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Sample records for hepatic tumors ct

  1. Therapeutic response assessment using 3D ultrasound for hepatic metastasis from colorectal cancer: Application of a personalized, 3D-printed tumor model using CT images.

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    Ye Ra Choi

    Full Text Available To evaluate accuracy and reliability of three-dimensional ultrasound (3D US for response evaluation of hepatic metastasis from colorectal cancer (CRC using a personalized 3D-printed tumor model.Twenty patients with liver metastasis from CRC who underwent baseline and after chemotherapy CT, were retrospectively included. Personalized 3D-printed tumor models using CT were fabricated. Two radiologists measured volume of each 3D printing model using 3D US. With CT as a reference, we compared difference between CT and US tumor volume. The response evaluation was based on Response Evaluation Criteria in Solid Tumors (RECIST criteria.3D US tumor volume showed no significant difference from CT volume (7.18 ± 5.44 mL, 8.31 ± 6.32 mL vs 7.42 ± 5.76 mL in CT, p>0.05. 3D US provided a high correlation coefficient with CT (r = 0.953, r = 0.97 as well as a high inter-observer intraclass correlation (0.978; 0.958-0.988. Regarding response, 3D US was in agreement with CT in 17 and 18 out of 20 patients for observer 1 and 2 with excellent agreement (κ = 0.961.3D US tumor volume using a personalized 3D-printed model is an accurate and reliable method for the response evaluation in comparison with CT tumor volume.

  2. Primary hepatic carcinoid tumor

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    Gao Jinbo

    2011-11-01

    Full Text Available Abstract Primary hepatic carcinoid tumor is rare and poses a challenge for diagnosis and management. We presented a case of primary hepatic carcinoid tumor in a 53-year-old female with a complaint of right upper abdominal pain. Computer tomography scans revealed a hypervascular mass in segment 4 of the liver. An ultrasonography-guided biopsy showed a carcinoid tumor. No other lesions were found by the radiological investigations. Surgery resection was performed and histopathological examination revealed a primary hepatic carcinoid tumor. Three years later, recurrence was found and transcatheter arterial chemoembolization was performed. After transcatheter arterial chemoembolization, the patient has been free of symptom and had no radiological disease progression for over 6 months. Surgical resection combination with transcatheter arterial chemoembolization is effective to offer excellent palliation.

  3. CT and MR imaging characteristics of infantile hepatic hemangioendothelioma

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    Feng Shiting, E-mail: fst1977@163.com [Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen Univeristy, 58th, The Second Zhongshan Road, Guangzhou (China); Chan Tao, E-mail: taochan@hku.hk [Department of Diagnostic Radiology, University of Hong Kong, Room 406, Block K, Queen Mary Hospital (Hong Kong); Ching, A.S.C., E-mail: chingsc@hotmail.com [Department of Diagnostic Radiology, University of Hong Kong, Room 406, Block K, Queen Mary Hospital (Hong Kong); Sun Canhui, E-mail: canhuisun@sina.com [Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen Univeristy, 58th, The Second Zhongshan Road, Guangzhou (China); Guo Huanyi, E-mail: guohuanyi@163.com [Department of Medical ultrasonics, The Third Affiliated Hospital, Sun Yat-Sen Univeristy, 600th, Tianhe Road, Guangzhou (China); Fan Miao, E-mail: cmu-sums@163.com [Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen Univeristy, 58th, The Second Zhongshan Road, Guangzhou (China); Meng Quanfei, E-mail: mzycoco@gmail.com [Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen Univeristy, 58th, The Second Zhongshan Road, Guangzhou (China); Li Ziping, E-mail: liziping163@tom.com [Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen Univeristy, 58th, The Second Zhongshan Road, Guangzhou (China)

    2010-11-15

    Aim: This study aims to analyze computed tomography (CT) and magnetic resonance (MR) imaging features of infantile hepatic hemangioendotheliomas before and after treatment. Materials and methods: CT and MR examinations of seven infants with biopsy proven hepatic hemangioendotheliomas were retrospectively analyzed. The distribution, number, size, imaging appearance, enhancement pattern and post-treatment changes of the tumors were evaluated. Results: A total of 153 hepatic hemangioendotheliomas were detected on CT (111) and MR (42) imaging. In six infants, 109/111 (98.2%) tumors were hypodense and 2/111 (1.8%) lesions contained calcification on unenhanced CT. On MR imaging, all 42 lesions in one infant were heterogeneously T1-hypointense and T2-hyperintense compared to the normal liver parenchyma. Contrast-enhanced CT and MRI showed peripheral rim (51.6%), uniform (48.4%), fibrillary (33.3%), and nodular (28.8%) contrast enhancement in the hepatic arterial phase. Homogeneous (100%), rim (98.2%) and mixed enhancement patterns were noted in tumors <1.0 cm, >2.0 cm and 1.0-2.0 cm in diameter respectively in the hepatic arterial phase. In three patients who underwent steroid therapy, follow-up CT examination demonstrated tumor size reduction and increased intra-tumoral calcification in two patients. Conclusion: Infantile hepatic hemangioendotheliomas show some typical imaging features and size-dependent pattern of contrast enhancement on CT and MR imaging, which allow accurate imaging diagnosis and post-treatment evaluation.

  4. Littoral cell angioma mimicking hepatic tumor

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    Wenhua Liang

    2012-07-01

    Full Text Available Littoral cell angioma is a rare vascular tumor of the spleen that was described by Falk et al. in 1991. Because of the limited number, untypical imaging manifestations, and lack of knowledge on this tumor type, these tumors are often misdiagnosed. In most cases, the tumor presents with multiple small hypoattenuating nodules in the spleen with delayed enhancement. However, solitary littoral cell angiomas have not been well described. We present the CT features of an unusual littoral cell angioma mimicking hepatic tumor.

  5. CT features of ovarian tumors

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    Akiba, Ryuzo; Izumi, Sigeru; Tsutsui, Fumio; Kurihara, Soju; Hisa, Naofumi

    1985-02-01

    CT findings were compared with macroscopic and histopathologic findings in 84 patients with ovarian tumors. Marginal irregularity of the tumor shown on CT exhibited marked adhesion to the greater omentum, enteron or pelvic wall at laparotomy. CT showed tumor capsules more than 10 mm in thickness in 5 of 27 patients with malignant ovarian carcinomas (18.5%) and 2 of 15 patients with endometrioid cystadenoma (13.3%). Various thickness of the capsule was seen on CT in 48.1% of the patients with malignant ovarian carcinomas and 60.0% of the patients with endometrioid cystadenoma. Diagnostic accuracy of CT for the presence of absence of solid tumors was 89.3%. Misdiagnosis was attributed to the presence of high specific gravidity of fluid contents within the tumor, partial volume phenomenon, various thickness of the capsule, coagulation, and hair mass seen in dermoid cyst. Solid tumor-like density was larger and more irregular in the group with malignant ovarian tumors than in the group with benign ones. Irregular cystic parts were seen on CT in a high incidence among the group with malignant ovarian carcinomas. Dermoid cyst was diagnosed easily by CT because CT numbers were specific to the contents of cyst. (Namekawa, K.).

  6. Dynamic CT of pancreatic tumors

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    Hosoki, T.

    1983-05-01

    Dynamic computed tomography was performed on 19 patients with clinically diagnosed pancreatic and peripancreatic tumors. There were 10 patients with pancreatic cancer, three with inflammatory pancreatic masses, two with cystadenoma, one with insuloma, and three with peripancreatic tumors. Computed tomography was performed with a Varian-V-360-3 scanner; scanning was for 30 consecutive sec at 3 sec intervals after the bolus injection of 50 ml of contrast medium into the antecubital vein. Dynamic computed tomography (CT) may be more useful than conventional contrast CT because it facilitates: (1) correct evaluation of tumor vascularity allowing a differential diagnosis; (2) location of the boundary between tumor and a nontumor tissue; (3) detection of small tumors; and (4) visualization of pancreatic invasion by peripancreatic tumors. In addition, contrast enhancement and the degree of vascular proliferation can be quantitatively assessed by analyzing time-density curves.

  7. CT of metastatic spinal tumor

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    Sakata, T. (Osaka Medical Coll., Takatsuki (Japan))

    1980-12-01

    CT findings of metastatic spinal tumor were classified into 6 types, i.e., consolidation, dissolution, mottle, doughnut, and ring types, and mixed type of these, and that of no findings. Some statistically significant relationship was found between prostatic cancer and consolidation type, and unknown primary cancer and dissolution type. Abnormal findings of bone scintigraphy was suspected to have metastatic spinal tumor by plain radiography and CT scan in 64/128 (50.0%) and 113/145 (78.6%), respectively. There was some relationship between plain radiographic findings and CT findings; between consolidation type of the former and consolidation type of the latter, dissolution type and dissolution type, compression fracture type and mixed type, the type of no findings and consolidation or mixed type. Most of the lesions detected by CT as consolidation or mixed type were revealed by plain radiography. Changes in Ca amount was not detected by plain radiography and CT scan if it was approximately less than 30% and 18% of the initial Ca respectively.

  8. CT EVALUATION OF THE HEPATIC MASS LESIONS

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    Aniruddha Basu

    2016-07-01

    Full Text Available Hepatic mass lesions represent a spectrum of disorders congenital, infective, neoplastic, and otherwise. The use of non-contrast and contrast enhanced CT enables to detect the liver lesions more adequately and detects other associated effects if any. CT delineates affected segments in the disease process and the extent of involvement. AIMS To study of effectiveness of CT in studying the CT patterns of different hepatic mass lesions and to correlate CT findings in hepatic mass lesions in various patients with FNAC and HPE findings. MATERIALS AND METHODS 50 cases of clinically suspected hepatic mass lesions were scanned by Philips 16 slice CT MX-16 EVO within the period of July 2015 - 1 st week of July 2016 in JMCH, Jorhat. All OPD and indoor patients of both sexes and patients in whom hepatic mass lesions were detected with other modalities of imaging were included. Hydatid cyst and haemangioma cases were excluded due to risk of anaphylaxis and haemorrhage during FNAC. All the patients were scanned pre and post IV contrast administration and data was recorded FNAC of the lesions were done by 20 G Chiba or 18 G Tru-Cut needle. The scans were viewed by two senior radiologists to minimise interpretative errors. RESULTS AND OBSERVATIONS In the 50 cases studied, 25 patients (50% had metastatic lesions, 10 patients (20% had hepatocellular carcinoma, 3 patients (6% had hepatoblastoma, 11 patients (22% had liver abscesses, 1 patient (2% had polycystic liver disease. These correlated well with CT-guided FNAC findings where FNAC was positive in cases as follows: Metastatic lesions 23 patients (46%, hepatocellular carcinoma 8 patients (16%, hepatoblastoma 3 patients (6%, liver abscesses 9 patients (18%, 1 patient (2% polycystic liver disease. CONCLUSION In this study, CT proved to be the diagnostic tool of choice for hepatic mass lesions. CT-guided FNAC and HPE findings correlated well with the CT diagnosis of hepatic masses. CT proved to be a fast imaging

  9. CT images of diffuse hepatic disease

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    Hara, Suguru; Kido, Choichiro; Satoh, Shigeki; Ashizawa, Tatsuhito (Aichi Cancer Center, Nagoya (Japan). Hospital)

    1982-12-01

    During three years, 198 cases of diffuse hepatic disease were computer tomographed. Of these, 52 cases of fatty liver showed CT values lower than the 62.3 +- 56 HU for normal liver. Cases with iso-density included 76 cases of liver cirrhosis (including 19 cases of liver cancer), 34 cases of chronic hepatitis, 3 cases of malignant lymphomatous infiltration, and 1 case each of amyloidosis and leukemia. Those cases with high-density included 28 cases of Thorotrast deposit (including 4 cases of liver cancer) and 1 case of Wilson's disease, hemochromatosis, and hemosiderosis. After careful investigation, it was demonstrated that CT has broad application and efficacy in diffuse hepatic diseases.

  10. The impact of PET/CT on the management of hepatic and extra hepatic metastases from gastrointestinal cancers

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    Polat, Erdal, E-mail: erdal066@yahoo.com [Kartal Kosuyolu High Specialty Training and Research Hospital, Department of Gastrointestinal Surgery, Istanbul (Turkey); Bostanci, Erdal Birol [Sakarya University, Faculty of Medicine, Department of General Surgery, Sakarya (Turkey); Aksoy, Erol [Turkiye Yuksek Ihtisas Teaching and Research Hospital, Department of Gastroenterological Surgery, Ankara (Turkey); Karaman, Kerem [Sakarya University, Faculty of Medicine, Department of General Surgery, Sakarya (Turkey); Poyraz, Nilufer Yildirim [Ataturk Teaching and Research Hospital, Department of Nuclear Medicine, Ankara (Turkey); Duman, Ugur [Sevket Yilmaz Training and Research Hospital, Department of General Surgery, Bursa (Turkey); Gencturk, Zeynep Biyikli [Ankara University, Faculty of Medicine, Department of Biostatistics, Ankara (Turkey); Yol, Sinan [Medeniyet University, Faculty of Medicine, Department of General surgery, Istanbul (Turkey)

    2015-06-15

    Highlights: • CT is more sensitive than PET/CT in detecting hepatic metastases. • PET/CT is more specific in detecting hepatic metastases. • CT and PET/CT have equal sensitivity in detecting extra hepatic metastases. • PET/CT is more specific in detecting extra hepatic metastases. • PET/CT has an impact of about 40% on changing the management strategies. - Abstract: Purpose: To investigate the efficacy of positron emission tomography/computed tomography (PET/CT) in detection and management of hepatic and extrahepatic metastases from gastrointestinal cancers. Materials and methods: Between February 2008 and July 2010, patients histopathologically diagnosed with gastrointestinal cancer and showing suspected metastasis on CT screening were subsequently evaluated with PET/CT. All patients were subgrouped according to histopathological origin and localization of the primary tumor. Localization of gastrointestinal cancers was further specified as lower gastrointestinal system (GIS), upper GIS, or hepato-pancreato-biliary (HPB). Both accuracy and impact of CT and PET/CT on patient management were retrospectively evaluated. Results: One hundred and thirteen patients diagnosed histopathologically with gastrointestinal cancers were retrospectively evaluated. Seventy-nine patients had adenocarcinoma and 34 patients other gastrointestinal tumors. Forty-one patients were in the upper GIS group, 30 patients in the HPB group, and 42 patients in the lower GIS group. Evaluation the diagnostic performance of PET/CT for suspected metastasis according to histopathological origin of the tumor, revealed that the sensitivity of PET/CT – although statistically not different – was higher in adenocarcinomas than in non-adenocarcinomas (90% (95% CI, 0.78–0.96) vs. 71.4% (95% CI, 0.45–0.88), P = 0.86). The specificity was not significantly different (85.7% (95% CI, 0.70–0.93) vs. 85% (95% CI, 0.63–0.94), P = 1.00). In the overall patient group; CT was significantly more

  11. Effect of heat sink on the recurrence of small malignant hepatic tumors after radiofrequency ablation

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    Zheng-Yu Lin

    2016-01-01

    Conclusions: The curative effect of MRI-guided RFA is better than those of US- and CT-guided ablation. The heat sink effect is an important factor affecting recurrence of hepatic malignant tumors after RFA.

  12. A new method for obtaining CT during arterial portography and CT hepatic angiography sequentially with a coaxial catheter system

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    Fujita, Masato; Maeda, Hiroko; Yamashita, Masato [Kyoto Second Red Cross Hospital (Japan)] [and others

    1997-04-01

    We designed a new method for obtaining CT during arterial portography (CTAP) and CT hepatic angiography (CTA) sequentially without repeated transfer of the patient between the CT scanner and the angiography suite. We needed only one arterial puncture and one ordinary angiographic coaxial catheter system with this method, which enabled both CTAP and CTA images to be successfully obtained without complication in all fifteen patients with suspected hepatocellular carcinoma. CTA demonstrated better tumor stains than dynamic CT or DSA in CTAP-positive lesions. (author)

  13. CT of perineural tumor extension: pterygopalatine fossa

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    Curtin, H.D.; Williams, R.; Johnson, J.

    1985-01-01

    Tumors of the oral cavity and paranasal sinuses can spread along nerves to areas apparently removed from the primary tumor. In tumors of the palate, sinuses, and face, this perineural spread usually involves the maxillary division of the trigeminal nerve. The pterygopalatine fossa is a pathway of the maxillary nerve and becomes a key landmark in the detection of neural metastasis by computed tomography (CT). Obliteration of the fat in the fossa suggests pathology. Case material illustrating neural extension is presented and the CT findings are described.

  14. The use of virtual reality for the functional simulation of hepatic tumors (case control study)

    National Research Council Canada - National Science Library

    Chen, Gang; Li, Xue-cheng; Wu, Guo-qing; Wang, Yi; Fang, Bin; Xiong, Xiao-feng; Yang, Ri-gao; Tan, Li-wen; Zhang, Shao-xiang; Dong, Jia-hong

    2010-01-01

    ... hepatic mass in a virtual reality (VR) environment may facilitate preoperative planning and successful surgical removal of a hepatic tumor. 9,10 Our aim was to design a system that can seamlessly convert a patient's cross-sectional imaging data (computed tomography [CT] or magnetic resonance imaging [MRI]) into a three-dimensional (3D) VR ...

  15. A case of pedunculated hepatic hemangioma mimicking submucosal tumor of the stomach.

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    Moon, Han Kook; Kim, Hyoung Su; Heo, Gyeong Mi; Shin, Woon Geon; Kim, Kyung Ho; Jang, Myoung Kuk; Lee, Jin Heon; Kim, Hak Yang; Kim, Doo Jin; Cho, Seong Jin

    2011-03-01

    Hepatic hemangioma is the most common benign tumor of the liver. Most such hemangiomas are small, asymptomatic, and have an excellent prognosis. Giant hepatic hemangioma has been reported in the literature, but the exophytic and pedunculated forms of hepatic hemangioma are rare. A 56-year-old woman was referred to our hospital under the suspicion of having a gastric submucosal tumor. Abdominal computer tomography (CT) scans showed a pedunculated mass from the left lateral segment of the liver into the gastric fundus, exhibiting the atypical CT findings of hepatic hemangioma. We therefore decided to perform laparoscopic resection based on the symptoms, relatively large diameter, inability to exclude malignancy, and risk of rupture of the exophytic lesion. The pathology indicated it to be a cavernous hemangioma of the liver. Herein we report a case of pedunculated hepatic hemangioma mimicking a submucosal tumor of the stomach due to extrinsic compression of the gastric fundus.

  16. Wedge-shaped parenchymal enhancement peripheral to the hepatic hemangioma : two-phase spiral CT findings

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    Kim, Kyoung Won; Kim, Tae Kyoung; Han, Joon Koo [College of Medicine and The Institute of Radiation Medicine, Seoul National University, Seoul (Korea, Republic of); Kim, Ah Young; Lee, Hyun Ju [Asan Medical Center, University of Ulsan , Asan (Korea, Republic of); Song, Chi Sung; Choi, Byung Ihn [Seoul City Boramae Hospital, Seoul (Korea, Republic of)

    2000-02-01

    To determine the incidence of hepatic hemangiomas associated with wedge-shaped parenchymal enhancements adjacent to the tumors as seen on two-phase spiral CT images obtained during the hepatic arterial phase and to characterize the two-phase spiral CT findings of those hemangiomas. One hundred and eight consecutive hepatic hemangiomas in 63 patients who underwent two-phase spiral CT scanning during an 11-month period were included in this study. Two-phase spiral CT scans were obtained during the hepatic arterial phase (30-second delay) and portal venous phase (65-second delay) after injection of 120 mL of contrast material at a rate of 3 mL/sec. We evaluated the frequency with which wedge-shaped parenchymal enhancement was adjacent to the hemangiomas during the hepatic arterial phase and divided hemangiomas into two groups according to whether or not wedge-shaped parenchymal enhancement was noted (Group A and Group B). The presence of such enhancement in hemangiomas was correlated with tumor size and the grade of intratumoral enhancement. In 24 of 108 hemangiomas, wedge-shaped parenchymal enhancement adjacent to hepatic tumors was seen on two-phase CT images obtained during the hepatic arterial phase. Mean hemangioma size was 22mm in group A and 24mm in group B. There was no statistically significant relationship between lesion size and the presence of wedge-shaped parenchymal enhancement adjacent to a hemangioma. In 91.7% and 100% of tumors in Group A, and in 9.6% and 17.8% in Group B, hemangiomas showed more than 50% intratumoral enhancement during the arterial and portal venous phase, respectively. Wedge-shaped parenchymal enhancements peripheral to hepatic hemangiomas was more frequently found in tumors showing more than 50% intratumoral enhancement during these two phases (p less than 0.01). Wedge-shaped parenchymal enhancements is not uncommonly seen adjacent to hepatic hemangiomas on two-phase spiral CT images obtained during the hepatic arterial phase. A

  17. Percutaneous extrapulmonary radiofrequency ablation for tumors in the hepatic dome.

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    Wang, Zhen-Yuan; Sun, Wen-Bing; Li, Ming-Ying; Zhang, Xiao-Xia; Ding, Xue-Mei

    2008-01-01

    This study aims to assess the feasibility of one lung ventilation and computed tomography-guided extrapulmonary percutaneous radiofrequency ablation for tumors in the hepatic dome. Eleven patients (10 men, 1 women; age range, 34-84 years) with 12 tumors in the hepatic dome were enrolled in the study after institutional review board approval and informed consent had been obtained. A 35F or 37F left-sided double-lumen endotracheal tube was intubated after general anesthesia was induced. The right lung is permitted to collapse, with selective left lungs ventilation. With CT monitoring, the RF electrode was inserted through the empty pleural space to the targeted tumor and radiofrequency ablation procedures were performed. The median operative time was 122 minutes. The median one lung ventilation time was 134 minutes. The procedures of one lung ventilation and percutaneous radiofrequency ablation were successfully performed. There was no bronchial intubation, one lung ventilation and percutaneous radiofrequency ablation related complications, excluding minor pleural effusions recovering without thoracentesis in 2 patients. Complete tumor necrosis was achieved in 10 patients (90.9%). One lung ventilation and computed tomography guided percutaneous extrapulmonary radiofrequency ablation for tumors in the hepatic dome appears to be useful and safe.

  18. Tumor induced hepatic myeloid derived suppressor cells can cause moderate liver damage.

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    Tobias Eggert

    Full Text Available Subcutaneous tumors induce the accumulation of myeloid derived suppressor cells (MDSC not only in blood and spleens, but also in livers of these animals. Unexpectedly, we observed a moderate increase in serum transaminases in mice with EL4 subcutaneous tumors, which prompted us to study the relationship of hepatic MDSC accumulation and liver injury. MDSC were the predominant immune cell population expanding in livers of all subcutaneous tumor models investigated (RIL175, B16, EL4, CT26 and BNL, while liver injury was only observed in EL4 and B16 tumor-bearing mice. Elimination of hepatic MDSC in EL4 tumor-bearing mice using low dose 5-fluorouracil (5-FU treatment reversed transaminase elevation and adoptive transfer of hepatic MDSC from B16 tumor-bearing mice caused transaminase elevation indicating a direct MDSC mediated effect. Surprisingly, hepatic MDSC from B16 tumor-bearing mice partially lost their damage-inducing potency when transferred into mice bearing non damage-inducing RIL175 tumors. Furthermore, MDSC expansion and MDSC-mediated liver injury further increased with growing tumor burden and was associated with different cytokines including GM-CSF, VEGF, interleukin-6, CCL2 and KC, depending on the tumor model used. In contrast to previous findings, which have implicated MDSC only in protection from T cell-mediated hepatitis, we show that tumor-induced hepatic MDSC themselves can cause moderate liver damage.

  19. Transthoracic percutaneous radiofrequency ablation for liver tumors in the hepatic dome.

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    Shibata, Toyomichi; Shibata, Toshiya; Maetani, Yoji; Kubo, Takeshi; Itoh, Kyo; Togashi, Kaori; Hiraoka, Masahiro

    2004-11-01

    Computed tomography (CT)-guided transthoracic radiofrequency ablation was performed for nine liver tumors of eight patients, which were located in the hepatic dome and undetectable by ultrasound (US). A total 11 sessions of ablation were performed. Complications were noted in five sessions (45%) and no complications were noted in six sessions (55%). Pneumothorax was noted in five sessions (45%), including two sessions (18%) with major pneumothorax requiring a chest tube. Major complications were seen in two sessions (18%), major pneumothorax and both major pneumothorax and moderate pleural effusion, respectively. CT-guided transthoracic radiofrequency ablation may be an alternative for treatments of liver tumor in the hepatic dome.

  20. CT-guided radiofrequency tumor ablation in children

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    Botsa, Evanthia [National and Kapodistrian University of Athens, First Pediatric Clinic, Agia Sofia Children' s Hospital, Athens (Greece); Poulou, Loukia S.; Koundouraki, Antonia; Thanos, Loukas [Sotiria General Hospital for Chest Diseases, Department of Medical Imaging and Interventional Radiology, Athens (Greece); Koutsogiannis, Ioannis [General Military Hospital NIMTS, Department of Medical Imaging, Athens (Greece); Ziakas, Panayiotis D. [Warren Alpert Medical School of Brown University Rhode Island Hospital, Division of Infectious Diseases, Providence, RI (United States); Alexopoulou, Efthimia [Attikon University Hospital, Second Department of Radiology, Athens University School of Medicine, Athens (Greece)

    2014-11-15

    Image-guided radiofrequency ablation is a well-accepted technique of interventional oncology in adults. To evaluate the efficacy and safety of CT-guided radiofrequency ablation as a minimally invasive treatment for metastatic neoplasms in children. A total of 15 radiofrequency ablation sessions were performed in 12 children and young adults (median age 9.5; range 5-18 years) with metastatic malignancies. Seven children and young adults had secondary hepatic lesions, three had pulmonary and two had bone lesions. Radiofrequency ablation was performed under conscious sedation. The median lesion size was 1.7 cm (range 1.3-2.8 cm). The median time for ablation was 8 min (range 7-10 min). Radiofrequency procedures were technically successful in all tumors. Postablation imaging immediately after, and 1 month and 3 months after radiofrequency ablation showed total necrosis in all patients. At 6-month follow-up, three patients (all with lesion size >2 cm) had local recurrence and underwent a second radiofrequency ablation session. At 2-year follow-up no patient had recurrence of the treated tumor. Post-ablation syndrome occurred in four children. No major complication occurred. CT-guided radiofrequency tumor ablation was safe and efficient for palliative treatment in our cohort of patients. (orig.)

  1. Uncommon hepatic tumors: iconographic essay - Part 1.

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    Pedrassa, Bruno Cheregati; da Rocha, Eduardo Lima; Kierszenbaum, Marcelo Longo; Bormann, Renata Lilian; Torres, Lucas Rios; D'Ippolito, Giuseppe

    2014-01-01

    Most malignant liver tumors are represented by hepatocellular carcinoma and cholangiocarcinoma; however a variety of other uncommon hepatic lesions might also be found. Common lesions such as hemangioma, focal nodular hyperplasia and metastases are well known and have already been extensively documented in the literature. The diagnosis of typical hepatic lesions may be done with some reliability by means of several imaging methods; on the other hand, uncommon lesions normally represent a diagnostic challenge for the radiologist. In this first part of the study, the authors will approach five uncommon liver tumors - angiosarcoma, angiomyolipoma, cystadenoma/biliary carcinoma, epithelioid hemangioendothelioma, and fibrolamellar hepatocellular carcinoma -, describing their main characteristics and image findings with focus on computed tomography and magnetic resonance imaging.

  2. Metastatic liver tumor from cystic ovarian carcinomas. CT and MRI appearance

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    Tang, Yi; Yamashita, Yasuyuki; Ogata, Ichiro; Namimoto, Tomohiro; Abe, Yasuko; Urata, Joji; Takahashi, Mutsumasa [Kumamoto Univ. (Japan). School of Medicine

    1999-08-01

    The initial and follow-up CT and MRI images of ten patients with hepatic metastases from ovarian tumors were retrospectively analyzed to establish their features and sequential changes in appearance. Ten patients with hepatic metastasis from ovarian tumors received initial and follow-up CT and MRI examinations. Six patients were followed up every two to three weeks before surgical tumor resection. Both CT and MR images were analyzed by two radiologists. A total of fourteen lesions were detected by CT and MRI in 10 patients. All 14 lesions were demonstrated as areas of marked hyperintensity on T2-weighted MRI. Eleven cyst-like tumors were demonstrated as round or oval low density lesions on CT and as areas of hypointensity on T1-weighted imaging. Three lesions were shown as solid masses with slightly low attenuation at the initial CT examination and slightly low or iso-intensity areas on T1-weighted imaging, and these lesions showed early peripheral globular enhancement and delayed enhancement on contrast-enhanced CT and MR imaging. Cystic formation was observed two to three weeks later after initial study in all the 3 solid lesions. Rapid subcapsular effusion, which showed obvious enhancement on delayed Gd-DTPA enhanced MR imaging, was observed in two patients. The hepatic metastatic tumor from cystic ovarian carcinoma may manifest as a well-defined cystic lesion or as a solid mass, and the solid mass shows delayed enhancement on contrast-enhanced CT and MR imaging. Furthermore, rapid cystic formation and rapid subcapsular extension is frequently seen. (author)

  3. Fusion imaging of real-time ultrasonography with CT or MRI for hepatic intervention

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    Lee, Min Woo [Dept. of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2014-12-15

    With the technical development of ultrasonography (US), electromagnetic tracking-based fusion imaging of real-time US and computed tomography/magnetic resonance (CT/MR) images has been used for percutaneous hepatic intervention such as biopsy and radiofrequency ablation (RFA). Because of the fusion imaging technique, the fused CT or MR images show the same plane and move synchronously while performing real-time US. With this information, fusion imaging can enhance lesion detectability and reduce the false positive detection of focal hepatic lesions with poor sonographic conspicuity. Three-dimensional US can also be fused with realtime US for the percutaneous RFA of liver tumors requiring overlapping ablation. When fusion imaging is not sufficient for identifying small focal hepatic lesions, contrast-enhanced US can be added to fusion imaging.

  4. Fusion imaging of real-time ultrasonography with CT or MRI for hepatic intervention

    Directory of Open Access Journals (Sweden)

    Min Woo Lee

    2014-10-01

    Full Text Available

    With the technical development of ultrasonography (US, electromagnetic tracking-based fusion imaging of real-time US and computed tomography/magnetic resonance (CT/MR images has been used for percutaneous hepatic intervention such as biopsy and radiofrequency ablation (RFA. Because of the fusion imaging technique, the fused CT or MR images show the same plane and move synchronously while performing real-time US. With this information, fusion imaging can enhance lesion detectability and reduce the false positive detection of focal hepatic lesions with poor sonographic conspicuity. Three-dimensional US can also be fused with realtime US for the percutaneous RFA of liver tumors requiring overlapping ablation. When fusion imaging is not sufficient for identifying small focal hepatic lesions, contrast-enhanced US can be added to fusion imaging.

  5. CT, MRI, and FDG-PET/CT imaging findings of abdominopelvic desmoplastic small round cell tumors: Correlation with histopathologic findings

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    Zhang Weidong, E-mail: dongw.z@163.com [State Key Laboratory of Oncology in South China, 651 Dongfengdong Road, Guangzhou, Guangdong 510060 (China) and Department of Radiology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong 510060 (China); Li Chuanxing, E-mail: lichuanh@mail.sysu.edu.cn [State Key Laboratory of Oncology in South China, 651 Dongfengdong Road, Guangzhou, Guangdong 510060 (China); Department of Radiology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong 510060 (China); Liu Qingyu, E-mail: liu.qingyu@163.com [Department of Radiology, No. 2 Affiliated Hospital, 107 Yanjiangxi Road, Sun Yat-sen University, Guangzhou, Guangdong 510120 (China); Hu Yingying, E-mail: yingyinghu1981@163.com [State Key Laboratory of Oncology in South China, 651 Dongfengdong Road, Guangzhou, Guangdong 510060 (China) and Department of Radiology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong 510060 (China); Cao Yun, E-mail: caoyun@mail.sysu.edu.cn [State Key Laboratory of Oncology in South China, 651 Dongfengdong Road, Guangzhou, Guangdong 510060 (China); Department of Pathology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong 510060 (China); Huang Jinhua, E-mail: drhuangjh@163.com [State Key Laboratory of Oncology in South China, 651 Dongfengdong Road, Guangzhou, Guangdong 510060 (China) and Department of Radiology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong 510060 (China)

    2011-11-15

    Objective: To analyze computed tomography (CT), magnetic resonance imaging (MRI), and fluorodeoxyglucose-positron emission tomography (FDG-PET)/CT imaging features of abdominopelvic desmoplastic small round cell tumor (DSRCT) and to improve the diagnostic efficacy of these techniques for the detection of such tumor. Methods: We retrospectively analyzed 7 cases of abdominopelvic DSRCT confirmed by histopathologic analysis. Among the 7 patients, 5 patients had undergone CT scanning, 2 of which were also examined with FDG-PET/CT imaging, and 2 had undergone MRI. Unenhanced and contrast-enhanced examinations were performed in all patients, and 2 patients had also undergone dynamic CT contrast-enhanced examinations. Image characteristics, such as shape, size, number, edge, attenuation, and intensity of each lesion before and after contrast enhancement were analyzed and compared with the pathomorphology of the tumors. Results: Multiple large masses in the abdominopelvis were detected in 6 cases, and a large mass in the pelvis was detected in 1 case. Six cases showed largest mass in pelvis, and 1 case in mesentery. None of the masses had a definite organ origin. CT showed soft tissue masses with patchy foci of hypodense areas. MR T1-weighted images revealed lesions with mild hypointense areas and patchy hypointense areas in 2 cases and lesions with patchy hyperintense areas in 1 case. T2-weighted images showed lesions with mixed isointense and hyperintense areas in 1 case and lesions with mixed hypointense, isointense, and hyperintense areas in another. Contrast-enhanced CT and T1-weighted images showed mildly heterogeneous enhancement of the lesions. Other associated findings included peritoneal seeding (n = 3), peritoneal effusions (n = 3), hepatic metastasis (n = 2), bone metastasis (n = 1), and mesenteric and retroperitoneal lymphadenopathy (n = 4). FDG-PET/CT showed multiple nodular foci of increased metabolic activity in the abdominopelvic masses, in the hepatic and

  6. Concurrent hepatic adenomatoid tumor and hepatic hemangioma: a case report.

    Science.gov (United States)

    Kim, Ji-Beom; Yu, Eunsil; Shim, Ju-Hyun; Song, Gi-Won; Kim, Gwang Un; Jin, Young-Joo; Park, Ho-Seop

    2012-06-01

    A 45-year-old male with alleged asymptomatic hepatic hemangioma of 4 years duration had right upper-quadrant pain and was referred to a tertiary hospital. Computed tomography and magnetic resonance imaging scans revealed a hypervascular mass of about 7 cm containing intratumoral multilobulated cysts. A preoperative liver biopsy was performed, but this failed to provide a definitive diagnosis. The patient underwent a partial hepatectomy of segments IV and VIII. The histologic findings revealed multifocal proliferation of flattened or cuboidal epithelioid cells and a highly vascular edematous stroma. Immunohistochemistry findings demonstrated that the epithelioid tumor cells were positive for cytokeratin (AE1/AE3), vimentin, calretinin, and cytokeratin 5/6, and were focally positive for CD10, and negative for WT1 and CD34, all of which support their mesothelial origin. Immunohistochemistry for a mesothelial marker should be performed for determining the presence of an adenomatoid tumor when benign epithelioid cells are seen.

  7. Concurrent hepatic adenomatoid tumor and hepatic hemangioma: a case report

    Directory of Open Access Journals (Sweden)

    Ji-Beom Kim

    2012-06-01

    Full Text Available A 45-year-old male with alleged asymptomatic hepatic hemangioma of 4 years duration had right upper-quadrant pain and was referred to a tertiary hospital. Computed tomography and magnetic resonance imaging scans revealed a hypervascular mass of about 7 cm containing intratumoral multilobulated cysts. A preoperative liver biopsy was performed, but this failed to provide a definitive diagnosis. The patient underwent a partial hepatectomy of segments IV and VIII. The histologic findings revealed multifocal proliferation of flattened or cuboidal epithelioid cells and a highly vascular edematous stroma. Immunohistochemistry findings demonstrated that the epithelioid tumor cells were positive for cytokeratin (AE1/AE3, vimentin, calretinin, and cytokeratin 5/6, and were focally positive for CD10, and negative for WT1 and CD34, all of which support their mesothelial origin. Immunohistochemistry for a mesothelial marker should be performed for determining the presence of an adenomatoid tumor when benign epithelioid cells are seen.

  8. Imaging of head and neck tumors -- methods: CT, spiral-CT, multislice-spiral-CT

    Energy Technology Data Exchange (ETDEWEB)

    Baum, Ulrich E-mail: baum@idr.med.uni-erlangen.de; Greess, Holger; Lell, Michael; Noemayr, Anton; Lenz, Martin

    2000-03-01

    Spiral-CT is standard for imaging neck tumors. In correspondence with other groups we routinely use spiral-CT with thin slices (3 mm), a pitch of 1.3-1.5 and an overlapping reconstruction increment (2-3 mm). In patients with dental fillings a short additional spiral parallel to the corpus of the mandible reduces artifacts behind the dental arches and improves the diagnostic value of CT. For the assessment of the base of the skull, the orbital floor, the palate and paranasal sinuses an additional examination in the coronal plane is helpful. Secondary coronal reconstructions of axial scans are helpful in the evaluation of the crossing of the midline by small tumors of the tongue base or palate. For an optimal vascular or tissue contrast a sufficient volume of contrast medium and a start delay greater than 70-80 s are necessary. In our opinion the best results can be achieved with a volume of 150 ml, a flow of 2.5 ml/s and a start delay of 80 s. Dynamic enhanced CT is only necessary in some special cases. There is clear indication for dynamic enhanced CT where a glomus tumor is suspected. Additional functional CT imaging during i-phonation and/or Valsalva's maneuver are of great importance to prove vocal cords mobility. Therefore, imaging during i-phonation is an elemental part of every thorough examination of the hypopharynx and larynx region. Multislice-spiral-CT allows almost isotropic imaging of the head and neck region and improves the assessment of tumor spread and lymph node metastases in arbitrary oblique planes. Thin structures (the base of the skull, the orbital floor, the hard palate) as well as the floor of the mouth can be evaluated sufficiently with multiplanar reformations. Usually, additional coronal scanning is not necessary with multislice-spiral-CT. Multislice-spiral-CT is especially advantageous in defining the critical relationships of tumor and lymph node metastases and for functional imaging of the hypopharynx and larynx not only in the

  9. A preoperative mathematic model for computed tomographic guided microwave ablation treatment of hepatic dome tumors.

    Science.gov (United States)

    Gao, Fei; Wang, Guo-Bao; Xiang, Zhan-Wang; Yang, Bin; Xue, Jing-Bing; Mo, Zhi-Qiang; Zhong, Zhi-Hui; Zhang, Tao; Zhang, Fu-Jun; Fan, Wei-Jun

    2016-05-03

    This study sought to prospectively evaluate the feasibility and safety of a preoperative mathematic model for computed tomographic(CT) guided microwave(MW) ablation treatment of hepatic dome tumors. This mathematic model was a regular cylinder quantifying appropriate puncture routes from the bottom up. A total of 103 patients with hepatic dome tumors were enrolled and randomly divided into 2 groups based on whether this model was used or not: Group A (using the model; n = 43) versus Group B (not using the model; n = 60). All tumors were treated by CT-guided MW ablation and follow-up contrast CT were reviewed. The average number of times for successful puncture, average ablation time, and incidence of right shoulder pain were less in Group A than Group B (1.4 vs. 2.5, P = 0.001; 8.8 vs. 11.1 minutes, P = 0.003; and 4.7% vs. 20%, P = 0.039). The technical success rate was higher in Group A than Group B (97.7% vs. 85.0%, P = 0.032). There were no significant differences between the two groups in primary and secondary technique efficacy rates (97.7% vs. 88.3%, P = 0.081; 90.0% vs. 72.7%, P = 0.314). No major complications occurred in both groups. The mathematic model of regular cylinder is feasible and safe for CT-guided MW ablation in treating hepatic dome tumors.

  10. Differential diagnosis of malignant ovarian tumors on CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Chae; Yoon, Myung Hwan; Yang, Dal Mo; Chung, Hyo Sun; Kim, Hyung Sik; Song, Ik Hyun; Chung, Yoon Ho; Lee, Young Suk [Chungang Gil Hospital, Inchon (Korea, Republic of)

    1996-07-01

    To assess the value of CT for the differential diagnosis of malignant ovarian tumors. We reviewed CT scans of 31 patients with surgically confirmed 46 malignant ovarian tumors. (29 epithelial tumors, 9 Krukenberg tumors, 6 germ cell tumors, and 2 sex cord-stromal tumors.) CT scans were evaluated for the mass (bilaterality, size, internal component, and margin), peritoneal spread pattern, ascites, invasion of adjacent organ, and lymphadenopathy. Bilateral masses were seen in epithelial or Krukenberg tumor in 61.1%(11/18) and 80%(4/5) respectively. Epithelial tumors showed predominantly cystic mass(37.9%, 11/29), irregular margin(82.8%, 24/29) of mass, and accompanying peritoneal and omental spread (66.7%, 12/18), while Krukenberg tumor showed predominantly solid mass(55.5%, 5/9), smooth margin of mass(100%, 5/5), and no peritoneal and omental spread. All cases with germ cell tumor or sex cord-stromal tumor showed unilateral mass. Relatively young aged, unilateral solid (66.7%, 4/6) tumors were germ cell tumor. Of these cases, septa within solid portion of mass were prominent in all dysgerminoma. (3/3) CT may be a valuable tool for the differential diagnosis of malignant ovarian tumors.

  11. Quantitative hepatic CT perfusion measurement: Comparison of Couinaud's hepatic segments with dual-source 128-slice CT

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Xuan [The Department of Radiology, Peking Union Medical College Hospital, Dongcheng District, Beijing, 100730 (China); Xue, Hua-dan, E-mail: bjdanna95@hotmail.com [The Department of Radiology, Peking Union Medical College Hospital, Dongcheng District, Beijing, 100730 (China); Jin, Zheng-yu, E-mail: jin_zhengyu@163.com [The Department of Radiology, Peking Union Medical College Hospital, Dongcheng District, Beijing, 100730 (China); Su, Bai-yan; Li, Zhuo; Sun, Hao; Chen, Yu; Liu, Wei [The Department of Radiology, Peking Union Medical College Hospital, Dongcheng District, Beijing, 100730 (China)

    2013-02-15

    Purpose: To compare the quantitative liver computed tomography perfusion (CTP) differences among eight hepatic segments. Materials and methods: This retrospective study was based on 72 acquired upper abdomen CTP scans for detecting suspected pancreas tumor. Patients with primary or metastatic liver tumor, any focal liver lesions except simple cyst (<3 cm in diameter), history of liver operation or splenectomy, evidence of liver cirrhosis or invasion of portal vein were excluded. The final analysis included 50 patients (M:F = 21:29, mean age = 43.2 years, 15–76 years). Arterial liver perfusion (ALP), portal-venous perfusion (PVP), total hepatic perfusion (THP = ALP + PVP), and hepatic perfusion index (HPI) of each hepatic segment were calculated and compared by means of one-way analysis of variance (ANOVA) and the Bonferonni correction method. Results: Compared to hepatic segments 5, 6, 7 and 8, segments 2 and 3 showed a tendency of higher ALPs, lower PVPs, and higher HPIs, most of which were statistically significant (p < 0.05). Hepatic segments 1 and 4 had higher mean values of ALP and HPI and lower mean values of PVP than segments 5, 6, 7 and 8 as well, although no significant differences were detected except for ALP and HPI for liver segments 1 and 7 (p = 0.001 and 0.035 respectively), and ALP for liver segments 1 and 5 (p = 0.039). Higher ALP and HPI were showed in hepatic segment 3 compared to segment 4 (p = 0.000 and 0.000 respectively). No significant differences were found for THP among eight segments. Conclusions: Intra-hepatic perfusion differences exist in normal hepatic parenchyma especially between lateral sector (segments 2 and 3) and right lobe (segments 5, 6, 7 and 8). This might have potential clinical significance in liver-perfusion-related protocol design and result analysis.

  12. Hepatic alveolar echinococcosis: correlative US and CT study

    Energy Technology Data Exchange (ETDEWEB)

    Didier, D.; Weiler, S.; Rohmer, P.; Lasseque, A.; Deschamps, J.P.; Vuitton, D.; Miguet, J.P.; Weill, F.

    1985-01-01

    A total of 24 cases of hepatic alveolar echinococcosis (HAE) due to Echinococcus multilocularis was assessed by US and CT. The diagnosis was confirmed in all cases by immunologic and histologic study. Both US and CT patterns of HAE showed changes of liver morphology in both contour and size. Abnormal areas of parenchyma were nodular or in fields, irregular, heterogeneous, and basically echogenic. Clustered microcalcifications were encountered within the abnormal parenchymal fields in 50% of cases, and necrotized zones occurred in 40% of cases. Dilatation of intrahepatic bile ducts was commonly seen, especially on US; hilar involvement was frequent. Follow-up by both techniques can display increases of primary lesions, occurrence of new foci, and local or regional extensions. Precise evaluations of the lesions arising from correlative use of US and CT permits adequate therapeutic management.

  13. Application of tumor necrosis factor antagonists in hepatic disease treatment

    Directory of Open Access Journals (Sweden)

    CHI Zhaochun

    2015-07-01

    Full Text Available All tumor necrosis factor (TNF antagonists are associated with hepatotoxicity and thus induce liver injury, commonly manifested as hepatitis B virus and hepatitis C virus reactivation, acute hepatitis, drug-induced liver disease, cholestasis, serum liver enzyme activity elevation, and even acute liver failure. Hence, the application of TNF antagonists in hepatic disease treatment remains controversial. This review summarizes currently available data on the mechanism and application of TNF antagonists in hepatic disease treatment. Although TNF antagonists have been applied for many years, large randomized controlled trials are still recommended to assess its efficacy and safety and to achieve a consensus.

  14. Hepatic arterial supply in 1297 CT-angiographies; Die arterielle Leberversorgung in 1297 CT-Angiografien

    Energy Technology Data Exchange (ETDEWEB)

    Loeschner, C.; Kausche, S.; Teichgraeber, U. [Jena University Hospital, Jena (Germany). Dept. of Radiology; Nagel, S.N. [Charite Universitaetsmedizin Berlin (Germany). Dept. of Radiology

    2015-04-15

    Analysis, evaluation and classification of hepatic arterial supply variants and determination of their frequency distribution in CT-angiographies. CT-angiographies of 1,568 patients were evaluated retrospectively for the period between January 1, 2010 and August 30, 2012. The hepatic arterial anatomy was assessed and categorized according to Michels's classification. So far unclassified variants were considered separately. Results: CT-angiographies of 1297 patients were included in the study. Type I according to Michels was seen in 937 cases (72.2%), followed by type V in 114 patients (8.8%) and type III in 83 patients (6.4%). Type X could not be found in any of the patients. Not yet classified variants were discovered in 26 patients. The most frequent variant in this connection was a right hepatic artery originating from the superior mesenteric artery with the left hepatic artery originating from the left gastric artery (n=10). Michels's classification could be largely confirmed on the basis of a radiologically examined patient population. Not yet classified variants were categorized into subgroups of the existing classification.

  15. CT-guided laser probe for ablation of brain tumors

    Directory of Open Access Journals (Sweden)

    Abdolhadi Daneshi

    2010-01-01

    Full Text Available   Abstract  In this study, 22 patients (15-75 years old were selected and transferred to CT scan for tumor ablation. For ablations, after prep and drep under the local anesthesia and mild sedation in proper position, small incision made and special needle inserted and guided by proper direction to the core of the tumor. Then, laser probe inserted through the needle and laser energy delivered. Although we have not a good prognosis in metastatic tumors but post-operative follow up and brain CT scan established the effect of laser on resection and evaporation and diminution of mass effect in tumor lesions.

  16. CT and MR imaging findings of palatal tumors

    Energy Technology Data Exchange (ETDEWEB)

    Kato, Hiroki, E-mail: hkato@gifu-u.ac.jp [Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1194 (Japan); Kanematsu, Masayuki, E-mail: masa_gif@yahoo.co.jp [Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1194 (Japan); High-level Imaging Diagnosis Center, Gifu University Hospital, 1-1 Yanagido, Gifu 501-1194 (Japan); Makita, Hiroki, E-mail: makitah@gifu-u.ac.jp [Department of Oral and Maxillofacial Sciences, Gifu University School of Medicine, Gifu (Japan); Kato, Keizo, E-mail: keizo@gifu-u.ac.jp [Department of Oral and Maxillofacial Sciences, Gifu University School of Medicine, Gifu (Japan); Hatakeyama, Daijiro, E-mail: hatakeya@gifu-u.ac.jp [Department of Oral and Maxillofacial Sciences, Gifu University School of Medicine, Gifu (Japan); Shibata, Toshiyuki, E-mail: shibat@gifu-u.ac.jp [Department of Oral and Maxillofacial Sciences, Gifu University School of Medicine, Gifu (Japan); Mizuta, Keisuke, E-mail: kmizuta@gifu-u.ac.jp [Department of Otolaryngology, Gifu University School of Medicine, Gifu (Japan); Aoki, Mitsuhiro, E-mail: aoki@gifu-u.ac.jp [Department of Otolaryngology, Gifu University School of Medicine, Gifu (Japan)

    2014-03-15

    Palatal tumors commonly arise from the minor salivary glands, and benign tumors account for approximately half of all minor salivary gland tumors. Minor salivary gland tumors have an affinity for the posterior hard palate and soft palate and virtually never arise in the midline, probably because of the distribution of palatal salivary glands. The majority of benign salivary gland tumors of the palate are pleomorphic adenomas, while the most common malignant salivary gland tumor is adenoid cystic carcinoma, followed by mucoepidermoid carcinoma, adenocarcinoma, and polymorphous low-grade adenocarcinoma. Epithelial tumors frequently arise from the soft palate. The majority of benign epithelial tumors of the palate are papillomas, while most malignant epithelial tumors are squamous cell carcinomas. Various types of mesenchymal tumors, including fibromas, lipomas, schwannomas, neurofibromas, hemangiomas, and lymphangiomas, also involve the palate. This article describes the CT and MR findings of benign and malignant palatal tumors.

  17. Triple-phase helical computed tomography of an arterio-hepatic venous shunt in a hepatic tumor in a dog.

    Science.gov (United States)

    Kutara, Kenji; Konno, Toshiaki; Kondo, Hirotaka; Yamazoe, Hinako; Matsunaga, Satoru

    2017-12-06

    A 10-year-old French bulldog presented with an abdominal tumor. Triple-phase helical computed tomography was performed, revealing a hepatic tumor, an enlarged hepatic lymph node, and no masses in other organs. The hepatic tumor demonstrated marked enhancement, similar to that of the aorta in the arterial phase. The tumor had rich vascularization and a hepatic arterio-venous shunt formed between the hepatic artery and middle hepatic vein. The hepatic tumor was surgically removed and histological diagnosis revealed a hepatic carcinoid tumor. During surgery, rapid massive arterial hemorrhage occurred from the site of the incision. The animal died without improvement post-surgery. In the case of an arterio-venous shunt in a hepatic tumor, it is important to be careful to avoid perioperative bleeding.

  18. Comparison between CT tumor size and pathological tumor size in frozen section examinations of lung adenocarcinoma.

    Science.gov (United States)

    Isaka, Tetsuya; Yokose, Tomoyuki; Ito, Hiroyuki; Imamura, Naoko; Watanabe, Masato; Imai, Kentaro; Nishii, Teppei; Woo, Tetsukan; Yamada, Kouzo; Nakayama, Haruhiko; Masuda, Munetaka

    2014-07-01

    We examined the appropriate measurement for pathological tumor size by comparing radiological and pathological tumor size of resected lung adenocarcinoma in FSE. We reviewed records of 59 resected specimens of lung adenocarcinoma for FSE from January to December 2008. Specimens were well-inflated with saline by using an injector before cutting into segments. After selecting the tumor segment of maximal diameter, we compared three ways of measuring pathological tumor size by using paired t-test: (I) macroscopic tumor size (MTS), measured with a metal straight ruler, (II) microscopic frozen section tumor size (FSTS), and (III) microscopic paraffin section tumor size (PSTS). We compared each discrepancy rate (DR) [DR=(CT tumor size-pathological tumor size)/CT tumor size×100] (%) between tumors that were air-containing type and solid-density type on CT scans, and also compared the tumors with lepidic component rates (LCR) ≥50% and LCR lung specimen must be sufficiently inflated to prevent tissue shrinking, and we propose MTS as the definition for pathological tumor size in FSE. The greater discordance observed between CT tumor size and microscopic tumor size was assumed to be due to shrinkage of the lepidic component in the tumor. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. Intraperitoneal desmoid tumor: achievements in CT. Tumor demoide intraperitoneal: hallazgos en TC

    Energy Technology Data Exchange (ETDEWEB)

    Soto Aguilar, M.C.; Navarro Sanchis, E.; Sanchez-Lafuente Rubio, J.; Vicente Romo, J.; Fuentes Limpiaez, J.J. (Hospital Regional Carlos Haya. Servicio de Radiodiagnostico. Malaga (Spain))

    1993-01-01

    We present two cases of intraperitoneal desmoid tumor studied by means of CT. Both presented in the form of solid masses with involvement of small bowel loops in asympthmatic patients. CT is useful for locating the mass and studying possible tumor recurrences, but there is no semiological data to differentiate them from other intraperitoneal solid neoplasms. (Author)

  20. Hepatic Involvement of Histiocytic Sarcoma: CT and MRI Findings

    Energy Technology Data Exchange (ETDEWEB)

    Kubo, Takatoshi [Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo 113-8654 (Japan); Kiryu, Shigeru; Akai, Hiroyuki [Department of Radiology, Institute of Medical Science, University of Tokyo, Tokyo 108-8639 (Japan); Ota, Yasunori [Department of Pathology, Institute of Medical Science, University of Tokyo, Tokyo 108-8639 (Japan); Tojo, Arinobu [Department of Hematology and Oncology, Institute of Medical Science, University of Tokyo, Tokyo 108-8639 (Japan); Yoshida, Hideo [Department of Gastroenterology, Japanese Red Cross Medical Center, Tokyo 150-8935 (Japan); Kato, Naoya [Advanced Medical Science, Institute of Medical Science, University of Tokyo, Tokyo 108-8639 (Japan); Nakano, Yoshiyasu [Department of Radiology, Institute of Medical Science, University of Tokyo, Tokyo 108-8639 (Japan); Ohtomo, Kuni [Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo 113-8654 (Japan)

    2016-11-01

    Histiocytic sarcoma in the liver is an extremely rare hematological malignancy. Herein, we reported the case of a 68-year-old woman who presented with characteristic wedge-shaped abnormality bounded by hepatic veins on computed tomography and magnetic resonance imaging of the liver. In the wedge-shaped area, decreased portal flow and the deposition of iron were observed. These imaging findings are consistent with intrasinusoidal tumor cell infiltration. A liver biopsy was performed, and histiocytic sarcoma was confirmed histopathologically.

  1. Hepatic involvement of histiocytic sarcoma: CT and MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Kubo, Takatosh; Ohtomo, Kuni [Graduate School of Medicine, University of Tokyo, Tokyo (Japan); Kiryu, Shigeru; Akai, Hiroyuki; Ora, Yasunori; Tojo, Arinobu; Yoshida, Hideo; Kato, Naoya; Nakano, Yoshiyasu [Institute of Medical Science, University of Tokyo, Tokyo (Japan)

    2016-09-15

    Histiocytic sarcoma in the liver is an extremely rare hematological malignancy. Herein, we reported the case of a 68-year-old woman who presented with characteristic wedge-shaped abnormality bounded by hepatic veins on computed tomography and magnetic resonance imaging of the liver. In the wedge-shaped area, decreased portal flow and the deposition of iron were observed. These imaging findings are consistent with intrasinusoidal tumor cell infiltration. A liver biopsy was performed, and histiocytic sarcoma was confirmed histopathologically.

  2. Use of Ga-68 DOTATATE PET/CT to confirm portal vein tumor thrombosis in a patient with pancreatic neuroendocrine tumor.

    Science.gov (United States)

    Lim, Tze Chwan; Tan, Eik Hock; Zaheer, Sumbul

    2011-06-01

    A 37-year-old man complained of increasing severity and frequency of abdominal pain over a 2-year period. Initial contrast-enhanced computed tomography of the abdomen demonstrated diffuse enlargement of the pancreas associated with a filling defect in the portal vein, splenomegaly with wedge-shaped peripheral splenic hypodensities and multiple hepatic hypodensities. Findings were suggestive of a pancreatic malignancy complicated by hepatic metastases, splenic infarcts, and portal vein thrombosis. We describe the use of gallium-68 DOTA-DPhe1, Tyr3-octreotate positron emission tomography/computed tomography (Ga-68 DOTATATE PET/CT) in confirming the diagnosis of a pancreatic neuroendocrine tumor with portal vein tumor thrombosis.

  3. Local treatment in unresectable hepatic metastases of carcinoid tumors: Experiences with hepatic artery embolization and radiofrequency ablation

    Directory of Open Access Journals (Sweden)

    van Coevorden Frits

    2005-11-01

    Full Text Available Abstract Background Hepatic metastases of carcinoid tumors cause incapacitating symptoms, but are usually diffuse and therefore unresectable. In this article we evaluate our experiences with local treatment techniques in the management of carcinoid patients with hepatic metastases and failing systemic treatment. Methods Fifteen consecutive carcinoid patients (11 men and 4 women; median age 60 years; range 45–71 years were treated with either hepatic artery embolization (HAE with Ivalon particles or radiofrequency ablation (RFA (percutaneously or intra-operatively. Follow-up evaluation was performed by CT scan and 24-hours urinary 5-HIAA excretions. Results A total of 18 HAE's was performed in 13 patients, while 10 lesions in 3 patients were treated with RFA. Median follow-up was 12.5 months (2 – 25 months. Median duration of symptoms was 22 months (8 – 193 months. Median overall decrease of 5-HIAA excretion 2 months after HAE was 32% with tumor regression on CT-scan in 4 patients (30% and improvement of symptoms with a median duration of 15 months in 3 of them (23%. Embolization led to fatal hepatic failure in one patient. The 3 patients treated with RFA showed a decrease of urinary 5-HIAA values of 34, 81 and 93% respectively, with tumor regression in all of them. Improvement of symptoms was reported in 2 patients up to 25 months. Conclusion Liver embolization performed late in the clinical course had limited effect on symptoms and biochemical and radiological parameters. First experiences with RFA are favorable and might encourage to apply RFA more widely in metastatic carcinoid.

  4. CT findings of ciliated hepatic foregut cyst mimicking metastasis: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kwak, Hyo Sung; Lee, Jeong Min; Kim, In Hwan [Chonbuk National University Hospital, Chonju (Korea, Republic of); Moon, Woo Sung [Medical School, Chonbuk National University, Chonju (Korea, Republic of)

    2000-07-01

    Ciliated hepatic foregut cyst (CHFC) is a rare benign lesion consisting of ciliated pseudostratified columnar epithelium, loose subepithelium, loose subepithelial connective tissue, a smooth muscle layer, and an outer fibrous capsule. we encountered a patient with retroperitoneal and posterior mediastinal neurilemmoma and additional CHFC mimicking metastasis. Abdominal CT examination demonstrated that the posterior mediastinal and retroperitoneal lesions were lobulated, well-defined tumors with aneural foraminal extension that were pathologically confirmed as neurilemmomas. Unenhanced CT indicated that the additional lesion was a slightly hypodense mass relative to surrounding parenchyma at the medial segment of the left lobe of the liver, and after the IV administration of contrast material, the lesion did not show enhancement. (author)

  5. Hepatic hemangioma with atypical sonographic features : value of two-phase spiral CT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Worl; Cho, June Sik; Lee, Young Hwan; Kang, Yong Soo; Kim, Hyoung Sub; Chung, Yon Su [Chungnam National Univ. College of Medicine, Taejon (Korea, Republic of)

    1997-08-01

    The purpose of this study was to evaluate enhancement patterns, as seen on two-phase spiral CT, of hepatic hemangiomas in which atypical features had been seen on sonography(US) Two-phase spiral CT scanning was performed in 18 patients in whom 24 atypical hemangiomas had been seen on US. Two-phase images were obtained at 25-45 seconds(arterial dominant phase) and 2-5 minutes(equilibrium phase) after the initiation of a bolus injection of contrast material(150ml, 5ml/sec). Enhancement patterns of hemangiomas during each phase were classified as homogeneous high, peripheral high, or low attenuation, and were retrospectively analyzed. In the arterial dominant phase of spiral CT, low attenuation was seen in nine hemangiomas (38%), globular or spotty peripheral high attenuation in 14(58%), and homogeneous high attenuation in one(4%). In the equilibrium phase, enhancement patterns were peripheral high attenuation(partial fill-in) in 18 lesions (75%), and homogeneous high attenuation(complete fill-in) in three (12.5%), In the other three(12.5%) enhancement showed no significant change;in one of these, density was slightly less than in the arterial phase, and two showed subtle peripheral high attenuation. Fourteen hemangiomas (58%) showed globular or spotty peripheral high attenuation in the arterial dominant phase and peripheral or homogeneous high attenuation with progressive centripetal enhancement in the equilibrium phase. Our results suggest that two-phase spiral CT during the arterial dominant and equilibrium phase is useful in differentiating hepatic hemangiomas with atypical features seen on US from malignant hepatic tumors.

  6. [CT diagnosis of adrenal gland tumors].

    Science.gov (United States)

    Uhlenbrock, D; Appel, W

    1983-06-01

    The article reports on 36 examinations conducted to identify a possible adrenal tumour, or leading to the discovery of a disease of the adrenal glands. Pathological findings were obtained in 17 cases, including 6 adenomas, 6 metastases, 1 leukaemic infiltrate, 1 primary carcinoma, 1 phaeochromocytoma, 1 cyst and 1 bilateral adrenal hyperplasia. In 16 patients, CT produced the correct diagnosis. No false-negative diagnosis were seen. The tumours are described in respect of their morphological characteristics and their density performance in the CT. This is followed by a comparative discussion involving the results obtained by other working groups. The ranking of CT in respect of diagnosis of adrenal tumours is discussed in comparison to the competing imaging methods. Since CT ranks very high as far as its diagnostic value is concerned, it should be given preference in the identification of adrenal tumours.

  7. CT and pathological features of primary hepatic angiosarcoma

    Directory of Open Access Journals (Sweden)

    XING Yaoyao

    2014-08-01

    Full Text Available ObjectiveTo present the computed tomography (CT findings and associated pathological features of eight cases of primary hepatic angiosarcoma (PHA. MethodsAll cases were confirmed by pathology. After a CT scan of the upper abdomen, all cases of PHA underwent enhanced scans in the arterial phase, portal venous phase, and delayed phase to observe the CT manifestations. The surgical specimens were subjected to conventional hematoxylin-eosin staining and immunohistochemistry and observed under a microscope. ResultsOf all patients, 5 cases were massive type, 2 cases were mixed type, and 1 case was multiple nodule type. CT scans revealed inhomogeneous low-density lesions, with necrosis of even lower density in the central part. In 4 cases of massive type, scattered high-density small pieces were observed in low-density areas; in one case of mixed type, high-density nodules were observed on the edge of mass. There were 7 cases of peripheral nodular irregular enhancement in the arterial phase, including 1 case with flocculent central enhancement and another with no enhancement. Lesions remained enhanced in the portal venous and delayed phases, but 1 case had no enhancement. Five in 9 lesions had sharp edges in the arterial and portal venous phases, with “sharpen rim perpendicular to pleura” signs at the boundaries with the surrounding normal liver tissue. The outer edges of 7 lesions were found to have “pseudocapsules” in the portal venous phase. ConclusionCT scans showed a large hypodense lesion with irregular necrotic areas or scattered hemorrhage in PHA patients, whist enhanced scans showed a progressive filling and necrotic area in the central part. There could be “sharpen rim perpendicular to pleura” and “pseudocapsule” signs at the edge. It might be helpful to improve the diagnosis through the above characteristic features.

  8. Mouse Hepatic Tumor Vascular Imaging by Experimental Selective Angiography.

    Directory of Open Access Journals (Sweden)

    Sang Kyum Kim

    Full Text Available Human hepatocellular carcinoma (HCC has unique vascular features, which require selective imaging of hepatic arterial perfusion and portal venous perfusion with vascular catheterization for sufficient evaluation. Unlike in humans, vessels in mice are too small to catheterize, and the importance of separately imaging the feeding vessels of tumors is frequently overlooked in hepatic tumor models. The purpose of this study was to perform selective latex angiography in several mouse liver tumor models and assess their suitability.In several ectopic (Lewis lung carcinoma, B16/F10 melanoma cell lines and spontaneous liver tumor (Albumin-Cre/MST1fl/fl/MST2fl/fl, Albumin-Cre/WW45fl/fl, and H-ras12V genetically modified mouse models, the heart left ventricle and/or main portal vein of mice was punctured, and latex dye was infused to achieve selective latex arteriography and/or portography.H-ras12V transgenic mice (a HCC and hepatic adenoma model developed multiple liver nodules that displayed three different perfusion patterns (portal venous or hepatic artery perfusion predominant, mixed perfusion, indicating intra-tumoral vascular heterogeneity. Selective latex angiography revealed that the Lewis lung carcinoma implant model and the Albumin-Cre/WW45fl/fl model reproduced conventional angiography findings of human HCC. Specifically, these mice developed tumors with abundant feeding arteries but no portal venous perfusion.Different hepatic tumor models showed different tumor vessel characteristics that influence the suitability of the model and that should be considered when designing translational experiments. Selective latex angiography applied to certain mouse tumor models (both ectopic and spontaneous closely simulated typical characteristics of human HCC vascular imaging.

  9. Simultaneous (18)F-FDOPA PET/CT-guided biopsy and radiofrequency ablation of recurrent neuroendocrine hepatic metastasis: further step toward a theranostic approach.

    Science.gov (United States)

    Imperiale, Alessio; Garnon, Julien; Bachellier, Philippe; Gangi, Afshin; Namer, Izzie Jacques

    2015-06-01

    PET/CT-guided biopsy may be useful to confirm the metabolic findings when conventional imaging fails to show morphological abnormalities. Herein, we report the results of simultaneous F-FDOPA (fluorodihydroxyphenylalanine) PET/CT-guided biopsy and RFA (radiofrequency ablation) in 1 patient with hepatic metastatic evolution of a well-differentiated ileal neuroendocrine tumor. Beyond FDG, FDOPA could be successfully recommended in patients with neuroendocrine tumor for planning PET/CT-guided diagnostic biopsy, ablative treatment, and immediate efficacy assessment in a 1-step examination.

  10. PET/CT in Neuroendocrine Tumors.

    Science.gov (United States)

    Castellucci, Paolo; Ambrosini, Valentina; Montini, Giancarlo

    2008-04-01

    Neuroendocrine tumors (NETs) are a rare group of neoplasms that originate from pluripotent stem cells or differentiated neuroendocrine cells, mostly localized in the bronchus, lungs, or gastroenteropancreatic tract. This issue reviews the results achieved with PET. The potential applications of the most commonly used receptor or metabolic positron-emitter radiopharmaceuticals in the field of NET to stage or restage disease, to detect unknown primary tumor, and to assess and monitor therapy response to different kind of treatments are analyzed. Copyright © 2008 Elsevier Inc. All rights reserved.

  11. Concurrent hepatic hemangioma and solitary fibrous tumor: diagnosis and management.

    Science.gov (United States)

    Kueht, Michael; Masand, Prakash; Rana, Abbas; Cotton, Ronald; Goss, John

    2015-07-24

    Hepatic solitary fibrous tumor (HSFT) is a very rare benign liver tumor without well-defined findings on imaging. Even with multiphase advanced contrast-enhanced liver imaging, a definitive preoperative diagnosis is impossible. The diagnostic process can be further complicated when there are two concurrent lesions with different radiologic appearances. Here, we compare the findings of a commonly encountered liver lesion, hepatic hemangioma, with those of an exceedingly rare lesion, HSFT. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author 2015.

  12. Effect of heat sink on the recurrence of small malignant hepatic tumors after radiofrequency ablation.

    Science.gov (United States)

    Lin, Zheng-Yu; Li, Guo-Lin; Chen, Jin; Chen, Zhong-Wu; Chen, Yi-Ping; Lin, Sun-Zhi

    2016-12-01

    The aim of this study was to investigate the effect of heat sink on the recurrence of hepatic malignant tumors heat sink effect is an important factor affecting recurrence of hepatic malignant tumors after RFA.

  13. Colorectal carcinoma evaluated by incremental dynamic CT; Comparison of CT density, histology, and tumor size

    Energy Technology Data Exchange (ETDEWEB)

    Furukawa, Hiroyoshi; Hara, Tsuyoshi; Taniguchi, Tetsushi (Shimizu Kosei Hospital, Shizuoka (Japan))

    1992-06-01

    Evaluation of incremental dynamic CT scan and histologic findings were compared in order to clarify the cause of the differences in colorectal carcinoma as observed on CT after administration of contrast medium. In 48 cases demonstrated on postcontrast dynamic CT scan, the CT density of the tumor was homogeneous (Type 1) in 26 (54.2%) cases and heterogeneous (Type 2) in 22 (45.8%) cases. Well differentiated adenocarcinoma was seen as Type 1 in 11 of 13 (84.6%) cases while moderately differentiated adenocarcinoma was of Type 1 in 15 of 29 (51.7%) cases. Poorly differentiated and mucinous adenocarcinoma were detected as Type 2 in all cases. A comparison of CT types and tumor size showed that as tumor size increased, the number of Type 1 cases decreased while Type 2 cases increased. Histologically, high density areas consisted mainly of well-developed tubular, branching glands of adenocarcinoma, while low density areas were composed of fibrous or mucinous stroma or necrosis. Dynamic CT scans for colorectal cancer are useful not only for preoperative staging but also for tissue characterization. (author).

  14. Three-dimensional CT angiography of the canine hepatic vasculature.

    Science.gov (United States)

    Jeong, Yucheol; Lim, Changyun; Oh, Sunkyoung; Jung, Joohyun; Chang, Jinhwa; Yoon, Junghee; Choi, Mincheol

    2008-12-01

    Eight Beagle dogs were anesthetized and were imaged using a single channel helical CT scanner. The contrast medium used in this study was iohexol (300 mg I/ml) and doses were 0.5 ml/kg for a cine scan, 3 ml/kg for an enhanced scan. The flow rate for contrast material administration was 2 ml/sec for all scans. This study was divided into three steps, with unenhanced, cine and enhanced scans. The enhanced scan was subdivided into the arterial phase and the venous phase. All of the enhanced scans were reconstructed in 1 mm intervals and the scans were interpreted by the use of reformatted images, a cross sectional histogram, maximum intensity projection and shaded surface display. For the cine scans, optimal times were a 9-sec delay time post IV injection in the arterial phase, and an 18-sec delay time post IV injection in the venous phase. A nine-sec delay time was acceptable for the imaging of the canine hepatic arteries by CT angiography. After completion of arterial phase scanning, venous structures of the liver were well visualized as seen on the venous phase.

  15. CT and MR imaging appearances of an extraosseous calcifying epithelial odontogenic tumor (Pindborg tumor).

    Science.gov (United States)

    Ching, A S; Pak, M W; Kew, J; Metreweli, C

    2000-02-01

    We herein report a rare case of extraosseous calcifying epithelial odontogenic tumor with local aggressive behavior. CT and MR imaging showed the distinctive appearances of this histologic entity. We briefly discuss the radiologic features of calcifying epithelial odontogenic tumor and the relevant literature.

  16. TRIPLE PHASE SPIRAL C.T. IN THE EVALUATION OF HEPATIC MASSES

    Directory of Open Access Journals (Sweden)

    Prasad

    2015-10-01

    Full Text Available BACKGROUND AND OBJECTIVE : The goal of the study is to determine the value of various phases of Triple, Helical CT, Hepatic arterial Phase (HAP, Portal venous phase (PVP and Equilibrium Phase (EP, is the detection and characterization of Hepatic Lesions and to evaluate whether u nenhanced and hepatic arterial phases when used in conjunction with porto venous phase would lead to detection of greater number of lesions or better characterization of lesion. METHODOLOGY : The study population consists of 50 Patients aged between 30 Years and 80 Years were examined with multiphase (plain, hepatic arterial, portal venous and equilibrium phases. Spiral CT of liver. Patients were referred for CT scan when liver diseases were suspected clinically, if ultrasound and other previous investi gations revealed lesions which had to be further evaluated by spiral CT and to detect liver metastases in known cases of primary extra hepatic malignancy. CT TECHNIQUE: Helical scanning of liver with Toshiba astein s4, continuous spiral run and the images were reconstructed at 5mm intervals. Contrast material 100ml was injected through 18 or 20G catheter at the rate of 3ml per second using automatic medrad power injector. Non - ionic contrast [IOHEXOl – 300mg perml was used in all the patients]. After obtaine d unenhanced CT scan HAP scanning was initiated 25 seconds after initiation of contrast injection. Portal venous phase scanning was initiated 60 - 65 seconds after start of contrast injection. Equilibrium phase scanning was initiated after 180 seconds after the start of contrast injection. IMAGE EVALUATION: All the images of 4 phases were reviewed. First Step : The presence, appearance and enhancement of each Lesion were noted in all phases and lesion were described Isodense, Hypodense Hyperdense based on thei r attenuation relative to liver parenchyma during that phase of scanning. Based on enhancement pattern of the lesion during various phases they were

  17. CT in primary malignant germ cell tumors of the retroperitoneum

    Energy Technology Data Exchange (ETDEWEB)

    Blomlie, V.; Lien, H.H.; Fossaa, S.D.; Jacobsen, A.B.; Stenwig, A.E. (Norske Radiumhospital, Oslo (Norway). Dept. of Diagnostic Radiology Norske Radiumhospital, Oslo (Norway). Dept. of Medical Oncology Norske Radiumhospital, Oslo (Norway). Dept. of Radiotherapy Norske Radiumhospital, Oslo (Norway). Dept. of Pathology)

    1991-03-01

    Malignant germ cell tumors may exist as a primary entity in the retroperitoneum. In a CT study of 14 males with this condition (2 seminomas and 12 non-seminomatous tumors) all masses were large, lobulated and of mixed density. Fat plane obliteration against adjacent structures was frequent. The aorta was embedded in 9 patients and the inferior vena cava was affected in 7, 2 of whom had signs of compromised caval blood flow. Distant metastases were found in the lungs (7 patients), liver (n=4), posterior mediastinum (n=3), and in brain and supraclavicular lymph nodes in one patient each. Serum biomarkers were elevated in 11 patients. An extragonadal germ cell tumor should be considered when CT of the abdomen reveals a large retroperitoneal mass with mixed density. (orig.).

  18. Hepatic hemangioma masquerading as a tumor originating from the stomach.

    Science.gov (United States)

    Zhang, Xingmao; Zhou, Zhixiang

    2015-03-01

    Hemangioma is the most common benign hepatic neoplasm. The majority of cases are asymptomatic and can be confirmed by imaging examinations, including enhanced computed tomography and magnetic resonance imaging. Exophytic growth is not common and pedunculated cases are extremely rare. The present study reports a case that was pre-operatively misdiagnosed as a stomach-originating tumor. Laparoscopic exploration confirmed that this tumor was a hepatic hemangioma with a long peduncle originating from the left edge of the liver. The final diagnosis of cavernous hemangioma was confirmed by postoperative pathology. This indicates that hepatic hemangioma with a long peduncle has the possibility to be inaccurately diagnosed. Laparoscopic examination is required for such cases.

  19. A solitary fibrous tumor of the retroperitoneum: CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Min; Kim, Chong Soo; Lee, Dong Keun; Cho, Baek Hwan [Chonbuk National Univ. College of Medicine, Chunju (Korea, Republic of); Han, Hyun Young [Euljy Mecical School, Seoul (Korea, Republic of)

    1999-01-01

    The solitary fibrous tumor is a rare spindle cell neoplasm of mesodermal origin. It usually arises in the pleura, though has recently been reported in the peritoneum and at nonserosal sites ; it is, however, extremely rare in the retroperitonum. The authors describe one case of a solitary fibrous tumor that occurred as a huge complex mass in the retroperitoneum of an adult. Preenhanced CT scans showed that the mass was sharply delineated from surrounding organs and that tumor density was the same as that of surrounding musculature. Peripheral Calcifications were noted, and postenhanced scans showed intense, gradual enhancement of solid portions of the mass, with nonenhanced cystic portions. Although not specific, solitary fibrous tumors must be included in the differential diagnosis of a large retroperitoneal tumor of complex consistency and with internal calcification.

  20. Arms Down Cone Beam CT Hepatic Angiography Performance Assessment: Vascular Imaging Quality and Imaging Artifacts.

    Science.gov (United States)

    Gonzalez-Aguirre, Adrian J; Petre, Elena N; Hsu, Meier; Moskowitz, Chaya S; Solomon, Stephen B; Durack, Jeremy C

    2018-01-11

    The practice of positioning patients' arms above the head during catheter-injected hepatic arterial phase cone beam CT (A-CBCT) imaging has been inherited from standard CT imaging due to image quality concerns, but interrupts workflow and extends procedure time. We sought to assess A-CBCT image quality and artifacts with arms extended above the head versus down by the side. We performed an IRB approved retrospective evaluation of reformatted and 3D-volume rendered images from 91 consecutive A-CBCTs (43 arms up, 48 arms down) acquired during hepatic tumor arterial embolization procedures. Two interventional radiologists reviewed all A-CBCT imaging and assigned vessel visualization scores (VVS) from 1 to 5, ranging from non-diagnostic to optimal visualization. Streak artifacts across axial images were rated from 1 to 3 based on resulting image quality (none to significant). Presence of respiratory or cardiac motion during acquisition, body mass index and radiation dose area product (DAP) were also recorded and analyzed. Univariate and multivariate analyses were used to assess the impact of arm position on VVS and imaging artifacts. VVS were not significantly associated with arm position during A-CBCT imaging. One reader reported more streak artifacts across axial images in the arms down group (p = 0.005). DAP was not statistically different between the groups (23.9 Gy cm2 [6.1-73.4] arms up, 26.1 Gy cm2 [4.2-102.6] arms down, p = 0.54). A-CBCT angiography performed with the arms above the head is not superior for clinically relevant hepatic vascular visualization compared to imaging performed with the arms by the patient's side.

  1. Evaluation of portal hypertension: a comparison of the use of liver perfusion CT with wedge hepatic venous pressure and hepatic

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Dong Jin; Kim, Young Joong; Park, Yong Sung; Lee, Tae Hee [University of Konyang College of Medicine, Daejeon (Korea, Republic of); Kim, Chong Soo; Kang, Heung Keun [Chonbuk National University Medical School, Jeonju (Korea, Republic of)

    2008-09-15

    We compared the hepatic perfusion indices obtained using hepatic perfusion CT with the wedge hepatic venous pressure (WHVP) and hepatic venous pressure gradient (HVPG) to determine the efficacy of the use of liver perfusion CT for the evaluation of portal hypertension. Thirty-five patients with liver cirrhosis underwent hepatic vein catheterization to measure WHVP and HVPG and underwent a liver perfusion CT examination. Arterial perfusion, portal perfusion, total perfusion and the hepatic perfusion index (HPI) were calculated by the methods described by Miles and Blomlely. The overall correlation coefficients (r) between the perfusion indices and WHVP and HVPG were calculated. An additional correlation coefficient of 23 alcoholic cirrhosis patients was calculated. Using Blomley's equation, HPI had a positive correlation with WHVP (r = .471; {rho} < .05) and HVPG (r = .482; {rho} < .05). For the alcoholic liver cirrhosis patients, HPI had a higher positive correlation with WHVP (r = .500; {rho} < .05) and HVPG (r = .539; {rho} < .05) than for the non-alcoholic cirrhosis patients. There was no statistical difference between the use of Miles' equation and Blomley's equation for the evaluation of portal hypertension. This preliminary study showed that HPI positively correlated with WHVP and HVPG, especially in alcoholic cirrhosis patients. Liver perfusion CT may be useful in the evaluation of portal hypertension.

