Tadateru Sumi

Salivary Gland Tumors: Use of Intravoxel Incoherent Motion MR Imaging for Assessment of Diffusion and Perfusion for the Differentiation of Benign from Malignant Tumors

PURPOSE To prospectively evaluate the intravoxel incoherent motion (IVIM) parameters (microvascular volume fraction, f; pure diffusion coefficient, D; and perfusion-related incoherent microcirculation, D*) for differentiating between benign and malignant salivary gland tumors. MATERIALS AND METHODS All participants in this prospective institutional review board-approved study provided written informed consent. The perfusion and diffusion of 20 (65%) benign (12 pleomorphic adenomas and eight Warthin tumors) and 11 (35%) malignant salivary gland tumors were assessed on the basis of the IVIM theory. Diffusion-weighted magnetic resonance imaging was performed by using 11 b values (0-800 sec/mm(2)). The IVIM parameters of the salivary gland tumors were determined by a radiologist, and significant differences between the tumor types were assessed by using the Steel-Dwass test. RESULTS The f values of Warthin tumors (0.156 ± 0.039 [standard deviation]) were significantly larger than those of pleomorphic adenomas (0.066 ± 0.031) (P = .003). The D values of malignant tumors (0.96 × 10(-3) mm(2)/sec ± 0.22) were significantly different from those of benign tumors (pleomorphic adenomas, 1.38 × 10(-3) mm(2)/sec ± 0.30 [P = .002]; Warthin tumors, 0.61 × 10(-3) mm(2)/sec ± 0.11 [P = .005]). The D* values of malignant tumors (21.99 × 10(-3) mm(2)/sec ± 19.01) were significantly smaller than those of Warthin tumors (42.64 × 10(-3) mm(2)/sec ± 20.17) (P = .022). The combination of D and D* criteria provided the best diagnostic accuracy (100%) for differentiation among the three tumor types. CONCLUSION IVIM imaging may be helpful for differentiation between benign and malignant salivary gland tumors.

Efficacy of Diffusion-Weighted Imaging for the Differentiation between Lymphomas and Carcinomas of the Nasopharynx and Oropharynx: Correlations of Apparent Diffusion Coefficients and Histologic Features

BACKGROUND AND PURPOSE: ADCs may help distinguish benign from malignant head and neck diseases. We sought to evaluate the effectiveness of ADC for differentiating between carcinomas and lymphomas of the nasopharynx and oropharynx. MATERIALS AND METHODS: We retrospectively compared the ADCs between 24 histologically proved lymphomas and 32 carcinomas, including 8 NPCs and 7 lymphomas of the nasopharynx, and 24 SCCs and 17 lymphomas of the oropharynx. ADCs were determined on tumor-by-tumor (overall ADCs) and pixel-by-pixel (ADC mapping) bases by using 2 b-values (500 and 1000 s/mm2). RESULTS: Lymphomas and oropharyngeal SCCs had unique histologic features in terms of keratinization, cell attenuation, stromal areas, and necrosis and had distinctive ADCs (0.503 ± 0.099 × 10−3 mm2/s for lymphomas and 0.842 ± 0.164 × 10−3 mm2/s for SCCs). However, NPCs and lymphomas were similar in terms of these histologic features, exhibiting comparable ADCs (0.567 ± 0.057 × 10−3 mm2/s for NPCs and 0.528 ± 0.094 × 10−3 mm2/s for lymphomas). Poorly and moderately differentiated SCCs with homogeneous T2 signals were indistinguishable from lymphomas on conventional MR images; however, ADCs of these SCC subtypes were significantly larger than those of lymphomas. ADC mapping profiles with respect to percentage of tumor areas of extremely low, intermediate, and high ADC levels were well-correlated with the histologic features of lymphomas, NPCs, and different types of SCCs. CONCLUSIONS: The effectiveness of ADC-based differentiation between lymphomas and carcinomas of the nasopharynx and oropharynx depends on their histologic characteristics.

