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Validation study of simulation codes was performed based on the measurement of a sphere phantom and the National Electrical Manufacturers Association (NEMA) body phantoms. SIMIND and Prominence Processor were used for the simulation. Both source and density maps were generated using the characteristics of 99m Tc energy. A full width at half maximum (FWHM) of the sphere phantom was measured and simulated. Simulated recovery coefficient and the background count coefficient of variation were also compared with the measured values in the body phantom study. When the two simulation codes were compared with actual measurements, maximum relative errors of FWHM values were 3.6% for Prominence Processor and -10.0% for SIMIND. The maximum relative errors of relative recovery coefficients exhibited 11.8% for Prominence Processor and -2.0% for SIMIND in the body phantom study. The coefficients of variation of the SPECT count in the background were significantly different among the measurement and two simulation codes. The simulated FWHM values and recovery coefficients paralleled measured results. However, the noise characteristic differed among actual measurements and two simulation codes in the background count statistics.

Targeted radioisotope therapy (TRT) is a radiotherapy using radioisotope or drug incorporating it and has been used as a treatment for selectively irradiating cancer cells. In recent years, interest in TRT has increased due to improvements in radionuclide production technology, development of new drugs and imaging modalities, and improvements in radiation technology. In order to enhance the effect of TRT, measurement of individual radiation doses to tumor tissue and organs at risk is important using highly quantitative nuclear medicine images. In this paper, we present a review of literature on optimization of TRT, which is a new research area from the perspective of radiation technology.

The aim of the present study was to clarify the routine protocols and the frequency of added or omitted imaging on nuclear medicine imaging in Japan. A nationwide survey on routine protocols and current state of added or omitted imaging in major nuclear medicine imaging were performed for Japanese nuclear medicine technologist. The survey showed that the routine protocols were almost 100% fixed, some of the routine protocols were found to be useful and percentage of imaging techniques such as single photon emission computed tomography/computed tomography that increased patient burden and reduced through put were low. Furthermore, the survey showed that additional or omission imaging were frequently performed on bone scintigraphy and positron emission tomography and added or omitted judgements were often depend upon the rule of thumb by nuclear medicine technologist. In this study, we have concluded that the quality of examination and the diagnosis might depend on the knowledge of nuclear medicine technologist, performed added or omitted imaging.

Radionuclide therapy has been used to help manage a range of diseases and has a role of growing importance, with an increasing impact on clinical practice globally. A survey in the field of Radionuclide therapy was conducted by reviewing 4199 science abstracts of main conference (Japanese Society of Radiological Technology, Japanese Society of Nuclear Medicine, Japanese Society of Nuclear Medicine Technology, Society of Nuclear Medicine and Molecular Imaging, European Association of Nuclear Medicine) held in 2016. This survey consisted of research content, modality for evaluation, dosimetry, radionuclide, and researcher's country. There tend to be a lot of studies related to targeted radionuclide therapy more than Japan (4%) in the United States (11%) or Europe (13%). Radiopharmaceuticals still un-approving in Japan were used in some of these studies. And many studies on dosimetry using PET or SPECT imaging were confirmed in the United States (37%) or in Europe (25%) compared with in Japan (14%). This survey has clarified the current status of Japan and global trend in the field of radionuclide therapy.

Cryoglobulinemia (Cg) in multiple myeloma (MM) is rare and no standard treatment has yet been established. Herein, we report a case of MM with Cg, successfully treated with a combination of lenalidomide and dexamethasone. A 76-year-old woman suffering from skin ulcerations, extremity pain and peripheral neuropathy was diagnosed as having IgG-kappa MM with Cg in 1992. She intermittently received conventional chemotherapy, immunosuppressant therapy and plasma exchange. Despite these treatments, Cg-related symptoms eventually became uncontrollable. She was admitted to our hospital in 2012 because of worsening skin symptoms involving both ankles. Plasmapheresis proved ineffective. Improvement of skin ulcerations and numbness was achieved with administration of lenalidomide at 25 mg daily with weekly dexamethasone, which also decreased the cryoglobulin level. The course of this patient suggests that lenalidomide plus dexamethasone is a promising treatment for MM with Cg.