  2. Multidetector CT and MR Imaging of Cardiac Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Young; Choe, Yeon Hyeon; Sung, Ki Ick; Park, Seung Woo; Kim, Ji Hye; Ko, Young Hyeh [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2009-04-15

    The purpose of this article is to provide a current review of the spectrum of multidetector CT (MDCT) and MRI findings for a variety of cardiac neoplasms. In the diagnosis of cardiac tumors, the use of MDCT and MRI can help differentiate benign from malignant masses. Especially, the use of MDCT is advantageous in providing anatomical information and MRI is useful for tissue characterization of cardiac masses. Knowledge of the characteristic MRI findings of benign cardiac tumors or thrombi can be helpful to avoid unnecessary surgical procedures. Presurgical assessment of malignant cardiac tumors with the use of MDCT and MRI may allow determination of the resectability of tumors and planning for the reconstruction of cardiac chambers.

  3. Abdominal Splenosis Mimicking Hepatic Tumor: A Case Report

    Directory of Open Access Journals (Sweden)

    Ming-Lun Yeh

    2008-11-01

    Full Text Available Diagnosis of abdominal splenosis is often undiagnosed until treatment for splenic rupture or splenectomy. This report describes a patient with splenosis mimicking hepatic tumor. The patient had a history of splenic trauma with splenectomy and chronic hepatitis C. After routine abdominal ultrasound revealed a liver nodule, further imaging studies, including magnetic resonance imaging, computed tomography and angiography, were performed. After the patient eventually underwent surgery, pathology revealed splenic tissue. Despite its distinguishable clinical features, splenosis is difficult to identify by modern imaging modalities. Therefore, accurate and timely diagnosis of this disease requires constant vigilance.

  4. Abdominal splenosis mimicking hepatic tumor: a case report.

    Science.gov (United States)

    Yeh, Ming-Lun; Wang, Liang-Yen; Huang, Ching-I; Hsieh, Ming-Yen; Lin, Zu-Yau; Chuang, Wan-Long; Chang, Wen-Tsan; Wu, Chun-Chieh; Chen, Chiao-Yun

    2008-11-01

    Diagnosis of abdominal splenosis is often undiagnosed until treatment for splenic rupture or splenectomy. This report describes a patient with splenosis mimicking hepatic tumor. The patient had a history of splenic trauma with splenectomy and chronic hepatitis C. After routine abdominal ultrasound revealed a liver nodule, further imaging studies, including magnetic resonance imaging, computed tomography and angiography, were performed. After the patient eventually underwent surgery, pathology revealed splenic tissue. Despite its distinguishable clinical features, splenosis is difficult to identify by modern imaging modalities. Therefore, accurate and timely diagnosis of this disease requires constant vigilance.

  5. Hepatic scar in a case of healed candidiasis showing prolonged enhancement on CT

    Energy Technology Data Exchange (ETDEWEB)

    Itai, Yuji; Yashiro, Naobumi

    1987-08-01

    A patient with acute myelocytic leukemia recovering from hepatic candidiasis after long-term administration of amphotericin B had large scar in the liver which showed prominent prolonged enhancement on postcontrast CT. Prolonged enhancement can occur in regions other than hepatic masses.

  6. An Unusual Case of Hepatic Tumor in an Elderly Patient

    Directory of Open Access Journals (Sweden)

    Huan-Lin Chen

    2009-09-01

    Full Text Available Malignant epithelioid hemangioendothelioma is a rare hepatic tumor of vascular origin. It is most commonly found in young to middle-aged women, and the tumors vary in their reported potential for malignancy. The etiologic factors are not yet clear, and some investigators have suggested an association with oral contraceptives, whereas others have noted an association with exposure to vinyl chloride, asbestos, thorotrast, major trauma to the liver, viral hepatitis, primary biliary cirrhosis, and alcohol consumption. The clinical manifestations are nonspecific, and most are asymptomatic. Among symptomatic patients, the most common symptom is right upper quadrant pain, followed by jaundice, weight loss, fatigue, ascites, hepatomegaly, and fever. The only definitive diagnosis requires immunohistochemical evidence of endothelial differentiation, which is demonstrated by the presence of factor VIII-related antigen and cytokeratins. As with most mesenchymal tumors, surgical resection is the most effective means of controlling local disease and preventing distant metastasis, although adjuvant therapies have been offered for patients with unresectable tumors or who are not transplant candidates. We present the case of an elderly man with a hepatic malignant epithelioid hemangioendothelioma, and we reviewed the English-language literature.

  7. Primary hepatic angiosarcoma: multi-institutional comprehensive cancer centre review of multiphasic CT and MR imaging in 35 patients

    Energy Technology Data Exchange (ETDEWEB)

    Pickhardt, Perry J.; Kitchin, Douglas; Lubner, Meghan G. [University of Wisconsin School of Medicine and Public Health, Department of Radiology, Madison, WI (United States); Ganeshan, Dhakshina M. [University of Texas MD Anderson Cancer Center, Department of Radiology, Houston, TX (United States); Bhalla, Sanjeev [Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Covey, Anne M. [Memorial Sloan-Kettering Cancer Center, Department of Radiology, New York, NY (United States)

    2014-10-04

    To assess the imaging features of primary hepatic angiosarcoma on multiphasic CT and MR. Multi-institutional review identified 35 adults (mean age, 57.1 years; 22M/13F) with pathologically proven hepatic angiosarcoma and pretreatment multiphasic CT (n = 33) and/or MR (n = 7). Multifocal hepatic involvement was seen in all 35 cases, with at least 10 lesions in 74.3 % (26/35). Mean size of the dominant mass was 8.9 ± 4.7 cm (range, 2.6-20 cm). Individual nodules were typically circumscribed. Arterial-phase foci of hypervascular enhancement without washout were seen in 89.7 % (26/29). Heterogeneously expanding foci of enhancement generally followed blood pool in 88.6 % (31/35). Progressive centripetal (n = 16) or diffuse ''flash-fill'' (n = 4) enhancement pattern resembling cavernous haemangiomas predominated in 20 cases, whereas a ''reverse haemangioma'' centrifugal pattern predominated in 11 cases. Rapid interval growth was seen in 24 (96.0 %) of 25 cases with serial imaging. Vascular invasion was not seen in any case. Underlying cirrhotic morphology was seen in 42.3 % (15/35). Primary hepatic angiosarcomas typically manifest as aggressive multifocal tumors containing small heterogeneous hypervascular foci that progressively expand and follow blood pool. The appearance can mimic cavernous haemangiomas, but distinction is generally possible. In the setting of cirrhosis, lack of tumour washout and vascular invasion argue against multifocal hepatocellular carcinoma. (orig.)

  8. Double puncture of single common femoral artery for CT hepatic arteriography and CT arterial portography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ho Kyoung; Lee, Sang Chun [Seoul Red Cross Hospital, Seoul (Korea, Republic of); Kim, Yun Hwan; Kim, Hyoung Rae; Kang, Chang Ho; Kim, Hong Won; Cho, Sung Bum; Suh, Won Hyuck [Korea Univ. College of Medicine, Seoul (Korea, Republic of)

    1998-11-01

    To evaluate the safety and efficacy of double puncture of a single common femoral artery for CT hepatic arteriography (CTHA) and CT arterial portography (CTAP) in patients with hepatocellular carcinoma. Between October and December 1995, 35 patients with hepatocellular carcinoma underwent double puncture of a single common femoral artery for combined CTHA and CTAP. Preangiographic laboratory data were as follows:platelet count from 28,000 to 250,000/mm{sup 3} (average, 124,500/mm{sup 3});prothrombin time from 45.8% to 100% (average, 85.3%). In the inguinal area, a pair of 21G puncture needles were used unilaterally for the first two femoral punctures, at a distance of 5-7mm;a 0.018'' guidewire for the insertion of a 4-F sheath in a coaxial micropuncture introducer set;and a 0.035'' guidewire and 4F check-flo sheath for the insertion of 4-F catheters. After being moved to the CT room, patients then underwent spiral CTHA and CTAP for further detection of hepatocellular carcinoma nodules. Transarterial chemoembolization followed, and the punctured site was then compressed by the usual finger compression method. After initial compression and one day later, we observed the puncture site for complications such as hematoma formation, thromboembolization or arteriovenous fistula, etc. Except for the formation of two mild hematomas, no remarkable severe complications were noted. Fifteen patients who had previously undergone combined spiral CTHA and CTAP using the bilateral femoral puncture method (with a 5-F check-flo sheath) felt more comfortable than when an earlier method was uded. For combined CTHA and CTAP, double puncture of a single common femoral artery is safer and more comfortable than the bilateral femoral puncture method.=20.

  9. Gastric injury from (90)Y to left hepatic lobe tumors adjacent to the stomach: fact or fiction?

    Science.gov (United States)

    Gates, Vanessa L; Hickey, Ryan; Marshall, Karen; Williams, Melissa; Salzig, Krystina; Lewandowski, Robert J; Salem, Riad

    2015-12-01

    Radioembolization with (90)Y microspheres is a locoregional radiation therapy for unresectable hepatic neoplasm. Non-target delivery of (90)Y microspheres resulting in gastrointestinal (GI) symptoms is a recognized complication; there is minimal knowledge regarding the radiation effect to the gastric wall from left hepatic lobe (90)Y treatments. Our aim was to study the incidence of GI complications when the target tissue (hepatic parenchyma ± tumor) is in close proximity to the gastric wall. We hypothesized that liver (tumor) to stomach proximity does not correlate with increased toxicity. Between November 2011 and September 2013, we studied all patients who underwent left lobe radioembolization with (90)Y glass microspheres. With Institutional Review Board (IRB) approval, we retrospectively reviewed MRI/CT images of these patients, identifying a subset of patients with the left hepatic lobe <1 cm from the gastric wall. Patients were seen in clinic 1 month posttreatment and subsequently at 3-month intervals. Short- and long-term gastric adverse events were tabulated. Ninety-seven patients successfully underwent left hepatic lobe (90)Y microsphere radioembolization in which the average distance from the liver to the stomach wall was 1.0 ± 2.8 mm. The average dose for patients who received radioembolization to the left hepatic lobe was 109 ± 57 Gy. Fifty patients had tumor within 1 cm of the gastric wall. The average dose for patients who received radioembolization to the left hepatic lobe with tumor within 1 cm of the gastric wall was 121 ± 41 Gy. There were no reportable or recordable medical events. Of the patients, 34% reported abdominal pain that was grade 1-2; 65% of the patients reported no abdominal pain. None of the 97 patients developed a clinically evident GI ulcer. Patients with left lobe tumors adjacent to or abutting the stomach do not exhibit acute or chronic radiation effects following radioembolization with glass microspheres.

  10. Gastric injury from {sup 90}Y to left hepatic lobe tumors adjacent to the stomach: fact or fiction?

    Energy Technology Data Exchange (ETDEWEB)

    Gates, Vanessa L.; Hickey, Ryan; Marshall, Karen; Williams, Melissa; Salzig, Krystina; Lewandowski, Robert J. [Robert H. Lurie Comprehensive Cancer Center, Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Chicago, IL (United States); Salem, Riad [Robert H. Lurie Comprehensive Cancer Center, Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Chicago, IL (United States); Northwestern University, Department of Medicine, Division of Hematology and Oncology, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL (United States)

    2015-12-15

    Radioembolization with {sup 90}Y microspheres is a locoregional radiation therapy for unresectable hepatic neoplasm. Non-target delivery of {sup 90}Y microspheres resulting in gastrointestinal (GI) symptoms is a recognized complication; there is minimal knowledge regarding the radiation effect to the gastric wall from left hepatic lobe {sup 90}Y treatments. Our aim was to study the incidence of GI complications when the target tissue (hepatic parenchyma ± tumor) is in close proximity to the gastric wall. We hypothesized that liver (tumor) to stomach proximity does not correlate with increased toxicity. Between November 2011 and September 2013, we studied all patients who underwent left lobe radioembolization with {sup 90}Y glass microspheres. With Institutional Review Board (IRB) approval, we retrospectively reviewed MRI/CT images of these patients, identifying a subset of patients with the left hepatic lobe <1 cm from the gastric wall. Patients were seen in clinic 1 month posttreatment and subsequently at 3-month intervals. Short- and long-term gastric adverse events were tabulated. Ninety-seven patients successfully underwent left hepatic lobe {sup 90}Y microsphere radioembolization in which the average distance from the liver to the stomach wall was 1.0 ± 2.8 mm. The average dose for patients who received radioembolization to the left hepatic lobe was 109 ± 57 Gy. Fifty patients had tumor within 1 cm of the gastric wall. The average dose for patients who received radioembolization to the left hepatic lobe with tumor within 1 cm of the gastric wall was 121 ± 41 Gy. There were no reportable or recordable medical events. Of the patients, 34 % reported abdominal pain that was grade 1-2; 65 % of the patients reported no abdominal pain. None of the 97 patients developed a clinically evident GI ulcer. Patients with left lobe tumors adjacent to or abutting the stomach do not exhibit acute or chronic radiation effects following radioembolization with glass

  11. [Trends in the incidence of hepatic tumors in childhood].

    Science.gov (United States)

    Mejía-Aranguré, Juan Manuel; Beutelspacher-Vázquez, Olbeth; Juárez-Ocaña, Servando; Vázquez-Langle, José; Martínez-García, María del Carmen; Fajardo-Gutiérrez, Arturo

    2002-01-01

    To evaluate the incidence trends of hepatic tumors among children living in Mexico City. A cross-sectional hospital survey was conducted to yield two databases. The first database contains the registry of all the cases of hepatic tumors occurring during the period 1982-1991, in public hospitals of Mexico City. The second database contains all hepatic tumor cases found between 1996 and 1999 in Hospital de Pediatría del Centro Médico Nacional "Siglo XXI" and in Hospital General del Centro Médico La Raza, both hospitals pertaining to Instituto Mexicano del Seguro Social (Mexican Institute of Social Security). The average annual incidence rates (AAIR) were calculated for each type of hepatic tumor. The rates were standardized with the direct method, using as standard the world population under 15 years of age. The trends were evaluated with the annual incidence rates and the average rate of change assuming a Poisson distribution. The AAIR for hepatoblastoma during the period 1982-1991 was three times higher for men than for women, with a value of 0.6 x 10(6). The group of 1-4 years of age was the most affected. For hepatocarcinomas the AAIR was two-fold for women (0.14) as compared to men. Between 1996-1999 the AAIR for hepatoblastoma was 5.11 in women and 1.85 in men. The age group with the highest rate was women under one year of age. The AAIR for hepatocarcinoma was 0.64 for males and 1.23 for females. The most affected age group was males aged 10 to 14 years. No significant upward or downward trend was found in the incidence of hepatoblastomas. A non-significant change rate of 10% was found for hepatocarcinoma. No significant trends were observed in the incidence of hepatic tumors in children of Mexico City aged under 15 years, during the periods 1982-1991 and 1996-1999. The English version of this paper is available at: http://www.insp.mx/salud/index.html.

  12. Functional hepatic imaging as a biomarker of primary and secondary tumor response to loco-regional therapies.

    Science.gov (United States)

    Lewis, H L; Ghasabeh, M A; Khoshpouri, P; Kamel, I R; Pawlik, T M

    2017-12-01

    Objective criteria to measure tumor response are a key tenet for assessment of treatment efficacy when evaluating a therapeutic modality. Several response criteria have been proposed including the Response Evaluation Criteria in Solid Tumors (RECIST), modified RECIST (mRECIST), RECIST 1-1, and European Association for the Study of the Liver (EASL) guidelines. Response following loco-regional therapies (LRT) can be particularly difficult to assess as post-treatment changes may not always relate to changes in lesion size. As imaging modalities and solid tumor therapies continue to advance, there has been growing recognition that measurement of actual tumoricidal activity may not always be related to tumor size, and accurate assessment of treatment response may vary by therapeutic modality. As such, the objective change in the physical size characteristics of a tumor may not accurately reflect biological response to treatment. Functional imaging encompasses methods that are capable of detecting or measuring changes in tissue metabolism, blood flow, or composition. Conventional imaging modalities such as magnetic resonance imaging (MRI) and computed topography (CT) now include techniques such as diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) maps, dynamic contrast enhancement (DCE-MRI), and perfusion CT (pCT). Use of functional cross-sectional imaging is particularly relevant to assess primary and secondary hepatic malignancies treated with LRT, such as trans-arterial chemoembolization (TACE), radiofrequency ablation (RFA), yttrium-90 (Y-90), and hepatic arterial infusion (HAI) chemotherapy. We herein review the imaging techniques, as well as the methodologies for measuring tumor response and survival, among patients treated with LRT for primary and secondary hepatic malignancies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Hepatic sinusoidal obstruction syndrome caused by herbal medicine: CT and MRI features

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Hua; Lou, Hai Yan [Dept. of Radiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou (China); Wang, Yi Xiang J. [Dept. of Radiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou (China); Xu, Xiao Jun; Zhang, Min Ming [Dept. of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou (China)

    2014-04-15

    To describe the CT and MRI features of hepatic sinusoidal obstruction syndrome (HSOS) caused by herbal medicine Gynura segetum. The CT and MRI features of 16 consecutive Gynura segetum induced HSOS cases (12 men, 4 women) were analyzed. Eight patients had CT; three patients had MRI, and the remaining five patients had both CT and MRI examinations. Based on their clinical presentations and outcomes, the patients were classified into three categories: mild, moderate, and severe. The severity of the disease was also evaluated radiologically based on the abnormal hepatic patchy enhancement in post-contrast CT or MRI images. Ascites, patchy liver enhancement, and main right hepatic vein narrowing or occlusion were present in all 16 cases. Hepatomegaly and gallbladder wall thickening were present in 14 cases (87.5%, 14/16). Periportal high intensity on T2-weighted images was present in 6 cases (75%, 6/8). Normal liver parenchymal enhancement surrounding the main hepatic vein forming a clover-like sign was observed in 4 cases (25%, 4/16). The extent of patchy liver enhancement was statistically associated with clinical severity classification (kappa = 0.565). Ascites, patchy liver enhancement, and the main hepatic veins narrowing were the most frequent signs of herbal medicine induced HSOS. The grade of abnormal patchy liver enhancement was associated with the clinical severity.

  14. Intra-abdominal desmoplastic small round cell tumors: CT findings and clinicopathological correlations in 13 cases

    Energy Technology Data Exchange (ETDEWEB)

    Chouli, Malik [Department of Radiology, Institute Gustave Roussy, 39 Rue Camille Desmoulines, 94805 Villejuif Cedex (France); Viala, Juliette [Department of Radiology, Institute Gustave Roussy, 39 Rue Camille Desmoulines, 94805 Villejuif Cedex (France); Dromain, Clarisse [Department of Radiology, Institute Gustave Roussy, 39 Rue Camille Desmoulines, 94805 Villejuif Cedex (France); Fizazi, Karim [Department of Medicine, Institute Gustave Roussy, 39 Rue Camille Desmoulines, 94805 Villejuif Cedex (France); Duvillard, Pierre [Department of Histopathology, Institute Gustave Roussy, 39 Rue Camille Desmoulines, 94805 Villejuif Cedex (France); Vanel, Daniel [Department of Radiology, Institute Gustave Roussy, 39 Rue Camille Desmoulines, 94805 Villejuif Cedex (France)]. E-mail: vanel@igr.fr

    2005-06-01

    Purpose: We report computed tomography (CT) findings in 13 patients with a primary abdominal desmoplastic small round cell tumor. Materials and methods: 13 cases (12 men, 1 woman, mean age = 24.8 years) were found in our hospital database between 1991 and 2003. Clinical, CT and histopathological features were studied retrospectively. Results: Peritoneal involvement was the most common feature. In 10 cases, several lobulated peritoneal soft tissue masses (with a mean of four masses per patient) were seen. Two patients had diffused irregular peritoneal carcinomatosis without any distinct peritoneal masses. One patient had a solitary mass in the pelvic space. The main sites of peritoneal involvement were the pelvic space (n 7), omentum (n = 5), retroperitoneal space (n = 4), small bowel mesentery (n = 3), paracolic gutter (n = 2 on the right and n = 1 on the left), transverse colon mesentery (n = 1), peri-splenic space (n = 1), peri-hepatic space (n 1). The soft tissue masses were often bulky (mean 6 cm, range 1-28 cm), lobulated and heterogeneous with hypodense areas (in 73% of cases). In six cases, moderate ascites was seen. In one case of pelvic involvement, unilateral hydronephrosis was seen. Adenopathies were present in seven cases at the time of the diagnosis (at intraperitoneal, retroperitoneal and pelvic sites in six patients and in the groin in one patient). Five patients had liver metastases (four lesions per case excepted one patient with 30 metastases). Associated thoracic metastases were seen in three patients. The diagnosis was confirmed with four CT-guided percutaneous biopsies. Conclusion: Although CT features are nonspecific, the diagnosis of desmoplastic small round cell tumor may be suspected in young men with multiple bulky heterogeneous peritoneal soft tissue masses. Imaging is useful for staging and also to guide biopsies.

  15. [MRI and CT-scan in presumed benign ovarian tumors].

    Science.gov (United States)

    Thomassin-Naggara, I; Bazot, M

    2013-12-01

    Radiological examinations are required for the assessment of complex or indeterminate ovarian masses, mainly using MRI and CT-scan. MRI provides better tissue characterization than Doppler ultrasound or CT-scan (LE2). Pelvic MRI is recommended in case of an indeterminate or complex ovarian ultrasonographic mass (grade B). The protocol of a pelvic MRI should include morphological T1 and T2 sequences (grade B). In case of solid portion, perfusion and diffusion sequences are recommended (grade C). In case of doubt about the diagnosis of ovarian origin, pelvic MRI is preferred over the CT-scan (grade C). MRI is the technique of choice for the difference between functional and organic ovarian lesion diagnosis (grade C). It can be useful in case of clinical diagnostic uncertainty between polycystic ovary syndrome and ovarian hyperstimulation and multilocular ovarian tumor syndrome (grade C). No MRI classification for ovarian masses is currently validated. The establishment of a presumption of risk of malignancy is required in a MRI report of adnexal mass with if possible a guidance on the histological diagnosis. In the absence of clinical or sonographic diagnosis, pelvic CT-scan is recommended in the context of acute painful pelvic mass in non-pregnant patients (grade C). It specifies the anomalies and allows the differential diagnosis with digestive and urinary diseases (LE4). Given the lack of data in the literature, the precautionary principle must be applied to the realization of a pelvic MRI in a pregnant patient. A risk-benefit balance should be evaluated case by case by the clinician and the radiologist and information should be given to the patient. In an emergency situation during pregnancy, pelvic MRI is an alternative to CT-scan for the exploration of acute pelvic pain in case of uncertain sonographic diagnosis (grade C). Copyright © 2013. Published by Elsevier Masson SAS.

  16. CT findings of malignant tumors of maxillary sinus

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hyun Ae; Byun, Hong Sik; Kim, Kie Hwan; Chin, Soo Yil [Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    1987-12-15

    CT findings of histologically proven malignant tumors of maxillary sinus in 36 patients were retrospectively analyzed. A variety of malignant tumors were included; 27 cases of squamous cell carcinoma, 3 malignant lymphomas, 2 malignant melanomas, 2 rhabdomyosarcomas, and chondrosarcoma, adenoid cystic carcinoma, and malignant ameloblastoma. CT staging was T4 in 19 cases, T3 in 16 cases and T2 in 1 case. The most common involved area beyond maxillary antrum was nasal cavity (25 cases), followed by ethmoid sinus (20 cases), orbit (19 cases), infratemporal fossa (17 cases), check skin (13 cases), pterygopalatine fossa (10 cases), and nasopharynx (6 cases). Skeletal destruction was seen in medial wall of antrum (31 cases), posterior wall of antrum (25 cases), anterior wall of antrum (23 cases), roof of antrum (19 cases), lamina papyracea (6 cases), and lateral wall of orbit (5 cases) in that order of frequency. Lymph node metastases were found in 2 cases of malignant melanoma, 2 cases of malignant lymphoma, and chondrosarcoma, squamous cell carcinoma, and malignant ameloblastoma. Predilection site of lymph node involvement was submandibular (3 cases), internal jugular (2 cases), parotid (2 cases), and retropharyngeal node (1 case)

  17. CT evaluation of hepatic paragonimiasis with simultaneous duodenal or splenic involvement.

    Science.gov (United States)

    Li, Xue-Ming; Yu, Jian-Qun; He, Du; Peng, Li-Qing; Chu, Zhi-Gang; Chen, Dong-Dong; Luo, Yi

    2012-01-01

    Paragonimiasis is a parasitic infection caused by the genus Paragonimus and usually leads to pulmonary disease. Hepatic paragonimiasis is rare, but duodenal and splenic involvement of this disease has not yet been reported in the literature. Herein, we report two rare cases of hepatic paragonimiasis with simultaneous duodenal or splenic involvement, respectively, and described their CT features. Both patients were lifelong residents of an endemic area of paragonimiasis and were confirmed clinicopathologically. Copyright © 2012 Elsevier Inc. All rights reserved.

  18. Intrahepatic transneedle inoculation of VX2 particles for obtaining a solitary hepatic tumor in an animal model

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Jin Han; Choi, Jong Cheol; Shin, Tae Beom; Park, Byeong Ho [Dong-A University, School of Medicine, Busan (Korea, Republic of)

    2005-07-15

    The purpose of this study was to develop a large animal (rabbit) model which has a proper solitary intrahepatic tumor with lower leakage rates through less traumatic methods. Consequently, we evaluated tumor progression following the intrahepatic inoculation of VX2 cells into New Zealand white rabbits to acquire baseline data on the progression of a VX2 tumor. Twenty New Zealand white rabbits, each weighting 2.5-3 kg, were selected for this study. A 1 mm{sup 3} VX2 tumor fragment was created and then minced to enable the particles to pass through a 21 G needle mounting in a tuberculin syringe with 0.1 ml of normal saline. The minced VX2 tumor particles were injected into the subcapsular parenchyma of the left hepatic lobe. A 21 G needle was used to avoid penetrating large hepatic vessels. In order to prevent hemorrhage or leakage of the VX2 tumor cells through the injection route, a purse-string suture around the puncture site was made using black silk 4-0. The tumor particles were then injected through the center of the suture. While removing the needle, the suture was tightened to prevent hemorrhage or leakage of the VX2 tumor cells through the injection route. Finally, the injection site was covered with a Surgical patch. The inoculated intrahepatic VX2 tumors were then imaged with a 16 channel multidetector CT every week for the duration of the study. The CT images covered from the lung apex to the pelvic floor. Two radiologists evaluated the size, location, and peritoneal seeding of the tumors as well as metastasis of other organs. Three rabbits were sacrificed as random beginning in the second week, and this process continued on a weekly basis for the duration of the study. The CT images and pathologic findings for the sacrificed rabbits were correlated. The inoculated intrahepatic VX2 tumors were not visible in the first week. By the second week 66.7% were visible on CT images and by the third week all tumors were visible. Of the twenty rabbits, three (15

  19. Lymphadenopathy resulting from acute hepatitis C infection mimicking metastatic breast carcinoma on FDG PET/CT.

    Science.gov (United States)

    Jacene, Heather A; Stearns, Vered; Wahl, Richard L

    2006-07-01

    We report a case documenting fluorodeoxyglucose (FDG) accumulation in upper abdominal lymph nodes resulting from acute hepatitis C infection. A 42-year-old African-American female with a history of metastatic breast carcinoma was found to have hypermetabolic porta hepatic, peripancreatic, and paraaortic lymphadenopathy and hypermetabolism in the spleen on a surveillance FDG positron emission tomography/computed tomography (PET/CT) scan. Concurrently, she was diagnosed with acute hepatitis C infection. Antiviral therapy was not recommended secondary to the low level of detectable virus at the time of diagnosis. Her breast cancer therapy regimen was continued unaltered. FDG PET/CT scan was repeated 2 months later as a result of concern that the hypermetabolic lymph nodes represented metastatic disease; however, the scan revealed complete resolution of the previously abnormal findings. The resolution of the lymphadenopathy and the patient's clinical course led to the conclusion that the most likely explanation for the FDG PET/CT findings was inflammation secondary to acute hepatitis C infection and not metastatic breast carcinoma. Inflammatory and infectious processes accumulate FDG, occasionally resulting in false-positives for malignancy. Infected macrophages in the lymph nodes draining the liver in this case and stimulation of a cellular immune response by the hepatitis C virus, with resultant cytokine production by cytotoxic and T-helper cells, offer possible explanations for the findings seen on FDG PET/CT in this case. This case highlights the importance of clinical history and laboratory correlation for the proper interpretation of FDG PET scans.

  20. Artifacts in conventional computed tomography (CT) and free breathing four-dimensional CT induce uncertainty in gross tumor volume determination

    DEFF Research Database (Denmark)

    Persson, Gitte Fredberg; Nygaard, Ditte Eklund; Af Rosenschöld, Per Munck

    2011-01-01

    PURPOSE: Artifacts impacting the imaged tumor volume can be seen in conventional three-dimensional CT (3DCT) scans for planning of lung cancer radiotherapy but can be reduced with the use of respiration-correlated imaging, i.e., 4DCT or breathhold CT (BHCT) scans. The aim of this study was to com...

  1. Heart tumors: magnetic resonance imaging and multislice spiral CT; Herztumoren: Magnetresonanztomographie und Mehrschicht-Spiral-CT

    Energy Technology Data Exchange (ETDEWEB)

    Krombach, G.A.; Spuentrup, E.; Buecker, A.; Mahnken, A.H.; Katoh, M.; Temur, Y.; Higgins, C.B.; Guenther, R.W. [Klinik fuer Radiologische Diagnostik, Universitaetsklinikum Aachen (Germany)

    2005-09-01

    Transthoracic echocardiography is usually the initial diagnostic test in patients with a suspected cardiac mass. However, this technique is restricted by its small field of views and insufficient acoustic window in some patients. Magnetic resonance imaging (MRI) and, since its introduction, multislice spiral computed tomography allow for detailed delineation of intra and pericardiac tumors, their extent, and their influence on cardiac function. Primary benign and malignant cardiac tumors have several characteristic features in MR imaging. Assessment of such features may narrow down the differential diagnosis or even allow for reliable diagnosis in selected cases. Many such features can also be assessed using MSCT. This article provides an overview of examination protocols of MRI and CT for cases in which a cardiac mass is suspected and describes the appearance of primary and secondary cardiac masses as well as intracavitary thrombi. (orig.)

  2. Prognostic value of tumor necrosis at CT in diffuse large B-cell lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Adams, Hugo J.A., E-mail: h.j.a.adams@gmail.com [Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht (Netherlands); Klerk, John M.H. de [Department of Nuclear Medicine, Meander Medical Center, Amersfoort (Netherlands); Fijnheer, Rob [Department of Hematology, Meander Medical Center, Amersfoort (Netherlands); Dubois, Stefan V. [Department of Pathology, Meander Medical Center, Amersfoort (Netherlands); Nievelstein, Rutger A.J.; Kwee, Thomas C. [Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht (Netherlands)

    2015-03-15

    Highlights: •CT is compulsory for staging newly diagnosed DLBCL. •Approximately 13.7% of DLBCL patients have tumor necrosis at CT. •Tumor necrosis status at CT is not associated with any NCCN-IPI factor. •Patients with tumor necrosis at CT have a significantly worse outcome. -- Abstract: Objective: To determine the prognostic value of tumor necrosis at computed tomography (CT) in newly diagnosed diffuse large B-cell lymphoma (DLBCL). Materials and methods: This retrospective study included 51 patients with newly diagnosed DLBCL who had undergone both unenhanced and intravenous contrast-enhanced CT before R-CHOP (rituximab, cyclophosphamide, hydroxydaunorubicin, oncovin and prednisolone) chemo-immunotherapy. Presence of tumor necrosis was visually and quantitatively assessed at CT. Associations between tumor necrosis status at CT and the National Comprehensive Cancer Network (NCCN) International Prognostic Index (IPI) factors were assessed. Cox regression analysis was used to determine the prognostic impact of NCCN-IPI scores and tumor necrosis status at CT. Results: There were no correlations between tumor necrosis status at CT and the NCCN-IPI factors categorized age (ρ = −0.042, P = 0.765), categorized lactate dehydrogenase (LDH) ratio (ρ = 0.201, P = 0.156), extranodal disease in major organs (φ = −0.245, P = 0.083), Ann Arbor stage III/IV disease (φ = −0.208, P = 0.141), and Eastern Cooperative Oncology Group (ECOG) performance status (φ = 0.015, P = 0.914). In the multivariate Cox proportional hazards model, only tumor necrosis status at CT was an independent predictive factor of progression-free survival (P = 0.003) and overall survival (P = 0.004). Conclusion: The findings of this study indicate the prognostic potential of tumor necrosis at CT in newly diagnosed DLBCL.

  3. Small submucosal tumors of the stomach: differentiation of gastric schwannoma from gastrointestinal stromal tumor with CT.

    Science.gov (United States)

    Choi, Jin Wook; Choi, Dongil; Kim, Kyoung-Mee; Sohn, Tae Sung; Lee, Jun Haeng; Kim, Hee Jung; Lee, Soon Jin

    2012-01-01

    To identify the CT features that help differentiate gastric schwannomas (GS) from small (5 cm or smaller) gastrointestinal stromal tumors (GIST) and to assess the growth rates of both tumors. We included 16 small GSs and 56 GISTs located in the stomach. We evaluated the CT features including size, contour, surface pattern, margins, growth pattern, pattern and degree of contrast enhancement, and the presence of intralesional low attenuation area, hemorrhage, calcification, surface dimpling, fistula, perilesional lymph nodes (LNs), invasion to other organs, metastasis, ascites, and peritoneal seeding. We also estimated the tumor volume doubling time. Compared with GISTs, GSs more frequently demonstrated a homogeneous enhancement pattern, exophytic or mixed growth pattern, and the presence of perilesional LNs (each p < 0.05). The intralesional low attenuation area was more common in GISTs than GSs (p < 0.05). Multivariate analyses indicated that a homogeneous enhancement pattern, exophytic or mixed growth pattern, and the presence of perilesional LNs were statistically significant (p < 0.05). Tumor volume doubling times for GSs (mean, 1685.4 days) were significantly longer than that of GISTs (mean, 377.6 days) (p = 0.004). Although small GSs and GISTs show similar imaging findings, GSs more frequently show an exophytic or mixed growth pattern, homogeneous enhancement pattern, perilesional LNs and grow slower than GISTs.

  4. Small Submucosal Tumors of the Stomach: Differentiation of Gastric Schwannoma from Gastrointestinal Stromal Tumor with CT

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jin Wook; Choi, Dong Gil; Kim, Kyoung Mee; Sohn, Tae Sung; Lee, Jun Haeng; Kim, Hee Jung; Lee, Soon Jin [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2012-07-15

    To identify the CT features that help differentiate gastric schwannomas (GS) from small (5 cm or smaller) gastrointestinal stromal tumors (GIST) and to assess the growth rates of both tumors. We included 16 small GSs and 56 GISTs located in the stomach. We evaluated the CT features including size, contour, surface pattern, margins, growth pattern, pattern and degree of contrast enhancement, and the presence of intralesional low attenuation area, hemorrhage, calcification, surface dimpling, fistula, perilesional lymph nodes (LNs), invasion to other organs, metastasis, ascites, and peritoneal seeding. We also estimated the tumor volume doubling time. Compared with GISTs, GSs more frequently demonstrated a homogeneous enhancement pattern, exophytic or mixed growth pattern, and the presence of perilesional LNs (each p < 0.05). The intralesional low attenuation area was more common in GISTs than GSs (p < 0.05). Multivariate analyses indicated that a homogeneous enhancement pattern, exophytic or mixed growth pattern, and the presence of perilesional LNs were statistically significant (p < 0.05). Tumor volume doubling times for GSs (mean, 1685.4 days) were significantly longer than that of GISTs (mean, 377.6 days) (p = 0.004). Although small GSs and GISTs show similar imaging findings, GSs more frequently show an exophytic or mixed growth pattern, homogeneous enhancement pattern, perilesional LNs and grow slower than GISTs.

  5. CT-based temperature monitoring during hepatic RF ablation : Feasibility in an animal model

    NARCIS (Netherlands)

    Bruners, Philipp; Pandeya, Ganga D.; Levit, Elena; Roesch, Eva; Penzkofer, Tobias; Isfort, Peter; Schmidt, Bernhardt; Greuter, Marcel J. W.; Oudkerk, Matthijs; Schmitz-Rode, Thomas; Kuhl, Christiane K.; Mahnken, Andreas H.

    2012-01-01

    Purpose: The aim of this paper was to establish non-invasive CT-based temperature monitoring during hepatic radiofrequency (RF) ablation in an ex vivo porcine model followed by transfer of the technique into a feasibility in vivo experiment. Materials and methods: Bipolar RF ablations were performed

  6. Midterm Safety and Efficacy of Irreversible Electroporation of Malignant Liver Tumors Located Close to Major Portal or Hepatic Veins.

    Science.gov (United States)

    Distelmaier, Martina; Barabasch, Alexandra; Heil, Philipp; Kraemer, Nils A; Isfort, Peter; Keil, Sebastian; Kuhl, Christiane K; Bruners, Philipp

    2017-12-01

    Purpose To investigate the efficacy and safety of irreversible electroporation (IRE) in the treatment of hepatic tumors not suitable for thermal ablation (radiofrequency ablation [RFA] or microwave ablation). Materials and Methods This was an institutional review board-approved prospective study in 29 patients (15 men, 14 women; mean age, 63 years ± 12 [standard deviation]) with 43 primary (n = 8) or secondary (n = 35) malignant liver tumors who underwent computed tomography (CT)-guided IRE. All target tumors were located immediately adjacent to major hepatic veins, portal veins, or both; thus, they were not considered suitable for RFA or microwave ablation. Patients underwent postinterventional CT and magnetic resonance (MR) imaging. Systematic follow-up MR imaging was performed for 24 months on average to assess complete ablation, intrahepatic tumor recurrence, and complications. The 95% confidence intervals (CIs) were determined for the rate of bile duct strictures, incomplete ablation, and tumor recurrence. Results Complete ablation was achieved in 40 (93%; 95% CI: 85, 100) of 43 target tumors, with a safety margin of 5-10 mm, and was confirmed at immediate postinterventional CT and MR imaging. In 13 (33%; 95% CI: 18, 47) of 40 completely ablated tumors, intrahepatic tumor recurrence was observed at 2-18 months. However, only two (15%; 95% CI: 0, 35) of these 13 tumors were observed within the ablation zone. In the remaining 11 (85%; 95% CI: 65, 100), tumor growth was observed alongside the needle tract. None of the two true local recurrences occurred at the site of the vessel. All adjacent vessels remained perfused at follow-up. Five (24%; 95% CI: 5, 39) of 21 patients with target tumors adjacent to portal veins developed mild to moderate cholestasis 2-6 weeks after IRE. Conclusion IRE is useful to avoid incomplete ablation secondary to heat-sink effects and damage to major blood vessels; however, needle tract seeding is observed in 26% of treated tumors, and

  7. Bile duct complications of hepatic arterial infusion chemotherapy evaluated by helical CT

    Energy Technology Data Exchange (ETDEWEB)

    Phongkitkarun, S. [Department of Diagnostic Radiology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)]. E-mail: rasih@mahidol.ac.th; Kobayashi, S. [Department of Diagnostic Radiology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Varavithya, V. [Department of Diagnostic Radiology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Huang, X. [Department of Biostatistics, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Curley, S.A. [Department of Surgical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Charnsangavej, C. [Department of Diagnostic Radiology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)

    2005-06-01

    AIM: To describe the imaging findings of bile duct complications of hepatic arterial infusion chemotherapy (HAIC) using helical CT, to set diagnostic criteria, to develop a CT grading system, and to correlate these with clinical findings and laboratory data. METHODS: Follow-up helical CT of the abdomen was performed every 3 months for 60 patients receiving HAIC. Three radiologists reviewed all CT studies before and after treatment, using either the picture archiving and communication system or hard copies. The findings of bile duct abnormalities were correlated with findings from other imaging techniques, clinical symptoms and laboratory data. RESULTS: Bile duct abnormalities developed in 34 (57%) of cases either during HAIC or 1 to 12 months after treatment. In 14 (41%) of these 34 patients, enhancement of the hepatic parenchyma along the dilated bile duct or in the segmental or lobar distribution was observed. In 43 cases (72%), normal or abnormal alkaline phosphatase levels were consistent with normal or abnormal CT findings, respectively. Increasing alkaline phosphatase and bilirubin levels were related to CT grade. CONCLUSION: Imaging findings of bile duct complications of HAIC are similar to those of primary sclerosing cholangitis, and correlate well with abnormal clinical and laboratory data. In the presence of such clinical abnormalities, thin-section helical CT with careful review of the imaging studies helps to determine the correct diagnosis, monitor the changes and guide appropriate treatment.

  8. Metastatic tumor of the pancreas: helical CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Soon Jin; Lee, Won Jae; Lim, Hyo Keun; Kim, Seung Hoon; Kim, Kyeong Ah; Choi, Sang Hee; Jang, Hyun Jung; Lee, Ji Yeon [Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul (Korea, Republic of)

    2000-04-01

    To analyze the helical computed tomographic (CT) findings of distant metastatic tumors to the pancreas and to determine the differential points between these and primary pamcreatic carcinomas. We sruveyed 22 patients with metastatic tumor of the pancreas, proven on the basis of clinical and pathological findings. Seventeen patients were men, and five were women, and their ages ranged between 36 and 83 years. Their primary conditions were lung cancer (n=3D15), rectal cancer (n=3D2), melanoma of the foot, chondrosarcoma of the sacrum, cervical cancer, leiomyosarcoma of the uterus, and extragonadal choriocarcinoma of the mediastinum. We retrospectively reviewed the abdominal helical CT findings, analysing the number, location, size and attenuation of masses, as well as secondary change, which included dilatation of the pancreatic and biliary ducts and invasion of peripancreatic tissue or vessels. We also evaluated the differential findings of primary pancreatic cancer. Sixteen patients had a solitary focal mass, while in five, two masses were present. Among the 22 patients, low-density nodular masses were present in 21; in the other, in whom multiple metastasis from chondrosarcoma had occurred, there was dense calcification. The size of metastatic masses varied, ranging from 0.6 to 6 cm in diameter. The pancreatic duct proximal to the mass was dilated in ten cases, while the bile duct was dilated in six. The metastatic masses masses demonstrated no peripancreatic or vascular invasion, though they showed a discrete margin and contour bulging. Single metastasis to the pancreas was most common, and metastatic masses had a discrete margin, with contour bulging. There was no peripancreatic or vascular invasion. If the metastasis involved a single low-attenuated mass, however, with pancreatic or biliary dilatation, it was difficult to differentiate this from primary pancreatic cancer. (author)

  9. An ancillary CT finding of intrapulmonary solitary fibrous tumor: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dong Jun; Rho, Ji Young; Kwon, Ah Young [CHA Bundang Medical Center, CHA University, Seongnam (Korea, Republic of)

    2017-02-15

    Intrapulmonary solitary fibrous tumor is extremely rare. A few reports have presented typical CT findings such as well-defined, variable—sized, heterogeneously or homogenously well-enhanced intrapulmonary nodules. We report herein a rare case of intrapulmonary solitary fibrous tumor that showed typical clinical and CT features, and we also provide an ancillary CT finding that shows a distinguishable tubular vascular structure within the nodule. The tubular vascular structure was conjoined to the proximal pulmonary vein. In this study, we highlight an ancillary CT finding reported for the first time for the diagnosis of a patient with intrapulmonary solitary fibrous tumor.

  10. Azadirachta indica modulates electrical properties and type of cell death in NDEA-induced hepatic tumors.

    Science.gov (United States)

    Bharati, Sanjay; Rishi, Praveen; Koul, Ashwani

    2014-09-01

    Tissue electrical conductivity is an important indicator of tissue structure and composition. Present study demonstrates modulatory effect of Azadirachta indica on the electrical conductivity and cell death in hepatic tumors. Hepatic tumors were generated by intraperitoneal injection of N-nitrosodiethylamine (cumulative dose: 200 μg/g body mass) to male BALB/c mice. Aqueous A. indica leaf extract (AAILE) was administered orally at a dosage of 100 μg/g body mass till the termination of experiment. At the end of experiment, electrical conductivity of hepatic tumors was measured with four-pin electrode method. Tissues and tumors were then processed for TUNEL assay and DNA fragmentation analysis. The levels of TNF-α were also determined in the normal hepatic and tumor tissue. Hepatic tumors had higher electrical conductivity compared to normal liver tissue. An increased necrotic cell percentage along with elevated TNF-α was also observed. Although, AAILE co-treatment resulted in tumors with higher electrical conductivity compared to normal animals. However, the electrical conductivity was decreased significantly compared to untreated tumors. A significant increase in apoptotic cell percentage and concomitant decrease in necrotic cell percentage along with the increased TNF-α level was observed in these tumors. The results suggest that A. indica modulated mode of cell death in tumors and type of cell death had significant contribution in determining hepatic tumor electrical conductivity.

  11. Multimodality functional imaging of spontaneous canine tumors using 64CU-ATSM and 18FDG PET/CT and dynamic contrast enhanced perfusion CT

    DEFF Research Database (Denmark)

    Hansen, Anders E; Kristensen, Annemarie T; Law, Ian

    2012-01-01

    To compare the distribution and uptake of the hypoxia tracer (64)Cu-diacetyl-bis(N(4)-methylthiosemicarbazone) ((64)Cu-ATSM) PET/CT, FDG PET/CT and dynamic contrast enhanced perfusion CT (DCE-pCT) in spontaneous canine tumors. In addition (64)Cu-ATSM distribution over time was evaluated.......To compare the distribution and uptake of the hypoxia tracer (64)Cu-diacetyl-bis(N(4)-methylthiosemicarbazone) ((64)Cu-ATSM) PET/CT, FDG PET/CT and dynamic contrast enhanced perfusion CT (DCE-pCT) in spontaneous canine tumors. In addition (64)Cu-ATSM distribution over time was evaluated....

  12. Hepatic pseudoaneurysm after traumatic liver injury; is CT follow-up warranted?

    DEFF Research Database (Denmark)

    Østerballe, Lene; Helgstrand, Frederik; Axelsen, Thomas

    2014-01-01

    INTRODUCTION: Hepatic pseudoaneurysm (HPA) is a rare complication after liver trauma, yet it is potentially fatal, as it can lead to sudden severe haemorrhage. The risk of developing posttraumatic HPA is one of the arguments for performing follow-up CT of patients with liver injuries. The aim...... of this study was to investigate the occurrence of HPA post liver trauma. METHODS: A retrospective study from 2000-2010 of conservatively treated patients with blunt liver trauma was performed to investigate the incidence and nature of HPA. After the initial CT scan patients were admitted to the department...... is not correlated to the severity of liver injury and it develops in 4% of patients after traumatic liver injury. In order to avoid potentially life-threatening haemorrhage from a post trauma hepatic pseudoaneurysm, it seems appropriate to do follow-up CT as part of the conservative management of blunt...

  13. Prostate-Specific Membrane Antigen PET/CT Findings for Hepatic Hemangioma.

    Science.gov (United States)

    Bhardwaj, Hemant; Stephens, Maximilian; Bhatt, Manoj; Thomas, Paul Anthony

    2016-12-01

    We report a case of a benign liver hemangioma with intense prostate-specific membrane antigen (PSMA) uptake on Ga PET/CT. A 77-year-old man with prostate adenocarcinoma underwent routine staging with PSMA PET/CT. This revealed an intensely PSMA-avid liver lesion. The known prostate adenocarcinoma was localized and had mild uptake. Diagnostic CT and MRI were characteristic of a hemangioma without interval growth over a 3-month period. PSMA PET/CT is becoming increasingly popular for staging in prostate cancer, and the presence of PSMA uptake in extra-prostatic tumors is being increasingly documented.

  14. CT and MRI of sphenoid tumors and pseudo tumors; Scanographie et IRM des tumeurs et pseudo-tumeurs du sphenoide

    Energy Technology Data Exchange (ETDEWEB)

    Beaujeux, R.; Dietemann, J.L.; Brun, F.; Bourjat, P. [Centre Hospitalier Universitaire, 67 - Strasbourg (France)

    1994-12-31

    The radiological features of the main tumors and pseudotumors of the sphenoid bone with CT and MRI are described in detail. The lesions are classified as tumors and pseudotumors of the sphenoid bone and sphenoid sinus and as neighboring tumors and pseudotumors with secondary sphenoid invasion. Metastases, chondromas, fibrous dysplasia, myelomas, plasmocytomas and chordomas are the most frequent sphenoid lesions. Tumors and pseudotumors of the sphenoid sinus mainly include mucoceles and cholesterin granulomas. Neighboring tumors are of intracranial origin (pituitary adenoma, meningioma, aneurysm) or originate in the nasopharynx (nasopharyngeal fibroma, malignant tumors) or the nasosinusal cavities (inverted papillomas, invasive aspergillosis, malignant tumors). The radiological features do no always allow diagnosing the tumoral type. However, the merits of CT and, even more, of MRI for an accurate assessment of extension is indisputable. (authors). 41 refs., 12 figs.

  15. Prevention and treatment of complications after radiofrequency ablation for hepatic tumors in high-risk locations

    Directory of Open Access Journals (Sweden)

    SONG Li

    2017-04-01

    Full Text Available Percutaneous radiofrequency ablation (RFA has been widely used in the treatment of malignant hepatic tumors and has achieved satisfactory effects. Complications after RFA have been taken seriously and the risk of the development of complications is closely associated with tumor location. It is a great challenge for physicians to perform RFA for hepatic tumors in high-risk locations due to related difficulties and risks. This article reviews the complications after RFA for hepatic tumors in high-risk locations and analyzes related control strategies.

  16. Prognostic value of tumor necrosis at CT in diffuse large B-cell lymphoma.

    Science.gov (United States)

    Adams, Hugo J A; de Klerk, John M H; Fijnheer, Rob; Dubois, Stefan V; Nievelstein, Rutger A J; Kwee, Thomas C

    2015-03-01

    To determine the prognostic value of tumor necrosis at computed tomography (CT) in newly diagnosed diffuse large B-cell lymphoma (DLBCL). This retrospective study included 51 patients with newly diagnosed DLBCL who had undergone both unenhanced and intravenous contrast-enhanced CT before R-CHOP (rituximab, cyclophosphamide, hydroxydaunorubicin, oncovin and prednisolone) chemo-immunotherapy. Presence of tumor necrosis was visually and quantitatively assessed at CT. Associations between tumor necrosis status at CT and the National Comprehensive Cancer Network (NCCN) International Prognostic Index (IPI) factors were assessed. Cox regression analysis was used to determine the prognostic impact of NCCN-IPI scores and tumor necrosis status at CT. There were no correlations between tumor necrosis status at CT and the NCCN-IPI factors categorized age (ρ=-0.042, P=0.765), categorized lactate dehydrogenase (LDH) ratio (ρ=0.201, P=0.156), extranodal disease in major organs (φ=-0.245, P=0.083), Ann Arbor stage III/IV disease (φ=-0.208, P=0.141), and Eastern Cooperative Oncology Group (ECOG) performance status (φ=0.015, P=0.914). In the multivariate Cox proportional hazards model, only tumor necrosis status at CT was an independent predictive factor of progression-free survival (P=0.003) and overall survival (P=0.004). The findings of this study indicate the prognostic potential of tumor necrosis at CT in newly diagnosed DLBCL. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. Hepatic perfusion changes in an experimental model of acute pancreatitis: Evaluation by perfusion CT

    Energy Technology Data Exchange (ETDEWEB)

    Tutcu, Semra [Department of Surgery, Celal Bayar University, School of Medicine, Manisa (Turkey); Serter, Selim, E-mail: serterselim@gmail.co [Department of Radiology, Celal Bayar University, School of Medicine, Manisa (Turkey); Kaya, Yavuz; Kara, Eray [Department of Surgery, Celal Bayar University, School of Medicine, Manisa (Turkey); Nese, Nalan [Department of Pathology, Celal Bayar University, School of Medicine, Manisa (Turkey); Pekindil, Goekhan [Department of Radiology, Celal Bayar University, School of Medicine, Manisa (Turkey); Coskun, Teoman [Department of Surgery, Celal Bayar University, School of Medicine, Manisa (Turkey)

    2010-08-15

    Purpose: It is known that acute pancreatitis may cause secondary changes in several organs. Liver is one of these involved organs. In different experimental studies hepatic damages were shown histopathologically in acute pancreatitis but there are a few studies about perfusion disorders that accompany these histopathologic changes. Perfusion CT (pCT) provides the ability to detect regional and global alterations in organ blood flow. The purpose of the study was to describe hepatic perfusion changes in experimental acute pancreatitis model with pCT. Materials and methods: Forty Sprague-Dawley rats of both genders with average weights of 250 g were used. Rats were randomized into two groups. Twenty rats were in control group and 20 in acute pancreatitis group. pCT was performed. Perfusion maps were formed by processing the obtained images with perfusion CT software. Blood flow (BF) and blood volume (BV) values were obtained from these maps. All pancreatic and liver tissues were taken off with laparotomy and histopathologic investigation was performed. Student's t test was used for statistical analyses. Results: In pCT we found statistically significant increase in blood volume in both lobes of liver and in blood flow in right lobe of the liver (p < 0.01). Although blood flow in left lobe of the liver increased, it did not reach statistical significance. Conclusion: The quantitative analysis of liver parenchyma with pCT showed that acute pancreatitis causes a significant perfusion changes in the hepatic tissue. Systemic mediators seem to be effective as well as local inflammatory changes in perfusion changes.

  18. Primary hepatic actinomycosis mimicking hepatic malignancy with metastatic lymph nodes by F-18 FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Kong, Eun Jung [Yeungnam Univ. Medical School and Hospital, Daegu (Korea, Republic of)

    2016-03-15

    Hepatic involvement is usually secondary to abdominal actinomycosis infection. Symptom onset is typically subscute and the disease follows a chronic and indolent course. These lesions are called inflammatory pseudotumors and cannot be differentiated from malignant tumors by radiological examination alone. Laboratory tests showed mild anemia; hemoglobin 119 g/L, elevated white blood cell count of 23,060/mm{sup 3}, AST 33 U/L, ALT 45 U/L, and γ-GT 155 U/L.

  19. Clinical application of SPECT-CT with 99mTc-Tektrotyd in bronchial and thymic neuroendocrine tumors (NETs).

    Science.gov (United States)

    Sergieva, Sonya; Robev, Bozhil; Dimcheva, Milena; Fakirova, Albena; Hristoskova, Radka

    2016-01-01

    Neuroendocrine tumors (NETs) of the thorax including bronchial and thymic tumors belong to foregut NETs. Limited loco-regional thoracic NETs can be resected with surgery, but in extensive metastatic disease the treatment is mainly palliative. A high incidence and density of somatostatin receptors (SSTR2, SSTR3, and SSTR5) are found in thoracic NETs. The purpose of this study was to evaluate the role of SPECT-CT somatostatin receptor scintigraphy (SRS) with 99mTc-Tektrotyd for imaging, staging and follow up of patients with bronchial and thymic neuroendocrine tumors. Forty-one patients with thoracic tumors with neuroendocrine differentiation were studied. Sixty-eight examinations including SPECT-CT studies of the neck and chest and/or abdomen and pelvis were carried out 2-4 hrs. post i.v. administration of aver-age 740 MBq activity dose of 99mTc-EDDA/HYNIC-TOC (Tektrotyd, Polatom). In all 41 investigated patients we obtained 81.25% (13/16), 88% (22/25) and 85.36% (35/41) of sensitivity, specificity and accuracy of this diagnostic approach, respectively. Somatostatin-receptor scintigraphy correctly identified all primary NETs located in the lungs and thymus. SPECT-CT studies with 99mTc-EDDA/HYNIC-TOC resulted in exact pre-surgical and pre-treatment N/M staging of bronchial and thymic NETs, except 2 cases with multiple hepatic metastases and 1 with massive suprarenal metastasis. It can be concluded that SPECT-CT with 99mTc-EDDA/HYNIC-TOC is a valuable tool for staging and follow-up of patients with thoracic NETs.

  20. Assessment of disease aggression in cystic pancreatic neuroendocrine tumors: A CT and pathology correlation study.

    Science.gov (United States)

    Yano, Motoyo; Misra, Sunil; Salter, Amber; Carpenter, Danielle H

    There are inconsistencies in the literature regarding the clinical significance of cystic components in pancreatic neuroendocrine tumors (NET). This may be related to differences in the identification of cystic NET through imaging and/or pathology. Tumors may also be microscopically or macroscopically cystic. Our primary objective is to determine radiology-pathology correlation for the identification of cystic components. Our secondary objective is to determine if cystic components are associated with indices of tumor aggression. 60 tumors with correlative surgical pathology were assessed retrospectively for cystic components on CT and pathology. Tumor was categorized as solid or cystic on CT and pathology. If cystic on pathology, cystic components were categorized as macroscopic or microscopic. Cystic components were estimated as disease aggression. Associations were tested with Chi square/Fisher's exact test and differences were tested with t-test/Wilcoxon rank sums test. There is moderate agreement between CT and histology for presence of cystic components. Discrepancies were mostly attributable to the presence of microscopic cystic components in tumors appearing solid on CT. There was no difference in size between cystic and solid tumors on CT or pathology. No association between CT-determined cystic components and tumor grade was found. Tumors with cystic components (cystic by CT, and macroscopically cystic by pathology) demonstrated less association with metastases than solid tumors. Cystic components, comprising ≥50% of the tumor by CT and observed macroscopically on pathology, are associated with less aggressive disease. Copyright © 2017 IAP and EPC. Published by Elsevier B.V. All rights reserved.

  1. Imaging of Hepatic Ectopic Pregnancy by 18F-FDG PET/CT.

    Science.gov (United States)

    Hao, Jingwen; Cheng, Zhen; Hu, Na; Xiao, Lizhi; Wang, Yunhua

    2016-09-01

    Hepatic ectopic pregnancy is an uncommon form of extrauterine pregnancy. A 31-year-old woman had acute abdominal pain and distention. Laboratory examination showed significantly increased serum β-human chorionic gonadotropin level. Both ultrasound and MRI identified a lesion located at the right lobe of the liver. FDG PET/CT was performed to determine whether the other causes of elevated β-human chorionic gonadotropin level, which showed an oval mass with mid peripherally increased FDG activity. After surgery, pathological results confirmed a diagnosis of hepatic ectopic pregnancy.

  2. Advanced 3D image processing techniques for liver and hepatic tumor location and volumetry

    Science.gov (United States)

    Chemouny, Stephane; Joyeux, Henri; Masson, Bruno; Borne, Frederic; Jaeger, Marc; Monga, Olivier

    1999-05-01

    To assist radiologists and physicians in diagnosing, and in treatment planning and evaluating in liver oncology, we have developed a fast and accurate segmentation of the liver and its lesions within CT-scan exams. The first step of our method is to reduce spatial resolution of CT images. This will have two effects: obtain near isotropic 3D data space and drastically decrease computational time for further processing. On a second step a 3D non-linear `edge- preserving' smoothing filtering is performed throughout the entire exam. On a third step the 3D regions coming out from the second step are homogeneous enough to allow a quite simple segmentation process, based on morphological operations, under supervisor control, ending up with accurate 3D regions of interest (ROI) of the liver and all the hepatic tumors. On a fourth step the ROIs are eventually set back into the original images, features like volume and location are immediately computed and displayed. The segmentation we get is as precise as a manual one but is much faster.

  3. Imaging Features of Radiofrequency Ablation with Heat-Deployed Liposomal Doxorubicin in Hepatic Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Cheng William, E-mail: williamhongcheng@gmail.com; Chow, Lucy, E-mail: lucychow282@gmail.com [National Institutes of Health, Center for Interventional Oncology, Clinical Center (United States); Turkbey, Evrim B., E-mail: evrimbengi@yahoo.com [National Institutes of Health, Radiology and Imaging Sciences, Clinical Center (United States); Lencioni, Riccardo, E-mail: riccardo.lencioni@med.unipi.it [Pisa University Hospital, Division of Diagnostic Imaging and Intervention, Department of Hepatology and Liver Transplantation (Italy); Libutti, Steven K., E-mail: slibutti@montefiore.org [Albert Einstein College of Medicine, Montefiore-Einstein Center for Cancer Care, Department of Surgery (United States); Wood, Bradford J., E-mail: bwood@nih.gov [National Institutes of Health, Center for Interventional Oncology, Clinical Center (United States)

    2016-03-15

    IntroductionThe imaging features of unresectable hepatic malignancies in patients who underwent radiofrequency ablation (RFA) in combination with lyso-thermosensitive liposomal doxorubicin (LTLD) were determined.Materials and MethodsA phase I dose escalation study combining RFA with LTLD was performed with peri- and post- procedural CT and MRI. Imaging features were analyzed and measured in terms of ablative zone size and surrounding penumbra size. The dynamic imaging appearance was described qualitatively immediately following the procedure and at 1-month follow-up. The control group receiving liver RFA without LTLD was compared to the study group in terms of imaging features and post-ablative zone size dynamics at follow-up.ResultsPost-treatment scans of hepatic lesions treated with RFA and LTLD have distinctive imaging characteristics when compared to those treated with RFA alone. The addition of LTLD resulted in a regular or smooth enhancing rim on T1W MRI which often correlated with increased attenuation on CT. The LTLD-treated ablation zones were stable or enlarged at follow-up four weeks later in 69 % of study subjects as opposed to conventional RFA where the ablation zone underwent involution compared to imaging acquired immediately after the procedure.ConclusionThe imaging features following RFA with LTLD were different from those after standard RFA and can mimic residual or recurrent tumor. Knowledge of the subtle findings between the two groups can help avoid misinterpretation and proper identification of treatment failure in this setting. Increased size of the LTLD-treated ablation zone after RFA suggests the ongoing drug-induced biological effects.

  4. Evaluation of thymic tumors with 18F-FDG PET-CT - A pictorial review

    Energy Technology Data Exchange (ETDEWEB)

    Sharma, Punit; Singhal, Abhinav; Bal, Chandrasekhar; Malhotra, Arun; Kumar, Rakesh [Dept. of Nuclear Medicine, All India Inst. of Medical Sciences, New Delhi (India)], e-mail: rkphulia@yahoo.com; Kumar, Arvind [Dept. of Surgical Disciplines, All India Inst. of Medical Sciences, New Delhi (India)

    2013-02-15

    Thymic tumors represent a broad spectrum of neoplastic disorders and pose considerable diagnostic difficulties. A non-invasive imaging study to determine the nature of thymic lesions can have significant impact on management of such tumors. 18F-flurorodeoxyglucose (18F-FDG) positron emission tomography-computed tomography (PET-CT) has shown promising results in characterization of thymic tumors. The objective of this article is to provide an illustrative tutorial highlighting the clinical utility of 18F-FDG PET-CT imaging in patients with thymic tumors. We have pictorially depicted the 18F-FDG PET-CT salient imaging characteristics of various thymic tumors, both epithelial and non-epithelial. Also discussed is the dynamic physiology of thymus gland which is to be kept in mind when evaluating thymic pathology on 18F-FDG PET-CT, as it can lead to interpretative pitfalls.

  5. Contrast Agents for Quantitative MicroCT of Lung Tumors in Mice

    Science.gov (United States)

    Lalwani, Kush; Giddabasappa, Anand; Li, Danan; Olson, Peter; Simmons, Brett; Shojaei, Farbod; Arsdale, Todd Van; Christensen, James; Jackson-Fisher, Amy; Wong, Anthony; Lappin, Patrick B; Eswaraka, Jeetendra

    2013-01-01

    The identification and quantitative evaluation of lung tumors in mouse models is challenging and an unmet need in preclinical arena. In this study, we developed a noninvasive contrast-enhanced microCTCT) method to longitudinally evaluate and quantitate lung tumors in mice. Commercially available μCT contrast agents were compared to determine the optimal agent for visualization of thoracic blood vessels and lung tumors in naïve mice and in non-small-cell lung cancer models. Compared with the saline control, iopamidol and iodinated lipid agents provided only marginal increases in contrast resolution. The inorganic nanoparticulate agent provided the best contrast and visualization of thoracic vascular structures; the density contrast was highest at 15 min after injection and was stable for more than 4 h. Differential contrast of the tumors, vascular structures, and thoracic air space by the nanoparticulate agent enabled identification of tumor margins and accurate quantification. μCT data correlated closely with traditional histologic measurements (Pearson correlation coefficient, 0.995). Treatment of ELM4–ALK mice with crizotinib yielded 65% reduction in tumor size and thus demonstrated the utility of quantitative μCT in longitudinal preclinical trials. Overall and among the 3 agents we tested, the inorganic nanoparticulate product was the best commercially available contrast agent for visualization of thoracic blood vessels and lung tumors. Contrast-enhanced μCT imaging is an excellent noninvasive method for longitudinal evaluation during preclinical lung tumor studies. PMID:24326223

  6. Treatment planning of paraspinal tumors with CT-myelography; Bestrahlungsplanung rueckenmarksnaher Tumoren und Zuhilfenahme der CT-Myelographie

    Energy Technology Data Exchange (ETDEWEB)

    Plathow, C.; Thilmann, C. [Deutsches Krebsforschungszentrum, Heidelberg (Germany). Abt. Strahlentherapie; Delorme, S. [Deutsches Krebsforschungszentrum, Heidelberg (Germany). Abt. Radiologische Diagnostik; Stippich, C. [Heidelberg Univ. (Germany). Abt. Neuroradiologie; Wannenmacher, M. [Heidelberg Univ. (Germany). Abt. fuer Strahlentherapie; Debus, J. [Deutsches Krebsforschungszentrum, Heidelberg (Germany). Abt. Strahlentherapie; Heidelberg Univ. (Germany). Abt. fuer Strahlentherapie

    2001-06-01

    Background and aim: Artifacts due to metal implants are an important problem in diagnostic radiology and radiotherapy planning in tumors such as chordoma of the spine. A strict differentiation between target and radiosensitive structures e.g. spinal cord is absolutely essential for high-dose radiotherapy. Up to now CT and MRI techniques have provided only limited image quality in such situations. We introduce an approach to facilitate segmentation by using the technique of CT-myelography for radiation treatment. Patient and method: A 48-year-old woman with multiple inoperable relapses of a chordoma in the lumbar spine and extensive metal instrumentation in this area was given to radiotherapy using IMRT-technique (intensity modulated). MRI- and CT-planning images did not allow differentiation between myelon, cauda equina, dural sac and tumor. In this situation we performed a CT-myelography with the patient in treatment position. Result: CT-myelographic images enabled precise differentiation between myelon, cauda equina and intraspinal tumor. A substantial improvement of the segmentation of the spinal cord was obtained. There was no compression of the dural sac along the spine. This information provided the basis for a precise radiotherapy planning in IMRT-technique. Conclusion: In situations where CT- and MRI-techniques are not able to generate precise images which allow differentiation between tumor, myelon and cauda equina because of metal artifacts, CT-myelography is a promising technique which may help the diagnostic radiologist and radiation oncologist in planning radiotherapy. (orig.) [German] Hintergrund und Ziel: Postoperative Metallartefakte sind ein grosses Problem sowohl in der Diagnostik als auch in der Strahlentherapieplanung von Tumoren wie dem Chordom der Wirbelsaeule, da haeufig weder CT noch MRT ausreichend exaktes Bildermaterial als Basis fuer eine hochdosierte Radiotherapie liefern koennen. Wir untersuchten die Anwendung der CT-Myelographie zur

  7. SU-E-J-267: Change in Mean CT Intensity of Lung Tumors During Radiation Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Mahon, R; Tennyson, N; Weiss, E; Hugo, G [Virginia Commonwealth University, Richmond, VA (United States)

    2015-06-15

    Purpose: To evaluate CT intensity change of lung tumors during radiation therapy. Methods: Repeated 4D CT images were acquired on a CT simulator during the course of therapy for 27 lung cancer patients on IRB approved protocols. All subjects received definitive radiation treatment ± chemotherapy. CT scans were completed prior to treatment, and 2–7 times during the treatment course. Primary tumor was delineated by an experienced Radiation Oncologist. Contours were thresholded between −100 HU and 200 HU to remove airways and bone. Correlations between the change in the mean tumor intensity and initial tumor intensity, SUVmax, and tumor volume change rate were investigated. Reproducibility was assessed by evaluating the variation in mean intensity over all phases in 4DCT, for a subgroup of 19 subjects. Results: Reproducibility of tumor intensity between phases as characterized by the root mean square of standard deviation across 19 subjects was 1.8 HU. Subjects had a mean initial tumor intensity of 16.5 ± 11.6 HU and an overall reduction in HU by 10.3 ± 8.5 HU. Evaluation of the changes in tumor intensity during treatment showed a decrease of 0.3 ± 0.3 HU/day for all subjects, except three. No significant correlation was found between change in HU/day and initial HU intensity (p=0.53), initial PET SUVmax (p=0.69), or initial tumor volume (p=0.70). The rate of tumor volume change was weakly correlated (R{sup 2}=0.05) with HU change (p=0.01). Conclusion: Most lung cancer subjects showed a marked trend of decreasing mean tumor CT intensity throughout radiotherapy, including early in the treatment course. Change in HU/day is not correlated with other potential early predictors for response, such as SUV and tumor volume change. This Result supports future studies to evaluate change in tumor intensity on CT as an early predictor of response.

  8. The effect of CT26 tumor-derived TGF-β on the balance of tumor growth and immunity.

    Science.gov (United States)

    Owyang, Stephanie Y; Zhang, Min; Walkup, Grace A; Chen, Grace E; Grasberger, Helmut; El-Zaatari, Mohamad; Kao, John Y

    2017-11-01

    TGF-β is an important target for many cancer therapies under development. In addition to suppressing anti-tumor immunity, it has pleiotropic direct pro- and anti- tumor effects. The actions of increased endogenous TGF-β production remain unclear, and may affect the outcomes of anti-TGF-β cancer therapy. We hypothesize that tumor-derived TGF-β (td-TGF-β) plays an important role in maintaining tumor remission by controlling tumor proliferation in vivo, and that decreasing td-TGF-β in the tumor microenvironment will result in tumor progression. The aim of this study was to examine the effect of TGF-β in the tumor microenvironment on the balance between its anti-proliferative and immunosuppressive effects. A murine BALB/c spontaneous colon adenocarcinoma cell line (CT26) was genetically engineered to produce increased active TGF-β (CT26-TGF-β), a dominant-negative soluble TGF-β receptor (CT26-TGF-β-R), or the empty neomycin cassette as control (CT26-neo). In vitro proliferation rates were measured. For in vivo studies, the three cell lines were injected into syngeneic BALB/c mice, and tumor growth was measured over time. Immunodeficient BALB/c nude mice were used to investigate the role of T and B cells. In vitro, CT26-TGF-β-R and CT26-TGF-β cells showed increased and suppressed proliferation, respectively, compared to control (CT26-neo), confirming TGF-β has direct anti-tumor effects. In vivo, we found that CT26-TGF-β-R cells displayed slower growth compared to control, likely secondary to reduced suppression of anti-tumor immunity, as this effect was ablated in immunodeficient BALB/c nude mice. However, CT26-TGF-β cells (excess TGF-β) exhibited rapid early growth compared to control, but later failed to progress. The same pattern was shown in immunodeficient BALB/c nude mice, suggesting the effect on tumor growth is direct, with minimal immune system involvement. There was minimal effect on systemic antitumor immunity as determined by peripheral

  9. Enhancement pattern of small hepatic hemangioma: findings on multiphase spiral CT and dynamic MRI

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Byung In; Lee, Seung Koo; Kim, Myeong Jin; Chung, Jae Joon; Yoo, Hyung Sik; Lee, Jong Tae [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1999-02-01

    To compare the enhancement characteristics of small hemangiomas seen on multiphase spiral CT and dynamic MR imaging. Thirteen patients with 20 hepatic hemangiomas less than 25mm in diameter underwent both multiphase spiral CT and dynamic MR imaging. All lesions were assigned to one of three classified into 3 categories according to the enhancement pattern seen on multiphase spiral CT : typical delayed pooling, atypical early enhancement, or continuous low attenuation. The enhancement patterns seen on spiral CT and on dynamic MRI were correlated. On CT scans, ten lesions (50%) showed delayed pooling. Six (30%) showed early arterial enhancement and four (20%) showed continuous low attenuation. On delayed-phase MRI, all lesions showed delayed high signal intensity compared to adjacent liver parenchyma. Four of six lesions with early enhancement on CT showed peripheral globular enhancement on early arterial-phase MRI. On multiphase spiral CT scans, small hemangiomas can show variable atypical enhancement features. In this situation, contrast-enhanced dynamic MRI is helpful for the diagnosis of hemangiomas.

  10. Dynamic CT vs 0.5 T MR imaging in the detection of surgically proven hepatic metastases.

    Science.gov (United States)

    Zeman, R K; Dritschilo, A; Silverman, P M; Clark, L R; Garra, B S; Thomas, D S; Ahlgren, J D; Smith, F P; Korec, S M; Nauta, R J

    1989-01-01

    Seventeen patients with 52 surgically proven hepatic metastases were studied preoperatively with dynamic CT and 0.5 T magnetic resonance (MR). Dynamic CT detected 38 metastases (73%), and the combination of short echo time (T1-weighted) and T2-weighted pulse sequences detected 46 lesions (88%). Magnetic resonance was also superior at assessing potential resectability. This study suggests that MR excels in detecting and anatomically localizing individual hepatic metastases.

  11. Radiological evaluation with Doppler sonography and multidetector CT angiography in congenital hepatic arteriovenous malformation in a newborn

    Energy Technology Data Exchange (ETDEWEB)

    Adaletli, Ibrahim; Kurugoglu, Sebuh; Kilic, Fahrettin [Istanbul University, Department of Radiology, Cerrahpasa Medical Faculty (Turkey); Senyuz, Osman F. [Istanbul University, Department of Paediatric Surgery, Cerrahpasa Medical Faculty (Turkey); Dervisoglu, Sergulen [Istanbul University, Department of Pathology, Cerrahpasa Medical Faculty (Turkey)

    2006-11-15

    Although hepatic arteriovenous malformations are rarely reported, they frequently have life-threatening complications such as cardiac failure and are associated with a high mortality rate. Consequently, accurate prenatal and early postnatal diagnosis is important and therapeutic procedures depend on the imaging features. We report the early postnatal sonographic, Doppler sonographic, multidetector CT and CT angiography findings of a congenital hepatic arteriovenous malformation in a newborn. (orig.)

  12. Thin section helical CT findings of klastskin tumor and benign stricture: cholangiographic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Guk Myeong; Han, Joon Koo; Kim, Tae Kyoung; Choi, Byung Ihn; Kim, Sun Whe; Cho, Yun Ku; Han, Man Chung; Yeon, Kyung Mo [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-10-01

    The purpose of this study was (1) to describe the thin section helical CT findings of hilar cholangiocarcinoma and of benign strcture, and to discuss the differential points between the two disease entities and (2) using cholangiographic correlation, to evaluate the diagnostic accuracy of helical CT in determining the extent of hilar cholangiocarcinoma. Twenty-seven patients with hilar cholangiocarcinoma and eight with benign biliary dilatation were studied. All except four with hilar cholangiocarcinoma, who underwentCT using a conventional scanner, were studied with two-phase helical CT. In all patients, cholangiographs were obtained by digital fluoroscopy after the injection of contrast materials into PTBD catheters. The level of obstruction was classified according to Bismuth, and 35 CT scans were studied blindly and retrospectively by two radiologists. The findings were analyzed for the presence of tumor, and then divided into two groups(cholangiocarcinomas and benign strictures), and the positive predictive value was calculated. The CT images of klatskin tumor were analyzed with special emphasis on the level and shape of the hilar obstruction. The level of biliary obstruction and extent of the tumor were carefully correlated with the results of cholangiography. Thin-section spiral CT correctly identified all tumor mass as a focal wall thickening obliterating the lumen. On arterial/portal phase CT scanning, 81% of infilterative tumors showed high attenuation. In all patients, differentiation between benign stricture and klaskin tumor was possible;correct identification of the level of obstruction and extent of tumor, according to Bismuth's classification, was possible in 63% of cases. For correct diagnosis of hilar cholangiocarcinoma and differentiation of benign stricture, helical CT was highly accurate and effective. Because of limital Z-axis resolution, however, the exact intraductal extent of the tumor was less accorately diagnosed.=20.

  13. A Spontaneously Ruptured Hepatic Metastasis From a Gastric Gastrointestinal Stromal Tumor That Presented as Hemoperitoneum

    Directory of Open Access Journals (Sweden)

    Jung-Hee Yoon

    2013-11-01

    Full Text Available Spontaneous hepatic hemorrhage is a rare condition that may be caused by an underlying hepatic tumor, most commonly hepatocellular carcinoma or hepatic adenoma. A spontaneous rupture of a hepatic metastasis from a gastric gastrointestinal stromal tumor is also extremely rare, and the majority of affected patients present with hypovolemic shock or an acute abdomen. In this article, we report the case of a 65-year-old man with a spontaneous rupture of a hepatic metastasis from a gastric gastrointestinal stromal tumor that presented as hypovolemic shock. Cross-sectional imaging studies (computed tomography or magnetic resonance imaging play a significant role in the diagnosis of this condition and guides its management.

  14. Comparison of neuroendocrine tumor detection and characterization using DOTATOC-PET in correlation with contrast enhanced CT and delayed contrast enhanced MRI

    Energy Technology Data Exchange (ETDEWEB)

    Giesel, F.L., E-mail: f.giesel@dkfz.de [Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120 Heidelberg (Germany); Kratochwil, C., E-mail: Clemens.kratochwil@t-online.de [Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120 Heidelberg (Germany); Mehndiratta, A., E-mail: dramit.mehndiratta@gmail.com [Keble College, Institute of Biomedical Engineering, University of Oxford, Parks Road, Oxford OX13PG (United Kingdom); Wulfert, S., E-mail: sarah.wulfert@googlemail.com [Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120 Heidelberg (Germany); Moltz, J.H., E-mail: Jan.Moltz@mevis.fraunhofer.de [Fraunhofer MEVIS, Bremen (Germany); Zechmann, C.M., E-mail: christian.zechmann@med.uni-heidelberg.de [Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120 Heidelberg (Germany); Kauczor, H.U., E-mail: Hans-ulrich.kauczor@med.uni-heidelberg.de [Department of Diagnostic and Interventional Radiology, University of Heidelberg, INF 110, 69120 Heidelberg (Germany); Haberkorn, U., E-mail: uwe.haberkorn@med.uni-heidelberg.de [Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120 Heidelberg (Germany); Ley, S., E-mail: ley@gmx.de [Department of Diagnostic and Interventional Radiology, University of Heidelberg, INF 110, 69120 Heidelberg (Germany); Department of Medical Imaging, Toronto General Hospital (Canada)

    2012-10-15

    Purpose: We evaluated the rate of successful characterization of gastroenteropancreatic neuroendocrine tumors (NETs) present with an increased somatostatin receptor, comparing CE-CT with CE-MRI, each in correlation with DOTATOC-PET. Methods and materials: 8 patients with GEP-NET were imaged using CE-MRI (Gd-EOB-DTPA), CE-CT (Imeron 400) and DOTATOC-PET. Contrast-enhancement of normal liver-tissue and metastasis was quantified with ROI-technique. Tumor delineation was assessed with visual-score in blind-read-analysis by two experienced radiologists. Results: Out of 40 liver metastases in patients with NETs, all were detected by CE-MRI and the lesion extent could be adequately assessed, whereas CT failed to detect 20% of all metastases. The blind-read-score of CT in arterial and portal phase was median −0.65 and −1.4, respectively, and 2.7 for delayed-MRI. The quantitative ROI-analysis presented an improved contrast-enhancement-ratio with a median of 1.2, 1.6 and 3.3 for CE-CT arterial, portal-phase and delayed-MRI respectively. Conclusion: Late CE-MRI was superior to CE-CT in providing additionally morphologic characterization and exact lesion extension of hepatic metastases from neuroendocrine tumor detected with DOTATOC-PET. Therefore, late enhanced Gd-EOB-DTPA-MRI seems to be the adequate imaging modality for combination with DOTATOC-PET to provide complementary (macroscopic and molecular) tumor characterization in hepatic metastasized NETs.

