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Aim We have conducted a series of behavioral tests, which cover a broad range of behavioral domains, on various strains of genetically engineered mice. For the behavioral screening, we have been using Image J plugins that we developed for most of the tests in the battery. Our behavioral analysis system with the plugins enables systematic and automated image analysis of behavior. The plugins are freely available on the “Mouse Phenotype Database” website (http://www.mouse-phenotype.org/software.html). Here, we release the source code of the plugins in a Git repository with the aim of promoting their use and expanding their functionality. Methods We published the source code of the Image J plugins for behavioral analysis at Git repository (https://github.com/neuroinformatics). The source code for light/dark transition, elevated plus maze, open filed, T‐maze, and fear conditioning tests was made publicly available in the repository. Conclusions The source code of the plugins for the behavioral tests as well as the pre‐compiled binaries can be freely obtained. The open source code could promote the development and modification of the plugins for additional behavioral indices in these tests and for other behavioral tests., We developed the Image J plugins for behavioral analysis, and the pre‐compiled plugins are freely available on the website of “Mouse Phenotype Database.” Here, we released the source code of the plugins in the Git repository.

This chapter gives an overview of disaster prevention and mitigation, i.e., disaster management, activities by the government. Such activities by the central government involve a number of tasks including maintenance and management of infrastructures, building disaster prevention plans, and research for promoting disaster management. The central government is also involved in accident investigation for securing safety and security for the people of Japan and arranging systems for public health. Local governments also carry out administration work for securing safety for the residents.

Understanding anatomical structures and biological functions based on gene expression is critical in a systemic approach to address the complexity of the mammalian brain, where >25 000 genes are expressed in a precise manner. Co-expressed genes are thought to regulate cell type- or region-specific brain functions. Thus, well-designed data acquisition and visualization systems for profiling combinatorial gene expression in relation to anatomical structures are crucial. To this purpose, using our techniques of microtomy-based gene expression measurements and WebGL-based visualization programs, we mapped spatial expression densities of genome-wide transcripts to the 3D coordinates of mouse brains at four post-natal stages, and built a database, ViBrism DB (http://vibrism.neuroinf.jp/). With the DB platform, users can access a total of 172 022 expression maps of transcripts, including coding, non-coding and lncRNAs in the whole context of 3D magnetic resonance (MR) images. Co-expression of transcripts is represented in the image space and in topological network graphs. In situ hybridization images and anatomical area maps are browsable in the same space of 3D expression maps using a new browser-based 2D/3D viewer, BAH viewer. Created images are shareable using URLs, including scene-setting parameters. The DB has multiple links and is expandable by community activity.

We developed a computational framework for automated integration of a large number of two-dimensional (2D) images with three-dimensional (3D) image datasets located in the standard 3D coordinate. We applied the framework to 2,810 para-sagittal sectioned mouse brain 2D images of in situ hybridization (ISH), archived in the BrainTx database (http://www.cdtdb.neuroinf.jp). We registered the ISH images into the mouse standard coordinate space for MR images, Waxholm space (WHS, https://www.nitrc.org/projects/incfwhsmouse) by linearly transforming them into each of a series of para-sagittal MR image slices, and identifying the best-fit slice by calculating the similarity metric value (δ). Transformed 2D images were compared with 3D gene expression image datasets, which were made using a microtomy-based microarray assay system, Transcriptome Tomography, and archived in the ViBrism DB (http://vibrism.neuroinf.jp): the 3D images are located in the WHS.We first transformed ISH images of 10 regionally expressed genes and compared them to signals of corresponding 3D expression images in ViBrism DB for evaluating the integration schema: two types of data, produced with different modalities and originally located in different dimensions, were successfully compared after enhancing ISH signals against background noise. Then, for the massive transformation of BrainTx database images, we parallelized our framework, using the IPython cluster package, and implemented it on the PC cluster provided for the Brain Atlasing Hackathon activity hosted by Neuroinformatics Japan Center in Japan. We could identify the best-fit positions for all of the ISH images. All programs were made available through the GitHub repository, at the web site of neuroinformatics/bah2016_registration (https://github.com/neuroinformatics/bah2016_registration).

