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Sample records for preoperative pns ct

  1. Preoperative PET/CT in early-stage breast cancer

    DEFF Research Database (Denmark)

    Bernsdorf, M; Berthelsen, A K; Timmermans-Wielenga, Vera

    2012-01-01

    The aim of this study was to assess the diagnostic and therapeutic impact of preoperative positron emission tomography and computed tomography (PET/CT) in the initial staging of patients with early-stage breast cancer.......The aim of this study was to assess the diagnostic and therapeutic impact of preoperative positron emission tomography and computed tomography (PET/CT) in the initial staging of patients with early-stage breast cancer....

  2. Preoperative CT evaluation of adenocarcinoma of the gastroesophageal junction

    International Nuclear Information System (INIS)

    Bennett, J.D.; Lefcoe, M.S.; Finley, R.; Yoshi, C.; Inculet, R.

    1988-01-01

    A retrospective review was undertaken of 53 preoperative computed tomographic (CT) scans obtained between March 1983 and April 1988 from patients undergoing surgery for adenocarcinoma of the gastroesophageal junction, and results were correlated with the surgical-pathologic findings. CT was unreliable in predicting aortic, pericardial, or pancreatic invasion (sensitivity, 0/8; specificity, 41/45). Of 45 pathologically positive nodal groups, the largest node measured on CT scans was 10 mm or less in 36 cases. The accuracy of preoperative CT in staging adenocarcinoma of the gastroesophageal junction is limited by its low sensitivity in detecting local invasion. Nodal size as measured with CT is not a reliable indicator of metastatic disease

  3. Preoperative CT evaluation on nasal cavity for transsphenoidal approach

    International Nuclear Information System (INIS)

    Saeki, Naokatsu; Yamaura, Akira; Hoshi, Seiichiro; Sunada, Souichi; Sunami, Kenro

    1997-01-01

    Preoperative bone CT scans sliced parallel to the surgical plane were evaluated in 32 cases of transsphenoidal surgery. This method predicted patients with narrow nasal cavity, and helped to determine the rhinological maneuvers for providing a wider operative field. In addition, it helps to plan the need and extent of sella floor removal in re-operated cases. There was relatively little difference in the width and length of the nasal cavity between acromegalic and non-acromegalic patients. Hence, bone CT scans are useful in the preoperative evaluation of patients undergoing transsphenoidal surgery. (author)

  4. Aneurysms of proximal pulmonary arteries: CT diagnosis and preoperative assessment

    International Nuclear Information System (INIS)

    Iula, G.; Ziviello, R.; Del Vecchio, W.

    1996-01-01

    We reviewed our experience with proximal pulmonary artery aneurysm (PPAA) to determine whether accurate preoperative evaluation (crucial to differential diagnosis and surgical planning) had been obtained on the basis of CT study alone. Three patients with PPAA were studied with contrast-enhanced CT. We evaluated the size and shape of PPAAs, their proximal and distal extent, eventual presence of intraluminal thrombi, dissection, perianeurysmal fibrosis, and rupture. The results were compared with surgical findings. In two patients the aneurysm involved the pulmonary trunk and both the right and left arteries origin. In one patient the aneurysm extended from the left artery origin to the hilum of the left lung. Contrast-enhanced CT alone allows detection of aneurysm in the pulmonary trunk, in right or left pulmonary arteries with precise preoperative evaluation of the extent, size, shape, and complications. The CT imaging was unable to establish the etiologic origin and presence of small intimal tears in PPAA. (orig.)

  5. Lower rectal cancer. Preoperative staging with CT air enema technique

    International Nuclear Information System (INIS)

    Kanazawa, Amane; Fujii, Shouichi; Iwata, Seiichirou

    2009-01-01

    Preoperative assessment of rectal cancer wall invasion is an important indication of the need for lateral side wall dissection. The purpose of this study was to determine the accuracy rates and clinical usefulness of air-enema CT in preoperative staging of lower rectal cancer. A total of 88 patients diagnosed with lower rectal cancer were examined with an air-enema CT preoperatively and had surgical resection performed. One group was T1-T2 while the other was T3-T4. Forty-two patients were T1-T2, and 46 patients were T3-T4. In univariate and multivariate analysis, irregularities of the rectal wall and spiculated appearance of the rectal wall were significant predictive factors in T3-T4. In patients with air-enema CT findings of rectal wall irregularities and speculated appearance, the accuracy rate for detecting T3-T4 was 85.2-86.45 percent. These results show that air-enema CT is useful for determining the preoperative staging of lower rectal cancer and indication of the need for lateral side wall dissection. (author)

  6. Preoperative 4D CT Localization of Nonlocalizing Parathyroid Adenomas by Ultrasound and SPECT-CT.

    Science.gov (United States)

    Hinson, Andrew M; Lee, David R; Hobbs, Bradley A; Fitzgerald, Ryan T; Bodenner, Donald L; Stack, Brendan C

    2015-11-01

    To evaluate 4-dimensional (4D) computed tomography (CT) for the localization of parathyroid adenomas previously considered nonlocalizing on ultrasound and single-photon emission CT with CT scanning (SPECT-CT). To measure radiation exposure associated with 4D-CT and compared it with SPECT-CT. Case series with chart review. University tertiary hospital. Nineteen adults with primary hyperparathyroidism who underwent preoperative 4D CT from November 2013 through July 2014 after nonlocalizing preoperative ultrasound and technetium-99m SPECT-CT scans. Sensitivity, specificity, predictive values, and accuracy of 4D CT were evaluated. Nineteen patients (16 women and 3 men) were included with a mean age of 66 years (range, 39-80 years). Mean preoperative parathyroid hormone level was 108.5 pg/mL (range, 59.3-220.9 pg/mL), and mean weight of the excised gland was 350 mg (range, 83-797 mg). 4D CT sensitivity and specificity for localization to the patient's correct side of the neck were 84.2% and 81.8%, respectively; accuracy was 82.9%. The sensitivity for localizing adenomas to the correct quadrant was 76.5% and 91.5%, respectively; accuracy was 88.2%. 4D CT radiation exposure was significantly less than the radiation associated with SPECT-CT (13.8 vs 18.4 mSv, P = 0.04). 4D CT localizes parathyroid adenomas with relatively high sensitivity and specificity and allows for the localization of some adenomas not observed on other sestamibi-based scans. 4D CT was also associated with less radiation exposure when compared with SPECT-CT based on our study protocol. 4D CT may be considered as first- or second-line imaging for localizing parathyroid adenomas in the setting of primary hyperparathyroidism. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  7. CT evaluation of preoperative cochlear implantation cochlear implantation

    International Nuclear Information System (INIS)

    Tan Xiuzhong; Zhong Lansheng; Lan Bowen; Huang Yaosheng; Du Baowen; Zhu Jian

    2004-01-01

    Objective: To evaluate CT scan as a preoperative evaluation for cochlear implantation candidates. Methods: Axial high-resolution temporal bone CT and three-dimensional reconstruction of inner ear were performed in 93 patients with sensorineural hearing loss. results: Among 81 patients with congenital sensorineural deafness, Mondini malformation was seen in 7 case (13 ears); large vestibular aqueduct syndrome (LVAS) was revealed in 5 cases (8 ears); and inner ear ossification was found in 1 case (2 ears). In 1 case (2 ears) of inner ear fibrosis, reduced cochlear signal was noted on MRI but no unremarkable findings was shown on CT scan, however, in the operation, the device could not inserted into the basal circle of the cochlea, due to fibrous obliteration. In 12 patients with post-speech deafness, chronic suppurative tympanitis was seen in 2 cases (4 ears), and inner ear ossification was revealed in 1 case (2 ears). Conclusion: CT plays an indispensable role in the pre-operative evaluation of cochlear implantation. T 2 -weighted FSE-MRI of the inner ear is a useful complementary to CT scan. (authors)

  8. Spiral CT versus conventional CT in the preoperative assessment of metallic intraocular foreign bodies

    International Nuclear Information System (INIS)

    Prokesch, R.; Bankier, A.; Ba-Ssalamah, A.; Imhof, H.; Lakits, A.; Scholda, C.

    1998-01-01

    Purpose: To compare the effectiveness of spiral CT versus conventional CT in the preoperative assessment of metallic intraocular foreign bodies. Results: All foreign bodies were detected by each scanning modality on the axial and on the reconstructed planes. The quality of the axial images was similar for spiral and conventional CT. The spiral technique provided high-quality reconstructed images which allowed accurate localization of the foreign bodies in all cases. Reconstructions by conventional technique were inadequate for preoperative assessment. The examination time for the total orbital volume was 18 s for spiral CT and 52 s for conventional CT. Radiation dose delivered to the lens was 35 mGy for spiral CT and 56 mGy for conventional CT axial scanning. Conclusion: Spiral CT multiplanar offers several significant advantages for the preoperative assessment of metallic intraocular foreign bodies compared to the conventional CT technique in clinical practice, including short examination time, minimized motion artifacts, reduced radiation exposure, and accurate localization. (orig.) [de

  9. Preoperative staging of lung cancer with combined PET-CT

    DEFF Research Database (Denmark)

    Fischer, Barbara; Lassen, Ulrik; Mortensen, Jann

    2009-01-01

    BACKGROUND: Fast and accurate staging is essential for choosing treatment for non-small-cell lung cancer (NSCLC). The purpose of this randomized study was to evaluate the clinical effect of combined positron-emission tomography and computed tomography (PET-CT) on preoperative staging of NSCLC...... one of the following: a thoracotomy with the finding of pathologically confirmed mediastinal lymph-node involvement (stage IIIA [N2]), stage IIIB or stage IV disease, or a benign lung lesion; an exploratory thoracotomy; or a thoracotomy in a patient who had recurrent disease or death from any cause...

  10. Preoperative CT planning of screw length in arthroscopic Latarjet.

    Science.gov (United States)

    Hardy, Alexandre; Gerometta, Antoine; Granger, Benjamin; Massein, Audrey; Casabianca, Laurent; Pascal-Moussellard, Hugues; Loriaut, Philippe

    2018-01-01

    The Latarjet procedure has shown its efficiency for the treatment of anterior shoulder dislocation. The success of this technique depends on the correct positioning and fusion of the bone block. The length of the screws that fix the bone block can be a problem. They can increase the risk of non-union if too short or be the cause of nerve lesion or soft tissue discomfort if too long. Suprascapular nerve injuries have been reported during shoulder stabilisation surgery up to 6 % of the case. Bone block non-union depending on the series is found around 20 % of the cases. The purpose of this study was to evaluate the efficiency of this CT preoperative planning to predict optimal screws length. The clinical importance of this study lies in the observation that it is the first study to evaluate the efficiency of CT planning to predict screw length. Inclusion criteria were patients with chronic anterior instability of the shoulder with an ISIS superior to 4. Exclusion criteria were patients with multidirectional instability or any previous surgery on this shoulder. Thirty patients were included prospectively, 11 of them went threw a CT planning, before their arthroscopic Latarjet. Optimal length of both screws was calculated, adding the size of the coracoid at 5 and 15 mm from the tip to the glenoid. Thirty-two-mm screws were used for patients without planning. On a post-operative CT scan with 3D reconstruction, the distance between the screw tip and the posterior cortex was measured. A one-sample Wilcoxon test was used to compare the distance from the tip of the screw to an acceptable positioning of ±2 mm from the posterior cortex. In the group without planning, screw 1 tended to differ from the acceptable positioning: mean 3.44 mm ± 3.13, med 2.9 mm, q1; q3 [0.6; 4.75] p = 0.1118, and screw 2 differed significantly from the acceptable position: mean 4.83 mm ± 4.11, med 3.7 mm, q1; q3 [1.7; 5.45] p = 0.0045. In the group with planning, position of

  11. Preoperative evaluation of the abdominal aortic aneurysm using spiral CT

    International Nuclear Information System (INIS)

    Chisuwa, Hisanao; Nishimaki, Keiji; Arai, Masayuki; Honda, Haruyasu; Urata, Koichi; Miyagawa, Yusuke; Makuuchi, Masatoshi; Shimizu, Mikio; Okamoto, Kohei.

    1995-01-01

    Six patients with abdominal aortic aneurysm (AAA) were studied with three-dimensionally reconstructed CT angiography (3D-CTA) in order to evaluate its usefulness as a diagnostic tool for vascular surgery patients. Images of the intravenously contrasted abdominal aorta were obtained with spiral scan during a single breath hold. The images of the abdominal aorta and its major branches were three-dimensionally reconstructed with a shaded surface display mode. The three-dimensional image reconstruction was successful in all the six cases and performed without difficulties. Shaded surface display presented a deficit to depict the aortic wall with mural thrombus. However, multidirectional display of the abdominal aorta and its branches facilitated interpretation of the anatomical details of the lesions and planning of surgical repair. 3D-CTA is an alternative to conventional aortography for preoperative diagnosis of AAA. Moreover it was shown to be noninvasive, easy to proceed. It presented good angiographical resolution that can be used as a precise diagnostic tool in vascular surgery. (author)

  12. Colorectal carcinoma: preoperative staging with water enema spiral CT

    International Nuclear Information System (INIS)

    Guan Sheng; Gao Jianbo; Li Yintai; Chen Xuejun; Yang Xuehua; Yang Xiaopeng; Cheng Jingliang

    2001-01-01

    Objective: To determine the value and limitation of water enema spiral CT (WESCT) in staging of colorectal carcinoma. Methods: Forty-eight patients with histologically proven rectum or colon carcinoma were included in this study. All of them were examined by SCT, and the preoperative staging of TNM and Duke were used based on the findings of SCT. The results of WESCT were compared with those of surgical and pathological examination in all cases. Results: All lesions in the 47 cases were demonstrated clearly by WESCT and the sensitivity was 97.9%; 39 cases of 48 patients were correctly staged with TNM and 42 cases with Duke, the accuracy was 81.3% and 87.5% respectively, which were higher than the overall 50 % accuracy reported by references; (3) The accuracy of WESCT was 89.6% (43/48) in T stage and 81.3% (39/48) in N stage. Three cases in M stage were all diagnosed correctly; Conclusion: WESCT scan is a better method of depicting the colorectal carcinoma. It allows for accurate depiction and staging of colorectal carcinoma, especially detecting the invasion of adjacent tissues and distant metastasis. It is the best imaging method for staging the colorectal carcinoma . However the value of WESCT for early T staging in colorectal carcinoma and minute metastasis of lymph nodes or liver is limited

  13. MRI, CT, and sonography in the preoperative evaluation of primary tumor extension in malignant pleural mesothelioma

    International Nuclear Information System (INIS)

    Layer, G.; Steudel, A.; Schild, H.H.; Schmitteckert, H.; Tuengerthal, S.; Schirren, J.; Kaick, G. van

    1999-01-01

    Purpose: Evaluation of the diagnostic value of the imaging modalities computed tomography (CT), magnetic resonance imaging (MRI), and thoracic sonography in the preoperative staging of malignant pleural mesothelioma. Results: The accuracy rates for CT were 85%, 98%, 83%, 73%, 71%, and 83%. MRI had an accuracy of 71%, 92%, 71%, 83%, 71%, and 96%, the thoracic ultrasound examinations of 76%, 63%, 51%, 60%, 71% and 89%. Conclusions: According to these results CT remains the method of choice in the preoperative assessment of T-stage of malignant pleural mesothelioma. MRI is of nearly the same value, but is not a must. Sonography may be supplementary method for operation planning. (orig./AJ) [de

  14. Clinical significance of CT in the preoperative diagnosis of the staging of rectal cancer patients

    International Nuclear Information System (INIS)

    Itano, Satoshi; Fuchimoto, Sadanori; Hamada, Fumihiro; Kimura, Takanobu; Iwagaki, Hiromi; Maeda, Tetsuya; Orita, Kunzo

    1987-01-01

    The value of computed tomography (CT) in the preoperative clinical staging of rectal cancer was prospectively studied in 28 patients with macroscopically proven cancer. The CT studies were based on the previously established CT diagnostic criteria for wall invasion (S factor), lymph node metastases (N factor), and liver metastases (H factor). When macroscopic findings were used as the standard, the accuracy of CT was 61 % for S factor, 32 % for N factor, and 86 % for H factor. Using histological findings as the standard, the accuracy was 48 % for S factor and 16 % for N factor. Overall, CT had a high accuracy for H factor in all sites of cancer (75 % in the rectosigmoid, 86 % in the area above the peritoneal reflection, and 90 % in the area below the peritoneal reflection). For the other S and N factors, CT seemed to be of limited value in the preoperative diagnosis. (Namekawa, K.)

  15. Utility of Electrocardiography (ECG)-Gated Computed Tomography (CT) for Preoperative Evaluations of Thymic Epithelial Tumors.

    Science.gov (United States)

    Ozawa, Yoshiyuki; Hara, Masaki; Nakagawa, Motoo; Shibamoto, Yuta

    2016-01-01

    Preoperative evaluation of invasion to the adjacent organs is important for the thymic epithelial tumors on CT. The purpose of our study was to evaluate the utility of electrocardiography (ECG)-gated CT for assessing thymic epithelial tumors with regard to the motion artifacts produced and the preoperative diagnostic accuracy of the technique. Forty thymic epithelial tumors (36 thymomas and 4 thymic carcinomas) were examined with ECG-gated contrast-enhanced CT using a dual source scanner. The scan delay after the contrast media injection was 30 s for the non-ECG-gated CT and 100 s for the ECG-gated CT. Two radiologists blindly evaluated both the non-ECG-gated and ECG-gated CT images for motion artifacts and determined whether the tumors had invaded adjacent structures (mediastinal fat, superior vena cava, brachiocephalic veins, aorta, pulmonary artery, pericardium, or lungs) on each image. Motion artifacts were evaluated using a 3-grade scale. Surgical and pathological findings were used as a reference standard for tumor invasion. Motion artifacts were significantly reduced for all structures by ECG gating ( p =0.0089 for the lungs and p ECG-gated CT and ECG-gated CT demonstrated 79% and 95% accuracy, respectively, during assessments of pericardial invasion ( p =0.03). ECG-gated CT reduced the severity of motion artifacts and might be useful for preoperative assessment whether thymic epithelial tumors have invaded adjacent structures.

  16. Detection and preoperative staging of carcinoma of the cervix: Comparison between MR imaging and CT

    International Nuclear Information System (INIS)

    Mayr, B.; Schmidt, H.; Baieri, P.; Scheidel, P.; Meier, W.; Schramm, T.

    1986-01-01

    Twenty-four patients with carcinoma of the cervix were examined preoperatively by MR imaging and CT. In all patients histopathologic confirmation was available for specimens obtained either by radical hysterectomy or at staging laparotomy. MR imaging was equivalent to contrast CT in the detection and evaluation of tumor extension in the cervix. Tumor extension to the parametria and pelvic wall was difficult to evaluate on both modalities, as neither had a higher accuracy than pelvic examination conducted under anesthesia. Nodal staging was nearly equivalent on MR imaging and CT. In the detection and staging of carcinoma of the cervix, MR imaged proved to be as good as CT with contrast agent enhancement

  17. The use of CT scan in the pre-operative staging of bronchogenic carcinoma

    International Nuclear Information System (INIS)

    Pada, C.C.

    1992-01-01

    Surgery remains the treatment of choice in patients with localized bronchogenic carcinoma. Pre-operative identification of inoperability spares the patient from unnecessary surgery. This prospective study was carried out to determine the correctness of judgement regarding a patient's operability or inoperability based on the pre-operative staging of CT scan; to find out the sensitivity, specificity and overall accuracy of the CT scan in estimating tumor description, nodal status and metastatic spread to the chest. Staging was done by 3 senior radiologists aware of the diagnosis. Both the surgical and histopathologic findings and staging were gathered and used as measurement of truth in arriving at the CT scan's accuracy. Overall accuracy rate of CT scan in determining operability or inoperability is 80%; tumor description accuracy of assessment is 87% and nodal status estimation has an accuracy of 60%. Sensitivity of CT scan is assessment of metastatic spread to the chest is 93%. There is no statistically significant difference in the judgement of operability or interpretability by CT scan compared to surgical and histopathologic results. The CT scan is recommended as a valuable tool in the pre-operative staging of patients with bronchogenic carcinoma who are candidates for surgery. (auth.). 21 refs.; 8 tabs

  18. Preoperative staging of rectal cancer by magnetic resonance imaging (MRI) and computed tomography (CT)

    International Nuclear Information System (INIS)

    Itabashi, Michiaki; Kameoka, Shingo; Nakajima, Kiyotaka; Izumi, Kiminari; Miyazaki, Kaname; Hamano, Kyoichi; Kouno, Atsushi

    1991-01-01

    To clarify the usefulness and limitations of CT and MRI in preoperative assessment of the wall invasion of rectal cancer, we compared the results of CT and MRI with the histopathological findings, classifying tumors by the region and site in 34 patients with rectal cancer. Subjects were patients preoperatively examined by MRI and CT. Overall, the percent of cases with the extent of invasion accurately assessed by MRI was 88.2%, and that by CT was 64.7%. In all instances of wrong assessment, the extent of invasion was overestimated. The accurate assessment rate was significantly higher for MRI than for CT. After classification by the region, the accurate assessment rate at Rs was low as 50% for both MRI and CT because slices were not perpendicular to the tumor. The accurate assessment rate was 100% for MRI and 82% for CT at Ra, and respectively 94% and 59% at Rb. The majority of tumors at Ra or Rb centering on the lateral wall of the rectum were accurately assessed either by MRI or CT. With tumors at Ra or Rb (particularly Rb) centering on the anterior or posterior wall, CT frequently failed to identify the extent of invasion accurately, so that MRI seemed more suitable for these tumors. (author)

  19. Preoperative CT prediction for Masaoka staging of thymic epithelial tumor

    International Nuclear Information System (INIS)

    Feng Zhan; Huang Zhen; Zhang Liang

    2013-01-01

    Objective: To discuss the value of CT prognosis on the Masaoka staging system of thymic epithelial tumors (TET) before surgical resection. Methods: The CT images of 102 patients with TET proved by surgery and pathology were reviewed retrospectively. The TET were reclassified according to Masaoka stage system. The size, homogeneity, sharp, contour, infiltration of surrounding tissue, and metastasis on CT were analyzed with Logistic analysis. The diagnostic value was also evaluated with a ROC curve. Results: Masaoka pathologic stages were stage Ⅰ for 36 (35.3 %), stage Ⅱ for 27 (26.5 %), stage Ⅲ for 30 (29.4 %), and stage Ⅳ for 9 (8.8 %). A multivariable Logistic regression model showed that TET with larger size of tumor (20/35, P = 0.0371, OR = 4.539), irregular or lobulated tumor contour (26/42, P = 0.0230, OR = 4.870), heterogeneous (21/33, P = 0.0154, OR = 6.020), infiltration of surrounding fat (25/32, P = 0.0019, OR = 14.005), and pleural seeding (11/11, P = 0.0032, OR = 36.153) were more likely to have stage Ⅲ or Ⅳ disease. The area under ROC curve was 0.940. Conclusions: The tumor CT imaging features can differentiate between stage Ⅰ, Ⅱ and stage Ⅲ, Ⅳ disease. This helps identified patients more likely to benefit from neoadjuvant therapy. (authors)

  20. Preoperative CT angiography reduces surgery time in perforator flap reconstruction

    NARCIS (Netherlands)

    Smit, Jeroen M.; Dimopoulou, Angeliki; Liss, Anders G.; Zeebregts, Clark J.; Kildal, Morten; Whitaker, Iain S.; Magnusson, Anders; Acosta, Rafael

    The use of perforator flaps in breast reconstructions has increased considerably in the past decade. A disadvantage of the perforator flap is difficult dissection, which results in a longer procedure. During spring 2006, we introduced CT angiography (CTA) as part of the diagnostic work-up in

  1. The diagnostic utility of ultrasonography, CT and PET/CT for the preoperative evaluation of cervical lymph node metastasis inpapillary thyroid cancer patients

    International Nuclear Information System (INIS)

    Kim Young Sang; Lee, Tae Hyun; Park, Dong Hee

    2016-01-01

    To compare the diagnostic utility of ultrasonography (US), CT and positron emission tomography/CT (PET/CT) in the preoperative evaluation of cervical lymph node metastasis in patients with papillary thyroid carcinoma. The study population consisted of 300 patients with pathologically diagnosed papillary thyroid carcinoma after thyroidectomy and neck dissection. Preoperative US, CT, and PET/CT findings were compared with pathologic outcomes after thyroidectomy and neck dissection. Sensitivity in detecting central lymph node metastasis (US 29.9%, CT 27.9%, PET/CT 18.8%) was lower than that for lateral lymph node metastasis (US 56.3%, CT 66.2%, PET/CT 43.7%). Specificity in detecting central lymph node metastasis (US 80.6%, CT 77.7%, PET/CT 83.0%) was lower than that for lateral lymph node metastasis (US 96.8%, CT 80.6%, PET/CT 95.2%). The combination of US and CT had higher specificity (77.3%) and higher sensitivity (33.1%) than US alone. PET/CT has no significant additional benefit over the combination of US and CT. In preoperative evaluations of neck lymph node metastasis, US and CT and PET/CT are more useful in lateral lymph node areas than in central lymph node areas. The combination of US and CT has higher sensitivity than US alone

  2. The diagnostic utility of ultrasonography, CT and PET/CT for the preoperative evaluation of cervical lymph node metastasis inpapillary thyroid cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim Young Sang; Lee, Tae Hyun; Park, Dong Hee [Dept. of Radiology, Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    2016-08-15

    To compare the diagnostic utility of ultrasonography (US), CT and positron emission tomography/CT (PET/CT) in the preoperative evaluation of cervical lymph node metastasis in patients with papillary thyroid carcinoma. The study population consisted of 300 patients with pathologically diagnosed papillary thyroid carcinoma after thyroidectomy and neck dissection. Preoperative US, CT, and PET/CT findings were compared with pathologic outcomes after thyroidectomy and neck dissection. Sensitivity in detecting central lymph node metastasis (US 29.9%, CT 27.9%, PET/CT 18.8%) was lower than that for lateral lymph node metastasis (US 56.3%, CT 66.2%, PET/CT 43.7%). Specificity in detecting central lymph node metastasis (US 80.6%, CT 77.7%, PET/CT 83.0%) was lower than that for lateral lymph node metastasis (US 96.8%, CT 80.6%, PET/CT 95.2%). The combination of US and CT had higher specificity (77.3%) and higher sensitivity (33.1%) than US alone. PET/CT has no significant additional benefit over the combination of US and CT. In preoperative evaluations of neck lymph node metastasis, US and CT and PET/CT are more useful in lateral lymph node areas than in central lymph node areas. The combination of US and CT has higher sensitivity than US alone.

  3. Importance of Preoperative Rectal Ultrasound and CT in Rectal Tumors

    International Nuclear Information System (INIS)

    Schnellyova, T.

    2011-01-01

    Introduction: The reason of high mortality of colorectal carcinoma is above all the fact, that majority of diseases are detected in progressive stage. Radical change in this unfavorable mortality rate can be achieved only by targeted search for early stages of the disease. Early diagnostics consists in rectoscopy and colonoscopy. Regarding X-ray methods it is X-ray irigography. Regarding CT examinations it is CT irigography, virtual colonoscopy. Another examination can be USG examination of abdomen and endo sonographic examination of rectum. Materials and methods: In the period from June 2006 to December 2010, in 60 patients out of the total number 106 examined patients, tumorous affection of rectum CT examination of pelvis and abdomen separately or pelvisand abdomen at one session was made in 3186 patients. In 115 patients we discovered malign tumorous illness of colon. Metastatic affection in the form of distant metastases was proven n 63 patients. 403 patients had CT irigography examination. In 77 out of them we diagnosed colon carcinoma. CT colonoscopy did not discover in our group of 30 patients examined the presence of colon carcinoma. Results: In the group of 60 patients who were diagnosed rectal carcinoma, in 29 patients expansive infiltrative affection was evaluated in endorectal sonography, histologically confirmed in 28 patients - 96,5 %, expansive affection in 41 patients with histological verification in 100 %. With CT we diagnosed 52 expansive tumorous processes, histologically confirmed in 47 patients - 90,38 %. In 63 patients expansive infiltrative process was evaluated, histologically confirmed in 52 patients 82,53 %. In total of 115 examinations there was conformance with histological examination in 99 patients - 86,08 %. In CT irigography we diagnosed colon tumour in 77 patients. Expansive growth was evaluated in 40 patients, histologically confirmed in 37 patients - 92,5 %. Expansive infiltrative expansion was evaluated in 37 patients, with

  4. Reassessment of CT images to improve diagnostic accuracy in patients with suspected acute appendicitis and an equivocal preoperative CT interpretation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Cheol; Yang, Dal Mo; Kim, Sang Won [Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Department of Radiology, Seoul (Korea, Republic of); Park, Seong Jin [Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Department of Radiology, Seoul (Korea, Republic of)

    2012-06-15

    To identify CT features that discriminate individuals with and without acute appendicitis in patients with equivocal CT findings, and to assess whether knowledge of these findings improves diagnostic accuracy. 53 patients that underwent appendectomy with an indeterminate preoperative CT interpretation were selected and allocated to an acute appendicitis group or a non-appendicitis group. The 53 CT examinations were reviewed by two radiologists in consensus to identify CT findings that could aid in the discrimination of those with and without appendicitis. In addition, two additional radiologists were then requested to evaluate independently the 53 CT examinations using a 4-point scale, both before and after being informed of the potentially discriminating criteria. CT findings found to be significantly different in the two groups were; the presence of appendiceal wall enhancement, intraluminal air in appendix, a coexistent inflammatory lesion, and appendiceal wall thickening (P < 0.05). Areas under the curves of reviewers 1 and 2 significantly increased from 0.516 and 0.706 to 0.677 and 0.841, respectively, when reviewers were told which CT variables were significant (P = 0.0193 and P = 0.0397, respectively). Knowledge of the identified CT findings was found to improve diagnostic accuracy for acute appendicitis in patients with equivocal CT findings. circle Numerous patients with clinically equivocal appendicitis do not have acute appendicitis circle Computed tomography (CT) helps to reduce the negative appendectomy rate circle CT is not always infallible and may also demonstrate indeterminate findings circle However knowledge of significant CT variables can further reduce negative appendectomy rate circle An equivocal CT interpretation of appendicitis should be reassessed with this knowledge. (orig.)

  5. Reassessment of CT images to improve diagnostic accuracy in patients with suspected acute appendicitis and an equivocal preoperative CT interpretation

    International Nuclear Information System (INIS)

    Kim, Hyun Cheol; Yang, Dal Mo; Kim, Sang Won; Park, Seong Jin

    2012-01-01

    To identify CT features that discriminate individuals with and without acute appendicitis in patients with equivocal CT findings, and to assess whether knowledge of these findings improves diagnostic accuracy. 53 patients that underwent appendectomy with an indeterminate preoperative CT interpretation were selected and allocated to an acute appendicitis group or a non-appendicitis group. The 53 CT examinations were reviewed by two radiologists in consensus to identify CT findings that could aid in the discrimination of those with and without appendicitis. In addition, two additional radiologists were then requested to evaluate independently the 53 CT examinations using a 4-point scale, both before and after being informed of the potentially discriminating criteria. CT findings found to be significantly different in the two groups were; the presence of appendiceal wall enhancement, intraluminal air in appendix, a coexistent inflammatory lesion, and appendiceal wall thickening (P < 0.05). Areas under the curves of reviewers 1 and 2 significantly increased from 0.516 and 0.706 to 0.677 and 0.841, respectively, when reviewers were told which CT variables were significant (P = 0.0193 and P = 0.0397, respectively). Knowledge of the identified CT findings was found to improve diagnostic accuracy for acute appendicitis in patients with equivocal CT findings. circle Numerous patients with clinically equivocal appendicitis do not have acute appendicitis circle Computed tomography (CT) helps to reduce the negative appendectomy rate circle CT is not always infallible and may also demonstrate indeterminate findings circle However knowledge of significant CT variables can further reduce negative appendectomy rate circle An equivocal CT interpretation of appendicitis should be reassessed with this knowledge. (orig.)

  6. Usefulness of preoperative three dimensional CT in laparoscopic cholecystectomy. Especially, its comparison to ERC

    International Nuclear Information System (INIS)

    Machida, Hiromichi; Nakaya, Yuzou; Kojima, Kojirou

    1996-01-01

    We studied the usefulness of three dimensional helical CT (3D-CT) combined with drip infusion cholangiography for determining the application of laparoscopic cholecystectomy (LC) and evaluating the cholecyst severity. The subjects were 56 patients who underwent LC with preoperative 3D-CT. Particularly, in 42 patients undergoing endoscopic retrograde cholangiography (ERC) and 3D-CT simultaneously, the results with both methods were compared. The detection rates of the original site, forward and backward direction, and left and right direction in the confluence form of the cystic duct by means of 3D-CT versus ERC were 100% vs. 92.9% 92.9% vs. 71.4%, and 92.9% vs. 88.1%, respectively. Abnormal biliary distribution was visualized in 5 cases and all of them were depicted by 3D-CT. The 3D-CT was superior to ERC in terms of X-ray dose and cost. These results indicate the usefulness of 3D-CT as a LC preoperative examination. (author)

  7. CT detection of thyroid pyramidal lobe in preoperative patients with thyroid tumors

    International Nuclear Information System (INIS)

    Shin, Gi Won; Kim, Dong Won

    2013-01-01

    Thyroid pyramidal lobe (TPL) is a normal variant of the thyroid gland, but few imaging studies of TPL have been published. The purpose of this study is to investigate the frequency, location, size (length, maximal AP diameter, maximal transverse diameter), and upper end level of TPL with its separation from the main thyroid gland on preoperative neck CT and to compare them with operative findings in order to assess the diagnostic accuracy of neck CT for detection TPL. 46 patients, who underwent preoperative neck CT before thyroidectomy, were included in the study. The frequency, location, size, and upper end level of TPL with its separation from the main thyroid gland on the neck CT was analyzed by a single radiologist. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of neck CT for detecting TPL was 77.8%, 89.5%, 91.3%, 73.9% and 82.6%. There was a significant difference in maximal AP diameter, location, upper end level, and its separation from main thyroid gland between CT and operative findings (p 0.05). Diagnostic accuracy of neck CT for detecting TPL was high, and the neck CT may be useful for evaluating TPL in the suprahyoid neck.

  8. The Use of SNOMED CT for Representing Concepts Used in Preoperative Guidelines

    NARCIS (Netherlands)

    Ahmadian, Leila; de Keizer, Nicolette F.; Cornet, Ronald

    2009-01-01

    The use of guidelines to improve quality of care depends on presenting them in a standard machine-interpretable form and using common terms in guidelines as well as in patient records. In this study, the use of SNOMED CT for representing concepts used in preoperative assessment guidelines was

  9. [The Clinical Application of Video Mediastinoscopy and CT in the N Staging of Preoperative Lung Cancer.].

    Science.gov (United States)

    Wang, Zhiheng; Qi, Weibo; Zhu, Yong; Lin, Ruobai

    2009-10-20

    Preoperative lung cancer with mediastinal lymph nodes metastasis can be diagnosed by vedio mediastinoscopy (VM) and CT. This study was to explore the value of VM and CT in the diagnosis of N staging of preoperative lung cancer, and to discuss the difference between the two methods. Forty-eight cases diagnosed of lung cancer by CT or PET-CT were examined by VM. The sensitivity, specificity, validity, positive predictive value and negative predictive value of VM and CT were speculated according to the postoperative pathological reports, and the difference between VM and CT in the diagnosis of lung cancer with mediastinal lymph nodes metastasis was discussed. (1)Under the examination of VM, 31 patients with the negative outcome received the direct operation; 14 patients with N2 received 2 courses of neoadjuvant chemotherapy before operation; 3 patients with N3 received chemotherapy and/or radiotherapy. (2)Forty-one cases with final diagnosis of lung cancer were used as samples to speculate the sensitivity, specificity, validity, positive predictive value and negative predictive value of VM. They were 93.3%, 100%, 97.6%, 100%, 96.3%, which of CT were 66.7%, 53.8%, 58.5%, 45.5%, 73.7% (Chi-square=4.083, P=0.039), the difference between VM and CT was statistically significant. (3)In this group, the complications of VM incidence rate was 2.08% (1/48), and the case was pneumothorax. VM is superior to CT in the diagnosis of N staging of preoperative lung cancer; Due to its safety and effectiveness, VM will be wildly used in the field of thoracic surgery.

  10. The Clinical Application of Video Mediastinoscopy and CT in the N Staging of Preoperative Lung Cancer

    Directory of Open Access Journals (Sweden)

    Zhiheng WANG

    2009-10-01

    Full Text Available Background and objective Preoperative lung cancer with mediastinal lymph nodes metastasis can be diagnosed by vedio mediastinoscopy (VM and CT. This study was to explore the value of VM and CT in the diagnosis of N staging of preoperative lung cancer, and to discuss the difference between the 2 methods. Methods 48 cases diagnosed of lung cancer by CT or PET-CT were examined by VM. The sensitivity, specificity, validity, positive predictive value and negative predictive value of VM and CT were speculated according to the postoperative pathological reports, and the difference between VM and CT in the diagnosis of lung cancer with mediastinal lymph nodes metastasis was discussed. Results ①Under the examination of VM, 31 patients with the negative outcome received the direct operation, 14 patients with N2 received 2 courses of neoadjuvant chemotherapy before operation, 3 patients with N3 received chemotherapy and/or radiotherapy. ②Forty-one cases with final diagnosis of lung cancer were used as samples to speculate the sensitivity, specificity, validity, positive predictive value and negative predictive value of VM. They were 93.3%, 100%, 97.6%, 100%, 96.3%, which of CT were 66.7%, 53.8%, 58.5%, 45.5%, 73.7% (χ2=4.083, P=0.039, the difference between VM and CT was statistically significant. ③In this group, the complications of VM incidence rate is 2.08% (1/48, the case is pneumothorax. Conclusion VM is superior to CT in the diagnosis of N staging of preoperative lung cancer, it is safe and effective, and there will be a wide perspective for VM in thoracic surgery.

  11. Multislice CT for preoperative diagnosis of pancreatic cancer

    International Nuclear Information System (INIS)

    Horiguchi, Akihiko; Ishihara, Shin; Ito, Masahiro

    2007-01-01

    We investigated the ability of multislice (MS) CT to visualize and diagnose the progression of pancreatic cancer. With regard to local progression, good diagnosis was possible for detecting the invasion of the intrapancreatic bile duct, duodenum, portal vein, arteries and other organs, and liver metastasis. Sensitivity was high but specificity was not good for detecting the invasion of the anterior and posterior pancreatic tissue. This is thought to be because of the positive diagnosis with pancreatitis that accompanies cancer. Pancreatic plexus invasion was also thought to be a cause of the lipid elevation of the nerve plexus and decreased sensitivity accompanying pancreatitis. Identification of cancer invasion and tumor periphery changes based on concomitant pancreatitis also depends on the amount of fibrous stroma, but this will require further investigation. Factors other than the size of lymph node metastases also need to be investigated. MS-CT can provide detailed volume data in a short time and making it an essential test in diagnosing the stage of pancreatic cancer. (author)

  12. The clinical significance of CT in the preoperative diagnosis of colon and rectal cancer

    International Nuclear Information System (INIS)

    Itano, Satoshi; Fuchimoto, Sadanori; Hamada, Fumihiro; Kimura, Takanobu; Orita, Kunzo

    1986-01-01

    The clinical significance of CT in the preoperative diagnosis of colon and rectal cancer was studied. Thirty four patients were investigated in this series. The diagnostic criteria of the CT examination were previously established in a study of wall invasion (S factor), lymph node metastasis (N factor), liver metastasis (H factor) and peritoneal dissemination (P factor). The CT diagnosis was done prospectively according to these criteria, and the CT diagnosis was compared with the macroscopic and histological diagnosis. The accuracy of the prospective diagnosis as to H, S, N and P factors was 79.4 %, 55.9 %, 41.2 % and 20.6 %, respectively. The diagnostic value of CT seemed to be acceptable as to the H factor, but limited to some extent to the S and N factors. (author)

  13. CT virtual reality in the preoperative workup of malunited distal radius fractures: preliminary results

    International Nuclear Information System (INIS)

    Rieger, Michael; Gruber, Hannes; Jaschke, Werner R.; Gabl, Markus; Mallouhi, Ammar

    2005-01-01

    Our objective was to evaluate the usefulness of CT virtual preoperative planning in the surgical repositioning of malunited distal radius fracture. Eleven patients with malunited distal radius fracture underwent multislice CT of both wrists. A preoperative workup was performed in a virtual reality environment created from the CT data sets. Virtual planning comprised three main procedures, carrying out the virtual osteotomy of the radius, prediction of the final position of the distal radius after osteotomy and computer-assisted manufacturing of a repositioning device, which was later placed at the surgical osteotomy site to reposition objectively the distal radius fragment before fixation with the osteosynthesis. All patients tolerated the surgical procedure well. During surgery, the orthopedic surgeons were not required in any of the cases to alter the position of the distal radius that was determined by the repositioning device. At postoperative follow-up, the anatomic relationship of the distal radius was restored (radial inclination, 21.4 ; volar tilt, 10.3 ; ulnar variance, 0.5 mm). Clinically, a significant improvement of pronation (P=0.012), supination (P=0.01), flexion (P=0.001) and extension (P=0.006) was achieved. Pain decreased from 54 to 7 points. CT virtual reality is a valuable adjunct for the preoperative workup and surgical reposition of malunited distal radius fractures. (orig.)

  14. Preoperative CT staging of colon carcinoma (excluding the recto-sigmoid region)

    International Nuclear Information System (INIS)

    Acunas, B.; Rozanes, I.; Acunas, G.; Sayi, I.; Gokmen, E.; Celik, L.

    1990-01-01

    28 Patients with colon carcinoma (excluding the recto-sigmoid region) underwent preoperative staging with computed tomography (CT). The CT had a sensitivity of 60 and 67 per cent for detection of extramural invasion, 75 per cent sensitivity and specificity for lymph node metastases and a sensitivity of 87 per cent and specificity of 95 per cent for liver metastases. Compared with the modified Dukes classification, CT correctly staged 50 per cent of the patients with Dukes A lesions; 40 per cent with Dukes B, 75 per cent with Dukes C and 85 per cent with Dukes D lesions. The data presented in this study showed that CT has limitations in the sensitivity and accuracy of staging local colonic carcinoma. However, the authors recommend its use for patients who are clinically suspected of having extensive disease. (author). 10 refs.; 4 figs.; 2 tabs

  15. FDG-PET/CT Imaging for Staging and Target Volume Delineation in Preoperative Conformal Radiotherapy of Rectal Cancer

    International Nuclear Information System (INIS)

    Bassi, Maria Chiara; Turri, Lucia; Sacchetti, Gianmauro; Loi, Gianfranco; Cannillo, Barbara; La Mattina, Pierdaniele; Brambilla, Marco; Inglese, Eugenio; Krengli, Marco

    2008-01-01

    Purpose: To investigate the potential impact of using 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) on staging and target volume delineation for patients affected by rectal cancer and candidates for preoperative conformal radiotherapy. Methods and Materials: Twenty-five patients diagnosed with rectal cancer T3-4 N0-1 M0-1 and candidates for preoperative radiotherapy underwent PET/CT simulation after injection of 5.18 MBq/kg of FDG. Clinical stage was reassessed on the basis of FDG-PET/CT findings. The gross tumor volume (GTV) and the clinical target volume (CTV) were delineated first on CT and then on PET/CT images. The PET/CT-GTV and PET/CT-CTV were analyzed and compared with CT-GTV and CT-CTV, respectively. Results: In 4 of 25 cases (24%), PET/CT affected tumor staging or the treatment purpose. In 3 of 25 cases (12%) staged N0 M0, PET/CT showed FDG uptake in regional lymph nodes and in a case also in the liver. In a patient with a single liver metastasis PET/CT detected multiple lesions, changing the treatment intent from curative to palliative. The PET/CT-GTV and PET/CT-CTV were significantly greater than the CT-GTV (p = 0.00013) and CT-CTV (p = 0.00002), respectively. The mean difference between PET/CT-GTV and CT-GTV was 25.4% and between PET/CT-CTV and CT-CTV was 4.1%. Conclusions: Imaging with PET/CT for preoperative radiotherapy of rectal cancer may lead to a change in staging and target volume delineation. Stage variation was observed in 12% of cases and a change of treatment intent in 4%. The GTV and CTV changed significantly, with a mean increase in size of 25% and 4%, respectively

  16. Preoperative CT analysis of the mandible and maxilla for permanent dental prosthetic implantation

    International Nuclear Information System (INIS)

    Rothman, S.L.G.; Rhodes, M.L.; Schwarz, M.; Chafetz, N.I.

    1987-01-01

    The Branemark technique for permanently implanting dental prostheses is becoming universally accepted. The surgeon requires detailed knowledge of the cross-sectional anatomy of the alveolar ridges and inferior alveolar nerve for safe placement of the titanium fixtures. Axial CT scans of the mandible and maxilla, with oblique and panoramic CT reformations, were obtained in more than 100 patients. This report describes the anatomic variations in the maxilla and mandible as they relate to dental implantation surgery. The authors demonstrate the utility of this technique in preoperative surgical planning and postoperative evaluation

  17. CT pre-operative planning of a new semi-implantable bone conduction hearing device

    Energy Technology Data Exchange (ETDEWEB)

    Law, Eric K.C.; Bhatia, Kunwar S.S. [Prince of Wales Hospital, The Chinese University of Hong Kong, Department of Imaging and Interventional Radiology, Hong Kong, SAR (China); Tsang, Willis S.S.; Tong, Michael C.F. [Prince of Wales Hospital, The Chinese University of Hong Kong, Department of Otorhinolaryngology, Head and Neck Surgery, Hong Kong, SAR (China); Shi, Lin [The Chinese University of Hong Kong, Department of Medicine and Therapeutics, Hong Kong, SAR (China); The Chinese University of Hong Kong, Chow Yuk Ho Technology Center for Innovative Medicine, Hong Kong, SAR (China)

    2016-06-15

    Accommodating a novel semi-implantable bone conduction hearing device within the temporal bone presents challenges for surgical planning. This study describes the utility of CT in pre-operative assessment of such an implant. Retrospective review of pre-operative CT, clinical and surgical records of 16 adults considered for device implantation. Radiological suitability was assessed on CT using 3D simulation software. Antero-posterior (AP) dimensions of the mastoid bone and minimum skull thickness were measured. CT planning results were correlated with operative records. Eight and five candidates were suitable for device placement in the transmastoid and retrosigmoid positions, respectively, and three were radiologically unsuitable. The mean AP diameter of the mastoid cavity was 14.6 mm for the transmastoid group and 4.6 mm for the retrosigmoid group (p < 0.05). Contracted mastoid and/or prior surgery were predisposing factors for unsuitability. Four transmastoid and five retrosigmoid positions required sigmoid sinus/dural depression and/or use of lifts due to insufficient bone capacity. A high proportion of patients being considered have contracted or operated mastoids, which reduces the feasibility of the transmastoid approach. This finding combined with the complex temporal bone geometry illustrates the importance of careful CT evaluation using 3D software for precise device simulation. (orig.)

  18. Chronic tuberculous empyema: relationships between preoperative CT findings and postoperative improvement measured by pulmonary function testing

    International Nuclear Information System (INIS)

    Kim, D.J.; Im, J.-G.; Goo, J.M.; Lee, H.J.; You, S.Y.; Song, J.W.

    2005-01-01

    AIMS: To evaluate whether preoperative computed tomography (CT) findings correlate with postoperative improvements in forced vital capacity (FVC) and forced expiratory volume during 1 s (FEV1) in persons who have undergone unilateral decortication because of unilateral chronic tuberculous empyema. METHODS: A retrospective study was carried out of 67 individuals who had undergone decortication because of chronic tuberculous empyema between January 1996 and December 2000. Of these, 13 subjects who had had preoperative chest CT and preoperative and postoperative pulmonary function tests (PFTs) were included in the investigation. On preoperative CT, the degree of volume reduction of the affected side was compared with that of the contralateral normal lung. The relative volume of empyema was calculated by dividing the volume occupied by the empyema by the sum of the total volume of the ipsilateral lung and the empyema volume. The thicknesses of pleura and extrapleural fat in the involved hemithorax were measured by CT at their thickest points, and the degree of atelectasis adjacent to the empyema in the diseased lung was assessed and classified. These five CT parameters and the ages of the patients were compared with preoperative and postoperative FVC and FEV1 changes. RESULTS: A significant negative correlation was found between FVC changes and the relative volume of the affected lung (FVC: p=0.039, RS=-0.58). FVC and FEV1 were found to be significantly and positively correlated with the relative volume of the empyema (FVC: p=0.005, RS=0.72; FEV1: p=0.014, RS=0.66) and the degree of atelectasis (FVC: p=0.007, RS=0.71; FEV1: p=0.029, RS=0.60) by Spearman's nonparametric correlation test. Other CT parameters and the ages of the patients were not found to be correlated with PFT changes. CONCLUSION: The relative volume of the affected side, the relative volume of empyema and the degree of atelectasis can predict improvements in FVC and FEV1 after decortication in patients

  19. Can lymphovascular invasion be predicted by preoperative multiphasic dynamic CT in patients with advanced gastric cancer?

    Energy Technology Data Exchange (ETDEWEB)

    Ma, Zelan; Liang, Cuishan; Huang, Xiaomei; Liu, Zaiyi [Southern Medical University, Guangzhou, Guangdong (China); Guangdong General Hospital, Guangdong Academy of Medical Sciences, Department of Radiology, Guangzhou, Guangdong Province (China); Liang, Changhong; Huang, Yanqi [Guangdong General Hospital, Guangdong Academy of Medical Sciences, Department of Radiology, Guangzhou, Guangdong Province (China); He, Lan [Guangdong General Hospital, Guangdong Academy of Medical Sciences, Department of Radiology, Guangzhou, Guangdong Province (China); South China University of Technology, School of Medicine, Guangzhou, Guangdong (China); Chen, Xin [The Affiliated Guangzhou First People' Hospital, Guangzhou Medical University, Department of Radiology, Guangzhou, Guangdong (China); Xiong, Yabing [Southern Medical University, Guangzhou, Guangdong (China)

    2017-08-15

    To determine whether multiphasic dynamic CT can preoperatively predict lymphovascular invasion (LVI) in advanced gastric cancer (AGC). 278 patients with AGC who underwent preoperative multiphasic dynamic CT were retrospectively recruited. Tumour CT attenuation difference between non-contrast and arterial (Δ{sub AP}), portal (Δ{sub PP}) and delayed phase (Δ{sub DP}), tumour-spleen attenuation difference in the portal phase (Δ{sub T-S}), tumour contrast enhancement ratios (CERs), tumour-to-spleen ratio (TSR) and tumour volumes were obtained. All CT-derived parameters and clinicopathological variables associated with LVI were analysed by univariate analysis, followed by multivariate and receiver operator characteristics (ROC) analysis. Associations between CT predictors for LVI and histopathological characteristics were evaluated by the chi-square test. Δ{sub PP} (OR, 1.056; 95% CI: 1.032-1.080) and Δ{sub T-S} (OR, 1.043; 95% CI: 1.020-1.066) are independent predictors for LVI in AGC. Δ{sub PP}, Δ{sub T-S} and their combination correctly predicted LVI in 74.8% (AUC, 0.775; sensitivity, 88.6%; specificity, 54.1%), 68.7% (AUC, 0.747; sensitivity, 68.3%; specificity, 69.4%) and 71.7% (AUC, 0.800; sensitivity, 67.6%; specificity, 77.8%), respectively. There were significant associations between CT predictors for LVI with tumour histological differentiation and Lauren classification. Multiphasic dynamic CT provides a non-invasive method to predict LVI in AGC through quantitative enhancement measurement. (orig.)

  20. Adenocarcinoma of the pancreatic head: preoperative helical CT. Criteria of resectability

    International Nuclear Information System (INIS)

    Kozima, Shigeru; Szelagowski, Carlos; Tisserand, Guy L.; Ocampo, Carlos; Zandalazini, Hugo; Silva, Walter; Oria, Alejandro; Vidovic, Gustavo; Varas, Pablo

    2001-01-01

    Objective: The purpose of this study is to determine the accuracy of biphasic helical CT scanning in predicting resectability of adenocarcinoma of the head of the pancreas by staying tumor involvement of the portal and superior mesenteric veins. Material and methods: 46 patients with proven adenocarcinoma of the head of the pancreas who underwent curative or palliative surgery were studied with preoperative biphasic helical CT scanning. Tumor involvement of the portal and mesenteric veins was graduated on a 1-3 scale based on circumferential contiguity of the tumor vessel. Grade 1: without contact; grade 2: tumor involvement of less than 50% of the vessel; grade 3: tumor involvement of more than 50%. Results: The total number of vessels evaluated was 92. In our series the preoperative biphasic helical CT was accurate in 77% for resectability and unresectability. Conclusion: Our experience of staging in 3 grades with biphasic helical CT, vessel involvement the portal and superior mesenteric veins of adenocarcinoma of the head of the pancreas is highly specific for unresectable tumor in patients who were graded 2 and 3. (author)

  1. Sphincter preservation in distal CT2N0 rectal cancer after preoperative chemoradiotherapy

    International Nuclear Information System (INIS)

    Wasserberg, Nir; Kundel, Yulia; Purim, Ofer; Keidar, Andrei; Kashtan, Hanoch; Sadot, Eran; Fenig, Eyal; Brenner, Baruch

    2014-01-01

    Preoperative chemoradiotherapy is usually not indicated for cT2N0 rectal cancer. Abdominoperineal resection is the standard treatment for distal rectal tumors. The aim of the study was to evaluate the actual sphincter-preservation rate in patients with distal cT2N0 rectal cancer given neoadjuvant chemoradiotherapy. Data were retrospectively collected for all patients who were diagnosed with distal cT2N0 rectal cancer at a tertiary medical center in 2000–2008 and received chemoradiotherapy followed by surgery (5–7 weeks later). Thirty-three patients (22 male) of median age 65 years (range, 32–88) were identified. Tumor distance from the anal verge ranged from 0 to 5 cm. R0 resection with sphincter preservation was accomplished in 22 patients (66%), with a 22% pathological complete response rate. Median follow-up time was 62 months (range 7–120). There were no local failures. Crude disease-free and overall survival were 82% and 86%, respectively. Factors associated with sphincter preservation were tumor location (OR = 0.58, p = 0.02, 95% CI = 0.37-0.91) and pathological downstaging (OR = 7.8, p = 0.02, 95% CI = 1.35-45.85). Chemoradiotherapy was well tolerated. High rates of sphincter preservation can be achieved after preoperative chemoradiotherapy for distal cT2N0 rectal cancer, with tolerable toxicity, without compromising oncological outcome

  2. CT-guided preoperative needle localization of MRI-detected breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Giagounidis, Elektra M. E-mail: giagounjdis@online.de; Markus, Ruwe; Josef, Luetzeler; Wemer, Audretsch; Mahdi, Rezai; Bernward, Kurtz

    2001-08-01

    To assess the value of accurate preoperative CT-guided needle localization of occult breast lesions, we reviewed a total of 39 needle-directed biopsies of breast tumors in 24 women. The average age was 52.9 years (range 31-67). All lesions were nonpalpable and mammographically, as well as sonographically occult. They were solely seen on MR-images. After demonstrating the suspicious region on CT scans, a hookwire was inserted. The correct position was confirmed by a control scan. The subsequent histopathological examination showed that 28 of the lesions (71.8%) were benign, among them mastopathy, fibrosis, fibroadenoma, papilloma, intramammary lymph node, liponecrosis and epitheliosis. Eleven lesions (28%) were malignant and showed either lobular, ductal or tubular cancer. Our results endorse that CT guided needle localization is a helpful method that allows a precise surgical excision of the suspect area with the removal of a minimal amount of breast tissue.

  3. Peritoneal implants without ascites. Preoperative CT diagnosis in colon carcinoma patients

    International Nuclear Information System (INIS)

    Saida, Yukihisa; Itai, Yuji; Tsunoda, Hiroko; Matsueda, Kiyoshi.

    1994-01-01

    We evaluated the preoperative CT findings in 10 patients with colon carcinoma in whom peritoneal metastases had been surgically confirmed. Seven patients lacked ascites. No CT findings suggestive of peritoneal metastasis were observed in two patients without ascites even by retrospective evaluation. A large mass was observed in the cul-de-sac in another. In the remaining four patients, small peritoneal metastases ranging from 8 to 11 mm in diameter were observed at the omentum in two, along the falciform ligament in one, and at both the omentum and the iliac fossa in one; three of these patients had received no prospective diagnosis of peritoneal metastasis prior to the surgery. In patients with advanced colon carcinoma with suspected serosal invasion, the entire peritoneal cavity should be carefully examined and interpreted using CT in order to detect small peritoneal implants even when ascites is absent. (author)

  4. Barium enema and CT volumetry for predicting pathologic response to preoperative chemoradiotherapy in rectal cancer patients.

    Science.gov (United States)

    Murono, Koji; Kawai, Kazushige; Tsuno, Nelson H; Ishihara, Soichiro; Yamaguchi, Hironori; Sunami, Eiji; Kitayama, Joji; Watanabe, Toshiaki

    2014-06-01

    Preoperative chemoradiotherapy has been widely used for the prevention of local recurrence of locally advanced rectal cancer, and the effect of chemoradiotherapy is known to be associated with overall survival. We aimed to evaluate the association of the pathologic response grade with tumor recurrence rate after chemoradiotherapy, using radiographic analysis and the Response Evaluation Criteria in Solid Tumors as the parameters. This study was conducted at a single tertiary care institution in Japan. This was a retrospective cohort study of patients undergoing preoperative chemoradiotherapy. A total of 101 low rectal cancer patients receiving preoperative chemoradiotherapy from July 2004 to August 2012 were enrolled. The tumor reduction rate was measured with the use of traditional Response Evaluation Criteria in Solid Tumors, barium enema, and CT volumetry, and the correlation between the reduction rate and the pathologic response grade was examined. The tumor reduction rate assessed according to Response Evaluation Criteria in Solid Tumors showed no association with the pathologic response grade (p =0.61). In contrast, the radiographic response rate by both barium enema and CT volumetry strongly correlated with the pathologic response grade (p volumetry had a lower recurrence rate (p =0.03, p =0.03, p =0.0002, and p =0.001). The difference between high responders and low responders was especially prominent by barium enema and CT volumetry. The study is limited by its retrospective nature. Double-contrast barium enema and CT volumetry were superior to Response Evaluation Criteria in Solid Tumors in evaluating the effect of chemoradiotherapy and predicting the likelihood of tumor recurrence.

  5. Accuracy of preoperative diagnosis for primary hyperparathyroidism by CT, US and scintigraphy

    International Nuclear Information System (INIS)

    Imada, Masanobu; Nonaka, Satoshi; Hayashi, Tatsuya; Kunibe, Isamu; Harabuchi, Yasuaki

    2003-01-01

    We determined the usefulness of computed tomography (CT), ultrasonography (US) and Tc-Tl subtraction scintigraphy for preoperative diagnosis in 12 patients with primary hyperparathyroidism, all of which were solitary adenoma. Seven (63.6%) of 11 tumors were detected by CT, 7 (58.3%) of 12 tumors were detected by US, and 7 (63.6%) of 11 tumors were detected by Tc-Tl subtraction scintigraphy. Of 7 tumors with size>10 mm, 6 (85.7%) were detected by CT, 5 (71.4%) were detected by US, and 6 (85.7%) were detected by Tc-Tl subtraction scintigraphy, whereas only 1 (25%) with a diameter of 10 mm was detected by each of CT or Tc-Tl subtraction scintigraphy and 2 (40%) with diameters 10 mm were detected by US. Of 6 tumors situated behind the thyroid gland or intra thyroid gland, 5 (83.3%) were detected by CT and all 6 (100%) were detected by US, Tl-Tc subtraction scintigraphy, which was employed for 5 tumors, detected all 5 (100%). However, in the tumors situated beneath the thyroid gland only 2 (40%) of 5, 1 (16.7%) of 6 and 2 (33.3%) of 6 were detected by CT, US and Tc-Tl subtraction scintigraphy respectively. In 5 tumors without thyroid disease, 4 (80%) of 5 were detected by both CT and US, 3 (75%) of 4 were detected by Tc-Tl subtraction scintigraphy. However, in 7 tumors with thyroid diseases (papillary carcinoma, follicular carcinoma, follicular adenoma, chronic thyroiditis, and adenomatous goiter), 3 (50%) of 6 were detected by CT, 3 (42.9%) of 7 were detected by US and 4 (57.1%) of 7 were detected by Tc-Tl subtraction scintigraphy. Location of tumor was the factor most likely to make appropriate diagnosis difficult for primary hyperparathyroidism by any assessment method. (author)

  6. Vascular involvement in pancreatic carcinoma. Pre-operative assessment by multislice CT angiography

    International Nuclear Information System (INIS)

    Ling Huawei; Guan Yongjing; Ding Bei; Lin Xiaozhu; Zhang Huan; Chen Kemin

    2002-01-01

    Objective: To study the value of multislice CT angiography (MSCTA) in the pre-operative assessment of vascular involvement in pancreatic carcinoma. Methods: 33 cases with pathologically proven pancreatic carcinoma underwent MSCTA prior to surgical intervention. The MSCTA findings in each of the 33 patients were evaluated prospectively by four radiologists. Vascular involvement of pancreatic carcinoma was validated at the time of surgery, which was a reference standard for comparison. Correlation was made between MSCTA findings and surgical results. Results: 11 out of 33 cases with pancreatic carcinoma were considered to be resectable by MSCTA with a positive predictive value of 82% in comparison with surgical findings. MSCTA also had high correlation with surgical results in assessing the non-resectability of pancreatic carcinoma (positive predictive value =95%). Conclusion: MSCTA could delineate the vascular involvement of pancreatic carcinoma with high accuracy and provided valuable information in the preoperative assessment of pancreatic carcinoma

  7. The correlation of preoperative CT, MR imaging, and clinical staging (FIGO) with histopathology findings in primary cervical carcinoma

    International Nuclear Information System (INIS)

    Oezsarlak, Oe.; Schepens, E.; Corthouts, B.; Beeck, B.O. de; Parizel, P.M.; De Schepper, A.M.; Tjalma, W.; Marck, E. van

    2003-01-01

    The aim of this study was to compare the preoperative findings of abdominal/pelvic CT and MRI with the preoperative clinical International Federation of Obstetrics and Gynecology (FIGO) staging and postoperative pathology report in patients with primary cancer of the cervix. Thirty-six patients with surgical-pathological proven primary cancer of the cervix were retrospectively studied for preoperative staging by clinical examination, CT, and MR imaging. Studied parameters for preoperative staging were the presence of tumor, tumor extension into the parametrial tissue, pelvic wall, adjacent organs, and lymph nodes. The CT was performed in 32 patients and MRI (T1- and T2-weighted images) in 29 patients. The CT and MR staging were based on the FIGO staging system. Results were compared with histological findings. The group is consisted of stage 0 (in situ):1, Ia:1, Ib:8, IIa:2, IIb:12, IIIa:4, IVa:6, and IVb:2 patients. The overall accuracy of staging for clinical examination, CT, and MRI was 47, 53, and 86%, respectively. The MRI incorrectly staged 2 patients and did not visualize only two tumors; one was an in situ (stage-0) and one stage-Ia (microscopic) disease. The MRI is more accurate than CT and they are both superior to clinical examination in evaluating the locoregional extension and preoperative staging of primary cancer of the cervix. (orig.)

  8. Anatomical and embryological considerations of renal vein abnormalities: The value of preoperative CT

    International Nuclear Information System (INIS)

    Hruby, W.; Hoelti, W.

    1986-01-01

    Renal vein abnormalities are an uncommon kind of vascular abnormality. The distribution in the general population is 1.5%-2.5% in unselected pathologic material. In 354 autopsies we have seen six cases of renal vein abnormalities; in 215 cases of major retroperitoneal surgery, seven renal vein abnormalities; and in 4,500 patients who underwent CT examinations of the retroperitoneal areas, 36 cases of atypical renal vein anatomy. The radiologist must be familiar with embryologic details to understand the development of renal vein abnormalities. The authors discuss the value of preoperative diagnosis for preventing a surgical disaster in major retroperitoneal surgery

  9. Preoperative evaluation of renal anatomy and renal masses with helical CT, 3D-CT and 3D-CT angiography.

    Science.gov (United States)

    Toprak, Uğur; Erdoğan, Aysun; Gülbay, Mutlu; Karademir, Mehmet Alp; Paşaoğlu, Eşref; Akar, Okkeş Emrah

    2005-03-01

    The aim of this prospective study was to determine the efficacy of three-dimensional computed tomography (3D-CT) and three-dimensional computed tomographic angiography (3D-CTA) that were reconstructed by using the axial images of the multiphasic helical CT in the preoperative evaluation of renal masses and demonstration of renal anatomy. Twenty patients that were suspected of having renal masses upon initial physical examination and ultrasonographic evaluation were examined through multiphasic helical CT. Two authors executed CT evaluations. Axial images were first examined and then used to reconstruct 3D-CT and 3D- CTA images. Number, location and size of the renal masses and other findings were noted. Renal vascularization and relationships of the renal masses with the neighboring renal structures were further investigated with 3D-CT and 3D-CTA images. Out of 20 patients, 13 had histopathologically proven renal cell carcinoma. The diagnoses of the remaining seven patients were xanthogranulomatous pyelonephritis, abscess, simple cyst, infected cyst, angiomyolipoma, oncocytoma and arteriovenous fistula. In the renal cell carcinoma group, 3 patients had stage I, 7 patients had stage II, and 3 patients had stage III disease. Sizes of renal cell carcinoma masses were between 23 mm to 60 mm (mean, 36 mm). Vascular invasion was shown in 2 renal cell carcinoma patients. Collecting system invasion was identified in 11 of 13 renal cell patients. These radiologic findings were confirmed with surgical specimens. Three-dimensional CT and 3D-CTA are non-invasive, effective imaging techniques for the preoperative evaluation of renal masses.

  10. Preoperative CT assessment of esophageal carcinoma : comparison between the patients with and without recurrence of esophageal carcinoma after surgical resection

    International Nuclear Information System (INIS)

    Lee, Young Hen; Oh, Yu Whan; Cho, Kyu Ran; Park, Bum Jin; Lee, Nam Jun; Chung, Kyoo Byung

    2001-01-01

    To determine whether preoperative CT is helpful in predicting the development of recurrent tumor following surgical resection in patients with esophageal cancer. Thirty patients with esophageal cancer in whom preoperative CT of the chest had been performed were included in the study. All had undergone esophagectomy, esophagogastrostomy and lymph node dissection at our institution between 1995 and 1997. They were divided into two groups according to the development of tumor recurrence during the follow-up period of three years. Sixteen patients (group I) suffered tumor recurrence, while the other 14 (group II) remained tumor-free after surgery. In each group, a review of the preoperative CT scans indicated the length, thickness, location and margin of the tumor, and the presence or absence of lymphadenopathy in the mediastinum and/or upper abdomen. Differences in preoperative CT findings between the two groups were assessed by statistical testing. Lymphadenopathy of the mediastinum and/or upper abdomen was seen in 11 (69%) of 16 patients in group I and three (21%) of 14 in group II (p .05). In group I, five esophageal tumors were located in the middle esophagus and eleven in the lower esophagus. In group II, such tumor was located one in the upper esophagus, six in the middle esophagus, and seven in the lower esophagus (p>.05). Patients with preoperative CT findings of lymphadenopathy and/or and indistinct primary tumor margin are more likely to develop tumor recurrence following surgical resection than those without these findings

  11. Preoperative assessment of gastric artery in patients with gastric cancer by CT angiography on 64-slice spiral CT

    International Nuclear Information System (INIS)

    Tang Lei; Zhang Xiaopeng; Sun Yingshi; Cao Kun; Qi Liping; Cui Yong; Wang Ning

    2010-01-01

    Objective: To evaluate the efficacy of different three-dimensional CTA methods on 64-slice sprial CT in the preoperative assessment of gastric arteries and their variations. Methods: Sixty-six consecutive patients with gastric cancer who underwent 64-slice spiral CT examinations preoperatively were retrospectively studied. To get the STS-MIP images, the thickness of slab was adjusted according to the inner diameter of targeted blood vessels and their cross-layer distribution. After four weeks, the AVVR images of all cases was got by the auto-vessel technique. The demonstration rates and origins of the direct and indirect feeding arteries were analyzed on AVVR and STS-MIP. McNemar tests were used to compare the detection rates of gastric feeding arteries by STS-MIP and AVVR. The relationship between CT value and display rate of vessels was analyzed using independent-samples t test. The variations of blood vessels were analyzed. Results: The display rate of indirect feeding arteries were all 100% (66/66) by STS-MIP and AVVR. The display rates of left gastric artery (LGA) and right gastroepiploic artery (RGEA) were 98.5% (65/66), 100.0% (66/66) and 97.0% (64/66), 100.0% (66/66) by STS-MIP and AVVR respectively. The display rates of right artery (RGA), left gastroepiploic artery (LGEA), short gastric artery (SGA) and posterior gastric artery (RGA), left gastroepiploic artery (LGEA), short gastric artery (SGA) and posterior gastric artery (PGA) by AVVR were lower than those of STS-MIP with statistical significances [RGA: 68.2% (45/66) vs. 98.5% (65/66), P<0.01; LGEA: 53.0% (35/66) vs. 97.0% (64/66), P<0.01; SGA: 7.6%(5/66) vs. 59.1% (39/66), P<0.01; PGA: 18.2% (12/66) vs. 63.6% (42/66), P<0.01]. The demonstration rates of LGEA, RGEA and SGA increased accompanied with the increasing of CT value in celiac axis (LGEA: 35 cases displayed with mean CT value of (272 ± 44) HU, 31 cases did not display with mean CT value of (229 ± 42) HU, t=4.043, P<0.01; RGEA: 64 cases

  12. Usefulness of preoperative chest multidetector CT for evaluation of breast cancer: comparison with breast MRI

    International Nuclear Information System (INIS)

    Chang, Yun Woo; Kim, Dong Hun; Lee, Min Hyuk

    2005-01-01

    To evaluate the efficacy of chest multidetector-row helical computed tomography (MDCT) in detecting breast cancer in preoperative metastasis work-ups and to assess the accuracy of MDCT compared with magnetic resonance imaging (MRI). MDCT were performed on 69 consecutive patients with 94 lesions of histologically proven breast cancer. Retrospectively, two radiologists performed a blind review of the MDCT images for margin, shape, mass enhancement pattern and the enhancing distribution of non-mass lesions with consensus. CT attenuation values were measured in the average HU on pre-enhancing and enhanced CT in gland, fat, muscle, and in masses with the largest region of interest (ROI). MDCT finding were analyzed and compared with breast MRI. Of the 91 breast lesions detected on MDCT, 64 were mass lesions and 24 were non-mass lesions on enhancement, 86 lesions were malignant and 5 were benign. Three pathologically proven malignant masses were not detected on MDCT. Positive predictive value, false positive rate and false negative rate were 94.5%, 5.3%, 3.2% respectively. The highly predictive features for malignancy were a spiculated or irregular margin, an irregular of round shape, and a heterogeneously or rim enhanced mass. Another highly predictive feature for malignancy was linear or segmentally distributed enhancing non-mass lesions. The CT values of masses in pre-enhanced scans were 38.6 ± 7.9 HU; these values increased to 110.9 ± 26.6 HU after contrast injection (90 sec). The attenuation values from enhancing CT of malignant lesions were significantly higher than those of non-enhancing lesions. The depiction of enhancing masses on MDCT compared with MR imaging were 88.6%. The extension of malignancy were equally well correlated MDCT with MR imaging. The diagnostic value of chest MDCT for preoperative staging is comparable with MR imaging for the detection and extension of lesions. Therefore, chest MDCT of breast cancer can add to the information obtained from

  13. Preoperative CT versus diffusion weighted magnetic resonance imaging of the liver in patients with rectal cancer; a prospective randomized trial

    Directory of Open Access Journals (Sweden)

    Michael P. Achiam

    2016-01-01

    Full Text Available Introduction. Colorectal cancer is one of the most frequent cancers in the world and liver metastases are seen in up to 19% of patients with colorectal cancers. Detection of liver metastases is not only vital for sufficient treatment and survival, but also for a better estimation of prognosis. The aim of this study was to evaluate the feasibility of diffusion weighted MRI of the liver as part of a combined MR evaluation of patients with rectal cancers and compare it with the standard preoperative evaluation of the liver with CT.Methods. Consecutive patients diagnosed with rectal cancers were asked to participate in the study. Preoperative CT and diffusion weighted MR (DWMR were compared to contrast enhanced laparoscopic ultrasound (CELUS.Results. A total of 35 patients were included, 15 patients in Group-1 having the standard CT evaluation of the liver and 20 patients in Group-2 having the standard CT evaluation of the liver and DWMR of the liver. Compared with CELUS, the per-patient sensitivity/specificity was 50/100% for CT, and for DWMR: 100/94% and 100/100% for Reader 1 and 2, respectively. The per-lesion sensitivity of CT and DWMR were 17% and 89%, respectively compared with CELUS. Furthermore, one patient had non-resectable metastases after DWMR despite being diagnosed with resectable metastases after CT. Another patient was diagnosed with multiple liver metastases during CELUS, despite a negative CT-scan.Discussion. DWMR is feasible for preoperative evaluation of liver metastases. The current standard preoperative evaluation with CT-scan results in disadvantages like missed metastases and futile operations. We recommend that patients with rectal cancer, who are scheduled for MR of the rectum, should have a DWMR of the liver performed at the same time.

