ViBrism DB: an interactive search and viewer platform for 2D/3D anatomical images of gene expression and co-expression networks.

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

MRI Findings of Inverted Urothelial Papilloma of the Bladder.

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

The Maximum standardized uptake value is more reliable than size measurement in early follow-up to evaluate potential pulmonary malignancies following radiofrequency ablation.

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

Simulation of supply chain disruptions considering establishments and power outages.

In this paper, we simulate the economic loss resulting from supply chain disruptions triggered by the Great East Japan Earthquake (GEJE) in 2011, applying data from firm-level supply chains and establishment-level attributes to an agent-based model. To enhance the accuracy of the simulation, we extend data and models in previous studies in four ways. First, we identify the damage to production facilities in the disaster-hit regions more accurately by using establishment-level census and survey data and geographic information system (GIS) data on the damages caused by the GEJE and subsequent tsunami. Second, the use of establishment-level data enables us to capture supply chains between non-headquarter establishments in disaster-hit regions and establishments in other regions. Third, we incorporate the effect of power outages after the GEJE on production reduction, which exacerbated the effect of the supply chain disruption, particularly in the weeks immediately after the GEJE. Finally, our model incorporates sectoral heterogeneity by employing sector-specific parameters. Our findings indicate that the extended method can significantly improve the accuracy of predicting the domestic production after the GEJE, particularly due to the first three improvements utilizing various data sources, not because of the use of more sector-specific parameters. Our method can be applied to predict the economic effect of future disasters, such as the Nankai Trough earthquake, on each region more precisely.

Preoperative graft volume assessment with 3D-CT volumetry in living-donor lobar lung transplantations.

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

The usefulness of pre-radiofrequency ablation SUV(max) in 18F-FDG PET/CT to predict the risk of a local recurrence of malignant lung tumors after lung radiofrequency ablation.

The aim of the present study was to assess the diagnostic usefulness of Fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in the prediction of local recurrence of malignant lung tumors by analyzing the pre-radiofrequency ablation (RFA) maximal standardized uptake value (SUV(max)). We performed a historical cohort study of consecutive malignant lung tumors treated by RFA from January 2007 to May 2008 at Okayama University Hospital. We selected only lung tumors examined by PET/CT within 90 days before RFA and divided them (10 primary and 29 metastatic) into 3 groups according to their tertiles of SUV(max). We calculated recurrence odds ratios in the medium group and the high group compared to the low group using multivariate logistic analysis. After we examined the relationship between SUV(max) and recurrence in a crude model, we adjusted for some factors. Tumors with higher SUV(max) showed higher recurrence odds ratios (medium group; 1.84, high group; 4.14, respectively). The tumor size also increased the recurrence odds ratio (2.67); we thought this was mainly due to selection bias because we excluded tumors less than 10mm in diameter. This study demonstrated the pre-RFA SUV(max) in PET/CT may be a prognostic factor for local recurrence of malignant lung tumors.

The predictive value of measurement of SUVmax and SCC-antigen in patients with pretreatment of primary squamous cell carcinoma of cervix.

OBJECTIVE: Use of positron emission tomography/computed tomography (PET/CT) and serum squamous cell carcinoma (SCC) antigen (SCC-ag) as predictors for poor prognosis of pretreatment of primary SCC of cervix. METHODS: The distribution of cases that scored positive for each of the biological parameters examined was correlated with maximum SUV (SUVmax) of PET/CT and serum SCC-ag for 52 participants prior to radiotherapy (RT) with or without concurrent chemotherapy (CCRT) with pretreatment of primary SCC of cervix. RESULTS: There were significant correlations between the SUVmax of the primary tumor and tumor maximum size (P=0.027), and the lymph node metastasis (P=0.039). The serum SCC-ag had a statistically significant association with the clinicopathological parameters such as FIGO stage (P=0.045) and tumor maximum size (P=0.008), although there was no correlation noted between the SUVmax of the primary tumor and the serum SCC-ag (R=0.155). The high SUVmax of the primary tumor (≥ 15.6) plus lymph node metastasis (a short-axis diameter of over 10mm with a SUVmax ≥ 3.5) were significant predictors for poor prognosis when compared with the low SUVmax of the primary tumor (<15.6) or the high SUVmax of the primary tumor plus negative lymph node metastasis (a short-axis diameter of under 10mm or SUVmax <3.5) (overall survival rate; P=0.0211). CONCLUSIONS: The present findings indicate that the high SUVmax of the primary tumor plus lymph node metastasis with pretreatment of primary SCC of cervix may be associated with a poor prognosis.