The height of the tsunami caused by the Sulawesi earthquake in 2018 was higher than that estimated from the magnitude of the earthquake, and its cause is not well understood. Although it is conceivable that tsunamis originated from landslides in several cases, it is not known whether landslides were occurring in the coastal area at the time. This report describes the results of a field survey conducted to investigate the traces of subsidence and the characteristics of the tsunami incidents in the bay far from the epicenter. Subsidence was observed at a minimum of seven points along the coast; in accord with the reports of eyewitnesses, this suggests that subsidence might have generated tsunamis.

We retrospectively evaluated the accumulation of fluorodeoxy glucose (FDG) in pulmonary malignancies without local recurrence during 2-year follow-up on positron emission tomography (PET)/computed tomography (CT) after radiofrequency ablation (RFA). Thirty tumors in 25 patients were studied (10 non-small cell lung cancers;20 pulmonary metastatic tumors). PET/CT was performed before RFA, 3 months after RFA, and 6 months after RFA. We assessed the FDG accumulation with the maximum standardized uptake value (SUVmax) compared with the diameters of the lesions. The SUVmax had a decreasing tendency in the first 6 months and, at 6 months post-ablation, FDG accumulation was less affected by inflammatory changes than at 3 months post-RFA. The diameter of the ablated lesion exceeded that of the initial tumor at 3 months post-RFA and shrank to pre-ablation dimensions by 6 months post-RFA. SUVmax was more reliable than the size measurements by CT in the first 6 months after RFA, and PET/CT at 6 months post-RFA may be more appropriate for the assessment of FDG accumulation than that at 3 months post-RFA.

A sequence of two strike-slip earthquakes occurred on April 14 and 16, 2016 in the intraplate region of Kyushu Island, Japan, apart from subduction zones, and caused significant damage and disruption to the Kumamoto region. The analyses of regional seismic catalog and available strong motion recordings reveal striking characteristics of the events, such as migrating seismicity, earthquake surface rupture, and major foreshock-mainshock earthquake sequences. To gain valuable lessons from the events, a UK Earthquake Engineering Field Investigation Team (EEFIT) was dispatched to Kumamoto, and earthquake damage surveys were conducted to relate observed earthquake characteristics to building and infrastructure damage caused by the earthquakes. The lessons learnt from the reconnaissance mission have important implications on current seismic design practice regarding the required seismic resistance of structures under multiple shocks and the seismic design of infrastructure subject to large ground deformation. The observations also highlight the consequences of cascading geological hazards on community resilience. To share the gathered damage data widely, geo-tagged photos are organized using Google Earth and the kmz file is made publicly available.

This prospective multicenter study aimed to evaluate the efficacy and safety of percutaneous radiofrequency (RF) ablation for lung cancer. From May 2008 to April 2012, 33 patients (26 men, 7 women; mean age 70.5 years) were enrolled. RF ablation was performed using an internally cooled or expandable multitined electrode. The primary endpoint was complete response (CR) determined using 18F fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) performed 6 months after RF ablation. The secondary endpoint was the incidence and grade of adverse events (AEs) evaluated using the Common Toxicity Criteria for Adverse Events, version 3.0. All patients underwent RF ablation and had efficacy analyses evaluated; however, FDG-PET/CT images before RF ablation were not available for two patients. The CR rate was 68 % (21 of 31 patients). One patient had a grade 5 AE unrelated to RF ablation. Grade ≥3 AEs occurred in 12 % of patients. During the follow-up period (median 37 months; range 1–55 months), five patients developed local tumor progression and nine (29 %) died. Overall survival at 1, 2, and 3 years was 97, 82, and 74 %, respectively. Percutaneous RF ablation is a safe, feasible, and effective treatment for small malignant lung tumors.

For multi-scale and multi-modal neural modeling, it is needed to handle multiple neural models described at different levels seamlessly. Database technology will become more important for these studies, specifically for downloading and handling the neural models seamlessly and effortlessly. To date, conventional neuroinformatics databases have solely been designed to archive model files, but the databases should provide a chance for users to validate the models before downloading them. In this paper, we report our on-going project to develop a cloud-based web service for online simulation called ''Simulation Platform''. Simulation Platform is a cloud of virtual machines running GNU/Linux. On a virtual machine, various software including developer tools such as compilers and libraries, popular neural simulators such as GENESIS, NEURON and NEST, and scientific software such as Gnuplot, R and Octave, are pre-installed. When a user posts a request, a virtual machine is assigned to the user, and the simulation starts on that machine. The user remotely accesses to the machine through a web browser and carries out the simulation, without the need to install any software but a web browser on the user's own computer. Therefore, Simulation Platform is expected to eliminate impediments to handle multiple neural models that require multiple software.

