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Objectives: The aim of this study was to reveal the differences in clinicopathological factors affecting maximum standardized uptake value (SUVmax) between esophageal squamous cell carcinoma (ESCC), non-small-cell lung cancer (NSCLC), and papillary thyroid cancer (PTC)., Methods: This study consisted of 119 patients with ESCC (n=43), PTC (n=40), or NSCLC (n=36). We investigated the correlations between SUVmax and clinicopathological factors by using Spearman's correlation coefficient and the Kruskal-Wallis test. Multiple regression analysis was used to investigate which clinicopathological factors significantly affected SUVmax in each cancer type., Results: The SUVmax correlated with glucose transporter-1 (GLUT-1) expression in NSCLC (r=0.536, P=0.007) and ESCC (r=0.597, P<0.001) but not in PTC. The SUVmax correlated with Ki-67 expression in NSCLC (r=0.381, P=0.022) and PTC (r=0.374, P=0.017) but not in ESCC. A high SUVmax was correlated with a higher pathological T stage (p-T stage) in NSCLC (r=0.536) and ESCC (r=0.597, both P<0.001) but not in PTC. An elevated SUVmax was significantly associated with pathological lymph node status (p-N) in NSCLC, but not in ESCC and PTC. In multiple regression analysis, p-T stage and GLUT-1 expression were statistically significant factors in ESCC, and p-T stage was a statistically significant factor in NSCLC. In PTC, Ki-67 showed a statistically significant association with SUVmax., Conclusion: SUVmax in NSCLC depended on the tumor invasion area; SUVmax in ESCC depended on tumor depth and GLUT-1 expression; and SUVmax in PTC might be associated with cell proliferation. The biological factors affecting SUVmax differ according to tumor type.

OBJECTIVE: We aimed to compare perfusion computed tomography (CTP) characteristics of the normal pancreas with those of chronic pancreatitis (CP) and to examine the possibility of evaluating pancreatic exocrine function with CTP. METHODS: Thirty-two patients (control group, n = 18; CP group, n = 14) who completed the whole pancreas CT perfusion examination with 256-slice CT were studied. Four parameters, including perfusion (PF), peak enhancement intensity (PEI), time-to-peak (TTP), and blood volume (BV), were measured and compared between the control and CP groups, and between patients with and without exocrine pancreatic insufficiency (EPI) in the CP group. Pancreatic exocrine function was determined via serum trypsinogen. RESULTS: There was no significant difference between the distribution of PF, PEI, and BV in different pancreas regions, namely, the head, body, and tail (P > 0.05). PF, PEI, and BV of the CP group were significantly decreased, and TTP was significantly increased compared with the control group (P < 0.05). A significant decrease of PF, PEI, and BV and increase of TTP were observed in patients with EPI than in patients without EPI (P < 0.05). CONCLUSIONS: Perfusion CT is an appropriate imaging technique to diagnose CP and may be useful as a screening test to rule out early EPI.

Objective: To examine the relationship between clinicopathological factors and fluorine-18-fluorodeoxyglucose (F-FDG) uptake in patients with papillary thyroid cancer (PTC)., Materials and Methods: Fifty-four patients were included in this study.F-FDG positron emission tomography was performed before surgery. Immunohistochemistry of glucose transporter (GLUT) was performed using postoperative histopathological specimens. We investigated the relationship between maximum standardized uptake value (SUVmax) and GLUT-1, GLUT-3, and GLUT-4 expression/SUVmax and prognostic risk factors {tumor size, age, sex, extrathyroidal extension, and lymph node metastasis [ly (+)]}., Results: GLUT-3 and GLUT-4 expressions significantly correlated with SUVmax (GLUT-3: r=0.38, P=0.008; GLUT-4: r=0.46, P=0.001), but GLUT-1 did not (r=0.21, P=0.147). The tumor size correlated with SUVmax (r=0.5, P<0.001), but GLUT-1, GLUT-3, and GLUT-4 did not (GLUT-1: r=0.006, P=0.681; GLUT-3: r=0.05, P=0.705; GLUT-4: r=-0.17, P=0.217). Both SUVmax and GLUT-4 expressions were statistically significant with ly (+) (SUVmax: P=0.012; GLUT-4: P=0.018), but GLUT-1 and GLUT-3 expressions were not (GLUT-1: P=0.165; GLUT-3: P=0.499). There was no significant difference between other clinicopathological factors and SUVmax or any GLUT expressions., Conclusion: F-FDG uptake in PTC may be determined by GLUT-3 and GLUT-4 expressions and may be related to tumor size and lymph node metastasis of PTC. F-FDG uptake may reflect tumor progression of PTC., (Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.)