The SUVmax of 18F-FDG PET correlates with histological grade in endometrial cancer.

OBJECTIVES: The objectives of this study were to assess the maximum standardized uptake value (SUVmax) of F-fluorodeoxyglucose (F-FDG) by a primary tumor of endometrial cancer with the use of positron emission tomography/computed tomography (PET/CT) and to assess its association with the clinical importance of the disease. METHODS: F-fluorodeoxyglucose PET/CT scan was performed on 44 participants within 2 weeks before surgery. F-fluorodeoxyglucose uptake was quantified by calculating the SUVmax. The distribution of cases that scored positive for each of the biological parameters examined was correlated with the SUVmax of the F-FDG PET/CT and the glucose transporter-1 expression status obtained by immunohistochemistry. RESULTS: The mean SUVmax of the primary endometrial cancer tumors was 17.6 (range, 3.04-34.74). There were significant correlations between the SUVmax of the primary tumor and the International Federation of Gynecology and Obstetrics (FIGO) grade (P < 0.001), maximum tumor size (P < 0.001), and glucose transporter-1 expression (P < 0.001). Furthermore, multivariate analysis showed that the FIGO grade was most significantly identified as a relation factor of SUVmax (> or =17.6) for endometrial cancer (P = 0.017). The present findings indicate that a significant relationship was seen between the SUVmax and the FIGO grade in endometrial cancer. CONCLUSION: We propose that the primary tumor's SUVmax obtained from F-FDG PET/CT may be associated with aggressive biological characteristics in endometrial cancer.

Open source code for behavior analysis in rodents.

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

Preliminary retrospective investigation of FDG-PET/CT timing in follow-up of ablated lung tumor.

OBJECTIVE: The aim of this study was to clarify the most appropriate follow-up initiation time point for positron emission tomography (PET)/computed tomography (CT) following radio frequency ablation (RFA) of lung tumors, and the cutoff values of maximum standard uptake value (SUV(max)) to evaluate local tumor progression. METHODS: We enrolled 15 patients (8 men, median age 62 years) with 60 tumors, who were treated with RFA of lung tumors and underwent fluorodeoxyglucose (FDG)-PET/CT following RFA. Local tumor progression was assessed by periodic chest CT images prior to and following intravenous administration of a contrast medium. The SUV(max) of three periods, namely, 0-3 months, 3-6 months, and 6-9 months after RFA, was evaluated. The appropriate time point for follow-up initiation and the cutoff value of SUV(max) were determined using receiver-operating characteristic (ROC) analysis. RESULTS: The median follow-up period was 357 days. Of 60 tumors, 10 showed local progression. The area under the ROC curve (Az) for the 6-9 months (P = 0.044) was the largest and almost equal to that of the 3-6 months (P = 0.024). Az for the 0-3 months was the smallest and statistically insignificant (P = 0.705). The cutoff value of 1.5 of SUV(max) at 3-9 months after RFA showed 77.8% sensitivity and 85.7-90.5% specificity. CONCLUSIONS: The appropriate follow-up initiation time point is at least 3 months following RFA. Thus, SUV(max) is a useful and reliable predictive indicator.

Inter-observer variations in FDG-PET interpretation for cancer screening.

BACKGROUND: Diagnostic guidelines for the use of 2-(fluorine 18) fluoro-2 deoxy-D-glucose (FDG)-positron emission tomography (PET) in cancer screening have yet to be established. We assessed inter-observer variability in screening FDG-PET. METHODS: Subjects comprised 40 individuals who underwent FDG-PET and computed tomography (CT) for cancer screening. To assess various patterns of FDG uptakes, three subsets of the cases were selected: 'Cancer', 15 cases with cancer; 'Not malignant', 15 cases with suspected cancer by FDG-PET who were confirmed as cancer-free; and 'Normal', 10 cases without remarkable FDG uptake who were confirmed as cancer-free. A total of 68 lesions made up of malignancy (n = 18), benign (n = 21), and physiological FDG uptake (n = 29) were interpreted by six physicians. Each observer reviewed each case three times. Step 1 involved interpretation of PET images alone, Step 2 involved side-by-side reading of PET and CT images, and Step 3 involved re-evaluation of findings with the results of other screening tests. We assessed inter-observer agreement for each step. RESULTS: Inter-observer agreement for all lesions at each step was moderate, compared to fair agreement for 'Normal' subjects. Inter-observer agreement of 'Cancer' and 'Not malignant' subjects in Step 1 were better than those in Step 2 and 3; however, the differences were not statistically significant. CONCLUSION: The interpretation of FDG-PET is adequately reproducible, while that of 'Normal' subjects is less reproducible. Improvement of inter-observer variability in assessing physiological FDG uptakes requires universal reporting criteria in FDG-PET. Correlative interpretation of PET, CT and other information may require standardization in subjects with suspected cancer by FDG-PET.