The purpose of this study was to analyze the detectability of colorectal neoplasia with fluorine-18-2-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (FDG-PET/CT). Data for a total of 492 patients who had undergone both PET/CT and colonoscopy were analyzed. After the findings of PET/CT and colonoscopy were determined independently, the results were compared in each of the six colonic sites examined in all patients. The efficacy of PET/CT was determined using colonoscopic examination as the gold standard. In all, 270 colorectal lesions 5 mm or more in size, including 70 pathologically confirmed malignant lesions, were found in 172 patients by colonoscopy. The sensitivity and specificity of PET/CT for detecting any of the colorectal lesions were 36 and 98%, respectively. For detecting lesions 11 mm or larger, the sensitivity was increased to 85%, with the specificity remaining consistent (97%). Moreover, the sensitivity for tumors 21 mm or larger was 96% (48/50). Tumors with malignant or high-grade pathology were likely to be positive with PET/CT. A size of 10 mm or smaller [odds ratio (OR) 44.14, 95% confidence interval (95% CI) 11.44-221.67] and flat morphology (OR 7.78, 95% CI 1.79-36.25) were significant factors that were associated with false-negative cases on PET/CT. The sensitivity of PET/CT for detecting colorectal lesions is acceptable, showing size- and pathology-dependence, suggesting, for the most part, that clinically relevant lesions are detectable with PET/CT. However, when considering PET/CT for screening purposes caution must be exercised because there are cases of false-negative results.

Purpose Evaluating the status of disease progression is critical for planning a therapeutic strategy for esophageal cancer. In this regard, F-18 fluorodeoxyglucose-labeled positron emission tomography (PET) is one of the most useful diagnostic modalities. However, there is room to improve its diagnostic performance, such as distinguishing lymph nodal metastases from false positives. In this study, we examined the diagnostic accuracy of fluorodeoxyglucose PET accompanied by computed tomography imaging (PET/CT) to detect regional lymph nodal metastasis from esophageal squamous cell carcinoma (ESCC). Methods A total of 102 patients diagnosed as ESCC were subjected to this study. These patients had a preoperative PET/CT examination to evaluate the existence of metastasis. The values of maximum standardized uptake value (SUVmax) in primary tumors and in metastasized lymph nodes were measured to analyze their relationship with various clinicopathologic characteristics including the status of tumor cell proliferation, which was assessed by immunohistochemistry for Ki-67. Results The SUVmax of the primary tumor was positively correlated with tumor size and vessel invasion, and was positively related with the SUVmax of lymph nodal metastasis, especially in cases of poorly differentiated ESCC. The SUVmax of metastasized lymph nodes was higher in larger-sized metastasized lymph nodes, whereas the Ki-labeling index of lymph nodal metastasis was positively related with the SUVmax per unit area (SUVmax/mm). The diagnostic accuracy of PET/CT (87.3%) was higher than that of conventional CT scans (78.4%). Conclusions The improved diagnostic accuracy of PET/CT can be explained by its ability to detect actively progressive metastasis at an early phase regardless of size.

A large earthquake of Mw 8.0 occurred in Samoa Islands region in the early morning of 29 September 2009 (local time). A large tsunami generated by the earthquake hit Samoa, American Samoa, and Tonga. The field investigation on evacuation behavior was carried out in Tutuila Island, American Samoa. The death ratio was low against the tsunami magnitude. This feature of this disaster resulted from waveform of tsunami, land use, residents' call, mayor's call, and so on.