  14. Preoperative assessment of the cancellous bone mineral density of the proximal humerus using CT data

    International Nuclear Information System (INIS)

    Krappinger, Dietmar; Roth, Tobias; Gschwentner, Martin; Suckert, Armin; Blauth, Michael; Hengg, Clemens; Kralinger, Franz

    2012-01-01

    Osteoporotic fractures of the proximal humerus show an increasing incidence. Osteoporosis not only influences the fracture risk after low-energy trauma, but also affects the mechanical stability of internal fixation. Preoperative assessment of the local bone quality may be useful in the surgical treatment of patients sustaining these injuries. The aim of the present study was to present a method for the preoperative assessment of the local cancellous bone mineral density (BMD) of the proximal humerus using CT data. In the first part of the study, CT scans of 30 patients with unilateral fractures of the proximal humerus after low-energy trauma were used. The local BMD was assessed on the contralateral uninjured side. All 30 patients additionally underwent dual-emission X-ray absorptiometry (DXA) of the lumbar spine, proximal femur, and forearm of the side of the uninjured proximal humerus within 6 weeks after trauma. Three independent trauma surgeons performed measurements on the uninjured proximal humerus twice with a time interval of 4 weeks in order to assess the inter- and intraobserver reliability of the method. In the second part of the study, the local BMD of 507 patients with either proximal humerus fractures or chronic shoulder instability was assessed by a single trauma surgeon. In both parts, the average HU values in standardized ROIs of the humeral head were automatically calculated after correcting for HU values below the water equivalent. A linear calibration equation was computed for the calculation from HU to BMD using a calibration device (EFP). The intra- and interobserver reliability was high (ICC > 0.95). Correlation coefficients between the local BMD of the proximal humerus and other anatomical sites were between 0.35 (lumbar spine) and 0.64 (forearm). We found a high correlation between the local BMD and age. The BMD in the fracture group was significantly lower than in the instability group. These patients were significantly older and more

  15. Preoperative assessment of the cancellous bone mineral density of the proximal humerus using CT data

    Energy Technology Data Exchange (ETDEWEB)

    Krappinger, Dietmar; Roth, Tobias; Gschwentner, Martin; Suckert, Armin; Blauth, Michael; Hengg, Clemens; Kralinger, Franz [Innsbruck Medical University, Department of Trauma Surgery and Sports Medicine, Innsbruck (Austria)

    2012-03-15

    Osteoporotic fractures of the proximal humerus show an increasing incidence. Osteoporosis not only influences the fracture risk after low-energy trauma, but also affects the mechanical stability of internal fixation. Preoperative assessment of the local bone quality may be useful in the surgical treatment of patients sustaining these injuries. The aim of the present study was to present a method for the preoperative assessment of the local cancellous bone mineral density (BMD) of the proximal humerus using CT data. In the first part of the study, CT scans of 30 patients with unilateral fractures of the proximal humerus after low-energy trauma were used. The local BMD was assessed on the contralateral uninjured side. All 30 patients additionally underwent dual-emission X-ray absorptiometry (DXA) of the lumbar spine, proximal femur, and forearm of the side of the uninjured proximal humerus within 6 weeks after trauma. Three independent trauma surgeons performed measurements on the uninjured proximal humerus twice with a time interval of 4 weeks in order to assess the inter- and intraobserver reliability of the method. In the second part of the study, the local BMD of 507 patients with either proximal humerus fractures or chronic shoulder instability was assessed by a single trauma surgeon. In both parts, the average HU values in standardized ROIs of the humeral head were automatically calculated after correcting for HU values below the water equivalent. A linear calibration equation was computed for the calculation from HU to BMD using a calibration device (EFP). The intra- and interobserver reliability was high (ICC > 0.95). Correlation coefficients between the local BMD of the proximal humerus and other anatomical sites were between 0.35 (lumbar spine) and 0.64 (forearm). We found a high correlation between the local BMD and age. The BMD in the fracture group was significantly lower than in the instability group. These patients were significantly older and more

  16. Preoperative cerebral aneurysm assessment by three-dimensional CT angiography. Feasibility of surgery without cerebral angiography

    International Nuclear Information System (INIS)

    Kashiwagi, Shiro; Yamashita, Katsuhiro; Kato, Shoichi; Ito, Haruhide; Kurokawa, Kensuke; Watanabe, Yutaka

    1999-01-01

    The purpose of this study is to assess the capability of three-dimensional CT angiography (3D-CTA) to replace conventional catheter angiography as a preoperative examination for unruptured intracranial aneurysms. A prospective study was designed to evaluate 18 patients with 20 unruptured intracranial aneurysms (13 middle cerebral artery aneurysms, 6 anterior communicating artery aneurysms, and 1 internal carotid posterior communicating artery aneurysm) who underwent surgery. There were 12 women and 6 men with the average age of 63 years old. All patients were initially diagnosed as having intracranial aneurysms by MR angiography, followed by 3D-CTA and conventional catheter angiography for confirmation. Three experienced neurosurgeons were in charge of the operations. One of the neurosurgeons (surgeon 1) was provided with only 3D-CTA as the preoperative radiological evaluation, while the others (surgeon 2 and 3) were given through assessments with MRA, 3D-CTA, and conventional angiography. Surgeon 1 carried out the operations under careful observation by the surgeons 2 and 3. Problems encountered by the surgeon 1 during surgery were recorded. Neck clipping in 19 aneurysms and dome wrapping in 1 were successfully accomplished. All patients were discharged without complication. Surgeries went smoothly in 16 aneurysms with 3D-CTA alone. Discrepancies between the 3D-CTA findings and microsurgical anatomy were noted in 4 aneurysms: the size of the neck was overestimated in 3 aneurysms, the relationships to parent arteries were obscure in 2 aneurysms, and a perforating artery problematic to neck clipping was missed in 1 aneurysms by 3D-CTA. The results of this study support the notion that 3D-CTA can replace conventional catheter angiography as preoperative examination in the majority of regular-sized anterior circulation aneurysms. Nevertheless, surgeons should recognize and be prepared for the fact that 3D-CTA can give false impression about the aneurysm neck and

  17. Preoperative staging of esophageal carcinoma with multidetector CT and virtual endoscopy

    International Nuclear Information System (INIS)

    Onbas, Omer; Eroglu, Atilla; Kantarci, Mecit; Polat, Pinar; Alper, Fatih; Karaoglanoglu, Nurettin; Okur, Adnan

    2006-01-01

    Purpose: The aim of this study was to assess the accuracy of multidetector computed tomography (MDCT), including virtual endoscopy (VE) for detection, precise localization, preoperative evaluation and staging of esophageal cancer (EC) by comparison with surgical and histopathological findings. Materials and methods: Between September 2003 and April 2005, 44 patients with histologically proven EC underwent MDCT and VE. Among 44 patients, the findings were confirmed in 24 at surgery. The accuracy of three-dimensional MDCT for detection, localization, and staging of EC was determined, and compared with surgical finding and histopathology. Results: The overall accuracy of three-dimensional multidetector row CT for detection of EC was 100% (24/24). MDCT staging was correct in 20 patients (83.3%). The T parameter was correctly assessed in 22 (91.7%) cases (understaged in 1 and overstaged in 1). The N parameter was correctly evaluated in 20 (83.4%) patients (understaged in 2 and overstaged in 2). The overall accuracy of VE for the morphologic classification of EC was 81.5%. Conclusions: Three-dimensional MDCT, along with VE is a promising method for preoperative evaluation and staging of EC. Although accuracy in N staging remains low in comparison to PET, it provides a larger amount of diagnostic and staging information

  18. From CT scanning to 3-D printing technology for the preoperative planning in laparoscopic splenectomy.

    Science.gov (United States)

    Pietrabissa, Andrea; Marconi, Stefania; Peri, Andrea; Pugliese, Luigi; Cavazzi, Emma; Vinci, Alessio; Botti, Marta; Auricchio, Ferdinando

    2016-01-01

    Three-dimensional printing technology is rapidly changing the way we produce all sort of objects, having also included medical applications. We embarked in a pilot study to assess the value of patient-specific 3-D physical manufacturing of spleno-pancreatic anatomy in helping during patient's counseling and for preoperative planning. Twelve patients scheduled for a laparoscopic splenectomy underwent contrast CT and subsequent post-processing to create virtual 3-D models of the target anatomy, and 3-D printing of the relative solid objects. The printing process, its cost and encountered problems were monitored and recorded. Patients were asked to rate the value of 3-D objects on a 1-5 scale in facilitating their understanding of the proposed procedure. Also 10 surgical residents were required to evaluate the perceived extra value of 3-D printing in the preoperative planning process. The post-processing analysis required an average of 2; 20 h was needed to physically print each model and 4 additional hours to finalize each object. The cost for the material employed for each object was around 300 euros. Ten patients gave a score of 5, two a score of 4. Six residents gave a score of 5, four a score of 4. Three-dimensional printing is helpful in understanding complex anatomy for educational purposes at all levels. Cost and working time to produce good quality objects are still considerable.

  19. Comparison of CT and 18F-FDG PET for Detecting Peritoneal Metastasis on the Preoperative Evaluation for Gastric Carcinoma

    International Nuclear Information System (INIS)

    Lim, Joon Seok; Kim, Myeong Jin; Yun, Mi jin

    2006-01-01

    The aim of our study was to compare the accuracy of CT and 18 F-FDG PET for detecting peritoneal metastasis in patients with gastric carcinoma. One-hundred-twelve patients who underwent a histologic confirmative exam or treatment (laparotomy, n = 107; diagnostic laparoscopy, n = 4; peritoneal washing cytology, n = 1) were retrospectively enrolled. All the patients underwent CT and 18 F-FDG PET scanning for their preoperative evaluation. The sensitivities, specificities and accuracies of CT and 18 FFDG PET imaging for the detection of peritoneal metastasis were calculated and then compared using Fisher's exact probability test (p 18 F-FDG PET imaging for detecting peritoneal metastasis. Based on the original preoperative reports, CT and 18 F-FDG PET showed sensitivities of 76.5% and 35.3% (p = 0.037), specificities of 91.6% and 98.9% (p = 0.035), respectively, and equal accuracies of 89.3% (p = 1.0). The receptor operating characteristics curve analysis showed a significantly higher diagnostic performance for CT (Az 0.878) than for PET (Az = 0.686) (p 0.004). The interobserver agreement for detecting peritoneal metastasis was good (κ value = 0.684) for CT and moderate ((κ value = 0.460) for PET. For the detection of peritoneal metastasis, CT was more sensitive and showed a higher diagnostic performance than PET, although CT had a relatively lower specificity than did PET

  20. Role of preoperative PET-CT in assessing mediastinal and hilar lymph node status in early stage lung cancer

    Directory of Open Access Journals (Sweden)

    Wei-Yang Lin

    2012-05-01

    Conclusion: Integrated PET-CT is a useful tool for predicting the negativity of mediastinal LN status pre-operatively in clinically early stage (Stages I and II lung cancer but may be relatively inaccurate in predicting hilar LN status and largely confounded by false positives caused by inflammatory process.

  1. MRI, PET/CT and ultrasound in the preoperative staging of endometrial cancer - A multicenter prospective comparative study

    DEFF Research Database (Denmark)

    Antonsen, Sofie Leisby; Jensen, Lisa Neerup; Loft, Annika

    2012-01-01

    OBJECTIVES: The aim of this prospective multicenter study was to evaluate and compare the diagnostic performance of PET/CT, MRI and transvaginal two-dimensional ultrasound (2DUS) in the preoperative assessment of endometrial cancer (EC). METHODS: 318 consecutive women with EC were included when...

  2. Role of multislice CT and magnetic resonance cholangiography in preoperative evaluation of potential donor in living related liver transplantation

    Directory of Open Access Journals (Sweden)

    Hossam M. Abdel-Rahman

    2016-03-01

    Conclusion: Multislice CT is a valuable tool in the evaluation of potential living liver donors that provides complete information on the hepatic vascular anatomy, the liver parenchyma, and volumetric measurements. MRC with a 3.0-T MR system demonstrates the preoperative biliary evaluation very well with a high accuracy rate.

  3. The role of multi-slice CT in preoperative staging of colonic tumors

    International Nuclear Information System (INIS)

    Zhang Miao; Chen Kemin; Zhao Zehua; Ling Huawei

    2005-01-01

    Objective: To determine the accuracy of multi-slice CT pneumocolon in the staging of colonic carcinomas. Methods: Thirty-six patients, who were strongly suspected to have colonic disorders, underwent CT pneumocolon before and after intravenous injection of iodinated contrast agent. CTVE, MPR, SSD, and Raysum images were then obtained by using 4 different softwares in workstation (ADW3.1). 33 positive cases were staged preoperatively according to TNM standard. All cases were proved by surgical or colonoscopic histology. Sensitivity and accuracy of MSCT were determined for the detection of cancers, lymph nodes, and metastases. Results: MSCT pneumocolon examinations demonstrated 32 lesions, missing one case. Sensitivity and positive accuracy value for T staging were 96.97% (32/33) and 87.88% (29/33), respectively; Sensitivity and positive accuracy value for lymph node involvement were 73.91% (17/23) and 69.57% (16/23), respectively. The density of metastatic lymph node was higher than that of normal one. Five cases in M stage were all diagnosed correctly. Conclusion: MSCT pneumocolon is a better method of depicting the colorectal carcinoma. It allows for accurate staging of the colorectal carcinoma, especially detecting the invasion of adjacent tissues and distant metastasis. However the value for early T staging in colorectal carcinoma and minute metastasis of lymph nodes is limited. It is helpful to combine all the findings of lymph nodes, including the size, density, and location, to make a correct diagnosis. (authors)

  4. Preoperative staging of lung cancer with PET/CT: cost-effectiveness evaluation alongside a randomized controlled trial

    DEFF Research Database (Denmark)

    Søgaard, Rikke; Fischer, Barbara Malene B; Mortensen, Jann

    2011-01-01

    PURPOSE: Positron emission tomography (PET)/CT has become a widely used technology for preoperative staging of non-small cell lung cancer (NSCLC). Two recent randomized controlled trials (RCT) have established its efficacy over conventional staging, but no studies have assessed its cost-effective......PURPOSE: Positron emission tomography (PET)/CT has become a widely used technology for preoperative staging of non-small cell lung cancer (NSCLC). Two recent randomized controlled trials (RCT) have established its efficacy over conventional staging, but no studies have assessed its cost......-effectiveness. The objective of this study was to assess the cost-effectiveness of PET/CT as an adjunct to conventional workup for preoperative staging of NSCLC. METHODS: The study was conducted alongside an RCT in which 189 patients were allocated to conventional staging (n = 91) or conventional staging + PET/CT (n = 98......) and followed for 1 year after which the numbers of futile thoracotomies in each group were monitored. A full health care sector perspective was adapted for costing resource use. The outcome parameter was defined as the number needed to treat (NNT)-here number of PET/CT scans needed-to avoid one futile...

  5. The value of multi-slice spiral CT in the preoperative assessment of living renal donor

    International Nuclear Information System (INIS)

    Li Qinghai; Yan Fuhua; Xu Pengju; Zhou Meiling; Zhu Tongyu; Xu Ming; Wang Guomin

    2008-01-01

    Objective: The purpose of this study is to assess the value of multi-slice spiral CT (MSCT) in the preoperative evaluation of living renal donor as a all in one modality. Methods: Thirty-six potential living renal donors underwent the examination using a GE light VCT scanner. Informed consent was obtained from all participants. The plain scan, early arterial phase, late arterial phase and excretory phase scans are performed in the former 25 donors (injection rate 5 rolls, total volume 100 mi, tube tension 120 kV). While in the later 11 donors (2 ml/s 40 ml +4 ml/s 60 ml), the scanning protocol included the plain scan ( 100 kV), vascular phase and excretory phase scans (100 kV). The excretory phase data were used in the reconstruction of CT urography in both groups. All images were reviewed by one radiologist and one urologist, and the findings of MSCT were compared with intraoperative findings for 33 donors, to investigate the utilities of MSCT in assessing renal vascularity, urinary tract and lesions of renal parenchyma. When discrepancies are found between the two reviewers, consensus was obtained via discussion. Au data was statiscally processed with SPSS for Windows. Results: MSCT angiography is in accordance with intraoperative findings in demonstrating the anatomy of renal arteries and renal vein trunk, accesary arteries, early branching of renal artery. The findings from CTA are highly in accordance with the intraoperative findings, which facilitate intraoperative ligation and reduce relevant complications. CTU demonstrates the anatomy of urinary, tract in good agreement with the intraoperative findings. The image quality of 3D vascularity and CTU between the two groups, scored 4.4 ± 1.2 vs 4.2 ± 1.3 and 4.6 ± 0.8 vs 4.4 ± 0.9 respectively, no statistical between-groups difference was found (Z=-0.89, -0.47, P>0.05). Conclusion: MSCT multiphase scanning combined with CTA and CTU play a important role in the evaluation of living renal donor, which

  6. The value of multislice spiral CT in the pre-operative diagnosis of cleft palate

    International Nuclear Information System (INIS)

    Tang Guangxi; Sun Lianfen; Zhang Xiaolin; Yu Chengxin; Lu Ji; Wang Xiaopeng; Li Liya; Yang Cheng; Wang Jun; Tian Yiqing

    2004-01-01

    Objective: To evaluate the practical value of multislice spiral CT (MSCT) in the preoperative diagnosis of cleft palate. Methods: Twenty patients with cleft palate were examined by using thin-slice (1.25 mm/4i) axial MSCT scanning and CT virtual endoscope (CTVE) imaging before and after operations. The cleft of each lesion was measured in the primary axial images. Results: Of the 20 cases, soft-and-hard cleft palate (grade II) was detected in 10 cases, with the clefts of soft palate between 1.5 cm and 2.2 cm, and the clefts of soft-and-hard palate between 1.2 cm and 2.0 cm. The right utter cleft palates were found in 3 cases with the clefts of soft palate between 2.0 cm and 2.5 cm, the clefts of soft-and-hard palate between 2.0 cm and 2.4 cm, and the clefts of hard palate between 1.8 cm and 2.2 cm. The left utter cleft palates (grade III) were found in 5 cases with the clefts of soft palate between 1.2 cm and 1.8 cm, the clefts of soft-and-hard palate between 0.9 cm and 2.0 cm, and the clefts of hard palate between 0.9 cm and 1.8 cm. The bilateral utter cleft palates (grade III) were detected in 2 cases with the clefts of soft palate between 2.1 cm and 2.3 cm, the clefts of soft-and-hard palate between 1.8 cm and 2.0 cm, and the clefts of hard palate between 1.9 cm and 2.3 cm. Conclusion: MSCT could excellently display the shape of all lesions before operation, especially the splitting degree of hard cleft palates in the axial images. Accurate measurements could be done for the cleft of different lesions in MSCT images. CTVE could clearly and directly show the shape of the lesion's interior surface. The pre-operative and post-operative images of each case could be perfectly compared by the combination of MSCT and CTVE

  7. The usefulness of CT and MR imaging in the preoperative evaluation of neoplasms of the craniofacial region

    International Nuclear Information System (INIS)

    Grzesiakowska, U.; Tacikowska, M.; Krajewski, R.; Starosciak, S.; Smorczewska, M.; Wiszniewska-Rawlik, D.

    2005-01-01

    The aim of the study was to determine the usefulness of CT and MR imaging in the preoperative evaluation of neoplasms of the craniofacial region. All the patients were treated surgically. CT and/or MR imaging was done in every patient for preoperative evaluation of soft tissue infiltration, destruction of bone structures, and metastasis of lymph nodes of the head and neck. The results of these imagings were compared with surgical evaluations and microscopic examination of postoperative specimens. Both CT and MR imaging have high accuracy in evaluating soft tissue infiltration. CT imaging is much better than MR in evaluating bony destruction. MR imaging is better in evaluating recurrent tumors, in which CT has very low specificity. MR imaging is the only method for evaluating infiltration of the central nervous system.The authors propose the following diagnostic algorithm: CT imaging for initial evaluation before treatment, MR imaging in suspected cases of infiltration of the central nervous system, and MR imaging in recurrent tumors after surgical and radiation treatment. (author)

  8. Estimation of carrying angle based on CT images in preoperative surgical planning for cubitus deformities

    International Nuclear Information System (INIS)

    Park, Shinsuk; Kim, Eugene

    2009-01-01

    Conventionally, the carrying angle of the elbow is measured using simple two-dimensional radiography or goniometry, which has questionable reliability. This study proposes a novel method for estimating carrying angles using computed tomography that can enhance the reliability of the angle measurement. Data of CT scans from 25 elbow joints were processed to build segmented three-dimensional models. The cross-sectional centerlines of the ulna and the humerus were traced from the 3D models, and the angle between 2 vectors formed from the centerlines of the humerus and the ulna was defined as the 'three-dimensional carrying angle.' These angles were compared with those measured by simple radiograph. Two cases of angular deformity were underwent surgery based on this preoperative surgical planning, and the postoperative 3D carrying angles were evaluated using the proposed method. The mean value of the calculated three-dimensional carrying angle was 20.7deg±3.61, while it was 16.3deg±3.21 based on simple radiography without statistical difference. Based on the 3D carrying angle estimations, 2 surgical cases of cubitus deformities were planned by comparison with the normal contra-lateral elbow. Postoperative angle estimations confirmed that the corrected angles were nearly identical to the planned angles for both cases. The results of this study showed that the carrying angle can be accurately estimated using three-dimensional CT and that the proposed method is useful in evaluating deformities of the elbow with high reliability. (author)

  9. Accuracy of CT enterography and magnetic resonance enterography imaging to detect lesions preoperatively in patients undergoing surgery for Crohn's disease.

    Science.gov (United States)

    Seastedt, Kenneth P; Trencheva, Koiana; Michelassi, Fabrizio; Alsaleh, Doaa; Milsom, Jeffrey W; Sonoda, Toyooki; Lee, Sang W; Nandakumar, Govind

    2014-12-01

    CT enterography and magnetic resonance enterography have emerged as first-line imaging technologies for the evaluation of the gastrointestinal tract in Crohn's disease. The purpose of this work was to evaluate the accuracy of these imaging modalities to identify Crohn's disease lesions preoperatively. This was a retrospective chart review. The study was conducted at a single institution. Seventy-six patients with Crohn's disease with preoperative CT enterography and/or magnetic resonance enterography were included in the study. The number of stenoses, fistulas, and abscesses on CT enterography and/or magnetic resonance enterography before surgery were compared with operative findings. Forty patients (53%) were women, 46 (60%) underwent surgery for recurrent Crohn's disease, and 46 (57%) had previous abdominal surgery. Thirty-six (47%) had a preoperative CT enterography and 43 (57%) had a preoperative magnetic resonance enterography. CT enterography sensitivity was 75% for stenosis and 50% for fistula. MRE sensitivity was 68% for stenosis and 60% for fistula. The negative predictive values of CT enterography and magnetic resonance enterography for stenosis were very low (54% and 65%) and were 85% and 81% for fistula. CT enterography had 76% accuracy for stenosis and 79% for fistula; magnetic resonance enterography had 78% accuracy for stenosis and 85% for fistula. Both were accurate for abscess. False-negative rates for CT enterography were 50% for fistula and 25% for stenosis. False-negative rates for magnetic resonance enterography were 40% for fistula and 32% for stenosis. Unexpected intraoperative findings led to modification of the planned surgical procedure in 20 patients (26%). This study was limited by its small sample size, its retrospective nature, and that some studies were performed at outside institutions. CT enterography and magnetic resonance enterography in patients with Crohn's disease were accurate for the identification of abscesses but not for

  10. Prediction of recurrence after HCC resection. Faint oily deposits in preoperative Lipiodol-CT of remnant liver tissue

    International Nuclear Information System (INIS)

    Yamamoto, M.; Iimuro, Y.; Mogaki, M.; Kachi, K.; Fujii, H.; Matsumoto, Y.

    1994-01-01

    In trying to clarify the high recurrence rate after removal of small hepatocellular carconoma (HCC), we assessed the postoperative evolution of minute hepatic Lipiodol deposits which had been diagnosed as artifacts on the preoperative Lipiodol-CT. Of 27 patients with solitary HCC less than 5 cm in diameter, 14 had such Lipiodol deposits in the preoperative CT and 9 of them (64%) developed recurrent tumors. On the other hand, 6 of the 13 patients without deposits (46%) suffered recurrence, but in 5 of these 6 patients the HCC was metachronous multicentric. The cumulative survival rate of the non-deposit group was better than that of the deposit group (p<0.1). The present study suggested that, even in patients with small HCC, minute concomitant tumors invisible by conventional imaging techniques may exist at the time of surgery. Some of these lesions without sufficient tumor vasculature showing a hypervascular blush on angiography appear to retain small, vague Lipiodol deposits. (orig.)

  11. Hydro-dynamic CT preoperative staging of gastric cancer: correlation with pathological findings. A prospective study of 107 cases

    International Nuclear Information System (INIS)

    D'Elia, F.; Zingarelli, A.; Grani, M.; Palli, D.

    2000-01-01

    The aim of this study was to evaluate the accuracy of dynamic CT in the preoperative staging of gastric cancer. One hundred seven patients affected by gastric cancer diagnosed by endoscopic biopsy were prospectively staged by dynamic CT prior to tumor resection. After an oral intake of 400-600 ml of tap water and an intravenous infusion of a hypotonic agent, 200 ml of non-ionic contrast agent were administered by power injector using a biphasic technique. The CT findings were prospectively analyzed and correlated with the pathological findings at surgery. The accuracy of dynamic CT for tumor detection was 80 and 99 % in early and advanced gastric cancer, respectively, with overall detection rate of 96 % (103 of 107). Three early (pT1) and one advanced (pT2) cancers were undetected. Tumor stage as determined by dynamic CT agreed with pathological findings in 83 of 107 patients with an overall accuracy of 78 %. The accuracy of CT in detecting increasing degrees of depth of tumor invasion when compared with pathological TNM staging was 20 % (3 of 15) and 87 % (80 of 92) in early and advanced cancer, respectively. The sensitivity, specificity, and accuracy of CT in the preoperative staging (pT3-pT4 vs pT1-pT2) was 93, 90, and 91.6 %, respectively. The sensitivity, specificity, and accuracy of CT in assessing metastasis to regional lymph nodes was 97.2, 65.7, and 87 %, respectively. Computed tomography correctly staged liver metastases in 105 of 107 patients with an overall sensitivity of 87.5 % and specificity of 99 %. The sensitivity of peritoneal involvement was 30 % when ascites or peritoneal nodules were absent. Our findings show that dynamic CT can play a role in the preoperative definition of gastric cancer stage. The results can be used to optimize the therapeutic strategy for each individual patient prior to surgery, thus avoiding unnecessary intervention and allowing careful planning of extended surgery in eligible patients. (orig.)

  12. Diagnostic performance of 64-section CT using CT gastrography in preoperative T staging of gastric cancer according to 7th edition of AJCC cancer staging manual

    International Nuclear Information System (INIS)

    Kim, Jin Woong; Shin, Sang Soo; Heo, Suk Hee; Lim, Hyo Soon; Jeong, Yong Yeon; Kang, Heoung Keun; Choi, Yoo Duk; Park, Young Kyu; Park, Chang Hwan

    2012-01-01

    To evaluate the accuracy of 64-section multidetector CT with CT gastrography for determining the depth of mural invasion in patients with gastric cancer according to the 7th edition of the AJCC cancer staging manual. A total of 127 patients with gastric cancer and who had undergone both esophago-gastro-duodenoscopy and 64-section CT were included in this study. Two radiologists independently reviewed the preoperative CT images with respect to the detectability and T-staging of the gastric cancers. The sensitivity, specificity, accuracy and overall accuracy of each reviewer for the T staging of gastric cancer were calculated. Overall, gastric cancer was detected in 123 (96.9%) of the 127 cancers on the CT images. Reviewer 1 correctly staged 98 gastric cancers, and reviewer 2 correctly classified 105 gastric cancers. The overall diagnostic accuracy of the T staging was 77.2% (98/127) for reviewer 1 and 82.7% (105/127) for reviewer 2. 64-section CT using CT gastrography showed a reasonable diagnostic performance for determining the T staging in patients with gastric cancer according to the 7th edition of the AJCC cancer staging manual. (orig.)

  13. 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.

  14. Clinical value of CT-based preoperative software assisted lung lobe volumetry for predicting postoperative pulmonary function after lung surgery

    Science.gov (United States)

    Wormanns, Dag; Beyer, Florian; Hoffknecht, Petra; Dicken, Volker; Kuhnigk, Jan-Martin; Lange, Tobias; Thomas, Michael; Heindel, Walter

    2005-04-01

    This study was aimed to evaluate a morphology-based approach for prediction of postoperative forced expiratory volume in one second (FEV1) after lung resection from preoperative CT scans. Fifteen Patients with surgically treated (lobectomy or pneumonectomy) bronchogenic carcinoma were enrolled in the study. A preoperative chest CT and pulmonary function tests before and after surgery were performed. CT scans were analyzed by prototype software: automated segmentation and volumetry of lung lobes was performed with minimal user interaction. Determined volumes of different lung lobes were used to predict postoperative FEV1 as percentage of the preoperative values. Predicted FEV1 values were compared to the observed postoperative values as standard of reference. Patients underwent lobectomy in twelve cases (6 upper lobes; 1 middle lobe; 5 lower lobes; 6 right side; 6 left side) and pneumonectomy in three cases. Automated calculation of predicted postoperative lung function was successful in all cases. Predicted FEV1 ranged from 54% to 95% (mean 75% +/- 11%) of the preoperative values. Two cases with obviously erroneous LFT were excluded from analysis. Mean error of predicted FEV1 was 20 +/- 160 ml, indicating absence of systematic error; mean absolute error was 7.4 +/- 3.3% respective 137 +/- 77 ml/s. The 200 ml reproducibility criterion for FEV1 was met in 11 of 13 cases (85%). In conclusion, software-assisted prediction of postoperative lung function yielded a clinically acceptable agreement with the observed postoperative values. This method might add useful information for evaluation of functional operability of patients with lung cancer.

  15. Accuracy of preoperative CT T staging of renal cell carcinoma: which features predict advanced stage?

    International Nuclear Information System (INIS)

    Bradley, A.J.; MacDonald, L.; Whiteside, S.; Johnson, R.J.; Ramani, V.A.C.

    2015-01-01

    Aims: To characterise CT findings in renal cell carcinoma (RCC), and establish which features are associated with higher clinical T stage disease, and to evaluate patterns of discrepancy between radiological and pathological staging of RCC. Materials and methods: Preoperative CT studies of 92 patients with 94 pathologically proven RCCs were retrospectively reviewed. CT stage was compared with pathological stage using the American Joint Committee on Cancer (AJCC), 7 th edition (2010). The presence or absence of tumour necrosis, perinephric fat standing, thickening of Gerota's fascia, collateral vessels were noted, and correlated with pT stage. The sensitivity, specificity, and positive (PPV) and negative predictive values (NPV) for predicting pT stage ≥pT3a were derived separately for different predictors using cross-tabulations. Results: Twenty-four lesions were pathological stage T1a, 21 were T1b, seven were T2a, 25 were T3a, 11 were T3b, four were T3c, and two were T4. There were no stage T2b. Sixty-three (67%) patients had necrosis, 27 (29%) thickening of Gerota's fascia (1 T1a), 25 had collateral vessels (0 T1a), 28 (30%) had fat stranding of <2 mm, 20 (21%) of 2–5mm and one (1%) of >5 mm. For pT stage ≥pT3a, the presence of perinephric fat stranding had a sensitivity, specificity, PPV and NPV of 74%, 65%, 63%, and 76%, respectively. Presence of tumour necrosis had a sensitivity, specificity, PPV, and NPV of 81%, 44%, 54%, and 72%, respectively. Thickening of Gerota's fascia had a sensitivity, specificity, PPV, and NPV of 52%, 90%, 81% and 70%, respectively; and enlarged collateral vessels had a sensitivity, specificity, PPV, and NPV value of 52%, 94%, 88%, and 71% respectively. Conclusion: The presence of perinephric stranding and tumour necrosis were not reliable signs for pT stage >T3a. Thickening of Gerota's fascia and the presence of collateral vessels in the peri- or paranephric fat had 90% and 94% specificity, with 82% and 88

  16. The Added Diagnostic Value of 18F-Fluorodihydroxyphenylalanine PET/CT in the Preoperative Work-Up of Small Bowel Neuroendocrine Tumors.

    Science.gov (United States)

    Addeo, Pietro; Poncet, Gilles; Goichot, Bernard; Leclerc, Loic; Brigand, Cécile; Mutter, Didier; Romain, Benoit; Namer, Izzie-Jacques; Bachellier, Philippe; Imperiale, Alessio

    2018-04-01

    The precise localization of the primary tumor and/or the identification of multiple primary tumors improves the preoperative work-up in patients with small bowel (SB) neuroendocrine tumor (NET). The present study assesses the diagnostic value of 18 F-fluorodihydroxyphenylalanine ( 18 F-FDOPA) positron emission tomography/computed tomography (PET/CT) during the preoperative wok-up of SB NETs. Between January 2010 and June 2017, all consecutive patients with SB NETs undergoing preoperative 18 F-FDOPA PET/CT and successive resection were analyzed. Preoperative work-up included computed tomography (CT), somatostatin receptor scintigraphy (SRS), and 18 F-FDOPA PET/CT. Sensitivity and accuracy ratio for primary and multiple tumor detection were compared with data from surgery and pathology. There were 17 consecutive patients with SB NETs undergoing surgery. Nine patients (53%) had multiple tumors, 15 (88%) metastatic lymph nodes, 3 (18%) peritoneal carcinomatosis, and 9 patients (53%) liver metastases. A total of 70 SB NETs were found by pathology. Surgery identified the primary in 17/17 (100%) patients and recognized seven of 9 patients (78%) with multiple synchronous SB. Preoperatively, 18 F-FDOPA PET/CT displayed a statistically significant higher sensitivity for primary tumor localization (100 vs. 23.5 vs. 29.5%) and multiple tumor detection (78 vs. 22 vs. 11%) over SRS and CT. Compared with pathology, 18 F-FDOPA PET/CT displayed the highest accuracy ratio for number of tumor detected over CT and SRS (2.0 ± 2.2 vs. 0.4 ± 0.7 vs. 0.6 ± 1.5, p = 0.0003). 18 F-FDOPA PET/CT significantly increased the sensitivity and accuracy for primary and multiple SB NET identification. 18 F-FDOPA PET/CT should be included systematically in the preoperative work-up of SB NET.

  17. Preoperative staging of lung cancer with PET/CT: cost-effectiveness evaluation alongside a randomized controlled trial

    International Nuclear Information System (INIS)

    Soegaard, Rikke; Fischer, Barbara Malene B.; Mortensen, Jann; Hoejgaard, Liselotte; Lassen, Ulrik

    2011-01-01

    Positron emission tomography (PET)/CT has become a widely used technology for preoperative staging of non-small cell lung cancer (NSCLC). Two recent randomized controlled trials (RCT) have established its efficacy over conventional staging, but no studies have assessed its cost-effectiveness. The objective of this study was to assess the cost-effectiveness of PET/CT as an adjunct to conventional workup for preoperative staging of NSCLC. The study was conducted alongside an RCT in which 189 patients were allocated to conventional staging (n = 91) or conventional staging + PET/CT (n = 98) and followed for 1 year after which the numbers of futile thoracotomies in each group were monitored. A full health care sector perspective was adapted for costing resource use. The outcome parameter was defined as the number needed to treat (NNT) - here number of PET/CT scans needed - to avoid one futile thoracotomy. All monetary estimates were inflated to 2010 EUR. The incremental cost of the PET/CT-based regimen was estimated at 3,927 EUR [95% confidence interval (CI) -3,331; 10,586] and the NNT at 4.92 (95% CI 3.00; 13.62). These resulted in an average incremental cost-effectiveness ratio of 19,314 EUR, which would be cost-effective at a probability of 0.90 given a willingness to pay of 50,000 EUR per avoided futile thoracotomy. When costs of comorbidity-related hospital services were excluded, the PET/CT regimen appeared dominant. Applying a full health care sector perspective, the cost-effectiveness of PET/CT for staging NSCLC seems to depend on the willingness to pay in order to avoid a futile thoracotomy. However, given that four outliers in terms of extreme comorbidity were all randomized to the PET/CT arm, there is uncertainty about the conclusion. When hospital costs of comorbidity were excluded, the PET/CT regimen was found to be both more accurate and cost saving. (orig.)

  18. Is a Double Contrast Barium Enema Necessary in Patients who Undergo a CT Colonography as a Preoperative Work-up?

    International Nuclear Information System (INIS)

    Lee, Ji Won; Lee, Soon Jin; Choi, Dong Il; Kim, Hee Jung; Chun, Ho Kyung; Yun, Seong Hyeon; Jeon, Yong Hwan; Park, Seung Bae; Kim, Min Ju

    2009-01-01

    To determine the efficiency of CT colonography (CTC), as compared with the double contrast barium enema (DCBE) for the preoperative work-up of colorectal neoplasms. A total of 39 patients underwent both a CTC and DCBE before surgery. Three abdominal radiologists and three colorectal surgeons retrospectively reviewed virtual double contrast (VDC) and DCBE images, regarding each examination for localization, conspicuity, extent and morphology of neoplasms. We reviewed the radiological reports of the CTC and DCBE for the polyps. In the case of both VDC and DCBE, 40 cancers were detected in 39 patients. According to abdominal radiologists, VDC showed the same ability to identify DCBE for localization of neoplasms (p 0.05). The performance of the CTC is comparable to the DCBE for the localization of main mass and polyps in patients with colorectal neoplasm. Barium enema don't seem to be necessary for patients who undergo a CTC as preoperative work-up

  19. Prognostic significance of standardized uptake value on preoperative 18F-FDG PET/CT in patients with ampullary adenocarcinoma

    International Nuclear Information System (INIS)

    Choi, Hye Jin; Kang, Chang Moo; Lee, Woo Jung; Jo, Kwanhyeong; Lee, Jong Doo; Lee, Jae-Hoon; Ryu, Young Hoon

    2015-01-01

    The purpose of this study was to investigate the prognostic value of 18 F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in patients with ampullary adenocarcinoma (AAC) after curative surgical resection. Fifty-two patients with AAC who had undergone 18 F-FDG PET/CT and subsequent curative resections were retrospectively enrolled. The maximum standardized uptake value (SUV max ) and tumor to background ratio (TBR) were measured on 18 F-FDG PET/CT in all patients. The prognostic significances of PET/CT parameters and clinicopathologic factors for recurrence-free survival (RFS) and overall survival (OS) were evaluated by univariate and multivariate analyses. Of the 52 patients, 19 (36.5 %) experienced tumor recurrence during the follow-up period and 18 (35.8 %) died. The 3-year RFS and OS were 62.3 and 61.5 %, respectively. Preoperative CA19-9 level, tumor differentiation, presence of lymph node metastasis, SUV max , and TBR were significant prognostic factors for both RFS and OS (p < 0.05) on univariate analyses, and patient age showed significance only for predicting RFS (p < 0.05). On multivariate analyses, SUV max and TBR were independent prognostic factors for RFS, and tumor differentiation, SUV max , and TBR were independent prognostic factors for OS. SUV max and TBR on preoperative 18 F-FDG PET/CT are independent prognostic factors for predicting RFS and OS in patients with AAC; patients with high SUV max (>4.80) or TBR (>1.75) had poor survival outcomes. The role of and indications for adjuvant therapy after curative resection of AAC are still unclear. 18 F-FDG uptake in the primary tumor could provide additive prognostic information for the decision-making process regarding adjuvant therapy. (orig.)

  20. Preoperative Radiographic and CT Findings Predicting Syndesmotic Injuries in Supination-External Rotation-Type Ankle Fractures.

    Science.gov (United States)

    Choi, Young; Kwon, Soon-Sun; Chung, Chin Youb; Park, Moon Seok; Lee, Seung Yeol; Lee, Kyoung Min

    2014-07-16

    The Lauge-Hansen classification system does not provide sufficient data related to syndesmotic injuries in supination-external rotation (SER)-type ankle fractures. The aim of the present study was to investigate factors helpful for the preoperative detection of syndesmotic injuries in SER-type ankle fractures using radiographs and computed tomography (CT). A cohort of 191 consecutive patients (104 male and eighty-seven female patients with a mean age [and standard deviation] of 50.7 ± 16.4 years) with SER-type ankle fractures who had undergone operative treatment were included. Preoperative ankle radiographs and CT imaging scans were made for all patients, and clinical data, including age, sex, and mechanism of injury (high or low-energy trauma), were collected. Patients were divided into two groups: the stable syndesmotic group and the unstable syndesmotic group, with a positive intraoperative lateral stress test leading to syndesmotic screw fixation. Fracture height, fracture length, medial joint space, extent of fracture, and bone attenuation were measured on radiographs and CT images and were compared between the groups. Binary logistic regression analysis was performed to identify the factors that significantly contributed to unstable syndesmotic injuries. Receiver operating characteristic curves were calculated, and cutoff values were suggested to predict unstable syndesmotic injuries on preoperative imaging measurements. Of the 191 patents with a SER-type ankle fracture, thirty-eight (19.9%) had a concurrent unstable syndesmotic injury. Age, sex, mechanism of injury, fracture height, medial joint space, and bone attenuation were significantly different between the two groups. In the binary logistic analysis, fracture height, medial joint space, and bone attenuation were found to be significant factors contributing to unstable syndesmotic injuries. The cutoff values for predicting unstable syndesmotic injuries were a fracture height of >3 mm and a medial

  1. Assessment of value of spiral CT in preoperative evaluation of endovascular graft exclusion for abdominal aortic aneurysm

    International Nuclear Information System (INIS)

    Jing Zaiping; Zhao Jun; Zhu Wenjiang; Xiao Yi

    1998-01-01

    Purpose: The assess the value of spiral CT (SCT) in preoperative evaluation of endovascular graft exclusion (EVGE) for abdominal aortic aneurysm (AAA). Methods: 41 case with AAA received SCT scanning. Two and three dimensional images were reconstructed, utilizing the shaded surface display (SSD), maximum-intensity Projection (MIP) and multiplanar reformation (MPR). Information were obtained regarding the size and features of AAA, length and diameters of aneurysm's neck, status of the branches of aorta, etc. Results: Nine patients had spinal CT study prior EVGE procedure and the grafts selected according to the parameters obtained by SCT matched perfectly to the needs of deployment. Conclusion: CTA provides high quality images. It is a high-speed and non-invasive method which can provide three-dimensional images of AAA and its main branches and all the parameters needed in EVGE

  2. Pre-operative evaluation of cleft palate using three dimensional computerized tomography (s-D CT)

    International Nuclear Information System (INIS)

    Azia, A.; Hashmi, R.

    1999-01-01

    Cleft palate is a congenital anomaly with major development concerns. Surgery with bone grafting is often required to correct the lesion. With the introduction of 3-D CT the evaluation of cleft pa late has become more accurate. We present two cases of cleft palate, which were operated upon with bone grafting. We employed 3-D CT techniques in addition to the conventional 2-D CT, 3-D CT improves the estimation of the required bone graft and signification reduces length of surgery and complications. (author)

  3. Diagnosis of preoperative staging of bladder cancer by CT and angiography

    International Nuclear Information System (INIS)

    Munechika, Hirotsugu; Saito, Kazuhiko; Tanaka, Osamu; Tomiie, Fumitaka; Aihara, Toshinori

    1982-01-01

    The accuracy of computed tomography (CT) and angiography in defining the extent of local invasion was studied retrospectively in 19 patients with surgically proven carcinoma of the bladder. The overall accuracy of CT and angiographic staging in these cases was 54 percent and 47 percent respectively. The diagnosis of carcinoma of the bladder by CT tended to do overstaging rather than understaging. A tangential view of the tumor-bearing area by the selective internal iliac arteriography allows an accurate estimation of the perivesical tumor extension. The topographic diagnosis should be made by CT prior to the angiographic study. (author)

  4. Assessing the registration of CT-scan data to intraoperative x rays by fusing x rays and preoperative information

    Science.gov (United States)

    Gueziec, Andre P.

    1999-05-01

    This paper addresses a key issue of providing clinicians with visual feedback to validate a computer-generated registration of pre-operative and intra-operative data. With this feedback information, the clinician may decide to proceed with a computer-assisted intervention, revert to a manual intervention, or potentially provide information to the computer system to improve the registration. The paper focuses on total hip replacement (THR) surgery, but similar techniques could be applied to other types of interventions or therapy, including orthopedics, neurosurgery, and radiation therapy. Pre-operative CT data is used to plane the surgery (select an implant type, size and precise position), and is registered to intra-operative X-ray images, allowing to execute the plan: mill a cavity with the implant's shape. (Intra-operative X-ray images must be calibrated with respect to the surgical device executing the plan). One novel technique presented in this paper consists of simulating a post-operative X-ray image of the tissue of interest before doing the procedure, by projecting the registered implant onto an intra-operative X- ray image (corrected for distortion or not), providing clinicians with familiar and easy to interpret images. As an additional benefit, this method provides new means for comparing various strategies for registering pre-operative data to the physical space of the operating room.

  5. CT colonography for preoperative examination of the proximal colon using a transanal drainage tube for acute malignant colonic obstruction

    International Nuclear Information System (INIS)

    Sasaki, Kazuaki; Hirano, Yuji; Oono, Keisuke; Sasaki, Kazunori; Someya, Tetsufumi; Harada, Keisuke; Ezoe, Eiri; Furuhata, Tomohisa; Hirata, Koichi

    2011-01-01

    The purpose of this study was to evaluate the feasibility of CT colonography for preoperative examination of the proximal colon using a transanal drainage tube in patients with acute colon obstruction caused by colorectal cancer. Ten patients who received initial treatment for acute malignant colon obstruction at our hospital between June 2004 and December 2008 were studied. In these patients, elective surgery was possible after transanal drainage tube insertion, and the colon on the oral side from the cancer lesion was examined using a drainage tube. Air was injected through the tube into the oral side of the colon, and CT colonography was assessed for the presence or absence of lesions on the oral side. The images of the oral side of the colon were good enough to allow adequate interpretation in 9 of the 10 patients. In the first patient, the visualization of the area near the lesion was somewhat fair, although the right side colon was well visualized. There were no complications associated with this examination. The present preoperative examination using a transanal drainage tube was useful for determining the extent of intestinal resection when patients were not candidates for colonoscopy or barium enema examination. (author)

  6. Comparison of CT during arterial portography, delayed iodine CT, and MR imaging for the preoperative evaluation of hepatic tumors

    International Nuclear Information System (INIS)

    Nelson, R.C.; Chezmar, J.L.; Sugarbaker, P.H.; Bernardino, M.E.

    1988-01-01

    Twenty-eight patients with neoplastic involvement of the liver were studied with CT during arterial portography, delayed iodine CT, and MR imaging, to determine the number, size, and location of focal hepatic lesions prior to hepatic tumor surgery. The MR pulse-sequences used included T1- and T2-weighted spin-echo (SE) sequences and inversion-recovery (IR) sequences at 0.5 T, 1.5 T, or both. Results were compared with operative and pathologic findings. The sensitivities for the detection of individual focal lesions are as follows: CT during arterial portography, delayed iodine CT, 77%, IR at 0.5 T, 74%; T1-weighted SE at 0.5 T, 69%; T2-weighted SE at 1.5 T, 55%, IR at 1.5 T, 50%; T2-weighted SE at 0.5 T, 48%, and T1-weighted SE at 1.5 T, 31%. The positive predictive values ranged from 88% to 100% for all techniques. The authors' data suggest that CT during arterial portography is a superior technique for evaluating patients prior to hepatic tumor surgery

  7. Anatomic and Quantitative Temporal Bone CT for Preoperative Assessment of Branchio-Oto-Renal Syndrome.

    Science.gov (United States)

    Ginat, D T; Ferro, L; Gluth, M B

    2016-12-01

    We describe the temporal bone computed tomography (CT) findings of an unusual case of branchio-oto-renal syndrome with ectopic ossicles that are partially located in the middle cranial fossa. We also describe quantitative temporal bone CT assessment pertaining to cochlear implantation in the setting of anomalous cochlear anatomy associated with this syndrome.

  8. Preoperative CT-Angiography Predicts Ex Vivo Vein Length for Right Kidneys After Laparoscopic Donor Nephrectomy

    NARCIS (Netherlands)

    Özdemir-van Brunschot, D.M.D.; Rottier, S.J.; Ouden, J.E. den; Jagt, M.F.P. van der; D'Ancona, F.C.H.; Kloke, H.J.; Vliet, D. van der; Schultze Kool, L.J.; Warle, M.C.

    2015-01-01

    BACKGROUND Implantation of a kidney with a short renal vein is technically more challenging and therefore prone for technique-related complications. It remains unclear whether pre-operative computed tomography angiography (CTA), to assess vascular anatomy of the donor kidney, can be used to predict

  9. Clinical utility of ultrasound and 99mTc sestamibi SPECT/CT for preoperative localization of parathyroid adenoma in patients with primary hyperparathyroidism

    International Nuclear Information System (INIS)

    Patel, C.N.; Salahudeen, H.M.; Lansdown, M.; Scarsbrook, A.F.

    2010-01-01

    Aim: To evaluate the accuracy of ultrasound and parathyroid scintigraphy using single photon-emission computed tomography/computed tomography (SPECT/CT) for the preoperative localization of solitary parathyroid adenomas in patients with primary hyperparathyroidism who would be suitable for minimally invasive parathyroid surgery. Materials and methods: Retrospective study of 63 consecutive patients with biochemical evidence of primary hyperparathyroidism referred for preoperative localization of parathyroid adenoma that proceeded to surgery in the same institution. All patients underwent high-resolution ultrasound and Technetium-99m sestamibi scintigraphy with planar and SPECT/CT imaging. The accuracy of preoperative imaging was compared to surgical and histological findings as the reference standard. Results: Fifty-nine patients had solitary parathyroid adenomas, three patients had multiglandular hyperplasia, and one patient had multiple parathyroid adenomas confirmed at surgery and histology. Thirty-five solitary parathyroid adenomas were identified preoperatively with ultrasound (64%) and 53 with SPECT-CT (90%). Concordant ultrasound and SPECT/CT findings were found in 35 cases (59%). An additional three adenomas were found with ultrasound alone and 18 adenomas with SPECT/CT alone. Fifty-one of the 56 adenomas localized using combined ultrasound and SPECT/CT were found at the expected sites during surgery. Combined ultrasound and SPECT/CT has an overall sensitivity of 95% and accuracy of 91% for the preoperative localization of solitary parathyroid adenomas. Conclusions: The combination of ultrasound and SPECT/CT has incremental value in accurately localizing solitary parathyroid adenomas over either technique alone, and allows selection of patients with primary hyperparathyroidism who would be suitable for minimally invasive surgery.

  10. The significance of preoperative CT during arterial portography in surgical treatment of patients with hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Hayashi, Takafumi; Suzuki, Kazunori; Konishi, Ichiro; Sato, Naoki; Yamashiro, Yutaka; Yamaguchi, Yumi; Hirooka, Yasuaki; Kaibara, Nobuaki

    1999-01-01

    This study was designed to elucidate the significance of preoperative computed tomography during arterial portography (CTAP) in surgical treatment of hepatocellular carcinoma (HCC). Eighteen patients with HCC whose minute lesions had been pointed out by CTAP preoperatively (CTAP positive group) were compared with another eight patients with HCC having postoperative recurrence in a region at where no tumors had been detected by preoperative CTAP (CTAP negative group) for preoperative location of tumor and postoperative pattern of recurrence. In the CTAP positive group, 11 patients had recurrence and the remaining seven patients had not. Disease-free periods up to recurrences were 8.7 months in an average in the 11 CTAP positive patients and 16.6 months in the CTAP-negative group, showing a significantly shorter interval in the CTAP positive patients. In recurred cases from the CTAP positive group, tumors identified by imaging procedures other than CTAP were solitary in four and multiple in seven cases, while all solitary in non-recurred cases. In the recurred CTAP positive cases, actual recurrence occurred in the same segment where a tumor had been pointed out by CTAP alone in five out of six cases of solitary recurrence; or involved the same segment where CTAP detected tumor (s) in four out of five cases of multiple recurrence. It is indicated that the possibility of postoperative recurrence of HCC is high in cases having minute lesions visualized by CTAP alone in addition to multiple lesions visualized by imaging procedures other than CTAP. We think that periodical imaging methods including CTAP are required for HCC patients. (author)

  11. [Preoperative assessment of renal vascular anatomy for donor nephrectomy: Is CT superior to MRI?].

    Science.gov (United States)

    Arvin-Berod, A; Bricault, I; Terrier, N; Skowron, O; Cadi, P; Boillot, B; Thuillier, C; Cluze, C; Descotes, J-L; Rambeaud, J-J; Long, J-A

    2011-01-01

    computed tomography angiography (CTA) and magnetic resonance angiography (MRA) are both used in the preoperative assessment of vascular anatomy before donor nephrectomy. Our objective was to determine retrospectively and to compare the sensitivity of CTA and MRA imaging in preoperative renal vascularisation in living kidney donors. between 1999 and 2007, 42 kidney donors were assessed in our center: 27 by MRA, 10 by CTA, and five by both techniques. Images were interpreted using multiplanar reconstructions. Results were compared retrospectively with peroperative findings; discordant cases were re-examined by an experienced radiologist. Numbers of vessels detected with imaging methods was compared with numbers actually found at the operating time. MRA showed 35/43 arteries (Se 81.4 %) and 33/34 veins (Se 97.1 %), and CTA showed 18/18 arteries (Se 100 %) and 15/16 veins (Se 93.8 %). The presence of multiple arteries was detected in only one third of cases (3/9) on MRI scans; this difference was statistically significant. The missed arteries were not detected on second examination of the MRI scans with the knowledge of peroperative findings. MRA is less sensitive than CTA for preoperative vascularisation imaging in living renal donors, especially in the detection of multiple renal arteries. 2010 Elsevier Masson SAS. All rights reserved.

  12. C.T. scanning in the pre-operative assessment of non-small cell lung cancer

    International Nuclear Information System (INIS)

    Goldstraw, P.

    1986-01-01

    The concept of T.N.M. staging is now widely adopted, providing an international shorthand to describe tumour extent. Throughout this article the system referred to is that of the American Joint Committee on Cancer Staging and End Results Reporting. It is generally now accepted that Stage I and II patients with N.S.C.L.C. benefit from pulmonary resection, whilst those with Stage III tumours by virtue of T3 status, N2 disease or M stage other than zero, do not. There are exceptions to this rule and they are discussed in the relevant section. The authors therefore consider the role of C.T. scanning in pre-operative staging under the following headings. Tumour characteristics: 1) indicators of malignancy, 2) extra-pulmonary extension; Nodal metastases: 1) hilar, 2) mediastinal; Metastases to distant sites

  13. Diagnostic performance of whole brain volume perfusion CT in intra-axial brain tumors: Preoperative classification accuracy and histopathologic correlation

    International Nuclear Information System (INIS)

    Xyda, Argyro; Haberland, Ulrike; Klotz, Ernst; Jung, Klaus; Bock, Hans Christoph; Schramm, Ramona; Knauth, Michael; Schramm, Peter

    2012-01-01

    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.

  14. Preoperative multidetector CT manifestations of perigastric lymph nodes in patients with early gastric cancer and pN0

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Jung Hyun; Yu, Jeong Sik; Chung, Jae Joon; Lim, Joo Hee; Cho, Eun Suk; Kim, Ki Whang [Dept. of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul (Korea, Republic of)

    2013-11-15

    To find the determinant of lymph node (LN) manifestations on preoperative multidetector CT (MDCT) in early gastric cancer (EGC) patients with pN0. One hundred and eighty-six consecutive patients with pT1pN0, the largest perigastric LN on preoperative MDCT, were categorized into two groups according to 8 different parameters [short (SD) and long diameter (LD) 4/6/8 mm, average attenuation 100 Hounsfield unit, short-to-long diameter-ratio (SLR) 0.7], and correlated with the size, gross type, depth of invasion and microscopic type of their primary lesions by the chi-square test and multiple logistic regression analysis. When the primary lesion was larger than 3 cm, the LNs were larger in 4 parameters (SD or LD, 4/6 mm; p < 0.05); gross type IIb patients showed smaller LNs in 5 parameters (SD 4/6 mm, LD 4/6/8 mm; p < 0.05); and patients with microscopically-undifferentiated lesions showed larger LNs in SD 4 mm or LD 8 mm by the chi-square test and multiple logistic regression analysis. The depth of invasion showed no significant difference in LN size. No factors revealed significant difference in LN attenuation or SLR. Benign regional LN enlargement is more frequent in EGC patients with larger size primary lesions or lesion with poor microscopic differentiation. However, this condition is less frequent in gross type IIb patients.

  15. Selection of colon cancer patients for neoadjuvant chemotherapy by preoperative CT scan

    DEFF Research Database (Denmark)

    Nørgaard, Anne; Dam, Claus; Jakobsen, Anders

    2014-01-01

    invasion (ETI), nodal stage (N-stage), extramural venous invasion (EVI) and the distance from tumor to nearest retroperitoneal fascia (DRF) were retrospectively assessed on the CT scan and compared blindly with the results of the pathological examination, including evaluation of the criteria for adjuvant...

  16. Preoperative assessment of hilar cholangiocarcinoma using multidetector-row CT. Correlation with histopathological findings

    International Nuclear Information System (INIS)

    Watadani, Takeyuki; Akahane, Masaaki; Ohtomo, Kuni; Yoshikawa, Takeharu

    2008-01-01

    Our aim was to investigate the diagnostic reliability of multidetector-row computed tomography (MDCT) for preoperative assessment of local tumoral spread in hilar cholangiocarcinoma. Thirteen of 30 consecutive patients with hilar cholangiocarcinoma who underwent surgery, excluding 17 patients who underwent biliary drainage or preoperative portal embolization, were retrospectively evaluated. Using MDCT systems of 4 detector rows or 16 detector rows, plain and dynamic contrast-enhanced images of three phases were obtained. Extent of tumor spread and lymph node metastasis were assessed with MDCT and compared with histopathological findings. The Bismuth-Corlette classification of hilar cholangiocarcinoma with MDCT were type I, 1 patient; type IIIa, 3 patients; type IIIb, 4 patients; and type IV, 5 patients; those with histopathological findings were type I, 1 patient; type IIIa, 2 patients; type IIIb, 4 patients; and type IV, 6 patients. One patient diagnosed as type IIIa with MDCT was pathologically diagnosed as type IV. Accuracy of MDCT in tumoral spread was 92.3%, although that of lymph node metastasis was 54%. MDCT is likely to play an important role in evaluation of focal lesion spread especially in intrapancreatic tumor invasion, although a greater number of cohort cases are necessary to clearly define its role. (author)

  17. Cost-effectiveness of preoperative SPECT/CT combined with lymphoscintigraphy vs. lymphoscintigraphy for sentinel lymph node excision in patients with cutaneous malignant melanoma

    Energy Technology Data Exchange (ETDEWEB)

    Stoffels, Ingo; Leyh, Julia; Schadendorf, Dirk; Klode, Joachim [University of Duisburg-Essen, Department of Dermatology, Venerology and Allergology, University-Hospital Essen, Essen (Germany); Mueller, Markus [University of Duisburg-Essen, Department of Medical controlling, University-Hospital Essen, Essen (Germany); Geisel, Marie Henrike [University of Duisburg-Essen, Institute for Medical Informatics, Biometry and Epidemiology, University-Hospital Essen, Essen (Germany); Poeppel, Thorsten [University of Duisburg-Essen, Department of Nuclear Medicine, University-Hospital Essen, Essen (Germany)

    2014-09-15

    Malignant melanoma has become a major growing interdisciplinary problem in public health worldwide. Sentinel lymph node excision (SLNE) in conjunction with preoperative SPECT/CT is considered the most sensitive and specific staging test for the detection of micrometastatic melanoma in regional lymph nodes. Among patients with clinically lymph node-negative melanoma, the use of SPECT/CT-aided SLNE compared with SLNE alone has been found to be associated with a higher frequency of metastatic involvement and a higher rate of disease-free survival. The aim of this study was to analyse the cost-effectiveness of SLNE with preoperative SPECT/CT for detecting sentinel lymph nodes versus that of standard SLNE with preoperative lymphoscintigraphy from a single-institution database. Cost-effectiveness analysis of two surgical approaches for SLNE for malignant melanoma at the University Hospital Essen, Skin Cancer Center in Essen, Germany. Between March 2003 and April 2011 464 patients eligible for SLNE were identified. Of these patients, 403 with clinically negative lymph nodes who underwent SLNE with or without preoperative SPECT/CT qualified for subsequent analysis. Between March 2003 and October 2008, 254 patients were operated upon with the standard technique. From November 2008, 149 patients underwent the SPECT/CT technique. Cost analysis showed a mean cost saving of EUR 710.50 when SPECT/CT was added to preoperative imaging. This was achieved by a reduction in operative time (median, Q1;Q3, 40 min, 40;50 min, vs. 45 min, 35;60 min; p = 0.002), hospital stay duration (5 days, 3;8 days, vs. 8 days, 4.5;14.5 days; p < 0.001) and more frequent use of local anaesthesia (90.6 % vs. 70.5 %; p < 0.001). The median cost of SLNE using SPECT/CT was EUR 1,619.7 (Q1;Q3 EUR 1,317.0;2,603.4) and of SLNE without SPECT/CT was EUR 2,330.2 (EUR 1,468.3;4,058.1; p < 0.001), a cost saving of 30.5 %. In patients with cutaneous melanoma, the use of preoperative SPECT/CT-aided SLNE compared

  18. Prediction of nodal involvement in primary rectal carcinoma without invasion to pelvic structures: accuracy of preoperative CT, MR, and DWIBS assessments relative to histopathologic findings.

    Directory of Open Access Journals (Sweden)

    Jun Zhou

    Full Text Available OBJECTIVE: To investigate the accuracy of preoperative computed tomography (CT, magnetic resonance (MR imaging and diffusion-weighted imaging with background body signal suppression (DWIBS in the prediction of nodal involvement in primary rectal carcinoma patients in the absence of tumor invasion into pelvic structures. METHODS AND MATERIALS: Fifty-two subjects with primary rectal cancer were preoperatively assessed by CT and MRI at 1.5 T with a phased-array coil. Preoperative lymph node staging with imaging modalities (CT, MRI, and DWIBS were compared with the final histological findings. RESULTS: The accuracy of CT, MRI, and DWIBS were 57.7%, 63.5%, and 40.4%. The accuracy of DWIBS with higher sensitivity and negative predictive value for evaluating primary rectal cancer patients was lower than that of CT and MRI. Nodal staging agreement between imaging and pathology was fairly strong for CT and MRI (Kappa value = 0.331 and 0.348, P<0.01 but was relatively weaker for DWIBS (Kappa value = 0.174, P<0.05. The accuracy was 57.7% and 59.6%, respectively, for CT and MRI when the lymph node border information was used as the criteria, and was 57.7% and 61.5%, respectively, for enhanced CT and MRI when the lymph node enhancement pattern was used as the criteria. CONCLUSION: MRI is more accurate than CT in predicting nodal involvement in primary rectal carcinoma patients in the absence of tumor invasion into pelvic structures. DWIBS has a great diagnostic value in differentiating small malignant from benign lymph nodes.

  19. Preoperative evaluation of the artery of adamkiewicz by MR angiography and CT angiography in patients with a thoracic aortic aneurysm

    International Nuclear Information System (INIS)

    Niinuma, Hiroyuki; Ohira, Atsushi; Makita, Shinji; Moriai, Yoshiteru; Hiramori, Katsuhiko; Yoshioka, Kunihiro; Nakajima, Takayuki; Kawazoe, Kohei

    2002-01-01

    Paraplegia is known as an extremely serious and important complication of surgical repair in patients with a thoraco-abdominal aortic aneurysm. It is important to evaluate the artery of Adamkiewicz (AdA) before surgical repair to prevent paraplegia. But the AdA is difficult to visualize by the invasive and hazardous, conventional selective angiography. The aim of this study was to visualize AdA by MR angiography (MRA) and CT angiography (CTA). Twenty-one consecutive patients with a thoracic aortic aneurysm underwent both gadolinium-enhanced, three-dimensional MRA and CTA using multislice helical CT. The AdA was successfully visualized in 15 of the 21 patients (71.4%) by MRA, and in 17 of those 21 patients (80.9%) by CTA. Its continuity was depicted in 12 of 15 patients (80%) by MRA, and in 9 of 17 patients (47%) by CTA. AdA was visualized at 85.7% by MRA or CTA, respectively. This study shows that CTA is a much more sensitive method to detect AdA than MRA. On the other hand, MRA is better to evaluate the continuity of AdA from the descending aorta to the anterior spinal artery, than CTA. Therefore, MRA and CTA are both useful for a preoperative evaluation of AdA and its detailed vascular anatomy from the aorta to the anterior spinal artery. (author)

  20. The value of MRI and CT in the pre-operative diagnosis of lumbar disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Hirabayashi, Shigeru; Kumano, Kiyoshi; Takahashi, Soichiro; Ishii, Jun (Kanto Rosai Hospital, Kawasaki, Kanagawa (Japan))

    1991-05-01

    A prospective analysis of computed tomography (CT) and magnetic resonance imaging (MRI) scans in 51 patients with lumbar disc herniation was made to determine the height of hernia for operation and, if impossible, the indications of myelography. Among the 51 patients, 40 (78%) received surgery based on these imaging modalities (Group A); and the remaining 11 (22%) underwent myelography for the confirmation of the height of hernia or detailed examination (Group B). Satisfactory or excellent surgical outcome was achieved in 95% in Group A and in 91% in Group B. Twenty seven patients had multiple disc herniation on CT and MRI; in 17 patients surgery was performed for one disc hernia that was radiologically found to compress the spinal nerve root; and in the other 10 hernia-related disc was not determined by either radiological or neurological manifestations. Satisfactory or excellent surgical outcome could, however, be achieved in 26 patients (96%). Myelography should be indicated when there is no neurological radicular sign in the lower extremities, and when there is no radiological evidence of the compressed spinal nerve root in spite of the presence of multiple disc herniation. The height of hernia may be determined when compression of the spinal nerve root is visualized on CT or MRI. (N.K.).

  1. The value of MRI and CT in the pre-operative diagnosis of lumbar disc herniation

    International Nuclear Information System (INIS)

    Hirabayashi, Shigeru; Kumano, Kiyoshi; Takahashi, Soichiro; Ishii, Jun

    1991-01-01

    A prospective analysis of computed tomography (CT) and magnetic resonance imaging (MRI) scans in 51 patients with lumbar disc herniation was made to determine the height of hernia for operation and, if impossible, the indications of myelography. Among the 51 patients, 40 (78%) received surgery based on these imaging modalities (Group A); and the remaining 11 (22%) underwent myelography for the confirmation of the height of hernia or detailed examination (Group B). Satisfactory or excellent surgical outcome was achieved in 95% in Group A and in 91% in Group B. Twenty seven patients had multiple disc herniation on CT and MRI; in 17 patients surgery was performed for one disc hernia that was radiologically found to compress the spinal nerve root; and in the other 10 hernia-related disc was not determined by either radiological or neurological manifestations. Satisfactory or excellent surgical outcome could, however, be achieved in 26 patients (96%). Myelography should be indicated when there is no neurological radicular sign in the lower extremities, and when there is no radiological evidence of the compressed spinal nerve root in spite of the presence of multiple disc herniation. The height of hernia may be determined when compression of the spinal nerve root is visualized on CT or MRI. (N.K.)

  2. PET/CT and histopathologic response to preoperative chemoradiation therapy in locally advanced rectal cancer

    DEFF Research Database (Denmark)

    Kristiansen, C.; Loft, A.; Berthelsen, Anne Kiil

    2008-01-01

    PURPOSE: The objective of this study was to investigate the possibility of using positron emission tomography/computer tomography to predict the histopathologic response in locally advanced rectal cancer treated with preoperative chemoradiation. METHODS: The study included 30 patients with locally...... is not able to predict the histopathologic response in locally advanced rectal cancer. There is an obvious need for other complementary methods especially with respect to the low sensitivity of positron emission tomography/computer tomography Udgivelsesdato: 2008/1...... advanced rectal adenocarcinoma treated with a combination of radiotherapy and concurrent Uftoral (uracil, tegafur) and leucovorine. All patients were evaluated by positron emission tomography/computer tomography scan seven weeks after end of chemoradiation, and the results were compared to histopathologic...

  3. PET/CT and Histopathologic Response to Preoperative Chemoradiation Therapy in Locally Advanced Rectal Cancer

    DEFF Research Database (Denmark)

    Kristiansen, Charlotte; Loft, Annika; Berthelsen, Anne K

    2008-01-01

    PURPOSE: The objective of this study was to investigate the possibility of using positron emission tomography/computer tomography to predict the histopathologic response in locally advanced rectal cancer treated with preoperative chemoradiation. METHODS: The study included 30 patients with locally...... of chemoradiation is not able to predict the histopathologic response in locally advanced rectal cancer. There is an obvious need for other complementary methods especially with respect to the low sensitivity of positron emission tomography/computer tomography....... advanced rectal adenocarcinoma treated with a combination of radiotherapy and concurrent Uftoral(R) (uracil, tegafur) and leucovorine. All patients were evaluated by positron emission tomography/computer tomography scan seven weeks after end of chemoradiation, and the results were compared...

  4. A combination of preoperative CT findings and postoperative serum CEA levels improves recurrence prediction for stage I lung adenocarcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Yamazaki, Motohiko, E-mail: xackey2001@gmail.com [Department of Radiology, Niigata University Graduate School of Medical and Dental Sciences (Japan); Ishikawa, Hiroyuki [Department of Radiology, Niigata University Graduate School of Medical and Dental Sciences (Japan); Kunii, Ryosuke [Division of Cellular and Molecular Pathology, Niigata University Graduate School of Medical and Dental Sciences (Japan); Tasaki, Akiko; Sato, Suguru; Ikeda, Yohei; Yoshimura, Norihiko [Department of Radiology, Niigata University Graduate School of Medical and Dental Sciences (Japan); Hashimoto, Takehisa; Tsuchida, Masanori [Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences (Japan); Aoyama, Hidefumi [Department of Radiology, Niigata University Graduate School of Medical and Dental Sciences (Japan)

    2015-01-15

    Objectives: To assess the prognostic value of combined evaluation of preoperative CT findings and pre/postoperative serum carcinoembryonic antigen (CEA) levels for pathological stage I lung adenocarcinoma. Methods: This retrospective study included 250 consecutive patients who underwent complete resection for ≤3-cm pathological stage I (T1–2aN0M0) adenocarcinomas (132 men, 118 women; mean age, 67.8 years). Radiologists evaluated following CT findings: maximum tumor diameter, percentage of solid component (%solid), air bronchogram, spiculation, adjacency of bullae or interstitial pneumonia (IP) around the tumor, notch, and pleural indent. These CT findings, pre/postoperative CEA levels, age, gender, and Brinkman index were assessed by Cox proportional hazards model to determine the best prognostic model. Prognostic accuracy was examined using the area under the receiver operating characteristic curve (AUC). Results: Median follow-up period was 73.2 months. In multivariate analysis, high %solid, adjacency of bullae or IP around the tumor, and high postoperative CEA levels comprised the best combination for predicting recurrence (P < 0.05). A combination of these three findings had a greater accuracy in predicting 5-year disease-free survival than did %solid alone (AUC = 0.853 versus 0.792; P = 0.023), with a sensitivity of 85.7% and a specificity of 74.3% at the optimal threshold. The best cut-off values of %solid and postoperative CEA levels for predicting high-risk patients were ≥48% and ≥3.7 ng/mL, respectively. Conclusion: Compared to %solid alone, combined evaluation of %solid, adjacency of bullae or IP change around the tumor, and postoperative CEA levels improves recurrence prediction for stage I lung adenocarcinoma.

  5. Quantitative CT analysis for the preoperative prediction of pathologic grade in pancreatic neuroendocrine tumors

    Science.gov (United States)

    Chakraborty, Jayasree; Pulvirenti, Alessandra; Yamashita, Rikiya; Midya, Abhishek; Gönen, Mithat; Klimstra, David S.; Reidy, Diane L.; Allen, Peter J.; Do, Richard K. G.; Simpson, Amber L.

    2018-02-01

    Pancreatic neuroendocrine tumors (PanNETs) account for approximately 5% of all pancreatic tumors, affecting one individual per million each year.1 PanNETs are difficult to treat due to biological variability from benign to highly malignant, indolent to very aggressive. The World Health Organization classifies PanNETs into three categories based on cell proliferative rate, usually detected using the Ki67 index and cell morphology: low-grade (G1), intermediate-grade (G2) and high-grade (G3) tumors. Knowledge of grade prior to treatment would select patients for optimal therapy: G1/G2 tumors respond well to somatostatin analogs and targeted or cytotoxic drugs whereas G3 tumors would be targeted with platinum or alkylating agents.2, 3 Grade assessment is based on the pathologic examination of the surgical specimen, biopsy or ne-needle aspiration; however, heterogeneity in the proliferative index can lead to sampling errors.4 Based on studies relating qualitatively assessed shape and enhancement characteristics on CT imaging to tumor grade in PanNET,5 we propose objective classification of PanNET grade with quantitative analysis of CT images. Fifty-five patients were included in our retrospective analysis. A pathologist graded the tumors. Texture and shape-based features were extracted from CT. Random forest and naive Bayes classifiers were compared for the classification of G1/G2 and G3 PanNETs. The best area under the receiver operating characteristic curve (AUC) of 0:74 and accuracy of 71:64% was achieved with texture features. The shape-based features achieved an AUC of 0:70 and accuracy of 78:73%.

  6. Protocol for CT in the position of discomfort: preoperative assessment of femoroacetabular impingement - how we do it and what the surgeon wants to know

    International Nuclear Information System (INIS)

    Grabinski, Rafal; Ou, Daniel; Saunder, Kate; Rotstein, Andrew; Singh, Parminder; Pritchard, Michael; O'Donnell, John

    2014-01-01

    The use of computed tomography of the hip in a position of discomfort (CT-POD) in combination with 2D and 3D surface rendering is a technique increasingly used to aid in the assessment and confirmation of femoral and acetabular bony abnormalities related to femoroacetabular impingement. The purpose of this article is to describe this dynamic method of assessment. Patients referred by orthopaedic surgeons for assessment of femoroacetabular impingement as part of preoperative planning and patients who required postoperative assessment of residual bony abnormalities were selected. This article describes the CT-POD technique and the information required by the referring surgeon. CT-POD is a new technique that provides valuable preoperative and postoperative information to the surgeon.

  7. Cardiac dual-source CT for the preoperative assessment of patients undergoing bariatric surgery

    International Nuclear Information System (INIS)

    Tognolini, A.; Arellano, C.S.; Marfori, W.; Sayre, J.W.; Hollada, J.L.; Goldin, J.G.; Dutson, E.P.; Ruehm, S.G.

    2013-01-01

    Aim: To assess the diagnostic value of coronary dual-source computed tomography (DSCT) as a comprehensive, non-invasive tool in the preoperative cardiac evaluation of patients undergoing bariatric surgery. Materials and methods: Thirty consecutive obese [average body mass index (BMI): 45 ± 7.6, range: 35–59] patients (24 women; six men; median age: 52 ± 15 years) were enrolled in this institutional review board (IRB)-approved, Health Insurance Portability and Accountability Act of 1996 (HIPAA)-compliant prospective study. Calcium scoring (CaS) and electrocardiography (ECG)-gated images of the coronary arteries were obtained with a large body habitus protocol (120 kV; 430 mAs; 100 ml iodinated contrast medium at 7 ml/s injection rate) on a DSCT machine. Qualitative (four-point: 1 = excellent to 4 = not delineable) coronary segmental analysis, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) measurements were performed. The presence and degree of vascular disease (four-grade scale: mild to severe) was correlated with CaS and cardiovascular (CV) risk stratification blood tests. In patients with severe stenosis (>70%), findings were compared with cardiac nuclear medicine imaging (single photon-emission computed tomography; SPECT) imaging. Results: The average HR, enhancement, and quality score were 64 ± 7 beats/min, 288 ± 66 HU and 1.8 ± .5, respectively. Ninety-three percent (417/450) of the coronary segments were rated diagnostic. The SNRs and CNRs were 17 ± 9 and 12 ± 7 for the right coronary artery; 17 ± 8 and 12 ± 7 for the left main coronary artery; 16 ± 9 and 11 ± 7 for the left anterior descending coronary artery; and 15 ± 7 and 10 ± 6 for the left circumflex coronary artery. Ten of the 30 patients (33%) demonstrated coronary artery disease (CAD) of which two (6%) showed three-vessel disease. Four (13%) patients showed severe disease: in three of which the presence of significant stenosis was confirmed by SPECT and by catheter

  8. Preoperative risk stratification using metabolic parameters of {sup 18}F-FDG PET/CT in patients with endometrial cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kitajima, Kazuhiro [Kobe University School of Medicine, Department of Radiology, Kobe (Japan); Kobe University Graduate School of Medicine, Department of Radiology, Kobe (Japan); Suenaga, Yuko; Ueno, Yoshiko; Maeda, Tetsuo; Sofue, Keitarou; Sugimura, Kazuro [Kobe University School of Medicine, Department of Radiology, Kobe (Japan); Ebina, Yasuhiko; Yamada, Hideto [Kobe University School of Medicine, Department of Obstetrics and Gynecology, Kobe (Japan); Okunaga, Takashi; Kubo, Kazuhiro [Kobe University Hospital, Department of Radiology Division, Kobe (Japan); Kanda, Tomonori [Teikyo University School of Medicine, Department of Radiology, Tokyo (Japan); Tamaki, Yukihisa [Shimane University School of Medicine, Department of Radiation Oncology, Shimane (Japan)

    2015-07-15

    To evaluate the usefulness of metabolic parameters obtained by {sup 18}F-FDG PET/CT for preoperative stratification of high-risk and low-risk endometrial carcinomas. Preoperative {sup 18}F-FDG PET/CT was performed in 56 women with endometrial cancer. Maximum standardized uptake values (SUVmax), metabolic tumour volume (MTV) and total lesion glycolysis (TLG) of primary tumours were compared with clinicopathological features of surgical specimens. Diagnostic performance in terms of differentiation of low-risk disease (endometrioid histology, histological grade 1 or 2, invasion of less than half of the myometrium, and FIGO stage I) from high-risk disease was assessed. MTV and TLG were significantly higher in patients with higher histological grade (p = 0.0026 and p = 0.034), larger tumour size (p = 0.002 and p = 0.0017), lymphovascular space involvement (LVSI; p = 0.012 and p = 0.0051), myometrial invasion (p = 0.027 and p = 0.031), cervical stromal invasion (p = 0.023 and p = 0.014), ovarian metastasis (p = 0.00022 and p = 0.00034), lymph node metastasis (p < 0.0001 and p < 0.0001), and higher FIGO stage (p = 0.0011 and p = 0.00048). SUVmax was significantly higher in patients with larger tumour size (p = 0.0025), LVSI (p = 0.00023) and myometrial invasion (p < 0.0001). The areas under the ROC curves (AUCs) for distinguishing high-risk from low-risk carcinoma were 0.625, 0.829 and 0.797 for SUVmax, MTV and TLG, respectively. AUCs for both MTV and TLG were significantly larger than that for SUVmax (p = 0.0049 and p = 0.021). The optimal TLG cut-off value of 70.2, determined by ROC analysis, was found to have 72.0 % sensitivity and 74.2 % specificity for risk stratification. MTV and TLG of primary endometrial cancer show better correlations with clinicopathological features and are more useful for differentiating high-risk from low-risk carcinoma than SUVmax. (orig.)

