[en] A total of 152 patients who underwent stent therapy or radiotherapy for the treatment of malignant superior vena cava syndrome, malignant tracheal stenosis, or malignant esophageal stenosis were retrospectively comparatively analyzed. Those response rates in superior vena cava syndrome were 93.3% in stent therapy, 61.7% in radiotherapy; respectively, 76.4% and 46.2%, in malignant tracheobronchial stenosis; 91.3% and 69.4% in malignant esophageal stenosis. Stent treatment for superior vena cava syndrome provided highest benefit among these strategies. (author). 60 refs

[en] Transcatheter arterial embolization (TAE) using powder or small particles of gelatin sponge soaked in the solution of the anticancer agents such as Mitomycin C and Adriamycin has been widely employed in the treatment of hepatocellular carcinoma. However, the role of anticancer agents in the therapy has not been investigated enough. In order to know the movement of anticancer agents, the authors injected gelatin sponge particles soaked in ^99mTc-pertechnetate into the proper hepatic artery of a patient with hepatocellular carcinoma who was followed up with a scintillation camera, and we confirmed that the ^99mTc-pertechnetate densely stayed in the tumor area up to at least 4 hours after TAE. In a case, in which gelatin sponge particles soaked in methylglucamine diatrizoate solution (76 % Urografin) was used, the movement of contrast media was checked by computed tomography and shown to be still present in the hepatocellular carcinoma 20 hours after TAE. These results suggest that the antineoplastic solution accumulates in the hepatocellular carcinoma for a long time enough to necrotize the tumor tissue. (author)

No abstract available

[en] Fifty-six untreated patients with hepatic masses underwent magnetic resonance imaging (MRI). The results of MRI were compared with those of the concurrent X-ray computed tomography (CT), angiography (AG), and ultrasonography. Thirty-five were hepatocellular carcinomas (HCC), 8 metastatic tumors, 9 hemangiomas (HG), 2 hepatic abscesses, and 2 hepatic cysts. Significant differences in T1 values were observed not only among the masses but also between masses and either normal tissues or liver cirrhosis. There was, however, no significant difference in T1 values between normal tissues and liver cirrhosis. While MRI was inferior to X-ray CT and AG in detecting HCC, it was slightly superior to X-ray CT in detecting portal invasion of HCC. In the diagnosis of HG, MRI surpassed the other three madalities. In conclusion, MRI may be of great value in the differential diagnosis of hepatic masses. (Namekawa, K.)

[en] Blood brain barrier (BBB) injury was evoked by the injection of hypertonic solution, 50% glucose or 80% sodium iothalamate, through the catheter placed in the common carotid artery of the adult mongrel dogs. Plain CT and then contrast CT were performed at 30 minutes intervals until 3 hours to determine the relationship between the degrees of contrast enhancement (CE) and the amount of injected hypertonic solution, and to examine the diminishing rates of CE according to time elapsed after the intravenous contrast injection. Another four groups of dogs received contrast CT immediately, at 1, 2 and 3 hours after the injection of hypertonic solution to examine the degree of repair of BBB injury. Contrast media, which was leaked through BBB injured by the injection of hypertonic solution, was recognized by CT, and the area of CE coincided exactly with the dyed area by Evans blue, injected intravenously after induction of BBB injury. Degrees of CE were found to correlate linearly to the amount of hypertonic solution within a certain range. These results indicate that CT can demonstrate BBB injury qualitatively and quantitatively. In sequential CT after the artificial injury of BBB, degree of CE diminished linearly with a half life of about 3 hours. Hydrocortisone accelerated this washout of leaked contrast media. Repair of BBB itself, determined by contrast CT which were performed at 1, 2 and 3 hours after the induction of BBB injury, has been accomplished until 3 hours, and not affected by the administration of hydrocortisone. These experimental results suggest that CT is the most promising method to detect quantitatively and non-invasively the degree and the extent of BBB injury in clinical cases. (J.P.N.)

[en] A 73-year-old woman with a large esophagorespiratory fistula underwent bronchoscopy and computed tomographic (CT) virtual endoscopy before stenting. Noninvasive CT virtual endoscopy showed the large fistula, and the CT findings agreed with the bronchoscopic findings

[en] In order to improve the selective catheterization technique, a new angio-imager with the digital memory of 512 x 512 x 8 bit was developed. A new device enabled the intravenous digital subtraction angiography, TV mapping for catheterization, TV x-ray film subtraction, and the decrease of x-ray exposure dose. When clinically applied the method was non-invasive and arteriography could be easily carried out with extremely low x-ray dose, suggesting the possibility of doing this on the outpatient basis. For the improvement of catheterization, indication of accurate position and orientation of a catheter and vessels while operation, precise subtraction of x-ray film, and the decrease of x-ray dose were possible by this method. (Nakanishi, T.)