To determine the effectiveness of living-donor lobar lung transplantation (LDLLT), it is necessary to predict the recipient's postoperative lung function. Traditionally, Date's formula, also called the segmental ratio, has used the number of lung segments to estimate the forced vital capacity (FVC) of grafts in LDLLT. To provide a more precise estimate of graft FVC, we calculated the volumes of the lower lobe and total lung using three-dimensional computed tomography (3D-CT) and the volume ratio between them. We calculated the volume ratio in 52 donors and tested the difference between the segmental volume ratios with a one-tailed t-test. We also calculated the predicted graft FVC in 21 LDLLTs using the segmental ratio pFVC(c) and the volume ratio pFVC(v), and then found the Pearson's correlation coefficients for both pFVC(c) and pFVC(v) with the recipients' actual FVC (rFVC) measured spirometrically 6 months after surgery. Significant differences were found between the segmental ratio and the average volume ratio for both sides (right, p＝0.03;left, p＝0.0003). Both pFVC(c) and pFVC(v) correlated significantly with rFVC at 6 months after surgery (p＝0.007 and 0.006). Both the conventional and the volumetric methods provided FVC predictions that correlated significantly with measured postoperative FVC.

The aim of this study was to evaluate the local efficacy of I-131 for F-18 fluorodeoxyglucose positron emission tomography (FDG PET)-positive lesions.Whole-body FDG PET/CT was performed on 37 patients (55 cases: 16 men, 21 women; age range: 24-82 years; mean age ± standard deviation: 60.5 ± 16.0 years) with differentiated thyroid cancer after total thyroidectomy. The metastatic or recurrent lesions were divided into 5 categories: primary tumor bed, lymph node, lung, bone, and other. The well-defined lesions were measured on CT, and the sizes were compared before and after radioactive iodine therapy.The analysis was performed on 37 patients with 44 lesions (lymph node:24, lung:16, bone:4). Sixteen lesions (70%) were increased and 7 (30%) showed no change or reduction when there was positive accumulation on FDG PET/CT and negative accumulation on I-131 (F(+)I(-)) group. In the positive accumulation for both FDG PET/CT and I-131 (F(+)I(+)) group, 5 lesions (63%) were increased and 3 (37%) showed no change or reduction. There was no significant difference for the tendency to increase in size between the F(+)I(-) and the F(+)I(+) groups.Lesions which show positive accumulations on FDG PET/CT have a greater tendency to increase in size. FDG-avid lesions are resistant to radioactive iodine therapy with or without I-131 uptake.

A large tsunami attacked Tutuila Island, American Samoa in the early morning on 29 September 2009 (local time), and killed 35 people. We must draw attention to be low death ratio compared with past tsunami disasters, while local people did not get tsunami warning information before tsunami coming and did not have tsunami knowledge. We carried out the field investigation on evacuation behavior of residents in Tutuila Island. The main findings are as follows: first, most residents evacuated some high ground areas close to their residential area. Secondly, almost all people evacuated on foot. Third, residents built social reality "We are dangerous when we are here". The reality was built by some people's behavior, e.g., mayor's call, residents' call, sounding the church bell and so on.

本研究は，被災後の居住規制により移住を余儀なくされた被災者の生活再建や地域社会の復興状況、および、それらを支援する中央・地方政府などの活動の長期的効果の把握を目的として実施した1994年フィリピン・ミンドロ地震津波災害による被害を受けた集落への現地調査の結果をまとめたものである．その結果，「Food-for-Work」と呼ばれる住宅再建手法などが効果的に作用し，政府による移住地開発は一定の成功を収めていることが分かった．ただし，さらに今後の動向には，土地所有者証明書の早期の発行や家庭をも巻き込んだ防災教育の継続が重要であることも分かった．

The objective of this study was to characterize MRI findings of inverted urothelial papilloma of the bladder.Data pertaining to 16 patients with 18 pathologically proven inverted urothelial papillomas of the bladder who had undergone MRI were retrospectively collected from seven institutions. The shape and surface characteristics of the tumors were evaluated using T2-weighted MR images. In addition, the signal intensity of inverted urothelial papillomas was visually assessed on T1-weighted, T2-weighted, and DW images and on early and delayed phase contrast-enhanced images.The shape of the 18 inverted urothelial papillomas of the bladder was classified as polypoid with a stalk for 16 tumors (89%) and polypoid without a stalk for two tumors (11%). All stalks were surrounded by urine in the bladder. A total of 15 of the tumor surfaces (83%) were nonpapillary and three (17%) were papillary. All 12 of the inverted urothelial papillomas for which evaluable T1-weighted images were available were isointense with the bladder wall. The lesions had a slightly higher signal intensity than the bladder wall in 15 of the patients (83%) and showed isointensity with the bladder wall in three patients (17%). A total of three patients (17%) had tiny hyperintense foci noted on T2-weighted images. All 16 of the inverted urothelial papillomas examined by DWI had very high signal intensity. All 13 of the lesions for which early phase images were obtained using dynamic contrast-enhanced MRI showed strong enhancement. When compared with early phase images, delayed phase images of the same 13 lesions showed that enhancement was stronger in two lesions (15%), similar in six lesions (46%), and weaker in five lesions (38%).On MRI, the typical appearance of inverted urothelial papillomas of the bladder is a polypoid shape with a nonpapillary surface and a thin short stalk surrounded by urine. Cystic foci are also occasionally seen within the tumor.

