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Cell reversal is observed when a current load is applied to the polymer electrolyte membrane fuel cell under fuel starvation conditions. Cell reversal causes severe corrosion (or oxidation) of the carbon support in the anode, which leads to a decrease in overall fuel cell performance. To suppress the corrosion reaction of carbon under cell reversal conditions and to increase the durability of fuel cells, studies on anode additives are being conducted. However, studies on the effect of additives on catalysts with different platinum contents have not been conducted. In this study, 20 wt%, 40 wt%, 60 wt% commercial Pt/C catalyst was applied to the anode, and 50 cycles of cell reversal were performed. Furthermore, the performance change with and without IrO2 as an additive was observed and its effect was assessed. Changes in the morphologies of the electrodes before and after cell reversal tests were also observed using a transmission electron microscope and a scanning electron microscope. The higher the platinum content of the catalyst, the more resistant to cell reversal. In addition, the addition of IrO2 to the anode effectively prevents performance degradation due to cell reversal.

An ideal polymer electrolyte membrane fuel cell (PEMFC) is one that continuously generates electricity as long as hydrogen and oxygen (or air) are supplied to its anode and cathode, respectively. However, internal and/or external conditions could bring about the degradation of its electrodes, which are composed of nanoparticle catalysts. Particularly, when the hydrogen supply to the anode is disrupted, a reverse voltage is generated. This phenomenon, which seriously degrades the anode catalyst, is referred to as cell reversal. To prevent its occurrence, iridium oxide (IrO2) particles were added to the anode in the membrane-electrode assembly of the PEMFC single-cells. After 100 cell reversal cycles, the single-cell voltage profiles of the anode with Pt/C only and the anodes with Pt/C and various IrO2 contents were obtained. Additionally, the cell reversal-induced degradation phenomenon was also confirmed electrochemically and physically, and the use of anodes with various IrO2 contents was also discussed.

BACKGROUND AND PURPOSE: O(6)-methylguanine-DNA methyltransferase (MGMT) promoter methylation status in primary and recurrent glioblastoma may change during treatment. The purpose of this study was to correlate MGMT promoter methylation status changes with DWI and DSC PWI features in patients with recurrent glioblastoma after standard treatment. MATERIALS AND METHODS: Between January 2008 and November 2016, forty patients with histologically confirmed recurrent glioblastoma were enrolled. Patients were divided into 3 groups according to the MGMT promoter methylation status for the initial and recurrent tumors: 2 groups whose MGMT promoter methylation status remained, group methylated (n = 13) or group unmethylated (n = 18), and 1 group whose MGMT promoter methylation status changed from methylated to unmethylated (n = 9). Normalized ADC and normalized relative CBV values were obtained from both the enhancing and nonenhancing regions, from which histogram parameters were calculated. The ANOVA and the Kruskal-Wallis test followed by post hoc tests were performed to compare histogram parameters among the 3 groups. The t test and Mann-Whitney U test were used to compare parameters between group methylated and group methylated to unmethylated. Receiver operating characteristic curve analysis was used to measure the predictive performance of the normalized relative CBV values between the 2 groups. RESULTS: Group methylated to unmethylated showed significantly higher means and 90th and 95th percentiles of the cumulative normalized relative CBV values of the nonenhancing region of the initial tumor than group methylated and group unmethylated (all P < .05). The mean normalized relative CBV value of the nonenhancing region of the initial tumor was the best predictor of methylation status change (P < .001), with a sensitivity of 77.78% and specificity of 92.31% at a cutoff value of 2.594. CONCLUSIONS: MGMT promoter methylation status might change in recurrent glioblastoma after standard treatment. The normalized relative CBV values of the nonenhancing region at the first preoperative MR imaging were higher in the MGMT promoter methylation change group from methylation to unmethylation in recurrent glioblastoma.

This study was performed to evaluate the effect of heat stress on the status of physiological responses, blood parameter, serum T3 and cortisol, and heat shock proteins (HSP 27, 70, and 90) of Hanwoo cattle. Six Hanwoo steers (242.8 ± 7.2 kg of BW) were housed in the climate-controlled respiration chambers. The experiment consisted of 7 days (control; 0 day) at thermoneutral (air temperature (Ta) of 15°C and relative humidity (RH) of 60%; temperature-humidity index (THI) = 64), and by 3 and 6 days (treatment groups) at heat stress (Ta of 35°C and RH of 60%; THI = 87). Body temperature of each parts (frank, rump, perineum and foot) and rectal temperature elevated in heat stress groups (3 days and 6 days) than the control group (0 day). Respiration rates increased in 3 days and 6 days (88.5 ± 0.96 bpm and 86.3 ± 0.63 bpm, respectively) from 0 days (39.5 ± 0.65 bpm). Feed intake significantly decreased in heat stress groups (3 days and 6 days, 3.7 ± 0.14 kg and 4.0 ± 0.15 kg, respectively) than the control group (0 day, 5.0 ± 0.00 kg). In addition, final BW significantly decreased in heat stress groups (3 days and 6 days, 211.8 ± 4.75 kg and 215.5 ± 3.50 kg, respectively) than the control group (0 day, 240.0 ± 25.00 kg). However, heat stress has no significant effect on blood parameter, serum T3 and cortisol. Nevertheless, heat stress increased HSPs mRNA expression in liver tissue, and serum concentration of HSPs. Despite Hanwoo cattle may have high adaptive ability to heat stress, our results suggested that heat stress directly effect on body temperature and respiration rate as well as serum and tissue HSPs. Therefore, we are recommended that HSPs could be the most appropriate indicators of Hanwoo cattle response to heat stress.

