Sachiko Nakano

Gunma University, Maebashi, Gunma Prefecture, Japan

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Publications (9)10.91 Total impact

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    ABSTRACT: Background The aim of this study was to evaluate the accuracy, safety, and role of splenic biopsy in the management of patients with non-mass-forming isolated splenomegaly and suspected malignant lymphoma. Methods Between 2001 and 2013, 137 biopsies were performed under computed tomography (CT) fluoroscopic guidance in 39 patients. All patients had splenomegaly based on the CT findings and a suspected diagnosis of malignant lymphoma based on their clinical symptoms. The spleen was the only accessible site to perform a biopsy, and no mass lesions could be identified in the spleen. Results The overall sensitivity, specificity, and diagnostic accuracy of image-guided biopsy for malignant lymphoma were 88%, 100% and 92%, respectively. Major complications occurred in 3 patients. In 1 patient, transcatheter arterial embolization was performed due to hemorrhage, and two patients needed blood transfusion because of hematoma development, without the need for further treatment. Conclusions Image-guided splenic core-needle biopsy is a safe and accurate technique with a high diagnostic accuracy in most patients who with non-mass-forming isolated splenomegaly and suspected underlying malignant lymphoma.
    PLoS ONE 11/2014; 9(11):e111657. DOI:10.1371/journal.pone.0111657 · 3.23 Impact Factor
  • Sachiko Nakano · Kenzo Okauchi · Yoshito Tsushima
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    ABSTRACT: A 62-year-old male presented with sudden onset of low back and right leg pain. Contrast-enhanced computed tomography demonstrated an abdominal aortic aneurysm (AAA), along with a large mass lesion causing vertebral body erosion. Magnetic resonance imaging (MRI) suggested that the mass lesion consisted of a chronic hematoma. Fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET) demonstrated increased uptake around the mass lesion, but not around the AAA. Surgical intervention was performed, and the subsequent histological diagnosis was chronic contained rupture of AAA. The mass lesion consisted of chronic hematoma and necrosis with inflammatory cell infiltration and hemosiderin deposition. This condition mimics some neoplastic diseases, but MRI and FDG-PET findings may help establish the correct diagnosis.
    Japanese journal of radiology 12/2013; DOI:10.1007/s11604-013-0271-z · 0.74 Impact Factor
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    ABSTRACT: PURPOSE:: The aim of this study was to investigate the feasibility of separately evaluating bronchial (BAP) and pulmonary arterial perfusion (PAP) of lung cancers using dual-input perfusion computed tomography. MATERIALS AND METHODS:: Twenty-nine lesions from 28 patients [19 men and 9 women; age, 65.8±11.3 y (mean±SD); range, 39 to 85 y] were included in this study (1 patient had 2 tumors). From computed tomography data, quantitative maps of PAP and BAP were created using the dual-input maximum-slope method. Total blood perfusion (TBP) was defined as the sum of PAP and BAP, and the percentage of PAP to TBP was defined as %PAP. Correlation of these values with tumor size, location, and pathologic type was statistically analyzed. RESULTS:: PAP ranged from 2.0 to 93.1 mL/min/100 mL (mean±SD, 26.8±26.4), BAP was 0 to 65.4 (25.1±19.12), TBP was 20.7 to 132.0 (52.0±29.0), and %PAP was 4% to 100% (48.8%±31.9%). PAP, TBP, and %PAP correlated negatively with tumor size (P<0.05). PAP and %PAP were higher in the peripheral zone than in the central zone (P<0.05). There was significant correlation between pathologic type and the respective perfusion parameters (P>0.05). CONCLUSIONS:: We were successful in separating the dual vascular supply to assess dual-input perfusion of lung cancer. We found perfusion of lung cancers to depend on tumor size and location. Acknowledging and assessing the dual vascular supply in lung perfusion may have clinical implications in the management of lung cancer treatment.
