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Purpose: The purpose of this study was to determine the most useful parameter of dual-time-point 2-deoxy-2-[¹⁸F]fluoro-D: -glucose positron emission tomography/computed tomography (PET/CT) for detection of hepatic metastases in patients with colorectal cancer.Procedures: Thirty-nine patients had undergone a dual-time-point PET/CT scan and a subsequent histopathological confirmation for a workup of hepatic metastases. Detection rates were compared for visual analysis score, standardized uptake value (SUV), tumor-to-liver uptake ratio (TLR), and percent changes of the SUV and TLR.Results: Of 91 liver lesions, 86 lesions were confirmed as metastases. The SUV and TLR of metastatic lesions on the delayed images were higher than those on the first scan (p < 0.001). The signal-to-noise ratio of the delayed PET scan was higher than that of the first scan (p < 0.0001). The TLR and SUV of the delayed scan showed the highest detection rates of 92% and 88%, whereas percent changes of SUV and TLR showed the lowest detection rates (51%, 67%). Visual analysis detected 87% on the delayed scan and 77% on the first scan.Conclusions: A delayed scan is more favorable for the detection of hepatic metastases of colorectal cancer, and the TLR on the delayed scan was the most useful parameter. [ABSTRACT FROM AUTHOR]

Whole-body bone scan is one of the most frequent diagnostic procedures in nuclear medicine. Especially, it plays a significant role in important procedures such as the diagnosis of osseous metastasis and evaluation of osseous tumor response to chemotherapy and radiation therapy. It can also be used to monitor the possibility of any recurrence of the tumor. However, it is a very time-consuming effort for radiologists to quantify subtle interval changes between successive whole-body bone scans because of many variations such as intensity, geometry, and morphology. In this paper, we present the most effective method of image enhancement based on histograms, which may assist radiologists in interpreting successive whole-body bone scans effectively. Forty-eight successive whole-body bone scans from 10 patients were obtained and evaluated using six methods of image enhancement based on histograms: histogram equalization, brightness-preserving bi-histogram equalization, contrast-limited adaptive histogram equalization, end-in search, histogram matching, and exact histogram matching (EHM). Comparison of the results of the different methods was made using three similarity measures peak signal-to-noise ratio, histogram intersection, and structural similarity. Image enhancement of successive bone scans using EHM showed the best results out of the six methods measured for all similarity measures. EHM is the best method of image enhancement based on histograms for diagnosing successive whole-body bone scans. The method for successive whole-body bone scans has the potential to greatly assist radiologists quantify interval changes more accurately and quickly by compensating for the variable nature of intensity information. Consequently, it can improve radiologists' diagnostic accuracy as well as reduce reading time for detecting interval changes. [ABSTRACT FROM AUTHOR]

A 47-year-old woman with systemic lupus erythematosus presented with a history of radical hysterectomy and pelvic lymph node dissection for cervical cancer Ia and brachytherapy for vaginal recurrence. Four years later, abnormal hypermetabolic lesion at vaginal vault on FDG-PET/CT was found and confirmed as vaginal recurrence by punch biopsy. So, she underwent anterior pelvic exenteration with urostomy. She underwent colostomy because of colonic fistula 1 week after anterior pelvic exenteration. She had wound problem near the colostomy site. The wound waxed and waned, however, no definite discharge was identified from wound. Three months later after anterior pelvic exenteration, FDG-PET/CT revealed multiple hypermetabolic lesions along the incision line, colostomy site and abdominopelvic lymph nodes. Biopsies of the skin and lymph nodes with FDG accumulation revealed an inflammatory granulation tissue and reactive lymphadenopathy. Definite symptom such as leakage of stool was not identified. One year later, there was no interval change of multiple hypermetabolic lesions on follow-up FDG-PET/CT. There was still wound problem. So, revision of colostomy was done with impression of subtle fistula between skin and colostomy. Multiple hypermetabolic lesions on FDG-PET/CT disappeared after 3 months of repair of colostomy. We reported a case showing high FDG accumulation at wound and paraaortic lymph node on PET/CT because of intestinocutaneous fistula around colostomy. These malignant mimicking FDG accumulations were disappeared after colostomy reversion. [ABSTRACT FROM AUTHOR]

