Satoshi Kato

Teikyo University Hospital, Edo, Tōkyō, Japan

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Publications (10)10.91 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: We report a case of well-differentiated fetal adenocarcinoma (WDFA) of the lung, with emphasis on dynamic CT (computed tomography) findings. The patient was a 38-year-old woman who was found to have a mass in the left upper lung field in chest radiograph screening. Chest radiograph showed a 5.5 cm well-defined mass in the left upper lung field. CT revealed a well-circumscribed mass measuring 5.5 × 5.5 × 5.0 cm with a lobulated margin in the left upper lobe. Intratumoral enhancing vasculature was noted in the early phase of dynamic CT. In the delayed phase, persistent and plateau enhancement was seen. The tumor also had consistently unenhanced areas, suggesting the presence of necrosis. Left upper lobectomy with mediastinal lymph node dissection was performed. The pathology specimen contained tubular glands consisting of non-ciliated columnar cells with areas of solid nests of epithelial cells with weakly eosinophilic cytoplasm (morule) mimicking fetal lung tissue. The tumor was moderately vascularized with areas of comedo necrosis; the stroma was relatively scanty. Final pathological diagnosis was WDFA with left hilar lymph node metastasis (stage T2bN1M0). This is the first report of dynamic CT findings of WDFA, a rare lung tumor. Although these findings are non-specific, they well reflected the pathological characteristics of this tumor.
    Japanese journal of radiology 10/2012; · 0.73 Impact Factor
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    ABSTRACT: To compare the diagnostic accuracy of contrast-enhanced computed tomography (CE-CT), contrast-enhanced ultrasonography (CE-US), superparamagnetic iron oxide-enhanced magnetic resonance imaging (SPIO-MRI), and gadoxetic acid-enhanced MRI (Gd-EOB-MRI) in the evaluation of colorectal hepatic metastases. In all, 111 patients with colorectal cancers were enrolled in this study. Of the 112 metastases identified in 46 patients, 31 in 18 patients were confirmed histologically and the remaining 81 in 28 patients were confirmed by follow-up imaging. CE-CT, CE-US, SPIO-MRI, and Gd-EOB-MRI were evaluated. Mean (of three readers, except for CE-US) area under the receiver operating characteristic curve (A(z) ), sensitivities, and positive predictive values (PPV) were calculated. Each value was compared to the others by variance z-test or chi-square test with Bonferroni correction. For all lesions, mean A(z) and sensitivity of Gd-EOB-MRI (0.992, 95% [56/59]) were significantly greater than those of CE-CT (0.847, 63% [71/112]) and CE-US (0.844, 73% [77/106]). For lesions ≤1 cm, mean A(z) and sensitivity of Gd-EOB-MRI (0.999, 92% [22/24]) were significantly greater than those of CE-CT (0.685, 26% [13/50]) and CE-US (0.7, 41% [18/44]). Mean A(z) (95% CI) of SPIO-MRI for all lesions (0.966 [0.929-0.987]) and lesions ≤ 1 cm (0.961 [0.911-0.988]) were significantly greater than those of CE-CT and CE-US. Mean sensitivity of SPIO-MRI for lesions ≤1 cm (63%, 26/41) was significantly greater than that of CE-CT. Gd-EOB-MRI and SPIO-MRI were more accurate than CE-CT and CE-US for evaluation of liver metastasis in patients with colorectal carcinoma.
    Journal of Magnetic Resonance Imaging 08/2011; 34(2):326-35. · 2.57 Impact Factor
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    ABSTRACT: The aim of this study was to determine a standard deviation (SD) that most reduces the radiation dose without sacrificing the diagnostic accuracy of thin-section computed tomography (CT) for clinical use. A total of 120 patients were examined by multidetector CT. They were assigned to one of four SD groups: 8, 9, 11, and 12. Each SD group consisted of 30 patients. The CT images of the same patients with SD10 that had formerly been examined were used for comparison. Two radiologists independently evaluated the degrees of image noise and diagnostic acceptability of the pulmonary diseases using a point score grading system. We compared the scores between each SD and the SD10 group. Generally, image noise was significantly more prominent in the higher-SD groups. The mean score of diagnostic acceptability was significantly lower in the SD12 group (4.2 ± 1.6) than in the SD10 group (4.6 ± 1.1) group (P < 0.001), whereas no difference was present between the SD8 (4.9 ± 0.7), SD9 (4.8 ± 1.0), and SD11 (4.4 ± 1.5) groups and the SD10 group (4.7 ± 1.1, 4.6 ± 1.4, 4.6 ± 1.1, respectively). Thin-section CT with SD12 is not acceptable. SD11 seems to be the setting with the lowest radiation dose while providing acceptable imaging quality for pulmonary thin-section CT.
    Japanese journal of radiology 07/2011; 29(6):405-12. · 0.73 Impact Factor
