Noboru Shindoh

Stabilization of a Percutaneously Implanted Port Catheter System for Hepatic Artery Chemotherapy Infusion

A port catheter system for hepatic artery infusion chemotherapy was implanted percutaneously via the left subclavian artery in 41 patients for treatment of unresectable liver metastases. The catheter tip was inserted into the gastroduodenal artery (GDA), the end hole was occluded with a guidewire fragment, and a side-hole for infusion was positioned at the bifurcation of the proper hepatic artery and the GDA. The GDA was embolized with steel coils around the infusion catheter tip via a transfemoral catheter. This procedure is designed to reduce the incidence of hepatic artery occlusion and infusion catheter dislocation.

Spontaneous intracranial hypotension: characteristic findings of radionuclide cisternography using In-111 DTPA

The authors describe two patients with spontaneous intracranial hypotension. The patients had the cardinal features of a postural headache. In both patients, radionuclide cisternography revealed cerebrospinal fluid (CSF) leakage at the cervicothoracic junction and early accumulation of isotope in the urinary tract. Postmyelography CT scans showed no underlying structural abnormalities. Both patients were treated successfully by intravenous infusion of low-osmolarity fluid. Radionuclide cisternography obtained after treatment in one of the patients showed that the CSF leak had disappeared. Radionuclide cisternography enabled the causes of spontaneous intracranial hypotension to be differentiated and visualized the sites of CSF leakage. It was also useful for evaluating changes in a CSF leak after treatment. FIGURE 1 FIGURE 2

Emphysematous pyelonephritis— conversion of type i to type II appearance on serial CT studies

Recently, emphysematous pyelonephritis (EPN) has been classified into two subtypes based on CT findings. We recently experienced a patient whose CT image changed from type I (extensive destruction of the renal parenchyma with a large amount of air density without any fluid collection) to type II (containing a large amount of fluid) during the course of conservative treatment. We believe that some patients with type I EPN can change to type II EPN.

Tuberculosis peritonitis: Gallium-67 scintigraphic appearance

Tuberculosis peritonitis is a rare manifestation of extrapulmonary tuberculosis. The results of gallium-67 scintigraphy of three patients with tuberculosis peritonitis were reviewed to assess its usefulness in the diagnosis of this condition. Tuberculosis peritonitis was associated with diffuse or focal abdominal localization and decreased hepatic accumulation of gallium-67. These gallium-67 scan features of tuberculosis peritonitis may help to optimize the diagnosis and management of this disease.

Paratesticular aggressive fibromatosis: CT findings

Aggressive fibromatoses commonly originate from the musculoskeletal system, mesentery, and retroperitoneum. We report a case of aggressive fibromatosis arising from the spermatic cord. On helical computed tomography, the lesion appeared as a solid mass with well-defined borders in the scrotum and with infiltrative features in the retroperitoneum.

Gallium-67 uptake in Bellini duct carcinoma of the kidney

Bellini duct carcinoma is a rare variant of renal cell carcinoma and usually has a poor prognosis. In this article, we report the Gallium-67 citrate (Ga-67) uptake in Bellini duct carcinoma. To our knowledge, this is the second reported case of Bellini duct carcinoma in which Ga-67 uptake was positive. We suggest that Ga-67 scintigraphy has potential utility in detecting Bellini duct carcinoma of the kidney. And if a hypovascular tumor of the kidney shows Ga-67 uptake, Bellini duct carcinoma should be included in the differential diagnosis.

Usefulness of thallium-201 SPECT imaging for the evaluation of local recurrence of colorectal cancer

PurposeTo clarify the accumulation of thallium-201 in recurrent tumors in patients who had undergone resection of colorectal cancer and to evaluate the usefulness of thallium-201 single photon emission computed tomography (SPECT) images for distinguishing recurrent tumors from postoperative changes.Materials and MethodsThallium-201 SPECT images and CT images of 22 consecutive patients suspected to have local recurrence of colorectal cancer based on clinical symptoms and signs were reviewed. CT was performed on all patients.ResultsIn nine of the 11 patients who had local recurrence, SPECT images showed positive thallium uptake, but in 10 of the 11 patients confirmed to have no recurrence, SPECT images showed negative thallium uptake. Sensitivity was 81.8% (9/11) specificity was 90.9% (10/11), and accuracy was 86.4% (19/22). There were five patients in whom CT results were inconclusive. All of them had rectal cancer and had undergone Miles’ operation, and all were correctly diagnosed by thallium-201 SPECT.ConclusionThallium-201 exhibited intense uptake in recurrent colorectal cancer. Thallium-201 SPECT is considered to be a useful diagnostic tool for the detection of recurrence of colorectal cancer, particularly in patients with inconclusive CT results.