the difference between the groups was significant. Gadolinium-enhanced MR imaging may thus be a useful method for assessing the effectiveness of therapy for spinal metastases.

Breast Neoplasms↗

PubMedDate not supplied

Improved reliability of repetitive RF interstitial heating in combination with brachytherapy: the effective use of water.

Interstitial heating and brachytherapy are often combined in the treatment of cancer. In such instances, a needle-type internal electrode is inserted into the RALS (remotely controlled afterloading system) catheter instead of a radioactive source. A problem with this approach, however, is that the temperature distribution pattern generated by the inserted electrode varies at any given target region in each heating treatment, which makes it difficult to accurately replicate the heating treatment protocol. This variation is suspected to be caused by non-uniformity in the small gap between the internal electrode and the inner surface of the surrounding catheter, causing electric currents to flow between the electrode and the heating material, which differs from procedure to procedure. To solve this problem, the gap was filled with water of high permittivity, and the temperature distribution was investigated using phantoms. With this method, a stable and reproducible temperature rise distribution was obtained in the phantom experiment.

Brachytherapy↗

PubMedDate not supplied

Calcification in caval membrane causing primary Budd-Chiari syndrome: CT demonstration.

We report two cases of membranous obstruction of the inferior vena cava (MOIVC) in which we observed patchy calcification in the membrane. The location of the calcification in the membrane was confirmed histologically. This finding was found histologically in four of eight cases of MOIVC, and it is a useful finding in the CT diagnosis of MOIVC.

Aged↗

PubMedDate not supplied

CT characteristics of intrahepatic, periportal, extramedullary hematopoiesis.

A case of primary myelofibrosis that showed intrahepatic periportal extramedullary hematopoiesis on CT and sonography is presented. Pathological correlation of the autopsy material was obtained. It should be included in the differential diagnosis of periportal abnormality on CT.

Aged↗

PubMedDate not supplied

A case of malignant mixed mesodermal tumor (MMMT) of the ovary: MR features before and after chemotherapy.

Malignant mixed mesodermal tumor (MMMT) of the ovary is rare. We describe the MR findings of this tumor before and after chemotherapy. Although MR findings were not specific to ovarian MMMT, MR images provided useful information about the effect of chemotherapy. Thus we could select appropriate therapy.

Aged↗

PubMedDate not supplied

Magnetic resonance imaging (MRI) and technetium-99m-methoxyisonitrile (MIBI) scintigraphy to evaluate the abnormal parathyroid gland and PEIT efficacy for secondary hyperparathyroidism.

PURPOSE: Percutaneous ethanol injection therapy (PEIT) of the abnormal parathyroid gland is an effective treatment in patients with chronic renal failure with dialysis that tends to be unresponsive to medication. To evaluate the efficacy of PEIT, we investigated the correlation between serum intact PTH (iPTH), and the findings of MR imaging and 99mTc-MIBI scintigraphy. MATERIALS AND METHODS: PEIT was performed 32 times in 24 patients with secondary hyperparathyroidism. Both MR imaging and MIBI scintigraphy were performed before and after PEIT. The detectability of parathyroid lesions was evaluated by MRI and MIBI scintigraphy with reference to ultrasound (B-mode) findings (as a standard) and the comparison of each treatment was done between imaging changes and serum iPTH levels. RESULTS: In the small parathyroid glands (< 0.5 ml with US), MR images detected abnormal glands in 74.0% (20/27), and MIBI accumulation was observed in 40.7% of the cases. Whereas, MR images and MIBI showed similar detectability (95.0% vs. 90.0%) to large parathyroid glands (> or = 0.5 ml with US). After PEIT, glands in which ethanol was successfully injected showed decreased signal intensity on T2-weighted images and decreased accumulation of MIBI. MR imaging and MIBI scintigraphy showed almost equivalent high sensitivity in evaluating therapeutic changes (73.3% vs. 76.4%) according to our evaluation category of more than 30% reduction of iPTH as effective. However, the specificity of MR imaging was much higher (100%) than that of MIBI scintigraphy in evaluating therapeutic effects. CONCLUSION: In conclusion, MRI provided better detectability of abnormal parathyroid glands than 99mTc-MIBI scintigraphy. The reduction of high signal intensity area after PEIT on T2-weighted MR images is considered an useful therapeutic evaluation guideline than the reduction of MIBI accumulation on scintigraphy.