A novel synthesis of coumarin derivatives by Bronsted acid-mediated condensation and intramolecular cyclization of phenols and propiolic acids was reported. This transformation requires the use of TfOH in place of a conventional metal mediator, and it occurs under mild conditions and provides rapid access to coumarin derivatives in good yields.

In this study, anthracenes were efficiently synthesized from o -alkynyldiarylmethane using a novel method that exploits the synergistic effect between Bi(OTf) 3 as the catalyst, and trifluoroacetic acid (TFA). Through this reaction, we achieved the rapid and efficient synthesis of anthracenes bearing various functional groups under mild conditions.

The aim of this study was to investigate the value of [18F]fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) in predicting lymph node status in node-negative endometrial cancer on preoperative magnetic resonance imaging (MRI). Patients with endometrial cancer who underwent both preoperative MRI and FDG-PET/CT followed by hysterectomy and lymphadenectomy were initially included. We then enrolled patients with MRI-defined node-negative disease (lymph nodes

Background Multiphasic multidetector computed tomography (MDCT) is widely used for the assessment and diagnosis of complicated renal cysts. Purpose To determine the optimal combination of postcontrast phases of MDCT for the evaluation of complicated renal cysts. Material and Methods In 164 renal cysts with pathology confirmation or follow-up >2 years, the Bosniak category was recorded by two radiologists in consensus. They reviewed the MDCT images during three interpretation sessions. In the first session, the radiologists evaluated two phases of images (unenhanced and corticomedullary phases), while during the second session, they evaluated two phases of images (unenhanced and parenchymal phases), and in the third session, they evaluated all three phases of images (unenhanced, corticomedullary, and parenchymal phases). The diagnostic accuracy for evaluating renal cysts was compared in each session using receiver-operating characteristics (ROC) analysis. Results There were 106 benign renal cysts and 58 malignant renal cysts. The areas under the ROC curves (AUCs) of the second and third sessions were greater than that of the first session ( P Conclusion Unenhanced and parenchymal phase CT scans are sufficient for differentiating malignant from benign renal cysts and there was no additional value by adding the corticomedullary phase to the combination of unenhanced and parenchymal phase CT.

The purpose of this study was to retrospectively compare the usefulness of T2-weighted imaging with and without fat suppression for differentiating angiomyolipomas (AMLs) without visible fat from other renal tumors.MRI was performed in 111 patients (66 men and 46 women; age range, 17-78 years) who had pathologically diagnosed (14 AMLs, 86 renal cell carcinomas [RCCs], and three other tumors) and clinically diagnosed (eight AMLs) renal masses without visible fat or a cystic portion on unenhanced CT. The signal intensity (SI), tumor-to-kidney SI ratio, tumor-to-spleen SI ratio on T2-weighted imaging and fat-suppressed T2-weighted imaging, and tumor-fat subtraction index were measured for each tumor. Receiver operating characteristic (ROC) analysis was used to evaluate diagnostic accuracy of SI ratios.The highest area under the ROC curve was 0.886 for tumor-to-kidney SI ratio on fat-suppressed T2-weighted imaging. With a tumor-to-kidney SI ratio of 0.9 on fat-suppressed T2-weighted imaging, the sensitivity, specificity, positive predictive value, and negative predictive value were 90.9%, 71.1%, 43.5%, and 97%, respectively. The highest tumor-to-kidney SI ratio of AMLs without visible fat was 1.09. Ninety-eight percent of renal tumors with a tumor-to-kidney SI ratio greater than 1.09 were RCCs (51/52), especially clear cell RCCs (82.7%, 43/52).Fat-suppressed T2-weighted imaging is more useful than T2-weighted imaging for differentiating AMLs without visible fat from non-AMLs. The high SI of solid renal masses on fat-suppressed T2-weighted imaging can be indicative of non-AMLs, especially RCCs.

A lack of reliable biomarkers for the early detection and risk of metastatic recurrences makes ovarian cancer the most lethal gynecological cancer. To understand the molecular mechanisms involved in ovarian cancer metastasis in vivo, we analyzed the transcriptional expression pattern in metastatic implants of human ovarian carcinoma xenografts in mice. The expression of 937 genes was significantly different, by at least 2-fold, in the xenografts compared with that in SK-OV-3 cells. We investigated the mechanisms that regulate the expression of one of the profoundly upregulated genes, interferon-induced transmembrane protein 1 (IFITM1), in the metastatic implants. Specific CpG sites within the IFITM1 promoter were hypomethylated in the metastatic implants relative to those in the wild-type SK-OV-3 cells. Treating wild-type SK-OV-3 cells with the demethylating agent 5-aza-2'-deoxycytidine enhanced IFITM1 expression in a dose-dependent manner, implying transcriptional regulation by promoter methylation. We also found that IFITM1 overexpression caused increased migration and invasiveness in SK-OV-3 cells. Our results demonstrate that IFITM1 could be a novel metastasis-promoting gene that enhances the metastatic phenotype in ovarian cancer via epigenetic transcriptional regulation. Our findings also suggest that the status of DNA methylation within the IFITM1 promoter region could be a biomarker indicating metastatic progression in ovarian cancer.

We reported the synthesis of highly water-stable iron oxide nanoparticles by a simple one-pot reaction. Non-toxic polyethylene glycol MW 600 (PEG) acted as a solvent, capping agent and reducing agent in the synthesis of iron oxide nanoparticles. As a result of the synthesis, PEGylated small-size (4.2 ± 0.39 nm average diameter and 7.2 ± 1.9 nm hydrodynamic sizes measuring by DLS) iron oxide nanoparticles (USPIO) were obtained, which show great colloidal stability in water and tolerate high salt concentration (0.75 M sodium chloride) and a wide pH range of 4 to 12. Oxidation of PEG was observed during the synthesis of iron oxide nanoparticles, which makes USPIO easy to functionalize with other molecules. Functionalization of the USPIO surface with fluorescein isothiocyanate (FITC) was conducted for investigating the possibility for multimodal imaging. Also the cytotoxicity test and lymph node imaging were performed by using the FITC labelled USPIO (FITC@USPIO). According to these results, the stable water dispersed USPIO and FITC@USPIO are expected to apply for multimodal in vivo imaging.

