Nobuo Akamatsu

Endometrial carcinoma: Dynamic MRI with turbo-FLASH technique

PURPOSE Our goal was to investigate the usefulness of dynamic MRI with the turbo-FLASH technique in estimating myometrial invasion by endometrial carcinoma. METHOD Forty-six patients with endometrial carcinomas were evaluated with pathologic correlation. Dynamic MRI was performed with the rapid administration of Gd-DTPA using the turbo-FLASH technique. RESULTS The inner muscle layer showed more rapid contrast enhancement effects than the outer muscle layer even after menopause. Contrast-to-noise ratio between the inner muscle layer and endometrial carcinoma was maximum at approximately 50 s after administration of Gd-DTPA. In postmenopausal women, the accuracy in estimating myometrial invasion with T2-weighted images, contrast-enhanced T1-weighted images, and dynamic MRI was 66.7, 77.8, and 92.6%, respectively. CONCLUSION Dynamic MRI with the turbo-FLASH technique is considered to be a useful imaging method for the estimation of myometrial invasion by endometrial carcinoma, especially in postmenopausal patients.

Phase II study of intraperitoneal carboplatin with intravenous paclitaxel in patients with suboptimal residual epithelial ovarian or primary peritoneal cancer: a Sankai Gynecology Cancer Study Group Study.

Purpose: To assess the antitumor efficacy and safety of 2 treatment modalities: intraperitoneal carboplatin combined with intravenous (IV) paclitaxel. Patients and Methods: Eligible patients were those with epithelial ovarian carcinoma or primary peritoneal carcinoma stages II to IV who underwent initial surgery and had a residual tumor size of 2 cm or larger. Patients received IV paclitaxel 175 mg/m2 followed by intraperitoneal carboplatin AUC6. The primary end point was a response. Secondary end points were toxicity, progression-free survival, and overall survival. Results: Twenty-six patients were enrolled, and 24 patients were eligible for assessment. The response rate was 83.3% (95% CI, 62.6%-95.3%; Table 4). The median progression-free survival was 25 months. The median overall survival had not been reached. Incidences of grade (G) 3/4 hematological toxicities were absolute neutrophil count, 96%; hemoglobin, 29%; and thrombocytopenia, 16%. Nonhematological toxicities included G2 liver function, 4%; G3 sensory neuropathy, 8%; and G3 myalgia and arthralgia, 4%. Conclusions: Intraperitoneal administration of carboplatin combined with IV paclitaxel was well tolerated and showed satisfactory response in the patients with bulky residual tumor. Large-scale phase III trial comparing with IV carboplatin is warranted in this patient population.

MR appearance of adenomatoid tumor of the uterus.

Reports on the radiological findings of adenomatoid tumor of the uterus are rare, and preoperative diagnosis is very difficult. To our knowledge, there have been no reports concerning the MR findings of adenomatoid tumor of the uterus. We report two cases of uterine adenomatoid tumor that showed the characteristic features of leiomyoma on MR images.

Sclerosing stromal tumor of the ovary with atypical magnetic resonance imaging findings in a middle-aged woman

We encountered a case of atypical sclerosing stromal tumor of the ovary (SST) in a middle-aged woman. This 52-year-old woman presented with a 2-year history of abdominal distention. Magnetic resonance imaging (MRI) showed a large mass extending from the pelvis to the epigastrium. T2-weighted MRI showed an island-shaped area of slight hyperintensity. Dynamic MRI demonstrated gradual light enhancement of the area in which T2-weighted imaging showed low intensity. The diagnosis of the tumor proved difficult because neither MRI findings nor the age of getting sick were atypical. We report this case with MRI findings and correlated pathology.

Ultrasound Estimation of Myometrial Invasion of Endometrial Cancer by Intrauterine Radial Scanning

The myometrial invasion of endometrial cancer was estimated by using intrauterine radial-scan ultrasonography and classified into the following four groups: no myometrial invasion, superficial invasion (below one-third), moderate invasion (above one-third but below two-thirds), and deep invasion (above two-thirds). The myometrial invasions were further examined histologically on the removed uterus. In 26 of 32 cases (81.3%), estimations by intrauterine radial scans agreed with the histologic assessment. In each of the remaining six cases, estimations by radial scans were lower than those by histologic examination.