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The WHO 2010 classification divides gastrointestinal neuroendocrine neoplasms (GI-NENs) into neuroendocrine tumor (NET) G1, NET G2, neuroendocrine carcinoma (NEC) and mixed adenoendocrine carcinoma (MANEC) groups. A total of 136 cases of GI-NENs diagnosed at our hospitals as gastrointestinal carcinoids, endocrine cell carcinomas and NENs over the last 11 years, using the WHO 2010 classification were assessed. Among the 136 cases, 88.2% (120/136) were classified into the NET group (NET G1/G2) and 11.8% (16/136) were classified into the NEC group (NEC/MANEC). The incidences of lymphatic and venous invasions were higher in the NEC group compared with in the NET group (P<0.0001 and P=0.0021, respectively). The immunohistochemical staining of cluster of differentiation 73 (CD73) was evaluated in GI-NENs. CD73 is a potentially useful molecule in tumor immunity. In general, CD73 on the tumor cell membrane converts adenosine monophosphate to adenosine, which restrains the production of interferon-γ and cytocidal activity. Although the association between stem cells of pancreatic NENs and CD73 has been reported, few studies have reported on CD73 expression in GI-NENs. Immunohistochemical CD73 expression on the cytomembrane of neuroendocrine cells was detected in 27.2% (37/136) of the GI-NENs. The positive ratio of CD73 was significantly higher in the NEC group compared with in the NET group (P=0.0015). CD73 is also considered as a potential biomarker of anti-programmed death-1 (PD-1) therapy. The expression of programmed death-ligand 1 (PD-L1) on the cytomembrane of GI-NENs was assessed. The positive ratio of PD-L1 was higher in the NEC group compared with in the NET group (P=0.0011). Furthermore, CD73 expression status was significantly correlated with PD-L1 expression (P<0.0001). These results indicate that CD73 may be an interesting candidate for a biomarker for certain prognostic factors and therapeutics concerning PD-1 therapy. [ABSTRACT FROM AUTHOR]

Gadoxetate Sodium (Gd-EOB-DTPA, EOB) is a new contrast agent for magnetic resonance (MR) imaging that allows both vascular and hepatobiliary imaging in one examination. Often in the arterial phase, however, appropriate scan timing is missed and contrast enhancement is not enough. In addition, to shorten the complete examination, some studies have been conducted to examine scan timing at the hepatobiliary phase earlier than 20 min after injection. We studied the optimal scan timing both at the arterial and the hepatobiliary phase. It was appropriate that multiphase acquisition of MR imaging at the arterial phase should be aimed around 25 sec after injection. Moreover, the liver-spleen contrast ratio (C(L-S)) at the hepatobiliary phase was highest at 60 min after injection, and the acquisition of an image earlier than 20 minutes lowered the C(L-S). In the future, it is desirable to establish how to use Gd-EOB-DTPA (EOB) for hepatic MR imaging after taking the extent of liver damage into consideration.

Although a large number of studies have been done on exposure to operators and doctors during interventional radiology(IVR), there have been very few reports on nurses. This study was carried out to clarify the situation regarding exposure for nurses, and provides examples of how to estimate and manage. We measured space dose-rate distributions with an ionization survey meter, and personal exposure dose by a small fluorescent grass dosimeter(Dose Ace). The experimental results disclosed that there tended to be two types of exposure depending on the task performed. Head and neck(collar level)were associated with the highest exposure dose, which was observed in nurses assisting operators. Alternatively, knees showed the highest exposure dose, which was observed in nurses observing and assisting the patient. When estimation of skin equivalent exposure at the knees is needed, it can be calculated by using the value measured at the collar level. Furthermore, in estimating exposure dose, the directional and energy characteristics of personal dosimeters should be considered adequate. For radiation management, a circular protective sheet can be placed around the patient's lower area and a protective screen near the patient's head, and basic and practical education can be given. We concluded that these are highly useful for the personal monitoring of nurses engaged in IVR.