Purpose This study aimed to evaluate the diagnostic performance of multidetector computed tomography (MDCT) for preoperative evaluation of perinephric fat invasion in patients with renal cell carcinomas (RCCs). Methods A total of 408 consecutive patients with surgically confirmed RCC who underwent MDCT were included in this study. Image analysis was first performed with axial-only CT images. A second analysis was then performed with both axial and coronal CT images. A qualitative analysis was then conducted by 2 reviewers who reached consensus. The reference standard was pathologic evaluation. Results The areas under the curve of the receiver operating characteristic analysis were 0.786 and 0.877 for axial-only images and 0.805 and 0.836 for combined images in both readers. The area under the curve of tumor size was 0.833, a similar value to that of the reviewers. In multivariate analysis, tumor size, a linear-nodular or nodular type of fat infiltration, and an irregular tumor margin were independent predicting factors for perinephric fat invasion. Conclusions The MDCT shows relatively high diagnostic performance in detecting perinephric fat invasion of RCC, but suffers from a relatively low positive predictive value. Tumor size, fat infiltration with a nodular appearance, and an irregular tumor margin were predictors for perinephric invasion.

Background We evaluated whether best overall response changes by designating primary renal lesions as either target or nontarget lesions and assessing response per Response Evaluation Criteria in Solid Tumors in mRCC patients treated with sunitinib. In addition, we evaluated whether discordance, if any, leads to a difference in predictive value of response in terms of time to progression (TTP) and overall survival (OS). Patients and Methods Patients with mRCC with an intact primary tumor and at least 1 extrarenal measurable lesion were included in this study. The variation of the sum of diameters (ΔSOD) of target lesions and best overall response, assessed from all target lesions and from metastasis-only target lesions, was documented separately. Results There were 41 patients included. Median ΔSOD of the primary lesion and metastatic target lesion were −6.0% (range, −34.0% to 17.6%), and −18.0% (range, −100.0% to 120.0%), respectively. For metastasis-only target lesions, the best overall response of 2 patients (4.9%) changed from stable disease to partial response. When we categorized patients into responders and nonresponders, response determination using metastasis-only target lesions resulted in significantly better discrimination of time to progression (14.9 vs. 4.3 months, P = .001) and overall survival (18.5 vs. 9.6 months, P = .036) between 2 groups. Using all target lesions, both TTP (14.9 vs. 5.4 months, P = .056) and OS (18.0 vs. 10.6 months, P = .155) were not statistically significant. Conclusion When treating nonnephrectomized mRCC patients, selecting metastasis-only lesions as target lesions might be better to determine response, which might be more representative of survival end point.

Monodisperse hollow carbon nanocapsules (200 nm) with mesoporous shells were synthesized by coating their outer shells with silica to prevent aggregation during their high-temperature annealing. Monodispersed silica nanoparticles were used as starting materials and octadecyltrimethoxysilane (C18TMS) was used as a carbon source to create core-shell nanostructures. These core-shell nanoparticles were coated with silica on their outer shell to form a second shell layer. This outer silica shell prevented aggregation during calcination. The samples were characterized by TEM, SEM, dynamic light scattering (DLS), UV/Vis spectroscopy, and by using the Brunauer-Emmett-Teller (BET) method. The as-synthesized hollow carbon nanoparticles exhibited a high surface area (1123 m(2) g(-1)) and formed stable dispersions in water after the pegylation process. The drug-loading and drug-release properties of these hollow carbon nanocapsules were also investigated.

Although tumor size is a prognostic factor in cervical cancer patients, its role in the diagnosis of lymph node metastasis is unclear. We therefore evaluated the diagnostic value of tumor and lymph node size compared with lymph node size alone in the detection of metastatic lymph nodes in patients with early-stage cervical cancer.We retrospectively evaluated 699 patients with International Federation of Obstetrics and Gynecology stage IB1-IIA cervical carcinoma who underwent magnetic resonance imaging before lymphadenectomy involving all visible lymph nodes in the surgical fields. Seven nodal groups were evaluated: para-aortic, both common iliac, both external iliac, and both internal/obturator areas. Pathologic evaluation was the diagnostic standard. The largest short-axis diameter of lymph nodes in each region and the largest tumor diameters were measured in magnetic resonance images. The value of additional information from magnetic resonance images was evaluated by receiver operating characteristic curve analysis.Of the 699 patients, 108 (15.8%) had lymph node metastases. The areas under the curve for measurements of lymph node size, tumor size, and both were (A) 0.635, (B) 0.706, and (C) 0.742, respectively (A vs B, P = 0.006; A vs C P < 0.001; B vs C, P = 0.002).This study illustrates that magnetic resonance imaging measurements of tumor size and tumor size plus lymph node size showed a higher diagnostic performance than lymph node size alone in predicting lymph node metastasis in patients with early-stage cervical cancer.

In this study, anthracenes were efficiently synthesized from o -alkynyldiarylmethane using a novel method that exploits the synergistic effect between Bi(OTf) 3 as the catalyst, and trifluoroacetic acid (TFA). Through this reaction, we achieved the rapid and efficient synthesis of anthracenes bearing various functional groups under mild conditions.