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    ABSTRACT: The aim of this study was to characterize computed tomography (CT) manifestations of local recurrence after stereotactic body radiation therapy (SBRT) for stage I non-small-cell lung cancer (NSCLC). A total of 27 stage I NSCLC patients who were treated with SBRT, including 5 patients with local recurrence, were retrospectively analyzed for serial CT examinations. A bulging margin appeared in 4 of the 5 cases (80%) with local recurrence and 1 of 22 cases (5%) without local recurrence. Air bronchograms were seen in 3 of 5 cases with local recurrence and 21 of 22 cases without local recurrence, but they subsequently disappeared in all 3 cases (100%) with local recurrence and in 4 of the 21 cases (19%) without local recurrence. Ipsilateral pleural effusion was observed in all 5 cases (100%) with local recurrence and in 5 of 22 cases (22%) without local recurrence. The opacity increased in size even after 12 months from the completion of SBRT in cases with local recurrence, whereas it decreased or did not change in size in cases without recurrence. Local recurrence should be suspected on CT when there was (1) a bulging margin, (2) disappearance of air bronchograms, (3) appearance of pleural effusion, or (4) increase in the abnormal opacity after 12 months.
    Japanese journal of radiology 05/2010; 28(4):259-65. · 0.73 Impact Factor
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    ABSTRACT: The aim of this study was to evaluate thinsection computed tomography (CT) and fluorodeoxyglucose positron emission tomography (FDG-PET) findings of localized pulmonary mucinous bronchioloalveolar carcinomas (BACs). From February 2000 to February 2009, there were seven patients with pulmonary localized mucinous BACs that were pathologically confirmed in the surgical specimens. Their CT findings were assessed regarding location, extent (percent) of groundglass opacity (GGO), margin characteristics, and the presence of air-containing spaces and contractive changes. We evaluated the presence of the "angiogram sign" in the patients who underwent enhanced CT. The maximum standardized uptake value (SUVmax) on FDG-PET was measured in four cases. All tumors were located in the lower lobes. The percentages of GGOs ranged from 0% to 70% (average 20%). The tumor margins were well defined in five cases and ill-defined in two cases. Air-containing spaces were seen in all cases. Evidence of contractive change was seen in two of the seven cases. The angiogram sign was identified in one of five patients who underwent enhanced CT. The SUVmax on FDG-PET ranged from 0.93 to 1.97 (mean 1.53). The imaging features of localized mucinous BACs include solid or partly solid attenuation, the presence of air-containing spaces, lack of contractive changes, and lower lobe predominance. Additionally, the SUVmax is markedly low on FDG-PET.
    Japanese journal of radiology 05/2010; 28(4):251-8. · 0.73 Impact Factor
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    ABSTRACT: To evaluate the relationship between SUVmax of primary lung cancers on FDG-PET and lymph node metastasis. The subjects were a total of consecutive 66 patients with lung cancer who were examined by FDG-PET and subsequently underwent surgery between October 2004 and January 2008. There were 41 males and 25 females, ranging in age from 45 to 83 years with an average of 68 years. The pathological subtypes of the lung cancers consisted of 49 adenocarcinomas, 11 squamous cell carcinomas, 2 adenosquamous carcinoma, 1 large cell carcinoma, 1 small cell carcinoma, 1 pleomorphic carcinoma and 1 mucoepidermoid carcinoma. We statistically compared (1) the mean SUVmax of lung cancer between the groups with and without lymph node metastasis (2) the frequency of lymph node metastasis between higher and lower SUVmax of lung cancer groups that were classified by using the median SUVmax of lung cancer, and (3) evaluated the relationship between the SUVmax of lung cancer and frequency of lymph node metastases, and (4) correlations between the SUVmax of lung cancer and number of the metastatic lymph nodes and pathological n stages. The difference in the average of the SUVmax of lung cancer between the cases with and without lymph node metastases was statistically significant (p = 0.00513). Lymph node metastasis was more frequently seen in the higher SUVmax of lung cancer group (17/33, 52%) than in the lower SUVmax of lung cancer group (7/33, 21%) with a statistically significant difference. There was no lymph node metastasis in lung cancers with an SUVmax of lung cancer less than 2.5, and lung cancers with an SUVmax of lung cancer more than 12 had a 70% frequency of lymph node metastasis. There were moderate correlations between SUVmax of lung cancer, and the number of the metastatic lymph nodes (gamma = 0.404, p = 0.001) and pathological n stage (gamma = 0.411, p = 0.001). The likelihood of lymph node metastasis increases with an increase of the SUV of a primary lung cancer.
    Annals of Nuclear Medicine 05/2009; 23(3):269-75. · 1.41 Impact Factor
