Hisao Tonami

Kanazawa Medical University, Kanazawa, Ishikawa, Japan

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Publications (85)158.61 Total impact

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    ABSTRACT: Background: The epidermal growth factor receptor (EGFR) mutation status of lung cancer is important because it means that EGFR-tyrosine kinase inhibitor treatment is indicated. The purpose of this prospective study is to determine whether EGFR mutation status could be identified with reference to preoperative factors. Materials and Methods: One hundred-forty eight patients with lung cancer (111 adenocarcinomas, 25 squamous cell carcinomas and 12 other cell types) were enrolled in this study. The EGFR mutation status of each lung cancer was analyzed postoperatively. Results: There were 58 patients with mutant EGFR lung cancers (mutant LC) and 90 patients with wild-type EGFR lung cancers (wild-type LC). There were significant differences in gender, smoking status, maximum tumor diameter in chest CT, type of tumor shadow, clinical stage between mutant LC and wild-type LC. EGFR mutations were detected only in adenocarcinomas. Maximum standardized uptake value (SUVmax:3.66±4.53) in positron emission tomography-computed tomography of mutant LC was significantly lower than that (8.26±6.11) of wild-type LC (p<0.0001). Concerning type of tumor shadow, the percentage of mutant LC was 85.7% (6/7) in lung cancers with pure ground glass opacity (GGO), 65.3%(32/49) in lung cancers with mixed GGO and 21.7%(20/92) in lung cancers with solid shadow (p<0.0001). For the results of discriminant analysis, type of tumor shadow (p=0.00036) was most significantly associated with mutant EGFR. Tumor histology (p=0.0028), smoking status (p=0.0051) and maximum diameter of tumor shadow in chest CT (p=0.047) were also significantly associated with mutant EGFR. The accuracy for evaluating EGFR mutation status by discriminant analysis was 77.0% (114/148). Conclusions: Mutant EGFR is significantly associated with lung cancer with pure or mixed GGO, adenocarcinoma, never-smoker, smaller tumor diameter in chest CT. Preoperatively, EGFR mutation status can be identified correctly in about 77 % of lung cancers.
    Asian Pacific journal of cancer prevention: APJCP 01/2014; 15(2):657-62. · 1.50 Impact Factor
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    ABSTRACT: Diffusion-weighted magnetic resonance imaging (DWI) is reported to be useful for detecting malignant lesions. The purpose of this study is to clarify characteristics of imaging, detection rate and sensitivity of DWI for recurrence or metastasis of lung cancer.
    Asian Pacific journal of cancer prevention: APJCP 01/2014; 15(16):6843-8. · 1.50 Impact Factor
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    ABSTRACT: Background: Diffusion-weighted imaging (DWI) makes it possible to detect malignant tumors based on the diffusion of water molecules. However, it is uncertain whether DWI has advantages over FDG-PET for distinguishing malignant from benign pulmonary nodules and masses. Materials and Methods: One hundred- forty-three lung cancers, 17 metastatic lung tumors, and 29 benign pulmonary nodules and masses were assessed in this study. DWI and FDG-PET were performed. Results: The apparent diffusion coefficient (ADC) value (1.27±0.35 ?10-3 mm2/sec) of malignant pulmonary nodules and masses was significantly lower than that (1.66±0.58 ?10-3 mm2/sec) of benign pulmonary nodules and masses. The maximum standardized uptake value (SUVmax: 7.47±6.10) of malignant pulmonary nodules and masses were also significantly higher than that (3.89±4.04) of benign nodules and masses. By using optimal cutoff values for ADC (1.44?10-3 mm2/sec) and for SUVmax (3.43), which were determined with receiver operating characteristics curves (ROC curves), the sensitivity (80.0%) of DWI was significantly higher than that (70.0%) of FDG-PET. The specificity (65.5%) of DWI was equal to that (65.5%) of FDG-PET. The accuracy (77.8%) of DWI was not significantly higher than that (69.3%) of FDG- PET for pulmonary nodules and masses. As the percentage of bronchioloalveolar carcinoma (BAC) component in adenocarcinoma increased, the sensitivity of FDG-PET decreased. DWI could not help in the diagnosis of mucinous adenocarcinomas as malignant, and FDG-PET could help in the correct diagnosis of 5 out of 6 mucinous adenocarcinomas as malignant. Conclusions: DWI has higher potential than PET in assessing pulmonary nodules and masses. Both diagnostic approaches have their specific strengths and weaknesses which are determined by the underlying pathology of pulmonary nodules and masses.
