[en] Purpose; To report our results of radiotherapy for T1 glottic cancers and to analyze the influence of various parameters. Materials and Methods; Reviewed were the outcome of 57 patients with T1 glottic cancers who received definitive radiotherapy between 1985 and 1993. Of 57 patients, 46 had T1a lesions and 11 T1b. Of 57 lesions, 29 were well differentiated carcinoma, 12 moderately, one poorly and 15 unknown. Seven patients were treated with cobalt-60 unit, 26 with 3-MV linear accelerator, 7 with 6-MV and 17 with 10-MV. Of 17 patients treated with 10-MV, 4 also received part of their treatment with a cobalt-60 unit. Right and left lateral parallel opposed fields was used with all patients. The average field size was 30cm², with typical field sizes ranging from 5x5 cm to 6x6 cm. Doses reported in this study refer to the central absorbed dose calculated at the central axis. The total radiation doses was 6000 cGy for 49 patients (86%) and the mean total radiation doses was 6100 cGy (range, 5600-7000 cGy). A daily fraction dose was 200 cGy for all patients. All courses of radiotherapy were delivered by using once-a-day fractionation 5 days per week without interruption. Chemotherapy was concurrently used with radiotherapy for 32 patients. Median follow-up was 53 months (range, 3-102 months). The local control and survival curves were adjusted and expressed by Kaplan-Meier method and comparison of the curves were calculated using the log-rank test. Results; Of 54 patients, 13 (24%) had local recurrence. Various parameters including substage; histologic grade; treatment machine; use of chemotherapy were analyzed. The only factor that influenced local control was treatment machine. The local control rate at five years was 93% for cases treated with cobalt-60 unit or a 3-MV linear accelerator and 53% for cases treated with a 6- or 10-MV linear accelerator. The local control rate for cases treated with cobalt-60 unit or a 3-MV linear accelerator was significantly better (p= .0055). Further, the local control rate for cases treated with cobalt-60 unit or a 3-MV linear accelerator was significantly better than that for cases treated with only a 6-MV linear accelerator (p= .0006). Of 57 patients, five died. The actuarial survival rate at five years was 92%. Conclusion; Low energy photon beams are more suitable in the treatment for T1 glottic cancers

[en] Dynamic CT scans were conducted on 94 persons who had been randomly selected among the patients and the volunteers. The test results were used to obtain the time-density curve. A part of the subjects (20 cases) underwent the renogram examination for the comparative studies. The cortico-aortic (CA) ratio derived from the time-density curve demonstrated good correlation between the dynamic CT and the renal function (r=0.68). When the dynamic CT studies and the renogram were compared, the vascular phase of the renogram showed strong correlation with CA ratio. Consequently the dynamic CT study with CA ratio was believed to demonstrate the renal function. (author)

[en] To investigate the correlation between nuclear medicine parameters determined by technetium-99m-DTPA-galactosyl-human serum albumin (Tc-99m-GSA) and liver function tests, canonical correlation analysis was performed. Tc-99m-GSA studies were performed on 47 patients with hepatocellular carcinoma (HCC) who had undergone transcatheter arterial embolization (TAE). The nuclear medicine parameters LU15, HH15 and LHL15, which are results of nuclear imaging tests, were chosen in combination with the following liver function tests: the serum bilirubin level (T.Bil), the serum albumin level (Alb), serum cholinesterase activity (Ch-E), the clearance rate of indocyanine green (KICG), the hepaplastin test (HPT) and the prothrombin time (PT). The canonical correlation coefficient was 0.7345 and the upper tail probability was 0.00167. A significant correlation was observed between the two sets of variables. The high structural coefficients of Ch-E, KICG and HPT indicated a close relationship with the nuclear medicine parameters, supporting the notion that these nuclear medicine parameters are useful for the estimation of liver damage. The structural coefficients of the nuclear medicine parameters were also high, with LU15 being a parameter as useful as both HH15 and LHL15. T.Bil may evaluate a liver function that is not measured by nuclear imaging techniques, so we should take T.Bil results into account before considering TAE. (author)

No abstract available

[en] Bone biopsy is necessary for the diagnosis of ambiguous, skeletal lesions. Although several merits of computed tomography (CT)-guided percutaneous needle biopsy have been documented, few radiologists have performed this procedure in Japan. We performed this procedure with a newly introduced bone biopsy needle (OSTYCUT, angiomed, Karlsruhe, Germany) under CT guidance and evaluated the results. CT-guided bone biopsy (pelvic [n=11] vertebral [n=10], femoral [n=1], stemal [n=1]) was performed in 19 consecutive patients. Seventeen patients were suspected metastatic disease, and the others were suspected primary bone tumor. All biopsies but one were diagnostic. Malignancy was proved in 11 lesions. Three patients with prostatic carcinoma were proved to show no malignancy of bone lesions after a series of hormonal and chemotherapies. In one patient with both malignant mesothelioma and cervical carcinoma, the biopsy specimen from thoracic vertebra proved metastasis from mesothelioma. CT-guided bone biopsy is useful to evaluate the presence of malignancy and the effect of therapy for it, and to determine the primary site. (author)

