Yoshihide Kanemaki

Intraductal Papilloma: Features on MR Ductography Using a Microscopic Coil

OBJECTIVE The purpose of this study was to describe the features of intraductal papilloma on MR ductography using a microscopic coil. CONCLUSION Intraductal papilloma appeared in most cases as a well-circumscribed mass with early enhancement and delayed washout associated with a dilated duct, predominantly showing signal hyperintensity on T1- and T2-weighted imaging.

Correlation of CT values, iodine concentration, and histological changes in the thyroid.

PURPOSE We have reported that in the thyroid, there is a linear correlation between iodine concentrations and CT values. However, the slope of the regression line was about three times as large as that in KI solutions. We investigated the factor(s) contributing to the increment of the slope of the regression line in the thyroid. METHOD Solutions of NH4I and thyroid hormones were used to investigate the regression line. Thirty-six thyroids were evaluated to investigate the correlation between the iodine concentrations and the area ratio of thyroid follicles, which were measured by preoperative CT and from tissue slices, respectively. RESULTS The slopes of the regression lines in the solutions were almost identical to those in KI solutions. In the thyroid, iodine concentrations were logarithmically correlated with the area ratio of follicles. CONCLUSION The decrease in CT values not only revealed a decrease of iodine concentration in the thyroid but also represented an increase of follicular cells and/or interstitial structures in the volume ratio secondary to it.

Diagnostic accuracy of high-resolution MRI using a microscopy coil for patients with presumed DCIS following mammography screening.

To prospectively evaluate the accuracy of high‐resolution (HR)‐MRI as a secondary examination in women with abnormal calcifications detected on mammography.

High-resolution MRI in detecting subareolar breast abscess.

OBJECTIVE Because subareolar breast abscess has a high recurrence rate, a more effective imaging technique is needed to comprehensively visualize the lesions and guide surgery. We performed a high-resolution MRI technique using a microscopy coil to reveal the characteristics and extent of subareolar breast abscess. CONCLUSION High-resolution MRI has potential diagnostic value in subareolar breast abscess. This technique can be used to guide surgery with the aim of reducing the recurrence rate.

Ductal carcinoma in situ: correlations between high-resolution magnetic resonance imaging and histopathology

PurposeThe aim of this retrospective study was to determine and correlate contrast-enhanced areas and multiple internal dark dots and lines on high-resolution magnetic resonance imaging (HR-MRI) with findings in surgical specimens of ductal carcinoma in situ (DCIS) and to evaluate the ability of HR-MRI to detect DCIS lesions and clarify HR-MRI features characteristic of DCIS.Materials and methodsThis study retrospectively reviewed 11 patients diagnosed with DCIS who had undergone HR-MRI. Pathological findings and results of HR-MRI were compared, and causes of periductal enhancements were analyzed.ResultsIn all patients, HR-MRI using microscopic coils revealed ductally, segmentally, or regionally enhanced areas containing multiple dark dots and lines, representing local enhancement of stroma adjacent to the mammary duct containing DCIS. Neovascularization, infiltration of inflammatory cells, and focal edema occurred in enhanced periductal stroma. Poorly enhanced linear or dot-like structures correlated with dilated mammary ducts displaying necrosis and tumor impaction.ConclusionDCIS was successfully depicted on HR-MRI using a microscopy coil in all 11 cases. Ductal, segmental, or regional areas of enhancement with multiple dark dots and lines on HR-MRI corresponded to mammary glands containing DCIS with periductal enhancement.

Desmoid Tumor of the Breast: The Role of Proton Magnetic Resonance Spectroscopy for a Benign Breast Lesion Mimicking a Malignancy

Abstract:  Desmoid tumor of the breast is an extremely rare condition. It is difficult to provide a correct preoperative diagnosis of desmoid tumor of the breast because of its tendency to mimic breast carcinoma on physical examination and conventional imaging such as mammography and sonography. We present a case of desmoid tumor of the breast that mimicked breast carcinoma, in which proton magnetic resonance spectroscopy assisted the result of biopsy, thus enabling a correct preoperative diagnosis.