    Asian Pacific journal of cancer prevention: APJCP 01/2014; 15(11):4629-35. · 1.50 Impact Factor
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    ABSTRACT: PURPOSE Anaphylactic shock is sometimes accompanied by local interstitial edema due to increased permeability. We performed examination of magnetic resonance (MR) imaging to detect edema in the larynx and brain during anaphylactic hypotension in anesthetized rats, with comparison of that during vasodilator-induced hypotension. METHOD AND MATERIALS Male Sprague Dawley rats were subjected to hypotension induced by the ovalbumin antigen (n=8) and a vasodilator sodium nitroprusside (n=8). Apparent diffusion coefficient and T2-relaxation time were quantified on MR imaging performed repeatedly for up to 68 min after an injection of either agent. The presence of laryngeal edema was also examined by histological examination. Separately, the occurrence of brain edema was assessed by measuring brain water content using the wet/dry method in the rats with anaphylaxis (n=5) or sodium nitroprusside (n=5), and the non-hypotensive control rats (n=5). Mast cells in the hypothalamus were morphologically examined. RESULTS Mean arterial blood pressure similarly decreased to 35 mmHg after an injection of the antigen or sodium nitroprusside. Hyperintensity on T2-weighted images, as reflected by elevated T2-relaxation time, was found in the larynx as early as 13 min after an injection of the antigen but not sodium nitroprusside. Postmortem histological examination revealed epiglottic edema in the rats with anaphylaxis, but not sodium nitroprusside. In contrast, no significant changes in T2-relaxation time or apparent diffusion coefficient were detectable in the brain of any rats studied. In separate experiments, brain water content quantified was not increased in either anaphylaxis or sodium nitroprusside rats, as compared with the non-hypotensive control rats. The number of mast cells was similar in the hypothalamus of rats with anaphylaxis and sodium nitroprusside, suggesting absence of anaphylactic reaction in the brain. CONCLUSION MR imaging elucidates presence of edema in larynx, but not brain, during anaphylactic hypotension in experimental study. CLINICAL RELEVANCE/APPLICATION MR evaluation by T2-relaxation time as well as apparent diffusion coefficient elucidates presence of edema in larynx, but not brain, during anaphylactic hypotension.
    Radiological Society of North America 2013 Scientific Assembly and Annual Meeting; 12/2013
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    ABSTRACT: Anaphylactic shock is sometimes accompanied by local interstitial edema due to increased vascular permeability. We performed magnetic resonance imaging (MRI) to compare edema in the larynx and brain of anesthetized rats during anaphylactic hypotension versus vasodilator-induced hypotension. Male Sprague Dawley rats were subjected to hypotension induced by the ovalbumin antigen (n=7) or a vasodilator sodium nitroprusside (SNP; n=7). Apparent diffusion coefficient (ADC) and T2-relaxation time (T2RT) were quantified on MRI performed repeatedly for up to 68 min after the injection of either agent. The presence of laryngeal edema was also examined by histological examination. Separately, the occurrence of brain edema was assessed by measuring brain water content using the wet/dry method in rats with anaphylaxis (n=5) or SNP (n=5) and the non-hypotensive control rats (n=5). Mast cells in hypothalamus were morphologically examined. Mean arterial blood pressure similarly decreased to 35 mmHg after an injection of the antigen or SNP. Hyperintensity on T2-weighted images (as reflected by elevated T2RT) was found in the larynx as early as 13 min after an injection of the antigen, but not SNP. A postmortem histological examination revealed epiglottic edema in the rats with anaphylaxis, but not SNP. In contrast, no significant changes in T2RT or ADC were detectable in the brains of any rats studied. In separate experiments, the quantified brain water content did not increase in either anaphylaxis or SNP rats, as compared with the non-hypotensive control rats. The numbers of mast cells with metachromatic granules in the hypothalamus were not different between rats with anaphylaxis and SNP, suggesting the absence of anaphylactic reaction in hypothalamus. Edema was detected using the MRI technique in the larynx during rat anaphylaxis, but not in the brain.
