Diagnostic Usefulness and Changing Value during Irradiation of Bone Metabolic Markers for Metastatic Bone Tumor

Objective: We examined the efficacy of Pyridinoline-cross-linked C-terminal telopeptide of type I collagen (ICTP) and C-terminal propep tide of the type I procollagen (PICP), as bone metabolic markers (BMM) that reflect the effects of radiotherapy in patients with metastatic bone tumors (MBT). Method: One-hundred eight patients who had had malignant tumors and been suspected of developing MBT were measured for ICTP and PICP. Ninety six patients with recognized MBT and 12 patients without MBT were evaluated for the diagnostic accuracy of MBT. Out of the 96 cases, 49 received radiotherapy and were measured for ICTP and PICP before and after the treatment. The 49 cases were divided into 25 cases (Com group) that had all of the MBT irradiated and 24 cases (InCom group) that could not have all sites irradiated. Increase ratios from before to after the radiotherapy were compared between ICTP and PICP. Results: In the 96 patients with MBT, both ICTP and PICP were observed to be significantly high. Diagnostic accuracy was 81.5% for ICTP, and 61.6% for PICP. InCom group showed an increase in ICTP by about 25% while no significant change was observed in the Com group. Conclusion: BMM has diagnostic significance in patients with MBT. Performing radiotherapy to every osseous lesion results in a decline or leveling-off of ICTP.departmental bulletin pape

The Significance of Delusions in Dementia Patients of Alzheimer Type from Clinical, Neuropsychological and Neuroimaging View Points

We studied 32 patients with dementia of Alzheimer type (DAT) using computed tomography of the brain (CT), single photon emission computed tomography (SPECT) and Hasegawa's dementia scales (HDS). Of these patients, 13 had delusions and 19 showed no psychotic symptoms. CT, SPECT and HDS findings were compared between the patients with delusions and those without delusions to determine whether there are differences in brain morphological, functional or cognitive changes between the two groups. We evaluated the degree of cortical atrophy, the size of the lateral ventricle and periventricular lucency by visual analyses on CT. We also evaluated morphological change of the brain by linear measurements on CT. The regions of interest (ROI) were localized in the left/ right prefrontal, temporoparietal and occipital regions. There were no statistical differences between DAT patients with delusions and those without delusions in age, duration of illness, HDS, and in visual analyses and linear measurements taken by CT scan. 123I iodoamphetamine (123I-IMP) uptake in patients with delusions differed from those without delusions in the right prefrontal region. The result would imply that decreased regional blood flow in the right prefrontal region may be causally related to the development of delusions in DAT patients.departmental bulletin pape

Comparison of Iomeprol 300 and 350 mgI/ml Syringe Preparations for Contrast-Enhanced Helical Computed Tomography of the Liver Using Bolus-Tracking Technology

Purpose: To evaluate contrast enhancement with iomeprol in helical computed tomography(CT) using bolus-tracking technology. Method: Helical CT examinations were performed on 114 patients using 100 ml of iomeprol administered via either a 300 mgI/ml syringe or a 350 mgI/ml syringe. After nonenhanced CT was performed, contrast-enhanced CT scans were obtained at optimal times during three phases, the early, late, and delayed phases, using bolus-tracking technology while infusing the contrast medium. Regions of interest were determined for the observed transverse sections of the aorta and liver, and the contrast index that was used for plotting time-density curves was defined as the difference in CT density before and after the administration of iomeprol. Time-density curves were plotted by body weight group to evaluate how the contrast enhancement was affected by different concentrations of the contrast medium. Results: When time-density curves obtained using iomeprol preparations containing different iodine concentrations for the different body weight groups were compared, the contrast enhancement tended to be greater for the 350 mgI preparation than the 300 mgI preparation. Conclusion: Contrast-enhanced CT can be performed with a 300 mgI preparation of iomeprol in patients weighing less than 60 kg; whereas a 350 mgI preparation is preferable for patients weighing 60 kg or more.departmental bulletin pape

Magnetic Resonance Imaging of the Normal Tongue: Qualitative Evaluation of Fat-suppressed Contrast Enhanced Images

Objective: For diagnosing the lesions on magnetic resonance imaging (MRI), it is necessary to understand normal structures on each sequence. In this study, we attempted to clarify structures of the normal tongue on fat -suppressed enhanced MRI qualitatively. Clinical material and method: Twenty-seven fat-suppressed enhanced MR images of normal tongue were studied, which were obtained using a T1 weighted spin echo pulse sequence (T1WI- E) with the chemical shift selective (CHESS) method by a superconducting MRI scanner operating at 1.5T. Tongue structures and their signal intensities on fat-suppressed enhanced images were assessed and compared to those obtained by non-enhanced T1WI. Results: Normal tongues were found to be composed of a symmetrical high signal area (HSA), low signal area (LSA), lingual septum, bilateral sublingual gland, and genioglossus muscle on non- enhanced T1WI. In the fat-suppressed enhanced images, HSA and lingual septum signal intensities were suppressed. Further, though the lingual mucosa was well visualized in fat-suppressed enhanced images (P<0.05), differentiation of HSA and LSA was difficult as compared to the non- enhanced scans (P<0.05). Conclusion: Fat-suppressed enhanced scans demonstrated simple anatomical structures as com- pared to conventional T1WI with independent signal intensity. Accordingly, we conclude that it is necessary to use both sequence for diagnosing the mass lesion located in the tongue.departmental bulletin pape