Abstract  We aimed to determine the efficacies of a non-anthracycline-containing regimen, docetaxel/capecitabine (TX), in comparison with an anthracycline-containing regimen, doxorubicin/cyclophosphamide (AC), as primary chemotherapy for node-positive early stage breast cancer. In this phase-III single center randomized study, we randomized 209 women with axillary node positive, stage II/III breast cancer to receive four cycles of either TX or AC followed by surgery and cross-over to the other treatment as an adjuvant therapy. The primary endpoint was tumor pathologic complete response (pCR). Clinical response rates, toxicity profiles, disease free survival (DFS), and overall survival were secondary objectives. In total, 204 patients had clinical and radiological evaluation of response, and underwent surgery. Compared with AC, TX increased pCR in primary tumors (21% vs. 10%, respectively, P = 0.024) and clinical response (84% vs. 65%, P = 0.003). TX was associated with less nausea and vomiting, but more stomatitis, diarrhea, myalgia, and skin/nail changes than AC. With a median follow-up of 37 months, there was no significant difference in DFS by treatment groups (P = 0.932). Fewer patients developed recurrence who achieved pCR in lymph node (LN) (P = 0.025; hazard ratio, 0.189; 95% CI, 0.044–0.815) in the multivariate analysis. TX showed superior efficacies to AC with increased pathologic and clinical complete response rates. Although these findings did not translate into a gain in DFS, the patients who achieved pCR in LN developed significantly less recurrence. [ABSTRACT FROM AUTHOR]

Summary Electrophoretic display system was fabricated to investigate the effectiveness of transparent polymer electrode using Poly (3,4-ethylenedioxythiophene) (PEDOT). The electrophoretic TiO2 nanoparticles were coated to modify the surface. As a transparent polymer electrode, 3,4-ethylenedioxythiophene (EDOT) was in-situ polymerized into PEDOT. When the reducing agent (N-dimethylacetamide, DMAc) was added, surface resistivity of PEDOT was dominantly reduced. With the DMAc addition of 40 wt % to the monomer content, surface resistivity was as low as 100 Ω/□, and transmittance was almost 80% in visible ray region. [ABSTRACT FROM AUTHOR]

AbstractBackground  The aim was to prove the low identification rate of sentinel lymph node biopsy (SNB) and to determine the feasibility of replacing axillary lymph node dissection (AND) in axillary lymph node positive patients after chemotherapy.Methods  From October 2001 to July 2005, 875 consecutive patients with primary operable breast cancer underwent SNB and AND. Among them, 238 received pre-operative chemotherapy. We compared the identification rate, false negative rate (FNR), negative predictive value (NPV), and accuracy of SNB in clinically node-positive patients with or without chemotherapy.Results  The identification rate was significantly lower in patients received chemotherapy (77.6%) than in those not received it (97.0%) (P < 0.001). In those received the therapy, the FNR was 5.6%, the NPV was 86.8%, and the accuracy was 95.9%. In those not received therapy, the FNR was 7.4% and the accuracy was 92.6% (differences not statistically significant).Conclusion  The identification rate in confirmed axillary lymph node-positive patients was significantly lower in patients received pre-operative chemotherapy, but accuracy did not differ significantly between the two groups. Thus, for patients who achieve complete axillary clearance by chemotherapy, SNB could replace AND. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to assess the diagnostic accuracy of 18F-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) with respect to lymph node (LN) metastasis in patients with advanced gastric cancer, and to ascertain the factors that affect this accuracy. Methods: Seventy-three patients with advanced gastric cancer, verified in all cases by endoscopic biopsy, were enrolled in this prospective study. We conducted FDG PET and other routine preoperative studies, including abdominal computed tomography (CT). Patients underwent either curative-intent gastrectomy and lymphadenectomy (n=67) or exploratory laparotomy. The Japanese system for the classification of gastric cancer was used for LN assessment. Results: FDG PET was able to detect primary lesions in 70 of the 73 cases. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value of FDG PET for LN metastasis were 40%, 95%, 91% and 56%, respectively. Signet-ring cell carcinoma was associated with the lowest sensitivity (15%), whereas other cell types could be detected with moderate sensitivity (30-71%) and high specificity (93–100%). According to multiple logistic regression, the standardised uptake value for primary tumours was the only independent variable to be significantly related to sensitivity for LN metastasis (p=0.02, odds ratio=1.14). CT was superior to PET in terms of sensitivity (p<0.0001), and PET was superior to CT in terms of specificity (p<0.0001) and PPV (p=0.05). Conclusion: FDG PET exhibits good specificity for LN staging of gastric cancer, and FDG uptake in the primary tumour is significantly related to the accuracy of FDG PET. Despite some clear limitations, FDG PET proved useful in the LN staging of FDG-avid gastric cancer. [ABSTRACT FROM AUTHOR]