  9. Preoperative Prediction of Ki-67 Labeling Index By Three-dimensional CT Image Parameters for Differential Diagnosis Of Ground-Glass Opacity (GGO.

    Directory of Open Access Journals (Sweden)

    Mingzheng Peng

    Full Text Available The aim of this study was to predict Ki-67 labeling index (LI preoperatively by three-dimensional (3D CT image parameters for pathologic assessment of GGO nodules. Diameter, total volume (TV, the maximum CT number (MAX, average CT number (AVG and standard deviation of CT number within the whole GGO nodule (STD were measured by 3D CT workstation. By detection of immunohistochemistry and Image Software Pro Plus 6.0, different Ki-67 LI were measured and statistically analyzed among preinvasive adenocarcinoma (PIA, minimally invasive adenocarcinoma (MIA and invasive adenocarcinoma (IAC. Receiver operating characteristic (ROC curve, Spearman correlation analysis and multiple linear regression analysis with cross-validation were performed to further research a quantitative correlation between Ki-67 labeling index and radiological parameters. Diameter, TV, MAX, AVG and STD increased along with PIA, MIA and IAC significantly and consecutively. In the multiple linear regression model by a stepwise way, we obtained an equation: prediction of Ki-67 LI=0.022*STD+0.001* TV+2.137 (R=0.595, R's square=0.354, p<0.001, which can predict Ki-67 LI as a proliferative marker preoperatively. Diameter, TV, MAX, AVG and STD could discriminate pathologic categories of GGO nodules significantly. Ki-67 LI of early lung adenocarcinoma presenting GGO can be predicted by radiologic parameters based on 3D CT for differential diagnosis.

  10. A proposal for combined MRI and PET/CT interpretation criteria for preoperative nodal staging in non-small-cell lung cancer

    International Nuclear Information System (INIS)

    Kim, Yoo Na; Yi, Chin A.; Lee, Kyung Soo; Lee, Ho Yun; Kim, Tae Sung; Chung, Myung Jin; Kwon, O.Jung; Chung, Man Pyo; Kim, Byung-Tae; Choi, Joon Young; Kim, Seon Woo; Han, Joungho; Shim, Young Mog

    2012-01-01

    To determine the positive reading criteria for malignant nodes when interpreting combined MRI and PET/CT images for preoperative nodal staging in non-small-cell lung cancer (NSCLC). Forty-nine patients with biopsy-proven NSCLC underwent both PET/CT and thoracic MRI [diffusion weighted imaging (DWI)]. Each nodal station was evaluated for the presence of metastasis by applying either inclusive (positive if either one read positive) or exclusive (positive if both read positive) criteria in the combined interpretation of PET/CT and MRI. Nodal stage was confirmed pathologically. The combined diagnostic accuracy of PET/CT and MRI was determined on per-nodal station and per-patient bases and compared with that of PET/CT alone. In 49 patients, 39 (19%) of 206 nodal stations harboured malignant cells. Out of 206 nodal stations, 186 (90%) had concordant readings, while the rest (10%) had discordant readings. Inclusive criteria of combined PET/CT and MRI helped increase sensitivity for detecting nodal metastasis (69%) compared with PET/CT alone (46%; P = 0.003), while specificity was not significantly decreased. Inclusive criteria in combined MRI and PET/CT readings help improve significantly the sensitivity for detecting nodal metastasis compared with PET/CT alone and may decrease unnecessary open thoracotomy. (orig.)

  11. Clinical evaluation of preoperative measurement of liver volume by CT volumetry

    International Nuclear Information System (INIS)

    Takahashi, Masahiro; Sasaki, Ryoko; Kato, Kenichi

    2003-01-01

    The utility of measuring liver volume by CT volumetry prior to hepatectomy for treatment of hepatobiliary diseases was assessed by investigating the relationship between liver volume and perioperative hepatic function, and some perioperative factors. Both residual liver volume (RLV) and functional residual liver volume rate (%FRLV) had a significant negative correlation with maximum postoperative total bilirubin (T. Bil) (r=-0.318, r=-0.477, respectively). Further, RLV and %FRLV exhibited a negative correlation with length of intensive care unit (ICU) stay (r=-0.297, r=-0.397, respectively). The ratio of patients with maximum postoperative T. Bil≥10 mg/dl among patients with RLV<500 ml was significantly higher than that among patients with RLV≥500 ml (p<0.05). Similarly, the ratio of patients with maximum postoperative T. Bil≥10 mg/dl among patients with %FRLV<40% was significantly higher than that among patients with %FRLV≥40% (p<0.05). Among patients with %FRLV<40%, maximum T. Bil for patients who underwent portal vein embolization (PVE) was significantly lower than that for patients who did not undergo PVE (p<0.05). When performing hepatectomy, the risk of severe postoperative liver failure is low as long as %FRLV and RLV are above 40% and 500 ml, respectively, and PVE is useful for performing extended hepatectomy when %FRLV is <40%. (author)

  12. Advantages of hybrid SPECT-CT imaging in preoperative localization of parathyroid glands in a patient with secondary hyperparathyroidism. A case report

    International Nuclear Information System (INIS)

    Cytawa, Wojciech; Teodorczyk, Jacek; Lass, Piotr

    2013-01-01

    Secondary hyperparathyroidism is a frequent complication of chronic renal failure. Patients resistant to pharmacotherapy are candidates for parathyroidectomy. Invasiveness of surgical treatment can be minimized by precise preoperative localization of parathyroid glands. Imaging modalities routinely used for this purpose are ultrasonography and MIBI-Tc99m scintigraphy. Our case report shows advantages of co-registered computer tomography and conventional SPECT imaging (SPECT/CT) in a patient with advanced secondary hyperparathyroidism successfully treated with surgery. Hybrid SPECT/CT parathyroid imaging enables better surgical planning and is superior to conventional scintigraphy

  13. Clinical value of surgical staging with preoperative 18F-FDG PET/CT evaluation for mediastinal lymph nodes in lung cancer

    International Nuclear Information System (INIS)

    Li Hong; Wang Xiaoming; Xu Weina; Xin Jun; Guo Qiyong

    2012-01-01

    Objective: To investigate the clinical value of preoperative 18 F-FDG PET/CT for surgical staging by evaluating mediastinal lymphadenopathy in lung cancer. Methods: Sixty-eight patients with lung cancer underwent both 18 F-FDG PET/CT and chest CT. The results of PET/CT and CT were compared with pathological results. χ 2 and t tests were used for data analysis. Results: A total of 222 mediastinal lymph nodes were resected in 68 patients and 84 (37.8%) were confirmed as metastases by pathology. The sensitivity, specificity, accuracy, positive and negative predictive values for PET/CT and CT were 71.4% (60/84) vs 48.8% (41/84), 66.7% (92/138) vs 49.3% (68/138), 68.5% (152/222) vs 49.1%(109/222), 56.6% (60/106) vs 36.9% (41/111), 79.3% (92/116) vs 61.3 % (68/111), respectively (χ 2 =8.96, 8.57, 17.19, 8.43, 8.88, all P<0.05). The staging consistency of PET/CT with pathology was 73.5% (50/68), which was significantly higher than that of CT with pathology (41.2% (28/68); χ 2 =14.55, P<0.01). The identification of N 1 and N 2 disease was, respectively, 66.7%(10/15) and 79.2% (19/24) by PET/CT, 13.3%(2/15) and 45.8% (11/24) by CT (χ 2 =8.89 and 5.69, both P<0.05). The SUV max of lymph nodes greater than and equal to 10 mm in short diameter was significantly higher than those with short diameters less than 10 mm (5.5±2.8 vs 2.2±0.9, t=5.17, P<0.05). Conclusion: Preoperative 18 F-FDG PET/CT is more accurate for evaluating mediastinal lymphadenopathy and staging in patients with lung cancer than CT, and therefore is more valuable for optimizing the best treatment strategies. (authors)

  14. Pre-operative CT angiography and three-dimensional image post processing for deep inferior epigastric perforator flap breast reconstructive surgery.

    Science.gov (United States)

    Lam, D L; Mitsumori, L M; Neligan, P C; Warren, B H; Shuman, W P; Dubinsky, T J

    2012-12-01

    Autologous breast reconstructive surgery with deep inferior epigastric artery (DIEA) perforator flaps has become the mainstay for breast reconstructive surgery. CT angiography and three-dimensional image post processing can depict the number, size, course and location of the DIEA perforating arteries for the pre-operative selection of the best artery to use for the tissue flap. Knowledge of the location and selection of the optimal perforating artery shortens operative times and decreases patient morbidity.

  15. MRI, CT, and sonography in the preoperative evaluation of primary tumor extension in malignant pleural mesothelioma; MRT, CT und Sonographie in der praeoperativen Beurteilung der Primaertumorausdehnung beim malignen Pleuramesotheliom

    Energy Technology Data Exchange (ETDEWEB)

    Layer, G.; Steudel, A.; Schild, H.H. [Radiologische Universitaetsklinik Bonn (Germany); Schmitteckert, H.; Tuengerthal, S.; Schirren, J. [Thoraxklinik Heidelberg-Rohrbach (Germany); Kaick, G. van [Deutsches Krebsforschungszentrum Heidelberg (Germany). Schwerpunkt fuer Onkologische Diagnostik und Therapie

    1999-04-01

    Purpose: Evaluation of the diagnostic value of the imaging modalities computed tomography (CT), magnetic resonance imaging (MRI), and thoracic sonography in the preoperative staging of malignant pleural mesothelioma. Results: The accuracy rates for CT were 85%, 98%, 83%, 73%, 71%, and 83%. MRI had an accuracy of 71%, 92%, 71%, 83%, 71%, and 96%, the thoracic ultrasound examinations of 76%, 63%, 51%, 60%, 71% and 89%. Conclusions: According to these results CT remains the method of choice in the preoperative assessment of T-stage of malignant pleural mesothelioma. MRI is of nearly the same value, but is not a must. Sonography may be supplementary method for operation planning. (orig./AJ) [Deutsch] Ziel: Evaluation der diagnostischen Wertigkeit der Schnittbildverfahren MRT, CT und Sonographie in der praeoperativen Diagnostik des Pleuramesothelioms. Ergebisse: Die Treffsicherheiten betrugen fuer die genannten anatomischen Regionen im CT 85%, 98%, 83%, 73%, 71%, und 83%, im MRT 71%, 92%, 71%, 83%, 71% bzw. 96%, waehrend sich fuer die thorakale Ultraschalluntersuchung Treffsicherheiten von 76%, 63%, 51%, 60%, 71% und 89% errechneten. Schlussfolgerungen: Die CT bleibt damit das Verfahren erster Wahl in der praeoperativen Diagnostik des malignen Pleuramesothelioms. Eine unbedingte Forderung nach praeoperativer Durchfuehrung einer MRT-Untersuchung ergibt sich nach der vorliegenden Studie nicht. Die Sonographie des Thorax und oberen Abdomens liefert einen wichtigen ergaenzenden Beitrag bei der Planung der Operation des malignen Pleuramesothelioms. (orig./AJ)

  16. Preoperative detection of hepatocellular carcinoma: comparison of combined constrast-enhanced MR imaging and combined CT during arterial portography and CT hepatic arteriography

    International Nuclear Information System (INIS)

    Kwak, H.S.; Kim, C.S.; Lee, J.M.; Seoul National University Medical Research Center

    2004-01-01

    The aim of this study was to compare Gd-DTPA-enhanced dynamic MR images, superparamagnetic iron oxide (SPIO)-enhanced MR images, combined Gd-DTPA-enhanced dynamic and SPIO-enhanced MR images, vs combined CT arterial portography (CTAP) and CT hepatic arteriography (CTHA), in the detection of hepatocellular carcinoma (HCC) using receiver operating characteristic (ROC) analysis. Twenty-four patients with 38 nodular HCCs (5-60 mm, mean 23.0 mm) were retrospectively analyzed. Image reviews were conducted on a liver segment-by-segment basis. A total of 192 segments, including 36 segments with 38 HCC, were reviewed independently by three radiologists. Each radiologist read four sets of images (set 1, unenhanced and Gd-DTPA-enhanced dynamic MR images; set 2, unenhanced and SPIO-enhanced MR images; set 3, combined Gd-DTPA-enhanced dynamic and SPIO-enhanced MR images; set 4, combined CTAP and CTHA). To minimize any possible learning bias, the reviewing order was randomized and the reviewing procedure was performed in four sessions at 2-week intervals. The diagnostic accuracy (Az values) for HCCs of combined CTAP and CTHA, combined Gd-DTPA-enhanced dynamic and SPIO-enhanced MR images, Gd-DTPA-enhanced dynamic MR images, and SPIO-enhanced MR images for all observers were 0.934, 0.963, 0.878, and 0.869, respectively. The diagnostic accuracy of combined CTAP and CTHA and combined Gd-DTPA-enhanced dynamic and SPIO-enhanced MR images was significantly higher than Gd-DTPA-enhanced dynamic MR images or SPIO-enhanced MR images (p<0.005). The mean specificity of combined CTAP and CTHA (93%) and combined Gd-DTPA-enhanced dynamic and SPIO-enhanced MR images (95%) was significantly higher than Gd-DTPA-enhanced dynamic MR images (87%) or SPIO-enhanced MR images (88%; p<0.05). Combined Gd-DTPA-enhanced dynamic and SPIO-enhanced MR images may obviate the need for more invasive combined CTAP and CTHA for the preoperative evaluation of patients with HCC

  17. Severe fuel damage investigations of KFK/PNS

    International Nuclear Information System (INIS)

    Fiege, A.

    1983-01-01

    This report is a comprehensive review of the objectives, the program planning, the status and the further procedure of the investigations of KfK/PNS on severe core damage. The investigations were started in 1981 and will be finished in 1985/86. (orig.) [de

  18. CT assessment-based direct surgical resection of part-solid nodules with solid component larger than 5 mm without preoperative biopsy: experience at a single tertiary hospital

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Min [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of); Asan Medical Center, Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Park, Chang Min; Song, Yong Sub; Kim, Hyungjin; Goo, Jin Mo [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of); Kim, Young Tae [Seoul National University College of Medicine, Department of Thoracic and Cardiovascular Surgery, Seoul (Korea, Republic of); Park, Young Sik [Seoul National University Hospital, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Internal Medicine, Seoul (Korea, Republic of)

    2017-12-15

    To retrospectively evaluate the feasibility of CT assessment-based direct surgical resection of part-solid nodules (PSNs) with solid components > 5 mm without preoperative percutaneous transthoracic needle biopsies (PTNBs). From January 2009-December 2014, 85 PSNs with solid components > 5 mm on CT were included. Preoperative PTNBs were performed for 41 PSNs (biopsy group) and CT assessment-based direct resections were performed for 44 PSNs (direct surgery group). Diagnostic accuracy and complication rates of the groups were compared. Pathological results of 83 PSNs excluding two indeterminate nodules included 76 adenocarcinomas (91.6%), two adenocarcinomas in situ (2.4%) and five benign lesions (6.0%). In the biopsy group, the overall sensitivity, specificity and accuracy for the diagnosis of adenocarcinoma were 78.9% (30/38), 100% (1/1) and 79.5% (31/39), respectively. Pneumothorax and haemoptysis occurred in 11 procedures (26.8%). In the direct surgery group, the respective values for the diagnosis of adenocarcinoma were 100% (38/38), 0% (0/6) and 86.4% (38/44), respectively. Seven pneumothoraces (15.9%); no haemoptysis occurred during localization procedures. There were no significant differences in diagnostic accuracy (P = 0.559) between the two groups. CT assessment-based direct resection can be reasonable for PSNs with solid part > 5 mm. (orig.)

  19. CT assessment-based direct surgical resection of part-solid nodules with solid component larger than 5 mm without preoperative biopsy: experience at a single tertiary hospital

    International Nuclear Information System (INIS)

    Lee, Sang Min; Park, Chang Min; Song, Yong Sub; Kim, Hyungjin; Goo, Jin Mo; Kim, Young Tae; Park, Young Sik

    2017-01-01

    To retrospectively evaluate the feasibility of CT assessment-based direct surgical resection of part-solid nodules (PSNs) with solid components > 5 mm without preoperative percutaneous transthoracic needle biopsies (PTNBs). From January 2009-December 2014, 85 PSNs with solid components > 5 mm on CT were included. Preoperative PTNBs were performed for 41 PSNs (biopsy group) and CT assessment-based direct resections were performed for 44 PSNs (direct surgery group). Diagnostic accuracy and complication rates of the groups were compared. Pathological results of 83 PSNs excluding two indeterminate nodules included 76 adenocarcinomas (91.6%), two adenocarcinomas in situ (2.4%) and five benign lesions (6.0%). In the biopsy group, the overall sensitivity, specificity and accuracy for the diagnosis of adenocarcinoma were 78.9% (30/38), 100% (1/1) and 79.5% (31/39), respectively. Pneumothorax and haemoptysis occurred in 11 procedures (26.8%). In the direct surgery group, the respective values for the diagnosis of adenocarcinoma were 100% (38/38), 0% (0/6) and 86.4% (38/44), respectively. Seven pneumothoraces (15.9%); no haemoptysis occurred during localization procedures. There were no significant differences in diagnostic accuracy (P = 0.559) between the two groups. CT assessment-based direct resection can be reasonable for PSNs with solid part > 5 mm. (orig.)

  20. Preoperative and Postoperative CT Scan Assessment of Pterygomaxillary Junction in Patients Undergoing Le Fort I Osteotomy: Comparison of Pterygomaxillary Dysjunction Technique and Trimble Technique-A Pilot Study.

    Science.gov (United States)

    Dadwal, Himani; Shanmugasundaram, S; Krishnakumar Raja, V B

    2015-09-01

    To determine the rate of complications and occurrence of pterygoid plate fractures comparing two techniques of Le Fort I osteotomy i.e., Classic Pterygomaxillary Dysjunction technique and Trimble technique and to know whether the dimensions of pterygomaxillary junction [determined preoperatively by computed tomography (CT) scan] have any influence on pterygomaxillary separation achieved during surgery. The study group consisted of eight South Indian patients with maxillary excess. A total of 16 sides were examined by CT. Preoperative CT was analyzed for all the patients. The thickness and width of the pterygomaxillary junction and the distance of the greater palatine canal from the pterygomaxillary junction was noted. Pterygomaxillary dysjunction was achieved by two techniques, the classic pterygomaxillary dysjunction technique (Group I) and Trimble technique (Group II). Patients were selected randomly and equally for both the techniques. Dysjunction was analyzed by postoperative CT. The average thickness of the pterygomaxillary junction on 16 sides was 4.5 ± 1.2 mm. Untoward pterygoid plate fractures occurred in Group I in 3 sides out of 8. In Trimble technique (Group II), no pterygoid plate fractures were noted. The average width of the pterygomaxillary junction was 7.8 ± 1.5 mm, distance of the greater palatine canal from pterygomaxillary junction was 7.4 ± 1.6 mm and the length of fusion of pterygomaxillary junction was 8.0 ± 1.9 mm. The Le Fort I osteotomy has become a standard procedure for correcting various dentofacial deformities. In an attempt to make Le Fort I osteotomy safer and avoid the problems associated with sectioning with an osteotome between the maxillary tuberosity and the pterygoid plates, Trimble suggested sectioning across the posterior aspect of the maxillary tuberosity itself. In our study, comparison between the classic pterygomaxillary dysjunction technique and the Trimble technique was made by using postoperative CT scan

  1. Use of 18F-FDG PET/CT in the preoperative evaluation of patients diagnosed with peritoneal carcinomatosis of ovarian origin, candidates to cytoreduction and hipec. A pending issue

    International Nuclear Information System (INIS)

    Lopez-Lopez, V.; Cascales-Campos, P.A.; Gil, J.; Frutos, L.; Andrade, R.J.; Fuster-Quiñonero, M.; Feliciangeli, E.; Gil, E.; Parrilla, P.

    2016-01-01

    Highlights: • CT showed the better results confirming ovarian peritoneal disease than 18 F-FDG PET/CT. • CT and 18 F-FDG PET/CT present a low detection capability for LSS-3 injury. • Main utility of 18 F-FDG PET/CT is the evaluation of extraperitoneal extension. - Abstract: Purpose: To evaluate the clinical usefulness of the results obtained with 18 F-FDG PET/CT in relation to CT in the preoperative staging of patients with peritoneal carcinomatosis secondary to primary or recurrent ovarian cancer candidates to cytoreductive surgery and hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC). Material and methods: A retrospective study comparing the results obtained with CT and 18 F-FDG PET/CT in the preoperative evaluation of a series of 59 patients was performed. In all patients the peritoneal carcinomatosis index (PCI) was determined by preoperative radiological CT and 18F-FDG PET/CT and compared with surgical PCI, which was considered as reference. Results: Of the 59 patients studied, in 55 peritoneal carcinomatosis presences were confirmed (4 patients had complete responses to neoadjuvant chemotherapy). The mean surgical, CT and 18F-FDG PET/CT PCI was 9.46 ± 7.70, 3.69 ± 3.96 and 2.25 ± 1.02, respectively. In the global disease detection, CT showed a higher positive likelihood ratio (LR+) than 18 F-FDG PET/CT (15.3, 95% CI 8.35–28.04 vs. 3.47, 95% CI 3.36–5.11) and a lower negative likelihood ratio (LR-) than 18F-FDG PET/CT (0.67, 95% CI 0.61–0.73 vs. 0.82, 95% CI 0.76–0.88). In every region of the abdomen the CT showed a greater LR+ than 18F-FDG PET/CT and a lower LR- than 18F-FDG PET/CT. Conclusions: CT showed the best diagnostic results compared to 18 F-FDG PET/CT to confirme the presence of peritoneal disease. The lower performance of the 18 F-FDG PET/CT suggests that the main utility of 18 F-FDG PET/CT is to evaluate a possible metastatic extraperitoneal spread of the disease.

  2. Adverse events during CT colonography for screening, diagnosis and preoperative staging of colorectal cancer: a Japanese national survey

    International Nuclear Information System (INIS)

    Nagata, Koichi; Takabayashi, Ken; Yasuda, Takaaki; Hirayama, Michiaki; Endo, Shungo; Nozaki, Ryoichi; Shimada, Takenobu; Kanazawa, Hidenori; Fujiwara, Masanori; Shimizu, Norihito; Iwatsuki, Tatema; Iwano, Teruaki; Saito, Hiroshi

    2017-01-01

    To retrospectively evaluate the frequencies and magnitudes of adverse events associated with computed tomographic colonography (CTC) for screening, diagnosis and preoperative staging of colorectal cancer. A Japanese national survey on CTC was administered by use of an online survey tool in the form of a questionnaire. The questions covered mortality, colorectal perforation, vasovagal reaction, total number of examinations, and examination procedures. The survey data was collated and raw frequencies were determined. Fisher's exact test was used to determine differences in event rates between groups. At 431 institutions, 147,439 CTC examinations were performed. No deaths were reported. Colorectal perforations occurred in 0.014% (21/147,439): 0.003% (1/29,823) in screening, 0.014% (13/91,007) in diagnosis and 0.028% (7/25,330) in preoperative staging. The perforation risk was significantly lower in screening than in preoperative staging CTC procedures (p = 0.028). Eighty-one per cent of perforation cases (17/21) did not require emergency surgery. Vasovagal reaction occurred in 0.081% (120/147,439): 0.111% (33/29,823) in screening, 0.088% (80/91,007) in diagnosis and 0.028% (7/25,330) in preoperative staging. The risk of colorectal perforation and vasovagal reaction in CTC is low. The frequency of colorectal perforation associated with CTC is least in the screening group and greatest in the preoperative-staging group. (orig.)

  3. Adverse events during CT colonography for screening, diagnosis and preoperative staging of colorectal cancer: a Japanese national survey

    Energy Technology Data Exchange (ETDEWEB)

    Nagata, Koichi [Japanese Society of Gastrointestinal Cancer Screening, Committee for Quality Assessment of Colorectal Cancer Screening, Tokyo (Japan); Gastrointestinal Advanced Imaging Academy, Tochigi (Japan); National Cancer Centre, Division of Screening Technology, Centre for Public Health Sciences, Tokyo (Japan); Takabayashi, Ken [Gastrointestinal Advanced Imaging Academy, Tochigi (Japan); National Cancer Centre, Division of Screening Technology, Centre for Public Health Sciences, Tokyo (Japan); Hokkaido Gastroenterology Hospital, Department of Radiology, Sapporo (Japan); Yasuda, Takaaki [Gastrointestinal Advanced Imaging Academy, Tochigi (Japan); National Cancer Centre, Division of Screening Technology, Centre for Public Health Sciences, Tokyo (Japan); Nagasaki Kamigoto Hospital, Department of Radiology, Nagasaki (Japan); Hirayama, Michiaki [Gastrointestinal Advanced Imaging Academy, Tochigi (Japan); Tonan Hospital, Department of Gastroenterology, Sapporo (Japan); Endo, Shungo [Gastrointestinal Advanced Imaging Academy, Tochigi (Japan); Fukushima Medical University, Department of Coloproctology, Aizu Medical Centre, Aizu-Wakamatsu, Fukushima (Japan); Nozaki, Ryoichi [Japanese Society of Gastrointestinal Cancer Screening, Committee for Quality Assessment of Colorectal Cancer Screening, Tokyo (Japan); Gastrointestinal Advanced Imaging Academy, Tochigi (Japan); Takano Hospital, Coloproctology Centre, Kumamoto (Japan); Shimada, Takenobu [Japanese Society of Gastrointestinal Cancer Screening, Committee for Quality Assessment of Colorectal Cancer Screening, Tokyo (Japan); Cancer Detection Centre of the Miyagi Cancer Society, Sendai, Miyagi (Japan); Kanazawa, Hidenori [National Cancer Centre, Division of Screening Technology, Centre for Public Health Sciences, Tokyo (Japan); Jichi Medical University, Department of Radiology, Shimotsuke, Tochigi (Japan); Fujiwara, Masanori [Gastrointestinal Advanced Imaging Academy, Tochigi (Japan); Kameda Medical Centre Makuhari, Radiology Section, Mihama-ku, Chiba (Japan); Shimizu, Norihito [Gastrointestinal Advanced Imaging Academy, Tochigi (Japan); Matsuoka Clinic, Radiology Section, Nara (Japan); Iwatsuki, Tatema [Gastrointestinal Advanced Imaging Academy, Tochigi (Japan); Matsuda Hospital, Radiology Section, Hamamatsu, Shizuoka (Japan); Iwano, Teruaki [Gastrointestinal Advanced Imaging Academy, Tochigi (Japan); Tokushima Kensei Hospital, Radiology Section, Tokushima (Japan); Saito, Hiroshi [Japanese Society of Gastrointestinal Cancer Screening, Committee for Quality Assessment of Colorectal Cancer Screening, Tokyo (Japan); National Cancer Centre, Division of Screening Assessment and Management, Centre for Public Health Sciences, Tokyo (Japan)

    2017-12-15

    To retrospectively evaluate the frequencies and magnitudes of adverse events associated with computed tomographic colonography (CTC) for screening, diagnosis and preoperative staging of colorectal cancer. A Japanese national survey on CTC was administered by use of an online survey tool in the form of a questionnaire. The questions covered mortality, colorectal perforation, vasovagal reaction, total number of examinations, and examination procedures. The survey data was collated and raw frequencies were determined. Fisher's exact test was used to determine differences in event rates between groups. At 431 institutions, 147,439 CTC examinations were performed. No deaths were reported. Colorectal perforations occurred in 0.014% (21/147,439): 0.003% (1/29,823) in screening, 0.014% (13/91,007) in diagnosis and 0.028% (7/25,330) in preoperative staging. The perforation risk was significantly lower in screening than in preoperative staging CTC procedures (p = 0.028). Eighty-one per cent of perforation cases (17/21) did not require emergency surgery. Vasovagal reaction occurred in 0.081% (120/147,439): 0.111% (33/29,823) in screening, 0.088% (80/91,007) in diagnosis and 0.028% (7/25,330) in preoperative staging. The risk of colorectal perforation and vasovagal reaction in CTC is low. The frequency of colorectal perforation associated with CTC is least in the screening group and greatest in the preoperative-staging group. (orig.)

  4. Is [F-18]-fluorodeoxyglucose FDG-PET/CT better than CT alone for the preoperative lymph node staging of muscle invasive bladder cancer?

    Energy Technology Data Exchange (ETDEWEB)

    Uttam, Mete; Pravin, Nayak; Anish, Bhattacharya; Nandita, Kakkar; Arup, Mandal, E-mail: uttam_mete@yahoo.com [PGIMER, Chandigarh, (India)

    2016-03-15

    Objective: To evaluate whether the use of [F-18]-FDG-PET/CT can accurately predict pelvic lymph node metastasis in patients with muscle invasive TCC of the bladder undergoing radical cystectomy. Materials and methods: Fifteen patients with muscle invasive bladder cancer had undergone FDG-PET/CT scan from the skull base to the mid-thighs after IV injection of 6.5MBq (Mega-Becquerel)/Kg of FDG. After intravenous hydration IV furosemide was given to overcome the difficulties posed by urinary excretion of {sup 18}F-FDG. PET/ CT data were analyzed as PET and CT images studied separately as well as fused PET/ CT images. The imaging findings were correlated with the histopathology of the nodes (gold standard). Results: CT and FDG-PET had demonstrated positive lymph nodes in 9 & 8 patients respectively. Among the 15 patients 3 had documented metastasis on histopathology. Both CT and PET could detect the nodes in all these 3 patients (100% sensitivity). Nodes were histologically negative amongst 6&5 patients who had node involvement by CT and PET respectively. Therefore, specificity, positive predictive value (PPV) & negative predictive value (NPV) for CT and PET/CT were 50%, 33.3%, 100% and 58.3%, 37.5%, 100% respectively. Conclusion: The theoretical advantage of this cutting edge technology for whole body imaging has not been translated into clinical practice as we found minimal advantage of combined FDG-PET/CT over CT alone for nodal staging of muscle invasive bladder cancer. This may be due to substantial overlap between standardized uptake values (SUVs) from active inflammatory processes with those of malignant lesion. (author)

  5. Laparoscopic resection aided by preoperative 3-D CT angiography for rectosigmoid colon cancer associated with a horseshoe kidney: A case report.

    Science.gov (United States)

    Maeda, Yoshiaki; Shinohara, Toshiki; Nagatsu, Akihisa; Futakawa, Noriaki; Hamada, Tomonori

    2014-11-01

    We herein report a case of laparoscopic high anterior resection with D3 lymph node dissection for rectosigmoid colon cancer with a horseshoe kidney. A 65-year-old Japanese man referred to our hospital for rectosigmoid colon cancer was found to have a horseshoe kidney on a CT scan. On 3-D CT angiography, an aberrant renal artery was visualized feeding the renal isthmus that arises from the aorta just below the root of the inferior mesenteric artery (IMA). Laparoscopic anterior rectal resection with D3 lymph node dissection was performed. During the operation, the IMA, left ureter, left gonadal vessels and hypogastric nerve plexus could be seen passing over the horseshoe kidney isthmus. With the aid of preoperative 3-D CT angiography, the root of the IMA was identified on the temporal side of the isthmus and divided safely just above the hypogastric nerve. As a horseshoe kidney is often accompanied by aberrant renal arteries and/or abnormal running of the ureter, 3-D CT angiography is useful for determining the location of these structures and avoiding intraoperative injury. © 2014 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.

  6. The role of three-dimensional multidetector CT gastrography in the preoperative imaging of stomach cancer: Emphasis on detection and localization of the tumor

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Woong; Shin, Sang Soo; Heo, Suk Hee; Lim, Hyo Soon; Park, Young Kyu; Jeong, Yong Yeon; Kang, Heoung Keun [Chonnam National University Medical School, Gwangju (Korea, Republic of); Lim, Nam Yeol [Dept. of Radiology, Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2015-02-15

    Multidetector CT (MDCT) gastrography has been regarded as a promising technique for the preoperative imaging of gastric cancer. It has the ability to produce various three-dimensional (3D) images. Because 3D reconstruction images are more effective and intuitive for recognizing abnormal changes in the gastric folds and subtle mucosal nodularity than two-dimensional images, 3D MDCT gastrography can enhance the detection rate of early gastric cancer, which, in turn, contributes to the improvement of the accuracy of preoperative tumor (T) staging. In addition, shaded surface display and tissue transition projection images provide a global view of the stomach, with the exact location of gastric cancer, which may replace the need for barium studies. In this article, we discuss technical factors in producing high-quality MDCT gastrographic images and present cases demonstrating the usefulness of MDCT gastrography for the detection and T staging of gastric cancer while emphasizing the significance of preoperative localization of gastric cancer in terms of surgical margin.

  7. Comparative studies of '18F-FDG PET/CT brain imaging and EEG in preoperative localization of temporal lobe epileptic focus

    International Nuclear Information System (INIS)

    Chen Ziqian; Zhao Chunlei; Liu Yao; Ni Ping; Zhong Qun; Bai Wei; Peng Dexin

    2012-01-01

    Objective: To compare the value of 18 F-FDG PET/CT brain imaging and EEG in preoperative localization of the epileptic focus at the temporal lobe. Methods: A total of 152 patients (108 males, 44 females, age ranged from 3 to 59 years old) with past history of temporal lobe epilepsy were included.All patients underwent 18 F-FDG PET/CT brain imaging and long-range or video EEG, and 29 patients underwent intracranial electrode EEG due to the failure to localize the disease focus by non-invasive methods.Histopathologic findings after operative treatment were considered the gold standard for disease localization. All patients were followed up for at least six months after the operation. The accuracy of the 18 F-FDG PET/CT brain imaging and long-range or video EEG examination were compared using χ 2 test. Results: The accuracy of locating the epileptic focus was 80.92% (123/152) for 18 F-FDG PET/CT brain imaging and 43.42% (66/152) for long-range or video EEG (χ 2 =22.72, P<0.01). The accuracy of locating the epileptic focus for the 29 cases with intracranial electrode EEG was 100%. Conclusions: Interictal 18 F-FDG PET/CT brain imaging is a sensitive and effective method to locate the temporal lobe epileptic focus and is better than long-range or video EEG. The combination of 18 F-FDG PET/CT brain imaging and intracranial electrode EEG examination can further improve the accuracy of locating the epileptic focus. (authors)

  8. Prognostic value of total lesion glycolysis on preoperative {sup 18}F-FDG PET/CT in patients with uterine carcinosarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong-Won [Sungkyunkwan University School of Medicine, Department of Obstetrics and Gynecology, Seoul (Korea, Republic of); Sungkyunkwan University School of Medicine, Samsung Advanced Institute for Health Sciences and Technology, Seoul (Korea, Republic of); Heo, Eun Jin [Sungkyunkwan University School of Medicine, Department of Obstetrics and Gynecology, Seoul (Korea, Republic of); Moon, Seung Hwan [Sungkyunkwan University School of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Lee, Hyunjong; Cheon, Gi Jeong [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Lee, Maria; Kim, Hee Seung; Chung, Hyun Hoon [Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul (Korea, Republic of)

    2016-11-15

    To investigate the relationship between functional tumour parameters measured during preoperative {sup 18}F-FDG PET/CT and clinical outcomes in patients with uterine carcinosarcoma. For patients with pathologically proven uterine carcinosarcoma, we determined the maximal and average standardized uptake values, cumulative total lesion glycolysis (TLG) and sum of all metabolic tumour volumes (MTVs). Their predictive value for recurrence and the effects of pretreatment functional tumour activity on patient survival were compared. Clinicopathological data from 28 eligible patients were reviewed. The median duration of progression-free survival was 18.6 months (range 6.1-84.5 months), and 10 (35.7 %) patients experienced recurrences. Univariate analyses showed significant associations between recurrence and tumour size, lymph node metastasis, high TLG and MTV values, and ovarian invasion. Multivariate analysis identified high TLG value as an independent risk factor for recurrence (p = 0.048, hazard ratio 115.261, 95 % confidence interval 1.041-12,765.483). Kaplan-Meier survival curves showed that progression-free survival significantly differed in groups categorized according to TLG (p = 0.007, log-rank test). Preoperative TLG measured with {sup 18}F-FDG PET/CT was statistically significantly associated with uterine carcinosarcoma recurrence. Metabolic parameters can provide useful quantitative criteria for disease prognostication in patients with uterine carcinosarcoma before treatment. (orig.)

  9. Volumetric dynamic contrast enhanced Computed Tomography (DCE-CT) for preoperative assessment of the vascularity of spinal metastases

    DEFF Research Database (Denmark)

    Lauridsen, Carsten Ammitzbøl

    Purpose To investigate the feasibility of measuring and grading the vascularity of spinal metastases using dynamic contrast enhanced CT (DCE-CT). Materials and methods Prior to surgical treatment of symptomatic metastatic spinal cord compression, 20 patients were examined using DCE-CT. The 320......–detector row CT scanner allowed a volumetric acquisition over a range of 16 cm, covering three to four vertebrae. Image analysis was performed at a dedicated workstation, encompassing quantitative and qualitative measurement of the arterial flow (AF) in mL/min/100mL of the vertebrae. The perfusion values...... were analysed using a single input, maximum slope model. The AF assessed by DCE-CT of affected and non-affected vertebrae will be compared, and furthermore, the correlation between AF and intraoperative blood loss will be examined. Results Preliminary results for 5 patients: In two patients the AF...

  10. User Requirements & Demand for Services and Applications in PNs

    DEFF Research Database (Denmark)

    Jiang, Bo

    This paper focuses on the methodology for analyses of user requirements and demand for specific services and applications in relation to personal networks (PNs). The paper has a strong user-centric approach to service and application development based on the widely accepted fact that future servi...... demand for services and applications in a PN setting. This further includes discussion of service categorization, service description and human-value issues as personalization, security and privacy, billing and price and human-computer interaction paradigms....

  11. The value of FDG positron emission tomography/computerised tomography (PET/CT) in pre-operative staging of colorectal cancer: a systematic review and economic evaluation.

    Science.gov (United States)

    Brush, J; Boyd, K; Chappell, F; Crawford, F; Dozier, M; Fenwick, E; Glanville, J; McIntosh, H; Renehan, A; Weller, D; Dunlop, M

    2011-09-01

    In the UK, colorectal cancer (CRC) is the third most common malignancy (behind lung and breast cancer) with 37,514 cases registered in 2006: around two-thirds (23,384) in the colon and one-third (14,130) in the rectum. Treatment of cancers of the colon can vary considerably, but surgical resection is the mainstay of treatment for curative intent. Following surgical resection, there is a comprehensive assessment of the tumour, it's invasion characteristics and spread (tumour staging). A number of imaging modalities are used in the pre-operative staging of CRCs including; computerised tomography (CT), magnetic resonance imaging, ultrasound imaging and positron emission tomography (PET). This report examines the role of CT in combination with PET scanning (PET/CT 'hybrid' scan). The research objectives are: to evaluate the diagnostic accuracy and therapeutic impact of fluorine-18-deoxyglucose (FDG) PET/CT for the pre-operative staging of primary, recurrent and metastatic cancer using systematic review methods; undertake probabilistic decision-analytic modelling (using Monte Carlo simulation); and conduct a value of information analysis to help inform whether or not there is potential worth in undertaking further research. For each aspect of the research - the systematic review, the handsearch study and the economic evaluation - a database was assembled from a comprehensive search for published and unpublished studies, which included database searches, reference lists search and contact with experts. In the systematic review prospective and retrospective patient series (diagnostic cohort) and randomised controlled trials (RCTs) were eligible for inclusion. Both consecutive series and series that are not explicitly reported as consecutive were included. Two reviewers extracted all data and applied the criteria independently and resolved disagreements by discussion. Data to populate 2 × 2 contingency tables consisting of the number of true positives, true negatives

  12. CT fluoroscopy-guided preoperative short hook wire placement for small pulmonary lesions: evaluation of safety and identification of risk factors for pneumothorax.

    Science.gov (United States)

    Iguchi, Toshihiro; Hiraki, Takao; Gobara, Hideo; Fujiwara, Hiroyasu; Matsui, Yusuke; Miyoshi, Shinichiro; Kanazawa, Susumu

    2016-01-01

    To retrospectively evaluate the safety of computed tomography (CT) fluoroscopy-guided short hook wire placement for video-assisted thoracoscopic surgery and the risk factors for pneumothorax associated with this procedure. We analyzed 267 short hook wire placements for 267 pulmonary lesions (mean diameter, 9.9 mm). Multiple variables related to the patients, lesions, and procedures were assessed to determine the risk factors for pneumothorax. Complications (219 grade 1 and 4 grade 2 adverse events) occurred in 196 procedures. No grade 3 or above adverse events were observed. Univariate analysis revealed increased vital capacity (odds ratio [OR], 1.518; P = 0.021), lower lobe lesion (OR, 2.343; P =0.001), solid lesion (OR, 1.845; P = 0.014), prone positioning (OR, 1.793; P = 0.021), transfissural approach (OR, 11.941; P = 0.017), and longer procedure time (OR, 1.036; P = 0.038) were significant predictors of pneumothorax. Multivariate analysis revealed only the transfissural approach (OR, 12.171; P = 0.018) and a longer procedure time (OR, 1.048; P = 0.012) as significant independent predictors. Complications related to CT fluoroscopy-guided preoperative short hook wire placement often occurred, but all complications were minor. A transfissural approach and longer procedure time were significant independent predictors of pneumothorax. Complications related to CT fluoroscopy-guided preoperative short hook wire placement often occur. Complications are usually minor and asymptomatic. A transfissural approach and longer procedure time are significant independent predictors of pneumothorax.

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

    Directory of Open Access Journals (Sweden)

    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

  14. Comparison between FDG Uptake and Pathologic or Immunohistochemical Parametersin Pre-operative PET/CT Scan of Patient with Primary Colorectal Cancer

    International Nuclear Information System (INIS)

    Na, Sae Jung; Chung, Yong An; Maeng, Lee So; Kim, Ki Jun; Sohn, Kyung Myung; Kim, Sung Hoon; Sohn, Hyung Sun; Chung, Soo Kyo

    2009-01-01

    To evaluate the relationship between F-18 FDG uptake of tumor in PET/CT scan and pathological or immunohistochemial parameters of colorectal cancer. 147 colorectal cancer patients who underwent both pre-operative F-18 FDG PET/CT scan and surgery were included. In cases with perceptible FDG uptake in primary tumor, the maximum standardized uptake value (SUVmax) was calculated. The pathologic results such as site, size, depth of invasion (T stage), growth pattern, differentiation of primary tumor, lymph node metastasis and Dukes-Astler and Coller stage and immunohistochemical markers such as expression of EGFR, MLH1, MSH2 and Ki-67 index were reviewed. 146 out of 147 PET/CT scans with colorectal cancer showed perceptible focal FDG uptake. SUVmax showed mild positive linear correlation with size of primary tumor (r=0.277, p=0.001) and Ki-67 index (r=0.226, p=0.019). No significant difference in F-18 FDG uptake was found according to site, depth of invasion (T stage), growth pattern, differentiation of primary tumor, presence of lymph node metastasis, Dukes-Astler and Coller stage and expression of EGFR. The degree of F-18 FDG uptake in colorectal cancer was associated with the size and the degree of Ki-67 index of primary tumor. It could be thought that FDG uptake of primary tumor has a correlation with macroscopic and microscopic tumor growth

  15. Clinico-statistical study on the patients who were applied preoperative CT imaging for dental implant treatment in Iwate Medical University Hospital

    International Nuclear Information System (INIS)

    Shoji, Satoru; Izumisawa, Mitsuru; Satoh, Hitoshi; Hoshino, Masayuki; Takahashi, Noriaki; Shozushima, Masanori; Nakasato, Tatsuhiko

    2007-01-01

    The diagnosis of jaw bones using X-ray computed tomography (CT) is important to determine placement of dental implants. A Clinico-statistical study were made on 490 cases which applied preoperative dental mutiplannar reconstructing CT (dental MPR) imaging for dental implant treatment in Iwate Medical University Hospital, during a five-year period from 2002 to 2006. The following results were obtained: The 490 cases consisted of 179 males and 311 females. They ranged in age from 16 to 80 years, the average age was 53.6 years old. The largest number of cases were in their 50's and, in most generations, there were more female cases than male. Similar cases have been increasing every year. Most patients were referred from other clinics to our hospital. Of the cases that underwent CT scanning more were mandible than maxilla. Implantation prearranged region revealed a predominance of mandible in anterior teeth, and maxilla in molar teeth. The cases that were using diagnostic surgical stents increased in the first three years, but were constant afterwards. (author)

  16. Use of (18)F-FDG PET/CT in the preoperative evaluation of patients diagnosed with peritoneal carcinomatosis of ovarian origin, candidates to cytoreduction and hipec. A pending issue.

    Science.gov (United States)

    Lopez-Lopez, V; Cascales-Campos, P A; Gil, J; Frutos, L; Andrade, R J; Fuster-Quiñonero, M; Feliciangeli, E; Gil, E; Parrilla, P

    2016-10-01

    To evaluate the clinical usefulness of the results obtained with (18)F-FDG PET/CT in relation to CT in the preoperative staging of patients with peritoneal carcinomatosis secondary to primary or recurrent ovarian cancer candidates to cytoreductive surgery and hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC). A retrospective study comparing the results obtained with CT and (18)F-FDG PET/CT in the preoperative evaluation of a series of 59 patients was performed. In all patients the peritoneal carcinomatosis index (PCI) was determined by preoperative radiological CT and 18F-FDG PET/CT and compared with surgical PCI, which was considered as reference. Of the 59 patients studied, in 55 peritoneal carcinomatosis presences were confirmed (4 patients had complete responses to neoadjuvant chemotherapy). The mean surgical, CT and 18F-FDG PET/CT PCI was 9.46±7.70, 3.69±3.96 and 2.25±1.02, respectively. In the global disease detection, CT showed a higher positive likelihood ratio (LR+) than (18)F-FDG PET/CT (15.3, 95% CI 8.35-28.04 vs. 3.47, 95% CI 3.36-5.11) and a lower negative likelihood ratio (LR-) than 18F-FDG PET/CT (0.67, 95% CI 0.61-0.73 vs. 0.82, 95% CI 0.76-0.88). In every region of the abdomen the CT showed a greater LR+ than 18F-FDG PET/CT and a lower LR- than 18F-FDG PET/CT. CT showed the best diagnostic results compared to (18)F-FDG PET/CT to confirme the presence of peritoneal disease. The lower performance of the (18)F-FDG PET/CT suggests that the main utility of (18)F-FDG PET/CT is to evaluate a possible metastatic extraperitoneal spread of the disease. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Co-registration of pre-operative CT with ex vivo surgically excised ground glass nodules to define spatial extent of invasive adenocarcinoma on in vivo imaging: a proof-of-concept study

    Energy Technology Data Exchange (ETDEWEB)

    Rusu, Mirabela [Case Western Reserve University, Department of Biomedical Engineering, Cleveland, OH (United States); GE Global Research, Niskayuna, NY (United States); Rajiah, Prabhakar [UT Southwestern Medical Center, Dallas, TX (United States); Cleveland Medical Center and Case Western Reserve University, University Hospitals, Cleveland, OH (United States); Gilkeson, Robert; Yang, Michael; Donatelli, Christopher; Linden, Philip [Cleveland Medical Center and Case Western Reserve University, University Hospitals, Cleveland, OH (United States); Thawani, Rajat; Madabhushi, Anant [Case Western Reserve University, Department of Biomedical Engineering, Cleveland, OH (United States); Jacono, Frank J. [Cleveland Medical Center and Case Western Reserve University, University Hospitals, Cleveland, OH (United States); Louis Stokes Cleveland VA Medical Center, Cleveland, OH (United States)

    2017-10-15

    To develop an approach for radiology-pathology fusion of ex vivo histology of surgically excised pulmonary nodules with pre-operative CT, to radiologically map spatial extent of the invasive adenocarcinomatous component of the nodule. Six subjects (age: 75 ± 11 years) with pre-operative CT and surgically excised ground-glass nodules (size: 22.5 ± 5.1 mm) with a significant invasive adenocarcinomatous component (>5 mm) were included. The pathologist outlined disease extent on digitized histology specimens; two radiologists and a pulmonary critical care physician delineated the entire nodule on CT (in-plane resolution: <0.8 mm, inter-slice distance: 1-5 mm). We introduced a novel reconstruction approach to localize histology slices in 3D relative to each other while using CT scan as spatial constraint. This enabled the spatial mapping of the extent of tumour invasion from histology onto CT. Good overlap of the 3D reconstructed histology and the nodule outlined on CT was observed (65.9 ± 5.2%). Reduction in 3D misalignment of corresponding anatomical landmarks on histology and CT was observed (1.97 ± 0.42 mm). Moreover, the CT attenuation (HU) distributions were different when comparing invasive and in situ regions. This proof-of-concept study suggests that our fusion method can enable the spatial mapping of the invasive adenocarcinomatous component from 2D histology slices onto in vivo CT. (orig.)

  18. Co-registration of pre-operative CT with ex vivo surgically excised ground glass nodules to define spatial extent of invasive adenocarcinoma on in vivo imaging: a proof-of-concept study

    International Nuclear Information System (INIS)

    Rusu, Mirabela; Rajiah, Prabhakar; Gilkeson, Robert; Yang, Michael; Donatelli, Christopher; Linden, Philip; Thawani, Rajat; Madabhushi, Anant; Jacono, Frank J.

    2017-01-01

    To develop an approach for radiology-pathology fusion of ex vivo histology of surgically excised pulmonary nodules with pre-operative CT, to radiologically map spatial extent of the invasive adenocarcinomatous component of the nodule. Six subjects (age: 75 ± 11 years) with pre-operative CT and surgically excised ground-glass nodules (size: 22.5 ± 5.1 mm) with a significant invasive adenocarcinomatous component (>5 mm) were included. The pathologist outlined disease extent on digitized histology specimens; two radiologists and a pulmonary critical care physician delineated the entire nodule on CT (in-plane resolution: <0.8 mm, inter-slice distance: 1-5 mm). We introduced a novel reconstruction approach to localize histology slices in 3D relative to each other while using CT scan as spatial constraint. This enabled the spatial mapping of the extent of tumour invasion from histology onto CT. Good overlap of the 3D reconstructed histology and the nodule outlined on CT was observed (65.9 ± 5.2%). Reduction in 3D misalignment of corresponding anatomical landmarks on histology and CT was observed (1.97 ± 0.42 mm). Moreover, the CT attenuation (HU) distributions were different when comparing invasive and in situ regions. This proof-of-concept study suggests that our fusion method can enable the spatial mapping of the invasive adenocarcinomatous component from 2D histology slices onto in vivo CT. (orig.)

  19. PERENCANAAN DAN EKSEKUSI STRATEGI PENYALURAN DANA TABUNGAN PERUMAHAN PEGAWAI NEGERI SIPIL DI BAPERTARUM-PNS

    Directory of Open Access Journals (Sweden)

    Suhartoyo Suhartoyo

    2015-08-01

    Full Text Available The aims of this study were to evaluate the strategy execution system that has been carried out by Bapertarum-PNS, to evaluate the external and internal conditions influencing the Bapertarum-PNS in increasing the amount of Housing Saving distribution, to formulate alternative strategies to increase the amount of Housing Saving distribution, to determine strategic priorities of Bapertarum-PNS in increasing the Housing Saving fund for the civil servants, and formulate a strategic execution plan of Bapertarum-PNS in carrying out the planned strategic priorities. This study used the analysis of internal and external factors, SWOT analysis to determine alternative strategies and used QSPM to search for strategic priorities and their execution stage using the strategic execution system of Kaplan and Norton. The values of IFE and EFE at Bapertarum-PNS are located in quadrant IV that is in the position of Growing and Developing. The position shows that the most effective effort to increase housing is establishing a strategy of product development. Determination of strategic prioritization generates priorities in order to increase the support value of home financing, develop new products and services, expand information services reaching across Indonesia, implement incentive mechanism for employees, expand cooperation with banking executives, promote the formation of law on Bapertarum-PNS as well as to improve coordination with stakeholders of Bapertarum- PNS.Keywords: Bapertarum-PNS, housing, priority strategy, strategy executionAbstrakTujuan penelitian ini adalah mengevaluasi sistem eksekusi strategi yang sudah dilakukan oleh Bapertarum-PNS, mengevaluasi kondisi ekternal dan internal yang memengaruhi Bapertarum-PNS dalam meningkatkan jumlah penyaluran Tabungan Perumahan, merumuskan alternatif strategi dalam meningkatkan jumlah penyaluran Tabungan Perumahan, menentukan prioritas strategi Bapertarum-PNS dalam meningkatkan penyaluran dana Tabungan

  20. [18F]-fluorocholine PET/CT for preoperative lymph node staging of Prostate Cancer.study

    DEFF Research Database (Denmark)

    Poulsen, Mads Hvid; Bouchelouche, Kirsten; Gerke, Oke

    the histopathological examination of the lymph nodes (the gold standard) was compared with the result of the FCH PET/CT scan which had been blinded. The inclusion criteria were prostate cancer and PSA>10 and/or Gleason ≥ 7 and/or T-stage ≥ 3 and that the patient awaited lymphadenectomy prior to curative therapy...

  1. The role of FDG-PET/CT in preoperative staging of sentinel lymph node biopsy-positive melanoma patients

    DEFF Research Database (Denmark)

    Frary, Charles; Gad, Dorte; Bastholt, Lars

    2016-01-01

    or uncover anything else of relevance. FDG-PET/CT did, however, provide false positive findings in 13 % (6/46) of these patients. These scans triggered additional, predominantly invasive, procedures, which did not ultimately have an impact on the therapeutic strategy. Thus, these findings indicate a need...

  2. Microsurgical management of cerebral aneurysms based in CT angiography with three-dimensional reconstruction (3D-CTA) and without preoperative cerebral angiography

    International Nuclear Information System (INIS)

    Gonzalez-Darder, J.M.; Pesudo-Martinez, J.V.; Feliu-Tatay, R.A.

    2001-01-01

    Objective. To study the possibilities of the microsurgical management of ruptured intracranial aneurysms with the sole preoperative information provided by computed tomography angiography with three-dimensional reconstruction (3D-CTA). Methods. Patients were studied with 3D-CTA after diagnosis of subarachnoid hemorrhage. If the study had an adequate quality and revealed an aneurysm congruent with the clinical findings or neurological examination and/or with the location of the bleeding on computed tomography (CT) scan an early microsurgical clipping of the lesion was done. When the quality of the 3D-CTA study was not adequate or the quality being adequate displayed no lesions or the findings were not accurate enough to warrant direct microsurgical treatment, the patient was studied with cerebral digital substraction (DS) angiography. A total of 44 consecutive patients harboring a total of 47 intracranial aneurysms diagnosed by 3D-CTA and without preoperative DS angiography were submitted to microsurgical clipping and included in the study. Results. The overall mortality was 15.9 % and the favorable results evaluated 6 months after discharge by means of the Glasgow outcome scale reached 70.4 %. All lesions were successfully clipped. Surgery was done a mean of 4.1 days after the admission bleeding. A total of four microlesions undiagnosed by 3D-CTA were found at surgery and clipped. Postoperative DS angiography and necropsy findings were also used as control of the 3D-CTA findings but no additional information was provided excepting the finding in DS angiography of an asymptomatic intracavemous aneurysm. Therefore the sensitivity of the 3D-CTA for diagnosis of symtomatic aneurysms was 100 % and the overall sensitivity 90.4 %. Conclusions. We have reached similar results in patients operated on with or without preoperative angiography. 3D-CTA provides very valuable anatomical information, which has an additional value in the microsurgical treatment of aneurysms of the

  3. CT fluoroscopy-guided preoperative short hook wire placement for small pulmonary lesions: evaluation of safety and identification of risk factors for pneumothorax

    Energy Technology Data Exchange (ETDEWEB)

    Iguchi, Toshihiro; Hiraki, Takao; Gobara, Hideo; Fujiwara, Hiroyasu; Matsui, Yusuke; Kanazawa, Susumu [Okayama University Medical School, Departments of Radiology, Okayama (Japan); Miyoshi, Shinichiro [Okayama University Medical School, General Thoracic Surgery, Okayama (Japan)

    2016-01-15

    To retrospectively evaluate the safety of computed tomography (CT) fluoroscopy-guided short hook wire placement for video-assisted thoracoscopic surgery and the risk factors for pneumothorax associated with this procedure. We analyzed 267 short hook wire placements for 267 pulmonary lesions (mean diameter, 9.9 mm). Multiple variables related to the patients, lesions, and procedures were assessed to determine the risk factors for pneumothorax. Complications (219 grade 1 and 4 grade 2 adverse events) occurred in 196 procedures. No grade 3 or above adverse events were observed. Univariate analysis revealed increased vital capacity (odds ratio [OR], 1.518; P = 0.021), lower lobe lesion (OR, 2.343; P = 0.001), solid lesion (OR, 1.845; P = 0.014), prone positioning (OR, 1.793; P = 0.021), transfissural approach (OR, 11.941; P = 0.017), and longer procedure time (OR, 1.036; P = 0.038) were significant predictors of pneumothorax. Multivariate analysis revealed only the transfissural approach (OR, 12.171; P = 0.018) and a longer procedure time (OR, 1.048; P = 0.012) as significant independent predictors. Complications related to CT fluoroscopy-guided preoperative short hook wire placement often occurred, but all complications were minor. A transfissural approach and longer procedure time were significant independent predictors of pneumothorax. (orig.)

  4. CT fluoroscopy-guided preoperative short hook wire placement for small pulmonary lesions: evaluation of safety and identification of risk factors for pneumothorax

    International Nuclear Information System (INIS)

    Iguchi, Toshihiro; Hiraki, Takao; Gobara, Hideo; Fujiwara, Hiroyasu; Matsui, Yusuke; Kanazawa, Susumu; Miyoshi, Shinichiro

    2016-01-01

    To retrospectively evaluate the safety of computed tomography (CT) fluoroscopy-guided short hook wire placement for video-assisted thoracoscopic surgery and the risk factors for pneumothorax associated with this procedure. We analyzed 267 short hook wire placements for 267 pulmonary lesions (mean diameter, 9.9 mm). Multiple variables related to the patients, lesions, and procedures were assessed to determine the risk factors for pneumothorax. Complications (219 grade 1 and 4 grade 2 adverse events) occurred in 196 procedures. No grade 3 or above adverse events were observed. Univariate analysis revealed increased vital capacity (odds ratio [OR], 1.518; P = 0.021), lower lobe lesion (OR, 2.343; P = 0.001), solid lesion (OR, 1.845; P = 0.014), prone positioning (OR, 1.793; P = 0.021), transfissural approach (OR, 11.941; P = 0.017), and longer procedure time (OR, 1.036; P = 0.038) were significant predictors of pneumothorax. Multivariate analysis revealed only the transfissural approach (OR, 12.171; P = 0.018) and a longer procedure time (OR, 1.048; P = 0.012) as significant independent predictors. Complications related to CT fluoroscopy-guided preoperative short hook wire placement often occurred, but all complications were minor. A transfissural approach and longer procedure time were significant independent predictors of pneumothorax. (orig.)

  5. Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) Combined with Positron Emission Tomography-Computed Tomography (PET-CT) and Video-Electroencephalography (VEEG) Have Excellent Diagnostic Value in Preoperative Localization of Epileptic Foci in Children with Epilepsy.

    Science.gov (United States)

    Wang, Gui-Bin; Long, Wei; Li, Xiao-Dong; Xu, Guang-Yin; Lu, Ji-Xiang

    2017-01-01

    BACKGROUND To investigate the effect that dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has on surgical decision making relative to video-electroencephalography (VEEG) and positron emission tomography-computed tomography (PET-CT), and if the differences in these variables translates to differences in surgical outcomes. MATERIAL AND METHODS A total of 166 children with epilepsy undergoing preoperative DCE-MRI, VEEG, and PET-CT examinations, surgical resection of epileptic foci, and intraoperative electrocorticography (ECoG) monitoring were enrolled. All children were followed up for 12 months and grouped by Engles prognostic classification for epilepsy. Based on intraoperative ECoG as gold standard, the diagnostic values of DCE-MRI, VEEG, PET-CT, DCE-MRI combined with VEEG, DCE-MRI combined with PET-CT, and combined application of DCE-MRI, VEEG, and PET-CT in preoperative localization for epileptic foci were evaluated. RESULTS The sensitivity of DCE-MRI, VEEG, and PET-CT was 59.64%, 76.51%, and 93.98%, respectively; the accuracy of DCE-MRI, VEEG, PET-CT, DCE-MRI combined with VEEG, and DCE-MRI combined with PET-CT was 57.58%, 67.72%, 91.03%, 91.23%, and 96.49%, respectively. Localization accuracy rate of the combination of DCE-MRI, VEEG, and PET-CT was 98.25% (56/57), which was higher than that of DCE-MRI combined with VEEG and of DCE-MRI combined with PET-CT. No statistical difference was found in the accuracy rate of localization between these three combined techniques. During the 12-month follow-up, children were grouped into Engles grade I (n=106), II (n=31), III (n=21), and IV (n=8) according to postoperative conditions. CONCLUSIONS All DCE-MRI combined with VEEG, DCE-MRI combined with PET-CT, and DCE-MRI combined with VEEG and PET-CT examinations have excellent accuracy in preoperative localization of epileptic foci and present excellent postoperative efficiency, suggesting that these combined imaging methods are suitable for serving as the

  6. Can pre-operative axial CT imaging predict syndesmosis instability in patients sustaining ankle fractures? Seven years' experience in a tertiary trauma center

    Energy Technology Data Exchange (ETDEWEB)

    Yeung, Tsz Wai; Chan, Chung Yan Grace; Chan, Wun Cheung Samuel; Yuen, Ming Keung [Tuen Mun Hospital, Department of Radiology, Tuen Mun (China); Yeung, Yuk Nam [Tune Mun Hospital, Department of Orthopaedics and Traumatology, Tuen Mun (China)

    2015-06-01

    The purpose of this study is to explore the diagnostic accuracy of CT measurements in predicting syndesmosis instability of injured ankle, with correlation to operative findings. From July 2006 to June 2013, 123 patients presented to a single tertiary hospital who received pre-operative CT for ankle fractures were retrospectively reviewed. All patients underwent open reduction and internal fixation for fractures and intra-operative syndesmosis integrity tests. The morphology of incisura fibularis was categorized as deep or shallow. The tibiofibular distance (TFD) between the medial border of the fibula and the nearest point of the lateral border of tibia were measured at anterior (aTFD), middle (mTFD), posterior (pTFD), and maximal (maxTFD) portions across the syndesmosis on axial CT images at 10 mm proximal to the tibial plafond. Statistical analysis was performed with independent samples t test and ROC curve analysis. Intraobserver reproducibility and inter-observers agreement were also evaluated. Of the 123 patients, 39 (31.7 %) were operatively diagnosed with syndesmosis instability. No significant difference of incisura fibularis morphology (deep or shallow) and TFDs was demonstrated respective to genders. The axial CT measurements were significantly higher in ankles diagnosed with syndesmosis instability than the group without (maxTFD means 7.2 ± 2.96 mm vs. 4.6 ± 1.4 mm, aTFD mean 4.9 ± 3.7 mm vs. 1.8 ± 1.4 mm, mTFD mean 5.3 ± 2.4 mm vs. 3.2 ± 1.6 mm, pTFD mean 5.3 ± 1.8 mm vs. 4.1 ± 1.3 mm, p < 0.05). Their respective cutoff values with best sensitivity and specificity were calculated; the aTFD (AUC 0.798) and maxTFD (AUC 0.794) achieved the highest diagnostic accuracy. The optimal cutoff levels were aTFD = 4 mm (sensitivity, 56.4 %; specificity, 91.7 %) and maxTFD = 5.65 mm (sensitivity, 74.4 %; specificity, 79.8 %). The inter-observer agreement was good for all aTFD, mTFD, pTFD, and maxTFD measurements (ICC 0.959, 0.799, 0.783, and 0.865). The ICC

  7. Can pre-operative axial CT imaging predict syndesmosis instability in patients sustaining ankle fractures? Seven years' experience in a tertiary trauma center

    International Nuclear Information System (INIS)

    Yeung, Tsz Wai; Chan, Chung Yan Grace; Chan, Wun Cheung Samuel; Yuen, Ming Keung; Yeung, Yuk Nam

    2015-01-01

    The purpose of this study is to explore the diagnostic accuracy of CT measurements in predicting syndesmosis instability of injured ankle, with correlation to operative findings. From July 2006 to June 2013, 123 patients presented to a single tertiary hospital who received pre-operative CT for ankle fractures were retrospectively reviewed. All patients underwent open reduction and internal fixation for fractures and intra-operative syndesmosis integrity tests. The morphology of incisura fibularis was categorized as deep or shallow. The tibiofibular distance (TFD) between the medial border of the fibula and the nearest point of the lateral border of tibia were measured at anterior (aTFD), middle (mTFD), posterior (pTFD), and maximal (maxTFD) portions across the syndesmosis on axial CT images at 10 mm proximal to the tibial plafond. Statistical analysis was performed with independent samples t test and ROC curve analysis. Intraobserver reproducibility and inter-observers agreement were also evaluated. Of the 123 patients, 39 (31.7 %) were operatively diagnosed with syndesmosis instability. No significant difference of incisura fibularis morphology (deep or shallow) and TFDs was demonstrated respective to genders. The axial CT measurements were significantly higher in ankles diagnosed with syndesmosis instability than the group without (maxTFD means 7.2 ± 2.96 mm vs. 4.6 ± 1.4 mm, aTFD mean 4.9 ± 3.7 mm vs. 1.8 ± 1.4 mm, mTFD mean 5.3 ± 2.4 mm vs. 3.2 ± 1.6 mm, pTFD mean 5.3 ± 1.8 mm vs. 4.1 ± 1.3 mm, p < 0.05). Their respective cutoff values with best sensitivity and specificity were calculated; the aTFD (AUC 0.798) and maxTFD (AUC 0.794) achieved the highest diagnostic accuracy. The optimal cutoff levels were aTFD = 4 mm (sensitivity, 56.4 %; specificity, 91.7 %) and maxTFD = 5.65 mm (sensitivity, 74.4 %; specificity, 79.8 %). The inter-observer agreement was good for all aTFD, mTFD, pTFD, and maxTFD measurements (ICC 0.959, 0.799, 0.783, and 0.865). The ICC

  8. Comparison between FDG Uptake and Clinicopathologic and Immunohistochemical Parameters in Pre-operative PET/CT Scan of Primary Gastric Carcinoma

    International Nuclear Information System (INIS)

    Han, Eun Ji; Choi, Woo Hee; Chung, Yong An; Kim, Ki Jun; Maeng, Lee So; Sohn, Kyung Myung; Jung, Hyun Suk; Sohn, Hyung Sun; Chung, Soo Kyo

    2009-01-01

    The purpose of this study was to find out what clinicopathologic or immunohistochemical parameter that may affect FDG uptake of primary tumor in PET/CT scan of the gastric carcinoma patient. Eighty-nine patients with stomach cancer who underwent pre-operative FDG PET/CT scans were included. In cases with perceptible FDG uptake in primary tumor, the maximum standardized uptake value (SUVmax) was calculated. The clinicopathologic results such as depth of invasion (T stage), tumor size, lymph node metastasis, tumor differentiation and Lauren's classification and immunohistochemical markers such as Ki-67 index, expression of p53, EGFR, Cathepsin D, c-erb-B2 and COX-2 were reviewed. Nineteen out of 89 gastric carcinomas showed imperceptible FDG uptake on PET/CT images. In cases with perceptible FDG uptake in primary tumor, SUVmax was significantly higher in T2, T3 and T4 tumors than T1 tumors (5.8±3.1 vs. 3.7±2.1, p=0.002). SUVmax of large tumors (above or equal to 3 cm) was also significantly higher than SUVmax of small ones (less than 3 cm) (5.7±3.2 vs. 3.7±2.0, p=0.002). The intestinal types of gastric carcinomas according to Lauren showed higher FDG uptake compared to the non-intestinal types (5.4±2.8 vs. 3.7±1.3, p=0.003). SUVmax between p53 positive group and negative group was significantly different (6.0±2.8 vs. 4.4±3.0, p=0.035). No significant difference was found in presence of LN metastasis, tumor differentiation, Ki-67 index, and expression of EGFR, Cathepsin D, c-erb-B2 and COX-2. T stage of gastric carcinoma influenced the detectability of gastric cancer on FDG PET/CT scan. When gastric carcinoma was perceptible on PET/CT scan, T stage, size of primary tumor, Lauren's classification and p53 expression were related to degree of FDG uptake in primary tumor

  9. Development of instruments and components for SANS and PNS

    Energy Technology Data Exchange (ETDEWEB)

    Park, Kook Nam; Lee, Chang Hee; Lee, C. H. and others

    2000-11-01

    The base floor of SANS was constructed by the 27 steel plates with horizontal flatness of {+-}0.5mm. That is for the two dimensional position sensitivity neutron detector(2D-PSD), which is operated in vacuum chamber, as moving smoothly. Concerned to the equipments, we designed and installed the inner-shielding of the PNS which will be used for research of magnetic structure and critical phenomena of the materials. In the development of experimental devices, we have designed and manufactured a beam-stop exchange unit and a detector carriage which are used for 2D-PSD. The detector carriage is to control the distance between sample and detector. The beam-stop exchange unit is to protect detector from exposure of direct neutron beam. Especially, many experimental devices or instruments such as high-resolution collimator, components for low temperature facility, multi-purpose vacuum chamber, etc. were made in domestic, it is worth meaningful in domestic availability and standardization for the neutron instrument component.

  10. Dose cone-beam CT alter treatment plans? Comparison of preoperative implant planning using panoramic versus cone-beam CT images

    International Nuclear Information System (INIS)

    Guerrero, Maria Eugenia; Jacobs, Reinhilde; Norge, Jorge; Castro, Carmen

    2014-01-01

    The present study was performed to compare the planning of implant placement based on panoramic radiography (PAN) and cone-beam computed tomography (CBCT) images, and to study the impact of the image dataset on the treatment planning. One hundred five partially edentulous patients (77 males, 28 females, mean age: 46 years, range: 26-67 years) seeking oral implant rehabilitation were referred for presurgical imaging. Imaging consisted of PAN and CBCT imaging. Four observers planned implant treatment based on the two-dimensional (2D) image datasets and at least one month later on the three-dimensional (3D) image dataset. Apart from presurgical diagnostic and dimensional measurement tasks, the observers needed to indicate the surgical confidence levels and assess the image quality in relation to the presurgical needs. All observers confirmed that both imaging modalities (PAN and CBCT) gave similar values when planning implant diameter. Also, the results showed no differences between both imaging modalities for the length of implants with an anterior location. However, significant differences were found in the length of implants with a posterior location. For implant dimensions, longer lengths of the implants were planned with PAN, as confirmed by two observers. CBCT provided images with improved scores for subjective image quality and surgical confidence levels. Within the limitations of this study, there was a trend toward PAN-based preoperative planning of implant placement leading towards the use of longer implants within the posterior jaw bone.

  11. Clinical applications of the superior epigastric artery perforator (SEAP) flap: anatomical studies and preoperative perforator mapping with multidetector CT.

    Science.gov (United States)

    Hamdi, Moustapha; Van Landuyt, Koenraad; Ulens, Sara; Van Hedent, Eddy; Roche, Nathalie; Monstrey, Stan

    2009-09-01

    Pedicled superior epigastric artery perforator (SEAP) flaps can be raised to cover challenging thoracic defects. We present an anatomical study based on multidetector computerized tomography (MDCT) scan findings of the SEA perforators in addition to the first reported clinical series of SEAP flaps in anterior chest wall reconstruction. (a) In the CT scan study, images of a group of 20 patients who underwent MDCT scan analysis were used to visualise bilaterally the location of musculocutaneous SEAP. X- and Y-axes were used as landmarks to localise the perforators. The X-axis is a horizontal line at the junction of sternum and xyphoid (JCX) and the Y-axis is at the midline. (b) In the clinical study, seven pedicled SEAP flaps were performed in another group of patients. MDCT images revealed totally 157 perforators with a mean of 7.85 perforators per patient. The dominant perforators (137 perforators) were mainly localised in an area between 1.5 and 6.5 cm from the X-axis on both sides and between 3 and 16 cm below the Y-axis. The calibre of these dominant perforators was judged as 'good' to 'very good' in 82.5% of the cases. The average dimension of the flap was 21.7x6.7 cm. All flaps were based on one perforator. Mean harvesting time was 110 min. There were no flap losses. Minor tip necrosis occurred in two flaps. One of them was treated with excision and primary closure. Our clinical experience indicates that the SEAP flap provides a novel and useful approach for reconstruction of anterior chest wall defects. CT-based imaging allows for anatomical assessment of the perforators of the superior epigastric artery (SEA).

