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Biomedical subjects

R A Castellino

Publications and source records attributed to R A Castellino.

At least 19 recordsLinked to original sources
PubMed1996

Non-Hodgkin lymphoma: contribution of chest CT in the initial staging evaluation.

PURPOSE: To analyze incremental information derived from routinely obtained chest computed tomographic (CT) scans compared with chest radiographs in newly diagnosed non-Hodgkin lymphoma and the effect of this information on staging and therapy. MATERIALS AND METHODS: Abnormalities on chest radiographs and CT scans obtained at specific sites were prospectively identified in 181 consecutive patients with no previous treatment. When discrepant information was found, the effect on staging and treatment was determined. RESULTS: CT and chest radiographic findings were negative in 99 (55%) patients. CT findings were positive and chest radiograph findings were negative in 17 (9%). Both chest radiograph and CT findings were positive in 65 (36%) patients, 16 with identical sites of disease and 49 with more extensive intrathoracic disease at CT. Most stage changes occurred in the diffuse large cell histologic subtype. CONCLUSION: Although routine chest CT findings increased stage of disease in some patients, it had no effect on initial treatment of newly diagnosed non-Hodgkin lymphoma at this institution.

Female↗
PubMed1996

The cisterna chyli: a potential mimic of retrocrural lymphadenopathy on CT scans.

PURPOSE: To determine the normal appearance of the cisterna chyli and how it may mimic an enlarged retrocrural lymph node on computed tomographic (CT) images. MATERIALS AND METHODS: CT scans were reviewed in 18 patients (17 with cancer, one with benign disease) who had tubular retrocrural structures of attenuation near that of water. The location, diameter, length, CT attenuation, duration of finding, change in size, and the status of intercurrent malignancy were recorded. RESULTS: The cisterna chyli was variably located at T12-L1 (n=11), at T11-T12 (n=5), and at T-12 (n=2). The average length was 3 cm. The average CT attenuation was 12.5 HU. On serial scans in 14 patients, the average change in size was 2.2 mm despite progression or regression of malignant disease at other sites in 11 patients. CONCLUSION: The cisterna chyli can mimic the appearance of an enlarged retrocrural lymph node. Proper identification depends on its characteristic location, tubular configuration, attenuation closer to that of water than soft tissue, and lack of substantial change in size despite changes in disease at other sites.

Contrast Media↗
PubMed1995

Characterization of reactive versus tumor-bearing lymph nodes with interstitial magnetic resonance lymphography in an animal model.

RATIONALE AND OBJECTIVES: To determine if magnetic resonance lymphography performed with subcutaneously administered AMI-227, a nanoparticulate iron oxide contrast agent, can distinguish reactive from tumor-bearing lymph nodes. MATERIALS AND METHODS: Mature male Copenhagen rats were inoculated with cell suspensions of R3327-MAT-LyLu rat prostate carcinoma (n = 21) or Freund's complete adjuvant (n = 15) in the left footpad to generate ipsilateral popliteal lymph node metastases or lymphadenitis. At 12 to 14 days after inoculation, T1-and T2-weighted magnetic resonance images of bilateral popliteal areas were obtained before and 24 hours after subcutaneous administration of AMI-227. Contrast-to-noise ratios were calculated in precontrast and postcontrast images. Bilateral popliteal nodes were excised for pathologic assessment. RESULTS: AMI-227 resulted in decreased contrast-to-noise ratios in reactive (T1-W = -7.01 +/- 1.13, T2- W = -31.64 +/- 5.35) and normal (T1 - W = -13.56 +/- 1.97, T2 - W = -21.62 +/- 2.51) nodes. Contrast-to-noise ratios were unchanged (T1 - W = -0.22 +/- 1.71, T2 - W = -2.20 +/- 4.19) in tumor-containing nodes. These differences in contrast-to-noise ratio changes between tumor-bearing versus nontumor-bearing nodes were statistically significant (P < 0.05). Histologic analysis showed similar distribution of AMI-227 within normal and reactive nodes, but not in tumor-bearing nodes. CONCLUSIONS: Differences in AMI-227-uptake between tumor- and nontumor-bearing nodes detected with magnetic resonance imaging are helpful for distinguishing the two entities.