The purpose of this study is to clarify the postoperative change of pericardial fat pad used in pulmonary resection to reinforce bronchial suture or bronchial stump. 5 cases who received chest computed tomography (CT) examination 2 times or more after the operation (once within one week after the operation) were enrolled. For evaluation, scoring system from 1 to 4 according to the percentage of remaining pericardial fat pad was applied(1 point: 0∼19%, 2 point: 20∼49%, 3 point: 50∼79%, 4 point: 80∼100%). At 1 to 2 months after the operation, almost all cases were 3 or 4 point. However, the scores declined to 1 or 2 point 5 months after the operation in almost all cases. It is likely that the pericardial fat pad remains to be effective in protecting bronchial stump or anastomosis 1 to 2 months after the operation.

Purpose: The purpose of this research was to understand the clinical discovery of a relapse, relapse time, and the presentation of the first relapse of non-small cell lung cancer(NSCLC)by examining cases of relapse after complete resection of NSCLC. Objective and method. Cases of relapse after complete resection of NSCLC in our hospital were examined., Results: Fifteen cases were evaluated. In half of these cases, relapse was discovered owing to increased tumor marker values. Of the patients, 60%had a relapse within 2 years after resection and 20%had a relapse 5 years after resection. The first relapse was a local recurrence in 9 cases, lung metastasis in 5 cases, and distant metastasis outside the thoracic cavity in 3 cases., Conclusion: The effectiveness of the tumor marker as a diagnostic parameter of relapse in NSCLC was demonstrated. Discovering distant metastases at the early postoperative period and relapse 5 years after resection are important.

Quality control (QC) detects changes in the performance of gamma cameras that could adversely affect interpretations of clinical studies. We used plate and sheet (57)Co flood sources to measure extrinsic uniformity during daily QC. Each source, when placed on the top of a collimated detector, allowed the acquisition of uniform images from both detectors, thus reducing the amount of time needed to perform daily QC. No serious problems with the gamma camera system were revealed by visual checks, and changes in detector sensitivity were rapidly determined by observing daily variations in the measured values of extrinsic uniformity. Furthermore, (57)Co flood sources confer advantages in that they shorten the time required for preparation of flood sources and reduce the consequent exposure of medical staff to radiation.

The aim of this study is to improve the image quality using a post process rather than a correction process at acquisition time. We used a smoothing filter that is widely used on a compact digital camera. Especially for nuclear medicine, when we use a short acquisition time, we will get images that have a large increase in statistical noise. For those images, we validated the efficiency of the smoothing filter by assessing two characteristic parameters. In addition, we defined the best smoothing filter parameters to get stable images that reduced the influence of statistical noise.

We retrospectively analyzed 81 relapsed or refractory adult T-cell leukemia-lymphoma (ATL) patients who received salvage therapy in our institution between 2000 and 2010. These patients had received chemotherapy, radiation, or hematopoietic stem cell transplantation (HSCT) as an initial treatment, and were then given chemotherapy, radiation, HSCT, or donor lymphocyte infusion (DLI) as salvage therapy. Median survival time was 3.9 months. Of 5 long-term survivors, who survived more than 2 years after the first salvage therapy, 4 patients received HSCT or DLI, and the other was given mogamulizumab as the salvage therapy. For patients with relapsed or refractory ATL, HSCT/DLI is a promising treatment for achieving long-term survival. Mogamulizumab may be the good choice for those who are ineligible for HSCT.

We carried out right upper lobectomy and mediastinal node dissection for a 67-year-old man with lung adenocaricinoma in the right upper lobe. Intraoperatively, we found the middle lobe vein, V2, and V3 in front of the pulmonary hilum, and did not found a part of the right apical pulmonary vein. We found a part of the right apical pulmonary vein placed between the right main pulmonary artery and the right upper lobe bronchus, after cutting the pulmonary artery branches to the right upper lobe. We should keep on mind the possibility of anomalous course of pulmonary vein when pulmonary surgery is planned. And, if this abnormality is doubted with the preoperative chest computed tomogrphy (CT) scan, threedimensional CT( 3D-CT) scan of the pulmonary vein is useful.