  12. A dose-volume comparison of prostate cancer (PC) radiotherapy (RT) techniques for penile-structures (PNS) - a neglected critical organ in PC RT

    International Nuclear Information System (INIS)

    Dabrowski, Jolanta; Myrianthopoulos, Leon; Nguyen, Ai; Chen, George; Vijayakumar, Srinivasan

    1996-01-01

    Purpose/Objective: Three-dimensional conformal RT(3DCRT) is revolutionizing the use of RT in PC. Rectum and bladder, and in some studies femoral heads are included as critical structures (CS) in comparing rival plans in 3DCRT. Although RT-induced impotence is a major complication of conventional RT, with 30-50% incidence, to date no study has included PNS as a CS. This study is an attempt to remedy this deficiency in the 3DCRT planning in PC. Materials and Methods: After immobilization with Aquaplast, computed-tomography (CT) scans were obtained in supine treatment position from top of lumbar-3 vertebra to lesser-trochanter of the femora with 5-8mm slice-thicknesses; IV contrast was used in all patients. Prostate, seminal vesicles (GTV), and CSs were outlined, including PNS. Corpora cavernosa and bulbous spongiosum together were identified as PNS. Appropriate margins for CTV and PTV were used; total margin to the block from GTV was 2cm. Tumor-minimum doses were prescribed to the 100% isodose line. Dose-volume histograms (DVHs) were obtained to compare three different techniques: 1. Conventional 4 field box technique (4FC) with equal weighting; 2. Six field (2 laterals and 4 obliques [45 degrees from midline] (6FO), with 50% dose delivery from the laterals; and 3. Four equally weighted, non-axial fields [2 laterals and 2 inferior anterior obliques at 45 degree couch and gantry rotations] (4FN). Results: A total of 12 patients are included in the study. The mean and range of percentage volume of PNS receiving more than 30, 60, and 90% of the prescribed dose are shown in the table below: Box plots, such as the example shown above, were used to compare techniques overall. The 6-field coplanar technique treated the least PNS volume beyond a given dose, followed by 4FC and 4FN techniques. The order of least to maximum percent of PNS treated in most individual patients also followed the same trend. In the majority, 6FO and 4FN delivered relatively comparable doses to

  13. Depression and health behaviors in Brazilian adults – PNS 2013

    Directory of Open Access Journals (Sweden)

    Marilisa Berti de Azevedo Barros

    Full Text Available ABSTRACT OBJECTIVE To evaluate the prevalence of health-related behaviors according to presence and type of depression in Brazilian adults. METHODS Based on a sample of 49,025 adults (18 to 59 years from the National Survey on Health 2013 (PNS 2013, we estimated the prevalence of health-related behaviors (smoking; passive smoking; frequent or risky alcohol consumption; leisure time physical activity; time watching TV; and eating pattern indicators, according to the presence of depression (minor and major, evaluated by the Patient Health Questionnaire – 9 (PHQ-9, and the report of depressive mood (in up to seven days or more than seven days over a two-week period. Prevalence ratios were estimated by Poisson regression. RESULTS Evaluated by the PHQ-9 scale, 9.7% of the Brazilian adults had depression and 3.9% presented major depression. About 21.0% reported depressive mood and, in 34.9% of them, that feeling has been present for more than seven days. In individuals with major depression (PHQ-9, higher prevalence was found in almost all unhealthy behaviors analyzed, in particular, smoking (PR = 1.65, passive smoking (PR = 1.55, risk alcohol consumption (PR = 1.72, TV for ≥ 5 hours/day (PR = 2.13, consumption of fat meat (PR = 1.43 and soft drink (PR = 1.42. The prevalence ratios tended to be lower in those with minor depression. Similar results were observed in adults with depressive mood. CONCLUSIONS This study detected relevant association between depression and health behaviors, in particular for smoking and physical activity. The associations found with the PHQ were similar to those observed with the application of a single question about depressive mood. Our results indicate the importance of assessing the presence of depression and the frequency and severity of symptoms when implementing actions for the promotion of healthy behaviors.

  14. Preoperative nodal staging of non-small cell lung cancer using 99mTc-sestamibi spect/ct imaging

    Directory of Open Access Journals (Sweden)

    Juliana Muniz Miziara

    2011-01-01

    predictive values of 67.7% and 91.2%, respectively. CONCLUSION: Single-photon emission computed tomography/computed tomography with 99mTc-sestamibi showed very low sensitivity and accuracy for the nodal staging of patients with non-small cell lung cancer, despite its high level of specificity. In addition, the performance of single-photon emission computed tomography/computed tomography added no relevant information compared to computed tomography that would justify its use in the routine preoperative staging of non-small cell lung carcinoma.

  15. Preoperative nodal staging of non-small cell lung cancer using 99mTc-sestamibi SPECT/CT imaging

    International Nuclear Information System (INIS)

    Miziara, Juliana Muniz; Rocha, Euclides Timoteo da; Miziara, Jose Elias Abrao; Garcia, Gustavo Fabene; Simoes, Maria Izilda Previato; Lopes, Marco Antonio; Kerr, Ligia Maria; Buchpiguel, Carlos Alberto

    2011-01-01

    .7% and 91.2%, respectively. Conclusion: Single-photon emission computed tomography/computed tomography with 99m Tc-sestamibi showed very low sensitivity and accuracy for the nodal staging of patients with non-small cell lung cancer, despite its high level of specificity. In addition, the performance of single-photon emission computed tomography/computed tomography added no relevant information compared to computed tomography that would justify its use in the routine preoperative staging of non-small cell lung carcinoma. (author)

  16. Characteristics of Metastatic Mediastinal Lymph Nodes of Non-Small Cell Lung Cancer on Preoperative F-18 FDG PET/CT

    International Nuclear Information System (INIS)

    Lee, Ah Young; Choi, Su Jung; Jung, Kyung Pyo; Park, Ji Sun; Lee, Seok Mo; Bae, Sang Kyun

    2014-01-01

    The aim of this study was to evaluate the characteristics of PET and CT features of mediastinal metastatic lymph nodes on F-18 FDG PET/CT and to determine the diagnostic criteria in nodal staging of non-small cell lung cancer. One hundred four non-small cell lung cancer patients who had preoperative F-18 FDG PET/CT were included. For quantitative analysis, the maximum SUV of the primary tumor, maximum SUV of the lymph nodes (SUVmax), size of the lymph nodes, and average Hounsfield units (aHUs) and maximum Hounsfield units (mHUs) of the lymph nodes were measured. The SUVmax, SUV ratio of the lymph node to blood pool (LN SUV/blood pool SUV), SUV ratio of the lymph node to primary tumor (LN SUV/primary tumor SUV), size, aHU, and mHU were compared between the benign and malignant lymph nodes. Among 372 dissected lymph node stations that were pathologically diagnosed after surgery, 49 node stations were malignant and 323 node stations benign. SUVmax, LN SUV/blood pool SUV, and size were significantly different between the malignant and benign lymph node stations (P <0.0001). However, there was no significant difference in LN SUV/primary tumor SUV (P =0.18), mHU (P =0.42), and aHU (P =0.98). Using receiver-operating characteristic curve analyses, there was no significant difference among these three variables (SUVmax, LN SUV/blood pool SUV, and size). The optimal cutoff values were 2.9 for SUVmax, 1.4 for LN SUV/blood pool SUV, and 5 mm for size. When the cutoff value of SUVmax≥2.9 and size≥5 mm were used in combination, the positive predictive value was 44.2%, and the negative predictive value was 90.9 %. When we evaluated the results based on the histology of the primary tumor, the negative predictive value was 92.3 % in adenocarcinoma (cutoff values of SUVmax≥2.3 and size≥5 mm) and 97.2 % in squamous cell carcinoma (cutoff values of SUVmax≥3.6 and size≥8 mm), separately. In the lymph node staging of non-small cell lung cancer, SUVmax, LN SUV/blood pool SUV

  17. 18F-FDG-PET/CT in the diagnosis of paraneoplastic neurological syndromes: a retrospective analysis

    International Nuclear Information System (INIS)

    Bannas, Peter; Weber, Christoph; Adam, Gerhard; Derlin, Thorsten; Lambert, Joerg; Mester, Janos; Klutmann, Susanne; Leypoldt, Frank

    2010-01-01

    Paraneoplastic neurological syndromes (PNS) constitute a challenging diagnostic problem, as the underlying tumour often remains unidentified for a long time, even with frequent conventional diagnostic procedures. For appropriate patient management timely identification of the tumour is critical. We evaluated the value of 18 F-FDG-PET/CT in the investigation of PNS. The case notes of 46 consecutive patients with clinically suspected PNS who underwent 18 F-FDG-PET/CT were reviewed retrospectively and the performance of PET/CT for detecting underlying tumours was assessed. PET/CT detected foci of increased 18 F-FDG uptake in 10 out of 46 patients. In six of these 10 patients combined PET/CT identified the underlying disease: four patients suffered from PNS; vasculitic and local metastatic disease was detected in two other patients. Based on our results, we believe that the role of positron emission tomography in the detection of occult neoplasms in patients with PNS has been overestimated in the past. In clinical practice, PNS is far more often suspected than proven. In our study combined PET/CT identified malignancy as the underlying cause of suspected PNS in only 8.7% (4/46). We believe that combined PET/CT should be reserved for stringently selected patients with a high clinical index of suspicion for PNS and after conventional imaging techniques fail to detect a tumour. (orig.)

  18. The usefulness of preoperative exercise stress myocardial single photon emission CT with thallium-201 to predict the responses to coronary revascularization

    International Nuclear Information System (INIS)

    Narita, Michihiro; Kurihara, Tadashi; Murano, Kenichi; Usami, Masahisa; Minamino, Takazoh; Katoh, Osamu; Higashino, Yorihiko.

    1989-01-01

    To evaluate the usefulness of preoperative exercise stress (Ex) myocardial single photon emission CT (SPECT) with thallium-201 to predict the responses to coronary revascularization (CRV), Ex-SPECT's were obtained in 42 patients with coronary artery disease (CAD). In 34 patients angioplasty was performed and in 18 patients coronary bypass surgery was undergone. Before and after CVR, Ex-SPECT's were obtained both at immediately after Ex (Initial) and 3 hours later (RD) by the rotating gamma camera. Initial images before CRV showed definite perfusion defects (+3) in 76 myocardial segments. Perfusion abnormalities at RD images were graded into (+3 to 0) by visual interpretation. '+3' indicated fixed defect and '0' indicated no perfusion abnormality. At RD images 17 segments showed fixed defect and 59 segments showed improved perfusion more than one grade. After CRV, all 59 segments with improved perfusion at RD images showed improvement of perfusion in comparison with initial images before CRV. Out of 17 segments with fixed defect before CRV, 14 segments showed perfusion defect with +3, while 3 segments showed improved perfusion after CRV. These 3 segments had ECG evidence of myocardial infarction. In these 3 segments, Ex-SPECT's before CRV showed abnormally low myocardial Tl washout rate (WOR) despite they indicated fixed defect visually. On the contrary, other 14 segments with fixed defect showed normal WOR before CRV. In conclusion, visually interpreted Ex-SPECT's before CRV predict the myocardial perfusion after CRV in most of cases. In a small number (especially infarction segments) Ex-SPECT's before CRV cannot predict the improvement of myocardial perfusion after CRV by visual inspection, but WOR abnormality before CRV is useful to prospect their results. (author)

  19. 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.

  20. Depression and health behaviors in Brazilian adults - PNS 2013.

    Science.gov (United States)

    Barros, Marilisa Berti de Azevedo; Lima, Margareth Guimarães; Azevedo, Renata Cruz Soares de; Medina, Lhais Barbosa de Paula; Lopes, Claudia de Souza; Menezes, Paulo Rossi; Malta, Deborah Carvalho

    2017-06-01

    To evaluate the prevalence of health-related behaviors according to presence and type of depression in Brazilian adults. Based on a sample of 49,025 adults (18 to 59 years) from the National Survey on Health 2013 (PNS 2013), we estimated the prevalence of health-related behaviors (smoking; passive smoking; frequent or risky alcohol consumption; leisure time physical activity; time watching TV; and eating pattern indicators), according to the presence of depression (minor and major), evaluated by the Patient Health Questionnaire - 9 (PHQ-9), and the report of depressive mood (in up to seven days or more than seven days) over a two-week period. Prevalence ratios were estimated by Poisson regression. Evaluated by the PHQ-9 scale, 9.7% of the Brazilian adults had depression and 3.9% presented major depression. About 21.0% reported depressive mood and, in 34.9% of them, that feeling has been present for more than seven days. In individuals with major depression (PHQ-9), higher prevalence was found in almost all unhealthy behaviors analyzed, in particular, smoking (PR = 1.65), passive smoking (PR = 1.55), risk alcohol consumption (PR = 1.72), TV for ≥ 5 hours/day (PR = 2.13), consumption of fat meat (PR = 1.43) and soft drink (PR = 1.42). The prevalence ratios tended to be lower in those with minor depression. Similar results were observed in adults with depressive mood. This study detected relevant association between depression and health behaviors, in particular for smoking and physical activity. The associations found with the PHQ were similar to those observed with the application of a single question about depressive mood. Our results indicate the importance of assessing the presence of depression and the frequency and severity of symptoms when implementing actions for the promotion of healthy behaviors. Avaliar a prevalência de comportamentos relacionados à saúde segundo a presença e tipo de depressão em adultos brasileiros. Com base em amostra de 49

  1. A Novel Prognostic Score, Based on Preoperative Nutritional Status, Predicts Outcomes of Patients after Curative Resection for Gastric Cancer.

    Science.gov (United States)

    Liu, Xuechao; Qiu, Haibo; Liu, Jianjun; Chen, Shangxiang; Xu, Dazhi; Li, Wei; Zhan, Youqing; Li, Yuanfang; Chen, Yingbo; Zhou, Zhiwei; Sun, Xiaowei

    2016-01-01

    PURPOSE: We aimed to determine whether preoperative nutritional status (PNS) was a valuable predictor of outcome in patients with gastric cancer (GC). METHODS: We retrospectively evaluated 1320 patients with GC undergoing curative resection. The PNS score was constructed based on four objective and easily measurable criteria: prognostic nutritional index (PNI) score 1, serum albumin nutritional-based prognostic score, is independently associated with OS in GC. Prospective studies are needed to validate its clinical utility.

  2. Analysis of 64-row multidetector CT images for preoperative angiographic evaluation of potential living kidney donors; Analyse der mehrphasigen 64-Zeilen-Multidetektor-Computertomographie zur praeoperativen angiographischen Evaluation potenzieller Lebendnierenspender

    Energy Technology Data Exchange (ETDEWEB)

    Blondin, D.; Andersen, K.; Kroepil, P.; Cohnen, M.; Moedder, U.; Jung, G. [Universitaetsklinikum Duesseldorf, Institut fuer Diagnostische Radiologie, Duesseldorf (Germany); Sandmann, W. [Universitaetsklinikum Duesseldorf, Klinik fuer Gefaesschirurgie und Nierentransplantation, Duesseldorf (Germany); Ivens, K. [Universitaetsklinikum Duesseldorf, Klinik fuer Nephrologie, Duesseldorf (Germany)

    2008-07-15

    Anatomical imaging and the ascertainment of any anomalies in the renal vessels and the ureters are essential in the planning of a kidney donation. The aim of the present study was to assess the value of 64-row multidetector CT in noninvasive examination of the renal vessels and ureters of potential living kidney donors. The evaluation embraced 63 living renal donors (LNS) who underwent preoperative CT examination from December 2004 to January 2007. The examinations were all carried out using a Somatom Sensation -Cardiac 64 (Siemens Medical Solutions, Germany). As well as CT angiography (CTA), a venous phase of the abdomen and a late phase after 15 min using low-dose technique were performed for CT urography (CTU). The radiological findings were compared with the surgical results, or with the angiograms in 2 cases. Sensitivity, specificity and both negative and positive predictive value were calculated. In the 63 (31 female, 32 male) donors CTA had a sensitivity of 100% in examination of the main and accessory renal arteries and of 98.3% when the venous and ureteric anatomy were assessed. The sensitivity of low-dose CTU was also 100%. The findings recorded in this study indicate that noninvasive preoperative planning with 64-row multidetector CTA and CTU is a reliable 'one-stop shopping' method of examination for potential living kidney donors. (orig.) [German] Die anatomische Darstellung und Erfassung moeglicher Anomalien der Nierengefaesse und Ureteren ist fuer die Planung einer Lebendnierenspende von essenzieller Bedeutung. Die vorliegende Untersuchung soll die Wertigkeit der nichtinvasiven Evaluation mit der 64-Zeilen-Multidetektor-CT untersuchen. In die Auswertung wurden 63 Lebendnierenspender (LNS) eingeschlossen, die im Zeitraum 12.2004 bis 01.2007 mit der CT praeoperativ untersucht wurden. Die Untersuchungen erfolgten mit einem Somatom-Sensation-Cardiac-64 (Siemens Medical Solutions, Deutschland). Neben einer CT-Angiographie (CTA) wurden eine

  3. A study on projection angles for an optimal image of PNS water's view on children

    International Nuclear Information System (INIS)

    Son, Sang Hyuk; Song, Young Geun; Kim, Sung Kyu; Hong, Sang Woo; Kim, Je Bong

    2007-01-01

    This study is to calculate the proper angle for the optimal image of PNS Water's view on children, comparing and analyzing the PNS Water's projection angles between children and adults at every age. This study randomly selected 50 patients who visited the Medical Center from January to May in 2005, and examined the incidence path of central ray, taking a PNS Water's and skull trans-Lat. view in Water's filming position while attaching a lead ball mark on the Orbit, EAM, and acanthion of the patient's skull. And then, we calculated the incidence angles (angle A) of the line connected from OML and the petrous ridge to the inferior margin of maxilla on general (random) patient's skull image, following the incidence path of central ray. Finally, we analyzed two pieces of the graphs at ages, developing out the patient's ideal images at PNS Water's filming position taken by a digital camera, and calculating the angle (angle B) between OML and IP(Image Plate). The angle between OML and IP is about 43 .deg. in 4-years-old children, which is higher than 37 .deg. as age increases the angle decreases, it goes to 37 .deg. around 30 years of age. That is similar result to maxillary growth period. We can get better quality of Water's image for children when taking the PNS Water's view if we change the projection angles, considering maxillary growth for patients in every age stage

  4. Value of preoperative enhanced multi-slice spiral CT scan for judging TNM staging of gastric cancer as well as its relationship with tumor marker and proliferation molecule expression

    Directory of Open Access Journals (Sweden)

    Ai-Jun Wu

    2016-12-01

    Full Text Available Objective: To study the value of preoperative enhanced multi-slice spiral CT scan for judging TNM staging of gastric cancer as well as its relationship with tumor marker and proliferation molecule expression. Methods: A total of 135 patients with gastric cancer who received surgical resection in our hospital between May 2012 and October 2015 were selected as the research subjects, preoperative enhanced multi-slice spiral CT scan was conducted to judge TNM staging, and serum was collected to determine the content of tumor markers; tumor tissue was collected after operation to determine the content of cytokines and pro-proliferation molecules. Results: CEA, CA199, CA153, CA125 and CA724 content in serum as well as TGFβ1, TGFβ2, VEGF, FGF2, PTP1B, PIK3CD, Survivin, Ezrin and YAP content in gastric cancer tissue of patients with TNM II, III and IV stage gastric cancer were significantly higher than those of patients with TNM I stage; CEA, CA199, CA153, CA125 and CA724 content in serum as well as TGFβ1, TGFβ2, VEGF, FGF2, PTP1B, PIK3CD, Survivin, Ezrin and YAP content in gastric cancer tissue of patients with TNM III and IV stage gastric cancer were significantly higher than those of patients with TNM II stage; CEA, CA199, CA153, CA125 and CA724 content in serum as well as TGFβ1, TGFβ2, VEGF, FGF2, PTP1B, PIK3CD, Survivin, Ezrin and YAP content in gastric cancer tissue of patients with TNM IV stage gastric cancer were significantly higher than those of patients with TNM III stage. Conclusions: TNM staging of gastric cancer decided by preoperative enhanced multi-slice spiral CT scan has good consistency with the content of tumor markers in serum and proliferation molecules in tumor lesion.

  5. Possible mechanism of PNS protection against cisplatin-induced nephrotoxicity in rat models.

    Science.gov (United States)

    Liu, Xinwen; Huang, Zhenguang; Zou, Xiaoqin; Yang, Yufang; Qiu, Yue; Wen, Yan

    2015-01-01

    This study investigates the mechanism of the protective effect of Panax notoginsenosides (PNS) against cisplatin-induced nephrotoxicity via the hypoxia inducible factor 1 (HIF-1)/Bcl-2/adenovirus E1B 19 kDa-interacting protein 3 (BNIP3) pathway of autophagy. The rats underwent intraperitoneal injection with a single dose of cisplatin and a subset of rats were also intraperitoneally injected with 31.35 mg/kg PNS once a day. After 24 h exposure to cisplatin, the concentrations of urinary N-acetyl-β-D-glucosaminidase (NAG), blood urea nitrogen (BUN) and serum creatinine (Scr) were determined. The rat renal tissue was examined using H&E-staining, and the mitochondria of renal tubular epithelial cells were observed using transmission electron microscopy. The expressions of microtubule-associated protein-1 light chain (LC)3, autophagy-related gene (Atg)5, Beclin-1 and BNIP3 in rat renal tissue were detected using western blotting. The expression of HIF-1 was detected by immunohistochemistry. The results showed that PNS significantly protected against cisplatin-induced nephrotoxicity, as evidenced by decreasing the concentration of blood BUN and Scr, the attenuation of renal histopathological changes and the mitochondrial damages of renal cells, and the increase of mitochondria autophagosome in renal tubular epithelial cells. Additionally, PNS significantly increased the expression of LC3 and the ratio of LC3II/LC3I in rat renal tissue. Moreover, PNS significantly increased the expression of HIF-1α, BNIP3, Atg5 and Beclin-1 in rat renal tissue. In conclusion, the protective effect of PNS on cisplatin-induced nephrotoxicity was mainly due to its ability to enhancing the mitochondrial autophagy of renal tissue via the HIF-1α/BNIP3 pathway, and here is the first demonstration about it.

  6. Preoperative evaluation

    International Nuclear Information System (INIS)

    Murphy, C.H.; Murphy, M.R.

    1987-01-01

    The value of a preoperative chest radiograph is twofold. The examination may reveal unsuspected pathology that would alter the approach to surgery of anesthesia. Secondly, it provides a baseline or reference from which to evaluate subsequent post-operative films. The percentage of detection of unsuspected pathology on preoperative chest radiographs has been shown to be exceedingly small in certain patient populations. The authors do not recommend routine use of preoperative chest radiographs in children or in adults under the age of 40 who do not smoke, unless (1) the surgical disease has chest manifestations; (2) there is historic or clinical evidence of a coexisting disease with chest involvement; or (3) there is a likelihood that post-operative management will require follow-up films

  7. The role of routine preoperative EUS when performed after contrast enhanced CT in the diagnostic work-up in patients suspected of pancreatic or periampullary cancer.

    Science.gov (United States)

    Cieslak, Kasia P; van Santvoort, Hjalmar C; Vleggaar, Frank P; van Leeuwen, Maarten S; ten Kate, Fibo J; Besselink, Marc G; Molenaar, I Quintus

    2014-01-01

    In patients suspected of pancreatic or periampullary cancer, abdominal contrast-enhanced computed tomography (CT) is the standard diagnostic modality. A supplementary endoscopic ultrasonography (EUS) is often performed, although there is only limited evidence of its additional diagnostic value. The aim of the study is to evaluate the additional diagnostic value of EUS over CT in deciding on exploratory laparotomy in patients suspected of pancreatic or periampullary cancer. We retrospectively analyzed 86 consecutive patients who routinely underwent CT and EUS before exploratory laparotomy with or without pancreatoduodenectomy for suspected pancreatic or periampullary carcinoma between 2007 and 2010. Primary outcomes were visibility of a mass, resectability on CT/EUS and resection with curative intent. A mass was visible on CT in 72/86 (84%) patients. In these 72 patients, EUS demonstrated a mass in 64/72 (89%) patients. Resectability was accurately predicted by CT in 65/72 (90%) and by EUS in 58/72 (81%) patients. In 14/86 (16%) patients no mass was seen on CT. EUS showed a mass in 12/14 (86%) of these patients. A malignant lesion was histological proven in 11/12 (92%) of these patients. Overall, resectability was accurately predicted by CT and EUS in 90% (77/86) and 84% (72/86), respectively. In patients with a visible mass on CT, suspected for pancreatic or periampullary cancer, EUS has no additional diagnostic value, does not influence the decision to perform laparotomy and should therefore not be performed routinely. In patients without a visible mass on CT, EUS is useful to confirm the presence of a tumor. Copyright © 2014 IAP and EPC. Published by Elsevier B.V. All rights reserved.

  8. Preoperative 18F-FDG-PET/CT imaging and sentinel node biopsy in the detection of regional lymph node metastases in malignant melanoma.

    Science.gov (United States)

    Singh, Baljinder; Ezziddin, Samer; Palmedo, Holger; Reinhardt, Michael; Strunk, Holger; Tüting, Thomas; Biersack, Hans-Jürgen; Ahmadzadehfar, Hojjat

    2008-10-01

    The objective of this study was to evaluate the role of preoperative 18F-fluorodeoxyglucose-positron emission tomography/computed tomography scanning, preoperative lymphoscintigraphy (LS), and sentinel lymph node biopsy in patients with malignant melanoma. Fifty-two patients (36 men: 16 women; mean age 55.0+/-13.0 years; median age 61 years; range 17-76 years) with malignant melanoma were selected. According to the latest version of the American Joint Committee on Cancer staging system, the disease in the study patients was initially classified as either stage I or II. The other primary tumor characteristics were mean Breslow depth=2.87 mm and median=2 mm; range 1-12.0 mm and Clarks levels III-V. None of the study patients had clinical or radiological evidence of regional lymph node metastatic disease. At least one sentinel node was identified in all patients. Preoperative LS detected a total of 111 sentinel lymph nodes (average 2.13 sentinel lymph node per patient) and demonstrated a single nodal draining basin in 38 (73%) patients and multiple (2-3 draining basins) in the remaining 14 (27%) patients. Fourteen out of the 52 patients (27%) had at least one involved sentinel node. Positron emission tomography was true positive in two patients with a sentinel node greater than 1 cm and false positive in two other patients. In this study, the detection of sentinel lymph node by LS and gamma probe had a sensitivity of 100%. In contrast, 18F-FDG-PET imaging demonstrated very low sensitivity (14.3%; 95% CI, 2.5 to 44%) and positive predictive value (50%; 95% CI, 9 to 90%) for localizing the subclinical nodal metastases. The specificity, net present value, and diagnostic accuracy were 94.7, 75, and 73%, respectively. Preoperative fluorodeoxyglucose-positron emission tomography/computed tomography imaging is not able to substitute LS/sentinel lymph node biopsy in patients at stage I or II.

  9. Is FDG PET/CT cost-effective for pre-operation staging of potentially operative non-small cell lung cancer? – From Chinese healthcare system perspective

    International Nuclear Information System (INIS)

    Wang, Yu-ting; Huang, Gang

    2012-01-01

    Objectives: The remarkable morbidity and mortality of lung cancer in the large population address major economic challenges to Chinese healthcare system. This study aims to assess the cost-effectiveness of fluorodeoxyglucose positron emission tomography (FDG PET)/CT for staging patients with non-small cell lung cancer (NSCLC) in China. Methods: Management of potentially operative NSCLC was modeled on decision analysis employing data in China. The strategies compared were conventional CT staging (strategy A), additional PET/CT in all patients (strategy B) or only in patients with normal-sized lymph nodes on CT (strategy C). Published medical data for Chinese patients was extracted. The costs corresponded to reimbursement by Chinese public health provider in 2010. Uncertainly of employed parameters was calculated in sensitivity analysis. Results: Taking strategy A as baseline, the incremental cost-effectiveness ratio (ICER) of strategy B was 23,800 RMB ($3500) per life year saved, which was acceptable in views of a developing country as China; while strategy C exhibited some loss of life years. Sensitivity analysis suggested the ICER (B–A) was raised more remarkably by a deterioration of PET specificity than by that of its sensitivity. The ICER was turned negative by PET specificity lower than 0.79. Economically, PET cost was proportional to the ICER (B–A), and decrease of palliative therapy cost could reduce both the ICER and overall cost. Conclusions: The PET/CT strategy is potentially cost-effective for management of NSCLC in China. Patients with nodal-positive CT results are not suggested to be excluded from further PET/CT. Furthermore, maintaining high specificity of PET in clinical scenarios is crucial. Prospective trials are warranted to transfer these results into policy making.

  10. Is FDG PET/CT cost-effective for pre-operation staging of potentially operative non-small cell lung cancer? - From Chinese healthcare system perspective

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Yu-ting, E-mail: wangyuting_330@163.com [Department of Nuclear Medicine, Renji Hospital, Shanghai Jiao Tong University, School of Medicine (China); Huang, Gang, E-mail: huang2802@163.com [Department of Nuclear Medicine, Renji Hospital, Shanghai Jiao Tong University, School of Medicine (China); Institute of Health Sciences, Shanghai Jiao Tong University School of Medicine (SJTUSM) and Shanghai Institutes for Biological Sciences (SIBS), Chinese Academy of Sciences - CAS (China)

    2012-08-15

    Objectives: The remarkable morbidity and mortality of lung cancer in the large population address major economic challenges to Chinese healthcare system. This study aims to assess the cost-effectiveness of fluorodeoxyglucose positron emission tomography (FDG PET)/CT for staging patients with non-small cell lung cancer (NSCLC) in China. Methods: Management of potentially operative NSCLC was modeled on decision analysis employing data in China. The strategies compared were conventional CT staging (strategy A), additional PET/CT in all patients (strategy B) or only in patients with normal-sized lymph nodes on CT (strategy C). Published medical data for Chinese patients was extracted. The costs corresponded to reimbursement by Chinese public health provider in 2010. Uncertainly of employed parameters was calculated in sensitivity analysis. Results: Taking strategy A as baseline, the incremental cost-effectiveness ratio (ICER) of strategy B was 23,800 RMB ($3500) per life year saved, which was acceptable in views of a developing country as China; while strategy C exhibited some loss of life years. Sensitivity analysis suggested the ICER (B-A) was raised more remarkably by a deterioration of PET specificity than by that of its sensitivity. The ICER was turned negative by PET specificity lower than 0.79. Economically, PET cost was proportional to the ICER (B-A), and decrease of palliative therapy cost could reduce both the ICER and overall cost. Conclusions: The PET/CT strategy is potentially cost-effective for management of NSCLC in China. Patients with nodal-positive CT results are not suggested to be excluded from further PET/CT. Furthermore, maintaining high specificity of PET in clinical scenarios is crucial. Prospective trials are warranted to transfer these results into policy making.

  11. Is FDG PET/CT cost-effective for pre-operation staging of potentially operative non-small cell lung cancer? - From Chinese healthcare system perspective.

    Science.gov (United States)

    Wang, Yu-ting; Huang, Gang

    2012-08-01

    The remarkable morbidity and mortality of lung cancer in the large population address major economic challenges to Chinese healthcare system. This study aims to assess the cost-effectiveness of fluorodeoxyglucose positron emission tomography (FDG PET)/CT for staging patients with non-small cell lung cancer (NSCLC) in China. Management of potentially operative NSCLC was modeled on decision analysis employing data in China. The strategies compared were conventional CT staging (strategy A), additional PET/CT in all patients (strategy B) or only in patients with normal-sized lymph nodes on CT (strategy C). Published medical data for Chinese patients was extracted. The costs corresponded to reimbursement by Chinese public health provider in 2010. Uncertainly of employed parameters was calculated in sensitivity analysis. Taking strategy A as baseline, the incremental cost-effectiveness ratio (ICER) of strategy B was 23,800RMB ($3500) per life year saved, which was acceptable in views of a developing country as China; while strategy C exhibited some loss of life years. Sensitivity analysis suggested the ICER (B-A) was raised more remarkably by a deterioration of PET specificity than by that of its sensitivity. The ICER was turned negative by PET specificity lower than 0.79. Economically, PET cost was proportional to the ICER (B-A), and decrease of palliative therapy cost could reduce both the ICER and overall cost. The PET/CT strategy is potentially cost-effective for management of NSCLC in China. Patients with nodal-positive CT results are not suggested to be excluded from further PET/CT. Furthermore, maintaining high specificity of PET in clinical scenarios is crucial. Prospective trials are warranted to transfer these results into policy making. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  12. 18F-FAZA PET/CT in the Preoperative Evaluation of NSCLC: Comparison with 18F-FDG and Immunohistochemistry.

    Science.gov (United States)

    Mapelli, Paola; Bettinardi, Valentino; Fallanca, Federico; Incerti, Elena; Compierchio, Antonia; Rossetti, Francesca; Coliva, Angela; Savi, Annarita; Doglioni, Claudio; Negri, Giampiero; Gianolli, Luigi; Picchio, Maria

    2018-01-01

    To assess the capability of 18F-FAZA PET/CT in identifying intratumoral hypoxic areas in early and locally advanced non-small cell lung cancer (NSCLC) patients and to compare 18FFAZA PET/CT with 18F-FDG PET/CT and histopathological biomarkers and to investigate whether the assessment of tumour to blood (T/B) and tumour to muscle (T/M) ratios provide comparable information regarding the hypoxic fractions of the tumour. Seven patients with NSCLC were prospectively enrolled (3 men, 4 women; median age: 71 years; range 63-80). All patients underwent to 18F-FDG PET/CT and 18F-FAZA PET/CT before surgery. Maximum standardized uptake value (SUVmax) was used to evaluate 18FFDG PET/CT images, while 18F-FAZA PET/CT images have been interpreted by using tumour-toblood (T/B) and tumour-to-muscle (T/M) ratio. Surgery was performed in all patients; immunohistochemical analysis for hypoxia biomarkers was performed on histologic tumor samples. All lung lesions showed intense 18F-FDG uptake (mean SUVmax: 7.35; range: 2.35-25.20). A faint 18F-FAZA uptake was observed in 6/7 patients (T/B < 1.2) while significant uptake was present in the remaining 1/7 (T/B and T/M=2.24). On both 2 and 4 h imaging after injection, no differences were observed between T/M and T/B (p=0.5), suggesting that both blood and muscle are equivalent in estimating the background activity for image analysis. Immunohisotchemical analysis showed low or absent staining for hypoxia biomarkers in 3 patients (CA-IX and GLUT-1: 0%; HIF-1α: mean 3.3%; range 0-10). Two patients showed staining for HIF-1α of 5%, with CA-IX being 60% and 30%, respectively and GLUT-1 being 30% and 80%, respectively; in 1/7 HIF-1α was 10%, CA-IX was 50% and GLUT-1 was 90%. In one patient a higher percentage of HIF-1α and CA-IX (20% and 70%, respectively) positive cells was present, with GLUT-1 being 30%. To the best of our knowledge, this is the first paper assessing hypoxia and glucose metabolism in comparison with immunohistochemistry

  13. Prognostic value of metabolic indices and bone marrow uptake pattern on preoperative 18F-FDG PET/CT in pediatric patients with neuroblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Li, Chao; Chen, Suyun; Huang, Shuo; Wu, Shuqi; Zhang, Linlin; Zhang, Fengxian; Wang, Hui [Shanghai Jiao Tong University School of Medicine, Department of Nuclear Medicine, Xinhua Hospital, Shanghai (China); Zhang, Jian [Shanghai Jiao Tong University School of Medicine, Department of Nuclear Medicine, Xinhua Hospital, Shanghai (China); Shanghai Universal Medical Imaging Diagnostic Center, Shanghai (China)

    2018-02-15

    To evaluate the prognostic value of metabolic parameters and bone marrow uptake (BMU) patterns on pretherapeutic 18-F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in pediatric patients with neuroblastoma (NB). Forty-seven pediatric patients with newly diagnosed neuroblastoma who underwent 18F-FDG PET/CT were retrospectively reviewed. Clinicopathological factors and metabolic parameters including maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG) and bone marrow uptake patterns on PET/CT were compared to predict recurrence-free survival (RFS) and overall survival (OS) by univariate and multivariate analysis. During the follow-up period, 27 (57.4%) patients experienced recurrence. MTV (P = 0.001), TLG (P = 0.004) and BMU patterns (P = 0.025) remained significant predictive factors for tumor recurrence, along with tumor size, histology, stage, lactate dehydrogenase (LDH) and other distant metastasis (except bone metastasis). Univariate analysis showed that histology, stage, tumor size (>37.25 cm), other distant metastasis, MTV (>88.10cm{sup 3}) and TLG (>1045.2 g) and BMU patterns correlated with both RFS and OS (P < 0.05). On multivariate analysis, TLG remained the only independent prognostic factor for RFS (P = 0.016) and OS (P = 0.012), and BMU patterns and MTV were statistically significant for OS (P = 0.024 and P = 0.038, respectively). Pretherapeutic 18F-FDG PET/CT can provide reliable prognostic information for neuroblastoma pediatric patients, and patients with high MTV, TLG and focal bone marrow (unifocal and multifocal) uptake on PET/CT may have inferior outcomes during subsequent treatment. (orig.)

  14. Repeat CT assessed CTV variation and PTV margins for short- and long-course pre-operative RT of rectal cancer

    International Nuclear Information System (INIS)

    Nijkamp, Jasper; Swellengrebel, Maurits; Hollmann, Birgit; Jong, Rianne de; Marijnen, Corrie; Vliet-Vroegindeweij, Corine van; Triest, Baukelien van; Herk, Marcel van; Sonke, Jan-Jakob

    2012-01-01

    Purpose: To quantify the inter-fraction shape variation of the CTV in rectal-cancer patients treated with 5 × 5 (SCRT) and 25 × 2 Gy (LCRT) and derive PTV margins. Methods and materials: Thirty-three SCRT with daily repeat CT scans and 30 LCRT patients with daily scans during the first week followed by weekly scans were included. The CTV was delineated on all scans and local shape variation was calculated with respect to the planning CT. Margin estimation was done using the local shape variation to assure 95% minimum dose for at least 90% of patients. Results: Using 482 CT scans, systematic and random CTV shape variation was heterogeneous, ranging from 0.2 cm close to bony structures up to 1.0 cm SD at the upper-anterior CTV region. A significant reduction in rectal volume during LCRT resulted in an average 0.5 cm posterior shift of the upper-anterior CTV. Required margins ranged from 0.7 cm close to bony structures up to 3.1 and 2.3 cm in the upper-anterior region for SCRT and LCRT, respectively. Conclusions: Heterogeneous shape variation demands anisotropic PTV margins. Required margins were substantially larger in the anterior direction compared to current clinical margins. These larger margins were, however, based on strict delineated CTVs, resulting in smaller PTVs compared to current practice.

  15. III Frontier of accurate diagnosis of breast cancer. 1. Present state and prospect of preoperative diagnosis of progression, differential diagnosis of benign and malign natures, and efficacy evaluation of neoadjuvant chemotherapy. 2) Clinical efficacy and problem of FDG-PET (PET/CT) in breast cancer

    International Nuclear Information System (INIS)

    Kitajima, Kazuhiro; Kaji, Yasushi; Hayashi, Mitsuhiro; Sunagawa, Masakatsu; Murakami, Kouji; Yamazaki, Erena

    2008-01-01

    On authors' experience and literature, clinical efficacy and limitation of fluorodeoxyglucose-positron emission tomography (FDG-PET) (PET/CT) in the breast cancer are described and discussed for detection of the primary lesion, preoperative staging and lymph node diagnosis, diagnosis of recurrence and remote metastasis, evaluation of therapeutic efficacy, and prediction of prognosis. For routine breast cancer screening, authors think PET/CT is not always effective because of many false positive/negative findings. PET/CT and subsequent CT with iodine contrast media are thought to be useful for preoperative staging and planning in conservative surgery though detection of micro-metastatic nodes are often difficult. PET is reportedly superior to 99m Tc-MDP scintigraphy in bone metastasis detection, but which conceivably depends on the nature (osteogenic/osteolytic) of the lesion. For recurrence and remote metastasis, the diagnostic sensitivity, specificity and accuracy of PET/CT are reported to be as high as 84-98, 84-94 and 86-97%, respectively. Standardization of PET/CT monitoring is now necessary to evaluate the therapeutic efficacy. SUV which indicates the degree of FDG accumulation in the lesion, can be used for prediction of prognosis in future. Awaited is the development of more effective PET/CT apparatus and agent (instead of FDG) for detection of small metastatic lesions, axillary lymphatic metastasis, and viable focus after therapeutic treatments. (R.T.)

  16. Observations at the CNS-PNS border of ventral roots connected to a neuroma

    Directory of Open Access Journals (Sweden)

    Sten Remahl

    2010-10-01

    Full Text Available Previous studies have shown that numerous sprouts originating from a neuroma, after nerve injury in neonatal animals, can invade spinal nerve roots. In this study the border between the central and peripheral nervous system (CNS-PNS border of ventral roots in kittens was examined with both light and electron microscopy after early postnatal sciatic nerve resection. A transient ingrowth of substance P positive axons was observed into the CNS, but no spouts remained 6 weeks after the injury. Using serial sections and electron microscopy it was possible to identify small bundles of unmyelinated axons that penetrated from the root fascicles for a short distance into the CNS. These axons ended blindly, sometimes with a growth cone-like terminal swelling filled with vesicles. The axon bundles were accompanied by p75 positive cells in both the root fascicles and the pia mater, but not in the CNS. It may thus be suggested that neurotrophin presenting p75 positive cells could facilitate axonal growth into the pia mater and that the lack of such cells in the CNS compartment might contribute to the failure of growth into the CNS. A maldevelopment of myelin sheaths at the CNS-PNS border of motor axons was observed and it seems possible that this could have consequences for the propagation of action potential across this region after neonatal nerve injury.

  17. Kif13b Regulates PNS and CNS Myelination through the Dlg1 Scaffold.

    Directory of Open Access Journals (Sweden)

    Roberta Noseda

    2016-04-01

    Full Text Available Microtubule-based kinesin motors have many cellular functions, including the transport of a variety of cargos. However, unconventional roles have recently emerged, and kinesins have also been reported to act as scaffolding proteins and signaling molecules. In this work, we further extend the notion of unconventional functions for kinesin motor proteins, and we propose that Kif13b kinesin acts as a signaling molecule regulating peripheral nervous system (PNS and central nervous system (CNS myelination. In this process, positive and negative signals must be tightly coordinated in time and space to orchestrate myelin biogenesis. Here, we report that in Schwann cells Kif13b positively regulates myelination by promoting p38γ mitogen-activated protein kinase (MAPK-mediated phosphorylation and ubiquitination of Discs large 1 (Dlg1, a known brake on myelination, which downregulates the phosphatidylinositol 3-kinase (PI3K/v-AKT murine thymoma viral oncogene homolog (AKT pathway. Interestingly, Kif13b also negatively regulates Dlg1 stability in oligodendrocytes, in which Dlg1, in contrast to Schwann cells, enhances AKT activation and promotes myelination. Thus, our data indicate that Kif13b is a negative regulator of CNS myelination. In summary, we propose a novel function for the Kif13b kinesin in glial cells as a key component of the PI3K/AKT signaling pathway, which controls myelination in both PNS and CNS.

  18. Combining Mean and Standard Deviation of Hounsfield Unit Measurements from Preoperative CT Allows More Accurate Prediction of Urinary Stone Composition Than Mean Hounsfield Units Alone.

    Science.gov (United States)

    Tailly, Thomas; Larish, Yaniv; Nadeau, Brandon; Violette, Philippe; Glickman, Leonard; Olvera-Posada, Daniel; Alenezi, Husain; Amann, Justin; Denstedt, John; Razvi, Hassan

    2016-04-01

    The mineral composition of a urinary stone may influence its surgical and medical treatment. Previous attempts at identifying stone composition based on mean Hounsfield Units (HUm) have had varied success. We aimed to evaluate the additional use of standard deviation of HU (HUsd) to more accurately predict stone composition. We identified patients from two centers who had undergone urinary stone treatment between 2006 and 2013 and had mineral stone analysis and a computed tomography (CT) available. HUm and HUsd of the stones were compared with ANOVA. Receiver operative characteristic analysis with area under the curve (AUC), Youden index, and likelihood ratio calculations were performed. Data were available for 466 patients. The major components were calcium oxalate monohydrate (COM), uric acid, hydroxyapatite, struvite, brushite, cystine, and CO dihydrate (COD) in 41.4%, 19.3%, 12.4%, 7.5%, 5.8%, 5.4%, and 4.7% of patients, respectively. The HUm of UA and Br was significantly lower and higher than the HUm of any other stone type, respectively. HUm and HUsd were most accurate in predicting uric acid with an AUC of 0.969 and 0.851, respectively. The combined use of HUm and HUsd resulted in increased positive predictive value and higher likelihood ratios for identifying a stone's mineral composition for all stone types but COM. To the best of our knowledge, this is the first report of CT data aiding in the prediction of brushite stone composition. Both HUm and HUsd can help predict stone composition and their combined use results in higher likelihood ratios influencing probability.

  19. The use of FDG-PET/CT and diffusion-weighted magnetic resonance imaging for response prediction before, during and after preoperative chemoradiotherapy for rectal cancer

    International Nuclear Information System (INIS)

    Lambrecht, Maarten; Roels, Sarah; Haustermans, Karin; Deroose, Christophe; Vandecaveye, Vincent; Keyzer, Frederik de; Penninckx, Freddy; Sagaert, Xavier; Cutsem, Eric van

    2010-01-01

    Purpose. To investigate the use of FDG-PET/CT before, during and after chemoradiotherapy (CRT) and diffusion-weighted magnetic resonance imaging (DW-MRI) before CRT for the prediction of pathological response (pCR) in rectal cancer patients. Material and methods. Twenty-two rectal cancer patients treated with long course CRT were included. An FDG-PET/CT was performed prior to the start of CRT, after 10 to 12 fractions of CRT and five weeks after the end of CRT. The tumor was delineated using a gradient based delineation method and the maximal standardized uptake values (SUV max ) were calculated. A DW-MRI was performed before start of CRT. Mean apparent diffusion coefficients (ADC) were determined. The ΔSUV max during and after CRT and the initial ADC values were correlated to the histopathological findings after total mesorectal excision (TME). Results. ΔSUV max during and after CRT significantly correlated with the pathological response to treatment (during CRT: ΔSUV max = 59% ± 12% for pCR vs. 25% ± 27% if no pCR, p=0.0036; post-CRT: 90% ± 11 for pCR vs. 63% ± 22 if no pCR p=0.013). ROC curve analysis revealed an optimal threshold for ΔSUV max of 40% during CRT and 76% after CRT. The initial ADC value was also significantly correlated with pCR (0.94 ± 0.12 x 10-3 mm 2 /s for pCR vs. 1.2 ± 0.24 x 10-3 mm 2 /s, p=0.002) and ROC curve analysis revealed an optimal threshold of 1.06 x 10-3 mm 2 /s. Combining the provided ΔSUV max thresholds during and after CRT increased specificity of the prediction (sensitivity 100% and specificity 94%). The combination of the thresholds for the initial ADC value and the ΔSUV max during CRT increased specificity of the prediction to a similar level (sensitivity of 100% and specificity of 94%). Conclusions. The combination of the different time points and the different imaging modalities increased the specificity of the response assessment both during and after CRT.

  20. Tumour 18 F-FDG Uptake on preoperative PET/CT may predict axillary lymph node metastasis in ER-positive/HER2-negative and HER2-positive breast cancer subtypes

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin You; Lee, Suck Hong; Kim, Suk [Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Department of Radiology, Seo-gu, Busan (Korea, Republic of); Kang, Taewoo [Pusan National University Hospital, Busan Cancer Center, Busan (Korea, Republic of); Bae, Young Tae [Pusan National University Hospital, Department of Surgery, Busan (Korea, Republic of)

    2015-04-01

    To evaluate the association between tumour FDG uptake on preoperative PET/CT and axillary lymph node metastasis (ALNM) according to breast cancer subtype. The records of 671 patients with invasive breast cancer who underwent {sup 18} F-FDG PET/CT and surgery were reviewed. Using immunohistochemistry, tumours were divided into three subtypes: oestrogen receptor (ER)-positive/human epidermal growth factor receptor 2 (HER2)-negative, HER2-positive, and triple-negative. Tumour FDG uptake, expressed as maximum standardized uptake value (SUV{sub max}), and clinicopathological variables were analysed. ALNM was present in 187 of 461 ER-positive/HER2-negative, 54 of 97 HER2-positive, and 38 of 113 triple-negative tumours. On multivariate analysis, high tumour SUV{sub max} (≥4.25) (P < 0.001), large tumour size (>2 cm) (P = 0.003) and presence of lymphovascular invasion (P < 0.001) were independent variables associated with ALNM. On subset analyses, tumour SUV{sub max} maintained independent significance for predicting ALNM in ER-positive/HER2-negative (adjusted odds ratio: 3.277, P < 0.001) and HER2-positive tumours (adjusted odds ratio: 14.637, P = 0.004). No association was found for triple-negative tumours (P = 0.161). Tumour SUV{sub max} may be an independent prognostic factor for ALNM in patients with invasive breast cancer, especially in ER-positive/HER2-negative and HER2-positive subtypes, but not in those with triple-negative subtype. (orig.)

  1. Preoperative nodal staging of non-small cell lung cancer using {sup 99m}Tc-sestamibi SPECT/CT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Miziara, Juliana Muniz; Rocha, Euclides Timoteo da; Miziara, Jose Elias Abrao; Garcia, Gustavo Fabene; Simoes, Maria Izilda Previato; Lopes, Marco Antonio; Kerr, Ligia Maria [Hospital de Cancer de Barretos, Barretos, SP (Brazil); Buchpiguel, Carlos Alberto, E-mail: julimiziara@ig.com.br [Faculdade de Medicina da Universidade da Sao Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, SP (Brazil)

    2011-07-01

    predictive values of 67.7% and 91.2%, respectively. Conclusion: Single-photon emission computed tomography/computed tomography with {sup 99m}Tc-sestamibi showed very low sensitivity and accuracy for the nodal staging of patients with non-small cell lung cancer, despite its high level of specificity. In addition, the performance of single-photon emission computed tomography/computed tomography added no relevant information compared to computed tomography that would justify its use in the routine preoperative staging of non-small cell lung carcinoma. (author)

  2. Preoperative volume calculation of the hepatic venous draining areas with multi-detector row CT in adult living donor liver transplantation: impact on surgical procedure

    International Nuclear Information System (INIS)

    Frericks, Bernd B.J.; Kirchhoff, Timm D.; Shin, Hoen-Oh; Stamm, Georg; Merkesdal, Sonja; Abe, Takehiko; Galanski, Michael; Schenk, Andrea; Peitgen, Heinz-Otto; Klempnauer, Juergen; Nashan, Bjoern

    2006-01-01

    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.)

  3. CT two-dimensional reformation versus three-dimensional volume rendering with regard to surgical findings in the preoperative assessment of the ossicular chain in chronic suppurative otitis media

    International Nuclear Information System (INIS)

    Guo, Yong; Liu, Yang; Lu, Qiao-hui; Zheng, Kui-hong; Shi, Li-jing; Wang, Qing-jun

    2013-01-01

    Purpose: To assess the role of three-dimensional volume rendering (3DVR) in the preoperative assessment of the ossicular chain in chronic suppurative otitis media (CSOM). Materials and methods: Sixty-six patients with CSOM were included in this prospective study. Temporal bone was scanned with a 128-channel multidetector row CT and the axial data was transferred to the workstation for multiplanar reformation (MPR) and 3DVR reconstructions. Evaluation of the ossicular chain according to a three-point scoring system on two-dimensional reformation (2D) and 3DVR was performed independently by two radiologists. The evaluation results were compared with surgical findings. Results: 2D showed over 89% accuracy in the assessment of segmental absence of the ossicular chain in CSOM, no matter how small the segmental size was. 3DVR was as accurate as 2D for the assessment of segmental absence. However, 3DVR was found to be more accurate than 2D in the evaluation of partial erosion of segments. Conclusion: Both 3DVR and 2D are accurate and reliable for the assessment of the ossicular chain in CSOM. The inclusion of 3DVR images in the imaging protocol improves the accuracy of 2D in detecting ossicular erosion from CSOM

  4. CT two-dimensional reformation versus three-dimensional volume rendering with regard to surgical findings in the preoperative assessment of the ossicular chain in chronic suppurative otitis media

    Energy Technology Data Exchange (ETDEWEB)

    Guo, Yong, E-mail: guoyong27@hotmail.com [Department of Radiology, Navy General Hospital, 6# Fucheng Road, Beijing 100048 (China); Liu, Yang, E-mail: liuyangdoc@sina.com [Department of Otorhinolaryngology, Navy General Hospital, 6# Fucheng Road, Beijing 100048 (China); Lu, Qiao-hui, E-mail: Luqiaohui465@126.com [Department of Radiology, Navy General Hospital, 6# Fucheng Road, Beijing 100048 (China); Zheng, Kui-hong, E-mail: zhengkuihong1971@sina.com [Department of Radiology, Navy General Hospital, 6# Fucheng Road, Beijing 100048 (China); Shi, Li-jing, E-mail: Shilijing2003@yahoo.com.cn [Department of Radiology, Navy General Hospital, 6# Fucheng Road, Beijing 100048 (China); Wang, Qing-jun, E-mail: wangqingjun77@163.com [Department of Radiology, Navy General Hospital, 6# Fucheng Road, Beijing 100048 (China)

    2013-09-15

    Purpose: To assess the role of three-dimensional volume rendering (3DVR) in the preoperative assessment of the ossicular chain in chronic suppurative otitis media (CSOM). Materials and methods: Sixty-six patients with CSOM were included in this prospective study. Temporal bone was scanned with a 128-channel multidetector row CT and the axial data was transferred to the workstation for multiplanar reformation (MPR) and 3DVR reconstructions. Evaluation of the ossicular chain according to a three-point scoring system on two-dimensional reformation (2D) and 3DVR was performed independently by two radiologists. The evaluation results were compared with surgical findings. Results: 2D showed over 89% accuracy in the assessment of segmental absence of the ossicular chain in CSOM, no matter how small the segmental size was. 3DVR was as accurate as 2D for the assessment of segmental absence. However, 3DVR was found to be more accurate than 2D in the evaluation of partial erosion of segments. Conclusion: Both 3DVR and 2D are accurate and reliable for the assessment of the ossicular chain in CSOM. The inclusion of 3DVR images in the imaging protocol improves the accuracy of 2D in detecting ossicular erosion from CSOM.

  5. Segmental analysis of cochlea on three-dimensional MR imaging and high-resolution CT. Application to pre-operative assessment of cochlear implant candidates

    International Nuclear Information System (INIS)

    Akiba, Hidenari; Himi, Tetsuo; Hareyama, Masato

    2002-01-01

    High-resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) have recently become standard pre-operative examinations for cochlear implant candidates. HRCT can demonstrate ossification and narrowing of the cochlea, but subtle calcification or soft tissue obstruction may not be detected by this method alone, and so conventional T2 weighted image (T2WI) on MRI has been recommended to disclose them. In this study, segmental analyses of the cochlea were made on three-dimensional MRI (3DMRI) and HRCT in order to predict cochlear implant difficulties. The study involved 59 consecutive patients with bilateral profound sensorineural hearing loss who underwent MRI and HRCT from November 1992 to February 1998. Etiologies of deafness were meningogenic labyrinthitis (n=9), tympanogenic labyrinthitis (n=12), and others (n=38). Pulse sequence of heavy T2WI was steady state free precession and 3DMRI was reconstructed by maximum intensity projection method. HRCT was reconstructed by bone algorithm focusing on the temporal bone. For alternative segmental analysis, cochleas were anatomically divided into five parts and each of them was classified by three ranks of score depending on 3DMRI or HRCT findings. There was a close correlation by ranks between the total score of the five parts on 3DMRI and HRCT (rs=0.86, P<0.001), and a statistically significant difference was identified between causes of deafness in the total score on 3DMRI or HRCT (P<0.001, respectively). There was a significant difference in the score among the five parts on each examination (P<0.001, respectively), and abnormal findings were more frequent in the inferior horizontal part (IHP) of the basal turn. Of the 35 patients who underwent cochlear implantation, no one had ossification in the IHP on HRCT and only one patient had an obstacle to implantation. When no signal void in the IHP on 3DMRI and no ossification in the IHP on HRCT were assumed to be the criteria for candidacy for cochlear

  6. Prognostic significance of preoperative metabolic tumour volume and total lesion glycolysis measured by {sup 18}F-FDG PET/CT in squamous cell carcinoma of the oral cavity

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, In Sun; Roh, Jong-Lyel; Choi, Seung-Ho; Nam, Soon Yuhl [University of Ulsan College of Medicine, Department of Otolaryngology, Asan Medical Center, Seoul (Korea, Republic of); Kim, Jae Seung [University of Ulsan College of Medicine, Department of Nuclear Medicine, Asan Medical Center, Seoul (Korea, Republic of); Cho, Kyung-Ja [University of Ulsan College of Medicine, Department of Pathology, Asan Medical Center, Seoul (Korea, Republic of); Kim, Sang Yoon [University of Ulsan College of Medicine, Department of Otolaryngology, Asan Medical Center, Seoul (Korea, Republic of); Biomedical Research Institute, Korean Institute of Science and Technology, Seoul (Korea, Republic of)

    2014-03-15

    Metabolic tumour volume (MTV) and total lesion glycolysis (TLG) from {sup 18}F-FDG PET/CT are emerging prognostic biomarkers in human solid cancers; yet few studies have investigated their clinical and prognostic significance in oral cavity squamous cell carcinoma (OSCC). The present retrospective study evaluated the utility of pretreatment MTV and TLG measured by {sup 18}F-FDG PET/CT to predict survival and occult metastasis (OM) in OSCC. Of 162 patients with OSCC evaluated preoperatively by {sup 18}F-FDG PET/CT, 105 who underwent definitive surgery with or without adjuvant therapy were eligible. Maximum standardized uptake value (SUV{sub max}), MTV and TLG were measured. For calculation of MTV, 3-D regions of interest were drawn and a SUV threshold of 2.5 was used for defining regions. Univariate and multivariate analyses identified clinicopathological and imaging variables associated with OM, disease-free survival (DFS) and overall survival (OS). The median (range) SUV{sub max}, MTV and TLG were 7.3 (0.7-41.9), 4.5 ml (0.7-115.1 ml) and 18.3 g (2.4-224.1 g), respectively. Of 53 patients with clinically negative lymph nodes, OM was detected in 19 (36 %). By univariate and multivariate analyses, MTV (P = 0.018) and TLG (P = 0.011) were both independent predictive factors for OM, although they were not independent of each other. The 4-year DFS and OS rates were 53.0 % and 62.0 %, respectively. Univariate and multivariate analyses revealed that MTV (P = 0.001) and TLG (P = 0.006), with different cut-off levels, were both independent predictive factors for DFS, although they were not independent of each other, and MTV (P = 0.001), TLG (P = 0.002) and the involved resection margin (P = 0.007) were independent predictive factors for OS. Pretreatment MTV and TLG may be useful in stratifying the likelihood of survival and predicting OM in OSCC. (orig.)

  7. Evaluation of PNS-computed heating and hypersonic shock tunnel data on sharp and inclined blunt cones

    International Nuclear Information System (INIS)

    Hudson, M.L.

    1988-01-01

    As part of the ongoing development and verification of the Parabolized Navier-Stokes (PNS) technique, computed heat transfer rates have been compared with recently acquired experimental data. The flow fields were computer for laminar and turbulent flow over sharp, blunt tripped sphere-cones at 0/degree/ to 20/degree/ angle of attack in a hypersonic shock tunnel flow at Mach numbers of 11, 13, and 16. Grid refinement studies were performed and minimum smoothing parameters were sought. The average percent difference between the measured mean heat transfer rate and the PNS-computed value was 12% for the sharp and blunt cones at 0/degree/ angle of attack. For the blunt cones at angle of attack, the average percent difference was 11% on the windward ray and 36% on the leeward ray. PNS-predicted flow physics such as boundary layer thickness, shock standoff distance, and crossflow separation were examined. 15 refs., 12 figs

  8. Comparing the different response of PNS and CNS injured neurons to mesenchymal stem cell treatment.

    Science.gov (United States)

    Monfrini, Marianna; Ravasi, Maddalena; Maggioni, Daniele; Donzelli, Elisabetta; Tredici, Giovanni; Cavaletti, Guido; Scuteri, Arianna

    2018-01-01

    Mesenchymal stem cells (MSCs) are adult bone marrow-derived stem cells actually proposed indifferently for the therapy of neurological diseases of both the Central (CNS) and the Peripheral Nervous System (PNS), as a panacea able to treat so many different diseases by their immunomodulatory ability and supportive action on neuronal survival. However, the identification of the exact mechanism of MSC action in the different diseases, although mandatory to define their real and concrete utility, is still lacking. Moreover, CNS and PNS neurons present many different biological properties, and it is still unclear if they respond in the same manner not only to MSC treatment, but also to injuries. For these reasons, in this study we compared the susceptibility of cortical and sensory neurons both to toxic drug exposure and to MSC action, in order to verify if these two neuronal populations can respond differently. Our results demonstrated that Cisplatin (CDDP), Glutamate, and Paclitaxel-treated sensory neurons were protected by the co-culture with MSCs, in different manners: through direct contact able to block apoptosis for CDDP- and Glutamate-treated neurons, and by the release of trophic factors for Paclitaxel-treated ones. A possible key soluble factor for MSC protection was Glutathione, spontaneously released by these cells. On the contrary, cortical neurons resulted more sensitive than sensory ones to the toxic action of the drugs, and overall MSCs failed to protect them. All these data identified for the first time a different susceptibility of cortical and sensory neurons, and demonstrated a protective action of MSCs only against drugs in peripheral neurotoxicity. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Diagnostic and prognostic value of 18F-FDG PET, CT, and MRI in perineural spread of head and neck malignancies.

    Science.gov (United States)

    Dercle, Laurent; Hartl, Dana; Rozenblum-Beddok, Laura; Mokrane, Fatima-Zohra; Seban, Romain-David; Yeh, Randy; Bidault, François; Ammari, Samy

    2018-04-01

    We assessed whether quantitative imaging biomarkers derived from fluorodeoxyglucose-positron emission tomography (18F-FDG PET) could be extracted from perineural spread (PNS) in head and neck malignancies (HNM) to improve patient risk stratification. A case-control exploratory study (1:2 ratio) enrolled 81 patients with FDG-avid HNM. The case-group comprised 28 patients with documented PNS (reference: expert consensus), including 14 squamous cell carcinomas (SCC). Imaging biomarkers were extracted from the PNS on 18F-FDG PET, CT-scan, and MRI. The control-group enrolled 53 SCCs. The Cox proportional-hazards regression model explored the association with overall survival by univariate and multivariate analyses. The rate of PNS detection by 18F-FDG PET was 100% in the case-group. Quantitative imaging biomarkers were not associated with the presence of sensory (p>0.20) or motor (p>0.10) symptoms. In SCC patients (case: 14; control: 53), PNS was associated with a hazard ratio of death of 5.5 (95%CI: 1.4:20.9) by multivariate analysis. Increased cranial nerve SUV max was significantly associated with poorer overall survival by univariate analysis (p=0.001). Our pilot study showed the feasibility of extracting 18F-FDG PET biomarkers from PNS in FDG-avid HNM. Our results encourage the development of new PET/CT- or PET/MRI-guided management strategies in further prospective studies. • 18F-FDG PET/CT detects PNS in FDG-avid HNM. • PNS metabolism is more heterogeneous than healthy tissue. • PNS diagnosis is crucial: most patients were asymptomatic, N0 and M0. • PNS diagnosis is associated with poorer overall survival in SCC. • PET/CT- or PET/MRI-guided management strategies should be evaluated.

  10. Preoperative localization of parathyroid tumor by computerized tomography

    International Nuclear Information System (INIS)

    Kan, Seiji; Hiraishi, Koji; Nakamura, Shoichiro; Yamamoto, Schuzo; Odachi, Motoaki; Yamashita, Toshiyuki.

    1984-01-01

    Five patients of primary hyperparathyroidism with urolithiasis underwent CT-scanning for the preoperative localization of parathyroid tumor. The tumor was identified in all patients but one, who had a multiple adenomatous goiter. In this case, postoperative observation of the CT-scan revealed the parathyroid tumor. It appears that if the size of the parathyroid tumor is about 1cm in diameter, there is a high possibility of preoperative localization by computerized tomography. (author)

  11. Peripheral nerve stimulation (PNS) in the trapezius muscle region alleviate chronic neuropathic pain after lower brachial plexus root avulsion lesion: A case report

    DEFF Research Database (Denmark)

    Sørensen, Jens Christian Hedemann; Meier, Kaare; Perinpam, Larshan

    Peripheral nerve stimulation (PNS) in the trapezius muscle region alleviate chronic neuropathic pain after lower brachial plexus root avulsion lesion: A case report......Peripheral nerve stimulation (PNS) in the trapezius muscle region alleviate chronic neuropathic pain after lower brachial plexus root avulsion lesion: A case report...

  12. HUBUNGAN IMT, RLPP DAN RIWAYAT DIABETES PADA KELUARGA DENGAN KADAR GULA DARAH SEWAKTU PADA PNS

    Directory of Open Access Journals (Sweden)

    Hafifatul Auliya Rahmy

    2015-03-01

    Full Text Available Diabetes melitus (DM adalah penyakit metabolik dengan karakteristik hiperglikemia. DM dan komplikasinya menyebabkan sekitar 4% kematian dari seluruh total kematian di dunia dan 3% di Di Indonesia. Skrining melalui pemeriksaan kadar gula darah sangat diperlukan untuk mencegah DM. Penelitian ini bertujuan  mengetahui kadar gula darah dan hubungan indeks massa tubuh, rasio lingkar pinggang pinggul dan riwayat diabetes pada keluarga dengan kadar gula darah. Penelitian dilakukan dengan desain cross sectional pada PNS di Direktorat Jenderal Perimbangan Keuangan bulan Februari - April 2014. Jumlah sampel berdasarkan hasil perhitungan sampel sebanyak 147 responden yang dipilih secara random. Analisis yang digunakan meliputi analisis univariat dan bivariat (regresi linear sederhana dan ­t test independen. Rata-rata kadar gula darah yang didapatkan adalah 177,52±27,67 mg/dl, rata-rata IMT adalah 23,93±4,20 m/kg2 pada perempuan dan 26,23±4,07 m/kg2 pada laki-laki dan rasio lingkar pinggang pinggul adalah 0,87±0,06 pada perempuan dan 0,90±0,04 pada laki-laki. Hasil penelitian menunjukkan adanya hubungan yang signifikan antara indeks massa tubuh, rasio lingkar pinggang pinggul dan riwayat diabetes pada keluarga dengan kadar gula darah (p value < 0,05. Pencegahan DM dapat dilakukan dengan skrining khususnya pada kelompok berisiko dengan pemantauan status gizi.

  13. Preparation of a novel bioavailable curcuminoid formulation (Cureit™) using Polar-Nonpolar-Sandwich (PNS) technology and its characterization and applications

    International Nuclear Information System (INIS)

    Amalraj, Augustine; Jude, Shintu; Varma, Karthik; Jacob, Joby; Gopi, Sreeraj; Oluwafemi, Oluwatobi S.; Thomas, Sabu

    2017-01-01

    Health benefits of curcuminoid are highly limited due to their poor aqueous solubility, very low systemic bioavailability, fast metabolic alterations and rapid elimination. In this study, a novel bioavailable curcuminoid formulation Cureit™ was prepared by using Polar-Nonpolar-Sandwich (PNS) technology with complete natural turmeric matrix (CNTM). The synthesized bioavailable curcuminoid formulation Cureit™ was characterizations by Nuclear magnetic resonance spectroscopy (NMR), scanning electron microscopy (SEM), X-ray diffraction (XRD), Fourier transform infra-red (IR), current-voltage (I-V) study, Quadrupole Time-of-Flight Mass Spectrometry (Q-TOF), differential scanning calorimeter (DSC) and thermogravimetric analysis (TGA). NMR study showed the presence of hydrogen bonding interactions with curcuminoids, polar and non-polar compounds in the PNS technology. SEM images indicated that Cureit™ was almost spherical and well dispersed with rough morphology, and separated with three layers of PNS formulation. The chemical profile of Cureit™ was analyzed by Q-TOF confirmed the presence of curcuminoids (curcumin, demethoxycurcumin and bismethoxycurcumin), lactones, sesquiterpenes and their derivatives derived from polar layer, aromatic turmerone, dihydroturmerone, turmeronol, curdione and bisacurone derived from non-polar layer. IR, XRD, DSC and TGA also confirmed the presence of curcuminoids with high stability in the PNS formulation. Various biological activities of Cureit™ were also discussed. - Highlights: • A novel bioavailable curcuminoid formulation Cureit™ was prepared. • Polar-Nonpolar-Sandwich technology is used with complete natural turmeric matrix. • Cureit™ was analyzed and predicted by NMR, SEM, XRD, IR, I-V, Q-TOF, DSC and TGA. • Cureit™ exhibited 10 fold higher bioavailable curcuminoid than pure curcuminoid.

  14. Preparation of a novel bioavailable curcuminoid formulation (Cureit™) using Polar-Nonpolar-Sandwich (PNS) technology and its characterization and applications

    Energy Technology Data Exchange (ETDEWEB)

    Amalraj, Augustine; Jude, Shintu; Varma, Karthik; Jacob, Joby [R& D Centre, Aurea Biolabs (P) Ltd, Kolenchery, Cochin, 682 311, Kerala (India); Gopi, Sreeraj, E-mail: sreeraj.gopi@plantlipids.com [R& D Centre, Aurea Biolabs (P) Ltd, Kolenchery, Cochin, 682 311, Kerala (India); Oluwafemi, Oluwatobi S. [Department of Applied Chemistry, University of Johannesburg, Doornfontein Campus, P.O. Box 17011, Doornfontein, 2028 Johannesburg (South Africa); Centre for Nanomaterials Science Research, University of Johannesburg, Johannesburg (South Africa); Thomas, Sabu [School of Chemical Sciences, Mahatma Gandhi University, Kottayam (India)

    2017-06-01

    Health benefits of curcuminoid are highly limited due to their poor aqueous solubility, very low systemic bioavailability, fast metabolic alterations and rapid elimination. In this study, a novel bioavailable curcuminoid formulation Cureit™ was prepared by using Polar-Nonpolar-Sandwich (PNS) technology with complete natural turmeric matrix (CNTM). The synthesized bioavailable curcuminoid formulation Cureit™ was characterizations by Nuclear magnetic resonance spectroscopy (NMR), scanning electron microscopy (SEM), X-ray diffraction (XRD), Fourier transform infra-red (IR), current-voltage (I-V) study, Quadrupole Time-of-Flight Mass Spectrometry (Q-TOF), differential scanning calorimeter (DSC) and thermogravimetric analysis (TGA). NMR study showed the presence of hydrogen bonding interactions with curcuminoids, polar and non-polar compounds in the PNS technology. SEM images indicated that Cureit™ was almost spherical and well dispersed with rough morphology, and separated with three layers of PNS formulation. The chemical profile of Cureit™ was analyzed by Q-TOF confirmed the presence of curcuminoids (curcumin, demethoxycurcumin and bismethoxycurcumin), lactones, sesquiterpenes and their derivatives derived from polar layer, aromatic turmerone, dihydroturmerone, turmeronol, curdione and bisacurone derived from non-polar layer. IR, XRD, DSC and TGA also confirmed the presence of curcuminoids with high stability in the PNS formulation. Various biological activities of Cureit™ were also discussed. - Highlights: • A novel bioavailable curcuminoid formulation Cureit™ was prepared. • Polar-Nonpolar-Sandwich technology is used with complete natural turmeric matrix. • Cureit™ was analyzed and predicted by NMR, SEM, XRD, IR, I-V, Q-TOF, DSC and TGA. • Cureit™ exhibited 10 fold higher bioavailable curcuminoid than pure curcuminoid.

  15. Pengembangan Kurikulum Diklat (Pendidikan dan Pelatihan Berbasis Kompetensi dalam Membangun Profesionalisme dan Kompetensi Pegawai Negeri Sipil (PNS

    Directory of Open Access Journals (Sweden)

    Widi Asih Nurhajati

    2018-01-01

    Full Text Available Diklat berbasis kompetensi diselenggarakan untuk mengatasi diskrepansi kompetensi PNS agar kemampuan PNS lulusan diklat sesuai dengan kompetensi yang diharapkan. Salah satu komponen dalam diklat berbasis kompetensi adalah kurikulum yang berbasis kompetensi berdasar pada kebutuhan akan kompetensi peserta diklat. Dalam rangka memenuhi tuntutan perkembangan jaman berikut situasi dan kondisi di masyarakat, pengembangan kurikulum diklat perlu dilakukan. Pengembangannya tetap menyesuaikan dengan landasan pengembangan kurikulum, yakni landasan filosofis, psikologis, sosiologis dan IPTEK. Pengembangan kurikulum diklat berbasis kompetensi juga menyesuaikan dengan model kurikulum yang dikehendaki, sehingga kurikulum tersebut nantinya dapat menghasilkan lulusan diklat dengan kemampuan sesuai yang diinginkan. Pengembangan kurikulum diklat berbasis kompetensi pada akhirnya diharapkan dapat membangun profesionalisme dan kompetensi PNS dalam menjawab tantangan di masa depan.Dengan demikian diklat akan menghasilkan lulusan, dalam hal ini PNS, yang profesional dan kompeten.  Abstract Competency-based training is held to overcome the discrepancy of civil servant competence to the ability of civil servants graduate training in accordance with the expected competencies. One component of competency-based training is a competency-based curriculum based on competency needs of training participants. In order to meet the demands of the development of the times following the situation and conditions in the community, the development of training curriculum needs to be done. Its development still adjusts to the curriculum development foundation, namely philosophical, psychological, sociological and science and technology. Development of competency-based training curriculum also adapts to the desired curriculum model, so that the curriculum will be able to produce training graduates with the desired ability. Development of competency-based training curriculum is ultimately

  16. PNS and statistical experiments simulation in subcritical systems using Monte-Carlo method on example of Yalina-Thermal assembly

    International Nuclear Information System (INIS)

    Sadovich, S.; Burnos, V.; Kiyavitskaya, H.; Fokov, Y.; Talamo, A.

    2013-01-01

    In subcritical systems driven by an external neutron source, the experimental methods based on pulsed neutron source (PNS) and statistical techniques play an important role for reactivity measurement. Simulation of these methods is very time-consumed procedure. For simulations in Monte-Carlo programs several improvements for neutronic calculations have been made. This paper introduces a new method for simulating PNS and statistical measurements. In this method all events occurred in the detector during simulation are stored in a file using PTRAC feature in the MCNP. After that with a special code (or post-processing) PNS and statistical methods can be simulated. Additionally different shapes of neutron pulses and its lengths as well as dead time of detectors can be included into the simulation. The methods described above have been tested on the sub-critical assembly Yalina-Thermal, located in the Joint Institute for Power and Nuclear Research SOSNY in Minsk (Belarus). A good agreement between experiment and simulation was shown. (authors)

  17. Clinical value of FDG-PET/CT in suspected paraneoplastic syndromes: a retrospective analysis of 137 patients

    Energy Technology Data Exchange (ETDEWEB)

    Bjoern Kristensen, Stine; Hess, Soeren; Petersen, Henrik; Hoeilund-Carlsen, Poul Flemming [Odense University Hospital, Department of Nuclear Medicine, Odense (Denmark)

    2015-12-15

    Paraneoplastic syndromes (PNS) are relatively infrequent manifestations appearing before or after a cancer declares itself. Autoimmune mechanisms may be involved, but their cause and pathogenesis are often unknown. Due to disparity of symptoms, PNS remain a major diagnostic challenge. We examined the value of FDG-PET/CT for ruling in or out malignancy in a heterogeneous group of patients with suspected PNS. We retrospectively extracted data from all patients referred 2009-2013 with suspected PNS. Data included age, sex, follow-up period, scan report, further diagnostic procedures, and final clinical diagnosis. Conclusions of the scan reports were compared to the final follow-up outcome as determined during an average follow-up of 31 months (range 6-51.5) in patients who were not diagnosed with cancer in immediate continuation of a positive PET/CT scan. A total of 137 patients were included. Main causes for referral were neurological (n = 67), rheumatological (n = 25), dermatological (n = 18), nephrological (n = 6), haematological (n = 2), abnormal biochemistry (n = 11), and others (n = 8). The cancer prevalence was 8.8 %. The FDG-PET/CT results were as follows: nine true positives, 22 false positives, 103 true negatives, and three false negatives. Corresponding diagnostic values were: sensitivity 75 %, specificity 82 %, accuracy 82 %, and positive and negative predictive values of 29 % and 97 %, respectively. FDG-PET/CT has in patients with suspected PNS an impressively high negative predictive value and may be of value in ruling out PNS, the more so, the more the number of false positives can be minimized or used in differential diagnosis. We believe that FDG-PET/CT may become an important adjunct to the work-up and triage of patients with suspected PNS. (orig.)