We investigated the diagnostic capabilities of I-131, Tl-201, and Tc-99m-MIBI (hexakis-2-methoxyisobutyl- isonitrile) scintigraphy for thyroid cancer metastases after total thyroidectomy over the entire body and for every locus before and after thyroid bed ablation. After total thyroidectomy of thyroid cancer, 36 cases were subjected to I-131 treatment 64 times. They consisted of 17 men and 19 women with 31 papillary carcinomas and 5 follicular carcinomas. Their ages were 22--75(an average of 60.5+/-12.3) years. I-131 scintigraphy(I-131), Tl-201 scintigraphy(Tl-201), and Tc-99m- MIBI scintigraphy (Tc-99m-MIBI) were performed. We defined the metastases as those cases in which serum thyroglobulin (Tg)increased significantly or in which we were able to prove the lesions on CT (computed tomography), MRI (magnetic resonance imaging) or bone scintigram. Three radiology medical specialists visually evaluated each scintigram and calculated the sensitivity, specificity, and likelihood ratio. For whole-body sensitivity, both Tl-201 and Tc-99m-MIBI were high before ablation and I-131 was high after ablation. Before ablation, the negative likelihood ratio was less than 0.1 for Tl-201 and Tc-99m-MIBI, while the positive likelihood ratio was more than 10 for Tl-201. After ablation, the positive likelihood ratio for I-131, Tl-201, and Tc-99m-MIBI was more than 10. The sensitivity of the mediastinum was appropriate, except for I-131 before ablation, and the sensitivity of the lung before and after ablation was inferior for either tracer. The specificity of the cervix for I-131 before ablation was markedly deteriorated, but it increased after ablation.

In order to understand the brain function, it is required integration of diverse information from the level of molecule to the level of neuronal networks. However, the huge amount of information is making it almost impossible for any individual researcher to construct an integrated view of the brain. To solve this problem, it is required useful neuroinformatics database and tools for preserving, maintaining and sharing of research accomplishments and resources. In the Neuroinformatics Research in Vision project in Japan, it has been developed an integrated system and tools for neuroinformatics in vision science named “Visiome Environment”.

We studied the differentiation of thyroid nodules using fine-needle aspiration biopsy (FNA) and Tl-201 scintigraphy quantitative analysis. One-hundred and thirty-one thyroid nodules were examined: 83 follicular lesions (58 benign and 25 malignant lesions) and 48 non-follicular lesions (8 benign and 40 malignant lesions). During Tl-201 scintigraphy examinations, an early and a delayed image were acquired 10 and 120 min after an intravenous injection, respectively. The T/N ratio (counts of nodular lesion/counts of contralateral normal thyroid tissue) of each image was calculated quantitatively. We assessed the ability of the Tl-201 scintigraphy and of the FNA analysis to differentiate benign and malignant lesions and determined the cut-off levels for the assays. For the follicular lesions, the area under the ROC (Receiver Operating Characteristic) curve (Az) for the Tl-201 scintigraphy data was greater than that for the FNA data. For the non-follicular lesions, the Az for the FNA data was greater than that for the Tl-201 scintigraphy data. We set cut-off levels at 1.370 for follicular lesions, and 1.070 for non-follicular lesions. The sensitivity and specificity were 76% and 82.7% for follicular lesions, and 90% and 87.5% for non-follicular lesions, respectively. The overall accuracy of the analysis was 84.0%.