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    ABSTRACT: To compare diagnostic capability of preoperative N-staging of lung cancer between thin-section CT of the mediastinum and FDG PET, and 5mm slice thickness CT. The subjects were 34 patients with lung carcinoma who were examined by both CT and PET, and subsequently underwent surgery between May 2005 and January 2007. CT was carried out with a 16 detector row helical CT scanner. The raw data were reconstructed into 5 mm slice thickness and 1mm slice thickness (thin-section CT). A total of 251 lymph node stations were retrospectively assessed for the presence of lymph node metastasis with thin-section CT, 5 mm CT and PET. In the interpretations of thin-section CT and 5 mm CT, we employed multi-criteria as follows: nodular calcification and intranodal fat as benign criteria, and short-axis diameter more than 10 mm (size criterion), focal low density other than fat, surrounding fat infiltration and convex margin in hilar lymph nodes, as malignant criteria. On PET, maximum standardized uptake value (SUVmax) of 2.5 or more was used as the criterion of malignancy. Sensitivity and specificity were compared between these examinations using McNemar test. Sensitivities and specificities of thin-section CT, 5 mm CT and PET were 25%, 25%, 25%, and 97%, 94%, 98%, respectively. The statistical analysis revealed that the specificity of 5 mm CT was significantly lower than those of thin-section CT (p=0.039) and PET (p=0.006), while no difference was present between thin-section CT and PET. Thin-section CT of the mediastinum using multiple criteria was comparable to PET in preoperative N-staging of lung cancer.
    European journal of radiology 03/2009; 73(3):510-7. · 2.65 Impact Factor
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    ABSTRACT: This study aimed to evaluate the validity of 0.5-mm thin-section computed tomography (CT) for the assessment of pulmonary nodular lesion in comparison with 1-mm CT. A total of 38 focal lesions from 30 patients, which were scanned with 0.5- and 1.0-mm collimation, were evaluated regarding the extent of ground-glass opacity (GGO) and well-defined margin, and the presence of pleural indentation, spicula, and internal air density. The frequency of each finding was statistically compared between 0.5- and 1-mm CT using the McNemar test. No statistically significant difference was observed between 0.5- and 1-mm CT for each finding. The use of 0.5-mm CT is not justified if the original collimation of multi-detector row CT is near 1 mm.
    Clinical imaging 01/2009; 33(1):11-4. · 0.73 Impact Factor
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    ABSTRACT: This study aimed to evaluate the efficacy of thin-section CT of the mediastinum in the assessment of thoracic lymph nodes in comparison with conventional CT. A total of 193 CT examinations from 193 patients with suspected pulmonary disease were reconstructed into thin-section CT and conventional CT. The appearances of the lymph nodes were assessed and compared between thin-section CT and conventional CT. Intranodal fat was more often detected on thin-section CT than on conventional CT (P<.001). There were no statistically significant differences in the frequencies of inhomogeneous enhancement and bulging margin of the hilar lymph node. Thin-section CT can improve clinical N-staging of lung cancer due to classification of enlarged mediastinal lymph nodes as benign based on identification of intranodal fat.
    Clinical Imaging 01/2007; 31(6):375-8. · 0.65 Impact Factor
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    ABSTRACT: To evaluate the diagnostic ability of multiplanar reformation (MPR) images of the lung in comparison with thin-section source CT images. MPR images were reconstructed for 79 patients with suspected pulmonary disease. Slice thicknesses of source images were 2 mm in 24, 1 mm in 30, and 0.5 mm in 25 cases. The presence of centrilobular nodules, emphysema, bronchiectasis, ground-glass opacity (GGO), consolidation, interstitial thickening, and pulmonary nodule was evaluated on thin-section source images by an experienced chest radiologist to establish gold standards and then subsequently assessed on the MPR images independently by two radiologists. The sensitivity, specificity, and accuracy of each finding were calculated regarding the results of thin-section source images as the gold standards. Accuracy for the detection of findings was also statistically compared among the three groups of different source slice thicknesses using Fisher's exact test. Accuracy for the detection of findings was significantly less (p < 0.05) in 2 mm slice MPR for centrilobular nodule, GGO, and interstitial thickening than in 1 mm or 0.5 mm slice MPR. No statistically significant difference was observed for any of the findings between 0.5 mm and 1 mm slice MPR. Rates of sensitivity, specificity, and accuracy of the MPR images for detection of the findings were 89-100%, 73-95%, and 84-95%, respectively. In comparison with thin-section source images, MPR images are comparably sensitive but not as specific for the detection of findings. When producing MPR images, the slice thickness of source images should be less than 2 mm.
    Nihon Igaku Hoshasen Gakkai zasshi. Nippon acta radiologica 11/2005; 65(4):378-83.

Publication Stats

49 Citations
10.91 Total Impact Points

Institutions

  • 2011
    • Teikyo University Hospital
      Edo, Tōkyō, Japan
  • 2007–2011
    • University of Yamanashi
      • Department of Radiology
      Kōhu, Yamanashi, Japan
  • 2005–2007
    • Kofu Municipal Hospital
      Kōhu, Yamanashi, Japan