  15. Extrahepatic Arteries Originating from Hepatic Arteries: Analysis Using CT During Hepatic Arteriography and Visualization on Digital Subtraction Angiography

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    Ozaki, Kumi, E-mail: ozakik-rad@umin.org [Kanazawa University Graduate School of Medical Science, Department of Radiology (Japan); Kobayashi, Satoshi [Kanazawa University Graduate School of Medical Science, Department of Quantum Medicine Technology (Japan); Matsui, Osamu; Minami, Tetsuya; Koda, Wataru; Gabata, Toshifumi [Kanazawa University Graduate School of Medical Science, Department of Radiology (Japan)

    2017-06-15

    PurposeTo investigate the prevalence and site of origin of extrahepatic arteries originating from hepatic arteries on early phase CT during hepatic arteriography (CTHA) was accessed. Visualization of these elements on digital subtraction hepatic angiography (DSHA) was assessed using CTHA images as a gold standard.Materials and MethodsA total of 943 patients (mean age 66.9 ± 10.3 years; male/female, 619/324) underwent CTHA and DSHA. The prevalence and site of origin of extrahepatic arteries were accessed using CTHA and visualized using DSHA.ResultsIn 924 (98.0%) patients, a total of 1555 extrahepatic branches, representing eight types, were found to originate from hepatic arteries on CTHA. CTHA indicated the following extrahepatic branch prevalence rates: right gastric artery, 890 (94.4%); falciform artery, 386 (40.9%); accessory left gastric artery, 161 (17.1%); left inferior phrenic artery (IPA), 43 (4.6%); posterior superior pancreaticoduodenal artery, 33 (3.5%); dorsal pancreatic artery, 26 (2.8%); duodenal artery, 12 (1.3%); and right IPA, 4 (0.4%). In addition, 383 patients (40.6%) had at least one undetectable branch on DSHA. The sensitivity, specificity, and accuracy of visualization on DSHA were as follows: RGA, 80.0, 86.8, and 80.4%; falciform artery, 53.9, 97.7, and 80.0%; accessory LGA, 64.6, 98.6, and 92.3%; left IPA, 76.7, 99.8, and 98.7%; PSPDA, 100, 99.7, and 99.9%; dorsal pancreatic artery, 57.7, 100, and 98.8%; duodenal artery, 8.3, 99.9, and 98.7%; and right IPA, 0, 100, and 99.6%, respectively.ConclusionExtrahepatic arteries originating from hepatic arteries were frequently identified on CTHA images. These arteries were frequently overlooked on DSHA.

  16. An automatic virtual patient reconstruction from CT-scans for hepatic surgical planning.

    Science.gov (United States)

    Soler, L; Delingette, H; Malandain, G; Ayache, N; Koehl, C; Clément, J M; Dourthe, O; Marescaux, J

    2000-01-01

    PROBLEM/BACKGROUND: In order to help hepatic surgical planning we perfected automatic 3D reconstruction of patients from conventional CT-scan, and interactive visualization and virtual resection tools. From a conventional abdominal CT-scan, we have developed several methods allowing the automatic 3D reconstruction of skin, bones, kidneys, lung, liver, hepatic lesions, and vessels. These methods are based on deformable modeling or thresholding algorithms followed by the application of mathematical morphological operators. From these anatomical and pathological models, we have developed a new framework for translating anatomical knowledge into geometrical and topological constraints. More precisely, our approach allows to automatically delineate the hepatic and portal veins but also to label the portal vein and finally to build an anatomical segmentation of the liver based on Couinaud definition which is currently used by surgeons all over the world. Finally, we have developed a user friendly interface for the 3D visualization of anatomical and pathological structures, the accurate evaluation of volumes and distances and for the virtual hepatic resection along a user-defined cutting plane. A validation study on a 30 patients database gives 2 mm of precision for liver delineation and less than 1 mm for all other anatomical and pathological structures delineation. An in vivo validation performed during surgery also showed that anatomical segmentation is more precise than the delineation performed by a surgeon based on external landmarks. This surgery planning system has been routinely used by our medical partner, and this has resulted in an improvement of the planning and performance of hepatic surgery procedures. We have developed new tools for hepatic surgical planning allowing a better surgery through an automatic delineation and visualization of anatomical and pathological structures. These tools represent a first step towards the development of an augmented

  17. Role of respiratory-gated PET/CT for pancreatic tumors: A preliminary result

    Energy Technology Data Exchange (ETDEWEB)

    Kasuya, Takeo, E-mail: kasumakidon@yahoo.co.jp [Department of Radiology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004 (Japan); Tateishi, Ukihide, E-mail: utateish@yokohama-cu.ac.jp [Department of Radiology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004 (Japan); Suzuki, Kazufumi, E-mail: kazufumi@dokkyomed.ac.jp [Department of Radiology, Dokkyo Medical University Graduate School of Medicine 880, Kitakobayashi, Mibu-cho, Shimotsugagun, Tochigi, 321-0293 (Japan); Daisaki, Hiromitsu, E-mail: hdaisaki@gmail.com [Division of Cancer Screening, Research Center for Cancer Prevention and Screening, National Cancer Center, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045 (Japan); Nishiyama, Yuji, E-mail: t116052g@yokohama-cu.ac.jp [Department of Radiology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004 (Japan); Hata, Masaharu, E-mail: hatahata@yokohama-cu.ac.jp [Department of Radiology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004 (Japan); Inoue, Tomio, E-mail: sec229@yokohama-cu.ac.jp [Department of Radiology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004 (Japan)

    2013-01-15

    Purpose: The aim of this study is to ascertain role of respiratory-gated PET/CT for accurate diagnosis of pancreatic tumors. Materials and methods: Prior to clinical study, the phantom study was performed to evaluate the impact of respiratory motion on lesion quantification. Twenty-two patients (mean age 65 years) with pancreatic tumors were enrolled. Pathological diagnoses by surgical specimens consisted of pancreatic cancer (n = 15) and benign intraductal papillary mucinous neoplasm (IPMN, n = 7). Whole-body scan of non-respiratory-gated PET/CT was performed at first, and subsequent respiratory-gated PET/CT for one bed position was performed. All PET/CT studies were performed prior to surgery. The SUV max obtained by non-respiratory-gated PET/CT and respiratory-gated PET/CT, and percent difference in SUVmax (%SUVmax) were compared. Results: The profile curve of 5 respiratory bin image was most similar to that of static image. The third bin of 5 respiratory bin image showed highest FWHM (24.0 mm) and FWTM (32.7 mm). The mean SUVmax of pancreatic cancer was similar to that of benign IPMN on non-respiratory-gated PET/CT (p = 0.05), whereas significant difference was found between two groups on respiratory-gated PET/CT (p = 0.016). The mean %SUV of pancreatic cancer was greater than that of benign IPMN (p < 0.0001). Identification of the primary tumor in pancreatic head (n = 13, 59%) was improved by using respiratory-gated PET/CT because of minimal affection of physiological accumulation in duodenum. Conclusion: Respiratory-gated PET/CT is a feasible technique for evaluation of pancreatic tumors and allows more accurate identification of pancreatic tumors compared with non-respiratory-gated PET/CT.

  18. The impact of share wave elastography in differentiation of hepatic hemangioma from malignant liver tumors in pediatric population.

    Science.gov (United States)

    Özmen, Evrim; Adaletli, Ibrahim; Kayadibi, Yasemin; Emre, Şenol; Kiliç, Fahrettin; Dervişoğlu, Sergülen; Kuruğoğlu, Sebuh; Şenyüz, Osman Faruk

    2014-09-01

    In children it is crucial to differentiate malignant liver tumors from the most common benign tumor, hepatic hemangiomas since the treatment strategies are quite different. We aimed to evaluate the efficiency of shear wave elastography (SWE) technique in differentiation of malignant hepatic tumors and hepatic hemangiomas. Twenty patients with hepatic tumor were included in our study. Two radiologists performed SWE for 13 patients with malignant hepatic tumors including hepatoblastoma (n=7), hepatocellular carcinoma (n=3), metastasis (n=2), embryonal sarcoma (n=1) and 7 patients with hepatic hemangioma. All of our patients were between the age of 1 and 192 months (mean age: 56.88 months). Receiver operating characteristic analysis was achieved to evaluate the diagnostic accuracy of SWE and to determine the optimal cut-off value in differentiation hepatic hemangioma from malignant hepatic tumors. The mean SWE values (in kPa) for the first observer were 46.94 (13.8-145) and 22.38 (6.6-49.6) and those for the second observer were 57.91 (11-237) and 23.87 (6.4-57.5), respectively for malignant hepatic tumors and hepatic hemangiomas. The SWE values of malignant hepatic tumors were significantly higher than those of hepatic hemangioma (p=0.02). The inter-observer agreement was almost perfect (0.81). The area under the receiver operating characteristic curve of SWE for differentiating the hepatic hemangioma from malignant hepatic tumors was 0.77 with a sensitivity of 72.7% and a specificity of 66.7% at a cutoff value of 23.62 with 95% confidence interval. Shear wave elastography can be helpful in differentiation of malignant hepatic tumors and hepatic hemangioma. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. A Case of Acute Q Fever Hepatitis Diagnosed by F-18 FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Beak, Sora [Hallym Univ. College of Medicine, Seoul (Korea, Republic of); Oh, Minyoung; Lee, Sand-Oh; Yu, Eunsil; Ryu Jin-Sook [Univ. of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2012-06-15

    A 53-year-old man with fever of unknown origin underwent F-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) as a workup for a fever of unknown origin. On presentation, he complained of fever, chills, and myalgia. The F-18 FDG PET/CT scan showed diffusely increased uptake of the liver with mild hepatomegaly. A liver biopsy then revealed fibrin-ring granulomas typically seen in Q fever. The patient was later serologically diagnosed as having acute Q fever as the titers for C. IgM and IgG were 64:1 and -16:1, respectively. He recovered completely following administration of doxycycline. This indicates that F-18 FDG PET/CT may be helpful for identifying hepatic involvement in Q fever as a cause of fever of unknown origin.

  20. Anti-tumoral effect of recombinant vaccinia virus through US guided injection in a rabbit model of hepatic VX2 carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Jong Young; Park, Byeong Ho; Kang, Myong Jin; Cho, Jin Han; Choi, Jong Cheol; Choi, Sun Seob; Nam, Kyung Jin; Hwang, Tae Ho; Jeong, Jin Sook [College of Medicine, Dong-A University, Busan (Korea, Republic of)

    2006-02-15

    The purpose of this study was to evaluate the anti-tumoral effect of recombinant vaccinia virus (rVV) (Thymidine kinase (-)/GM-CSF (+)) that was administered as a US guided intratumoral injection in a rabbit model of hepatic VX2 carcinoma. VX2 carcinoma was implanted in the livers of 12 rabbits. US was performed at every week interval to detect hepatic mass after the implantation of VX2 carcinoma. The accurate tumor size and volume was evaluated with CT when the tumor was detected on US. US guided injection of rVV (10{sup 9} pfu/ml) was preformed in three rabbits, intravenous injection of the same dose of rVV was done in two rabbits and another seven rabbits that were without any treatment were selected as a control group. We evaluated the change of the hepatic tumor size and extrahepatic metastasis on serial CT. Tumor specimens were harvested from rabbits that were killed at 8 weeks after VX2 implantation. These tissues were histoimmuopathologically compared to each other (the virus injection group and the control group). The differences between these groups were statistically assessed with student t-tests. Tumor growth was significantly suppressed in the US guided injection group compared with the intravenous injection group or the control group ({rho} < 0.01). The intravenous injection group showed statistically significant tumor suppression compared to the control group ({rho} < 0.01) until 2 weeks after virus injection. Quantification of the pulmonary metastatic nodules was performed in view of both the number and volume. The average number or volume of the pulmonary metastatic nodules in the US injection group was much smaller than these in the control group. Histopathologically, the tumors of the US guided injection group showed less extensive necrosis than those of the control group. Immunohistochemically, the tumor of the US guided injection group showed more prominent infiltration of CD4 (+) and CD8 (+) lymphocytes than did the tumors of the other group

  1. CT assessment of the correlation between clinical examination and bone involvement in oral malignant tumors

    Energy Technology Data Exchange (ETDEWEB)

    Albuquerque, Marco Antonio Portela; Oliveira, Ilka Regina Souza; Cavalcanti, Marcelo Gusmao Paraiso [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Odontologia. Dept. de Radiologia], e-mail: mgpcaval@usp.br; Kuruoshi, Marcia Etsuko [Universidade de Sao Paulo (USP), SP (Brazil). Hospital Universitario. Dept. de Radiologia

    2009-07-01

    Oral cancers have a tendency to invade the surrounding bone structures, and this has a direct influence on the treatment management and on outcomes. The objective of this study was to correlate the clinical parameters (location, clinical presentation and TNM staging) of oral malignant tumors that can be associated with a potential of bone invasion and determine the accuracy of clinical examination to predict bone involvement, using computed tomography (CT). Twenty five patients, with oral malignant tumors were submitted to clinical and CT examinations. CT was considered the standard parameter to evaluate the presence of bone involvement. Clinical assessment of location, presentation form and TNM staging of the tumors were then compared to the CT findings in predicting bone involvement. Bone involvement was observed in 68% of the cases. It was predicted that tumors located in the retromolar trigone and hard palate, with a clinical aspect of infiltrative ulcer or nodule and classified in stage IV had a high potential to cause bone involvement. The clinical examination assessment of these tumors showed to be a valuable tool to predict bone invasion, with high sensitivity (82%) and specificity (87.5%), based on the results found in the CT images. No statistical significance was found between the CT and clinical examinations regarding bone involvement. The identification of some clinical parameters such as location, clinical presentation, and TNM stage, associated with a detailed clinical examination, was considered a valuable tool for the assessment of bone destruction by oral malignant tumors. (author)

  2. Analysis of enhancement pattern of sellar and parasellar tumors using two-phase helical CT

    Energy Technology Data Exchange (ETDEWEB)

    Woo, Ji Young; Na, Dong Gyu; Roh, Hong Gee; Byun, Hong Sik; Ryoo, Jae Wook [Medical School of Sungkyunkwan Univ., Seoul (Korea, Republic of)

    2002-01-01

    To assess the enhancement patterns of sellar and parasellar tumors at two-phase helical CT. Thirty-two patients with pathologically proven sellar and parasellar tumors (meningioma (n=17), pituitary mocroadenoma (n=6), neurogenic tumor (n=5), cavernous angioma (n=1), chondrosarcoma (n=1), osteosarcoma (n=1), sphenoid carcinoma (n=1)) were included in this study. Two-phase helical CT was performed after the injection of 90 mL of contrast materials at a rate of 3 mL/sec. Transverse helical CT scans were obtained during the early and late phases, with scannin dealys of 30 and 120 seconds, respectively. Delayed coronal images were obtained after delayed axial images. Attenuation change and the enhancement patterns of the tumors were visually assessed; the former was also assessed quantitatively as the ratio of the CT number at late-phase axial and coronal scanning to that at early-phase scanning. Visual assessment of two-phase helical CT images revealed decreased attenuation in all 17 meningiomas, no change in all six pituitary macroadenomas and increased attenuation in 5 all five neurogenic tumors on late-phase axial scans as compared with early phase scans. Coronal images showed decreased attenuation in all 17 meningiomas, increased attenuation in all five neurogenic tumors and no change in four pituitary macroadenomas (66.7%). The ratio of CT numbers was significantly different between meningiomas, neurogenic tumors and pituitary macroadenomas (p< 0.05). According to their histopathology, sellar and parasellar tumors showed characteristic enhancement patterns at two-phase helical CT. An analysis of the observed enhancement patterns can be useful in the differential diagnosis of juxtasellar tumors.

  3. [Evaluation of CT-Guided Percutaneous Needle Biopsy for Diagnosis of Renal Tumor].

    Science.gov (United States)

    Kato, Taiki; Sugiyama, Takayuki; Matsushita, Yuto; Suzuki, Takahisa; Motoyama, Daisuke; Matsumoto, Rikiya; Otsuka, Atsushi; Furuse, Hiroshi; Tsukui, Hiroe; Ushio, Takasuke; Nasu, Hatsuko; Ozono, Seiichiro

    2017-02-01

    We performed computed tomographic (CT)-guided percutaneous needle biopsy for renal tumors that were difficult to diagnose or were inoperable malignant renal tumors. Nineteen patients who underwent CT-guided percutaneous needle biopsy between November 2007 and March 2015 at Hamamatsu University Hospital were included in this study. The median tumor diameter was 78 mm (40-140 mm). Seventeen patients were diagnosed pathologically by biopsy, but 2 patients could not be diagnosed despite the existence of adequate sample volume. One patient had an adverse complication ; fever (CTCAE ver 4.0 grade 1). The median duration of follow-up was 21 months (0-111 months), no one had tumor seeding along a needle tract. CT-guided percutaneous needle biopsy of renal tumors is helpful for pathological diagnosis and further treatment planning. However, there are still some limitations to obtain an accurate diagnosis.

  4. Ossifying renal tumor of infancy: findings at ultrasound, CT and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Hwan; Choi, Young Hun; Kim, Woo Sun; Cheon, Jung-Eun [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Medical Research Center, The Institute of Radiation Medicine, Seoul (Korea, Republic of); Moon, Kyung Chul [Seoul National University College of Medicine, Department of Pathology, Seoul (Korea, Republic of)

    2014-05-15

    A 4-month-old boy presented with persistent gross hematuria. At ultrasonography, a 3.5-cm echogenic mass with posterior shadowing and tumor vascularity was detected within the right renal pelvis. Precontrast CT showed a slightly hyperattenuating mass in the renal pelvis. At MRI the mass was heterogeneously hypointense on T2-weighted images and isointense on T1-weighted images. Contrast-enhanced CT and MRI both revealed peripheral enhancement of the mass. A histological diagnosis of ossifying renal tumor of infancy was made after open pyelostomy and tumor enucleation. We suggest that ossifying renal tumor of infancy should be considered when a mass with posterior acoustic shadowing and tumor vascularity on US, hyperattenuation on precontrast CT and hypointensity on T2-weighted MRI is seen within the renal pelvis of an infant with hematuria. (orig.)

  5. The importance of PET/CT in the evaluation of patients with Ewing tumors

    Directory of Open Access Journals (Sweden)

    Júlio Brandão Guimarães

    2015-06-01

    Full Text Available Abstract The effective evaluation for the treatment of patients with Ewing tumors depends on the accuracy in the determination of the primary tumor extent and the presence of metastatic disease. Currently, no universally accepted staging system is available to assess Ewing tumors. The present study aimed at discussing the use of PET/CT as a tool for staging, restaging and assessment of therapeutic response in patients with Ewing tumors. In spite of some limitations of PET/CT as compared with anatomical imaging methods, its relevance in the assessment of these patients is related to the capacity of the method to provide further physiological information, which often generates important clinical implications. Currently, the assessment of patients with Ewing tumor should comprise a study with PET/CT combined with other anatomical imaging modalities, such as radiography, computed tomography and magnetic resonance imaging.

  6. Pedunculated Hepatic Hemangioma Masquerading as a Peritoneal Tumor. A Case Report.

    Science.gov (United States)

    El Hajjam, Mostafa; Lacout, Alexis; Marzouqi, Mohamed Karji-Al; Lacombe, Pascal; Marcy, Pierre Yves

    2016-01-01

    Although being classically located inside the liver parenchyma, hemangiomas may occasionally develop outside the extra-hepatic capsule, thus appearing as a pedunculated mass. We report the case of a 66-year-old anal cancer female patient presenting with an asymptomatic sub-hepatic mass. Incidental diagnosis of a pedunculated hepatic hemangioma was strongly suggested by the typical imaging features on computed tomography (CT) and magnetic resonance (MR) examinations, and was confirmed by histopathological examination. Exophytic pedunculated growth is a rare and atypical feature of hepatic hemangioma. Thin contrast- enhanced sections and multiplanar CT and MR scan reformations helped to the final diagnosis of hemangioma, showing its origin from the liver edge. Surgical resection is mandatory to prevent threatening mass pedicle torsion.

  7. Comparison of CT and MRI brain tumor imaging using a canine glioma model.

    Science.gov (United States)

    Whelan, H T; Clanton, J A; Wilson, R E; Tulipan, N B

    1988-01-01

    A canine gliosarcoma model was used to study the effectiveness of magnetic resonance imaging (MRI) with gadolinium contrast enhancement in defining the histologic margins of brain tumors. The effectiveness of this technique was compared to conventional computed tomography (CT) using iodinated contrast enhancement. Cultured canine gliosarcoma cells were injected into the left hemisphere of adult mongrel dogs. The dogs developed brain tumors and progressive clinical signs. Serial MRI with and without gadolinium diethylene triamine penta-acetic acid was compared to serial CT with and without sodium iothalamate obtained on the same days. After the final scans, animals were sacrificed; the brains were removed and processed for routine histopathologic study. All tumors were visualized with contrast-enhanced MRI which proved most sensitive. Gadolinium di-ethylene triamine penta-acetic acid caused bright enhancement of tumors in a distribution that consistently corresponded to areas of pathologically proved tumor infiltration. Gross and microscopic autopsy findings correlated better with MRI than with CT which tended to produce poorer resolution and underrepresent the size of viable tumor. Gadolinium-enhanced MRI is more accurate than unenhanced MRI, unenhanced CT, or enhanced CT in defining the histologic margins of tumors.

  8. Diffuse Hepatic Hemangiomatosis without Extrahepatic Involvement in an Adult Patient

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Hui; Park, Soo Youn; Ihn, Yon Kwon; Hwang, Seong Su [St. Vincent' s Hospital, College of Medicine, The Catholic University of Korea, Suwon (Korea, Republic of)

    2008-12-15

    We report an extremely rare case of a diffuse hepatic hemangiomatosis without extrahepatic involvement in an adult. The imaging findings of this tumor were similar to those of a hepatic hemangioma and included contrast enhancement with a centripetal filling pattern of the entire hepatic tumor on the delayed phase of a dynamic CT and inhomogeneous diffuse uptake of the entire tumor on blood-pool images obtained five hours later on a 99mTc-labeled red blood cell scan. Despite its rarity, diffuse hepatic hemangiomatosis can be suggested in adult patients with diffusely involved hepatic tumors showing the radiological findings of a hepatic hemangioma.

  9. Surgical Resection of a Leiomyosarcoma of the Inferior Vena Cava Mimicking Hepatic Tumor

    Directory of Open Access Journals (Sweden)

    Junji Ueda

    2013-01-01

    Full Text Available Introduction. Leiomyosarcomas of vascular origin are particularly rare tumors occurring mainly in the inferior vena cava (IVC. They are malignant, slow-growing tumors with a poor prognosis. This paper reports on a rare case of surgical resection of an IVC leiomyosarcoma mimicking a hepatic tumor. Case Presentation. A 65-year-old Japanese male was admitted for evaluation of an abdominal tumor. Enhanced computed tomography of the abdomen revealed a slightly enhanced heterogeneous tumor, 18 mm in diameter, between the Spiegel lobe of the liver and the IVC in early-phase images, with no enhancement or washout in late-phase images. We diagnosed this tumor as either a hepatic tumor in the Spiegel lobe or a retroperitoneal tumor such as leiomyosarcoma or liposarcoma and performed a laparotomy. On the basis of surgical findings, we extirpated the tumor by performing a wedge resection of the wall of the IVC and suturing the primary IVC wall. Pathological findings led to a further diagnosis of the tumor as a leiomyosarcoma originating in the IVC. Thirty-seven months after the operation, multiple liver and lung metastases were detected, and the patient died from multiple organic failures. Conclusion. We experienced a rare case of a leiomyosarcoma of IVC mimicking hepatic tumor.

  10. Fluorine-18 labeled amino acids for tumor PET/CT imaging.

    Science.gov (United States)

    Qi, Yiqiang; Liu, Xiaohui; Li, Jun; Yao, Huiqian; Yuan, Shuanghu

    2017-09-01

    Tumor glucose metabolism and amino acid metabolism are usually enhanced, (18)F-FDG for tumor glucose metabolism PET imaging has been clinically well known, but tumor amino acid metabolism PET imaging is not clinically familiar. Radiolabeled amino acids (AAs) are an important class of PET/CT tracers that target the upregulated amino acid transporters to show elevated amino acid metabolism in tumor cells. Radiolabeled amino acids were observed to have high uptake in tumor cells but low in normal tissues and inflammatory tissues. The radionuclides used in labeling amino acids include (15)O, (13)N, (11)C, (123)I, (18)F and (68)Ga, among which the most commonly used is (18)F [1]. Available data support the use of certain (18)F-labeled AAs for PET/CT imaging of gliomas, neuroendocrine tumors, prostate cancer and breast cancer [2, 3]. With the progress of the method of (18)F labeling AAs [4-6], (18)F-labeled AAs are well established for tumor PET/CT imaging. This review focuses on the current status of key clinical applications of 18F-labeled AAs in tumor PET/CT imaging.

  11. CT evaluation of tumorous lesion extending in and into the infratemporal fossa

    Energy Technology Data Exchange (ETDEWEB)

    Ariji, Yoshiko; Ariji, Eiichiro; Moriguchi, Shinji; Kanda, Shigenobu (Kyusyu Univ., Fukuoka (Japan). Faculty of Dentistry)

    1990-04-01

    Twenty patients with tumorous lesions extending in and into the infratemporal fossa were examined by CT at the Department of Dental Radiology, Kyusyu University Dental Hospital during the period from March, 1985 to September, 1988. They ranged in age from 6 to 75 years (mean, 52.7 years). Eleven were males. CT images of these patients were analyzed in detail and the results include: CT appearances of extension in and into the infratemporal fossa were classified into four types according to the primary site. Further, in cases of tumors originating in the oral cavity the appearances were subclassified into three types. In 17 of 20 patients (85%), bone involvement adjacent to the infratemporal fossa was detected by CT. The changes on CT images were considered to reflect clinical signs, such as trismus and sensory changes involving the fifth nerve (the second and the third division) and others. (author).

  12. Surgical Control of a Primary Hepatic Carcinoid Tumor: A Case Report

    Directory of Open Access Journals (Sweden)

    Norio Yokoigawa

    2009-04-01

    Full Text Available We report a primary hepatic carcinoid tumor occurring in a 47-year-old man. The patient consulted our hospital complaining of epigastralgia. Abdominal ultrasonography, computed tomography scanning, and magnetic resonance imaging showed a large mass in the right lobe of the liver. FDG-PET revealed 18F-FDG uptake by the right hepatic lobe. The tumor was a solid mass with cystic components, approximately 15 cm in diameter. We conducted an extended right lobectomy of the liver. The resected specimen was a solid tumor with cystic components and hemorrhagic lesion. Microscopic findings showed that the tumor cells had round nuclei and formed trabecular patterns. Immunohistologically, tumor cells were stained positive for chromogranin A, neuron specific enolase, CD56, and S-100. Careful examinations before and after the operation revealed no other possible origin of the tumor. Based on these findings, the tumor was diagnosed as a primary hepatic carcinoid. This is a report of a rare case of a primary hepatic carcinoid tumor with a discussion of several other relevant reports.

  13. Laparoscopic resection of isolated hepatic splenosis mimicking liver tumors: case report with a literature review.

    Science.gov (United States)

    Liu, Kun; Liang, Yuelong; Liang, Xiao; Yu, Hong; Wang, Yifan; Cai, Xiujun

    2012-10-01

    Isolated hepatic splenosis is a rare condition in hepatobiliary surgery. In this study, we report a case of this condition managed by laparoscopic surgery. A 38-year-old male hepatitis B virus carrier, who had a motorcycle accident and splenectomy 14 years before the current incident, was hospitalized due to a hepatic mass. His laboratory tests were consistent with a hyposplenic state, whereas radiologic images revealed a benign tumor in the left liver lobe located in a site difficult to access with preoperative biopsy. Therefore, we performed a laparoscopic exploration and total resection, which revealed a bluish oval encapsulated nodule in the narrow gap between the diaphragm, falciform ligament, and left hepatic capsule. The pathologic diagnosis was hepatic splenosis. Unlike other patients with multiple intraperitoneal lesions and relatively normal splenism, this is the first case of isolated hepatic splenosis with evident hyposplenism managed by laparoscopic approach in the English literature.

  14. Hybrid opto-electronic processor for the delineation of tumors of the liver from CT-Scan images

    Science.gov (United States)

    Fasquel, Jean-Baptiste; Bruynooghe, Michel M.; Meyrueis, Patrick

    2001-12-01

    In order to help hepatic surgery planning, an unsupervised method is needed to automate the delineation of liver tumors. Moreover, due to the large amount of images acquired by Computer Tomography Scanner (CT-Scan), the processing has to be fast for a clinical use. Current methods are based on filterings and have the drawback of being time consuming. In this paper, to reach the purpose of speed and quality, we propose a fast unsupervised method which is implementable on an opto-electronical processor. The proposed method is based on the expansion/compression paradigm and combines a multiresolution approach with the principal component analysis (PCA). The multiresolution representation is done by several Gaussian filterings. The compression of the expanded information is then achieved by only keeping the first PCA factorial image. Endly, the object of interest is detected and delineated using the standard valley thresholding technique which is applied to the first factorial image. For the delineation of liver tumors, regions of interest (ROI) containing tumors have been preliminary extracted before applying PCA. Experimental results obtained by the processing of difficult clinical cases show, according to the radiologist experts, that our method is able to efficiently delineate liver tumors. Because Gaussian filterings are time consuming when carried out on a digital processor, we propose to implement them on an optical correlator. Clinical cases have been processed using the resulting opto-electronical processor to show the feasibility of such an implementation.

  15. Percutaneous radiofrequency ablation for hepatic tumors abutting the diaphragm: clinical assessment of the heat-sink effect of artificial ascites.

    Science.gov (United States)

    Nam, Sang Yu; Rhim, Hyunchul; Kang, Tae Wook; Lee, Min Woo; Kim, Young-Sun; Choi, Dongil; Lee, Won Jae; Park, Yulri; Chang, Ilsoo; Lim, Hyo K

    2010-02-01

    This study was designed to assess whether artificial ascites has a heat-sink effect on the ablation zone for percutaneous radiofrequency ablation (RFA) of hepatic tumors abutting the diaphragm. We retrospectively assessed 28 patients who underwent percutaneous RFA for the treatment of a single nodular hepatic tumor that abutted the diaphragm from July 2000 to December 2006. All patients underwent ultrasound-guided RFA using internally cooled electrodes. A single ablation for 12 minutes was applied using 3-cm active-tip electrodes. We divided patients into two groups on the basis of whether artificial ascites was introduced before RFA: Group A consisted of patients who received artificial ascites with a mean of 760 mL of a 5% dextrose in water solution (n = 15) and group B consisted of patients who did not receive artificial ascites (n = 13). The volume of the ablation zone was measured on CT images obtained immediately after the ablation procedure, and imaging findings were compared for both groups using the Student's t test. We also compared the local tumor progression rate between both groups using the chi-square test (mean follow-up, 37.4 months). There was no significant difference between the two patient groups with regard to age, sex, Child-Pugh class, or tumor location (p > 0.05). The tumors were significantly smaller in group A patients (mean +/- SD, 1.6 +/- 0.5 cm) than in group B patients (2.1 +/- 0.7 cm) (p = 0.019). The mean volume of the RFA zone was 31.6 +/- 11.9 cm(3) in group A patients and 30.9 +/- 11.0 cm(3) in group B patients. There was no significant difference between the groups in the ablation volume (p = 0.871). Local tumor progression was noted in four patients (26.7%) in group A and in three patients (23.1%) in group B. There was no significant difference in the local tumor progression rate between the two groups (p = 0.83). Artificial ascites did not show a heat-sink effect on the volume of the ablation zone after percutaneous RFA for the

  16. Tumor volume assessment by 18F-FDG PET/CT in patients with oral cavity cancer with dental artifacts on CT or MR images.

    Science.gov (United States)

    Baek, Chung-Hwan; Chung, Man Ki; Son, Young-Ik; Choi, Joon Young; Kim, Hyung-Jin; Yim, Yoo Jeong; Ko, Young Hyeh; Choi, Jeesun; Cho, Jae Keun; Jeong, Han-Sin

    2008-09-01

    The purpose of this study was to investigate the clinical usefulness of PET/CT or CT-attenuated PET in the evaluation of patients with oral cavity cancer (OCC) in whom dental artifacts distorted the conventional CT or MR images of the oral cavity. A PET/CT scan, in addition to a CT or MRI scan, was performed in 69 patients with OCC who had dentures or dental implants. A total of 64 PET/CT, 64 CT, and 27 MR images were analyzed including images from scans performed on 40 patients with OCC without dental artifacts on the conventional images; these were used for comparison. The CT-attenuated PET scan for the detection of primary tumors was compared with the CT or MRI scan. We also evaluated the correlation between the PET/CT volume and the pathologic volume using a regression analysis. In addition, subgroup analysis was performed to determine what proportion of subjects benefited most from the PET/CT. CT-attenuated PET detected more primary tumors than did CT in patients with OCC with dental artifacts (95.3% vs. 75.0%, respectively; P=0.0016). PET/CT volume with a standardized uptake value (SUV) cutoff point of 3.5 predicted the pathologic volume more accurately than did the other cutoff points in patients with OCC with or without artifacts. After comparing pathologic volume and PET/CT(SUV 3.5) volume, the following regression equation was developed: log (pathologic volume)=0.6 x log (PET/CT(SUV 3.5) volume) + 1.3 (R(2) = 0.42, Pdental artifacts on the conventional imaging, PET/CT could provide useful clinical information about the primary tumors, particularly in cases with advanced tumors.

  17. Autoradiographic and histopathological studies of boric acid-mediated BNCT in hepatic VX2 tumor-bearing rabbits: Specific boron retention and damage in tumor and tumor vessels.

    Science.gov (United States)

    Yang, C H; Lin, Y T; Hung, Y H; Liao, J W; Peir, J J; Liu, H M; Lin, Y L; Liu, Y M; Chen, Y W; Chuang, K S; Chou, F I

    2015-12-01

    Hepatoma is a malignant tumor that responds poorly to conventional therapies. Boron neutron capture therapy (BNCT) may provide a better way for hepatoma therapy. In this research, (10)B-enriched boric acid (BA, 99% (10)B) was used as the boron drug. A multifocal hepatic VX2 tumor-bearing rabbit model was used to study the mechanisms of BA-mediated BNCT. Autoradiography demonstrated that BA was selectively targeted to tumors and tumor vessels. Histopathological examination revealed the radiation damage to tumor-bearing liver was concentrated in the tumor regions during BNCT treatment. The selective killing of tumor cells and the destruction of the blood vessels in tumor masses may be responsible for the success of BA-mediated BNCT for liver tumors. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Identification of intra-hepatic communicating veins through the arch sign on CT-scan.

    Science.gov (United States)

    Morel, Alexandre; Rivoire, Michel; Basso, Valéria; Meeus, Pierre; Peyrat, Patrice; Dupré, Aurélien

    2017-06-01

    Knowledge of vascular outflow is essential in liver surgery. Communicating veins between the right hepatic vein (RHV) and the middle hepatic vein (MHV) have been described and allowed us to perform new surgical procedures. The aim of this study was to predict the existence of intra-hepatic venous anastomosis by identifying communicating veins on 2D CT-scan imaging. We retrospectively analysed data from 32 patients operated on for liver tumours between 2004 and 2013 who underwent a bisegmentectomy VI-VII enlarged to the RHV and/or a bisegmentectomy VII-VIII and/or a left hepatectomy enlarged to the MHV and who had pre and post-operative CT-scans. Patients with cirrhosis were excluded. We first analysed post-operative images and, in patients with a proven collateral vein, looked for evidence of this on pre-operative imaging. We then validated this pre-operative sign against post-operative imaging. Collaterals from both the RHV and the MHV formed an arch visible on pre-operative imaging which predicted the development of intrahepatic venous anastomosis in 20 patients. In 14 patients, a perfect match between the arch sign and development of collaterals was observed (n = 28). Sensitivity, specificity, negative and positive predictive values were 87, 80, 80, and 87%, respectively. Positive and negative likelihood ratio tests were 4.3 and 0.16, respectively. Communicating veins between the RHV and the MHV are frequent and can be predicted by the arch sign on 2D CT-scan. Hence the arch sign can be very useful when planning liver surgery.

  19. A new procedure of percutaneous microwave coagulation therapy under artificial hydrothorax for patients with liver tumors in the hepatic dome.

    Science.gov (United States)

    Shimada, S; Hirota, M; Beppu, T; Shiomori, K; Marutsuka, T; Matsuo, A; Tanaka, E; Ogawa, M

    2001-01-01

    Percutaneous microwave coagulation therapy (PMCT) has been widely used as an effective minimal invasive therapy for small liver tumors. The occurrence of a sonographic masked space due to the presence of the lung, however, has become a major obstacle to visualizing the whole tumor in the hepatic dome. To facilitate the use of PMCT for liver tumors in the hepatic dome, we developed PMCT in combination with the artificial hydrothorax method (percutaneous transdiaphragmatic MCT: PTD-MCT). Our new approach for PMCT to the hepatic tumors located in Couinaud's segments VIII or VII just under the diaphragm resulted in a successful treatment. The separation of the lung from the diaphragm by the infusion of saline into the pleural cavity enabled us not only to visualize the whole tumor in the hepatic dome to accurately target the tumor, but also helped us to avoid injuring the lung. PTD-MCT is therefore strongly recommended for the treatment of liver tumors in the hepatic dome.

  20. PET/MR Outperforms PET/CT in Suspected Occult Tumors.

    Science.gov (United States)

    Sekine, Tetsuro; Barbosa, Felipe de Galiza; Sah, Bert-Ram; Mader, Cäcilia E; Delso, Gaspar; Burger, Irene A; Stolzmann, Paul; Ter Voert, Edwin E; von Schulthess, Gustav K; Veit-Haibach, Patrick; Huellner, Martin W

    2017-02-01

    To compare the diagnostic accuracy of PET/MR and PET/CT in patients with suspected occult primary tumors. This prospective study was approved by the institutional review board. Sequential PET/CT-MR was performed in 43 patients (22 male subjects; median age, 58 years; range, 20-86 years) referred for suspected occult primary tumors. Patients were assessed with PET/CT and PET/MR for the presence of a primary tumor, lymph node metastases, and distant metastases. Wilcoxon signed-rank test was performed to compare the diagnostic accuracy of PET/CT and PET/MR. According to the standard of reference, a primary lesion was found in 14 patients. In 16 patients, the primary lesion remained occult. In the remaining 13 patients, lesions proved to be benign. PET/MR was superior to PET/CT for primary tumor detection (sensitivity/specificity, 0.85/0.97 vs 0.69/0.73; P = 0.020) and comparable to PET/CT for the detection of lymph node metastases (sensitivity/specificity, 0.93/1.00 vs 0.93/0.93; P = 0.157) and distant metastases (sensitivity/specificity, 1.00/0.97 vs 0.82/1.00; P = 0.564). PET/CT tended to misclassify physiologic FDG uptake as malignancy compared with PET/MR (8 patients vs 1 patient). PET/MR outperforms PET/CT in the workup of suspected occult malignancies. PET/MR may replace PET/CT to improve clinical workflow.

  1. Automatic Lung Tumor Segmentation on PET/CT Images Using Fuzzy Markov Random Field Model

    Directory of Open Access Journals (Sweden)

    Yu Guo

    2014-01-01

    Full Text Available The combination of positron emission tomography (PET and CT images provides complementary functional and anatomical information of human tissues and it has been used for better tumor volume definition of lung cancer. This paper proposed a robust method for automatic lung tumor segmentation on PET/CT images. The new method is based on fuzzy Markov random field (MRF model. The combination of PET and CT image information is achieved by using a proper joint posterior probability distribution of observed features in the fuzzy MRF model which performs better than the commonly used Gaussian joint distribution. In this study, the PET and CT simulation images of 7 non-small cell lung cancer (NSCLC patients were used to evaluate the proposed method. Tumor segmentations with the proposed method and manual method by an experienced radiation oncologist on the fused images were performed, respectively. Segmentation results obtained with the two methods were similar and Dice’s similarity coefficient (DSC was 0.85 ± 0.013. It has been shown that effective and automatic segmentations can be achieved with this method for lung tumors which locate near other organs with similar intensities in PET and CT images, such as when the tumors extend into chest wall or mediastinum.

  2. CT diagnosis of sellar and juxtasellar lesions, 3. Non-tumorous lesions

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Tatsuya (Nagoya Univ. (Japan). Faculty of Medicine)

    1982-08-01

    A study is made of the usefulness and limitations of the CT diagnosis of sellar and juxtasellar lesions other than tumors. This study is based on 112 verified cases at Nagoya University Hospital from October, 1976, to December, 1981. The lesions included in this study are classified into four groups: vascular, inflammatory, traumatic lesion, and congenital anomaly. Although cerebral angiography is the cardinal method for the diagnosis of vascular lesions, CT is useful for the evaluation of a giant aneurysm, the localization of bleeding, or infarction by a ruptured aneurysm. Radiation brain necrosis, a special form of vascular lesion, can also be diagnosed if the critical analysis is made after previous irradiation. CT findings are helpful for the local diagnosis of acute inflammatory lesions, such as basal meningitis or abscess, but specific diagnosis is made on the basis of clinical signs and CSF study. Abnormal CT findings are obtained from a chronic inflammatory process, such as arachnoiditis adhesiva, glanuloma, or mucocele. Differential diagnosis is necessary with brain tumors. The CT findings of an arachnoid cyst are often diagnostic. Metrizamide or air cisternography, either combined with CT or without it, is important for the diagnosis of basal meningoencephalocele and hypothalamic hamaroma. Pneumocephalus and an intracranial foreign body resulting from a head injury can be diagnosed by plain skull and CT. The diagnosis of CSF leakage or prolapse cerebri associated with a skull-base fracture has been most difficult, but even it is possible by a combination of polytomography and high-resolution CT with metrizamide cisternography.

  3. The effect of housing temperature on the growth of CT26 tumor expressing fluorescent protein EGFP

    Science.gov (United States)

    Yuzhakova, Diana V.; Shirmanova, Marina V.; Lapkina, Irina V.; Serebrovskaya, Ekaterina O.; Lukyanov, Sergey A.; Zagaynova, Elena V.

    2016-04-01

    To date, the effect of housing temperature on tumor development in the immunocompetent mice has been studied on poorly immunogenic cancer models. Standard housing temperature 20-26°C was shown to cause chronic metabolic cold stress and promote tumor progression via suppression of the antitumor immune response, whereas a thermoneutral temperature 30-31°C was more preferable for normal metabolism of mice and inhibited tumor growth. Our work represents the first attempt to discover the potential effect of housing temperature on the development of highly immunogenic tumor. EGFP-expressing murine colon carcinoma CT26 generated in Balb/c mice was used as a tumor model. No statistically significant differences were shown in tumor incidences and growth rates at 20°C, 25°C and 30°C for non-modified CT26. Maintaining mice challenged with CT26-EGFP cells at 30°C led to complete inhibition of tumor development. In summary, we demonstrated that the housing temperature is important for the regulation of growth of highly immunogenic tumors in mice through antitumor immunity.

  4. Supratentorial primary intra-axial tumors in children. MR and CT evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Higano, S.; Takahashi, S.; Kurihara, N.; Singh, L.N.; Yamada, S. [Tohoku Univ., School of Medicine, Sendai (Japan). Dept. of Radiology; Ishii, K. [Sendai Municipal Hospital (Japan). Dept. of Radiology; Matsumoto, K. [Miyagi Cancer Center, Natori (Japan). Dept. of Radiology; Shirane, R. [Tohoku Univ., School of Medicine, Sendai (Japan). Dept. of Neurosurgery; Katakura, R. [Miyagi Cancer Center, Natori (Japan). Dept. of Neurosurgery

    1997-11-01

    Purpose: To evaluate the MR and CT features of pediatric supratentorial intra-axial tumors with respect to different diagnosis and the role of each investigation modality. Material and Methods: MR and CT findings in 40 children with 12 types of pathologically proven histological tumors were reviewed. Results: The location of tumors might be one clue to differential diagnosis. In our material, cysts (60%), calcifications (45%), and intratumoral hemorrhages (27%) were found in the tumors. Characteristic features noted in some lesions included: peritumoral hemosiderin deposition in cavernous angiomas; intratumoral flow void in a choroid plexus carcinoma and in glioblastomas; and hemicerebral atrophy in germinomas. A comparison between malignant and benign tumors showed perifocal edema and a mass effect to be signifcantly more common in malignant lesions. Homogeneous enhancement suggested a benign tumor and an inhomogeneous pattern represented malignancy, while the lack of obvious enhancement did not always suggest benignity. Intratumoral calcium deposition was a not uncommon finding in malignant tumors. Conclusion: In most cases, the exact diagnosis should be made hy histological examination but it is important for treatment planning that the appropriate depiction of tumor extension and tissue characterization be made by MR and CT. (orig.).

  5. Dual tracer functional imaging of gastroenteropancreatic neuroendocrine tumors using 68Ga-DOTA-NOC PET-CT and 18F-FDG PET-CT: competitive or complimentary?

    Science.gov (United States)

    Naswa, Niraj; Sharma, Punit; Gupta, Santosh Kumar; Karunanithi, Sellam; Reddy, Rama Mohan; Patnecha, Manish; Lata, Sneh; Kumar, Rakesh; Malhotra, Arun; Bal, Chandrasekhar

    2014-01-01

    This study aimed to compare the diagnostic performance of Ga-DOTANOC PET/CT with F-FDG PET/CT in the patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs). Data of 51 patients with definite histological diagnosis of GEP-NET who underwent both Ga-DOTA-NOC PET-CT and F-FDG PET-CT within a span of 15 days were selected for this retrospective analysis. Sensitivity, specificity, and predictive values were calculated for Ga-DOTA-NOC PET-CT and F-FDG PET-CT, and results were compared both on patientwise and regionwise analysis. Ga-DOTA-NOC PET-CT is superior to F-FDG PET-CT on patientwise analysis (P NOC PET-CT is superior to F-FDG PET-CT only for lymph node metastases (P NOC PET-CT detected more liver and skeletal lesions compared with F-FDG PET-CT, the difference was not statistically significant. In addition, the results of combined imaging helped in selecting candidates who would undergo the appropriate mode of treatment, whether octreotide therapy or conventional chemotherapy Ga-DOTA-NOC PET-CT seems to be superior to F-FDG PET-CT for imaging GEP-NETs. However, their role seems to be complementary because combination of Ga-DOTA-NOC PET-CT and F-FDG PET-CT in such patients helps demonstrate the total disease burden and segregate them to proper therapeutic groups.

  6. The impact of share wave elastography in differentiation of hepatic hemangioma from malignant liver tumors in pediatric population

    Energy Technology Data Exchange (ETDEWEB)

    Özmen, Evrim, E-mail: evrimkilicdr@gmail.com [Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, 34300, Kocamustafapasa, Istanbul (Turkey); Adaletli, İbrahim, E-mail: iadaletli@yahoo.com [Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, 34300, Kocamustafapasa, Istanbul (Turkey); Kayadibi, Yasemin, E-mail: ysmnkurdoglu@gmail.com [Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, 34300, Kocamustafapasa, Istanbul (Turkey); Emre, Şenol, E-mail: senolemre@hotmail.com [Department of Pediatric Surgery, Cerrahpasa Medical Faculty, Istanbul University, 34300, Kocamustafapasa, Istanbul (Turkey); Kılıç, Fahrettin, E-mail: fahrettinkilic@hotmail.com [Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, 34300, Kocamustafapasa, Istanbul (Turkey); Dervişoğlu, Sergülen, E-mail: selozmen@gmail.com [Department of Pathology, Cerrahpasa Medical Faculty, Istanbul University, 34300, Kocamustafapasa, Istanbul (Turkey); Kuruğoğlu, Sebuh, E-mail: sebuhk@yahoo.com [Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, 34300, Kocamustafapasa, Istanbul (Turkey); Şenyüz, Osman Faruk, E-mail: ofsenyuz@gmail.com [Department of Pediatric Surgery, Cerrahpasa Medical Faculty, Istanbul University, 34300, Kocamustafapasa, Istanbul (Turkey)

    2014-09-15

    Highlights: • We evaluated the impact of share wave elastography technique in differentiation hepatic hemangiomas from malignant liver tumors in pediatric population. • Share wave technique can increase the diagnostic capability of conventional ultrasonography in the differential diagnosis of liver tumors in children. • Share wave elastography is a potential adjunctive diagnostic technique for pediatric liver tumors. - Abstract: Objective: In children it is crucial to differentiate malignant liver tumors from the most common benign tumor, hepatic hemangiomas since the treatment strategies are quite different. We aimed to evaluate the efficiency of shear wave elastography (SWE) technique in differentiation of malignant hepatic tumors and hepatic hemangiomas. Methods: Twenty patients with hepatic tumor were included in our study. Two radiologists performed SWE for 13 patients with malignant hepatic tumors including hepatoblastoma (n = 7), hepatocellular carcinoma (n = 3), metastasis (n = 2), embryonal sarcoma (n = 1) and 7 patients with hepatic hemangioma. All of our patients were between the age of 1 and 192 months (mean age: 56.88 months). Receiver operating characteristic analysis was achieved to evaluate the diagnostic accuracy of SWE and to determine the optimal cut-off value in differentiation hepatic hemangioma from malignant hepatic tumors. Results: The mean SWE values (in kPa) for the first observer were 46.94 (13.8–145) and 22.38 (6.6–49.6) and those for the second observer were 57.91 (11–237) and 23.87 (6.4–57.5), respectively for malignant hepatic tumors and hepatic hemangiomas. The SWE values of malignant hepatic tumors were significantly higher than those of hepatic hemangioma (p = 0.02). The inter-observer agreement was almost perfect (0.81). The area under the receiver operating characteristic curve of SWE for differentiating the hepatic hemangioma from malignant hepatic tumors was 0.77 with a sensitivity of 72.7% and a specificity of 66

  7. CT staging and preoperative assessment of resectability for thymic epithelial tumors

    Science.gov (United States)

    Shen, Yan; Gu, Zhitao; Ye, Jianding; Mao, Teng; Chen, Wenhu

    2016-01-01

    Background The aim of this study was to determine the computed tomography (CT) features potentially helpful for accurate staging and predicting resectability of thymic epithelial tumors (TET). Methods One hundred and thirty-eight consecutive TET patients undergoing surgical resection from April 2010 to November 2011 were prospectively entered into a database. All patients were staged according to the Masaoka-Koga staging system. The relationship between CT features with tumor staging and complete resection was reviewed after surgery. Results Surgico-pathological staging was stage I in 63, stage II in 32, stage III in 32, and stage IV in 11 patients. Preoperative CT staging was highly consistent with postoperative surgico-pathological staging (Kappa =0.525). Tumor shape, contour, enhancement, with or without invasion of the adjacent structures (mediastinal fat, mediastinal pleura, lung, pericardium, mediastinal vessels, phrenic nerve), and presence of pleural, pericardial effusionor intrapulmonary metastasis were correlated with Masaoka-Koga staging (P0.05). Tumor size, presence of calcification and mediastinal lymph node enlargement were not correlated with complete tumor resection (P>0.05). Tumor shape, contour, internal density, enhancement pattern, and invasion of adjacent structures were related to complete resection of the primary tumor in univariate analysis (P<0.05). However, upon multivariate logistic regression, only absence of artery systems invasion was predictive of complete resection (P<0.05). Conclusions Clinical staging of TET could be accurately evaluated with CT features including tumor shape, contour, enhancement pattern, with or without invasion of adjacent structures, and presence of pleural, pericardial effusion or intrapulmonary metastasis. Absence of arterial system invasion on CT was the only predictive feature for predicting complete resection of TET. PMID:27114831

  8. A massive hepatic tumor demonstrating hepatocellular, cholangiocarcinoma and neuroendocrine lineages: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Rachel E. Beard

    2017-01-01

    Conclusion: This is one of the only reports of a hepatic tumor arising from hepatocellular carcinoma, cholangiocarcinoma and neuroendocrine lineages. Increased awareness of this tumor type may optimize improve future management.

  9. CT findings of gallbladder metastases: Emphasis on differences according to primary tumors

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Won Seok; Kim, Se Hyung; Lee, Eun Sun; Lee, Kyoung Bun; Shin, Cheong Il; Han, Joon Koo [Seoul National University Hospital, Seoul (Korea, Republic of); Yoon, Won Jae [Dept. of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

    2014-06-15

    To describe computed tomography (CT) features of metastatic gallbladder (GB) tumors (Mts) from various primary tumors and to determine whether there are differential imaging features of Mts according to different primary tumors. Twenty-one patients who had pathologically confirmed Mts and underwent CT were retrospectively enrolled. Clinical findings including presenting symptoms, type of surgery, and interval between primary and metastatic tumors were recorded. Histologic features of primary tumor and Mts including depth of invasion were also reviewed. Imaging findings were analyzed for the location and morphology of Mts, pattern and degree of enhancement, depth of invasion, presence of intact overlying mucosa, and concordance between imaging features of primary and metastatic tumors. Significant differences between the histologist of Mts and imaging features were determined. The most common primary tumor metastasized to the GB was gastric cancer (n = 8), followed by renal cell carcinoma (n = 4) and hepatocellular carcinoma (n = 3). All Mts (n = 21) manifested as infiltrative wall thickenings (n = 15) or as polyploid lesions (n = 6) on CT, similar to the features of primary GB cancers. There were significant differences in the morphology of Mts, enhancement pattern, enhancement degree, and depth of invasion according to the histology of primary tumors (p < 0.05). Metastatic adenocarcinomas of the GB manifested as infiltrative and persistently enhancing wall thickenings, while non-adenocarcinomatous metastases usually manifested as polypoid lesions with early wash-in and wash-out. Although CT findings of MGTs are similar to those of primary GB cancer, they are significantly different between the various histologies of primary tumors.

  10. Gastroenteropancreatic Neuroendocrine Tumors: Standardizing Therapy Monitoring with 68Ga-DOTATOC PET/CT Using the Example of Somatostatin Receptor Radionuclide Therapy

    Directory of Open Access Journals (Sweden)

    Wolfgang Luboldt

    2010-11-01

    Full Text Available The purpose of this study was to standardize therapy monitoring of hepatic metastases from gastroenteropancreatic neuroendocrine tumors (GEP-NETs during the course of somatostatin receptor radionuclide therapy (SRRT. In 21 consecutive patients with nonresectable hepatic metastases of GEP-NETs, chromogranin A (CgA and 68Ga-DOTATOC PET/CT were compared before and after the last SRRT. On 68Ga-DOTATOC PET/CT, the maximum standard uptake values (SUVmax of normal liver and hepatic metastases were calculated. In addition, the volumes of hepatic metastases (volume of interest [VOI] were measured using four cut-offs to separate normal liver tissue from metastases (SUVmax of the normal liver plus 10% [VOIliver+10%], 20% [VOIliver+20%], 30% [VOIliver+30%] and SUV = 10 [VOI10SUV]. The SUVmaxof the normal liver was below 10 (7.2 ± 1.3 in all patients and without significant changes. Overall therapy changes (Δ per patient (mean [95% CI] were statistically significant with p < .01 for ΔCgA = −43 (−69 to −17, ΔSUVmax = −22 (−29 to −14, and ΔVOI10SUV = −53 (−68 to −38% and significant with p < .05 for ΔVOIliver+10% = −29 (−55 to −3%, ΔVOIliver+20% = −32 (−62 to −2 and ΔVOIliver+30% = −37 (−66 to −8. Correlations were found only between ΔCgA and ΔVOI10SUV (r = .595; p < .01, ΔSUVmax and ΔVOI10SUV (0.629, p < .01, and SUVmax and ΔSUVmax (r = .446; p < .05. 68Ga-DOTATOC PET/CT allows volumetric therapy monitoring via an SUV-based cut-off separating hepatic metastases from normal liver tissue (10 SUV recommended.

  11. Differentiation of large (≥5 cm) gastrointestinal stromal tumors from benign subepithelial tumors in the stomach: Radiologists’ performance using CT

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Ye Ra [Department of Radiology, Seoul National University Hospital (Korea, Republic of); Kim, Se Hyung, E-mail: shkim7071@gmail.com [Department of Radiology, Seoul National University Hospital (Korea, Republic of); The Institute of Radiation Medicine, Seoul National University Hospital (Korea, Republic of); Kim, Sun-Ah [Department of Radiology, Seoul National University Hospital (Korea, Republic of); Shin, Cheong-il [Department of Radiology, Seoul National University Hospital (Korea, Republic of); The Institute of Radiation Medicine, Seoul National University Hospital (Korea, Republic of); Kim, Hyung Jin; Kim, Seong Ho [Department of Radiology, Seoul National University Hospital (Korea, Republic of); Han, Joon Koo; Choi, Byung Ihn [Department of Radiology, Seoul National University Hospital (Korea, Republic of); The Institute of Radiation Medicine, Seoul National University Hospital (Korea, Republic of)

    2014-02-15

    Purpose: To identify significant CT findings for the differentiation of large (≥5 cm) gastric gastrointestinal stromal tumors (GIST) from benign subepithelial tumors and to assess whether radiologists’ performance in differentiation is improved with knowledge of significant CT criteria. Materials and methods: One-hundred twenty patients with pathologically proven large (≥5 cm) GISTs (n = 99), schwannomas (n = 16), and leiomyomas (n = 5) who underwent CT were enrolled. Two radiologists (A and B) retrospectively reviewed their CT images in consensus for the location, size, degree and pattern of enhancement, contour, growth pattern and the presence of calcification, necrosis, surface ulceration, or enlarged lymph nodes. CT findings considered significant for differentiation were determined using uni- and multivariate statistical analyses. Thereafter, two successive review sessions for the differentiation of GIST from non-GIST were independently performed by two other reviewers (C and D) with different expertise of 2 and 9 years using a 5-point confidence scale. At the first session, reviewers interpreted CT images without knowledge of significant CT findings. At the second session, the results of statistical analyses were provided to the reviewers. To assess improvement in radiologists’ performance, a pairwise comparison of receiver operating curves (ROC) was performed. Results: Heterogeneous enhancement, presence of necrosis, absence of lymph nodes, and mean size of ≥6 cm were found to be significant for differentiating GIST from schwannoma (P < 0.05). Non-cardial location, heterogeneous enhancement, and presence of necrosis were differential CT features of GIST from leiomyoma (P < 0.05). Multivariate analyses indicated that absence of enlarged LNs was the only statistically significant variable for GIST differentiating from schwannoma. The area under the curve of both reviewers obtained using ROC significantly increased from 0.682 and 0.613 to 0.903 and 0

  12. Detection of preoperative wilms tumor rupture with CT: a report from the Children's Oncology Group.

    Science.gov (United States)

    Khanna, Geetika; Naranjo, Arlene; Hoffer, Fredric; Mullen, Elizabeth; Geller, James; Gratias, Eric J; Ehrlich, Peter F; Perlman, Elizabeth J; Rosen, Nancy; Grundy, Paul; Dome, Jeffrey S

    2013-02-01

    To retrospectively determine the diagnostic performance of computed tomography (CT) in identifying the presence or absence of preoperative Wilms tumor rupture. The cohort was derived from the AREN03B2 study of the Children's Oncology Group. The study was approved by the institutional review board and was compliant with HIPAA. Written informed consent was obtained before enrollment. The diagnosis of Wilms tumor rupture was established by central review of notes from surgery and/or pathologic examination. Seventy Wilms tumor cases with rupture were matched to 70 Wilms tumor controls without rupture according to age and tumor weight (within 6 months and 50 g, respectively). CT scans were independently reviewed by two radiologists, and the following CT findings were assessed: poorly circumscribed mass, perinephric fat stranding, peritumoral fat planes obscured, retroperitoneal fluid (subcapsular vs extracapsular), ascites beyond the cul-de-sac, peritoneal implants, ipsilateral pleural effusion, and intratumoral hemorrhage. All fluids were classified as hemorrhagic or nonhemorrhagic by using a cutoff of 30 HU. The relationship between CT findings and rupture was assessed with logistic regression models. The sensitivity and specificity for detecting Wilms tumor rupture were 54% (36 of 67 cases) and 88% (61 of 69 cases), respectively, for reviewer 1 and 70% (47 of 67 cases) and 88% (61 of 69 cases), respectively, for reviewer 2. Interobserver agreement was substantial (ĸ = 0.76). All imaging signs tested, except peritoneal implants, intratumoral hemorrhage, and subcapsular fluid, showed a significant association with rupture (P ≤ .02). The attenuation of ascitic fluid did not have a significant correlation with rupture (P = .9990). Ascites beyond the cul-de-sac was the single best indicator of rupture for both reviewers, followed by perinephric fat stranding and retroperitoneal fluid for reviewers 1 and 2, respectively (P < .01). CT has moderate specificity but

  13. Hepatic trauma: CT findings and considerations based on our experience in emergency diagnostic imaging

    Energy Technology Data Exchange (ETDEWEB)

    Romano, Luigia; Giovine, Sabrina; Guidi, Guido; Tortora, Giovanni; Cinque, Teresa; Romano, Stefania E-mail: stefromano@libero.it

    2004-04-01

    Abdominal blunt trauma represents the main cause of death in people of age less than 40 years; the liver injury occurs frequently, with an incidence varying from 3 to 10%. Isolated hepatic lesions are rare and in 77-90% of cases, lesions of other organs and viscera are involved. Right hepatic lobe is a frequent site of injury, because it is the more voluminous portion of liver parenchyma; posterior superior hepatic segments are proximal to fixed anatomical structures such as ribs and spine that may have an important role in determining of the lesion. The coronal ligaments' insertion in this parenchymal region augments the effect of acceleration-deceleration mechanism. Associated lesions usually are homolateral costal fractures, laceration or contusion of the inferior right pulmonary lobe, haemothorax, pneumothorax, renal and/or adrenal lesions. Traumatic lesions of left hepatic lobe are rare and usually associated with direct impact on the superior abdomen, such as in car-crash when the wheel causes a compressive effect on thorax and abdomen. Associated lesions to left hepatic lobe injuries correlated to this mechanism are: sternal fractures, pancreatic, myocardial, gastrointestinal tract injuries. Lesions of the caudal lobe are extremely rare, usually not isolated and noted with other large parenchymal lesions. The Institution of Specialized Trauma Centers and the technical progress in imaging methodology developed in the last years a great reduction of mortality. New diagnostic methodologies allow a reduction of negatives laparotomies and allow the possibility of conservative treatment of numerous traumatic lesions; however, therapy depends from imaging findings and clinical conditions of the patient. Computed tomography (CT) certainly presents a large impact on diagnosis and management of patients with lesions from blunt abdominal traumas. It is important to establish a prognostic criteria allowing decisions for conservative or surgical treatment; CT

  14. Improving diagnosis of tumor-induced osteomalacia with Gallium-68 DOTATATE PET/CT.

    Science.gov (United States)

    Clifton-Bligh, Roderick J; Hofman, Michael S; Duncan, Emma; Sim, Ie-Wen; Darnell, David; Clarkson, Adele; Wong, Tricia; Walsh, John P; Gill, Anthony J; Ebeling, Peter R; Hicks, Rodney J

    2013-02-01

    Tumor-induced osteomalacia (TIO) is a rarely diagnosed disorder presenting with bone pain, fractures, muscle weakness, and moderate-to-severe hypophosphatemia resulting from fibroblast growth factor 23-mediated renal phosphate wasting. Tumors secreting fibroblast growth factor 23 are often small and difficult to find with conventional imaging. We studied the utility of (68)Ga-DOTA-octreotate (DOTATATE) somatostatin receptor positron emission tomography (PET)/computed tomography (CT) imaging in the diagnosis of TIO. A multicenter case series was conducted at tertiary referral hospitals. Six patients with TIO diagnosed between 2003 and 2012 in Australia were referred for DOTATATE PET imaging. We reviewed the clinical history, biochemistry, imaging characteristics, histopathology, and clinical outcome of each patient. Each case demonstrated delayed diagnosis despite severe symptoms. DOTATATE PET/CT imaging demonstrated high uptake and localized the tumor with confidence in each case. After surgical excision, there was resolution of clinical symptoms and serum phosphate, except in one patient who demonstrated residual disease on PET/CT. All tumors demonstrated high somatostatin receptor subtype 2 cell surface receptor expression using immunohistochemistry. In patients with TIO, DOTATATE PET/CT can successfully localize phosphaturic mesenchymal tumors and may be a practical first step in functional imaging for this disorder. Serum phosphate should be measured routinely in patients with unexplained muscle weakness, bone pain, or stress fractures to allow earlier diagnosis of TIO.

  15. Percutaneous ultrasound guided implantation of VX2 for creation of a rabbit hepatic tumor model.

    Science.gov (United States)

    White, Sarah B; Chen, Jeane; Gordon, Andrew C; Harris, Kathleen R; Nicolai, Jodi R; West, Derek L; Larson, Andrew C

    2015-01-01

    Creation of a VX2 tumor model has traditionally required a laparotomy and surgical implantation of tumor fragments. Open surgical procedures are invasive and require long procedure times and recovery that can result in post-operative morbidity and mortality. The purpose of this study is to report the results of a percutaneous ultrasound guided method for creation of a VX2 model in rabbit livers. A total of 27 New Zealand white rabbits underwent a percutaneous ultrasound guided approach, where a VX2 tumor fragment was implanted in the liver. Magnetic resonance imaging was used to assess for tumor growth and necropsy was performed to determine rates of tract seeding and metastatic disease. Ultrasound guided tumor implantation was successful in all 27 rabbits. One rabbit died 2 days following the implantation procedure. Two rabbits had no tumors seen on follow-up imaging. Therefore, tumor development was seen in 24/26 (92%) rabbits. During the follow-up period, tract seeding was seen in 8% of rabbits and 38% had extra-hepatic metastatic disease. Therefore, percutaneous ultrasound guided tumor implantation safely provides reliable tumor growth for establishing hepatic VX2 tumors in a rabbit model with decreased rates of tract seeding, compared to previously reported methods.

  16. Percutaneous ultrasound guided implantation of VX2 for creation of a rabbit hepatic tumor model.

    Directory of Open Access Journals (Sweden)

    Sarah B White

    Full Text Available Creation of a VX2 tumor model has traditionally required a laparotomy and surgical implantation of tumor fragments. Open surgical procedures are invasive and require long procedure times and recovery that can result in post-operative morbidity and mortality. The purpose of this study is to report the results of a percutaneous ultrasound guided method for creation of a VX2 model in rabbit livers. A total of 27 New Zealand white rabbits underwent a percutaneous ultrasound guided approach, where a VX2 tumor fragment was implanted in the liver. Magnetic resonance imaging was used to assess for tumor growth and necropsy was performed to determine rates of tract seeding and metastatic disease. Ultrasound guided tumor implantation was successful in all 27 rabbits. One rabbit died 2 days following the implantation procedure. Two rabbits had no tumors seen on follow-up imaging. Therefore, tumor development was seen in 24/26 (92% rabbits. During the follow-up period, tract seeding was seen in 8% of rabbits and 38% had extra-hepatic metastatic disease. Therefore, percutaneous ultrasound guided tumor implantation safely provides reliable tumor growth for establishing hepatic VX2 tumors in a rabbit model with decreased rates of tract seeding, compared to previously reported methods.

  17. Giant cell tumor of the rib: Two cases of F-18 FDG PET/CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hye Lim; Yoo, Le Ryung; Lee, Yeong Joo; Jung, Chan Kwon [Seoul St. Mary' s Hospital, College of MedicineThe Catholic University of Korea, Seoul (Korea, Republic of); Park, Sonya Young Ju [Molecular Imaging Program, Dept. of Radiology, Stanford Hospital and Clinics, Stanford (Korea, Republic of)

    2017-06-15

    We report two cases of giant cell tumor arising from the rib and their F-18 FDG PET/CT findings. The two patients complained of chest wall pain, and large lobulated soft tissue masses with intense FDG uptake were seen on F-18 FDG PET/CT. A malignant tumor such as osteosarcoma or chondrosarcoma was suspected due to the large size of the mass, bony destruction, and intense FDG uptake. En bloc resection was performed and final pathologic results revealed giant cell tumor of the rib. Giant cell tumor of the rib is very rare, and larger lesions with high FDG uptake can be misdiagnosed as an intrathoracic malignancy arising from the rib, pleura, or chest wall.

  18. Automatic computer aided analysis algorithms and system for adrenal tumors on CT images.

    Science.gov (United States)

    Chai, Hanchao; Guo, Yi; Wang, Yuanyuan; Zhou, Guohui

    2017-12-04

    The adrenal tumor will disturb the secreting function of adrenocortical cells, leading to many diseases. Different kinds of adrenal tumors require different therapeutic schedules. In the practical diagnosis, it highly relies on the doctor's experience to judge the tumor type by reading the hundreds of CT images. This paper proposed an automatic computer aided analysis method for adrenal tumors detection and classification. It consisted of the automatic segmentation algorithms, the feature extraction and the classification algorithms. These algorithms were then integrated into a system and conducted on the graphic interface by using MATLAB Graphic user interface (GUI). The accuracy of the automatic computer aided segmentation and classification reached 90% on 436 CT images. The experiments proved the stability and reliability of this automatic computer aided analytic system.

  19. Multi-Detector row CT urography on a 16-row CT scanner in the evaluation of urothelial tumors

    Energy Technology Data Exchange (ETDEWEB)

    Tsili, A.C. [University Hospital of Ioannina, Department of Clinical Radiology, Ioannina (Greece); University of Ioannina, Medical School, Ioannina (Greece); Efremidis, S.C.; Tsampoulas, C. [University Hospital of Ioannina, Department of Clinical Radiology, Ioannina (Greece); Kalef-Ezra, J. [University Hospital of Ioannina, Department of Medical Physics, Ioannina (Greece); Giannakis, D.; Sofikitis, N. [University Hospital of Ioannina, Department of Urology, Ioannina (Greece); Alamanos, Y. [University Hospital of Ioannina, Department of Hygiene and Public Health, Ioannina (Greece)

    2007-04-15

    The purpose of this study was to assess the role of multi-detector row CT urography (MDCTU), on a 16-row CT scanner in the evaluation of patients with painless hematuria, with emphasis placed in the detection of urothelial tumors. We retrospectively reviewed the MDCT urographies of 75 patients, referred for painless hematuria. The CT protocol included unenhanced images, obtained with a detector configuration of 16 x 1.5 mm and pitch of 1.2, nephrographic and excretory-phase images, obtained with a detector collimation of 16 x 0.75 mm and pitch of 1.2. Axial and coronal reformatted images were evaluated. Three-dimensional reformation of the excretory-phase images was performed using the volume-rendering technique. The standard of reference included clinical and imaging follow-up, cystoscopic, surgical and histologic findings. In 55 (73%) of 75 patients, the cause of hematuria was identified on MDCTU; the most common cause was urothelial cancer, including seven tumors with a diameter equal or smaller than 0.5 cm in diameter. Sixteen-row MDCTU provided satisfactory results in the investigation of patients with painless hematuria. The main advantage of the technique is its ability to detect uroepithelial malignancies. (orig.)

  20. Targeting behavior of hepatic artery injected temperature sensitive liposomal adriamycin on tumor-bearing rats.

    Science.gov (United States)

    Zou, Y Y; Ueno, M; Yamagishi, M; Horikoshi, I; Yamashita, I; Tazawa, K; Gu, X Q

    1990-01-01

    Temperature sensitive liposomal Adriamycin (LADM) was injected into the hepatic artery of rats bearing implanted hepatic tumors. Two hours after the injection, the liver was heated at 42 degrees C and maintained for six minutes at that temperature using local hyperthermia. Blood samples were taken at regular intervals until 8 hours after injection, at which time the animals were sacrificed and the drug distribution in the tissues was examined. Results indicate that the Adriamycin was released from the liposome, with the drug concentration in circulation peaking at 30 minutes after heating. High drug levels (25.2 micrograms/g of wet tissue) in the tumor and high tumor/liver Adriamycin level ratios (TLAR; 4.1) were found. The drug levels and the TLAR of the liposomal Adriamycin injection combined with heating (LADM H) were significantly different from those of the same dose of aqueous Adriamycin with heating (ADM H) or aqueous Adriamycin (ADM) and LADM without heating. The experiment shows that the LADM is cleared from the liver slowly, and when hyperthermia treatment at phase-transition temperature of the liposome is performed, the drug level in an implanted hepatic tumor is increased, and in the parenchyma is decreased. The results imply that targeting the hepatic tumor in this way may be an effective therapeutic method, and the drug release from the liposome may be controlled externally. This method appears promising for clinical practice.

  1. Keratocystic odontogenic tumor: case report with CT and ultrasonography findings

    Energy Technology Data Exchange (ETDEWEB)

    Sumer, A Pinar; Sumer, Mahmut; Celenk, Peruze; Danaci, Murat [Faculty of Dentistry, University of Ondokuz Mayis, Samsun (Turkmenistan); Gunhan, Oemer [Gulhane Military Medicine Academy, Ankara (Turkmenistan)

    2012-03-15

    Keratocystic odontogenic tumor (KCOT) is a benign odontogenic tumor with a potentially aggressive and infiltrative behavior. KCOT is most commonly occurred in mandible and demonstrate a unilocular, round, oval, scalloped radiolucent area, while large lesions may appear multilocular. An important characteristic of KCOT is its propensity to grow in an antero-posterior direction within medullary cavity of bone causing minimal expansion. Definitive diagnosis relies on histological examination. In this report, a KCOT that had an expansion both buccal and lingual cortical bone is described including its features in computed tomography and ultrasonographic exams. The lesion was removed surgically via an intraoral approach under local anesthesia and histologically reported as a KCOT.

  2. Anatomic variations of the hepatic arteries in 250 patients studied with 64-row CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Cecco, Carlo Nicola de [University of Rome Sapienza, Polo Pontino, Department of Radiological Sciences, Latina (Italy); University of Rome Sapienza, St. Andrea Hospital, Department of Radiology, Rome (Italy); Ferrari, Riccardo; Rengo, Marco; Paolantonio, Pasquale; Vecchietti, Fabrizio; Laghi, Andrea [University of Rome Sapienza, Polo Pontino, Department of Radiological Sciences, Latina (Italy)

    2009-11-15

    The aim of our study was to determine the frequency of different hepatic arterial variants identified on abdominal CT angiography (CTA) with a 64-row CT system and a high resolution protocol. A total of 250 consecutive abdominal CTAs performed on a 64-row CT system were evaluated. Two radiologists in consensus analyzed arterial phase images; the anatomical findings were grouped according to Michels' classification. An anomalous arterial pattern was observed in 34% of the cases. The most common anomaly was Michels type III (9.2%), followed by types II and V (5.2%), type VI (4.0%), types IV, VII, and IX (2.0%), and type VIII (0.6%). No cases of type X were detected. Unclassified variations were observed in 3.3% of the cases. The new generation of 64-row MDCT allows optimal visualization of splanchnic vascular anomalies with a minimally invasive examination. This visualization is extended to those vessels with a small caliber and slow flow resulting in difficult recognition by classic angiographic studies. The knowledge of anomalous arterial patterns could be very useful in the preoperative planning of surgical and interventional liver procedures. (orig.)

  3. Hepatic outflow obstruction at middle hepatic vein tributaries or inferior right hepatic veins after living donor liver transplantation with modified right lobe graft: comparison of CT and Doppler ultrasound.

    Science.gov (United States)

    Hwang, Hye Jeon; Kim, Kyoung Won; Jeong, Woo Kyoung; Kim, So Yeon; Song, Gi-Won; Hwang, Shin; Lee, Sung-Gyu

    2009-09-01

    The objective of our study was to compare CT and Doppler ultrasound in the diagnosis of hepatic outflow obstruction at the middle hepatic vein (MHV) tributaries and inferior right hepatic veins (RHVs) after living donor liver transplantation (LDLT) with modified right lobe grafts. Thirty-seven venographies were performed in 36 patients after LDLT with modified right lobe grafts, evaluating 51 MHV tributaries and 25 inferior RHVs. They were classified as obstructed or nonobstructed. On Doppler ultrasound or CT, flow patterns of the MHV tributaries and inferior RHVs or the relative parenchymal attenuation, enhancement, and opacification of these veins were evaluated for the diagnosis of hepatic outflow obstruction. McNemar tests were performed to compare the diagnostic values of Doppler ultrasound and CT. On the basis of hepatic venography, 33 MHV tributaries were categorized as obstructed and 18 as nonobstructed, and 16 inferior RHVs were categorized as obstructed and nine as nonobstructed. For the diagnosis of MHV tributary obstruction, Doppler ultrasound was more sensitive and accurate, although less specific, than CT (97% vs 39%, respectively, p ultrasound was more sensitive (94% vs 31%, respectively) and accurate (84% vs 56%) than CT, although less specific (67% vs 100%), for the diagnosis of inferior RHV obstruction, with a statistical significance only for sensitivity (p = 0.002, 0.092, and 0.248, respectively). Doppler ultrasound is more sensitive and accurate than CT for the detection of obstruction at the MHV tributaries and inferior RHVs in patients after LDLT using modified right lobe grafts. Although current CT criteria produce high specificity and may reduce unnecessary invasive venographies, optimal CT criteria with acceptable sensitivity should be reestablished.

  4. A chance-constrained programming level set method for longitudinal segmentation of lung tumors in CT.

    Science.gov (United States)

    Rouchdy, Youssef; Bloch, Isabelle

    2011-01-01

    This paper presents a novel stochastic level set method for the longitudinal tracking of lung tumors in computed tomography (CT). The proposed model addresses the limitations of registration based and segmentation based methods for longitudinal tumor tracking. It combines the advantages of each approach using a new probabilistic framework, namely Chance-Constrained Programming (CCP). Lung tumors can shrink or grow over time, which can be reflected in large changes of shape, appearance and volume in CT images. Traditional level set methods with a priori knowledge about shape are not suitable since the tumors are undergoing random and large changes in shape. Our CCP level set model allows to introduce a flexible prior to track structures with a highly variable shape by permitting a constraint violation of the prior up to a specified probability level. The chance constraints are computed from two given points by the user or from segmented tumors from a reference image. The reference image can be one of the images studied or an external template. We present a numerical scheme to approximate the solution of the proposed model and apply it to track lung tumors in CT. Finally, we compare our approach with a Bayesian level set. The CCP level set model gives the best results: it is more coherent with the manual segmentation.

  5. Anti-tumor and immunomodulatory activities of an exopolysaccharide from Rhizopus nigricans on CT26 tumor-bearing mice.

    Science.gov (United States)

    Zhu, Lei; Cao, Jianfeng; Chen, Guochuang; Xu, Yanghui; Lu, Jingbo; Fang, Fang; Chen, Kaoshan

    2016-07-01

    This study was aimed to investigate the anti-tumor and immunomodulatory activities of an exopolysaccharide (EPS) from Rhizopus nigricans. Our results showed EPS could significantly inhibit the tumor growth and increase the immune organs index of CT26 tumor-bearing mice. EPS treatment increased the productions of interleukin-2 (IL-2) and tumor necrosis factor-α (TNF-α) levels in serum. The increase of percentage of CD8(+) cytotoxic T cells among total spleen T lymphocyte was also observed. Furthermore, EPS remarkably stimulate spleen lymphocytes proliferation in the absence or presence of mitogens. In addition, we found that EPS had synergistic effect with chemotherapy and improved immunosuppressive effect induced by 5-Fu. In summary, these findings indicated that the antitumor effects of EPS might be partly due to immune function activation and it might have potential to be used in the treatment for colorectal cancer. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Malignant Peripheral Nerve Sheath Tumor: MRI and CT Findings

    Directory of Open Access Journals (Sweden)

    K. O. Kragha

    2015-01-01

    important in its diagnosis. A rare case of MPNST that produced urinary retention and bowel incontinence is presented that may aid clinicians in the diagnosis of this rare clinical entity. Motor weakness, central enhancement, and immunohistochemistry may assist in the diagnosis of MPNST and differentiation between benign peripheral nerve sheath tumor (BPNST and MPNST.

  7. CT Findings of Intrarenal Yolk Sac Tumor with Tumor Thrombus Extending into the Inferior Vena Cava: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Shao Chun; Li, Xue Hua; Sun, Can Hui; Feng, Shi Ting; Peng, Zhen Peng; Huang, Si Yun; Li, Zi Ping [Dept. of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou (China)

    2014-10-15

    Yolk sac tumor (YST) is a rare germ cell neoplasm of childhood that usually arises from the testis or ovary. The rare cases of YST in various extragonadal locations have been reported, but the primary intrarenal YST is even more uncommon. Here, we report a case of a primary intrarenal YST with tumor thrombus of the inferior vena cava and left renal vein in a 2-year-old boy, with an emphasis on the CT features. To our knowledge, this is the first reported case of an intrarenal YST with intravascular involvement.