    Allergy, asthma & immunology research 11/2013; 5(6):389-96. · 2.65 Impact Factor
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    ABSTRACT: BACKGROUND AND PURPOSE:ADC provides a measure of water molecule diffusion in tissue. The aim of this study was to evaluate whether the fractional change in ADC during therapy can be used as a valid predictive indicator of treatment response in head and neck squamous cell carcinoma treated with chemoradiotherapy.MATERIALS AND METHODS:Forty patients underwent DWI at pretreatment and 3 weeks after the start of treatment. The pretreatment ADC, fractional change in ADC, tumor regression rate, and other clinical variables were compared with locoregional control and locoregional failure and were analyzed by using logistic regression analysis and receiver operating characteristic analysis. Furthermore, progression-free survival curves divided by the corresponding threshold value were compared by means of the log-rank test.RESULTS:The fractional change in ADCprimary, the fractional change in ADCnode, primary tumor volume, nodal volume, tumor regression ratenode, N stage, and tumor location revealed significant differences between locoregional failure and locoregional control (P < .05). In univariate analysis, the fractional change in ADCprimary, fractional change in ADCnode, tumor regression ratenode, N stage, and tumor location showed significant association with locoregional control (P < .05). In multivariate analysis, however, only the fractional change in ADCprimary was identified as a significant and independent predictor of locoregional control (P = .04). A threshold fractional change in ADCprimary of 0.24 revealed a sensitivity of 100%, specificity of 78.7%, and overall accuracy of 84.8% for the prediction of locoregional control. Progression-free survival of the 2 groups divided by the fractional change in ADCprimary at 0.24 showed a significant difference (P < .05).CONCLUSIONS:The results suggest that the fractional change in ADCprimary is a valid imaging biomarker for predicting treatment response in head and neck squamous cell carcinoma treated with chemoradiotherapy.
    American Journal of Neuroradiology 09/2013; · 3.17 Impact Factor
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    ABSTRACT: The intercarotid distance (ICD) between cavernous carotid arteries (CCAs) is an important factor for avoiding injury of the internal carotid artery during transsphenoidal surgery. The ICD between CCAs in pituitary adenoma patients is generally larger than in normal individuals. However, the movement of the CCA during transsphenoidal surgery is not known. The aim of this study is to measure the ICD between CCAs in pituitary adenoma patients before and after surgery. We reviewed 138 pituitary adenoma patients who were treated with resection via the transsphenoidal approach. The CCA diameter and the ICD between CCAs were measured from preoperative and postoperative MR images. The CCA diameter was similar at the preoperative and postoperative time points. On the other hand, the ICD between CCAs was shorter at postoperative time point (19.4 ± 4.5 mm) than at the preoperative time point (20.9 ± 4.9 mm) (P = 0.048). Above all, invasion type adenomas had more significant ICD change at the postoperative time point (23.8 ± 3.8 mm) than at the preoperative time point (21.6 ± 3.9 mm) (P = 0.008). Also in multivariate analysis, cavernous sinus invasion of adenoma was independently associated with ICD contraction >2 mm (P = 0.027). It is important to know the change in ICD between CCAs after transsphenoidal surgery, particularly for pituitary adenomas with cavernous sinus invasion. The position of the CCA should be known before and during transsphenoidal surgery, as well before and during the second operation to avoid vascular injuries.
    Pituitary 05/2013; · 2.67 Impact Factor
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    ABSTRACT: The aim of this study was to assess whether migration of thallium-201 (Tl) to the olfactory bulb were reduced in patients with olfactory impairments in comparison to healthy volunteers after nasal administration of Tl. 10 healthy volunteers and 21 patients enrolled in the study (19 males and 12 females; 26-71 years old). The causes of olfactory dysfunction in the patients were head trauma (n = 7), upper respiratory tract infection (n = 7), and chronic rhinosinusitis (n = 7). TlCl was administered unilaterally to the olfactory cleft, and SPECT-CT was conducted 24 h later. Separate MRI images were merged with the SPECT images. Tl olfactory migration was also correlated with the volume of the olfactory bulb determined from MRI images, as well as with odor recognition thresholds measured by using T&T olfactometry. Nasal Tl migration to the olfactory bulb was significantly lower in the olfactory-impaired patients than in healthy volunteers. The migration of Tl to the olfactory bulb was significantly correlated with odor recognition thresholds obtained with T&T olfactometry and correlated with the volume of the olfactory bulb determined from MRI images when all subjects were included. Assessment of the Tl migration to the olfactory bulb was the new method for the evaluation of the olfactory nerve connectivity in patients with impaired olfaction.