Objective: To prospectively evaluate the breast cancer detection of prone breast positron emission tomography (PET) images in comparison with supine whole-body PET images., Material and Methods: One hundred and eighteen female patients (age range 28-91 years) with 122 lesions suspected of having breast cancer underwent fluorine-18 fluorodeoxyglucose PET for preoperative staging. After the whole-body image was acquired, prone breast PET imaging was performed. The findings from both images were compared with the histopathologic results. Sensitivity, specificity, positive predictive value, negative predictive value (NPV), and accuracy were used to compare the diagnostic accuracy of prone breast PET images with that of whole-body PET images., Results: Sensitivity, specificity, positive predictive value, NPV, and accuracy of whole-body PET images were 83, 50, 97, 17, and 80%, and of prone breast PET images they were 95, 50, 96, 43, and 93%. Ten of 114 breast cancerous lesions (8.8%) were detected on prone breast PET images alone. Statistical difference was found between the sensitivity, accuracy, and NPV of prone breast PET images and those of whole-body PET images (P<0.0001 for sensitivity and accuracy and P<0.0009 for NPV)., Conclusion: Our data about the 122 lesions, suspected of breast cancer, with regard to the usefulness of prone breast PET imaging indicate that prone breast PET images are effective in detecting breast cancer.

The 3-dimensional image was excellent as a result of the fast scanning and narrow collimation using multidetector computed tomography (CT); and the parallel escalation in the capabilities of the workstation allow the use of CT angiography/CT cholangiography image fusion. We demonstrated the feasibility of fusion images of the hepatobiliary system. We believe that fusion images are extremely valuable for applications such as preoperative planning for hepatic and bile duct resection.

We report a rare case of diaphragmatic hemangioma with computed tomography and magnetic resonance imaging findings. A routine chest radiograph in a 75-year-old woman revealed a nodular opacity in the right lower lung field. Multidetector-row computed tomography revealed a well-circumscribed nodule arising from the diaphragm or pleura. Dynamic magnetic resonance imaging of the nodule showed a pattern of gradually increasing signal intensity. On the basis of the intraoperative and histopathologic findings, venous hemangioma arising from the diaphragm was diagnosed.

The concentrations of (99m)Tc, (123)I, (67)Ga, and (201)Tl of the discharge water and the sewage sludge from Kurume Central Sewage Treatment Plant were determined once a week for 2 mo. The radiopharmaceutical doses injected into the patients for all of four hospitals that use nuclear medicines in the service area of the plant were also surveyed. Approximately 1.5% of the (99m)Tc, 1.5% of the (123)I, 4.3% of the (67)Ga, and 0.41% of the (201)Tl of the injected doses were detected in the discharged water from the plant. The behavior of these radionuclides in the sewage treatment system was analyzed using a compartment model. The analyses suggest that the average residence times in storage tanks and drainage pipes before entering the plant were 9.5 h for (99m)Tc, 81 h for (123)I, 120 h for (67)Ga, and 480 h for (201)Tl.

We report a case of bronchioloalveolar carcinoma that required approximately 1 year to diagnose due to alternating periods of exacerbation and improvement of abnormal opacity on chest radiography. It is important to consider the diagnosis of bronchioloalveolar carcinoma when consolidative opacities simulating pneumonia show an alternating pattern of worsening and improvement.

Alveolar adenoma of the lung is a rare benign neoplasm with distinctive gross and microscopic findings. Radiographically, alveolar adenoma usually presents as a well-circumscribed, peripheral, solitary nodule. The authors describe the contrast-enhanced computed tomography and magnetic resonance imaging features of alveolar adenoma of lung. Magnetic resonance imaging demonstrated the presence of a cystic space with central fluid and thin-rim enhancement. These findings are suggestive of a benign nodule, and alveolar adenoma of lung should be added to the differential diagnosis of nodules that demonstrate this pattern of enhancement and are probably benign.

Purpose: The purpose of this study was to evaluate the MR findings of ganglioneuroma and to correlate imaging and histologic features., Method: Conventional SE and contrast-enhanced dynamic MRI was used to examine 10 patients with pathologically confirmed ganglioneuroma. The morphologic features, signal intensity, and dynamic enhancement pattern of the tumors were retrospectively analyzed and correlated with histologic features., Results: Capsules were present in all tumors histologically and were also detected in five tumors on postcontrast T1-weighted images. A whorled appearance corresponding to interlacing bundles of Schwann cells and collagen fibers on histologic specimens was visualized in five tumors on T1-and/or T2-weighted images. Tumors with markedly high signal intensity on T2-weighted images consisted histologically of a large amount of myxoid stroma and relatively few cellular and fibrous components. Tumors with intermediate to high signal intensity consisted of numerous cellular and fibrous components and little myxoid stroma. Early enhancement of tumors was usually lacking in dynamic MR studies; however enhancement gradually increased., Conclusion: The results suggest that the MR features of ganglioneuroma are well correlated with histologic findings.

Purpose: The purpose of this work was to compare dynamic MRI (D-MRI) with dynamic CT (D-CT) for the diagnosis of peripheral cholangiocarcinoma (PCC) of the liver., Method: Twenty patients with PCC underwent both D-CT and D-MRI during the early, middle, and delayed phase after contrast medium administration. The findings from D-MRI were compared with those from D-CT., Results: D-CT and D-MRI exhibited a similar tumoral enhancement pattern, and this enhancement was more conspicuous on D-MRI. A wedge-like enhancement area peripheral to the tumor was observed in 9 (45%) patients on D-CT and 11 (55%) patients on D-MRI. Ductal dilatation was found in 13 (65%) patients on both techniques. Vascular involvement and extrahepatic invasion were seen in nine (45%) and two (10%) patients, respectively. The relationship of the tumor to the vessels and surrounding organs was more easily evaluated on D-CT., Conclusion: Both D-CT and D-MRI can provide important information for the diagnosis of PCC. D-CT is better than D-MRI for demonstrating vascular involvement and extrahepatic invasion. D-MRI gives more conspicuous enhancement.