  8. Brain tumor delineation based on CT and MR imaging. Implications for radiotherapy treatment planning

    NARCIS (Netherlands)

    Heesters, M A; Wijrdeman, H K; Struikmans, H; Witkamp, T; Moerland, M A

    1993-01-01

    This paper deals with the impact MRI may have on radiotherapy treatment planning of brain tumors. The authors analyzed differences in size and position of treatment fields as indicated by three observers (two radiotherapists and one neuroradiologist) using CT or MR based radiotherapy planning

  9. Prognostic value of tumor necrosis at CT in diffuse large B-cell lymphoma

    NARCIS (Netherlands)

    Adams, Hugo J A; De Klerk, John M H; Fijnheer, Rob; Dubois, Stefan V.; Nievelstein, Rutger A J; Kwee, Thomas C.

    2015-01-01

    Objective To determine the prognostic value of tumor necrosis at computed tomography (CT) in newly diagnosed diffuse large B-cell lymphoma (DLBCL). Materials and methods This retrospective study included 51 patients with newly diagnosed DLBCL who had undergone both unenhanced and intravenous

  10. Hepatic hemangioma: contrast enhancement patterns on two-phase spiral CT

    Energy Technology Data Exchange (ETDEWEB)

    Yun, Eun Joo; Choi, Byung Ihn; Han, Joon Koo; Jang, Hyun Jung; Kim, Tae Kyoung; Kim, Ah Young; Lee, Ki Yeol [Seoul National Univ., Seoul (Korea, Republic of). Coll. of Medicine

    1998-01-01

    To evaluate contrast enhancement patterns of hemangioma according to size, as seen during the arterial and portal venous phase of spiral CT. Overall, the most common enhancement pattern was peripheral high (44/82, 53.7%), during the arterial and portal venous phase. The second and third most common patterns were uniform high (11/82, 13.4%) and peripheral high-uniform high (9/82, 11.0%), also during the arterial and portal venous phase. In tumors smaller than 20 mm, low-low attenuation was seen in eight (9.8%), and iso-low attenuation in two (2.4%), during the arterial and portal venous phase, respectively. On two-phase spiral CT, the most common enhancement pattern of hemangioma was peripheral high, seen during the arterial and portal venous phase. However, a small hemangioma less than 2cm may show atypical patterns, including low and iso attenuation. (author). 23 refs., 1 tab., 4 figs.

  11. Selective Internal Radiotherapy (SIRT) of Hepatic Tumors: How to Deal with the Cystic Artery

    Energy Technology Data Exchange (ETDEWEB)

    Theysohn, Jens M., E-mail: jens.theysohn@uni-due.de [University Hospital Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology (Germany); Mueller, Stefan [University Hospital Essen, Department of Nuclear Medicine (Germany); Schlaak, Joerg F.; Ertle, Judith [University Hospital Essen, Department of Gastroenterology and Hepatology (Germany); Schlosser, Thomas W. [University Hospital Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology (Germany); Bockisch, Andreas [University Hospital Essen, Department of Nuclear Medicine (Germany); Lauenstein, Thomas C. [University Hospital Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology (Germany)

    2013-08-01

    PurposeSelective internal radiotherapy (SIRT) with the beta emitter yttrium-90 (Y90) is a rapidly developing therapy option for unresectable liver malignancies. Nontarget irradiation of the gallbladder is a complication of SIRT. Thus, we aimed to assess different strategies to avoid infusion of Y90 into the cystic artery (CA).MethodsAfter hepatic digital subtraction angiography and administration of technetium-99m-labeled human serum albumin ({sup 99}mTc-HSA), 295 patients with primary or secondary liver tumors underwent single-photon emission computed tomography/computed tomography (SPECT/CT). Different measures were taken before repeated Y90 mapping and SIRT to avoid unintended influx into the CA where necessary. Clinical symptoms, including pain, fever, or a positive Murphy sign, were assessed during patient follow-up.ResultsA significant {sup 99}mTc-HSA accumulation in the gallbladder wall (higher {sup 99}mTc-HSA uptake than in normal liver tissue) was seen in 20 patients. The following measures were taken to avoid unintended influx into the CA: temporary/permanent occlusion of the CA with gelfoam (n = 5)/microcoil (n = 1), induction of vasospasm with a microwire (n = 4), or altering catheter position (n = 10). Clinical signs of cholecystitis were observed in only one patient after temporary CA occlusion with gelfoam and were successfully treated by antibiotics. Cholecystectomy was not required for any patient.ConclusionIt is important to identify possible nontarget irradiation of the gallbladder. The risk for radiation-induced cholecystitis can be easily minimized by temporary or permanent CA embolization, vasospasm induction, or altering the catheter position.

  12. {sup 18}F-FDG PET/CT in Primary AL Hepatic Amyloidosis Associated with Multiple Myeloma

    Energy Technology Data Exchange (ETDEWEB)

    Son, Youn Mi; Bak, Cheol Hee [Seoul Medical Center, Seoul (Korea, Republic of); Choi, Joon Young; Cheon, Mi Ju; Kim, Young Eun; Lee, Kyung Han; Kim, Byung Tae [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2011-10-15

    We report here on a rare case of primary AL hepatic amyloidosis associated with multiple myeloma in a 64-year-old woman. The patient was referred for evaluating her progressive jaundice and right upper quadrant pain. {sup 18}F-fluorodeoxyglucose ({sup 18}F-FDG) positron emission tomography (PET)/computed tomography (CT) showed diffusely and markedly increased {sup 18}F-FDG uptake in the liver. Although there have been several case studies showing positive {sup 18}F-FDG uptake in pulmonary amyloidosis, to the best of our knowledge, the {sup 18}F-FDG PET/CT findings of hepatic amyloidosis or primary hepatic amyloidosis associated with multiple myeloma have not been reported previously.

  13. Differentiation of small hepatic hemangioma from small hepatocellular carcinoma: recently introduced spectral CT method.

    Science.gov (United States)

    Lv, Peijie; Lin, Xiao Zhu; Li, Jianying; Li, Weixia; Chen, Kemin

    2011-06-01

    To investigate the usefulness of computed tomographic (CT) spectral imaging parameters in differentiating small (≤3 cm) hepatic hemangioma (HH) from small hepatocellular carcinoma (HCC), with or without cirrhosis, during the late arterial phase (AP) and portal venous phase (PVP). This prospective study was institutional review board approved, and written informed consent was obtained from all patients. The authors examined 49 patients (39 men, 10 women; 65 lesions) with CT spectral imaging during the AP and the PVP. Twenty-one patients had HH; nine, HCC with cirrhosis; and 19, HCC without cirrhosis. Iodine concentrations were derived from iodine-based material-decomposition CT images and normalized to the iodine concentration in the aorta. The difference in iodine concentration between the AP and PVP (ie, iodine concentration difference [ICD]) and the lesion-to-normal parenchyma ratio (LNR) were calculated. Two readers qualitatively assessed lesion types on the basis of conventional CT characteristics. Sensitivity and specificity were compared between the qualitative and quantitative studies. The two-sample t test was performed to compare quantitative parameters between HH and HCC. Normalized iodine concentrations (NICs) and LNRs in patients with HH differed significantly from those in patients with HCC and cirrhosis and those in patients with HCC without cirrhosis: Mean NICs were 0.47 mg/mL ± 0.24 (standard deviation) versus 0.23 mg/mL ± 0.10 and 0.23 mg/mL ± 0.08, respectively, during the AP and 0.83 mg/mL ± 0.38 versus 0.47 mg/mL ± 0.86 and 0.52 mg/mL ± 0.11, respectively, during the PVP. Mean LNRs were 5.87 ± 3.36 versus 2.56 ± 1.10 and 2.29 ± 0.87, respectively, during the AP and 2.01 ± 1.33 versus 0.96 ± 0.16 and 0.93 ± 0.26, respectively, during the PVP. The mean ICD for the HH group (1.37 mg/mL ± 0.84) was significantly higher than the mean ICDs for the HCC-cirrhosis (0.33 mg/mL ± 0.29) (P NIC and LNR had higher sensitivity and specificity

  14. Correlation between internal fiducial tumor motion and external marker motion for liver tumors imaged with 4D-CT.

    Science.gov (United States)

    Beddar, A Sam; Kainz, Kristofer; Briere, Tina Marie; Tsunashima, Yoshikazu; Pan, Tinsu; Prado, Karl; Mohan, Radhe; Gillin, Michael; Krishnan, Sunil

    2007-02-01

    We investigated the correlation between the motions of an external marker and internal fiducials implanted in the liver for 8 patients undergoing respiratory-based computed tomography (four-dimensional CT [4D-CT]) procedures. The internal fiducials were gold seeds, 3 mm in length and 1.2 mm in diameter. Four patients each had one implanted fiducial, and the other four had three implanted fiducials. The external marker was a plastic box, which is part of the Real-Time Position Management System (RPM) used to track the patient's respiration. Each patient received a standard helical CT scan followed by a time-correlated CT-image acquisition (4D-CT). The 4D-CT images were reconstructed in 10 separate phases covering the entire respiratory cycle. The internal fiducial motion is predominant in the superior-inferior direction, with a range of 7.5-17.5 mm. The correlation between external respiration and internal fiducial motion is best during expiration. For 2 patients with their three fiducials separated by a maximum of 3.2 cm, the motions of the fiducials were well correlated, whereas for 2 patients with more widely spaced fiducials, there was less correlation. In general, there is a good correlation between internal fiducial motion imaged by 4D-CT and external marker motion. We have demonstrated that gating may be best performed at the end of the respiratory cycle. Special attention should be paid to gating for patients whose fiducials do not move in synchrony, because targeting on the correct respiratory amplitude alone would not guarantee that the entire tumor volume is within the treatment field.

  15. Correlation of intra-tumor 18F-FDG uptake heterogeneity indices with perfusion CT derived parameters in colorectal cancer.

    Directory of Open Access Journals (Sweden)

    Florent Tixier

    Full Text Available Thirty patients with proven colorectal cancer prospectively underwent integrated 18F-FDG PET/DCE-CT to assess the metabolic-flow phenotype. Both CT blood flow parametric maps and PET images were analyzed. Correlations between PET heterogeneity and perfusion CT were assessed by Spearman's rank correlation analysis.Blood flow visualization provided by DCE-CT images was significantly correlated with 18F-FDG PET metabolically active tumor volume as well as with uptake heterogeneity for patients with stage III/IV tumors (|ρ|:0.66 to 0.78; p-value<0.02.The positive correlation found with tumor blood flow indicates that intra-tumor heterogeneity of 18F-FDG PET accumulation reflects to some extent tracer distribution and consequently indicates that 18F-FDG PET intra-tumor heterogeneity may be associated with physiological processes such as tumor vascularization.

  16. Gallium-68-dotatate PET/CT is better than CT in the management of somatostatin expressing tumors: First experience in Africa.

    Science.gov (United States)

    Lawal, Ismaheel O; Ololade, Kehinde O; Lengana, Thabo; Reyneke, Florette; Ankrah, Alfred O; Ebenhan, Thomas; Vorster, Mariza; Sathekge, Mike M

    2017-01-01

    In this study we aimed to present our experience on the use of Gallium-68-dotatate with positron emission tomography, computed tomography ((68) Ga-dotatate PET/CT) in the management of neuroendocrine tumors (NET) and other somatostatin expressing tumors. We retrospectively reviewed patients with histologically confirmed or biochemically suspected NET and other somatostatin expressing (SSTR) tumors imaged at our department with (68)Ga-dotatate PET/CT. We determined the performance of this imaging technique as well as its impact on patients management. A total of 203 patients were studied: 103 females, 100 males median age 52years. The commonest tumor type was gastroenteropancreatic NET (41% of patients) and the commonest sites of distant metastases were lymph nodes and the liver 34.0% and 30.5% respectively. Positron emission tomography detected foci of disease in 19 patients where CT was falsely negative. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of (68) Ga-dotatate PET/CT imaging of NET and other SST expressing tumors were 94.16%, 91.89%, 95.55%, 89.47% and 96.55% respectively. Gallium-68-dotatate PET/CT was better than CT in detecting primary sites of the disease and highly sensitive and specific for diagnosis and treatment of NET and other SSTR expressing tumors.

  17. Nephrogenic rests mimicking Wilms' tumor on CT

    Energy Technology Data Exchange (ETDEWEB)

    Subhas, Naveen; Siegelman, Stanley S. [Russell H. Morgan Department of Radiology, The Johns Hopkins Hospital and School of Medicine, 600 N. Wolfe St., 21287, Baltimore, MD (United States); Argani, Pedram [Department of Pathology, Johns Hopkins Hospital and School of Medicine, 21287, Baltimore, MD (United States); Gearhart, John P. [Department of Pediatric Urology, Brady Urologic Institute, The Johns Hopkins Hospital and School of Medicine, 21287, Baltimore, MD (United States)

    2004-02-01

    Nephrogenic rests (NR) are persistent benign remnants of embryonic renal tissue. A small percentage of these may develop into Wilms' tumor (WT). Radiologic imaging is relied upon to differentiate between these entities, with the hallmark of malignant transformation being growth on serial imaging studies. There is, however, considerable overlap in their imaging characteristics. The authors present a case of two biopsy-proven NR in a 2-year-old girl with sporadic aniridia that were indistinguishable from WT on initial radiologic studies. One of the NR grew on serial imaging studies mimicking a WT, but after resection was confirmed to be a benign hyperplastic NR on pathologic examination. (orig.)

  18. CT restaging of testicular germ cell tumors: The incidence of isolated pelvic metastases.

    Science.gov (United States)

    Sadow, Cheryl A; Maurer, Amma N; Prevedello, Luciano M; Sweeney, Christopher J; Silverman, Stuart G

    2016-08-01

    We determined the incidence of isolated pelvic metastases at restaging computed tomography (CT) in patients with testicular germ cell tumors to consider if imaging the pelvis could be omitted. After receiving IRB approval for this HIPAA-compliant retrospective study, medical records of 560 men (mean age 32.8) with 583 testicular germ cell tumors who underwent 3683 restaging CT scans of the abdomen and pelvis were reviewed to determine the proportion of patients with metastatic disease in the pelvis alone, as verified by histology or by resolution after therapy. Chi-square statistical analysis tested the association between factors currently thought to predispose patients to pelvic metastases. Patients were also categorized by clinical stage, tumor histology, and initial treatment. Isolated pelvic metastases were detected in nine (1.6%) of 560 men. Neither bulky abdominal disease (p=0.85) nor extratesticular invasion by the primary tumor (p=0.37) were statistically significant in predicting which patients were more likely to have isolated pelvic metastases. Among the nine patients with isolated pelvic recurrence, only three (0.7%) of 408 men with no known pelvic disease at initial staging and no tumor marker elevation at restaging had isolated pelvic metastases. Isolated pelvic recurrence was not statistically different when analyzed by initial stage and treatment. The incidence of isolated pelvic metastases in testicular germ cell tumors at restaging CT is low, but no group of patients was found to be without risk. Therefore, given the small, if any, risk of radiation-induced harm, the decision about whether to include routine pelvic CT in surveillance protocols should be individualized. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Characterization and staging of rectal tumors: endoscopic ultrasound versus MRI / CT. Pictorial essay.

    Science.gov (United States)

    Badea, Radu; Gersak, Mariana M; Dudea, Sorin M; Graur, Florin; Hajjar, Nadim Al; Furcea, Luminita

    2015-06-01

    Endoscopic ultrasound is recommended for rectal cancer staging. Transrectal ultrasound approach is able to overcome one of the limitations of this technique regarding circumferential rectal stenosis. Prior intrarectal administration of a small amount of fluid contrast agent optimizes the method, making it easier to distinguish the layers of the rectal wall and tumor formation. Endoscopic ultrasound focuses on the gray-scale mode. Additional procedures provide useful information for tumor assessment: Doppler ultrasound helps identify chaotic intratumoral vascularization; 3D ultrasound allows the assessment and accurate measurement of the tumor; elastography can identify focal tumor dysplasia within adenomas; contrast-enhanced ultrasound allows characterization of tumor microvasculature. Even if they are not as accurate in distinguishing rectal wall layers, cross-sectional imaging techniques (CT, MRI) can identify the anatomical relationships of advanced locoregional cancers, as well as possible distant metastasis. This paper aims at illustrating the main pathological aspects of endoscopic ultrasound multimodal examination useful for cancer staging.

  20. CT Imaging Findings after Stereotactic Radiotherapy for Liver Tumors

    Directory of Open Access Journals (Sweden)

    Olga R. Brook

    2015-01-01

    Full Text Available Purpose. To study radiological response to stereotactic radiotherapy for focal liver tumors. Materials and Methods. In this IRB-approved, HIPAA-compliant study CTs of 68 consecutive patients who underwent stereotactic radiotherapy for liver tumors between 01/2006 and 01/2010 were retrospectively reviewed. Two independent reviewers evaluated lesion volume and enhancement pattern of the lesion and of juxtaposed liver parenchyma. Results. 36 subjects with hepatocellular carcinoma (HCC, 25 with liver metastases, and seven with cholangiocarcinoma (CCC were included in study. Mean follow-up time was 5.6 ± 7.1 months for HCC, 6.4 ± 5.1 months for metastases, and 10.1 ± 4.8 months for the CCC. Complete response was seen in 4/36 (11.1% HCCs and 1/25 (4% metastases. Partial response (>30% decrease in long diameter was seen in 25/36 (69% HCCs, 14/25 (58% metastases, and 7/7 (100% of CCCs. Partial response followed by local recurrence (>20% increase in long diameter from nadir occurred in 2/36 (6% HCCs and 4/25 (17% metastases. Liver parenchyma adjacent to the lesion demonstrated a prominent halo of delayed enhancement in 27/36 (78% of HCCs, 19/21 (91% of metastases, and 7/7 (100% of CCCs. Conclusion. Sustainable radiological partial response to stereotactic radiotherapy is most frequent outcome seen in liver lesions. Prominent halo of delayed enhancement of the adjacent liver is frequent finding.

  1. Soy protein isolate inhibits hepatic tumor promotion in mice fed a high-fat liquid diet.

    Science.gov (United States)

    Mercer, Kelly E; Pulliam, Casey F; Pedersen, Kim B; Hennings, Leah; Ronis, Martin Jj

    2017-03-01

    Alcoholic and nonalcoholic fatty liver diseases are risk factors for development of hepatocellular carcinoma, but the underlying mechanisms are poorly understood. On the other hand, ingestion of soy-containing diets may oppose the development of certain cancers. We previously reported that replacing casein with a soy protein isolate reduced tumor promotion in the livers of mice with alcoholic liver disease after feeding a high fat ethanol liquid diet following initiation with diethylnitrosamine. Feeding soy protein isolate inhibited processes that may contribute to tumor promotion including inflammation, sphingolipid signaling, and Wnt/β-catenin signaling. We have extended these studies to characterize liver tumor promotion in a model of nonalcoholic fatty liver disease produced by chronic feeding of high-fat liquid diets in the absence of ethanol. Mice treated with diethylnitrosamine on postnatal day 14 were fed a high-fat liquid diet made with casein or SPI as the sole protein source for 16 weeks in adulthood. Relative to mice fed normal chow, a high fat/casein diet led to increased tumor promotion, hepatocyte proliferation, steatosis, and inflammation. Replacing casein with soy protein isolate counteracted these effects. The high fat diets also resulted in a general increase in transcripts for Wnt/β-catenin pathway components, which may be an important mechanism, whereby hepatic tumorigenesis is promoted. However, soy protein isolate did not block Wnt signaling in this nonalcoholic fatty liver disease model. We conclude that replacing casein with soy protein isolate blocks development of steatosis, inflammation, and tumor promotion in diethylnitrosamine-treated mice fed high fat diets. Impact statement The impact of dietary components on cancer is a topic of great interest for both the general public and the scientific community. Liver cancer is currently the second leading form of cancer deaths worldwide. Our study has addressed the effect of the protein

  2. Losartan improves the distribution and efficacy of doxorubicin in CT26 tumor.

    Science.gov (United States)

    Xiao, L; Hu, S Q; Wang, L Y; Liu, J X; Li, X Y

    2015-10-01

    The effectiveness of chemotherapeutic agents is impaired by limited delivery of chemotherapeutic agents to the tumor cells. Improving drug penetration in tumor tissues is very important. We tested whether losartan, a selective antagonist against type 1 angiotensin II receptors (AT1R) with noted antifibrotic activity, can enhance the penetration and efficacy of doxorubicin. BALB/C mice, which implanted with CT26 tumor cells, were divided into four groups: control, doxorubicin alone, losartan alone and doxorubicin + losartan combination groups. At day 0, the losartan alone and doxorubicin + losartan combination groups received losartan; and at day 8, the doxorubicin alone and doxorubicin + losartan combination groups received doxorubicin i.v. Tumor growth and intratumoral distribution of doxorubicin were evaluated. The mechanism underlying the enhanced anti-tumor effect of the combination of doxorubicin and losartan was investigated by immunohistochemical analysis. Treatment with losartan alone did not suppress tumor growth; In contrast, treatment with doxorubicin alone decreased tumor growth; losartan and doxorubicin were administered in combination, had a synergistic effect that the tumor growth was much more inhibited. The decreased proliferation as indicated by down-regulation of Ki67, and increased apoptosis as indicated by TUNEL and caspase-3 staining. The expression of tumor suppressor gene P53 increased in doxorubicin + losartan combination groups. Losartan can increase the therapeutic effectiveness of doxorubicin, yielding more great antitumor benefit. This study provided a rationale for initiating clinical trials using losartan in combination with chemotherapeutic agents to increase their therapeutic effectiveness.

  3. Perfusion-CT monitoring of cryo-ablated renal cells tumors

    Directory of Open Access Journals (Sweden)

    Vespasiani Giuseppe

    2009-10-01

    Full Text Available Abstract Background No single and thoroughly validated imaging method in monitoring of cryoablated renal cell carcinoma (RCC is available. The purpose of our study was to determine the feasibility of dynamic contrast-enhanced perfusion CT (pCT in evaluating the hemodynamic response of RCC. Methods 15 patients (14 male, 1 female; age range, 43-81 years; mean age, 62 years with cryoablated RCC via a transperitoneal approach, underwent to pCT 6-8 months after cryo-therapy. pCT was performed for 65 seconds after intravenous injection of contrast medium (80 mL, 370 mg iodine per millilitre, 4 mL/sec. Perfusion parameters (Time/Density curve; Blood flow, BF; Blood Volume, BV; Mean Transit Time, MTT; Permeability-Surface Area Product, PS were sampled in the cryoablated tumor area and in ipsilateral renal cortex using deconvolution-based method. A tumor was considered to be not responsive to treatment by CT evidence of pathological contrast enhancement in the cryoablated area or renal mass persistence compared with the preoperative CT control. Written informed consent was obtained from all participants before the study. Results After cryotherapy, successfully ablated tumor (n = 13 showed decrease in BV (5,39 +/- 1,28 mL/100 g, BF (69,92 +/- 20,12 mL/100 g/min and PS (16,66 +/- 5,67 mL/100 g/min value and increased value of MTT (25,35 +/- 4,3 sec compared with those of normal renal cortex (BV: 117,86 +/- 31,87 mL/100 g/min; BF: 392,39 +/- 117,32 mL/100 g/min; MTT: 18,02 +/- 3,6 sec; PS: 81,68 +/- 22,75 mL/100 g/min. In one patient, assessment of perfusion parameters was not feasible for breathing artifacts. One tumor showed poor response to treatment by the evidence of nodular contrast enhancement in the region encompassing the original lesion. Two typical enhancement patterns were obtained comparing the Time-Density curves of responsive and not responsive ablated tumors. Conclusion Perfusion CT seems to be a feasible and promising technique in

  4. CT-guided stereotaxic implantation of Ommaya reservoir for cystic brain tumor

    Energy Technology Data Exchange (ETDEWEB)

    Nakasato, Nobukazu; Niizuma, Hiroshi; Johkura, Hidefumi; Katoh, Seiya; Otsuki, Taisuke; Katakura, Ryuichi; Suzuki, Jiro

    1988-02-01

    We report the use of CT-guided stereotaxic system to implant Ommaya reservoir in 26 patients with cystic brain tumors consisting of 16 gliomas, 3 craniopharyngiomas, 3 metastatic brain tumors and 5 other and unknown pathologies, on the way of their biopsy. The entire procedure was carried out in the CT room using Leksell's CT stereotaxic system. In 24 cases with supratentorial tumors, it was at the option of the operator to take any approach such as frontal, posterior temporal and parietal approaches. Especially in 3 cases of craniopharyngioma, we inserted the tube into their cyst directly so that the ventricle should not be open to the cyst. Also in cases of a pontine glioma and a C-P angle metastatic tumor, we used retromastoid approach to the posterior fossa by making patient's heads turned about 30 to 40 deg to contralateral side of the approach, with slight flexion of the neck. Minimal bleeding occurred during operation in one case, however, it showed no clinical symptoms. Advantages of this method are as follows: Operative invasion is minimal; The surgeon can check the course of the cannula and position of the tip of Ommaya tube even at operation, and can modify it, if necessary.

  5. Repeatability of quantitative FDG-PET/CT and contrast-enhanced CT in recurrent ovarian carcinoma: test-retest measurements for tumor FDG uptake, diameter, and volume.

    Science.gov (United States)

    Rockall, Andrea G; Avril, Norbert; Lam, Raymond; Iannone, Robert; Mozley, P David; Parkinson, Christine; Bergstrom, Donald; Sala, Evis; Sarker, Shah-Jalal; McNeish, Iain A; Brenton, James D

    2014-05-15

    Repeatability of baseline FDG-PET/CT measurements has not been tested in ovarian cancer. This dual-center, prospective study assessed variation in tumor 2[18F]fluoro-2-deoxy-D-glucose (FDG) uptake, tumor diameter, and tumor volume from sequential FDG-PET/CT and contrast-enhanced computed tomography (CECT) in patients with recurrent platinum-sensitive ovarian cancer. Patients underwent two pretreatment baseline FDG-PET/CT (n = 21) and CECT (n = 20) at two clinical sites with different PET/CT instruments. Patients were included if they had at least one target lesion in the abdomen with a standardized uptake value (SUV) maximum (SUVmax) of ≥ 2.5 and a long axis diameter of ≥ 15 mm. Two independent reading methods were used to evaluate repeatability of tumor diameter and SUV uptake: on site and at an imaging clinical research organization (CRO). Tumor volume reads were only performed by CRO. In each reading set, target lesions were independently measured on sequential imaging. Median time between FDG-PET/CT was two days (range 1-7). For site reads, concordance correlation coefficients (CCC) for SUVmean, SUVmax, and tumor diameter were 0.95, 0.94, and 0.99, respectively. Repeatability coefficients were 16.3%, 17.3%, and 8.8% for SUVmean, SUVmax, and tumor diameter, respectively. Similar results were observed for CRO reads. Tumor volume CCC was 0.99 with a repeatability coefficient of 28.1%. There was excellent test-retest repeatability for FDG-PET/CT quantitative measurements across two sites and two independent reading methods. Cutoff values for determining change in SUVmean, SUVmax, and tumor volume establish limits to determine metabolic and/or volumetric response to treatment in platinum-sensitive relapsed ovarian cancer. ©2014 American Association for Cancer Research.

  6. Micro-CT Imaging of RGD-Conjugated Gold Nanorods Targeting Tumor In Vivo

    Directory of Open Access Journals (Sweden)

    Xiaochao Qu

    2016-01-01

    Full Text Available Gold nanomaterials as computed tomography (CT contrast agents at lower X-ray dosage to get a higher contrast have advantages of longer imaging time and lower toxic side effects compared to current contrast agents. As a receptor for Cyclo (Arg-Gly-Asp-D-Phe-Lys (RGD peptide, integrin αvβ3 is overexpressed on some tumor cells and tumor neovasculature. In this paper, we conjugated the RGD peptide on the surface of gold nanorods (AuNRs, designated as RGD-AuNRs, a promising candidate in applications such as tumor targeting and imaging capability for micro-CT imaging. Integrin αvβ3-positive U87 cells and integrin αvβ3-negative HT-29 cells were chosen to establish animal models relatedly and then texted the tumor targeting ability and imaging capability of RGD-AuNRs in vitro and in vivo. The MTT assay and stability measurement showed that RGD-conjugation eliminated their cytotoxicity and improved their biocompatibility and stability. Dark-field imaging of U87 cells and HT-29 cells testified the binding affinities and uptake abilities of RGD-AuNRs, and the results showed that RGD-AuNRs were more specifical to U87 cells. The enhanced micro-CT imaging contrast of intramuscular and subcutaneous injection illustrated the feasibility of RGD-AuNRs to be contrast agents. Furthermore, the micro-CT imaging of targeting U87 and HT-29 tumor models verified the targeting abilities of RGD-AuNRs.

  7. Hemoperitoneum Caused by Hepatic Necrosis and Rupture Following a Snakebite: a Case Report with Rare CT Findings and Successful Embolization

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Jae Hong; Yoo, Dong Gon; Choi, Soo Jung; Lee, Jong Hyeog; Park, Man Soo; Kwak, Jin Ho; Jung, Seung Mun; Ryu, Dae Shick [GangNeung Asan Hospital, University of Ulsan College of Medicine, Gangneung (Korea, Republic of)

    2007-12-15

    Snakebites are a relatively common occurrence worldwide and are estimated to affect greater than 2.5 million humans annually, of whom more than 100,000 will die. Imaging manifestations associated with this entity have rarely been described in the scientific literature. We recently obtained a successful clinical outcome after gelatin sponge sheet embolization of the hepatic artery in the case of a snakebite which caused hemoperitoneum associated with hepatic necrosis and rupture. Until now, this type of complication after a snakebite has not been reported in the literature. We report the computed tomographic and angiographic findings in a case of a snakebite resulting in hemoperitoneum caused by hepatic rupture and necrosis with active bleeding. In conclusion, snakebites have complex venomous effects. They may lead to various changes in hemostasis. In our case, snakebite-induced coagulopathy by a Korean viper resulted in hepatic necrosis and rupture with active bleeding. To our knowledge, this is the first published case about CT findings of hepatic necrosis and rupture with active bleeding after a snakebite and should be recognized as a possible complication following snakebites. We report the computed tomographic and angiographic findings in the case of a recently obtained successful clinical outcome after embolization of the hepatic artery in the case of a snakebite causing hemoperitoneum associated with hepatic necrosis and rupture with active bleeding.

  8. Anatomical variations of hepatic arterial system, coeliac trunk and renal arteries: an analysis with multidetector CT angiography.

    Science.gov (United States)

    Ugurel, M S; Battal, B; Bozlar, U; Nural, M S; Tasar, M; Ors, F; Saglam, M; Karademir, I

    2010-08-01

    The purpose of our investigation was to determine the anatomical variations in the coeliac trunk-hepatic arterial system and the renal arteries in patients who underwent multidetector CT (MDCT) angiography of the abdominal aorta for various reasons. A total of 100 patients were analysed retrospectively. The coeliac trunk, hepatic arterial system and renal arteries were analysed individually and anatomical variations were recorded. Statistical analysis of the relationship between hepatocoeliac variations and renal artery variations was performed using a chi(2) test. There was a coeliac trunk trifurcation in 89% and bifurcation in 8% of the cases. Coeliac trunk was absent in 1%, a hepatosplenomesenteric trunk was seen in 1% and a splenomesenteric trunk was present in 1%. Hepatic artery variation was present in 48% of patients. Coeliac trunk and/or hepatic arterial variation was present in 23 (39.7%) of the 58 patients with normal renal arteries, and in 27 (64.3%) of the 42 patients with accessory renal arteries. There was a statistically significant correlation between renal artery variations and coeliac trunk-hepatic arterial system variations (p = 0.015). MDCT angiography permits a correct and detailed evaluation of hepatic and renal vascular anatomy. The prevalence of variations in the coeliac trunk and/or hepatic arteries is increased in people with accessory renal arteries. For that reason, when undertaking angiographic examinations directed towards any single organ, the possibility of variations in the vascular structure of other organs should be kept in mind.

  9. Gastric Schwannoma mimicking malignant gastrointestinal stromal tumor and misdiagnosed by (18)F-FDG PET/CT.

    Science.gov (United States)

    Zhang, Yiqiu; Li, Beilei; Cai, Liang; Hou, Xiaoguang; Shi, Hongcheng; Hou, Jun

    2015-01-01

    Gastric Schwannoma is a rare benign mesenchymal tumor that accounts for only 0.2% of all gastric tumors. The current study presents a case of gastric Schwannoma misdiagnosed as malignant gastrointestinal stromal tumor (GIST) by esophagogastroduodenoscopy, endoscopic ultrasonography, and contrast-enhanced or not enhanced and (18)F-FDG PET/CT imaging.

  10. Reduced hepatic tumor incidence in cyclin G1-deficient mice

    DEFF Research Database (Denmark)

    Jensen, Michael Rugaard; Factor, Valentina M; Fantozzi, Anna

    2003-01-01

    Cyclin G1 is a transcriptional target of the tumor suppressor p53, and its expression is increased after DNA damage. Recent data show that cyclin G1 can regulate the levels of p53 by a mechanism that involves dephosphorylation of Mdm2 by protein phosphatase 2A. To understand the biologic role...

  11. The impact of respiratory motion on tumor quantification and delineation in static PET/CT imaging

    Science.gov (United States)

    Liu, Chi; Pierce, Larry A., II; Alessio, Adam M.; Kinahan, Paul E.

    2009-12-01

    Our aim is to investigate the impact of respiratory motion on tumor quantification and delineation in static PET/CT imaging using a population of patient respiratory traces. A total of 1295 respiratory traces acquired during whole body PET/CT imaging were classified into three types according to the qualitative shape of their signal histograms. Each trace was scaled to three diaphragm motion amplitudes (6 mm, 11 mm and 16 mm) to drive a whole body PET/CT computer simulation that was validated with a physical phantom experiment. Three lung lesions and one liver lesion were simulated with diameters of 1 cm and 2 cm. PET data were reconstructed using the OS-EM algorithm with attenuation correction using CT images at the end-expiration phase and respiratory-averaged CT. The errors of the lesion maximum standardized uptake values (SUVmax) and lesion volumes between motion-free and motion-blurred PET/CT images were measured and analyzed. For respiration with 11 mm diaphragm motion and larger quiescent period fraction, respiratory motion can cause a mean lesion SUVmax underestimation of 28% and a mean lesion volume overestimation of 130% in PET/CT images with 1 cm lesions. The errors of lesion SUVmax and volume are larger for patient traces with larger motion amplitudes. Smaller lesions are more sensitive to respiratory motion than larger lesions for the same motion amplitude. Patient respiratory traces with relatively larger quiescent period fraction yield results less subject to respiratory motion than traces with long-term amplitude variability. Mismatched attenuation correction due to respiratory motion can cause SUVmax overestimation for lesions in the lower lung region close to the liver dome. Using respiratory-averaged CT for attenuation correction yields smaller mismatch errors than those using end-expiration CT. Respiratory motion can have a significant impact on static oncological PET/CT imaging where SUV and/or volume measurements are important. The impact is

  12. Role of [sup 99m]Tc-labeled RBC SPECT in the diagnosis of hepatic hemangioma; Comparison with US, CT and angiography

    Energy Technology Data Exchange (ETDEWEB)

    Kagei, Kenji; Itoh, Kazuo; Tsukamoto, Eriko; Nakada, Kunihiro; Fujimori, Kenji; Nagao, Kazuhiko; Kanegae, Kakuko; Furudate, Masayori (Hokkaido Univ., Sapporo (Japan). School of Medicine)

    1993-02-01

    The roles of planar imaging and SPECT with [sup 99m]Tc-labeled RBC, US, dynamic CT and angiography in the diagnosis of hepatic hemangioma were evaluated. The study group consisted of 18 patients with a total of 40 hemangiomas and 13 patients with a total of 21 non-hemangiomas. Among these patients, 5 patients with a total of 8 hemangiomas and 10 patients with a total of 14 non-hemangiomas were diagnosed by operation and biopsy. In all 40 hemangiomas, sensitivity for planar imaging was 35%, SPECT 50%, US 53%, dynamic CT 82% and angiography 81%. When the tumor size was greater than 2.2 cm by SPECT and 2.8 cm by planar imaging, their sensitivity for both methods was 100%. Specificity for planar imaging was 100%, SPECT 95%, US 81%, dynamic CT 100% and angiography 83%. One patient with hepatocellular carcinoma diagnosed by angiography showed increased uptake on SPECT. Because of the highest accuracy for SPECT in hemangioma greater than 2.0 cm, SPECT should be considered to be the method of choice for noninvasive diagnosis of hemangioma. (author).

  13. Fulminant Hepatic Failure Caused by Diffuse Liver Metastases following Gastrointestinal Stromal Tumor Resection

    Directory of Open Access Journals (Sweden)

    Abdel-Rauf Zeina

    2009-01-01

    Full Text Available Metastatic tumors to the liver resulting in fulminant hepatic failure are a rare occurrence and have not been previously described in patients with gastrointestinal stromal tumor (GIST. A 70 year-old man was referred to hospital with postprandial discomfort. On examination a 19.5 cm large epithelioid GIST of the stomach was diagnosed. The mass exhibited unfavorable prognostic features: mitotic index 18/50 high-power fields, large primary tumor size and male sex. Complete tumor resection with negative margins was achieved and metastases were not detected. The patient presented six months later with jaundice, asterixis and elevated liver enzymes. Computerized tomography showed multiple liver hypodense lesions representing metastases. Treatment with imatinib mesylate was of no avail and the patient died 3 days later as the result of hepatic failure. Massive liver metastases can, even though rarely, be responsible for fulminant hepatic failure. Clinical and radiological follow-up are crucial in patients with GIST even after surgical resection.

  14. Gastrointestinal stromal tumor (GIST coexisting with pancreatic cancer and hepatic hemangioma

    Directory of Open Access Journals (Sweden)

    M. A. Beltrán

    2014-11-01

    Full Text Available The occurrence of gastric gastrointestinal stromal tumors (GIST associated to pancreatic adenocarcinoma has been reported in 0.2% pancreatic cancers. There are no published reports on distal pancreatic adenocarcinoma associated to gastric antral GIST. Herein, we discuss a 75 years-old female patient who was admitted to our institution with upper digestive hemorrhage. The endoscopy showed large, superficial erosions over the cardias and, on the posterior wall of the antrum, a rounded sub-mucosal non-eroded lesion suspected of gastric GIST. An abdominal computed tomography scan found a hepatic hemangioma on the left hepatic lobe. In the pancreatic distal body and tail a solid exophytic lesion was identified. The surgical findings confirmed the radiologic diagnostic. The biopsy reported a hepatic hemangioma. The pancreatic tail and the proximal part of the body harbored a well-differentiated ductal adenocarcinoma measuring 3.4 cm x 3 cm x 2.5 cm with negative margins. The gastric tumor measured 4 cm x 2.5 cm x 1 cm, was positive for CD117, CD34, and DOG-1; it had a positive Ki67 in less than 2%, and 2 or less mitoses per 50 high-power fields. This uncommon case illustrates the occurrence of synchronous tumors of different cellular origins in the same patient, which were diagnosed during the study for another unrelated condition. The individual incidence of these tumors is low and if associated they probably will continue to be found incidentally.

  15. Calculating tumor trajectory and dose-of-the-day using cone-beam CT projections

    CERN Document Server

    Jones, Bernard L; Miften, Moyed

    2015-01-01

    Purpose: Cone-beam CT (CBCT) projection images provide anatomical data in real-time over several respiratory cycles, forming a comprehensive picture of tumor movement. We developed and validated a method which uses these projections to determine the trajectory of and dose to highly mobile tumors during each fraction of treatment. Methods: CBCT images of a respiration phantom were acquired, the trajectory of which mimicked a lung tumor with high amplitude (up to 2.5 cm) and hysteresis. A template-matching algorithm was used to identify the location of a steel BB in each CBCT projection, and a Gaussian probability density function for the absolute BB position was calculated which best fit the observed trajectory of the BB in the imager geometry. Two modifications of the trajectory reconstruction were investigated: first, using respiratory phase information to refine the trajectory estimation (Phase), and second, using the Monte Carlo (MC) method to sample the estimated Gaussian tumor position distribution. Resu...

  16. Contrast enhanced ultrasound in the evaluation and percutaneous treatment of hepatic and renal tumors

    Energy Technology Data Exchange (ETDEWEB)

    Meloni, Maria Franca, E-mail: meloni.mariafranca@gmail.com [Department of Radiology, Ospedale Valduce, Como (Italy); Smolock, Amanda [Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI (United States); Cantisani, Vito; Bezzi, Mario; D' Ambrosio, Ferdinando [Department of Radiology, Oncology and Anatomo-Pathology “Sapienza” University of Rome, Rome (Italy); Proiti, Maria [Department of Internal Medicine, Vittorio-Emanuele University Hospital, Catania (Italy); Lee, Fred [Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI (United States); Aiani, Luca [Department of Radiology, Ospedale Valduce, Como (Italy); Calliada, Fabrizio [Department of Radiology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia (Italy); Ferraioli, Giovanna [Ultrasound Unit, Infectious Diseases Department, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia (Italy)

    2015-09-15

    Highlights: • Image-guided percutaneous ablation techniques are increasingly being used for the treatment of malignant tumors of the liver and kidney when surgery is not indicated. • Percutaneous ablation relies on imaging at every step of the process in order to detect, guide, and confirm complete tumor coagulation. • CEUS is a real-time dynamic imaging technique that plays an important role in the management of patients treated with ablation for malignant tumors. • This review focuses on the role of CEUS in the evaluation of patients undergoing percutaneous treatments for hepatic and renal tumors. - Abstract: Image-guided percutaneous ablation techniques are increasingly being used for the treatment of malignant tumors of the liver and kidney. Contrast enhanced ultrasound (CEUS) is a real-time dynamic imaging technique that plays an important role in the pre-, intra-, and post-procedural management of these patients. This review will focus on the role of CEUS in the evaluation of patients undergoing treatment with percutaneous ablation for hepatic or renal tumors.

  17. Improvement of internal tumor volumes of non-small cell lung cancer patients for radiation treatment planning using interpolated average CT in PET/CT.

    Directory of Open Access Journals (Sweden)

    Yao-Ching Wang

    Full Text Available Respiratory motion causes uncertainties in tumor edges on either computed tomography (CT or positron emission tomography (PET images and causes misalignment when registering PET and CT images. This phenomenon may cause radiation oncologists to delineate tumor volume inaccurately in radiotherapy treatment planning. The purpose of this study was to analyze radiology applications using interpolated average CT (IACT as attenuation correction (AC to diminish the occurrence of this scenario. Thirteen non-small cell lung cancer patients were recruited for the present comparison study. Each patient had full-inspiration, full-expiration CT images and free breathing PET images by an integrated PET/CT scan. IACT for AC in PET(IACT was used to reduce the PET/CT misalignment. The standardized uptake value (SUV correction with a low radiation dose was applied, and its tumor volume delineation was compared to those from HCT/PET(HCT. The misalignment between the PET(IACT and IACT was reduced when compared to the difference between PET(HCT and HCT. The range of tumor motion was from 4 to 17 mm in the patient cohort. For HCT and PET(HCT, correction was from 72% to 91%, while for IACT and PET(IACT, correction was from 73% to 93% (*p<0.0001. The maximum and minimum differences in SUVmax were 0.18% and 27.27% for PET(HCT and PET(IACT, respectively. The largest percentage differences in the tumor volumes between HCT/PET and IACT/PET were observed in tumors located in the lowest lobe of the lung. Internal tumor volume defined by functional information using IACT/PET(IACT fusion images for lung cancer would reduce the inaccuracy of tumor delineation in radiation therapy planning.

  18. 3D-CT imaging processing for qualitative and quantitative analysis of maxillofacial cysts and tumors

    Energy Technology Data Exchange (ETDEWEB)

    Cavalcanti, Marcelo de Gusmao Paraiso [Sao Paulo Univ., SP (Brazil). Faculdade de Odontologia. Dept. de Radiologia; Antunes, Jose Leopoldo Ferreira [Sao Paulo Univ., SP (Brazil). Faculdade de Odotologia. Dept. de Odontologia Social

    2002-09-01

    The objective of this study was to evaluate spiral-computed tomography (3D-CT) images of 20 patients presenting with cysts and tumors in the maxillofacial complex, in order to compare the surface and volume techniques of image rendering. The qualitative and quantitative appraisal indicated that the volume technique allowed a more precise and accurate observation than the surface method. On the average, the measurements obtained by means of the 3D volume-rendering technique were 6.28% higher than those obtained by means of the surface method. The sensitivity of the 3D surface technique was lower than that of the 3D volume technique for all conditions stipulated in the diagnosis and evaluation of lesions. We concluded that the 3D-CT volume rendering technique was more reproducible and sensitive than the 3D-CT surface method, in the diagnosis, treatment planning and evaluation of maxillofacial lesions, especially those with intra-osseous involvement. (author)

  19. Anorectal giant condyloma acuminatum (Buschke-Loewenstein tumor): CT and radiographic manifestations

    Energy Technology Data Exchange (ETDEWEB)

    Balthazar, E.J.; Streiter, M.; Megibow, A.J.

    1984-03-01

    Giant condyloma acuminatum (Buschke-Loewenstein tumor) is an unusual variety of venereal wart characterized by a large size, cauliflower-like appearance, and locally invasive nature. CT examination of two patients with anorectal giant condylomata revealed the papillomatous and invasive nature of the lesion and the extent of tumor; there was infiltration of the subcutaneous tissue, perirectal fascial planes, and luminal narrowing with marked thickening of the rectal wall. The pathologic specimens showed benign histologic finding in one case and a mixed pattern with areas of malignant degeneration in the other. CT accurately demonstrated the exact location and extent of the lesions. The presence of malignant degeneration in this inherently invasive lesion can be established only on histologic examination.

  20. CT findings of primary retroperitoneal cystic tumors. Special emphasis on the distinction benignancy from malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Nobusawa, Hiroshi; Hashimoto, Touji; Munechika, Hirotsugu [Showa Univ., Tokyo (Japan). School of Medicine] [and others

    1995-10-01

    We describe the CT findings of primary retroperitoneal cystic tumors in 20 patients (cystic lymphangioma, 9; cystic teratoma, 3; cystic neurinoma, 4; mucinous cystadenocarcinoma, 3; synovial sarcoma, 1). CT findings were retrospectively reviewed and the findings correlated with the pathological findings to determine malignant or benign cystic tumors. Definite criteria for malignancy were invasion to surrounding organ and the presence of distant metastasis. However, the sensitivity of these criteria was very low (25%). Enhancement of an intracystic solid component was a reliable criterion (p<0.05) for malignancy (sensitivity 75%, specificity 81%, accuracy 80%). Either unilocular cystic appearance or the presence of a `neck` (between the cystic mass and paraaortic region) strongly suggested the possibility of benignancy (specificity 100%). The `neck` was thought to be morphologically specific for cystic lymphangioma. (author).

  1. Neuroendocrine tumor recurrence: diagnosis with 68Ga-DOTATATE PET/CT.

    Science.gov (United States)

    Haug, Alexander R; Cindea-Drimus, Ramona; Auernhammer, Christoph J; Reincke, Martin; Beuschlein, Felix; Wängler, Björn; Uebleis, Christopher; Schmidt, Gerwin P; Spitzweg, Christine; Bartenstein, Peter; Hacker, Marcus

    2014-02-01

    To evaluate diagnostic performance of gallium 68-tetraazacyclododecane tetraacetic acid-octreotate ((68)Ga-DOTATATE) in detection of recurrent neuroendocrine tumors (NETs). Approval was waived by the local ethics committee for this retrospective study. Between 2007 and 2011, 63 patients (mean age, 58 years) were examined with (68)Ga-DOTATATE positron emission tomography (PET)/computed tomography (CT) after primary NET curative resection. Reasons for PET/CT were regular follow-up examinations (n = 30), increased plasma levels of tumor markers (n = 27), or clinical suspicion of recurrence (n = 6). Final diagnosis was determined with histopathologic verification (n = 25) or clinical follow-up (n = 38). PET/CT scans were evaluated in consensus by two readers without blinding to clinical information and independently by two readers with blinding. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Final diagnosis of NET recurrence was determined in 29 patients. In three other patients, tumors of nonneuroendocrine origin were diagnosed. (68)Ga-DOTATATE PET/CT helped identify NET recurrence in 26 of 29 patients (sensitivity, 90%) and exclude presence of recurrent NET in 28 of 34 patients (specificity, 82% ). PET/CT provided false-positive and false-negative results in six and three patients (PPV, 81% [26 of 32]; NPV, 90% [28 of 31]; accuracy, 86% [54 of 63]). In gastroenteropancreatic NET (n = 45), sensitivity was 94% (17 of 18); specificity was 89% (24 of 27); PPV was 85% (17 of 20); NPV was 96% (24 of 25); and accuracy was 91% (41 of 45). Two blinded readers achieved sensitivity of 79% (23 of 29) and 76% (22 of 29); specificity of 85% (29 of 34) and 94% (32 of 34) (κ = 0.80); and accuracy of 83% and 86%. (68)Ga-DOTATATE PET/CT is accurate in detection of recurrent NET. Blinded PET/CT review markedly decreased sensitivity, underlining importance of considering clinical parameters in NET recurrence. Present

  2. {sup 18}F-FDG PET/CT compared to conventional imaging modalities in pediatric primary bone tumors

    Energy Technology Data Exchange (ETDEWEB)

    London, Kevin [The Children' s Hospital at Westmead, Department of Nuclear Medicine, Sydney, NSW (Australia); University of Sydney, Discipline of Paediatrics and Child Health, Sydney Medical School, Sydney, NSW (Australia); Stege, Claudia; Kaspers, Gertjan [VU Medical Centre, Divisions of Paediatric Oncology/Haematology, Amsterdam (Netherlands); Cross, Siobhan; Dalla-Pozza, Luciano [The Children' s Hospital at Westmead, Department of Oncology, Sydney (Australia); Onikul, Ella [The Children' s Hospital at Westmead, Department of Medical Imaging, Sydney (Australia); Graf, Nicole [The Children' s Hospital at Westmead, Department of Pathology, Sydney (Australia); Howman-Giles, Robert [The Children' s Hospital at Westmead, Department of Nuclear Medicine, Sydney, NSW (Australia); University of Sydney, Discipline of Imaging, Sydney Medical School, Sydney, NSW (Australia)

    2012-04-15

    F-Fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) is useful in adults with primary bone tumors. Limited published data exist in children. To compare hybrid FDG positron emission tomography/computed tomography (PET/CT) with conventional imaging (CI) modalities in detecting malignant lesions, predicting response to chemotherapy and diagnosing physeal involvement in pediatric primary bone tumors. Retrospective analysis of PET/CT and CI reports with histopathology or follow-up > 6 months as reference standard. Response parameters and physeal involvement at diagnosis were compared to histopathology. A total of 314 lesions were detected in 86 scans. Excluding lung lesions, PET/CT had higher sensitivity and specificity than CI (83%, 98% and 78%, 97%, respectively). In lung lesions, PET/CT had higher specificity than CI (96% compared to 87%) but lower sensitivity (80% compared to 93%). Higher initial SUV{sub max} and greater SUV{sub max} reduction on PET/CT after chemotherapy predicted a good response. Change in tumor size on MRI did not predict response. Both PET/CT and MRI were very sensitive but of low specificity in predicting physeal tumor involvement. PET/CT appears more accurate than CI in detecting malignant lesions in childhood primary bone tumors, excluding lung lesions. It seems better than MRI at predicting tumor response to chemotherapy. (orig.)

  3. The clinical impact of {sup 18}F-FDG PET/CT in extracranial pediatric germ cell tumors

    Energy Technology Data Exchange (ETDEWEB)

    Hart, Adam; Vali, Reza; Marie, Eman; Shammas, Amer [The Hospital for Sick Children and University of Toronto, Department of Medical Imaging, Nuclear Medicine, Toronto, ON (Canada); Shaikh, Furqan [The Hospital for Sick Children and University of Toronto, Division of Haematology and oncology, Toronto, ON (Canada)

    2017-10-15

    Extracranial germ cell tumors are an uncommon pediatric malignancy with limited information on the clinical impact of {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in the literature. The purpose of this study was to evaluate and compare the clinical impact on management of {sup 18}F-FDG PET/CT with diagnostic computed tomography (CT) in pediatric extracranial germ cell tumor. The list of {sup 18}F-FDG PET/CT performed for extracranial germ cell tumor between May 2007 and November 2015 was obtained from the nuclear medicine database. {sup 18}F-FDG PET/CT and concurrent diagnostic CT were obtained and independently reviewed. Additionally, the patients' charts were reviewed for duration of follow-up and biopsy when available. The impact of {sup 18}F-FDG PET/CT compared with diagnostic CT on staging and patient management was demonstrated by chart review, imaging findings and follow-up studies. During the study period, 9 children (5 males and 4 females; age range: 1.6-17 years, mode age: 14 years) had 11 {sup 18}F-FDG PET/CT studies for the evaluation of germ cell tumor. Diagnostic CTs were available for comparison in 8 patients (10 {sup 18}F-FDG PET/CT studies). The average interval between diagnostic CT and PET/CT was 7.2 days (range: 0-37 days). In total, five lesions concerning for active malignancy were identified on diagnostic CT while seven were identified on PET/CT. Overall, {sup 18}F-FDG PET/CT resulted in a change in management in 3 of the 9 patients (33%). {sup 18}F-FDG PET/CT had a significant impact on the management of pediatric germ cell tumors in this retrospective study. Continued multicenter studies are required secondary to the rarity of this tumor to demonstrate the benefit of {sup 18}F-FDG PET/CT in particular clinical scenarios. (orig.)

  4. Multiparametric Monitoring of Early Response to Antiangiogenic Therapy: A Sequential Perfusion CT and PET/CT Study in a Rabbit VX2 Tumor Model

    Directory of Open Access Journals (Sweden)

    Jung Im Kim

    2014-01-01

    Full Text Available Objectives. To perform dual analysis of tumor perfusion and glucose metabolism using perfusion CT and FDG-PET/CT for the purpose of monitoring the early response to bevacizumab therapy in rabbit VX2 tumor models and to assess added value of FDG-PET to perfusion CT. Methods. Twenty-four VX2 carcinoma tumors implanted in bilateral back muscles of 12 rabbits were evaluated. Serial concurrent perfusion CT and FDG-PET/CT were performed before and 3, 7, and 14 days after bevacizumab therapy (treatment group or saline infusion (control group. Perfusion CT was analyzed to calculate blood flow (BF, blood volume (BV, and permeability surface area product (PS; FDG-PET was analyzed to calculate SUVmax, SUVmean, total lesion glycolysis (TLG, entropy, and homogeneity. The flow-metabolic ratio (FMR was also calculated and immunohistochemical analysis of microvessel density (MVD was performed. Results. On day 14, BF and BV in the treatment group were significantly lower than in the control group. There were no significant differences in all FDG-PET-derived parameters between both groups. In the treatment group, FMR prominently decreased after therapy and was positively correlated with MVD. Conclusions. In VX2 tumors, FMR could provide further insight into the early antiangiogenic effect reflecting a mismatch in intratumor blood flow and metabolism.

  5. Hepatic parenchymal changes following transcatheter embolization and chemoembolization in a rabbit tumor model.

    Directory of Open Access Journals (Sweden)

    Yong Wang

    Full Text Available OBJECTIVE: To compare the effects of transcatheter arterial chemoembolization (TACE with transcatheter arterial embolization (TAE on liver function, hepatic damage, and hepatic fibrogenesis in a rabbit tumor model. MATERIALS AND METHODS: Thirty-nine New Zealand white rabbits implanted with VX2 tumors in the left liver lobes were randomly divided into three groups: TAE, TACE, and control group. In the TAE group (n = 15, polyvinyl alcohol particles (PVAs were used for left hepatic artery embolization. In the TACE group (n = 15, the tumors were treated with left hepatic arterial infusions of a suspension of 10-hydroxycamptothecin and lipiodol, followed by embolization with PVAs. In the control group (n = 9, the animals received sham treatment with distilled water. Serum and liver samples were collected at 6 hours, 3 days and 7 days after treatment. Liver damage was measured using a liver function test and histological analyses. Liver fibrogenesis and hepatic stellate cell (HSC activation were evaluated using Sirius Red and anti-alpha-smooth muscle actin (α-SMA immunohistochemical stains. RESULTS: TACE caused liver injury with greater increases in serum alanine aminotransferase and aspartate aminotransferase levels on day 3 (P<0.05. Histological analyses revealed increased hepatic necrosis in adjacent non-tumorous liver tissue from day 3 compared to the TAE group (Suzuki score of 2.33±1.29 versus 1.13±1.18, P = 0.001. HSC activation and proliferation were significantly increased in the TACE group compared to the control group at 3 and 7 days after treatment (0.074±0.014 vs. 0.010±0.006, and 0.088±0.023 vs. 0.017±0.009, P<0.05. Sirius Red staining demonstrated a statistically significant increase in collagen deposition in the livers in the TACE group 7 days after embolization compared to the control group (0.118±0.012 vs. 0.060±0.017, P = 0.05. CONCLUSION: The results of this animal study revealed that TACE induced

  6. Hepatic arterial embolization and chemoembolization for the treatment of patients with metastatic neuroendocrine tumors: variables affecting response rates and survival

    National Research Council Canada - National Science Library

    Gupta, Sanjay; Johnson, Marcella M; Murthy, Ravi; Ahrar, Kamran; Wallace, Michael J; Madoff, David C; McRae, Stephen E; Hicks, Marshall E; Rao, Sujaya; Vauthey, Jean-Nicolas; Ajani, Jaffer A; Yao, James C

    2005-01-01

    The objective of this study was to determine the prognostic variables that influence response and survival in patients with metastatic neuroendocrine tumors who are treated with hepatic arterial embolization (HAE...

  7. Mitophagy Controls the Activities of Tumor Suppressor p53 to Regulate Hepatic Cancer Stem Cells.

    Science.gov (United States)

    Liu, Kai; Lee, Jiyoung; Kim, Ja Yeon; Wang, Linya; Tian, Yongjun; Chan, Stephanie T; Cho, Cecilia; Machida, Keigo; Chen, Dexi; Ou, Jing-Hsiung James

    2017-10-19

    Autophagy is required for benign hepatic tumors to progress into malignant hepatocellular carcinoma. However, the mechanism is unclear. Here, we report that mitophagy, the selective removal of mitochondria by autophagy, positively regulates hepatic cancer stem cells (CSCs) by suppressing the tumor suppressor p53. When mitophagy is enhanced, p53 co-localizes with mitochondria and is removed by a mitophagy-dependent manner. However, when mitophagy is inhibited, p53 is phosphorylated at serine-392 by PINK1, a kinase associated with mitophagy, on mitochondria and translocated into the nucleus, where it binds to the NANOG promoter to prevent OCT4 and SOX2 transcription factors from activating the expression of NANOG, a transcription factor critical for maintaining the stemness and the self-renewal ability of CSCs, resulting in the reduction of hepatic CSC populations. These results demonstrate that mitophagy controls the activities of p53 to maintain hepatic CSCs and provide an explanation as to why autophagy is required to promote hepatocarcinogenesis. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. CT diagnosis and differentiation of benign and malignant varieties of solitary fibrous tumor of the pleura

    Science.gov (United States)

    You, Xiaofang; Sun, Xiwen; Yang, Chunyan; Fang, Yong

    2017-01-01

    Abstract To investigate computed tomography (CT) characteristics of benign and malignant solitary fibrous tumors of the pleura (SFTPs). Preoperative CTs for 60 SFTP cases (49 benign and 11 malignant) with subsequently confirmed diagnoses were retrospectively analyzed. Tumor morphologies included mounded or mushroom umbrella-shape (19 cases, 31.7%), quasi-circular or oval-shape (30 cases, 50%), and growth resembling a casting mould (12 cases, 20%). Maximum tumor diameters were 1.1 to 18.9 cm (average: 6.4 ± 4.8 cm). Fifty-seven cases had clear boundaries, and 3 had partially coarse boundaries. Twenty-seven cases showed homogeneous density; 33, “geographic”-patterned inhomogeneous density; 6, calcifications; 12, intratumor blood vessels; and 3, thick nourishing peritumoral blood vessels. Pleural thickening (regular and irregular) was found adjacent to tumors in 4, compression of adjacent ribs with absorption and cortical sclerosis in 2, and location adjacent to ribs with bony destruction in 1. Four cases had a small amount of lung tissue enfolded along the boundary, 2 had multiple peritumoral pulmonary bullae, and 9 had small ipsilateral pleural effusions. Compared with benign and malignant SFTPs were larger (P < .001), had inhomogeneous density, and were more commonly associated with intratumor blood vessels and pleural effusions (P < .01). CT revealed characteristic patterns in SFTPs, including casting mould-like growth, rich blood supply, and “geographic”-patterned enhancement. In addition, larger tumor size, inhomogeneous intensities, abundant intratumor blood vessels, and pleural effusions were more common with malignancy. Lastly, multislice CT angiography can reveal feeding arteries and help guide surgical management. PMID:29245313

  9. Differentiation of primary chordoma, giant cell tumor and schwannoma of the sacrum by CT and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Si, Ming-Jue, E-mail: smjsh@hotmail.com [Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025 (China); Wang, Cheng-Sheng [Department of Radiology, Union Hospital, Fujian Medical University, Fuzhou 350001 (China); Ding, Xiao-Yi, E-mail: dingxiaoyi1965@hotmail.com [Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025 (China); Yuan, Fei, E-mail: yuanfeirj@hotmail.com [Department of Pathology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025 (China); Du, Lian-Jun; Lu, Yong [Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025 (China); Zhang, Wei-Bin [Department of Orthopedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025 (China)

    2013-12-01

    Objective: To evaluate criteria to differentiate sacral chordoma (SC), sacral giant cell tumor (SGCT) and giant sacral schwannoma (GSS) with CT and MRI. Materials and methods: CT and MR images of 22 SCs, 19 SGCTs and 8 GSSs were reviewed. The clinical and imaging features of each tumor were analyzed. Results: The mean ages of SC, SGCT and GSS were 55.1 ± 10.7, 34.3 ± 10.7 and 42.4 ± 15.7 years old. SCs (77.3%) were predominantly located in the midline of lower sacrum, while most SGCTs (73.7%) and GSSs (87.5%) were eccentrically located in upper sacrum. There were significant differences in age, location, eccentricity, morphology of bone residues, intratumoral bleeding and septations. Multiple small cysts were mainly observed in SGCTs (73.7%) with large central cysts in GSSs (87.5%). SGCTs expanded mainly inside sacrum while SCs and GSSs often extended into pelvic cavity (P = 0.0022). Involvement of sacroiliac joints and muscles were also different. Ascending extension within sacral canal was only displayed in SCs. The preservation of intervertebral discs showed difference between large and small tumors (P = 0.0002), regardless of tumor type (P = 0.095). No significant difference was displayed in gender (P = 0.234) or tumor size (P = 0.0832) among three groups. Conclusion: Age, epicenter of the lesion (midline vs. eccentric and upper vs. lower sacral vertebra), bone residues, cysts, bleeding, septation, expanding pattern, muscles and sacroiliac joint involvement can be criteria for diagnosis. Fluid–fluid level is specific for SGCTs and ascending extension within the sacral canal for SCs. The preservation of intervertebral discs is related to tumor size rather than tumor type.

  10. Proteomic analysis of tumor tissue in CT-26 implanted BALB/C mouse after treatment with ascorbic acid

    National Research Council Canada - National Science Library

    Lee, Jihye; Lee, Gunsup; Park, Jin Hee; Lee, Sukchan; Yeom, Chang-Hwan; Na, Byungjo; Park, Seyeon

    2012-01-01

    .... Proteome changes of tumor tissue were investigated after intraperitoneal administration of a high concentration of ascorbic acid in BALB/C mice implanted with CT-26 cancer cells using two-dimensional...

  11. Incidental diagnosis of tumor thrombosis on FDG PET/CT imaging.

    Science.gov (United States)

    Erhamamci, S; Reyhan, M; Nursal, G N; Torun, N; Yapar, A F

    2015-01-01

    Clinical data are presented on patients with tumor thrombosis (TT) incidentally detected on FDG PET/CT imaging, as well as determining its prevalence and metabolic characteristics. Out of 12,500 consecutive PET/CT examinations of patients with malignancy, the PET/CT images of 15 patients with TT as an incidental finding were retrospectively investigated. A visual and semiquantitative analyses was performed on the PET/CT scans. An evaluation was made of the pattern of FDG uptake in the involved vessel as linear or focal via visual analyses. For the semiquantitative analyses, the metabolic activity was measured using SUVmax by drawing the region of interest at the site of the thrombosis and tumor (if any). The prevalence of occult TT was 0.12%. A total of 15 patients had various malignancies including renal (1 patient), liver (4), pancreas (2), stomach (1), colon (1), non-Hodgkin lymphoma (1), leiomyosarcoma (1), endometrial (1), ovarian (1), malign melanoma (1) and parotid (1). Nineteen vessels with TT were identified in 15 patients; three patients had more than one vessel. Various vessels were affected; the most common was the inferior vena cava (n=7) followed by the portal (n=5), renal (n=3), splenic (n=1), jugular (n=1), common iliac (n=1) and ovarian vein (n=1). The FDG uptake pattern was linear in 12 and focal in 3 patients. The mean SUVmax values in the TT and primary tumors were 8.40±4.56 and 13.77±6.80, respectively. Occult TT from various malignancies and locations was found incidentally in 0.12% of patients. Interesting cases with malign melanoma and parotid carcinoma and with TT in ovarian vein were first described by FDG PET/CT. Based on the linear FDG uptake pattern and high SUVmax value, PET/CT may accurately detect occult TT, help with the assessment of treatment response, contribute to correct tumor staging, and provide additional information on the survival rates of oncology patients. Copyright © 2015 Elsevier España, S.L.U. and SEMNIM. All

  12. Quantitative evaluation of CT-perfusion map as indicator of tumor response to transarterial chemoembolization and radiofrequency ablation in HCC patients

    Energy Technology Data Exchange (ETDEWEB)

    Ippolito, Davide, E-mail: davide.atena@tiscalinet.it [School of Medicine, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza, MB (Italy); Department of Diagnostic Radiology, H. S. Gerardo Monza, Via Pergolesi 33, 20900 Monza, MB (Italy); Fior, Davide; Bonaffini, Pietro Andrea; Capraro, Cristina [School of Medicine, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza, MB (Italy); Department of Diagnostic Radiology, H. S. Gerardo Monza, Via Pergolesi 33, 20900 Monza, MB (Italy); Leni, Davide; Corso, Rocco [Department of Interventional Radiology, H. S. Gerardo Monza, Via Pergolesi 33, 20900 Monza, MB (Italy); Sironi, Sandro [School of Medicine, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza, MB (Italy); Department of Diagnostic Radiology, H. S. Gerardo Monza, Via Pergolesi 33, 20900 Monza, MB (Italy)

    2014-09-15

    Highlights: • We examine perfusion values in two different categories of treated HCC patients. • Perfusion parameters are not influenced by TACE or RFA treatments. • CT-p represents a non-invasive diagnostic technique able to assess treatment response. - Abstract: Purpose: To assess if radiofrequency ablation (RFA) and transarterial chemoembolization (TACE) may influence the evaluation of perfusion parameters obtained with CT-perfusion (CT-p) in HCC treated patients. Materials and methods: Thirty-three consecutive cirrhotic patients with biopsy-proven diagnosis of HCC lesions and candidates to TACE or RFA were included. The CT-p study of hepatic parenchyma and of treated lesions was performed about 1 month after treatment on 16 multidetector CT after injection of 50 mL of non ionic contrast agent (350 mg I/mL) at a flow rate of 6 mL/s acquiring 40 dynamic scans. A dedicated perfusion software which generated a quantitative map of arterial and portal perfusion by means of colour scale was employed.The following perfusion parameters were assessed before and after RFA or TACE treatment: hepatic perfusion (HP), arterial perfusion (AP), blood volume (BV), time to peak (TTP), hepatic perfusion index (HPI). Results: A complete treatment was obtained in 16 cases and incomplete treatment in the 17 remaining cases. The perfusion data of completely treated lesions were: HP 10.2 ± 6.3; AP 10.4 ± 7; BV 4.05 ± 4.8; TTP 38.9 ± 4.2; HPI 9.9 ± 9.2, whereas in partially treated lesions were: HP 43.2 ± 15.1 mL/s/100 g; AP 38.7 ± 8.8 mL/min; BV 20.7 ± 9.5 mL/100 mg; TTP 24 ± 3.7 s; HPI 61.7 ± 7.5%. In adjacent cirrhotic parenchyma, the parameters of all evaluated patients were: HP 13.2 ± 4; AP 12.3 ± 3.4; BV 11.8 ± 2.8; TTP 43.9 ± 2.9; and HPI 17.1 ± 9.8. A significant difference (P < 0.001) was found for all parameters between residual viable tumor tissue (P < 0.001) compared to successfully treated lesion due to the presence of residual arterial vascular

  13. Clinical evaluation of CT in diagnosis of postoperative recurrent tumors of the paranasal sinuses; Kliniczna ocena tomografii komputerowej w rozpoznawaniu pooperacyjnej wznowy nowotworow zatok przynosowych

    Energy Technology Data Exchange (ETDEWEB)

    Jankowska-Kuc, M.; Bochnia, M.; Rak, J. [Akademia Medyczna, Wroclaw (Poland)

    1994-12-31

    The role of computed tomography (CT) in diagnose of postoperative recurrent tumors of the paranasal sinuses was evaluated in 21 cases. CT provided significant information in 19 cases. Two patients had false negative CT findings of recurrent tumor. Despite of limitations CT is a useful diagnostic tool for detection of recurrences. CT display more possibility in discovering of bone destruction than in evaluating of deep infiltrations. (author) 5 refs, 2 tabs

  14. MRI findings of hepatic hemangioma with a special reference to tumor size

    Energy Technology Data Exchange (ETDEWEB)

    Ogata, Ichiro; Yamashita, Yasuyuki; Hatanaka, Yoshimi; Nishiharu, Taizi; Urata, Zyouzi; Matsukawa, Tetsuya; Yamamoto, Hiroaki; Takahashi, Mutsumasa [Kumamoto Univ. (Japan). School of Medicine

    1997-01-01

    The purpose of this research is to define the appearance of hepatic hemangiomas on T{sub 2}-weighted and dynamic gadolinium-enhanced FLASH magnetic resonance (MR) images. With 1.5-T MR imaging, T{sub 1} and T{sub 2}-weighted spin echo and dynamic gadolinium-enhanced FLASH, and postcontrast, T{sub 1}-weighted spin echo images were obtained in 74 patients. Signal intensity, internal architecture, margin on T{sub 2}-weighted images and pattern of enhancement on dynamic images were correlated with tumor size. As a result, in all, 96 hemangiomas were depicted. On T{sub 2}-weighted images, 90 tumors were very hyperintense and 6 tumors were slightly hyperintense relative to the surrounding liver. Tumors of very hyperintensity, homogenous architecture or with septation tended to be larger than those without these findings (p<0.0001). 53 tumors showed peripheral enhancement, while 17 tumors showed total enhancement. Tumor size of former enhancement pattern was significantly larger than that of later enhancement pattern. So we concluded that MR appearance of hemangioma has close relationship with tumor size. (author)

  15. Primary hepatic actinomycosis mimicking a tumor (inflammatory pseudotumor: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Ayşe Batirel

    2015-06-01

    Full Text Available Actinomycosis often manifests with abscesses in the cervicofacial region. Hepatic involvement occurs usually secondary to an intraabdominal infection. “Isolated or primary hepatic actinomycosis (PHA defines actinomycosis in which the source of infection cannot be demonstrated elsewhere. Herein, we aimed to highlight hepatic actinomycosis in the differential diagnosis of hepatic mass lesions, and also its occurrence even in patients without underlying risk factors. A 24-year-old man, who presented with epigastric and right-upper-quadrant abdominal pain, fever, weight loss, and had a tumor-like mass in the liver was admitted to our hospital. He had no predisposing risk factors or comorbidities. We reviewed all the cases with PHA, who had no predisposing risk factors, in English medical literature from 1993 to 2014. Actinomycotic hepatic pseudotumors should be considered in the differential diagnosis of solitary liver lesions even in patients without any predisposing factors. Multi-disciplinary approach is important in the diagnosis and management. J Microbiol Infect Dis 2015;5(2: 79-84

  16. The minimal ablative margin of radiofrequency ablation of hepatocellular carcinoma (> 2 and < 5 cm) needed to prevent local tumor progression: 3D quantitative assessment using CT image fusion.

    Science.gov (United States)

    Kim, Young-Sun; Lee, Won Jae; Rhim, Hyunchul; Lim, Hyo K; Choi, Dongil; Lee, Ji Young

    2010-09-01

    The aim of this study was to elucidate the minimal ablative margin for percutaneous radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC) (> 2 and ablative margin quantitatively. Risk factors for local tumor progression (the thinnest ablative margin, tumor size, and the effect of hepatic vessels) were assessed by multivariate analysis. Patients underwent follow-up for 12.9-46.6 months (median, 28.1 months). The tumors were 2.1-4.8 cm (mean +/- SD, 2.7 +/- 0.6 cm) in diameter. The thinnest ablative margins ranged from 0 to 6 mm (1.0 +/- 1.4 mm). A 5-mm safety margin was achieved in only 2.7% (3/110) of cases. In 47.3% (52/110) of cases, vessel-induced indentation of the ablation zone contributed to the thinnest ablative margins. Local tumor progression was detected in 27.3% (30/110) of cases. Concordance between local tumor progression and the thinnest margin was observed in 83.3% (25/30) of cases. The incidence of concordant local tumor progression was 22.7% (25/110), 18.9% (10/53), 5.9% (2/34), and 0% (0/15) in tumors with the thinnest ablative margin of > or = 0, > or = 1, > or = 2, and > or = 3 mm, respectively. An insufficient ablative margin was the sole significant factor associated with local tumor progression. When the thickness of the ablative margin is evaluated by CT image fusion, a margin of 3 mm or more appears to be associated with a lower rate of local tumor progression after percutaneous RFA of HCC.

  17. TU-H-CAMPUS-JeP2-02: Interobserver Variability of CT, PET-CT and MRI Based Primary Tumor Delineation for Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Karki, K; Hugo, G; Saraiya, S; Jan, N; Schuster, J; Schutzer, M; Fahrner, L; Groves, R; Ford, J; Weiss, E [Virginia Commonwealth University, Richmond, VA (United States)

    2016-06-15

    Purpose: Target delineation in lung cancer radiotherapy has, in general, large variability. MRI has so far not been investigated in detail for lung cancer delineation variability. The purpose of this study is to investigate delineation variability for lung tumors using MRI and compare it to CT alone and PET-CT based delineations. Methods: Seven physicians delineated the primary tumor volumes of nine patients for the following scenarios: (1) CT only; (2) post-contrast T1-weighted MRI registered with diffusion-weighted MRI; and (3) PET-CT fusion images. To compute interobserver variability, the median surface was generated from all observers’ contours and used as the reference surface. A single physician labeled the interface types (tumor to lung, atelectasis (collapsed lung), hilum, mediastinum, or chest-wall) on the median surface. Volume variation (normalized to PET-CT volume), minimum distance (MD), and bidirectional local distance (BLD) between individual observers’ contours and the reference contour were measured. Results: CT- and MRI-based normalized volumes were 1.61±0.76 (mean±SD) and 1.38±0.44, respectively, both significantly larger than PET-CT (p<0.05, paired t-test). The overall uncertainty (root mean square of SD values over all points) of both BLD and MD measures of the observers for the interfaces were not significantly different (p>0.05, two-samples t-test) for all imaging modalities except between tumor-mediastinum and tumor-atelectasis in PET-CT. The largest mean overall uncertainty was observed for tumor-atelectasis interface, the smallest for tumor-mediastinum and tumor-lung interfaces for all modalities. The whole tumor uncertainties for both BLD and MD were not significantly different between any two modalities (p>0.05, paired t-test). Overall uncertainties for the interfaces using BLD were similar to using MD. Conclusion: Large volume variations were observed between the three imaging modalities. Contouring variability appeared to

  18. Using X-ray in-line phase-contrast imaging for the investigation of nude mouse hepatic tumors.

    Directory of Open Access Journals (Sweden)

    Qiang Tao

    Full Text Available The purpose of this paper is to report the noninvasive imaging of hepatic tumors without contrast agents. Both normal tissues and tumor tissues can be detected, and tumor tissues in different stages can be classified quantitatively. We implanted BEL-7402 human hepatocellular carcinoma cells into the livers of nude mice and then imaged the livers using X-ray in-line phase-contrast imaging (ILPCI. The projection images' texture feature based on gray level co-occurrence matrix (GLCM and dual-tree complex wavelet transforms (DTCWT were extracted to discriminate normal tissues and tumor tissues. Different stages of hepatic tumors were classified using support vector machines (SVM. Images of livers from nude mice sacrificed 6 days after inoculation with cancer cells show diffuse distribution of the tumor tissue, but images of livers from nude mice sacrificed 9, 12, or 15 days after inoculation with cancer cells show necrotic lumps in the tumor tissue. The results of the principal component analysis (PCA of the texture features based on GLCM of normal regions were positive, but those of tumor regions were negative. The results of PCA of the texture features based on DTCWT of normal regions were greater than those of tumor regions. The values of the texture features in low-frequency coefficient images increased monotonically with the growth of the tumors. Different stages of liver tumors can be classified using SVM, and the accuracy is 83.33%. Noninvasive and micron-scale imaging can be achieved by X-ray ILPCI. We can observe hepatic tumors and small vessels from the phase-contrast images. This new imaging approach for hepatic cancer is effective and has potential use in the early detection and classification of hepatic tumors.

  19. Using X-ray in-line phase-contrast imaging for the investigation of nude mouse hepatic tumors.

    Science.gov (United States)

    Tao, Qiang; Li, Dongyue; Zhang, Lu; Luo, Shuqian

    2012-01-01

    The purpose of this paper is to report the noninvasive imaging of hepatic tumors without contrast agents. Both normal tissues and tumor tissues can be detected, and tumor tissues in different stages can be classified quantitatively. We implanted BEL-7402 human hepatocellular carcinoma cells into the livers of nude mice and then imaged the livers using X-ray in-line phase-contrast imaging (ILPCI). The projection images' texture feature based on gray level co-occurrence matrix (GLCM) and dual-tree complex wavelet transforms (DTCWT) were extracted to discriminate normal tissues and tumor tissues. Different stages of hepatic tumors were classified using support vector machines (SVM). Images of livers from nude mice sacrificed 6 days after inoculation with cancer cells show diffuse distribution of the tumor tissue, but images of livers from nude mice sacrificed 9, 12, or 15 days after inoculation with cancer cells show necrotic lumps in the tumor tissue. The results of the principal component analysis (PCA) of the texture features based on GLCM of normal regions were positive, but those of tumor regions were negative. The results of PCA of the texture features based on DTCWT of normal regions were greater than those of tumor regions. The values of the texture features in low-frequency coefficient images increased monotonically with the growth of the tumors. Different stages of liver tumors can be classified using SVM, and the accuracy is 83.33%. Noninvasive and micron-scale imaging can be achieved by X-ray ILPCI. We can observe hepatic tumors and small vessels from the phase-contrast images. This new imaging approach for hepatic cancer is effective and has potential use in the early detection and classification of hepatic tumors.

  20. Specificity of unenhanced CT for non-invasive diagnosis of hepatic steatosis: implications for the investigation of the natural history of incidental steatosis

    Energy Technology Data Exchange (ETDEWEB)

    Pickhardt, Perry J.; Hahn, Luke [University of Wisconsin School of Medicine and Public Health, Department of Radiology, Madison, WI (United States); Park, Seong Ho [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea, Republic of); Lee, Sung-Gyu [University of Ulsan College of Medicine, Asan Medical Center, Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Seoul (Korea, Republic of); Bae, Kyongtae T. [University of Pittsburgh, Department of Radiology, Pittsburgh, PA (United States); Yu, Eun Sil [University of Ulsan College of Medicine, Asan Medical Center, Department of Pathology, Seoul (Korea, Republic of)

    2012-05-15

    To determine a highly specific liver attenuation threshold at unenhanced CT for biopsy-proven moderate to severe hepatic steatosis ({>=}30% at histology). 315 asymptomatic adults (mean age {+-} SD, 31.5 {+-} 10.1 years; 207 men, 108 women) underwent same-day unenhanced liver CT and ultrasound-guided liver biopsy. Blinded to biopsy results, CT liver attenuation was measured using standard region-of-interest methodology. Multiple linear regression analysis was used to assess the relationship of CT liver attenuation with patient age, gender, BMI, CT system, and hepatic fat and iron content. Thirty-nine subjects had moderate to severe steatosis and 276 had mild or no steatosis. A liver attenuation threshold of 48 HU was 100% specific (276/276) for moderate to severe steatosis, with no false-positives. Sensitivity, PPV and NPV at this HU threshold was 53.8%, 100% and 93.9%. Hepatic fat content was the overwhelming determinant of liver attenuation values, but CT system (P < 0.001), and hepatic iron (P = 0.035) also had a statistically significant independent association. Unenhanced CT liver attenuation alone is highly specific for moderate to severe hepatic steatosis, allowing for confident non-invasive identification of large retrospective/prospective cohorts for natural history evaluation of incidental non-alcoholic fatty liver disease. Low sensitivity, however, precludes effective population screening at this threshold. (orig.)