    PLoS ONE 01/2013; 8(2):e57671. · 3.53 Impact Factor
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    ABSTRACT: Hepatic venoconstriction occurs in rat anaphylactic hypotension. However, the exact venoconstrictive site remains unknown, and we therefore attempted to determine its location by using hepatic venography and histology. Anaphylaxis was induced in anesthetized Sprague-Dawley rats by i.v. administration of ovalbumin antigen. Venography of the portal vein (n = 8) was obtained at baseline and maximal hepatic venoconstriction. We separately examined photomicrographs of the liver sections. Along with systemic hypotension, portal venous pressure increased to a peak of 28 ± 3 cm- H2O at 2 min after antigen injection. Post-antigen portal venography revealed that 40% of portal venuls (76 vessels/total 188 vessels) with diameters from 160 to 300 μm were not visualized, suggesting that stenosis or obliteration occurred distally. The corresponding upstream portal vessels exhibited markedly bulging. Stenosis was also observed in some portal branches with diameters from 180 to 420 μm (9%; 17 vessels/total 188 vessels). Light microscopically, most portal venules with an estimated baseline diameter less than 110 μm showed stenosis, but statistically significant stenosis was found in those with baseline diameters of 20-70 μm. In conclusion, anaphylactic hepatic venoconstriction occurs over a wide range of portal veins with diameters less than 420 μm, and occurs markedly in portal venules with diameters less than 70 μm in anesthetized rats.
    Biomedical Research 01/2013; 34(2):61-8. · 1.15 Impact Factor
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    ABSTRACT: PURPOSE: The purpose of our study was to evaluate the degree of radiotoxicity to lymphocytes in thyroid cancer after iodine-131(I-131) therapy using γ-H2AX foci immunodetection. METHODS: This study focused on 15 patients who underwent I-131 therapy for differentiated thyroid cancer after surgery. All patients received 3.7 GBq of I-131. Venous blood samples were collected from each patient before therapy and 4 days thereafter. Lymphocytes were isolated from the blood samples and subjected to γ-H2AX immunofluorescence staining. RESULTS: The number (mean ± SD) of foci per lymphocyte nucleus was 0.41 ± 0.51 before and 6.19 ± 1.80 after radioiodine therapy, and this difference was statistically significant (P = 0.001 < 0.05). Absorbed doses estimated for the 15 patients were 0.77 ± 0.31 Gy applying standard line in vitro external radiation doses. CONCLUSION: γ-H2AX foci immunodetection in lymphocytes may detect radiation-induced DNA damage associated with I-131 therapy for thyroid cancer, and may facilitate estimation of the radiation doses absorbed with this therapy.
    Annals of Nuclear Medicine 12/2012; · 1.41 Impact Factor
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    ABSTRACT: The purpose of this study was to evaluate the incidence and predictors of seed migration after transperineal interstitial prostate brachytherapy. From March 2007 to March 2011, 121 patients with stage T1-T2 prostate cancer underwent transperineal interstitial prostate brachytherapy. Pre-planning was performed 3 weeks prior to implantation, and the implants were inserted using the standard parallel needle insertion technique. All patients underwent a series of radiographs [chest radiography, kidney-ureter-bladder (KUB) radiography, and a CT scan] to assess whether seed migration had occurred on postoperative days 1 and 30, and 12 months. Seed migration occurred in 31 (25.6 %) of 121 patients. A total of 51 of 7,883 (0.65 %) implanted seeds migrated. Migration was detected on postoperative day 1 in 16 patients, day 30 in 13 patients and at 12 months in 4 patients (migration occurred at different times in 2 patients). The migrated seeds were found in the lungs, pelvis, heart, mediastinum, kidney, inguinal canal, liver and sacrum. The number of needles was a statistically significant factor in seed migration. The seeds migrated to many organs. No decrease in the dose administered to the prostate or adverse effects associated with seed migration were noted.
