Interstitial pneumonia in a patient treated with TAS-102 for metastatic colorectal cancer: a case report.

BACKGROUND: TAS-102, a new treatment option for patients with metastatic colorectal cancer that is refractory or intolerant to standard therapies, has been improving survival with acceptable tolerability and adverse events. Adverse hematological events associated with TAS-102 treatment were extensively profiled in the RECOURSE trial, but pulmonary toxicities associated with TAS-102 therapy are distinctly uncommon. In a recent early post-marketing phase vigilance on TAS-102 in Japan, seven cases of pulmonary disease were reported, but patient follow-up in this study was incomplete. Here, we present the first case of interstitial lung disease occurring in association with TAS-102 treatment. CASE PRESENTATION: A 57-year-old Japanese man who had previously received two standard treatments was admitted in 2014, at which time we administered TAS-102 (110 mg/day) as a third-line chemotherapy. He was safely treated with TAS-102 for the first planned cycle; however, approximately 4 days after receiving the second cycle of TAS-102, he complained of high fever and subsequent dyspnea with severe hypoxemia and went to the emergency room. A chest X-ray revealed diffuse coarse reticular shadows with ground-glass opacity on both lungs. Furthermore, a chest computed tomography scan showed thickening of the bronchovascular bundles with extensive ground-glass opacification and pleural effusions in both lung fields. In addition, a peripheral blood lymphocyte stimulation test with TAS-102 showed higher values compared with control samples. Consequently, we suspected drug-induced interstitial pneumonia, and discontinued treatment. Our patient was given an initial administration of high-dose methylprednisolone (1000 mg/day) for 3 days and oxygen. Our patient was discharged with oral prednisolone (20 mg/day) and improved symptomatically and radiologically. CONCLUSIONS: These findings suggest that interstitial pneumonia is a rare complication of TAS-102 chemotherapy, but the possibility of interstitial pneumonia should always be considered when a patient presents with a respiratory disorder while undergoing TAS-102 systemic chemotherapy. Prompt discontinuation of TAS-102 and treatment with high-dosage corticosteroids is needed to avoid exacerbating respiratory symptoms.

Assessment of MR Imaging as a Tool to Differentiate between the Major Histological Types of Uterine Sarcomas.

OBJECTIVES: We retrospectively compared and quantified magnetic resonance (MR) images to distinguish major histological types of uterine sarcomas and malignant and benign tumors. METHODS: MR images were obtained from patients who underwent preoperative examinations. We compared 25 pathologically confirmed uterine sarcomas (8 leiomyosarcomas, 11 carcinosarcomas, 6 endometrial stromal sarcomas) with 25 uterine leiomyomas. MR findings included tumor size, location, contour, signal intensity (SI), and contrast enhancement. Analysis focused on the contrast ratio (CR) of SI in T2-weighted images for the areas of lowest, highest, and main SI of each tumor as well as the contrast-enhanced ratio (CER) for the main solid part of each tumor in contrast-enhanced T1-weighted images. We evaluated diffusion-weighted (DW) images and apparent diffusion coefficient (ADC) values in 18 tumors (4 sarcomas, 14 leiomyomas). RESULTS: Uterine sarcomas and leiomyomas differed significantly in tumor location, contour, hemorrhaging, necrotic and cystic components, CR for the area of lowest SI (P < 0.05), CR for the area of main SI (P < 0.01), and CER (P < 0.05). Leiomyosarcomas were larger than carcinosarcomas or endometrial stromal sarcomas, and the CR for the area of lowest SI of leiomyosarcomas (P < 0.05) was significantly lower. The CER for endometrial stromal sarcomas (P < 0.05) showed the most homogeneous enhancement. Hemorrhagic or necrotic and cystic components were found more often in larger tumors, although there was no significant difference in their occurrence between sarcoma types. All uterine sarcomas showed high intensity on DW images. The ADC values were lower of uterine sarcomas than leiomyomas, although the difference was not statistically significant. CONCLUSION: Quantitative assessment using the CR or CER was useful for distinguishing benign and malignant uterine tumors as well as major histological types of uterine sarcomas.