  18. Brain tumor and CT, 1

    International Nuclear Information System (INIS)

    Suzuki, Nobuyuki; Katada, Kazuhiro; Shinomiya, Youichi; Sano, Hirotoshi; Kanno, Tetsuo

    1981-01-01

    It is very important for a neurosurgeon to know the consistency of a brain tumor preoperatively, since the information which is of much use in indicating the likely difficulty of the operation, which operative tools should be selected, the amount of bleeding to be expected from the tumor, and so on. The authors, therefore, tried to evaluate the consistency of brain tumors preoperatively 27 cases in which the margin of the tumor was made clear with a homogeneous stain were studied concerning the relationship between the tumor consistency and the CT findings. The results are as follows: 1) A higher CT number on a plain CT indicated a harder consistency of the tumor. 2) A lesser contrast index (CT number on enhancement CT/CT number on plain CT) showed a harder consistency of the tumor. (author)

  19. Preoperative embolization of gigantic meningioma

    International Nuclear Information System (INIS)

    Wang Hongsheng; Chen Huaqun; Dong Congsong; Li Wenhui; Dai Zhenyu; Chen Guozhi

    2006-01-01

    Objective: To evaluate the clinical efficacy of preoperative embolization in treatment of patients with gigantic meningioma. Methods: Fourteen cases of gigantic meningioma diameter from 6 to 11 cm were measured by CT and MRI scan. DSA manifested that they are vascularizd meningioma and showed the mainly feeding arteries. We used getation sponge to superselectively embilized the feeding arteries. All tumors were performed surgical excision 3-7 days after the embolization. Results: DSA showed the blood supplies in the tumors in 9 cases were completely blocked, and that in 5 cases were dramatically eliminated. All patients were operated 3-7 days after the embolization. During the operations the bleeding were dramatically decreased and the operation time was shortened compared with those in unembolized cases. It helps us remove the tumors easy and quickly from the attachments. No complication occurred during and after the operations. Conclusion: Preoperative embolization of gigantic meningioma is a useful and relatively safe method in helping surgicaly and completely excised of tumor with significant reduction of blood loss and operation time. (authors)

  20. Characterizing Rat PNS Electrophysiological Response to Electrical Stimulation Using in vitro Chip-Based Human Investigational Platform (iCHIP)

    Energy Technology Data Exchange (ETDEWEB)

    Khani, Joshua [Georgetown Univ., Washington, DC (United States); Prescod, Lindsay [Georgetown Univ., Washington, DC (United States); Enright, Heather [Georgetown Univ., Washington, DC (United States); Felix, Sarah [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Osburn, Joanne [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Wheeler, Elizabeth [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Kulp, Kris [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2015-08-18

    Ex vivo systems and organ-on-a-chip technology offer an unprecedented approach to modeling the inner workings of the human body. The ultimate goal of LLNL’s in vitro Chip-based Human Investigational Platform (iCHIP) is to integrate multiple organ tissue cultures using microfluidic channels, multi-electrode arrays (MEA), and other biosensors in order to effectively simulate and study the responses and interactions of the major organs to chemical and physical stimulation. In this study, we focused on the peripheral nervous system (PNS) component of the iCHIP system. Specifically we sought to expound on prior research investigating the electrophysiological response of rat dorsal root ganglion cells (rDRGs) to chemical exposures, such as capsaicin. Our aim was to establish a protocol for electrical stimulation using the iCHIP device that would reliably elicit a characteristic response in rDRGs. By varying the parameters for both the stimulation properties – amplitude, phase width, phase shape, and stimulation/ return configuration – and the culture conditions – day in vitro and neural cell types - we were able to make several key observations and uncover a potential convention with a minimal number of devices tested. Future work will seek to establish a standard protocol for human DRGs in the iCHIP which will afford a portable, rapid method for determining the effects of toxins and novel therapeutics on the PNS.

  1. Orexin A and Orexin Receptor 1 axonal traffic in dorsal roots at the CNS/PNS interface

    Directory of Open Access Journals (Sweden)

    Damien eColas

    2014-02-01

    Full Text Available Hypothalamic orexin/hypocretin neurons send long axonal projections through the dorsal spinal cord in lamina I-II of the dorsal horn at the interface with the peripheral nervous system (PNS. We show that in the dorsal horn OXA fibers colocalize with substance P (SP positive afferents of dorsal root ganglia (DRG neurons known to mediate sensory processing. Further, OR1 is expressed in p75NTR and SP positive DRG neurons, suggesting a potential signaling pathway between orexin and DRG neurons. Interestingly, DRG sensory neurons have a distinctive bifurcating axon where one branch innervates the periphery and the other one the spinal cord (pseudo-unipolar neurons, allowing for potential functional coupling of distinct targets. We observe that OR1 is transported selectively from DRG toward the spinal cord, while OXA is accumulated retrogradely toward the DRG. We hence report a rare situation of asymmetrical neuropeptide receptor distribution between axons projected by a single neuron. This molecular and cellular data are consistent with the role of OXA/OR1 in sensory processing, including DRG neuronal modulation, and support the potential existence of an OX/HCRT circuit between CNS and PNS.

  2. [Preoperative structured patient education].

    Science.gov (United States)

    Lamarche, D

    1993-04-01

    This article describes the factors that motivated the nursing staff of the cardiac surgery unit at the Royal Victoria Hospital in Montreal, to revise their preoperative teaching program. The motivating factors described are the length of the preoperative waiting period; the level of preoperative anxiety; the decreased length of hospital stay; the dissatisfaction of the nursing staff with current patient teaching practices; and the lack of available resources. The reorganization of the teaching program was based upon the previously described factors combined with a review of the literature that demonstrated the impact of preoperative anxiety, emotional support and psycho-educational interventions upon the client's recovery. The goals of the new teaching program are to provide the client and the family with cognitive and sensory information about the client's impending hospitalization, chronic illness and necessary lifestyle modifications. The program consists of a system of telephone calls during the preoperative waiting period; a videotape viewing; a tour of the cardiac surgery unit; informal discussion groups; and the availability of nursing consultation to decrease preoperative anxiety. The end result of these interventions is more time for client support and integration of necessary information by the client and family. This kind of program has the potential to provide satisfaction at many levels by identifying client's at risk; increasing client knowledge; increasing support; decreasing anxiety during the preoperative waiting period; and decreasing the length of hospital stay. The nursing staff gained a heightened sense of accomplishment because the program was developed according to the nursing department's philosophy, which includes primary nursing.(ABSTRACT TRUNCATED AT 250 WORDS)

  3. CT images of gossypiboma

    International Nuclear Information System (INIS)

    Jeon, Hae Jeong; Lim, Jong Nam; Choi, Young Chil; Park, Jeong Hee

    1994-01-01

    Surgical sponges retained after laparotomy can cause serious problem if they were not be identified in early state. In these circumstances abdominal CT yields the accurate diagnostic images. The purpose of this report is to present highly indicative findings permitting correct preoperative diagnosis of the gossypiboma. We experienced three cases in which CT showed the images sufficiently characteristic to suggest the correct preoperative diagnosis. We evaluated retrospectively the radiological images of gossypiboma confirmed by operation. Three patients were admitted due to palpable masses. Two female patients had medical histories of cesarean sections and a male patient had been operated due to malignant fibrous histiocytoma, previously. Abdominal CT scan of one case revealed huge ovoid hypodense mass with enhanced peripheral rim. Calcific spots and whirl-like stripes were noted within the lesion. Towel was found in pathologic specimen. CT images of two patients showed well-encapsulated, mixed fluid and soft tissue density mass with several gas bubbles. Surgical sponges were found within abscesses. The authors conclude that these characteristic CT findings and careful histories of surgery are very useful for correct pre-operative diagnosis and permit the guideline for the optimal plan of the surgical treatment

  4. CT images of gossypiboma

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Hae Jeong; Lim, Jong Nam; Choi, Young Chil; Park, Jeong Hee [College of Medicine, Kon-Kuk University, Seoul (Korea, Republic of)

    1994-04-15

    Surgical sponges retained after laparotomy can cause serious problem if they were not be identified in early state. In these circumstances abdominal CT yields the accurate diagnostic images. The purpose of this report is to present highly indicative findings permitting correct preoperative diagnosis of the gossypiboma. We experienced three cases in which CT showed the images sufficiently characteristic to suggest the correct preoperative diagnosis. We evaluated retrospectively the radiological images of gossypiboma confirmed by operation. Three patients were admitted due to palpable masses. Two female patients had medical histories of cesarean sections and a male patient had been operated due to malignant fibrous histiocytoma, previously. Abdominal CT scan of one case revealed huge ovoid hypodense mass with enhanced peripheral rim. Calcific spots and whirl-like stripes were noted within the lesion. Towel was found in pathologic specimen. CT images of two patients showed well-encapsulated, mixed fluid and soft tissue density mass with several gas bubbles. Surgical sponges were found within abscesses. The authors conclude that these characteristic CT findings and careful histories of surgery are very useful for correct pre-operative diagnosis and permit the guideline for the optimal plan of the surgical treatment.

  5. Difficult Myotomy Is Not Determined by Preoperative Therapy and Does Not Impact Outcome

    Science.gov (United States)

    Villadolid, Desiree V.; Al-Saadi, Sam; Rosemurgy, Alexander S.

    2007-01-01

    Objectives: The impact of preoperative endoscopic therapy on the difficulty of laparoscopic Heller myotomy and the impact of the difficulty of the myotomy on long-term outcome has not been determined. This study was undertaken to determine whether preoperative therapy impacts the difficulty of laparoscopic Heller myotomy and whether preoperative therapy or difficulty of myotomy impacts long-term outcomes. Methods: Since 1992, 305 patients, 56% male, median age 49 years, underwent laparoscopic Heller myotomy and were prospectively followed. The difficulty of the laparoscopic Heller myotomy was scored by the operating surgeon for the most recent 170 consecutive patients on a scale of 1 (easiest) to 5 (most difficult). Patients scored their symptoms before and after myotomy using a Likert scale from 0 (never/not bothersome) to 10 (always/very bothersome). Results: Before myotomy, 66% of patients underwent endoscopic therapy: 33% dilation, 11% Botox, and 22% both. Preoperative endoscopic therapy did not correlate with the difficulty of the myotomy (P=NS). Median follow-up was 25 months. Regardless of the difficulty of the myotomy, dysphagia improved with myotomy (Pmyotomy. Conclusions: Laparoscopic Heller myotomy improves the frequency and severity of dysphagia. The difficulty of laparoscopic Heller myotomy is not impacted by preoperative therapy, and neither preoperative therapy nor difficulty of the myotomy impact long-term outcome. PMID:17931516

  6. CT in colon cancer

    International Nuclear Information System (INIS)

    Fujita, Nobuyuki; Hasegawa, Takashi; Kubo, Kozo; Ogawa, Hajime; Sato, Yukihiko; Tomita, Masayoshi; Hanawa, Makoto; Matsuzawa, Tohru; Nishioka, Ken

    1990-01-01

    CT pictures from 59 lesions of advanced colon cancer including rectal cancer were reviewed to evaluate a role of CT in preoperative staging diagnosis. CT findings were recorded following general rules for clinical and pathological studies on cancer of colon rectum and anus, proposed by Japanese society for cancer of colon and rectum. Tumors were detected in 90% of advanced colon cancers. Sensitivity in local extension (S factor) was 58.0%. Sensitivity in lymphonode involvement (N factor) was 50.0%. Sensitivity in final staging diagnosis, dividing colon cancer into two groups below st II and above st III, was 63.3%. Further study should be necessitated to provide useful information for preoperative staging diagnosis of colon cancer. (author)

  7. Immediate preoperative enteral nutrition (preoperative enteral nutrition

    Directory of Open Access Journals (Sweden)

    Lađević Nebojša

    2017-01-01

    Full Text Available Nutritional support of surgical patients is a necessary part of the treatment. It alone cannot cure the disease but it significantly affects the recovery of patients and supports surgical interventions. Patients in malnutrition have shown to have significantly more postoperative infectious and non-infectious complications. This significantly prolongs treatment time and increases costs. However, there is one fact that cannot be expressed in money, which is the patient's impression of the surgical intervention. Adequate preoperative patient support, based on the intake of liquid nutritive solutions, reduces preoperative stress and deflects the metabolic response. Now, it is recommended for adults and children older than one year to drink clear liquid up to 2 hours before induction in anesthesia. Appropriate enteral nutrition has a significant place in the postoperative recovery of patients. Enteral nutrition is reducing complications, mainly infectious complications because the function of the digestive system as one large immune system is preserved. Perioperative enteral nutrition is a necessary part of the modern treatment of surgical patients. In addition to the significant effect on the occurrence of postoperative complications, it is also important that this type of diet improves the psychological status of patients.

  8. The Diagnostic Value of 18F-FDG PET/CT Imaging in Preoperative Staging of Colorectal Cancer%18F-FDG PET/CT显像在结直肠癌术前分期中的价值

    Institute of Scientific and Technical Information of China (English)

    王大龙; 于丽娟; 田墨涵; 任美丽; 张士德; 高波

    2012-01-01

    Objective To evaluate the value of 18F-FDG PET/CT on the TNM staging of colorectal cancer before surger-y. Materials and Methods 33 patients with colorectal tumor received 18F-FDG PET/CT before surgery. PET/CT findings were compared with pathological results and statistical analysis were performed. Results The sensitivity, accuracy of diagnosing primary colorectal lesions was 100% ,96. 97% respectively by PET/CT. The diagnostic accuracy of local chorion invasion and Lymph node metastasis and distant metastasis and TNM stage before operation in colorectal cancer were 75. 00% ,78. 12% ,96.87% ,71.87% respectively, and the correlation with pathological results were 0.429,0. 559,0. 920,0. 619, respectively ( P < 0. 05 ) . Kappa coefficients showed that the correlation between manifestations on PET/CT and operative pathology were good. Conclusion PET/CT is an effective diagnostic imaging method in evaluating the staging of colorectal carcinomas before surgery.%目的 探讨18F-FDG PET/CT在结直肠癌术前TNM分期中的应用价值.资料与方法 33例疑结直肠肿瘤患者均于手术治疗前行全身PET/CT扫描,将患者PET/CT检查结果与手术病理学检查结果进行比较分析.结果 PET/CT诊断结直肠癌原发灶的敏感性、准确性分别为100%和96.97%;PET/CT对术前结直肠癌侵犯局部浆膜、淋巴结转移、远处转移及TNM分期的准确性分别为75.00%、78.12%、96.87%和71.87%,经Kappa一致性检验,PET/CT 上述诊断结果与手术病理学检查结果具有较好的一致性(0.429,0.559,0.920,0.619,P均<0.05).结论 结直肠癌18F-FDG PET/CT术前检查,是结盲肠癌的术前临床分期中有效的影像学评价手段.

  9. The preoperative imaging evaluation for cochlear implantation

    International Nuclear Information System (INIS)

    Liu Zhonglin; Wang Zhenchang; Fu Lin; Li Yong; Xian Junfang; Yang Bentao; Lan Baosen; Li Yongxin; Zheng Jun; Song Yan; Liu Bo; Chen Xueqing; He Haili

    2006-01-01

    Objective: To analyze CT and MRI findings of temporal bone and to evaluate preoperative diagnostic value for cochlear implantation. Methods: One hundred and sixty candidates for cochlear implantation were examined with axial CT scan, 64 of them also with coronal CT scan, and 119 patients with MRI. Results: All of 320 ears were well-aerated, and 206 ears had mastoid cavities extended posteriorly to the sigmoid sinus. The length from posterior-lateral tympanic wall to the outer cortex was (2.34±0.42) mm (left side) and (2.25±0.40) mm (right side) (U=1.887, P 1 and T 2 signal on MRI. The congenital malformations of inner ear occurred in 67 ears, including complete dysplasia in 1 ear, cochlear hypodysplasia in 6 ears, Mondini deformation in 5 ears, enlarged vestibular aqueduct in 40 ears, dysplastic semicircular canal and the vestibulae in 10 ears, and narrowing of internal auditory canal in 5 ears. Conclusion: Preoperative imaging examinations can provide critical information to ensure successful cochlear' implantation. (authors)

  10. Value of retrospective image fusion of 18F-FDG PET and MRI for preoperative staging of head and neck cancer: Comparison with PET/CT and contrast-enhanced neck MRI

    International Nuclear Information System (INIS)

    Kanda, Tomonori; Kitajima, Kazuhiro; Suenaga, Yuko; Konishi, Jyunya; Sasaki, Ryohei; Morimoto, Koichi; Saito, Miki; Otsuki, Naoki; Nibu, Ken-ichi; Sugimura, Kazuro

    2013-01-01

    Purpose: To assess the clinical value of retrospective image fusion of neck MRI and 18 F-fluorodeoxyglucose ( 18 F-FDG) PET for locoregional extension and nodal staging of neck cancer. Materials and methods: Thirty patients with carcinoma of the oral cavity or hypopharynx underwent PET/CT and contrast-enhanced neck MRI for initial staging before surgery including primary tumor resection and neck dissection. Diagnostic performance of PET/CT, MRI, and retrospective image fusion of PET and MRI (fused PET/MRI) for assessment of the extent of the primary tumor (T stage) and metastasis to regional lymph nodes (N stage) was evaluated. Results: Accuracy for T status was 87% for fused PET/MRI and 90% for MRI, thus proving significantly superior to PET/CT, which had an accuracy of 67% (p = 0.041 and p = 0.023, respectively). Accuracy for N status was 77% for both fused PET/MRI and PET/CT, being superior to MRI, which had an accuracy of 63%, although the difference was not significant (p = 0.13). On a per-level basis, the sensitivity, specificity and accuracy for detection of nodal metastasis were 77%, 96% and 93% for both fused PET/MRI and PET/CT, compared with 49%, 99% and 91% for MRI, respectively. The differences for sensitivity (p = 0.0026) and accuracy (p = 0.041) were significant. Conclusion: Fused PET/MRI combining the individual advantages of MRI and PET is a valuable technique for assessment of staging neck cancer

  11. Value of retrospective image fusion of {sup 18}F-FDG PET and MRI for preoperative staging of head and neck cancer: Comparison with PET/CT and contrast-enhanced neck MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kanda, Tomonori [Department of Radiology, Kobe University Graduate School of Medicine, Kobe (Japan); Department of Radiology, Hyogo Cancer Center, Hyogo (Japan); Kitajima, Kazuhiro, E-mail: kitajima@med.kobe-u.ac.jp [Department of Radiology, Kobe University Graduate School of Medicine, Kobe (Japan); Suenaga, Yuko; Konishi, Jyunya [Department of Radiology, Kobe University Graduate School of Medicine, Kobe (Japan); Sasaki, Ryohei [Division of Radiation Oncology, Department of Radiology, Kobe University Graduate School of Medicine, Kobe (Japan); Morimoto, Koichi; Saito, Miki; Otsuki, Naoki; Nibu, Ken-ichi [Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe (Japan); Sugimura, Kazuro [Department of Radiology, Kobe University Graduate School of Medicine, Kobe (Japan)

    2013-11-01

    Purpose: To assess the clinical value of retrospective image fusion of neck MRI and {sup 18}F-fluorodeoxyglucose ({sup 18}F-FDG) PET for locoregional extension and nodal staging of neck cancer. Materials and methods: Thirty patients with carcinoma of the oral cavity or hypopharynx underwent PET/CT and contrast-enhanced neck MRI for initial staging before surgery including primary tumor resection and neck dissection. Diagnostic performance of PET/CT, MRI, and retrospective image fusion of PET and MRI (fused PET/MRI) for assessment of the extent of the primary tumor (T stage) and metastasis to regional lymph nodes (N stage) was evaluated. Results: Accuracy for T status was 87% for fused PET/MRI and 90% for MRI, thus proving significantly superior to PET/CT, which had an accuracy of 67% (p = 0.041 and p = 0.023, respectively). Accuracy for N status was 77% for both fused PET/MRI and PET/CT, being superior to MRI, which had an accuracy of 63%, although the difference was not significant (p = 0.13). On a per-level basis, the sensitivity, specificity and accuracy for detection of nodal metastasis were 77%, 96% and 93% for both fused PET/MRI and PET/CT, compared with 49%, 99% and 91% for MRI, respectively. The differences for sensitivity (p = 0.0026) and accuracy (p = 0.041) were significant. Conclusion: Fused PET/MRI combining the individual advantages of MRI and PET is a valuable technique for assessment of staging neck cancer.

  12. [Preoperative fasting. An update].

    Science.gov (United States)

    Spies, C D; Breuer, J P; Gust, R; Wichmann, M; Adolph, M; Senkal, M; Kampa, U; Weissauer, W; Schleppers, A; Soreide, E; Martin, E; Kaisers, U; Falke, K J; Haas, N; Kox, W J

    2003-11-01

    In Germany the predominant standard of preoperative care for elective surgery is fasting after midnight, with the aim of reducing the risk of pulmonary aspiration. However, for the past several years the scientific evidence supporting such a practice has been challenged. Experimental and clinical studies prove a reliable gastric emptying within 2 h suggesting that, particularly for limited intake of clear fluids up to 2 h preoperatively, there would be no increased risk for the patient. In addition, the general incidence of pulmonary aspiration during general anaesthesia (before induction, during surgery and during recovery) is extremely low, has a good prognosis and is more a consequence of insufficient airway protection and/or inadequate anaesthetic depth rather than due to the patient's fasting state. Therefore, primarily to decrease perioperative discomfort for patients, several national anaesthesia societies have changed their guidelines for preoperative fasting. They recommend a more liberal policy regarding per os intake of both liquid and solid food, with consideration of certain conditions and contraindications. The following article reviews the literature and gives an overview of the scientific background on which the national guidelines are based. The intention of this review is to propose recommendations for preoperative fasting regarding clear fluids for Germany as well.

  13. Preoperative cardiac computed tomography for demonstration of congenital cardiac septal defect in adults

    Energy Technology Data Exchange (ETDEWEB)

    Eom, Hye-Joung; Yang, Dong Hyun; Kang, Joon-Won; Lim, Tae-Hwan [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, Seoul (Korea, Republic of); Kim, Dae-Hee; Song, Jong-Min; Kang, Duk-Hyun; Song, Jae-Kwan [University of Ulsan College of Medicine, Department of Cardiology and Heart Institute, Cardiac Imaging Center, Asan Medical Center, Seoul (Korea, Republic of); Kim, Joon Bum; Jung, Sung-Ho; Choo, Suk Jung; Chung, Cheol Hyun; Lee, Jae Won [University of Ulsan College of Medicine, Department of Cardiothoracic surgery, Cardiac Imaging Center, Asan Medical Center, Seoul (Korea, Republic of)

    2015-06-01

    We aimed to evaluate the role of preoperative cardiac computed tomography (CT) for adults with congenital cardiac septal defect (CSD). Sixty-five consecutive patients who underwent preoperative CT and surgery for CSD were included. The diagnostic accuracy of CT and the concordance rate of the subtype classification of CSD were evaluated using surgical findings as the reference standard. Sixty-five patients without CSD who underwent cardiac valve surgery were used as a control group. An incremental value of CT over echocardiography was described retrospectively. Sensitivity and specificity of CT for diagnosis of CSD were 95 % and 100 %, respectively. The concordance rate of subtype classification was 91 % in CT and 92 % in echocardiography. The maximum size of the defect measured by CT correlated well with surgical measurement (r = 0.82), and the limit of agreement was -0.9 ± 7.42 mm. In comparison with echocardiography, CT was able to detect combined abnormalities in three cases, and exclusively provided correct subtype classification or clarified suspected abnormal findings found on echocardiography in seven cases. Cardiac CT can accurately demonstrates CSD in preoperative adult patients. CT may have an incremental role in preoperative planning, particularly in those with more complex anatomy. (orig.)

  14. Interventions for preoperative smoking cessation

    DEFF Research Database (Denmark)

    Møller, A; Villebro, N

    2005-01-01

    Smokers have a substantially increased risk of intra- and postoperative complications. Preoperative smoking intervention may be effective in decreasing this incidence. The preoperative period may be a well chosen time to offer smoking cessation interventions due to increased patient motivation....

  15. Clinico-statistical study of preoperative examination for the dental implant using multi-detector row computed tomography

    International Nuclear Information System (INIS)

    Sekiya, Keiko; Mori, Shintaro; Sekiya, Kotaro

    2008-01-01

    In April 2006, a new affiliated hospital opened at Nihon University School of Dentistry at Matsudo, and the latest model was introduced into the department of radiology. CT examinations for preoperative dental implant going on 64 multi-detector row CT, the number of cases has increased. CT examination is useful for preoperative dental implant, and many studies of concerning clinical studies using CT images have been reported. The purpose of this study was to the clinico-statistical studies of preoperative CT examinations for dental implant at our radiology department using 64 multi-detector row CT. The subjects consisted of 5174 regions in 1312 cases of preoperative CT examinations, between April 2006 and December 2007. CT machine used was the Aquilion TM 64 (Toshiba Medical Systems, Japan), and the workstation used was the ZIOSTATION (ZIOSOFT, Japan). All of CT examinations were performed the position of implant placement and disease examined from CT findings. The following results were obtained: The 1312 cases consisted of 426 males and 886 females. Patient age ranged from 16 yrs to 86 yrs old, the average age were 55.5 yrs old. Six hundred and seventy four cases were ordered at another private dental office not our hospital, and 638 cases were ordered at our hospital. The numbers of implant placement were on the average of 3.9, and the rate got higher with age. The lesions which detected by preoperative CT examination were maxillary sinusitis, periodontitis, ectopic calcification, and mucous retention cyst. (author)

  16. Clinical Utility of Preoperative Computed Tomography in Patients With Endometrial Cancer.

    Science.gov (United States)

    Bogani, Giorgio; Gostout, Bobbie S; Dowdy, Sean C; Multinu, Francesco; Casarin, Jvan; Cliby, William A; Frigerio, Luigi; Kim, Bohyun; Weaver, Amy L; Glaser, Gretchen E; Mariani, Andrea

    2017-10-01

    The aim of this study was to determine the clinical utility of routine preoperative pelvic and abdominal computed tomography (CT) examinations in patients with endometrial cancer (EC). We retrospectively reviewed records from patients with EC who underwent a preoperative endometrial biopsy and had surgery at our institution from January 1999 through December 2008. In the subset with an abdominal CT scan obtained within 3 months before surgery, we evaluated the clinical utility of the CT scan. Overall, 224 patients (18%) had a preoperative endometrial biopsy and an available CT scan. Gross intra-abdominal disease was observed in 10% and 20% of patients with preoperative diagnosis of endometrioid G3 and type II EC, respectively, whereas less than 5% of patients had a preoperative diagnosis of hyperplasia or low-grade EC. When examining retroperitoneal findings, we observed that a negative CT scan of the pelvis did not exclude the presence of pelvic node metastasis. Alternately, a negative CT scan in the para-aortic area generally reduced the probability of finding para-aortic dissemination but with an overall low sensitivity (42%). However, the sensitivity for para-aortic dissemination was as high as 67% in patients with G3 endometrioid cancer. In the case of negative para-aortic nodes in the CT scan, the risk of para-aortic node metastases decreased from 18.8% to 7.5% in patients with endometrioid G3 EC. Up to 15% of patients with endometrioid G3 cancer had clinically relevant incidental findings that necessitated medical or surgical intervention. In patients with endometrioid G3 and type II EC diagnosed by the preoperative biopsy, CT scans may help guide the operative plan by facilitating preoperative identification of gross intra-abdominal disease and enlarged positive para-aortic nodes that are not detectable during physical examinations. In addition, CT may reveal other clinically relevant incidental findings.

  17. Preoperative bone scans

    International Nuclear Information System (INIS)

    Charkes, N.D.; Malmud, L.S.; Caswell, T.; Goldman, L.; Hall, J.; Lauby, V.; Lightfoot, W.; Maier, W.; Rosemond, G.

    1975-01-01

    Strontium nitrate Sr-87m bone scans were made preoperatively in a group of women with suspected breast cancer, 35 of whom subsequently underwent radical mastectomy. In 3 of the 35 (9 percent), the scans were abnormal despite the absence of clinical or roentgenographic evidence of metastatic disease. All three patients had extensive axillary lymph node involvement by tumor, and went on to have additional bone metastases, from which one died. Roentgenograms failed to detect the metastases in all three. Occult bone metastases account in part for the failure of radical mastectomy to cure some patients with breast cancer. It is recommended that all candidates for radical mastectomy have a preoperative bone scan. (U.S.)

  18. Diagnostic yield of preoperative computed tomography imaging and the importance of a clinical decision for lung cancer surgery

    International Nuclear Information System (INIS)

    Sato, Shuichi; Koike, Teruaki; Yamato, Yasushi

    2010-01-01

    This study aimed to evaluate the diagnostic yield of preoperative computed tomography (CT) imaging and the validity of surgical intervention based on the clinical decision to perform surgery for lung cancer or suspected lung cancer. We retrospectively evaluated 1755 patients who had undergone pulmonary resection for lung cancer or suspected lung cancer. CT scans were performed on all patients. Surgical intervention to diagnose and treat was based on a medical staff conference evaluation for the suspected lung cancer patients who were pathologically undiagnosed. We evaluated the relation between resected specimens and preoperative CT imaging in detail. A total of 1289 patients were diagnosed with lung cancer by preoperative pathology examination; another 466 were not pathologically diagnosed preoperatively. Among the 1289 patients preoperatively diagnosed with lung cancer, the diagnoses were confirmed postoperatively in 1282. Among the 466 patients preoperatively undiagnosed, 435 were definitively diagnosed with lung cancer, and there were 383 p-stage I disease patients. There were 38 noncancerous patients who underwent surgery with a diagnosis of confirmed or suspected lung cancer. Among the 1755 patients who underwent surgery, 1717 were pathologically confirmed with lung cancer, and the diagnostic yield of preoperative CT imaging was 97.8%. Among the 466 patients who were preoperatively undiagnosed, 435 were compatible with the predicted findings of lung cancer. Diagnostic yields of preoperative CT imaging based on clinical evaluation are sufficiently reliable. Diagnostic surgical intervention was acceptable when the clinical probability of malignancy was high and the malignancy was pathologically undiagnosed. (author)

  19. Value of dual-phase 18F-FDG PET/CT in preoperative staging of bladder cancer%18F-FDG PET/CT双时相显像在膀胱癌术前分期中的临床价值

    Institute of Scientific and Technical Information of China (English)

    李洪生; 吴湖炳; 王巧愚; 韩彦江; 王全师

    2014-01-01

    目的:探讨18F-FDG PET/CT双时相显像在膀胱癌术前分期中的应用价值。方法2003年5月~2012年5月进行18F-FDG PET/CT检查的膀胱癌初诊患者73例,男54例,女19例,年龄58.7(41~80)岁。所有患者18F-FDG PET/CT常规全身显像后,口服40 mg呋塞米并多饮水,多次排尿,服呋塞米后约2 h憋尿充盈膀胱,再进行18F-FDG PET/CT盆腔延迟显像。所有患者于18F-FDG PET/CT检查后1周内进行手术治疗,将PET/CT与手术病理学检查结果进行对比分析,评价18F-FDG PET/CT双时相显像在膀胱癌术前分期中的应用价值。结果18F-FDG PET/CT双时相显像对膀胱癌原发灶的T分期与病理分期符合率为63.0%(46/73),其中pT4期膀胱癌的分期符合率为100%(7/7);另外检出75.0%(6/8)的淋巴结转移灶,100%(4/4)的远隔器官转移灶和100%(4/4)原发性第二种恶性肿瘤病灶。结论本研究结果表明18F-FDG PET/CT双时相显像在T分期方面,尽管对pTa、pT1、pT2、pT3期膀胱癌的T分期价值不大,但对pT4期膀胱癌的T分期可能有重要的应用价值;在膀胱癌的N分期、M分期及发现第二种原发癌方面也可能有重要的应用价值。%Objective To investigate the clinical value of dual-phase 18F-FDG PET/CT with oral diuretics in preoperative staging of bladder cancer. Methods The imaging data were analyzed of 73 patients with bladder cancer undergoing preoperative dual-phase 18F-FDG PET/CT with oral diuretic between May, 2003 and May, 2012. All the patients underwent whole-body PET/CT scan 60 min after intravenous injection of 270-350 MBq of 18F-FDG. Additional delayed pelvic PET/CT images were acquired after forced diuresis using oral furosemide (40 mg). All the patients underwent subsequent radical cystectomy, and 18F-FDG PET/CT findings were compared with the histopathologic results to evaluate the value of dual-phase 18F-FDG PET/CT in preoperative staging. Results The

  20. The role of high-resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) in the diagnosis of preoperative and postoperative complications caused by acquired cholesteatomas; CT und MRT des erworbenen Cholesteatoms: Prae- und postoperative Bildgebung

    Energy Technology Data Exchange (ETDEWEB)

    Krestan, C.; Czerny, C. [Abteilung fuer Osteologie, Univ.-Klinik fuer Radiodiagnostik, Wien (Austria); Gstoettner, W. [Univ.-Klinik fuer Hals-Nasen-Ohren-Heilkunde, Frankfurt (Germany); Franz, P. [Univ.-Klinik fuer Hals-Nasen-Ohren-Heilkunde, Wien (Austria)

    2003-03-01

    The role of high-resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) in the diagnosis of preoperative and postoperative complications caused by acquired cholesteatomas will be described in this paper. The pre- and postoperative imaging of the temporal bone was performed with HRCT and MRI. HRCT and MRI were performed in the axial and coronal plane. MRI was done with T2 weighted and T1 weighted sequences both before and after the intravenous application of contrast material. All imaging findings were confirmed clinically or surgically. The preoperative cholesteatoma-caused complications depicted by HRCT included bony erosions of the ossicles, scutum, facial canal in the middle ear, tympanic walls including the tegmen tympani, and of the labyrinth. The preoperative cholesteatoma-caused complications depicted by MRI included signs indicative for labyrinthitis, and brain abscess. Postoperative HRCT depicted bony erosions caused by recurrent cholesteatoma, bony defects of the facial nerve and of the labyrinth, and a defect of the tegmen tympani with a soft tissue mass in the middle ear. Postoperative MRI delineated neuritis of the facial nerve, labyrinthitis, and a meningo-encephalocele protruding into the middle ear. HRCT and MRI are excellent imaging tools to depict either bony or soft tissue complications or both if caused by acquired cholesteatomas. According to our findings and to the literature HRCT and MRI are complementary imaging methods to depict pre- or postoperative complications of acquired cholesteatomas if these are suspected by clinical examination. (orig.) [German] In dieser Arbeit wird die Rolle der hochaufloesenden Computertomographie (HRCT) und der Magnetresonanztomographie (MRT) zur Abklaerung prae- und postoperativ bedingter Komplikationen erworbener Cholesteatome beschrieben. Die Bildgebung wurde sowohl mit der HRCT als auch mit der MRT durchgefuehrt. Die HRCT und die MRT wurden in axialer und koronaler Ebene (auch

  1. Assessment of the usefulness of the standardized uptake values and the radioactivity levels for the preoperative diagnosis of thyroid cancer measured by using 18F-FDG PET/CT dual-time-point imaging

    Science.gov (United States)

    Lee, Hyeon-Guck; Hong, Seong-Jong; Cho, Jae-Hwan; Han, Man-Seok; Kim, Tae-Hyung; Lee, Ik-Han

    2013-02-01

    The purpose of this study was to assess and compare the changes in the SUV (standardized uptake value), the 18F-FDG (18F-fluorodeoxyglucose) uptake pattern, and the radioactivity level for the diagnosis of thyroid cancer via dual-time-point 18F-FDG PET/CT (positron emission tomographycomputed tomography) imaging. Moreover, the study aimed to verify the usefulness and significance of SUV values and radioactivity levels to discriminate tumor malignancy. A retrospective analysis was performed on 40 patients who received 18F-FDG PET/CT for thyroid cancer as a primary tumor. To set the background, we compared changes in values by calculating the dispersion of scattered rays in the neck area and the lung apex, and by comparing the mean and SD (standard deviation) values of the maxSUV and the radioactivity levels. According to the statistical analysis of the changes in 18F-FDG uptake for the diagnosis of thyroid cancer, a high similarity was observed with the coefficient of determination being R2 = 0.939, in the SUVs and the radioactivity levels. Moreover, similar results were observed in the assessment of tumor malignancy using dual-time-point. The quantitative analysis method for assessing tumor malignancy using radioactivity levels was neither specific nor discriminative compared to the semi-quantitative analysis method.

  2. Preoperative diagnosis of Amyand's hernia by ultrasound and computed tomography

    Directory of Open Access Journals (Sweden)

    Husam Vehbi

    2016-06-01

    Full Text Available Inguinal hernia is the most common seen groin hernias which mostly contain bowel. The incidence of vermiform appendix in an inguinal hernia is seen in 1% of all inguinal hernia. This is known as Amyand's hernia. Appendix within a hernia can be normal or complicated by appendicitis. Most of these cases are not diagnosed preoperatively and managed during surgery. Preoperative diagnosis of these cases is so rare. Very few cases have been reported so far.In our case, we diagnosed an inflamed appendix in a 49 years old female within right inguinal hernia by using ultrasound and confirmed it by CT scan. Keywords: Amyand's hernia, Appendicitis

  3. MR and CT for malignant hypernephromas

    International Nuclear Information System (INIS)

    Uhlenbrock, D.; Fischer, C.; Ruehl, G.; Beyer, H.K.; Hummelsheim, P.; Bochum Univ.; Marienhospital, Herne; Bochum Univ.

    1987-01-01

    Forty patients with histologically confirmed hypernephromas were examined by MR and CT. As regards T-staging, MR had an accuracy of 97 % and CT of 91%; for N-staging, MR had an accuracy of 85% and CT of 91% and, with regard to infiltration of the renal vein, MR was correct in 88% of cases and CT in 81%. MR was most accurate in the pre-operative assessment of tumour spread, demonstrating caval involvement in 100% and lymph node metastases in 97%. On the other hand, infiltration of the renal pelvis could be assessed in only 65% of cases; in 27% the assessment was not possible and in 8% one could not be certain. CT proved to be at its best for staging of lymph nodes, but in 15% it was not possible to identify infiltration of the renal vein. MR was not greatly superior to CT in the preoperative diagnosis and staging of hypernephromas. (orig.) [de

  4. The efficacy of preoperative positron emission tomography-computed tomography (PET-CT) for detection of lymph node metastasis in cervical and endometrial cancer: clinical and pathological factors influencing it.

    Science.gov (United States)

    Nogami, Yuya; Banno, Kouji; Irie, Haruko; Iida, Miho; Kisu, Iori; Masugi, Yohei; Tanaka, Kyoko; Tominaga, Eiichiro; Okuda, Shigeo; Murakami, Koji; Aoki, Daisuke

    2015-01-01

    We studied the diagnostic performance of (18)F-fluoro-2-deoxy-d-glucose-positron emission tomography/computed tomography in cervical and endometrial cancers with particular focus on lymph node metastases. Seventy patients with cervical cancer and 53 with endometrial cancer were imaged with (18)F-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography before lymphadenectomy. We evaluated the diagnostic performance of (18)F-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography using the final pathological diagnoses as the golden standard. We calculated the sensitivity, specificity, positive predictive value and negative predictive value of (18)F-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography. In cervical cancer, the results evaluated by cases were 33.3, 92.7, 55.6 and 83.6%, respectively. When evaluated by the area of lymph nodes, the results were 30.6, 98.9, 55.0 and 97.0%, respectively. As for endometrial cancer, the results evaluated by cases were 50.0, 93.9, 40.0 and 95.8%, and by area of lymph nodes, 45.0, 99.4, 64.3 and 98.5%, respectively. The limitation of the efficacy was found out by analyzing it by the region of the lymph node, the size of metastatic node, the historical type of tumor in cervical cancer and the prevalence of lymph node metastasis. The efficacy of positron emission tomography/computed tomography regarding the detection of lymph node metastasis in cervical and endometrial cancer is not established and has limitations associated with the region of the lymph node, the size of metastasis lesion in lymph node and the pathological type of primary tumor. The indication for the imaging and the interpretation of the results requires consideration for each case by the pretest probability based on the information obtained preoperatively. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. Single-Blinded Prospective Implementation of a Preoperative Imaging Checklist for Endoscopic Sinus Surgery.

    Science.gov (United States)

    Error, Marc; Ashby, Shaelene; Orlandi, Richard R; Alt, Jeremiah A

    2018-01-01

    Objective To determine if the introduction of a systematic preoperative sinus computed tomography (CT) checklist improves identification of critical anatomic variations in sinus anatomy among patients undergoing endoscopic sinus surgery. Study Design Single-blinded prospective cohort study. Setting Tertiary care hospital. Subjects and Methods Otolaryngology residents were asked to identify critical surgical sinus anatomy on preoperative CT scans before and after introduction of a systematic approach to reviewing sinus CT scans. The percentage of correctly identified structures was documented and compared with a 2-sample t test. Results A total of 57 scans were reviewed: 28 preimplementation and 29 postimplementation. Implementation of the sinus CT checklist improved identification of critical sinus anatomy from 24% to 84% correct ( P identification of sinus anatomic variants, including those not directly included in the systematic review implemented. Conclusion The implementation of a preoperative endoscopic sinus surgery radiographic checklist improves identification of critical anatomic sinus variations in a training population.

  6. Adopting preoperative fasting guidelines.

    Science.gov (United States)

    Anderson, Megan; Comrie, Rhonda

    2009-07-01

    In 1999, the American Society of Anesthesiologists adopted preoperative fasting guidelines to enhance the quality and efficiency of patient care. Guidelines suggest that healthy, non-pregnant patients should fast six hours from solids and two hours from liquids. Although these guidelines are in place, studies suggest that providers are still using the blanket statement "NPO after midnight" without regard to patient characteristics, the procedure, or the time of the procedure. Using theory to help change provider's beliefs may help make change more successful. Rogers' Theory of Diffusion of Innovations can assist in changing long-time practice by laying the groundwork for an analysis of the benefits and disadvantages of proposed changes, such as changes to fasting orders, while helping initiate local protocols instead of additional national guidelines.

  7. Clinical application of CT and CT-guided percutaneous transthoracic needle biopsy in patients with indeterminate pulmonary nodules

    Energy Technology Data Exchange (ETDEWEB)

    Cardoso, Luciana Vargas; Souza Júnior, Arthur Soares, E-mail: fabianonatividade@terra.com.br [Rio Preto-Ultra-X Radiological Diagnosis Institute, São José do Rio Preto, SP (Brazil)

    2014-07-15

    Objective: To investigate the clinical application of CT and CT-guided percutaneous transthoracic needle biopsy (CT-PTNB) in patients with indeterminate pulmonary nodules (IPNs). Methods: We retrospectively studied 113 patients with PNs undergoing CT and CT-PTNB. Variables such as gender, age at diagnosis, smoking status, CT findings, and CT-PTNB techniques were analyzed. Data analysis was performed with the Student's t-test for independent samples the chi-square test, and normal approximation test for comparison of two proportions. Results: Of the 113 patients studied, 68 (60.2%) were male and 78 (69%) were smokers. The diameter of malignant lesions ranged from 2.6 cm to 10.0 cm. Most of the IPNs (85%) were located in the peripheral region. The biopsied IPNs were found to be malignant in 88 patients (77.8%) and benign in 25 (22.2%). Adenocarcinoma was the most common malignant tumor, affecting older patients. The IPN diameter was significantly greater in patients with malignant PNs than in those with benign IPNs (p < 0.001). Having regular contour correlated significantly with an IPN being benign (p = 0.022), whereas spiculated IPNs and bosselated IPNs were more often malignant (in 50.7% and 28.7%, respectively). Homogeneous attenuation and necrosis were more common in patients with malignant lesions (51.9% and 26.9%, respectively). Conclusions: In our sample, CT and CT-PTNB were useful in distinguishing between malignant and benign IPNs. Advanced age and smoking were significantly associated with malignancy. Certain CT findings related to IPNs (larger diameter, spiculated borders, homogeneous attenuation, and necrosis) were associated with malignancy. (author)

  8. PENGARUH KEPUASAN KERJA DAN GAYA KEPEMIMPINAN TRANSFORMASIONAL TERHADAP ORGANIZATIONAL CITIZENSHIP BEHAVIOR PEGAWAI NEGERI SIPIL (PNS (Studi Pada Kantor Pertanahan Kabupaten Tanah Laut

    Directory of Open Access Journals (Sweden)

    Mahrita .

    2016-08-01

    Full Text Available This study aimed to analyze the effects of job satisfaction (X1 and Transformational Leadership Style (X2 as independent variables simultaneously and partially on Organizational Citizenship Behavior (Y as the dependent variable in the Civil Service, Tanah Laut District Land Office. This research method uses a questionnaire to 32 employees in Tanah Laut District Land Office as a sample. Sampling technique used is the Census. Using variable measurement technique Likert scale with a weight scale from 1 to 5. To analyze the influence of variables Job Satisfaction and Transformational Leadership Style on Organizational Citizenship Behavior (Y using a statistical technique of linear regression. The results showed that the variables job satisfaction and Transformational Leadership Style jointly significant effect on Organizational Citizenship Behavior PNS Tanah Laut District Land Office. Variables Job Satisfaction partially not significant effect on Organizational Citizenship Behavior PNS Tanah Laut District Land Office. Variable Transformational Leadership Style partially not significant effect on Organizational Citizenship Behavior PNS Tanah Laut District Land Office. Keywords: Job Satisfaction, and Transformational Leadership Style Organizational Citizenship Behavior

  9. Total Peroxy Nitrates (ΣPNs in the atmosphere: the Thermal Dissociation-Laser Induced Fluorescence (TD-LIF technique and comparisons to speciated PAN measurements

    Directory of Open Access Journals (Sweden)

    B. W. LaFranchi

    2010-05-01

    Full Text Available Peroxyacetyl nitrate (PAN and its chemical analogues are increasingly being quantified in the ambient atmosphere by thermal dissociation (TD followed by detection of either the peroxyacyl radical or the NO2 product. Here we present details of the technique developed at University of California, Berkeley which detects the sum of all peroxynitrates (ΣPNs via laser-induced fluorescence (LIF of the NO2 product. We review the various deployments and compare the Berkeley ΣPNs measurements with the sums of PAN and its homologue species detected individually by other instruments. The observed TD-LIF ΣPNs usually agree to within 10% with the summed individual species, thus arguing against the presence of significant concentrations of unmeasured PAN-type compounds in the atmosphere, as suggested by some photochemical mechanisms. Examples of poorer agreement are attributed to a sampling inlet design that is shown to be inappropriate for high NOx conditions. Interferences to the TD-LIF measurements are described along with strategies to minimize their effects.

  10. CT diagnosis of annular pancreas

    International Nuclear Information System (INIS)

    Ueno, Eiko; Isobe, Yoshinori; Niimi, Akiko; Shimizu, Yasushi; Yamada, Akiyoshi; Hanyu, Fujio

    1987-01-01

    CT scan was performed in two cases of annular pancreas which could be found in one case preoperatively and in the other case retrospectively. CT scan demonstrated secondary changes of annular pancreas such as medial displacement and dilatation of the duodenal bulb in the former case and stenosis of the duodenal loop and thickened soft tissue density around the narrow segment of the duodenal loop in the latter case, although it failed to demonstrate the peninsular protrusion of the parenchyma of the pancreas head. These findings suggest high possibility of diagnosing annular pancreas by CT scan. (author)

  11. The Incidence and Anatomy of Accessory Pudendal Arteries as Depicted on Multidetector-Row CT Angiography: Clinical Implications of Preoperative Evaluation for Laparoscopic and Robot-Assisted Radical Prostatectomy

    International Nuclear Information System (INIS)

    Park, Beom Jin; Sung, Deuk Jae; Kim, Min Ju; Cho, Sung Bum; Kim, Yun Hwan; Chung, Kyoo Byung; Kang, Seok Ho; Cheon, Jun

    2009-01-01

    To help preserve accessory pudendal arteries (APAs) and to ensure optimal postoperative sexual function after a laparoscopic or robot-assisted radical prostatectomy, we have evaluated the incidence of APAs as detected on multidetector-row CT (MDCT) angiography and have provided a detailed anatomical description. The distribution of APAs was evaluated in 121 consecutive male patients between February 2006 and July 2007 who underwent 64- channel MDCT angiography of the lower extremities. We defined an APA as any artery located within the periprostatic region running parallel to the dorsal vascular complex. We also subclassified APAs into lateral and apical APAs. Two radiologists retrospectively evaluated the origin, course and number of APAs; the final APA subclassification based on MDCT angiography source data was determined by consensus. We identified 44 APAs in 36 of 121 patients (30%). Two distinct varieties of APAs were identified. Thirty-three APAs (75%) coursed near the anterolateral region of the prostatic apex, termed apical APAs. The remaining 11 APAs (25%) coursed along the lateral aspect of the prostate, termed lateral APAs. All APAs originated from the internal obturator artery and iliac artery or a branch of the iliac artery such as the inferior vesical artery. The majority of apical APAs arose from the internal obturator artery (84%). Seven patients (19%) had multiple APAs. APAs are more frequently detected by the use of MDCT angiography than as suggested by previous surgical studies. The identification of APAs on MDCT angiography may provide useful information for the surgical preservation of APAs during a laparoscopic or robot-assisted radical prostatectomy

  12. Preoperative evaluation of locally spreaded pelvic tumors

    International Nuclear Information System (INIS)

    Baramia, M.; Todua, F.; Gotsadze, D.; Khutulashvili, N.; Lashkhi, K.; Nadareishvili, A.

    1998-01-01

    Am of the study: preoperative evaluation of patients with locally advanced pelvic tumors subjected to pelvic exenteration. Determine operability to avoid explorative laparatomies, which cause serious complications in these patients. Evaluate condition of urinary system in case of this pathology. Materials and methods: 34 patients with locally advanced pelvic tumors where pelvic exenteration was attempted were studied. Along with other methods of diagnostic CT and MRI were performed. Results: In all patients secondary involvement of the urinary bladder was noted. In 30 patients CT and MR findings were confirmed (88,2%) intraoperatively and different types of pelvic organs exenteration were performed. In 1 case spread of tomoruos infiltrate to the pelvic wall and common iliac vessels was detected intraoperatively (patient had history of radiation therapy). In 2 cases carcinomatosis of the peritoneum was found. In 1 case involvement of urinary bladder was simulated by close attachment of enlarged uterus. Conclusion: Obtained results show, that CT and MR are highly informative methods of disease spread evaluation and thus determining operability. Radiotherapy performed prior to operation sets difficulties in differentiation for tumourous infiltrate and post-radiotherapy changes in pelvis. (Full text)

  13. New concepts in preoperative imaging of anorectal malformation

    International Nuclear Information System (INIS)

    Taccone, A.; Delliacqua, A.; Marzoli, A.; Martucciello, G.; Jasonni, V.; Dodero, P.; Salomone, G.

    1992-01-01

    In this study of 14 patients with anorectal anomalies CT and MRI were employed for preoperative assessment. The use of a pressure enhanced water soluble enema via the colostomy proved to be an extremely efficient method for showing a fistula. MRI studies were enhanced by the use of vaseline oil and in one case this technique was used prior to surgery to provide important information by injecting through a perineal fistula. CT and axial MRI proved to be more valuable than sagittal MRI which is only useful for the length of the atretic segment. The authors consider that a combined approach using pressure enhanced water soluble enema and MRI will provide the most valuable preoperative information to plan a successful operative approach and enable an accurate prognostic evaluation of continence in these difficult and complex patients. (orig.)

  14. Clinical target volume for rectal cancer. Preoperative radiotherapy

    International Nuclear Information System (INIS)

    Lorchel, F.; Bossel, J.F.; Baron, M.H.; Goubard, O.; Bartholomot, B.; Mantion, G.; Pelissier, E.P.; Maingon, P.

    2001-01-01

    The total meso-rectal excision allows the marked increase of the local control rate in rectal cancer. Therefore, the meso-rectal space is the usual field for the spread of rectal cancer cells. It could therefore be considered as the clinical target volume in the preoperative plan by the radiation oncologist. We propose to identify the mesorectum on anatomical structures of a treatment-position CT scan. (authors)

  15. Torsion of the greater omentum: A rare preoperative diagnosis

    International Nuclear Information System (INIS)

    Tandon, Ankit Anil; Lim, Kian Soon

    2010-01-01

    Torsion of the greater omentum is a rare acute abdominal condition that is seldom diagnosed preoperatively. We report the characteristic computed tomography (CT) scan findings and the clinical implications of this unusual diagnosis in a 41-year-old man, who also had longstanding right inguinal hernia. Awareness of omental torsion as a differential diagnosis in the acute abdomen setting is necessary for correct patient management

  16. The ultrastructure of tumor cells in patients with rectal cancer after pre-operative irradiation and intra-operative cryotherapy

    International Nuclear Information System (INIS)

    Vyinnik, Yu.O.; Kotenko, O.Je.; Nevzorov, V.P.; Chyibyisov, L.P.

    2000-01-01

    Electronic microscopy of the tumor cells was performed to confirm the efficacy of combined pre-operative gamma-therapy and intraoperative cryotherapy (CT). Pre-operative irradiation at the dose of 20 Gy accompanied by intra-operative cryotherapy caused the changes in the ultrastructure, the depth and degree of which allow to consider them destructive and irreversible

  17. Target volume delineation in external beam partial breast irradiation: Less inter-observer variation with preoperative- compared to postoperative delineation

    International Nuclear Information System (INIS)

    Leij, Femke van der; Elkhuizen, Paula H.M.; Janssen, Tomas M.; Poortmans, Philip; Sangen, Maurice van der; Scholten, Astrid N.; Vliet-Vroegindeweij, Corine van; Boersma, Liesbeth J.

    2014-01-01

    The challenge of adequate target volume definition in external beam partial breast irradiation (PBI) could be overcome with preoperative irradiation, due to less inter-observer variation. We compared the target volume delineation for external beam PBI on preoperative versus postoperative CT scans of twenty-four breast cancer patients

  18. Target volume delineation in external beam partial breast irradiation: less inter-observer variation with preoperative- compared to postoperative delineation

    NARCIS (Netherlands)

    Leij, F. van der; Elkhuizen, P.H.M.; Janssen, T.M.; Poortmans, P.M.P.; Sangen, M. van der; Scholten, A.N.; Vliet-Vroegindeweij, C. van; Boersma, L.J.

    2014-01-01

    The challenge of adequate target volume definition in external beam partial breast irradiation (PBI) could be overcome with preoperative irradiation, due to less inter-observer variation. We compared the target volume delineation for external beam PBI on preoperative versus postoperative CT scans of

  19. Preoperative chemoradiation therapy for advanced rectal cancer

    International Nuclear Information System (INIS)

    Tsujinaka, Toshimasa; Murotani, Masahiro; Iihara, Keisuke

    1997-01-01

    Preoperative concurrent chemoradiation therapy with 5-fluorouracil and cisplatin was applied for advanced rectal cancer. Eligible criteria were as follows: no previous treatment, more than hemicircular occupation, T 3 or more, invasion to adjacent organs or lymph node metastasis on CT scan, tumor fixation by digital examination. Eleven patients were enrolled with this regimen consisting of 5-FU; 500 mg/day x 5/w x 4, CDDP; 10 mg/day x 5/w x 4 and radiation; 2 Gy x 5/w x 4. As a toxicity, grade 2 leukopenia in 2 cases, grade 2 GI symptoms in one case and radiation dermatitis was observed in 8 cases. As a local response, there were PR in 10 cases and NC in 1 case. Surgical resection was performed on 8 patients. Histological responses in the resected specimens were grade 2, 5 cases; grade 1b, 1 case; and grade 1a, 2 cases. Operative radicalities were grade A, 3 cases; grade B, 3 cases; and grade C, 2 cases. Preoperative chemoradiation is one of the effective options in multimodal treatment for advanced rectal cancer. (author)

  20. Medial depression with bony dehiscence of lamina papyracea as an anatomic variation: CT evaluation

    International Nuclear Information System (INIS)

    Na, Sun Young; Lee, Young Uk; Youn, Eun Kyung; Suh, Sang Gyung; Kim, Dong Hyun

    1994-01-01

    To evaluate the incidence and CT findings of the medial depression and bony dehiscence of lamina papyracea as an anatomic variation. 1472 PNS CTs of the patients with symptoms of chronic sinusitis were retrospectively evaluated. The total incidence of depressed lamina papyracea as an anatomic variation was 3.5%(52/1472) on PNS CT. There was a statistically significant correlation between the increasing age and the incidence of depressed lamina papyracea. Depression of lamina papyracea anterior to the basal lamella were more common than those of the posterior depression. Associated findings were herniation of adjacent fatty tissue in all cases and the medial bowing and hypertrophied configuration of the medial rectus muscle without significant herniation in 19 cases(34%). Nontraumatic, asymptomatic depression with bony dehiscence of lamina papyracea as an anatomic variation is not uncommon with the incidence of 3.5%. Recognition of its existence and degree may be helpful in avoiding various ocular complication during ethmoid surgery

  1. Preoperative diagnosis of lymph node metastasis in thoracic esophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Eguchi, Reiki; Yamada, Akiyoshi; Ueno, Keiko; Murata, Yoko [Tokyo Women`s Medical Coll. (Japan)

    1996-10-01

    From 1994 to 1995, to evaluate the utility of preoperative CT, EUS (endoscopic ultrasonography) and US in the diagnosis of lymph node metastasis in thoracic esophageal cancer, 94 patients with thoracic esophageal cancer who underwent esophagectomy were studied clinicopathologically. The sensitivity of EUS diagnosis of upper mediastinal lymph node metastasis (85%), left-sided paragastrin lymph node metastasis (73-77%), and especially lower paraesophageal lymph node metastasis (100%) were good. But due to their low-grade specificity in EUS diagnosis, their overall accuracy was not very good. On the other hand, the overall accuracy of the CT diagnosis of lymph node metastasis was fine. However, sensitivity, the most important clinical factor in the CT diagnosis of lymph node metastasis was considerably inferior to EUS. The assessment of the diagnosis of lymph node metastasis around the tracheal bifurcation and the pulmonary hilum and the left para-cardial lesion by CT or EUS was poor. It was concluded that lymph node metastasis of these area must be the pitfall in preoperative diagnosis. The average diameter of the lymph nodes and the proportion of cancerous tissue in the lymph nodes diagnosed as metastatic lymph nodes by CT was larger than that of the false negative lymph nodes. However, the lymph nodes diagnosed as true positives by EUS showed no such tendency. This must be the reason the sensitivity of the EUS diagnosis and specificity of the CT diagnosis were favorable, but the specificity of the EUS diagnosis and especially the sensitivity of the CT diagnosis were not as good. (author)

  2. Preoperative diagnosis of lymph node metastasis in thoracic esophageal cancer

    International Nuclear Information System (INIS)

    Eguchi, Reiki; Yamada, Akiyoshi; Ueno, Keiko; Murata, Yoko

    1996-01-01

    From 1994 to 1995, to evaluate the utility of preoperative CT, EUS (endoscopic ultrasonography) and US in the diagnosis of lymph node metastasis in thoracic esophageal cancer, 94 patients with thoracic esophageal cancer who underwent esophagectomy were studied clinicopathologically. The sensitivity of EUS diagnosis of upper mediastinal lymph node metastasis (85%), left-sided paragastrin lymph node metastasis (73-77%), and especially lower paraesophageal lymph node metastasis (100%) were good. But due to their low-grade specificity in EUS diagnosis, their overall accuracy was not very good. On the other hand, the overall accuracy of the CT diagnosis of lymph node metastasis was fine. However, sensitivity, the most important clinical factor in the CT diagnosis of lymph node metastasis was considerably inferior to EUS. The assessment of the diagnosis of lymph node metastasis around the tracheal bifurcation and the pulmonary hilum and the left para-cardial lesion by CT or EUS was poor. It was concluded that lymph node metastasis of these area must be the pitfall in preoperative diagnosis. The average diameter of the lymph nodes and the proportion of cancerous tissue in the lymph nodes diagnosed as metastatic lymph nodes by CT was larger than that of the false negative lymph nodes. However, the lymph nodes diagnosed as true positives by EUS showed no such tendency. This must be the reason the sensitivity of the EUS diagnosis and specificity of the CT diagnosis were favorable, but the specificity of the EUS diagnosis and especially the sensitivity of the CT diagnosis were not as good. (author)

  3. Collision broadening and shift of the potassium 4p-ns and 4p-nd lines by argon

    International Nuclear Information System (INIS)

    Hohimer, J.P.; Gee, J.

    1982-01-01

    A two-step laser excitation technique was used to investigate the collisional broadening and shift of excited-state potassium transitions. Measurements were also made to determine that the broadening and shift constants were unaffected by optical pumping and saturation effects. Values for the argon collisional-broadening and shift constants for the potassium 4p-ns (n = 8--11) and 4p-nd (n = 6--9) transitions were determined from line-shape measurements. The values of these constants (in units of 10 -9 rad s -1 atom -1 cm 3 at 110 0 C) and their one-sigma statistical uncertainties are (4P/sub 1/2/-8S/sub 1/2/): γ = 17.03 +- 0.15, β = -14.58 +- 0.29; (4P/sub 3/2/-8S/sub 1/2/): γ = 17.45 +- 0.24, β = -14.71 +- 0.30; (4P/sub 1/2/-9S/sub 1/2/): γ = 17.29 +- 0.15, β = -24.16 +- 0.15; (4P/sub 3/2/-9S/sub 1/2/): γ = 17.35 +- 0.12, β = -24.16 +- 0.09; (4P/sub 1/2/-10S/sub 1/2/): γ = 15.62 +- 0.07, β = -29.49 +- 0.22; (4P/sub 3/2/-10S/sub 1/2/): γ = 15.80 +- 0.11, β = -29.86 +- 0.27; (4P/sub 1/2/-11S/sub 1/2/): γ = 12.69 +- 0.09, β = -33.66 +- 0.11; (4P/sub 3/2/-11S/sub 1/2/): γ = 12.85 +- 0.17, β = -35.10 +- 0.23; (4P/sub 1/2/-6D/sub 3/2/): γ = 13.75 +- 0.27, β = -8.28 +- 0.16; (4P/sub 3/2/-6D/sub 5/2/): γ = 15.15 +- 0.41, β = -8.96 +- 0.10; (4P/sub 1/2/-7D/sub 3/2/): γ = 18.60 +- 0.21, β = -16.00 +- 0.18; (4P/sub 3/2/-7D/sub 5/2/): γ = 19.64 +- 0.25, β = -15.16 +- 0.21; (4P/sub 1/2/-8D/sub 3/2/): γ = 19.94 +- 0.09, β = -24.14 +- 0.22; (4P/sub 3/2/-8D/sub 5/2/): γ = 19.80 +- 0.06, β = -24.16 +- 0.18; (4P/sub 1/2/-9D/sub 3/2/): γ = 17.40 +- 0.13, β = -30.17 +- 0.28; (4P/sub 3/2/-9D/sub 5/2/): γ = 17.50 +- 0.27, β = -29.47 +- 0.12. The overall accuracy of these measurements is estimated to be about 5%

  4. CT diagnosis of rectal cancer

    International Nuclear Information System (INIS)

    Kanda, Hiroshi; Hachisuka, Kitao; Yamaguchi, Akihiro

    1986-01-01

    Preoperative diagnosis of the depth of invasion and lymph node metastasis of rectal cancer were studied using the findings of computed tomography (CT). Of one hundred and four cases operated on for rectal cancer over a period of 32 months, thirty five cases were examined by CT with the use of olive oil enema and contrast enhancement using a 60 % Conray drip infusion with reference to the histological findings. For direct invasion into the wall, the diagnoses by CT were coincident with microscopic findings in 75 % of cancers of the rectosigmoid, in 75 % of the upper rectum and in 84 % of the lower rectum. Of all cases, 28 (80 %) were diagnosed correctly. As to local lymph node metastasis, 74 % of all diagnoses by CT corresponded with the histological diagnosis. Moreover, seventeen cases were evaluated for lateral lymph node metastasis, and the diagnostic accuracy by CT was 88 %. In conclusion, preoperative CT evaluation of the extension into the rectal wall and lymph node metastasis in rectal cancer was considesed useful. (author)

  5. Preoperative alcoholism and postoperative morbidity

    DEFF Research Database (Denmark)

    Tonnesen, H; Kehlet, H

    1999-01-01

    BACKGROUND: Preoperative risk assessment has become part of daily clinical practice, but preoperative alcohol abuse has not received much attention. METHODS: A Medline search was carried out to identify original papers published from 1967 to 1998. Relevant articles on postoperative morbidity...... in alcohol abusers were used to evaluate the evidence. RESULTS: Prospective and retrospective studies demonstrate a twofold to threefold increase in postoperative morbidity in alcohol abusers, the most frequent complications being infections, bleeding and cardiopulmonary insufficiency. Wound complications...... to postoperative morbidity. CONCLUSION: Alcohol consumption should be included in the preoperative assessment of likely postoperative outcome. Reduction of postoperative morbidity in alcohol abusers may include preoperative alcohol abstinence to improve organ function, or perioperative alcohol administration...

  6. Medulloblastoma in children: CT and MRI findings

    International Nuclear Information System (INIS)

    Tortori-Donati, P.; Fondelli, M.P.; Rossi, A.; Cama, A.; Caputo, L.; Andreussi, L.; Garre, M.L.

    1996-01-01

    Our purpose was to determine whether medulloblastoma (MB) shows specific neuroradiological features which may be employed in differential diagnosis from other common posterior cranial fossa tumours in childhood. Preoperative MRI was performed on 20 children with MB, and preoperative CT in 17 of them. All underwent surgery and histopathological diagnosis. There was a constant relationship between high density on CT and low signal on T1-weighted images. Signal behaviour on T2-weighted images and the degree of contrast enhancement were more variable. Most tumours arose in the midline, from the cerebellar vermis, involving the fourth ventricle, but hemisphere and extra-axial neoplasms were also seen. The combination of high density on CT and low signal on T1-weighted images is highly suggestive of MB and may assist preoperative differential diagnosis from other posterior cranial fossa tumours. (orig.). With 9 figs., 2 tabs

  7. An analysis of preoperative localization of parathyroid glands in hyperparathyroidism associated with thyroid diseases

    International Nuclear Information System (INIS)

    Komatsu, Makoto; Inoue, Kazuaki; Itoh, Atsuko.

    1996-01-01

    Recently hyperparathyroidism associated with some thyroid diseases, especially nonmedually thyroid carcinoma has been payed attention to. In this study we analyzed 12 cases of hyperparathyroidism (6 cases independent of thyroid diseases and 6 cases associated with thyroid diseases) and estimated the affect of association with thyroid diseases on the preoperative localization of the parathyroid glands. The results of preoperative localization of the parathyroid glands in cases independent of thyroid diseases were relatively satisfactory. On the other hand, the preoperative localization in cases associated with thyroid diseases came to false result in about half of them. It was far from satisfactory. Association of thyroid diseases strongly affected the preoperative localization of the parathyroid glands in hyperparathyroidism. Conventional imaging such as ultrasonography, CT, MRI and 201 Tl- 99m TC subtraction scintigraphy alone were not satisfactory. Now 99m Tc-MIBI scintigraphy is expected to be one of reliable imaging methods for progress in the preoperative localization. (author)

  8. Preoperative localization strategies for primary hyperparathyroidism: an economic analysis.

    Science.gov (United States)

    Lubitz, Carrie C; Stephen, Antonia E; Hodin, Richard A; Pandharipande, Pari

    2012-12-01

    Strategies for localizing parathyroid pathology preoperatively vary in cost and accuracy. Our purpose was to compute and compare comprehensive costs associated with common localization strategies. A decision-analytic model was developed to evaluate comprehensive, short-term costs of parathyroid localization strategies for patients with primary hyperparathyroidism. Eight strategies were compared. Probabilities of accurate localization were extracted from the literature, and costs associated with each strategy were based on 2011 Medicare reimbursement schedules. Differential cost considerations included outpatient versus inpatient surgeries, operative time, and costs of imaging. Sensitivity analyses were performed to determine effects of variability in key model parameters upon model results. Ultrasound (US) followed by 4D-CT was the least expensive strategy ($5,901), followed by US alone ($6,028), and 4D-CT alone ($6,110). Strategies including sestamibi (SM) were more expensive, with associated expenditures of up to $6,329 for contemporaneous US and SM. Four-gland, bilateral neck exploration (BNE) was the most expensive strategy ($6,824). Differences in cost were dependent upon differences in the sensitivity of each strategy for detecting single-gland disease, which determined the proportion of patients able to undergo outpatient minimally invasive parathyroidectomy. In sensitivity analysis, US alone was preferred over US followed by 4D-CT only when both the sensitivity of US alone for detecting an adenoma was ≥ 94 %, and the sensitivity of 4D-CT following negative US was ≤ 39 %. 4D-CT alone was the least costly strategy when US sensitivity was ≤ 31 %. Among commonly used strategies for preoperative localization of parathyroid pathology, US followed by selective 4D-CT is the least expensive.

  9. Utility of 16-multidetector CT angiography in the preoperative ...

    African Journals Online (AJOL)

    shanker

    b Department of Radiology, Faculty of Medicine, Alexandria University, Egypt c Department of ... We reported the number and origin of renal arteries and the presence of early branching arteries. Renal venous ... Seven small accessory renal arteries in seven donors were missed by radiology reviewers. Early branching.

  10. Brain tumor and CT, 1. Relationship between the consistency of a brain tumor and the CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, N.; Katada, K.; Shinomiya, Y.; Sano, H.; Kanno, T. (Fujita Gakuen Univ., School of Medicine, Toyoake, Aichi (Japan))

    1981-08-01

    It is very important for a neurosurgeon to know the consistency of a brain tumor preoperatively, since the information is of much use in indicating the likely difficulty of the operation, which operative tools should be selected, the amount of bleeding to be expected from the tumor, and so on. The authors, therefore, tried to evaluate the consistency of brain tumors preoperatively. Twenty-seven cases in which the margin of the tumor was made clear with a homogeneous stain were studied concerning the relationship between the tumor consistency and the CT findings. The results are as follows: 1) A higher CT number on a plain CT indicated a harder consistency of the tumor. 2) A lesser contrast index (CT number on enhancement CT/CT number on plain CT) showed a harder consistency of the tumor.

  11. Preoperative localization of endocrine pancreatic tumours by intra-arterial dynamic computed tomography

    International Nuclear Information System (INIS)

    Ahlstroem, H.; Magnusson, A.; Grama, D.; Eriksson, B.; Oeberg, K.; Loerelius, L.E.; Akademiska Sjukhuset, Uppsala; Akademiska Sjukhuset, Uppsala

    1990-01-01

    Eleven patients with biochemically confirmed endocrine pancreatic tumours were examined with intra-arterial (i.a.) dynamic computed tomography (CT) and angiography preoperatively. Seven of the patients suffered from the multiple endocrine neoplasia type 1 (MEN-1) syndrome. All patients were operated upon and surgical palpation and ultrasound were the peroperative localization methods. Of the 33 tumours which were found at histopathologic analysis of the resected specimens in the 11 patients, 7 tumours in 7 patients were correctly localized by both i.a. dynamic CT and angiography. Six patients with MEN-1 syndrome had multiple tumours and this group of patients together had 28 tumours, of which 5 (18%) were localized preoperatively by both CT and angiography. I.a. dynamic CT, with the technique used by us, does not seem to improve the localization of endocrine pancreatic tumours, especially in the rare group of MEN-1 patients, as compared with angiography. (orig.)

  12. Interventions for preoperative smoking cessation

    DEFF Research Database (Denmark)

    Thomsen, Thordis; Villebro, Nete; Møller, Ann Merete

    2014-01-01

    BACKGROUND: Smokers have a substantially increased risk of postoperative complications. Preoperative smoking intervention may be effective in decreasing this incidence, and surgery may constitute a unique opportunity for smoking cessation interventions. OBJECTIVES: The objectives of this review...... are to assess the effect of preoperative smoking intervention on smoking cessation at the time of surgery and 12 months postoperatively, and on the incidence of postoperative complications. SEARCH METHODS: We searched the Cochrane Tobacco Addiction Group Specialized Register in January 2014. SELECTION CRITERIA......: Randomized controlled trials that recruited people who smoked prior to surgery, offered a smoking cessation intervention, and measured preoperative and long-term abstinence from smoking or the incidence of postoperative complications or both outcomes. DATA COLLECTION AND ANALYSIS: The review authors...

  13. Preoperative staging of rectal cancer.

    Science.gov (United States)

    Smith, Neil; Brown, Gina

    2008-01-01

    Detailed preoperative staging using high resolution magnetic resonance imaging (MRI) enables the selection of patients that require preoperative therapy for tumour regression. This information can be used to instigate neoadjuvant therapy in those patients with poor prognostic features prior to disturbing the tumour bed and potentially disseminating disease. The design of trials incorporating MR assessment of prognostic factors prior to therapy has been found to be of value in assessing treatment modalities and outcomes that are targeted to these preoperative prognostic subgroups and in providing a quantifiable assessment of the efficacy of particular chemoradiation treatment protocols by comparing pre-treatment MR staging with post therapy histology assessment. At present, we are focused on achieving clear surgical margins of excision (CRM) to avoid local recurrence. We recommend that all patients with rectal cancer should undergo pre-operative MRI staging. Of these, about half will have good prognosis features (T1-T3b, N0, EMVI negative, CRM clear) and may safely undergo primary total mesorectal excision. Of the remainder, those with threatened or involved margins will certainly benefit from pre-operative chemoradiotherapy with the aim of downstaging to permit safe surgical excision. In the future, our ability to recognise features predicting distant failure, such as extramural vascular invasion (EMVI) may be used to stratify patients for neo-adjuvant systemic chemotherapy in an effort to prevent distant relapse. The optimal pre-operative treatment regimes for these patients (radiotherapy alone, systemic chemotherapy alone or combination chemo-radiotherapy) is the subject of current and future trials.