    Journal of thoracic imaging 01/2013; 28(4). DOI:10.1097/RTI.0b013e318281dcee · 1.49 Impact Factor
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    ABSTRACT: PURPOSE:: The aim of this study was to investigate the feasibility of separately evaluating bronchial (BAP) and pulmonary arterial perfusion (PAP) of lung cancers using dual-input perfusion computed tomography. MATERIALS AND METHODS:: Twenty-nine lesions from 28 patients [19 men and 9 women; age, 65.8±11.3 y (mean±SD); range, 39 to 85 y] were included in this study (1 patient had 2 tumors). From computed tomography data, quantitative maps of PAP and BAP were created using the dual-input maximum-slope method. Total blood perfusion (TBP) was defined as the sum of PAP and BAP, and the percentage of PAP to TBP was defined as %PAP. Correlation of these values with tumor size, location, and pathologic type was statistically analyzed. RESULTS:: PAP ranged from 2.0 to 93.1 mL/min/100 mL (mean±SD, 26.8±26.4), BAP was 0 to 65.4 (25.1±19.12), TBP was 20.7 to 132.0 (52.0±29.0), and %PAP was 4% to 100% (48.8%±31.9%). PAP, TBP, and %PAP correlated negatively with tumor size (P<0.05). PAP and %PAP were higher in the peripheral zone than in the central zone (P<0.05). There was significant correlation between pathologic type and the respective perfusion parameters (P>0.05). CONCLUSIONS:: We were successful in separating the dual vascular supply to assess dual-input perfusion of lung cancer. We found perfusion of lung cancers to depend on tumor size and location. Acknowledging and assessing the dual vascular supply in lung perfusion may have clinical implications in the management of lung cancer treatment.
    Journal of Thoracic Imaging 01/2013; · 1.49 Impact Factor
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    ABSTRACT: OBJECTIVE: L: -[3-(18)F]-alpha-methyltyrosine ((18)F-FAMT) is an amino-acid tracer for positron emission tomography (PET), with uptake related to overexpression of L-type amino-acid transporter 1 and proliferative activity in tumour cells. This study evaluated the diagnostic performance of (18)F-FAMT PET compared with 2-[(18)F]-fluoro-2-deoxy-D: -glucose ((18)F-FDG) PET in patients with multiple myeloma (MM). METHODS: Eleven patients with MM (newly diagnosed, n = 3; relapsed after treatment, n = 8) underwent whole-body (18)F-FAMT and (18)F-FDG PET within a 2-week interval. Magnetic resonance imaging (MRI) of the spine was also performed to assess patterns of bone marrow infiltration. Tracer uptake was semi-quantitatively evaluated using maximal standardized uptake value (SUV(max)). Mean SUV was also determined for normal bone marrow and the aortic arch as mediastinal background SUV to calculate lesion-to-bone marrow (L/B) and lesion-to-mediastinum (L/M) ratios, respectively. Those values were statistically compared using Student's t test. RESULTS: In 8 patients showing focal infiltration on MRI, 34 FDG-avid bone lesions were identified, with each showing increased FAMT uptake. Mean SUV(max) and L/B ratio of FDG (3.1 ± 1.2 and 3.3 ± 1.9, respectively) were significantly higher than those of FAMT (2.0 ± 1.0 and 2.6 ± 1.1, respectively; p < 0.05 each). In contrast, the L/M ratio of FDG showed no significant difference to that of FAMT (2.2 ± 1.0 and 2.4 ± 1.2, respectively; p = 0.3). CONCLUSIONS: Clear (18)F-FAMT PET uptake was seen in most (18)F-FDG-avid lesions among patients with MM, and an equivalent semi-quantitative value was obtained using L/M ratio. Our preliminary data suggest that (18)F-FAMT PET provides a useful imaging modality for detecting active myelomatous lesions.
    Annals of Nuclear Medicine 08/2012; 26(10). DOI:10.1007/s12149-012-0645-9 · 1.51 Impact Factor
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    ABSTRACT: To evaluate the findings of hepatic metastases from malignant pheochromocytoma/paraganglioma on non-contrast-enhanced and contrast-enhanced ultrasonography (US) and compare them with other imaging modalities. US was performed on eight patients with 65 hepatic metastases. Non-contrast computed tomography (CT), meta-iodo-benzyl-guanidine scintigraphy ((123)I-MIBG), and fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET) were also performed. Magnetic resonance imaging, including diffusion-weighted imaging (DWI), was performed on six patients. Forty of the 65 lesions (61.5%) were detected on non-contrast-enhanced US: 27 were hyperechoic (67.5%), 10 were hypoechoic (25.0%), and 3 (7.5%) were isoechoic. Sixteen of 17 lesions appeared hypervascular in the arterial phase of dynamic contrast-enhanced US. On delayed images, contrast-enhanced US demonstrated 64 of 65 metastatic tumors (98.5%), and 51 of them were delineated as enhancement defects. Non-contrast-enhanced CT revealed 61 (93.8%) of 65, FDG-PET revealed 44 (67.7%) of 65, and DWI revealed 30 (90.9%) of 33. On (123)I-MIBG scintigraphy, seven patients had abnormal uptakes in the liver, suggesting metastases. There were no significant differences between the detectability of US and other modalities. On contrast-enhanced US, nearly all hepatic metastases were delineated. Most lesions showed hypervascularity on dynamic contrast-enhanced US, suggesting the usefulness of this technique.