The difficulty in delineating tumor is a major obstacle for better outcomes in cancer treatment of patients. The use of single-imaging modality is often limited by inadequate sensitivity and resolution. Here, we present the synthesis and the use of monodisperse iron oxide nanoparticles coated with fluorescent silica nano-shells for fluorescence and magnetic resonance dual imaging of tumor. The as-synthesized core–shell nanoparticles were designed to improve the accuracy of diagnosis via simultaneous tumor imaging with dual imaging modalities by a single injection of contrast agent. The iron oxide nanocrystals (~11 nm) were coated with Rhodamine B isothiocyanate-doped silica shells via reverse microemulsion method. Then, the core–shell nanoparticles (~54 nm) were analyzed to confirm their size distribution by transmission electron microscopy and dynamic laser scattering. Photoluminescence spectroscopy was used to characterize the fluorescent property of the dye-doped silica shell-coated nanoparticles. The cellular compatibility of the as-prepared nanoparticles was confirmed by a trypan blue dye exclusion assay and the potential as a dual-imaging contrast agent was verified by in vivo fluorescence and magnetic resonance imaging. The experimental results show that the uniform-sized core–shell nanoparticles are highly water dispersible and the cellular toxicity of the nanoparticles is negligible. In vivo fluorescence imaging demonstrates the capability of the developed nanoparticles to selectively target tumors by the enhanced permeability and retention effects and ex vivo tissue analysis was corroborated this. Through in vitro phantom test, the core/shell nanoparticles showed a T2 relaxation time comparable to Feridex® with smaller size, indicating that the as-made nanoparticles are suitable for imaging tumor. This new dual-modality-nanoparticle approach has promised for enabling more accurate tumor imaging.

Although its capability has been overlooked, sonography can be a useful screening tool for adrenal lesion in adults. In this article, we discuss scan technique, patient positioning, and anatomic consideration for adrenal sonography in adults and illustrate sonographic appearance of normal adrenal gland as well as adrenal tumors and tumor-like lesions.

Molecular imaging is one of the most promising tools for diagnosis of cancer. We assessed whether commercially available superparamagnetic iron oxide nanoparticles (SPIO; Feridex®) could be utilized as a dual modality contrast agent for terahertz (THz) imaging as well as magnetic resonance (MR) imaging. Feridex particles were transfected into SKOV3 cancer cells, at concentrations of 0, 0.35, 0.70, and 1.38 mM, and the magnetic and optical properties of the particles were examined by MR and THz reflection imaging. Mice were inoculated with Feridex-labeled SKOV3 cells, and in vivo MR and THz images were taken 1, 3, 7, and 14 days after inoculation. THz images and T2*-weighted MR images of Feridex-labeled SKOV3 tumors showed similar patterns; the signal intensities of both image sets increased with Feridex concentration. The signal intensity of in vivo MR and THz images from mice decreased over time. H&E and Prussian blue staining results correlated with imaging data. Dual-modality molecular MR and THz imaging of Feridex-labeled cells may be used to identify cancer cells both in vivo and in vitro. Such a noninvasive multimodal imaging method may be valuable in future cellular and molecular studies.

Background Lymph node (LN) status is an important parameter for determining the treatment strategy and for predicting the prognosis for patients with uterine cervical cancer. Computer-aided diagnosis (CAD) can be feasible for differentiating metastatic from non-metastatic lymph nodes in patients with uterine cervical cancer Purpose To determine the usefulness of CAD that comprehensively evaluates MR images and clinical findings for detecting LN metastasis in uterine cervical cancer. Material and Methods In 680 LNs from 143 patients who underwent radical hysterectomy for uterine cervical cancer, the CAD system using the Bayesian classifier estimated the probability of metastasis based on MR findings and clinical findings. We compared the diagnostic accuracy for detecting metastatic LNs in the CAD and MR findings. Results Metastasis was diagnosed in 70 (12%) LNs from 34 (24%) patients. The area under ROC curves of CAD (0.924) was greater than those of the mean ADC (0.854), minimum ADC (0.849), maximum ADC (0.827), short-axis diameter (0.856) and long-axis diameter (0.753) ( P < 0.05). The specificity and accuracy of the CAD (86%, 86%) were greater than those of the mean ADC (77%, 77%), maximum ADC (77%, 77%), minimum ADC (68%, 70%), and short-axis diameter (65%, 67%) ( P < 0.05). Conclusion CAD system can improve the diagnostic performance of MR for detecting metastatic LNs in uterine cervical cancer.

Lymph node metastasis is an important prognostic factor in cervical cancer patients. We report THz imaging for detecting micro-metastatic foci in the lymph nodes of early-stage uterine cervical cancer patients. Five paraffin-embedded metastatic lymph nodes from two cervical cancer patients were imaged using a THz time-domain spectroscopy system in the reflection mode. The size and shape of the tumor regions were compared with those from histopathologic examinations. The metastatic portions of lymph nodes as small as 3 mm were well delineated by THz imaging. The reflected peak amplitudes were lower in metastatic portions than in the normal portions of lymph nodes, and the difference in their peak-to-peak amplitudes was ~5%.

Backgound Accurate preoperative diagnosis of fat scanty angiomyolipomas is an important clinical issue. By evaluating the low signal intensity of angiomyolipomas in MR T2-weighted images the diagnostic accuracy can be elevated. Purpose To retrospectively assess the usefulness of T2-weighted MR imaging for differentiating low-fat angiomyolipomas (AMLs) from other renal tumors. Material and Methods We retrospectively evaluated 71 patients with surgically proven renal masses (10 AMLs, 57 renal cell carcinomas [RCCs], and four oncocytomas), all of which showed no visible fat as well as gradual enhancement patterns on contrast-enhanced CT. Signal intensity was measured in each renal mass and in the spleen on T2-weighted images, and each signal intensity ratio (SIR) was calculated; SIR values were then compared in the AML and non-AML groups. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic performance of the two parameters for differentiating the two groups. Results The SIR values (77 ± 24% vs. 162 ± 79%, p = 0.002) were significantly lower in the AML than in the non-AML group. The area under the ROC curve was 0.926 for SIR. The sensitivity and specificity in the diagnosis of AMLs were 90% and 90.2%, using SIR cut-off of 92.5%. Conclusion Signal intensity measurements on T2-weighted MR images can differentiate AML from non-AML in the kidney.