  1. Renal Tumor Cryoablation Planning. The Efficiency of Simulation on Reconstructed 3D CT Scan

    Directory of Open Access Journals (Sweden)

    Ciprian Valerian LUCAN

    2010-12-01

    Full Text Available Introduction & Objective: Nephron-sparing surgical techniques risks are related to tumor relationships with adjacent anatomic structures. Complexity of the renal anatomy drives the interest to develop tools for 3D reconstruction and surgery simulation. The aim of the article was to assess the simulation on reconstructed 3D CT scan used for planning the cryoablation. Material & Method: A prospective randomized study was performed between Jan. 2007 and July 2009 on 27 patients who underwent retroperitoneoscopic T1a renal tumors cryoablation (RC. All patients were assessed preoperatively by CT scan, also used for 3D volume rendering. In the Gr.A, the patients underwent surgery planning by simulation on 3D CT scan. In the Gr.B., patients underwent standard RC. The two groups were compared in terms of surgical time, bleeding, postoperative drainage, analgesics requirement, hospital stay, time to socio-professional reintegration. Results: Fourteen patients underwent preoperative cryoablation planning (Gr.A and 13 patients underwent standard CR (Gr.B. All parameters analyzed were shorter in the Gr.A. On multivariate logistic regression, only shortens of the surgical time (138.79±5.51 min. in Gr.A. vs. 140.92±5.54 min in Gr.B. and bleeding (164.29±60.22 mL in Gr.A. vs. 215.38±100.80 mL in Gr.B. achieved statistical significance (p<0.05. The number of cryoneedles assessed by simulation had a 92.52% accuracy when compared with those effectively used. Conclusions: Simulation of the cryoablation using reconstructed 3D CT scan improves the surgical results. The application used for simulation was able to accurately assess the number of cryoneedles required for tumor ablation, their direction and approach.

  2. SU-E-QI-20: A Review of Advanced PET and CT Image Features for the Evaluation of Tumor Response

    Energy Technology Data Exchange (ETDEWEB)

    Lu, W [University of Maryland School of Medicine, Baltimore, MD (United States)

    2014-06-15

    Purpose: To review the literature in using quantitative PET and CT image features for the evaluation of tumor response. Methods: We reviewed and summarized more than fifty papers that use advanced, quantitative PET/CT image features for the evaluation of tumor response. We also discussed future works on extracting disease-specific features, combining multiple and complementary features in response modeling, delineating tumor in multimodality images, and exploring biological explanations of these advanced features. Results: Advanced PET image features considering spatial information, such as tumor volume, tumor shape, total glycolytic volume, histogram distance, and texture features (characterizing spatial distribution of FDG uptake) have been found more informative than the traditional SUVmax for the prediction of tumor response. Advanced CT features, including volumetric, attenuation, morphologic, structure, and texture descriptors, have also been found advantage over the traditional RECIST and WHO criteria in certain tumor types. Conclusions: Advanced, quantitative FDG PET/CT image features have been shown promising for the evaluation of tumor response. With the emerging multi-modality imaging performed at multiple time points for each patient, it becomes more important to analyze the serial images quantitatively, select and combine both complementary and contradictory information from various sources, for accurate and personalized evaluation of tumor response to therapy.

  3. The immunomodulatory activities of licorice polysaccharides (Glycyrrhiza uralensis Fisch.) in CT 26 tumor-bearing mice.

    Science.gov (United States)

    Ayeka, Peter Amwoga; Bian, YuHong; Githaiga, Peter Mwitari; Zhao, Ying

    2017-12-15

    The increasing use of complementary and alternative medicine (CAM) has kindled the need for scientific evaluation of the mechanism of action of CAMs. Although, licorice, a common ingredient in many Traditional Chinese medicine (TCM) has attracted great attention for its antitumor and immunomodulatory activities, the mechanism of action of its polysaccharides is still unclear. Here we report the immunomodulatory activity of licorice polysaccharides in vivo. The differential anticancer activities of licorice polysaccharides by tumorigenesis and immunomodulation was evaluated in vivo. Six weeks old, 120 CT-26 tumor bearing BALB/c mice, weighing 20 ± 2 g were used. They were randomly divided into six groups, three groups receiving high molecular weight (fraction A), low molecular weight (fraction B) polysaccharides and crude extract (fraction C); positive, negative and normal groups receiving cytoxin, saline and normal diet respectively. Weight of mice and tumors was determined and tumorigenicity assay calculated to determine the anticancer effects. Immunomodulatory potential was determined by immune organ indices, immune cell population and serum cytokine levels using immune organ weight and index, flow cytometry and cytokine/chemokine bead panel kit respectively. Licorice polysaccharides exhibited immunomodulatory activities in CT 26 tumor bearing BALB/c mice. The polysaccharides significantly suppressed tumor growth and increased immune organ index. Furthermore, the immunomodulatory effect was evident with activation of CD4 + and CD8 + immune cells population. The polysaccharides also affected the production of various cytokines, by increasing IL 2, IL 6, IL 7 levels and a decreasing TNFα levels. In summary, licorice polysaccharide especially of low molecular weight exhibit anticancer and immunomodulatory activities by suppressing tumor growth and improving general health of mice. They also augment the thymus/spleen index and population of T lymphocytes

  4. Polydopamine-coated gold nanostars for CT imaging and enhanced photothermal therapy of tumors

    Science.gov (United States)

    Li, Du; Shi, Xiangyang; Jin, Dayong

    2016-12-01

    The advancement of biocompatible nanoplatforms with dual functionalities of diagnosis and therapeutics is strongly demanded in biomedicine in recent years. In this work, we report the synthesis and characterization of polydopamine (pD)-coated gold nanostars (Au NSs) for computed tomography (CT) imaging and enhanced photothermal therapy (PTT) of tumors. Au NSs were firstly formed via a seed-mediated growth method and then stabilized with thiolated polyethyleneimine (PEI-SH), followed by deposition of pD on their surface. The formed pD-coated Au NSs (Au-PEI@pD NSs) were well characterized. We show that the Au-PEI@pD NSs are able to convert the absorbed near-infrared laser light into heat, and have strong X-ray attenuation property. Due to the co-existence of Au NSs and the pD, the light to heat conversion efficiency of the NSs can be significantly enhanced. These very interesting properties allow their uses as a powerful theranostic nanoplatform for efficient CT imaging and enhanced phtotothermal therapy of cancer cells in vitro and the xenografted tumor model in vivo. With the easy functionalization nature enabled by the coated pD shell, the developed pD-coated Au NSs may be developed as a versatile nanoplatform for targeted CT imaging and PTT of different types of cancer.

  5. Automated measurements of metabolic tumor volume and metabolic parameters in lung PET/CT imaging

    Science.gov (United States)

    Orologas, F.; Saitis, P.; Kallergi, M.

    2017-11-01

    Patients with lung tumors or inflammatory lung disease could greatly benefit in terms of treatment and follow-up by PET/CT quantitative imaging, namely measurements of metabolic tumor volume (MTV), standardized uptake values (SUVs) and total lesion glycolysis (TLG). The purpose of this study was the development of an unsupervised or partially supervised algorithm using standard image processing tools for measuring MTV, SUV, and TLG from lung PET/CT scans. Automated metabolic lesion volume and metabolic parameter measurements were achieved through a 5 step algorithm: (i) The segmentation of the lung areas on the CT slices, (ii) the registration of the CT segmented lung regions on the PET images to define the anatomical boundaries of the lungs on the functional data, (iii) the segmentation of the regions of interest (ROIs) on the PET images based on adaptive thresholding and clinical criteria, (iv) the estimation of the number of pixels and pixel intensities in the PET slices of the segmented ROIs, (v) the estimation of MTV, SUVs, and TLG from the previous step and DICOM header data. Whole body PET/CT scans of patients with sarcoidosis were used for training and testing the algorithm. Lung area segmentation on the CT slices was better achieved with semi-supervised techniques that reduced false positive detections significantly. Lung segmentation results agreed with the lung volumes published in the literature while the agreement between experts and algorithm in the segmentation of the lesions was around 88%. Segmentation results depended on the image resolution selected for processing. The clinical parameters, SUV (either mean or max or peak) and TLG estimated by the segmented ROIs and DICOM header data provided a way to correlate imaging data to clinical and demographic data. In conclusion, automated MTV, SUV, and TLG measurements offer powerful analysis tools in PET/CT imaging of the lungs. Custom-made algorithms are often a better approach than the manufacturer

  6. Topology polymorphism graph for lung tumor segmentation in PET-CT images

    Science.gov (United States)

    Cui, Hui; Wang, Xiuying; Zhou, Jianlong; Eberl, Stefan; Yin, Yong; Feng, Dagan; Fulham, Michael

    2015-06-01

    Accurate lung tumor segmentation is problematic when the tumor boundary or edge, which reflects the advancing edge of the tumor, is difficult to discern on chest CT or PET. We propose a ‘topo-poly’ graph model to improve identification of the tumor extent. Our model incorporates an intensity graph and a topology graph. The intensity graph provides the joint PET-CT foreground similarity to differentiate the tumor from surrounding tissues. The topology graph is defined on the basis of contour tree to reflect the inclusion and exclusion relationship of regions. By taking into account different topology relations, the edges in our model exhibit topological polymorphism. These polymorphic edges in turn affect the energy cost when crossing different topology regions under a random walk framework, and hence contribute to appropriate tumor delineation. We validated our method on 40 patients with non-small cell lung cancer where the tumors were manually delineated by a clinical expert. The studies were separated into an ‘isolated’ group (n = 20) where the lung tumor was located in the lung parenchyma and away from associated structures / tissues in the thorax and a ‘complex’ group (n = 20) where the tumor abutted / involved a variety of adjacent structures and had heterogeneous FDG uptake. The methods were validated using Dice’s similarity coefficient (DSC) to measure the spatial volume overlap and Hausdorff distance (HD) to compare shape similarity calculated as the maximum surface distance between the segmentation results and the manual delineations. Our method achieved an average DSC of 0.881  ±  0.046 and HD of 5.311  ±  3.022 mm for the isolated cases and DSC of 0.870  ±  0.038 and HD of 9.370  ±  3.169 mm for the complex cases. Student’s t-test showed that our model outperformed the other methods (p-values <0.05).

  7. SU-F-207-06: CT-Based Assessment of Tumor Volume in Malignant Pleural Mesothelioma

    Energy Technology Data Exchange (ETDEWEB)

    Qayyum, F; Armato, S; Straus, C; Husain, A; Vigneswaran, W; Kindler, H [The University of Chicago, Chicago, IL (United States)

    2015-06-15

    Purpose: To determine the potential utility of computed tomography (CT) scans in the assessment of physical tumor bulk in malignant pleural mesothelioma patients. Methods: Twenty-eight patients with malignant pleural mesothelioma were used for this study. A CT scan was acquired for each patient prior to surgical resection of the tumor (median time between scan and surgery: 27 days). After surgery, the ex-vivo tumor volume was measured by a pathologist using a water displacement method. Separately, a radiologist identified and outlined the tumor boundary on each CT section that demonstrated tumor. These outlines then were analyzed to determine the total volume of disease present, the number of sections with outlines, and the mean volume of disease per outlined section. Subsets of the initial patient cohort were defined based on these parameters, i.e. cases with at least 30 sections of disease with a mean disease volume of at least 3mL per section. For each subset, the R- squared correlation between CT-based tumor volume and physical ex-vivo tumor volume was calculated. Results: The full cohort of 28 patients yielded a modest correlation between CT-based tumor volume and the ex-vivo tumor volume with an R-squared value of 0.66. In general, as the mean tumor volume per section increased, the correlation of CT-based volume with the physical tumor volume improved substantially. For example, when cases with at least 40 CT sections presenting a mean of at least 2mL of disease per section were evaluated (n=20) the R-squared correlation increased to 0.79. Conclusion: While image-based volumetry for mesothelioma may not generally capture physical tumor volume as accurately as one might expect, there exists a set of conditions in which CT-based volume is highly correlated with the physical tumor volume. SGA receives royalties and licensing fees through the University of Chicago for computer-aided diagnosis technology.

  8. ⁶⁸Ga-DOTA-TOC-PET/CT detects heart metastases from ileal neuroendocrine tumors.

    Science.gov (United States)

    Calissendorff, Jan; Sundin, Anders; Falhammar, Henrik

    2014-09-01

    Metastases from ileal neuroendocrine tumors (NETs) to the myocardium are rare and generally seen in patients with widespread metastatic NET disease. The objectives of this investigation were to describe the frequency of intracardiac metastases in ileal NET patients examined by (68)Ga-DOTA-TOC-PET/CT and to describe the cases in detail. All (68)Ga-DOTA-TOC-PET/CT examinations performed at the Karolinska University Hospital since 2010 until April 2012 were reviewed. In all, 128 out of 337 examinations were in patients with ileal NETs. Four patients had seven myocardiac metastases, yielding a frequency of 4.3 % in patients with ileal NETs. One patient had cardiac surgery while three were treated with somatostatin analogs. The cardiac metastases did not affect the patients' activity of daily life. (68)Ga-DOTA-TOC-PET/CT is an established imaging modality in identifying cardiac metastases in ileal NETs. Prospective studies are needed to confirm the true clinical value of (68)Ga-DOTA-TOC-PET/CT in detecting cardiac metastases in both ileal and non-ileal NETs.

  9. MRI and CT findings of the giant cell tumors of the skull; five cases and a review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Kashiwagi, Nobuo [Department of Diagnostic Radiology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 3-3 Nakamichi 1-Chome, Higashinari, Osaka 537-0025 (Japan)]. E-mail: kasiwagi-no@mc.pref.osaka.jp; Hirabuki, Norio [Department of Radiology, Yao Municipal Hospital (Japan); Andou, Kumiko [Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawachou, Nishinomiya-city, Hyogo 663-8851 (Japan); Yoshifumi, Narumi [Department of Diagnostic Radiology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 3-3 Nakamichi 1-Chome, Higashinari, Osaka 537-0025 (Japan); Tanaka, Hisashi [Department of Radiology, Osaka University Medical School, 2-2 Yamadaoka, 565-0871 Suita-city, Osaka (Japan); Morino, Hideo [Department of Pathology, Kansai Rosai Hospital, 3-1-69 Inabaso, Amagasaki-city, Hyogo (Japan); Taki, Takuyu [Department of Neurosurgery, Kansai Rosai Hospital, 3-1-69 Inabaso, Amagasaki-city, Hyogo (Japan); Ishikura, Reiichi [Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawachou, Nishinomiya-city, Hyogo 663-8851 (Japan); Hirota, Seiichi [Department of Pathology, Hyogo College of Medicine, 1-1 Mukogawachou, Nishinomiya-city, Hyogo 663-8851 (Japan); Onishi, Hiromitu [Department of Radiology, Osaka University Medical School, 2-2 Yamadaoka, 565-0871 Suita-city, Osaka (Japan); Nakamura, Hironobu [Department of Radiology, Osaka University Medical School, 2-2 Yamadaoka, 565-0871 Suita-city, Osaka (Japan)

    2006-06-15

    Purpose: To investigate CT and MR findings of giant cell tumors (GCTs) of the skull, an unusual site for such tumors. Materials and methods: CT and MR features of five histologically proven giant cell tumors of the skull were retrospectively reviewed. We also reviewed 22 cases in the literature that included MR or CT findings. Results: Three of the tumors originated from the temporal bone with predominantly medial extension, and the other two were centered in the body of the sphenoid bone and featured symmetrical soft tissue extension. CT images with bone window settings showed reactive bone changes for all three tumors of the temporal bone, suggesting slow growth for example, an expanded intradiploic space, expansive remodelling and development of foci of pressure erosion. GCTs of the sphenoid bone showed purely osteolytic changes without remodelling. Although the MR signals and enhancement patterns varied, all the tumors of the temporal bone had a markedly low intensity area on T2-weighted images, which was not seen in the tumors of the sphenoid bone. The findings for our cases generally corresponded to those reported in the literature. Conclusion: Giant cell tumors of the skull have two preferential sites and may have characteristic tendencies as to their extent. Bone changes and MR signals appear to show differences between the two sites.

  10. Hepatic glycerol metabolism in tumorous rats: a 13C nuclear magnetic resonance study.

    Science.gov (United States)

    Liu, K J; Drucker, Y; Jarad, J

    1995-02-15

    Cancer cachexia contributes to the demise of a significant number of cancer patients, and severe loss of adipose tissue is a prominent component of this syndrome. One of the products of fat catabolism is glycerol, and its turnover is elevated in the cancerous state. Since glycerol is also one of the most important gluconeogenic substrates, its role in the augmented and abnormal gluconeogenesis of cancer hosts needs to be defined. In the present study, we examined hepatic glycerol metabolism in livers of Fischer 344 rats bearing s.c. nonmetastatic adenocarcinoma R3230AC. Five weeks after tumor inoculation, the liver was removed and perfused with 5 mM [2-13C]glycerol while 13C nuclear magnetic resonance spectroscopy was performed. In the livers of tumorous rats, we found: (a) lipogenesis from glycerol was augmented; (b) the rate of hepatic glycerol uptake was unchanged; (c) glucose production from glycerol was not altered; and (d) conversion of glycerol 3-phosphate to dihydroxyacetone phosphate remains the rate-limiting step. Therefore, it appears that, in cancer hosts, diminished glycerol clearance is not due to reduction in hepatic glycerol uptake or metabolism, and the abnormal gluconeogenesis involves the pathway prior to the entry of glycerol. The exaggerated lipolysis is probably used for the pathological hepatomegaly, and the availability of the cytosolic hydrogen acceptor remains the rate-limiting factor for glycerol metabolism.

  11. Ultrasonographic Findings of Hepatic Hemangioma : Analysis of Echo-Patterns According to Tumor Size

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kang Hoon; Lee, Hae Giu; Choi, Byung Gil; Jung, Jung Im; Lee, Sung Yong; Yim, Jung Ik; Shinn, Kyung Sub [Catholic University College of Medicine, Seoul (Korea, Republic of)

    1995-12-15

    We performed a retrospective analysis of ultrasonographic features of hepatic hemangiomas according to tumor size. After an initial ultrasonographic examination, 5l hepatic hemangiomas in 4l patients were confirmed by one or combined examinations of 99mTc RBC SPECT, computed tomography, magnetic resonance imaging. angiography or ultrasonographic follow up. Definition of margin, internal echogenicity,peripheral rim and posterior enhancement were evaluated by two radiologists. Forty seven cases(92%) of 51 hemangiomas appeared to be well defined. Of 29 hemangiomas with less than 3cm in diameter. 25 cases (86%)showed homogeneous internal echogenicity. Of 22 hemangiomas with above 3 cm in diameter, 16 cases (73%) showed inhomogeneous echogenicity. Of 12 hemangiomas (24%) with peripheral rim, nine cases revealed hyperechoic rim and two hypoechoic rim. The remaining one case showed hyperechoic rim and hypoechoic rim alternately. Hemangiomas with greater than 3cm in diameter had higher incidence of inhomogeneous echogenicity, peripheral rim and posterior enhancement than those less than 3 cm(P<0.05). The majority of small hepatic hemangiomas are well defined homogeneous hyperechoic masses. On the other hand, large hemangiomas tended to have higher incidence of inhomogeneous internal echogenicity, posterior enhancement and a peripheral hyperechoic rim. A hyperechoic mass with a hypoechoic rim should also be considered as a candidate for hepatic hemangioma

  12. Leiomyomas in the gastric cardia: CT findings and differentiation from gastrointestinal stromal tumors

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Hyun Kyung [Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of); Kim, Young Hoon, E-mail: yhkrad@gmail.com [Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of); Lee, Yoon Jin; Park, Ji Hoon; Kim, Ji Young; Lee, Kyoung Ho [Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of); Lee, Hye Seung [Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of)

    2015-09-15

    Highlights: • Gastric leiomyomas frequently involve the gastric cardia. • Gastric cardial leiomyomas and GISTs could be differentiated with CT. • Differentiation of cardial leiomyomas and GISTs can help choosing surgical procedure. - Abstract: Objective: To describe CT findings of leiomyomas and gastrointestinal stromal tumors (GISTs) in the gastric cardia and to identify their differentiating features. Materials and methods: CT images of pathologically proven leiomyomas (n = 26) and GISTs (n = 19) in the gastric cardia were retrospectively reviewed for esophagogastric junction (EGJ) involvement, contour, surface, growth pattern, enhancement pattern and degree of the tumor, and the presences of intralesional low attenuation, calcification and surface dimples or ulcers. The long (LD) and short diameters (SD), LD/SD ratio, and attenuation value of each lesion were measured. Results: EGJ involvement, homogeneous enhancement, intermediate or low enhancement, absences of intralesional low attenuation and surface dimples or ulcers, LD/SD ratio >1.2, and attenuation value ≤71.2 HU were significant findings for differentiating leiomyomas from GISTs (P < 0.05 for each finding). An LD/SD ratio of >1.2 and attenuation value of ≤71.2 HU yielded sensitivities of 84.6% and 61.5%, and specificities of 52.6% and 84.2%, respectively, on the receiver operating characteristic curve analysis. When at least five of these seven criteria were used in combination, the sensitivity and specificity for diagnosing leiomyomas were 100% (26 of 26) and 89.5% (17 of 19), respectively. When any six of these criteria were used, a specificity of 100% was achieved. Conclusions: CT features including EGJ involvement, enhancement pattern and degree, presences of intralesional low attenuation and surface dimples or ulcers, LD/SD ratio, and attenuation value could help differentiating leiomyomas from GISTs in the gastric cardia, particularly in the manner of combination.

  13. Splenosis Mimicking Relapse of a Neuroendocrine Tumor at Gallium-68-DOTATOC PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Treglia, Giorgio; Luca, Giovanella [Oncology Institute of Southern Switzerland, Bellinzona (Switzerland); Barbara, Muoio; Carmelo, Caldarella [Catholic Univ., Rome (Italy)

    2014-06-15

    A 48-year-old female patient underwent splenopancreasectomy for a 4-cm pancreatic neuroendocrine tumor (pNET), grade G2, located in the pancreatic tail. One year after surgery, the patient presented an increased serum level of the tumor marker chromogranin A (value: 160 U/l). Therefore, she underwent somatostatin receptor PET/CT using gallium-68-DOTATOC for restaging. This imaging method showed a focal area of increased radiopharmaceutical uptake corresponding to a 2.5-cm nodule located in the left superior abdomen near a clip from the previous surgery, suggesting a possible relapse of pNET. Based on this PET/CT finding, the patient underwent ultrasonography-guided core biopsy of this nodule. Histology did not reveal findings suggestive of pNET but identified spleen tissue most likely caused by splenosis accidentally seeded at the previous operation. It is likely that the increased serum level of the tumor marker chromogranin A was due to the chronic proton-pump inhibitors use. Somatostatin receptor PET/CT is an accurate imaging method for staging and restaging pNET, presenting high sensitivity and specificity in this setting. Nevertheless, possible sources of false-negative and -positive findings with this method should be taken into account. Inflammatory lesions represent the most frequent causes of false-positive findings for pNET at somatostatin receptor imaging because inflammatory cellsmay overexpress somatostatin receptors on their cell surface. In our case, we showed that splenosis may represent a possible cause of false-positive findings for pNET relapse due to the physiological uptake of somatostatin analogs by the spleen tissue.

  14. A Prospective Comparison of 18F-FDG PET/CT and CT as Diagnostic Tools to Identify the Primary Tumor Site in Patients with Extracervical Carcinoma of Unknown Primary Site

    DEFF Research Database (Denmark)

    Moller, Anne Kirstine H; Loft, Annika; Berthelsen, Anne K

    2012-01-01

    AbstractBackground. The aim of the present study was to evaluate prospectively the diagnostic value of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) and conventional CT regarding the ability to detect the primary tumor site in patients with extracerv....../CT and CT alone in regard to sensitivity, specificity, and accuracy.Conclusion. In the general CUP population with multiple extracervical metastases (18)F-FDG PET/CT does not represent a clear diagnostic advantage over CT alone regarding the ability to detect the primary tumor site....

  15. 18F-FDG PET/CT Finding of Drop Metastases from Germ Cell Tumor of Pineal Gland.

    Science.gov (United States)

    Jain, Tarun K; Basher, Rajender K; Sood, Ashwani; Mittal, Bhagwant R; Prakash, Gaurav; Bhatia, Anmol

    2017-06-01

    Tumors of the pineal region are rare, accounting for fewer than 1% of all intracranial neoplasms. Fifty percent of pineal region tumors are germ cell tumors (GCTs). However, spinal seeding and extracranial metastases from intracranial GCTs are uncommon. We present a case of pineal gland GCT in which 18F-FDG PET/CT imaging demonstrated drop metastases to the spinal cord in addition to tracer uptake in the primary lesion. © 2017 by the Society of Nuclear Medicine and Molecular Imaging.

  16. Preoperative FDG PET/CT in adrenocortical cancer depicts massive venous tumor invasion.

    Science.gov (United States)

    Lapa, Constantin; Werner, Rudolf A; Brumberg, Joachim; Higuchi, Takahiro

    2014-06-01

    A 79-year-old woman presented with abdominal pain. Ultrasound revealed an intra-abdominal mass in the left renal region. Comprehensive endocrine workup was unremarkable. The patient was referred for further diagnostic workup. FDG PET/CT revealed a hypermetabolic mass in the left adrenal region. In addition, pathologically increased tracer uptake of 2 renal veins (the upper vein crossing in front of the aorta the lower one crossing behind the aorta) and the inferior vena cava raised the concern for malignant venous infiltration. Adrenalectomy, nephrectomy, and thrombectomy were carefully planned and performed. Adrenocortical carcinoma with tumor thrombus and caval extension was proven by histopathology.

  17. Transcatheter arterial infusion with heated saline changes the vascular permeability of rabbit hepatic tumors.

    Science.gov (United States)

    Cao, Wei; Lu, Qiang; Li, Jing-Hua; Zhou, Chang-Xi; Zhu, Jia; Wan, Yi; Liu, Yu-Feng

    2011-12-01

    The vascular permeability of tumors can be changed by transarterial infusion heat, but the mechanisms remain unknown. The aim of this study was to analyze the underlying causes of changes in tumor vascular permeability after heated perfusion via two different modes. Thirty rabbits with VX2 hepatic tumors were randomly divided into three groups of 10 rabbits each. The hepatic artery was selectively catheterized via a femoral approach, and unheated saline (control group) or heated saline (60°C) was then injected in either a continuous (transcatheter arterial continuous perfusion [TACP]) or a pulsed (transcatheter arterial pulsed perfusion [TAPP]) manner. Changes in vascular permeability in the tumors were assessed using the following markers and methods: (1) qualitative assessment by visual estimation on digital subtraction angiography performed after the heat infusion procedure on live animals and quantitative assessment by spectrophotometry using Evans blue dye extravasation on tumor and liver tissue after animals were sacrificed and (2) kinase domain receptor or vascular endothelial growth factor (VEGF), expressed in vascular endothelial cells, assessed by immunohistochemical staining, Western blot analysis, and reverse transcription polymerase chain reaction. Tumor staining increased in the TAPP group more than in the TACP group, but not in the control group, assessed on digital subtraction angiography. Extracted dye was higher in tumors in the TAPP group than in those in the TACP group; extracted dye in both groups was higher than in the control group. Kinase domain receptor protein and messenger ribonucleic acid expression were both higher in the TAPP group than in the TACP and control groups. VEGF protein expression was lower in the TAPP and TACP groups than in the control group, but VEGF messenger ribonucleic acid expression was higher in the TACP group than in the TAPP and control groups, and VEGF messenger ribonucleic acid expression was lower in the TAPP

  18. Artificial pleural effusion in percutaneous microwave ablation of hepatic tumors near the diaphragm under the guidance of ultrasound

    OpenAIRE

    Wang, Gang; Sun, Yao; Cong, Lin; Jing, Xuehong; YU, JING

    2015-01-01

    Objective: To evaluate the feasibility, safety and efficacy of artificial pleural effusion in percutaneous microwave ablation of hepatic tumors near the diaphragm under ultrasound guidance. Methods: For localization and navigation of tumors near the dome of the diaphragm by ultrasound during microwave ablation in 14 tumors of 11 cases, artificial pleural effusion was performed in the volume of 1000~1500 ml of Normal saline or 5% Glucose injection solution via the right thoracic cavity. The tu...

  19. Artificial pleural effusion in percutaneous microwave ablation of hepatic tumors near the diaphragm under the guidance of ultrasound.

    Science.gov (United States)

    Wang, Gang; Sun, Yao; Cong, Lin; Jing, Xuehong; Yu, Jing

    2015-01-01

    To evaluate the feasibility, safety and efficacy of artificial pleural effusion in percutaneous microwave ablation of hepatic tumors near the diaphragm under ultrasound guidance. For localization and navigation of tumors near the dome of the diaphragm by ultrasound during microwave ablation in 14 tumors of 11 cases, artificial pleural effusion was performed in the volume of 1000~1500 ml of Normal saline or 5% Glucose injection solution via the right thoracic cavity. The tumor marker, AFP was monitored before and after operation in 6 times in a period of 2 years. We analyzed the successful rate and effectiveness of artificial pleural effusion. The successful rate of artificial pleural effusion was 100% without complications. Artificial hydrothorax on the right eliminated the interference of intrapulmonary gas to the visualization of hepatic tumors near the diaphragm on ultrasound. In the follow-up of 2 years, the ablation rate reached to 92.9% with no serious complications. The AFP value before operation was in significant statistical difference with the others after operation (P = 0.000). Artificial pleural effusion aids the visualization of hepatic tumors near the diaphragm on ultrasound. A good therapeutic effectiveness can be reached in percutaneous microwave ablation of tumors in the hepatic dome under the guidance of ultrasound.

  20. Artificial pleural effusion in percutaneous microwave ablation of hepatic tumors near the diaphragm under the guidance of ultrasound

    Science.gov (United States)

    Wang, Gang; Sun, Yao; Cong, Lin; Jing, Xuehong; Yu, Jing

    2015-01-01

    Objective: To evaluate the feasibility, safety and efficacy of artificial pleural effusion in percutaneous microwave ablation of hepatic tumors near the diaphragm under ultrasound guidance. Methods: For localization and navigation of tumors near the dome of the diaphragm by ultrasound during microwave ablation in 14 tumors of 11 cases, artificial pleural effusion was performed in the volume of 1000~1500 ml of Normal saline or 5% Glucose injection solution via the right thoracic cavity. The tumor marker, AFP was monitored before and after operation in 6 times in a period of 2 years. We analyzed the successful rate and effectiveness of artificial pleural effusion. Results: The successful rate of artificial pleural effusion was 100% without complications. Artificial hydrothorax on the right eliminated the interference of intrapulmonary gas to the visualization of hepatic tumors near the diaphragm on ultrasound. In the follow-up of 2 years, the ablation rate reached to 92.9% with no serious complications. The AFP value before operation was in significant statistical difference with the others after operation (P = 0.000). Conclusions: Artificial pleural effusion aids the visualization of hepatic tumors near the diaphragm on ultrasound. A good therapeutic effectiveness can be reached in percutaneous microwave ablation of tumors in the hepatic dome under the guidance of ultrasound. PMID:26629218

  1. Stereotactic radiosurgery for intradural spine tumors using cone-beam CT image guidance.

    Science.gov (United States)

    Monserrate, Andrés; Zussman, Benjamin; Ozpinar, Alp; Niranjan, Ajay; Flickinger, John C; Gerszten, Peter C

    2017-01-01

    OBJECTIVE Cone-beam CT (CBCT) image guidance technology has been widely adopted for spine radiosurgery delivery. There is relatively little experience with spine radiosurgery for intradural tumors using CBCT image guidance. This study prospectively evaluated a series of intradural spine tumors treated with radiosurgery. Patient setup accuracy for spine radiosurgery delivery using CBCT image guidance for intradural spine tumors was determined. METHODS Eighty-two patients with intradural tumors were treated and prospectively evaluated. The positioning deviations of the spine radiosurgery treatments in patients were recorded. Radiosurgery was delivered using a linear accelerator with a beam modulator and CBCT image guidance combined with a robotic couch that allows positioning correction in 3 translational and 3 rotational directions. To measure patient movement, 3 quality assurance CBCTs were performed and recorded in 30 patients: before, halfway, and after the radiosurgery treatment. The positioning data and fused images of planning CT and CBCT from the treatments were analyzed to determine intrafraction patient movements. From each of 3 CBCTs, 3 translational and 3 rotational coordinates were obtained. RESULTS The radiosurgery procedure was successfully completed for all patients. Lesion locations included cervical (22), thoracic (17), lumbar (38), and sacral (5). Tumor histologies included schwannoma (27), neurofibromas (18), meningioma (16), hemangioblastoma (8), and ependymoma (5). The mean prescription dose was 17 Gy (range 12-27 Gy) delivered in 1-3 fractions. At the halfway point of the radiation, the translational variations and standard deviations were 0.4 ± 0.5, 0.5 ± 0.8, and 0.4 ± 0.5 mm in the lateral (x), longitudinal (y), and anteroposterior (z) directions, respectively. Similarly, the variations immediately after treatment were 0.5 ± 0.4, 0.5 ± 0.6, and 0.6 ± 0.5 mm along x, y, and z directions, respectively. The mean rotational angles were 0

  2. Can the localization of primary colonic tumors be improved by staging CT without specific bowel preparation compared to optical colonoscopy?

    Energy Technology Data Exchange (ETDEWEB)

    Feuerlein, Sebastian; Grimm, Lars J.; Davenport, Matthew S.; Haystead, Clare M.; Miller, Chad M.; Neville, Amy M. [Department of Radiology, Duke University Medical Center, DUMC 3808, Durham, NC 27710 (United States); Jaffe, Tracy A., E-mail: tracy.jaffe@duke.edu [Department of Radiology, Duke University Medical Center, DUMC 3808, Durham, NC 27710 (United States)

    2012-10-15

    Objectives: To investigate the ability of staging computed tomography (CT) without bowel preparation to accurately localize colonic tumors compared to optical colonoscopy. Methods: The local institutional review board approved this retrospective and HIPAA-compliant study. Forty-six patients with colonic adenocarcinoma, preoperative colonoscopy, and staging CT within 60 days of resection were included. Patients underwent contrast enhanced CT imaging without bowel preparation or oral contrast. The colon was divided into four segments with the operative reports used as the standard. Rectal and cecal cancers were excluded. CT scans were reviewed by 5 readers in a segmental binary fashion using a 5-point confidence scale in two sessions blinded and unblinded to the colonoscopy report. Results: At surgery 49 tumors were found in 46 patients. Readers detected 86.1%, 74.3%, and 66.9% of lesions with 92.0%, 94.1%, and 95.4% accuracy for confidence scores of ≥3, ≥4, and 5. CT interobserver agreement was good (κ = 0.82) for the unblinded and moderate (κ = 0.60) for the blinded read. Colonoscopic localization was only 78.7% accurate with 2 tumors undiscovered. Colonoscopic accuracy was low in the descending colon (57.1%) and the transverse colon (55.6%). Conclusions: Preoperative staging CT is more accurate than colonoscopy in the localization of colonic tumors.

  3. Gallium-68-DOTA-NOC PET/CT of patients with gastroenteropancreatic neuroendocrine tumors: a prospective single-center study.

    Science.gov (United States)

    Naswa, Niraj; Sharma, Punit; Kumar, Abhishek; Nazar, Aftab Hasan; Kumar, Rakesh; Chumber, Sunil; Bal, Chandrashekhar

    2011-11-01

    The objective of this study was to evaluate the role of (68)Ga-labeled [1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid]-1-NaI(3)-octreotide (DOTA-NOC) PET/CT in the diagnosis and management of gastroenteropancreatic neuroendocrine tumors (NETs). One hundred nine patients (median age, 50 years) with gastroenteropancreatic NETs underwent (68)Ga-DOTA-NOC PET/CT. PET/CT was performed after injection of 132-222 MBq (4-6 mCi) of (68)Ga-DOTA-NOC. Images were evaluated by two experienced nuclear medicine physicians both qualitatively as well as quantitatively (maximum standardized uptake value [SUV(max)]). Results of PET/CT were compared with the results of conventional imaging. Histopathology results, when available, and follow-up PET/CT or conventional imaging with biochemical markers were considered to be the reference standards. Gallium-68-DOTA-NOC PET/CT showed sensitivity and specificity of 78.3% and 92.5%, respectively, for primary tumor and 97.4% and 100% for metastases. It was better than a conventional imaging modality for the detection of both primary tumor (p NOC PET/CT appears to be a highly sensitive and specific modality for the detection of gastroenteropancreatic NET. It is better than conventional imaging for the evaluation of gastroenteropancreatic NETs and can have a significant impact on patient management.

  4. Improved Benefit of SPECT/CT Compared to SPECT Alone for the Accurate Localization of Endocrine and Neuroendocrine Tumors

    Directory of Open Access Journals (Sweden)

    Gonca G. Bural

    2012-12-01

    Full Text Available Objective: To assess the clinical utility of SPECT/ CT in subjects with endocrine and neuroendocrine tumors compared to SPECT alone. Material and Methods: 48 subjects (31 women;17 men; mean age 54±11 with clinical suspicion or diagnosis of endocrine and neuroendocrine tumor had 50 SPECT/CT scans (32 Tc-99m MIBI, 5 post treatment I-131, 8 In-111 Pentetreotide, and 5 I-123 MIBG. SPECT alone findings were compared to SPECT/CT and to pathology or radiological follow up. Results: From the 32 Tc-99m MIBI scans, SPECT accurately localized the lesion in 22 positive subjects while SPECT/CT did in 31 subjects. Parathyroid lesions not seen on SPECT alone were smaller than 10 mm. In five post treatment I-131 scans, SPECT alone neither characterized, nor localized any lesions accurately. SPECT/CT revealed 3 benign etiologies, a metastatic lymph node, and one equivocal lesion. In 8 In-111 Pentetreotide scans, SPECT alone could not localize primary or metastatic lesions in 6 subjects all of which were localized with SPECT/CT. In five I-123 MIBG scans, SPECT alone could not detect a 1.1 cm adrenal lesion or correctly characterize normal physiologic adrenal uptake in consecutive scans of the same patient with prior history of adrenelectomy, all of which were correctly localized and characterized with SPECT/CT. Conclusion: SPECT/CT is superior to SPECT alone in the assessment of endocrine and neuroendocrine tumors. It is better in lesion localization and lesion characterization leading to a decrease in the number of equivocal findings. SPECT/CT should be included in the clinical work up of all patients with diagnosis or suspicion of endocrine and neuroendocrine tumors. (MIRT 2012;21:91-96

  5. Serum tumor necrosis factor-alpha level in hepatitis E virus-related acute viral hepatitis and fulminant hepatic failure in pregnant women.

    Science.gov (United States)

    Salam, Gyaneshwori Devi; Kumar, Ashok; Kar, Premashis; Aggarwal, Sarita; Husain, Akhtar; Sharma, Shashi

    2013-08-01

    The host response in hepatitis E virus (HEV)-related liver disease of pregnant women is unclear. This study was carried out to evaluate the serum concentration of tumor necrosis factor (TNF)-α in HEV-related acute viral hepatitis (AVH) and fulminant hepatic failure (FHF) in pregnant women in relation to pregnancy outcome. The study included 262 pregnant and 158 non-pregnant women with jaundice. There were 160 healthy asymptomatic pregnant women and 124 healthy asymptomatic non-pregnant women as controls. The jaundiced patients were classified as AVH or FHF. Serum TNF-α level was assayed by commercially available enzyme-linked immunoassay kits. A significantly higher level of TNF-α was observed in HEV-infected pregnant women than non-HEV pregnant women (P pregnant women compared with AVH and FHF of HEV infected non-pregnant women (P = 0.036 and P = 0.010, respectively). The HEV-infected pregnant FHF expired group had significantly higher levels of TNF-α than the non-pregnant FHF expired group (P = 0.025). TNF-α levels were significantly higher in AVH of HEV-infected pregnant women than healthy pregnant controls (P women having preterm delivery and low birthweight newborns compared with non-HEV and healthy pregnant women. Higher serum concentration of TNF-α observed in HEV infected AVH and FHF pregnant cases shows that pregnancy with HEV infection increases TNF-α secretion. TNF-α may be an important factor in the outcomes of pregnancy due to HEV infection. © 2012 The Japan Society of Hepatology.

  6. FDG-PET provides the best correlation with the tumor specimen compared to MRI and CT in rectal cancer.

    Science.gov (United States)

    Buijsen, Jeroen; van den Bogaard, Jørgen; Janssen, Marco H M; Bakers, Frans C H; Engelsman, Stephanie; Öllers, Michel; Beets-Tan, Regina G H; Nap, Marius; Beets, Geerard L; Lambin, Philippe; Lammering, Guido

    2011-02-01

    To compare CT-, MR- and PET-CT based tumor length measurements in rectal cancer with pathology. Twenty-six rectal cancer patients underwent both MR and PET-CT imaging followed by short-course radiotherapy (RT 5×5 Gy) and surgery within 3 days after RT. Tumor length was measured manually and independently by 2 observers on CT, MR and PET. PET-based tumor length measurements were also generated automatically using the signal-to-background-ratio (SBR) method. All measurements were correlated with the tumor length on the pathological specimen. CT-based measurements did not show a valuable correlation with pathology. MR-based measurements correlated only weakly, but still significantly (Pearson correlation=0.55 resp. 0.57; p<0.001). Manual PET measurements reached a good correlation with pathology, but less strong (Pearson correlation 0.72 and 0.76 for the two different observers) than automatic PET-CT based measurements, which provided the best correlation with pathology (Pearson correlation of 0.91 (p<0.001)). Bland-Altman analysis demonstrated in general an overestimation of the tumor diameter using manual measurements, while the agreement of automatic contours and pathology was within acceptable ranges. A direct comparison of the different modalities revealed a significant better precision for PET-based auto-contours as compared to all other measurements. Automatically generated PET-CT based contours show the best correlation with the surgical specimen and thus provide a useful and powerful tool to accurately determine the largest tumor dimension in rectal cancer. This could be used as a quick and reliable tool for target delineation in radiotherapy. However, a 3D volume analysis is needed to confirm these results. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  7. CT findings of the mediastinal tumors -excluding mediastinal granuloma and primary carcinoma-

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyung Soo; Im, Chung Kie; Han, Man Chung [College of Medicine, Seoul National University, Seoul (Korea, Republic of)

    1985-06-15

    Computerized Tomography can make accurate diagnosis in most of the mediastinal tumors and cysts by assessing their location, shape and internal architecture. Authors analysed and present CT findings of 89 surgically proven mediastinal tumors and cysts that were studied and treated in Seoul National University Hospital during recent 5 years. The results are as follows; 1. The most common tumor was teratoma (25 cases). Neurogenic tumor (20 cases), thymic tumor or cyst (16 cases), lymphoma (7 cases), bronchogenic cyst (6 cases), intrathoracic goiter (6 cases), pericardial cyst (3 cases) and cystic hygroma (2 cases) were next in order of frequency. 2. The most constant findings of teratoma was thick walled cystic area (100%), while pathognomonic fat and calcified density were seen only in 52% and 48% of cases, respectively. 22 cases were located in anterior mediastinum, 2 cases were in posterior mediastinum and a case is in middle mediastinum. 3. There were 20 cases of neurogenic tumor consisting of 6 neurilemmomas, 7 ganglioneuromas, 4 neurofibromas, 1 ganglioneuroblastoma, 1 neuroblastoma and 1 malignant schwannoma. Most of them were located in posterior mediastinum with exception of 2 neurilemmomas arising from left vagus nerve and left recurrent laryngeal nerve in middle mediastinum. Cystic change was seen in 2 cases of neurilemmoma and in a case of ganglioneuroma. Calcification was seen in 3 cases, of neuroblastoma, a neurilemmoma, and a ganglioneuroma. 4. There were 11 cases of thymoma showing homogeneous solid mass with speckeld calcification in 4 cases and irregular cystic change in 3 cases. 2 cases were invasive thymoma and myasthenia gravis was present in 4 cases. A cases of thymolipoma and a case of thymic cyst were included. 5. Lymphoma (2 Hodgkin's and 4 non-Hodgkin's) appeared as lobulated, matted mass in anterior mediastinum especially in prevascular area expanding bilaterally.

  8. Semiautomated registration of pre- and intraoperative CT for image-guided percutaneous liver tumor ablation interventions.

    Science.gov (United States)

    Gunay, Gokhan; Luu, Manh Ha; Moelker, Adriaan; van Walsum, Theo; Klein, Stefan

    2017-07-01

    In CT-guided liver tumor ablation interventions, registration of a preoperative contrast-enhanced CT image to the intraoperative CT image is hypothesized to improve guidance. This is a highly challenging registration task due to differences in patient poses and large deformations, and therefore high registration errors are expected. In this study, our objective is to develop a method that enables users to locally improve the registration where the registration fails, with minimal user interaction. The method is based on a conventional nonrigid intensity-based registration framework, extended with a novel point-to-surface penalty. The point-to-surface penalty serves to improve the alignment of the liver boundary, while requiring minimal user interaction during the intervention: annotating some points on the liver surface at those regions where the conventional registration seems inaccurate. The method is evaluated on 18 clinical datasets. It improves registration accuracy compared with the conventional nonrigid registration in terms of average surface distance (from 2.75 to 2.05 mm) and target registration error (from 6.92 to 5.8 mm). In this study, we introduce a semiautomated registration algorithm that improves the accuracy of image registration. © 2017 American Association of Physicists in Medicine.

  9. Perfusion CT Changes in Liver Metastases from Pancreatic Neuroendocrine Tumors During Everolimus Treatment.

    Science.gov (United States)

    D'Onofrio, Mirko; Cingarlini, Sara; Ortolani, Silvia; Crosara, Stefano; DE Robertis, Riccardo; Vallerio, Paola; Grego, Elisabetta; Ciaravino, Valentina; Ruzzenente, Andrea; Landoni, Luca; Scarpa, Aldo; Bassi, Claudio; Tortora, Giampaolo

    2017-03-01

    To evaluate modifications of perfusional parameters assessed by perfusion computed tomography (P-CT) of liver metastases (LM) from pancreatic neuroendocrine tumors (PanNETs) during everolimus treatment. All patients with LMs from G1-2 PanNETs undergoing everolimus treatment between January 2013 and January 2015 were prospectively evaluated with P-CT at baseline, and after 2 and 4 months of therapy. Size, perfusion, blood volume (BV), peak enhancement intensity (PEI) and time to peak for each lesion were calculated. A total of 33 LMs in nine patients with G1-2 PanNETs were prospectively evaluated: 23/33 (69.7%) were responders, 10/33 (30.3%) were non-responders. Among perfusional parameters, only numerical peak enhancement intensity values significantly differed between the two groups at baseline (p=0.043). BV increase was the most significant perfusional modification identifying responding lesions, even at an early stage of treatment, with a high positive predictive value (89.47%). P-CT seems to be useful for prediction of response to everolimus of LMs from PanNETs. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  10. Determination of the integrated CT number of the whole liver in patients with severe hepatitis. As an indicator of the functional reserve of the liver

    Energy Technology Data Exchange (ETDEWEB)

    Kumahara, Tadashi; Muto, Yasutoshi; Moriwaki, Hisataka; Yoshida, Takashi; Tomita, Eiichi (Gifu Univ. (Japan). Faculty of Medicine)

    1989-06-01

    A study was conducted to estimate the functional reserve of the liver of patients with severe hepatitis by computed tomography (CT), in particular employing the integrated CT number of the whole liver (ICTN). ICTN was calculated by integrating the product of 'area' times 'mean CT number' of the liver in each CT slice for the entire height of the liver. The following results were obtained: (1) In patients with fulminant hepatitis (FH) as well as those with subacute hepatitis (SAH), ICTN was found to be significantly lower as compared to that of patients with acute hepatitis (AH) or non-hepatic diseases. In addition, in FH and SAH patients, ICTN showed a larger degree of decrease when compared with such conventional parameters as either estimated liver volume or mean hepatic CT number. Thus, ICTN seems to more sensitively reflect the changes in functional reserve of the liver. (2) ICTN showed significant positive correlations with prothrombin time and plasma BCAA/AAA ratio, and a significant negative correlation with plasma methionine level. (3) Time course of changes in ICTN correlated well with the clinical features of severe hepatitis. In particular, patients with initial ICTN values above 20 lcenter dotHU/m/sup 2/ of body surface area showed significantly higher survival rate than those with initial ICTN below 20. In conclusion, ICTN well indicates the functional reserve of the liver, and is further suggested to be valuable as a parameter to predict the prognosis of patients with severe hepatitis. (author).

  11. Using {sup 18F} FDG PET/CT to Detect an occult Mesenchymal Tumor Causing Oncogenic Osteomalacia

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Hyo Jung; Choi, Yun Jung; Kim, Hyun Jeong; Jeong, Yong Hyu; Cho, Arthur; Lee, Jae Hoon; Yun, Mijin; Lee, Jong Doo; Kang, Won Jun [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    2011-09-15

    Oncogenic osteomalacia is a rare paraneoplastic syndrome characterized by renal phosphate excretion, hypophosphatemia, and osteomalacia. This syndrome is often caused by tumors of mesenchymal origin. Patients with oncogenic osteomalacia have abnormal bone mineralization, resulting in a high frequency of fractures. Tumor resection is the treatment of choice, as it will often correct the metabolic imbalance. Although oncogenic osteomalacia is a potentially curable disease, diagnosis is difficult and often delayed because of the small size and sporadic location of the tumor. Bone scintigraphy and radiography best characterize osteoma lacia; magnetic resonance imaging findings are nonspecific. Here, we report a case of oncogenic osteomalacia secondary to a phosphaturic mesenchymal tumor that was successfully detected by {sup 18F} fluorodeoxyglucose positron emission tomography/computed tomography ({sup 18F} FDG PET/CT). This case illustrates the advantages of {sup 18F} FDG PET/CT in detecting the occult mesenchymal tumor that causes oncogenic osteomalacia.

  12. Difference of contrast enhancement characteristics of hepatic hemangiomas according to lesion size on two-phase spiral CT

    Energy Technology Data Exchange (ETDEWEB)

    Koh, Sung Hye; Yoon, Suk Kwon; Yang, Dal Mo; Yoon, Myung Hwan; Kim, Hak Soo; Kim, Hyung Sik; Chung, Jin Woo [Chungang Gil Hospital, Incheon (Korea, Republic of)

    1998-06-01

    The purpose of this study is to determine the different of enhancement patterns of hepatic hemangioma according to the lesion size, using dual-phase spiral CT. Fifty-nine lesions in 45 patients with hepatic hemangiomas were subjected to spiral CT. According to size, the lesions were divided into two groups (<2.5 cm : n=34;> {>=} 2.5 cm : n=25). The enhancement patterns of the lesions were classified as one of four types (homogeneous hyperdense, peripheral hyperdense, central hyperdense, peripheral hyperdense, central hyperdense, or hypodense) during the early phase, and as one of five types (homogeneous hyperdense, peripheral hyperdense, central hyperdense, hypodense of isodense) during the delayed phase. We evaluated differences in enhancement patterns during the early and delayed phase according to lesion size. During the early phase, the enhancement patterns of lesions large than 2.5 cm were peripheral hyperdense (96%) or homogeneous hyperdense (4%); those of less than 2.5 cm were peripheral hyperdense (53%), homogenous hyperdense (26%), hypodense (18%), or central hyperdense (3%). Thus, hemangiomas in these two groups usually showed a peripheral enhancement patterns were more common. During the delayed phase, the enhancement patterns of lesions larger than 2.5 cm were peripheral hyperdense (3%), or isodense (3%). Thus, the enhancement patterns of lesions larger than 2.5 cm showed a homogeneous enhancement pattern. The enhancement patterns of hepatic hemangiomas differ according to lesion size. A knowledge of these differences is helpful in the diagnosis of hepatic hemangioma. (author). 16 refs., 2 tabs., 3 figs.

  13. Incremental value of arterial and equilibrium phase compared to hepatic venous phase CT in the preoperative staging of colorectal liver metastases: an evaluation with different reference standards.

    Science.gov (United States)

    Wicherts, Dennis A; de Haas, Robbert J; van Kessel, Charlotte S; Bisschops, Robertus H C; Takahara, Taro; van Hillegersberg, Richard; Bipat, Shandra; Rinkes, Inne H M Borel; van Leeuwen, Maarten S

    2011-02-01

    To evaluate the incremental value of arterial and equilibrium phase compared to hepatic venous phase multidetector row CT (MDCT) in the preoperative staging of colorectal liver metastases (CLM) and to determine the influence of the reference standard. Fifty-three consecutive CLM patients underwent 16 detector row CT in hepatic arterial, venous, and equilibrium phase before surgery between March 2003 and January 2007. Detected lesions were characterized by three independent radiologists. The reference standard consisted of intraoperative palpation and ultrasound of the liver, and histopathological examination of the resected specimen. Additionally, data of follow-up CT was added. Statistical analysis was performed on a per-lesion basis. According to the reference standard 251 lesions were present, of which 203 (81%) were malignant (mean size: 29.4 ± 22.5 mm), and 41 (16%) were benign (mean size: 8.3 ± 7.7 mm). Sensitivity rates for CLM were comparable between triphasic and hepatic venous phase CT (P>0.05). Sensitivity for the detection of CLM lowered from 60-77% to 52-68% when follow-up CT was added to the reference standard. Arterial and equilibrium phase CT have no incremental value compared to hepatic venous phase MDCT in the detection of CLM. Sensitivity rates are, however, influenced by the type of reference standard used. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

  14. Hepatitis

    Science.gov (United States)

    ... yourself against hepatitis A is by vaccination. Other ways to protect yourself include avoiding rimming and other anal and oral contact. While condom use is essential in preventing the spread of HIV, hepatitis B and other STDs, it does not ...

  15. Blood Serum Alpha Fetoprotein Enhancer Binding Protein, a Tumor Suppressor, Decreases in Chronic HBV Hepatitis Patients as Hepatocellular Cancer Appears

    Directory of Open Access Journals (Sweden)

    James N. Riggins

    2010-01-01

    Full Text Available Chronic hepatitis increases the risk of hepatocellular carcinoma (HCC. To test whether circulating proteins reflect hepatic carcinogenesis, sera from patients and controls were albumin depleted, enriched for glycoproteins, digested with trypsin, and subjected to reverse phase chromatography and tandem mass spectrometry. Alpha-fetoprotein enhancer binding protein (AFPebp, a tumor suppressor, was repeatedly identified in sera from chronic HBV hepatitis patients. We independently identified and quantified AFPebp with a deuterated, phenylisocyanate-labeled synthetic peptide standard. Elevated AFPebp levels in sera from chronic HBV hepatitis patients decreased as cancer developed. These data suggest that rising AFPebp levels in chronic HBV hepatitis may be protective, while falling levels may contribute to HCC development.

  16. Flat-Panel Cone-Beam Ct-Guided Radiofrequency Ablation of Very Small (≤1.5 cm) Liver Tumors: Technical Note on a Preliminary Experience

    Energy Technology Data Exchange (ETDEWEB)

    Cazzato, Roberto Luigi, E-mail: r.cazzato@unicampus.it; Buy, Xavier, E-mail: x.buy@bordeaux.unicancer.fr; Alberti, Nicolas, E-mail: nicoalbertibdx@gmail.com; Fonck, Mariane, E-mail: m.fonk@bordeaux.unicancer.fr [Institut Bergonié 229 Cours de l’Argonne, Department of Radiology (France); Grasso, Rosario Francesco, E-mail: r.grasso@unicampus.it [Università “Campus Bio-Medico di Roma”, Department of Radiology and Diagnostic Imaging (Italy); Palussière, Jean, E-mail: j.palussiere@bordeaux.unicancer.fr [Institut Bergonié 229 Cours de l’Argonne, Department of Radiology (France)

    2015-02-15

    PurposeThe aim of the present study was to investigate the technical feasibility of flat-panel cone-beam CT (CBCT)-guided radiofrequency ablation (RFA) of very small (<1.5 cm) liver tumors.Materials and MethodsPatients included were candidates for hepatic percutaneous RFA as they had single biopsy-proven hepatic tumors sized ≤1.5 cm and poorly defined on ultrasonography. Following apnea induction, unenhanced CBCT scans were acquired and used to deploy the RF electrode with the aid of a virtual navigation system. If the tumor was not clearly identified on the unenhanced CBCT scan, a right retrograde arterial femoral access was established to carry out hepatic angiography and localize the tumor. Patients’ lesions and procedural variables were recorded and analyzed.ResultsThree patients (2 male and 1 female), aged 68, 76, and 87 years were included; 3 lesions (2 hepato-cellular carcinoma and 1 metastasis from colorectal cancer) were treated. One patient required hepatic angiography. Cycles of apnea used to acquire CBCT images and to deploy the electrode lasted <120 s. Mean fluoroscopic time needed to deploy the electrode was 36.6 ± 5.7 min. Mean overall procedural time was 66.0 ± 22.9 min. No peri- or post-procedural complications were noted. No cases of incomplete ablation were noted at 1-month follow-up.ConclusionPercutaneous CBCT-guided liver RFA with or without arterial hepatic angiography is technically feasible.

  17. Antioxidant oils and Salmonella enterica Typhimurium reduce tumor in an experimental model of hepatic metastasis

    Directory of Open Access Journals (Sweden)

    Sorenson BS

    2011-05-01

    Full Text Available Brent S Sorenson, Kaysie L Banton, Lance B Augustin, Arnold S Leonard, Daniel A SaltzmanDepartment of Surgery, University of Minnesota Medical School, Minneapolis, MN, USAAbstract: Fruit seeds high in antioxidants have been shown to have anticancer properties and enhance host protection against microbial infection. Recently we showed that a single oral dose of Salmonella enterica serovar Typhimurium expressing a truncated human interleukin-2 gene (SalpIL2 is avirulent, immunogenic, and reduces hepatic metastases through increased natural killer cell populations in mice. To determine whether antioxidant compounds enhance the antitumor effect seen in SalpIL2-treated animals, we assayed black cumin (BC, black raspberry (BR, and milk thistle (MT seed oils for the ability to reduce experimental hepatic metastases in mice. In animals without tumor, BC and BR oil diets altered the kinetics of the splenic lymphocyte response to SalpIL2. Consistent with previous reports, BR and BC seed oils demonstrated independent antitumor properties and moderate adjuvant potential with SalpIL2. MT oil, however, inhibited the efficacy of SalpIL2 in our model. Based on these data, we conclude that a diet high in antioxidant oils promoted a more robust immune response to SalpIL2, thus enhancing its antitumor efficacy.Keywords: antioxidants, colorectal cancer, tumor models, metastasis

  18. Estimation of lung tumor position from multiple anatomical features on 4D-CT using multiple regression analysis.

    Science.gov (United States)

    Ono, Tomohiro; Nakamura, Mitsuhiro; Hirose, Yoshinori; Kitsuda, Kenji; Ono, Yuka; Ishigaki, Takashi; Hiraoka, Masahiro

    2017-09-01

    To estimate the lung tumor position from multiple anatomical features on four-dimensional computed tomography (4D-CT) data sets using single regression analysis (SRA) and multiple regression analysis (MRA) approach and evaluate an impact of the approach on internal target volume (ITV) for stereotactic body radiotherapy (SBRT) of the lung. Eleven consecutive lung cancer patients (12 cases) underwent 4D-CT scanning. The three-dimensional (3D) lung tumor motion exceeded 5 mm. The 3D tumor position and anatomical features, including lung volume, diaphragm, abdominal wall, and chest wall positions, were measured on 4D-CT images. The tumor position was estimated by SRA using each anatomical feature and MRA using all anatomical features. The difference between the actual and estimated tumor positions was defined as the root-mean-square error (RMSE). A standard partial regression coefficient for the MRA was evaluated. The 3D lung tumor position showed a high correlation with the lung volume (R = 0.92 ± 0.10). Additionally, ITVs derived from SRA and MRA approaches were compared with ITV derived from contouring gross tumor volumes on all 10 phases of the 4D-CT (conventional ITV). The RMSE of the SRA was within 3.7 mm in all directions. Also, the RMSE of the MRA was within 1.6 mm in all directions. The standard partial regression coefficient for the lung volume was the largest and had the most influence on the estimated tumor position. Compared with conventional ITV, average percentage decrease of ITV were 31.9% and 38.3% using SRA and MRA approaches, respectively. The estimation accuracy of lung tumor position was improved by the MRA approach, which provided smaller ITV than conventional ITV. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

  19. Bitargeted microemulsions based on coix seed ingredients for enhanced hepatic tumor delivery and synergistic therapy.

    Science.gov (United States)

    Qu, Ding; Sun, Wenjie; Liu, Mingjian; Liu, Yuping; Zhou, Jing; Chen, Yan

    2016-04-30

    A hepatic tumor bitargeted microemulsions drug delivery system using coix seed oil and coix seed polysaccharide (CP) acting as anticancer components, as well as functional excipients, was developed for enhanced tumor-specific accumulation by CP-mediated enhancement on passive tumor targeting and modification of galactose stearate (tumor-targeted ligand). In the physicochemical characteristics studies, galactose stearate-modified coix seed multicomponent microemulsions containing 30% CP (w%) (Gal-C-MEs) had a well-defined spherical shape with a small size (47.63 ± 1.41 nm), a narrow polydispersity index (PDI, 0.101 ± 0.002), and a nearly neutral surface charge (-4.37 ± 1.76 mV). The half-maximal inhibitory concentration (IC50) of Gal-C-MEs against HepG2 cells was 70.2 μg/mL, which decreased by 1.8-fold in comparison with that of coix seed multicomponent microemulsions (C-MEs). The fluorescence intensity of fluorescein isothiocyanate (FITC)-loaded Gal-C-MEs (FITC-Gal-C-MEs) internalized by HepG2 cells was 1.8-fold higher than that of FITC-loaded C-MEs (FIT C-C-MEs), but the cellular uptake of the latter became reduce by 1.6-fold when the weight ratio of CP decreased up to 10%. In the cell apoptosis studies, C-MEs (containing 30% CP) did not show a significant difference with Gal-C-MEs, but exhibited 3.3-fold and 1.5-fold increase relative to C-MEs containing 10% CP and 20% CP, respectively. In the in vivo tumor targeting studies, Cy5-loaded Gal-C-MEs (Cy5-Gal-C-MEs), notably distributed in the tumor sites and still found even at 48 h post-administration, displayed the strongest capability of tumor tissue accumulation and retention among all the test groups. Most importantly, Gal-C-MEs had stronger inhibition of tumor growth, prolonged survival time and more effectively tumor cell apoptosis induction in comparison with C-MEs containing different amounts of CP, which further confirmed that a certain amount of CP and tumor-targeted ligand were of great importance to

  20. 3D Liver Tumor Segmentation in CT Images Using Improved Fuzzy C-Means and Graph Cuts

    Directory of Open Access Journals (Sweden)

    Weiwei Wu

    2017-01-01

    Full Text Available Three-dimensional (3D liver tumor segmentation from Computed Tomography (CT images is a prerequisite for computer-aided diagnosis, treatment planning, and monitoring of liver cancer. Despite many years of research, 3D liver tumor segmentation remains a challenging task. In this paper, an efficient semiautomatic method was proposed for liver tumor segmentation in CT volumes based on improved fuzzy C-means (FCM and graph cuts. With a single seed point, the tumor volume of interest (VOI was extracted using confidence connected region growing algorithm to reduce computational cost. Then, initial foreground/background regions were labeled automatically, and a kernelized FCM with spatial information was incorporated in graph cuts segmentation to increase segmentation accuracy. The proposed method was evaluated on the public clinical dataset (3Dircadb, which included 15 CT volumes consisting of various sizes of liver tumors. We achieved an average volumetric overlap error (VOE of 29.04% and Dice similarity coefficient (DICE of 0.83, with an average processing time of 45 s per tumor. The experimental results showed that the proposed method was accurate for 3D liver tumor segmentation with a reduction of processing time.

  1. "Pseudo washout" sign in high-flow hepatic hemangioma on gadoxetic acid contrast-enhanced MRI mimicking hypervascular tumor.

    Science.gov (United States)

    Doo, Kyung Won; Lee, Chang Hee; Choi, Jae Woong; Lee, Jongmee; Kim, Kyeong Ah; Park, Cheol Min

    2009-12-01

    The purpose of this article is to describe the "pseudo washout" sign of high-flow hepatic hemangioma that mimics hypervascular tumor on gadoxetic acid-enhanced MRI. High-flow hemangiomas might show relatively low signal intensity because of gadoxetic acid contrast uptake in the surrounding normal liver parenchyma during the equilibrium (3-minute delay) phase. Such findings are called pseudo washout and can mimic hypervascular hepatic tumors. However, high-flow hemangioma can be diagnosed by observing bright signal intensity on T2-weighted imaging, arterial phase-dominant enhancement, pseudo washout sign during the equilibrium phase, and isointense or slightly increased signal intensity on subtraction images.

  2. Multicentric Castleman's disease with multiple hepatic mass lesions mimicking malignant liver tumors.

    Science.gov (United States)

    Ueki, Toshimitsu; Nasuno, Masaru; Kaiume, Hiroko; Hiroshima, Yuki; Sumi, Masahiko; Watanabe, Masahide; Inoue, Dai; Masaki, Yasufumi; Sato, Yasuharu; Kojima, Masaru; Kobayashi, Hikaru

    2017-01-01

    Multicentric Castleman's disease (MCD) is a rare, non-malignant lymphoproliferative disorder. We report a case of MCD with multiple liver masses. A 26-year-old woman presented with asymptomatic anemia and hypoalbuminemia. Laboratory tests detected high CRP levels and findings indicative of polyclonal gammopathy. Abdominal CT revealed multiple hepatic large masses (≤10 cm) and partial calcification in the right lobe. Multiple enlarged lymph nodes were also identified in the cardiophrenic angle and porta hepatis. We suspected hepatic malignancy, but pathological examinations of the liver and lymph nodes demonstrated polyclonal plasma cell infiltration and fibrosis. IL-6 staining was positive for plasma cell infiltration of lymph nodes. A few plasma cells were positive for IgG4, and tests for HIV and HHV-8 were negative. Serum IL-6 and plasma VEGF levels were both elevated (45 and 536 pg/ml, respectively). The patient was diagnosed with plasma cell type MCD. We started treatment with PSL 1 mg/kg/day, which led to improvement of anemia, hypoalbuminemia, and high CRP levels. Marginal regression of liver masses was also observed. At the last follow-up, the patient had been progression-free for 18 months. To our knowledge, this is the first report of a plasma cell type MCD with liver masses.

  3. Noise-reducing algorithms do not necessarily provide superior dose optimisation for hepatic lesion detection with multidetector CT.

    Science.gov (United States)

    Dobeli, K L; Lewis, S J; Meikle, S R; Thiele, D L; Brennan, P C

    2013-03-01

    To compare the dose-optimisation potential of a smoothing filtered backprojection (FBP) and a hybrid FBP/iterative algorithm to that of a standard FBP algorithm at three slice thicknesses for hepatic lesion detection with multidetector CT. A liver phantom containing a 9.5-mm opacity with a density of 10 HU below background was scanned at 125, 100, 75, 50 and 25 mAs. Data were reconstructed with standard FBP (B), smoothing FBP (A) and hybrid FBP/iterative (iDose(4)) algorithms at 5-, 3- and 1-mm collimation. 10 observers marked opacities using a four-point confidence scale. Jackknife alternative free-response receiver operating characteristic figure of merit (FOM), sensitivity and noise were calculated. Compared with the 125-mAs/5-mm setting for each algorithm, significant reductions in FOM (pSuperior performance for hepatic lesion detection was not shown with either a smoothing FBP algorithm or a hybrid FBP/iterative algorithm compared with a standard FBP technique, even though noise reduction with thinner slices was demonstrated with the alternative approaches. Reductions in image noise with non-standard CT algorithms do not necessarily translate to an improvement in low-contrast object detection.

  4. Feasibility of Preoperative FDG PET/CT Total Hepatic Glycolysis in the Remnant Liver for the Prediction of Postoperative Liver Function.

    Science.gov (United States)

    Cho, Arthur; Chung, Yong Eun; Choi, Jin Sub; Kim, Kyung Sik; Choi, Gi Hong; Park, Young Nyun; Kim, Myeong-Jin

    2017-03-01

    The objective of our study was to investigate the prognostic value of total glycolysis of the remnant liver, which reflects both metabolic and anatomic liver function, for predicting postoperative hepatic insufficiency. Patients who underwent 18 F-FDG PET/CT and abdominal CT within 1 month of major hepatectomy were retrospectively analyzed. Total liver volume, remnant liver volume, the ratio of the remnant hepatic volume to the preoperative hepatic volume (RFRHV), and mean standardized uptake value (SUV mean ) were measured, and total glycolysis of the remnant liver was calculated. Clinical hepatic function reserve values, including the indocyanine green retention rate at 15 minutes, the model for end-stage liver disease (MELD) score, and aspartate aminotransferase to platelet ratio index (APRI), were calculated. Univariate and multivariate analyses were performed, and an optimal model for predicting hepatic insufficiency was developed. ROC curves were used to compare diagnostic performance. Of 149 patients, seven patients had hepatic insufficiency. The SUV mean showed the highest sensitivity (100%; specificity, 31.7%) for predicting hepatic insufficiency, and total glycolysis of the remnant liver showed the highest specificity (96.5%; sensitivity, 57.1%) for predicting hepatic insufficiency. On multivariate analysis, the odds ratio of APRI (> 5.4) and total glycolysis of the remnant liver (≤ 625.6) was 46.3 and 82.9, respectively, for predicting hepatic insufficiency. On ROC curve analysis, a new model composed of APRI and total glycolysis of the remnant liver showed a higher area under the ROC curve (A z ) value (A z = 0.899) than SUV mean (0.659), MELD score (0.618), APRI (0.693), RFRHV (0.797), and remnant liver volume (0.762). The total glycolysis of the remnant liver has moderate sensitivity and high specificity for predicting hepatic insufficiency. Combining the total glycolysis of the remnant liver and APRI yielded the best diagnostic performance for

  5. CT and MR findings of placental site trophoblastic tumor: a report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kang Hoon; Song, Kyung Sup; Byun, Jae Young; Bae, Seog Nyeon; Kim, Hyeon Sook [The Catholic Univ. of Korea, Seoul (Korea, Republic of)

    1999-01-01

    Placental site trophoblastic tumor (Pst) is a very rare form of gestational trophoblastic disease ; we encountered two cases. MR imaging of the first patient revealed a solid uterine mass, slightly hyperintense to normal myometrium on T1-weighted images and hyperintense on T2-weighted images. After intravenous gadolinium infusion, the mass was more enhanced than normal myometrium, and PSTT was confirmed pathologically after total hysterectomy. In the second patient, PSTT was proven pathologically after laparoscopic left adnexectomy and wedge resection of the right ovary. Postoperative enhanced CT scans revealed a well-enhanced right ovarian mass and extensive metastasis to the liver, pancreas, both adrenals, the stomach, lung and brain, but no mass was detected in the uterus. Many of these metastatic lesions were infiltrating low density masses associated with highly enhanced tubular or serpiginous structures, while some were of very high density.

  6. Arteries of the falciform ligament on C-arm CT hepatic arteriography: The hepatic falciform artery and the Sappey's superior artery

    Energy Technology Data Exchange (ETDEWEB)

    Hur, Saebeom; Chung, Jin Wook; Lee, Jae Hwan; Cho, SooBeum; Kim, Minuk; Lee, Myungsu; Kim, Hyo-Cheol; Jae, Hwan Jun [Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Zhou, Chun Gao [First Affiliated Hospital of Nanjing Medical University, Department of Interventional Radiology, Nanjing, Jangsu (China)

    2017-04-15

    To investigate the prevalence, anatomy and distribution of the hepatic falciform artery (HFA) and Sappey's superior artery (SSA) using C-arm CT hepatic arteriography (C-arm CTHA). From January 2011 to December 2012, 220 patients who underwent C-arm CTHA during initial transarterial treatment for hepatocellular carcinoma were included in this retrospective study. The HFAs and SSAs prevalence and origin were evaluated using axial images of C-arm CTHA. A 5-point scale for HFAs and a 4-point scale for SSAs were used to designate the radiologically conspicuous arteries. The prevalences of the total HFAs and SSAs were 95 % (n=209) and 22 % (n=49), while those of radiologically conspicuous HFAs and SSAs were 62 % (n=137) and 10 % (n=22), respectively. Thirty HFAs (22 % of radiologically conspicuous HFAs and 14 % of the total study population) were distributed in the subcutaneous layer of the anterior abdominal wall, while the majority of SSAs ran through the superior part of the falciform ligament in the left-anterior direction and anastomosed with left inferior phrenic artery. Our study using C-arm CTHA revealed that the prevalence of the HFA is higher than the existing knowledge and proved the existence of the SSA radiologically for the first time. (orig.)

  7. Radiofrequency thermal ablation of malignant hepatic tumors: post-ablation syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jung Bin; Rhim, Hyunchul; Kim, Yongsoo; Koh, Byung Hee; Cho, On Koo; Seo, Heung Suk; Lee, Seung Ro [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

    2000-07-01

    To evaluate post-ablation syndrome after radiofrequency thermal ablation of malignant hepatic tumors. Forty-two patients with primary (n=3D29) or secondary (n=3D13) hepatic tumors underwent radiofrequency thermal ablation. A total of 65 nodules ranging in size from 1.1 to 5.0 (mean, 3.1) cm were treated percutaneously using a 50W RF generator with 15G expandable needle electrodes. We retrospectively evaluated the spectrum of post-ablation syndrome including pain, fever ({>=}3D 38 deg C), nausea, vomiting, right shoulder pain, and chest discomfort according to frequency, intensity and duration, and the findings were correlated with tumor location and number of ablations. We also evaluated changes in pre-/post-ablation serum aminotransferase (ALT/AST) and prothrombin time, and correlated these findings with the number of ablations. Post-ablation syndrome was noted in 29 of 42 patients (69.0%), and most symptoms improved with conservative treatment. The most important of these were abdominal plan (n=3D20, 47.6%), fever (n=3D8, 19.0%), and nausea (n=3D7, 16.7%), and four of 42 (9.5%) patients complained of severe pain. The abdominal pain lasted from 3 hours to 5.5 days (mean; 20.4 hours), the fever from 6 hours to 5 days (mean; 63.0 hours). And the nausea from 1 hours to 4 days (mean; 21.0 hours). Other symptoms were right shoulder pain (n=3D6, 14.3%), chest discomfort (n=3D3, 7.1%), and headache (n=3D3, 7.1%). Seventeen of 20 patients (85%) with abdominal pain had subcapsular tumor of the liver. There was significant correlation between pain, location of the tumor, and a number of ablations. After ablation, ALT/AST was elevated more than two-fold in 52.6%/73.7% of patients, respectively but there was no significant correlation with the number of ablation. Post-ablation syndrome is a frequent and tolerable post-procedural process after radiofrequency thermal ablation. The spectrum of this syndrome provides a useful guideline for the post-ablation management. (author)

  8. Impact of anatomical location on value of CT-PET co-registration for delineation of lung tumors

    NARCIS (Netherlands)

    Fitton, Isabelle; Steenbakkers, Roel J. H. M.; Gilhuijs, Kenneth; Duppen, Joop C.; Nowak, Peter J. C. M.; van Herk, Marcel; Rasch, Coen R. N.

    2008-01-01

    PURPOSE: To derive guidelines for the need to use positron emission tomography (PET) for delineation of the primary tumor (PT) according to its anatomical location in the lung. METHODS AND MATERIALS: In 22 patients with non-small-cell lung cancer, thoracic X-ray computed tomography (CT) and PET were

  9. Glycogen storage disease type Ia mice with less than 2% of normal hepatic glucose-6-phosphatase-α activity restored are at risk of developing hepatic tumors.

    Science.gov (United States)

    Kim, Goo-Young; Lee, Young Mok; Kwon, Joon Hyun; Cho, Jun-Ho; Pan, Chi-Jiunn; Starost, Matthew F; Mansfield, Brian C; Chou, Janice Y

    2017-03-01

    Glycogen storage disease type Ia (GSD-Ia), characterized by impaired glucose homeostasis and chronic risk of hepatocellular adenoma (HCA) and carcinoma (HCC), is caused by a deficiency in glucose-6-phosphatase-α (G6Pase-α or G6PC). We have previously shown that G6pc-/- mice receiving gene transfer mediated by rAAV-G6PC, a recombinant adeno-associated virus (rAAV) vector expressing G6Pase-α, and expressing 3-63% of normal hepatic G6Pase-α activity maintain glucose homeostasis and do not develop HCA/HCC. However, the threshold of hepatic G6Pase-α activity required to prevent tumor formation remained unknown. In this study, we constructed rAAV-co-G6PC, a rAAV vector expressing a codon-optimized (co) G6Pase-α and showed that rAAV-co-G6PC was more efficacious than rAAV-G6PC in directing hepatic G6Pase-α expression. Over an 88-week study, we showed that both rAAV-G6PC- and rAAV-co-G6PC-treated G6pc-/- mice expressing 3-33% of normal hepatic G6Pase-α activity (AAV mice) maintained glucose homeostasis, lacked HCA/HCC, and were protected against age-related obesity and insulin resistance. Of the eleven rAAV-G6PC/rAAV-co-G6PC-treated G6pc-/- mice harboring 0.9-2.4% of normal hepatic G6Pase-α activity (AAV-low mice), 3 expressing 0.9-1.3% of normal hepatic G6Pase-α activity developed HCA/HCC, while 8 did not (AAV-low-NT). Finally, we showed that the AAV-low-NT mice exhibited a phenotype indistinguishable from that of AAV mice expressing ≥3% of normal hepatic G6Pase-α activity. The results establish the threshold of hepatic G6Pase-α activity required to prevent HCA/HCC and show that GSD-Ia mice harboring <2% of normal hepatic G6Pase-α activity are at risk of tumor development. Published by Elsevier Inc.

  10. SU-D-202-03: Statistical Segmentation On Quantitative CT for Assessing Spatial Tumor Response During Radiation Therapy Delivery

    Energy Technology Data Exchange (ETDEWEB)

    Schott, D; Chen, X; Klawikowski, S; Noid, G; Dalah, E; Li, X [Medical College of Wisconsin, Milwaukee, WI (United States); Schmidt, T [Marquette University, Milwaukee, WI (United States)

    2016-06-15

    Purpose: Develop a method to segment regions of interest (ROIs) in tumor with statistically similar Hounsfield unit (HU) values and/or HU changes during chemoradiation therapy (CRT) delivery, to assess spatial tumor treatment response based on daily CTs during CRT delivery. Methods: Generate a three region map of ROIs with differential HUs, by sampling neighboring voxels around a selected voxel and comparing to the mean of the entire ROI using a t-test. The cumulative distribution function, P, is calculated from the t-test. The P value is assigned to be the value at the selected voxel, and this is repeated over all voxels in the initial ROI. Three regions are defined as: (1-P) < 0.00001 (mid region), and 0.00001 < (1-P) (mean greater than baseline and mean lower than baseline). The test is then expanded to compare daily CT sets acquired during routine CT-guided RT delivery using a CT-on-rails. The first fraction CT is used as the baseline for comparison. We tested 15 pancreatic head tumor cases undergoing CRT, to identify the ROIs and changes corresponding to normal, fibrotic, and tumor tissue. The obtained ROIs were compared with MRI-ADC maps acquired pre- and post-CRT. Results: The ROIs in 13 out of 15 patients’ first fraction CTs and pre-CRT MRIs matched the general region and slices covered, as well as in 6 out of the 9 patients with post-CRT MRIs. The high HU region designated by the t-test was seen to correlate with the tumor region in MR, and these ROIs are positioned within the same region over the course of treatment. In patients with poorly delineated tumors in MR, the t-test was inconclusive. Conclusion: The proposed statistical segmentation technique shows the potential to identify regions in tumor with differential HUs and HU changes during CRT delivery for patients with pancreas head cancer.