[en] Purpose: The effect of local injection of anticancer drugs by balloon catheter, i.e., balloon occluded arterial infusion (BOAI), on the prognosis of cervical cancer treated with radiotherapy were retrospectively estimated. Methods and Materials: Sixty-five patients with cervical cancer (Stage I-IV) treated by irradiation were included in the study. Among the 65 cases, 2 were in Stage I, 13 in Stage II, 40 in Stage III, and 10 in Stage IV. Patients who received surgical resection were excluded. Thirty-nine patients received BOAI and 44 received brachytherapy. Twenty-six patients were not indicated for BOAI because of insufficient renal function, hepatic complications, hematological complications, and refusal from the patients. Cisplatin (0.9-1.7 mg/kg), Adriamycin (0.7-0.9 mg/kg), and Pepleomycin (0.4-0.6 mg/kg) were administered simultaneously into the bilateral internal iliac arteries by BOAI. External irradiation was given by 10 MV x-ray. Total dose administered to the regional lymph nodes by the external irradiation was 48.3 ± 8.7 Gy. Radium was used at brachytherapy. The dose delivered by the brachytherapy at point A was 45.3 ± 14.9 Gy. Patients without brachytherapy received 26.1 ± 19.1 Gy of boost irradiation by the external photon beam. The survival probabilities of the patients were calculated by Kaplan-Meier method. Results: The 5-year survival rates of the Stage III patients with and without BOAI were 53 ± 13% and 24 ± 18%, respectively (p = 0.036). By multivariate analyses using Cox's proportional hazard model, stage and BOAI were selected as significant predictors of the prognosis. Transient bone marrow suppression was observed in about half of the patients with BOAI. No significant increase of the incidence of the late radiation damage by BOAI in rectum or in urinary bladder was observed. Conclusion: Balloon occluded arterial infusion of anticancer drugs may improve the prognosis of the patients with cervical cancer without increasing the incidence of the late radiation damage. A larger scale prospective randomized study is desired

[en] Merits over demerits of combining chemotherapy (CT) and radiotherapy for primary brain malignant lymphoma (PBML) has recently been emphasized. In our institution solo-local brain irradiation (LB) supported with chemotherapy has been performed on four patients to avoid therapeutic brain damage. Results in radiotherapy in 17 patients with PBML from 1987 to 1995 were retrospectively analyzed. 16 patients completed the radiation schedule with consisting of 45.9±6.5 Gy. Among the 16 patients three were treated with whole brain irradiation (WB) nine with WBLB and the four LB. Complete disappearance (CR) was obtained in 81.3%. Early death occurred in 4 out of 5 patients with non-telencephalic, i.e., mid brain pontine and ventricular based lesions. Overall MST was 25.5 months. Disease free survival (DFS) was better in WB + WBLB group than LB (p<0.05). Averaged relapsing time was 24.8 month in WB + WBLB and 8.2 in LB. No statistical differences were found in survival rate between WB (+) and WB (-) and in DFS between CT (+) and CT (-). Activity index was improved in 7 but worsened in 4 patients after radiotherapy. In conclusion solo-local brain irradiation supported with chemotherapy did not show any merit than whole brain based therapy. (author)

[en] The purpose of this study was to explore the optimal contrast material (CM) concentration for distinguishing CM, carotid stent (CS), and neck components in cone-beam computed tomography (CBCT) during carotid angiography (CBCT-CA). A neck phantom containing CS and contrast-filled imitation vessels of 9 mm diameter was scanned using CBCT. CM (300 mgI/ml) was used in concentrations of 100, 50, 33, 10, 5, and 1%. In a clinical study, 30 patients with a CS (Precise or Wallstent) underwent CBCT-CA with CM injected at a rate of 3 ml/s and a concentration of 10 or 20%. In the basic study, CBCTA using 5% CM enabled clear distinction among the three components under windowing at 1500 width and 300 center, and showed the exact diameter of the imitation vessel. Pixel values of CM inside the Precise and the Wallstent were 622.2±32.9 (mean±SD) and 746.0±27.9, respectively. In the clinical study using CM at concentrations of 10 and 20%, pixel values of CM inside the Wallstent were 632.3±69.2 and 1024.5±99.0, respectively. Optimal CM concentration for distinguishing among the three components was 5% in the basic study; the optimal concentration was 10% in the clinical study. (author)