Ionizing Radiation Induces Macrophage Foam Cell Formation and Aggregation Through JNK-Dependent Activation of CD36 Scavenger Receptors

PURPOSE Irradiated arteries of cancer patients can be associated with atherosclerosis-like lesions containing cholesterol-laden macrophages (foam cells). Endothelial cell damage by irradiation does not completely explain the foam cell formation. We investigated the possible underlying mechanisms for ionizing radiation (IR)-induced foam cell formation. METHODS AND MATERIALS Human peripheral blood monocytes were activated by macrophage colony-stimulating factor and then treated with varying doses of IR in vitro in the absence of endothelial cells. Scavenger receptor expression and foam cell formation of IR-treated macrophages were investigated in the presence or absence of oxidized low-density lipoprotein. We also assessed the importance of mitogen-activated protein kinase activity in the macrophage colony-stimulating factor-activated human monocytes (macrophages) for the foam cell formation. RESULTS We found that IR treatment of macrophage colony-stimulating factor-activated human peripheral blood monocytes resulted in the enhanced expression of CD36 scavenger receptors and that cholesterol accumulated in the irradiated macrophages with resultant foam cell formation in the presence of oxidized low-density lipoprotein. Furthermore, when cultured on collagen gels, human macrophages formed large foam cell aggregates in response to IR. Antibodies against CD36 inhibited the IR-induced foam cell formation and aggregation, indicating that the IR-induced foam cell formation and the subsequent aggregation are dependent on functional CD36. In addition, we found that IR of human macrophages resulted in c-Jun N-terminal kinase activation and that c-Jun N-terminal kinase inhibition suppressed IR-induced CD36 expression and the subsequent foam cell formation and aggregation. CONCLUSION Taken together, these results suggest that IR-induced foam cell formation is mediated by c-Jun N-terminal kinase-dependent CD36 activation.

Diagnostic performance of MRI relative to CT for metastatic nodes of head and neck squamous cell carcinomas

To compare the diagnostic abilities of magnetic resonance imaging (MRI) and computed tomography (CT) based on the architectural changes in the nodal parenchyma.

Multiparametric MR Imaging of Sinonasal Diseases: Time-Signal Intensity Curve– and Apparent Diffusion Coefficient–Based Differentiation between Benign and Malignant Lesions

BACKGROUND AND PURPOSE: The sinonasal region is a platform for a broad spectrum of benign and malignant diseases, and image-based differentiation between benign and malignant diseases in this area is often difficult. Here, we evaluated multiparametric MR imaging with combined use of TICs and ADCs for the differentiation between benign and malignant sinonasal tumors and tumorlike diseases. MATERIALS AND METHODS: TICs obtained from dynamic contrast-enhanced MR imaging and ADCs were analyzed on a lesion-by-lesion (overall TIC and ADC) and pixel-by-pixel (TIC and ADC mapping) basis in patients with benign (n = 21) or malignant (n = 23) sinonasal tumors and tumorlike diseases. The TICs were semiautomatically classified into 5 distinctive patterns (flat, slow uptake, rapid uptake with low washout ratio, rapid uptake with high washout ratio, and miscellaneous). ADCs were determined by using b-values of 500 and 1000 s/mm2. RESULTS: Malignant sinonasal tumors had small (<25%) areas of the type 1 flat TIC profile as determined by pixel-by-pixel TIC analysis and large (≥50%) areas of low or extremely low ADCs (≤1.2 × 10−3 mm2/s) as determined by ADC mapping. Consequently, stepwise classification on the basis of TICs and ADCs successfully (at 100% accuracy) discriminated malignant from benign sinonasal diseases in the present patient cohort. CONCLUSIONS: Multiparametric MR imaging by using TICs and ADCs may help differentiate benign and malignant sinonasal diseases.

Parallel imaging technique for the external carotid artery and its branches: Comparison of balanced turbo field echo, phase contrast, and time-of-flight sequences

To evaluate the parallel imaging technique in the external carotid artery and its branches using 3D balanced turbo field echo (3D bTFE), 3D phase‐contrast (3D PC), and 3D time‐of‐flight (3D TOF) MR angiography (MRA) sequences.

Imaging features of the lacrimal and salivary glands of patients with IgG4-related Mikulicz’s disease: a report of three cases

We present ultrasonographic (US) and magnetic resonance (MR) imaging features of the lacrimal and salivary glands of three patients with IgG4-related Mikulicz’s disease (IgG4-MD). US revealed punched-out, soap-bubble, or reticular patterns of parenchymal hypoechogenicity of the involved lacrimal, parotid, and submandibular glands. Conventional MR imaging features were less specific. However, apparent diffusion coefficients of many of the involved glands were reduced compared with healthy glands. We discuss possible histological changes in the affected glands that were attributable to the observed imaging features. We also discuss the differences in imaging features between IgG4-MD and Sjögren’s syndrome (SS). We conclude that US may be a useful adjunct for diagnosing IgG4-MD and that MR sialography could effectively distinguish IgG4-MD from SS.