Objectives:The objective of this study was to evaluate the diagnostic performance in managing early-stage cervical cancer according to the International Federation of Gynecology and Obstetrics (FIGO) stage or tumor size.Methods/Materials:We performed a retrospective review of patients with FIGO stages IB1 to IIA cervical carcinoma who underwent magnetic resonance imaging (MRI) before lymphadenectomy. Lymphadenectomy involved all visible lymph nodes in the surgical fields. We compared the accuracy of MRI for detecting metastatic lymph nodes in the FIGO IB and IIA groups and in the nonbulky (≤4 cm) and bulky (>4) tumor groups. χ2 analysis was used to compare the accuracy of MRI for detecting metastatic lymph nodes. P ≤ 0.05 was considered statistically significant.Results:Three hundred five patients were included. Lymph node metastases were present in 49 (16.1%) of these patients. The sensitivity, specificity, and positive and negative predictive values were 7%, 99.3%, 31.3%, and 95.8% in the nonbulky tumor group and 43.8%, 97.1%, 70%, and 91.8% in the bulky tumor group (P = 0.001, P = 0.0097, P = 0.0479, and P = 0.0142, respectively).Conclusions:For predicting lymph node metastasis with MRI in early-stage cervical cancer patients, MRI showed a higher diagnostic performance in the bulky tumor group compared with that in the nonbulky tumor group and had a low value in the nonbulky tumor group, even when accounting for FIGO stage.

To determine the accuracy of multi-detector CT (MDCT) compared with the surgical findings, such as peritoneal seeding and metastatic lymph nodes, in ovarian cancer patients.Fifty-seven FIGO stage IA-IV ovarian cancer patients, who underwent MDCT before primary surgery, were included in this study. Two radiologists evaluated the following imaging findings in consensus: the presence of nodular, plaque-like or infiltrative soft-tissue lesions in peritoneal fat or on the serosal surface; presence of ascites; parietal peritoneal thickening or enhancement; and small bowel wall thickening or distortion. We also evaluated the presence of lymph node metastases. To allow region-specific comparisons, the peritoneal cavity was divided into 13 regions and retroperitoneal lymph nodes were divided into 3 regions. Descriptive statistical data were thus obtained.The MDCT sensitivity, specificity, positive predictive values, and negative predictive values were 45, 72, 46, and 72%, respectively, for detecting peritoneal seeding and 21, 90, 52, and 69%, respectively, for detecting lymph node metastasis.MDCT is moderately accurate for detecting peritoneal metastasis and lymph node metastasis in ovarian cancer patients.

Background:This meta-analysis was performed to investigate the outcome of laparoscopic surgery for endometrial carcinoma compared with laparotomy.Methods:We searched the MEDLINE (PubMed), EMBASE, and Cochrane Review databases in September 2007. Three independent evaluators selected the articles according to predetermined selection criteria.Results:Thirteen comparative studies (5 prospective and 8 retrospective) that met the selection criteria were included. In a fixed-effects meta-analysis, the overall survival and therecurrence rate showed no significant differences between the laparoscopy and the laparotomy groups, with odds ratios of 0.84 (95% confidence interval, 0.64-1.62) and 0.90 (95% confidence interval, 0.49-1.16), respectively. However, the complication rate was lower in the laparoscopy group than in the laparotomy group with an odds ratio of 0.43 (95% confidence interval, 0.32-0.58).Conclusions:The survival outcome and recurrence rate after laparoscopic surgery for endometrial carcinoma were similar to those in the laparotomy procedures. However, the complication rate was lower after laparoscopy compared with laparotomy.

We compared the tumour size measured by magnetic resonance imaging (MRI) with that of gross specimen regarding the virtual tumour volume. Eighty three patients with International Federation of Obstetrics and Gynecology (FIGO) stage Ib to IIa cervical cancer underwent MRI before radical hysterectomy. The largest tumour diameter was determined by both MRI and gross specimen measurement. Tumour volume was calculated by the standard technique of multiplying the sum of the areas by the slice thickness. Paired t-test was used to compare the MRI and gross specimen derived diameters. Pearson correlation coefficient was calculated to evaluate the relationship between the tumour size and volume. The mean diameters of the MRI and gross specimen derived tumour measurements were 3.0 cm (standard deviation, 0.9 cm) and 3.5 cm (standard deviation, 1.2 cm) (p0.001), respectively. Mean MRI-based tumour volume was 12.5 cm(3) (standard deviation, 10.4 cm(3)). Tumour diameter measured by MRI had a significantly higher correlation with tumour volume measured by MRI (r(p)=0.734) compared with that measured on the gross specimen (r(p)=0.690; Steiger's Z test, p=0.019). The tumour diameter measured by MRI was smaller than gross specimen measurement and correlated more closely with tumour volume in patients with cervical cancer. This study illustrates the value of MRI as a tool for tumour size measurement.