[en] The aim of this study was to investigate the usefulness of magnetic resonance (MR) imaging in the evaluation of renal function, with particular attention to the effects of water load. Ten healthy volunteers underwent dynamic MR imaging after an injection of gadolinium diethylenetriaminepenta-acetic acid (Gd-DTPA) as a contrast agent to evaluate renal function by the following four methods: the positive method [longitudinal relaxation time (T1) shortening is the dominant effect], the negative method [transverse relaxation time (T2) shortening is the dominant effect] and two intermediate methods by switching the Gd-DTPA concentrations used in the positive and negative methods. A prolonged cortical peak time and a reduced medullary peak level were observed by the positive method under a dehydrated condition, suggesting that these variables were slightly influenced by Gd-DTPA concentrated in the medulla. By the negative method, low signals due to T2* (T2* is the effective transverse relaxation time, typically shorter than T2) shortening appeared in the medulla under normal conditions, but these signals were unclear when the subject was under an overhydrated condition. These results indicate that water metabolism, in addition to imaging parameters and Gd-DTPA dose levels, should be considered when renal function is evaluated by dynamic MR imaging. Analysis of both the pattern of MR images and the time-signal intensity curves may be useful in the evaluation of renal function. The results also indicate that the positive method is perferred when the patient is overhydrated as it allows the evaluation of the local renal kinetic function by recording changes in the regional contract agent levels. (author)

[en] The results of radiotherapy were investigated in 49 patients with lung cancer admitted to the Department of Radiology, Okayama University Hospital. Of the 26 patients not undergoing surgery, the one-year survival rate was 100 % in the stage I patients, 55 % in the stage III patients and 56 % in the stage IV patients, and the two-year survival rate was 50 % in the stage I patients, 0 % in the stage III patients and 9 % in the stage IV patients. A significant difference in survival between patients irradiated with over 60 Gy and patients irradiated with less than 60 Gy was recognized among those not undergoing surgery. However, with respect to the frequency of local recurrence and distant metastases, a correlation with the irradiated dose was not demonstrated. Local recurrence and distant metastases were not observed in 5 of 6 patients who received preventive irradiation after curative surgery was conducted. Concerning 11 patients after non-curative surgery, local recurrence and distant metastases were recognized in 3 of them, and 7 of them showed a favourable outcome brought about by the irradiation after surgery as expected. In 6 patients with local recurrence after surgery, the survival period after radiotherapy was less than 13 months. (author)

[en] MRI has gained a prominent position in the diagnosis of brain tumors. We examined 30 cases of meningiomas and distinguished their subtype according to the criteria of Rubinic histology. We discussed the MRI findings and compared then with X-CT findings so to their intensity, delination of tumors, whether accompanied by peripheral edema, and T₁ values. MRI delinated the tumors as well as CE-CT. No remarkable difference was found between the subtypes. (author)

[en] Endoscopic RI-lymphography was performed in 29 patients, with single photon emission computed tomography (SPECT) also performed in 19 of them. The lymph flow from the cardia was directly evaluated in lymphograms and compared with the RI uptake of each lymph node and the incidence of lymph node metastasis of previously resected carcinoma of the cardia in patients according to the location of the lymph node. Endoscopic RI-lymphography performed in combination with SPECT was considered to be highly useful for imaging lymph flow of the cardiac region. SPECT and RI-lymphography indicated rich lymph flow from the cardia to the periaortic region, and this finding was consistent with the incidence of lymph node metastasis according to the location of the lymph node in patients who had previously undergone resection of cancer of the cardia. Careful examination for metastasis to lymph nodes around the abdominal aorta was considered to be necessary, especially in patients with carcinoma of the cardia. (author)

[en] A 47-year-old woman with right breast cancer underwent partial mastectomy and had irradiations to the primary and metastatic sites, including the left supraclavicular region. During catheterization of the left internal mammary artery for arterial infusion therapy, the patient developed an iatrogenic dissection and subsequent occlusion of the left subclavian artery. Arterial infusion of tissue plasminogen activator into the artery resulted in recanalization and improvement of clinical signs and symptoms. (author)