We evaluated the respiratory functions of patients with pulmonary emphysema who underwent lung volume reduction surgery (LVRS) by the mean transit time (MTT) with Xe-133 lung ventilation scintigraphy, forced expiration volume in 1 sec (FEV1.0), residual volume (RV), distance walked in 6 min (6-min walk), and the Hugh-Jones classification (H-J classification) before and after LVRS. In 69 patients with pulmonary emphysema (62 men, 7 women; age range, 47-75 years; mean age, 65.4 years +/- 6.1, preoperative H-J classification, III (two were II)-V) who underwent LVRS, all preoperative and postoperative parameters (MTT 3 weeks after LVRS and the others 3 months after LVRS) were judged statistically by the Wilcoxon signed-ranks test and Odds ratio. Every postoperative parameter was improved with a significant difference (P < 0.05) compared to preoperative parameters. MTT at 3 weeks after LVRS was not associated with %FEV1.0 and the H-J classification at 3 months after LVRS, but was associated with RV and a 6-min walk at 3 months after LVRS. MTT was useful for the clinical evalution of aerobic capability after LVRS.

We examined the diagnostic capability of a quantitative evaluation by determining the optimum area for comparisons with nodule and optimum imaging time by Tl-201 scintigraphy in thyroid follicular nodules, retrospectively. Ninety-one thyroid follicular nodules, for which the pathological diagnosis had been established, were examined (60 benign, 31 malignant). After 74 MBq of Tl-201 chloride was injected intravenously, Tl-201 scintigrams were obtained at 10, 20, 30, and 120 min. For the quantitative evaluation, the area with the greatest accumulation in the nodule and a comparative region in the contralateral thyroid and the soft tissues in the cervical region were manually selected as the region of interest (ROI) referring to Tc-99m pertechnetate scintigrams and ultrasonographic findings as a guide by two radiologists, and the T/N ratio (tumor/normal tissue ratio) and T/S ratio (tumor/soft tissue ratio) were calculated. The pixel counts were determined for all ROI. A summary index of overall test performance can be calculated as the area under the receiver operating characteristic (ROC) curve (Area (Az)), and the likelihood ratios were also calculated. We estimated the cut-off on a fitted binormal ROC curve. Multiple regression analyses were used to investigate the relationships between the optimum quantitative evaluation and 5 independent variables. A p value below 5% was considered to be significant. The T/N ratio and T/S ratio were significantly higher in the malignant group at 10 min (0.844 and 0.702), 20 min (0.844 and 0.704), 30 min (0.841 and 0.670), and 120 min (0.887 and 0.733), respectively (p0.01). The Az for the T/N ratio was greatest at 120 min. The multiple regression analysis showed that only 'benign or malignant' was a significant variable in the T/N ratio at 120 min. It correlated significantly in interobserver (r = 0.80) and intraobserver (r = 0.80) studied (p0.001). An assessment of the cut-off value of the T/N ratio at 120 min, at the cut-off of 1.255, the likelihood ratio for positive test result was greatest at 8.56, while at the cut-off of 1.010, the likelihood ratio for negative test result was lowest at 0.165. The T/N ratio at 120 min was more useful than the other condition to distinguish between benign and malignant thyroid follicular nodules.

Bottom-gate-type thin film transistors using ZnO as an active channel layer (ZnO–TFT) have been constructed. The ZnO layers were deposited using pulsed laser deposition at 450 °C at an oxygen pressure of 3 m Torr, and the material that was formed had a background carrier concentration of less than 5×1016 cm−3. A double layer gate insulator consisting of SiO2 and SiNx was effective in suppressing leakage current and enabling the ZnO–TFT to operate successfully. The Ion/Ioff ratio of ZnO–TFTs fabricated on Si wafers was more than 105 and the optical transmittance of ZnO–TFTs fabricated on glass was more than 80%. These results show that it is possible to fabricate a transparent TFT that can even be operated in the presence of visible light.