Recent advances in 3D computed tomography techniques for simulation and navigation in hepatobiliary pancreatic surgery.

A few years ago it could take several hours to complete a 3D image using a 3D workstation. Thanks to advances in computer science, obtaining results of interest now requires only a few minutes. Many recent 3D workstations or multimedia computers are equipped with onboard 3D virtual patient modeling software, which enables patient-specific preoperative assessment and virtual planning, navigation, and tool positioning. Although medical 3D imaging can now be conducted using various modalities, including computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), and ultrasonography (US) among others, the highest quality images are obtained using CT data, and CT images are now the most commonly used source of data for 3D simulation and navigation image. If the 2D source image is bad, no amount of 3D image manipulation in software will provide a quality 3D image. In this exhibition, the recent advances in CT imaging technique and 3D visualization of the hepatobiliary and pancreatic abnormalities are featured, including scan and image reconstruction technique, contrast-enhanced techniques, new application of advanced CT scan techniques, and new virtual reality simulation and navigation imaging.

Infantile hemangioma of the liver in an adult: a case report and review of the literature.

Infantile hemangioma (IH), a representative vascular liver tumor, usually occurs in infancy or early childhood but rarely in adults. In this study, we describe a case of IH in a 47-year-old female and we also review the literature. A plain computed tomography (CT) image revealed five hypoattenuating masses in the liver. A dynamic study revealed the masses appeared to be well-enhanced in the arterial phase, and were considered to be high-flow hemangiomas. The tumors appeared as hypointense tumors on the T1-weighted images and as hyperintensities on fat-suppression T2-weighted images. Following the administration of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA), tumors appeared to be well-enhanced in the arterial phase. In the portal phase, tumors demonstrated isointensity compared with the surrounding liver parenchyma, and hypointensity in the equilibrium and hepatobiliary phases. The apparent diffusion coefficient (ADC) values ranged from 2.0 to 2.4x10(-3) mm2/sec. Microscopically, the tumors were composed of numerous capillary-like small vessels lined with plump endothelial cells, arranged in a single layer without mitoses, and small bile ducts were trapped and scattered within the tumor. These findings were considered to be characteristic of IH. To the best of our knowledge, this case is the third report on IH in adults.

Evaluation of a new chromogenic agar medium for Alicyclobacillus acidoterrestris.

Spoilage of fruit juices by a thermoacidophilic spore-forming bacterium, Alicyclobacillus acidoterrestris, is a big problem for fruit juice industries worldwide. We have developed a novel chromogenic selective agar medium (EAATSM) for the isolation and enumeration of A. acidoterrestris. A. acidoterrestris strains appeared as blue colonies on the EAATSM. Other Alicyclobacillus strains appeared as white colonies or were inhibited. A study comparing EAATSM and YSG agar was carried out using artificially contaminated samples of 50 fruit juice products. The correlation coefficient between EAATSM and YSG was 0.991.

The relationship between GLUT-1 and vascular endothelial growth factor expression and 18F-FDG uptake in esophageal squamous cell cancer patients.

PURPOSE: To examine the relationship between glucose transporter-1 (GLUT-1) and vascular endothelial growth factor (VEGF) expression and (18)F-FDG uptake in esophageal squamous cell cancer patients. MATERIALS AND METHODS: Fifty-seven patients (52 male and 5 female) were included in this study. (18)F-FDG PET/CT was performed prior to the surgery. Immunohistochemistry was performed using postoperative histopathological specimens. The estimation of immunohistochemistry was conducted using scoring analysis. We investigated the correlations between maximum standardized uptake value (SUV(max)) and GLUT-1/VEGF expressions/pathologic tumor length (p-tumor length), and the relationships between pathologic T (p-T) stage and GLUT-1/VEGF expressions/SUV(max) and between lymph node metastasis (p-N) stage and GLUT-1/VEGF expressions/SUV(max). RESULTS: SUV(max) significantly correlated with GLUT-1 expressions and p-tumor length (GLUT-1: r = 0.475, P < 0.001; p-tumor length: r = 0.475, P < 0.001). SUV(max) of the primary tumor had a significant relationship with p-T stage, p-N stage, and VEGF expression (p-T stage: P < 0.001; p-N stage: P = 0.037; VEGF expression: P = 0.009). There was a statistically significant difference between GLUT-1 expression and p-T stage/VEGF expression, but not p-N stage (p-T stage: P = 0.012; VEGF expression: P = 0.01; p-N stage: P = 0.572). VEGF expression had a significant relationship with p-T stage, but not with p-N stage (p-T stage: P = 0.032; p-N stage: P = 0.763). CONCLUSION: (18)F-FDG uptake can be determined by GLUT-1 and VEGF. SUV(max) would have a connection with the tumor progression and lymph node metastasis.