The objective of this study was to assess the role of (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) for the characterization of ovarian masses that were diagnosed as ovarian malignancies by magnetic resonance imaging (MRI). We performed a retrospective review of eight patients with pathologically confirmed borderline ovarian tumors (BOT) who underwent MRI and FDG-PET before surgical staging from August 2005 to March 2007. We assessed the PET imaging of the BOT, measured the FDG uptake and quantified the findings as a standardized uptake value (SUV). The FDG-PET scans, of all eight patients, showed uptake of FDG with a mean SUV of less than 2.0 in the solid portion of the masses evaluated. We conclude that the MRI-PET differences may help differentiate borderline from malignant ovarian tumors.

To prospectively determine the accuracy of portal venous phase helical multi-detector row computed tomography (CT) for bladder lesion evaluation in patients with hematuria by using cystoscopy as the reference standard.The study was approved by the institutional review board for human investigation, and informed consent was obtained from all patients. This study included 118 patients (91 male, 27 female; age range, 15-87 years; mean age +/- standard deviation, 62 years +/- 14) who underwent portal venous phase multi-detector row CT (scanning delay, 70 seconds; section thickness, 2 mm) and conventional cystoscopy because of painless gross hematuria or recurrent microscopic hematuria. Two reviewers with different experience levels independently evaluated the bladder for lesions at CT in a prospective fashion. The kappa statistic was used to determine the per lesion and per patient agreement between the two reviewers and between the CT and cystoscopic findings. The sensitivity and specificity of multi-detector row CT for bladder lesion detection were analyzed for numbers of lesions and for numbers of patients.Multi-detector row CT showed excellent per lesion (kappa = 0.839) and per patient (kappa = 0.881) agreement between the two reviewers. Respective per lesion and per patient agreement between the CT and cystoscopic findings was also excellent in the first (kappa = 0.866 and kappa = 0.881) and second (kappa = 0.802 and kappa = 0.863) reviewers. The sensitivity and specificity of multi-detector row CT were 89%-92% and 88%-97%, respectively, in the per lesion analysis and 95% and 91%-93%, respectively, in the per patient analysis for both reviewers. All statistical parameters of diagnostic accuracy were similar between the two reviewers (P.05).Portal venous phase multi-detector row CT can provide high accuracy and reader agreement for bladder lesion detection in patients with painless gross hematuria and recurrent microscopic hematuria; these results indicate that multi-detector row CT can be used as the initial bladder examination in such patients.

Background and Objectives Pelvic exenteration offers the last chance of cure for some advanced or recurrent gynecologic malignancy patients. The aim of this prospective study was to analyze factors associated with recurrence and survival after pelvic exenteration. Methods Forty-six women with advanced or recurrent gynecologic malignancies were enrolled between July 2001 and February 2006. All pelvic exenteration surgery was performed by the same gynecological oncologist. Results Two patients were excluded due to the discovery of peritoneal disease during surgery. Multivariate analysis showed that a tumor size >4 cm was the only factor associated with risk of recurrence after surgery (P = 0.014), that margin status was the only factor associated with disease-free survival (P = 0.0.047), and that margin status and lymph node metastasis were associated with overall survival (P = 0.017 and 0.012, respectively). Conclusions Pelvic exenteration and reconstruction was found to have a potential to provide long-term survival without postoperative mortality although the morbidity rate is somewhat high. Multivariate analysis showed that tumor size >4 cm was a predictive factor for recurrence, and that margin status and lymph node metastasis were predictive factors for survival. J. Surg. Oncol. 2007;96:560–568. © 2007 Wiley-Liss, Inc.

The purpose of this study was to assess the impact of music on anxiety and perceived pain during transrectal ultrasound-guided prostate biopsy.Forty consecutive men with an elevated serum prostate specific antigen (PSA) level and/ or an abnormal digital rectal examination referred for transrectal ultrasound-guided prostate biopsy were recruited and allocated to a music (n = 20) or a non-music (n = 20) group. Anxiety was assessed prior to and after biopsy and pain was assessed after biopsy in each patient using visual analog scales (VAS) in the same setting, and group anxiety scores were compared.Patients in the music group experienced less anxiety (P = .046) during the procedure, but group pain scores were not significantly different.Music was found to decrease anxiety effectively during transrectal ultrasound-guided prostate biopsy.

Purpose The purpose of this article was to retrospectively evaluate computed tomographic (CT) findings in patients with pathologically proved clear cell carcinoma of the ovary. Methods CT scans of seven patients (age range, 28-79 years; mean age, 46 years) with nine lesions of histologically proved primary ovarian clear cell carcinoma of the ovary were retrospectively evaluated by two radiologists in consensus. Scans were evaluated for the laterality, size, mass characteristic, margin, attenuation of the cystic portion, internal architecture, and presence of lumen protruding mass. Results Tumors were unilateral in five patients. The average size of the tumors was 8.6 cm (range, 2.6-12.1 cm). All the masses showed mainly cystic appearance. All nine masses had smooth margin. Average attenuation of the cystic portion of the masses was 24.2 HU (Hounsfield unit) (range, 13-34 HU). Tumors usually appeared as unilocular cystic mass (n=6). Lumen protruding masses appeared in seven tumors. Conclusion On CT scans, primary ovarian clear cell carcinomas appeared as large unilocular, mainly cystic, smooth marginated mass with lumen protruding solid portion and high-attenuated cystic portion.

OBJECTIVE. The purpose of this article is to assess the accuracy of MRI in detecting pelvic and paraaortic lymph node metastasis from uterine cervical cancer using various imaging criteria.CONCLUSION. Although MRI analysis resulted in relatively low sensitivity, size and margin (spiculated or lobulated) were useful criteria for predicting lymph node metastasis from cervical cancer.

OBJECTIVE. The purpose of our study was to determine whether the CT findings of ovarian metastasis from stomach cancer differ from those of ovarian metastasis from colon cancer.CONCLUSION. On contrast-enhanced CT scans, ovarian metastatic lesions from stomach cancer appear more solid than, more frequently have dense enhancement of the solid portion, and are smaller than ovarian metastatic lesions from colon cancer.