Objective: Working group on JJ1017 nuclear medicine domain extension code in the Japanese Society of Nuclear Medicine has created nuclear medicine extension codes keeping the integrity with JJ1017. The objective of this study was to investigate the usefulness of nuclear medicine extension codes in real clinical settings., Method: Nuclear medicine examinations of each institution were extracted from the examination master table and then the target subset of examinations to be coded with JJ1017 were identified. For this subset, working process was conducted, during which the followings compared conformity rate, application rate of representative frequently code set and compliance rate of nuclear medicine extension codes., Results: Without using representative frequently code set, it was difficult to invent the same code for the same examination. By using the representative frequently code set, the same code expression could be invented for the same examination. Furthermore, using nuclear medicine extension codes additionally, these which could not be appropriately coded with representative frequently code set alone., Conclusion: Nuclear medicine extension codes keeping the integrity with JJ1017, was proved to be useful to improve the accuracy of coding.

We showed scanner dependence of brain (18)F-FDG and (11)C-PiB images by using phantom examination with nine kinds of positron emission tomography (PET) scanners. We used two types of phantoms, cylindrical phantom with 15 cm inside diameter and three-dimensional (3D) brain phantom, and we set the body phantom on the bed to examine the effect of scatter and random coefficients from outside of the axial field of view (AFOV). Radioactivity and distance of the two phantoms were determined by a pilot study to obtain a condition similar to the clinical study. Axial uniformity was evaluated by circular region of interest (ROI) of 12 cm diameter, set in the center of the reconstruction image of the cylindrical phantom. As a result, the standardized uptake value (SUV) was lower than the true value in some scanners, and there was a scanner in which the axial uniformity was deteriorated by high radioactivity outside the AFOV. In the cylindrical phantom, the axial uniformity of the scanner was improved using the new dead-time correction method; however, it was not improved in the 3D brain phantom. Quality-controlled PET scanners are important to maintain constant levels for multicenter studies.

Causes of thrombocytopenia are diverse, and infection with plasmodia often brings about thrombocytopenia. Japan is not an endemic area of malaria infection at present and most cases are travelers to endemic areas. In some cases, initial clinical diagnoses may not be correct because of a variety of symptoms, physical findings and laboratory abnormalities. A 67-year-old female, who had traveled to South American countries 2 months before the onset of the disease, presented with a case of vivax malaria. Because of the patient's high fever, profound thrombocytopenia (1.5 x 10(4)/microl), and elevated platelet-associated IgG on admission, our initial diagnosis was acute type idiopathic thrombocytopenic purpura (ITP). However, we recognized her tertian fever and plasmodial vivax in erythrocytes 4 days later. She responded promptly to anti-parasitic therapy after diagnosis of malaria and her laboratory data also improved. Travel history is indicative of malaria infection in some cases with thrombocytopenia mimicking acute ITP.

A total of 108 patients with a normal pancreaticobiliary junction who had gallbladder wall thickness as shown by ultrasonography or computed tomography underwent secretin injection magnetic resonance cholangiopancreatography. Based on the changes in the diameter of the biliary system after secretin injection, patients were categorized into the intensified group (n = 19) or the non-intensified group (n = 89). The mean (+/- SD) biliary amylase level in the bile duct was 41674 (+/- 59779) IU/L in the intensified group, which was significantly higher than that in the non-intensified group (210 (+/- 418)) IU/L (p < 0.0001). There were four patients with carcinoma of the gallbladder in the intensified group and their biliary amylase level in the bile duct was 90783 (+/- 82528) IU/L. Pancreatobiliary reflux similar to that seen in patients with pancreaticobiliary maljunction can occur in persons with a normal pancreaticobiliary junction and this may be associated with carcinoma of the gallbladder. Secretin injection magnetic resonance cholangiopancreatography proved useful to identify such persons.

Purpose: In scintigraphy of the sentinel lymph node, it is common to use a lead plate as a shield to reduce star artifact and scattered radiation in the portion surrounding the injected site of radioactive colloid. We have developed an imaging method without using a lead plate, and examined its usefulness in phantom and clinical imagings., Methods, Results: Star artifact was eliminated using a medium energy collimator. Effects of scattered radiation from the injection site were reduced by setting energy window at higher level., Conclusions: Our method without using a lead plate can be applied to dynamic data acquisition and imaging of a portion where it is difficult to place a lead plate. It also seems to be a useful imaging method in that it takes patients' feelings into consideration.