    Japanese journal of radiology 07/2012; 30(8):635-41. · 0.73 Impact Factor
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    ABSTRACT: It is well known that significant variations in stomach size, shape, and respiratory motion lead to uncertainties in target localization during treatment for gastric lymphoma. In this study, the usefulness of 4D-CT for radiation planning of gastric MZBCL/MALT was evaluated. Treatment planning using 4DCT (plan A) and conventional planning with a uniform margin (plan B) were compared using dose volume histograms (DVH) of the planning target volume (PTV) and the organ at risk, as well as the dose coverage of the clinical target volume (CTV) assessed by weekly online cone beam CT (CBCT) during the treatment course. In addition, regarding the image quality of CBCT , the interobserver agreement for the delineated volume of the CTV on CBCT was analyzed. The mean PTV of plan A was significantly smaller than that of plan B (p = 0.008). The mean doses to the liver and heart in plan A were significantly lower than those in plan B (p = 0.02 and 0.03, respectively). The reductions of V(20) of each kidney in plan A compared with those in plan B were 4.8 ± 2.4% in the right kidney and 16.3 ± 10.4% in the left. There was no significant difference in the dose coverage of the CTV between the plans during the treatment course. The interobserver agreement for the volume of the CTV was moderate correlation. Treatment planning using 4DCT for gastric MZBCL/MALT was useful for effective and safe irradiation with minimizing exposure of the organ at risk.
    Journal of Radiation Research 03/2012; 53(2):333-7. · 1.45 Impact Factor
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    ABSTRACT: PURPOSE To evaluate the capability of the diffusion-weighted MR imaging with navigator-triggered prospective acquisition correction (PACE) at 3T for the assessment of hepatic fibrosis. METHOD AND MATERIALS Single-shot echo-planar diffusion-weighted MR imaging at 3T was performed with b values of 0, 400, and 800 sec/mm2. Free-breathing navigator-triggered PACE was employed. The relationship between apparent diffusion coefficient (ADC) and hepatic fibrosis was investigated in 82 patients with biopsy-proven hepatic fibrosis and 16 with healthy liver. Receiver operating characteristic (ROC) curve analysis was performed to determine whether fibrosis stages (F score) of F2 or greater and F3 or greater could be predicted using ADC. Multiple regression analysis was performed to investigate the extent to which fibrosis stages could be predicted and explained using ADC and serum fibrosis markers (platelet count, hyaluronic acid, and collagen type IV). RESULTS The ADCs were 1.36±0.06,1.24±0.05, 1.16±0.10, 1.15±0.11, 1.09±0.11x10-3mm2/sec in fibrotic stages F0, F1, F2, F3, and F4, respectively. There were significant differences between ADCs of F0 and F1 (p<0.001), F1 and F2 (p<0.01), and F3 and F4 (p<0.001). No difference was seen in ADCs of F2 compared with F3. There was significant negative correlation between ADCs and fibrosis stages (r=-0.823, p<0.001). ROC curve indicated that the discrimination ability in terms of area under curve (AUC) was 0.960 for stages of F2 or greater and 0.907 for stages of F3 or greater. Sensitivities and specificities for F2 or greater were 73 % and 100 % with a cut-off value of 1.29x10-3mm2/sec, and 85 % and 87 % for F3 or greater with a cut-off value of 1.20x10-3mm2/sec, respectively. The results of multiple regression analysis showed that ADC and platelet count were significant explanatory variables, and the following multiple regression prediction equation was obtained: F score=8.812-3.370x[ADCx10-3]-0.015x[platelet count x10-3]. CONCLUSION Diffusion-weighted MR imaging with navigator-triggered PACE at 3T is useful for the assessment of hepatic fibrosis. CLINICAL RELEVANCE/APPLICATION ADC measurement with navigator-triggered PACE at 3T is a promising biomarker for the assessment of hepatic fibrosis.
