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Kazuro Sugimura

Publications and source records attributed to Kazuro Sugimura.

33 records · Page 2Linked to original sources
PubMed2002

Postsurgical pelvis: treatment follow-up.

Imaging for recurrence and complications of gynecologic malignancies following treatment with radical hysterectomy, chemotherapy, and radiation therapy has become an important determinant for treatment options available to patients. MR imaging and computed tomography can be used to provide evidence of limited local disease recurrence and thereby identify disease that is still potentially curable with adjuvant treatments. This article examines the imaging modalities currently used to detect recurrence and assist in making treatment changes for gynecologic malignancies and presents specific patient findings following definitive primary treatment of uterine cancer and ovarian cancer with radical hysterectomy, radiation therapy, or chemotherapy.

Endometrial Neoplasms↗
PubMed2002

A case with primary amyloidosis of the liver and spleen: radiologic findings.

A case with primary amyloidosis of the liver and spleen is presented. In the liver, ultrasonography showed heterogeneous echogenicity. Portal phase CT showed heterogeneous enhancement, and delayed phase CT showed delayed enhancement with focal hypoattenuating areas. Bone scintigraphy showed diffuse accumulation. In the spleen, arterial phase CT showed the lack of parenchymal enhancement, and T2-weighted MR imaging showed decreased signal intensity. The combination of imaging findings of the liver and spleen was suggestive of amyloidosis.

Aged↗
PubMed2002

Contrast-enhanced MR perfusion imaging and MR angiography: utility for management of pulmonary arteriovenous malformations for embolotherapy.

OBJECTIVE: The purpose of this study was to assess the capability of MR perfusion imaging and angiography (MRA) for management of pulmonary arteriovenous malformation (PAVM). METHODS AND PATIENTS: Eight patients, having 15 PAVMs underwent pulmonary angiography (PAG), CT, MR perfusion imaging and MRA. For the pretherapeutic management, MRA was compared with PAG and CT regarding detectability and diameter of vasculature. For post-therapeutic management, the change in size of aneurysmal sac, any residual contrast-enhancement and the blood supply within the sac were evaluated. RESULTS: All PAVMs with aneurysmal sac, feeding artery and draining vein diameters of equal to or more than 3 mm, were identified and measured with similar results by all modalities. On follow-up studies, 7 (58.4%) out of 12 treated PAVMs showed a decrease in size and residual contrast-enhancement. The residual contrast-enhancement was considered as bronchial artery-to-pulmonary artery collateral flow by MR perfusion imaging. CONCLUSION: MR perfusion imaging and MRangiography are useful for management of PAVMs over 3 mm in diameter.

Adolescent↗
PubMed2002

MR imaging of lung cancer.

Since publication of the Radiologic Diagnostic Oncology Group Report in 1991, the clinical application of pulmonary magnetic resonance (MR) imaging to patients with lung cancer has been limited. Computed tomography has been much more widely available for staging of lung cancer in clinical situations. Currently, ventilation and perfusion scintigraphy is the only modality that demonstrates pulmonary function while 2-[fluorine-18]-fluoro-2-deoxy-D-glucose positron emission tomography is the only modality that reveals biological glucose metabolism of lung cancer. However, recent advancements in MR imaging have made it possible to evaluate morphological and functional information in lung cancer patients more accurately and quantitatively. Pulmonary MR imaging may hold significant potential to substitute for nuclear medicine examinations. In this review, we describe recent advances in MR imaging of lung cancer, focusing on (1) characterization of solitary pulmonary nodules; (2) differentiation from secondary change; evaluation of (3) medastinal invasion, (4) chest wall invasion, (5) lymph node metastasis, and (6) distant metastasis; and (7) pulmonary functional imaging. We believe that further basic studies, as well as clinical applications of newer MR techniques, will play an important role in the management of patients with lung cancer.

Contrast Media↗
PubMed2002

Differentiation of metastatic versus non-metastatic mediastinal lymph nodes in patients with non-small cell lung cancer using respiratory-triggered short inversion time inversion recovery (STIR) turbo spin-echo MR imaging.