  14. Clinical application of preoperative endovascular management for jugular paraganglioma

    International Nuclear Information System (INIS)

    Yu Juming; Fan Guoping; Zhong Weixing; Zhang Yongping; Peng Haiteng; Cheng Yongde

    2009-01-01

    Objective: To investigate the clinical value of preoperative angiography and embolization managements for jugular paraganglioma. Methods: Fourteen patients with jugular paraganglioma were carefully evaluated with CT, MRI and clinical ENT exams. Bilateral carotid and affected-side vertebral angiography together with embolization of the feeding arteries and tumor nidi were performed in all 14 patients before surgery. Internal carotid artery balloon occlusive test was employed to check the function of Willis' circle in 7 patients. The tumors were excised within 48 hours after embolization. Results: Preoperative angiographic and embolization procedures of jugular paraganglioma were successfully accomplished in all patients. The mean blood loss during the surgery was obviously less than usual. Of seven cases who passed the internal carotid artery balloon occlusive test,carotid artery ligation was adopted in 3. No new symptoms and signs of nervous system developed after the surgery and during the follow-up period. Conclusion: The angiography and embolization of feeding-arteries and tumor nidi, and the preoperative balloon occlusive test of carotid artery performed before the surgery of jugular paraganglioma are safe and reliable, which can be regarded as a routine preoperative preparation. (authors)

  15. Patterns of Response After Preoperative Treatment in Gastric Cancer

    International Nuclear Information System (INIS)

    Diaz-Gonzalez, Juan A.; Rodriguez, Javier; Hernandez-Lizoain, Jose L.; Ciervide, Raquel; Gaztanaga, Miren; San Miguel, Inigo; Arbea, Leire; Aristu, J. Javier; Chopitea, Ana; Martinez-Regueira, Fernando; Valenti, Victor; Garcia-Foncillas, Jesus; Martinez-Monge, Rafael; Sola, Jesus J.

    2011-01-01

    Purpose: To analyze the rate of pathologic response in patients with locally advanced gastric cancer treated with preoperative chemotherapy with and without chemoradiation at our institution. Methods and Materials: From 2000 to 2007 patients were retrospectively identified who received preoperative treatment for gastric cancer (cT3-4/ N+) with induction chemotherapy (Ch) or with Ch followed by concurrent chemoradiotherapy (45 Gy in 5 weeks) (ChRT). Surgery was planned 4-6 weeks after the completion of neoadjuvant treatment. Pathologic assessment was used to investigate the patterns of pathologic response after neoadjuvant treatment. Results: Sixty-one patients were analyzed. Of 61 patients, 58 (95%) underwent surgery. The R0 resection rate was 87%. Pathologic complete response was achieved in 12% of the patients. A major pathologic response (<10% of residual tumor) was observed in 53% of patients, and T downstaging was observed in 75%. Median follow-up was 38.7 months. Median disease-free survival (DFS) was 36.5 months. The only patient-, tumor-, and treatment-related factor associated with pathologic response was the use of preoperative ChRT. Patients achieving major pathologic response had a 3-year actuarial DFS rate of 63%. Conclusions: The patterns of pathologic response after preoperative ChRT suggest encouraging intervals of DFS. Such a strategy may be of interest to be explored in gastric cancer.

  16. Preoperative radiotherapy of maxillary sinus cancer

    International Nuclear Information System (INIS)

    Kim, Jae Chul; Park, In Kyu

    1998-01-01

    This study was to evaluate the effectiveness of preoperative radiotherapy in maxillary sinus cancer. A retrospective analysis was done for 42 patients with maxillary sinus cancer who were treated with radiation with or without surgery from April 1986 to September 1996. There were 27 male and 15 female patients. Patients' age ranged from 24 to 75 years (median 56 years). Stage distribution showed 2 in T2, 19 in T3, and 21 in T4 lesions. The histologic type was squamous cell carcinoma in 38, undifferentiated carcinoma in 1, transitional cell carcinoma in 1, and adenoid cystic carcinoma in 2 patients, All patients were treated with radiation initially with a dosage range of 50.4-70.2 Gy (median 70.2 Gy) before further evaluation of remnant disease. Eleven patients were given induction chemotherapy (2 cycles of 5-fluorouracil and cisplatin) concurrently with radiotherapy. Six to eight weeks after radiotherapy with or without chemotherapy, computerized tomography (CT) of paranasal sinus was taken to evaluate remnant disease. If the CT finding showed remnant disease, a Caldwell-Luc procedure was done to get the specimen of suspicious lesions. A radical maxillectomy was done if the specimen was proven to contain malignancy. In contrast periodic follow-up examination was done without any radical surgery if the tissue showed only granulation tissue. Follow-up period ranged from 3 to 92 months with a median 16 months. Nine (21.4%) patients showed complete response (CR) and 33 patients (78.6%) showed persistent disease (PER) to initial radiotherapy. Among the 9 CR patients, 7 patients had no evidence of disease (NED), 1 patient had local failure, and 1 patient had regional failure. Among 33 PER patients, salvage total maxillectomy was done in 10 patients, and the surgery was not feasible or refused in 23 patients. Following the salvage radical surgery, 2 patients were NED and 8 patients were PER status. Overall and disease- free survival rate at 5 years was 23.1% and 16

  17. Preoperative radiotherapy of maxillary sinus cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Chul; Park, In Kyu [College of Medicine, Kyungpook National Univ., Taegu (Korea, Republic of)

    1998-09-01

    This study was to evaluate the effectiveness of preoperative radiotherapy in maxillary sinus cancer. A retrospective analysis was done for 42 patients with maxillary sinus cancer who were treated with radiation with or without surgery from April 1986 to September 1996. There were 27 male and 15 female patients. Patients' age ranged from 24 to 75 years (median 56 years). Stage distribution showed 2 in T2, 19 in T3, and 21 in T4 lesions. The histologic type was squamous cell carcinoma in 38, undifferentiated carcinoma in 1, transitional cell carcinoma in 1, and adenoid cystic carcinoma in 2 patients, All patients were treated with radiation initially with a dosage range of 50.4-70.2 Gy (median 70.2 Gy) before further evaluation of remnant disease. Eleven patients were given induction chemotherapy (2 cycles of 5-fluorouracil and cisplatin) concurrently with radiotherapy. Six to eight weeks after radiotherapy with or without chemotherapy, computerized tomography (CT) of paranasal sinus was taken to evaluate remnant disease. If the CT finding showed remnant disease, a Caldwell-Luc procedure was done to get the specimen of suspicious lesions. A radical maxillectomy was done if the specimen was proven to contain malignancy. In contrast periodic follow-up examination was done without any radical surgery if the tissue showed only granulation tissue. Follow-up period ranged from 3 to 92 months with a median 16 months. Nine (21.4%) patients showed complete response (CR) and 33 patients (78.6%) showed persistent disease (PER) to initial radiotherapy. Among the 9 CR patients, 7 patients had no evidence of disease (NED), 1 patient had local failure, and 1 patient had regional failure. Among 33 PER patients, salvage total maxillectomy was done in 10 patients, and the surgery was not feasible or refused in 23 patients. Following the salvage radical surgery, 2 patients were NED and 8 patients were PER status. Overall and disease- free survival rate at 5 years was 23.1% and 16

  18. Preoperative fasting: a clinical audit.

    Science.gov (United States)

    Roberts, Stuart

    2013-01-01

    This clinical audit examines the adherence to guidelines suggested by the Royal College of Nursing (2005); the results uphold previous studies of a preoperative starving period for patients undergoing elective surgical procedures. Patients excessively starved of food or fluids report problems relating to their health. These include hunger, distress and complaints of nausea.

  19. Detection of underlying malignancy in patients with paraneoplastic neurological syndromes: comparison of {sup 18}F-FDG PET/CT and contrast-enhanced CT

    Energy Technology Data Exchange (ETDEWEB)

    Schramm, N.; Schmid-Tannwald, C.; Meinel, F.G.; Reiser, M.F.; Rist, C. [Ludwig-Maximilians-University Hospital Munich, Institute for Clinical Radiology, Munich (Germany); Rominger, A. [Ludwig-Maximilians-University Hospital Munich, Department of Nuclear Medicine, Munich (Germany); Schmidt, C. [Ludwig-Maximilians-University Hospital Munich, Department of Neurology, Munich (Germany); Morelli, J.N. [Texas A and M Health Sciences Center, Department of Radiology, Temple, TX (United States)

    2013-07-15

    To determine the value of combined {sup 18}F-FDG PET/CT with diagnostic contrast-enhanced CT (CECT) in detecting primary malignancies and metastases in patients with paraneoplastic neurological syndromes (PNS) and to compare this with CECT alone. PET/CT scans from 66 patients with PNS were retrospectively evaluated. Two blinded readers initially reviewed the CECT portion of each PET/CT scan. In a second session 3 months later, the readers analysed the combined PET/CT scans. Findings on each study were assessed using a four-point-scale (1 normal/benign; 2 inconclusive, further diagnostic work-up may be necessary; 3 malignant; 4 inflammatory). Sensitivity and specificity for malignant findings were calculated for PET/CT and CECT. Interreader agreement was determined by calculating Cohen's kappa. Pooled data from clinical follow-up (including histopathology and follow-up imaging, median follow-up 20.0 months) served as the reference gold standard. Both readers classified 12 findings in ten patients (15 %) as malignant on the PET/CT scans (two patients had two primary tumours). One such imaging finding (suspected thymic cancer) was false-positive (i.e. benign histology). The most common tumours were bronchial carcinoma (n = 3), lymph node metastases of gynaecological tumours (n = 3) and tonsillar carcinoma (n = 2). Three of 12 findings (25 %) were not detected by CECT alone (cervical carcinoma, lymph node metastasis and tonsillar carcinoma). In a per-patient analysis, sensitivity and specificity for malignant findings were 100 % and 90 % for PET/CT and 78 % and 88 % for CECT. In 24 % (reader 1) and 21 % (reader 2) of the patients, the PET/CT findings were inconclusive. Of these findings, 57 % (reader 1) and 56 % (reader 2) were only diagnosed with PET (e.g. focal FDG uptake of the thyroid, gastrointestinal tract and ovaries). On follow-up, none of these findings corresponded to malignancy. Overall agreement between the two readers was excellent with a Cohen

  20. Relevance of computerized tomography in the preoperative evaluation of patients with vulvar cancer

    DEFF Research Database (Denmark)

    Andersen, Kjeld; Zobbe, Vibeke; Thranov, Ingrid Regitze

    2015-01-01

    University Hospital, Rigshospitalet. The patients underwent a gynecological examination, chest x-ray and a preoperative CT scanning of the chest, abdomen and pelvis. It was registered whether the radiological findings regarding the extent of the tumor, lymph node involvement, incidental findings...

  1. Laryngeal amyloidosis with laryngocele: MRI and CT

    International Nuclear Information System (INIS)

    Arslan, A.; Ceylan, N.; Cetin, A.; Demirci, A.

    1998-01-01

    A case of laryngeal amyloidosis associated with a laryngocele is reported. Preoperative CT showed diffuse thickening of the epiglottis, aryepiglottic folds and false vocal cords with well-defined calcific foci. MRI revealed contrast enhancement and increased signal intensity on T2-weighted images. (orig.)

  2. Sclerosing encapsulating peritonitis in chronic ambulatory peritoneal dialysis;preoperative catheter drainage : a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Tae Hoon [Dankook Univ. Hospital, Seoul (Korea, Republic of)

    1996-10-01

    Sclerosing encapsulating peritonitis is a well recognized, but uncommon, complication of chronic ambulatory peritoneal dialysis. I report a case of sclerosing encapsulating peritonitis in which percutaneous catheter drainage was performed preoperatively. Ultrasonography(US) and computed tomography(CT) showed a large multi-septated cystic mass which occupied nearly all the peritoneal cavity. Percutaneous drainage with two 8.5 French catheters was preoperatively performed under fluoroscopy and about 2100 ml of bloody fluid was drained for 20 days. On follow-up CT, the size of the cyst had significantly decreased and anoperation was performed. It is considered that percutaneous catheter drainage is useful in the preoperative decompression of sclerosing encapsulating peritonitis.

  3. Sclerosing encapsulating peritonitis in chronic ambulatory peritoneal dialysis;preoperative catheter drainage : a case report

    International Nuclear Information System (INIS)

    Kim, Tae Hoon

    1996-01-01

    Sclerosing encapsulating peritonitis is a well recognized, but uncommon, complication of chronic ambulatory peritoneal dialysis. I report a case of sclerosing encapsulating peritonitis in which percutaneous catheter drainage was performed preoperatively. Ultrasonography(US) and computed tomography(CT) showed a large multi-septated cystic mass which occupied nearly all the peritoneal cavity. Percutaneous drainage with two 8.5 French catheters was preoperatively performed under fluoroscopy and about 2100 ml of bloody fluid was drained for 20 days. On follow-up CT, the size of the cyst had significantly decreased and anoperation was performed. It is considered that percutaneous catheter drainage is useful in the preoperative decompression of sclerosing encapsulating peritonitis

  4. A retrospective analysis of preoperative staging modalities for oral squamous cell carcinoma.

    Science.gov (United States)

    Kähling, Ch; Langguth, T; Roller, F; Kroll, T; Krombach, G; Knitschke, M; Streckbein, Ph; Howaldt, H P; Wilbrand, J-F

    2016-12-01

    An accurate preoperative assessment of cervical lymph node status is a prerequisite for individually tailored cancer therapies in patients with oral squamous cell carcinoma. The detection of malignant spread and its treatment crucially influence the prognosis. The aim of the present study was to analyze the different staging modalities used among patients with a diagnosis of primary oral squamous cell carcinoma between 2008 and 2015. An analysis of preoperative staging findings, collected by clinical palpation, ultrasound, and computed tomography (CT), was performed. The results obtained were compared with the results of the final histopathological findings of the neck dissection specimens. A statistical analysis using McNemar's test was performed. The sensitivity of CT for the detection of malignant cervical tumor spread was 74.5%. The ultrasound obtained a sensitivity of 60.8%. Both CT and ultrasound demonstrated significantly enhanced sensitivity compared to the clinical palpation with a sensitivity of 37.1%. No significant difference was observed between CT and ultrasound. A combination of different staging modalities increased the sensitivity significantly compared with ultrasound staging alone. No significant difference in sensitivity was found between the combined use of different staging modalities and CT staging alone. The highest sensitivity, of 80.0%, was obtained by a combination of all three staging modalities: clinical palpation, ultrasound and CT. The present study indicates that CT has an essential role in the preoperative staging of patients with oral squamous cell carcinoma. Its use not only significantly increases the sensitivity of cervical lymph node metastasis detection but also offers a preoperative assessment of local tumor spread and resection borders. An additional non-invasive cervical lymph node examination increases the sensitivity of the tumor staging process and reduces the risk of occult metastasis. Copyright © 2016 European

  5. Pre-operative evaluation for thorax surgery

    International Nuclear Information System (INIS)

    Silva Luis, Saenz; Morales, Oscar Alberto

    2002-01-01

    A pre-operative analysis of the function of the breathing system is made in the patient that will be taken to thorax surgery. The paper includes risk factors, pre-operative clinical evaluation and of breathing and cardiovascular system

  6. A case of transitional cell carcinoma associated with pericalyceal diverticulum diagnosed by CT guided percutaneous cystgraphy

    International Nuclear Information System (INIS)

    Sasaki, Fumio; Koga, Sukehiko; Takeuchi, Akira; Anno, Hirofumi; Hujita, Tamio

    1983-01-01

    Computed tomography (CT) performed on a 42-year-old male patient with a chief complaint of hematuria revealed a renal cyst with a thickened and irregularly shaped wall. CT with contrast medium injected into the cyst by puncture under CT guide detected tumors on the cystic wall preoperatively. (Ueda, J.)

  7. Cement stress predictions after anatomic total shoulder arthroplasty are correlated with preoperative glenoid bone quality.

    Science.gov (United States)

    Terrier, Alexandre; Obrist, Raphaël; Becce, Fabio; Farron, Alain

    2017-09-01

    We hypothesized that biomechanical parameters typically associated with glenoid implant failure after anatomic total shoulder arthroplasty (aTSA) would be correlated with preoperative glenoid bone quality. We developed an objective automated method to quantify preoperative glenoid bone quality in different volumes of interest (VOIs): cortical bone, subchondral cortical plate, subchondral bone after reaming, subchondral trabecular bone, and successive layers of trabecular bone. Average computed tomography (CT) numbers (in Hounsfield units [HU]) were measured in each VOI from preoperative CT scans. In parallel, we built patient-specific finite element models of simulated aTSAs to predict cement stress, bone-cement interfacial stress, and bone strain around the glenoid implant. CT measurements and finite element predictions were obtained for 20 patients undergoing aTSA for primary glenohumeral osteoarthritis. We tested all linear correlations between preoperative patient characteristics (age, sex, height, weight, glenoid bone quality) and biomechanical predictions (cement stress, bone-cement interfacial stress, bone strain). Average CT numbers gradually decreased from cortical (717 HU) to subchondral and trabecular (362 HU) bone. Peak cement stress (4-10 MPa) was located within the keel hole, above the keel, or behind the glenoid implant backside. Cement stress, bone-cement interfacial stress, and bone strain were strongly negatively correlated with preoperative glenoid bone quality, particularly in VOIs behind the implant backside (subchondral trabecular bone) but also in deeper trabecular VOIs. Our numerical study suggests that preoperative glenoid bone quality is an important parameter to consider in aTSA, which may be associated with aseptic loosening of the glenoid implant. These initial results should now be confronted with clinical and radiologic outcomes. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc

  8. Pre-operative simulation of pediatric mastoid surgery with 3D-printed temporal bone models.

    Science.gov (United States)

    Rose, Austin S; Webster, Caroline E; Harrysson, Ola L A; Formeister, Eric J; Rawal, Rounak B; Iseli, Claire E

    2015-05-01

    As the process of additive manufacturing, or three-dimensional (3D) printing, has become more practical and affordable, a number of applications for the technology in the field of pediatric otolaryngology have been considered. One area of promise is temporal bone surgical simulation. Having previously developed a model for temporal bone surgical training using 3D printing, we sought to produce a patient-specific model for pre-operative simulation in pediatric otologic surgery. Our hypothesis was that the creation and pre-operative dissection of such a model was possible, and would demonstrate potential benefits in cases of abnormal temporal bone anatomy. In the case presented, an 11-year-old boy underwent a planned canal-wall-down (CWD) tympano-mastoidectomy for recurrent cholesteatoma preceded by a pre-operative surgical simulation using 3D-printed models of the temporal bone. The models were based on the child's pre-operative clinical CT scan and printed using multiple materials to simulate both bone and soft tissue structures. To help confirm the models as accurate representations of the child's anatomy, distances between various anatomic landmarks were measured and compared to the temporal bone CT scan and the 3D model. The simulation allowed the surgical team to appreciate the child's unusual temporal bone anatomy as well as any challenges that might arise in the safety of the temporal bone laboratory, prior to actual surgery in the operating room (OR). There was minimal variability, in terms of absolute distance (mm) and relative distance (%), in measurements between anatomic landmarks obtained from the patient intra-operatively, the pre-operative CT scan and the 3D-printed models. Accurate 3D temporal bone models can be rapidly produced based on clinical CT scans for pre-operative simulation of specific challenging otologic cases in children, potentially reducing medical errors and improving patient safety. Copyright © 2015 Elsevier Ireland Ltd. All rights

  9. CT findings in ileo-caval thrombosis

    International Nuclear Information System (INIS)

    Harder, T.; Distelmaier, W.; Koester, O.

    1982-01-01

    Thrombosis of a large vein can be demonstrated by CT. The thrombosed vein has a hyperdense lumen, with a somewhat increased diameter which does not opacify after intravenous contrast injection, but which shows a narrow hyperdense margin. Collateral vesels in the pelvic or paravertebral plexus and dilated veins in the abdominal skin are indirect evidence of ileo-caval thrombosis. CT can also demonstrate the cranial extent of a caval thrombosis. Venous thrombosis demonstrated by CT is an important additional finding in the pre-operative examination of the abdomen. (orig.) [de

  10. Preoperative staging of rectal cancer

    International Nuclear Information System (INIS)

    Schaefer, A.O.; Baumann, T.; Pache, G.; Langer, M.; Wiech, T.

    2007-01-01

    Accurate preoperative staging of rectal cancer is crucial for therapeutic decision making, as local tumor extent, nodal status, and patterns of metastatic spread are directly associated with different treatment strategies. Recently, treatment approaches have been widely standardized according to large studies and consensus guidelines. Introduced by Heald, total mesorectal excision (TME) is widely accepted as the surgical procedure of choice to remove the rectum together with its enveloping tissues and the mesorectal fascia. Neoadjuvant radiochemotherapy also plays a key role in the treatment of locally advanced stages, while the use of new drugs will lead to a further improvement in oncological outcome. Visualization of the circumferential resection margin is the hallmark of any preoperative imaging and a prerequisite for high-quality TME surgery. The aim of this article is to present an overview on current cross-sectional imaging with emphasis on magnetic resonance imaging. Future perspectives in rectal cancer imaging are addressed. (orig.)

  11. Interventions for preoperative smoking cessation

    DEFF Research Database (Denmark)

    Thomsen, Thordis; Villebro, N.; Møller, Ann Merete

    2010-01-01

    Background Smokers have a substantially increased risk of postoperative complications. Preoperative smoking intervention may be effective in decreasing this incidence, and surgery may constitute a unique opportunity for smoking cessation interventions. Objectives The objective of this review...... was to assess the effect of preoperative smoking intervention on smoking cessation at the time of surgery and 12 months postoperatively and on the incidence of postoperative complications. Search strategy The specialized register of the Cochrane Tobacco Addiction Group was searched using the free text...... and keywords (surgery) or (operation) or (anaesthesia) or (anesthesia). MEDLINE, EMBASE and CINAHL were also searched, combining tobacco- and surgery-related terms. Most recent search April 2010. Selection criteria Randomized controlled trials that recruited people who smoked prior to surgery, offered...

  12. FFTF preoperational survey. Program report

    International Nuclear Information System (INIS)

    Twitty, B.L.; Bicehouse, H.J.

    1980-12-01

    The FFTF will become operational with criticality early in 1980. This facility is composed of the test reactor, fuel examination cells, expended fuel storage systems and fuel handling systems. The reactor and storage systems are sodium-cooled with the heat load dumped to the ambient air through heat exchangers. In order to assure that the operation of the FFTF has minimal impact on the environment, a monitoring program has been established. Prior to operation of a new facility, a preoperational environmental survey is required. It is the purpose of this report to briefly describe the environmental survey program and to provide the background data obtained during the preoperational phase of the survey program. Nine stations in the program of particular importance to FFTF are discussed in detail with results of monitoring given. No unexplained trends were noted

  13. The value of preoperative planning.

    Science.gov (United States)

    Graves, Matt L

    2013-10-01

    "Better to throw your disasters into the waste paper basket than to consign your patients to the scrap heap" has been a proverb of Jeff Mast, one of the greatest fracture and deformity surgeons in the history of our specialty. Stated slightly more scientifically, one of the major values of simulation is that it allows one to make mistakes in a consequence-free environment. Preoperative planning is the focus of this article. The primary goal is not to provide you with a recipe of how to steps. Rather, the primary goal of this article is to explain why preoperative planning should be standard, to clarify what should be included, and to provide examples of what can happen when planning is ignored. At the end of this, we should all feel the need to approach fracture care more intellectually with forethought, both in our own practices and in our educational system.

  14. [Preoperative fasting guidelines: an update].

    Science.gov (United States)

    López Muñoz, A C; Busto Aguirreurreta, N; Tomás Braulio, J

    2015-03-01

    Anesthesiology societies have issued various guidelines on preoperative fasting since 1990, not only to decrease the incidence of lung aspiration and anesthetic morbidity, but also to increase patient comfort prior to anesthesia. Some of these societies have been updating their guidelines, as such that, since 2010, we now have 2 evidence-based preoperative fasting guidelines available. In this article, an attempt is made to review these updated guidelines, as well as the current instructions for more controversial patients such as infants, the obese, and a particular type of ophthalmic surgery. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Comparison of spiral CT angiography with conventional digital subtraction angiography in the evaluation of renal transplant donors: a pilot study

    International Nuclear Information System (INIS)

    Chu, C.; Young, N.; Lau, H.

    2001-01-01

    Conventional digital subtraction renal arteriography (IA-DSA) has been traditionally used as the preoperative imaging modality for assessment of renal vascular anatomy for renal transplant donors. This study evaluates the potential use of spiral CT angiography in replacing IA-DSA in the preoperative assessment of this group of patients. Seven patients underwent both spiral CT angiography and IA-DSA between October 1997 and April 1998. It is concluded that spiral CT angiography can demonstrate the number, length and location of renal arteries and it is suggested that spiral CT angiography can potentially replace IA-DSA in the preoperative assessment of renal donors. Copyright (2001) Blackwell Science Pty Ltd

  16. Preoperative nutrition therapy - novel developments

    OpenAIRE

    Ljungqvist, Olle; Nygren, Jonas; Hausel, Jonatan; Thorell, Anders

    2000-01-01

    Elective surgery has until recently been performed in the overnight fasted state in order to reduce the risk of aspiration of gastric content during the induction of anaesthesia. However, in order to increase the preoperative well-being of surgical patients, most western countries have changed their routines during the last 10-15 years, allowing intake of clear fluids up to 2 hours before anaesthesia in most patients. Animal studies have demonstrated that undergoing different situations of st...

  17. Diagnostic imaging in liver transplantation. Preoperative evaluation and postoperative complications

    International Nuclear Information System (INIS)

    Schroeder, T.; Ruehm, S.G.

    2005-01-01

    Complimentary to orthotopic liver transplantation (OLT), living donor liver transplantation (LDLT) is increasingly considered a therapeutic option in the therapy of end-stage liver disease. Accurate pre- and postoperative imaging is crucial for the transplantation success and represents an established part of the current evaluation algorithms. This article summarizes the most important requirements and the current imaging standards. Preoperative imaging is important for exclusion of transplantation contraindications in the recipient and for reliable assessment of anatomical variants in the donor. The main purpose of postoperative imaging is the early detection and characterization of complications. In both instances, multislice CT currently represents the most versatile and reliable imaging modality, still superior to MRI. For postoperative follow-up, the imaging modality of first choice is still bedside ultrasound; however, unclear findings usually need to be further assessed by CT. (orig.) [de

  18. Computed tomography for preoperative planning in total hip arthroplasty: what radiologists need to know

    Energy Technology Data Exchange (ETDEWEB)

    Huppertz, Alexander [Charite - University Hospitals Berlin, Department of Radiology, Berlin (Germany); Imaging Science Institute Charite, Berlin (Germany); Radmer, Sebastian [Proendo, Orthopedic Surgery, Berlin (Germany); Wagner, Moritz; Hamm, Bernd [Charite - University Hospitals Berlin, Department of Radiology, Berlin (Germany); Roessler, Torsten [Klinikum Ernst von Bergmann, Department of Trauma and Orthopedic Surgery, Potsdam (Germany); Sparmann, Martin [Proendo, Orthopedic Surgery, Berlin (Germany); Charite - University Hospital, Berlin (Germany)

    2014-08-15

    The number of total hip arthroplasties is continuously rising. Although less invasive surgical techniques, sophisticated component design, and intraoperative navigation techniques have been introduced, the rate of peri- and postoperative complications, including dislocations, fractures, nerve palsies, and infections, is still a major clinical problem. Better patient outcome, faster recovery and rehabilitation, and shorter operation times therefore remain to be accomplished. A promising strategy is to use minimally invasive techniques in conjunction with modular implants, aimed at independently reconstructing femoral offset and leg length on the basis of highly accurate preoperative planning. Plain radiographs have clear limitations for the correct estimation of hip joint geometry and bone quality. Three-dimensional assessment based on computed tomography (CT) allows optimizing the choice and positions of implants and anticipating difficulties to be encountered during surgery. Postoperative CT is used to monitor operative translation and plays a role in arthroplastic quality management. Radiologists should be familiar with the needs of orthopedic surgeons in terms of CT acquisition, post-processing, and data transfer. The CT protocol should be optimized to enhance image quality and reduce radiation exposure. When dedicated orthopedic CT protocols and state-of-the-art scanner hardware are used, radiation exposure can be decreased to a level just marginally higher than that of conventional preoperative radiography. Surgeons and radiologists should use similar terminology to avoid misunderstanding and inaccuracies in the transfer of preoperative planning. (orig.)

  19. Correlative Imaging in a Patient with Cystic Thymoma: CT, MR and PET/CT Comparison

    International Nuclear Information System (INIS)

    Romeo, Valeria; Esposito, Alfredo; Maurea, Simone; Camera, Luigi; Mainenti, Pier Paolo; Palmieri, Giovannella; Buonerba, Carlo; Salvatore, Marco

    2015-01-01

    Cystic thymoma is a rare variant of thymic neoplasm characterized by almost complete cystic degeneration with mixed internal structure. We describe a case of a 60 year-old woman with a cystic thymoma studied with advanced tomographic imaging stydies. CT, MRI and PET/CT with 18 F-FDG were performed; volumetric CT and MRI images provided better anatomic evaluation for pre-operative assessment, while PET/CT was helpful for lesion characterization based on 18 F-FDG uptake. Although imaging studies are mandatory for pre-operative evaluation of cystic thymoma, final diagnosis still remains surgical. A 60-year-old woman with recent chest pain and no history of previous disease was admitted to our departement to investigate the result of a previous chest X-ray that showed bilateral mediastinal enlargement; for this purpose, enhanced chest CT scan was performed using a 64-rows scanner (Toshiba, Aquilion 64, Japan) before and after intravenous bolus administration of iodinated non ionic contrast agent; CT images demonstrated the presence of a large mediastinal mass (11×8 cm) located in the anterior mediastinum who extended from the anonymous vein to the cardio-phrenic space, compressing the left atrium and causing medium lobe atelectasis; bilateral pleural effusion was also present. In conclusion, correlative imaging plays a foundamental role for the diagnostic evaluation of patient with cystic thymoma. In particular, volumetric CT and MRI studies can provide better anatomic informations regarding internal structure and local tumor spread for pre-operative assessment. Conversely, metabolic imaging using 18 F-FDG PET/CT is helpful for lesion characterization differentiating benign from malignant lesion on the basis of intense tracer uptake. The role of PET/MRI is still under investigation. However, final diagnosis still remains surgical even though imaging studies are mandatory for pre-operative patient management

  20. Endoscopic ultrasonography and computed tomography scanning for preoperative staging of colonic cancer

    DEFF Research Database (Denmark)

    Malmstrøm, M L; Gögenur, I; Riis, L B

    2017-01-01

    PURPOSE: With an increasing demand for more accurate preoperative staging methods for colon cancer, we aimed to compare preoperative tumour (T)- and nodal (N)-stage in patients with left-sided colon cancer by endoscopic ultrasonography (EUS) and computed tomography (CT) with post......-operative histology as gold standard. METHODS: A total of 44 patients were prospectively recruited at Herlev and Roskilde University Hospitals during November 2014-January 2016. Thirty-five patients were included in the final analysis and underwent EUS, CT and surgery within 2 weeks. Diagnostic values were evaluated...... difficult to evaluate due to small patient numbers. EUS could be considered as a supplement to CT scans in selecting patients for neoadjuvant therapies, or local transmural treatment, in the future. TRIAL REGISTRATION: NCT02324023....

  1. Dynamic helical CT mammography of breast cancer

    International Nuclear Information System (INIS)

    Yamamoto, Akira; Fukushima, Hitoshi; Okamura, Ryuji; Nakamura, Yoshiaki; Morimoto, Taisuke; Urata, Yoji; Mukaihara, Sumio; Hayakawa, Katsumi

    2006-01-01

    The purpose of this study was to determine whether dynamic helical computed tomography (CT)-mammography could assist in selecting the most appropriate surgical method in women with breast cancer. Preoperative contrast-enhanced helical CT scanning of the breast was performed on 133 female patients with suspicion of breast cancer at the same time as clinical, mammographic, and/or ultrasonographic examinations. The patients were scanned in the prone position with a specially designed CT-compatible device. A helical scan was made with rapid intravenous bolus injection (3 ml/s) of 100 ml of iodine contrast material. Three-dimensional maximum intensity projection (MIP) images were reconstructed, and CT findings were correlated with surgical and histopathological findings. Histopathological analysis revealed 84 malignant lesions and seven benign lesions. The sensitivity, specificity, and accuracy levels of the CT scanning were 94.6%, 58.6%, and 78.9%. Helical scanning alone revealed additional contralateral carcinomas in three of four patients and additional ipsilateral carcinomas in three of five patients. However, the technique gave false-positive readings in 24 patients. The preoperative CT-mammogram altered the surgical method in six patients. Dynamic helical CT-mammography in the prone position may be one of the choices of adjunct imaging in patients with suspected breast cancer scheduled for surgery. (author)

  2. Clinical application of helical CT colonography

    International Nuclear Information System (INIS)

    Zeng Huiliang; Zhu Xinjin; Liang Rujian; Liang Jianhao; Ou Weiqian; Wen Haomao

    2009-01-01

    Objective: To investigate the clinical value of 16-slice helical CT colonography in the diagnosis of colon tumor and polypus. Methods: 16-slice helical CT volumetric scanning was performed in 18 patients with colonic disease, including colonic tumor (n=16) and colonic polypus (n=2). 3D images, virtual endoscopy and multiplanar reformation were obtained in the AW4.1 workstation. CT appearances were compared with operation and fiberoptic colonoscopy. Results: Satisfied results were achieved from 18 patients, no difference found in results between CT colonography and operation in 16 patients with colonic tumor. Conclusion: 16-slice helical CT colonography is of great value in preoperative staging of colonic tumor and have a high value in clinical application. (authors)

  3. CT and MR imaging of craniopharyngioma

    Energy Technology Data Exchange (ETDEWEB)

    Tsuda, M. [Tohoku Univ. School of Medicine, Sendai (Japan). Dept. of Radiology; Takahashi, S. [Tohoku Univ. School of Medicine, Sendai (Japan). Dept. of Radiology; Higano, S. [Tohoku Univ. School of Medicine, Sendai (Japan). Dept. of Radiology; Kurihara, N. [Tohoku Univ. School of Medicine, Sendai (Japan). Dept. of Radiology; Ikeda, H. [Tohoku Univ. School of Medicine, Sendai (Japan). Dept. of Neurosurgery; Sakamoto, K. [Tohoku Univ. School of Medicine, Sendai (Japan). Dept. of Radiology

    1997-05-01

    We reviewed imaging findings of CT and MR imaging in 20 cases of surgically confirmed craniopharyngioma in an attempt to determine their relation to patterns of tumor extent. The relationship between these patterns and the frequency of preoperative CT diagnosis and MR imaging diagnosis according to the surgical diagnosis were determined. The CT technique was superior to MR imaging in the detection of calcification. The MR imaging technique was superior to CT for determining tumor extent and provided valuable information about the relationships of the tumor to surrounding structures. Thus, CT and MR imaging have complementary roles in the diagnosis of craniopharyngiomas. In cases of possible craniopharyngioma, noncontrast sagittal T1-weighted images may enable the identification of the normal pituitary, possibly leading to the correct diagnosis. (orig.)

  4. CT and MR imaging of craniopharyngioma

    International Nuclear Information System (INIS)

    Tsuda, M.; Takahashi, S.; Higano, S.; Kurihara, N.; Ikeda, H.; Sakamoto, K.

    1997-01-01

    We reviewed imaging findings of CT and MR imaging in 20 cases of surgically confirmed craniopharyngioma in an attempt to determine their relation to patterns of tumor extent. The relationship between these patterns and the frequency of preoperative CT diagnosis and MR imaging diagnosis according to the surgical diagnosis were determined. The CT technique was superior to MR imaging in the detection of calcification. The MR imaging technique was superior to CT for determining tumor extent and provided valuable information about the relationships of the tumor to surrounding structures. Thus, CT and MR imaging have complementary roles in the diagnosis of craniopharyngiomas. In cases of possible craniopharyngioma, noncontrast sagittal T1-weighted images may enable the identification of the normal pituitary, possibly leading to the correct diagnosis. (orig.)

  5. Results of preoperative chemoradiotherapy for T4 rectal cancer

    International Nuclear Information System (INIS)

    Sato, Harunobu; Maeda, Koutarou; Masumori, Koji; Koide, Yoshikazu; Noro, Tomohito; Honda, Katsuyuki; Shiota, Miho; Matsuoka, Shinji; Toyama, Kunihiro

    2011-01-01

    We reviewed clinical records of 11 cases with preoperative chemoradiotherapy to evaluate the clinical effectiveness of chemoradiotherapy for T4 rectal cancer. The preoperative radiotherapy consisted of 40-50 Gy delivered in fractions of 1.8-2.0 Gy per day, five days per week. A treatment of 5-fluorouracil, 500 mg/body per day intravenously, or oral tegafur-uracil (UFT)-E (300 mg/m 2 ) with l-leucovorin (75 mg) per day, or oral S-1 (80 mg/m 2 ) per day five days per week, was given during radiotherapy. One patient died due to pelvic abscess in 63 days after chemoradiotherapy. Invasive findings to the adjacent organs identified by CT and MRI disappeared in 6 cases with complete or partial response 1 month after chemoradiotherapy. Curative surgery was performed in 7 patients. Although the adjacent organs were also removed during surgery in 7 patients, there was no histological invasion to the adjacent organs in 4 patients, and one patient had histological complete disappearance of tumor. Although complications after surgery were found in all of the patients, they were improved by conservative treatment. Two of 7 patients with curative surgery had recurrence, but the rest of them survived without recurrence. Preoperative chemoradiotherapy was expected to be an effective treatment to improve the resection rate and prognosis for T4 rectal cancer. However, it was thought that it was necessary to be careful about severe toxicity, such as pelvic abscess. (author)

  6. Computer guided pre-operative planning and dental implant placement

    Directory of Open Access Journals (Sweden)

    Dušan Grošelj

    2007-05-01

    Full Text Available Background: Implants in dentistry are, besides fixed, removable and maxillofacial prosthodontics, one of the reliable possibility to make functional and aesthetic rehabilitation of the edentulism. Surgical and prosthodontic implant complications are often an inattentive consequence of wrong diagnosis, planning, and placement. In this article we present a technique using a highly advanced software program along with a rapid prototyping technology named stereolithography. A planning software for implant placement needs basically the high quality computed tomographic scan of one or both jaws for making accurate preoperative diagnostics and 3D preoperative plan. Later individual drill guide is designed and generated based on both the CT images and the preoperative planning. The patient specific drill guide transfers the virtual planning to the patient’s mouth at time of surgery.Conclusions: The advantages of computer guided implantology are the better prepared surgery with visualisation of critical anatomic structures, assessment of available bone and data about bone quality, increased confidence for the surgeon, deceased operative time, less frequent use of bone grafts, higher quality of collaboration between specialists and prosthetic lab and better communication with patients. Radiographic examination of the operation field for computer guided planning for implant placement is due to high costs justified as the most important information source on the areas to be implanted.

  7. Helical 3D-CT images of soft tissue tumors in the hand

    Energy Technology Data Exchange (ETDEWEB)

    Otani, Kazuhiro; Kikuchi, Hiraku; Tan, Akihiro; Hamanishi, Chiaki; Tanaka, Seisuke [Kinki Univ., Osaka-Sayama (Japan). School of Medicine

    2000-02-01

    X-ray, ultrasonograph CT, MRI and angiography are used to detect tumoral lesions. Recently, helical CT has been revealed to be a useful method for the diagnosis and preoperative evaluation of soft tissue tumors, by which high quality and accurate three dimensional (3D) images can be obtained quickly. We analyzed the preoperative 3D-CT images of soft tissue tumors in the hands of 11 cases (hemangioma in 6 cases, giant cell tumor, lipoma, angiofibroma, chondrosarcoma and malignant fibro-histiocytoma in one case each). Enhanced 3D-CT clearly visualized hemangiomas and solid tumors from the surrounding tissues. The tumors could easily be observed from any direction and color-coded according to the CT number. Helical 3D-CT was thus confirmed to be useful for the diagnosis and preoperative planning by indicating the details of tumor expansion into surrounding tissues. (author)

  8. Preoperative diagnosis and surgical strategy in congenital auditory ossicular malformation of 26 ears

    International Nuclear Information System (INIS)

    Kanazawa, Yuji; Naito, Yasushi; Shinohara, Shogo; Fujiwara, Keizo; Kikuchi, Masahiro; Yamazaki, Hiroshi; Kurihara, Risa; Kishimoto, Ippei

    2012-01-01

    We retrospectively analyzed 26 ears of 21 subjects having auditory ossicular malformation and who had undergone auditory reconstruction between April 2004 and December 2010 at our clinic. We checked preoperative condition, pathological classification, surgical procedure, and hearing improvement. We could predict pathological conditions precisely from preoperative computed tomography (CT), including incudostapedial disconnection (9/12, 75%) and malleus and/or incus fixation (7/12, 58%), which tended to be present in external ear malformation, and stapes footplate fixation (0/12, 0%). We could not, however, predict complex malformation (0/8, 0%). Overall success was 90% (18/20) in the 20 ears observed for at least 1 year. In the 2 ears without improved hearing, the first had congenital cholesteatoma and no stapes superstructure, was treated with type IV tympanoplasty. The second had malleus, incus, and stapes fixation and discontinuity between the incus and stapes, and was treated with type III tympanoplasty and stapes mobilization. Preoperative diagnosis is difficult in mixed congenital auditory ossicular malformation, especially stapes footplate fixation, possibly requiring unexpected procedures, with a poor hearing outcome. Preoperative status must thus be evaluated precisely using hearing, tympanometry, acoustic reflex test, and CT. Temporal bone CT and external ear findings are useful in diagnosing middle-ear malformation. Subjects' informed consent should also be obtained due to the possible need for changing procedure based on findings during surgery. (author)

  9. Importance of preoperative imaging in acetabular revision surgery - a case report.

    Science.gov (United States)

    Schmitz, Hc; Egidy, Cc; Al-Khateeb, H; Cárdenas, G; Gehrke, T; Kendoff, D

    2012-01-01

    Acetabular defects, particularly as a result of protrusion of acetabular components into the hemipelvis, may cause serious complications during revision procedures as a result of iatrogenic injury to surrounding anatomical structures. In these challenging cases, we advocate the utilisation of preoperative three dimensional imaging. MRI and CT- imaging offer superior understanding of the three-dimensional quality of bony defects and the relationship of implants to important anatomical structures. Appropriate preoperative planning may also prevent major complications during the removal of the pre-existing hardware, prior to re-implantation of implants. Potential complications include injury of nerves, blood vessels and other intrapelvic structures.In our case, a major bony defect of the acetabulum was a result of the protrusion of an implanted reinforcement ring. A preoperative, contrast-enhanced CT scan showed that the urethra was in close proximity to the hook of the reinforcement ring.The preoperative imaging aided in identifying and understanding the potential complications that could occur intraoperatively. Additionally, it delineated the intact anatomic structures prior to surgery, which could have medico-legal implications.The importance of preoperative imaging and the existing literature is discussed within this case description.

  10. Efficacy for preoperative screening of liver metastasis using computed tomography and ultrasonography in patients with colon cancer

    International Nuclear Information System (INIS)

    Kotanagi, Hitoshi; Sato, Emi; Murakoshi, Satoshi

    2000-01-01

    To establish an effective examination system for preoperative evaluation of liver metastasis by colon cancer, we analyzed the sensitivity, cost, and efficacy of computed tomography (CT) and ultrasonography (US) in 354 patients (including 63 patients with liver metastasis). The presence or absence of liver metastasis was ultimately diagnosed 5 years after the operation. The sensitivity, specificity, and accuracy for detecting liver metastasis were 65%, 94%, and 89%, respectively for CT, 57%, 97%, and 91% for US, and 65%, 93%, and 88% for CT plus US, and there were no significant differences among them. Neither CT nor US could fully detect intrahepatic cancer spread. The cost of detection of one patient with liver metastasis was 6,298 points for plain CT, 20,169 points for enhanced CT, and 5,773 points for US. It was concluded that CT plus US should not be employed for preoperative assessment of liver metastasis, because the detection rate of the two modalities is not significantly different, and these modalities do not compensate for each other's defects. From the standpoint of the cost-benefit relationship, US should be selected for preoperative evaluation of liver metastasis. (author)

  11. Preoperative chemoradiation using oral capecitabine in locally advanced rectal cancer

    International Nuclear Information System (INIS)

    Kim, Jun-Sang; Kim, Jae-Sung; Cho, Moon-June; Song, Kyu-Sang; Yoon, Wan-Hee

    2002-01-01

    Purpose: Capecitabine (Xeloda) is a new orally administered fluoropyrimidine carbamate that was rationally designed to exert its effect by tumor-selective activation. We attempted to evaluate the efficacy and toxicity of preoperative chemoradiation using capecitabine in locally advanced rectal cancer. Methods and Materials: Between July 1999 and March 2001, 45 patients with locally advanced rectal cancer (cT3/T4 or N+) were treated with preoperative chemoradiation. Radiation of 45 Gy/25 fractions was delivered to the pelvis, followed by a 5.4 Gy/3 fractions boost to the primary tumor. Chemotherapy was administered concurrent with radiotherapy and consisted of 2 cycles of 14-day oral capecitabine (1650 mg/m 2 /day) and leucovorin (20 mg/m 2 /day), each of which was followed by a 7-day rest period. Surgery was performed 6 weeks after the completion of chemoradiation. Results: Thirty-eight patients received definitive surgery. Primary tumor and node downstaging occurred in 63% and 90% of patients, respectively. The overall downstaging rate, including both primary tumor and nodes, was 84%. A pathologic complete response was achieved in 31% of patients. Twenty-one patients had tumors located initially 5 cm or less from the anal verge; among the 18 treated with surgery, 72% received sphincter-preserving surgery. No Grade 3 or 4 hematologic toxicities developed. Other Grade 3 toxicities were as follows: hand-foot syndrome (7%), fatigue (4%), diarrhea (4%), and radiation dermatitis (2%). Conclusion: These preliminary results suggest that preoperative chemoradiation with capecitabine is a safe, well-tolerated, and effective neoadjuvant treatment modality for locally advanced rectal cancer. In addition, this preoperative treatment has a considerable downstaging effect on the tumor and can increase the possibility of sphincter preservation in distal rectal cancer

  12. Preoperative fasting time in children.

    LENUS (Irish Health Repository)

    Adeel, S

    2012-02-01

    The aim of preoperative fasting is to prevent regurgitation and pulmonary aspiration while limiting potential problems of thirst, dehydration and hypoglycaemia. The American Society of Anaesthesiologists (ASA) has suggested guidelines for preoperative fasting for children undergoing elective surgery. We did a postal survey to determine the current practice regarding these guidelines amongst all specialist registrars in anaesthesia in Ireland. A questionnaire was sent to all specialist registrars in anaesthesia (90 in total), 60 (67%) were returned and analysed. The question asked was how long children should be kept fasting before elective surgery. The results of our survey suggest that most of the respondents are following the ASA guidelines for clear fluids and solids however there were differing opinion regarding the duration of fasting for formula milk and breast milk. In conclusion, we would recommend greater awareness and collaboration between anaesthetists, nurses and surgeons to ensure that fasting instructions are consistent with the ASA guidelines and that patient and their parents understand these directives as well.

  13. Preoperative irradiation of hypernephroid carcinoma

    International Nuclear Information System (INIS)

    Akbar, D.

    1982-01-01

    Since 1969, preoperative irradiation of hypernephiroid carcinoma has been a routine measure at the Steglitz medical clinic: It consists in the application of a focal dose of 30 Gy, fractionated into doses of 2.5 Gy, as Betatron pendulum irradiation (42 MeV photons) covering the para-aortic lymph nodes. After a treatment-free interval of 3 weeks, radical nephrectomy is carried through. Of 178 patients, 47 were in tumor stage I, 15 in stage II, 83 in stage III and 33 in stage IV. In 99 patients the treatment dated back longer than 5 years; the survival rate was 52%. 67% of the patients had survived longer than 3 years. Operation lethality was 3%. The preoperative irradiation pursues the following aims: 1. Devitalization of potentially proliferating cells in the tumor periphery, and thus prevention of displaced tumor cells growing on and postoperative local recidivations; 2. Shrinking of the tumor, facilitating the surgical intervention. In a third of the cases a measurable alteration of the tumor was confirmed by X-ray. The low operation lethality of 3% is attributed to this. (orig./MG) [de

  14. Preoperative embolization of facial angiomas

    International Nuclear Information System (INIS)

    Causmano, F.; Bruschi, G.; De Donatis, M.; Piazza, P.; Bassi, P.

    1988-01-01

    Preoperative embolization was performed on 27 patients with facial angiomas supplied by the external carotid branches. Sixteen were males and 11 females; 13 of these angiomas were high-flow arterio-venous (A-V), 14 were low-flow capillary malformations. Fourteen patients underwent surgical removal after preoperative embolization; in this group embolization was carried out with Spongel in 3 cases and with Lyodura in 11 cases. In 12 of these patients the last angiographic examination was performed 3-6 years later: angiography evidenced no recurrence in 8 cases (67%), while in 3 cases (25%) there was capillary residual angioma of negligible size. Treatment was unsuccessful in one patient only, due to the large recurrent A-V angioma. Thirteen patients underwent embolization only, which was carried out with Lyodura in 10 cases, and with Ivalon in 3 cases. On 12 of these patients the last angiographic study was performed 2-14 months later: there was recurrent A-V angioma in 5 patients (42%), who underwent a subsequent embolization; angiography evidenced no recurrence in the other 7 patients (58%). In both series, the best results were obtained in the patients with low-flow capillary angiomas. Embolization and subsequent surgical removal are the treatment of choice for facial angiomas; embolization alone is useful in the management of surgically inacessible vascular malformations, and it can be the only treatment in patients with small low-flow angiomas when distal occlusion of the feeding vessel with Lyodura or Ivalon particles is performed

  15. Changes in computed tomography features following preoperative chemotherapy for nephroblastoma: relation to histopathological classification

    International Nuclear Information System (INIS)

    Olsen, Oeystein E.; Jeanes, Annmarie C.; Roebuck, Derek J.; Owens, Catherine M.; Sebire, Neil J.; Risdon, Rupert A.; Michalski, Anthony J.

    2004-01-01

    The objective of this study is to assess computed tomography (CT) changes, both volume estimates and subjective features, following preoperative chemotherapy for nephroblastoma (Wilms' tumour) in patients treated on the United Kingdom Children's Cancer Study Group Wilms' Tumour Study-3 (UKW-3) protocol and to compare CT changes and histopathological classification. Twenty-one nephroblastomas in 15 patients treated on UKW-3 were included. All patients were examined by CT before and after preoperative chemotherapy treatment. CT images were reviewed (estimated volume change and subjectively assessed features). CT changes were compared to histopathological classification. Of the 21 tumours, all five high-risk tumours decreased in volume following chemotherapy (median -79%; range -37 to -91%). The sole low-risk tumour decreased in volume by 98%. Ten intermediate-risk tumours decreased in volume (median -72%; range -6 to -98%) and five intermediate-risk tumours increased (median +110%; range +11 to +164%). None of the five high-risk tumours, compared to 15/16 intermediate or low-risk tumours, became less dense and/or more homogeneous, or virtually disappeared, following chemotherapy. Volume change following chemotherapy did not relate to histopathological risk group. Changes in subjectively assessed qualitative CT features were more strongly related to histopathological risk group. (orig.)

  16. Clinical Application of colored three-dimensional CT (3D-CT) for brain tumors using helical scanning CT (HES-CT)

    International Nuclear Information System (INIS)

    Ogura, Yuko; Katada, Kazuhiro; Fujisawa, Kazuhisa; Imai, Fumihiro; Kawase, Tsukasa; Kamei, Yoshifumi; Kanno, Tetsuo; Takeshita, Gen; Koga, Sukehiko

    1995-01-01

    We applied colored three-dimensional CT (colored 3D-CT) images to distinguish brain tumors from the surrounding vascular and bony structures using a work station system and helical scanning CT (HES-CT). CT scanners with a slip-ring system were employed (TCT-900S and X vigor). A slice thickness of 2 mm and bed speed of 2 mm/s were used. The volume of contrast medium injected was 60 to 70 ml. Four to 8 colors were used for the tissue segmentation on the workstation system (xtension) using the data transferred from HES-CT. Tissue segmentation succeeded on the colored 3D-CT images in all 13 cases. The relationship between the tumors and the surrounding structures were easily recognized. The technique was useful to simulate operative fields, because deep structures could be visualized by cutting and drilling the colored 3D-CT volumetric data. On the basis of our findings, we suggest that colored 3D-CT images should be used as a supplementary aid for preoperative simulation. (author)

  17. The clinical efficacy of 1 mm-slice CT of the middle ear

    International Nuclear Information System (INIS)

    Noda, Kazuhiro; Noiri, Teruhisa; Doi, Katsumi; Koizuka, Izumi; Tanaka, Hisashi; Mishiro, Yasuo; Okumura, Shin-ichi; Kubo, Takeshi

    2000-01-01

    The efficacy of the preoperative 1 mm-slice CT for evaluating the condition of the ossicular chain and the facial canal was assessed. CT findings were compared with the operative findings of middle ears in 120 cases of chronic otitis media or cholesteatoma that underwent tympanoplasty. The reliability of 1 mm-slice CT in detecting any defect of the ossicular chain was much superior to those of 2 mm-slice CT previously reported, and the difference between them is essential for preoperative information. On the other hand, thinner slice than 1 mm may be unnecessary, especially in routine use. (author)

  18. The clinical efficacy of 1 mm-slice CT of the middle ear

    Energy Technology Data Exchange (ETDEWEB)

    Noda, Kazuhiro; Noiri, Teruhisa [Kawanishi Municipal Hospital, Hyogo (Japan); Doi, Katsumi; Koizuka, Izumi; Tanaka, Hisashi; Mishiro, Yasuo; Okumura, Shin-ichi; Kubo, Takeshi

    2000-02-01

    The efficacy of the preoperative 1 mm-slice CT for evaluating the condition of the ossicular chain and the facial canal was assessed. CT findings were compared with the operative findings of middle ears in 120 cases of chronic otitis media or cholesteatoma that underwent tympanoplasty. The reliability of 1 mm-slice CT in detecting any defect of the ossicular chain was much superior to those of 2 mm-slice CT previously reported, and the difference between them is essential for preoperative information. On the other hand, thinner slice than 1 mm may be unnecessary, especially in routine use. (author)

  19. CT pelvimetry

    International Nuclear Information System (INIS)

    Vicens, J.L.; Charles, G.; Le Berre, J.; Flageat, J.

    1989-01-01

    Pelvimetry aims at providing the obstetrician with information on the size and morphology of the female pelvis, thus enabling him to assess the obstetrical prognosis as accurately as possible. Computed tomography (CT) has several advantages, in particular the lower mother and fetus radiation dose. After a brief description of obstetrical anatomy, the usual CT exploration method is presented and its results are considered in terms of measurements, indices and morphological findings. If performed with a very strict exploration procedure, CT pelvimetry is a very reliable, fact and comfortable method of examination. All these advantages, combined with the minimized patient dose, should lead to an increasingly widespread use of this technique [fr

  20. Preoperative patient education: evaluating postoperative patient outcomes.

    Science.gov (United States)

    Meeker, B J

    1994-04-01

    Preoperative teaching is an important part of patient care and can prevent complications, as well as promote patient fulfillment during hospitalization. A study was conducted at Alton Ochsner Medical Foundation in New Orleans, LA, in 1989, to determine the impact of a preoperative teaching program on the incidence of postoperative atelectasis and patient satisfaction. Results showed no significant difference of postoperative complications and patient gratification after participating in a structured preoperative teaching program. As part of this study, it was identified that a patient evaluation tool for a preoperative teaching class needed to be developed. The phases of this process are explained in the following article.

  1. Adjunctive role of preoperative liver magnetic resonance imaging for potentially resectable pancreatic cancer.

    Science.gov (United States)

    Kim, Hyoung Woo; Lee, Jong-Chan; Paik, Kyu-Hyun; Kang, Jingu; Kim, Young Hoon; Yoon, Yoo-Seok; Han, Ho-Seong; Kim, Jaihwan; Hwang, Jin-Hyeok

    2017-06-01

    The adjunctive role of magnetic resonance imaging of the liver before pancreatic ductal adenocarcinoma has been unclear. We evaluated whether the combination of hepatic magnetic resonance imaging with multidetector computed tomography using a pancreatic protocol (pCT) could help surgeons select appropriate candidates and decrease the risk of early recurrence. We retrospectively enrolled 167 patients in whom complete resection was achieved without grossly visible residual tumor; 102 patients underwent pCT alone (CT group) and 65 underwent both hepatic magnetic resonance imaging and pCT (magnetic resonance imaging group). By adding hepatic magnetic resonance imaging during preoperative evaluation, hepatic metastases were newly discovered in 3 of 58 patients (5%) without hepatic lesions on pCT and 17 of 53 patients (32%) with indeterminate hepatic lesions on pCT. Patients with borderline resectability, a tumor size >3 cm, or preoperative carbohydrate antigen 19-9 level >1,000 U/mL had a greater rate of hepatic metastasis on subsequent hepatic magnetic resonance imaging. Among 167 patients in whom R0/R1 resection was achieved, the median overall survival was 18.2 vs 24.7 months (P = .020) and the disease-free survival was 8.5 vs 10.0 months (P = .016) in the CT and magnetic resonance imaging groups, respectively (median follow-up, 18.3 months). Recurrence developed in 82 (80%) and 43 (66%) patients in the CT and magnetic resonance imaging groups, respectively. The cumulative hepatic recurrence rate was greater in the CT group than in the magnetic resonance imaging group (P magnetic resonance imaging should be considered in patients with potentially resectable pancreatic ductal adenocarcinoma, especially those with high tumor burden. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. CT Scan

    Science.gov (United States)

    ... disease, lung nodules and liver masses Monitor the effectiveness of certain treatments, such as cancer treatment Detect ... scan done in a hospital or an outpatient facility. CT scans are painless and, with newer machines, ...

  3. Thoracic CT

    Science.gov (United States)

    ... through a vein (IV) in your hand or forearm. It may be given through the rectum using ... CT scan Vertebra, thoracic (mid back) Normal lung anatomy Thoracic organs References Gotway MB, Panse PM, Gruden ...

  4. CT Enterography

    Science.gov (United States)

    ... a CT scan can be reformatted in multiple planes, and can even generate three-dimensional images. These ... other medical conditions, and if you have a history of heart disease, asthma, diabetes, kidney disease or ...

  5. CT of malignant otitis externa

    International Nuclear Information System (INIS)

    Klose, K.C.; Elies, W.; Technische Hochschule Aachen

    1991-01-01

    Computed tomography was performed preoperatively in 20 patients suffering from malignant external otitis. The CT findings were nearly completely confirmed by the intraoperative findings. A circumscribed or diffuse thickening of the cartilaginous wall of the external auditory canal and an inflammatory infiltration of the subtemporal fossa are, in combination, most suspicious signs of malignant external otitis. Computed tomography enabels detailed information on the extension of the pneumatic system and the grade of involvement of bones and soft tissues in malignant external otitis. A modified classification of malignant external otitis based on computed tomographic findings is proposed. (orig.) [de

  6. Role of CT scan in diagnosis of acute appendicitis

    International Nuclear Information System (INIS)

    Salem, O.A.; Khasawneh, M.

    2007-01-01

    To evaluate the diagnostic accuracy of the spiral-CT in patients with clinically suspected acute appendicitis. A total of 124 patients referred for CT scan with suspected appendicitis between January 2005 and October 2006 were assessed for the appendiceal size and the presence of signs of appendicitis. The findings were correlated with surgical histopathology. CT scan had a sensitivity of 95 percent and a specifity of 93 percent and an overall accuracy of 92 percent. The use of spiral CT in patients with equivocal clinical presentation suspected of having acute appendicitis can lead to significant improvement in the preoperative diagnosis. (author)

  7. Interventions for preoperative smoking cessation

    DEFF Research Database (Denmark)

    Thomsen, Thordis; Villebro, Nete; Møller, Ann Merete

    2010-01-01

    a smoking cessation intervention, and measured preoperative and long-term abstinence from smoking and/or the incidence of postoperative complications. Data collection and analysis The authors independently assessed studies to determine eligibility. Results were discussed between the authors. Main results...... Eight trials enrolling a total of 1156 people met the inclusion criteria. One of these did not report cessation as an outcome. Two trials initiated multisession face to face counselling at least 6 weeks before surgery whilst six used a brief intervention. Nicotine replacement therapy (NRT) was offered......; pooled RR 10.76 (95% confidence interval (CI) 4.55 to 25.46, two trials) and RR 1.41 (95% CI 1.22 to 1.63, five trials) respectively. Four trials evaluating the effect on long-term smoking cessation found a significant effect; pooled RR 1.61 (95% CI 1.12 to 2.33). However, when pooling intensive...

  8. SISTEM KOMPENSASI PNS BERBASIS KINERJA

    Directory of Open Access Journals (Sweden)

    Hanif Hanif

    2017-04-01

    Full Text Available Abstract-Human resource occupies a strategic position within an organization , because the human resources directly involved in the management process from the planning stage to the evaluation , therefore the policy in the field of human resources should be directed at improving the welfare of justice , in accordance with the proportion and responsibility of each employee . In achieving the objectives of the organization , human resource potential must be maximized , the achievement of organizational goals depends not only on facilities and pre means but rather depends on the performance of its human resources .

  9. Cystic lymphangioma of the spleen: US-CT-MRI correlation

    Energy Technology Data Exchange (ETDEWEB)

    Bezzi, M.; Spinelli, A.; Pierleoni, M.; Andreoli, G.M. [Dept. of Radiology, University of Rome ' La Sapienza' (Italy)

    2001-07-01

    A case of a surgically confirmed cystic lymphangioma of the spleen is presented. Preoperative imaging consisted of US, contrast-enhanced CT and MRI, all showing a multiloculated lesion with small cystic cavities divided by thin septa, corresponding to dilated lymphatic spaces. Preoperative studies correlated well with the pathologic findings. Cystic lymphangioma of the spleen is a very rare condition and is usually solitary and asymptomatic. Large lymphangiomas may be an indication for splenectomy, since the risk of rupture is high even from minor abdominal trauma. Preoperative diagnosis may be achieved with correlated noninvasive imaging. (orig.)

  10. The value of X-ray CT in orbital fractures

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Myung Hee; Lee, Jae Mun; Kim, Choon Yul; Bahk, Yong Whee [Catholic Medical College, Seoul (Korea, Republic of)

    1986-08-15

    On the pulse from the trauma transiting to posterior side of the orbit, orbital fractures are occurred through the weak point of the orbital wall. Invagination of soft tissue or entrapment of muscles may be associated with orbital fracture. In condition of inaccurate diagnosis, appropriate surgical repairment is impossible and complication such as diplopia or enophthalmia are developed. CT scan is diagnostic procedure which demonstrates accurately the site and state of orbital fracture, and its associated findings. The authors has been studied in 21 orbital CT scan to evaluate the relative value of plain X rays and CT scans in the diagnosis of orbital fractures during the period from January 1982 to September 1985. The conclusions were as follows: 1. Diagnostic rate was 100% by CT, 40% by initial and 80% by retrospective interpretation of conventional X-ray films. 2. Low X-ray diagnostic rate of medical wall fractures (26.7%) was due to thinness of the bone. 3. Medial wall fractures were associated with floor fractures in 46%. 4. Orbital soft tissue injuries and abnormalities of PNS were precisely evaluated by CT scan.

  11. [Preoperative imaging/operation planning for liver surgery].

    Science.gov (United States)

    Schoening, W N; Denecke, T; Neumann, U P

    2015-12-01

    The currently established standard for planning liver surgery is multistage contrast media-enhanced multidetector computed tomography (CM-CT), which as a rule enables an appropriate resection planning, e.g. a precise identification and localization of primary and secondary liver tumors as well as the anatomical relation to extrahepatic and/or intrahepatic vascular and biliary structures. Furthermore, CM-CT enables the measurement of tumor volume, total liver volume and residual liver volume after resection. Under the condition of normal liver function a residual liver volume of 25 % is nowadays considered sufficient and safe. Recent studies in patients with liver metastases of colorectal cancer showed a clear staging advantage of contrast media-enhanced magnetic resonance imaging (CM-MRI) versus CM-CT. In addition, most recent data showed that the use of liver-specific MRI contrast media further increases the sensitivity and specificity of detection of liver metastases. This imaging technology seems to lead closer to the ideal "one stop shopping" diagnostic tool in preoperative planning of liver resection.

  12. Preoperative computed tomography for determining nodal status combined with histologic grading as a prognostic factor for patients with tongue carcinoma

    International Nuclear Information System (INIS)

    Ogura, Ichiro; Kurabayashi, Tohru; Amagasa, Teruo; Iwaki, Hiroshi; Sasaki, Takehito

    2001-01-01

    The purpose of this study was to evaluate the predictive value of preoperative neck computed tomography (CT) in combination with histologic grading as a prognostic factor for patients with tongue carcinoma. Fifty-five patients with squamous cell carcinoma of the tongue were examined by CT prior to radical neck dissection. The locoregional failure and survival rates of these patients were analyzed in relation to their clinical characteristics, histologic grading (World Health Organization, WHO) based on tongue biopsy, and imaging diagnoses prior to surgery. Logistic multivariate regression analysis showed that both histologic grading and number of metastatic lymph nodes on CT were significant and independent prognostic factors in locoregional failure (p=0.009 and p=0.009, respectively). When the numebr of metastatic lymph nodes detected on preoperative neck CT were combined with the histologic grading for the evaluation, the five-year overall survival rates of A group (0 node with any Grade, or 1 node with Grade I-II) and B group (1 node with Grade III, or 2 or more nodes with any Grade) were 74.5% and 37.5%, respectively (p=0.001). The difference was more significant than histologic grading alone or the number of metastatic lymph nodes seen on CT alone. The combination of preoperative neck CT with histologic grading of the primary tumor is useful as a prognostic indicator for patients with tongue carcinoma. (author)

  13. Internal Fixation of Complicated Acetabular Fractures Directed by Preoperative Surgery with 3D Printing Models.

    Science.gov (United States)

    Liu, Zhao-Jie; Jia, Jian; Zhang, Yin-Guang; Tian, Wei; Jin, Xin; Hu, Yong-Cheng

    2017-05-01

    The purpose of this article is to evaluate the efficacy and feasibility of preoperative surgery with 3D printing-assisted internal fixation of complicated acetabular fractures. A retrospective case review was performed for the above surgical procedure. A 23-year-old man was confirmed by radiological examination to have fractures of multiple ribs, with hemopneumothorax and communicated fractures of the left acetabulum. According to the Letounel and Judet classification, T-shaped fracture involving posterior wall was diagnosed. A 3D printing pelvic model was established using CT digital imaging and communications in medicine (DICOM) data preoperatively, with which surgical procedures were simulated in preoperative surgery to confirm the sequence of the reduction and fixation as well as the position and length of the implants. Open reduction with internal fixation (ORIF) of the acetabular fracture using modified ilioinguinal and Kocher-Langenbeck approaches was performed 25 days after injury. Plates that had been pre-bent in the preoperative surgery were positioned and screws were tightened in the directions determined in the preoperative planning following satisfactory reduction. The duration of the operation was 170 min and blood loss was 900 mL. Postoperative X-rays showed that anatomical reduction of the acetabulum was achieved and the hip joint was congruous. The position and length of the implants were not different when compared with those in preoperative surgery on 3D printing models. We believe that preoperative surgery using 3D printing models is beneficial for confirming the reduction and fixation sequence, determining the reduction quality, shortening the operative time, minimizing preoperative difficulties, and predicting the prognosis for complicated fractures of acetabulam. © 2017 Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

  14. Preoperative diagnosis of N-factor by MR in primary lung cancer

    International Nuclear Information System (INIS)

    Akata, Soichi; Amino, Saburo; Abe, Kimihiko

    1993-01-01

    We compared the accuracies of preoperative diagnosis of N-factor by CT and MR in 71 cases of primary lung cancer. Lymph nodes larger than 10 mm in diameter were defined as positive. As a result, CT and MR both achieved an accuracy of more than 80%. MR was inefficient in detecting calcification and showed lower spatial resolution than CT; however, MR was useful in detecting hilar lymph nodes because of the signal loss of blood vessels. MR should be used to detect the contralateral hilar lymph nodes swelling because the sensitivity in the hilus is 20% higher in MR than in CT and the information about the contralateral hilar lymph nodes is more important than ipsilateral hilar lymph nodes for operation. (author)

  15. Impaired anastomotic healing after preoperative radiotherapy ...

    African Journals Online (AJOL)

    Background. Patients with rectal carcinoma undergoing total mesorectal excision (TME) have a lower recurrence rate with preoperative radiotherapy (RT). The aim of this study was to assess the side-effects in patients who had preoperative RT compared with those who did not receive it (because of palliative resections, ...

  16. Preoperative Smoking Status and Postoperative Complications

    DEFF Research Database (Denmark)

    Pedersen, Marie Grønkjær; Eliasen, Marie; Skov-Ettrup, Lise Skrubbeltrang

    2014-01-01

    To systematically review and summarize the evidence of an association between preoperative smoking status and postoperative complications elaborated on complication type.......To systematically review and summarize the evidence of an association between preoperative smoking status and postoperative complications elaborated on complication type....

  17. Preoperative breast radiation therapy: Indications and perspectives

    DEFF Research Database (Denmark)

    Lightowlers, S V; Boersma, L J; Fourquet, A

    2017-01-01

    Preoperative breast radiation therapy (RT) is not a new concept, but older studies failed to change practice. More recently, there has been interest in revisiting preoperative RT using modern techniques. This current perspective discusses the indications, summarises the published literature and t...

  18. New concepts in preoperative imaging of anorectal malformation. New concepts in imaging of ARM

    Energy Technology Data Exchange (ETDEWEB)

    Taccone, A.; Delliacqua, A.; Marzoli, A. (Children' s Hospital G. Gaslini, Genoa (Italy). Dept. of Radiology); Martucciello, G.; Jasonni, V. (Children' s Hospital G. Gaslini, Genoa (Italy). Dept. of Pediatric Surgery); Dodero, P. (Children' s Hospital G. Gaslini, Genoa (Italy). Dept. of Intensive Care Unit); Salomone, G. (Children' s Hospital G. Gaslini, Genoa (Italy). Surgical Emergency Unit)

    1992-06-01

    In this study of 14 patients with anorectal anomalies CT and MRI were employed for preoperative assessment. The use of a pressure enhanced water soluble enema via the colostomy proved to be an extremely efficient method for showing a fistula. MRI studies were enhanced by the use of vaseline oil and in one case this technique was used prior to surgery to provide important information by injecting through a perineal fistula. CT and axial MRI proved to be more valuable than sagittal MRI which is only useful for the length of the atretic segment. The authors consider that a combined approach using pressure enhanced water soluble enema and MRI will provide the most valuable preoperative information to plan a successful operative approach and enable an accurate prognostic evaluation of continence in these difficult and complex patients. (orig.).

  19. [PRELIMINARY APPLICATION OF VIRTUAL PREOPERATIVE RECONSTRUCTION PLANNING IN Pilon FRACTURES].

    Science.gov (United States)

    Wang Xiaoping; Wei, Zhantu; Huang, Jian; Chen, Luyao; Hu, Shiqiang; Wu, Weiwei; Tu, Yumin; Guo, Sheng; Xu, Guotai; Deng, Zhicheng

    2016-01-01

    To investigate the application value of three-dimensional reconstruction and virtual preoperative planning for Pilon fractures. Between July 2010 and June 2014, 16 patients with closed Pilon fracture were treated, including 12 males and 4 females with an average age of 36.5 years (range, 22-53 years) and a mean disease duration of 10.2 days (range, 6-14 days). According to AO/Orthopaedic Trauma Association (AO/OTA) typing, 2 cases were rated as 43.B2 type, 3 cases as 43.B3 type, 3 cases as 43.C1 type, 2 cases as 43.C2 type, and 6 cases as 43.C3 type. The preoperative CT data from 16 patients were imported into Mimics10.01 software to establish the detailed fracture three-dimensional digital models. Virtual operation of fracture reduction and implanting internal fixation was performed on the models, and the optional surgical planning was made. Based on the virtual preoperative planning, operations were performed. Established detailed three-dimensional Pilon fracture digital models could perfectly reflect the fracture characteristics, could be observed at any direction, and aided for fracture classification accurately. Virtual fracture operations of reduction, internal fixation and other could be performed to simulate the clinical operation, which could assist the surgeon better preoperative planning in achieving visual presentation and improving the communication. The operation time was 70-130 minutes (mean, 87.8 minutes); intraoperative blood loss volume was 30-150 mL (mean, 71.9 mL). The wounds healed by first intension in all patients. The mean follow-up time was 11.6 months (range, 8-18 months). Postoperative radiological results at 3 groups showed good anatomic reduction according to the Burwell-Charnley criteria, and the fracture healing time was 3-6 months (mean, 3.7 months). There was no complication of internal fixation loosening or breakage during follow-up. The American Orthopedic Foot and Ankle Society (AOFAS) score was 71-100 (mean, 92.3); the results

  20. Proposed radiological criteria for pre-operative determination of resectability in peritoneal-based malignancies

    International Nuclear Information System (INIS)

    Tan, Grace Hwei Ching; Chanyaputhipong, Jendana; Teo, Melissa Ching Ching; Kwek, Jin Wei; Hosseini, Reza; Tham, Chee Kian; Soo, Khee Chee

    2016-01-01

    The selection of patients for cytoreductive surgery (CRS) and hyperthermic intra-peritoneal chemotherapy infusion (HIPEC) is important, and relies heavily on imaging. However, it has been reported that Computer Tomographic (CT) scans may only achieve a low sensitivity of 33% for peritoneal disease. We propose a set of radiological criteria for pre-operative determination of resectability of peritoneal disease in peritoneal-based malignancies and validate this in our cohort of patients. A retrospective review of all patients who underwent laparotomy with a view for CRS and HIPEC, at the National Cancer Centre Singapore from January 2000 to April 2010, was performed. Intra-operative Peritoneal Cancer Index (PCI) scores were recorded. The pre-operative imaging was reviewed with a senior radiologist who was blinded, and recorded the radiological PCI scores (CT-PCI) and eight additional CT prognostic factors (CT-PF). The CT-PCI and CT-PF scores were then compared with the intra-operative findings to determine the radiological accuracy. The scores and the individual prognostic factors were then evaluated for their predictive ability for unresectability. Comparison of the CT-PCI and PCI scores showed a concordance correlation coefficient at 0.52 (95% CI 0.34–0.7). Accuracy was increased with the addition CT-PF. The presence of omental caking and ascites were predictors of unresectability. We propose a scoring system which is able to predict for unresectable disease with a specificity of 80% and a sensitivity of 62%. With our proposed criteria, and scoring system, the selection of patients for CRS and HIPEC can be improved, and unnecessary exploratory operations avoided.

  1. CT staging of renal pelvis tumor

    International Nuclear Information System (INIS)

    Yoon, Soo Woong; Cho, Kyoung Sik; Lee, Jong Hwa; Ham, Su Yeon; Won, Yeong Cheol; Ji, Eun Kyung; Choi, Seong Hun; Shin, Byung Suck

    1999-01-01

    To assess the value of computed tomography (CT) in the preoperative staging of transitional cell carcinoma (TCC) of the renal pelvis. We retrospectively evaluated the CT TNM staging of 38 patients with TCC of the renal pelvis who had undergone preoperative abdominal CT examination between January 1990 and January 1998. In CT staging for differentiation between early-stage (T0-2) and advanced-stage disease (T3-T4), three criteria were used, namely the presence or obliteration of the renal sinus fat layer, the smoothness or irregularity of margin between the tumor and renal parenchyma, and the presence or absence of hydronephrosis proximal to the tumor. CT staging was performed by two genitourinary radiologists blinded to the pathologic results, and was compared with pathologic staging. Pathologic results revealed 19 cases of early stage disease (T0=8, T1=9, T2=2) and 19 of advanced stage (T3=12, T4=7). Overall CT staging accuracy was 82%(31/38) ; four cases were overstaged and three were understaged. In early-stage disease, sensitivity and specificity were 79%, and 84%, and in advanced stage disease were 83% and 80%. Three of four overstaged cases showed hydronephrosis proximal to the tumor. In the second CT staging, using proximal hydronephrosis of the tumor as a criterion for early-stage disease, the sensitivity and specificity of early-stage disease were 95% and 75%, respectively, and the specificity of advanced-stage disease was 95%. When hydronephrosis proximal to a tumor was considered to be a sign of early stage disease, the CT staging of renal pelvic TCC was highly accurate

  2. Three-dimensional CT of the mandible

    International Nuclear Information System (INIS)

    Zinreich, S.J.; Price, J.C.; Wang, H.; Ahn, H.S.; Kashima, H.