    Radiological Society of North America 2011 Scientific Assembly and Annual Meeting; 11/2011
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    ABSTRACT: To investigate the correlation of vascular endothelial growth factor (VEGF) A and its isoform VEGF₁₂₁ mRNA expression with F-18 fluorodeoxyglucose (FDG) uptake and aggressiveness in lung adenocarcinoma. Twenty-three patients with lung adenocarcinoma underwent FDG PET before surgery. As semi-quantitative analysis for FDG uptake, partial volume corrected standardized uptake value (PVC-SUV) of the tumor was calculated. Total RNA from lung adenocarcinoma tissue was prepared from the frozen specimens. Using the real-time reverse transcription polymerase chain reaction method, we analyzed the mRNA level of VEGF-A and VEGF-A isoform VEGF₁₂₁ mRNA level. 18S ribosomal RNA was used as an endogenous control. VEGF-A and VEGF₁₂₁ mRNA levels had significantly positive correlation with PVC-SUV in lung adenocarcinoma (r = 0.477, p = 0.021, r = 0.539, p = 0.008, respectively), while they were not correlated with tumor size (≤3 or >3 cm). VEGF-A and VEGF₁₂₁ mRNA levels of the low FDG uptake group were significantly lower than those of the high FDG uptake group (p = 0.005 and p = 0.004, respectively). FDG uptake (PCV-SUV) of aggressive lung adenocarcinoma was higher than that of non-aggressive lung adenocarcinoma (p = 0.01). VEGF-A and VEGF₁₂₁ mRNA levels of aggressive lung adenocarcinoma were higher than those of non-aggressive lung adenocarcinoma (p = 0.0001 and p = 0.0001, respectively). VEGF-A and VEGF₁₂₁ mRNA levels may correlate with FDG uptake and aggressiveness in lung adenocarcinoma. These findings support the hypothesis that VEGF-A and VEGF₁₂₁ may help in predicting the outcome in patients with lung adenocarcinoma.
    Annals of Nuclear Medicine 10/2010; 25(1):29-36. · 1.41 Impact Factor
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    ABSTRACT: The purpose of this study was to evaluate the usefulness of high-resolution MRI (HR-MRI) and proton MR spectroscopy ((1)H-MRS) for monitoring the early therapeutic response to radiotherapy. Twenty rabbits with VX2 carcinoma were divided into control (n = 8) and irradiation (n = 12) groups. The irradiation group underwent HR-MRI and (1)H-MRS using a microscopy coil at 1, 3, 7 or 14 days after irradiation. Rabbits in the control group were subjected to HR-MRI and (1)H-MRS at the same time intervals. All rabbits were killed after imaging and subjected to histopathologic examinations. The diameter of necrosis by HR-MRI was then compared to that on the gross specimens. The ratios of choline/creatine (Cho/Cr) and lactate/creatine (Lac/Cr) on the tumor and necrotic area detected by in vivo (1)H-MRS were compared between the control and irradiation groups, respectively. In addition, the ratios of Cho/Cr and Lac/Cr were compared between the tumor and necrotic area in each irradiation group. A significant correlation was found between the diameter of necrosis in each sequence of HR-MRI and that in the gross specimens (r = 0.84-0.91, p = 0.03- < 0.003). The ratios of Lac/Cr in the tumors of the irradiation groups were significantly higher than those in the control groups after 1 day and 3 days of irradiation (p = 0.04, and p = 0.02). Histological analysis showed necrosis and swelling of the endothelia of capillaries and arterioles at 1 day and 3 days after irradiation. It was suggested that HR-MRI and (1)H-MRS are useful methods for monitoring the early therapeutic response to radiotherapy.
    Journal of Radiation Research 10/2010; 51(6):699-705. · 1.45 Impact Factor
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    ABSTRACT: To assess whether the combined evaluation of vascular endothelial growth factor D (VEGF-D) expression and fluorodeoxyglucose (FDG) uptake correlates with lymph node metastasis and post-operative recurrence in patients with lung adenocarcinoma. Forty-six patients with lung adenocarcinomas, who had undergone both preoperative FDG PET imaging and thoracotomy, were enrolled in this study. The surgically resected tumor specimens were used to assess the protein levels of VEGF-D as measured by immunohistochemical assay. The patients were divided into the following four groups: those who were VEGF-D negative and had low FDG uptake (group I, 3 patients), VEGF-D positive and had low FDG uptake (group II, 20 patients), VEGF-D negative and had high FDG uptake (group III, 13 patients), and VEGF-D positive and had high FDG uptake (group IV, 10 patients). Lymph node metastases were seen only in group III. The 5-year disease-free survival rates were 66.7% in group I, 83.9% in group II, 8.3% in group III, and 64.0% in group IV (p < 0.0001). Thus, patients in group III exhibited the most unfavorable prognoses for recurrence. In multivariate analysis, the combined evaluation of VEGF-D expression and FDG uptake was an independent parameter for post-operative recurrence (p = 0.018). A combination of low VEGF-D expression and high FDG uptake may be a biological indicator of lymph node metastasis and post-operative recurrence in patients with lung adenocarcinoma.