Assessment of Chronic Pancreatitis: Use of Whole Pancreas Perfusion With 256-Slice Computed Tomography.

OBJECTIVE: We aimed to compare perfusion computed tomography (CTP) characteristics of the normal pancreas with those of chronic pancreatitis (CP) and to examine the possibility of evaluating pancreatic exocrine function with CTP. METHODS: Thirty-two patients (control group, n = 18; CP group, n = 14) who completed the whole pancreas CT perfusion examination with 256-slice CT were studied. Four parameters, including perfusion (PF), peak enhancement intensity (PEI), time-to-peak (TTP), and blood volume (BV), were measured and compared between the control and CP groups, and between patients with and without exocrine pancreatic insufficiency (EPI) in the CP group. Pancreatic exocrine function was determined via serum trypsinogen. RESULTS: There was no significant difference between the distribution of PF, PEI, and BV in different pancreas regions, namely, the head, body, and tail (P > 0.05). PF, PEI, and BV of the CP group were significantly decreased, and TTP was significantly increased compared with the control group (P < 0.05). A significant decrease of PF, PEI, and BV and increase of TTP were observed in patients with EPI than in patients without EPI (P < 0.05). CONCLUSIONS: Perfusion CT is an appropriate imaging technique to diagnose CP and may be useful as a screening test to rule out early EPI.

Compact Dry(R) X-BC for the enumeration of Bacillus cereus in food samples.

We evaluated the effectiveness of using Compact Dry(R) X-BC (CD-XBC), a ready-to-use and self-diffusing dry medium sheet culture system based on a novel detection principle, for the detection and enumeration of Bacillus cereus. All 13 B. cereus strains, which were studied for the inclusivity study, grew as blue/green colonies on the CD-XBC. When 3 yeast strains and 103 bacterial strains other than B. cereus were tested for the exclusivity study, 5 strains formed white colonies, and 4 strains formed blue/green colonies, while 94 other strains failed to grow. The 4 strains that formed blue/green colonies were B. thuringiensis, which is known to have the same biochemical features as B. cereus. The CD-XBC method was compared with the MYP agar method (MYP) and the NGKG agar method (NGKG) in 130 artificially contaminated food samples. The correlation coefficients between CD-XBC and MYP, and CD-XBC and NGKG were 0.972 and 0.971, respectively.

Utility of multidetector row CT in diagnosing branch duct IPMNs of the pancreas compared with MR cholangiopancreatography and endoscopic ultrasonography.

This study aimed to compare the usefulness of multidetector row CT (MDCT), MR cholangiopancreatography (MRCP), and endoscopic ultrasonography (EUS) in diagnosing branch duct intraductal papillary mucinous neoplasms (IPMNs) of the pancreas. Imaging and pathological findings were retrospectively evaluated for 25 patients with branch duct IPMNs of the pancreas who underwent surgical resection (13 adenomas, 4 borderline lesions, and 8 carcinomas). MDCT and MRCP were performed on all 25 patients, whereas EUS was performed on 22 patients. MDCT and MRCP were used to identify features predictive of malignancy, including carcinoma, borderline lesions, and the presence of thickened irregular walls/septa or a solid mass. EUS was used to identify the presence of intramural nodules or a solid mass. Correlations between histopathology and maximum diameter of the main pancreatic duct (MPD) or cyst size detected by MDCT and MRCP were also examined. Presence of a solid mass was highly correlated with malignancy with all imaging methods (MDCT; P=0.001, MRCP; P=0.008, EUS; P<0.001, respectively). Presence of thickened irregular walls/septa on MDCT correlated well with malignancy (P=0.019). In contrast, presence of thickened irregular walls/septa on MRCP and intramural nodules on EUS did not correlate with malignancy. No significant correlation was found between malignancy and average maximum MPD diameter or cyst size (P>0.05), though values tended to be larger in malignant tumors. Our results suggest that the presence of thickened irregular walls/septa or a solid mass on MDCT are highly correlated with malignancy, and that MDCT is useful for diagnosis of branch duct IPMNs of the pancreas.