  11. CT anatomy of the vagus nerve with radiological-pathological correlation of the intrathoracic vagal neurogenic tumors

    Energy Technology Data Exchange (ETDEWEB)

    Miyagawa, Hideo [Nagoya City Univ. (Japan). Medical School

    2000-11-01

    The correlation in the title was evaluated since vagus nerve in the thoracic cavity had not been assessed by CT hitherto. For the purpose to examine the nerve imaging, subjects were a patient of neurofibromatosis and a normal volunteer. CT was done with Siemens Somato Plus 4 and General Electric-Yokokawa HiSpeed Advantage SG. For the same purpose, 100 cases of thoracic image by the latter apparatus were retrospectively assessed. Finally, the correlation in the title was examined retrospectively with combination of MR imaging in 9 cases who had undergone a surgery treatment of vagal neurogenic tumors (4 malignant and 4 benign cases of schwannoma and 1 neurofibromatosis). The nerve was found to be imaged by the ordinary CT and thus, which was thought to be useful for surgery, prognosis assessment and diagnosis of neurogenic tumors together with MRI. (K.H.)

  12. The value of {sup 18}F-FDG PET/CT in the management of malignant peripheral nerve sheath tumors

    Energy Technology Data Exchange (ETDEWEB)

    Khiewvan, Benjapa [University of Texas MD Anderson Cancer Center, Department of Nuclear Medicine, Houston, TX (United States); Mahidol University, Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine Siriraj Hospital, Bangkok (Thailand); Macapinlac, Homer A.; Chuang, Hubert H. [University of Texas MD Anderson Cancer Center, Department of Nuclear Medicine, Houston, TX (United States); Lev, Dina; Al Sannaa, Ghadah [University of Texas MD Anderson Cancer Center, Department of Cancer Biology, Houston, TX (United States); McCutcheon, Ian E. [University of Texas MD Anderson Cancer Center, Department of Neurosurgery, Houston, TX (United States); Slopis, John M. [University of Texas MD Anderson Cancer Center, Department of Neuro-Oncology, Houston, TX (United States); Wei, Wei [University of Texas MD Anderson Cancer Center, Department of Biostatistics, Houston, TX (United States)

    2014-09-15

    Our objective was to determine how positron emission tomography (PET)/CT had been used in the clinical treatment of malignant peripheral nerve sheath tumor (MPNST) patients at The University of Texas MD Anderson Cancer Center. We reviewed a database of MPNST patients referred to MD Anderson Cancer Center during 1995-2011. We enrolled 47 patients who underwent PET/CT imaging. Disease stage was based on conventional imaging and PET/CT findings using National Comprehensive Cancer Network (NCCN) guidelines. Treatment strategies based on PET/CT and conventional imaging were determined by chart review. The maximum and mean standardized uptake values (SUV{sub max}, SUV{sub mean}), metabolic tumor volume (MTV), total lesion glycolysis (TLG), change in SUV{sub max}, change in MTV, and change in TLG were calculated from the PET/CT studies before and after treatment. Response prediction was based on imaging studies performed before and after therapy and categorized as positive or negative for residual tumor. Clinical outcome was determined from chart review. PET/CT was performed for staging in 16 patients, for restaging in 29 patients, and for surveillance in 2 patients. Of the patients, 88 % were correctly staged with PET/CT, whereas 75 % were correctly staged with conventional imaging. The sensitivity to detect local recurrence and distant metastasis at restaging was 100 and 100 % for PET/CT compared to 86 and 83 % for conventional imaging, respectively. PET/CT findings resulted in treatment changes in 31 % (5/16) and 14 % (4/29) of patients at staging and restaging, respectively. Recurrence, MTV, and TLG were prognostic factors for survival, whereas SUV{sub max} and SUV{sub mean} were not predictive. For 21 patients who had imaging studies performed both before and after treatment, PET/CT was better at predicting outcome (overall survival, progression-free survival) than conventional imaging. A decreasing SUV{sub max} ≥ 30 % and decrease in TLG and MTV were significant

  13. Preoperative Diagnosis of Gastric Tumors by Three-dimensional Multidetector Row CT and Double Contrast Barium Meal Study: Correlation with Surgical and Histologic Results

    Directory of Open Access Journals (Sweden)

    Bang-Bin Chen

    2007-11-01

    Conclusion: MDCT has a similar high accuracy in the preoperative diagnosis of different gastric tumors compared with DCBM and provides additional information including tumor depth, lymph node and hepatic metastasis. Therefore, MDCT may be used as a primary tool for preoperative tumor diagnosis and staging.

  14. Relationship of preoperative gastric cancer CT enhancement ratio and perfusion parameters with serum tumor marker levels and proliferation molecule expression in tumor lesions

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    Yong-Hong Wang

    2017-06-01

    Full Text Available Objective: To study the relationship of preoperative gastric cancer CT enhancement ratio and perfusion parameters with serum tumor marker levels and proliferation molecule expression in tumor lesions. Methods: A total of 68 patients with gastric cancer treated in the Second Hospital of Yulin City between May 2012 and May 2016 were chosen as observation group and sub-divided into early and middle gastric cancer group (n=41 and advanced gastric cancer group (n=27 according to the tumor stage; 50 patients diagnosed with benign gastric diseases in our hospital during the same period were selected as benign gastric lesion group. CT enhancement rate and perfusion parameters of three groups of patients were detected by CT scan, serum tumor marker levels were evacuated by enzyme-linked immunosorbent assay (ELISA, and the proliferation gene mRNA expression levels were detected by RTPCR method. Results: CER, AF, BV and CL levels of advanced gastric cancer group were higher than those of early and middle gastric cancer group and benign gastric lesion group; serum CA72-4, CA19-9, CA125 and CEA contents of advanced gastric cancer group were higher than those of early and middle gastric cancer group and benign gastric lesion group; CADM1, miRNA-34a and Cystatin M mRNA expression in tissue of advanced gastric cancer group were lower than those of early and middle gastric cancer group and benign gastric lesion group while Survivin and I2PP2A mRNA expression were higher than those of early and middle gastric cancer group and benign gastric lesion group. The Pearson test showed that the CT enhancement rate and perfusion parameters in patients with gastric cancer are directly correlated with the serum tumor marker levels and the proliferation gene expression in tumor lesions. Conclusion: Preoperative gastric cancer CT enhancement rate and perfusion parameters are directly related to the tumor malignancy, and can be used as a reliable method for the long-term tumor

  15. {sup 18}F-FDG-PET/CT of orofacial tumors, a value of whole-body imaging approach

    Energy Technology Data Exchange (ETDEWEB)

    Ferda, Jiri [Department of Nuclear Medicine, University Hospital Plzen and Medical Faculty Plzen, Alej Svobody 80, 306 40 Plzen (Czech Republic); Department of Radiology, University Hospital Plzen and Medical Faculty Plzen, Alej Svobody 80, 306 40 Plzen (Czech Republic)], E-mail: ferda@fnplzen.cz; Ferdova, Eva [Department of Nuclear Medicine, University Hospital Plzen and Medical Faculty Plzen, Alej Svobody 80, 306 40 Plzen (Czech Republic); Department of Radiology, University Hospital Plzen and Medical Faculty Plzen, Alej Svobody 80, 306 40 Plzen (Czech Republic); Zahlava, Jan [Department of Nuclear Medicine, University Hospital Plzen and Medical Faculty Plzen, Alej Svobody 80, 306 40 Plzen (Czech Republic); Walter, Jiri [Department of Stomatosurgery, University Hospital Plzen and Medical Faculty Plzen, Alej Svobody 80, 306 40 Plzen (Czech Republic); Mukensnabl, Petr; Daum, Ondrej [sikls Institute of Pathological Anatomy, University Hospital Plzen and Medical Faculty Plzen, Alej Svobody 80, 306 40 Plzen (Czech Republic); Kreuzberg, Boris [Department of Nuclear Medicine, University Hospital Plzen and Medical Faculty Plzen, Alej Svobody 80, 306 40 Plzen (Czech Republic)

    2010-02-15

    Aim: Staging of head and neck tumors is one of the most difficult tasks in imaging techniques, due to the very complicated head and neck anatomy and serious problems with the differentiation of reactive enlarged lymph nodes and lymph nodes involved with metastases. The aim of the study was to evaluate the validity of the whole-body approach in the assessment of head and neck malignancies using {sup 18}F-FDG-PET/CT. Materials and methods: The analysis of a group of 1750 consecutive whole-body procedures in all indications of {sup 18}F-FDG-PET/CT was made according to: the presence of orofacial tumors; their histology; findings concerning the spread outside head and neck region; and findings concerning the primary staging or restaging. The examinations of head and neck tumors were performed after intravenous application of the {sup 18}F-FDG and its accumulation for one hour. Drinking and speaking is restricted during this accumulation to prevent artificial muscle {sup 18}F-FDG uptake and to minimize false positive findings. In our hospital, high resolution PET is followed by the sub-millimeter isotropic acquisition of CT data after intravenous application of an iodinated contrast material. The acquisitions of head and neck region and trunk are performed separately to obtain optimal resolution in both regions. Results: 105 examinations of the orofacial tumors were performed on 87 patients in a group of 1750 consecutive PET/CT examinations. The ratio between primary staging and restaging was 3:7. The most frequent indications were carcinomas of the tongue (19 examinations) and carcinomas of the salivary glands (19 examinations). The metastatic spread of the tumor outside the region of the head and neck was noted in 12 cases. Conclusion: Our findings of distant metastases confirmed the importance of the use of whole-body PET/CT in this indication.

  16. Salivary gland tumors of the parotid gland: CT and MR imaging findings with emphasis on intratumoral cystic components

    Energy Technology Data Exchange (ETDEWEB)

    Kato, Hiroki; Watanabe, Haruo [Gifu University School of Medicine, Department of Radiology, Gifu (Japan); Kanematsu, Masayuki [Gifu University School of Medicine, Department of Radiology, Gifu (Japan); Gifu University Hospital, High-Level Imaging Diagnosis Center, Gifu (Japan); Mizuta, Keisuke; Aoki, Mitsuhiro [Gifu University School of Medicine, Department of Otolaryngology, Gifu (Japan)

    2014-09-15

    The purpose of this study was to assess computed tomography (CT) and magnetic resonance (MR) imaging findings of salivary gland tumors of the parotid gland with emphasis on intratumoral cystic components. Seventy-two histopathologically confirmed salivary gland tumors of the parotid gland (44 benign and 28 malignant), which underwent both CT and MR imaging including contrast-enhanced study, were included in this study. We retrospectively reviewed images for the presence, number, occupying rate, margin characteristics, distribution, and predominant MR signal intensity of intratumoral cystic components. The prevalence of cystic components was greater in malignant than benign tumors (79 vs. 50 %, p < 0.05). The number and occupying rate were similar between benign and malignant tumors. The irregular margins were more frequent in malignant than benign tumors (73 vs. 27 %, p < 0.01). The frequency of eccentric location was greater in benign than malignant tumors (91 vs. 55 %, p < 0.01), whereas the frequency of centric location was greater in malignant than benign tumors (32 vs. 0 %, p < 0.01). On T1-weighted images, the frequency of hyperintensity was greater in benign than malignant tumors (50 vs. 9 %, p < 0.01), whereas that of isointensity was greater in malignant than benign tumors (50 vs. 0 %, p < 0.01). Multiple logistic regression analysis showed that the absence of irregular margins of cystic components only was significantly correlated with the presence of benign salivary gland tumors (p < 0.01). Imaging features of intratumoral cystic components may help to differentiate benign from malignant tumors of the parotid salivary gland. (orig.)

  17. Hypofractionated radiotherapy for lung tumors with online cone beam CT guidance and active breathing control

    Directory of Open Access Journals (Sweden)

    Wang Xin

    2010-02-01

    Full Text Available Abstract Background To study the set-up errors, PTV margin and toxicity of cone beam CT (CBCT guided hypofractionated radiotherapy with active breathing control (ABC for patients with non-small cell lung cancer (NSCLC or metastatic tumors in lung. Methods 32 tumors in 20 patients were treated. Based on the location of tumor, dose per fraction given to tumor was divided into three groups: 12 Gy, 8 Gy and 6 Gy. ABC is applied for every patient. During each treatment, patients receive CBCT scan for online set-up correction. The pre- and post-correction setup errors between fractions, the interfractional and intrafractional, set-up errors, PTV margin as well as toxicity are analyzed. Results The pre-correction systematic and random errors in the left-right (LR, superior-inferior (SI, anterior-posterior (AP directions were 3.7 mm and 5.3 mm, 3.1 mm and 2.1 mm, 3.7 mm and 2.8 mm, respectively, while the post-correction residual errors were 0.6 mm and 0.8 mm, 0.8 mm and 0.8 mm, 1.2 mm and 1.3 mm, respectively. There was an obvious intrafractional shift of tumor position. The pre-correction PTV margin was 9.5 mm in LR, 14.1 mm in SI and 8.2 mm in AP direction. After CBCT guided online correction, the PTV margin was markedly reduced in all three directions. The post-correction margins ranged 1.5 to 2.1 mm. The treatment was well tolerated by patients, of whom there were 4 (20% grade1-2 acute pneumonitis, 3 (15% grade1 acute esophagitis, 2 (10% grade1 late pneumonitis and 1 (5% grade 1 late esophagitis. Conclusion The positioning errors for lung SBRT using ABC were significant. Online correction with CBCT image guidance should be applied to reduce setup errors and PTV margin, which may reduce radiotherapy toxicity of tissues when ABC was used.

  18. Automatic and manual image fusion of 111 In-pentetreotide SPECT and diagnostic CT in neuroendocrine tumor imaging - An evaluation

    Directory of Open Access Journals (Sweden)

    Hedlund Elisabeth

    2010-01-01

    Full Text Available In the clinical diagnosis of neuroendocrine tumors (NET, the results of examinations, such as high-resolution computed tomography (CT and single photon computerized tomography (SPECT, have conventionally been interpreted separately. The aim of the present study was to evaluate Hermes Multimodality™ 5.0 H Image Fusion software-based automatic and manual image fusion of SPECT and CT for the localization of NET lesions. Out of 34 NET patients who were examined by means of somatostatin receptor scintigraphy (SRS with 111In- pentetreotide along with SPECT, 22 patients had a CT examination of the abdomen, which was used in the fusion analysis. SPECT and CT data were fused using software with a registration algorithm based on normalized mutual information. The criteria for acceptable fusion were established at a maximum cranial or caudal dislocation of 25 mm between the images and at a reasonable consensus (in order of less than 1 cm between outline of the reference organs. The automatic fusion was acceptable in 13 of the 22 examinations, whereas 9 fusions were not. However all the 22 examinations were acceptable at the manual fusion. The result of automatic fusion was better when the slice thickness of 5 mm was applied at CT examination, when the number of slices was below 100 in CT data and when both examinations included uptakes of pathological lesions. Retrospective manual image fusion of SPECT and CT is a relatively inexpensive but reliable method to be used in NET imaging. Automatic image fusion with specified software of SPECT and CT acts better when the number of CT slices is reduced to the SPECT volume and when corresponding pathological lesions appear at both SPECT and CT examinations.

  19. Ectopic ACTH and CRH Co-secreting Tumor Localized by 68Ga-DOTA-TATE PET/CT.

    Science.gov (United States)

    Papadakis, Georgios Z; Bagci, Ulas; Sadowski, Samira M; Patronas, Nicholas J; Stratakis, Constantine A

    2015-07-01

    Diagnosis of ectopic adrenocorticotropic hormone (ACTH) and corticotropin-releasing hormone (CRH) co-secreting tumors causing Cushing syndrome (CS) is challenging because these tumors are rare and their diagnosis is frequently confused with Cushing disease (CD), caused by the effect of CRH on the pituitary. We report a case of a 21-year-old male patient who was referred to our institution with persistent hypercortisolemia and CS after undergoing unnecessary transsphenoidal surgery (TSS). ⁶⁸Ga-DOTA-TATE PET/CT revealed increased tracer uptake in the thymus, which was histologically proven to be a neuroendocrine tumor (NET) that stained positive for ACTH and CRH. Imaging with ¹⁸F-FDG PET/CT was not diagnostic.

  20. The diagnostic accuracy of US, CT, MRI and (1)H-MRS for the evaluation of hepatic steatosis compared with liver biopsy: a meta-analysis

    NARCIS (Netherlands)

    Bohte, A.E.; van Werven, J.R.; Bipat, S.; Stoker, J.

    2011-01-01

    OBJECTIVE: To meta-analyse the diagnostic accuracy of US, CT, MRI and (1)H-MRS for the evaluation of hepatic steatosis. METHODS: From a comprehensive literature search in MEDLINE, EMBASE, CINAHL and Cochrane (up to November 2009), articles were selected that investigated the diagnostic performance

  1. FDG-avid portal vein tumor thrombosis from hepatocellular carcinoma in contrast-enhanced FDG PET/CT

    Directory of Open Access Journals (Sweden)

    Canh Nguyen

    2015-01-01

    Full Text Available Objective(s: In this study, we aimed to describe the characteristics of portal vein tumor thrombosis (PVTT, complicating hepatocellular carcinoma (HCC in contrast-enhanced FDG PET/CT scan. Methods: In this retrospective study, 9 HCC patients with FDG-avid PVTT were diagnosed by contrast-enhanced fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT, which is a combination of dynamic liver CT scan, multiphase imaging, and whole-body PET scan. PET and CT DICOM images of patients were imported into the PET/CT imaging system for the re-analysis of contrast enhancement and FDG uptake in thrombus, the diameter of the involved portal vein, and characteristics of liver tumors and metastasis. Results: Two patients with previously untreated HCC and 7 cases with previously treated HCC had FDG-avid PVTT in contrast-enhanced FDG PET/CT scan. During the arterial phase of CT scan, portal vein thrombus showed contrast enhancement in 8 out of 9 patients (88.9%. PET scan showed an increased linear FDG uptake along the thrombosed portal vein in all patients. The mean greatest diameter of thrombosed portal veins was 1.8 ± 0.2 cm, which was significantly greater than that observed in normal portal veins (P<0.001. FDG uptake level in portal vein thrombus was significantly higher than that of blood pool in the reference normal portal vein (P=0.001. PVTT was caused by the direct extension of liver tumors. All patients had visible FDG-avid liver tumors in contrast-enhanced images. Five out of 9 patients (55.6% had no extrahepatic metastasis, 3 cases (33.3% had metastasis of regional lymph nodes, and 1 case (11.1% presented with distant metastasis. The median estimated survival time of patients was 5 months. Conclusion: The intraluminal filling defect consistent with thrombous within the portal vein, expansion of the involved portal vein, contrast enhancement, and linear increased FDG uptake of the thrombus extended from liver tumor are

  2. Percutaneous CT-Guided Ablation in the Hepatic Dome: Artificially Induced Pneumothorax for Safe Transpleural Access

    Directory of Open Access Journals (Sweden)

    Leonardo Guedes Moreira Valle

    2015-01-01

    Full Text Available Ablative therapies have become a great alternative to surgical treatment of hepatic nodules. Some technical difficulties may negatively influence the effectiveness of this therapy, such as lesions located near the diaphragm. The transthoracic approach is commonly used to access these lesions. However, it is associated with an increased risk of complications, such as pneumothorax, hemothorax, alveolar bleeding, and others.We report a case of a radiofrequency ablation of a lesion in the hepatic dome, where an artificially induced pneumothorax was performed to guarantee a safe and effective access. The air was easily injected by a spinal needle and later aspirated by a single-lumen catheter. Induced pneumothorax shoud be considered in ablation of hepatic dome lesions, mainly when the transhepatic access is not appropriate.

  3. Hepatitis B surface antigen fusions delivered by DNA vaccination elicit CTL responses to human papillomavirus oncoproteins associated with tumor protection.

    Science.gov (United States)

    Haigh, O; Kattenbelt, J; Cochrane, M; Thomson, S; Gould, A; Tindle, R

    2010-10-01

    We describe the construction and evaluation of a recombinant hepatitis B surface antigen (HBsAg)-vectored DNA vaccine encoding the E7 and E6 tumor-associated oncoproteins of human papillomavirus (HPV) type 16. We show the induction of effector and memory cytotoxic T lymphocyte responses to E7 and E6 class I-restricted epitopes after a single immunization, which were associated with tumor prevention and therapy. The findings vindicate the use of a HBsAg-based DNA vaccine as a vehicle to elicit responses to co-encoded tumor antigens, and have specific implications for the development of a therapeutic vaccine for HPV-associated squamous carcinomas.

  4. Retroperitoneal bronchogenic cyst presenting paraadrenal tumor incidentally detected by {sup 18}F-FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Ye Ri; Choi, Ji Youn; Lee, Sang Mi; Kim, Yeo Joo; Cho, Hyun Deuk; Lee, Jeong Won; Jeon, Youn Soo [Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of)

    2015-03-15

    A follow-up 18F-fluorodeoxyglucose ({sup 18}F-FDG) PET/CT scan of a 57-year-old asymptomatic male who had undergone total thyroidectomy for thyroid cancer revealed a 5.0 x 4.0-cm, well-defined, ovoid-shaped mass around the left adrenal gland without definite FDG uptake. On the adrenal CT scan, the left paraadrenal tumor showed high attenuation on the precontrast scan without enhancement. The average Hounsfield unit (HU) was 58.1 on the precontrast scan and 58.4 on the postcontrast scan. The patient underwent laparoscopic adrenalectomy for resection of the left paraadrenal tumor. The final histopathologic examination revealed a bronchogenic cyst. Although retroperitoneal bronchogenic cysts are rare, they should be considered in the differential diagnosis of retroperitoneal cystic tumors. The preoperative diagnosis is difficult, but a contrast-enhanced CT scan or {sup 18}F-FDG PET/CT scan may be useful for differentiating hyperattenuated cysts from other soft tissue masses.

  5. Noise-reducing algorithms do not necessarily provide superior dose optimisation for hepatic lesion detection with multidetector CT

    Science.gov (United States)

    Dobeli, K L; Lewis, S J; Meikle, S R; Thiele, D L; Brennan, P C

    2013-01-01

    Objective: To compare the dose-optimisation potential of a smoothing filtered backprojection (FBP) and a hybrid FBP/iterative algorithm to that of a standard FBP algorithm at three slice thicknesses for hepatic lesion detection with multidetector CT. Methods: A liver phantom containing a 9.5-mm opacity with a density of 10 HU below background was scanned at 125, 100, 75, 50 and 25 mAs. Data were reconstructed with standard FBP (B), smoothing FBP (A) and hybrid FBP/iterative (iDose4) algorithms at 5-, 3- and 1-mm collimation. 10 observers marked opacities using a four-point confidence scale. Jackknife alternative free-response receiver operating characteristic figure of merit (FOM), sensitivity and noise were calculated. Results: Compared with the 125-mAs/5-mm setting for each algorithm, significant reductions in FOM (p<0.05) and sensitivity (p<0.05) were found for all three algorithms for all exposures at 1-mm thickness and for all slice thicknesses at 25 mAs, with the exception of the 25-mAs/5-mm setting for the B algorithm. Sensitivity was also significantly reduced for all exposures at 3-mm thickness for the A algorithm (p<0.05). Noise for the A and iDose4 algorithms was approximately 13% and 21% lower, respectively, than for the B algorithm. Conclusion: Superior performance for hepatic lesion detection was not shown with either a smoothing FBP algorithm or a hybrid FBP/iterative algorithm compared with a standard FBP technique, even though noise reduction with thinner slices was demonstrated with the alternative approaches. Advances in knowledge: Reductions in image noise with non-standard CT algorithms do not necessarily translate to an improvement in low-contrast object detection. PMID:23392194

  6. Evaluation of the tumor registration error in biopsy procedures performed under real-time PET/CT guidance.

    Science.gov (United States)

    Fanchon, Louise M; Apte, Adytia; Schmidtlein, C Ross; Yorke, Ellen; Hu, Yu-Chi; Dogan, Snjezana; Hatt, Mathieu; Visvikis, Dimitris; Humm, John L; Solomon, Stephen B; Kirov, Assen S

    2017-10-01

    The purpose of this study is to quantify tumor displacement during real-time PET/CT guided biopsy and to investigate correlations between tumor displacement and false-negative results. 19 patients who underwent real-time 18 F-FDG PET-guided biopsy and were found positive for malignancy were included in this study under IRB approval. PET/CT images were acquired for all patients within minutes prior to biopsy to visualize the FDG-avid region and plan the needle insertion. The biopsy needle was inserted and a post-insertion CT scan was acquired. The two CT scans acquired before and after needle insertion were registered using a deformable image registration (DIR) algorithm. The DIR deformation vector field (DVF) was used to calculate the mean displacement between the pre-insertion and post-insertion CT scans for a region around the tip of the biopsy needle. For 12 patients one biopsy core from each was tracked during histopathological testing to investigate correlations of the mean displacement between the two CT scans and false-negative or true-positive biopsy results. For 11 patients, two PET scans were acquired; one at the beginning of the procedure, pre-needle insertion, and an additional one with the needle in place. The pre-insertion PET scan was corrected for intraprocedural motion by applying the DVF. The corrected PET was compared with the post-needle insertion PET to validate the correction method. The mean displacement of tissue around the needle between the pre-biopsy CT and the postneedle insertion CT was 5.1 mm (min = 1.1 mm, max = 10.9 mm and SD = 3.0 mm). For mean displacements larger than 7.2 mm, the biopsy cores gave false-negative results. Correcting pre-biopsy PET using the DVF improved the PET/CT registration in 8 of 11 cases. The DVF obtained from DIR of the CT scans can be used for evaluation and correction of the error in needle placement with respect to the FDG-avid area. Misregistration between the pre-biopsy PET and the CT acquired with the

  7. Vascular segmentation in hepatic CT images using adaptive threshold fuzzy connectedness method.

    Science.gov (United States)

    Guo, Xiaoxi; Huang, Shaohui; Fu, Xiaozhu; Wang, Boliang; Huang, Xiaoyang

    2015-06-19

    Fuzzy connectedness method has shown its effectiveness for fuzzy object extraction in recent years. However, two problems may occur when applying it to hepatic vessel segmentation task. One is the excessive computational cost, and the other is the difficulty of choosing a proper threshold value for final segmentation. In this paper, an accelerated strategy based on a lookup table was presented first which can reduce the connectivity scene calculation time and achieve a speed-up factor of above 2. When the computing of the fuzzy connectedness relations is finished, a threshold is needed to generate the final result. Currently the threshold is preset by users. Since different thresholds may produce different outcomes, how to determine a proper threshold is crucial. According to our analysis of the hepatic vessel structure, a watershed-like method was used to find the optimal threshold. Meanwhile, by using Ostu algorithm to calculate the parameters for affinity relations and assigning the seed with the mean value, it is able to reduce the influence on the segmentation result caused by the location of the seed and enhance the robustness of fuzzy connectedness method. Experiments based on four different datasets demonstrate the efficiency of the lookup table strategy. These experiments also show that an adaptive threshold found by watershed-like method can always generate correct segmentation results of hepatic vessels. Comparing to a refined region-growing algorithm that has been widely used for hepatic vessel segmentation, fuzzy connectedness method has advantages in detecting vascular edge and generating more than one vessel system through the weak connectivity of the vessel ends. An improved algorithm based on fuzzy connectedness method is proposed. This algorithm has improved the performance of fuzzy connectedness method in hepatic vessel segmentation.

  8. Tumor volume in subcutaneous mouse xenografts measured by microCT is more accurate and reproducible than determined by 18F-FDG-microPET or external caliper

    DEFF Research Database (Denmark)

    Jensen, Mette Munk; Jørgensen, Jesper Tranekjaer; Binderup, Tina

    2008-01-01

    and reproducible measures of tumor size in mice compared with caliper measurements. Furthermore, we evaluated the accuracy of tumor volume determined from 18F-fluorodeoxyglucose (18F-FDG) PET. METHODS: Subcutaneously implanted human breast adenocarcinoma cells in NMRI nude mice served as tumor model. Tumor volume......BACKGROUND: In animal studies tumor size is used to assess responses to anticancer therapy. Current standard for volumetric measurement of xenografted tumors is by external caliper, a method often affected by error. The aim of the present study was to evaluate if microCT gives more accurate...... (n = 20) was determined in vivo by external caliper, microCT and 18F-FDG-PET and subsequently reference volume was determined ex vivo. Intra-observer reproducibility of the microCT and caliper methods were determined by acquiring 10 repeated volume measurements. Volumes of a group of tumors (n = 10...

  9. Differentiation of germinomas from other tumors in the pineal region with CT and MR imaging, with special reference to extension patterns to the thalami

    Energy Technology Data Exchange (ETDEWEB)

    Furusawa, Tetsuya [Niigata Univ. (Japan). School of Medicine

    1998-03-01

    To determine the computed tomography (CT) and magnetic resonance (MR) characteristics of pineal region germinomas, the author reviewed images from 40 patients with pineal region tumors. These tumors were divided into two groups: those with germinomas (n=17), and those with other tumors in the pineal region (5 with a germ cell tumor other than germinoma; 8, mixed germ cell tumor; 8, pineal parenchymal tumor; and 2, miscellaneous tumors; n=23). All cases were investigated with CT; 31 of the cases were also investigated with MR imaging. The following parameters comprised statistically significant differences between the two groups: maximum size of the tumor, tumor density of the precontrast CT, signal intensity of precontrast T1-weighted spin-echo images, and homogeneity of the tumor on both precontrast and postcontrast studies. This study found that extension patterns of pineal region tumors into the thalamus have significant implications in differentiating germinomas from other tumors of this region. Germinomas are characterized by thalamic extension without lateral displacement of the third ventricle walls due to direct compression by tumors (p=0.0034). The analysis of tumor extension patterns, combined with the parameters mentioned above, may provide a more accurate differential diagnosis in pineal region tumors, leading to prompt and appropriate treatment. (author)

  10. Mass-forming intrahepatic cholangiocarcinoma: Enhancement patterns in the arterial phase of dynamic hepatic CT - Correlation with clinicopathological findings

    Energy Technology Data Exchange (ETDEWEB)

    Fujita, Nobuhiro; Asayama, Yoshiki; Nishie, Akihiro; Ishigami, Kousei; Ushijima, Yasuhiro; Okamoto, Daisuke; Moirta, Koichiro; Honda, Hiroshi [Kyushu University, Department of Clinical Radiology, Graduate School of Medical Sciences, Higashi-ku, Fukuoka (Japan); Takayama, Yukihisa [Kyushu University, Department of Radiology Informatics and Network, Graduate School of Medical Sciences, Higashi-ku, Fukuoka (Japan); Shirabe, Ken [Kyushu University, Department of Surgery and Science, Graduate School of Medical Sciences, Higashi-ku, Fukuoka (Japan); Aishima, Shinichi [Saga University Hospital, Department of Pathology and Microbiology, Faculty of Medicine, Saga City, Saga (Japan); Wang, Huanlin; Oda, Yoshinao [Kyushu University, Department of Anatomic Pathology, Graduate School of Medical Sciences, Higashi-ku, Fukuoka (Japan)

    2017-02-15

    To evaluate the relationship between the enhancement pattern of intrahepatic cholangiocarcinomas (ICCs) in the hepatic arterial phase (HAP) of dynamic hepatic CT and the clinicopathological findings with special reference to the perihilar type and the peripheral type. Forty-seven patients with pathologically proven ICCs were enrolled. Based on the enhancement pattern in the HAP, the lesions were classified into three groups: a hypovascular group (n=13), rim-enhancement group (n=18), and hypervascular group (n=16). The clinicopathological findings were compared among the three groups. Perihilar-type ICCs were significantly more frequently observed in the hypovascular group than in the rim-enhancement and hypervascular groups (p=0.006 and p <0.001, respectively). Lymphatic invasion, perineural invasion, and biliary invasion were significantly more frequent in the hypovascular group than the rim- enhancement group (p=0.001, p=0.025 and p=0.029, respectively) or hypervascular group (p <0.001, p <0.001 and p=0.025, respectively). Patients with hypovascular lesions showed significantly poorer disease-free survival than patients with rim-enhancing or hypervascular lesions (p=0.001 and p=0.001, respectively). Hypovascularity was an independent preoperative prognostic factor for disease-free survival (p<0.001). Hypovascular ICCs in the HAP tend to be of perihilar type and to have more malignant potential than other ICCs. (orig.)

  11. Computer-aided detection of hepatocellular carcinoma in multiphase contrast-enhanced hepatic CT: a preliminary study

    Science.gov (United States)

    Xu, Jian-Wu; Suzuki, Kenji; Hori, Masatoshi; Oto, Aytekin; Baron, Richard

    2011-03-01

    Malignant liver tumors such as hepatocellular carcinoma (HCC) account for 1.25 million deaths each year worldwide. Early detection of HCC is sometimes difficult on CT images because the attenuation of HCC is often similar to that of normal liver parenchyma. Our purpose was to develop computer-aided detection (CADe) of HCC using both arterial phase (AP) and portal-venous phase (PVP) of contrast-enhanced CT images. Our scheme consisted of liver segmentation, tumor candidate detection, feature extraction and selection, and classification of the candidates as HCC or non-lesions. We used a 3D geodesic-active-contour model coupled with a level-set algorithm to segment the liver. Both hyper- and hypo-dense tumors were enhanced by a sigmoid filter. A gradient-magnitude filter followed by a watershed algorithm was applied to the tumor-enhanced images for segmenting closed-contour regions as HCC candidates. Seventy-five morphologic and texture features were extracted from the segmented candidate regions in both AP and PVP images. To select most discriminant features for classification, we developed a sequential forward floating feature selection method directly coupled with a support vector machine (SVM) classifier. The initial CADe before the classification achieved a 100% (23/23) sensitivity with 33.7 (775/23) false positives (FPs) per patient. The SVM with four selected features removed 96.5% (748/775) of the FPs without any removal of the HCCs in a leave-one-lesion-out cross-validation test; thus, a 100% sensitivity with 1.2 FPs per patient was achieved, whereas CADe using AP alone produced 6.4 (147/23) FPs per patient at the same sensitivity level.

  12. Indicação e tratamento dos tumores benignos do fígado Indication and treatment of benign hepatic tumors

    Directory of Open Access Journals (Sweden)

    Júlio Cezar Uili Coelho

    2011-12-01

    Full Text Available INTRODUÇÃO: Os tumores hepáticos benignos ocorrem em 9% da população. A grande maioria dessas neoplasias é diagnosticada em pacientes assintomáticos durante a realização de exames de imagem de rotina. OBJETIVO: Apresentar os principais aspectos das indicações e tratamento dos tumores hepáticos benignos. MÉTODOS: Foi realizada revisão de literatura baseada em pesquisa no PubMed, Bireme e Scielo cruzando os descritores neoplasia hepática, hemangioma, adenoma e hiperplasia nodular focal. Foram selecionados, estudos de técnicas cirúrgicas e acrescentada a experiência dos autores. O hemangioma é o tumor hepático mais comum, sendo identificado entre 5% e 7% das necropsias. É mais comum nas mulheres entre as 3ª e 5ª décadas da vida e pode aumentar de tamanho na gravidez e com a administração de estrogênios. Apesar de não estabelecida, a sua causa está relacionada com os hormônios sexuais. As complicações incluem inflamação, coagulopatia, sangramento e compressão de estruturas vizinhas. Rotura espontânea é excepcional, com somente 35 casos descritos na literatura internacional. O adenoma e a hiperplasia nodular focal predominam no sexo feminino e na faixa etária de 20 a 40 anos. Enquanto o primeiro requer ressecção hepática pelo risco de sangramento e malignização, o segundo deve ter conduta expectante. CONCLUSÕES: Os tumores hepáticos benignos mais comuns são em ordem decrescente de frequência o hemangioma, hiperplasia nodular focal e o adenoma. A diferenciação entre tumores benignos e malignos é geralmente realizada com segurança com base nos dados clínicos e nos exames de imagem. O hemangioma e a hiperplasia nodular focal geralmente tem conduta expectante, enquanto que o adenoma requer ressecção pelo risco de hemorragia e de transformação em carcinoma.BACKGROUND: Benign hepatic tumors occur in 9% of the population. The majority is diagnosed in asymptomatic patients during routine imaging exams

  13. Malignant phyllodes tumor of the breast metastasizing to the vulva: {sup 18}F FDG PET CT Demonstrating rare metastasis from a rare tumor

    Energy Technology Data Exchange (ETDEWEB)

    Khangembam, Bang Kim Chand Ra; Sharma, Punit; Singla, Su Has; Singhal, Abinav; Dhull, Varun Singh; Bal, Chand Rasek Har; Kumar, Rakesh [All India Institute of Medical Sciences, New Delhi (India)

    2012-09-15

    Phyllodes tumors are extremely rare fibroepithelial neoplasms accounting for 0.3 to 0.5% of all female breast tumors with an incidence of 2.1 per 1 million women. They are classified histologically into benign, borderline and malignant varieties. The majority of them are benign, with only 25% being malignant. Surgery remains the mainstay of treatment. One characteristic is that although the malignant variety tends to metastasize and recur, the benign form has also been found to behave in a similar manner. Benign phyllodes tumor has a 21% risk of local recurrence, while that of the malignant variety ranges from 20 to 32%. In patients with malignant phyllodes tumor, the rate of distant metastases ranges from 25 to 40%. The most frequent sites of distant metastasis is uncommon as this tumor spreads by hematogeneous route. Other sites for distant metastasis have been reported sporadically, including the duodenum, pancreas, brain, nasal cavity, forearm, parotid, skin, oral cavity, skeletal muscle, mandible and maxilla. We present a rare case of recurrent malignant phyllodes tumor with metastasis to the vulva, which has not been reported in the literature to the best of our knowledge. A 49 year old female who had undergone lumpectomy and locoregional radiotherapy 1 year previously for malignant phyllodes tumor of the right breast presented with difficulty in breathing and cervical lymphadenopathy. Chest X ray showed multiple pulmonary nodules suggestive of metastasis. She was referred for restaging with 18F fluorodeoxyglucose (FDG)positron emission tomography computed tomography (PET CT)FDG PET CT. Maximum intensity projection (MIP)PET images revealed multiple FDG avid enlarged cervical lymph nodes, bilateral pulmonary nodules along with left pleural effusion and extensive bone marrow metastases. The interesting finding was an intensely FDG avid (SUV{sup max}-21.4)subcutaneous soft tissue density lesion (measuring 2.0x2.2x2.0cm)in the vulva, which was later proved to be

  14. Exposure (mAs) optimisation of a multi-detector CT protocol for hepatic lesion detection: Are thinner slices better?

    Science.gov (United States)

    Dobeli, Karen Leigh; Lewis, Sarah Jane; Meikle, Steven Richard; Thiele, David Lewis; Brennan, Patrick Christopher

    2014-04-01

    The purpose of this work was to determine the exposure-optimised slice thickness for hepatic lesion detection with CT. A phantom containing spheres (diameter 9.5, 4.8 and 2.4 mm) with CT density 10 HU below the background (50 HU) was scanned at 125, 100, 75 and 50 mAs. Data were reconstructed at 5-, 3- and 1-mm slice thicknesses. Noise, contrast-to-noise ratio (CNR), area under the curve (AUC) as calculated using receiver operating characteristic analysis and sensitivity representing lesion detection were calculated and compared. Compared with the 125 mAs/5 mm slice thickness setting, significant reductions in AUC were found for 75 mAs (P mAs (P mAs (P mAs at all three slice thicknesses (P mAs exposures was approximately 10, 30 and 50% higher, respectively, than that at 125 mAs exposure. CNRs decreased in an irregular manner with reductions in exposure and slice thickness. This study demonstrated no advantage to using slices below 5 mm thickness, and consequently thinner slices are not necessarily better. © 2013 The Authors. Journal of Medical Imaging and Radiation Oncology © 2013 The Royal Australian and New Zealand College of Radiologists.

  15. Does the pretreatment tumor sampling location correspond with metabolic activity on 18F-FDG PET/CT in breast cancer patients scheduled for neoadjuvant chemotherapy?

    Energy Technology Data Exchange (ETDEWEB)

    Koolen, Bas B., E-mail: b.koolen@nki.nl [Department of Nuclear Medicine, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Department of Surgical Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Elshof, Lotte E. [Department of Nuclear Medicine, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Department of Surgical Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Loo, Claudette E. [Department of Radiology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Wesseling, Jelle [Department of Pathology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Vrancken Peeters, Marie-Jeanne T.F.D. [Department of Surgical Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Vogel, Wouter V. [Department of Nuclear Medicine, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Rutgers, Emiel J.Th. [Department of Surgical Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Valdés Olmos, Renato A. [Department of Nuclear Medicine, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands)

    2013-12-01

    Purpose: To define the correlation between the core biopsy location and the area with highest metabolic activity on 18F-FDG PET/CT in stage II–III breast cancer patients before neoadjuvant chemotherapy. Also, we would like to select a subgroup of patients in which PET/CT information may optimize tumor sampling. Methods: A PET/CT in prone position was acquired in 199 patients with 203 tumors. The distance and relative difference in standardized uptake value (SUV) between core biopsy localization (indicated by a marker) and area with highest degree of FDG uptake were evaluated. A distance ≥2 cm and a relative difference in SUV ≥25% were considered clinically relevant and a combination of both was defined as non-correspondence. Non-correspondence for different tumor characteristics (TNM stage, lesion morphology on MRI and PET/CT, histology, subtype, grade, and Ki-67) was assessed. Results: Non-correspondence was found in 28 (14%) of 203 tumors. Non-correspondence was significantly associated with T-stage, lesion morphology on MRI and PET/CT, tumor diameter, and histologic type. It was more often seen in tumors with a higher T-stage (p = 0.028), diffuse (non-mass) and multifocal tumors on MRI (p = 0.001), diffuse and multifocal tumors on PET/CT (p < 0.001), tumors >3 cm (p < 0.001), and lobular carcinomas (p < 0.001). No association was found with other features. Conclusion: Non-correspondence between the core biopsy location and area with highest FDG uptake is regularly seen in stage II–III breast cancer patients. PET/CT information and possibly FDG-guided biopsies are most likely to improve pretreatment tumor sampling in tumors >3 cm, lobular carcinomas, and diffuse and multifocal tumors.

  16. Activated Hepatic Stellate Cells Induce Tumor Progression of Neoplastic Hepatocytes in a TGF-β Dependent Fashion

    Science.gov (United States)

    MIKULA, M.; PROELL, V.; FISCHER, A.N.M.; MIKULITS, W.

    2010-01-01

    The development of hepatocellular carcinomas from malignant hepatocytes is frequently associated with intra- and peritumoral accumulation of connective tissue arising from activated hepatic stellate cells. For both tumorigenesis and hepatic fibrogenesis, transforming growth factor (TGF)-β signaling executes key roles and therefore is considered as a hallmark of these pathological events. By employing cellular transplantation we show that the interaction of neoplastic MIM-R hepatocytes with the tumor microenvironment, containing either activated hepatic stellate cells (M1-4HSCs) or myofibroblasts derived thereof (M-HTs), induces progression in malignancy. Cotransplantation of MIM-R hepatocytes with M-HTs yielded strongest MIM-R generated tumor formation accompanied by nuclear localization of Smad2/3 as well as of β-catenin. Genetic interference with TGF-β signaling by gain of antagonistic Smad7 in MIM-R hepatocytes diminished epithelial dedifferentiation and tumor progression upon interaction with M1-4HSCs or M-HTs. Further analysis showed that tumors harboring disrupted Smad signaling are devoid of nuclear β-catenin accumulation, indicating a crosstalk between TGF-β and β-catenin signaling. Together, these data demonstrate that activated HSCs and myofibroblasts directly govern hepatocarcinogenesis in a TGF-β dependent fashion by inducing autocrine TGF-β signaling and nuclear β-catenin accumulation in neoplastic hepatocytes. These results indicate that intervention with TGF-β signaling is highly promising in liver cancer therapy. PMID:16883581

  17. Detection of Preoperative Wilms Tumor Rupture with CT: A Report from the Children’s Oncology Group

    Science.gov (United States)

    Naranjo, Arlene; Hoffer, Fredric; Mullen, Elizabeth; Geller, James; Gratias, Eric J.; Ehrlich, Peter F.; Perlman, Elizabeth J.; Rosen, Nancy; Grundy, Paul; Dome, Jeffrey S.

    2013-01-01

    Purpose: To retrospectively determine the diagnostic performance of computed tomography (CT) in identifying the presence or absence of preoperative Wilms tumor rupture. Materials and Methods: The cohort was derived from the AREN03B2 study of the Children’s Oncology Group. The study was approved by the institutional review board and was compliant with HIPAA. Written informed consent was obtained before enrollment. The diagnosis of Wilms tumor rupture was established by central review of notes from surgery and/or pathologic examination. Seventy Wilms tumor cases with rupture were matched to 70 Wilms tumor controls without rupture according to age and tumor weight (within 6 months and 50 g, respectively). CT scans were independently reviewed by two radiologists, and the following CT findings were assessed: poorly circumscribed mass, perinephric fat stranding, peritumoral fat planes obscured, retroperitoneal fluid (subcapsular vs extracapsular), ascites beyond the cul-de-sac, peritoneal implants, ipsilateral pleural effusion, and intratumoral hemorrhage. All fluids were classified as hemorrhagic or nonhemorrhagic by using a cutoff of 30 HU. The relationship between CT findings and rupture was assessed with logistic regression models. Results: The sensitivity and specificity for detecting Wilms tumor rupture were 54% (36 of 67 cases) and 88% (61 of 69 cases), respectively, for reviewer 1 and 70% (47 of 67 cases) and 88% (61 of 69 cases), respectively, for reviewer 2. Interobserver agreement was substantial (ĸ = 0.76). All imaging signs tested, except peritoneal implants, intratumoral hemorrhage, and subcapsular fluid, showed a significant association with rupture (P ≤ .02). The attenuation of ascitic fluid did not have a significant correlation with rupture (P = .9990). Ascites beyond the cul-de-sac was the single best indicator of rupture for both reviewers, followed by perinephric fat stranding and retroperitoneal fluid for reviewers 1 and 2, respectively (P

  18. Biliary anatomy in potential right hepatic lobe living donor liver transplantation (LDLT): the utility of CT cholangiography in the setting of inconclusive MRCP.

    Science.gov (United States)

    McSweeney, Sean E; Kim, Tae Kyoung; Jang, Hyun-Jung; Khalili, Korosh

    2012-01-01

    To determine the utility of CT cholangiography (CT-Ch) in preoperative evaluation of the biliary anatomy of living-donor liver transplantation (LDLT) donors when magnetic resonance cholangiopancreatography (MRCP) is inconclusive. Over a 2-year period, 22 potential living liver donors underwent contrast-enhanced CT-Ch for preoperative evaluating biliary anatomy due to inconclusive results on MRCP and subsequently donated their right hepatic lobe. Nineteen of them underwent intraoperative cholangiography and were included in this study. Two radiologists retrospectively reviewed both MRCP and CT-Ch with 1-month interval and documented the types of bile duct branching patterns and visualization score of intrahepatic bile ducts (4-point scale). There were no complications associated with CT-Ch examinations. CT-Ch was concordant with the reference standard in 18/19 (95%) including 7/8 typical branching type and 11/11 anomalous branching types. MRCP was concordant with the reference standard in 14/19 (74%) including 4/8 typical branching types and 10/11 anomalous branching types. The discordant case by CT-Ch was the identification of a tiny accessory right intrahepatic duct joining the common bile duct which was not visualized on intraoperative cholangiography. CT-Ch showed higher visualization score (mean, 3.9) than MRCP (mean, 2.6) (P<.001). CT-Ch can be effectively used for the depiction of the branching pattern of the bile duct at the hepatic hilum when MRCP is inconclusive. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  19. Detection of urothelial tumors: comparison of urothelial phase with excretory phase CT urography--a prospective study.

    Science.gov (United States)

    Metser, Ur; Goldstein, Mark A; Chawla, Tanya P; Fleshner, Neil E; Jacks, Lindsay M; O'Malley, Martin E

    2012-07-01

    To compare contrast material-enhanced computed tomographic (CT) urography 60 seconds after injection of contrast material (urothelial phase [UP]) after intravenous administration of a diuretic with the standard 5-minute delayed excretory phase (EP) in a high-risk population for upper tract tumors. Institutional review board approval and informed consent were obtained. Eighty CT urographic examinations in 77 patients known to have or at high risk for urothelial malignancy were included. After intravenous administration of a diuretic, dual-phase CT urography was performed at 60 seconds (UP) and 5 minutes (EP) after intravenous administration of contrast material. Two experienced abdominal radiologists independently interpreted each phase more than 1 month apart to minimize recall bias. Urinary tract distention and location and size of all lesions suspected of being urothelial tumors were recorded. Standard of reference was obtained from prospective study interpretation and surgical histopathologic findings. Generalized estimating equations for logistic regression were used to compare performance measures and adjust for the correlation of repeated measures within patients. There were 23 upper and 61 lower urinary tract tumors confirmed in 15 and 32 patients, respectively. For detection of bladder tumors, there was higher sensitivity for the UP than the EP (89.3% [109 of 122] vs 70.5% [86 of 122], respectively; Purography after injection of a diuretic has a higher lesion detection rate than the EP for both upper and lower urinary tract tumors, which suggests its possible use as a single-phase protocol for evaluation of the entire urinary tract in patients at high risk for urothelial tumors. © RSNA, 2012.

  20. PET and PET/CT in tumour of undetermined origin; PET y PET/CT en tumor de origen indeterminado

    Energy Technology Data Exchange (ETDEWEB)

    Garcia O, J.R. [Nuclear Medicine and Molecular Imaging, PET/CT, Centro Medico ABC, Mexico D.F. (Mexico)

    2007-07-01

    In this presentation the following conclusions were obtained regarding the use of PET and PET/CT in patient with cancer of unknown primary: 1. Detection of the primary one in 1/3 at 1/2 of patient. 2. It detects metastases in other places in 50%. 3. It changes the initial therapy planned in 1/3 at 1/2 of patient. 4. Useful in initial phases of protocol study to limit the other procedures. After standard evaluation. Before advanced protocol. 5. PET/CT study increases the % of primary detection, although in a non significant way vs. PET. 6. They are required more studies to value their utility to a more objective manner. (Author)

  1. A pilot study of the prognostic significance of metabolic tumor size measurements in PET/CT imaging of lymphomas

    Science.gov (United States)

    Kallergi, Maria; Botsivali, Maria; Politis, Nikolaos; Menychtas, Dimitrios; Georgakopoulos, Alexandros; Chatziioannou, Sofia

    2015-03-01

    This study explores changes in metabolic tumor volume, metabolic tumor diameter, and maximum standardized uptake value (SUVmax), for earlier and more accurate identification of lymphomas' response to treatment using 18F- FDG PET/CT. Pre- and post-treatment PET/CT studies of 20 patients with Hodgkin disease (HL) and 7 patients with non- Hodgkin lymphoma (NHL) were retrospectively selected for this study. The diameter and volume of the metabolic tumor was determined by an in-house developed adaptive local thresholding technique based on a 50% threshold of the maximum pixel value within a region. Statistical analysis aimed at exploring associations between metabolic size measurements and SUVmax and the ability of the three biomarkers to predict the patients' response to treatment as defined by the four classes in the European Organization for Research and Treatment of Cancer (EORTC) guidelines. Results indicated moderate correlations between % change in metabolic tumor volume and % change in metabolic tumor maximum diameter (R=0.51) and between % change in maximum diameter and % change in SUVmax (R=0.52). The correlation between % change in tumor volume and % change in SUVmax was weak (R=0.24). The % change in metabolic tumor size, either volume or diameter, was a "very strong" predictor of response to treatment (R=0.89), stronger than SUVmax (R=0.63). In conclusion, metabolic tumor volume could have important prognostic value, possibly higher than maximum metabolic diameter or SUVmax that are currently the standard of practice. Volume measurements, however, should be based on robust and standardized segmentation methodologies to avoid variability. In addition, SUV-peak or lean body mass corrected SUV-peak may be a better PET biomarker than SUVmax when SUV-volume combinations are considered.

  2. Genomic sequencing identifies a few mutations driving the independent origin of primary liver tumors in a chronic hepatitis murine model.

    Science.gov (United States)

    Yang, Zuyu; Jia, Mingming; Liu, Guojing; Hao, Huaining; Chen, Li; Li, Guanghao; Liu, Sixue; Li, Yawei; Wu, Chung-I; Lu, Xuemei; Wang, Shengdian

    2017-01-01

    With the development of high-throughput genomic analysis, sequencing a mouse primary cancer model provides a new opportunity to understand fundamental mechanisms of tumorigenesis and progression. Here, we characterized the genomic variations in a hepatitis-related primary hepatocellular carcinoma (HCC) mouse model. A total of 12 tumor sections and four adjacent non-tumor tissues from four mice were used for whole exome and/or whole genome sequencing and validation of genotyping. The functions of the mutated genes in tumorigenesis were studied by analyzing their mutation frequency and expression in clinical HCC samples. A total of 46 single nucleotide variations (SNVs) were detected within coding regions. All SNVs were only validated in the sequencing samples, except the Hras mutation, which was shared by three tumors in the M1 mouse. However, the mutated allele frequency varied from high (0.4) to low (0.1), and low frequency (0.1-0.2) mutations existed in almost every tumor. Together with a diploid karyotype and an equal distribution pattern of these SNVs within the tumor, these results suggest the existence of subclones within tumors. A total of 26 mutated genes were mapped to 17 terms describing different molecular and cellular functions. All 41 human homologs of the mutated genes were mutated in the clinical samples, and some mutations were associated with clinical outcomes, suggesting a high probability of cancer driver genes in the spontaneous tumors of the mouse model. Genomic sequencing shows that a few mutations can drive the independent origin of primary liver tumors and reveals high heterogeneity among tumors in the early stage of hepatitis-related primary hepatocellular carcinoma.

  3. Genomic sequencing identifies a few mutations driving the independent origin of primary liver tumors in a chronic hepatitis murine model.

    Directory of Open Access Journals (Sweden)

    Zuyu Yang

    Full Text Available With the development of high-throughput genomic analysis, sequencing a mouse primary cancer model provides a new opportunity to understand fundamental mechanisms of tumorigenesis and progression. Here, we characterized the genomic variations in a hepatitis-related primary hepatocellular carcinoma (HCC mouse model. A total of 12 tumor sections and four adjacent non-tumor tissues from four mice were used for whole exome and/or whole genome sequencing and validation of genotyping. The functions of the mutated genes in tumorigenesis were studied by analyzing their mutation frequency and expression in clinical HCC samples. A total of 46 single nucleotide variations (SNVs were detected within coding regions. All SNVs were only validated in the sequencing samples, except the Hras mutation, which was shared by three tumors in the M1 mouse. However, the mutated allele frequency varied from high (0.4 to low (0.1, and low frequency (0.1-0.2 mutations existed in almost every tumor. Together with a diploid karyotype and an equal distribution pattern of these SNVs within the tumor, these results suggest the existence of subclones within tumors. A total of 26 mutated genes were mapped to 17 terms describing different molecular and cellular functions. All 41 human homologs of the mutated genes were mutated in the clinical samples, and some mutations were associated with clinical outcomes, suggesting a high probability of cancer driver genes in the spontaneous tumors of the mouse model. Genomic sequencing shows that a few mutations can drive the independent origin of primary liver tumors and reveals high heterogeneity among tumors in the early stage of hepatitis-related primary hepatocellular carcinoma.

  4. The role of 68Ga-DOTA-NOC PET/CT in evaluating neuroendocrine tumors: real-world experience from two large neuroendocrine tumor centers.

    Science.gov (United States)

    Haidar, Mohamad; Shamseddine, Ali; Panagiotidis, Emmanouil; Jreige, Mario; Mukherji, Deborah; Assi, Rita; Abousaid, Rayan; Ibrahim, Toni; Haddad, Marwan M; Vinjamuri, Sobhan

    2017-02-01

    Our aim was to assess the role of Ga-DOTA-NOC PET/CT as a tool for the management of neuroendocrine tumors (NETs), evaluating the clinical impact on patients from two large NET centers in different geopolitical settings. This is a retrospective study of patients with NETs who underwent Ga-DOTA-NOC PET/CT at Royal Liverpool University Hospital (UK) and at Mount Lebanon Hospital (Lebanon). Indications for imaging and findings of the PET/CT along with demographic and clinical outcome data were recorded and evaluated. Four hundred and forty-five patients fulfilled the inclusion criteria, with a median age at the time of diagnosis of 56 (range: 3-90) years; 248 (55.7%) patients were male.Ga-DOTA-NOC PET/CT was indicated for staging in 193 (43.4%) patients, for diagnosis in 124 (27.9%) patients, for follow-up in 97 (21.7%) patients, and for identification of a primary NET site in 31 (7%) patients.One hundred and four (27.9%) patients underwent Ga-DOTA-NOC PET/CT for the primary diagnosis of NET, of whom 66 (52.7%) patients presented with a clinical suspicion of NET, 10 (8.3%) patients presented with a biochemical suspicion of NET only, and 48 (38.8%) patients presented with a suspicious NET lesion discovered on another imaging modality. The most common clinical presentation was typical carcinoid syndrome [4 (33%) patients].Results on the basis of histology were used as the gold standard for the diagnosis in 57% of patients and the remaining on the basis of follow-up as per established clinical consensus. Sensitivity, specificity, negative-predictive value, and positive-predictive value of PET/CT were 87.1, 97.7, 79.6, and 98.7%, respectively, for the entire sample. Accuracy was measured using the receiver operating characteristic curve analysis with an area under the curve of 0.924 (95% confidence interval: 0.874-0.974). Ga-DOTA-NOC PET/CT is a highly sensitive and specific study for the diagnosis and follow-up of patients with neuroendocrine tumors. These results

  5. Transarterial chemoembolization combined with sorafenib for the treatment of hepatocellular carcinoma with hepatic vein tumor thrombus

    Directory of Open Access Journals (Sweden)

    Zhang YF

    2016-07-01

    Full Text Available Yong-Fa Zhang,1–3,* Wei Wei,1–3,* Jia-Hong Wang,1–3,* Li Xu,1–3 Pei-En Jian,1–3 Cheng-Zuo Xiao,4 Xiao-Ping Zhong,1–3 Ming Shi,1–3 Rong-Ping Guo1–3 1Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center, 2State Key Laboratory of Oncology in South China, 3Collaborative Innovation Center for Cancer Medicine, Guangzhou, 4Department of General Surgery, Shenzhen Shajing Affiliated Hospital of Guangzhou Medical University, Shenzhen, People’s Republic of China *These authors contributed equally to this work Objective: To compare the treatment outcomes of sorafenib plus transarterial chemoembolization (TACE vs TACE alone in patients with hepatocellular carcinoma (HCC and hepatic vein tumor thrombus (HVTT.Methods: Twenty patients who were initially diagnosed with HCC and HVTT and received TACE combined with sorafenib during February 2009 to October 2013 were included in the study. To minimize selection bias, these patients were compared with 60 case-matched controls selected from a pool of 81 patients (in a 1:3 ratio who received TACE alone during the same period. The primary end point was overall survival (OS. The secondary end points were time to progression, disease control rate, and adverse events.Results: After a median follow-up period of 12.5 months (range, 1.03–44.23 months, the OS of the combined group was found to be significantly higher compared with the monotherapy group (14.9 vs 6.1 months, P=0.010. The time to progression was found to be significantly longer in the combined group (4.9 vs 2.4 months, P=0.016. Univariate and multivariate analyses revealed that the treatment allocation was an independent predictor of OS.Conclusion: Sorafenib plus TACE was well tolerated and was more effective in treating patients with advanced HCC and HVTT. Future trials with prospective larger samples are required to validate these results. Keywords: hepatocellular carcinoma, hepatic vein tumor thrombus, prognosis

  6. Assessment of tumor heterogeneity by CT texture analysis: Can the largest cross-sectional area be used as an alternative to whole tumor analysis?

    Energy Technology Data Exchange (ETDEWEB)

    Ng, Francesca, E-mail: kher_shing_ng@yahoo.co.uk [Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood, Middlesex (United Kingdom); Kozarski, Robert, E-mail: r.kozarski@herts.ac.uk [CliCr, University of Hertfordshire, Hatfield, Hertfordshire (United Kingdom); Ganeshan, Balaji, E-mail: b.ganeshan@sussex.ac.uk [Clinical Imaging Sciences, University of Sussex, Falmer, Sussex (United Kingdom); Goh, Vicky, E-mail: vicky.goh@kcl.ac.uk [Cancer Imaging, Division of Imaging Sciences and Biomedical Engineering, Kings College London, King' s Health Partners, London (United Kingdom)

    2013-02-15

    Objective: To determine if there is a difference between contrast enhanced CT texture features from the largest cross-sectional area versus the whole tumor, and its effect on clinical outcome prediction. Methods: Entropy (E) and uniformity (U) were derived for different filter values (1.0–2.5: fine to coarse textures) for the largest primary tumor cross-sectional area and the whole tumor of the staging contrast enhanced CT in 55 patients with primary colorectal cancer. Parameters were compared using non-parametric Wilcoxon test. Kaplan–Meier analysis was performed to determine the relationship between CT texture and 5-year overall survival. Results: E was higher and U lower for the whole tumor indicating greater heterogeneity at all filter levels (1.0–2.5): median (range) for E and U for whole tumor versus largest cross-sectional area of 7.89 (7.43–8.31) versus 7.62 (6.94–8.08) and 0.005 (0.004–0.01) versus 0.006 (0.005–0.01) for filter 1.0; 7.88 (7.22–8.48) versus 7.54 (6.86–8.1) and 0.005 (0.003–0.01) versus 0.007 (0.004–0.01) for filter 1.5; 7.88 (7.17–8.54) versus 7.48 (5.84–8.25) and 0.005 (0.003–0.01) versus 0.007 (0.004–0.02) for filter 2.0; and 7.83 (7.03–8.57) versus 7.42 (5.19–8.26) and 0.005 (0.003–0.01) versus 0.006 (0.004–0.03) for filter 2.5 respectively (p ≤ 0.001). Kaplan–Meier analysis demonstrated better separation of E and U for whole tumor analysis for 5-year overall survival. Conclusion: Whole tumor analysis appears more representative of tumor heterogeneity.

  7. Hepatic natural killer cells exclusively kill splenic/blood natural killer-resistant tumor cells by the perforin/granzyme pathway

    NARCIS (Netherlands)

    Vermijlen, David; Luo, Dianzhong; Froelich, Christopher J.; Medema, Jan Paul; Kummer, Jean Alain; Willems, Erik; Braet, Filip; Wisse, Eddie

    2002-01-01

    Hepatic natural killer (NK) cells are located in the liver sinusoids adherent to the endothelium. Human and rat hepatic NK cells induce cytolysis in tumor cells that are resistant to splenic or blood NK cells. To investigate the mechanism of cell death, we examined the capacity of isolated, pure

  8. Fusion imaging using a hybrid SPECT-CT camera improves port perfusion scintigraphy for control of hepatic arterial infusion of chemotherapy in colorectal cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Denecke, Timm; Lehmkuhl, Lukas; Peters, Nils; Pech, Maciej; Ricke, Jens; Felix, Roland; Amthauer, Holger [Charite-Universitatsmedizin Berlin - Klinik fur Strahlenheilkunde und PET-Zentrum Berlin, Campus Virchow-Klinikum, Berlin (Germany); Hildebrandt, Bert; Nicolaou, Annett; Riess, Hanno [Charite-Universitatsmedizin Berlin - Medizinische Klinik m.S. Haematologie Onkologie, Campus Virchow-Klinikum, Berlin (Germany)

    2005-09-01

    Exclusive and homogeneous perfusion of the liver is considered essential for the efficacy of hepatic arterial infusion of chemotherapy (HAI). The aim of this study was to evaluate port perfusion scintigraphy in colorectal cancer patients using a hybrid SPECT-CT system for control of minimally invasive intra-arterial port systems within the scope of a phase II trial. In 24 consecutive patients, the perfusion territories of intra-arterial hepatic port systems were assessed by port scintigraphy with{sup 99m}Tc-labelled macroaggregated albumin employing planar imaging, SPECT and SPECT-CT (acquired with a hybrid SPECT-CT camera). The results of blinded reading of the scintigraphic modalities concerning the intra- and extrahepatic perfusion pattern were compared with combined image analysis (angiography and contrast-enhanced dedicated CT) and patient history for validation. Extrahepatic perfusion was correctly seen in three patients, while suspected extrahepatic perfusion could be excluded in one. In 46 liver lobes, perfusion patterns were correctly visualised by SPECT-CT in 100% of cases (planar, 67%; SPECT, 86%). Assessing the perfusion pattern inside the liver on a segmental basis (segments, n=138), SPECT-CT revealed correct segmental assignment of tracer distribution in 100% and was significantly superior to SPECT alone (accuracy, 84%; p<0.001). The scintigraphic findings resulted in changes in therapeutic management in 8/24 patients (33%); in two of these the relevant findings were visualised only by SPECT-CT. In patients receiving HAI, port perfusion scintigraphy by fusion imaging with a hybrid SPECT-CT system provides important information for therapy optimisation and appears to be superior to SPECT alone. (orig.)

  9. The Adnectin CT-322 is a novel VEGF receptor 2 inhibitor that decreases tumor burden in an orthotopic mouse model of pancreatic cancer

    Directory of Open Access Journals (Sweden)

    Miller Andrew F

    2008-11-01

    Full Text Available Abstract Background Pancreatic cancer continues to have a 5-year survival of less than 5%. Therefore, more effective therapies are necessary to improve prognosis in this disease. Angiogenesis is required for tumor growth, and subsequently, mediators of angiogenesis are attractive targets for therapy. Vascular endothelial growth factor (VEGF is a well-characterized mediator of tumor angiogenesis that functions primarily by binding and activating VEGF receptor 2 (VEGFR2. In this study, we evaluate the use of CT-322, a novel biologic (Adnectin. This small protein is based on a human fibronectin domain and has beneficial properties in that it is fully human, stable, and is produced in bacteria. CT-322 binds to and inhibits activation of VEGFR2. Methods The efficacy of CT-322 was evaluated in vivo using two orthotopic pancreatic tumor models. The first model was a human tumor xenograft where MiaPaCa-2 cells were injected into the tail of the pancreas of nude mice. The second model was a syngeneic tumor using Pan02 cells injected into pancreas of C57BL/6J mice. In both models, therapy was initiated once primary tumors were established. Mice bearing MiaPaCa-2 tumors were treated with vehicle or CT-322 alone. Gemcitabine alone or in combination with CT-322 was added to the treatment regimen of mice bearing Pan02 tumors. Therapy was given twice a week for six weeks, after which the animals were sacrificed and evaluated (grossly and histologically for primary and metastatic tumor burden. Primary tumors were also evaluated by immunohistochemistry for the level of apoptosis (TUNEL, microvessel density (MECA-32, and VEGF-activated blood vessels (Gv39M. Results Treatment with CT-322 was effective at preventing pancreatic tumor growth and metastasis in orthotopic xenograft and syngeneic models of pancreatic cancer. Additionally, CT-322 treatment increased apoptosis, reduced microvessel density and reduced the number of VEGF-activated blood vessels in tumors

  10. The effects of percutaneous ethanol injection followed by 20-kHz ultrasound and microbubbles on rabbit hepatic tumors.

    Science.gov (United States)

    Shen, Zhi Yong; Xia, Gan Lin; Wu, Ming Feng; Ji, Lei Yan; Li, Yong Jun

    2016-02-01

    Low-frequency ultrasound (US) in combination with microbubbles (MBs) is able to inhibit the growth of VX2 rabbit liver tumors. In this study, we investigated the feasibility of using percutaneous ethanol injection (PEI) followed by low-frequency ultrasound and microbubbles (USMB) to inhibit VX2 tumor growth. Eighteen New Zealand rabbits with hepatic VX2 tumors were divided into three groups: PEI, low-frequency ultrasound and MBs followed by PEI (USMB + PEI), and PEI followed by USMB (PEI + USMB). PEI was performed by ultrasound-guided injection of 95% anhydrous alcohol into internal liver tumors in rabbits twice a week for 2 weeks. The US parameters were 20 kHz, 2 W/cm(2), 40% duty cycle, 5 min, and once every other day for 2 weeks. Magnetic resonance imaging (MRI) was used to observe tumors before and after treatment, to examine changes in the tumors, and to measure the diameters of the tumors. All animals were followed up for 180 days after tumor implantation. Autopsy was performed at the end of the scheduled follow-up or immediately after death. Anatomically observed metastatic sites included the liver, lung, abdomen, and pelvic cavity. The survival time of all rabbits was recorded. After 4 weeks of treatment, on MRI, the tumor diameters in the PEI, USMB + PEI, and PEI + USMB groups were 8.33 ± 1.83, 19 ± 2.61, and 4.5 ± 1.22 mm, respectively. There was a significant difference in tumor size indicated by MRI in the three groups. Tumor size was smaller in the PEI + USMB group than in the PEI and USMB + PEI groups, with t = 4.54, p = 0.0062, and t = 16.38, p ethanol injection followed by low-frequency ultrasound and microbubbles can be effective in inhibiting rabbit liver tumors and prolonging survival time.

  11. Imaging of lung metastasis tumor mouse model using [{sup 18}F]FDG small animal PET and CT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, June Youp; Woo, Sang Keun; Lee, Tae Sup [Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul (Korea, Republic of)] (and others)

    2007-02-15

    The purpose of this study is to image metastaic lung melanoma model with optimal pre-conditions for animal handling by using [{sup 18}F]FDG small animal PET and clinical CT. The pre-conditions for lung region tumor imaging were 16-22 h fasting and warming temperature at 30 .deg. C. Small animal PET image was obtained at 60 min postinjection of 7.4 MBq [{sup 18}F]FDG and compared pattern of [{sup 18}F]FDG uptake and glucose standard uptake value (SUVG) of lung region between Ketamine/Xylazine (Ke/Xy) and Isoflurane (Iso) anesthetized group in normal mice. Metastasis tumor mouse model to lung was established by intravenous injection of B16-F10 cells in C57BL/6 mice. In lung metastasis tumor model, [{sup 18}F]FDG image was obtained and fused with anatomical clinical CT image. Average blood glucose concentration in normal mice were 128.0 {+-} 22.87 and 86.0 {+-} 21.65 mg/dL in Ke/Xy group and Iso group, respectively. Ke/Xy group showed 1.5 fold higher blood glucose concentration than Iso group. Lung to Background ratio (L/B) in SUVG image was 8.6 {+-} 0.48 and 12.1 {+-}0.63 in Ke/Xy group and Iso group, respectively. In tumor detection in lung region, [{sup 18}F]FDG image of Iso group was better than that of Ke/Xy group, because of high L/B ratio. Metastatic tumor location in [{sup 18}F]FDG small animal PET image was confirmed by fusion image using clinical CT. Tumor imaging in small animal lung region with [{sup 18}F]FDG small animal PET should be considered pre-conditions which fasting, warming and an anesthesia during [{sup 18}F]FDG uptake. Fused imaging with small animal PET and CT image could be useful for the detection of metastatic tumor in lung region.

  12. Quantitative imaging values of CT, MR, and FDG-PET to differentiate pineal parenchymal tumors and germinomas: are they useful?

    Energy Technology Data Exchange (ETDEWEB)

    Kakigi, Takahide; Okada, Tomohisa; Kanagaki, Mitsunori; Yamamoto, Akira; Fushimi, Yasutaka; Sakamoto, Ryo; Togashi, Kaori [Kyoto University Graduate School of Medicine, Department of Diagnostic Imaging and Nuclear Medicine, Sakyo-ku, Kyoto (Japan); Arakawa, Yoshiki; Takahashi, Jun C. [Kyoto University Graduate School of Medicine, Department of Neurosurgery, Kyoto (Japan); Mikami, Yoshiki [Kyoto University Graduate School of Medicine, Department of Pathology, Kyoto (Japan); Shimono, Taro [Osaka City University Graduate School of Medicine, Department of Radiology, Osaka (Japan)

    2014-04-15

    Quantitative values of CT attenuation, apparent diffusion coefficient (ADC), and standardized uptake value (SUV) were investigated for differentiation between pineal parenchymal tumors (PPTs) and germinomas. Differences in age, sex, and calcification pattern were also evaluated. Twenty-three patients with PPTs and germinomas in 20 years were retrospectively enrolled under the approval of the institutional review board. CT attenuation, ADC, and SUV (20, 13, and 10 patients, respectively) were statistically compared between the two tumors. Differences in sex and patterns of calcification (''exploded'' or ''engulfed'') were also examined. Mean patient ages were compared among three groups of pineoblastoma, pineal parenchymal tumor of intermediate differentiation, (PPTID) and pineocytoma and germinoma. None of the quantitative values of CT attenuation, ADC, and SUV showed significant differences between PPTs and germinomas (p >.05). However, there was a significant difference in age (p <.05) among the three groups of pineoblastoma (mean age ± standard deviation 7.0 ± 8.7 years), PPTID, and pineocytoma (53.7 ± 11.4 years) and germinoma (19.1 ± 8.1 years). Sex also showed significant differences between PPTs and germinomas (p =.039). Exploded pattern of calcification was found in 9 of 11 PPT patients and engulfed pattern in 7 of 9 patients with germinomas. No reverse pattern was observed, and the patterns of calcification were considered highly specific of tumor types. None of the quantitative imaging values could differentiate PPTs from germinomas. Age, sex, and calcification patterns were confirmed useful in differentiating these tumors to some degree. (orig.)

  13. Transarterial Chemoembolization for Metastatic Neuroendocrine Tumors With Massive Hepatic Tumor Burden: Is the Benefit Worth the Risk?

    National Research Council Canada - National Science Library

    Kitano, Mio; Davidson, Gail W; Shirley, Lawrence A; Schmidt, Carl R; Guy, Gregory E; Khabiri, Hooman; Dowell, Joshua D; Shah, Manisha H; Bloomston, Mark

    2016-01-01

    .... While transarterial chemoembolization (TACE) is effective in treating patients with NET metastatic to the liver, there are limited data on its utility and benefit in patients with large hepatic involvement...

  14. Automated method for extraction of lung tumors using a machine learning classifier with knowledge of radiation oncologists on data sets of planning CT and FDG-PET/CT images.

    Science.gov (United States)

    Arimura, Hidetaka; Jin, Ze; Shioyama, Yoshiyuki; Nakamura, Katsumasa; Magome, Taiki; Sasaki, Masayuki

    2013-01-01

    We have developed an automated method for extraction of lung tumors using a machine learning classifier with knowledge of radiation oncologists on data sets of treatment planning computed tomography (CT) and 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT images. First, the PET images were registered with the treatment planning CT images through the diagnostic CT images of PET/CT. Second, six voxel-based features including voxel values and magnitudes of image gradient vectors were derived from each voxel in the planning CT and PET /CT image data sets. Finally, lung tumors were extracted by using a support vector machine (SVM), which learned 6 voxel-based features inside and outside each true tumor region determined by radiation oncologists. The results showed that the average DSCs for 3 and 6 features for three cases were 0.744 and 0.899, and thus the SVM may need 6 features to learn the distinguishable characteristics. The proposed method may be useful for assisting treatment planners in delineation of the tumor region.

  15. Does the presence of tumor-induced cortical bone destruction at CT have any prognostic value in newly diagnosed diffuse large B-cell lymphoma?

    NARCIS (Netherlands)

    Adams, Hugo J A; de Klerk, John M H; Fijnheer, Rob; Heggelman, Ben G F; Dubois, Stefan V.; Nievelstein, Rutger A J; Kwee, Thomas C.

    2015-01-01

    Purpose: To determine the prognostic value of tumor-induced cortical bone destruction at computed tomography (CT) in newly diagnosed diffuse large B-cell lymphoma (DLBCL). Materials and methods: This retrospective study included 105 patients with newly diagnosed DLBCL who had undergone CT and bone

  16. Intraarterial Hepatic SPECT/CT Imaging Using 99mTc-Macroaggregated Albumin in Preparation for Radioembolization.

    Science.gov (United States)

    Gates, Vanessa L; Singh, Nimarta; Lewandowski, Robert J; Spies, Stewart; Salem, Riad

    2015-08-01

    Current standard practice for radioembolization treatment planning makes use of nuclear medicine imaging (NMI) of (99m)Tc-macroaggregated albumin ((99m)Tc-MAA) arterial distributions for the assessment of lung shunting and extrahepatic uptake. Our aim was to retrospectively compare NMI with mapping angiography in the detection and localization of extrahepatic (99m)Tc-MAA and to evaluate the typical and atypical findings of NMI in association with catheter placement. One hundred seventy-four patients underwent diagnostic angiography in preparation for radioembolization. (99m)Tc-MAA was administered to the liver via a microcatheter positioned in the desired hepatic artery. Planar scintigraphy imaging followed by SPECT/CT imaging was obtained within 2 h. All images were reviewed for hepatic and extrahepatic (99m)Tc-MAA deposition and compared with the mapping angiogram. Intrahepatic lobe shunting was present on NMI in only 2.9% of the cases but was present in 62.5% of the patients with portal vein thrombosis. Extrahepatic distributions included lungs (100%), the gallbladder (49%) if present, and locations involving hepaticoenteric arterial anatomy recognized on angiograms (16%). Free pertechnetate was identified on 38% of the nuclear medicine images. Three percent of nuclear medicine images showed alternative findings such as a thyroid nodule or metallic artifact. Patients being considered for radioembolization should undergo both angiography and scintigraphy for the assessment of hepaticoenteric arterial anatomy, hepatopulmonary shunting, and appropriate dosimetry considerations. Knowledge of the expected distribution of (99m)Tc-MAA with normal variants and potential nontarget delivery to adjacent structures is critical in improving clinical outcomes. © 2015 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

  17. Ultrastable polyethyleneimine-stabilized gold nanoparticles modified with polyethylene glycol for blood pool, lymph node and tumor CT imaging

    Science.gov (United States)

    Zhang, Yongxing; Wen, Shihui; Zhao, Lingzhou; Li, Du; Liu, Changcun; Jiang, Wenbin; Gao, Xiang; Gu, Wentao; Ma, Nan; Zhao, Jinhua; Shi, Xiangyang; Zhao, Qinghua

    2016-03-01

    Development of new long-circulating contrast agents for computed tomography (CT) imaging of different biological systems still remains a great challenge. Here, we report the design and synthesis of branched polyethyleneimine (PEI)-stabilized gold nanoparticles (Au PSNPs) modified with polyethylene glycol (PEG) for blood pool, lymph node, and tumor CT imaging. In this study, thiolated PEI was first synthesized and used as a stabilizing agent to form AuNPs. The formed Au PSNPs were then grafted with PEG monomethyl ether via PEI amine-enabled conjugation chemistry, followed by acetylation of the remaining PEI surface amines. The formed PEGylated Au PSNPs were characterized via different methods. We show that the PEGylated Au PSNPs with an Au core size of 5.1 nm have a relatively long half-decay time (7.8 h), and display a better X-ray attenuation property than conventionally used iodine-based CT contrast agents (e.g., Omnipaque), and are hemocompatible and cytocompatible in a given concentration range. These properties of the Au PSNPs afford their uses as a contrast agent for effective CT imaging of the blood pool and major organs of rats, lymph node of rabbits, and the xenografted tumor model of mice. Importantly, the PEGylated Au PSNPs could be excreted out of the body with time and also showed excellent in vivo stability. These findings suggest that the formed PEGylated Au PSNPs may be used as a promising contrast agent for CT imaging of different biological systems.Development of new long-circulating contrast agents for computed tomography (CT) imaging of different biological systems still remains a great challenge. Here, we report the design and synthesis of branched polyethyleneimine (PEI)-stabilized gold nanoparticles (Au PSNPs) modified with polyethylene glycol (PEG) for blood pool, lymph node, and tumor CT imaging. In this study, thiolated PEI was first synthesized and used as a stabilizing agent to form AuNPs. The formed Au PSNPs were then grafted with PEG

  18. Evaluation of thoracic tumors with (18)F-FMT and (18)F-FDG PET-CT: a clinicopathological study.

    Science.gov (United States)

    Kaira, Kyoichi; Oriuchi, Noboru; Shimizu, Kimihiro; Ishikita, Tomohiro; Higuchi, Tetsuya; Imai, Hisao; Yanagitani, Noriko; Sunaga, Noriaki; Hisada, Takeshi; Ishizuka, Tamotsu; Kanai, Yoshikatsu; Endou, Hitoshi; Nakajima, Takashi; Endo, Keigo; Mori, Masatomo

    2009-03-01

    L-[3-(18)F]-alpha-methyltyrosine ((18)F-FMT) is an aminoacid tracer for positron emission tomography (PET). The aim of this study was to determine whether PET-CT with (18)F-FMT provides additional information for the preoperative diagnostic workup as compared with (18)F-FDG PET. PET-CT studies with (18)F-FMT and (18)F-FDG were performed as a part of the preoperative workup in 36 patients with histologically confirmed bronchial carcinoma, 6 patients with benign lesions and a patient with atypical carcinoid. Expression of L-type amino acid transporter 1 (LAT1), CD98, Ki-67 labeling index, VEGF, CD31 and CD34 of the resected tumors were analyzed by immunohistochemical staining, and correlated with the uptake of PET tracers. For the detection of pulmonary malignant tumors, (18)F-FMT PET exhibited a sensitivity of 84% whereas the sensitivity for (18)F-FDG PET was 89% (p = 0.736). (18)F-FMT PET-CT and (18)F-FDG PET-CT agreed with pathological staging in 85 and 68%, respectively (p = 0.151). (18)F-FMT uptake was closely correlated with LAT1, CD98, cell proliferation and angiogenesis. The specificity of (18)F-FMT PET for diagnosing thoracic tumors was higher than that of (18)F-FDG PET. Our results suggest that coexpression of LAT1 and CD98 in addition to cell proliferation and angiogenesis is relavant for the progression and metastasis of lung cancer.