Adult↗

PubMedDate not supplied

Detection of minute pleural fluid in the pleural retracted space associated with peripheral lung cancer: evaluation with MR imaging.

PURPOSE: To evaluate the efficacy of magnetic resonance imaging (MRI) in detecting minute pleural fluid in the pleural retracted space (PRS) associated with peripheral lung cancer. MATERIALS AND METHODS: Our subjects were 20 patients with peripheral lung cancer in whom thin-section CT in the lung window setting demonstrated lesions adjacent to the pleural surface, and who were referred for MR imaging. The imaging findings were retrospectively evaluated and correlated with the histopathologic specimens. Pleural fluid was aspirated for cytology under ultrasound (US) guidance in six patients. RESULTS: STIR MR images revealed water SI areas beneath the chest wall associated with the lung cancer, whereas, on CT images, lung cancer and minute pleural fluid in the PRS showed similar soft-tissue density without enabling easy differentiation. Two of the six patients who underwent aspiration cytology showed malignancy. All histopathologic specimens obtained from 18 patients who underwent surgery showed pleural retraction corresponding to the water SI areas on STIR images. Histopathological study revealed that the fibrotic focus of the tumor tended to occur more intensively when the shape of pleural retraction was thinner and deeper. CONCLUSION: Water SI areas on STIR images were thought to suggest pleural fluid retention in the PRS. MRI was sensitive in detecting minute pleural fluid in the PRS and may help to avoid overdiagnosis of chest wall invasion induced from peripheral lung cancers.

Adult↗

PubMedDate not supplied

Diagnosis of chest wall invasion by lung cancer: useful criteria for exclusion of the possibility of chest wall invasion with MR imaging.

PURPOSE: To compare the accuracy of thin-section CT, conventional static MR imaging (conventional MRI), and breathing dynamic echo planar magnetic resonance imaging (BDEPI) in evaluating lung cancer invasion to the chest wall. MATERIALS AND METHODS: Thin-section CT, conventional MRI, and BDEPI were performed preoperatively in 20 patients suspected of having primary lung cancers adjacent to the chest wall on conventional CT. The results of imaging findings were compared with those of surgical and histopathological findings. RESULTS: All patients were confirmed to have no chest wall invasion after surgery. By thin-section CT, 10 of 20 patients were correctly diagnosed as having no chest wall invasion (50% specificity). Two of the 20 patients were incorrectly diagnosed as having chest wall invasion by conventional MRI and BDEPI (90% specificity). CONCLUSION: When chest wall invasion is suspected on CT scans, static and breathing dynamic MRI are recommended to avoid false positive interpretations.

Adenocarcinoma↗

PubMedDate not supplied

A phase II multicentric trial of S-1 combined with 24 h-infusion of cisplatin in patients with advanced gastric cancer.

BACKGROUND: The aim of this multicentric trial was to determine the clinical toxicities and antitumor effects of a chemotherapy regimen of S-1 combined with cisplatin in patients with inoperable locally or metastatic advanced gastric cancer. PATIENTS AND METHODS: Forty-two patients were entered into the study. S-1 (80 mg/m2) was administered orally daily for 14 consecutive days and 24-h infusion of cisplatin (70 mg/m2) was administered on day 8 of every 28-day cycle. RESULTS: The overall response rate was 50% and complete response rate was 5%. The most common adverse event was leucopenia, which occurred with grade 3 in 7 patients (16.6%) and grade 4 in 2 patients (4.8%). Non-hematological adverse events were generally mild. The median survival time was 342 days. The 2-year survival rate was 22.9%. CONCLUSION: This combination chemotherapy is active, convenient and well tolerated in patients with high-grade advanced gastric cancer.

Adult↗