Evaluation of CD56 and CD57 immunostainings for discrimination between endocrine ductal carcinoma in situ and intraductal papilloma

Endocrine ductal carcinoma in situ (E‐DCIS) is an intraductal carcinoma characterized by endocrine features and expression of neuroendocrine markers. E‐DCIS and intraductal papilloma (IDP) resemble in their clinical features. However, the former is an intraductal carcinoma, and the latter is an intraductal benign lesion. It is sometimes difficult to distinguish E‐DCIS from IDP because both can show near solid intraductal cellular proliferation. Discrimination between lesions is important not only histopathologically, but also clinically. This study aimed to evaluate the applicability of CD56 and CD57 for the discrimination between E‐DCIS and IDP. Specimens were obtained from 17 E‐DCIS patients as the subject group, and 27 IDP patients as the control group, diagnosed in St Marianna University Hospital. E‐DCIS was diagnosed using Chromogranin A, Synaptophysin, and Grimelius stainings by the premise of histopathological features. These specimens were subjected to CD56, CD57 immunostainings. Staining results were compared between E‐DCIS and IDP. In our study, CD56 revealed significant differences for distinguishing E‐DCIS from IDP as determined by Fishers test (cutoff: not less than 33–67%< immunopositivity, P < 0.05). We found that not only E‐DCIS but also IDP revealed immunopositivity for CD56. However, it is considered that E‐DCIS diagnosis is possible by diffuse immunopositivity of CD56 after having been based on histopathology.

Clinical efficacy and value of redistributed subclavian arterial infusion chemotherapy for locally advanced breast cancer

PurposeThe aim of this study was to evaluate the efficacy and safety of redistributed subclavian arterial infusion chemotherapy (RESAIC). We have focused on the local response, quality of life (QOL), and complications. We have also investigated factors that influence the local response of RESAIC.Materials and methodsThe subjects were patients with locally advanced breast cancer whose tumors were resistant to standard systemic chemotherapy (at least more than two regimens), those who were physically unable to tolerate systemic chemotherapy, and patients with locally recurrent breast cancer. The registration period was between April 2006 and May 2009.ResultsA total of 24 cases in 22 patients (mean age 59.5 years, range 36–82 years) were entered in the study. The local response rate of RESAIC was 77.3% (17/22). The QOL score showed improvement on average. There were no serious complications during catheter port implantation, and there was hematological toxicity over grade 3 in 27.3% (6/22) of patients. A significant difference between responders and nonresponders was seen in patients with a replaced type tumor (on imaging, diffuse contrast enhancement was seen in whole quadrants) (P = 0.043), and the patients underwent radiotherapy (P = 0.043).ConclusionRESAIC is an effective, safe treatment for locally advanced breast cancer. Because it was reviewed in only a few cases, however, large-scale studies are warranted.

Microcalcifications of Breast Tissue: Appearance on Synchrotron Radiation Imaging with 6-μm Resolution

OBJECTIVE The purpose of this study was to use synchrotron radiation imaging with 6-microm resolution to evaluate amorphous and pleomorphic breast tissue microcalcifications. CONCLUSION Synchrotron radiation imaging depicted microcalcifications as small as 24 microm. Imaging with this technique revealed that most amorphous and pleomorphic calcifications on conventional mammograms are clusters of fine specks and that in addition to the shape or density of a speck, the distribution density of clustered specks is a factor determining the apparent shape.

Sensitive detection of voids in solid materials by refraction-enhanced synchrotron radiation imaging

Voids in opaque materials (minute air bubbles) were imaged with synchrotron radiation in a refraction enhancement mode. The voids are imaged by an enhanced x-ray intensity inside the bubble, surrounded by a border region with decreased x-ray intensity, thus allowing sensitive detection of air bubbles in plastic materials. As those “impurities” could not be depicted with conventional radiography, and optical inspection is not useful if the matrix is opaque, this in-situ imaging technique offers the potential to obtain information of air inclusions, voids, and cracking that appear inadvertently in opaque plastics and possibly in metals as well.