  19. Hepatic hemangiosarcoma: imaging findings and differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Rademaker, J.; Galanski, M. [Department of Radiology I, Medical School Hannover (Germany); Widjaja, A. [Department of Gastroenterology and Hepatology, Medical School Hannover (Germany)

    2000-01-01

    Primary hepatic angiosarcoma is a rare mesenchymal tumor of the liver that usually presents with nonspecific symptoms in elderly men. We present four cases of hepatic hemangiosarcoma and discuss the imaging characteristics of this entity. Our series shows that this tumor is not uncommon in younger patients with no associated risk factors such as previous exposure to thorotrast or vinyl chloride. Our experiences on a limited number of patients suggests that the combined use of angiography and dual-phase helical CT provides a better identification of the tumor and its complications. Analysis of imaging studies in patients with hepatic hemangiosarcoma reveals hypervascular lesions. Common complications were portal vein thrombosis, Budd-Chiari syndrome, as well as arterio-venous or arterio-portal shunts. Due to the vascularity of the tumor, percutaneous liver biopsy is hazardous. (orig.)

  20. Antiproliferative effect of novel platinum(II) and palladium(II) complexes on hepatic tumor stem cells in vitro.

    Science.gov (United States)

    Miklášová, Natalia; Fischer-Fodor, Eva; Lönnecke, Peter; Tomuleasa, Ciprian Ionuţ; Virag, Piroska; Schrepler, Maria Perde; Mikláš, Roman; Dumitrescu, Luminiţa Silaghi; Hey-Hawkins, Evamarie

    2012-03-01

    Novel platinum and palladium complexes with (2-isopropoxyphenyl)dicyclohexylarsine and (2-methoxyphenyl)dicyclohexylarsine ligands were synthesized and tested on different tumor cells. Adducts with general formula MX(2)L(2) (M = Pt(II), Pd(II); X = Cl or I; L = organoarsenic ligand) were fully characterized. According to the crystallographic data, in all complexes the organoarsenic ligands coordinate the metal center through the arsenic atom only, in a trans arrangement with the halogen atoms. The antiproliferative potential of complexes 1-4 was evaluated in vitro on human tumor cell lines. A markedly biological activity was observed against the chemoresistant hepatic tumor stem cell line, the normal hepatic stem cells and towards the hepatocellular carcinoma (non-stem) cells. The new compounds toxicity is selectively limited in normal liver cells, unlikeness with the oxaliplatin, which displays a more intense effect in normal cells, compared with the two tumor cell lines. The stem cells treatment with compounds 1-4 causes DNA damages; the antimitotic effect of these compounds is based on their genotoxicity and on the capacity to form crosslinks with the DNA interstrand. In the case of platinum complexes 1 and 3 this mechanism gives rise to specific lesions on DNA that induces apoptosis in stem cells, influencing their selectivity in tumor cell growth inhibition. Compounds 1, 2 and 4 display higher activity against tumor stem cells. The novel platinum complexes 1 and 3 are more efficient against tumor stem cells than oxaliplatin, and if used in combination with sorafenib-based monoclonal anticancer therapy, complexes 1, 3 and 4 have the ability to induce superior chemosensitivity relative to sorafenib than the standard platinum-based drug, making them promising candidates for prodrug development. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  1. Integrated Fluorine-18 Fluorodeoxyglucose (18F-FDG) PET/CT Compared to Standard Contrast-Enhanced CT for Characterization and Staging of Pulmonary Tumors Eligible for Surgical Resection

    Energy Technology Data Exchange (ETDEWEB)

    Quaia, E.; Tona, G.; Gelain, F.; Lubin, E.; Pizzolato, R.; Boscolo, E.; Bussoli, L. (Dept. of Radiology, Cattinara Hospital, Univ. of Trieste, Trieste (Italy))

    2008-11-15

    Background: Accurate staging is necessary to determine the appropriate therapy in patients with lung cancer. Few studies have compared integrated fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) and contrast-enhanced CT in the characterization and staging of pulmonary tumors considered eligible for surgical resection. Purpose: To compare 18F-FDG PET/CT with standard contrast-enhanced CT for the diagnosis and staging of lung neoplasms eligible for surgical resection. Material and Methods: Seventy-six consecutive patients (56 male, 20 female; mean age+-SD, 63.4+-20 years) with 84 pulmonary tumors suspected for malignancy and considered eligible for surgical resection were prospectively enrolled. Seventy-three malignant (65 non-small-cell lung carcinomas, one small-cell lung cancer, two carcinoids, and five metastases) and 11 benign lung tumors (three hamartomas, two sarcoidosis, one amyloidosis, one Wegener granulomatosis, one tuberculosis, and three areas of scarring) were finally diagnosed by histology. Tumor staging was based on the revised American Joint Committee on Cancer. Results: In lesion characterization, the sensitivity and specificity of 18F-FDG PET/CT versus contrast-enhanced CT were 90% vs. 83% and 18% vs. 63% (P<0.05, McNemar test), respectively. In nodal staging, the sensitivity and specificity of 18F-FDG PET/CT versus contrast-enhanced CT were 78% vs. 46% and 80% vs. 93% (P<0.05), respectively. Conclusion: In patients with lung neoplasms considered eligible for surgical resection, 18F-FDG PET/CT versus contrast-enhanced CT revealed higher sensitivity in nodal staging, but lower specificity both in lesion characterization and nodal staging.

  2. Pitfalls of Tc-99m RBC SPECT in diagnosis of hepatic hemangioma: correlation with enhancing pattern on two-phase dynamic CT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hwa Jin; Chang, Jae Chun; Park, Won Kyu [Yeungnam Univ. School of Medicine, Taegu (Korea, Republic of)

    1997-10-01

    To elucidate the pitfalls of Tc-99m RBC liver SPECT in the diagnosis of hepatic hemangioma, and to compare this modality with two-phase dynamic CT. Forty patients with 48 liver masses, suspected on ultrasonography to be hemangiomas, underwent two-phase dynamic CT scanning and SPECT within a two week period. All masses were diagnosed through pathologic and follow up radiologic studies. The final diagnoses were hemangioma(n=3D42), metastasis(n=3D2), abscess(n=3D2), hepatocellular carcinoma(n=3D1), and cholangiocarcinoma(n=3D1). Sensitivities and specificities of CT and SPECT for the diagnosis of hemangioma and the relationship between false positives or false negatives seen on SPECT and the pattern of contrast enhancement seen on CT were investigated. The sensitivities of CT and SPECT for the diagnosis of hemangioma were 95.2%(40/42) and 76.2%(32/42), respectively. The false-negative rate of SPECT was significantly higher in the early enhancing (54.5%, 6/11) than in the late enhancing type (13.8%, 4/29) and in the 'less than 1 cm group, false-negatives (70%, 7/10) were more common than in the 'more than 1 cm' group(9.4%, 3/32). For the two lesions with false-positive findings on SPECT, the final diagnosis was metastasis, and two false-negative lesion, seen on CT, were misread as metastases. Four other lesions were negative in both studies. For the detection of hepatic hemangioma, two-phase dynamic CT is a better modality than SPECT. False positives on SPECT occurred in metastasis, and false negatives are more common in the small lesion and early enhancing group than in the late enhancing group. Between the two groups, there is a difference in hemodynamics, and considerable further pathological in vestigation is needed.=20.

  3. Antisense oligonucleotide against hTERT (Cantide inhibits tumor growth in an orthotopic primary hepatic lymphoma mouse model.

    Directory of Open Access Journals (Sweden)

    Bo Yang

    Full Text Available BACKGROUND: Human xenograft models, resulting from orthotopic transplantation (implantation into the anatomically correct site of histologically intact tissue into animals, are important for investigating local tumor growth, vascular and lymphatic invasion at the primary tumor site and metastasis. METHODOLOGY/PRINCIPAL FINDINGS: We used surgical orthotopic transplantation to establish a nude mouse model of primary hepatic lymphoma (PHL, HLBL-0102. We performed orthotopic transfer of the HLBL-0102 tumor for 42 generations and characterized the tumor cells. The maintenance of PHL characteristics were supported by immunohistochemical and cytogenetic analysis. We also report the antitumor effect of Cantide, an antisense phosphorothioate oligonucleotide against hTERT, on the growth of HLBL-0102 tumors. We showed a significant, dose-dependent inhibition of tumor weight and serum LDH activity in the orthotopically transplanted animals by Cantide. Importantly, survival was prolonged in Cantide-treated HLBL-0102 tumor-bearing mice when compared to mock-treated mice. CONCLUSIONS/SIGNIFICANCE: Our study provided the basis for the development of a clinical trial protocol to treat PHL.

  4. Tumor Tracking Method Based on a Deformable 4D CT Breathing Motion Model Driven by an External Surface Surrogate

    Energy Technology Data Exchange (ETDEWEB)

    Fassi, Aurora, E-mail: aurora.fassi@mail.polimi.it [Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano (Italy); Schaerer, Joël; Fernandes, Mathieu [CREATIS, CNRS UMR 5220, INSERM U1044, Université Lyon 1, INSA-Lyon, Villeurbanne (France); Department of Radiotherapy, Centre Léon Bérard, Lyon (France); Riboldi, Marco [Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano (Italy); Bioengineering Unit, CNAO Foundation, Pavia (Italy); Sarrut, David [CREATIS, CNRS UMR 5220, INSERM U1044, Université Lyon 1, INSA-Lyon, Villeurbanne (France); Department of Radiotherapy, Centre Léon Bérard, Lyon (France); Baroni, Guido [Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano (Italy); Bioengineering Unit, CNAO Foundation, Pavia (Italy)

    2014-01-01

    Purpose: To develop a tumor tracking method based on a surrogate-driven motion model, which provides noninvasive dynamic localization of extracranial targets for the compensation of respiration-induced intrafraction motion in high-precision radiation therapy. Methods and Materials: The proposed approach is based on a patient-specific breathing motion model, derived a priori from 4-dimensional planning computed tomography (CT) images. Model parameters (respiratory baseline, amplitude, and phase) are retrieved and updated at each treatment fraction according to in-room radiography acquisition and optical surface imaging. The baseline parameter is adapted to the interfraction variations obtained from the daily cone beam (CB) CT scan. The respiratory amplitude and phase are extracted from an external breathing surrogate, estimated from the displacement of the patient thoracoabdominal surface, acquired with a noninvasive surface imaging device. The developed method was tested on a database of 7 lung cancer patients, including the synchronized information on internal and external respiratory motion during a CBCT scan. Results: About 30 seconds of simultaneous acquisition of CBCT and optical surface images were analyzed for each patient. The tumor trajectories identified in CBCT projections were used as reference and compared with the target trajectories estimated from surface displacement with the a priori motion model. The resulting absolute differences between the reference and estimated tumor motion along the 2 image dimensions ranged between 0.7 and 2.4 mm; the measured phase shifts did not exceed 7% of the breathing cycle length. Conclusions: We investigated a tumor tracking method that integrates breathing motion information provided by the 4-dimensional planning CT with surface imaging at the time of treatment, representing an alternative approach to point-based external–internal correlation models. Although an in-room radiograph-based assessment of the

  5. Tumor tracking method based on a deformable 4D CT breathing motion model driven by an external surface surrogate.

    Science.gov (United States)

    Fassi, Aurora; Schaerer, Joël; Fernandes, Mathieu; Riboldi, Marco; Sarrut, David; Baroni, Guido

    2014-01-01

    To develop a tumor tracking method based on a surrogate-driven motion model, which provides noninvasive dynamic localization of extracranial targets for the compensation of respiration-induced intrafraction motion in high-precision radiation therapy. The proposed approach is based on a patient-specific breathing motion model, derived a priori from 4-dimensional planning computed tomography (CT) images. Model parameters (respiratory baseline, amplitude, and phase) are retrieved and updated at each treatment fraction according to in-room radiography acquisition and optical surface imaging. The baseline parameter is adapted to the interfraction variations obtained from the daily cone beam (CB) CT scan. The respiratory amplitude and phase are extracted from an external breathing surrogate, estimated from the displacement of the patient thoracoabdominal surface, acquired with a noninvasive surface imaging device. The developed method was tested on a database of 7 lung cancer patients, including the synchronized information on internal and external respiratory motion during a CBCT scan. About 30 seconds of simultaneous acquisition of CBCT and optical surface images were analyzed for each patient. The tumor trajectories identified in CBCT projections were used as reference and compared with the target trajectories estimated from surface displacement with the a priori motion model. The resulting absolute differences between the reference and estimated tumor motion along the 2 image dimensions ranged between 0.7 and 2.4 mm; the measured phase shifts did not exceed 7% of the breathing cycle length. We investigated a tumor tracking method that integrates breathing motion information provided by the 4-dimensional planning CT with surface imaging at the time of treatment, representing an alternative approach to point-based external-internal correlation models. Although an in-room radiograph-based assessment of the reliability of the motion model is envisaged, the developed

  6. Incidental tenosynovial huge cell tumors of the flexor hallucis longus muscle: seldom differential diagnosis of metabolic lesions using F18-FDG PET/CT; Inzidenteller tenosynovialer Riesenzelltumor des Musculus flexor hallucis longus. Seltene Differenzialdiagnose stoffwechselaktiver Laesionen in der F-18-FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Koestner, W.; Daemmrich, M.; Derlin, T.

    2016-03-15

    Tenosynovial huge cell tumors are seldom benign tumors in extremities originating from bone joint synovia and tendon sheats. In F18-FDG PET/CT imaging the tenosynovial huge cell tumors show increased metabolic activity and can trigger false diagnoses.

  7. Real-time US-CT/MRI image fusion for guidance of thermal ablation of liver tumors undetectable with US: results in 295 cases.

    Science.gov (United States)

    Mauri, Giovanni; Cova, Luca; De Beni, Stefano; Ierace, Tiziana; Tondolo, Tania; Cerri, Anna; Goldberg, S Nahum; Solbiati, Luigi

    2015-02-01

    This study was designed to assess feasibility of US-CT/MRI fusion-guided ablation in liver tumors undetectable with US. From 2002 to 2012, 295 tumors (162 HCCs and 133 metastases; mean diameter 1.3 ± 0.6 cm, range 0.5-2.5 cm) detectable on contrast-enhanced CT/MRI, but completely undetectable with unenhanced US and either totally undetectable or incompletely conspicuous with contrast-enhanced US (CEUS), were treated in 215 sessions using either internally cooled radiofrequency or microwave with standard ablation protocols, guided by an image fusion system (Virtual Navigation System, Esaote S.p.A., Genova, Italy) that combines US with CT/ MRI images. Correct targeting and successful ablation of tumor were verified after 24 hours with CT or MRI. A total of 282 of 295 (95.6 %) tumors were correctly targeted with successful ablation achieved in 266 of 295 (90.2 %). Sixteen of 295 (5.4 %) tumors were correctly targeted, but unsuccessfully ablated, and 13 of 295 (4.4 %) tumors were unsuccessfully ablated due to inaccurate targeting. There were no perioperative deaths. Major complications were observed in 2 of the 215 treatments sessions (0.9 %). Real-time virtual navigation system with US-CT/MRI fusion imaging is precise for targeting and achieving successful ablation of target tumors undetectable with US alone. Therefore, a larger population could benefit from ultrasound guided ablation procedures.

  8. Effect of tumor volume on the enhancement pattern of parathyroid adenoma on parathyroid four-dimensional CT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Kyoung [Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of); Dongguk University Ilsan Hospital, Department of Radiology, Goyang-si (Korea, Republic of); Yun, Tae Jin; Kim, Ji-hoon; Kang, Koung Mi; Choi, Seung Hong; Sohn, Chul-Ho [Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of); Seoul National University Hospital, Department of Radiology, Jongno-gu, Seoul (Korea, Republic of); Lee, Kyu Eun; Kim, Su-jin [Seoul National University Hospital, Department of Surgery, Seoul (Korea, Republic of); Won, Jae-Kyung [Seoul National University Hospital, Department of Pathology, Seoul (Korea, Republic of)

    2016-05-15

    The purpose of this study is to assess the effect of tumor volume on the enhancement pattern of parathyroid adenoma (PTA) on four-dimensional computed tomography (4D-CT). We analyzed the enhancement patterns of PTA on four-phase 4D-CT in 44 patients. Dependency of the changes of Hounsfield unit values (ΔHU) on the tumor volumes and clinical characteristics was evaluated using linear regression analyses. In addition, an unpaired t test was used to compare ΔHU of PTAs between PTA volume ≥1 cm{sup 3} and <1 cm{sup 3}, thyroid gland, and lymph node. PTA volume based on CT was the strongest factor on the ΔHU{sub Pre} {sub to} {sub Arterial} and ΔHU{sub Arterial} {sub to} {sub Venous} and ΔHU{sub Arterial} {sub to} {sub Delayed} (R {sup 2} = 0.34, 0.25, and 0.32, respectively, P < 0.001 for both). PTA ≥1 cm {sup 3} had statistically significant greater enhancement between the unenhanced phase and the arterial phase than PTA <1 cm {sup 3} (mean values ± standard deviations (SDs) of ΔHU{sub Pre} {sub to} {sub Arterial}, 102.7 ± 33.7 and 57.5 ± 28.8, respectively, P < 0.001). PTA ≥1 cm {sup 3} showed an early washout pattern on the venous phase, whereas PTA <1 cm {sup 3} showed a progressive enhancement pattern on the venous phase (mean values ± SDs of ΔHU{sub Arterial} {sub to} {sub Venous}, -13.2 ± 31.6 and 14.4 ± 32.7, respectively; P = 0.009). The enhancement pattern of PTA on 4D-CT is variable with respect to PTA volume based on CT. Therefore, the enhancement pattern of PTA on 4D-CT requires careful interpretation concerning the tumor volume, especially in cases of PTA <1 cm {sup 3}. (orig.)

  9. Association of the miR-196a2 C>T and miR-499 A>G polymorphisms with hepatitis B virus-related hepatocellular carcinoma risk: an updated meta-analysis

    Directory of Open Access Journals (Sweden)

    Zhu SL

    2016-04-01

    Full Text Available Shao-Liang Zhu,1,* Jian-Hong Zhong,1,* Wen-Feng Gong,1,* Hang Li,2 Le-Qun Li11Department of Hepatobiliary Surgery, 2Department of Ultrasound, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, People’s Republic of China*These authors contributed equally to this workBackground: This study meta-analyzed data on the possible association of the miR-196a2 C>T (rs11614913 and miR-499 A>G (rs3746444 polymorphisms with risk of hepatitis B virus (HBV-related hepatocellular carcinoma (HCC.Methods: Databases in PubMed, EMBASE, Web of Science, China BioMedicine, and Google Scholar were systematically searched to identify relevant studies. Meta-analyses were performed to examine the association of the miR-196a2 C>T and miR-499 A>G polymorphisms with HBV-related HCC risk. Odds ratios (ORs and 95% confidence intervals (95% CIs were calculated.Results: A total of 13 studies involving 3,964 cases and 5,875 healthy controls were included. Random-effect meta-analysis showed that the T allele and TT genotype of miR-196a2 C>T were associated with significantly lower HBV-related HCC risk (allelic model, OR =0.84, 95% CI =0.71–0.99, P=0.04; homozygous model, OR =0.68, 95% CI =0.47–0.98, P=0.04. In contrast, miR-499 A>G showed no significant association with HBV-related HCC risk in either overall pooled analysis or ethnic subgroup analysis according to any of the four genetic models. Based on analysis of ethnic subgroups, neither miR-196a2 C>T nor miR-499 A>G was significantly associated with risk of HBV-related HCC in Chinese population.Conclusion: The polymorphism miR-196a2 C>T, but not miR-499 A>G, may be associated with decreased HBV-related HCC risk. These conclusions should be verified in large, well-designed studies.Keywords: microRNA, single nucleotide polymorphisms, hepatitis B virus related, meta-analysis, hepatocellular carcinoma

  10. In vivo tumor grading of prostate cancer using quantitative 111In-capromab pendetide SPECT/CT.

    Science.gov (United States)

    Seo, Youngho; Aparici, Carina Mari; Cooperberg, Matthew R; Konety, Badrinath R; Hawkins, Randall A

    2010-01-01

    We have developed an in vivo method to quantify antibody uptake using (111)In-capromab pendetide SPECT combined with CT (SPECT/CT). Our goal was to evaluate this method for potential grading of prostate tumors. Our phantom experiments focused on the robustness of an advanced iterative reconstruction algorithm that involves corrections for photon attenuation, scatter, and geometric blurring caused by radionuclide collimators. The conversion factors between image values and tracer concentrations (in Bq/mL) were calculated from a uniform phantom filled with an aqueous solution of (111)InCl(3) using the same acquisition protocol and reconstruction parameters as for patient studies. In addition, the spatial resolution of the reconstructed images was measured from a point source phantom. The measured spatial resolution was modeled into a point-spread function, and the point-spread function was implemented in a deconvolution-based partial-volume-error correction algorithm. The recovery capability to correctly estimate true tracer concentrations was tested using prostatelike and bladderlike lesion phantoms fitted in the modified National Electrical Manufacturers Association/International Electrotechnical Commission body phantom. Patients with biopsy-proven prostate cancer (n = 10) who underwent prostatectomy were prospectively enrolled in the preoperative SPECT/CT studies at the San Francisco Veterans Affairs Medical Center. The CT portion of SPECT/CT was used to generate CT-based attenuation maps and as an anatomic localization tool for clinical interpretation. Pathologic Gleason grades were compared with in vivo antibody uptake value (AUV) normalized by injected dose, effective half-life, and injection-scan time difference. AUVs were calculated in each lobe of the prostate gland with cylindric volumes of interest having dimensions of 1.5 cm in both diameter and height. Reconstructed SPECT images further corrected by the deconvolution-based partial-volume-error correction

  11. CT features of nonfunctioning islet cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Eelkema, E.A.; Stephens, D.H.; Ward, E.M.; Sheedy, P.F. II

    1984-11-01

    To determine the computed tomographic (CT) characteristics of nonfunctioning islet cell carcinoma of the pancreas, the CT scans of 27 patients with that disease were reviewed. The pancreatic tumor was identified as a mass in 26 patients (96%) Of the 25 tumors evaluated with contrast enhancement, 20 became partially diffusely hyperdense relative to nearby normal pancreatic tissue. Hepatic metastases were identified in 15 patients (56%), regional lymphadenopathy in 10 (37%), atrophy of the gland proximal to the tumor in six (22%), dilatation of the biliary ducts in five (19%), and dilatation of the pancreatic duct in four (15%). The CT appearances of the nonfunctioning islet cell tumors were compared with those of 100 ordinary (ductal) pancreatic adenocarcinomas. Although the two types of tumors were sometimes indistinguishable, features found to be more characteristic of islet cell carcinoma included a pancreatic mass of unusually large size, calcification within the tumor, and contrast enhancement of either the primary tumor or hepatic metastases. Involvement of the celiac axis or proximal superior mesenteric artery was limited to ductal carcinoma.

  12. Observer Performance in the Detection and Classification of Malignant Hepatic Nodules and Masses with CT Image-Space Denoising and Iterative Reconstruction

    Science.gov (United States)

    Yu, Lifeng; Li, Zhoubo; Manduca, Armando; Blezek, Daniel J.; Hough, David M.; Venkatesh, Sudhakar K.; Brickner, Gregory C.; Cernigliaro, Joseph C.; Hara, Amy K.; Fidler, Jeff L.; Lake, David S.; Shiung, Maria; Lewis, David; Leng, Shuai; Augustine, Kurt E.; Carter, Rickey E.; Holmes, David R.; McCollough, Cynthia H.

    2015-01-01

    Purpose To determine if lower-dose computed tomographic (CT) scans obtained with adaptive image-based noise reduction (adaptive nonlocal means [ANLM]) or iterative reconstruction (sinogram-affirmed iterative reconstruction [SAFIRE]) result in reduced observer performance in the detection of malignant hepatic nodules and masses compared with routine-dose scans obtained with filtered back projection (FBP). Materials and Methods This study was approved by the institutional review board and was compliant with HIPAA. Informed consent was obtained from patients for the retrospective use of medical records for research purposes. CT projection data from 33 abdominal and 27 liver or pancreas CT examinations were collected (median volume CT dose index, 13.8 and 24.0 mGy, respectively). Hepatic malignancy was defined by progression or regression or with histopathologic findings. Lower-dose data were created by using a validated noise insertion method (10.4 mGy for abdominal CT and 14.6 mGy for liver or pancreas CT) and images reconstructed with FBP, ANLM, and SAFIRE. Four readers evaluated routine-dose FBP images and all lower-dose images, circumscribing liver lesions and selecting diagnosis. The jackknife free-response receiver operating characteristic figure of merit (FOM) was calculated on a per–malignant nodule or per-mass basis. Noninferiority was defined by the lower limit of the 95% confidence interval (CI) of the difference between lower-dose and routine-dose FOMs being less than −0.10. Results Twenty-nine patients had 62 malignant hepatic nodules and masses. Estimated FOM differences between lower-dose FBP and lower-dose ANLM versus routine-dose FBP were noninferior (difference: −0.041 [95% CI: −0.090, 0.009] and −0.003 [95% CI: −0.052, 0.047], respectively). In patients with dedicated liver scans, lower-dose ANLM images were noninferior (difference: +0.015 [95% CI: −0.077, 0.106]), whereas lower-dose FBP images were not (difference −0.049 [95% CI:

  13. CT Findings of Completely Regressed Hepatocellular Carcinoma with Main Portal Vein Tumor Thrombosis after Transcatheter Arterial Chemoembolization

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Jeong Hee; Kim, Hyo Cheol; Chung, Jin Wook; Jae, Hwan Jun; Park, Jae Hyung [Seoul National University Hospital, Seoul (Korea, Republic of); Yoon, Jung Hwan [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2010-02-15

    The objective of this study was to determine the sequential CT findings of controlled hepatocellular carcinoma (HCC) with main portal vein (MPV) thrombosis with the use of transcatheter arterial chemoembolization and additional intra-arterial cisplatin infusion. From January 2004 to September 2006, 138 patients with HCC invading MPV were referred to the angiography unit of our institution for chemoembolization and additional intra-arterial cisplatin infusion. Until August 2008, seven (5%) of 138 patients were followed-up and found not to have tumor recurrence. CT scans were retrospectively reviewed by two radiologists, focusing on the following parameters: the extent of portal vein thrombosis, the diameter of the affected portal vein, and enhancement of portal vein thrombosis. The extent of portal vein thrombosis at the initial presentation was variable: left portal vein (LPV) and MPV (n = 1), right portal vein (RPV) and MPV (n = 3), as well as RPV, LPV and MPV (n = 3). The extent and diameter of the affected portal vein decreased during follow-up examinations. In addition, the degree of enhancement for tumor thrombi and serum alpha-feto-protein levels decreased after the transcatheter arterial chemoembolization. Portal vein thrombosis was found to be completely resolved in one patient, whereas residual thrombus without viability was persistent in six patients. If chemoembolization is effective in patients with HCC that invades the portal vein, the extent and enhancement of portal vein thrombosis is reduced, but residual thrombosis frequently persists for months or years, without evidence of a viable tumor.

  14. Quantification of Tumor Burden in a Genetically Engineered Mouse Model of Lung Cancer by Micro-CT and Automated Analysis

    Directory of Open Access Journals (Sweden)

    Kai H. Barck

    2015-04-01

    Full Text Available Genetically engineered mouse models (GEMMs of lung cancer closely recapitulate the human disease but suffer from the difficulty of evaluating tumor growth by conventional methods. Herein, a novel automated image analysis method for estimating the lung tumor burden from in vivo micro-computed tomography (micro-CT data is described. The proposed tumor burden metric is the segmented soft tissue volume contained within a chest space region of interest, excluding an estimate of the heart volume. The method was validated by comparison with previously published manual analysis methods and applied in two therapeutic studies in a mutant K-ras GEMM of non–small cell lung carcinoma. Mice were imaged by micro-CT pre-treatment and stratified into four treatment groups: an antibody inhibiting vascular endothelial growth factor (anti-VEGF, chemotherapy, combination of anti-VEGF and chemotherapy, or control antibody. In the first study, post-treatment imaging was performed 4 weeks later. In the second study, mice were scanned serially on a high-throughput scanner every 2 weeks for 8 weeks during treatment. In both studies, the automated tumor burden estimates were well correlated with manual metrics (r value range: 0.83-0.93, P < .0001 and showed a similar, significant reduction in tumor growth in mice treated with anti-VEGF alone or in combination with chemotherapy. Given the fully automated nature of this technique, the proposed analysis method can provide a valuable tool in preclinical drug research for screening and randomizing animals into treatment groups and evaluating treatment efficacy in mouse models of lung cancer in a highly robust and efficient manner.

  15. FDG PET/CT appearance of portal vein tumor thrombus in the gastric primitive neuroectodermal tumor: uncommon primary tumor site with rare finding.

    Science.gov (United States)

    Aras, Mustafa; Dede, Fuat; Dane, Faysal; Aktas, Bilge; Turoglu, Halil Turgut

    2013-01-01

    Gastric primitive neuroectodermal tumor (PNET) is a very rare tumor. There are only a few case reports in the literature. Although cases with FDG uptake in the portal venous tumor thrombus (PVTT) in different primary malignancies have been evaluated before, the coexistence of PNET and PVTT has not been reported yet. Herein, we report the case of a gastric PNET with PVTT, which resolved after 3 cycles of polychemotherapy except for a residual tumor focus in the gastric corpus.

  16. A case of giant cell tumor of sacrum with unusual pulmonary metastases: CT and FDG PET findings.

    Science.gov (United States)

    Zhang, Yuyang; Reeve, Isaac P; Lewis, David H

    2012-09-01

    A 43-year-old woman was admitted for concern of postcurettage recurrence of left sacral giant cell tumor (GCT). Both MRI and FDG PET revealed a large lesion in the left sacrum with characteristics concerning for local recurrence. Preoperative staging CT showed no evidence of remote metastases. Subsequent restaging CT and FDG PET demonstrate the interval development of a 5 × 6-mm pulmonary nodule in the right lung base within 40 days after curettage with hypermetabolic features on PET, concerning for pulmonary metastasis of GCT, which was later confirmed by biopsy. As an exception, benign GCT can demonstrate metastases, rapid growth rate, and enhanced FDG avidity on PET for both primary and metastatic lesions. Our case illustrates the importance of recognizing these exceptional features when interpreting FDG PET of GCT to prevent the misinterpretation of metastases as perhaps other etiologies, such as infection.

  17. HIV Nef-M1 Effects on Colorectal Cancer Growth in Tumor-induced Spleens and Hepatic Metastasis.

    Science.gov (United States)

    Harrington, Willie; Bond, Vincent; Huang, Ming Bo; Powell, Michael; Lillard, James; Manne, Upender; Bumpers, Harvey

    2009-08-05

    CXCR4 receptors have been implicated in tumorigenesis and proliferation, making it a potential target for colorectal cancer therapy. Expression of this chemokine receptor on cellular surfaces appears to promote metastasis by directly stimulating tumor cell migration and invasion. The receptor/ligand, CXCR4/SDF-1alpha, pair are critically important to angiogenesis and vascular remodeling which supports cancer proliferation. Our work has shown that a novel apoptotic peptide of HIV-1, Nef-M1, can act as a CXCR4 antagonist, inducing apoptosis in CXCR4 containing cells. Four colorectal tumor cell lines (HT-29, LS174t, SW480, WiDr), were evaluated for their response to Nef-M1 peptide via in vivo and in vitro. The presence of CXCR4 receptors on tumor cells was determined using immunohistochemical and RT-PCR analyses. Solid xenografts derived from tumor cell lines grown in SCID mice, were evaluated for the persistence of the receptor. Xenografts propagated in SCID mice from each of the four cell lines demonstrated high levels of receptor expression as well. The effects of Nef-M1 in vivo via splenic injected mice and subsequent hepatic metastasis also demonstrated dramatic reduction of primary tumor growth in the spleen and secondary invasion of the liver. We concluded that Nef-M1 peptide, through physical interaction(s) with CXCR4, drives apoptotic reduction in in vivo primary tumor growth and metastasis.

  18. Computed tomography hepatic arteriography has a hepatic falciform artery detection rate that is much higher than that of digital subtraction angiography and 99mTc-MAA SPECT/CT: Implications for planning 90Y radioembolization?

    Energy Technology Data Exchange (ETDEWEB)

    Burgmans, M.C., E-mail: mburgmans@hotmail.com [Department of Diagnostic Radiology, Singapore General Hospital, Outram Road, Singapore 169608 (Singapore); Too, C.W., E-mail: too.chow.wei@singhealth.com.sg [Department of Diagnostic Radiology, Singapore General Hospital, Outram Road, Singapore 169608 (Singapore); Kao, Y.H., E-mail: yung.h.kao@gmail.com [Department of Nuclear Medicine and PET, Singapore General Hospital, Outram Road, Singapore 169608 (Singapore); Goh, A.S.W., E-mail: anthony.goh.s.w@sgh.com.sg [Department of Nuclear Medicine and PET, Singapore General Hospital, Outram Road, Singapore 169608 (Singapore); Chow, P.K.H., E-mail: gsupc@singnet.com.sg [Department of General Surgery, Singapore General Hospital, Outram Road, Singapore 169608 (Singapore); Office of Clinical Sciences, Duke-NUS Graduate Medical School Singapore, 8 College Road, Singapore 169857 (Singapore); Department of Surgical Oncology, National Cancer Center Singapore, 11 Hospital Drive, Singapore 169610 (Singapore); Tan, B.S., E-mail: tan.bien.soo@sgh.com.sg [Department of Diagnostic Radiology, Singapore General Hospital, Outram Road, Singapore 169608 (Singapore); Tay, K.H., E-mail: tay.kiang.hiong@sgh.com.sg [Department of Diagnostic Radiology, Singapore General Hospital, Outram Road, Singapore 169608 (Singapore); Lo, R.H.G., E-mail: richard.lo.h.g@sgh.com.sg [Department of Diagnostic Radiology, Singapore General Hospital, Outram Road, Singapore 169608 (Singapore)

    2012-12-15

    Purpose: To compare the hepatic falciform artery (HFA) detection rates of digital subtraction angiography (DSA), computed tomography hepatic arteriography (CTHA) and 99mTc-macroaggregated albumin (99mTc-MAA) single photon emission computed tomography with integrated CT (SPECT/CT) and to correlate HFA patency with complication rates of yttrium-90 (90Y) radioembolization. Material and methods: From August 2008 to November 2010, 79 patients (range 23–83 years, mean 62.3 years; 67 male) underwent pre-treatment DSA, CTHA and 99mTc-MAA scintigraphy (planar/SPECT/CT) to assess suitability for radioembolization with 90Y resin microspheres. Thirty-seven patients were excluded from the study, because CTHA was performed with a catheter position that did not result in opacification of the liver parenchyma adjacent to the falciform ligament. DSA, CTHA and 99mTc-MAA SPECT/CT images and medical records were retrospectively reviewed. Results: A patent HFA was detected in 22 of 42 patients (52.3%). The HFA detection rates of DSA, CTHA and 99mTc-MAA SPECT/CT were 11.9%, 52.3% and 13.3%, respectively (p < 0.0001). An origin from the segment 4 artery was seen in 51.7% of HFAs. Prophylactic HFA coil-embolization prior to 90Y microspheres infusion was performed in 2 patients. Of the patients who underwent radioembolization with a patent HFA, none developed supra-umbilical radiation dermatitis. One patient experienced epigastric pain attributed to post-embolization syndrome and was managed conservatively. Conclusion: The HFA detection rate of CTHA is superior to that of DSA and 99mTc-MAA SPECT/CT. Complications related to non-target radiation of the HFA vascular territory rarely occur, even in patients undergoing radioembolization with a patent HFA.

  19. The influence of CT based attenuation correction on PET/CT registration: an evaluation study

    Science.gov (United States)

    Yaniv, Ziv; Wong, Kenneth H.; Banovac, Filip; Levy, Elliot; Cleary, Kevin

    2007-03-01

    We are currently developing a PET/CT based navigation system for guidance of biopsies and radiofrequency ablation (RFA) of early stage hepatic tumors. For these procedures, combined PET/CT data can potentially improve current interventions. The diagnostic efficacy of biopsies can potentially be improved by accurately targeting the region within the tumor that exhibits the highest metabolic activity. For RFA procedures the system can potentially enable treatment of early stage tumors, targeting tumors before structural abnormalities are clearly visible on CT. In both cases target definition is based on the metabolic data (PET), and navigation is based on the spatial data (CT), making the system highly dependent upon accurate spatial alignment between these data sets. In our institute all clinical data sets include three image volumes: one CT, and two PET volumes, with and without CT-based attenuation correction. This paper studies the effect of the CT-based attenuation correction on the registration process. From comparing the pairs of registrations from five data sets we observe that the point motion magnitude difference between registrations is on the same scale as the point motion magnitude in each one of the registrations, and that visual inspection cannot identify this discrepancy. We conclude that using non-rigid registration to align the PET and CT data sets is too variable, and most likely does not provide sufficient accuracy for interventional procedures.

  20. Diagnostic accuracy of hepatic hemangioma and its decision tree on ultrasonography, computed tomography and angiography

    Energy Technology Data Exchange (ETDEWEB)

    Uesaka, Katsuhiko; Takayasu, Kenichi; Muramatu, Yukio; Moriyama, Noriyuki; Matsue, Hiroto; Yamada, Tatsuya; Hasegawa, Hiroshi

    1988-08-01

    Fifty seven lesions in 31 patients with hepatic hemangioma were concurrently imaged with ultrasonography (US), computed tomography (CT), and angiography (AG). Rates of lesion detection and qualitative diagnosis were 73.7 % and 59.5 %, respectively, for US; 89.5 % and 88.2 % for CT ; ad 89.5 % and 90.2 % for AG. Each of the three imaging methods had a diagnostic rate of 100 % for tumors more than 5 cm. In diagnosing tumors 5 cm or less, US was less sensitive than CT and AG (62.5 % vs 85.0 %). The qualitative diagnostic rate of both CT and AG was 90 % regardless of tumor diameter. As for US, it was 76.5 % in lesions more than 5 cm, and 48.0 % in lesions 5 cm or less. The necessity of decision tree of CT and the other imaging methods in hepatic hemangioma is presented. (Namekawa, K.).

  1. Diagnosis and evaluation of surveying examination by intracranial tumor in dogs CT; Diagnostico e avaliacao topografica de neoplasias intracranianas pelo exame de TC em caes

    Energy Technology Data Exchange (ETDEWEB)

    Romaldini, Andre Fonseca; Santos, Debora Rodrigues dos; Oliveira, Juliana Messias; Abreu, Felipe Andrei Suarez; Wallace, Verena; Pacheco, Eduardo Nelson da Silva, E-mail: andreromaldini@gmail.com [Hospital Santa Ines de Sao Paulo, Santana, SP (Brazil)

    2012-07-01

    The use of computed tomography (CT) revolutionized image diagnostic in veterinary medicine and currently can be considered one of the most useful tools for the imaging evaluation of intracranial tumor in dogs. Computed tomography of the brain in small animals allows visualization of intracranial tumor, compression of adjacent structures such as cerebral parenchyma, falx or lateral ventricles, and evaluate secondary hemorrhages and edema. The CT imaging provides essential information to indicate the surgical approach for a possible tumor resection or biopsy, including the correct location and boundaries structures involved, and also can be used to monitor the clinical treatment. However, only histopathological examination is able to confirm the final diagnosis. (author)

  2. Ga-68 DOTATOC PET/CT-Guided Biopsy and Cryoablation with Autoradiography of Biopsy Specimen for Treatment of Tumor-Induced Osteomalacia

    Energy Technology Data Exchange (ETDEWEB)

    Maybody, Majid, E-mail: maybodym@mskcc.org [Memorial Sloan Kettering Cancer Center, Interventional Radiology Service (United States); Grewal, Ravinder K. [Memorial Sloan Kettering Cancer Center, Molecular Imaging and Therapy Service, Department of Radiology (United States); Healey, John H. [Memorial Sloan Kettering Cancer Center, Orthopedic Surgical Oncology Service, Department of Surgery (United States); Antonescu, Cristina R. [Memorial Sloan Kettering Cancer Center, Department of Pathology (United States); Fanchon, Louise [Memorial Sloan Kettering Cancer Center, Department of Physics (United States); Hwang, Sinchun [Memorial Sloan Kettering Cancer Center, Department of Radiology (United States); Carrasquillo, Jorge A. [Memorial Sloan Kettering Cancer Center, Molecular Imaging and Therapy Service, Department of Radiology (United States); Kirov, Assen [Memorial Sloan Kettering Cancer Center, Department of Physics (United States); Farooki, Azeez [Memorial Sloan Kettering Cancer Center, Department of Medicine (United States)

    2016-09-15

    Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome caused by small benign tumors of mesenchymal origin also known as phosphaturic mesenchymal tumors mixed connective tissue variant. Excellent prognosis is expected with eradication of the culprit tumor. These small tumors are notoriously difficult to localize with conventional imaging studies; this often leads to an extensive work up and prolonged morbidity. We report a patient with clinical diagnosis of TIO whose culprit tumor was localized with Ga-68 DOTATOC PET/CT and MRI. Biopsy and cryoablation were performed under Ga-68 DOTATOC PET/CT guidance. Autoradiography of the biopsy specimen was performed and showed in situ correlation between Ga-68 DOTATOC uptake and histopathology with millimeter resolution.

  3. Preoperative volume calculation of the hepatic venous draining areas with multi-detector row CT in adult living donor liver transplantation: impact on surgical procedure

    Energy Technology Data Exchange (ETDEWEB)

    Frericks, Bernd B.J. [Hanover Medical School, Departments of Radiology and Surgery, Hannover (Germany); University of Berlin, Department of Radiology, Berlin (Germany); Charite - University Medicine Berlin, Department of Radiology and Nuclear Medicine, Berlin (Germany); Kirchhoff, Timm D.; Shin, Hoen-Oh; Stamm, Georg; Merkesdal, Sonja; Abe, Takehiko; Galanski, Michael [Hanover Medical School, Departments of Radiology and Surgery, Hannover (Germany); Hanover Medical School, Department of Diagnostic Radiology, Hannover (Germany); Schenk, Andrea; Peitgen, Heinz-Otto [Hanover Medical School, Departments of Radiology and Surgery, Hannover (Germany); MeVis - Center for Medical Diagnostic Systems and Visualization, Bremen (Germany); Klempnauer, Juergen [Hanover Medical School, Departments of Radiology and Surgery, Hannover (Germany); Hanover Medical School, Department of Visceral- and Transplantation Surgery, Hannover (Germany); Nashan, Bjoern [Hanover Medical School, Departments of Radiology and Surgery, Hannover (Germany); Hanover Medical School, Department of Visceral- and Transplantation Surgery, Hannover (Germany); Dalhousie University, Multi Organ Transplant Program, Halifax, Nova Scotia (Canada)

    2006-12-15

    The purpose was to assess the volumes of the different hepatic territories and especially the drainage of the right paramedian sector in adult living donor liver transplantation (ALDLT). CT was performed in 40 potential donors of whom 28 underwent partial living donation. Data sets of all potential donors were postprocessed using dedicated software for segmentation, volumetric analysis and visualization of liver territories. During an initial period, volumes and shapes of liver parts were calculated based on the individual portal venous perfusion areas. After partial hepatic congestion occurring in three grafts, drainage territories with special regard to MHV tributaries from the right paramedian sector, and the IRHV were calculated additionally. Results were visualized three-dimensionally and compared to the intraoperative findings. Calculated graft volumes based on hepatic venous drainage and graft weights correlated significantly (r=0.86,P<0.001). Mean virtual graft volume was 930 ml and drained as follows: RHV: 680 ml, IRHV: 170 ml (n=11); segment 5 MHV tributaries: 100 ml (n=16); segment 8 MHV tributaries: 110 ml (n=20). When present, the mean aberrant venous drainage fraction of the right liver lobe was 28%. The evaluated protocol allowed a reliable calculation of the hepatic venous draining areas and led to a change in the hepatic venous reconstruction strategy at our institution. (orig.)

  4. Comparison of diagnostic performance of CT and MRI for abdominal staging of pediatric renal tumors: a report from the Children's Oncology Group

    Energy Technology Data Exchange (ETDEWEB)

    Servaes, Sabah [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Khanna, Geetika [Washington University School of Medicine, Pediatric Radiology, St. Louis Children' s Hospital, Mallinckrodt Institute for Radiology, 510 S. Kingshighway, Campus Box 8131-MIR, St. Louis, MO (United States); Naranjo, Arlene [University of Florida, Department of Biostatistics, Gainesville, FL (United States); Geller, James I. [Cincinnati Children' s Hospital Medical Center, Division of Oncology, Cincinnati, OH (United States); Ehrlich, Peter F. [University of Michigan, Department of Surgery, C.S. Mott Children' s Hospital, Ann Arbor, MI (United States); Gow, Kenneth W. [Seattle Children' s Hospital, Pediatric Surgery, Seattle, WA (United States); Perlman, Elizabeth J. [Ann and Robert H. Lurie Children' s Hospital of Chicago, Department of Pathology, Chicago, IL (United States); Dome, Jeffrey S. [Children' s National Medical Center, Center for Cancer and Blood Disorders, Washington, DC (United States); Gratias, Eric; Mullen, Elizabeth A. [Harvard University, Dana Farber Cancer Institute and Boston Children' s Hospital, Boston, MA (United States)

    2014-08-19

    CT and MRI are both used for abdominal staging of pediatric renal tumors. The diagnostic performance of the two modalities for local and regional staging of renal tumors has not been systematically evaluated. To compare the diagnostic performance of CT and MRI for local staging of pediatric renal tumors. The study population was derived from the AREN03B2 study of the Children's Oncology Group. Baseline abdominal imaging performed with both CT and MRI within 30 days of nephrectomy was available for retrospective review in 82 renal tumor cases. Each case was evaluated for capsular penetration, lymph node metastasis, tumor thrombus, preoperative tumor rupture, and synchronous contralateral lesions. The surgical and pathological findings at central review were the reference standard. The sensitivity of CT and MRI for detecting capsular penetration was 68.6% and 62.9%, respectively (P = 0.73), while specificity was 86.5% and 83.8% (P = 1.0). The sensitivity of CT and MRI for detecting lymph node metastasis was 76.5% and 52.9% (P = 0.22), and specificity was 90.4% and 92.3% (P = 1.0). Synchronous contralateral lesions were identified by CT in 4/9 cases and by MRI in 7/9 cases. CT and MRI have similar diagnostic performance for detection of lymph node metastasis and capsular penetration. MR detected more contralateral synchronous lesions; however these were present in a very small number of cases. Either modality can be used for initial loco-regional staging of pediatric renal tumors. (orig.)

  5. Metabolic Tumor Burden Assessed by Dual Time Point [(18)F]FDG PET/CT in Locally Advanced Breast Cancer: Relation with Tumor Biology.

    Science.gov (United States)

    Garcia-Vicente, Ana María; Pérez-Beteta, Julián; Pérez-García, Víctor Manuel; Molina, David; Jiménez-Londoño, German Andrés; Soriano-Castrejón, Angel; Martínez-González, Alicia

    2017-08-01

    The aim of the study was to investigate the influence of dual time point 2-deoxy-2-[(18)F]fluoro-D-glucose ([(18)F]FDG) positron emission tomography/x-ray computed tomography (PET/CT) on the standard uptake value (SUV) and volume-based metabolic variables of breast lesions and their relation with biological characteristics and molecular phenotypes. Retrospective analysis including 67 patients with locally advanced breast cancer (LABC). All patients underwent a dual time point [(18)F]FDG PET/CT, 1 h (PET-1) and 3 h (PET-2) after [(18)F]FDG administration. Tumors were segmented following a three-dimensional methodology. Semiquantitative metabolic variables (SUVmax, SUVmean, and SUVpeak) and volume-based variables (metabolic tumor volume, MTV, and total lesion glycolysis, TLG) were obtained. Biologic prognostic parameters, such as the hormone receptors status, p53, HER2 expression, proliferation rate (Ki-67), and grading were obtained. Molecular phenotypes and risk-classification [low: luminal A, intermediate: luminal B HER2 (-) or luminal B HER2 (+), and high: HER2 pure or triple negative] were established. Relations between clinical and biological variables with the metabolic parameters were studied. The relevance of each metabolic variable in the prediction of phenotype risk was assessed using a multivariate analysis. SUV-based variables and TLG obtained in the PET-1 and PET-2 showed high and significant correlations between them. MTV and SUV variables (SUVmax, SUVmean, and SUVpeak) where only marginally correlated. Significant differences were found between mean SUV variables and TLG obtained in PET-1 and PET-2. High and significant associations were found between metabolic variables obtained in PET-1 and their homonymous in PET-2. Based on that, only relations of PET-1 variables with biological tumor characteristics were explored. SUV variables showed associations with hormone receptors status (p metabolic variables and Ki-67, HER2, or p53 expression

  6. Treatment of a Recurrent Chest Wall Desmoid Tumor Using a CT-Guided Steroid Injection

    Energy Technology Data Exchange (ETDEWEB)

    Rhee, Sung Jung; Paik, Sang Hyun; Shin, Hwa Kyoon; Paik, Jai Soung; Lee, Eun Hye [Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of)

    2012-06-15

    We report on a 41-year-old woman with a chest wall desmoid tumour who was successfully treated with a computed tomography (CT)-guided steroid injection. She presented with a palpable mass in the right upper chest wall and was treated by surgical excision and postoperative radiation therapy due to recurrence of the mass at the surgical site. At 20 months after the second operation, a recurrent mass was again detected in the anterosuperior portion of the previous surgical site on CT. We performed a CT-guided steroid injection weekly for 4 weeks by applying a mixture of 3 mL of triamcinolone acetonide (40 mg/mL) and 3 mL of 1% Lidocaine, administering 4-6 mL of the mixture, to the lesion. Six months later, CT showed a marked decrease in the size of the mass.

  7. Percutaneous CT-Guided Cryoablation as an Alternative Treatment for an Extensive Pelvic Bone Giant Cell Tumor

    Energy Technology Data Exchange (ETDEWEB)

    Panizza, Pedro Sergio Brito; Albuquerque Cavalcanti, Conrado Furtado de [Sírio Libânes Hospital, Radiology and Imaged Guided Intervention Service (Brazil); Yamaguchi, Nise Hitomi [Instituto Avanços em Medicina (Brazil); Leite, Claudia Costa; Cerri, Giovanni Guido; Menezes, Marcos Roberto de, E-mail: marcos.menezes@hc.fm.usp.br [Sírio Libânes Hospital, Radiology and Imaged Guided Intervention Service (Brazil)

    2016-02-15

    A giant cell tumor (GCT) is an intermediate grade, locally aggressive neoplasia. Despite advances in surgical and clinical treatments, cases located on the spine and pelvic bones remain a significant challenge. Failure of clinical treatment with denosumab and patient refusal of surgical procedures (hemipelvectomy) led to the use of cryoablation. We report the use of percutaneous CT-guided cryoablation as an alternative treatment, shown to be a minimally invasive, safe, and effective option for a GCT with extensive involvement of the pelvic bones and allowed structural and functional preservation of the involved bones.

  8. Imatinib mesylate induces responses in patients with liver metastases from gastrointestinal stromal tumor failing intra-arterial hepatic chemotherapy

    Directory of Open Access Journals (Sweden)

    Fiorentini Giammaria

    2006-01-01

    Full Text Available Background: Imatinib mesylate represents a real major paradigm shift in cancer therapy, targeting the specific molecular abnormalities, crucial in the etiology of tumor. Intra-arterial hepatic chemotherapy (IAHC followed by embolization, has been considered an interesting palliative option for patients with liver metastases from gastrointestinal stromal tumor (GIST, due to the typically hypervascular pattern of the tumor. Aims: We report our experience with IAHC followed by Imatinib mesylate, in order to show the superiority of the specific molecular approach in liver metastases from GIST. Materials and Methods: Three patients (pts with pretreated massive liver metastases from GIST, received IAHC with Epirubicin 50 mg/mq, every 3 weeks for 6 cycles. At the evidence of progression, they received Imatinib mesylate. Results: We observed progressive diseases in all cases. In 1998, one patient underwent Thalidomide at 150 mg orally, every day for 4 months, with evidence of stable disease and clinical improvement. In 2001, two patients received Imatinib mesylate at 400 mg orally, every day, with evidence of partial response lasting 18+ months and 16 months. One of them had grade 3 neutropenia, with suspension of therapy for 3 weeks. Conclusion: No patient treated with IAHC, reported objective responses, but two of them obtained partial response after the assumption of Imatinib mesylate and one showed temporary stabilization with thalidomide. Imatinib mesylate represents a new opportunity in GIST therapy, targeting the specific molecular alteration. It seems to be superior to conventional intra arterial hepatic chemotherapy.

  9. Simulation of dosimetric consequences of 4D-CT-based motion margin estimation for proton radiotherapy using patient tumor motion data

    Science.gov (United States)

    Koybasi, Ozhan; Mishra, Pankaj; St. James, Sara; Lewis, John H.; Seco, Joao

    2014-02-01

    For the radiation treatment of lung cancer patients, four-dimensional computed tomography (4D-CT) is a common practice used clinically to image tumor motion and subsequently determine the internal target volume (ITV) from the maximum intensity projection (MIP) images. ITV, which is derived from short pre-treatment 4D-CT scan (variability. Inaccurate tumor localization may result in under-dosage of the tumor or over-dosage of the surrounding tissues. The purpose of this study is therefore to assess the degree of tumor under-dosage in case of regular and irregular breathing for proton radiotherapy using ITV-based treatment planning. We place a spherical lesion into a modified XCAT phantom that is also capable of producing 4D images based on irregular breathing, and move the tumor according to real tumor motion data, which is acquired over multiple days by tracking gold fiducial markers implanted into the lung tumors of patients. We derive ITVs by taking the union of all tumor positions during 6 s of tumor motion in the phantom using the first day patient tumor tracking data. This is equivalent to ITVs generated clinically from cine-mode 4D-CT MIP images. The treatment plans created for different ITVs are then implemented on dynamic phantoms with tumor motion governed by real tumor tracking data from consecutive days. By comparing gross tumor volume dose distribution on days of ‘treatment’ with the ITV dose distribution, we evaluate the deviation of the actually delivered dose from the predicted dose. Our results have shown that the proton treatment planning on ITV derived from pre-treatment cine-mode 4D-CT can result in under-dosage (dose covering 95% of volume) of the tumor by up to 25.7% over 3 min of treatment for the patient with irregular respiratory motion. Tumor under-dosage is less significant for the patient with relatively regular breathing. We have demonstrated that proton therapy using the pre-treatment 4D-CT based ITV method can lead to significant

  10. Tumorer

    DEFF Research Database (Denmark)

    Prause, J.U.; Heegaard, S.

    2005-01-01

    oftalmologi, øjenlågstumorer, conjunctivale tumorer, malignt melanom, retinoblastom, orbitale tumorer......oftalmologi, øjenlågstumorer, conjunctivale tumorer, malignt melanom, retinoblastom, orbitale tumorer...

  11. Suspected de novo Hepatitis B in a Patient Receiving Anti-Tumor Necrosis Factor Alpha Therapy for the Treatment of Crohn's Disease

    Directory of Open Access Journals (Sweden)

    Tetsuya Ishida

    2014-01-01

    Full Text Available We report a 45-year-old female patient who developed acute hepatic disorder during anti-tumor necrosis factor α therapy for the treatment of Crohn's disease (CD. She was diagnosed as colonic CD and placed on infliximab (IFX. She was negative for hepatitis B surface antigen at the initiation of IFX therapy, but developed acute hepatitis after the 30th administration of IFX 4 years and 1 month after the first administration. She was suspected to have had occult hepatitis B virus infection before IFX therapy, and de novo hepatitis B was considered the most likely diagnosis. Hepatitis subsided after discontinuation of anti-tumor necrosis factor α therapy and initiation of treatment with entecavir. She started to receive adalimumab to prevent relapse of CD. She has continued maintenance therapy with entecavir and adalimumab and has since been asymptomatic. As de novo hepatitis B may be fatal, virological testing for hepatitis B is essential for patients who are being considered for treatment that may weaken the immune system.

  12. Hepatitis B Virus Reactivation and Prophylaxis During Solid Tumor Chemotherapy: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Paul, Sonali; Saxena, Akriti; Terrin, Norma; Viveiros, Kathleen; Balk, Ethan M; Wong, John B

    2016-01-05

    Solid tumor chemotherapy regimens pose a risk for hepatitis B virus (HBV) reactivation, but screening and antiviral prophylaxis remains controversial because of insufficient evidence. To determine the risk for HBV reactivation with and without antiviral prophylaxis and the effectiveness of prophylaxis in adults with solid tumors and chronic or resolved HBV infection. MEDLINE through 1 July 2015 and Web of Science, Cochrane Central Register of Controlled Trials, TOXNET, and Scopus through 1 March 2015. 26 English-language observational studies and randomized, controlled trials in patients with chronic or resolved HBV receiving chemotherapy for solid tumors. Study characteristics, quality, and risk of bias were assessed by 1 researcher and verified by another independent researcher. Random-effects model meta-analyses were used to estimate the risk and odds ratio (OR) of reactivation with versus without antiviral prophylaxis. Reactivation in chronic HBV without prophylaxis ranged from 4% to 68% (median, 25%) with substantial heterogeneity. Prophylaxis reduced the risk for HBV reactivation (OR, 0.12 [95% CI, 0.06 to 0.22]), HBV-related hepatitis (OR, 0.18 [CI, 0.10 to 0.32]), and chemotherapy interruption (OR, 0.10 [CI, 0.04 to 0.27]). In 3 studies of patients with resolved HBV infection, none received HBV prophylaxis and reactivation risk ranged from 0.3% to 9.0%. Significant heterogeneity in underlying study populations and treatment regimens, incomplete baseline data, possibility of publication bias, and limited study quality. Most studies were observational and from Asia. In patients with chronic HBV receiving solid tumor chemotherapy, the risk for HBV reactivation is similar to the risk with other types of immunosuppressive therapy. Results support HBV screening and antiviral prophylaxis before initiation of chemotherapy for solid tumors. National Center for Advancing Translational Sciences and National Institutes of Health.

  13. Changes in tumor blood flow in postoperative malignant glioma during radiotherapy. Evaluation by SPECT and dynamic CT

    Energy Technology Data Exchange (ETDEWEB)

    Seiki, Yoshikatsu; Sugo, Nobuo; Kuroki, Takao; Onagi, Atsuo; Shibata, Iekado [Toho Univ., Tokyo (Japan). School of Medicine; Machida, Keiichi; Tachiki, Kazuhiro [Toho Univ., Tokyo (Japan). Omori Hospital

    2002-09-01

    The purpose of this study was to use SPECT ({sup 123}I-iofetamine (IMP) and {sup 201}TlCl) and dynamic CT to examine changes in blood flow and metabolism caused by radiotherapy utilized as an adjunct to postoperative chemotherapy for malignant gliomas. SPECT was performed on 7 patients (4 with glioblastoma and 3 with anaplastic astrocytoma), and dynamic CT was used to evaluate 10 patients (8 with glioblastoma and 2 with anaplastic astrocytoma) before irradiation, and after receiving 10-20 Gy and 20-60 Gy total radiation. A region of interest (ROI) was selected in each tumor and in the ipsilateral cerebellum. The radioactivity in each ROI was calculated by dynamic SPECT from 0 to 5 minutes. The mean counts/pixel in the tumor ROI was then divided by the mean counts/pixel in the ROI of the ipsilateral cerebellum and the resulting value was designated as the count ratio (CR). Assuming the pre-treatment CR to be 100%, we next investigated relative changes in the post-irradiation CRs (rCR). The rCR in the tumor did not significantly differ after radiotherapy (106.8{+-}16.5% at 10-20 Gy and 91.6{+-}23.6% at 20-60 Gy). The accumulation of {sup 201}TlCl in the tumor significantly decreased [82.3{+-}3.1% at 10-20 Gy (p<0.05) and 62.1{+-}13.5% at 20-60 Gy (p<0.05)]. On dynamic CT, the peak time clearly decreased [10.85{+-}2.01 sec. at pre-irradiation vs. 7.79{+-}1.56 sec. at 10-20 Gy (p<0.05) and 8.25{+-}2.70 sec. at 20-60 Gy], and the peak value increased [4.89{+-}2.75 HU at pre-irradiation vs. 9.87{+-}3.75 at 10-20 Gy (p<0.05) and 6.08{+-}2.78 at 20-60 Gy]. These data indicate that postoperative changes in blood flow in malignant glioma occurring at doses of 10-20 Gy during radiotherapy are mainly due to increased permeability of the vascular wall within the tumor. (author)

  14. Feasibility of using single photon counting X-ray for lung tumor position estimation based on 4D-CT

    Energy Technology Data Exchange (ETDEWEB)

    Aschenbrenner, Katharina P.; Hesser, Juergen W. [Heidelberg Univ., Mannheim (Germany). Dept. of Experimental Radiation Oncology; Heidelberg Univ. (Germany). IWR; Guthier, Christian V. [Heidelberg Univ., Mannheim (Germany). Dept. of Experimental Radiation Oncology; Lyatskaya, Yulia [Brigham and Women' s Center, Boston, MA (United States); Harvard Medical School, Boston, MA (United States); Boda-Heggemann, Judit; Wenz, Frederik [Heidelberg Univ., Mannheim (Germany). Dept. of Radiation Oncology

    2017-10-01

    In stereotactic body radiation therapy of lung tumors, reliable position estimation of the tumor is necessary in order to minimize normal tissue complication rate. While kV X-ray imaging is frequently used, continuous application during radiotherapy sessions is often not possible due to concerns about the additional dose. Thus, ultra low-dose (ULD) kV X-ray imaging based on a single photon counting detector is suggested. This paper addresses the lower limit of photons to locate the tumor reliably with an accuracy in the range of state-of-the-art methods, i.e. a few millimeters. 18 patient cases with four dimensional CT (4D-CT), which serves as a-priori information, are included in the study. ULD cone beam projections are simulated from the 4D-CTs including Poisson noise. The projections from the breathing phases which correspond to different tumor positions are compared to the ULD projection by means of Poisson log-likelihood (PML) and correlation coefficient (CC), and template matching under these metrics. The results indicate that in full thorax imaging five photons per pixel suffice for a standard deviation in tumor positions of less than half a breathing phase. Around 50 photons per pixel are needed to achieve this accuracy with the field of view restricted to the tumor region. Compared to CC, PML tends to perform better for low photon counts and shifts in patient setup. Template matching only improves the position estimation in high photon counts. The quality of the reconstruction is independent of the projection angle. The accuracy of the proposed ULD single photon counting system is in the range of a few millimeters and therefore comparable to state-of-the-art tumor tracking methods. At the same time, a reduction in photons per pixel by three to four orders of magnitude relative to commercial systems with flatpanel detectors can be achieved. This enables continuous kV image-based position estimation during all fractions since the additional dose to the

  15. In vivo characterization of tumor vasculature using iodine and gold nanoparticles and dual energy micro-CT

    Science.gov (United States)

    Clark, Darin P.; Ghaghada, Ketan; Moding, Everett J.; Kirsch, David G.; Badea, Cristian T.

    2013-03-01

    Tumor blood volume and vascular permeability are well established indicators of tumor angiogenesis and important predictors in cancer diagnosis, planning and treatment. In this work, we establish a novel preclinical imaging protocol which allows quantitative measurement of both metrics simultaneously. First, gold nanoparticles are injected and allowed to extravasate into the tumor, and then liposomal iodine nanoparticles are injected. Combining a previously optimized dual energy micro-CT scan using high-flux polychromatic x-ray sources (energies: 40 kVp, 80 kVp) with a novel post-reconstruction spectral filtration scheme, we are able to decompose the results into 3D iodine and gold maps, allowing simultaneous measurement of extravasated gold and intravascular iodine concentrations. Using a digital resolution phantom, the mean limits of detectability (mean CNR = 5) for each element are determined to be 2.3 mg mL-1 (18 mM) for iodine and 1.0 mg mL-1 (5.1 mM) for gold, well within the observed in vivo concentrations of each element (I: 0-24 mg mL-1, Au: 0-9 mg mL-1) and a factor of 10 improvement over the limits without post-reconstruction spectral filtration. Using a calibration phantom, these limits are validated and an optimal sensitivity matrix for performing decomposition using our micro-CT system is derived. Finally, using a primary mouse model of soft-tissue sarcoma, we demonstrate the in vivo application of the protocol to measure fractional blood volume and vascular permeability over the course of five days of active tumor growth.

  16. Nerve Sheath Tumors in Neurofibromatosis Type 1: Assessment of Whole-Body Metabolic Tumor Burden Using F-18-FDG PET/CT.

    Directory of Open Access Journals (Sweden)

    Johannes Salamon

    Full Text Available To determine the metabolically active whole-body tumor volume (WB-MTV on F-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT in individuals with neurofibromatosis type 1 (NF1 using a three-dimensional (3D segmentation and computerized volumetry technique, and to compare PET WB-MTV between patients with benign and malignant peripheral nerve sheath tumors (PNSTs.Thirty-six NF1 patients (18 patients with malignant PNSTs and 18 age- and sex-matched controls with benign PNSTs were examined by F-18-FDG PET/CT. WB-MTV, whole-body total lesion glycolysis (WB-TLG and a set of semi-quantitative imaging-based parameters were analyzed both on a per-patient and a per-lesion basis.On a per-lesion basis, malignant PNSTs demonstrated both a significantly higher MTV and TLG than benign PNSTs (p < 0.0001. On a per-patient basis, WB-MTV and WB-TLG were significantly higher in patients with malignant PNSTs compared to patients with benign PNSTs (p < 0.001. ROC analysis showed that MTV and TLG could be used to differentiate between benign and malignant tumors.WB-MTV and WB-TLG may identify malignant change and may have the potential to provide a basis for investigating molecular biomarkers that correlate with metabolically active disease manifestations. Further evaluation will determine the potential clinical impact of these PET-based parameters in NF1.

  17. Impact of 4D-(18)FDG-PET/CT imaging on target volume delineation in SBRT patients with central versus peripheral lung tumors. Multi-reader comparative study.

    Science.gov (United States)

    Chirindel, Alin; Adebahr, Sonja; Schuster, Daniel; Schimek-Jasch, Tanja; Schanne, Daniel H; Nemer, Ursula; Mix, Michael; Meyer, Philipp; Grosu, Anca-Ligia; Brunner, Thomas; Nestle, Ursula

    2015-06-01

    Evaluation of the effect of co-registered 4D-(18)FDG-PET/CT for SBRT target delineation in patients with central versus peripheral lung tumors. Analysis of internal target volume (ITV) delineation of central and peripheral lung lesions in 21 SBRT-patients. Manual delineation was performed by 4 observers in 2 contouring phases: on respiratory gated 4DCT with diagnostic 3DPET available aside (CT-ITV) and on co-registered 4DPET/CT (PET/CT-ITV). Comparative analysis of volumes and inter-reader agreement. 11 cases of peripheral and 10 central lesions were evaluated. In peripheral lesions, average CT-ITV was 6.2 cm(3) and PET/CT-ITV 8.6 cm(3), resembling a mean change in hypothetical radius of 2 mm. For both CT-ITVs and PET/CT-ITVs inter reader agreement was good and unchanged (0.733 and 0.716; p=0.58). All PET/CT-ITVs stayed within the PTVs derived from CT-ITVs. In central lesions, average CT-ITVs were 42.1 cm(3), PET/CT-ITVs 44.2 cm(3), without significant overall volume changes. Inter-reader agreement improved significantly (0.665 and 0.750; p1 ml in average for all observers. The addition of co-registered 4DPET data to 4DCT based target volume delineation for SBRT of centrally located lung tumors increases the inter-observer agreement and may help to avoid geographic misses. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Use of 18F-FDG-PET-CT for Assessment of Response to Neoadjuvant Chemotherapy in Children With Wilms Tumor.

    Science.gov (United States)

    Qin, Zhen; Tang, Yiyun; Wang, Hui; Cai, Wei; Fu, Hongliang; Li, Jianing; Ma, Chao

    2015-07-01

    The aim of this study was to evaluate the predictive value of fluorine-18-fluorodeoxyglucose positron emission tomography with computed tomography (F-FDG-PET-CT) in the assessment of histologic response to neoadjuvant chemotherapy in children with Wilms tumors (WTs). We prospectively registered 12 patients with WTs who were treated with 2 cycles of neoadjuvant chemotherapy and surgery. All patients underwent sequential F-FDG-PET-CT before (PET-CT1) and after (PET-CT2) neoadjuvant chemotherapy. Maximum standardized uptake value (SUVmax) was measured on PET-CT1 (SUV1) and PET-CT2 (SUV2). The percentage change in SUVmax (SUVmax reduction) was calculated. After surgery the effects of neoadjuvant chemotherapy were graded histopathologically: ≥90% necrosis indicated a good response and chemotherapy, SUVmax reduction was significantly different between the good response group and the poor response group (P=0.035). A significant, in terms of P value, correlation was found between pathologic response and SUVmax reduction (r=0.700; 95% confidence interval, 0.060-0.935; P=0.011). A threshold of 66% reduction in SUVmax was identified, with which partition, there were 8 good histologic responders (≥66% decrease in SUVmax) and 4 poor responders. The histologic complete response rate of the good responders was 87.5%, whereas that of poor responders was 0%. SUV1≥7 and SUV2≥2.4 were both considered to be with high risk of recurrence. In patients with SUV1≥7, 4/5 cases relapsed and 4/6 patients with SUV2≥2.4 relapsed. As there seems to be a good correlation of changes in SUVmax and histologic response, PET-CT has the potential of predicting the response to neoadjuvant chemotherapy in children with WT. SUV1 and SUV2 by themselves might be a good prognosticator of the clinical outcome of WT pediatric patients treated with International Society of Pediatric Oncology protocols, although the reduction rate of SUVmax is much less powerful for prognosis.

  19. Paraneoplastic precocious puberty and excessively rapid somatic growth associated with pediatric malignant hepatic tumor: 1 report of 2 cases

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ok Hwa; Bahk, Yong Whee [Cathalic University College of Medicine, Seoul (Korea, Republic of)

    1990-04-15

    Sexual precocity in a 28-months-old boy and markedly accelerated skeletal growth with large body in a 5 years and 5 months-old-girl are reported. The former resulted from human chorionic gonadotropin-producing hepatoblastoma and the latter from cerebral gigantism associated with hepatoma. These two different disorders are discussed on the common basis of rare association of malignant hepatic tumors with precocious sexual and / or somatic growth. The clinical manifestations, chemical abnormalities, and the radiologic findings are presented with a brief review of the literature.

  20. New orally active DNA minor groove binding small molecule CT-1 acts against breast cancer by targeting tumor DNA damage leading to p53-dependent apoptosis.

    Science.gov (United States)

    Saini, Karan Singh; Hamidullah; Ashraf, Raghib; Mandalapu, Dhanaraju; Das, Sharmistha; Siddiqui, Mohd Quadir; Dwivedi, Sonam; Sarkar, Jayanta; Sharma, Vishnu Lal; Konwar, Rituraj

    2017-04-01

    Targeting tumor DNA damage and p53 pathway is a clinically established strategy in the development of cancer chemotherapeutics. Majority of anti-cancer drugs are delivered through parenteral route for reasons like severe toxicity, lack of stability, and poor enteral absorption. Current DNA targeting drugs in clinical like anthracycline suffers from major drawbacks like cardiotoxicity. Here, we report identification of a new orally active small molecule curcumin-triazole conjugate (CT-1) with significant anti-breast cancer activity in vitro and in vivo. CT-1 selectively and significantly inhibits viability of breast cancer cell lines; retards cells cycle progression at S phase and induce mitochondrial-mediated cell apoptosis. CT-1 selectively binds to minor groove of DNA and induces DNA damage leading to increase in p53 along with decrease in its ubiquitination. Inhibition of p53 with pharmacological inhibitor as well as siRNA revealed the necessity of p53 in CT-1-mediated anti-cancer effects in breast cancer cells. Studies using several other intact p53 and deficient p53 cancer cell lines further confirmed necessity of p53 in CT-1-mediated anti-cancer response. Pharmacological inhibition of pan-caspase showed CT-1 induces caspase-dependent cell death in breast cancer cells. Most interestingly, oral administration of CT-1 induces significant inhibition of tumor growth in LA-7 syngeneic orthotropic rat mammary tumor model. CT-1 treated mammary tumor shows enhancement in DNA damage, p53 upregulation, and apoptosis. Collectively, CT-1 exhibits potent anti-cancer effect both in vitro and in vivo and could serve as a safe orally active lead for anti-cancer drug development. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  1. CT urography in women with primary or recurrent pelvic tumors. Background and initial experiences; CT-Urographie bei Frauen mit primaeren oder rezidivierenden Beckentumoren. Hintergrund und erste Erfahrungen

    Energy Technology Data Exchange (ETDEWEB)

    Seifert, S.; Mueller-Lisse, U.G.; Degenhart, C.; Mourched, F.; Reiser, M.F. [Klinikum der Ludwig-Maximilians-Universitaet, Campus Innenstadt, Institut fuer Klinische Radiologie, Muenchen (Germany); Jundt, K. [Klinikum der Ludwig-Maximilians-Universitaet, Campus Innenstadt, Klinik und Poliklinik fuer Gynaekologie und Geburtshilfe, Muenchen (Germany); Stief, C.G.; Mueller-Lisse, U.L. [Klinikum der Ludwig-Maximilians-Universitaet, Campus Innenstadt, Klinik und Poliklinik fuer Urologie, Muenchen (Germany)

    2011-07-15

    Malignant tumors of the female pelvis account for 12-13% of newly diagnosed solid neoplasms among women in the USA and Germany. German guidelines advocate diagnostic imaging for local recurrence and metastasis while there are no recommendations for primary tumors. As excretory urography has been replaced by the excretory phase of computed tomography urography (CTU) in many institutions, two independent observers retrospectively evaluated CTUs of primary or recurrent female pelvic tumors to rule out associations between CTU findings and subsequent urologic measures. Among 31 CTUs of 27 women (age 29-84 years, mean 57 years) with 15 primary and 13 recurrent tumors, 83-100% of unremarkable proximal, middle and distal ureter segments were completely delineated in the excretory phase (delay 6-29 min, mean 16 min). The most common pathological findings included distal ureter obstruction (n=19, 61%), bladder compression (n=13, 42%) and bladder invasion (n=8, 26%). Out of 20 pathologically altered urinary tracts 8 were subsequently subjected to urologic measures (2-tailed Fisher exact test, p=0.0215) but none of the 10 unremarkable urinary tracts were treated. It appears that CTU is a sensible pre-therapeutic test for the urinary tract for primary and recurrent female pelvic tumors. (orig.) [German] Maligne Beckentumoren stellen 12-13% aller neu diagnostizierten soliden Neoplasien bei Frauen in den USA und in Deutschland dar. Deutsche Leitlinien befuerworten bildgebende Untersuchungen bei Lokalrezidiven und Metastasen; fuer Primaertumoren gibt es keine einschlaegigen Empfehlungen. Da das Ausscheidungsurogramm durch die Ausscheidungsaufnahme der CT-Urographie (CTU) weitgehend abgeloest ist, wurde bei weiblichen Beckentumoren oder deren Rezidive der Zusammenhang zwischen CTU-Befunden und nachfolgenden operativen urologischen Massnahmen retrospektiv von 2 unabhaengigen Auswertern geprueft. Bei 31 CTUs von 27 Frauen (Alter 29-84, Median 57 Jahre) mit 15 Primaertumoren und 13

  2. Pericardial, But Not Hepatic, Fat by CT Is Associated With CV Outcomes and Structure: The Multi-Ethnic Study of Atherosclerosis.

    Science.gov (United States)

    Shah, Ravi V; Anderson, Amanda; Ding, Jingzhong; Budoff, Matthew; Rider, Oliver; Petersen, Steffen E; Jensen, Majken Karoline; Koch, Manja; Allison, Matthew; Kawel-Boehm, Nadine; Wisocky, Jessica; Jerosch-Herold, Michael; Mukamal, Kenneth; Lima, João A C; Murthy, Venkatesh L

    2017-09-01

    The study sought to determine the associations between local (pericardial) fat and incident cardiovascular disease (CVD) events and cardiac remodeling independent of markers of overall adiposity. The impact of pericardial fat-a local fat depot encasing the heart-on myocardial function and long-term CV prognosis independent of systemic consequences of adiposity or hepatic fat is an area of active debate. We studied 4,234 participants enrolled in the MESA (Multi-Ethnic Study of Atherosclerosis) study with concomitant cardiac magnetic resonance imaging and computed tomography (CT) measurements for pericardial fat volume and hepatic attenuation (a measure of liver fat). Poisson and Cox regression were used to estimate the annualized risk of incident hard atherosclerotic CVD (ASCVD), all-cause death, heart failure, all-cause CVD, hard coronary heart disease, and stroke as a function of pericardial and hepatic fat. Generalized additive models were used to assess the association between cardiac magnetic resonance indices of left ventricular (LV) structure and function and pericardial fat. Models were adjusted for relevant clinical, demographic, and cardiometabolic covariates. MESA study participants with higher pericardial and hepatic fat were more likely to be older, were more frequently men, and had a higher prevalence of cardiometabolic risk factors (including dysglycemia, dyslipidemia, hypertension), as well as adiposity-associated inflammation. Over a median 12.2-year follow-up (interquartile range: 11.6 to 12.8 years), pericardial fat was associated with a higher rate of incident hard ASCVD (standardized hazard ratio: 1.22; 95% confidence interval: 1.10 to 1.35; p = 0.0001). Hepatic fat by CT was not significantly associated with hard ASCVD (standardized hazard ratio: 0.96; 95% confidence interval: 0.86 to 1.08; p = 0.52). Higher pericardial fat was associated with greater indexed LV mass (37.8 g/m2.7 vs. 33.9 g/m2.7, highest quartile vs. lowest quartile; p

  3. Low enhancement on multiphase contrast-enhanced CT images: an independent predictor of the presence of high tumor grade of clear cell renal cell carcinoma.

    Science.gov (United States)

    Zhu, Ye-Hua; Wang, Xun; Zhang, Jin; Chen, Yong-Hui; Kong, Wen; Huang, Yi-Ran

    2014-09-01

    The purpose of this study was to assess the relation between tumor enhancement on multiphase contrast-enhanced CT images and Fuhrman grade of clear cell renal cell carcinoma. A single-institution retrospective review was conducted on the records of 255 patients who underwent radical or partial nephrectomy and received a histologic diagnosis of clear cell renal cell carcinoma. Two radiologists recorded the radiographic features of each patient, including the attenuation value of the lesion, lesion size, calcification within the lesion, cystic versus solid appearance, and margin regularity. Parameters representing the extent of tumor enhancement were defined and calculated. The association between tumor enhancement and Fuhrman grade was analyzed, and multivariate analysis was performed to find independent predictors of high tumor grade. Significant differences existed in tumor enhancement among different Fuhrman grades (p enhancement (p enhancement parameter had a sensitivity of 0.84 and specificity of 0.93 in prediction of high tumor grade. In the multivariate analysis, more advanced age, irregular margin, and low tumor enhancement were the three independent predictors of high tumor grade. Tumor enhancement of clear cell renal cell carcinoma on multiphase contrast-enhanced CT images is associated with Fuhrman grade. Low tumor enhancement in the corticomedullary phase is an independent predictor of high tumor grade. This system may be helpful in clinical decision making about the care of patients treated by nonsurgical approaches.

  4. CT-based volumetric tumor growth velocity: A novel imaging prognostic indicator in oropharyngeal cancer patients receiving radiotherapy.