Animals↗
PubMed1995

CT bone window photography in patients with cancer.

PURPOSE: To assess the utility of routinely photographing computed tomographic (CT) bone windows in patients with cancer. MATERIALS AND METHODS: The impression section of body CT reports were reviewed in 4,683 patients with cancer (2,240 female and 2,443 male patients, aged 2 months to 97 years [mean, 55 years]). RESULTS: The presence of definite or possible bone metastasis was mentioned in 523 (11.2%) patients. No prior radiologic examination was available in 165 patients. In the 358 patients who had undergone previous radiologic examinations, findings were positive in 271 and normal or indeterminate in 87. In 252 (5.4%) patients, CT with bone windows may have been needed for diagnosis of bone metastasis: 110 had extensive nonosseous metastases, 77 had no osseous metastasis, 19 had bone findings that were not followed up radiologically, and 46 had bone lesions that were new findings. These new lesions were visible on scans photographed at soft-tissue windows in 45 (97.8%) patients. CONCLUSION: Routine photography of CT bone windows is not necessary in patients with cancer.

Adolescent↗
PubMed1994

Low-density supradiaphragmatic band artifact on advanced multiple-beam equalization radiography of the chest.

RATIONALE AND OBJECTIVES: A low-density dark band artifact was found above the diaphragm on advanced multiple-beam equalization radiography (AMBER) of the chest and was evaluated. METHODS: Fifty consecutive chest radiographs were evaluated for the presence of the artifact. AMBER radiographs of a phantom were scanned with a microdensitometer. RESULTS AND CONCLUSION: The presence of the artifact is confirmed on the patient chest radiographs (present in 84% on posteroanterior view; 94% on lateral view) and on the phantom images. The artifact was probably caused by a delayed system response to scanning across a sharp boundary.

Artifacts↗
PubMed1994

AMI-227-enhanced MR lymphography: usefulness for differentiating reactive from tumor-bearing lymph nodes.

PURPOSE: To determine the value of magnetic resonance (MR) lymphography enhanced with AMI-227, a superparamagnetic reticuloendothelial-system-specific contrast agent, to distinguish normal and reactive from tumor-bearing lymph nodes. MATERIALS AND METHODS: Mature male Copenhagen rats were inoculated with cell suspensions of R3327-MATLyLu rat prostate carcinoma (n = 16) or Complete Freund Adjuvant (n = 15) to generate ipsilateral popliteal lymph node metastases or lymphadenitis. At 12-14 days after inoculation, T1- and T2-weighted MR images of bilateral popliteal areas were obtained before and 24 hours after administration of AMI-227 (dose, 30 mumol Fe/kg). The contralateral popliteal nodes served as controls. Contrast-to-noise ratios (C/Ns) between the nodes and adjacent muscle were calculated in pre- and postcontrast images. Subsequently, bilateral popliteal nodes were excised. RESULTS: AMI-227 resulted in decreased C/N in reactive nodes (T1-weighted, -186% +/- 90% [standard deviation]; T2-weighted, -205% +/- 96%) and normal nodes (n = 7) (T1-weighted, -306% +/- 82; T2-weighted, -350% +/- 96). C/N remained unchanged or increased (T1-weighted, 88% +/- 92; T2-weighted, 306% +/- 256) (P < .05). CONCLUSION: Differences in AMI-227 uptake at MR imaging may help differentiate tumor-bearing from nontumor-bearing nodes.

Animals↗
PubMed1994

Specificity of high-resolution CT findings in pulmonary asbestosis: do patients scanned for other indications have similar findings?