F-18 FDG PET demonstration of a thyroid metastasis in a patient with colon cancer.

A 51-year-old man with a history of surgical removal of sigmoid colon cancer underwent F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) to search for distant metastases and/or local recurrence because the carcinoembryonic antigen level was elevated. F-18 FDG PET images showed increased focal FDG uptake in the left lobe of the thyroid. Computed tomography images showed thyroid tumor in the left lobe as well as F-18 FDG PET images. Thereafter he underwent thyroidectomy and the resected specimen was histopathlogically shown to have thyroid metastasis from colon cancer. F-18 FDG PET was useful to detect thyroid metastasis from colon cancer as well as the most frequently seen metastatic sites such as liver, lungs, and lymph nodes.

Customizable neuroinformatics database system: XooNIps and its application to the pupil platform.

The developing field of neuroinformatics includes technologies for the collection and sharing of neuro-related digital resources. These resources will be of increasing value for understanding the brain. Developing a database system to integrate these disparate resources is necessary to make full use of these resources. This study proposes a base database system termed XooNIps that utilizes the content management system called XOOPS. XooNIps is designed for developing databases in different research fields through customization of the option menu. In a XooNIps-based database, digital resources are stored according to their respective categories, e.g., research articles, experimental data, mathematical models, stimulations, each associated with their related metadata. Several types of user authorization are supported for secure operations. In addition to the directory and keyword searches within a certain database, XooNIps searches simultaneously across other XooNIps-based databases on the Internet. Reviewing systems for user registration and for data submission are incorporated to impose quality control. Furthermore, XOOPS modules containing news, forums schedules, blogs and other information can be combined to enhance XooNIps functionality. These features provide better scalability, extensibility, and customizability to the general neuroinformatics community. The application of this system to data, models, and other information related to human pupils is described here.

Reduced cardiac uptake and enhanced washout of 123I-MIBG in pure autonomic failure occurs conjointly with Parkinson's disease and dementia with Lewy bodies.

UNLABELLED: The purpose of this study was to investigate myocardial uptake of 123I-metaiodobenzylguanidine (MIBG) in patients with pure autonomic failure (PAF), which has pathologic features in common with idiopathic Parkinson's disease (IPD) and dementia with Lewy bodies (DLB). METHODS: Six patients with PAF, 130 with IPD, 21 with DLB, 9 with corticobasal degeneration (CBD), 11 with progressive supranuclear palsy (PSP), and 11 with multiple-system atrophy (MSA) underwent myocardial 123I-MIBG scintigraphy, as did 16 control patients. RESULTS: Resulting heart-to-mediastinum (H/M) ratios were significantly lower in patients with PAF, IPD, or DLB than in patients with CBD, PSP, or MSA and in the controls. H/M ratios were lower for delayed images than for early ones in patients with PAF, IPD, or DLB, whereas the ratios were higher for delayed images in patients with CBD and in the controls. CONCLUSION: Cardiac sympathetic denervation and enhanced washout of 123I-MIBG from sympathetic nerve terminals may develop in parallel in patients with PAF, IPD, or DLB.

Percutaneous radiofrequency ablation for patients with malignant lung tumors: a phase II prospective multicenter study (JIVROSG-0702).

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

Diagnostic capabilities of I-131, TI-201, and Tc-99m-MIBI scintigraphy for metastatic differentiated thyroid carcinoma after total thyroidectomy.

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

pEYFP-Nuc vector is a useful tool for three-dimensional and time-lapse observation of nuclear morphology of Jurkat cells during apoptosis.