    Science.gov (United States)

    Perni, Subha; Mohamed, Abdallah S R; Scott, Jacob; Enderling, Heiko; Garden, Adam S; Gunn, G Brandon; Rosenthal, David I; Fuller, Clifton D

    2016-12-01

    Volumetric tumor growth velocity (TGV) reflects in vitro tumor aggressiveness, but its prognostic value has not been investigated in vivo. We examined the prognostic impact of TGV on oncologic outcomes in patients with oropharyngeal squamous cell cancer (OSCC). 101 OSCC patients with two pretreatment CTs with time gap of 2 or more weeks treated at a single institution between 2004 and 2008 were identified. Primary tumor and nodal targets were segmented in scans. Linear growth rates were calculated. Recursive partitioning analysis (RPA) identified cut point associated with outcomes. Median follow-up was 59months (range 7-118). Median primary TGV was 0.65% increase per day (range 0-9.37%). RPA identified TGV cut point associated with local control (LC) of 1% per day. Patients with higher TGV had decreased 5-year LC (73% vs. 98%, p=0.0004), distant control (DC, 62% vs. 91%, p=0.0007), and overall survival (OS, 38% versus 93%, pTGV⩾1% per day independently predicted worsened LC (p = 0.02), DC (p = 0.003), and OS (p TGV cutoff was not significantly predictive of LC, DC, or OS for a subset of presumed HPV-positive patients. OSCC TGV⩾1% per day is a substantive negative prognostic indicator for disease control and overall survival, particularly in HPV non-associated tumors. This novel CT-based volumetric assessment of TGV suggests a simple methodology for risk stratification of patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Quantitative assessment of simultaneous F-18 FDG PET/MRI in patients with various types of hepatic tumors: Correlation between glucose metabolism and apparent diffusion coefficient.

    Science.gov (United States)

    Kong, Eunjung; Chun, Kyung Ah; Cho, Ihn Ho

    2017-01-01

    Metabolism and water diffusion may have a relationship or an effect on each other in the same tumor. Knowledge of their relationship could expand the understanding of tumor biology and serve the field of oncologic imaging. This study aimed to evaluate the relationship between metabolism and water diffusivity in hepatic tumors using a simultaneous positron emission tomography/magnetic resonance imaging (PET/MRI) system with F-18 fluorodeoxyglucose (FDG) and to reveal the metabolic and diffusional characteristics of each type of hepatic tumor. Forty-one patients (mean age 63 ± 13 years, 31 male) with hepatic tumors (18 hepatocellular carcinoma [HCC], six cholangiocarcinoma [CCC], 10 metastatic tumors, one neuroendocrine malignancy, and six benign lesions) underwent FDG PET/MRI before treatment. Maximum standard uptake (SUVmax) values from FDG PET and the apparent diffusion coefficient (ADC) from the diffusion-weighted images were obtained for the tumor and their relationships were examined. We also investigated the difference in SUVmax and ADC for each type of tumor. SUVmax showed a negative correlation with ADC (r = -0.404, p = 0.009). The median of SUVmax was 3.22 in HCC, 6.99 in CCC, 6.30 in metastatic tumors, and 1.82 in benign lesions. The median of ADC was 1.039 × 10-3 mm/s2 in HCC, 1.148 × 10-3 mm/s2 in CCC, 0.876 × 10-3 mm/s2 in metastatic tumors, and 1.323 × 10-3 mm/s2 in benign lesions. SUVmax was higher in metastatic tumors than in benign lesions (p = 0.023). Metastatic tumors had a lower ADC than CCC (p = 0.039) and benign lesions (p = 0.004). HCC had a lower ADC than benign lesions, with a suggestive trend (p = 0.06). Our results indicate that SUVmax is negatively correlated with ADC in hepatic tumors, and each group of tumors has different metabolic and water diffusivity characteristics. Evaluation of hepatic tumors by PET/MRI could be helpful in understanding tumor characteristics.

  6. Diagnostic performance of whole brain volume perfusion CT in intra-axial brain tumors: Preoperative classification accuracy and histopathologic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Xyda, Argyro, E-mail: argyro.xyda@med.uni-goettingen.de [Department of Neuroradiology, Georg-August University, University Hospital of Goettingen, Robert-Koch Strasse 40, 37075 Goettingen (Germany); Department of Radialogy, University Hospital of Heraklion, Voutes, 71110 Heraklion, Crete (Greece); Haberland, Ulrike, E-mail: ulrike.haberland@siemens.com [Siemens AG Healthcare Sector, Computed Tomography, Siemensstr. 1, 91301 Forchheim (Germany); Klotz, Ernst, E-mail: ernst.klotz@siemens.com [Siemens AG Healthcare Sector, Computed Tomography, Siemensstr. 1, 91301 Forchheim (Germany); Jung, Klaus, E-mail: kjung1@uni-goettingen.de [Department of Medical Statistics, Georg-August University, Humboldtallee 32, 37073 Goettingen (Germany); Bock, Hans Christoph, E-mail: cbock@gmx.de [Department of Neurosurgery, Johannes Gutenberg University Hospital of Mainz, Langenbeckstraße 1, 55101 Mainz (Germany); Schramm, Ramona, E-mail: ramona.schramm@med.uni-goettingen.de [Department of Neuroradiology, Georg-August University, University Hospital of Goettingen, Robert-Koch Strasse 40, 37075 Goettingen (Germany); Knauth, Michael, E-mail: michael.knauth@med.uni-goettingen.de [Department of Neuroradiology, Georg-August University, University Hospital of Goettingen, Robert-Koch Strasse 40, 37075 Goettingen (Germany); Schramm, Peter, E-mail: p.schramm@med.uni-goettingen.de [Department of Neuroradiology, Georg-August University, University Hospital of Goettingen, Robert-Koch Strasse 40, 37075 Goettingen (Germany)

    2012-12-15

    Background: To evaluate the preoperative diagnostic power and classification accuracy of perfusion parameters derived from whole brain volume perfusion CT (VPCT) in patients with cerebral tumors. Methods: Sixty-three patients (31 male, 32 female; mean age 55.6 ± 13.9 years), with MRI findings suspected of cerebral lesions, underwent VPCT. Two readers independently evaluated VPCT data. Volumes of interest (VOIs) were marked circumscript around the tumor according to maximum intensity projection volumes, and then mapped automatically onto the cerebral blood volume (CBV), flow (CBF) and permeability Ktrans perfusion datasets. A second VOI was placed in the contra lateral cortex, as control. Correlations among perfusion values, tumor grade, cerebral hemisphere and VOIs were evaluated. Moreover, the diagnostic power of VPCT parameters, by means of positive and negative predictive value, was analyzed. Results: Our cohort included 32 high-grade gliomas WHO III/IV, 18 low-grade I/II, 6 primary cerebral lymphomas, 4 metastases and 3 tumor-like lesions. Ktrans demonstrated the highest sensitivity, specificity and positive predictive value, with a cut-off point of 2.21 mL/100 mL/min, for both the comparisons between high-grade versus low-grade and low-grade versus primary cerebral lymphomas. However, for the differentiation between high-grade and primary cerebral lymphomas, CBF and CBV proved to have 100% specificity and 100% positive predictive value, identifying preoperatively all the histopathologically proven high-grade gliomas. Conclusion: Volumetric perfusion data enable the hemodynamic assessment of the entire tumor extent and provide a method of preoperative differentiation among intra-axial cerebral tumors with promising diagnostic accuracy.

  7. Single minimum incision endoscopic radical nephrectomy for renal tumors with preoperative virtual navigation using 3D-CT volume-rendering

    Directory of Open Access Journals (Sweden)

    Shioyama Yasukazu

    2010-04-01

    Full Text Available Abstract Background Single minimum incision endoscopic surgery (MIES involves the use of a flexible high-definition laparoscope to facilitate open surgery. We reviewed our method of radical nephrectomy for renal tumors, which is single MIES combined with preoperative virtual surgery employing three-dimensional CT images reconstructed by the volume rendering method (3D-CT images in order to safely and appropriately approach the renal hilar vessels. We also assessed the usefulness of 3D-CT images. Methods Radical nephrectomy was done by single MIES via the translumbar approach in 80 consecutive patients. We performed the initial 20 MIES nephrectomies without preoperative 3D-CT images and the subsequent 60 MIES nephrectomies with preoperative 3D-CT images for evaluation of the renal hilar vessels and the relation of each tumor to the surrounding structures. On the basis of the 3D information, preoperative virtual surgery was performed with a computer. Results Single MIES nephrectomy was successful in all patients. In the 60 patients who underwent 3D-CT, the number of renal arteries and veins corresponded exactly with the preoperative 3D-CT data (100% sensitivity and 100% specificity. These 60 nephrectomies were completed with a shorter operating time and smaller blood loss than the initial 20 nephrectomies. Conclusions Single MIES radical nephrectomy combined with 3D-CT and virtual surgery achieved a shorter operating time and less blood loss, possibly due to safer and easier handling of the renal hilar vessels.

  8. Early prediction of tumor recurrence based on CT texture changes after stereotactic ablative radiotherapy (SABR) for lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Mattonen, Sarah A. [Department of Medical Biophysics, The University of Western Ontario, London, Ontario N6A 5C1 (Canada); Palma, David A. [Department of Medical Biophysics, The University of Western Ontario, London, Ontario N6A 5C1 (Canada); Department of Oncology, The University of Western Ontario, London, Ontario N6A 4L6 (Canada); Division of Radiation Oncology, London Regional Cancer Program, London, Ontario N6A 4L6 (Canada); Haasbeek, Cornelis J. A.; Senan, Suresh [Department of Radiation Oncology, VU University Medical Center, Amsterdam 1081 HV (Netherlands); Ward, Aaron D., E-mail: aaron.ward@uwo.ca [Department of Medical Biophysics, The University of Western Ontario, London, Ontario N6A 5C1 (Canada); Department of Oncology, The University of Western Ontario, London, Ontario N6A 4L6 (Canada)

    2014-03-15

    Purpose: Benign computed tomography (CT) changes due to radiation induced lung injury (RILI) are common following stereotactic ablative radiotherapy (SABR) and can be difficult to differentiate from tumor recurrence. The authors measured the ability of CT image texture analysis, compared to more traditional measures of response, to predict eventual cancer recurrence based on CT images acquired within 5 months of treatment. Methods: A total of 24 lesions from 22 patients treated with SABR were selected for this study: 13 with moderate to severe benign RILI, and 11 with recurrence. Three-dimensional (3D) consolidative and ground-glass opacity (GGO) changes were manually delineated on all follow-up CT scans. Two size measures of the consolidation regions (longest axial diameter and 3D volume) and nine appearance features of the GGO were calculated: 2 first-order features [mean density and standard deviation of density (first-order texture)], and 7 second-order texture features [energy, entropy, correlation, inverse difference moment (IDM), inertia, cluster shade, and cluster prominence]. For comparison, the corresponding response evaluation criteria in solid tumors measures were also taken for the consolidation regions. Prediction accuracy was determined using the area under the receiver operating characteristic curve (AUC) and two-fold cross validation (CV). Results: For this analysis, 46 diagnostic CT scans scheduled for approximately 3 and 6 months post-treatment were binned based on their recorded scan dates into 2–5 month and 5–8 month follow-up time ranges. At 2–5 months post-treatment, first-order texture, energy, and entropy provided AUCs of 0.79–0.81 using a linear classifier. On two-fold CV, first-order texture yielded 73% accuracy versus 76%–77% with the second-order features. The size measures of the consolidative region, longest axial diameter and 3D volume, gave two-fold CV accuracies of 60% and 57%, and AUCs of 0.72 and 0.65, respectively

  9. Assessing Tumor Response to Treatment in Patients with Lung Cancer Using Dynamic Contrast-Enhanced CT

    DEFF Research Database (Denmark)

    Strauch, Louise S; Eriksen, Rie Ø; Sandgaard, Michael

    2016-01-01

    Reviews and Meta-Analyses (PRISMA) guidelines. Only original research articles concerning treatment response in patients with lung cancer assessed with DCE-CT were included. To assess the validity of each study we implemented Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). The initial search...... after treatment. Four out of five studies that measured blood flow post anti-angiogenic treatments found that blood flow was significantly decreased. DCE-CT may be a useful tool in assessing treatment response in patients with lung cancer. It seems that particularly permeability and blood flow...

  10. Extracranial tumor vascularity: determination by dynamic CT scanning. Part II. The unit approach

    Energy Technology Data Exchange (ETDEWEB)

    Som, P.M.; Lanzieri, C.F.; Sacher, M.; Lawson, W.; Biller, H.F.

    1985-02-01

    Twenty-eight patients had combined conventional drip infusion CT scans. The information about the anatomic location of the lesion, its configuration, its cross-sectional appearance, its vacularity (as determined by dynamic signature curves), and its clinical presentation were considered as a single overall unit. This diagnostic approach allowed a diagnosis to be made on virtually all of these enhancing lesions without resorting to either a digital venous imaging study or angiographic procedure. In 17 of these cases, such an invasive second procedure was performed either to confirm the CT impression as part of this study or as part of a therapeutic embolization procedure.

  11. Extracranial tumor vascularity: determination by dynamic CT scanning. Part 1. Concepts and signature curves

    Energy Technology Data Exchange (ETDEWEB)

    Som, P.M.; Lanzieri, C.F.; Sacher, M.; Lawson, W.; Biller, H.F.

    1985-02-01

    Combined conventional drip infusion-dynamic CT scanning was performed on 28 patients with clinically discovered neck or parapharyngeal space masses. Seventeen of these also had digital venous study or angiographic studies either to confirm the CT diagnosis or as part of an embolization procedure. The studies indicate that the initial portion of the dynamic scan curve can be characteristically classified as either an arterial, venous, or hypovascular signature curve. The current ideas of how these curves are generated, the specific appearance of these signature curves, and the types of pathologic conditions that correlate with each curve are discussed.

  12. CT-Guided Bone Biopsies in Metastatic Castration-Resistant Prostate Cancer: Factors Predictive of Maximum Tumor Yield.

    Science.gov (United States)

    Holmes, Michael G; Foss, Erik; Joseph, Gabby; Foye, Adam; Beckett, Brooke; Motamedi, Daria; Youngren, Jack; Thomas, George V; Huang, Jiaoti; Aggarwal, Rahul; Alumkal, Joshi J; Beer, Tomasz M; Small, Eric J; Link, Thomas M

    2017-08-01

    To evaluate the success rate of CT-guided bone biopsies in metastatic castration-resistant prostate cancer (mCRPC) and to investigate associated technical, imaging, and clinical parameters affecting diagnostic yields. Eighty CT-guided bone biopsy specimens were obtained from 72 men (median age, 68 y; range, 49-89 y) enrolled in a multicenter trial to identify mechanisms of resistance in mCRPC. Successful biopsy was determined by histologic confirmation of tumor cells and successful isolation of RNA for molecular analysis. The overall success rate of CT-guided bone biopsies was 69% (55/80) based on histology and 64% (35/55) based on isolation of molecular material for RNA sequencing. Biopsies performed in lesions with areas of radiolucency had significantly higher diagnostic yields compared with lesions of predominantly dense sclerosis (95% vs 33%; P = .002) and lesions of predominantly subtle sclerosis (95% vs 65%; P = .04). Success rates increased in lesions with density ≤ 475 HU (79% for ≤ 475 HU vs 33% for > 475 HU; P = .001) and in lesions with ill-defined margins (76% for ill-defined margins vs 36% for well-circumscribed margins; P = .005). Alkaline phosphatase was the only clinical parameter to correlate significantly with diagnostic yield (83% for > 110 U/L vs 50% for ≤ 110 U/L; P = .001). Image-guided bone tumor biopsies can be successfully used to acquire cellular and molecular material for analyses in patients with osteoblastic prostate cancer metastases. Diagnostic yields are significantly increased in lesions with areas of radiolucency, density ≤ 475 HU, ill-defined margins, and interval growth and in patients with alkaline phosphatase > 110 U/L. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

  13. The differentiation of malignant and benign musculoskeletal tumors by F-18 FDG PET/CT studies-determination of maxSUV by analysis of ROC curve

    Energy Technology Data Exchange (ETDEWEB)

    Kong, Eun Jung; Cho, Ihn Ho; Chun, Kyung Ah; Won, Kyu Chang; Lee, Hyung Woo; Choi, Jun Heok; Shin, Duk Seop [Yeungnam University College of Medicine, Daegu (Korea, Republic of)

    2007-12-15

    We evaluated the standard uptake value (SUV) of F-18 FDG at PET/CT for differentiation of benign from malignant tumor in primary musculoskeletal tumors. Forty-six tumors (11 benign and 12 malignant soft tissue tumors, 9 benign and 14 malignant bone tumors) were examined with F-18 FDG PET/CT (Discovery ST, GE) prior to tissue diagnosis. The maxSUV(maximum value of SUV) were calculated and compared between benign and malignant lesions. The lesion analysis was based on the transverse whole body image. The maxSUV with cutoff of 4.1 was used in distinguishing benign from malignant soft tissue tumor and 3.05 was used in bone tumor by ROC curve. There was a statistically significant difference in maxSUV between benign (n = 11; maxSUV 3.4 {+-} 3.2) and malignant (n = 12; maxSUV 14.8 {+-} 12.2) lesion in soft tissue tumor ({rho} = 0.001). Between benign bone tumor (n = 9; maxSUV 5.4 {+-} 4.0) and malignant bone tumor (n = 14; maxSUV 7.3 {+-} 3.2), there was not a significant difference in maxSUV. The sensitivity and specificity for differentiating malignant from benign soft tissue tumor was 83% and 91%, respectively. There were four false positive malignant bone tumor cases to include fibrous dysplasia, Langerhans-cell histiocytosis (n = 2) and osteoid osteoma. Also, one false positive case of malignant soft tissue tumor was nodular fasciitis. The maxSUV was useful for differentiation of benign from malignant lesion in primary soft tissue tumors. In bone tumor, the low maxSUV correlated well with benign lesions but high maxSUV did not always mean malignancy.

  14. Tendencia de la incidencia de los tumores hepáticos en la infancia Incidence trends of hepatic tumors in childhood

    Directory of Open Access Journals (Sweden)

    Juan Manuel Mejía-Aranguré

    2002-04-01

    áticos en niños menores de 15 años, de 1982 a 1991, y de 1996 a 1999.Objective. To evaluate the incidence trends of hepatic tumors among children living in Mexico City. Material and Methods. A cross-sectional hospital survey was conducted to yield two databases. The first database contains the registry of all the cases of hepatic tumors occurring during the period 1982-1991, in public hospitals of Mexico City. The second database contains all hepatic tumor cases found between 1996 and 1999 in Hospital de Pediatría del Centro Médico Nacional "Siglo XXI" and in Hospital General del Centro Médico La Raza, both hospitals pertaining to Instituto Mexicano del Seguro Social (Mexican Institute of Social Security. The average annual incidence rates (AAIR were calculated for each type of hepatic tumor. The rates were standardized with the direct method, using as standard the world population under 15 years of age. The trends were evaluated with the annual incidence rates and the average rate of change assuming a Poisson distribution. Results. The AAIR for hepatoblastoma during the period 1982-1991 was three times higher for men than for women, with a value of 0.6 x10(6. The group of 1-4 years of age was the most affected. For hepatocarcinomas the AAIR was two-fold for women (0.14 as compared to men. Between 1996-1999 the AAIR for hepatoblastoma was 5.11 in women and 1.85 in men. The age group with the highest rate was women under one year of age. The AAIR for hepatocarcinoma was 0.64 for males and 1.23 for females. The most affected age group was males aged 10 to 14 years. No significant upward or downward trend was found in the incidence of hepatoblastomas. A non-significant change rate of 10% was found for hepatocarcinoma. Conclusions. No significant trends were observed in the incidence of hepatic tumors in children of Mexico City aged under 15 years, during the periods 1982-1991 and 1996-1999.

  15. Evaluation of {sup 68}Ga-DOTA-TOC PET/CT for the detection of duodenopancreatic neuroendocrine tumors in patients with MEN1

    Energy Technology Data Exchange (ETDEWEB)

    Morgat, Clement; Mazere, Joachim; Hindie, Elif; Fernandez, Philippe [CNRS, INCIA, Bordeaux (France); University of Bordeaux, INCIA, Bordeaux (France); University Hospital of Bordeaux, Department of Nuclear Medicine, Bordeaux (France); Velayoudom-Cephise, Fritz-Line; Nunes, Marie-Laure; Tabarin, Antoine [USN Haut-Leveque, Department of Endocrinology, Pessac (France); Schwartz, Paul; Guyot, Martine [University Hospital of Bordeaux, Department of Nuclear Medicine, Bordeaux (France); Gaye, Delphine [University Hospital of Bordeaux, Department of Radiology, Pessac (France); Vimont, Delphine; Schulz, Juergen [CNRS, INCIA, Bordeaux (France); University of Bordeaux, INCIA, Bordeaux (France); Smith, Denis [University Hospital of Bordeaux, Department of Oncology, Bordeaux (France)

    2016-07-15

    Somatostatin receptor scintigraphy with {sup 111}In-pentetreotide (SRS) is used to detect duodenopancreatic neuroendocrine tumors (dpNETs) in multiple endocrine neoplasia type 1 (MEN1). However, SRS has limited sensitivity for this purpose. Positron emission tomography/computed tomography (PET/CT) with {sup 68}Ga-DOTA-TOC has a higher rate of sporadic dpNETs detection than SRS but there is little data for dpNETs detection in MEN1. To compare the performances of {sup 68}Ga-DOTA-TOC PET/CT, SRS and contrast-enhanced computed tomography (CE-CT) to diagnose dpNETs in MEN1. Single-institution prospective comparative study Nineteen consecutive MEN1 patients (aged 47 ± 13 years) underwent {sup 68}Ga-DOTA-TOC PET/CT, SRS, and CE-CT within 2 months in random order. Blinded readings of images were performed separately by experienced physicians. Unblinded analysis of CE-CT, combined with additional magnetic resonance imaging, endoscopic-ultrasound, {sup 18}F-2-fluoro-deoxy-d-glucose ({sup 18}F-FDG) PET/CT or histopathology results served as reference standard for dpNETs diagnosis. The sensitivity of {sup 68}Ga-DOTA-TOC PET/CT, SRS, and CE-CT was 76, 20, and 60 %, respectively (p < 0.0001). All the true-positive lesions detected by SRS were also depicted on {sup 68}Ga-DOTA-TOC PET/CT. {sup 68}Ga-DOTA-TOC PET/CT detected lesions of smaller size than SRS (10.7 ± 7.6 and 15.2 ± 5.9 mm, respectively, p < 0.03). False negatives of {sup 68}Ga-DOTA-TOC PET/CT included small dpNETs (<10 mm) and {sup 18}F-FDG PET/CT positive aggressive dpNETs. No false positives were recorded. In addition, whole-body mapping with {sup 68}Ga-DOTA-TOC PET/CT identified extra-abdominal MEN1-related tumors including one neuroendocrine thymic carcinoma identified by the three imaging procedures, one bronchial carcinoid undetected by CE-CT and three meningiomas undetected by SRS. Owing to higher diagnostic performance, {sup 68}Ga-DOTA-TOC PET/CT (or alternative {sup 68}Ga-labeled somatostatin analogues

  16. Percutaneous radiofrequency thermal ablation of lung VX2 tumors in a rabbit model: evaluation with helical CT findings for the complete and partal ablation

    Energy Technology Data Exchange (ETDEWEB)

    Jin, Gong Yong; Han, Young Min; Lim, Yeong Su; Jang, Kyu Yun; Lee, Sang Yong; Chung, Gyung Ho [School of Medicine, Chonbuk National Univ., Chonju (Korea, Republic of)

    2004-05-01

    To evaluate the radiologic findings for complete and partial ablation after percutaneous CT-guided transthoracic radiofrequency ablation (RFA) of lung VX2 tumor implanted in rabbits. Thirteen rabbits with successfully implanted lung VX2 were used. Three rabbits as controls did not receive RFA while the other ten rabbits underwent RFA; 5 complete and 5 partial. RFA was performed using an internally cooled, 17-gauge electrode (Radionics, Burlington, MA) with a 1-cm active tip under CT guidance. Postprocedural CT was performed within 3 days, and we analyzed the ablated size, enhancement pattern, shape, margin, and complications of the complete and partial ablation groups. Rabbits were sacrificed after postprocedural CT with an overdose of ketamine, and pathologic findings of the ablated groups were compared with those of the control group. The size of the ablated lesions and the enhancement pattern differed between the completely and partially ablated groups on chest CT. The size of the ablated lesions was increased by 47.1% in the completely ablated group and by 2.1% in the partially ablated group. In the completely ablated group, VX2 tumor showed absolutely no enhancement, whereas only ablated pulmonary parenchyma outside VX2 showed mild enhancement on enhanced CT. In the partial ablated group, a part of VX2 became strongly enhanced on enhanced CT. On microscopic examination, the completely ablated group demonstrated that a viable tumor cell was not visible. In the partially ablated group, however, a viable tumor cell within the surrounding fibrous capsule on the peripheral area of the VX2 was observed. The important CT findings for evaluation of complete and partial RFA are the ablated size and enhancement pattern of the ablated lesion.

  17. Comparison of the prognostic values of {sup 68}Ga-DOTANOC PET/CT and {sup 18}F-FDG PET/CT in patients with well-differentiated neuroendocrine tumor

    Energy Technology Data Exchange (ETDEWEB)

    Sharma, Punit; Naswa, Niraj; Kc, Sudhir Suman; Yadav, Yashwant; Kumar, Rakesh; Bal, Chandrasekhar [All India Institute of Medical Sciences, Department of Nuclear Medicine, Ansari Nagar, New Delhi (India); Alvarado, Luis Andres; Dwivedi, Alok Kumar [Texas Tech University Health Sciences Center, Division of Biostatistics and Epidemiology, El Paso, TX (United States); Ammini, Ariachery C. [All India Institute of Medical Sciences, Department of Endocrinology and Metabolism, New Delhi (India)

    2014-12-15

    To determine the prognostic value of {sup 68}Ga-DOTANOC PET/CT in patients with well-differentiated neuroendocrine tumor (NET), and to compare the prognostic value with that of {sup 18}F-FDG PET/CT and other conventional clinicopathological prognostic factors. Data from 37 consecutive patients (age 46.6 ± 13.5 years, 51 % men) with well-differentiated NET who underwent {sup 68}Ga-DOTANOC PET/CT and {sup 18}F-FDG PET/CT were analyzed. All patients underwent a baseline visit with laboratory and radiological examinations. Clinical and imaging follow-up was performed in all patients. Progression-free survival (PFS) was measured from the date of the first PET/CT scan to the first documentation of progression of disease. {sup 68}Ga-DOTANOC PET/CT was positive in 37 of the 37 patients and {sup 18}F-FDG PET/CT was positive in 21. During follow-up 10 patients (27 %) showed progression of disease and 27 (73 %) showed no progression (24 stable disease, 3 partial response). The median follow-up was 25 months (range 2 - 52 months). Among the variables evaluated none was significantly different between the progressive disease and nonprogressive disease groups, with only SUVmax on {sup 68}Ga-DOTANOC PET/CT being borderline significant (P = 0.073). In the univariate analysis for PFS outcome, SUVmax on {sup 68}Ga-DOTANOC PET/CT (HR 0.122, 95 % CI 0.019 - 0.779; P = 0.026) and histopathological tumor grade (HR 4.238, 95 % CI 1.058 - 16.976; P = 0.041) were found to be associated with PFS. Other factors including age, sex, primary site, Ki-67 index, TNM stage, {sup 18}F-FDG PET/CT status (positive/negative), SUVmax on {sup 18}F-FDG PET/CT and type of treatment were not significant. In multivariable analysis, only SUVmax on {sup 68}Ga-DOTANOC PET/CT was found to be an independent positive predictor of PFS (HR 0.122, 95 % CI 0.019 - 0.779; P = 0.026). SUVmax measured on {sup 68}Ga-DOTANOC PET/CT is an independent, positive prognostic factor in patients with well-differentiated NET and

  18. (90) Y radiation lobectomy: Outcomes following surgical resection in patients with hepatic tumors and small future liver remnant volumes.

    Science.gov (United States)

    Lewandowski, Robert J; Donahue, Larry; Chokechanachaisakul, Attasit; Kulik, Laura; Mouli, Samdeep; Caicedo, Juan; Abecassis, Michael; Fryer, Jonathan; Salem, Riad; Baker, Talia

    2016-07-01

    The purpose of this study is to assess operative, post-operative, and long-term outcomes in patients who underwent radiation lobectomy (RL) for tumor control and/or hypertrophy of small future liver remnant (FLR) prior to resection. Right lobar +/- segment 4 radioembolization was performed prior to lobectomy/tri-segmentectomy in patients with hepatic tumor but inadequate FLR. Parenchymal/tumor volumes were calculated from pre/post-RL imaging; FLR/%FLR hypertrophy were determined. Complications were graded by the Clavien-Dindo classification. Thirteen patients (HCC n = 10, cholangiocarcinoma n = 2, mCRC n = 1) underwent RL prior to resection. The median time between RL and post-RL imaging was 40 days (23-190 days); the median time to resection was 86 days (30-210 days). Median FLR increased significantly [pre: 33% (22-43%); post: 43% (29-69%), P 50% pathologic necrosis. Median follow up time after surgery was 604 days (144-1,416 days); one death occurred. In this preliminary study, radiation lobectomy was a safe and effective method to achieve remnant liver hypertrophy while providing tumor control. This approach may facilitate safe resection and favorable post-operative outcomes.J. Surg. Oncol. 2016;114:99-105. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  19. Differentiation of pancreatic serous cystadenoma from endocrine tumor and intraductal papillary mucinous neoplasm based on washout pattern on multiphase CT.

    Science.gov (United States)

    Sahara, Shinya; Kawai, Nobuyuki; Sato, Morio; Ikoma, Akira; Minamiguchi, Hiroki; Nakai, Motoki; Sanda, Hiroki; Nakata, Kouhei; Takeuchi, Taizou; Tanaka, Takami; Shirai, Shintaro; Sonomura, Tetsuo

    2012-01-01

    To evaluate the washout (WO) pattern of serous cystadenomas (SCAs) compared with endocrine tumors (ETs) and intraductal papillary mucinous neoplasm (IPMN). Patients with serous cystadenoma (n = 12), ET (n = 29), and IPMN (n = 35) underwent 4-phase computed tomography CT. Tumors were categorized as hyperdense or hypodense. Computed tomographic values measured were unenhanced attenuation (AU), pancreatic attenuation (A12, 12 seconds), portal attenuation (A35), and equilibrium (A158). Computed tomographic parameters calculated were wash-in (WI) = A12 - AU; WO = A12 - A35; and washout ratio (WOR) = WO/WI × 100/22. Hyperdense SCAs had significantly higher WOR than did hyperdense ETs (P = 0.001). Among the 3 hypodense tumors, SCAs had the significantly highest WOR (P < 0.05/3). Relative to the pancreas, the WOR of SCAs were equivalent, whereas the WOR of ETs and IPMNs were significantly lower. Hyperdense SCAs had significantly higher WOR than did hyperdense ETs, and hypodense SCAs had the significantly highest WOR among the three.

  20. Embolotherapy for Neuroendocrine Tumor Liver Metastases: Prognostic Factors for Hepatic Progression-Free Survival and Overall Survival

    Energy Technology Data Exchange (ETDEWEB)

    Chen, James X. [Hospital of the University of Pennsylvania, Division of Interventional Radiology, Department of Radiology (United States); Rose, Steven [University of San Diego Medical Center, Division of Interventional Radiology, Department of Radiology (United States); White, Sarah B. [Medical College of Wisconsin, Division of Interventional Radiology, Department of Radiology (United States); El-Haddad, Ghassan [Moffitt Cancer Center, Division of Interventional Radiology, Department of Radiology (United States); Fidelman, Nicholas [University of San Francisco Medical Center, Division of Interventional Radiology, Department of Radiology (United States); Yarmohammadi, Hooman [Memorial Sloan Kettering Cancer Center, Division of Interventional Radiology, Department of Radiology (United States); Hwang, Winifred; Sze, Daniel Y.; Kothary, Nishita [Stanford University Medical Center, Division of Interventional Radiology, Department of Radiology (United States); Stashek, Kristen [Hospital of the University of Pennsylvania, Department of Pathology (United States); Wileyto, E. Paul [University of Pennsylvania, Department of Biostatistics and Epidemiology (United States); Salem, Riad [Northwestern Memorial Hospital, Division of Interventional Radiology, Department of Radiology (United States); Metz, David C. [Hospital of the University of Pennsylvania, Division of Gastroenterology, Department of Medicine (United States); Soulen, Michael C., E-mail: michael.soulen@uphs.upenn.edu [Hospital of the University of Pennsylvania, Division of Interventional Radiology, Department of Radiology (United States)

    2017-01-15

    PurposeThe purpose of the study was to evaluate prognostic factors for survival outcomes following embolotherapy for neuroendocrine tumor (NET) liver metastases.Materials and MethodsThis was a multicenter retrospective study of 155 patients (60 years mean age, 57 % male) with NET liver metastases from pancreas (n = 71), gut (n = 68), lung (n = 8), or other/unknown (n = 8) primary sites treated with conventional transarterial chemoembolization (TACE, n = 50), transarterial radioembolization (TARE, n = 64), or transarterial embolization (TAE, n = 41) between 2004 and 2015. Patient-, tumor-, and treatment-related factors were evaluated for prognostic effect on hepatic progression-free survival (HPFS) and overall survival (OS) using unadjusted and propensity score-weighted univariate and multivariate Cox proportional hazards models.ResultsMedian HPFS and OS were 18.5 and 125.1 months for G1 (n = 75), 12.2 and 33.9 months for G2 (n = 60), and 4.9 and 9.3 months for G3 tumors (n = 20), respectively (p < 0.05). Tumor burden >50 % hepatic volume demonstrated 5.5- and 26.8-month shorter median HPFS and OS, respectively, versus burden ≤50 % (p < 0.05). There were no significant differences in HPFS or OS between gut or pancreas primaries. In multivariate HPFS analysis, there were no significant differences among embolotherapy modalities. In multivariate OS analysis, TARE had a higher hazard ratio than TACE (unadjusted Cox model: HR 2.1, p = 0.02; propensity score adjusted model: HR 1.8, p = 0.11), while TAE did not differ significantly from TACE.ConclusionHigher tumor grade and tumor burden prognosticated shorter HPFS and OS. TARE had a higher hazard ratio for OS than TACE. There were no significant differences in HPFS among embolotherapy modalities.

  1. Evaluation of dual-input perfusion in lung cancer using a 320-detector CT: Its correlation with tumor size, location, and presence of metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Eun Ju; Lee, Ki Nam; Roh, Mee Sook; Son, Choon Hee [Dong-A University College of Medicine, Busan (Korea, Republic of); Roh, Mee Sook [Dept. of Radiology, Dongnam Institute of Radiological and Medical Sciences, Busan (Korea, Republic of)

    2016-11-15

    The purposes of our study were to assess the dual blood supply of lung cancer using a computed tomography (CT) perfusion technique, and to analyze the correlations between dual perfusion and various characteristics of lung cancer. Thirty-five consecutive patients with lung tumors highly suggestive of malignancy were included in this study. All subjects underwent a dual-input dynamic perfusion volume scan using a 320-detector-row CT before CT-guided biopsy. The pulmonary trunk and the descending thoracic aorta were selected for the arterial input functions. From the CT data, pulmonary arterial perfusion (PP), aortic perfusion (AP), and the perfusion index [PI = PP / (PP + AP)] were calculated using the dual-input maximum-slope method. We statistically analyzed the relationship of the perfusion data with tumor locations (central, peripheral, and abutting the pleural lesions), tumor volumes, and the presence of lymph node metastasis or distant metastasis. All subjects were pathologically diagnosed with primary lung cancers via CT-guided aspiration biopsy. The overall mean PI was 53.7 ± 7.2%. The PI showed a significant difference according to the tumor location (central, 49.2 ± 3.3%; peripheral, 56.2 ± 6.7%; abutting the pleural lesions, 48.9 ± 7.6%, p = 0.047). In contrast, no significant difference was detected in tumor size or the presence of metastasis (p > 0.05). We found that the proportion of dual perfusion in lung cancer was significantly dependent on the location of the tumor, while tumor size or the presence of metastasis was not distinctly associated with dual perfusion.

  2. Reducing iodine load in hepatic CT for patients with chronic liver disease with a combination of low-tube-voltage and adaptive statistical iterative reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Noda, Yoshifumi [Department of Radiology and Services, Gifu University Hospital, 1-1 Yanagido, Gifu 501-1194 (Japan); Kanematsu, Masayuki, E-mail: masa_gif@yahoo.co.jp [Department of Radiology and Services, Gifu University Hospital, 1-1 Yanagido, Gifu 501-1194 (Japan); Department of Radiology Services, Gifu University Hospital, 1-1 Yanagido, Gifu 501-1194 (Japan); Goshima, Satoshi; Kondo, Hiroshi; Watanabe, Haruo; Kawada, Hiroshi; Kawai, Nobuyuki; Tanahashi, Yukichi [Department of Radiology and Services, Gifu University Hospital, 1-1 Yanagido, Gifu 501-1194 (Japan); Miyoshi, Toshiharu R.T. [Department of Radiology Services, Gifu University Hospital, 1-1 Yanagido, Gifu 501-1194 (Japan); Bae, Kyongtae T. [Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA (United States)

    2015-01-15

    Highlights: • 80 kVp CT scanning was successfully applied to the hepatic imaging. • Iodine contrast material load was reduced to 400 mg iodine/kg. • Image quality and the detectability of HCCs were maintained. - Abstract: Purpose: To prospectively assess the effect of reduced iodine load to contrast enhancement, image quality, and detectability of hepatocellular carcinomas (HCCs) in hepatic CT with a combination of 80 kVp tube voltage setting and adaptive statistical iterative reconstruction (ASIR) technique in patients with chronic liver disease. Materials and methods: This HIPAA-compliant study was approved by our institutional review board and written informed consent was obtained in all patients. During a recent 9-month period, 170 consecutive patients (114 men and 56 women; age range, 40–85 years; mean, 67.7 years) with suspected chronic liver diseases were randomized into three CT groups according to the following iodine-load and tube-voltage protocols: 600 milligram per kilogram body weight (mg/kg) iodine load and 120 peak kilovolt (kVp) tube voltage setting (600-120 group), 500 mg/kg and 80 kVp (500-80 group), and 400 mg/kg and 80 kVp (400-80 group). Analysis of variance was conducted to evaluate differences in CT number, background noise, signal-to-noise ratio (SNR), effective dose, HCC-to-liver contrast-to-noise ratio (CNR), and figure of merit (FOM). Sensitivity, specificity, and area under the receiver-operating-characteristic curve (AUC) were compared to assess the detectability of HCCs. Results: Vascular and hepatic enhancement in the 400-80 and 500-80 groups was comparable to or greater than that in the 600-120 group (P < .05). Subjective image quality was comparable among the three groups. Sensitivity, specificity, and AUC for detecting HCCs were comparable among the groups. The effective dose was kept low (3.3–4.1 mSv) in all three groups. Conclusion: Iodine load can be reduced by 33% in CT of the liver with a combination of 80 kVp tube

  3. Evaluation of (68)Ga-DOTA-TOC PET/CT for the detection of duodenopancreatic neuroendocrine tumors in patients with MEN1.

    Science.gov (United States)

    Morgat, Clément; Vélayoudom-Céphise, Fritz-Line; Schwartz, Paul; Guyot, Martine; Gaye, Delphine; Vimont, Delphine; Schulz, Jürgen; Mazère, Joachim; Nunes, Marie-Laure; Smith, Denis; Hindié, Elif; Fernandez, Philippe; Tabarin, Antoine

    2016-07-01

    Somatostatin receptor scintigraphy with (111)In-pentetreotide (SRS) is used to detect duodenopancreatic neuroendocrine tumors (dpNETs) in multiple endocrine neoplasia type 1 (MEN1). However, SRS has limited sensitivity for this purpose. Positron emission tomography/computed tomography (PET/CT) with (68)Ga-DOTA-TOC has a higher rate of sporadic dpNETs detection than SRS but there is little data for dpNETs detection in MEN1. To compare the performances of (68)Ga-DOTA-TOC PET/CT, SRS and contrast-enhanced computed tomography (CE-CT) to diagnose dpNETs in MEN1. Single-institution prospective comparative study Nineteen consecutive MEN1 patients (aged 47 ± 13 years) underwent (68)Ga-DOTA-TOC PET/CT, SRS, and CE-CT within 2 months in random order. Blinded readings of images were performed separately by experienced physicians. Unblinded analysis of CE-CT, combined with additional magnetic resonance imaging, endoscopic-ultrasound, (18)F-2-fluoro-deoxy-D-glucose ((18)F-FDG) PET/CT or histopathology results served as reference standard for dpNETs diagnosis. The sensitivity of (68)Ga-DOTA-TOC PET/CT, SRS, and CE-CT was 76, 20, and 60 %, respectively (p TOC PET/CT. (68)Ga-DOTA-TOC PET/CT detected lesions of smaller size than SRS (10.7 ± 7.6 and 15.2 ± 5.9 mm, respectively, p TOC PET/CT included small dpNETs (TOC PET/CT identified extra-abdominal MEN1-related tumors including one neuroendocrine thymic carcinoma identified by the three imaging procedures, one bronchial carcinoid undetected by CE-CT and three meningiomas undetected by SRS. Owing to higher diagnostic performance, (68)Ga-DOTA-TOC PET/CT (or alternative (68)Ga-labeled somatostatin analogues) should replace (111)In-pentetreotide in the investigation of MEN1 patients.

  4. Mesenchymal tumors of the pancreas. CT patterns; Tumori mesenchimali del pancreas: aspetti con tomografia computerizzata

    Energy Technology Data Exchange (ETDEWEB)

    Ferrozzi, F.; Cusmano, F.; Zuccoli, G.; Tognini, G.; Bassi, S. [Parma Univ., Parma (Italy). Ist. di Scienze Radiologiche; Gabrielli, M. [Parma Univ., Parma (Italy). Ist. di Anatomia Patologica

    1999-10-01

    Purpose of this item is to report the CT patterns of pancreatic mesenchymal lesions and to investigate the capabilities and limitations of this technique in terms of characterization. In selected cases, CT can provide virtually diagnostic information (lipoma and teratoma), or at least highly suggestive findings (NHL, plexiform neurofibroma, lymphangioma). Moreover, knowledge of the variable morphostructural patterns of mesenchymal hisototypes (SCH, Sarcoma etc.) permits to include them in the differential diagnosis of pancreatic masses. [Italian] Scopo di questo rapporto e' descrivere gli aspetti semeiologici dei tumori mesenchimali del pancreas con la TC verificandone le possibilita e i limiti per la caratterizzazione. Pur nella rarita' dei reperti considerati, la TC puo' consentire l'effettiva caratterizzazione in alcuni casi (lipoma, neurofibroma plessiforme, linfangioma) o includere anche istotipi meno comuni (Schwannoma, sarcomi, ecc.) nelle possibilita' diagnostico-differenziali nel caso di processi espansivi pancreatici.

  5. In vivo diagnostic imaging using micro-CT: sequential and comparative evaluation of rodent models for hepatic/brain ischemia and stroke.

    Directory of Open Access Journals (Sweden)

    Naoto Hayasaka

    Full Text Available BACKGROUND: There is an increasing need for animal disease models for pathophysiological research and efficient drug screening. However, one of the technical barriers to the effective use of the models is the difficulty of non-invasive and sequential monitoring of the same animals. Micro-CT is a powerful tool for serial diagnostic imaging of animal models. However, soft tissue contrast resolution, particularly in the brain, is insufficient for detailed analysis, unlike the current applications of CT in the clinical arena. We address the soft tissue contrast resolution issue in this report. METHODOLOGY: We performed contrast-enhanced CT (CECT on mouse models of experimental cerebral infarction and hepatic ischemia. Pathological changes in each lesion were quantified for two weeks by measuring the lesion volume or the ratio of high attenuation area (%HAA, indicative of increased vascular permeability. We also compared brain images of stroke rats and ischemic mice acquired with micro-CT to those acquired with 11.7-T micro-MRI. Histopathological analysis was performed to confirm the diagnosis by CECT. PRINCIPAL FINDINGS: In the models of cerebral infarction, vascular permeability was increased from three days through one week after surgical initiation, which was also confirmed by Evans blue dye leakage. Measurement of volume and %HAA of the liver lesions demonstrated differences in the recovery process between mice with distinct genetic backgrounds. Comparison of CT and MR images acquired from the same stroke rats or ischemic mice indicated that accuracy of volumetric measurement, as well as spatial and contrast resolutions of CT images, was comparable to that obtained with MRI. The imaging results were also consistent with the histological data. CONCLUSIONS: This study demonstrates that the CECT scanning method is useful in rodents for both quantitative and qualitative evaluations of pathologic lesions in tissues/organs including the brain, and is

  6. Noise properties for three weighted Feldkamp algorithms using a 256-detecotor row CT-scanner: case study for hepatic volumetric cine imaging.

    Science.gov (United States)

    Mori, Shinichiro; Endo, Masahiro; Obata, Takayuki; Kishimoto, Riwa; Kato, Hirotoshi; Kandatsu, Susumu; Tsujii, Hirohiko; Tanada, Shuji

    2006-08-01

    In cone-beam geometry, image quality may be degraded or artifacts may occur if the cone angle is substantially wide. This is because a cone-beam scan along a circular orbit does not collect the complete set of data required to make an exact reconstruction of all volumetric data. To increase temporal resolution and thus image quality in cone-beam geometry, Silver proposed the new half-scan algorithm (NHS-FDK), which extends Parker's weighting function (HS-FDK) by utilizing a larger range up to 2pi. Here, we evaluated these algorithms for hepatic contrast-enhanced CT in cine scan mode using a 256-detector row CT. The full-scan (FS-FDK) images show uniform distribution of the image noise and CT-number uniformity. Image noise and CT-number uniformity with HS-FDK and NHS-FDK images follow the initial projection angle. HS-FDK images therefore have more changeable higher intensity (brighter) and a lower intensity (darker) areas than respective FS-FDK and NHS-FDK images. We concluded that, considering the trade-off between image quality and temporal resolution, the NHS-FDK algorithm is useful in volumetric cine imaging for the abdomen.

  7. HVJ-liposome-mediated transfection of HSVtk gene driven by AFP promoter inhibits hepatic tumor growth of hepatocellular carcinoma in SCID mice.

    Science.gov (United States)

    Hirano, T; Kaneko, S; Kaneda, Y; Saito, I; Tamaoki, T; Furuyama, J; Tamaoki, T; Kobayashi, K; Ueki, T; Fujimoto, J

    2001-01-01

    Suicide gene therapy using ganciclovir (GCV) with transfection of the herpes thymidine kinase (HSVtk) gene has been studied for cancer therapy. The present study demonstrates an efficient method of suicide gene therapy for multiple hepatic tumors, involving repetitive transfection of the HSVtk gene driven by the alpha-fetoprotein (AFP) promoter using hemagglutinating virus of Japan (HVJ)-liposomes. AFP-producing cells (HUH7) and AFP-nonproducing cells (LS180) were injected subcutaneously (s.c.) to establish tumors in nude mice. Two plasmid constructs, bacterial LacZ gene driven by the AFP promoter (AFPLacZ), and HSVtk gene driven by the AFP promoter (AFPTK1) were encapsulated into the HVJ-liposome and used. When AFPLacZ was injected into the s.c. tumors, expression of LacZ gene was confined to HUH7 tumors. Repeated transfection of AFPTK1 followed by GCV treatment markedly suppressed growth of HUH7 tumors, and apoptosis of HUH7 cells was recognized in the tumor. Next, HUH7 cells were injected into the portal vein in severe combined immunodeficiency mice to establish a hepatic tumor model. After inoculation with the tumor, HVJ-liposomes containing the AFPTK1 plasmid vector were injected into the portal vein via the splenic hilum, followed by GCV treatment. This gene therapy significantly inhibited the growth of tumors in the liver and markedly improved survival. Three injections of the AFPTK1 plasmid vector completely inhibited tumor growth. This procedure seems to have great potential for the treatment of multiple hepatic tumors.

  8. [CT urography in women with primary or recurrent pelvic tumors : background and initial experiences].

    Science.gov (United States)

    Seifert, S; Mueller-Lisse, U G; Degenhart, C; Jundt, K; Mourched, F; Stief, C G; Reiser, M F; Mueller-Lisse, U L

    2011-07-01

    Malignant tumors of the female pelvis account for 12-13% of newly diagnosed solid neoplasms among women in the USA and Germany. German guidelines advocate diagnostic imaging for local recurrence and metastasis while there are no recommendations for primary tumors. As excretory urography has been replaced by the excretory phase of computed tomography urography (CTU) in many institutions, two independent observers retrospectively evaluated CTUs of primary or recurrent female pelvic tumors to rule out associations between CTU findings and subsequent urologic measures. Among 31 CTUs of 27 women (age 29-84 years, mean 57 years) with 15 primary and 13 recurrent tumors, 83-100% of unremarkable proximal, middle and distal ureter segments were completely delineated in the excretory phase (delay 6-29 min, mean 16 min). The most common pathological findings included distal ureter obstruction (n=19, 61%), bladder compression (n=13, 42%) and bladder invasion (n=8, 26%). Out of 20 pathologically altered urinary tracts 8 were subsequently subjected to urologic measures (2-tailed Fisher exact test, p=0.0215) but none of the 10 unremarkable urinary tracts were treated. It appears that CTU is a sensible pre-therapeutic test for the urinary tract for primary and recurrent female pelvic tumors.

  9. Prognostic significance of metabolic tumor volume measured by {sup 18}F FDG PET/CT in operable primary breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jahae; Yoo, Su Woong; Kang, Sae Ryung; Cho, Sang Geon; Oh, Jong Ryool; Chong, Ari; Min, Jung Joon; Bom, Hee Seung; Yoon, Jung Han; Song, Ho Chun [Chonnam National Univ. Medical School and Hospital, Gwangju (Korea, Republic of)

    2012-12-15

    We investigated whether PET indices measured by {sup 18}F fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) can predict prognosis in patients with operable primary breast cancer. We reviewed 53 patients with operable primary breast cancer who underwent pretreatment FDG PET/CT. PET indices, maximum standardized uptake value (SUV) and metabolic tumor volume (MTV), were measured in the primary breast tumor (P), metastatic lymph nodes (N) and total tumor (T). The cox proportional hazards model was used with age, tumor size, clinical lymph node status, method od of surgery, presence or absence of neoadjuvant chemo therapy, histological type, histological grade, hormone grade, hormone receptors and HER2 status to predict disease free survival (DFS) and overall survival (OS). Median follow up period was 50 months (range, 17 73 months), during which 17 patients had recurrent disease and nine of whom died. The univariate analysis showed that high SUV of N (N{sup SUV,} =0.011), MTV of N (N{sup MTV,} =0.011) and MTV of T (T{sup MTV,} =0.045) as well as high histological grade (=0.008), negative estrogen ( =0.045) and negative progesterone ( =0.029) receptor status were associated with shorter DFS. High N{sup SUV(}=0.035) and N{sup MTV(} =0.035) and T{sup MTV(}=0.035)as well as high histological grade (=0.012) and negative estrogen receptor status ( =0.009)were associated with shorted OS. N{sup SUV,} N{sup MTVa}nd T{sup MTw}ere found to be significantly associated with high histological grade ( =0.005). However, those failed to be statistically significant prognostic factors on multivariate analysis PET indices seem to be useful in the preoperative evaluation of prognosis in patients with operable primary breast cancer, N{sup SUV,} N{sup MTVa}nd T{sup MTVm}ight be considerable factors associated with patient outcome in operable breast cancer.

  10. Solitary Fibrous Tumors of the Pleura of the Thorax: CT and FDG PET Characteristics in a Tertiary Referral Center.

    Science.gov (United States)

    Yeom, Yoo Kyung; Kim, Mi Young; Lee, Hyun Joo; Kim, Sung-Soo

    2015-09-01

    This study was conducted to describe the characteristics of a solitary fibrous tumor of the pleura (SFTP) on chest CT, and FDG PET. Furthermore, we analyze the prognosis of SFTP using large data confirmed in a tertiary referral hospital. From January 1997 to March 2012, 41 patients (21 males and 20 females; median age: 59 yr; age range: 27-85 yr) who were pathologically diagnosed with SFTP were consecutively examined. The CT findings, including the size, shape, homogeneity, and anatomic location (chest wall, intrapulmonary/fissure space, diaphragm, and mediastinum) of the SFTP, the F-fluorodeoxyglucose positron emission tomography (FDG PET) findings, and the histopathology findings were evaluated. Most of the patients had a mass-type (70.7%), oval/elliptical (80.5%), and homogeneous (70.7%) SFTP with a median diameter of 6.0 cm (range: 1-17). The most common anatomic location was the chest wall (43.9%), followed by the intrapulmonary/fissure space (22.0%), diaphragm (22.0%), and mediastinum (12.3%). For all the 9 patients, the mean maxSUV was 2.9 (SD = 1.16; range: 1.2-4.9) on FDG PET. The malignant SFTP (median: 3.6, range: 2.5-4.9) showed more hypermetabolic than benign SFTP (median: 2.0, range: 1.2-3.1) (P = 0.049). Through familiarity with the various features of the SFTP with regard to its size and location on the preoperative CT and FDG PET, we can add this rare pleural neoplasm to the differential diagnosis of other more common conditions. Moreover, an appropriate treatment choice can be made.

  11. The role of combined Ga-DOTANOC and (18)FDG PET/CT in the management of patients with pancreatic neuroendocrine tumors.

    Science.gov (United States)

    Partelli, Stefano; Rinzivillo, Maria; Maurizi, Angela; Panzuto, Francesco; Salgarello, Matteo; Polenta, Vanessa; Delle Fave, Gianfranco; Falconi, Massimo

    2014-01-01

    The aim of this study was to evaluate the effect of combined (68)Ga and (18)F-FDG PET/CT on treatment management for patients with pancreatic neuroendocrine tumor (PNET). Between January 2012 and April 2014, 49 consecutive patients with a cytologically and/or histologically proven diagnosis of PNET underwent combined (68)Ga and (18)FDG PET/CT on the same day. The study group consisted of 21 males and 28 females with a median age of 59 years. Disease detection was achieved in 48 out of the 49 cases with (68)Ga imaging, and in 36 of the 49 cases with (18)FDG PET/CT. These results corresponded to sensitivities of 98% for (68)Ga versus 73% for (18)FDG PET/CT. Patients with NET-G1/NET-G2 had a positive (68)Ga and negative (18)FDG PET/CT in 13 cases, whereas both (68)Ga and (18)FDG PET/CT were positive in 27 cases. Patients with NEC-G3 were positive by both (68)Ga and (18)FDG PET/CT in 7 cases and positive only by (18)FDG in 1 case. Another NEC-G3 patient was only positive by (68)Ga PET/CT. The median Ki67 was 7% for (68)Ga PET/CT-positive tumors and 10% for tumors with both (68)Ga and (18)FDG PET/CT positivity (p = 0.130). Half of the patients with a prevalent uptake of (18)FDG (n = 7) had an NEC-G3 compared with 12% of patients with a prevalent uptake of (68)Ga (p = 0.012). There were no significant differences between patients with positive (68)Ga and those with positive (18)FDG with regards to treatment choice. The association of (18)FDG slightly increases sensitivity of (68)Ga PET/CT alone in the diagnosis of PNET. A combined dual tracer PET/CT does not influence the choice of treatment strategy.

  12. Does the presence of tumor-induced cortical bone destruction at CT have any prognostic value in newly diagnosed diffuse large B-cell lymphoma?

    Energy Technology Data Exchange (ETDEWEB)

    Adams, Hugo J.A.; Nievelstein, Rutger A.J.; Kwee, Thomas C. [University Medical Center Utrecht, Department of Radiology and Nuclear Medicine, Utrecht (Netherlands); Klerk, John M.H. de [Meander Medical Center, Department of Nuclear Medicine, Amersfoort (Netherlands); Fijnheer, Rob [Meander Medical Center, Department of Hematology, Amersfoort (Netherlands); Heggelman, Ben G.F. [Meander Medical Center, Department of Radiology, Amersfoort (Netherlands); Dubois, Stefan V. [Meander Medical Center, Department of Pathology, Amersfoort (Netherlands)

    2015-05-01

    To determine the prognostic value of tumor-induced cortical bone destruction at computed tomography (CT) in newly diagnosed diffuse large B-cell lymphoma (DLBCL). This retrospective study included 105 patients with newly diagnosed DLBCL who had undergone CT and bone marrow biopsy (BMB) before R-CHOP (rituximab, cyclophosphamide, hydroxydaunorubicin, Oncovin, and prednisolone) chemo-immunotherapy. Cox regression analyses were used to determine the associations of cortical bone status at CT (absence vs. presence of tumor-induced cortical bone destruction), BMB findings (negative vs. positive for lymphomatous involvement), and dichotomized National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI) strata (low risk vs. high risk) with progression-free survival (PFS) and overall survival (OS). Univariate Cox regression analysis indicated that cortical bone status at CT was no significant predictor of either PFS or OS (p = 0.358 and p = 0.560, respectively), whereas BMB findings (p = 0.002 and p = 0.013, respectively) and dichotomized NCCN-IPI risk strata (p = 0.002 and p = 0.003, respectively) were significant predictors of both PFS and OS. In the multivariate Cox proportional hazards model, only the dichotomized NCCN-IPI score was an independent predictive factor of PFS and OS (p = 0.004 and p = 0.003, respectively). The presence of tumor-induced cortical bone destruction at CT was not found to have any prognostic implications in newly diagnosed DLBCL. (orig.)

  13. Termoablação a laser de tumores hepáticos: atualização Laser-induced thermoablation of hepatic tumors: an update review

    Directory of Open Access Journals (Sweden)

    Giuseppe D'Ippolito

    2004-06-01

    Full Text Available A termoablação por raio laser de tumores hepáticos tem despontado como alternativa válida de tratamento em pacientes que não são candidatos a ressecção cirúrgica. O procedimento pode ser realizado por via percutânea, laparoscópica ou por laparotomia, e orientado por métodos de imagem. O objetivo deste trabalho é apresentar o mecanismo de ação deste método, bem como as suas indicações, contra-indicações, complicações e resultados clínicos, baseados em revisão bibliográfica.Laser-induced thermoablation has been used as a reliable method for producing coagulation necrosis in hepatic tumors in patients who are not suitable for surgical treatment. The procedure can be performed percutaneously, using image-guiding methods, by open laparotomy or laparoscopy. We review the current literature and discuss the principles, indications, complications and clinical results as well as the potential limitations and contraindications of this novel technique.

  14. Hepatic Kaposi sarcoma. Sonographic and computed tomographic aspects

    Energy Technology Data Exchange (ETDEWEB)

    Defalque, D.; Menu, Y.; Nahum, H.; Matheron, S.; Girard, P.M.

    1988-10-01

    AIDS-related Kaposi sarcoma is most often multicentric and extensive. Hepatic involvement is unusual and asymptomatic. An anicteric cholestasis may exist. Ultrasonography shows a pedicular echogenic infiltration and a heterogeneous parenchyma with small hyperechoic nodules. On CT, these hypodense lesions are related to the involvement of the hepatic pedicle. This is linked to angiosarcomatous tumorous tissue infiltration of the liver evolving along portal branches. In a patient suffering from cutaneous or digestive Kaposi sarcoma lesions, these radiological aspects are suggestive of hepatic involvement.

  15. Image-Based Analysis of Tumor Localization After Intra-Arterial Delivery of Technetium-99m-Labeled SPIO Using SPECT/CT and MRI

    Directory of Open Access Journals (Sweden)

    In Joon Lee MD, PhD

    2017-01-01

    Full Text Available The aim of this study is to evaluate the localization of 99mTc-labeled dextran-coated superparamagnetic iron oxide (SPIO nanoparticles to the liver tumor using image-based analysis. We delivered 99mTc-SPIO intravenously or intra-arterially (IA with/without Lipiodol to compare the tumor localization by gamma scintigraphy, single-photon emission computed tomography (SPECT, and magnetic resonance imaging (MRI in a rabbit liver tumor. The gamma and SPECT image-based analysis shows that the uptake ratio of the tumor to the normal liver parenchyma is highest after delivery of 99mTc-SPIO with Lipiodol IA and that well correlates with the trend of the signal decrease in the liver MRIs. Intra-arterial delivery of SPIO with Lipiodol might be a good drug delivery system targeting the hepatic tumors, as confirmed by image-based analysis.

  16. Image-Based Analysis of Tumor Localization After Intra-Arterial Delivery of Technetium-99m-Labeled SPIO Using SPECT/CT and MRI.

    Science.gov (United States)

    Lee, In Joon; Park, Ji Yong; Kim, Young-Il; Lee, Yun-Sang; Jeong, Jae Min; Kim, Jaeil; Kim, Euishin Edmund; Kang, Keon Wook; Lee, Dong Soo; Jeong, Seonji; Kim, Eun Jeong; Kim, Young Il; Chung, Jin Wook

    2017-01-01

    The aim of this study is to evaluate the localization of (99m)Tc-labeled dextran-coated superparamagnetic iron oxide (SPIO) nanoparticles to the liver tumor using image-based analysis. We delivered (99m)Tc-SPIO intravenously or intra-arterially (IA) with/without Lipiodol to compare the tumor localization by gamma scintigraphy, single-photon emission computed tomography (SPECT), and magnetic resonance imaging (MRI) in a rabbit liver tumor. The gamma and SPECT image-based analysis shows that the uptake ratio of the tumor to the normal liver parenchyma is highest after delivery of (99m)Tc-SPIO with Lipiodol IA and that well correlates with the trend of the signal decrease in the liver MRIs. Intra-arterial delivery of SPIO with Lipiodol might be a good drug delivery system targeting the hepatic tumors, as confirmed by image-based analysis.

  17. Evaluation of Clinical Contributions Provided by Addition of the Brain, Calvarium, and Scalp to the Limited Whole Body Imaging Area in FDG-PET/CT Tumor Imaging

    Directory of Open Access Journals (Sweden)

    Bekir Tasdemir

    2014-01-01

    Full Text Available Purpose. The aim of this study was to detect additional findings in whole body FDG-PET/CT scan including the brain, calvarium, and scalp (compared to starting from the base of the skull in cancer patients and to determine contributions of these results to tumor staging and treatment protocols. Materials and Methods. We noted whether the findings related to the brain, calvarium, and scalp in 1359 patients had a potential to modify staging of the disease, chemotherapy protocol, radiotherapy protocol, and surgical management. We identified rates of metastatic findings on the brain, calvarium, and scalp according to the tumor types on FDG-PET/CT scanning. Results. We found FDG-PET/CT findings for malignancy above the base of the skull in 42 patients (3.1%, one of whom was a patient with an unknown primary tumor. Twenty-two of the metastatic findings were in the brain, 16 were in the calvarium, and two were in the scalp. Conclusion. This study has demonstrated that addition of the brain to the limited whole body FDG-PET/CT scanning may provide important contributions to the patient’s clinical management especially in patients with lung cancer, bladder cancer, malignant melanoma, breast cancer, stomach cancer, and unknown primary tumor.

  18. TU-C-12A-11: Comparisons Between Cu-ATSM PET and DCE-CT Kinetic Parameters in Canine Sinonasal Tumors

    Energy Technology Data Exchange (ETDEWEB)

    La Fontaine, M; Bradshaw, T [University of Wisconsin, Madison, Wisconsin (United States); Kubicek, L [University of Florida, Gainesville, Florida (United States); Forrest, L [University of Wisconsin-Madison, Madison, Wisconsin (United States); Jeraj, R [University of Wisconsin, Madison, WI (United States)

    2014-06-15

    Purpose: Regions of poor perfusion within tumors may be associated with higher hypoxic levels. This study aimed to test this hypothesis by comparing measurements of hypoxia from Cu-ATSM PET to vasculature kinetic parameters from DCE-CT kinetic analysis. Methods: Ten canine patients with sinonasal tumors received one Cu-ATSM PET/CT scan and three DCE-CT scans prior to treatment. Cu-ATSM PET/CT and DCE-CT scans were registered and resampled to matching voxel dimensions. Kinetic analysis was performed on DCE-CT scans and for each patient, the resulting kinetic parameter values from the three DCE-CT scans were averaged together. Cu-ATSM SUVs were spatially correlated (r{sub spatial}) on a voxel-to-voxel basis against the following DCE-CT kinetic parameters: transit time (t{sub 1}), blood flow (F), vasculature fraction (v{sub 1}), and permeability (PS). In addition, whole-tumor comparisons were performed by correlating (r{sub ROI}) the mean Cu-ATSM SUV (SUV{sub mean}) with median kinetic parameter values. Results: The spatial correlations (r{sub spatial}) were poor and ranged from -0.04 to 0.21 for all kinetic parameters. These low spatial correlations may be due to high variability in the DCE-CT kinetic parameter voxel values between scans. In our hypothesis, t{sub 1} was expected to have a positive correlation, while F was expected to have a negative correlation to hypoxia. However, in wholetumor analysis the opposite was found for both t{sub 1} (r{sub ROI} = -0.25) and F (r{sub ROI} = 0.56). PS and v{sub 1} may depict angiogenic responses to hypoxia and found positive correlations to Cu-ATSM SUV for PS (r{sub ROI} = 0.41), and v{sub 1} (r{sub ROI} = 0.57). Conclusion: Low spatial correlations were found between Cu-ATSM uptake and DCE-CT vasculature parameters, implying that poor perfusion is not associated with higher hypoxic regions. Across patients, the most hypoxic tumors tended to have higher blood flow values, which is contrary to our initial hypothesis. Funding

  19. The value of 68Ga-DOTATATE PET/CT in diagnosis and management of neuroendocrine tumors compared to current FDA approved imaging modalities: a review of literature

    Science.gov (United States)

    Mojtahedi, Alireza; Thamake, Sanjay; Tworowska, Izabela; Ranganathan, David; Delpassand, Ebrahim S

    2014-01-01

    Neuroendocrine tumors (NETs) are rare group of neoplasms arising from nervous and endocrine systems. Somatostatin analogue imaging is a functional imaging modality of choice for evaluating the NETs. Recent availability of positron emitting radioisotope labeled somatostatin analogues to image neuroendocrine cancers, has raised the interests to use this new imaging modality in management of patients with NETs. 68Ga-DOTATATE PET/CT has demonstrated superiority in lesion detection compared to Octreoscan, MIBG scintigraphy and MRI. In this article, we reviewed the published studies evaluating the role of 68Ga-DOTATATE PET in diagnosis and management of patients with neuroendocrine tumors and comparing it to current FDA approved imaging modalities including Octreoscan, MIBG scintigraphy, 18F FDG PET/CT, CT and MRI. PMID:25143861

  20. The value of (68)Ga-DOTATATE PET/CT in diagnosis and management of neuroendocrine tumors compared to current FDA approved imaging modalities: a review of literature.

    Science.gov (United States)

    Mojtahedi, Alireza; Thamake, Sanjay; Tworowska, Izabela; Ranganathan, David; Delpassand, Ebrahim S

    2014-01-01

    Neuroendocrine tumors (NETs) are rare group of neoplasms arising from nervous and endocrine systems. Somatostatin analogue imaging is a functional imaging modality of choice for evaluating the NETs. Recent availability of positron emitting radioisotope labeled somatostatin analogues to image neuroendocrine cancers, has raised the interests to use this new imaging modality in management of patients with NETs. (68)Ga-DOTATATE PET/CT has demonstrated superiority in lesion detection compared to Octreoscan, MIBG scintigraphy and MRI. In this article, we reviewed the published studies evaluating the role of (68)Ga-DOTATATE PET in diagnosis and management of patients with neuroendocrine tumors and comparing it to current FDA approved imaging modalities including Octreoscan, MIBG scintigraphy, (18)F FDG PET/CT, CT and MRI.

  1. [Increase of alpha-fetoprotein in pancreatic endocrine tumors with hepatic metastases. Apropos of 2 cases].

    Science.gov (United States)

    Lesur, G; Bergemer, A M; Turner, L; Parlier, H; Bernades, P; Dupuy, P

    1996-03-01

    We report two cases of metastatic non-functioning pancreatic endocrine tumour with very elevated plasma levels of alpha-fetoprotein. In these two cases, serial plasma levels of alpha-fetoprotein, initially normal, correlated well with hepatic tumour progression and were associated with fatal outcome. These results suggest that elevated plasma concentration of alpha-fetoprotein may be caused by metastatic pancreatic endocrine tumour and than alpha-fetoprotein serial measurement may be useful in prognostic evaluation.

  2. Effect of Sipjeondaebo-Tang on Cancer-Induced Anorexia and Cachexia in CT-26 Tumor-Bearing Mice

    Science.gov (United States)

    Jung, Ki Yong; Woo, Sang-Mi; Jun, Chan-Yong; Park, Jong Hyeong; Shin, Yong Cheol; Ko, Seong-Gyu

    2014-01-01

    Cancer-associated anorexia and cachexia are a multifactorial condition described by a loss of body weight and muscle with anorexia, asthenia, and anemia. Moreover, they correlate with a high mortality rate, poor response to chemotherapy, poor performance status, and poor quality of life. Cancer cachexia is regulated by proinflammatory cytokines such as interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), and tumor necrosis factor-α (TNF-α). In addition, glucagon like peptide-1 (GIP-1), peptide YY (PYY), ghrelin, and leptin plays a crucial role in food intake. In this study, we investigated the therapeutic effects of one of the traditional herbal medicines, Sipjeondaebo-tang (Juzen-taiho-to in Japanese; SJDBT), on cancer anorexia and cachexia in a fundamental mouse cancer anorexia/cachexia model, CT-26 tumor-bearing mice. SJDBT was more significantly effective in a treatment model where it was treated after anorexia and cachexia than in a prevention model where it was treated before anorexia and cachexia on the basis of parameters such as weights of muscles and whole body and food intakes. Moreover, SJDBT inhibited a production of IL-6, MCP-1, PYY, and GLP-1 and ameliorated cancer-induced anemia. Therefore, our in vivo studies provide evidence on the role of SJDBT in cancer-associated anorexia and cachexia, thereby suggesting that SJDBT may be useful for treating cancer-associated anorexia and cachexia. PMID:24963216

  3. Effect of Sipjeondaebo-tang on cancer-induced anorexia and cachexia in CT-26 tumor-bearing mice.

    Science.gov (United States)

    Choi, Youn Kyung; Jung, Ki Yong; Woo, Sang-Mi; Yun, Yee Jin; Jun, Chan-Yong; Park, Jong Hyeong; Shin, Yong Cheol; Cho, Sung-Gook; Ko, Seong-Gyu

    2014-01-01

    Cancer-associated anorexia and cachexia are a multifactorial condition described by a loss of body weight and muscle with anorexia, asthenia, and anemia. Moreover, they correlate with a high mortality rate, poor response to chemotherapy, poor performance status, and poor quality of life. Cancer cachexia is regulated by proinflammatory cytokines such as interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), and tumor necrosis factor- α (TNF- α). In addition, glucagon like peptide-1 (GIP-1), peptide YY (PYY), ghrelin, and leptin plays a crucial role in food intake. In this study, we investigated the therapeutic effects of one of the traditional herbal medicines, Sipjeondaebo-tang (Juzen-taiho-to in Japanese; SJDBT), on cancer anorexia and cachexia in a fundamental mouse cancer anorexia/cachexia model, CT-26 tumor-bearing mice. SJDBT was more significantly effective in a treatment model where it was treated after anorexia and cachexia than in a prevention model where it was treated before anorexia and cachexia on the basis of parameters such as weights of muscles and whole body and food intakes. Moreover, SJDBT inhibited a production of IL-6, MCP-1, PYY, and GLP-1 and ameliorated cancer-induced anemia. Therefore, our in vivo studies provide evidence on the role of SJDBT in cancer-associated anorexia and cachexia, thereby suggesting that SJDBT may be useful for treating cancer-associated anorexia and cachexia.

  4. Sleeping Beauty insertional mutagenesis in mice identifies drivers of steatosis-associated hepatic tumor.

    Science.gov (United States)

    Tschida, Barbara R; Temiz, Nuri A; Kuka, Timothy P; Lee, Lindsey A; Riordan, Jesse D; Tierrablanca, Carlos A; Hullsiek, Robert; Wagner, Sandra; Hudson, Wendy A; Linden, Michael A; Amin, Khalid; Beckmann, Pauline J; Heuer, Rachel A; Sarver, Aaron L; Yang, Ju Dong; Roberts, Lewis R; Nadeau, Joseph H; Dupuy, Adam J; Keng, Vincent W; Largaespada, David

    2017-10-09

    Hepatic steatosis is a strong risk factor for the development of hepatocellular carcinoma (HCC), yet little is known about the molecular pathology associated with this factor. In this study, we performed a forward genetic screen using Sleeping Beauty (SB) transposon insertional mutagenesis in mice treated to induce hepatic steatosis, and compared the results to human HCC data. In humans, we determined that steatosis increased the proportion of female HCC patients, a pattern also reflected in mice. Our genetic screen identified 203 candidate steatosis-associated HCC genes, many of which are altered in human HCC and are members of established HCC-driving signaling pathways. The protein kinase A/cyclic AMP signaling pathway was altered frequently in mouse and human steatosis-associated HCC. We found that activated PKA expression drove steatosis-specific liver tumorigenesis in a mouse model. Another candidate HCC driver, the N-acetyltransferase NAT10, which we found to be overexpressed in human steatosis-associated HCC and associated with decreased survival in human HCC, also drove liver tumorigenesis in a steatotic mouse model. This study identifies genes and pathways promoting HCC that may represent novel targets for prevention and treatment in the context of hepatic steatosis, an area of rapidly growing clinical significance. Copyright ©2017, American Association for Cancer Research.

  5. Incidental visualization of hepatic hemangioma by Tc-99m-HDP bone scan

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Yong An; O, Joo Hyun; Kim, Jung Ho; Yoo, Ie Ryung; Kim, Sung Hoon; Sohn, Hyung Sun; Chung, Soo Kyo [College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2005-08-15

    Hepatic hemangioma is the most common benign liver tumor and must be considered in the differential diagnosis of other space occupying hepatic masses. A 54-year-old man was referred to evaluate bone metastases of lung adenocarcinoma. In our case, we thought that a focal hepatic uptake in the bone scan was a metastatic lesion because of underlying lung adenocarcinoma. However, the findings of abdominal CT and Tc-99m RBC scan results were deemed to be characteristic of hepatic hemangioma. The biopsy of the lesion was not performed.

  6. SU-F-R-54: CT-Texture Based Early Tumor Treatment Response Assessment During Radiation Therapy Delivery: Small Cell Versus Non-Small Cell Lung Cancers

    Energy Technology Data Exchange (ETDEWEB)

    Paul, J; Gore, E; Li, X [Medical College of Wisconsin, Milwaukee, WI (United States)

    2016-06-15

    Purpose: Tumor treatment response may potentially be assessed during radiation therapy (RT) by analyzing changes in CT-textures. We investigated the different early RT-responses between small cell (SCLC) and non-small cell lung cancer (NSCLC) as assessed by CT-texture. Methods: Daily diagnostic-quality CT acquired during routine CT-guided RT using a CT-on-Rails for 13-NSCLC and 5-SCLC patients were analyzed. These patient had ages ranging from 45–78 and 38–63 years, respectively, for NSCLC and SCLC groups, and tumor-stages ranging from T2-T4, and were treated with either RT or chemotherapy and RT with 45–66Gy/ 20–34 fractions. Gross-tumor volume (GTV) contour was generated on each daily CT by populating GTV contour from simulation to daily CTs with manual editing if necessary. CT-texture parameters, such as Hounsfield Unit (HU) histogram, mean HU, skewness, kurtosis, entropy, and short-run high-gray level emphasis (SRHGLE), were calculated in GTV from each daily CT-set using an in house software tool. Difference in changes of these texture parameters during RT between NSCLC and SCLC was analyzed and compared with GTV volume changes. Results: Radiation-induced changes in CT-texture were different between SCLC and NSCLC. Average changes from first to the last fractions for NSCLC and SCLC in GTV were 28±10(12–44) and 30±15(11–47) HU (mean HU reduction), 12.7% and 18.3% (entropy), 50% and 55% (SRHGLE), 19% and 22% (kurtosis), and 5.2% and 22% (skewness), respectively. Good correlation in kurtosis changes and GTV was seen (R{sup 2}=0.8923) for SCLC, but not for NSCLC (R{sup 2}=0.4748). SCLC had better correlations between GTV volume reduction and entropy (SCLC R{sup 2}=0.847; NSCLC R{sup 2}=0.6485), skewness (SCLC R{sup 2}=0.935; NSCLC R{sup 2}=0.7666), or SRHGLE (SCLC R{sup 2}=0.9619; NSCLC R{sup 2}=0.787). Conclusion: NSCLC and SCLC exhibited different early RT-responses as assessed by CT-texture changes during RT-delivery. The observed larger changes in

  7. FDG-PET/CT for detection of the unknown primary head and neck tumor

    DEFF Research Database (Denmark)

    Johansen, Jørgen; Petersen, H; Godballe, C

    2011-01-01

    The benefit of FDG-PET in addition to standard work-up for carcinoma of unknown primary (CUP) and metastatic neck lesions has been widely described. However, most studies have been of retrospective nature with large heterogeneities in terms of workup standards and patient selection leaving severa...... questions to be answered regarding the real value of PET in CUP. We here present an overview of the literature with focus on the current evidence of FDG-PET in detecting a primary in CUP and discuss the rationale of PET/CT in the diagnostic armamentarium of CUP.......The benefit of FDG-PET in addition to standard work-up for carcinoma of unknown primary (CUP) and metastatic neck lesions has been widely described. However, most studies have been of retrospective nature with large heterogeneities in terms of workup standards and patient selection leaving several...

  8. CT Perfusion Characteristics Identify Metastatic Sites in Liver

    Directory of Open Access Journals (Sweden)

    Yuan Wang

    2015-01-01

    Full Text Available Tissue perfusion plays a critical role in oncology because growth and migration of cancerous cells require proliferation of new blood vessels through the process of tumor angiogenesis. Computed tomography (CT perfusion is an emerging functional imaging modality that measures tissue perfusion through dynamic CT scanning following intravenous administration of contrast medium. This noninvasive technique provides a quantitative basis for assessing tumor angiogenesis. CT perfusion has been utilized on a variety of organs including lung, prostate, liver, and brain, with promising results in cancer diagnosis, disease prognostication, prediction, and treatment monitoring. In this paper, we focus on assessing the extent to which CT perfusion characteristics can be used to discriminate liver metastases from neuroendocrine tumors from normal liver tissues. The neuroendocrine liver metastases were analyzed by distributed parameter modeling to yield tissue blood flow (BF, blood volume (BV, mean transit time (MTT, permeability (PS, and hepatic arterial fraction (HAF, for tumor and normal liver. The result reveals the potential of CT perfusion as a tool for constructing biomarkers from features of the hepatic vasculature for guiding cancer detection, prognostication, and treatment selection.

  9. PET/CT Based In Vivo Evaluation of 64Cu Labelled Nanodiscs in Tumor Bearing Mice

    DEFF Research Database (Denmark)

    Huda, Pie; Binderup, Tina; Pedersen, Martin Cramer

    2015-01-01

    64Cu radiolabelled nanodiscs based on the 11 α-helix MSP1E3D1 protein and 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphatidylcholine lipids were, for the first time, followed in vivo by positron emission tomography for evaluating the biodistribution of nanodiscs. A cancer tumor bearing mouse model...... radiolabelling of proteins via a chelating agent, DOTA, was developed. The reaction was performed at sufficiently mild conditions to be compatible with labelling of the protein part of a lipid-protein particle while fully conserving the particle structure including the amphipathic protein fold....

  10. 68Ga-PSMA PET/CT Imaging Predicting Intraprostatic Tumor Extent, Extracapsular Extension and Seminal Vesicle Invasion Prior to Radical Prostatectomy in Patients with Prostate Cancer.

    Science.gov (United States)

    von Klot, Christoph-Alexander J; Merseburger, Axel S; Böker, Alena; Schmuck, Sebastian; Ross, Tobias L; Bengel, Frank M; Kuczyk, Markus A; Henkenberens, Christoph; Christiansen, Hans; Wester, Hans-Jürgen; Solass, Wiebke; Lafos, Marcel; Derlin, Thorsten

    2017-12-01

    68Ga-labeled prostate-specific membrane antigen (PSMA) ligand positron emission tomography/computed tomography (PET/