OBJECTIVES: To differentiate between metastatic and non-metastatic lymph nodes in patients with non-small cell lung cancer using respiratory-triggered short inversion time inversion recovery (STIR) turbo spin-echo (SE) MR imaging. METHODS AND PATIENTS: One hundred and forty mediastinal lymph nodes were detected in 25 patients with non-small cell lung cancer who underwent respiratory-triggered STIR turbo SE imaging. Ratios of signal intensity of lymph nodes to 0.9% saline phantoms (lymph node-saline ratio) were compared by Student's t-test using the pathological diagnosis as the gold standard. The threshold value of the lymph node-saline ratio was determined for a positive test, and tested for its capability to provide a differential diagnosis. RESULTS: One hundred and forty lymph nodes were diagnosed and classified into two groups: metastatic lymph node (n=21) and non-metastatic lymph node (n=119). The mean lymph node-saline ratio in the non-metastatic lymph node group (0.42+/-0.01; mean+/-standard error) was significantly lower than that of the metastatic lymph node group (0.77+/-0.02, P<0.0001). When 0.6 was adapted as the threshold for a positive test, sensitivity, specificity, and accuracy for differentiating metastatic lymph node from non-metastatic lymph node per lymph nodes were 100, 96, and 96%, and sensitivity, specificity, and accuracy for differentiating metastatic lymph node from non-metastatic lymph node per patients were 100, 75, and 88%, respectively. CONCLUSIONS: Both metastatic and non-metastatic lymph nodes in patients with non-small cell lung cancer were well differentiated using respiratory-triggered STIR turbo SE imaging.

Adult↗
PubMed2002

Neoadjuvant androgen withdrawal prior to external radiotherapy for locally advanced adenocarcinoma of the prostate.

BACKGROUND: It is unclear whether positive interactions between radiation and androgen withdrawal for patients with locally advanced prostate cancer is synergistic or additive. The present study aimed to clarify the significance of neoadjuvant androgen ablation prior to external radiotherapy in a human prostate LNCaP tumor model and in patients with locally advanced prostate cancer. METHODS: Comparisons were made between the effect of castration prior to radiation on the growth of subcutaneous LNCaP tumors implanted into male nude mice and their serum prostate-specific antigen (PSA) levels, and the results of castration or radiation alone. Twenty-nine patients with histologically proven and locally advanced adenocarcinoma of the prostate were treated with luteinizing hormone-releasing hormone analog at least 3 months before, during, and after external radiation therapy with a total dose of 70 Gy. The toxicity and response to this therapy were evaluated. RESULTS: Treatment combining castration and radiation resulted in synergistic inhibition of LNCaP tumor growth and a significant delay in the emergence of androgen-independent recurrence as opposed to either treatment alone. The external radiotherapy was completed in 28 patients (96.6%), resulting in a reduction of serum PSA levels in all 28 patients to below 1.0 ng/mL. All patients were alive after a mean follow-up period of 34 months (range 11-53) with a 3-year PSA relapse-free survival rate of 83.7%. Among several factors examined, only the Gleason score was significantly associated with PSA relapse-free survival in univariate analysis, but not in multivariate analysis. Thirteen of 28 patients (46%) and 7 of 28 (25%) also showed at least one form of gastrointestinal or genitourinary toxicity, respectively. Of these patients, 8 with gastrointestinal toxicities, and 1 with genitourinary toxicity, experienced acute complications higher than grade 3. CONCLUSION: The experimental findings objectively suggested the use of neoadjuvant androgen withdrawal prior to radiation therapy. Although our clinical experience is preliminary, combined androgen ablation and radiation therapy may also be effective in controlling locally advanced prostate cancer, with tolerable side-effects.

Adenocarcinoma↗
PubMed2002

Solitary pulmonary nodules: potential role of dynamic MR imaging in management initial experience.

PURPOSE: To evaluate the utility of dynamic magnetic resonance (MR) imaging in the management of solitary pulmonary nodules (SPNs). MATERIALS AND METHODS: Fifty-eight patients with 58 pathologic analysis-proved SPNs (diameter < 30 mm) underwent dynamic 1.5-T MR imaging. The 58 SPNs were classified into three groups at pathologic analysis: malignant SPNs (n = 38), active infections (n = 10), or benign SPNs (n = 10). From signal intensity-time curves generated after the bolus injection of contrast material, the maximum relative enhancement ratio and slope of enhancement were calculated and statistically compared among the three groups. Threshold values of these two dynamic MR indexes were determined on the basis of positive differentiations. RESULTS: The mean relative enhancement ratio and mean slope of enhancement for the malignant SPN group were significantly higher than those for the benign SPN group and significantly lower than those for the active infection group (P <.05). With 0.15 as the threshold maximum relative enhancement ratio for distinguishing the malignant SPN and active infection groups from the benign SPN group, the sensitivity, specificity, and accuracy were 100%, 70%, and 95%, respectively. With 0.025/sec as the threshold slope of enhancement, all SPNs with malignancy and active infection were clearly distinguished from benign SPNs. CONCLUSION: Dynamic MR indexes were useful in the differentiation between SPNs that necessitated further evaluation or treatment (malignancy and active infection) and SPNs that did not necessitate further evaluation or treatment (benign nodules).

Adolescent↗
PubMedDate not supplied

MR imaging of disorders associated with female infertility: use in diagnosis, treatment, and management.