BACKGROUND The objective of the current study was to determine the accuracy of magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT) for detecting lymph node metastases in patients with uterine cervical carcinoma compared with thin-section histopathologic results from systemic lymphadenectomy. METHODS Twenty-two patients with International Federation of Obstetrics and Gynecology (FIGO) Stage IB–IVA cervical carcinoma who underwent both MRI and PET/CT before lymphadenectomy were included in this study. Lymphadenectomy involved removing all visible lymph nodes in the surgical fields. To enable region-specific comparisons, paraaortic and pelvic lymph nodes were divided into seven regions: the paraaortic area, both common iliac areas, both external iliac areas, and both internal iliac/obturator areas. Histopathologic evaluation of lymph nodes was the diagnostic standard. Chi-square analysis was used to compare the accuracy of MRI and PET/CT for the detection of metastatic lymph nodes. A P value ≤ 0.05 was considered statistically significant. RESULTS With MRI, the sensitivity, specificity, and accuracy rates for detecting metastatic lymph nodes in each lymph node group were 30.3% (10 of 33 lymph node groups), 92.6% (112 of 121 lymph node groups), and 72.7% (122 of 154 lymph node groups), respectively; with PET/CT, those rates were 57.6% (19 of 33 lymph node groups), 92.6% (112 of 121 lymph node groups), and 85.1% (131 of 154 lymph node groups), respectively. Statistical analysis showed that PET/CT was more sensitive than MRI (P = 0.026) but that there were no statistical differences noted with regard to specificity (P = 1.000) or accuracy (P = 0.180). Power analysis demonstrated that a sample size of 685 lymph node groups (98 patients) would be necessary to demonstrate that PET/CT was more accurate than MRI (α = 0.05; β = 0.80). CONCLUSIONS PET/CT was more sensitive than MRI for detecting lymph node metastases in patients with uterine cervical carcinoma. Cancer 2006. © 2006 American Cancer Society.

Objective: The computed tomography (CT) findings of ovarian metastases from colon cancer were evaluated and were compared with those of primary malignant ovarian tumors. Methods: Sixteen patients with 21 masses from coloncancer and 20 patients with 31 primary malignant ovarian tumors were included in this study. The CT findings (laterality, size, margin, shape, mass characteristic, strong enhancement of cyst wall, enhancement of solid portion, amount of ascites, peritoneal seeding, lymph node enlargement, and metastasis) and ages of the patients in both groups were compared. Univariate analysis, the Pearson Χ 2 test, and the independent-samples t test were used to distinguish them. Results: A smooth margin of the tumor (odds ratio = 24.3, 95% confidence interval: 2.9-204.2) and cystic nature of the mass (Pearson Χ 2 = 12.96, P = 0.005) were strong predictors of ovarian metastasis from colon cancer. Conclusion: Ovarian metastases from colon cancer show a smooth margin and more cystic nature on CT compared with primary malignant ovarian tumors.

Objective To determine the accuracy of the preoperative staging of uterine cervical cancer by magnetic resonance (MR) imaging in 115 patients in a prospective study. Methods A prospective study was performed in 115 patients who underwent MR imaging at 1.5 T before surgery or biopsy. Histopathologic findings were correlated with MR imaging results for all patients. Results The accuracy of preoperative tumor staging by MR imaging in the 115 patients was 77%. In terms of the evaluation of parametrial status, this study had an accuracy of 94% and a sensitivity of 38%. The accuracy and sensitivity of MR imaging for vaginal invasion were 81% and 87%, respectively. In terms of lymph node metastasis, this study had an accuracy of 97% and a sensitivity of 36%. Conclusion Magnetic resonance imaging has high accuracy in the preoperative staging of uterine cervical cancer.

Purpose: To assess the usefulness of volume measurement using 3D US for depicting metastatic cervical lymph nodes. Material and Methods: Thirty-five cervical lymph nodes in 13 patients with primary head and neck malignancy were included in this study. US with volume acquisition was prospectively performed with a 5–10 MHz linear mechanical volume probe. Volume measurement of the node was calculated using a 3D automatic volume calculation program. The excised nodes matched on US were examined histopathologically. Results: The volume of malignant nodes ranged from 0.444 to 4.442 cm3, the volume of the benign nodes from 0.143 to 1.176 cm3. Combinations of high positive (>80%) and negative (>90%) predictive values were obtained at a cut-off value of 0.7 cm3. Conclusion: Volume measurement of cervical nodes using 3D US can be a useful tool for differentiating metastatic from benign nodes in patients with primary head and neck malignancy.

Terahertz (THz) imaging was used to differentiate the metastatic states of frozen lymph nodes (LNs) by using spectroscopic integration technique (SIT). The metastatic states were classified into three groups: healthy LNs, completely metastatic LNs, and partially metastatic LNs, which were obtained from three mice without infection and six mice infected with murine melanoma cells for 30 days and 15 days, respectively. Under histological examination, the healthy LNs and completely metastatic LNs were found to have a homogeneous cellular structure but the partially metastatic LNs had interfaces of the melanoma and healthy tissue. THz signals between the experimental groups were not distinguished at room temperature due to high attenuation by water in the tissues. However, a signal gap between the healthy and completely metastatic LNs was detected at freezing temperature. The signal gap could be enhanced by using SIT that is a signal processing method dichotomizing the signal difference between the healthy cells and melanoma cells with their normalized spectral integration. This technique clearly imaged the interfaces in the partially metastatic LNs, which could not be achieved by existing methods using a peak point or spectral value. The image resolution was high enough to recognize a metastatic area of about 0.7 mm size in the partially metastatic LNs. Therefore, this pilot study demonstrated that THz imaging of the frozen specimen using SIT can be used to diagnose the metastatic state of LNs for clinical application. (C) 2017 Optical Society of America

Gastrointestinal stromal tumor (GIST) is a recently described mesenchymal tumor that can develop in any portion of the gastrointestinal tract. The occurrence of a GIST in the urinary tract is rare, but GIST can present as tumor of the urinary tract or invade the urinary tract. This is the first reported case of GIST in the ileal neobladder, which presented as a submucosal tumor. The patient underwent an open exploration and partial resection of the neobladder pouch.