OBJECTIVE: High-resolution CT findings in patients with asbestosis include subpleural curvilinear densities, subpleural density in dependent portions of the lung, parenchymal bands, thickened septal lines, and honeycomb lung. Our objective was to examine the prevalence of these CT findings in a random group of patients scanned for a variety of clinical reasons not specifically related to occupational exposure. MATERIALS AND METHODS: One hundred sixty-eight CT studies of the thorax were performed at six levels in 168 patients examined for a variety of clinical indications. The scans were evaluated by two radiologists for the presence of subpleural curvilinear densities, subpleural density in dependent locations, parenchymal bands, thickened septal lines, and honeycomb lung. RESULTS: CT scans of 11 patients showed pleural plaques suggesting previous exposure to asbestos. Among the 157 studies showing no evidence of pleural plaques, CT scans showed subpleural curvilinear densities in dependent areas in 32 (20%); subpleural curvilinear densities in nondependent areas in 19 (12%); parenchymal bands in 47 (30%); thickened septal lines in dependent areas in 93 (59%), and septal lines in nondependent areas in 67 (43%); subpleural density in dependent areas in 66 (42%); and honeycomb lung in five (3%). CONCLUSION: Subpleural curvilinear densities, subpleural density in dependent locations, parenchymal bands, and thickened septal lines occur as isolated and as combined CT findings in patients with a variety of underlying diseases or conditions unrelated to asbestosis and by themselves are nonspecific findings. Their occurrence, even in patients with CT evidence of pleural plaques, does not necessarily indicate the presence of asbestosis.

Asbestosis↗
PubMed1992

Preaortic iliac venous confluence ("marsupial cava"): a rare anomaly of the inferior vena cava.

A patient was shown by computed tomography (CT) to have a rare developmental anomaly of the inferior vena cava (IVC), in which the iliac venous confluence is located anterior (rather than posterior) to the right common iliac artery. Recognition of the anomaly is important prior to surgical intervention in that area, as well as to prevent misinterpretation of the anomaly as representing adenopathy.

Aorta, Abdominal↗
PubMed1992

Diagnostic imaging studies in patients with newly diagnosed Hodgkin's disease.

A variety of diagnostic imaging studies are used to evaluate patients with newly diagnosed Hodgkin's disease which provide important information to determine stage and guide patient management. The following will review the current status of diagnostic imaging studies as applied to evaluation of the thorax, abdomen and pelvis, with comment on areas under investigation.

Hodgkin Disease↗
PubMed1990

Lymph nodes of the posterior iliac crest: CT and lymphographic observations.

This report draws attention to a group of lymph nodes that lie in proximity to the posterior iliac crest. These lymph nodes are visualized at times on routine lymphographic studies and, when enlarged, are demonstrated on computed tomographic scans. These lymph nodes are at risk for involvement with Hodgkin disease and the non-Hodgkin lymphomas.

Adult↗
PubMed1990

Mediastinal lymph node enlargement on CT scans in patients with usual interstitial pneumonitis.

Usual interstitial pneumonitis (UIP) is a chronic pulmonary process with a characteristic peripheral fibrotic pattern on gross pathologic lung sections and CT scans. This condition is often idiopathic, but asbestosis, rheumatoid arthritis, and scleroderma may cause the same peripheral fibrosis in the lungs. UIP is associated with an increased incidence of pulmonary neoplasms. The purpose of this study was to evaluate the size of mediastinal lymph nodes in patients with UIP in whom no evidence was seen of malignancy or current active infection. CT scans of 14 patients (12 with idiopathic pulmonary fibrosis and two with collagen vascular disorders) were assessed for lymph node location (American Thoracic Society mediastinal map) and size. In 13 of 14 patients, nodes measured greater than threshold size values. Nodes as large as 20 x 30 mm were identified in three patients. Nodal sites 10R, 4R, 2R, 5, and 6 were most commonly abnormal. We conclude that increase in the size of mediastinal lymph nodes as shown on chest CT scans is common in patients with UIP, occurs without superimposed infectious or malignant complications, and is thus presumably part of the chronic inflammatory process. Consequently, lymphadenopathy in these patients does not suggest that they have lung cancer also.

Adult↗