Masaomi Kuroki

Comparison of diagnostic and prognostic capabilities of 18F-FDG-PET/CT, 131I-scintigraphy, and diffusion-weighted magnetic resonance imaging for postoperative thyroid cancer

PurposeThe first aim of this study was to compare the detectability of metastasis of postoperative differentiated thyroid cancer (DTC) among 131I whole body scintigraphy (IWBS), fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT), and diffusion-weighted magnetic resonance imaging (DWI). The second aim was to clarify the association between the image pattern and prognosis.Materials and methodsWe evaluated 70 postoperative DTC patients on both a patient basis and an organ basis (lymph nodes, lung, bone), and we analyzed the correlation between the image pattern and the prognosis.ResultsFor the patient-basis analysis, the detectability by IWBS, PET/CT, and DWI was 67.1%, 84.2%, and 57.6%, respectively. IWBS provided complementary information to that provided by PET/CT in 11 of 70 (15.7%) cases. For the organ-basis analysis, IWBS was the best detector for lymph node metastasis (72.4%). PET/CT was superior to IWBS for detecting metastasis of bone (85.7% vs. 71.4%) and lung (94.1% vs. 62.7%). For the correlation analysis, PET and DWI positivity were the factors predicting a poor prognosis.ConclusionPET/CT was the best modality for detecting metastases in postoperative DTC patients, although IWBS provided complementary information. Because PET/CT and DWI gave similar information (e.g., positivity) suggesting poor prognoses, the combination of IWBS and DWI might be the method of choice for monitoring postoperative DTC.

High-resolution computed tomography findings of P. westermani.

Paragonimiasis westermani, or Oriental lung fluke, is a common parasitic zoonosis, which is acquired from eating the flesh of wild boar or freshwater crabs. After being ingested by humans, the larvae of P. westermani migrate across small intestinal mucosa into the intra-abdominal space, and then finally into to the pleural space and lung parenchyma. High-resolution CT findings of P. westermani consist of worm cysts, migration track, peripheral density, bronchial wall thickening, and centrilobular nodules, which prompt serological tests and detection of eggs in sputum or BAL fluid for definitive diagnosis.

Incidence of pulmonary embolism in younger versus older patients using CT.

Objective The aim of this study is to compare the incidence of pulmonary embolism (PE) on computed tomography (CT) studies between younger and older patients to determine if there is an age-related bias for overutilization of CT pulmonary angiography (CTPA) in younger patients. Material and Methods Six hundred thirty-one consecutive CTPA cases for suspected acute PE between 11/10/2003 and 3/19/2004 were retrospectively studied. Of these 631 cases, 59 patients were found to have clots in the pulmonary arteries (ranging from central to subsegmental PA). CTPA was performed using multidetector CT at 1.25-mm collimation, 120 kVp, 320 mA. Patients were categorized by gender and age: A, less than 20 (n=11); B, 20 to 29 (n=44); C, 30 to 39 (n=59); D, 40 to 49 (n=90); E, 50 to 59 (n=120); F, 60 to 69 (n=114); G, 70 to 79 (n=104); H, 80 to 89 (n=72); I, 90 or more (n=21). The incidences of PE were calculated in each gender and age group. To compare the incidence of PE between younger and older groups, they were divided into 2 groups at the ages of 40 (<39 and ≥40), 50 (<49 and ≥50), and 60 (<59 and ≥60). Statistical analysis was performed using the χ2 test. Results The incidences of PE were 11.9% in males (A, 0%; B, 17.6%; C, 10%; D, 8.3%; E, 13.3%; F, 6.9%; G, 17.5%; H, 23.5%; I, 0%), 7.7% in females (A, 0%; B, 7.4%; C, 5.1%; D, 12.5%; E, 4.2%; F, 14.5%; G, 7.8%; H, 5.5%; I, 0%), and 9.4% in total patients (A, 0%; B, 11.1%; C, 6.8%; D, 11.1%; E, 7.5%; F, 10.5%; G, 11.5%; H, 9.7%; I, 0%). No significant differences in the incidences of PE were observed when patients were divided at the age of 40 (male, female, total; P=1.0, 0.6252, 0.7220), at the age of 50 (male, female, total; P=0.6748, 0.6879, 1.0), or at the age of 60 (male, female, total; P=0.8458, 0.7046, 0.6820). Conclusion No statistically significant difference in the incidence of PE was observed between younger and older patients. Our findings suggest that there is no age-related bias for overutilization of CT angiography (CTA) in younger patients.