Relationship between clinicopathological factors and fluorine-18-fluorodeoxyglucose uptake in patients with papillary thyroid cancer.

OBJECTIVE: To examine the relationship between clinicopathological factors and fluorine-18-fluorodeoxyglucose (F-FDG) uptake in patients with papillary thyroid cancer (PTC). MATERIALS AND METHODS: Fifty-four patients were included in this study.F-FDG positron emission tomography was performed before surgery. Immunohistochemistry of glucose transporter (GLUT) was performed using postoperative histopathological specimens. We investigated the relationship between maximum standardized uptake value (SUVmax) and GLUT-1, GLUT-3, and GLUT-4 expression/SUVmax and prognostic risk factors {tumor size, age, sex, extrathyroidal extension, and lymph node metastasis [ly (+)]}. RESULTS: GLUT-3 and GLUT-4 expressions significantly correlated with SUVmax (GLUT-3: r=0.38, P=0.008; GLUT-4: r=0.46, P=0.001), but GLUT-1 did not (r=0.21, P=0.147). The tumor size correlated with SUVmax (r=0.5, P<0.001), but GLUT-1, GLUT-3, and GLUT-4 did not (GLUT-1: r=0.006, P=0.681; GLUT-3: r=0.05, P=0.705; GLUT-4: r=-0.17, P=0.217). Both SUVmax and GLUT-4 expressions were statistically significant with ly (+) (SUVmax: P=0.012; GLUT-4: P=0.018), but GLUT-1 and GLUT-3 expressions were not (GLUT-1: P=0.165; GLUT-3: P=0.499). There was no significant difference between other clinicopathological factors and SUVmax or any GLUT expressions. CONCLUSION: F-FDG uptake in PTC may be determined by GLUT-3 and GLUT-4 expressions and may be related to tumor size and lymph node metastasis of PTC. F-FDG uptake may reflect tumor progression of PTC.

Glucose transporter expression of an esophageal gastrointestinal tumor detected by F-18 FDG PET/CT.

A 74-year-old woman had dysphagia and underwent esophagogastroduodenoscopy. A giant submucosal tumor was seen from the middle to the lower esophagus. Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG-PET/CT) was performed and F-18 FDG was found to accumulate in the submucosal tumor. The maximum standardized uptake value of the early phase was 4.93 and that of the delayed phase was 6.48. Gastrointestinal stromal tumor (GIST) was confirmed by both fine needle aspiration under endoscopic ultrasound and postoperative histopathologic findings. We stained the postoperative histopathologic specimen to investigate glucose transporter (GLUT) expression using immunohistochemistry, which revealed that GLUT-1 had a weak expression on membranes and GLUT-4 had a strong expression on membranes or in cytoplasm. GLUT-3 had no expression on membranes or in cytoplasm. Esophageal GIST is rare and the relationship between GLUT expression and F-18 FDG accumulation in GIST is probably rare.

Comparison of sclerosing cholangitis with autoimmune pancreatitis and infiltrative extrahepatic cholangiocarcinoma: multidetector-row computed tomography findings.