A 22-year-old woman with severe acute hepatitis underwent a Tc-99m galactosyl human serum albumin (GSA) scan. Intense accumulation was observed in the cephalic region of the right hepatic lobe, whereas the accumulation was reduced in the left lobe and the caudal region of the right lobe. A computed tomographic (CT) scan showed that the left lobe and the caudal region of the right posterior segment had atrophied and become hypodense, which were thought to represent postnecrotic scarring after massive hepatic necrosis. The relatively hyperdense region in the right lobe was slightly swollen and was thought to represent regenerating liver tissue or a "potato liver." Compared with the CT, the regions of elevated Tc-99m GSA accumulation correlated well with the areas of regenerating liver tissue, and the regions with reduced accumulation corresponded closely with the areas of postnecrotic scarring. On a Tc-99m phytate scan, unlike the Tc-99m GSA scan, the radiocolloid accumulation was intense in the left lobe and caudal region of the right lobe and reduced in the cephalic region of the right lobe. Together, the Tc-99m GSA scan and the Tc-99m phytate scan formed a set of exact "nega-posi" images. Biopsy specimens obtained during laparoscopy showed a few hepatocyte columns in the postnecrotic scarred left lobe. Severe disruption of the hepatocytes, prominent inflammatory cell infiltration, and obvious Kupffer cell hypertrophy and clustering were also observed.

Objective: To compare the diagnostic capabilities of various serum thyroglobulin levels (Tg) and Tl-201 scintigraphy with regard to thyroid follicular lesions.Methods: We examined 80 thyroid follicular lesions (benign: 55, malignant: 25) in patients with nodular goiter for whom a pathological diagnosis was made based on surgical findings. Tg was measured by an I-125 (radioimmunoassay) method. In Tl-201 scintigraphy, 74 MBq of Tl-201 chloride was intravenously injected and imaged after 10 minutes (early image) and after 120 minutes (delayed image), and the scintigrams were evaluated both visually and quantitatively, with special attention paid to the part of the nodule with the highest accumulation of Tl-201 chloride. The cutoff levels of Tg for categorizing the lesions as malignant were set at 40, 100, 300, 500, 1,000 and 2,500 μg/l. In Tl-201 scintigraphy, method 1 involved high uptake on both early and delayed images, method 2 involved high uptake on only the early image, and method 3 involved high uptake on only the early image or the same accumulation in comparison with the normal region on the early image, with no washout being quantitatively judged as indicative of malignancy. A summary index of overall test performance can be calculated as the area under the receiver operating characteristic (ROC) curve (Area (Az)). Likelihood ratios for several cutoff levels were also calculated.Results: In the diagnosis, Az of Tl-201 (0.95) was larger than that of Tg (0.65). The sensitivity and accuracy of Tg at each cutoff level (sensitivity: 4.0% to 76.0%, accuracy: 50.0% to 72.5%) were lower than with Tl-201 scintigraphy (methods 1–3, sensitivity: 76.0–100%, accuracy: 77.5–88.8%). The likelihood ratio for the positive results of method 1 for Tl-201 scintigraphy, were greatest in the present study (13.9), and the likelihood ratio for the negative results of method 3 for Tl-201 scintigraphy, (0) was smallest in the present study.Conclusion: Diagnosis based on Tl-201 washout patterns in which quantitative evaluation is combined with visual evaluation appears to be more useful for the differentiation of malignant thyroid follicular lesions than diagnosis by Tg.

Nontumorous decrease in99mTc-GSA accumulation has not been well covered in the literature. Understanding of this phenomenon is, however, essential for accurate evaluation of regional hepatic function. Scintigrams (transaxial SPECT) of 269 patients who underwent99mTc-GSA liver scintigraphy were reviewed for the presence of nontumorous decreases in99mTc-GSA accumulation. Nontumorous decreases in99mTc-GSA accumulation were seen in 32 of 269 patients (12%). In 16 of the 32 patients (6%), nontumorous decreases in99mTc-GSA accumulation corresponded to regional decrease in portal venous flow. The causes of such decrease in portal venous flow were portal thrombus of hepatocellular carcinomas in eight patients, portal venous stenosis or occlusion by hilar cholangiocarcinomas in five patients, inter alia. In eight patients (3%), the regions with decreased99mTc-GSA accumulation correlated with massive hepatic necrosis in fulminant hepatitis, scar in hepatitis, or confluent fibrosis in cirrhotic liver. In two patients (0.7%) with hilar cholangiocarcinomas, the possible causes of lobar decrease in99mTc-GSA accumulation were thought to be lobar decrease in portal venous flow, lobar biliary stasis, or both. In four patients (1.5%), the exact causes of nontumorous decrease in99mTc-GSA accumulation could not be determined.