Purpose: The goal of this work was to determine whether 3D reconstruction of images from CT during intravenous injection of contrast medium, performed in tandem with advanced rendering algorithms, could accurately depict major anatomic structures and hepatic tumors., Method: Thirty-one patients (22 with hepatocellular carcinoma, 8 with metastatic lesions, and 1 with intrahepatic cholangiocarcinoma) underwent CT imaging. Twenty-three of the 31 patients underwent needle biopsy or surgery, yielding a histologic diagnosis. The remaining eight patients were diagnosed from imaging findings and laboratory data. We compared the ability of maximum intensity projection (MIP) and volume-rendered technique (VRT) images to depict the hepatic veins and intrahepatic portal veins., Results: Both MIP and VRT depicted the course of vessels up to the second or third branches. The techniques did not significantly differ. In this regard, in most cases, visualization of the liver surface and tumor was excellent with VRT images., Conclusion: Volume-rendered 3D-CT images during intravenous injection without the MIP technique produced 3D images of high quality with excellent visualization of tumors and their relationships to vital structures.

Objective: We performed this study to identify and characterize the CT findings of lymphocytic interstitial pneumonia (LIP)., Materials and Methods: The CT findings of two patients with LIP were reviewed and correlated with their histologic specimens., Results: Chest CT of the two patients showed areas of increased attenuation in both lung fields which were associated with nodular and cystic lesions surrounding the peribronchovascular bundles. The most characteristic abnormality identified on CT was the presence of multiple cysts throughout both lungs. Macroscopic findings of lung biopsy specimens included multiple nodular and cystic lesions., Conclusion: This description of multiple pulmonary cysts formation in LIP is new.

The records of 49 patients with nodular histiocytic lymphomas (NH) who were treated from 1972 to 1985 in hospitals belonging to the JLRTG were retrospectively reviewed. The actuarial survival rate and relapse-free survival rate of all patients after 5 years were 55.0 and 51.3%, respectively. Twenty-one patients with stage I disease had a significantly better survival rate than did 12 patients with stage II disease (P less than 0.01). Without combination chemotherapy, all 15 patients with stage I NH treated by radiation therapy were in complete remission, and 14 of them remained alive and well. Among these 15 patients, no difference in relapse was observed between patients who received involved field irradiation (1 of 6) and those who received extended field irradiation (2 of 9). Patients with stage II or more NH should be treated with intensive chemotherapy and radiotherapy, as are patients with diffuse histiocytic lymphoma (DH). However, involved field radiotherapy with careful follow-up observation may be the treatment of choice for patients with stage I NH, provided their tumors are not bulky.

An earlier review of the lateral chest radiographs of 8,610 Hiroshima and Nagasaki Adult Health Study subjects revealed 48 persons with posterior longitudinal ligament ossification (PLLO) in the thoracic region. Seven additional PLLO cases detected outside that observation period brought the total to 55. Among them, 15 patients with neurological signs and/or the greatest degree of thoracic PLLO were selected for computed tomography (CT) of the spine in the present study. Computed tomography proved extremely valuable in identifying the location, shape, and severity of PLLO. In two cases, CT differentiated some lesions previously regarded to be PLLO as actually due to hypertrophic margins of vertebral bodies. Possible explanations are included for the development of the laminated or tandem type PLLO, and PLLO that is located laterally rather than in midline.

A 12-year-old patient with non-Hodgkin's lymphoma, who developed central nervous system (CNS) relapse, was successfully treated with the following new regimen: cerebrospinal irradiation (CSpRT), high-dose chemotherapy, and autologous bone marrow transplantation (ABMT). He received remission induction therapy comprising intrathecal methotrexate and systemic chemotherapy, followed by cranial and spinal irradiations in doses of 2,000 cGy in 10 fractions over 5 days, and 1,200 cGy in 6 fractions over 3 days, respectively. He then received chemotherapy comprising 4 infusions of 1 g/m2 cytosine arabinoside and an intravenous injection of 4 mg/kg ACNU. His bone marrow, collected and cryopreserved after the remission induction therapy, was infused immediately after the high-dose chemotherapy. The granulocyte and platelet counts reached the nadir level on days 10 and 6 after ABMT, respectively, gradually recovering to the normal level in about 1 month. Neither severe infection nor bleeding was noted during the aplastic phase. No neurological deficits have been observed for 12 months. The short-time CSpRT and high-dose chemotherapy followed by ABMT are thus demonstrated to reduce neurotoxicities and bone marrow toxicities and to produce a good therapeutic effect against CNS involvement in lymphoma.