Search PubMed⌕ Search

Biomedical subjects

E M Sager

Publications and source records attributed to E M Sager.

31 records · Page 2Linked to original sources

The role of CT in demonstrating perivesical tumor growth in the preoperative staging of carcinoma of the urinary bladder.

Carcinoma of the urinary bladder was staged both clinically and by CT in 32 patients before they underwent total cystectomy. Eleven of the patients had perivesical growth demonstrated at histopathological examination of the cystectomy specimen. This was diagnosed by CT in all 11 of these patients before cystectomy, but it was discovered by clinical staging in only four patients prior to cystectomy. Seven patients without histopathologically proved perivesical growth were considered to have perivesical spread as demonstrated by CT findings. Three of these patients had perivesical fibrosis that was misinterpreted as perivesical tumor growth, and in all seven patients the perivesical changes were adjacent to the area of present or previous changes in the bladder wall. CT is a valuable addition to clinical staging because it demonstrates perivesical tumor growth.

Carcinoma↗

Lymphography following complete dissection of iliac lymph nodes.

Twenty-five patients with carcinoma of the uterine cervix stage I were treated by radical hysterectomy and complete iliac lymph node dissection. None of the patients had postoperative lymphedema. Postoperative lymphography was performed in 6 of the patients. The flow time of contrast medium from the foot to the inguinal region was compared with that of a control group. Five different postoperative flow patterns were observed. No delay of the flow was found.

Collateral Circulation↗

Increased detectability of liver metastases by the use of contrast enhancement in computed tomography. A comparison between the precontrast, the immediate postcontrast and the one hour postcontrast scan.

The precontrast, immediate postcontrast and the one hour postcontrast CT scans were analysed in search for liver metastases in 75 patients with malignant disease. The use of high dose intravenous contrast medium (42 g I) increased the number of hepatic metastases detected. The one hour postcontrast scan revealed a few more lesions than the immediate postcontrast scan. Further investigations on this subject are necessary before any definite conclusions can be made as our series of patients is small. In routine CT the most practical procedure in search for liver metastases is: 1) Scanning of the liver without contrast medium. 2) Incremental dynamic scanning during and immediately following injection of contrast medium. 3) If there is still uncertainty: Scanning at a later time, for example at one hour after injection of contrast medium.

Contrast Media↗

Positioning of temperature measurement points using multiplanar computed tomography.

A method is described for the use of computed tomography and multiplanar reconstruction to depict in single images the full course of obliquely running thermometry catheters. In 14 patients given thermoradiotherapy for locally advanced breast carcinoma, reformatted images of the full catheter course were obtained for all 98 catheters so far tested. The main clinical advantage of this time-consuming procedure was the ability to determine the localization within the catheters of individual temperature measurement points of multipoint thermistor probes. It was also possible to study the localization of the measurement points in relation to the tumour margins.

Breast Neoplasms↗

Absorbed dose resulting from a specially designed computed tomography technique for examination of the urinary bladder.

The absorbed spatial dose distribution resulting from a specially designed CT protocol for examination of the urinary bladder has been investigated with TLD rods in a body phantom containing tissue equivalent material. The CT examination consisted of scout view and both pre- and postcontrast scan series with 5 mm slice thickness and 5 mm unscanned intervals between successive scans. Cross-sectional dose distribution for one scan in the plane of the ovaries was measured as well as the dose profile for one scan along a line through the ovary parallel to the axis of rotation. Based on these measurements, the dose resulting from the whole CT examination was calculated, both with contiguous and noncontiguous scans. The ovarian dose was calculated for different positions of the ovaries in relation to the scanned area. The absorbed dose varied between 8.3 mGy and 9.7 mGy with the actual technique used. When contiguous scans with the same thickness were taken, the ovarian dose increased with a factor from 1.7 to 1.9. The dose resulting from the CT protocol of the urinary bladder was of the same magnitude as absorbed dose resulting from urography. When the diagnostic gain from a precise definition of tumor extent was taken into account, the dose resulting from the CT protocol was judged acceptable.

Female↗

Contrast-enhanced computed tomography in carcinoma of the urinary bladder. The use of different injection methods.

Computed tomography (CT) scans of the urinary bladder were taken before and in combination with intravenous contrast medium injection in 30 patients with invasive bladder carcinoma. Three different ways of injecting the same amount of intravenous contrast material were used in three groups, each consisting of ten patients. In the first group the contrast medium was given during 90 seconds, in the second group during 40 seconds and in the third one, the first half during 20 seconds and the second half during 90 seconds. The attenuation in the tumors and in the bladder wall was measured in Hounsfield units. Independent of injection method, all tumors showed significantly higher contrast enhancement than the bladder wall when the injection was terminated. The difference in contrast enhancement was greatest in the group where the shortest injection time was used and greatest immediately after the conclusion of the injection. The difference in contrast enhancement between tumor and bladder wall was visible on the monitor in all cases.

Contrast Media↗

Contrast-enhanced computed tomography to show perivesical extension in bladder carcinoma.

Fifty-two patients (53 lesions) with muscle invasive carcinoma (T2/T3) of the urinary bladder were examined with computed tomography (CT) before planned total cystectomy. The object of CT was to demonstrate perivesical growth. All patients were examined before and after intravenous injection of contrast medium. The stages obtained from the precontrast and postcontrast scans were compared with the histopathologic stage from the cystectomy specimen. CT staged correctly 35 of the 53 lesions in the precontrast series and 46 of the 53 lesions in the postcontrast series. The improved accuracy from contrast enhancement resulted primarily from fewer cases being overstaged. The use of intravenous contrast medium improved accuracy of CT in evaluation of perivesical tumor growth.

Adenocarcinoma↗

Computed tomography of invasive bladder carcinoma after diagnostic transurethral resection.

Fourteen patients with known muscle invasive bladder carcinoma were examined with computed tomography (CT) before and five to seven days after diagnostic transurethral resection (TUR). The CT examinations included pre- and postcontrast series. In order to standardize the technique, we examined on a distended bladder. No significant changes occurred for the whole group after TUR. Individual changes were seen. In six patients the largest measured area of the bladder tumor increased after resection and in four the largest measured thickness increased, and this should be borne in mind when CT is used to evaluate tumor response to treatment. Perivesical changes occurred only after extensive diathermy or perforation. They did not show contrast enhancement and could therefore not be mistaken for tumor growth.

Aged↗

Inherited predisposition to breast carcinoma. Results of first round examination of 537 women at risk.

Five hundred and thirty seven women at risk for breast carcinoma were identified. Family history was detailed and each woman given genetic counselling. Diagnostic examination for breast carcinoma was performed at the major hospitals of Norway, and included physical examination by expert surgeon, mammography and/or ultrasonography, and fine needle aspiration cytology when appropriate. Altogether 8 carcinomas and 5 cases of atypical hyperplasia were found, compared with 1.6 and 0.3 expected, respectively, from population studies. The finding exceeded the expected numbers described by autosomal dominant inheritance. In addition we found one carcinoma in situ. It is concluded that the methods employed are suitable to identify and examine women at risk for breast carcinoma. It is suggested that atypical hyperplasia may be the precancerous lesion, and should be treated as such.

Adult↗