    1988-01-01

    Seventeen patients with mandibular oblation for facial neoplasia, primary neoplasm, and trauma were evaluated with CT and three-dimensional CT. In eight of these patients, a computerized acrylic model was generated for preoperative planning and postoperative reconstruction. The ramus and body of the mandible were reconstructed with mirror image and fusion techniques. Reconstructions of the anterior mandible were generated from models including the midface, skull based, and residual mandibular fragments. The results are preliminary; however, the authors believe that these represent a powerful new tool and a significant advance in mandibular reconstructive technique, reduced anesthesia time, and the optimized restoration of dental alignment and facial contour

  3. CT characteristics of peripheral organizing pneumonia

    International Nuclear Information System (INIS)

    Yang, Seong Oh; Choi, Chul Soon; Kim, Myung Joon; Lee, Kyung Soo; Choi, Hyung Sik; Jun, Young Hwan; Park, Yong Koo

    1988-01-01

    Diagnostic dilemma of persistent mass-forming parenchymal opacity in the lung periphery occurs occasionally in the realm of diagnostic radiology. Until recently, literature on the role of computed tomography in peripheral organizing pneumonia, which is difficult to differentiate from malignancy, has little been published. We experienced one case of pathologically proven organizing pneumonia diagnosed preoperatively by chest CT. When it comes to solitary peripheral mass density in the lung, we think that CT can be proved useful in the diagnosis of benign organizing pneumonia by showing regular and smoothly corrugate margin, peripheral contrast enhancement with inner low density, and air-trapping by intervening normal lung parenchyma.

  4. Preoperative treatment with capecitabine, cetuximab and radiotherapy for primary locally advanced rectal cancer : A phase II clinical trial

    NARCIS (Netherlands)

    Eisterer, Wolfgang; de Vries, Alexander; Öfner, Dietmar; Rabl, Hans; Koplmüller, Renate; Greil, Richard; Tschmelitsch, Jöerg; Schmid, Rainer; Kapp, Karin; Lukas, Peter; Sedlmayer, Felix; Höfler, Gerald; Gnant, Michael; Thaler, Josef; Widder, Joachim

    2014-01-01

    BACKGROUND/AIM: To investigate the feasibility and safety of preoperative capecitabine, cetuximab and radiation in patients with MRI-defined locally advanced rectal cancer (LARC, cT3/T4). PATIENTS AND METHODS: 31 patients with LARC were treated with cetuximab and capecitabine concomitantly with 45

  5. CT staging of colon cancer

    Energy Technology Data Exchange (ETDEWEB)

    Dighe, S. [Department of Radiology, Royal Marsden Hospital, Sutton SM5 2TT (United Kingdom); Swift, I. [Department of Surgery, Mayday University Hospital, Croydon CR7 7YE (United Kingdom); Brown, G. [Department of Radiology, Royal Marsden Hospital, Sutton SM5 2TT (United Kingdom)], E-mail: gina.brown@rmh.nhs.uk

    2008-12-15

    Computer tomography (CT) has been the principal investigation in the staging of colon cancers. The information obtained with routine CT has been limited to identifying the site of the tumour, size of the tumour, infiltration into surrounding structures and metastatic spread. The Foxtrot trial National Cancer Research Institute (NCRI) has been specifically designed to evaluate the efficacy of neoadjuvant treatment in colon cancers by using preoperative chemotherapy with or without an anti-Epidermal Growth Factor Receptor (EGFR) monoclonal antibody to improve outcome in high-risk operable colon cancer. Patients are selected based on their staging CT examination. The criteria for poor prognosis are T4 and T3 tumours with more than 5 mm extramural depth. Thus the success of the trial would depend upon the confidence of the radiologist to identify the patients that would receive the neoadjuvant treatment. The aim of this review is to explain the process of identifying high-risk features seen on the staging CT images. This will help to identify a cohort of patients that could truly benefit from neoadjuvant strategies.

  6. CT staging of colon cancer

    International Nuclear Information System (INIS)

    Dighe, S.; Swift, I.; Brown, G.

    2008-01-01

    Computer tomography (CT) has been the principal investigation in the staging of colon cancers. The information obtained with routine CT has been limited to identifying the site of the tumour, size of the tumour, infiltration into surrounding structures and metastatic spread. The Foxtrot trial National Cancer Research Institute (NCRI) has been specifically designed to evaluate the efficacy of neoadjuvant treatment in colon cancers by using preoperative chemotherapy with or without an anti-Epidermal Growth Factor Receptor (EGFR) monoclonal antibody to improve outcome in high-risk operable colon cancer. Patients are selected based on their staging CT examination. The criteria for poor prognosis are T4 and T3 tumours with more than 5 mm extramural depth. Thus the success of the trial would depend upon the confidence of the radiologist to identify the patients that would receive the neoadjuvant treatment. The aim of this review is to explain the process of identifying high-risk features seen on the staging CT images. This will help to identify a cohort of patients that could truly benefit from neoadjuvant strategies

  7. Repeated surgeries in invasive lobular breast cancer with preoperative MRI: Role of additional carcinoma in situ and background parenchymal enhancement.

    Science.gov (United States)

    Preibsch, H; Richter, V; Bahrs, S D; Hattermann, V; Wietek, B M; Bier, G; Kloth, C; Blumenstock, G; Hahn, M; Staebler, A; Nikolaou, K; Wiesinger, B

    2017-05-01

    Analysing the influence of additional carcinoma in situ (CIS) and background parenchymal enhancement (BPE) in preoperative MRI on repeated surgeries in patients with invasive lobular carcinoma (ILC) of the breast. Retrospective analysis of 106 patients (mean age 58.6±9.9years) with 108 ILC. Preoperative tumour size as assessed by MRI, mammography and sonography was recorded and compared to histopathology. In contrast-enhanced MRI, the degree of BPE was categorised by two readers. The influence of additionally detected CIS and BPE on the rate of repeated surgeries was analysed. Additional CIS was present in 45.4% of the cases (49/108). The degree of BPE was minimal or mild in 80% of the cases and moderate or marked in 20% of the cases. In 17 cases (15.7%) at least one repeated surgery was performed. In n=15 of these cases, repeated surgery was performed after BCT (n=9 re-excisions, n=6 conversions to mastectomy), in n=2 cases after initial mastectomy. The initial surgical procedure (p=0.008) and additional CIS (p=0.046) significantly influenced the rate of repeated surgeries, while tumour size, patient age and BPE did not (p=ns). Additional CIS was associated with a higher rate of repeated surgeries, whereas BPE had no influence. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. A Pilot Comparison of 18F-fluorocholine PET/CT, Ultrasonography and 123I/99mTc-sestaMIBI Dual-Phase Dual-Isotope Scintigraphy in the Preoperative Localization of Hyperfunctioning Parathyroid Glands in Primary or Secondary Hyperparathyroidism

    Science.gov (United States)

    Michaud, Laure; Balogova, Sona; Burgess, Alice; Ohnona, Jessica; Huchet, Virginie; Kerrou, Khaldoun; Lefèvre, Marine; Tassart, Marc; Montravers, Françoise; Périé, Sophie; Talbot, Jean-Noël

    2015-01-01

    Abstract We compared 18F-fluorocholine hybrid positron emission tomography/X-ray computed tomography (FCH-PET/CT) with ultrasonography (US) and scintigraphy in patients with hyperparathyroidism and discordant, or equivocal results of US and 123I/99mTc-sesta-methoxyisobutylisonitrile (sestaMIBI) dual-phase parathyroid scintigraphy. FCH-PET/CT was performed in 17 patients with primary (n = 11) lithium induced (n = 1) or secondary hyperparathyroidism (1 dialyzed, 4 renal-transplanted). The reference standard was based on results of surgical exploration and histopathological examination. The results of imaging modalities were evaluated, on site and by masked reading, on per-patient and per-lesion bases. In a first approach, equivocal images/foci were considered as negative. On a per-patient level, the sensitivity was for US 38%, for scintigraphy 69% by open and 94% by masked reading, and for FCH-PET/CT 88% by open and 94% by masked reading. On a per-lesion level, sensitivity was for US 42%, for scintigraphy 58% by open and 83% by masked reading, and for FCH-PET/CT 88% by open and 96% by masked reading. One ectopic adenoma was missed by the 3 imaging modalities. Considering equivocal images/foci as positive increased the accuracy of the open reading of scintigraphy or of FCH-PET/CT, but not of US. FCH-PET/CT was significantly superior to US in all approaches, whereas it was more sensitive than scintigraphy only for open reading considering equivocal images/foci as negative (P = 0.04). FCH uptake was more intense in adenomas than in hyperplastic parathyroid glands. Thyroid lesions were suspected in 9 patients. They may induce false-positive results as in one case of oncocytic thyroid adenoma, or false-negative results as in one case of intrathyroidal parathyroid adenoma. Thyroid cancer (4 cases) can be visualized with FCH as with 99mTc-sestaMIBI, but the intensity of uptake was moderate, similar to that of parathyroid hyperplasia. This pilot study confirmed

  9. Micro-pleural Metastasis Without Effusion: CT and US Findings

    International Nuclear Information System (INIS)

    Na, Hyoung Il; Yoo, Seung Min; Kim, Yang Soo; Lee, Hwa Yeon; Song, In Sup; Shim, Hyung Jin; Kwak, Byung Kook; Shin, Jong Wook

    2004-01-01

    Pleural metastasis from malignancy is commonly combined with effusion. We report the ultrasonographic and CT findings in a rare case of micro-pleural metastasis without effusion. A 34-year-old male patient with lung cancer underwent video-assisted thoracoscopic surgery (VATS), prior to open thoracotomy. VATS revealed multiple metastatic micronodules on the pleura, which were overlooked on the preoperative CT scan. The HRCT images and chest ultrasonograms showed clear evidence of pleural micro-nodules

  10. Micro-pleural Metastasis Without Effusion: CT and US Findings

    Energy Technology Data Exchange (ETDEWEB)

    Na, Hyoung Il; Yoo, Seung Min; Kim, Yang Soo; Lee, Hwa Yeon; Song, In Sup; Shim, Hyung Jin; Kwak, Byung Kook; Shin, Jong Wook [Chung-Ang University College of Medicine, Seoul (Korea, Republic of)

    2004-09-15

    Pleural metastasis from malignancy is commonly combined with effusion. We report the ultrasonographic and CT findings in a rare case of micro-pleural metastasis without effusion. A 34-year-old male patient with lung cancer underwent video-assisted thoracoscopic surgery (VATS), prior to open thoracotomy. VATS revealed multiple metastatic micronodules on the pleura, which were overlooked on the preoperative CT scan. The HRCT images and chest ultrasonograms showed clear evidence of pleural micro-nodules

  11. Preoperative radiological assessment of children with pectus excavatum

    International Nuclear Information System (INIS)

    Kilda, A.; Barauskas, V.; Basevicius, A.; Lukosevicius, S.

    2005-01-01

    Objective: The degree of the pediatric chest deformation that should be subjected to corrective surgical treatment or conservative treatment remains poorly defined as recognized. In the present study, using preoperative and postoperative radiological examination data, we aim to assess what degree of chest wall deformation changes statistically reliably after surgery. Materials and methods: Radiological chest examinations were performed for 88 children before and after remedial operations. Chest X-ray and CT scans were done to measure transversal chest width; sagittal left chest side depth, sagittal right chest side depth, sternovertebral distance, and vertebral body length. Derivative indices were also estimated: the Vertebral Index, the Frontosagittal Index, the Haller index, and the asymmetry index. Computerized assessment of data was used. For statistical analysis, the software 'STATISTICA 6.0' was used. Results: Postoperatively, the Vertebral Index increased approximately by 2.37±2.72; the Frontosagittal Index decreased by 4.60±4.34, and the Haller index value increased approximately up by 0.45±0.49. Statistically reliable deformation index difference before and after surgery was not detected when the Vertebral Index was below 26.2, p=0.08; the Frontosagittal Index was above 32.9, p=0.079; and the Haller Index was less than 3.12, p=0.098. Conclusions: Preoperative CT scanning, coupled with assessment of the chest wall shape and the deformation degree, would be necessary for pediatric patients. The following deformation indices are indications for surgical treatment: VI > 26, FSI 3.1. (author)

  12. Value of preoperative cervical discography

    International Nuclear Information System (INIS)

    Kwon, Jong Won; Kim, Sung Hyun; Lee, Joon Woo

    2006-01-01

    The aim of this study was to describe the method and the value of cervical discography as correlated with the MR findings. Twenty-one discs in 11 consecutive patients who underwent cervical discography were analyzed. MR and CT discography (CTD) were performed in all patients. Discography was performed after swallowing barium for visualizing the pharynx and the esophagus to prevent penetration. We also analyzed the preceding causes of the subjects' cervical pain. The results of the pain provocation test were classified into concordant pain, discordant pain and a negative test. MRI was analyzed according to the T2-signal intensity (SI) of the disc, disc height, annular bulging and disc herniation. The CTD was analyzed for degeneration or radial tear of the disc, epidural leakage of the contrast agent and pooling of the contrast agent at the periphery of the disc. The pain provocation tests were correlated with the MR and CTD findings. We used the chi-square test to analyze the results. Concordant pain was observed in 14 cases, discordant pain in 3 cases and there were negative tests in 4 cases. There were no complications related to the procedure. Four patients had undergone anterior cervical fusion and four patients that developed after traffic injuries. The decreased T2-SI and annular bulging on MRI, disc degeneration and peripheral pooling of the contrast agent on CT were significantly correlated with pain provocation. When the diagnosis of disc disease is difficult with performing MRI, cervical discography with using swallowed barium solution to reduce the penetration of the esophagus or hypopharynx may play be helpful. The decreased T2-SI and annular bulging on MRI correlated significantly with a positive result on the pain provocation test

  13. Perforated appendicitis: accuracy of CT diagnosis and correlation of CT findings with the length of hospital

    International Nuclear Information System (INIS)

    Siddiqui, H.A.; Afzal, S.

    2007-01-01

    To determine the sensitivity and specificity of CT findings in the differentiation of perforated from nonperforated appendicitis and correlate CT diagnosis with the length of hospital stay. The study included 70 patients who presented with right lower quadrant abdominal pain and underwent preoperative CT scan followed by appendectomy. Patients were divided into two groups of having perforated and nonperforated appendicitis on the basis of CT scan findings. The surgical and pathological reports combined were considered the reference standard for the diagnosis of perforated appendicitis. Various CT scan findings and average duration of hospital stay in days was compared by t-test. Twenty-six (37%) of 70 patients had perforated appendicitis. It was correctly identified on pre-operative CT scan in 18 patients. There were 18 true positive diagnoses, 43 true negative diagnoses, 1 false positive diagnosis and 8 false negative diagnoses which yielded a sensitivity of 69%, specificity of 97%, positive predictive value of 94% and negative predictive value of 84%. Mean length of hospital stay in perforated group was 6.3 days and 2.9 days in nonperforated group. Severe periappendiceal inflammation, periappendiceal and or abdominopelvic fluid and abscess were significantly associated with perforated appendicitis and with a significant longer hospital stay (p <.001). CT scan is 69% sensitive and 97% specific for the diagnosis of perforated appendicitis and constellation of CT findings can be used to select patients with perforated appendicitis for initial non-operative management. Presence of CT signs of significant appendiceal inflammation is independent predictor of longer hospital stay. (author)

  14. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Sinuses Computed tomography (CT) of the sinuses ... CT of the Sinuses? What is CT (Computed Tomography) of the Sinuses? Computed tomography, more commonly known ...

  15. CT scanning in two cases of lipoma of the spinal cord

    NARCIS (Netherlands)

    Dossetor, R.S.; Kaiser, M.; Veiga-Pires, J.A.

    1979-01-01

    Two cases of lipoma of the spinal cord are presented. CT gives a specific diagnosis in this condition without any contrast being given. It is important to make a preoperative diagnosis, as in lipoma of the spinal cord biopsy is dangerous and frequently makes the patient worse. CT is also valuable as

  16. Detailed Review of CT Scans Aids Assessment of the Airway in ...

    African Journals Online (AJOL)

    Two cases are presented that illustrate the importance of information gained from CT scans of the head and neck taken in patients presenting for maxillo-facial surgery. The first case involved a 25 year old with a massive tumour filling his mouth. Pre-operative assessment was done without reviewing the CT scans of his ...

  17. SENDS criteria from the diversification of MAST procedures. Implementation of preoperative simulation

    International Nuclear Information System (INIS)

    Rieger, B.

    2015-01-01

    Minimal access spinal technologies (MAST) lead to a diversification of surgical procedures, which requires careful selection of the procedure and outcome monitoring. For a rational selection of the procedure simulation, endoscopy, navigation, decompression and stabilization (SENDS) criteria can be derived from the development of the MAST procedures. Preoperative simulation has diagnostic and therapeutic values. The SENDS criteria can be verified indirectly via outcome control. Biomechanically meaningful diagnostic x-rays of the spinal segment to be surgically treated are currently carried out with the patient in inclination and reclination. Software-related preoperative simulation based on these x-ray images facilitates the selection and implementation of the MAST procedure. For preoperative simulation motion shots are needed in inclination, neutral position and reclination and the dimensions can be obtained using an x-ray ball or a computed tomography (CT) scan. The SENDS criteria are useful because established procedures based on these criteria reach a comparable outcome. Preoperative simulation appears to be a useful selection criterion. Preoperatively it is necessary to collate patient and segment information in order to provide each patient with individualized treatment. So far there is no evidence for a better outcome after preoperative simulation but a reduction of surgery time and intraoperative radiation exposure could already be demonstrated. Minimally invasive methods should be preferred if there is a comparable outcome. The establishment of new procedures has to be accompanied by the maintenance of a spine register. Minimally invasive surgical procedures should be individualized for each patient and segment. Mobility X-ray images should be prepared for use with the preoperative simulation as the information content significantly increases with respect to the MAST procedure. (orig.) [de

  18. Multidetector-row computed tomography for the preoperative evaluation of axillary nodal status in patients with breast cancer

    International Nuclear Information System (INIS)

    Ogasawara, Yutaka; Doihara, Hiroyoshi; Shiraiwa, Misaki; Ishihara, Setsuko

    2008-01-01

    We evaluated the effectiveness of multidetector-row computed tomography (MD-CT) for detecting axillary lymph nodal status (ALNS) in patients with breast cancer. We reviewed 42 patients with breast cancer. A metastatic lymph node on MD-CT was defined as oval or round, with more than 5 mm on the short axis. We evaluated ALNS preoperatively by both palpation and MD-CT findings and performed sentinel lymph node biopsy (SLNB) and complete axillary lymph node dissection (ALND). For establishing the ALNS, MD-CT showed a sensitivity of 76.9%, a specificity of 96.6%, and an accuracy of 90.5%. On the basis of the MD-CT findings, misdiagnosis was made in 4 of the 42 patients, only one of which was false positive. On the other hand, one patient with a histologically negative sentinel lymph node (SLN) result had metastasis only in a non-SLN. Preoperative MD-CT showed a positive node in this patient. Multidetector-row computed tomography assists in identifying women who require ALND without SLNB, with sufficient positive predictive value. False-negative detection by SLNB could be avoided with careful interpretation of the axillary lymph nodes shown by MD-CT. (author)

  19. 16. PRE-OPERATIVE BLADDER IRRIGATION

    African Journals Online (AJOL)

    Esem

    effectiveness of using preoperative bladder irrigation with 1% povidone iodine in reducing ... consenting patient who presented to the department of surgery for open ..... infections in a tertiary care center in south-western. Nigeria. International ...

  20. Preoperative bowel preparation in children: Polyethylene glycol ...

    African Journals Online (AJOL)

    Preoperative bowel preparation in children: Polyethylene glycol versus normal saline. ... In children, (is this standard of care?: this method is mostly followed) this is usually ... Patients and Methods: Thirty patients, admitted in the Department of ...

  1. Preoperative Alcohol Consumption and Postoperative Complications

    DEFF Research Database (Denmark)

    Eliasen, Marie; Grønkjær, Marie; Skov-Ettrup, Lise Skrubbeltrang

    2013-01-01

    OBJECTIVE:: To systematically review and summarize the evidence of the association between preoperative alcohol consumption and postoperative complications elaborated on complication type. BACKGROUND:: Conclusions in studies on preoperative alcohol consumption and postoperative complications have...... been inconsistent. METHODS:: A systematic review and meta-analysis based on a search in MEDLINE, EMBASE, CINAHL, and PsycINFO citations. Included were original studies of the association between preoperative alcohol consumption and postoperative complications occurring within 30 days of the operation.......30-2.49), prolonged stay at the hospital (RR = 1.24; 95% CI: 1.18-1.31), and admission to intensive care unit (RR = 1.29; 95% CI: 1.03-1.61). Clearly defined high alcohol consumption was associated with increased risk of postoperative mortality (RR = 2.68; 95% CI: 1.50-4.78). Low to moderate preoperative alcohol...

  2. Preoperative lymph-node staging of invasive urothelial bladder cancer with 18F-fluorodeoxyglucose positron emission tomography/computed axial tomography and magnetic resonance imaging

    DEFF Research Database (Denmark)

    Jensen, Thor Knak; Holt, Per; Gerke, Oke

    2011-01-01

    OBJECTIVE: The treatment and prognosis of bladder cancer are based on the depth of primary tumour invasion and the presence of metastases. A highly accurate preoperative tumour, node, metastasis (TNM) staging is critical to proper patient management and treatment. This study retrospectively...... investigated the value of ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography/computed axial tomography (¹⁸F-FDG PET/CT) and magnetic resonance imaging (MRI) for preoperative N staging of bladder cancer. Material and methods. From June 2006 to January 2008, 48 consecutive patients diagnosed with bladder......) for MRI and ¹⁸F-FDG PET/CT, respectively. The differences in specificity and negative predictive values were not statistically significant. Conclusions. No significant statistical difference between ¹⁸F-FDG PET/CT and MRI for preoperative N staging of urothelial bladder cancer was found in the study...

  3. CT cystography

    International Nuclear Information System (INIS)

    Tsili, A.

    2012-01-01

    Full text: Cancer of the urinary bladder is one of the commonest urothelial neoplasms. Conventional cystoscopy remains the mainstay in the diagnosis of urinary bladder carcinomas. But it is an invasive and uncomfortable procedure, associated with complications. Computed tomographic (CT) virtual cystoscopy has been proposed as an alternative imaging modality with potential advantages in the detection of urinary bladder neoplasms and good patient acceptance. It is a minimally invasive technique, allowing imaging of the urinary bladder in multiple planes and a 360 0 view. CT cystoscopy provides information about the location, size and morphologic features of urinary bladder lesions, indicating appropriate areas for biopsy. It can be performed in cases in which conventional cystoscopy is not feasible, such as in the presence of urethral strictures, marked prostatic hypertrophy or active bleeding, and in cases in which cystoscopic findings are inconclusive. The technique can be used to evaluate areas of the urinary bladder difficult to evaluate with cystoscopy, such as the anterior bladder neck and narrowmouthed diverticula. Finally, virtual cystoscopy provides both intraluminal and extraluminal pathologic changes, so intravesical disease and exrtavesical extension can be evaluated in the same study. One of the limitations of this technique is the difficulty to demonstrate small-sized lesions. The introduction of multi-detector row CT (MDCT) scanners was a major technological advancement because among other things it substantially improves z-axis resolution by reducing section collimation and allowing the detection of very small lesions. The near isotropic or isotropic pixels achieved with a multidetector CT scanner, enable the creation of multiplanar reformatted images with a resolution very close to that of the axial images and three-dimensional (3D) renderings of outstanding quality. Transverse, multiplanar reformations and virtual endoscopic images are complementary

  4. Multislice CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Prokop, Mathias E-mail: mathias.prokop@univie.ac.at

    2000-11-01

    Multislice CT has overcome past limitations of CT angiography (CTA): Scan length and spatial resolution can be simultaneously optimized with multislice CTA, contrast medium can be saved, and the evaluation of large anatomic areas and vessels smaller than 1 mm become possible. This article describes how to optimize scanning protocols and contrast injection, and discusses the main clinical applications of this new technique. Only three main scanning protocolssuffice for all indications. A high speed / high-volume protocol (using 4*2mm or 4*2.5mm collimation) can be employed to scan the chest or abdomen in 8-10s, or to cover the whole abdominal aorta and the peripheral runoff including the feet within 40-65s. A high resolution protocol (using 4*1mm or 4*1.25mm) can be employed for the aorta and most regional vascular beds. It allows for near isotrophic imaging and depicts fine vascular structures with excellent detail. Ultra-high resolution protocols (using 2*0.5mm or 4*0.5mm collimation) yield totally isotropic data sets, and are mainly reserved for cerebrovascular imaging. Image processing techniques, and, in particular, volume rendering have made image presentation faster and easier. Multislice CTA exceeds MRA in spatial resolution and is now able to display even small vascular side branches. Its main indications will be aortic diseases, suspected pulmonary embolism but also renal artery stenoses, preoperative workup of abdominal or cerebral vessels, and acute vascular diseases. Multisplice CTA will become a strong competitor of other minimally invasive vascular imaging techniques.

  5. Prognosis on follow-up CT of chronic subdural hematomas treated by burr hole evacuation

    International Nuclear Information System (INIS)

    Higeta, Toshiaki; Yamada, Hiroshi; Itoh, Hakuji

    1986-01-01

    A consecutive series of 47 adult patients with chronic subdural hematoma was studied in respect to postoperative follow-up CT after burr hole evacuation. In 15 of our patients, the CT scan was normalized within 60 days. Six patients required reoperation because of reaccumulation or of poor re-expansion, and in 13 patients the follow-up CT showed a persisting subdural fluid collection even after 60 postoperative days. Further studying the correlation between the prognosis on follow-up CT and various factors, such as patient's age, preoperative neurological condition and CT findings or others, authors found that the elderly, especially older than 70 years, had a poor prognosis, and that the prognosis was correlated to the density and the thickness of hematoma on preoperative CT scan. (author)

  6. Evaluation of pre and post-operative spinal plain CT and CT-myelography

    International Nuclear Information System (INIS)

    Nagase, Joji; Inoue, Shunichi; Miyasaka, Hitoshi; Kamata, Sakae; Shinohara, Hiroyasu.

    1983-01-01

    Confirmation of the level of scan slices is essential for the CT diagnosis of spinal and spinal-cord diseases. Pre- and postoperative comparison should be made on the same level. For reading of plain CT and CTM, window levels should be identical pre- and postoperatively. Both methods demonstrated the spinal canal, morphology of the spinal cord, and three-Fdimensional pathologic pictures inside and outside the spinal cord. Preoperative CT contributed useful information on the pathologic conditions and selection of surgical procedures and routes. Postoperative plain CT confirmed surgical results, and CTM revealed the spinal cord and the subarachnoid space, as well as the range and degree of decompression from the spinal cord. (Chiba, N.)

  7. Evaluation of abdominal CT in the initial treatment of abdominal trauma

    International Nuclear Information System (INIS)

    Watanabe, Shinsuke; Ishii, Takashi; Kuwata, Katsuya; Yoneyama, Chihiro; Kitamura, Kazuya; Sasaki, Yoshifumi; Kamachi, Masahiro; Nishiguchi, Hiroyasu.

    1986-01-01

    During the last four years 102 patients with abdominal trauma were examined by CT for preoperative evaluation in our hospital. In 35 patients (34 %), the CT scans revealed no abnormal findings. They were all managed conservatively except for one case of perforated small bowel. In 67 patients (66 %) CT revealed evidences of substantial abdominal or retroperitoneal trauma. In 30 of them CT findings were confirmed by surgery. Hepatic injury is usually easily recognized by CT. CT is also useful for the detection of renal or splenic injuries. The majority of those parenchymatous organ injuries were successfully managed with conservative therapy, despite apparent traumatic lesions revealed by CT. Repeat CT scans is proved to be very useful to follow the changes of these traumatic lesions. In conclusion, application of abdominal CT is extremely useful for the initial decision making in treatment of patients with abdominal trauma and for the follow-up observation of injured lesions. (author)

  8. Results of preoperative concurrent chemoradiotherapy for locally advanced rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Sang Gyu; Kim, Su Ssan; Bae, Hoon Sik [Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of)

    2007-03-15

    We performed a retrospective non-randomized clinical study of locally advanced rectal cancer, to evaluate the anal sphincter preservation rates, down staging rates and survival rates of preoperative chemoradiotherapy. From January 2002 to December 2005, patients with pathologically confirmed rectal cancer with clinical stage T2 or higher, or patients with lymph node metastasis were enrolled in this study. A preoperative staging work-up was conducted in 36 patients. All patients were treated with preoperative chemoradiotherapy, and curative resection was performed for 26 patients at Hallym University Sacred Heart Hospital. Radiotherapy treatment planning was conducted with the use of planning CT for all patients. A total dose of 45.0 {approx} 52.2 Gy conventionally fractionated three-dimensional radiotherapy was delivered to the whole pelvis. Chemotherapy was given at the first and fifth week of radiation therapy with continuous infusion i.v. 5-FU (Fluorouracil) and LV (Leucovorine). Surgical resection was performed 2 to 4 weeks after the completion of the chemoradiotherapy regimen. The complete resection rate with negative resection margin was 100% (26/26). However, a pathologically complete response was not seen after curative resection. Surgery was done by LAR (low anterior resection) in 23 patients and APR (abdomino-perineal resection) in 3 patients. The sphincter preservation rate was 88.5% (23/26), down staging of the tumor occurred in 12 patients (46.2%) and down-sizing of the tumor occurred in 19 patients (73%). Local recurrence after surgical resection developed in 1 patient, and distant metastasis developed in 3 patients. The local recurrence free survival rate, distant metastasis free survival rate, and progression free survival rate were 96.7%, 87% and 83.1%, respectively. Treatment related toxicity was minimal except for one grade 3, one grade 4 anemia, one grade 3 leukopenia, and one grade 3 ileus. Preoperative concurrent chemoradiotherapy for locally

  9. Cardiac CT

    International Nuclear Information System (INIS)

    Dewey, Marc

    2011-01-01

    Computed tomography of the heart has become a highly accurate diagnostic modality that is attracting increasing attention. This extensively illustrated book aims to assist the reader in integrating cardiac CT into daily clinical practice, while also reviewing its current technical status and applications. Clear guidance is provided on the performance and interpretation of imaging using the latest technology, which offers greater coverage, better spatial resolution, and faster imaging. The specific features of scanners from all four main vendors, including those that have only recently become available, are presented. Among the wide range of applications and issues to be discussed are coronary artery bypass grafts, stents, plaques, and anomalies, cardiac valves, congenital and acquired heart disease, and radiation exposure. Upcoming clinical uses of cardiac CT, such as plaque imaging and functional assessment, are also explored. (orig.)

  10. Cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Dewey, Marc [Charite - Universitaetsmedizin Berlin (Germany). Inst. fuer Radiologie

    2011-07-01

    Computed tomography of the heart has become a highly accurate diagnostic modality that is attracting increasing attention. This extensively illustrated book aims to assist the reader in integrating cardiac CT into daily clinical practice, while also reviewing its current technical status and applications. Clear guidance is provided on the performance and interpretation of imaging using the latest technology, which offers greater coverage, better spatial resolution, and faster imaging. The specific features of scanners from all four main vendors, including those that have only recently become available, are presented. Among the wide range of applications and issues to be discussed are coronary artery bypass grafts, stents, plaques, and anomalies, cardiac valves, congenital and acquired heart disease, and radiation exposure. Upcoming clinical uses of cardiac CT, such as plaque imaging and functional assessment, are also explored. (orig.)

  11. Prognostic value of preoperative intratumoral FDG uptake heterogeneity in patients with epithelial ovarian cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Maria; Kim, Hee Seung; Chung, Hyun Hoon; Kim, Jae-Weon; Park, Noh-Hyun; Song, Yong Sang [Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul (Korea, Republic of); Lee, Hyunjong; Cheon, Gi Jeong [Seoul National University College of Medicine, Department of Nuclear Medicine, Cancer Research Institute, Seoul (Korea, Republic of)

    2017-01-15

    To investigate the prognostic value of intratumoral FDG uptake heterogeneity (IFH) derived from PET/CT in patients with epithelial ovarian cancer (EOC). We retrospectively reviewed patients with pathologically proven epithelial ovarian cancer who underwent preoperative {sup 18}F-FDG PET/CT scans. PET/CT parameters such as maximum and average standardized uptake values (SUV{sub max} and SUV{sub avg}), sum of all metabolic tumour volume (MTV), cumulative total lesion glycolysis (TLG) and IFH were assessed. Regression analyses were used to identify clinicopathological and imaging variables associated with disease-free survival (DFS). Clinicopathological data were reviewed for 61 eligible patients. The median duration of DFS was 13 months (range, 6-26 months), and 18 (29.5 %) patients experienced recurrence. High IFH values were associated with tumour recurrence (P = 0.005, hazard ratio 4.504, 95 % CI 1.572-12.902). The Kaplan-Meier survival graphs showed that DFS significantly differed in groups categorized based on IFH (P = 0.002, log-rank test). Moreover, there were significant differences in DFS (P = 0.009) and IFH (P = 0.040) between patients with and without recurrence. Preoperative IFH measured by {sup 18}F-FDG PET/CT was significantly associated with EOC recurrence. FDG-based heterogeneity could be a useful and potential predicator of EOC recurrence before treatment. (orig.)

  12. CT colonography: colonic distention improved by dual positioning but not intravenous glucagon

    International Nuclear Information System (INIS)

    Morrin, Martina M.; Keogan, Mary T.; Kruskal, Jonathan B.; Yam, Chun-Shan; Raptopoulos, Vassilios; Farrell, Richard J.

    2002-01-01

    The aim of this study was to determine whether intravenous (IV) glucagon and dual positioning administered prior to CT colonography enhances colonic distention. We assessed the effect of dual positioning and IV glucagon on colonic distention in 96 patients who underwent CT colonography examinations. The CT colonography was performed in both supine and prone positions. Seventy-four patients received glucagon (1 mg i.v.) immediately prior to CT scanning and 22 patients did not. The bowel was divided into ten segments and colonic distention was scored by two radiologists in the supine, prone, and combined supine/prone positions using a five-point scale: 1=collapsed; 2=poorly visualized; ≥3=adequate distention; 4=entire segment visualized and well distended; 5=excellent distention. A combined segmental and overall supine/prone distention score was calculated based on the sum of the mean score for each position. There was no significant difference in the degree of colonic distention between patients who received glucagon and those who did not [supine/prone distention score (mean±SE): 3.63±0.2 vs 3.85±0.2; p=n.s.]. The degree of colonic distention was greater in the prone position in both the glucagon (3.87±0.2 vs 3.38±0.2; p<0.05) and non-glucagon groups (4.01±0.2 vs 3.69±0.2; p=N.S.) particularly in the proximal colon. There was almost perfect agreement between both radiologists in their scoring of colonic distention on a per-patient basis (k=0.9; p<0.001). Of 1480 bowel segments, 1261 (85.2%) were adequately distended in the glucagon group compared with 370 of 440 bowel segments (84%) in the non-glucagon group (p=n.s.) Colonic distention at CT colonography is improved by dual positioning but not by the administration of intravenous glucagon. While our results suggest that other smooth muscle relaxants, including butyl scopolamine, may only have a limited role in improving colonic distention in CT colonography, further studies are required. (orig.)

  13. Low-dose dental CT

    International Nuclear Information System (INIS)

    Rustemeyer, P.; Eich, H.T.; John-Mikolajewski, V.; Mueller, R.D.

    1999-01-01

    Purpose: The intention of this study was to reduce patient dose during dental CT in the planning for osseointegrated implants. Methods and Materials: Dental CTs were performed with a spiral CT (Somatom Plus 4, Siemens) and a dental software package. Use of the usual dental CT technique (120 kVp; 165 mA, 1 s rotation time, 165 mAs; pitch factor 1) was compared with a new protocol (120 kVp; 50 mA; 0.7 s rotation time; 35 mAs; pitch factor 2) which delivered the best image quality at the lowest possible radiation dose, as tested in a preceding study. Image quality was analysed using a human anatomic head preparation. Four radiologists analysed the images independently. A Wilcoxon rank pair-test was used for statistic evaluation. The doses to the thyroid gland, the active bone marrow, the salivary glands, and the eye lens were determined in a tissue-equivalent phantom (Alderson-Rando Phantom) with lithium fluoride thermoluminescent dosimeters at the appropriate locations. Results: By mAs reduction from 165 to 35 and using a pitch factor of 2, the radiation dose could be reduced by a factor of nine (max.) (e.g., the bone marrow dose could be reduced from 23.6 mSv to 2.9 mSv, eye lens from 0.5 mSv to 0.3 mSv, thyroid gland from 2.5 mSv to 0.5 mSv, parotid glands from 2.3 mSv to 0.4 mSv). The dose reduction did not lead to an actual loss of image quality or diagnostic information. Conclusion: A considerable dose reduction without loss of diagnostic information is achievable in dental CT. Dosereducing examination protocols like the one presented may further expand the use of preoperative dental CT. (orig.) [de

  14. A STUDY OF CORRELATION BETWEEN NASAL ENDOSCOPY AND CT SCAN IN CASES OF CHRONIC RHINOSINUSITIS

    Directory of Open Access Journals (Sweden)

    Arun Kumar

    2015-07-01

    Full Text Available BACKGROUND: The accurate diagnosis of Chronic Rhinosinusitis (CRS is still a challenge therefore, the American Academy of Otorhinolaryngology - Head and Neck Surgery (AAO - HNS 1 has met in a multidisciplinary encounter and formulated a consensus based on only clinical symptoms. The computed tomography (CT scan and the nasal endoscopy (NE were introduced to make an accurate diagnosis of CRS and verify the disease severity. AIM: The aim of this study is to make a correlation between nasal endoscopy and CT scan in cases of clinically diagnosed Chronic Rhinosinusitis patients. METHOD: A study was carried out on 90 patients at Jhalawar Medical College, Jhalawar (Raj. during Sept. 20 12 to Dec. 2014. Diagnostic Nasal Endoscopy and CT Scan PNS done in patients, suffering from Chronic Rhinosinusitis. As a classification instruments, Metson / Gliklich's classification was used to evaluate the tomographic diagnosis and the Stankiewicz / Chow' s classification to evaluate the endoscopic diagnosis of Chronic Rhinosinusitis. RESULTS: Our study showed high specificity of endoscopy in comparison to CT scan though CT scan results are more sensitive. CONCLUSION: Endoscopy can confirm a Chronic Rhinosi nusitis diagnosis, but cannot rule it out, and that CT should be performed in cases of suspected CRS even if mucopurulence is not noted on endoscopy. The CT scan and the nasal endoscopy making easier the treatment planning and the disease resolution.

  15. 4D CT and lung cancer surgical resectability: a technical innovation

    International Nuclear Information System (INIS)

    Troupis, John M.; Pasricha, Sundeep S.; Narayanan, Harish; Rybicki, Frank J.

    2014-01-01

    A 74-year-old man presents with a left upper lobe lung adenocarcinoma, which demonstrated a wide base intimately with the aortic arch. We utilised 4D CT technique with a wide field of view CT unit to preoperatively determine likely surgical resectability. We propose that 4D CT may be of use in further investigating lung cancer with likely invasion of adjacent structures.

  16. CT-Urography; Urografia CT

    Energy Technology Data Exchange (ETDEWEB)

    Dalla Palma, Ludovico; Grotto, Maurizio [Trieste Univ., Trieste (Italy). Dipartimento di scienze cliniche, morfologiche e tecnologiche, UCO di radiologia; Morra, Aldo [CRO, Aviano (Italy). Reparto di radiologia

    2005-09-15

    In this paper we present an overview of CT-Urography. With the advent of multislice CT scanners and the evolution of image processing methods this technique now affords optimal urographic images comparable to those obtained with conventional techniques. We describe the acquisition techniques and protocols used by the various authors. Effective radiation dose has conditioned the use of CT-Urography so that the tendency today is to reduce the number of scans by performing, after the non enhanced scan, a single contrast-enhanced scan comprising both the nephrographic and urographic phase. With the use of multislice CT the quality of the urogram improves with the number of slices. We illustrate a variety of processing techniques, multiplanar reconstruction (MPR), maximum (MIP) and average intensity projection (AIP) and volume rendering (VR) and present a series of upper urinary tract tumours testifying to the superiority of the AIP technique over MIP. We then review the results of comparative studies of CT-Urography with conventional urography in upper urinary tract diagnostics. Finally, we describe the advantages and limitations of CT-Urography. [Italian] Gli Autori presentano una panoramica sulla Urografia TC (Uro TC). L'avvento della TC multistrato e l'evoluzione delle tecniche di elaborazione consentono di ottenere dei quadri urografici ottimali comparativi con quelli convenzionali. Vengono ricordate le varie tecniche di acquisizione e i protocolli usati dai vari Autori. La dose effettiva di radiazioni ha rappresentato uno dei fattori condizionanti per cui oggi prevale l'orientamento di ridurre il numero di scansioni, considerando dopo la scansione senza mezzo di contrasto un'unica scansione contrasto grafica comprendente sia la fase nefrografica che quella urografica. Con l'uso della TC multistrato la qualita dell'urogramma migliora con l'aumento del numero degli strati. Vengono descritte le varie tecniche di elaborazione, la

  17. Five fractions of radiation therapy followed by 4 cycles of FOLFOX chemotherapy as preoperative treatment for rectal cancer.

    Science.gov (United States)

    Myerson, Robert J; Tan, Benjamin; Hunt, Steven; Olsen, Jeffrey; Birnbaum, Elisa; Fleshman, James; Gao, Feng; Hall, Lannis; Kodner, Ira; Lockhart, A Craig; Mutch, Matthew; Naughton, Michael; Picus, Joel; Rigden, Caron; Safar, Bashar; Sorscher, Steven; Suresh, Rama; Wang-Gillam, Andrea; Parikh, Parag

    2014-03-15

    Preoperative radiation therapy with 5-fluorouracil chemotherapy is a standard of care for cT3-4 rectal cancer. Studies incorporating additional cytotoxic agents demonstrate increased morbidity with little benefit. We evaluate a template that: (1) includes the benefits of preoperative radiation therapy on local response/control; (2) provides preoperative multidrug chemotherapy; and (3) avoids the morbidity of concurrent radiation therapy and multidrug chemotherapy. Patients with cT3-4, any N, any M rectal cancer were eligible. Patients were confirmed to be candidates for pelvic surgery, provided response was sufficient. Preoperative treatment was 5 fractions radiation therapy (25 Gy to involved mesorectum, 20 Gy to elective nodes), followed by 4 cycles of FOLFOX [5-fluorouracil, oxaliplatin, leucovorin]. Extirpative surgery was performed 4 to 9 weeks after preoperative chemotherapy. Postoperative chemotherapy was at the discretion of the medical oncologist. The principal objectives were to achieve T stage downstaging (ypT chemotherapy. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Computer-aided segmentation system for 3D chest CT

    International Nuclear Information System (INIS)

    Iwasawa, Tae; Komagata, Takanobu; Ogura, Takashi; Iwao, Yuma; Goto, Toshiyuki; Asakura, Akira; Inoue, Tomio

    2012-01-01

    We will introduce the quantitative analysis of the chest CT images using computer-assisted segmentation system (Gaussian Histogram Normalized Correlation; GHNC). This system can divide the lung into several patterns, for example, normal, emphysema and fibrous lesion, and measure each lesion volume quantitatively. We analyzed 3D-CT images of 20 patients with lung cancer. GHNC could measure the volumes of emphysema and fibrosis lesions, respectively. GHNC analysis will be feasible for preoperative CT evaluation, especially in the patients with combined pulmonary fibrosis and emphysema. (author)

  19. Cholesterol granuloma of the petrous apex: CT diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Lo, W.W.M.; Solti-Bohman, L.G.; Brackmann, D.E.; Gruskin, P.

    1984-12-01

    Cholesterol granuloma of the petrous apex is a readily recognizable and treatable entity that is more common than previously realized. Cholesterol granuloma grows slowly in the petrous apex as a mass lesion until it produces hearing loss, tinnitus, vertigo, and facial twitching. Twelve cases of cholesterol granuloma of the petrous apex are illustrated; ten of these analyzed in detail, especially with respect to CT findings. A sharply and smoothly marginated expansile lesion in the petrous apex, isodense with plain and nonenhancing on CT, is in all probability a cholesterol granuloma. Preoperative recognition by CT is important for planning proper treatment.

  20. Cholesterol granuloma of the petrous apex: CT diagnosis

    International Nuclear Information System (INIS)

    Lo, W.W.M.; Solti-Bohman, L.G.; Brackmann, D.E.; Gruskin, P.

    1984-01-01

    Cholesterol granuloma of the petrous apex is a readily recognizable and treatable entity that is more common than previously realized. Cholesterol granuloma grows slowly in the petrous apex as a mass lesion until it produces hearing loss, tinnitus, vertigo, and facial twitching. Twelve cases of cholesterol granuloma of the petrous apex are illustrated; ten of these analyzed in detail, especially with respect to CT findings. A sharply and smoothly marginated expansile lesion in the petrous apex, isodense with plain and nonenhancing on CT, is in all probability a cholesterol granuloma. Preoperative recognition by CT is important for planning proper treatment

  1. The effect of steroid treatment on intracranial malignant lymphoma and its serial CT findings

    International Nuclear Information System (INIS)

    Takahashi, Yoshio; Ito, Kazunori; Mikami, Junichi; Ueda, Mikiya; Sato, Hiroyuki

    1984-01-01

    We treated 2 cases of intracranial malignant lymphoma presumably originating in the cerebellum and 1 case of intracranial malignant lymphoma presumably originating in the corpus callosum and ventricular ependium, by means of the administration of steroids. There resulted a marked shrinkage of the tumor shadow on CT. Though massive steroids are known to diminish the tumor shadow in CT images, steroids in ordinary doses induce such a shrinkage only rarely. The preoperative diagnosis of intracranial malignant lymphoma, therefore, seemed feasible if, besides plain CT, enhanced CT, and AG findings, the effect of steroid treatment on the CT image was taken into consideration. (author)

  2. CT portography in the presence of liver steatosis. Potential for a false-negative result

    International Nuclear Information System (INIS)

    Steiner, W.; Scheidler, J.; Kohz, P.; Staebler, A.; Reiser, M.

    1994-01-01

    CT portography is the most sensitive technique currently available for the preoperative diagnosis of liver metastases. We report on a patient with liver steatosis in whom ultrasound examination revealed two liver metastases in the follow up after resection of a papillary carcinoma. The liver metastases could be clearly identified both on plain CT and on enhanced CT with dynamic bolus contrast medium injection. Because of the small difference in attenuation values between liver parenchyma and metastases the two liver metastases had not been recognized on CT portography. When severe and diffuse liver steatosis is present CT portography may fail to detect metastases or small hepatocellular carcinoma. (orig.)

  3. Sinonasal polyposis: investigation by direct coronal CT

    International Nuclear Information System (INIS)

    Drutman, J.; Harnsberger, H.R.; Babbel, R.W.; Sonkens, J.W.; Braby, D.

    1994-01-01

    To demonstrate the typical clinical and CT features of sinonasal polyposis, we reviewed the clinical records and preoperative direct coronal CT scans of 35 patients with surgically proven disease. Symptoms included progressive nasal stuffiness (100 %), rhinorrhea (69 %), facial pain (60 %), headache (43 %) and anosmia (17 %). We found associations with rhinitis (46 %), asthma (29 %) and aspirin sensitivity (9 %). Coronal CT features included polypoid masses in the nasal cavity (91 %), partial or complete pansinus opacification (90 %), enlargement of infundibula (89 %), bony attenuation of the ethmoid trabeculae (63 %) and nasal septum (37 %), opacified ethmoid sinuses with convex lateral walls (51 %) and air-fluid levels (43 %). The latter feature correlated with symptoms and signs of acute sinusitis in only 40 % of patients. Recognition of sinonasal polyposis is important to the endoscopic surgeon since it can be the most troubling sinonasal inflammatory disease to manage due to its aggressive nature and tendency to recur despite appropriate treatment. (orig.)

  4. CT-based injury classification

    International Nuclear Information System (INIS)

    Mirvis, S.E.; Whitley, N.O.; Vainright, J.; Gens, D.

    1988-01-01

    Review of preoperative abdominal CT scans obtained in adults after blunt trauma during a 2.5-year period demonstrated isolated or predominant liver injury in 35 patients and splenic injury in 33 patients. CT-based injury scores, consisting of five levels of hepatic injury and four levels of splenic injury, were correlated with clinical outcome and surgical findings. Hepatic injury grades I-III, present in 33 of 35 patients, were associated with successful nonsurgical management in 27 (82%) or with findings at celiotomy not requiring surgical intervention in four (12%). Higher grades of splenic injury generally required early operative intervention, but eight (36%) of 22 patients with initial grade III or IV injury were managed without surgery, while four (36%) of 11 patients with grade I or II injury required delayed celiotomy and splenectomy (three patients) or emergent rehospitalization (one patient). CT-based injury classification is useful in guiding the nonoperative management of blunt hepatic injury in hemodynamically stable adults but appears to be less reliable in predicting the outcome of blunt splenic injury

  5. The influence of somatostatin receptor scintigraphy during preoperative staging of non-functioning pancreatic neuroendocrine tumours

    International Nuclear Information System (INIS)

    Jilesen, A.P.J.; Hoefnagel, S.J.M.; Busch, O.R.C.; Bennink, R.J.; Gouma, D.J.; Nieveen van Dijkum, E.J.M.

    2016-01-01

    Aim: To determine whether somatostatin receptor scintigraphy (SRS) influences the preoperative staging and clinical management of non-functioning pancreatic neuroendocrine tumours (NF-pNETs). Materials and methods: All SRS examinations performed between 2002–2013 were selected. Patients with NF-pNET were included if both computed tomography (CT) and SRS was performed during preoperative staging. The diagnostic accuracy of CT and SRS for detecting NF-pNET metastases was analysed. Altered TNM classification and changed clinical management were calculated. Changed management was defined as a change from surgical resection into systemic treatment or vice versa. NF-pNETs were defined as tumours without clinical symptoms of hormonal hypersecretion. Results: Overall, 62 patients with NF-pNET were included with a mean age of 57 years (SD: 12.4) 2 . In 28 patients (45%), CT and SRS were correct and in agreement in the detection of primary tumour/metastases. In 34 patients (55%), one of the techniques was incorrect and therefore, there was no agreement. SRS altered the TNM classification in 14 patients (23%) and clinical management in nine patients (15%). In patients without metastases on CT, SRS detected lymph node metastases in one patient. The sensitivity to detect the primary tumour with CT was 95% and with SRS was 73%. In detecting metastases, the sensitivity and specificity were both 85% for CT versus 80% and 90% for SRS. Conclusion: Overall, CT and SRS were in agreement in the detection of NF-pNET. In NF-pNET without suspicious metastatic lesions on CT, SRS has limited value. SRS may be indicated to confirm lesions suspicious for neuroendocrine tumours metastases. - Highlights: • In 28 patients (45%), CT and SRS were correct and in agreement in the detection of primary tumor/metastases. • In 34 patients (55%) one of the modalities was incorrect and therefore, there was no agreement. • Sensitivity to detect the primary tumor with CT and SRS were 95% versus 73

  6. Postoperative CT appearance in chronic subdural hematomas

    Energy Technology Data Exchange (ETDEWEB)

    Kaneko, Takaaki; Nishikawa, Michio; Handa, Hajime; Iwaki, Kazuo; Sawai, Teruaki; Munaka, Masahiro

    1988-05-01

    Postoperative CT appearances in 65 cases of chronic subdural hematomas were evaluated in terms of patient's age, preoperative neurological symptoms and CT findings, final outcomes, and so on. All of the cases were treated with trepanation and irrigation. CT appearances were divided into four different types as follows; Type Ia: No abnormal findings in the subdural sapce, Type Ib: The same as above except for a linear high density suggestive of thickened outer membrane, Type II: Persistence subdural fluid collection and widened cortical sulci which indicate underlining brain atrophy, Type III: Remaining hematoma and/or density changes during follow-up period. Although the mean age of the patients in type Ib was higher than those in type Ia and reexpansion of the brain appear to delay in type Ib and preoperative CT in type Ib tended to show mixed density, final outcome in both groups were excellent. Characteristics in type II were that most of cases were in the eighth decade, preceding head injury was unclear, preoperative psychiatric symptoms and disturbance of consciousness were common and postoperative improvement of the symptoms was not satisfactory compared to other types. Aged patients as in type Ib and type II and thick hematomas of over 2 cm depth with mixed or high density tended to show type III postoperatively. All of the nine patients who required reoperation were included in this type. The present study indicates that thick hematomas with sizable mass effect and mixed or high density in the aged must be carefully treated, such as with placement of the subdural drainage or keeping the patient in the Trendelenburg position, to facilitate postoperative reexpansion of the brain.

  7. Five Fractions of Radiation Therapy Followed by 4 Cycles of FOLFOX Chemotherapy as Preoperative Treatment for Rectal Cancer

    International Nuclear Information System (INIS)

    Myerson, Robert J.; Tan, Benjamin; Hunt, Steven; Olsen, Jeffrey; Birnbaum, Elisa; Fleshman, James; Gao, Feng; Hall, Lannis; Kodner, Ira; Lockhart, A. Craig; Mutch, Matthew; Naughton, Michael; Picus, Joel; Rigden, Caron; Safar, Bashar; Sorscher, Steven; Suresh, Rama; Wang-Gillam, Andrea; Parikh, Parag

    2014-01-01

    Background: Preoperative radiation therapy with 5-fluorouracil chemotherapy is a standard of care for cT3-4 rectal cancer. Studies incorporating additional cytotoxic agents demonstrate increased morbidity with little benefit. We evaluate a template that: (1) includes the benefits of preoperative radiation therapy on local response/control; (2) provides preoperative multidrug chemotherapy; and (3) avoids the morbidity of concurrent radiation therapy and multidrug chemotherapy. Methods and Materials: Patients with cT3-4, any N, any M rectal cancer were eligible. Patients were confirmed to be candidates for pelvic surgery, provided response was sufficient. Preoperative treatment was 5 fractions radiation therapy (25 Gy to involved mesorectum, 20 Gy to elective nodes), followed by 4 cycles of FOLFOX [5-fluorouracil, oxaliplatin, leucovorin]. Extirpative surgery was performed 4 to 9 weeks after preoperative chemotherapy. Postoperative chemotherapy was at the discretion of the medical oncologist. The principal objectives were to achieve T stage downstaging (ypT < cT) and preoperative grade 3+ gastrointestinal morbidity equal to or better than that of historical controls. Results: 76 evaluable cases included 7 cT4 and 69 cT3; 59 (78%) cN+, and 7 cM1. Grade 3 preoperative GI morbidity occurred in 7 cases (9%) (no grade 4 or 5). Sphincter-preserving surgery was performed on 57 (75%) patients. At surgery, 53 patients (70%) had ypT0-2 residual disease, including 21 (28%) ypT0 and 19 (25%) ypT0N0 (complete response); 24 (32%) were ypN+. At 30 months, local control for all evaluable cases and freedom from disease for M0 evaluable cases were, respectively, 95% (95% confidence interval [CI]: 89%-100%) and 87% (95% CI: 76%-98%). Cases were subanalyzed by whether disease met requirements for the recently activated PROSPECT trial for intermediate-risk rectal cancer. Thirty-eight patients met PROSPECT eligibility and achieved 16 ypT0 (42%), 15 ypT0N0 (39%), and 33 ypT0-2 (87

  8. Five Fractions of Radiation Therapy Followed by 4 Cycles of FOLFOX Chemotherapy as Preoperative Treatment for Rectal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Myerson, Robert J., E-mail: rmyerson@radonc.wustl.edu [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Tan, Benjamin [Division of Medical Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Hunt, Steven [Section of Colorectal Surgery, Washington University School of Medicine, St. Louis, Missouri (United States); Olsen, Jeffrey [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Birnbaum, Elisa; Fleshman, James [Section of Colorectal Surgery, Washington University School of Medicine, St. Louis, Missouri (United States); Gao, Feng [Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri (United States); Hall, Lannis [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Kodner, Ira [Section of Colorectal Surgery, Washington University School of Medicine, St. Louis, Missouri (United States); Lockhart, A. Craig [Division of Medical Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Mutch, Matthew [Section of Colorectal Surgery, Washington University School of Medicine, St. Louis, Missouri (United States); Naughton, Michael; Picus, Joel; Rigden, Caron [Division of Medical Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Safar, Bashar [Section of Colorectal Surgery, Washington University School of Medicine, St. Louis, Missouri (United States); Sorscher, Steven; Suresh, Rama; Wang-Gillam, Andrea [Division of Medical Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Parikh, Parag [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States)

    2014-03-15

    Background: Preoperative radiation therapy with 5-fluorouracil chemotherapy is a standard of care for cT3-4 rectal cancer. Studies incorporating additional cytotoxic agents demonstrate increased morbidity with little benefit. We evaluate a template that: (1) includes the benefits of preoperative radiation therapy on local response/control; (2) provides preoperative multidrug chemotherapy; and (3) avoids the morbidity of concurrent radiation therapy and multidrug chemotherapy. Methods and Materials: Patients with cT3-4, any N, any M rectal cancer were eligible. Patients were confirmed to be candidates for pelvic surgery, provided response was sufficient. Preoperative treatment was 5 fractions radiation therapy (25 Gy to involved mesorectum, 20 Gy to elective nodes), followed by 4 cycles of FOLFOX [5-fluorouracil, oxaliplatin, leucovorin]. Extirpative surgery was performed 4 to 9 weeks after preoperative chemotherapy. Postoperative chemotherapy was at the discretion of the medical oncologist. The principal objectives were to achieve T stage downstaging (ypT < cT) and preoperative grade 3+ gastrointestinal morbidity equal to or better than that of historical controls. Results: 76 evaluable cases included 7 cT4 and 69 cT3; 59 (78%) cN+, and 7 cM1. Grade 3 preoperative GI morbidity occurred in 7 cases (9%) (no grade 4 or 5). Sphincter-preserving surgery was performed on 57 (75%) patients. At surgery, 53 patients (70%) had ypT0-2 residual disease, including 21 (28%) ypT0 and 19 (25%) ypT0N0 (complete response); 24 (32%) were ypN+. At 30 months, local control for all evaluable cases and freedom from disease for M0 evaluable cases were, respectively, 95% (95% confidence interval [CI]: 89%-100%) and 87% (95% CI: 76%-98%). Cases were subanalyzed by whether disease met requirements for the recently activated PROSPECT trial for intermediate-risk rectal cancer. Thirty-eight patients met PROSPECT eligibility and achieved 16 ypT0 (42%), 15 ypT0N0 (39%), and 33 ypT0-2 (87

  9. Influence of Preoperative Chemoradiotherapy on the Surgical Strategy According to the Clinical T Stage of Patients With Rectal Cancer

    Science.gov (United States)

    Park, In Ja; Lee, Jong Lyul; Yoon, Yong Sik; Kim, Chan Wook; Lim, Seok-Byung; Lee, Jong Seok; Park, Seong Ho; Park, Jin Hong; Kim, Jong Hoon; Yu, Chang Sik; Kim, Jin Cheon

    2015-01-01

    Abstract The aim of this study was to evaluate the pathologic responses and changes to surgical strategies following preoperative chemoradiotherapy (PCRT) in rectal cancer patients according to their clinical T stage (cT). The use of PCRT has recently been extended to less advanced disease. The authors enrolled 650 patients with cT2 to 4 mid and low rectal cancer who received both PCRT and surgical resection. The rate of total regression and the proportion of local excision were compared according to the cT category. The 3-year recurrence-free survival (RFS) rate was compared using the log-rank test according to patient cT category, pathologic stage, and type of surgical treatment. Patients with cT2 were older (P = 0.001), predominately female (P = 0.028), and had low-lying rectal cancer (P = 0.008). Pathologic total regression was achieved most frequently in cT2 patients (54% of cT2 versus 17.6% of cT3 versus 8.2% of cT4; P rectal cancer, optimal surgical treatment may be achieved with the tailored use of PCRT. PMID:26717384

  10. Accuracy of 18F-FDG PET/CT for lymph node staging in non-small-cell lung cancers

    Institute of Scientific and Technical Information of China (English)

    LIU Bao-jun; DONG Jing-cheng; XU Chang-qing; ZUO Chuan-tao; LE Jing-jing; GUAN Yi-hui; ZHAO Jun; WU Jin-feng; DUAN Xiao-hong; CAO Yu-xue

    2009-01-01

    Background This retrospective study evaluated the diagnostic accuracy of 2-(F18)-fluoro-2-deoxy-D-glucose-positron emission tomography(18F-FDG-PET)/COmputed tomography(PET/CT)in the preoperative diagnosis of metastatic mediastinal and hilar lymph node in patients with non-small-cell lung cancer(NSCLC).Methods A total of 39 patients received preoperative 18F-FDG PET/CT and the postoperative biopsy.We compared preoperative PET/CT scan results with corresponding intraoperative histopathalogic findings in 39 NSCLC patients.The sensitivity,specificity,accuracy,positive and negative predictive value of 18F-FDG PET/CT were assessed.Results Histopathologic examination confirmed metastasis in 57 out of the 208 excised lymph nodes;23 of the 57 nodes were mediastinal and hilar lymph nodes.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of PET/CT in the preoperative diagnosis of mediastinal lymph node metastasis in NSCLC patients were 65%,96.8%,92%,78.5%and 90%,respectively.Conclusions PET/CT scan showed good accuracy in the preoperative diagnosis of mediastinal and hilar lymph node metastasis in the patients with NSCLC.We recommend that PET/CT scanning be used as a first-line evaluation tool for tumor diagnosis,therapy evaluation and follow-up.

  11. CT image construction of a totally deflated lung using deformable model extrapolation

    International Nuclear Information System (INIS)

    Sadeghi Naini, Ali; Pierce, Greg; Lee, Ting-Yim

    2011-01-01

    Purpose: A novel technique is proposed to construct CT image of a totally deflated lung from a free-breathing 4D-CT image sequence acquired preoperatively. Such a constructed CT image is very useful in performing tumor ablative procedures such as lung brachytherapy. Tumor ablative procedures are frequently performed while the lung is totally deflated. Deflating the lung during such procedures renders preoperative images ineffective for targeting the tumor. Furthermore, the problem cannot be solved using intraoperative ultrasound (U.S.) images because U.S. images are very sensitive to small residual amount of air remaining in the deflated lung. One possible solution to address these issues is to register high quality preoperative CT images of the deflated lung with their corresponding low quality intraoperative U.S. images. However, given that such preoperative images correspond to an inflated lung, such CT images need to be processed to construct CT images pertaining to the lung's deflated state. Methods: To obtain the CT images of deflated lung, we present a novel image construction technique using extrapolated deformable registration to predict the deformation the lung undergoes during full deflation. The proposed construction technique involves estimating the lung's air volume in each preoperative image automatically in order to track the respiration phase of each 4D-CT image throughout a respiratory cycle; i.e., the technique does not need any external marker to form a respiratory signal in the process of curve fitting and extrapolation. The extrapolated deformation field is then applied on a preoperative reference image in order to construct the totally deflated lung's CT image. The technique was evaluated experimentally using ex vivo porcine lung. Results: The ex vivo lung experiments led to very encouraging results. In comparison with the CT image of the deflated lung we acquired for the purpose of validation, the constructed CT image was very similar. The

  12. The Usefulness of 99mTc-Sestamibi Scan in Preoperative Localization in Primary Hyperparathyroidism

    International Nuclear Information System (INIS)

    Baik, S. H.; Kim, S. M.; Choi, K. M.; Choi, Y. S.; Kim, S. J.; Yu, J. M.; Choi, D. S.; Choe, J. C.

    1995-01-01

    An accurate preoperative localization in patients with primary hyperparathyroidism is important for successful surgical intervention. There are many methods for the localization of the primary hyperparathyroidism such as ultrasonography, computerized tomography(CT), magnetic resonance imaging(MRI), angiography and 201 T1/ 99m Tc-subtraction scan. Among them 201T1/99mTc subtraction scan in known as the most accurate tool for preoperative localization. Recently 201 T1/ 99m Tc-Sestamibi has been used for parathyroid gland imaging. We experienced 19 primary hyperparathyroidisms accurately localized with 201 T1/ 99m Tcsubtraction imaging and 99m Tc-Sestamibi. The sensitivities of the 99m Tc-Sestamibi, 201T1/99mTc subtraction imaging, CT and US were 100%(5/5), 89.5%(17/19) and 61.7(12/19) respectively. With the combination of 99m Tc-Sestamibi and 201 T1/ 99T c-subtraction imaging we could localize with 100% accuracy. Although the case number is small, this study suggests that the 99m Tc-Sestamibi parathyroid scan is very useful and easy to use for preoperative localization in primary hyperparathyroidism.

  13. Catawba nuclear station preoperational ALARA review

    International Nuclear Information System (INIS)

    Deal, W.P.

    1985-01-01

    This paper describes the particular emphasis placed on preoperational as los as reasonably achievable (ALARA) considerations at Duke Power's Catawba Nuclear Station. A strong station commitment to the ALARA philosophy, and review of existing capabilities, led to development of an aggressive two-part ALARA program. Capabilities consisted of sufficient numbers of available personnel, lengthy lead time during construction, a very detailed plastic model, and a sister plant of similar design. The program, as developed, consisted of a preoperational program, which looked at design and construction aspects of ALARA, and the operational program, dealing with the ALARA committee and operational problems. MAnagement's philosophy of holding everyone responsible for ALARA provided the motivation to organize the preoperational program to use that resource. The Health Physics group accepted responsibility for development, coordination, and reviewer training. The problem provided a base to build on as station personnel gained experience in their own crafts and radiation protection in general

  14. CT urography

    Energy Technology Data Exchange (ETDEWEB)

    Korobkin, M. [Dept. of Radiology, Univ. of Michigan, Ann Arbor, MI (United States)

    2005-11-15

    With the advent of multidetector row CT scanners, evaluation of the urothelium of the entire urinary tract with high-resolution thin sections during a single breath-hold has become a reality. Multidetector CT urography (MDCTU) is a single examination that allows evaluation of potential urinary tract calculi, renal parenchymal masses, and both benign and malignant urothelial lesions. Initial results with this new technique are encouraging. Current investigations of MDCTU focus on methods to improve opacification and distension of the upper urinary tract - the collecting systems, pelvis, and ureters. The role of abdominal compression, infusion of saline and/or furosemide, and optimal time delay of excretory phase imaging is being explored. Upper tract urothelial malignancies, including small lesions less the 5 mmin diameter, can be detected with high sensitivity. Methods to reduce radiation exposure are being explored, including split-bolus contrast injection techniques that combine nephrographic and excretory phases into a single phase. It is likely that in the near future, radiological evaluation of significant unexplained hematuria or of known or prior urothelial malignancy will consist of a single examination - MDCTU. (orig.)

  15. Pre-operative fasting guidelines: an update

    DEFF Research Database (Denmark)

    Søreide, E; Eriksson, L I; Hirlekar, G

    2005-01-01

    Liberal pre-operative fasting routines have been implemented in most countries. In general, clear fluids are allowed up to 2 h before anaesthesia, and light meals up to 6 h. The same recommendations apply for children and pregnant women not in labour. In children......Liberal pre-operative fasting routines have been implemented in most countries. In general, clear fluids are allowed up to 2 h before anaesthesia, and light meals up to 6 h. The same recommendations apply for children and pregnant women not in labour. In children...

  16. Preoperative evaluation of hilar vessel anatomy with 3-D computerized tomography in living kidney donors.

    Science.gov (United States)

    Tombul, S T; Aki, F T; Gunay, M; Inci, K; Hazirolan, T; Karcaaltincaba, M; Erkan, I; Bakkaloglu, A; Yasavul, U; Bakkaloglu, M

    2008-01-01

    Digital subtract angiography is the gold standard for anatomic assessment of renal vasculature for living renal donors. However, multidetector-row computerized tomography (MDCT) is less invasive than digital subtract angiography and provides information of kidney stones and other intra-abdominal organs. In this study, preoperative MDCT angiography results were compared with the peroperative findings to evaluate the accuracy of MDCT for the evaluation of renal anatomy. From December 2002 to May 2007, all 60 consecutive living kidney donors were evaluated with MDCT angiography preoperatively. We reported the number and origin of renal arteries, presence of early branching arteries, and any intrinsic renal artery disease. Renal venous anatomy was evaluated for the presence of accessory, retroaortic, and circumaortic veins using venous phase axial images. The calyces and ureters were assessed with delayed topograms. The results of the MDCT angiography were compared with the peroperative findings. A total of 67 renal arteries were seen peroperatively in 60 renal units. Preoperative MDCT angiography detected 64 of them. The two arteries not detected by MDCT had diameters less than 3 mm. Anatomic variations were present in nine veins, five of which were detected by CT angiography. Sensitivity of MDCT angiography for arteries and veins was 95% and 93%, respectively. Positive predictive values were 100% for both arteries and veins. MDCT angiography offers a less invasive, rapid, and accurate preoperative investigation modality for vascular anatomy in living kidney donors. It also provides sufficient information about extrarenal anatomy important for donor surgery.

  17. A comparison of radiological and historical findings in osteosarcomas following pre-operative chemotherapy

    International Nuclear Information System (INIS)

    Sommer, H.J.; Riebel, T.; Winkler, K.; Heise, U.; Delling, G.; Hamburg Univ.; Hamburg Univ.

    1985-01-01

    Since the introduction of pre-operative chemotherapy, osteosarcomas have shown a more favourable prognosis. Reaction of the tumour due to chemotherapy is judged pre-operative primarily by radiology (plain films, angiography, CT, scintigraphy). There is little evidence concerning the radiological appearances after pre-operative chemotherapy and morphological changes, particularly in respect of tumour regression. Specific radiological changes were therefore compared with pathological findings following chemotherapy and operation in 17 patients with osteosarcomas. Tumours were examined which showed radiological evidence of intra- and extra-osseous sclerosis or lysis and which still were classified as vital tumour tissue. Tumour planes were reconstructed from large histological sections of the operative specimen and compared with the radiological appearances. Sclerosis was found to be due to reactive new bone formation or to mineralisation of the osteosarcomatous tissue. Lysis correlated with persistent vital tumour, or in connective tissue. Nine out of ten cases, regarded as vital on radiological evidence, showed vital tumour cells on histological section. Lyses and scleroses were not reliable indications of the pre-operative state of the osteosarcoma following chemotherapy. On the other hand, combined qualitative radiological criteria for assesing tumour vitality, proved to be helpful. (orig.) [de

  18. Estimates of effective dose in adult CT examinations

    International Nuclear Information System (INIS)

    Mohamed, Mustafa Awad Elhaj.

    2015-12-01

    The goal of study was to estimate effective dose (E) in adult CT examinations for Toshiba X64 slice using CT. Exp version 2.5 software in Sudan. Using of CT in medical diagnosis delivers radiation doses to patients that are higher than those from other radiological procedures. lack of optimized protocols could be an additional source of increased dose in developing countries. In order to achieve these objectives, data of CT-scanner has been collected from three hospitals ( ANH, ZSH and MMH). Data collected included equipment information and scan parameters for individual patients, who were used to asses. 300 adult patients underwent head, chest, abdomen-pelvis and peivis CT examinations. The CT1_w , CTD1_vol, DLP, patient effective dos and organ doses were estimated, using CT exposure parameters and CT Exp version 2.5 software. A large variation of mean effective dose and organ doses among hospitals was observed for similar CT examinations. These variations largely originated from different CT scanning protocols used in different hospitals and scan length. The mean effective dose in this study in the Brain, PNS, Chest, pulmonary, Abdomen-pelvis, Pelvis, KUB and CTU were 3.2 mSv, 2.6 mSv, 18.9 mSv 17.6 mSv 27.1 mSv, 11.2 mSv, 9.6 mSv and 23.7 mSv respectively, and organ equivalent, doses presented in this study in this study for the eye lens (for head), lungs and thymus ( for chest) , liver, kidney and small intest ( for abdomen t-pelvis), bladder, uterus and gonads ( for pelvis), were 62.9 mSv, 39.5 mSv, 34.1 mSv, 53.9 mSv, 52.6 mSv, 58.1 mSv, 37 mSv, and 34.6 mSv, respectively. These values were mostly comparable to and slightly higher than the values of effective doses reported from similar studies the United Kingdom, Tanzania, Australia, Canada and Sudan. It was concluded that patient effective dose and organ doses could be substantially minimized through careful selection of scanning parameters based on clinical indications of study, patient size, and body

  19. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... are the limitations of CT of the Sinuses? What is CT (Computed Tomography) of the Sinuses? Computed ... nasal cavity by small openings. top of page What are some common uses of the procedure? CT ...

  20. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... the limitations of CT Scanning of the Head? What is CT Scanning of the Head? Computed tomography, ... than regular radiographs (x-rays). top of page What are some common uses of the procedure? CT ...

  1. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, ... preferable over CT scanning. top of page Additional Information and Resources RTAnswers.org: Radiation Therapy for Bladder ...

  2. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... view of the body's interior. Refinements in detector technology allow nearly all CT scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, ...

  3. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... view of the body's interior. Refinements in detector technology allow nearly all CT scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, ...

  4. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... view of the body's interior. Refinements in detector technology allow nearly all CT scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, ...

  5. Utility of three-dimensional helical CT in the diagnosis of breast cancer

    International Nuclear Information System (INIS)

    Maeda, Yoshiaki; Hata, Yoshinobu; Matsuoka, Shinnichi; Nakajima, Nobuhisa; Ito, Toichi; Osada, Tadahiro; Sano, Fumio

    2004-01-01

    Although utility of three-dimensional (3D) helical CT for preoperative examination of breast cancer has been discussed, the accuracy of the helical CT in diagnosing breast cancer has not been fully evaluated. In this study 56 malignant and 28 benign breast tumors were evaluated preoperatively with 3D-helical CT, and their imaging results were compared with pathological findings of surgical specimens. Helical CT identified the presence of malignancy in 54 out of the 56 cancer cases tested and the sensitivity and specificity in distinguishing between malignant and benign tumors were 82% and 57%, respectively. The sensitivity and specificity in diagnosing the presence of metastatic axillary lymph nodes using helical CT were 70% and 80%, respectively. The sensitivity and specificity in diagnosing the presence of extensive intraductal component (EIC) using helical CT were 71% and 86%, respectively. Helical CT visualized all of the tumors in multifocal breast cancer cases. In conclusion, 3D-helical CT is a useful modality for preoperative examination of breast cancer, especially for assessing axillary lymph node status, and EIC, and will be helpful for conducting sentinel lymph node biopsy (SNLB) and breast-conserving surgery. (author)

  6. CT volumetry of intrathoracic space occupying processes

    International Nuclear Information System (INIS)

    Berberich, W.; Schnabel, K.; Kaick, G. van; Kayser, K.