    Annals of Nuclear Medicine 08/2010; 24(7):533-40. · 1.41 Impact Factor
  • Clinical nuclear medicine 05/2010; 35(5):374-5. · 3.92 Impact Factor
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    ABSTRACT: We performed palliative radiotherapy with a single-fraction of 8 Gy using a three-dimensional conformal radiotherapy (3D-CRT) technique for patients with dyspnea due to a bulky nasooropharyngeal lesion who had chemotherapy-refractory, recurrent, aggressive lymphoma. After palliative radiotherapy, a complete response with acceptable toxicity was achieved at the irradiated sites of two patients, and the symptoms resolved completely. These results indicated that a single fraction of 8 Gy using 3D-CRT is an effective palliative treatment for chemotherapy-refractory, recurrent, aggressive lymphoma.
    Japanese journal of radiology 04/2010; 28(3):220-3. · 0.73 Impact Factor
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    ABSTRACT: The purpose of this study was to evaluate prospectively the depiction of hypervascular hepatocellular carcinoma on 64-MDCT scans obtained with contrast agents of varying iodine concentrations administered with and without saline flush. The study included 149 patients, among whom 36 patients with hypervascular hepatocellular carcinoma were identified. Patients were randomly assigned to one of three protocols: A, contrast material of 300 mg I/mL; B, 370 mg I/mL; C, 370 mg I/mL plus saline flush. In all protocols, the same iodine load per kilogram of body weight (516 mg/kg) was administered for the same injection duration (30 seconds). Enhancement values in the aorta, liver, and portal vein and tumor-liver contrast were measured at multiphase CT. Aortic enhancement was significantly different between protocols A and B (p = 0.04, p < 0.0001) and protocols B and C (p = 0.02, p < 0.001) in the first and second phases. Portal venous enhancement was significantly different between protocols B and C (p = 0.02) in the first phase and between protocols B and C and protocols A and C (p < 0.01, p = 0.02) in the second phase. Tumor-liver contrast was significantly different between protocols A and B (p = 0.03, p = 0.02) and protocols B and C (p = 0.03, p = 0.04) in the first and second phases but not between protocols A and C. There was no significant difference in hepatic enhancement among the three protocols. Use of moderate concentration was more effective than use of a high concentration of contrast material for depiction of hepatocellular carcinoma. Adding a saline flush to the high-concentration protocol eliminated the difference in depiction of hepatocellular carcinoma between the moderate- and high-concentration protocols.
    American Journal of Roentgenology 09/2009; 193(3):738-44. · 2.90 Impact Factor
  • Yasuaki Kuginuki, Hisao Tonami
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    ABSTRACT: PURPOSE To utilize computational fluid dynamics model of blood flow in abdominal aortic aneurysm using multi-slice CT angiographic datasets for the assessment of rupture risk of individual aneurysms. METHOD AND MATERIALS Twenty-four patients with abdominal aortic aneurysm were enrolled. Among these, three aneurysms were ruptured after CT examination. Based on the 64-slice multi-slice CT angiographic datasets, three-dimensional grid-based models of aneurysm were built. Based on the experimental results, pulsatile flow was simulated. A laminar, incomprehensive flow-based inlet condition, zero traction-force outlet boundary, and no-slip wall boundary conditions was applied. The visualized flow pattern, wall pressure, and wall shear stress were obtained and compared between ruptured and un-ruptured aneurysms, respectively. RESULTS In three cases with ruptured aneurysm, the flow patterns were turbulent and complicated. The eddies with a reduction in velocity were seen during pre-systolic flow acceleration within the aneurysm. These eddies were mostly situated outside the main stream in the concavities of the aneurysm. During the post-systolic deceleration, large vortices were seen within the aneurysm. During the diastole, these vortices did not fully disappear. These particular flow patterns were not observed in cases with un-ruptured aneurysm. In cases with ruptured aneurysm, the areas of high wall pressure were observed in regions of the vortices. On the other hand, the wall shear stress was not increased in these regions. CONCLUSION The image-based numerical simulation is highly promising technique for estimating the blood flow state within the aneurysm. It is expected that this methodology will improve the accuracy of computational predictions utilized for the assessment of risk of rupture in individual abdominal aortic aneurysms. CLINICAL RELEVANCE/APPLICATION Numerical simulation of blood flow in abdominal aortic aneurysm using 64-slice multi-slice CT angiography datasets predicts its risk of rupture.
    Radiological Society of North America 2008 Scientific Assembly and Annual Meeting; 12/2008