Objective Although renal sinus fat invasion has prognostic significance in patients with renal cell carcinomas (RCCs), there are no previous studies about the value of multidetector computed tomography (MDCT) about this issue in the current literature. Materials and methods A total of 863 consecutive patients (renal sinus fat invasion in 110 patients (12.7%)) from single institutions with surgically-confirmed renal cell carcinoma who underwent MDCT between 2010 and 2012 were included in this study. The area under the curves (AUCs) of the receiver operating characteristic (ROC) analysis was used to compare diagnostic performance. Reference standard was pathologic examination. Weighted κ statistics were used to measure the level of interobserver agreement. Multivariate logistic regression model was used to find the predictors for renal sinus fat invasion. Image analysis was first performed with axial-only CT images. A second analysis was then performed with both axial and coronal CT images. A qualitative analysis was then conducted by two reviewers who reached consensus regarding tumor size, decreased perfusion, tumor margin, vessel displacement, and lymph node metastasis. The reference standard was pathologic evaluation. Results The AUCs of the ROC analysis were 0.881 and 0.922 for axial-only images and 0.889 and 0.902 for combined images in both readers. The AUC of tumor size was 0.884, a similar value to that of the reviewers. In multivariate analysis, tumor size, a linear-nodular or nodular type of fat infiltration, and an irregular tumor margin were independent predicting factors for perinephric fat invasion. Conclusion MDCT shows relatively high diagnostic performance in detecting perinephric fat invasion of RCC but suffers from a relatively low PPV related to low prevalence of renal sinus fat invasion. Applying tumor size alone we could get similar diagnostic performance to those of radiologists. Tumor size, fat infiltration with a nodular appearance, and an irregular tumor margin were predictors for perinephric invasion.

To investigate the diagnostic performance of 15-min delayed contrast-enhanced computed tomography (15-DECT) compared with that of chemical shift magnetic resonance (CSMR) imaging in differentiating hyperattenuating adrenal masses and to perform subgroup analysis in underlying malignancy and non-malignancy. This study included 478 adrenal masses in 453 patients examined with 15-DECT and 235 masses in 217 patients examined with CSMR. Relative percentage washout (RPW) and absolute percentage washout (APW) on 15-DECT, and signal intensity index (SII) and adrenal-to-spleen ratio (ASR) on CSMR were measured. Sensitivity, specificity and accuracy of 15-DECT and CSMR were analysed for characterisation of adrenal adenoma. Subgroup analyses were performed in patients with and without underlying malignancy. Attenuation and size of the masses on unenhanced CT correlated with the risk of non-adenoma. RPW calculated from 15-DECT showed the highest diagnostic performance for characterising hyperattenuating adrenal masses regardless of underlying malignancy, and the sensitivity, specificity and accuracy were 91.7 %, 74.8 % and 88.1 %, respectively in all patients. The risk of non-adenoma increased approximately threefold as mass size increased 1 cm or as its attenuation value increased by 10 Hounsfield units. 15-DECT was more accurate than CSMR in characterising hyperattenuating adrenal masses regardless of underlying malignancy. • Delayed contrast-enhanced CT and chemical shift magnetic resonance (CSMR) characterise adrenal lesions. • 15-min DECT is more accurate than CSMR in characterising hyperattenuating adrenal masses. • Sensitivity of CSMR decreases as the CT attenuation of adenomas increases. • Risk of non-adenoma is increased 2.9-fold as size increased by 1 cm. • Risk of non-adenoma is increased 2.9-fold as attenuation increased by 10 HU.

Objective The aim of this study was to elucidate the significance of tumor volume as a risk factor for predicting lymph node metastasis. Methods We applied the tumor volume index to the data that were collected for 327 Korean patients with endometrial cancer who underwent preoperative assessment including magnetic resonance imaging (MRI) and subsequent surgery including systematic lymphadenectomy. The volume index, which we previously reported in the literature, was defined as the product of maximum longitudinal diameter along the uterine axis, maximum anteroposterior diameter in a sagittal section image, and maximum horizontal diameter in a horizontal section image according to MRI data, from 425 Japanese women with endometrial cancer. Relationships between lymph node metastasis and results of preoperative examinations including volume index were analyzed by logistic regression analysis. Results The prevalence of affected lymph nodes was 14.2%. Multivariate analysis showed that high-grade histology assessed by endometrial biopsy [odds ratio (OR); 2.9, 95% confidence interval (CI): 1.4–6.4], volume index (OR; 2.4, 95% CI: 1.1–5.3), node enlargement assessed by MRI (OR; 4.2, 95% CI: 1.4–13.2), and high serum cancer antigen (CA)125 level (OR; 3.6, 95% CI: 1.6–8.1) were significantly and independently related to lymph node metastasis. When volume index was excluded from the analysis, myoinvasion assessed by MRI was an independent risk factor for lymph node metastasis as well as high-grade histology, node enlargement, and high serum CA125 level. Conclusion Volume index is compatible with myometrial invasion as a factor for predicting lymph node metastasis in endometrial cancer.