PURPOSE: The aim of this study was to compare multidetector-row computed tomography (MDCT) findings between cases of sclerosing cholangitis with autoimmune pancreatitis (SC-AIP) and infiltrative extrahepatic cholangiocarcinoma (IEC). MATERIALS AND METHODS: We retrospectively assessed MDCT findings from 16 IEC cases and 13 SC-AIP cases. MDCT findings were analyzed with regard to location, length, wall thickness, contour, stricture wall enhancement pattern, proximal duct diameter, and the presence of diffuse concentric thickening in the proximal duct and gallbladder wall thickness. RESULTS: Stricture length, stricture wall thickness, and proximal duct diameter were significantly smaller for SC-AIP than for IEC: 19.3 +/- 8.7 vs. 31.8 +/- 12.0 mm (P = 0.004), 2.1 +/- 1.3 vs. 4.1 +/- 1.3 mm (P < 0.001), and 9.2 +/- 3.9 vs. 13.3 +/- 5.0 mm (P = 0.012), respectively. SC-AIP was correlated with stricture location in both the intrapancreatic and hilar hepatic bile ducts, concentric stricture contour (P < 0.001), and diffuse concentric thickening of the proximal bile duct (P = 0.010). Overall values of sensitivity, specificity, and accuracy used to distinguish between SC-AIP and IEC for stricture wall thickness of <3.0 mm and concentric contour were 76.9%, 93.8%, and 86.2%, respectively, and 100%, 87.5%, 93.1%, respectively. CONCLUSION: Concentric contour and stricture wall thicknesses of <3.0 mm may help distinguish between SC-AIP and IEC.

The clinical characteristics and non-steroidal treatment for radiation-induced bronchiolitis obliterans organizing pneumonia syndrome after breast-conserving therapy.

PURPOSE: A rare and unique occurrence of radiation-induced pulmonary injury was observed outside the tangential field for early breast cancer treatment. The findings appeared to be idiopathic and were termed radiation-induced bronchiolitis obliterans organizing pneumonia (BOOP) syndrome. The goal of this study was to report and determine the incidence, analyze the characteristics of the pulmonary lesions on the images and also investigate the treatment methods. MATERIALS AND METHODS: A retrospective analysis was conducted of 616 consecutive patients that underwent breast-conserving therapy (BCT) from January 1992 to December 2008. The patients were observed at least one year after radiotherapy for BCT. Radiotherapy was administered by 4 MV photons in all patients. The patients underwent chest X-rays periodically. If the BOOP syndrome was found, chest computed tomography (CT) were conducted to identify the characteristics of the pulmonary lesion outside the radiation field. RESULTS: The incidence of the radiation-induced BOOP syndrome was 12 patients (1.9%). Six of them had fever and cough, 6 had no symptoms. The pulmonary lesions were classified into four patterns on chest CT. Progression of the pulmonary lesions observed on chest X-ray were classified into three patterns. BOOP syndrome appeared within 5.6 months after radiotherapy and completely disappeared within 12 months after its onset. Their clinical conditions were not severe and these pulmonary lesions disappeared gradually without use of steroids in our institution. There was no death caused by BOOP syndrome. CONCLUSIONS: Although the incidence of BOOP syndrome and its associated prognosis are not significant, this clinical condition must be carefully followed using diagnositic imaging in order to not over administer steroids.

[Drug eruption (erythema multiforme type) following chemoradiotherapy with mitomycin C and 5-fluorouracil administration for squamous cell carcinoma of the anal canal].

We report a case of drug eruption (erythema multiforme type) in a 54-year-old woman, following concurrent chemoradiotherapy for squamous cell carcinoma of the anal canal. Chemotherapy comprised one cycle of mitomycin C 10 mg/m2/day (intravenous bolus injection)on day 1 and 5-fluorouracil(5-FU)1, 000 mg/m 2/day (continuous intravenous infusion) on days 1-4 of radiotherapy. External irradiation of the pelvic space was performed, using daily fractions of 1. 5 Gy(total dose, 33 Gy). From day 4 after chemoradiotherapy, erythema appeared proximal to the forearm site used for drug administration. On day 6, erythema was noted on the trunk, hip and thigh. We suspected erythema multiforme based on the appearance of wheals and target lesions of the skin and a patient history of chemoradiotherapy. Steroids were administered orally, which resolved systemic eruption at week 2. The patient also experienced grade 3 leukocytopenia, neutropenia, thrombopenia, diarrhea, and anorexia. Although we could not provide sufficient chemotherapy and radiation therapy due to severe side effects, squamous cell carcinoma of the anal canal responded extremely well with a marked decrease in complete response. We surmise that the drug eruption was associated with 5-FU. Concurrent chemoradiotherapy is safe and effective for squamous cell carcinoma of the anal canal, but care is required to prevent drug eruption during treatment.