Magnetic resonance (MR) imaging has extended the usefulness of imaging in evaluation of pelvic disorders associated with female infertility. The causes of female infertility include ovulatory disorders (ie, pituitary adenoma and polycystic ovarian syndrome), disorders of the fallopian tubes (ie, hydrosalpinx and pelvic inflammatory disease), uterine disorders (ie, müllerian duct anomaly, adenomyosis, and leiomyoma), and pelvic endometriosis. Although laparoscopy, hysteroscopy, hysterosalpingography, and transvaginal ultrasonography are the most effective techniques for evaluation of pelvic disorders related to female infertility, MR imaging is used in a variety of clinical settings in diagnosis, treatment, and management. The applications of MR imaging include evaluation of the functioning uterus and ovaries, visualization of pituitary adenomas, differentiation of müllerian duct anomalies, and accurate noninvasive diagnosis of adenomyosis, leiomyoma, and endometriosis. In addition, MR imaging helps predict the outcome of conservative treatment for adenomyosis, leiomyoma, and endometriosis and may lead to selection of better treatment plans and management. Finally, MR imaging may serve as an adjunct to diagnostic laparoscopy and hysterosalpingography in patients with hydrosalpinx, peritubal adhesions, or pelvic adhesions related to endometriosis.

Adult↗
PubMedDate not supplied

Comparison of magnetic resonance imaging and ultrasonography in the prenatal diagnosis of congenital thoracic abnormalities.

OBJECTIVES: To evaluate prenatal MRI in the diagnosis of fetal thoracic abnormalities and to determine whether MRI provides useful information in addition to that of ultrasonography (US). METHODS: Ultrafast MR scanning was performed in 7 pregnant women in whom US was suspicious of fetal congenital anomalies of the thorax [3 cases of congenital diaphragmatic hernia (CDH), 3 cases of chylothorax and 1 case of congenital cystic adenomatoid malformation (CCAM) type III]. The presence, position, size and characteristics of the congenital lesions were determined and compared with postnatal diagnoses. RESULTS: The MRI diagnoses were 3 cases of CDH, 2 of chylothorax and one each of esophageal atresia and CCAM type III. The results of MRI were in agreement with those of US in 6 cases and in disagreement in 1 case of esophageal atresia. Final diagnoses were confirmed at surgery or autopsy in all fetuses. Combined use of MR and US imaging enabled a correct diagnosis in 5 cases and led to an error in the diagnosis of 1 fetus with bronchial stenosis, which had been diagnosed as CCAM type III by US and MRI. MRI led to a correct diagnosis in 1 fetus with esophageal atresia, in whom US had been equivocal in the prenatal diagnosis. CONCLUSION: MRI helped further characterize the fetal thoracic lesions and confirmed or changed the prenatal diagnosis based on US. MRI seems to be powerful in the prenatal diagnosis of thoracic lesions that are atypical or complicated by multiple abnormalities.

Adult↗
PubMedDate not supplied

Radiotherapy for medically inoperable non-small cell lung cancer at clinical stage I and II.

We reviewed the records of 36 patients with medically inoperable stage I-II non-small cell lung carcinoma who were treated with radiotherapy. The median dose to the target was 60 Gy with conventional fractionation. Fifteen patients were treated without elective irradiation fields, while the remaining 21 were treated with extended fields including elective mediastinal regional lymph nodes. The overall survival rates at three and five years were 32.3% and 18.8%, the cause-specific survival rates were 40.9% and 27.3%, and the local control rates were 31.7% and 23.8%, respectively. In multivariate analysis the radiation dose had a marginally significant influence on the cause-specific survival, while tumor size had a significant influence on the local control rate. Only one patient had relapse in the regional mediastinal lymph nodes as the only site of metastasis. We conclude that the dose used in the present study is inadequate and recommend that further efforts be made to improve local control by dose escalation within a small target volume.

Aged↗
PubMedDate not supplied

Double cancer, cholangiocellular and hepatocellular carcinomas, in the cirrhotic liver.

A 70-year-old male patient presented with cirrhotic liver caused by hepatitis C virus and complicated with hepatocellular carcinoma. The carcinoma was effectively treated by transarterial chemoembolization, but cholangiocellular carcinoma occurred in a different segment of the liver and rapidly grew and metastasized systemically. He died 13 months after the first admission. Double cancer of the liver is uncommon, but it must be considered in the differential diagnosis of cases of hepatocellular carcinoma associated with chronic hepatitis or cirrhosis. Failure to note the occurrence of cholangiocellular carcinoma is thought to be a diagnostic pitfall in the follow-up studies of patients with hepatocellular carcinoma.

Aged↗