Ken Ono

Comparison of diffusion-weighted MRI and 2-[fluorine-18]-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) for detecting primary colorectal cancer and regional lymph node metastases.

To examine the usefulness of diffusion‐weighted MRI (DW‐MRI) for the detection of both primary colorectal cancer and regional lymph node metastases, and compare its performance with 2‐[fluorine‐18]‐fluoro‐2‐deoxy‐D‐glucose positron emission tomography (FDG‐PET) in the same patients.

Intraarterial Chemotherapy or Chemoembolization for Locally Advanced and/or Recurrent Hepatic Tumors: Evaluation of the Feeding Artery with an Interventional CT System

AbstractPurpose: To evaluate the utility of an interventional CT system for intraarterial chemotherapy or chemoembolization for locally advanced and/or recurrent hepatic tumors. Methods: Thirty-eight patients with locally advanced or recurrent hepatic tumors underwent 73 intraarterial contrast-enhanced CT (IA-CECT) examinations immediately before chemotherapy or chemoembolization. The degree of tumor vascularity on angiography and enhancement on IA-CECT was classified into three grades: no, mild, or marked vascularity. The IA-CECT grades were compared with the angiographic grades. Results: Twenty-nine (69%) of 42 examinations that were interpreted as having no or mild vascularity on angiography were classified as marked enhancement on IA-CECT. Based on IA-CECT findings, the position of the catheter was changed in 14 (19%) of 73 CT examinations. The reasons for the reposition were as follows: weak or no enhancement of the tumor (n = 11) or strong enhancement of the gallbladder wall (n = 3). The treatment strategy was changed in three patients (8%). No major complications relating to the interventional procedures were observed. Conclusions: IA-CECT is a reliable method when evaluating the perfusion of the tumor and adjacent normal tissues. The interventional CT system is useful for performing safe and effective intraarterial chemotherapy or chemoembolization in patients with locally advanced and/or recurrent hepatic tumors.

A case of diffuse-type primary hepatic lymphoma mimicking diffuse hepatocellular carcinoma

Primary hepatic lymphoma (PHL) is a very rare disease, especially in the diffuse type. We report a case of a middle-aged man with hepatitis C virus infection who developed diffuse-type PHL mimicking diffuse hepatocellular carcinoma (HCC). Contrast-enhanced computed tomography (CT) and magnetic resonance imaging showed diffusely infiltrated hypovascular lesions throughout the liver, but no intrahepatic portal venous thrombus was observed. Diffusion-weighted imaging and 18F-FDG positron emission tomography/CT, respectively, showed a very low apparent diffusion coefficient value and high FDG uptake. These findings were more suggestive of diffuse-type PHL than diffuse HCC. Liver biopsy examination confirmed a diagnosis of diffuse large B-cell lymphoma. Systemic staging revealed no evidence of nodal or bone marrow involvement, so PHL was diagnosed. The patient was treated with chemotherapy and achieved complete remission. We suggest that a combination of image modalities may enable differentiation of diffuse-type PHL from diffuse HCC.

The detection rates and tumor clinical/pathological stages of whole-body FDG-PET cancer screening

Objective: FDG-PET has been used for cancer screening, mainly in East-Asia, and cancers are found not infrequently. However, their stages have not been clarified. We examined the detection rates of various cancers using whole-body PET for the screening of cancers in asymptomatic individuals, focusing on their clinical and pathological stages.Methods: Whole-body PET was obtained as a part of our cancer screening program among 3,426 healthy subjects. All subjects participated in a course of PET examination in conjunction with conventional examinations including a medical questionnaire, tumor markers, immunological fecal occult blood test, neck and abdominal ultrasonography and whole body computed tomography. A diagnosis and staging was obtained by an analysis of the pathological findings or by an analysis of the clinical follow-up data.Results: Malignant tumors were discovered in 65 lesions found in 3,426 participants (1.90%). The PET findings were true-positive in 46 of the 65 cancer cases. The cancers were found in the following organs: the colon 14; thyroid gland 10; stomach 7; lung 5; liver 3; breast 2; and one each in the kidney, gallbladder, esophagus, pancreas and retroperitoneum. The stages were as follows: stage 0 5, stage I 17, stage II 10, stage III 7, and stage IV 6. One was an unknown primary. There were 19 false-negative findings (0.6%) on PET. Six cancers (0.18%) were missed in our screening program.Conclusions: PET imaging has the potential to detect a wide variety of cancers at potentially curative stages. Most PET-negative cancers are early stage cancers, and thus can be detected using other conventional examinations such as endoscopy.

Chest wall and axillary lymph node FDG uptake associated with cancer vaccine therapy for lung cancer.

Cancer vaccines are now undergoing clinical investigations, and clinical trials of therapeutic cancer vaccines have been conducted mainly for advanced cancer patients. We experienced 2 cases of multifocal F-18 fluoro-2-deoxy-D-glucose uptake in the chest wall and axillary lymph nodes associated with personalized peptide vaccine therapy for recurrent lung cancer. In this article, we report fluoro-2-deoxy-D-glucose -positron emission tomography and positron emission tomography/computed tomography findings.

Evaluation of vascular supply with angio-computed tomography during intra-arterial chemotherapy for brain tumors

We report the utility of a combined angiography and computed tomography (angio-CT) system in assessing drug distribution to the tumor during intra-arterial chemotherapy for metastatic brain tumors in a 65-year-old man. Although digital subtraction angiography did not clearly show tumor perfusion in two cerebellar tumors, angio-CT provided definite tumor perfusion in the complicated vascular territory, and anticancer agents were infused based on its findings. To our knowledge, however, this application for intra-arterial chemotherapy of brain tumors has not been previously described.