Publications (89) View all
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Article: Phase II Study of Preoperative Chemoradiation with S-1 plus Oxaliplatin in Patients with Locally Advanced Rectal Cancer.
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ABSTRACT: We conducted a phase II study of preoperative chemoradiation (CRT) with S-1 plus oxaliplatin in patients with locally advanced rectal cancer. The total radiotherapy dose was 50.4 Gy. Chemotherapy consisted of oxaliplatin 50 mg/m(2) on day 1, 8, 22 and 29, and S-1 80 mg/m(2) /day on day 1-14 and 22-35. Tumor apparent diffusion coefficient (ADC) was measured by diffusion weighted magnetic resonance imaging (DW-MRI) before and after CRT. Total mesorectal excision was performed within 6±2 weeks. The primary endpoint was pathologic complete response (pCR) rate. A total of 38 patients were enrolled. The pCR rate was 22.9% (8/35, 95% CI, 10.9-42.1), and ten patients (28.6%) showed near-total tumor regression. There was no grade 4 adverse event, and grade 3 adverse events included leukopenia (5.4%), diarrhea (5.4%), anorexia (2.7%), and nausea (2.7%). Tumor ADCs were calculated in 38 patients (including those who participated in the phase I study). The post-CRT ADC (p=0.037) and the percentage change in ADC (p=0.026) were significantly correlated with pathologic response. In conclusion, preoperative CRT with S-1 plus oxaliplatin showed promising results in pathologic responses and favorable toxicity profiles.Cancer Science 10/2012; · 3.33 Impact Factor -
Article: Role of computed tomography enterography/magnetic resonance enterography: is it in prime time?
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ABSTRACT: Today, cross-sectional imaging modalities, such as computed tomography enterography (CTE) and magnetic resonance enterography (MRE), are particularly suited to evaluate small bowel diseases, especially Crohn's disease (CD). It is well known that CTE/MRE can provide excellent assessment of disease activity as well as the macroscopic features, extramural abnormalities, and complications of the small intestine in patients with CD. In general, CTE is considered as the first-line modality for the evaluation of suspected inflammatory bowel disease and for long-term assessment or follow-up of these patients. Because of the advantage of lack of radiation, MRE is being used more frequently, especially in children or young patients with CD.Clinical endoscopy. 09/2012; 45(3):269-73. -
Article: Comparison between CT colonography and double-contrast barium enema for colonic evaluation in patients with renal insufficiency.
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ABSTRACT: To compare the CT colonography (CTC) and double-contrast barium enema (DCBE) for colonic evaluation in patients with renal insufficiency. Two sequential groups of consecutive patients with renal insufficiency who had a similar risk for colorectal cancer, were examined by DCBE (n = 182; mean ± SD in age, 51 ± 6.4 years) and CTC (n = 176; 50 ± 6.7 years), respectively. CTC was performed after colon cleansing with 250-mL magnesium citrate (n = 87) or 4-L polyethylene glycol (n = 89) and fecal tagging. DCBE was performed after preparation with 250-mL magnesium citrate. Patients with colonic polyps/masses of ≥ 6 mm were subsequently recommended to undergo a colonoscopy. Diagnostic yield and positive predictive value (PPV) for colonic polyps/masses, examination quality, and examination-related serum electrolyte change were retrospectively compared between the two groups. Both the CTC and DCBE were positive for colonic polyps/masses in 28 (16%) of 176 and 11 (6%) of 182 patients, respectively (p = 0.004). Among patients with positive findings, 17 CTC and six DCBE patients subsequently underwent a colonoscopy and yielded a PPV of 88% (15 of 17 patients) and 50% (3 of 6 patients), respectively (p = 0.089). Thirteen patients with adenomatous lesions were detected in the CTC group (adenocarcinoma [n = 1], advanced adenoma [n = 6], and non-advanced adenoma [n = 6]), as compared with two patients (each with adenocarcinoma and advanced adenoma) in the DCBE group (p = 0.003). Six (3%) of 176 CTC and 16 (9%) of 182 DCBE examinations deemed to be inadequate (p = 0.046). Electrolyte changes were similar in the two groups. In patients with renal insufficiency, CTC has a higher diagnostic yield and a marginally higher PPV for detecting colorectal neoplasia, despite a similar diagnostic yield for adenocarcinoma, and a lower rate of inadequate examinations as compared with DCBE.Korean journal of radiology: official journal of the Korean Radiological Society 05/2012; 13(3):290-9. · 1.32 Impact Factor -
Article: Early postoperative bleeding after living donor liver transplantation
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ABSTRACT: We discuss the clinical impacts of early postoperative bleedings after LDLT and CT findings or CT angiographic findings compared with angiography according to the various bleeding causes. Sudden development of hematoma as well as extravasation of contrast material on CT scan are thought to be predictive CT findings of early postoperative bleeding in post-hepatic transplant patients. Careful consideration for these findings can prevent the progression into a catastrophic status that requires surgical management.Abdominal Imaging 04/2012; 34(3):365-370. · 1.73 Impact Factor -
Article: Three-dimensional CT enterography using oral gastrografin in patients with small bowel obstruction: comparison with axial CT images or fluoroscopic findings
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ABSTRACT: BackgroundTo evaluate the feasibility of 3D CT enterography using oral gastrografin in patients with small bowel obstruction (SBO), focusing on improving diagnostic performance as compared with the use of axial CT imagings and fluoroscopic findings. Material and methodsFor a 10-month period, 18 patients with known SBO detected clinically and radiologically were enrolled. In all patients, gastrografin was ingested prior to CT enterography. Twelve patients underwent a fluoroscopic examination. Images were randomly assessed for confidence for the level, for the cause of SBO, and for the assessment of the interpretability of each image by two gastrointestinal radiologists. The results were considered statistically significant using the Wilcoxon rank sum test. ResultsAll patients (100%) well tolerated the administration of oral gastrografin. The use of 3D CT enterography significantly improved diagnostic confidence for the interpretation of the level, cause of SBO, and the assessment of the interpretability of each image as compared with the use of axial CT images (P<0.05). 3D CT enterography was superior as compared to fluoroscopic examination (P<0.05). ConclusionThe use of gastrografin for 3D CT enterography is a safe and feasible technique for precise evaluation of known or suspected SBO. KeywordsComputer tomography-CT, multidetector-row CT-CT enterography-Small bowel obstruction-Contrast mediaAbdominal Imaging 04/2012; 35(5):556-562. · 1.73 Impact Factor