Using a pEYFP-Nuc vector, which contains nucleic acid sequences of a nuclear localization signal, we established a Jurkat-YN cell line that expressed enhanced yellow fluorescent protein (EYFP) in the nucleus. We observed three-dimensional and time-lapse changes in nuclear morphology of Jurkat-YN cells during Fas-induced apoptosis using a confocal laser scanning microscope. The nuclear forms visualized by EYFP were almost equal in quality to those visualized by SYTO59, a nucleic acid stain for living cells. Three-dimensional deformities in the nuclear form were observed during apoptosis before chromatin condensation became apparent, indicating these deformities are characteristic morphological changes of the early stage of apoptosis. In conclusion, the pEYFP-Nuc vector is a useful tool in the time-lapse observation of nuclear morphology of living cells during apoptosis.

Cepharanthine enhances in vitro and in vivo thermosensitivity of a mouse fibrosarcoma, FSa-II, based on increased apoptosis.

Cepharanthine (Ce) is a biscoclaurine alkaloid extracted from Stephania cepharantha Hayata. In our previous study, Ce significantly enhanced thermosensitivity and thereby reduced thermotolerance in vitro, and intra-peritoneal injection of Ce slightly enhanced thermosensitivity in vivo. In the present study, we investigated Ce's effect in vitro on the pattern of cell death after heating and the effect of intra-tumoral injection of Ce on in vivo thermosensitivity using a mouse fibrosarcoma, FSa-II, and C3H/He mice. Ce significantly enhanced the in vitro thermosensitivity of FSa-II cells with heating at 44 degrees C, with increased Ce concentration. Time-lapse microscopic observation of individual cells confirmed that Ce treatment hastened both apoptosis (specifically, apoptotic budding) and necrosis (as indicated by staining with propidium iodide). Staining with annexin V-enhanced green fluorescent protein indicated that Ce used concomitantly with heating significantly increased the proportion of cells in the early stage of apoptosis. Ce combined with heating also significantly increased the proportion of cells with high intracellular caspase-3 activity, as detected by a substrate of caspase-3, PhiPhiLux-G1D2. The intra-tumoral injection of Ce, followed by heating at 44 degrees C, significantly delayed in vivo tumor growth, and this delay increased in a Ce concentration-dependent manner. Ce injected 30 min before heating delayed tumor growth more than Ce injected immediately before heating. These findings suggest the potential of Ce as a thermosensitizer to increase apoptosis of tumor cells.

Hepatectomy simulation discrepancy between radionuclide receptor imaging and CT volumetry: influence of decreased unilateral portal venous flow.

BACKGROUND: Regional dysfunction demonstrated by Tc-99m-diethylenetriamine-penta-acetic acid-galactosyl human serum albumin (GSA) scintigraphy due to regional decrease in the portal venous flow has previously been reported. In this study, we call attention to the significance of unilateral portal venous flow decrease for preoperative hepatectomy simulation, and evaluate the hepatectomy simulation discrepancy between Tc-99m-GSA single-photon emission computed tomography (SPECT) and CT volumetry. METHODS: Twenty-four hepatectomy candidates underwent preoperative hepatectomy simulation by both Tc-99m-GSA SPECT and CT volumetry. Both anatomical and functional resection ratios were calculated by means of CT volumetry and Tc-99m-GSA SPECT, respectively. The differences and ratios between anatomical and functional resection ratios were calculated in all patients, and compared in patients with and without unilateral portal venous flow decrease. RESULTS: Anatomical resection ratios were 28.0 +/- 11.7 (mean +/- standard deviation) in patients with unilateral portal venous flow decrease, and 42.1 +/- 15.7 in patients without unilateral portal venous flow decrease (p = 0.0127). Functional resection ratios were 14.7 +/- 12.8 in patients with unilateral portal venous flow decrease and 40.5 +/- 14.6 in patients without (p = 0.0004). The differences between anatomical and functional resection ratios were 13.0 +/- 7.9 in patients with unilateral portal venous flow decrease and 5.6 +/- 3.1 in patients without (p = 0.0099). The ratios between anatomical and functional resection ratios were 0.48 +/- 0.29 in patients with unilateral portal venous flow decrease and 0.86 +/- 0.10 in patients without (p = 0.0018). In 12 of the 13 patients with unilateral portal venous flow decrease, anatomical resection ratios were found to be larger than functional resection ratios, whereas this happened in only 6 of 11 patients without unilateral portal venous flow decrease (p = 0.0063). CONCLUSION: Unilateral portal venous flow decrease is suspected to be a major factor in the discrepancy between hepatectomy simulations with radionuclide receptor imaging and CT volumetry.

The usefulness of serum thyroglobulin levels and Tl-201 scintigraphy in differentiating between benign and malignant thyroid follicular lesions.

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