    Japanese journal of radiology 01/2012; 30(4):310-6. DOI:10.1007/s11604-012-0051-1 · 0.74 Impact Factor
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    ABSTRACT: Reversible posterior leukoencephalopathy syndrome (RPLS) is uncommon neurological syndrome that is characterized by specific clinical and radiologic findings. Previous reported associations of RPLS include hypertension, eclampsia, renal impairment and drugs. Prompt diagnosis and therapy is critical to ensure resolution of the neurological disability. Some cases have been reported in association with the increased use of antineoplastic agents in cancer patients. We report the case of a 62-year-old man who was diagnosed with RPLS after receiving carboplatin and paclitaxel chemotherapy for lung cancer. This case appears to be the first recognized association of RPLS with this regimen.
    Internal Medicine 01/2012; 51(8):911-5. DOI:10.2169/internalmedicine.51.6723 · 0.97 Impact Factor
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    ABSTRACT: A 63-year-old man underwent computed tomography (CT) using intravenous low-osmolar iodine contrast medium (LOCM) 6 days after undergoing high-dose (131)I-MIBG therapy for metastatic pheochromocytoma. Immediately after the CT examination, his blood pressure increased to 260/160 mmHg (from 179/101 mmHg before the examination). Phentolamine mesilate was administered, and the blood pressure rapidly went back to normal. Although hypertensive crisis after administration of LOCM is rare, this case suggests that high-dose (131)IMIBG therapy may be a risk factor for hypertensive crisis after administration of intravenous LOCM.
    Japanese journal of radiology 07/2011; 29(6):449-51. DOI:10.1007/s11604-011-0573-y · 0.74 Impact Factor
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    ABSTRACT: PURPOSE Accurate diagnosis of mass-forming pancreatic diseases is difficult, because there has been no specific imaging procedure to differentiate malignant neoplasm and benign disorders. There have been many studies showing that positron emission tomography (PET) with [F-18] 2-fluoro-2-deoxy-D-glucose (F-18-FDG) could not differentiate malignant neoplasm from benign disorders in patients with pancreatic disease. We have been showing the clinical utility of PET with [F-18] alpha-methyl tyrosine (F-18-FMT) for the differential diagnosis of tumors. The present study aims to investigate the usefulness of whole-body PET with F-18-FDG and F-18-FMT to evaluate mass-forming pancreatic diseases. METHOD AND MATERIALS PET studies with F-18-FDG and F-18-FMT were performed in 11 patients. The uptake of tracers was semi quantitatively evaluated using standardized uptake value. The difference between the disease group was compared and the statistical significance was determined positive with p<0.05. Pathological diagnosis was confirmed by operation or endoscopic retrograde cholangiopancreatography. Biochemical analysis including tumor markers was performed. Written informed consent was secured from all patients. RESULTS Histological analysis revealed that pancreatic lesion included pancreas cancer (n=5), mass-forming pancreatitis (n=3), and autoimmune pancreatitis (n=3). Four patients with pancreas cancer (4/5) showed elevation of serum tumor marker level, although one patient with mass-forming pancreatitis (1/3) and autoimmune pancreatitis (1/3) showed elevated tumor marker. Uptake of F-18-FDG was increased in all patients with pancreas cancer, mass-forming pancreatitis, and autoimmune pancreatitis. There was no significant difference in the F-18-FDG uptake between them. In contrast, significant difference in the uptake of F-18-FMT was noted between pancreas cancer and autoimmune pancreatitis. CONCLUSION The present preliminary study indicated that F-18-FMT is useful for differential diagnosis of mass-forming pancreatic lesions. Clinical relevance/application Differential diagnosis of mass-forming pancreatic lesions could be done by F-18-FMT PET in cases showing positive finding on F-18-FDG PET. F-18-FDG PET could evaluate distant metastasis and systemic complication of autoimmune pancreatitis. CLINICAL RELEVANCE/APPLICATION This work was performed in Gunma university hospital as a clinical research.
    Radiological Society of North America 2008 Scientific Assembly and Annual Meeting; 12/2008