18F-FDG-PET findings of rare case of nonsecretory plasmablastic myeloma.

A 61-year-old woman presented with pancytopenia and underwent a bone marrow biopsy. The patient was diagnosed with nonsecretory myeloma (plasmablastic type) based on both the bone marrow biopsy findings and her laboratory data. Fluorine-18 fluorodeoxyglucose-positron emission tomography ((18)F-FDG-PET) was performed prior to chemotherapy showing diffuse bone marrow uptake, splenic uptake, and focal uptake of the right anterior chest wall. The patient underwent an (18)F-FDG-PET examination to evaluate the curative effects after three cycles of chemotherapy, and no abnormal uptake on (18)F-FDG-PET was found. Bone marrow biopsy to evaluate the curative effect showed no viable tumor cells. We present a rare case of nonsecretory plasmablastic myeloma detected by (18)F-FDG-PET.

Episomal high copy number maintenance of hairpin-capped DNA bearing a replication initiation region in human cells.

We previously found that a plasmid bearing a replication initiation region efficiently initiates gene amplification in mammalian cells and that it generates extrachromosomal double minutes and/or chromosomal homogeneously staining regions. During analysis of the underlying mechanism, we serendipitously found that hairpin-capped linear DNA was stably maintained as numerous extrachromosomal tiny episomes for more than a few months in a human cancer cell line. Generation of such episomes depended on the presence of the replication initiation region in the original plasmid. Despite extrachromosomal maintenance, episomal gene expression was epigenetically suppressed. The Southern blot analysis of the DNA of cloned cells revealed that the region around the hairpin end was diversified between the clones. Furthermore, the bisulfite-modified PCR and the sequencing analyses revealed that the palindrome sequence that derived from the original hairpin end or its end-resected structure were well preserved during clonal long term growth. From these data, we propose a model that explains the formation and maintenance of these episomes, in which replication of the hairpin-capped DNA and cruciform formation and its resolution play central roles. Our findings may be relevant for the dissection of mammalian replicator sequences.

Comparison of dynamic MRI at 3.0 T and MDCT of pancreatobiliary disease: evaluation with source, MPR, CPR, and MIP images for image quality and hepatic arterial and portal venous vessel conspicuity.

PURPOSE: To compare contrast material-enhanced three-dimensional (3D) magnetic resonance imaging (MRI) at 3.0T and multidetector row computed tomography (MDCT) in the same patient with regard to image quality of pancreatobiliary disease and hepatic vascular conspicuity. MATERIALS AND METHODS: This study enrolled 32 patients with pancreatobiliary disease who underwent both gadolinium-enhanced 3D dynamic MRI and multiphasic CT using 16-MDCT. Data analysis of image quality was performed by two radiologists based on source images, multiplanar reconstruction (MPR), curved planar reconstruction (CPR), and maximum intensity projection (MIP) reconstruction. Determination of image quality was based on a 4-point image quality rating scale. RESULTS: The overall image quality of the MRI axial images was superior to that of the axial MDCT images. The MRI protocol yielded an average score of 3.8 points versus 3.5 for the CT imaging. No significant difference was found between 3.0T MRI and MDCT images in MPR or CPR image quality. Image quality for visualization of the distal intrahepatic segmental arteries was significantly improved using MDCT imaging. No significant difference was found between the MDCT and 3.0T MR in portal vein branch image quality. CONCLUSION: High-resolution dynamic contrast-enhanced MR imaging at 3.0T is a comprehensive technique which provides high image quality in pancreatobiliary disease.

MR imaging of prostate cancer at 3T with an external phased-array coil: evaluation of T2-weighted images.