We investigated the efficacy of oral vitamin B12 (B12) therapy in patients with B12-deficiency anemia. Between June 1994 and June 2000, 17 patients, who were diagnosed as having B12-deficiency anemia and gave their informed consent, were enrolled in this study. Of these patients, 7 were further treated with a maintenance dose of methylcobalamin (1,500 micrograms daily for 7 days every 1-3 months). Correction of hematological and neurological abnormalities was prompt. The hemoglobin level and serum concentration of B12 were normalized within two months after starting the treatment. Recovery from neurological disturbance was observed within one month. To maintain a normal serum concentration of B12, a 7-day regime of administration was needed every month in 3 patients, every 2 months in 3 patients, and every 3 months in 1 patient. These results demonstrate the effectiveness of oral cobalamin therapy, and also that oral intermittent therapy is useful for maintaining a normal serum B12 concentration. Oral cobalamin therapy might be as effective as conventional injection therapy, and useful for long-term treatment.

From January 1984 to April 1988, we treated 20 patients with adult lymphoblastic leukemia (ALL) and 2 patients with lymphoblastic lymphoma with a protocol which we modified L-10M of Sloan-Kettering Cancer Center. Since the median follow up time is now over 5 years, we report the most recent outcome. Thirteen patients were male and 9 were female. The median age was 31, ranging from 15 to 71 years of age, and there were no Ph1 positive patients. The complete remission (CR) rate was 81.8%. Median CR duration was 32 months and the 5-year continuous CR rate was 33.3%. No significant prognostic factor for CR rate was found. Age at achievement CR and duration were significant prognostic factors. The 5-year continuous CR rate of patients below 35 years old was 54.5%. In this group the leukocyte count was a significant prognostic factor. All patients with a leukocyte count above 1 x 10(4)/microliters relapsed. However, in patients with a WBC below 1 x 10(4)/microliters, the 5-year continuous CR rate was 75%. Based on these results, it seems reasonable to treat patients with ALL by different therapeutic strategies according to the risk factors.

It is known that cystatins have not only regulatory functions in cellular protein catabolism, but also other physiological functions against viral and/or bacterial infection. Recently we have fond cystatin in the human hair shaft. The activity of human hair cystatin in a water extract of pieces of it reached a plateau after 3-hour incubation. The activity of cystatin was compared among three different lengths of hair. The shorter the hair was cut, the more hair cystatin was extracted. Cystatin was more easily extracted by adding a water-soluble detergent. On the basis of these results, the loss of human hair cystatin from the hair shaft seemed to be affected by the condition of the hair surface and by the detergents in hair shampoo.

Forty fresh gastric cancer specimens were examined by immunohistological staining using anti-BrdU monoclonal antibody, and simultaneously the specimens were studied by DNA ploidy pattern, EGF with flowcytometer and the immunohistological staining. For EGF study, the same 40 gastric cancer formalin fixed specimens were used. The results of flowcytometric measurement were divided into diploid and aneuploid patterns. BrdU positive stained cancer cells were observed in growing border area than in the center of tumor, and histologically in P(+), n(+), ps(+), INF gamma, and in scirrhous type, deep spread type and advanced stage. This data suggested that the BrdU labeling index seemed to be related to invasion, proliferation, and metastasis of cancer cells. However the positive rates of EGF were higher in ps(+), deep spread type and BrdU positive type but not in P(+), n(+), and EGF was considered to related to invasion but not to be related to metastasis. Although aneuploid pattern cancer showed high BrdU labeling index in ps(+), diploid pattern didn't indicate such tendency. High BrdU positive rate aneuploid cancer were seemed to grow quickly, advance in short period and own worse character. Further investigation would be necessary.

In a previous study, we found that crocidolite (an asbestos fiber) had an inhibitory effect on the differentiation process of HL-60 cells induced by dimethyl sulfoxide (DMSO). Here we describe the cathepsin B-like enzyme HL-60 cells and the changes of its activity during cell differentiation with or without crocidolite treatment. The cathepsin B-like enzyme in HL-60 cell extracts had almost the same characteristics and the already known cathepsin B as for the pH optima and the effects of proteinase inhibitors. The cathepsin B-like enzyme activity increased according to the cell differentiation induced by DMSO, however, its activity was depressed by crocidolite treatment.

It was confirmed that the function of DMSO as an inducer of cell differentiation was suppressed by co-culture of crocidolite asbestos, using the activity of protein kinase C as indicator, because DMSO reacted with .OH radical released by stimulation with crocidolite and wasted itself. SOD inhibited the effect of crocidolite, because SOD reacted with .O2- released by stimulation with crocidolite and inhibited the subsequent development of .OH.