    1984-01-01

    Preoperative CT volumetry was performed in 39 patients with intrathoracic neoplasms. The results are compared to postoperative volume measures of the surgical preparation. The correlation of both measuring series was very high (rho = .94). The estimated influence of systematic and stochastic errors was only 10 to 15%. The authors outline the consequences for clinical practice: by means of the better quantification in the T category of the TNM system, the surgeon is in a position to make a more precise preoperative planning. The reliable numeric in vivo determination of regression and growth velocity of tumors and/or metastases allows for the first time an exact quantification of control examinations during and after radiotherapy or chemotherapy. This will possibly lead to a more precise individual prognosis. In experimental radiotherapy a more detailed-description of the evolution of experimental tumors in the living animal will be possible by this procedure. (orig.) [de

  7. Preoperational test report, primary ventilation system

    International Nuclear Information System (INIS)

    Clifton, F.T.

    1997-01-01

    This represents a preoperational test report for Primary Ventilation Systems, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system provides vapor space filtered venting of tanks AY101, AY102, AZ101, AZ102. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System

  8. Preoperative biliary drainage for pancreatic cancer

    NARCIS (Netherlands)

    van Heek, N. T.; Busch, O. R.; van Gulik, T. M.; Gouma, D. J.

    2014-01-01

    This review is to summarize the current knowledge about preoperative biliary drainage (PBD) in patients with biliary obstruction caused by pancreatic cancer. Most patients with pancreatic carcinoma (85%) will present with obstructive jaundice. The presence of toxic substances as bilirubin and bile

  9. PREOPERATIVE ENDOSCOPIC MARKING OF UNPALPABLE COLONIC TUMORS

    Directory of Open Access Journals (Sweden)

    A. L. Goncharov

    2013-01-01

    Full Text Available The identification of small colon lesions is one of the major problems in laparoscopic colonic resection.Research objective: to develop a technique of visualization of small tumors of a colon by preoperative endoscopic marking of a tumor.Materials and methods. In one day prior to operation to the patient after bowel preparation the colonoscopy is carried out. In the planned point near tumor on antimesentery edge the submucous infiltration of marking solution (Micky Sharpz blue tattoo pigment, UK is made. The volume of entered solution of 1–3 ml. In only 5 months of use of a technique preoperative marking to 14 patients with small (the size of 1–3 cm malignant tumors of the left colon is performed.Results. The tattoo mark was well visualized by during operation at 13 of 14 patients. In all cases we recorded no complications. Time of operation with preoperative marking averaged 108 min, that is significantly less in comparison with average time of operation with an intra-operative colonoscopy – 155 min (р < 0.001.Conclusions. The first experience of preoperative endoscopic marking of non palpable small tumors of a colon is encouraging. Performance of a technique wasn't accompanied by complications and allowed to reduce significantly time of operation and to simplify conditions of performance of operation.

  10. Preoperative exercise training to improve postoperative outcomes

    NARCIS (Netherlands)

    Valkenet, K.

    2017-01-01

    It is common knowledge that better preoperative physical fitness is associated with better postoperative outcomes. However, as a result of aging of the population and improved surgical and anaesthesia techniques, the proportion of frail patients with decreased physical fitness levels undergoing

  11. Interdisciplinary preoperative patient education in cardiac surgery.

    NARCIS (Netherlands)

    Weert, J. van; Dulmen, S. van; Bar, P.; Venus, E.

    2003-01-01

    Patient education in cardiac surgery is complicated by the fact that cardiac surgery patients meet a lot of different health care providers. Little is known about education processes in terms of interdisciplinary tuning. In this study, complete series of consecutive preoperative consultations of 51

  12. Preoperative diagnosis of malignant hyperthermia | Brand ...

    African Journals Online (AJOL)

    Southern African Journal of Anaesthesia and Analgesia. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 9, No 1 (2003) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Preoperative diagnosis of malignant ...

  13. Preoperational test report, primary ventilation system

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, F.T.

    1997-11-04

    This represents a preoperational test report for Primary Ventilation Systems, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system provides vapor space filtered venting of tanks AY101, AY102, AZ101, AZ102. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

  14. Ampullopancreatic carcinoma: preoperative TNM classification with endosonography

    NARCIS (Netherlands)

    Tio, T. L.; Tytgat, G. N.; Cikot, R. J.; Houthoff, H. J.; Sars, P. R.

    1990-01-01

    Endosonography (ES) was used for the preoperative TNM (1987) staging of tumors in 43 patients with pancreatic cancer and 24 patients with ampullary carcinomas. These results were correlated with the histologic findings of resected specimens. Early-stage tumors could be distinguished from advanced

  15. Preoperative screening: value of previous tests.

    Science.gov (United States)

    Macpherson, D S; Snow, R; Lofgren, R P

    1990-12-15

    To determine the frequency of tests done in the year before elective surgery that might substitute for preoperative screening tests and to determine the frequency of test results that change from a normal value to a value likely to alter perioperative management. Retrospective cohort analysis of computerized laboratory data (complete blood count, sodium, potassium, and creatinine levels, prothrombin time, and partial thromboplastin time). Urban tertiary care Veterans Affairs Hospital. Consecutive sample of 1109 patients who had elective surgery in 1988. At admission, 7549 preoperative tests were done, 47% of which duplicated tests performed in the previous year. Of 3096 previous results that were normal as defined by hospital reference range and done closest to the time of but before admission (median interval, 2 months), 13 (0.4%; 95% CI, 0.2% to 0.7%), repeat values were outside a range considered acceptable for surgery. Most of the abnormalities were predictable from the patient's history, and most were not noted in the medical record. Of 461 previous tests that were abnormal, 78 (17%; CI, 13% to 20%) repeat values at admission were outside a range considered acceptable for surgery (P less than 0.001, frequency of clinically important abnormalities of patients with normal previous results with those with abnormal previous results). Physicians evaluating patients preoperatively could safely substitute the previous test results analyzed in this study for preoperative screening tests if the previous tests are normal and no obvious indication for retesting is present.

  16. Preoperational test report, vent building ventilation system

    International Nuclear Information System (INIS)

    Clifton, F.T.

    1997-01-01

    This represents a preoperational test report for Vent Building Ventilation Systems, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system provides Heating, Ventilation, and Air Conditioning (HVAC) for the W-030 Ventilation Building. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System

  17. Preoperative evaluation : risk management and implementation aspects

    NARCIS (Netherlands)

    Klei, W.A. van

    2002-01-01

    In preoperative risk management the anesthesiologist uses diagnostic information to estimate the probability of outcomes and to decide on the anesthetic strategy in a particular patient. The aim of this thesis was explore to what extent simple patient characteristics, particularly obtained from

  18. Preoperative Detection of Sarcopenic Obesity Helps to Predict the Occurrence of Gastric Leak After Sleeve Gastrectomy.

    Science.gov (United States)

    Gaillard, Martin; Tranchart, Hadrien; Maitre, Sophie; Perlemuter, Gabriel; Lainas, Panagiotis; Dagher, Ibrahim

    2018-03-02

    Sleeve gastrectomy (SG) has become the primary procedure for many bariatric teams and staple-line leak represents its most feared complication. Sarcopenic obesity combines the risks of obesity and depleted lean mass leading possibly to an inferior surgical outcome after abdominal surgery. The aim of this study was to evaluate the existence of a potential link between radiologically determined sarcopenic obesity and staple-line leak risk after SG. A retrospective analysis of a prospective database was performed in consecutive patients undergoing SG as primary procedure. Total psoas muscles (TPA) and total visible muscles (TMA) areas were measured on a preoperative computed tomography (CT). Sarcopenia was defined as lowest tertile of skeletal muscular mass indexes (muscular areas over square of height) in each gender (using TPA or TMA). Multivariate analysis was performed to determine preoperative risk factors for staple-line leak. During the study period, 205 patients were included in the analysis. Median BMI was 40.8 kg/m 2 (34.2-49.6), and 9 patients (4.4%) presented a gastric leak. The sex-specific cut-offs for skeletal muscular mass index according to TPA were 8.2 cm 2 /m 2 for men and 6.08 cm 2 /m 2 for women. After multivariate analysis, preoperative weight (OR = 1043) and sarcopenia (TPA) (OR = 5204) were independent predictive factors for gastric leak. The present series suggests that CT scan-determined sarcopenic obesity is associated with increased risk of gastric leak after SG. This preoperatively radiological examination would be a useful clinical tool to tailor patient management according to gastric leak risk.

  19. Evaluation of noninvasive tests for the preoperative staging of carcinoma of the esophagus: a prospective study

    International Nuclear Information System (INIS)

    Inculet, R.I.; Keller, S.M.; Dwyer, A.; Roth, J.A.

    1985-01-01

    A prospective study was undertaken to define the usefulness of conventional full-lung linear tomography, radionuclide liver plus spleen and bone scans, and thoracic and abdominal computed tomography for the preoperative staging of carcinoma of the esophagus. Thirty-three patients with carcinoma of the esophagus were studied. The computed tomographic (CT) scan of the thorax and upper abdomen was the single most accurate noninvasive study. With computed tomography, the relationship of the tumor to the tracheobronchial tree was the feature most useful in predicting local resectability. In all patients with the finding of tracheobronchial compression by the tumor, the tumor could not be resected completely. The predictive value of this CT finding in patients with locally unresectable tumor was high (0.83), indicating its usefulness in assessing unresectability. The CT finding of visible separation between tumor mass and tracheobronchial tree was present in 10 of 14 patients with locally resectable tumor (predictive value, 0.63). However, tumor abutting the tracheobronchial tree without compression was a poor predictor of unresectability (predictive value, 0.36). The radionuclide bone scan was the only other noninvasive study to demonstrate a metastasis not evident by CT scan. The combination of chest and abdominal CT scan, bone scan, and bronchoscopy before operation will accurately stage the majority of patients with esophageal cancer but no noninvasive test is of sufficient reliability to exclude patients from operative resection if otherwise indicated

  20. Teratoma with intraventricular free fat on CT

    International Nuclear Information System (INIS)

    Miura, Naohisa; Fuchinoe, Tokuro; Yahagi, Yasuji; Nakamura, Toshihiko

    1983-01-01

    Intracranial fat-containing congenital tumors are characterized by negative absorption values on computed tomography(CT). We are reporting a case of teratoma with intraventricular free fat diagnosed preoperatively by CT. The case is a 19-year-old female who was admitted to our hospital because of contineous severe headache, nausea and vomiting. At the time of admission, her physical and neurological examination was negative except for bilateral papilledema. CT demonstrated marked enlargement of the right lateral ventricle. In addition, there was negative absorption value (-90 H.U.), suggesting free fat, within right frontal horn layering above the CSF with a fluid level. Metrizamide ventriculography demonstrated complete obstruction and revealed an irregular shadow defect at the right foramen of Monro. At surgery, yellowish cheese-like material, white hair was found on the surface of the CSF. Tumor arose from the floor of the right foramen of Monro and extended upward. The patient made an uneventful recovery and was discharged 17 days after surgery. Intraventricular free fat is likely that to be released from the teratoma cyst ruptured spontaneously when the patient complained of severe headache 40 days prior to admission. There have been several published reports of the CT appearances of intracranial fat-containing tumors, however, teratoma with intraventricular free fat is very rare. It was concluded that fat-containing tumors should be highly suspected, when negative absorption values were found on CT. (author)

  1. Phase II Study of Preoperative Helical Tomotherapy With a Simultaneous Integrated Boost for Rectal Cancer

    International Nuclear Information System (INIS)

    Engels, Benedikt; Tournel, Koen; Everaert, Hendrik; Hoorens, Anne; Sermeus, Alexandra; Christian, Nicolas; Storme, Guy; Verellen, Dirk; De Ridder, Mark

    2012-01-01

    Purpose: The addition of concomitant chemotherapy to preoperative radiotherapy is considered the standard of care for patients with cT3–4 rectal cancer. The combined treatment modality increases the complete response rate and local control (LC), but has no impact on survival or the incidence of distant metastases. In addition, it is associated with considerable toxicity. As an alternative strategy, we explored prospectively, preoperative helical tomotherapy with a simultaneous integrated boost (SIB). Methods and Materials: A total of 108 patients were treated with intensity-modulated and image-guided radiotherapy using the Tomotherapy Hi-Art II system. A dose of 46 Gy, in daily fractions of 2 Gy, was delivered to the mesorectum and draining lymph nodes, without concomitant chemotherapy. Patients with an anticipated circumferential resection margin (CRM) of less than 2 mm, based on magnetic resonance imaging, received a SIB to the tumor up to a total dose of 55.2 Gy. Acute and late side effects were scored using the National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0. Results: A total of 102 patients presented with cT3–4 tumors; 57 patients entered the boost group and 51 the no-boost group. One patient in the no-boost group developed a radio-hypersensitivity reaction, resulting in a complete tumor remission, a Grade 3 acute and Grade 5 late enteritis. No other Grade ≥3 acute toxicities occurred. With a median follow-up of 32 months, Grade ≥3 late gastrointestinal and urinary toxicity were observed in 6% and 4% of the patients, respectively. The actuarial 2-year LC, progression-free survival and overall survival were 98%, 79%, and 93%. Conclusions: Preoperative helical tomotherapy displays a favorable acute toxicity profile in patients with cT3–4 rectal cancer. A SIB can be safely administered in patients with a narrow CRM and resulted in a promising LC.

  2. Preoperative White Matter Lesions Are Independent Predictors of Long-Term Survival after Internal Carotid Endarterectomy

    Directory of Open Access Journals (Sweden)

    Niku Oksala

    2014-06-01

    Full Text Available Background: Cerebral white matter lesions (WMLs predict long-term survival of conservatively treated acute stroke patients with etiology other than carotid stenosis. In carotid endarterectomy patients, WMLs are associated with severe carotid stenosis and unstable plaques, with the risk of perioperative complications and with increased 30-day perioperative risk of death. However, no data exist on their effect on postoperative long-term survival, a factor important when considering the net benefit from carotid endarterectomy. Whether this effect is independent of classical risk factors and indications for surgery is not known either. We hypothesized that WMLs could be evaluated from preoperative routine computed tomography (CT scans and are predictors of postoperative survival, independent of classical cardiovascular risk factors, indication category and degree of carotid stenosis. Methods: A total of 353 of 481 (73.4% consecutive patients subjected to carotid endarterectomy due to different indications, i.e. asymptomatic stenosis (n = 28, 7.9%, amaurosis fugax (n = 52, 14.7%, transient ischemic attack (n = 135, 38.2% or ischemic stroke (n = 138, 39.1%, from prospective vascular registries during the years 2001-2010 with digital preoperative CT scans, were included in the study. WMLs were rated by a radiologist (Wahlund criteria in a blinded fashion. Internal carotid artery (ICA stenoses were angiographically graded (Results: WML severity could be assessed with a substantial intraobserver agreement (Spearman's rho 0.843, p Conclusions: WMLs in a preoperative CT scan provide a substantially reliable estimate of postoperative long-term survival of carotid endarterectomy patients independent of currently used criteria, i.e. cardiovascular risk factors, indication category and degree of ipsilateral ICA stenosis.

  3. Diagnostic efficacy of the preoperative lymphoscintigraphy, Ga-67 scintigraphy and computed tomography for detection of lymph node metastasis in cases with ovarian or endometrial carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Ozalp, S.; Yalcin, O.T.; Polay, S. [Osmangazi Univ. School of Medicine, Dept. of Obstetrics and Gynecology, Eskisehir (Turkey); Aslan, N.; Vardareli, E. [Osmangazi Univ. School of Medicine, Dept. of Nuclear Medicine, Eskisehir (Turkey); Adapinar, B. [Osmangazi Univ. School of Medicine, Dept. of Radiology, Eskisehir (Turkey)

    1999-02-01

    Background: To investigate the diagnostic efficacy of preoperative lymphoscintigraphy (LS), Ga-67 scintigraphy (GS) and computed tomography (CT) for detection of lymph node metastasis in patients with endometrial or ovarian carcinoma. Methods: The results of preoperative LS, GS and CT used to detect lymph node metastasis were compared to the postoperative histopathological results of lymph node dissection materials of a total of 37 patients, including 16 patients with endometrial and 21 patients with ovarian carcinomas. The diagnostic efficacy of these methods for detecting lymph node metastasis were calculated. Results: When the results of all of the patients were taken into account, the preoperative LS, GS and CT were found to have sensitivities of 50%, 20% and 40% and specificities of 51.8%, 96.3%, and 92.6%, respectively, for detection of pelvic lymph node metastasis. The same methods had sensitivities of 27.3%, 27.3% and 72.7% and specificities of 88.5%, 88.5%, 84.6%, respectively, for detecting para-aortic lymph node metastasis in all patients. Conclusion: These data suggested that although LS, GS and CT had relatively high specificity, low sensitivity of these imaging methods precluded their routine preoperative use for diagnosis of lymph node metastasis of ovarian or endometrial carcinoma. (au) 22 refs.

  4. Injuries of the tibio-talar joint and preoperative planning

    International Nuclear Information System (INIS)

    Zwipp, H.

    1991-01-01

    The treatment of bony, osteochondral, and ligamentous injuries of the tibio-talar requires precise preoperative planning by radiological investigation. This is essential to a correct understanding of the underlying pathology and will allow a proper classification of the injury, which is the basis of treatment. Conventional radiography using anteroposterior and lateral X-rays with comparative views of the noninjured side and, if necessary, rotated spot views and tomography are of high value especially in osteochondral fractures of the talus. Intraoperative control images in both planes after osteosynthesis are mandatory. For evaluation of the postoperative course and severity of arthrosis formation, the classification system of Bargon has proved its worth. In addition, tomography of the tibio-talar joint in two planes is useful especially in tibial pilon fractures, some malleolar fractures, and peripheral talar fractures. In talar fracture dislocations with concomitant compartment syndrome an emergency CT scan can be helpful to determine the optimal surgical approach. In these cases a 3-D reconstruction also might be of assistance. If there is evidence of partial or total talar necrosis, magnetic resonance imaging can be extremely helpful. However, in most cases implants considerably limit the validity of the image obtained. Ultrasonography offers a noninvasive, reproducible, and very inexpensive alternative and should be performed in cases of chondral-osteochondral talar rim avulsions and juvenile osteochondral ligament ruptures. It can also be used as a dynamic method for stress examination in fibular ligament ruptures and soft tissue injuries such as dislocation of the peroneal tendons. The use of arthrography, stress-tenography, and arthro-CT scan nowadays has become extremely limited. (orig.) [de

  5. Preoperative Chemotherapy Versus Preoperative Chemoradiotherapy for Stage III (N2) Non-Small-Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Higgins, Kristin [Department of Radiation Oncology, Duke University of Medical Center, Durham, NC (United States); Chino, Junzo P [Department of Radiation Oncology, Duke University of Medical Center, Durham, NC (United States); Marks, Lawrence B [Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC (United States); Ready, Neal [Department of Medicine, Division of Medical Oncology, Duke University of Medical Center, Durham, NC (United States); D' Amico, Thomas A [Department of Surgery, Division of Cardiovascular and Thoracic Surgery, Duke University of Medical Center, Durham, NC (United States); Clough, Robert W; Kelsey, Chris R [Department of Radiation Oncology, Duke University of Medical Center, Durham, NC (United States)

    2009-12-01

    Purpose: To compare preoperative chemotherapy (ChT) and preoperative chemoradiotherapy (ChT-RT) in operable Stage III non-small-cell lung cancer. Methods and Materials: This retrospective study analyzed all patients with pathologically confirmed Stage III (N2) non-small-cell lung cancer who initiated preoperative ChT or ChT-RT at Duke University between 1995 and 2006. Mediastinal pathologic complete response (pCR) rates were compared using a chi-square test. The actuarial overall survival, disease-free survival, and local control were estimated using the Kaplan-Meier method and compared using the log-rank test. Multivariate Cox regression analysis was also performed. Results: A total of 101 patients who initiated preoperative therapy with planned resection were identified. The median follow-up was 20 months for all patients and 38 months for survivors. The mediastinal lymph nodes were reassessed after preoperative therapy in 88 patients (87%). Within this group, a mediastinal pCR was achieved in 35% after preoperative ChT vs. 65% after preoperative ChT-RT (p = 0.01). Resection was performed in 69% after ChT and 84% after ChT-RT (p = 0.1). For all patients, the overall survival, disease-free survival, and local control rate at 3 years was 40%, 27%, and 66%, respectively. No statistically significant differences were found in the clinical endpoints between the ChT and ChT-RT subgroups. On multivariate analysis, a mediastinal pCR was associated with improved disease-free survival (p = 0.03) and local control (p = 0.03), but not overall survival (p = 0.86). Conclusion: Preoperative ChT-RT was associated with higher mediastinal pCR rates but not improved survival.

  6. Preoperative Chemotherapy Versus Preoperative Chemoradiotherapy for Stage III (N2) Non-Small-Cell Lung Cancer

    International Nuclear Information System (INIS)

    Higgins, Kristin; Chino, Junzo P.; Marks, Lawrence B.; Ready, Neal; D'Amico, Thomas A.; Clough, Robert W.; Kelsey, Chris R.

    2009-01-01

    Purpose: To compare preoperative chemotherapy (ChT) and preoperative chemoradiotherapy (ChT-RT) in operable Stage III non-small-cell lung cancer. Methods and Materials: This retrospective study analyzed all patients with pathologically confirmed Stage III (N2) non-small-cell lung cancer who initiated preoperative ChT or ChT-RT at Duke University between 1995 and 2006. Mediastinal pathologic complete response (pCR) rates were compared using a chi-square test. The actuarial overall survival, disease-free survival, and local control were estimated using the Kaplan-Meier method and compared using the log-rank test. Multivariate Cox regression analysis was also performed. Results: A total of 101 patients who initiated preoperative therapy with planned resection were identified. The median follow-up was 20 months for all patients and 38 months for survivors. The mediastinal lymph nodes were reassessed after preoperative therapy in 88 patients (87%). Within this group, a mediastinal pCR was achieved in 35% after preoperative ChT vs. 65% after preoperative ChT-RT (p = 0.01). Resection was performed in 69% after ChT and 84% after ChT-RT (p = 0.1). For all patients, the overall survival, disease-free survival, and local control rate at 3 years was 40%, 27%, and 66%, respectively. No statistically significant differences were found in the clinical endpoints between the ChT and ChT-RT subgroups. On multivariate analysis, a mediastinal pCR was associated with improved disease-free survival (p = 0.03) and local control (p = 0.03), but not overall survival (p = 0.86). Conclusion: Preoperative ChT-RT was associated with higher mediastinal pCR rates but not improved survival.

  7. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography (CT) is a fast, painless exam that uses special ... the limitations of Children's CT? What is Children's CT? Computed tomography, more commonly known as a CT or CAT ...

  8. Comparison of Oral Contrast-Enhanced Transabdominal Ultrasound Imaging With Transverse Contrast-Enhanced Computed Tomography in Preoperative Tumor Staging of Advanced Gastric Carcinoma.

    Science.gov (United States)

    He, Xuemei; Sun, Jing; Huang, Xiaoling; Zeng, Chun; Ge, Yinggang; Zhang, Jun; Wu, Jingxian

    2017-12-01

    This study assessed the diagnostic performance of transabdominal oral contrast-enhanced ultrasound (US) imaging for preoperative tumor staging of advanced gastric carcinoma by comparing it with transverse contrast-enhanced computed tomography (CT). This retrospective study included 42 patients with advanced gastric cancer who underwent laparoscopy, radical surgery, or palliative surgery because of serious complications and had a body mass index of less than 25 kg/m 2 . A cereal-based oral contrast agent was used for transabdominal oral contrast-enhanced US. Retrospective analyses were conducted using preoperative tumor staging data acquired by either transabdominal oral contrast-enhanced US or transverse contrast-enhanced CT. Both contrast-enhanced US and contrast-enhanced CT examinations were reviewed by 2 experienced radiologists independently for preoperative tumor staging according to the seventh edition of the TNM classification. The accuracy, sensitivity, and specificity were calculated by comparing the results of contrast-enhanced US and contrast-enhanced CT with pathologic findings. The overall accuracies of the imaging modalities were compared by the McNemar test. No significant difference was noted in the overall accuracy of transabdominal oral contrast-enhanced US (86% [36 of 42]) and transverse contrast-enhanced CT (83% [35 of 42] P > .999). For stage T2 to T4 gastric cancer, the accuracies of transabdominal oral contrast-enhanced US were 88%, 86%, and 98%, respectively, and those of transverse contrast-enhanced CT were 93%, 83%, and 90%. The overall accuracy of transabdominal oral contrast-enhanced US was comparable with that of transverse contrast-enhanced CT for preoperative tumor staging of advanced gastric cancer. © 2017 by the American Institute of Ultrasound in Medicine.

  9. Computed Tomography (CT) Perfusion as an Early Predictive Marker for Treatment Response to Neoadjuvant Chemotherapy in Gastroesophageal Junction Cancer and Gastric Cancer - A Prospective Study

    DEFF Research Database (Denmark)

    Lundsgaard Hansen, Martin; Fallentin, Eva; Lauridsen, Carsten

    2014-01-01

    OBJECTIVES: To evaluate whether early reductions in CT perfusion parameters predict response to pre-operative chemotherapy prior to surgery for gastroesophageal junction (GEJ) and gastric cancer. MATERIALS AND METHODS: Twenty-eight patients with adenocarcinoma of the gastro-esophageal junction (GEJ......-operative chemotherapy in GEJ and gastric cancer. As a single diagnostic test, CT Perfusion only has moderate sensitivity and specificity in response assessment of pre-operative chemotherapy making it insufficient for clinical decision purposes....

  10. Non-enhanced CT versus contrast-enhanced CT in integrated PET/CT studies for nodal staging of rectal cancer

    International Nuclear Information System (INIS)

    Tateishi, Ukihide; Maeda, Tetsuo; Morimoto, Tsuyoshi; Miyake, Mototaka; Arai, Yasuaki; Kim, E.E.

    2007-01-01

    The purpose of the present study was to determine the diagnostic accuracy of non-enhanced CT and contrast-enhanced CT in integrated PET/CT studies for preoperative nodal staging of rectal cancer. Retrospective analysis was performed in 53 patients with pathologically proven rectal cancer who had been referred for preoperative staging. All patients underwent integrated PET/CT consisting of non-enhanced and contrast-enhanced CT followed by whole-body fluorine-18-fluorodeoxyglucose ([ 18 F]FDG) PET. Both non-enhanced and contrast-enhanced PET/CT images were evaluated separately by two observers in consensus. The reference standard was histopathologic results. For nodal staging of rectal cancer, we compared diagnostic accuracy on a per-patient basis between the two modalities. Nodal staging was correctly determined with non-enhanced studies in 37 patients (70%) and with contrast-enhanced studies in 42 patients (79%). On a per-patient basis, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of regional lymph node staging were 85%, 68%, 83%, 72%, and 79%, respectively, with contrast-enhanced studies, and 85%, 42%, 73%, 62%, and 70%, respectively, with non-enhanced studies. The difference in the accuracy of nodal staging between the two modalities was not significant (p = 0.063). Compared with non-enhanced studies, contrast-enhanced studies determined more correctly the status of pararectal lymph nodes (p 0.002), internal iliac lymph nodes (p = 0.004), and obturator lymph nodes (p < 0.0001). Contrast-enhanced PET/CT is superior to non-enhanced PET/CT for precise definition of regional nodal status in rectal cancer. (orig.)

  11. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Head Computed tomography (CT) of the head uses special x-ray ... What is CT Scanning of the Head? Computed tomography, more commonly known as a CT or CAT ...

  12. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Abdomen and Pelvis Computed tomography (CT) of the abdomen and pelvis is a ... is CT Scanning of the Abdomen/Pelvis? Computed tomography, more commonly known as a CT or CAT ...

  13. Comparison of preoperative computerized tomography scan imaging of temporal bone with the intra-operative findings in patients undergoing mastiodectomy

    International Nuclear Information System (INIS)

    Gerami, H.; Naghavi, E.; Wahabi-Moghadam, M.; Forghanparast, K.; Akbar, Manzar H.

    2009-01-01

    Objective was to compare the consistency rates of pre- and intra-operative radiological findings in patients with chronic suppurative otitis media (CSOM). In a cross-sectional study, 80 patients with CSOM underwent pre-operative CT scanning and we compared the results with intra-operative clinical findings during mastiodectomy from 2000-2004 in the Otology Department, Amiralmomenin Hospital of Guilan Medical University, Rasht, Iran. Sensitivity, specificity, positive and negative predictive value of CT scan in tympanic and mastoid cholesteatoma, ossicular chain erosion, tegmentympani erosion, dehiscence of facial canal, lateral semicircular canal (LSCC) fistula were assessed. Then, correlation between radiological findings and intra-operative findings were calculated. The mean age of patients was 27.9+-16.3 years. Mostly were males (n=57 [71.3%]). Correlation of preoperative radiological images with intra-operative clinical findings were moderate to good on tympanic cholesteatoma, mastoid cholesteatoma and ossicular chain erosion, but weak and insignificant in cases of tegmen erosion, facial canal dehiscene and LSCC fistulae. Preoperative CT scan may be helpful in decision-making for surgery in cases of cholesteatoma and ossicular erosion. Despite of limitations radiological scanning is a useful adjunct to management of CSOM. (author)

  14. Preoperative blood transfusions for sickle cell disease

    Science.gov (United States)

    Estcourt, Lise J; Fortin, Patricia M; Trivella, Marialena; Hopewell, Sally

    2016-01-01

    Background Sickle cell disease is one of the commonest severe monogenic disorders in the world, due to the inheritance of two abnormal haemoglobin (beta globin) genes. Sickle cell disease can cause severe pain, significant end-organ damage, pulmonary complications, and premature death. Surgical interventions are more common in people with sickle cell disease, and occur at much younger ages than in the general population. Blood transfusions are frequently used prior to surgery and several regimens are used but there is no consensus over the best method or the necessity of transfusion in specific surgical cases. This is an update of a Cochrane review first published in 2001. Objectives To determine whether there is evidence that preoperative blood transfusion in people with sickle cell disease undergoing elective or emergency surgery reduces mortality and perioperative or sickle cell-related serious adverse events. To compare the effectiveness of different transfusion regimens (aggressive or conservative) if preoperative transfusions are indicated in people with sickle cell disease. Search methods We searched for relevant trials in The Cochrane Library, MEDLINE (from 1946), Embase (from 1974), the Transfusion Evidence Library (from 1980), and ongoing trial databases; all searches current to 23 March 2016. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register: 18 January 2016. Selection criteria All randomised controlled trials and quasi-randomised controlled trials comparing preoperative blood transfusion regimens to different regimens or no transfusion in people with sickle cell disease undergoing elective or emergency surgery. There was no restriction by outcomes examined, language or publication status. Data collection and analysis Two authors independently assessed trial eligibility and the risk of bias and extracted data. Main results Three trials with 990 participants were eligible for inclusion in the review. There were no

  15. Preoperative computer tomography evaluation in transcatheter aortic valve replacement (TAVI)

    International Nuclear Information System (INIS)

    Groudeva, V.; Stoynova, V.; Trendafilova, D.; Dzhorgova, Y.; Nachev, G.

    2014-01-01

    Transcatheter aortic valve replacement is rapidly emerging technique alternative to surgery in high risk patients. Imaging and especially computer tomography is important in preoperative assessment of the aortic ring and the prosthetic valve choice. The aim of this study is to share authors initial experience in CT assessment of the aortic ring prior to Transcatheter aortic valve replacement. 49 patients (mean age 76,55) underwent 320 rows MDCT (Acquilon One) prior TAVI. Protocol involved scanning from thoracic inlet to common femoral arteries. Aortic root size, aortic diameter at the level of coronary sinuses and the sinotubular junction and distance to coronary ostia were evaluated on a Vitrea work station. MDCT established maximal aortic ring diameter from 18 to 31 mm mean 25,04 mm while the lesser rate was from 16 to 21 mm. Accordingly positioned prostheses were in 34,75% No. 23, in 49% - No. 26 and in16,3% - No. 29. MDCT is crucial in aortic valve assessment prior to TAVI in experienced hands and multidisciplinary team. (authors) Key words: TRANSCATHETER AORTIC VALVE REPLACEMENT (TAVI). MDCT AORTIC VALVE ASSESSMENT

  16. Combined diagnosis of lateral cervical masses by RI-scintigraphy, ultrasound and CT-scanning

    International Nuclear Information System (INIS)

    Yang, Kuang-Tsuong; Yamashita, Toshio; Sasa, Hidehiko

    1984-01-01

    Careful palpation, plain X-rays and angiography are useful in the diagnosis of lateral cervical masses, but accurate preoperative evaluation sometimes needs further examinations. Recently several new auxiliary procedures have become available such as RI-scintigraphy, Ultrasound, and CT-scanning but even these may not be sufficient when used singly. When all these procedures were combined preoperatively in the case of lateral cervical masses and the results were compared with the findings at time of surgery and the pathology of the extirpated masses, acurate preoperative diagnose were possible. (author)

  17. Pre-operative haematological investigations in paediatric orofacial ...

    African Journals Online (AJOL)

    Pre-operative haematological investigations in paediatric orofacial cleft repair: Any relevance to management outcome? ... Aim and Objectives: To determine the value of routine pre-operative haematologic investigations in children undergoing orofacial cleft repair. Background: Although routine pre-operative laboratory ...

  18. Preoperative modifiable risk factors in colorectal surgery

    DEFF Research Database (Denmark)

    van Rooijen, Stefanus; Carli, Francesco; Dalton, Susanne O

    2017-01-01

    in higher mortality rates and greater hospital costs. The number and severity of complications is closely related to patients' preoperative performance status. The aim of this study was to identify the most important preoperative modifiable risk factors that could be part of a multimodal prehabilitation...... program. METHODS: Prospectively collected data of a consecutive series of Dutch CRC patients undergoing colorectal surgery were analyzed. Modifiable risk factors were correlated to the Comprehensive Complication Index (CCI) and compared within two groups: none or mild complications (CCI ... complications (CCI ≥20). Multivariate logistic regression analysis was done to explore the combined effect of individual risk factors. RESULTS: In this 139 patient cohort, smoking, malnutrition, alcohol consumption, neoadjuvant therapy, higher age, and male sex, were seen more frequently in the severe...

  19. Pre-operative concurrent chemoradiotherapy for stage IIIA (N2) Non-Small cell lung cancer

    International Nuclear Information System (INIS)

    Lee, Kyu Chan; Ahn, Yong Chan; Park, Keun Chil

    1999-01-01

    This is to evaluate the acute complication, resection rate, and tumor down-staging after pre-operative concurrent chemoradiotherapy for stage IIIA (N2) non-small cell lung cancer. Fifteen patients with non-small cell lung cancer were enrolled in this study from May 1997 to June 1998 in Samsung Medical Center. The median age of the patients was 61 (range, 45-67) years and male to female ratio was 12:3. Pathologic types were squamous cell carcinoma (11) and adenocarcinoma (4). Pre-operative clinical tumor stages were cT1 in 2 patients, cT2 in 12, and cT3 in 1 and all were N2. Ten patients were proved to be N2 with mediastinoscopic biopsy and five had clinically evident mediastinal lymph node metastases on the chest CT scans. Pre-operative radiation therapy field included the primary tumor, the ipsilateral hilum, and the mediastinum. Total radiation dose was 45 Gy over 5 weeks with daily dose of 1.8 Gy. Pre-operative concurrent chemotherapy consisted of two cycles of intraventous cis-Platin (100 mg/m 2 ) on day 1 and oral Etoposide (50 mg/m 2 /day) on days 1 through 14 with 4 weeks' interval. Surgery was followed after the pre-operative re-evaluation including chest CT scan in 3 weeks of the completion of the concurrent chemoradiotherapy if there was no evidence of disease progression. Full dose radiation therapy was administered to all the 15 patients. Planned two cycles of chemotherapy was completed in 11 patients and one cycle was given to four. One treatment related death of acute respiratory distress syndrome occurred in 15 days of surgery. Hospital admission was required in three patients including one with radiation pneumonitis and two with neutropenic fever. Hematologic complications and other acute complications including esophagitis were tolerable. Resection rate was 92.3% (12/13) in 13 patients excluding two patients who refused surgery. Pleural seeding was found in one patient after thoracotomy and tumor resection was not feasible. Post-operative tumor

  20. Pre-operative concurrent chemoradiotherapy for stage IIIA (N2) Non-Small cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyu Chan; Ahn, Yong Chan; Park, Keun Chil [College of Medicine, Sungkyunkwan Univ., Seoul (Korea, Republic of)] [and others

    1999-06-01

    This is to evaluate the acute complication, resection rate, and tumor down-staging after pre-operative concurrent chemoradiotherapy for stage IIIA (N2) non-small cell lung cancer. Fifteen patients with non-small cell lung cancer were enrolled in this study from May 1997 to June 1998 in Samsung Medical Center. The median age of the patients was 61 (range, 45-67) years and male to female ratio was 12:3. Pathologic types were squamous cell carcinoma (11) and adenocarcinoma (4). Pre-operative clinical tumor stages were cT1 in 2 patients, cT2 in 12, and cT3 in 1 and all were N2. Ten patients were proved to be N2 with mediastinoscopic biopsy and five had clinically evident mediastinal lymph node metastases on the chest CT scans. Pre-operative radiation therapy field included the primary tumor, the ipsilateral hilum, and the mediastinum. Total radiation dose was 45 Gy over 5 weeks with daily dose of 1.8 Gy. Pre-operative concurrent chemotherapy consisted of two cycles of intraventous cis-Platin (100 mg/m{sup 2}) on day 1 and oral Etoposide (50 mg/m{sup 2}/day) on days 1 through 14 with 4 weeks' interval. Surgery was followed after the pre-operative re-evaluation including chest CT scan in 3 weeks of the completion of the concurrent chemoradiotherapy if there was no evidence of disease progression. Full dose radiation therapy was administered to all the 15 patients. Planned two cycles of chemotherapy was completed in 11 patients and one cycle was given to four. One treatment related death of acute respiratory distress syndrome occurred in 15 days of surgery. Hospital admission was required in three patients including one with radiation pneumonitis and two with neutropenic fever. Hematologic complications and other acute complications including esophagitis were tolerable. Resection rate was 92.3% (12/13) in 13 patients excluding two patients who refused surgery. Pleural seeding was found in one patient after thoracotomy and tumor resection was not feasible. Post

  1. Evaluation of preoperative embolization of meningioma

    International Nuclear Information System (INIS)

    Park, Sung Tae; Suh, Dae Chul; Lee, Ho Kyu; Choi, Choong Gon; Lee, Myung Jun; Ji, Eun Kyung; Shin, Byung Suck; Kim, Chang Jin; Kim, Jong Uk; Whang, C. Jin

    1998-01-01

    To evaluate the efficacy and safety of preoperative embolization of intrancranial meningioma.Materials and Methods : We retrospectively reviewed intrancranial meningioma patients (n=37) who underwent preoperative embolization. They were categorized into two groups, skull base lesions (n=22) and non-skull base lesions (n=15), according to tumor location. In addition, embolization results were classified by comparison between pre- and post-embolization angiography as complete (residual tumor staining 10 or 30%). In each group, estimated blood loss (EBL) was estimated by amount of intraoperative transfusion with pre- and post-operative hemoglobin level. Tumor resectability was evaluated by follow-up computed tomography. New symptoms occurring within 24 hours of embolization were considered to be those associated with embolization ; symptoms improved by conservative treatment were regarded as mild, while those resulting in new deficits were considered severe. Results : In the group with skull base lesions (n=22), complete embolization with the criteria of residual tumor staining of less than 30% was performed in 14 patients(EBL=1770ml;complete surgical removal in nine patients and incomplete removal four). Incomplete embolization was performed in eight patients (EBL=3210ml; complete and incomplete removal each in four patients). In the group with non-skull base lesions, complete embolization with the criteria of residual tumor staining of less than 10% was performed in five patients (EBL=970ml) and incomplete embolization in ten (EBL=2260ml). Complete tumor removal was possible in this group regardless of the completeness of preoperative tumor embolization. In a case of intraventricular meningioma (3%), intratumoral hemorrhage occurred on the day following embolization. Other mild post-embolization complications occurred in three cases (8%). Conclusion : Preoperative embolization can be an effective and safe procedure for meningioma and may reduce intraoperative blood

  2. Religiousness and preoperative anxiety: a correlational study

    OpenAIRE

    Aghamohammadi Kalkhoran, Masoomeh; Karimollahi, Mansoureh

    2007-01-01

    Abstract Background Major life changes are among factors that cause anxiety, and one of these changes is surgery. Emotional reactions to surgery have specific effects on the intensity and velocity as well as the process of physical disease. In addition, they can cause delay in patients recovery. This study is aimed at determining the relationship between religious beliefs and preoperative anxiety. Methods This survey is a correlational study to assess the relationship between religious belief...

  3. Implications of preoperative hypoalbuminemia in colorectal surgery.

    OpenAIRE

    Truong, A; Hanna, MH; Moghadamyeghaneh, Z; Stamos, MJ

    2016-01-01

    Serum albumin has traditionally been used as a quantitative measure of a patient’s nutritional status because of its availability and low cost. While malnutrition has a clear definition within both the American and European Societies for Parenteral and Enteral Nutrition clinical guidelines, individual surgeons often determine nutritional status anecdotally. Preoperative albumin level has been shown to be the best predictor of mortality after colorectal cancer surgery. Specifically in colorect...

  4. CT-scanning in otolaryngology, 2

    International Nuclear Information System (INIS)

    Kusakari, Jun; Endo, Satomi; Hara, Akira

    1982-01-01

    Combined computerized tomography-sialography was performed in 28 patients with parotid tumors. Sialography was performed in the usual fashion. After confirming the presence of the contrast material within the parotid gland by X-ray, 4 to 5 scannings were done at the width of 10 mm below Repid's base line. With this procedure, the parotid gland was clearly demonstrated and the location of the tumor was shown as a shadow defect. Although the nature of the tumor, especially whether it was malignant or benign was difficult to predict, the CT-findings regarding the size and location of the tumor were completely coincident with the operative findings in all the cases. Accurate appraisal of the relation between the tumor and the facial nerve was possible in all but two cases. The preoperative information obtained from CT-scanning is extremely useful in the case of parotid tumor surgery. (author)

  5. Comparison between angiography and CT scan in the urologic field

    Energy Technology Data Exchange (ETDEWEB)

    Fujioka, Toshio; Takao, Masaya; Odajima, Kunio; Nakamura, Hiroshi

    1988-02-01

    Seventy-five consecutive patients with urological diseases were examined preoperatively by means of computerized tomography and renal angiography. Classification of the diseases were 53 renal diseases which included renal cell carcinoma, sarcoma, cyst, renal bleeding, arteriovenous fistula, trauma, hydronephrosis and tuberculosis, 11 vesical diseases which included bladder tumor and endometriosis, 9 adrenal diseases which included primary aldosteronism, Cushing syndrome, pheochromocytoma, and metastatic tumor, and 1 case of intra-abdominal testes. For renal diseases, both angiography and CT were useful imaging tools. For vesical diseases, CT was a more useful imaging method but, for adrenal diseases, angiography was superior to CT. CT offers certain advantages over conventional techniques but, in the near future, it may be replaced by MRI. On the contrary, angiography will remain popular for a long time, because angiography is the only way to show which vessels feed organs.

  6. CT reconstruction technique in lumbar intraneuroforaminal disc herniation

    International Nuclear Information System (INIS)

    Volle, E.; Claussen, C.; Kern, A.; Stoltenburg, G.

    1988-01-01

    The CT appearance of the lumbar neural foramina and contents is described in detail and compared to histopathological specimens. Direct axial scans with secondary sagittal, coronal and paraxial reconstruction series of slices of the neuralforamen were derived from lumbar spine examination of fifty normal adults. These normal parameters were then used to evaluate and subdivide 20 patients with disc herniation involving the neuralforamen. The new paraxial reformation was able to show an intraneuroforaminal disc involvement. CT-reformation technique and operative results in intraneuroforaminal disc herniation correspond in 80%. This improvement in preoperative diagnosis demonstrates to the neurosurgeon the full extent of disc herniation and results in an optimized operative approach. (orig.)

  7. CT reconstruction technique in lumbar intraneuroforaminal disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Volle, E.; Claussen, C.; Kern, A.; Stoltenburg, G.

    1988-04-01

    The CT appearance of the lumbar neural foramina and contents is described in detail and compared to histopathological specimens. Direct axial scans with secondary sagittal, coronal and paraxial reconstruction series of slices of the neuralforamen were derived from lumbar spine examination of fifty normal adults. These normal parameters were then used to evaluate and subdivide 20 patients with disc herniation involving the neuralforamen. The new paraxial reformation was able to show an intraneuroforaminal disc involvement. CT-reformation technique and operative results in intraneuroforaminal disc herniation correspond in 80%. This improvement in preoperative diagnosis demonstrates to the neurosurgeon the full extent of disc herniation and results in an optimized operative approach.

  8. 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.

  9. Spinal CT scan, 1

    International Nuclear Information System (INIS)

    Nakagawa, Hiroshi

    1982-01-01

    Methods of CT of the cervical and thoracic spines were explained, and normal CT pictures of them were described. Spinal CT was evaluated in comparison with other methods in various spinal diseases. Plain CT revealed stenosis due to spondylosis or ossification of posterior longitudinal ligament and hernia of intervertebral disc. CT took an important role in the diagnosis of spinal cord tumors with calcification and destruction of the bone. CT scan in combination with other methods was also useful for the diagnosis of spinal injuries, congenital anomalies and infections. (Ueda, J.)

  10. PET/CT in the evaluation of anti-NMDA-receptor encephalitis: what we need to know as a NM physician

    International Nuclear Information System (INIS)

    Padma, S.; Shanmuga Sundaram, P.; Marmattom, Bobby Varkey

    2011-01-01

    Anti N-methyl-D-aspartate receptor encephalitis (ANMDARE), also known as limbic encephalitis (LE), is a treatable rare disorder characterized by personality changes, irritability, depression, seizures, memory loss and sometimes dementia. It is classified under paraneoplastic syndrome (PNS) and produces antibodies against NR1 and NR2 subunits of glutamate aspartate receptor. It is thought to be closely related with malignancies like small cell lung cancer, ovarian teratoma and Hodgkin's lymphoma, apart from testis, breast and rarely gastric malignancies. Non-paraneoplastic encephalitis cases are the ones with no detectable malignancy and may be triggered by severe infection. As nuclear medicine physicians, we must be aware of the diverse presentation of ANMDARE or LE and should include a whole body positron emission tomography/computed tomography (PET/CT) and not just brain PET/CT during imaging. We describe the first case of PET/CT in an idiopathic ANMDARE Indian adolescent girl. (author)

  11. Preoperative virtual reduction reduces femoral malrotation in the treatment of bilateral femoral shaft fractures.

    Science.gov (United States)

    Omar, Mohamed; Suero, Eduardo M; Hawi, Nael; Decker, Sebastian; Krettek, Christian; Citak, Musa

    2015-10-01

    In bilateral femoral shaft fractures, significant malrotation (>15°) occurs in about 40 % of cases after intramedullary nailing. Most of the methods that provide rotational control during surgery are based on a comparison to the intact femur and, thus, not applicable for bilateral fractures. In this study, we evaluated if preoperative virtual reduction can help improving rotational alignment in patients with bilateral femoral shaft fractures. Seven patients with bilateral femoral shaft fractures were initially treated with external fixation of both femurs. After obtaining a CT scan of both legs, the fractures were reduced virtually using the software program VoXim®, and the amount and direction of rotational correction were calculated. Subsequently, the patients were treated by antegrade femoral nailing and rotation was corrected to the preoperatively calculated amount. After external fixation, the mean rotational difference between both legs was 15.0° ± 10.2°. Four out of seven patients had a significant malrotation over 15°. Following virtual reduction, the mean rotational difference between both legs was 2.1° ± 1.2°. After intramedullary nailing, no case of malrotation occurred and the mean rotational difference was 6.1° ± 2.8°. Preoperative virtual reduction allows determining the pretraumatic femoral antetorsion and provided useful information for the definitive treatment of bilateral femoral shaft fractures. We believe that this procedure is worth being implemented in the clinical workflow to avoid malrotation after intramedullary nailing.

  12. Virtual 3-dimensional preoperative planning with the dextroscope for excision of a 4th ventricular ependymoma.

    Science.gov (United States)

    Anil, S M; Kato, Y; Hayakawa, M; Yoshida, K; Nagahisha, S; Kanno, T

    2007-04-01

    Advances in computer imaging and technology have facilitated enhancement in surgical planning with a 3-dimensional model of the surgical plan of action utilizing advanced visualization tools in order to plan individual interactive operations with the aid of the dextroscope. This provides a proper 3-dimensional imaging insight to the pathological anatomy and sets a new dimension in collaboration for training and education. The case of a seventeen-year-old female, being operated with the aid of a preoperative 3-dimensional virtual reality planning and the practical application of the neurosurgical operation, is presented. This young lady presented with a two-year history of recurrent episodes of severe, global, throbbing headache with episodes of projectile vomiting associated with shoulder pain which progressively worsened. She had no obvious neurological deficits on clinical examination. CT and MRI showed a contrast-enhancing midline posterior fossa space-occupying lesion. Utilizing virtual imaging technology with the aid of a dextroscope which generates stereoscopic images, a 3-dimensional image was produced with the CT and MRI images. A preoperative planning for excision of the lesion was made and a real-time 3-dimensional volume was produced and surgical planning with the dextroscope was made and the lesion excised. Virtual reality has brought new proportions in 3-dimensional planning and management of various complex neuroanatomical problems that are faced during various operations. Integration of 3-dimensional imaging with stereoscopic vision makes understanding the complex anatomy easier and helps improve decision making in patient management.

  13. Preoperative chemoradiotherapy in locally advanced gastric cancer, a phase I/II feasibility and efficacy study

    Energy Technology Data Exchange (ETDEWEB)

    Trip, Anouk K. [Department of Radiation Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Poppema, Boelo J. [Department of Medical Oncology, University Medical Centre Groningen (Netherlands); Berge Henegouwen, Mark I. van [Department of Surgical Oncology, Academic Medical Centre – University of Amsterdam (Netherlands); Siemerink, Ester [Department of Internal Medicine, Ziekenhuisgroep Twente, Hengelo (Netherlands); Beukema, Jannet C. [Department of Radiation Oncology, University Medical Centre Groningen (Netherlands); Verheij, Marcel [Department of Radiation Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Plukker, John T.M. [Department of Surgical Oncology, University Medical Centre Groningen (Netherlands); Richel, Dick J. [Department of Medical Oncology, Academic Medical Centre – University of Amsterdam (Netherlands); Hulshof, Maarten C.C.M. [Department of Radiation Oncology, Academic Medical Centre – University of Amsterdam (Netherlands); Sandick, Johanna W. van [Department of Surgical Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Cats, Annemieke [Department of Gastroenterology and Hepatology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Jansen, Edwin P.M. [Department of Radiation Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Hospers, Geke A.P., E-mail: g.a.p.hospers@umcg.nl [Department of Medical Oncology, University Medical Centre Groningen (Netherlands)

    2014-08-15

    Objectives: This study was initiated to investigate the feasibility and efficacy of preoperative radiotherapy with weekly paclitaxel and carboplatin in locally advanced gastric cancer. Methods: In a prospective study, patients with locally advanced gastric cancer stage IB-IV(M0) were treated with chemoradiotherapy followed by surgery 4–6 weeks after the last irradiation. Chemoradiotherapy consisted of radiation to a total dose of 45 Gy given in 25 fractions of 1.8 Gy, combined with concurrent weekly carboplatin and paclitaxel. Results: Between December 2007 and January 2012, 25 patients with cT3 (64%) or cT4 (36%) gastric cancer were included. One patient discontinued concurrent chemotherapy in the 4th week due to toxicity, but completed radiotherapy. Another patient discontinued chemoradiotherapy after the 3rd week due to progressive disease. Grade III adverse events of chemoradiotherapy were: gastrointestinal 12%, haematological 12% and other 8%. All patients, except one who developed progressive disease, were operated. Surgical complications were: general/infectious 48%, anastomotic leakage 12%, and bowel perforation 8%. Postoperative mortality was 4%. Microscopically radical resection rate was 72%. Pathological complete response rate was 16% and near complete response rate 24%. Conclusions: In this study, preoperative chemoradiotherapy for patients with locally advanced gastric cancer was associated with manageable toxicity and encouraging pathological response rates.

  14. Preoperative chemoradiotherapy in locally advanced gastric cancer, a phase I/II feasibility and efficacy study

    International Nuclear Information System (INIS)

    Trip, Anouk K.; Poppema, Boelo J.; Berge Henegouwen, Mark I. van; Siemerink, Ester; Beukema, Jannet C.; Verheij, Marcel; Plukker, John T.M.; Richel, Dick J.; Hulshof, Maarten C.C.M.; Sandick, Johanna W. van; Cats, Annemieke; Jansen, Edwin P.M.; Hospers, Geke A.P.

    2014-01-01

    Objectives: This study was initiated to investigate the feasibility and efficacy of preoperative radiotherapy with weekly paclitaxel and carboplatin in locally advanced gastric cancer. Methods: In a prospective study, patients with locally advanced gastric cancer stage IB-IV(M0) were treated with chemoradiotherapy followed by surgery 4–6 weeks after the last irradiation. Chemoradiotherapy consisted of radiation to a total dose of 45 Gy given in 25 fractions of 1.8 Gy, combined with concurrent weekly carboplatin and paclitaxel. Results: Between December 2007 and January 2012, 25 patients with cT3 (64%) or cT4 (36%) gastric cancer were included. One patient discontinued concurrent chemotherapy in the 4th week due to toxicity, but completed radiotherapy. Another patient discontinued chemoradiotherapy after the 3rd week due to progressive disease. Grade III adverse events of chemoradiotherapy were: gastrointestinal 12%, haematological 12% and other 8%. All patients, except one who developed progressive disease, were operated. Surgical complications were: general/infectious 48%, anastomotic leakage 12%, and bowel perforation 8%. Postoperative mortality was 4%. Microscopically radical resection rate was 72%. Pathological complete response rate was 16% and near complete response rate 24%. Conclusions: In this study, preoperative chemoradiotherapy for patients with locally advanced gastric cancer was associated with manageable toxicity and encouraging pathological response rates

  15. Clinical target volume delineation including elective nodal irradiation in preoperative and definitive radiotherapy of pancreatic cancer

    Directory of Open Access Journals (Sweden)

    Caravatta Luciana

    2012-06-01

    Full Text Available Abstract Background Radiotherapy (RT is widely used in the treatment of pancreatic cancer. Currently, recommendation has been given for the delineation of the clinical target volume (CTV in adjuvant RT. Based on recently reviewed pathologic data, the aim of this study is to propose criteria for the CTV definition and delineation including elective nodal irradiation (ENI in the preoperative and definitive treatment of pancreatic cancer. Methods The anatomical structures of interest, as well as the abdominal vasculature were identified on intravenous contrast-enhanced CT scans of two different patients with pancreatic cancer of the head and the body. To delineate the lymph node area, a margin of 10 mm was added to the arteries. Results We proposed a set of guidelines for elective treatment of high-risk nodal areas and CTV delineation. Reference CT images were provided. Conclusions The proposed guidelines could be used for preoperative or definitive RT for carcinoma of the head and body of the pancreas. Further clinical investigations are needed to validate the defined CTVs.

  16. Markerless registration for image guided surgery. Preoperative image, intraoperative video image, and patient

    International Nuclear Information System (INIS)

    Kihara, Tomohiko; Tanaka, Yuko

    1998-01-01

    Real-time and volumetric acquisition of X-ray CT, MR, and SPECT is the latest trend of the medical imaging devices. A clinical challenge is to use these multi-modality volumetric information complementary on patient in the entire diagnostic and surgical processes. The intraoperative image and patient integration intents to establish a common reference frame by image in diagnostic and surgical processes. This provides a quantitative measure during surgery, for which we have been relied mostly on doctors' skills and experiences. The intraoperative image and patient integration involves various technologies, however, we think one of the most important elements is the development of markerless registration, which should be efficient and applicable to the preoperative multi-modality data sets, intraoperative image, and patient. We developed a registration system which integrates preoperative multi-modality images, intraoperative video image, and patient. It consists of a real-time registration of video camera for intraoperative use, a markerless surface sampling matching of patient and image, our previous works of markerless multi-modality image registration of X-ray CT, MR, and SPECT, and an image synthesis on video image. We think these techniques can be used in many applications which involve video camera like devices such as video camera, microscope, and image Intensifier. (author)

  17. Multidetector CT and MRI in diseases of the GI tract

    International Nuclear Information System (INIS)

    Bruel, J.M.; Gallix, B.

    2003-01-01

    With the introduction of spiral scanning then multidetector technologies, the accuracy for diagnosing digestive tract diseases with CT has been highly improved, and CT is used more and more in the evaluation of patients with suspected gastrointestinal disorders. CT is able to demonstrate both the intramural and the extra-mural components of the disease, and has a major role in the preoperative staging and the follow-up Improvements of CT protocols, such as CT-enteroclysis, or multiplanar 2D and 3D post-processing, including now techniques for 'virtual endoscopy', lead to discuss new indications in which CT could now compete with conventional X-rays series and video-endoscopy. This precise study of the digestive wall, the peri-digestive fat, the digestive tract blood supply, may be performed by MRI, under the condition of access to high level machines and standardized protocols. MR-enteroclysis and MR-virtual colonoscopy could be performed with much lower risk for the patient, in terms of radiation dose or contrast adverse effects. Endo-luminal coils should give to MR an ultra-high resolution for analysing the different layers of the gastrointestinal wall. Learning objectives: to review how to perform CT and MRI protocols for digestive tract imaging, to recognize the CT arid MR patterns of the main digestive tract diseases, to discuss the value, limits and role of CT and MR in digestive tract diseases, to discuss the potential role of CT and MR new technological developments for digestive tract imaging in the upcoming future Conclusion: CT is nowadays a modality of choice for digestive imaging. Improvements in technologies and indications, the necessary discussion of the risks and benefits for the patient should let the radiologists consider MRI in gastrointestinal disorders as an important part of the routine activity in clinical MRI. (authors)

  18. Mandibular fracture caused by periodontal abscess: Radiological, US, CT and MRI findings.

    Science.gov (United States)

    Mazza, D; Marini, M; Tesei, J; Primicerio, P

    2006-09-01

    Mandibular fracture is a rare but possible outcome of a periodontal abscess. A case of complete fracture of the mandible with abscess infiltrating the surrounding soft tissues is described. The patient reported nor trauma, nor locoregional surgery. Ultrasonography and orthopantomography revealed the fracture of the mandible and the abscess at the masseter muscle. Further preoperative diagnostic examinations included CT and MRI. CT revealed the complete fracture line more clearly; MR the extension of the abscess.

  19. Adrenal haemangioma: Correlation of CT, MR and histology in a case report

    International Nuclear Information System (INIS)

    Dammann, F.; Wehrmann, M.; Rieber, A.

    1995-01-01

    Adrenal hemangiomas are a rare occurrence. The literature reports only 29 cases that have been treated by surgery. Whereas in about half of these cases CT has been applied for diagnostic evaluation, there are only two cases reporting MRI findings. Since MRI has been gaining in significance for diagnostic examination of adrenal lesions, the communication reports the surgery of an adrenal hemangioma and correlates the pre-operative CT and MRI examinations with the results of the histopathological findings. (orig./MG) [de

  20. The Role of Fine Needle Aspiration in the Diagnosis of Parotid Gland Tumors: Correlation With Preoperative Computerized Tomography Tumor Size.

    Science.gov (United States)

    Ghantous, Yasmine; Naddaf, Raja; Barak, Michal; Abd-Elraziq, Murad; Abu Eln-Naaj, Imad

    2016-03-01

    The role of fine needle aspiration cytology (FNAC) in the diagnosis of parotid gland masses is still controversial, regarding its sensitivity and specificity that vary between 41% and 100% and between 86% and 100% respectively.The aim of this study was to identify the specificity and sensitivity of FNAC of parotid gland tumors in relation to the tumor size as characterized preoperatively by computer tomography. The medical files of 79 patients whom were referred to the MaxilloFacila Surgery Department, Rambam medical center, over a 10.5-year period (2000-2010) were analyzed retrospectively.The extensity of the operation was determined by the location of the tumor as presented in computed tomography (CT) radiography, and preoperative FNAC examination.The majority of the masses were located in the superficial lobe (88.52%), and only 11.48% of the patients were located in the deep lobe (8:1 ratio). FNAC results were nondiagnostic in 7 patients (8.86%), 62 patients were diagnosed as inflammatory and benign lesion in (78.48%), malignant tumors were diagnosed in 10 patients (12.65%).The sensitivity in our study was 90%, the specificity was 98%, positive predictive value was 90%, negative predictive value was 98%, and diagnostic accuracy was 88%. The positive predictive value was 90%, the negative predictive value was 98%.Analyzing the effect of the preoperative CT size upon the accuracy of the FNAC diagnosis, we found that lesion with preoperative CT size greater than 24 mm has a more accurate FNAC result (P = 0.034).

  1. Demonstration of infective endocarditis by cardiac CT and transoesophageal echocardiography: comparison with intra-operative findings.

    Science.gov (United States)

    Koo, Hyun Jung; Yang, Dong Hyun; Kang, Joon-Won; Lee, Joo Yeon; Kim, Dae-Hee; Song, Jong-Min; Kang, Duk-Hyun; Song, Jae-Kwan; Kim, Joon Bum; Jung, Sung-Ho; Choo, Suk Jung; Chung, Cheol Hyun; Lee, Jae-Won; Lim, Tae-Hwan

    2018-02-01

    We aimed to compare imaging findings of infective endocarditis between computed tomography (CT) and transoesophageal echocardiography (TEE) using surgical inspection as a reference standard. Forty-nine patients (aged 54 ± 17 years, 69% men) who underwent pre-operative CT and TEE for infective endocarditis were included. Twelve of these patients had prosthetic valve endocarditis. Imaging findings of infective endocarditis were classified as vegetation, leaflet perforation, abscess/pseudoaneurysm, and paravalvular leakage. Diagnostic performances of CT and TEE were evaluated using surgical inspection as a reference standard. Interobserver agreements for CT findings were obtained using Cohen's κ test. The detection rates of infective endocarditis per patient with CT and TEE were 93.9% (46/49) and 95.9% (47/49), respectively. In per-imaging analysis, the sensitivities of CT and TEE were not significantly different for both native and prosthetic valve infective endocarditis (sensitivity: vegetation, 100% in TEE and 90.9% in CT; leaflet perforation, 87.5% in TEE and 50.0% in CT; abscess/pseudoaneurysm, 40.0% in TEE and 60.0% in CT; paravalvular leakage, 100% in TEE and 50.0% in CT). Interobserver agreements for CT findings were substantial or excellent (0.79-0.88). Cardiac CT can accurately demonstrate infective endocarditis in pre-operative patients with a similar diagnostic accuracy to TEE. The interobserver agreements for the CT findings of infective endocarditis were excellent. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

  2. Preoperational test report, recirculation ventilation systems

    International Nuclear Information System (INIS)

    Clifton, F.T.

    1997-01-01

    This represents a preoperational test report for Recirculation Ventilation Systems, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system provides vapor space cooling of tanks AY1O1, AY102, AZ1O1, AZ102 and supports the ability to exhaust air from each tank. Each system consists of a valved piping loop, a fan, condenser, and moisture separator; equipment is located inside each respective tank farm in its own hardened building. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System

  3. Preoperational test report, raw water system

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, F.T.

    1997-10-29

    This represents the preoperational test report for the Raw Water System, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system supplies makeup water to the W-030 recirculation evaporative cooling towers for tanks AY1O1, AY102, AZ1O1, AZ102. The Raw Water pipe riser and associated strainer and valving is located in the W-030 diesel generator building. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

  4. Preoperational test report, recirculation ventilation systems

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, F.T.

    1997-11-11

    This represents a preoperational test report for Recirculation Ventilation Systems, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system provides vapor space cooling of tanks AY1O1, AY102, AZ1O1, AZ102 and supports the ability to exhaust air from each tank. Each system consists of a valved piping loop, a fan, condenser, and moisture separator; equipment is located inside each respective tank farm in its own hardened building. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

  5. Preoperational test report, primary ventilation condensate system

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, F.T.

    1997-01-29

    Preoperational test report for Primary Ventilation Condensate System, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system provides a collection point for condensate generated by the W-030 primary vent offgas cooling system serving tanks AYIOI, AY102, AZIOI, AZI02. The system is located inside a shielded ventilation equipment cell and consists of a condensate seal pot, sampling features, a drain line to existing Catch Tank 241-AZ-151, and a cell sump jet pump. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

  6. Preoperational test report, raw water system

    International Nuclear Information System (INIS)

    Clifton, F.T.

    1997-01-01

    This represents the preoperational test report for the Raw Water System, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system supplies makeup water to the W-030 recirculation evaporative cooling towers for tanks AY1O1, AY102, AZ1O1, AZ102. The Raw Water pipe riser and associated strainer and valving is located in the W-030 diesel generator building. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System

  7. Preoperative steroid in abdominal wall reconstruction

    DEFF Research Database (Denmark)

    Jensen, Kristian Kiim; Brøndum, Tina Lee; Belhage, Bo

    2016-01-01

    INTRODUCTION: Preoperative administration of high-dose glucocorticoid leads to improved recovery and decreased length of stay after abdominal surgery. Even so, studies on administration of glucocorticoids for patients undergoing abdominal wall reconstruction (AWR) for giant ventral hernia repair...... defect exceeding 10 cm will be randomised for intravenous administration of either 125 mg methylprednisolone or saline at the induction of anaesthesia. The primary endpoint is pain at rest on the first post-operative day. Patients will be followed until 30 days post-operatively, and secondary outcomes...

  8. Preoperative Chemoradiation Therapy in Combination With Panitumumab for Patients With Resectable Esophageal Cancer: The PACT Study

    Energy Technology Data Exchange (ETDEWEB)

    Kordes, Sil [Department of Medical Oncology, Academic Medical Center, Amsterdam (Netherlands); Berge Henegouwen, Mark I. van [Department of Surgery, Academic Medical Center, Amsterdam (Netherlands); Hulshof, Maarten C. [Department of Radiotherapy, Academic Medical Center, Amsterdam (Netherlands); Bergman, Jacques J.G.H.M. [Department of Gastroenterology, Academic Medical Center, Amsterdam (Netherlands); Vliet, Hans J. van der [Department of Medical Oncology, Vrije Universiteit Medical Center, Amsterdam (Netherlands); Kapiteijn, Ellen [Department of Medical Oncology, Leiden University Medical Center, Leiden (Netherlands); Laarhoven, Hanneke W.M. van; Richel, Dick J. [Department of Medical Oncology, Academic Medical Center, Amsterdam (Netherlands); Klinkenbijl, Jean H.G. [Department of Surgery, Academic Medical Center, Amsterdam (Netherlands); Meijer, Sybren L. [Department of Pathology, Academic Medical Center, Amsterdam (Netherlands); Wilmink, Johanna W. [Department of Medical Oncology, Academic Medical Center, Amsterdam (Netherlands)

    2014-09-01

    Purpose: Preoperative chemoradiation therapy (CRT) has become the standard treatment strategy for patients with resectable esophageal cancer. This multicenter phase 2 study investigated the efficacy of the addition of the epidermal growth factor receptor (EGFR) inhibitor panitumumab to a preoperative CRT regimen with carboplatin, paclitaxel, and radiation therapy in patients with resectable esophageal cancer. Methods and Materials: Patients with resectable cT1N1M0 or cT2-3N0 to -2M0 tumors received preoperative CRT consisting of panitumumab (6 mg/kg) on days 1, 15, and 29, weekly administrations of carboplatin (area under the curve [AUC] = 2), and paclitaxel (50 mg/m{sup 2}) for 5 weeks and concurrent radiation therapy (41.4 Gy in 23 fractions, 5 days per week), followed by surgery. Primary endpoint was pathologic complete response (pCR) rate. We aimed at a pCR rate of more than 40%. Furthermore, we explored the predictive value of biomarkers (EGFR, HER 2, and P53) for pCR. Results: From January 2010 until December 2011, 90 patients were enrolled. Patients were diagnosed predominantly with adenocarcinoma (AC) (80%), T3 disease (89%), and were node positive (81%). Three patients were not resected due to progressive disease. The primary aim was unmet, with a pCR rate of 22%. Patients with AC and squamous cell carcinoma reached a pCR of 14% and 47%, respectively. R0 resection was achieved in 95% of the patients. Main grade 3 toxicities were rash (12%), fatigue (11%), and nonfebrile neutropenia (11%). None of the biomarkers was predictive for response. Conclusions: The addition of panitumumab to CRT with carboplatin and paclitaxel was safe and well tolerated but could not improve pCR rate to the preset criterion of 40%.

  9. Preoperative Chemoradiation Therapy in Combination With Panitumumab for Patients With Resectable Esophageal Cancer: The PACT Study

    International Nuclear Information System (INIS)

    Kordes, Sil; Berge Henegouwen, Mark I. van; Hulshof, Maarten C.; Bergman, Jacques J.G.H.M.; Vliet, Hans J. van der; Kapiteijn, Ellen; Laarhoven, Hanneke W.M. van; Richel, Dick J.; Klinkenbijl, Jean H.G.; Meijer, Sybren L.; Wilmink, Johanna W.

    2014-01-01

    Purpose: Preoperative chemoradiation therapy (CRT) has become the standard treatment strategy for patients with resectable esophageal cancer. This multicenter phase 2 study investigated the efficacy of the addition of the epidermal growth factor receptor (EGFR) inhibitor panitumumab to a preoperative CRT regimen with carboplatin, paclitaxel, and radiation therapy in patients with resectable esophageal cancer. Methods and Materials: Patients with resectable cT1N1M0 or cT2-3N0 to -2M0 tumors received preoperative CRT consisting of panitumumab (6 mg/kg) on days 1, 15, and 29, weekly administrations of carboplatin (area under the curve [AUC] = 2), and paclitaxel (50 mg/m 2 ) for 5 weeks and concurrent radiation therapy (41.4 Gy in 23 fractions, 5 days per week), followed by surgery. Primary endpoint was pathologic complete response (pCR) rate. We aimed at a pCR rate of more than 40%. Furthermore, we explored the predictive value of biomarkers (EGFR, HER 2, and P53) for pCR. Results: From January 2010 until December 2011, 90 patients were enrolled. Patients were diagnosed predominantly with adenocarcinoma (AC) (80%), T3 disease (89%), and were node positive (81%). Three patients were not resected due to progressive disease. The primary aim was unmet, with a pCR rate of 22%. Patients with AC and squamous cell carcinoma reached a pCR of 14% and 47%, respectively. R0 resection was achieved in 95% of the patients. Main grade 3 toxicities were rash (12%), fatigue (11%), and nonfebrile neutropenia (11%). None of the biomarkers was predictive for response. Conclusions: The addition of panitumumab to CRT with carboplatin and paclitaxel was safe and well tolerated but could not improve pCR rate to the preset criterion of 40%

  10. CT appearance of splenosis

    Energy Technology Data Exchange (ETDEWEB)

    Mendelson, D.S.; Cohen, B.A.; Armas, R.R.

    1982-12-01

    Splenosis is an unusual complication of splenic trauma. The computed tomographic (CT) appearance of splenosis is described. One should consider this diagnosis when faced with a history of splenic trauma and multiple round or oval masses at CT.

  11. CT appearance of splenosis

    International Nuclear Information System (INIS)

    Mendelson, D.S.; Cohen, B.A.; Armas, R.R.

    1982-01-01

    Splenosis is an unusual complication of splenic trauma. The computed tomographic (CT) appearance of splenosis is described. One should consider this diagnosis when faced with a history of splenic trauma and multiple round or oval masses at CT

  12. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, ... prescribed procedure with your doctor, the medical facility staff and/or your insurance provider to get a ...

  13. Computed Tomography (CT) -- Head

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    Full Text Available ... scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, ... prescribed procedure with your doctor, the medical facility staff and/or your insurance provider to get a ...

  14. Abdominal and Pelvic CT

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    Full Text Available ... cavities (ventricles) in patients with hydrocephalus . diseases or malformations of the skull. CT scanning is also performed ... biopsy ) from the brain. assess aneurysms or arteriovenous malformations through a technique called CT angiography. For more ...

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    Full Text Available ... CT scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector ... Safety page for more information about radiation dose. Women should always inform their physician and x-ray ...

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    Full Text Available ... CT scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector ... Safety page for more information about radiation dose. Women should always inform their physician and x-ray ...

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    Full Text Available ... CT scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector ... Safety page for more information about radiation dose. Women should always inform their physician and x-ray ...

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    Full Text Available ... view of the body's interior. Refinements in detector technology allow nearly all CT scanners to obtain multiple ... preferable over CT scanning. top of page Additional Information and Resources RTAnswers.org: Radiation Therapy for Bladder ...

  20. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... CT of the Sinuses? CT is usually the first test ordered when a sinus tumor is suspected. ... Radiology (ACR) and the Radiological Society of North America (RSNA), comprising physicians with expertise in several radiologic ...

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    Full Text Available ... CT scanner or may be over the weight limit—usually 450 pounds—for the moving table. CT ... type your comment or suggestion into the following text box: Comment: E-mail: Area code: Phone no: ...

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    Full Text Available ... microphone. top of page How does the procedure work? In many ways CT scanning works very much ... CT scan, an experienced radiologist can diagnose many causes of abdominal pain or injury from trauma with ...

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    Full Text Available ... the scanning. Any motion, whether breathing or body movements, can lead to artifacts on the images. This ... clinical problems. CT is less sensitive to patient movement than MRI. CT can be performed if you ...

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    Full Text Available ... the scanning. Any motion, whether breathing or body movements, can lead to artifacts on the images. This ... clinical problems. CT is less sensitive to patient movement than MRI. CT can be performed if you ...

  5. Computed Tomography (CT) -- Head

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    Full Text Available ... the scanning. Any motion, whether breathing or body movements, can lead to artifacts on the images. This ... clinical problems. CT is less sensitive to patient movement than MRI. CT can be performed if you ...

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    Full Text Available ... to a CD or DVD. CT images of internal organs, bones, soft tissue and blood vessels provide ... clicking and whirring sounds as the CT scanner's internal parts, not usually visible to you, revolve around ...

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    Full Text Available ... about tumors of the nasal cavity and sinuses. plan for surgery by defining anatomy. top of page ... for sinusitis. CT of the sinuses can help plan the safest and most effective surgery. CT of ...

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    Full Text Available ... When the image slices are reassembled by computer software, the result is a very detailed multidimensional view ... Safety Images related to Computed Tomography (CT) - Head Videos related to Computed Tomography (CT) - Head Sponsored by ...

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    Full Text Available ... sinus cavities – hollow, air-filled spaces within the bones of the face surrounding the nasal cavity. CT ... CD or DVD. CT images of internal organs, bones, soft tissue and blood vessels provide greater detail ...

  11. Computed Tomography (CT) -- Head

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    Full Text Available ... microphone. top of page How does the procedure work? In many ways CT scanning works very much ... head CT scanning. Manufacturers of intravenous contrast indicate mothers should not breastfeed their babies for 24-48 ...

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    Full Text Available ... over time. top of page What are the benefits vs. risks? Benefits Viewing a