1.5T Magnetic resonance (MR) imaging has become an accepted method for assessing prostate cancer. However, the role of 1.5T MRI in local staging of prostate cancer is limited. It is hoped that 3.0T MRI will be more useful in local staging of prostate cancer. The purpose of this study was to evaluate the tissue contrast, artifact presence, and image quality of T2-weighted images (T2WI) of prostate cancer using 3T MRI with a phased-array coil at different slice thicknesses and fields of view (FOV). We examined 15 patients with prostate cancer. We obtained MR images at slice thicknesses of 2 mm and 5 mm in both small and large FOV. The image obtained at a slice thickness of 2 mm with a small FOV had inferior tissue contrast compared to the other images (P<0.05), but there was no statistically significant difference in contrast between images obtained at a slice thickness of 2 mm with a large FOV and those obtained at a slice thickness of 5 mm. Artifacts were rated equally among the parameter combinations. The overall image quality obtained at a slice thickness of 2 mm with a large FOV was significantly superior to the other three imaging parameters (p<0.05). The image obtained at a slice thickness of 2 mm with a large FOV was superior to the other three images in evaluating T2WI of prostate cancer with 3T MRI.

Improved breast cancer detection of prone breast fluorodeoxyglucose-PET in 118 patients.

OBJECTIVE: To prospectively evaluate the breast cancer detection of prone breast positron emission tomography (PET) images in comparison with supine whole-body PET images. MATERIAL AND METHODS: One hundred and eighteen female patients (age range 28-91 years) with 122 lesions suspected of having breast cancer underwent fluorine-18 fluorodeoxyglucose PET for preoperative staging. After the whole-body image was acquired, prone breast PET imaging was performed. The findings from both images were compared with the histopathologic results. Sensitivity, specificity, positive predictive value, negative predictive value (NPV), and accuracy were used to compare the diagnostic accuracy of prone breast PET images with that of whole-body PET images. RESULTS: Sensitivity, specificity, positive predictive value, NPV, and accuracy of whole-body PET images were 83, 50, 97, 17, and 80%, and of prone breast PET images they were 95, 50, 96, 43, and 93%. Ten of 114 breast cancerous lesions (8.8%) were detected on prone breast PET images alone. Statistical difference was found between the sensitivity, accuracy, and NPV of prone breast PET images and those of whole-body PET images (P<0.0001 for sensitivity and accuracy and P<0.0009 for NPV). CONCLUSION: Our data about the 122 lesions, suspected of breast cancer, with regard to the usefulness of prone breast PET imaging indicate that prone breast PET images are effective in detecting breast cancer.

Diffusion-weighted imaging of soft tissue tumors: usefulness of the apparent diffusion coefficient for differential diagnosis.

PURPOSE: We evaluated the efficacy of using the apparent diffusion coefficient (ADC) to differentiate soft tissue tumors. MATERIALS AND METHODS: We examined 88 histologically proven tumors (44 benign, 8 intermediate, 36 malignant) using diffusion-weighted magnetic resonance images. Images of the tumors were obtained using a single-shot, spin-echo type echo-planar imaging sequence. The tumors were classified histologically as myxoid or nonmyxoid. We then compared the ADC values of the myxoid and nonmyxoid tumors; the benign and malignant myxoid tumors; and the benign, intermediate, and malignant nonmyxoid tumors. RESULTS: The mean ADC value of the myxoid tumors (2.08 +/- 0.51 x 10(-3) mm(2)/s) was significantly greater than that of the nonmyxoid tumors (1.13 +/- 0.40 x 10(-3) mm(2)/s) (P < 0.001). There was no significant difference in the mean ADC values between benign myxoid tumors (2.10 +/- 0.50 x 10(-3) mm(2)/s) and malignant myxoid tumors (2.05 +/- 0.58 x 10(-3) mm(2)/s). The mean ADC value of benign nonmyxoid tumors (1.31 +/- 0.46 x 10(-3) mm(2)/s) was significantly higher than that of malignant nonmyxoid tumors (0.94 +/- 0.25 x 10(-3) mm(2)/s) (P < 0.001). CONCLUSION: The ADC value might be useful for diagnosing the malignancy of nonmyxoid soft tissue tumors.