Investigating of the Usefulness of Multidetector-row Computed Tomography for Diagnosing Abdominal Visceral Pseudoaneurysms

Abdominal visceral pseudoaneurysms are rare, but rapid diagnosis is clinically important because of the associated conditions that are often fatal. Multidetector-row computed tomography (MDCT) is important in the diagnosis and treatment of many human conditions. This study thus sought to investigate the usefulness of MDCT for diagnosing abdominal visceral pseudoaneurysms. We retrospectively assessed the MDCT diagnosis of pseudoaneurysms and identification of the responsible vessels or cases diagnosed with an abdominal visceral pseudoaneurysm via angiography. The study comprised 35 patients who underwent MDCT preoperatively and in whom angiography detected an abdominal visceral pseudoaneurysm over a 7-year period. Using the angiography findings as the gold standard, we investigated whether a pseudoaneurysm and the responsible vessel could be diagnosed using preoperatively imaged MDCT findings. For angiography and MDCT, diagnosis was reached on the basis of two radiologists\u27 agreement. Of 35 patients (28 males and 7 females), the median subject age was 67 years (range: 22–84 years). We found that MDCT could preoperatively detect abnormal findings such as hematomas in all patients. MDCT detected the presence of a pseudoaneurysm in 88.6% (31/35) of patients and identified the responsible vessel in 71% (25/35) of patients. In 6 patients, MDCT findings could successfully reveal both the pseudoaneurysm and the extravasation. MDCT was effective for diagnosing abdominal visceral pseudoaneurysms and it could be useful for determining treatment strategies and aiding treatment techniques in such patients

Clinical Significance of Reverse Redistribution Phenomenon for 201Tl Scintigraphy in Nonischemic Disease

The reverse redistribution phenomenon (RR) on 201Tl SPECT has been focused mainly on ischemic improvement regions after reperfusion therapy or vasospastic angina pectoris. However, RR analysis has not been used in the context of non-ischemic disease. The aim of this study was to evaluate the clinical role of RR on 201Tl SPECT in patients without a history of myocardial ischemia. We retrospectively enrolled 86 patients showing RR by myocardial perfusion SPECT and studied 75 other patients as a control group. For quantitative analysis, each 201Tl SPECT polar map was divided into 13 segments. Differences between the RR and control group were assessed with respect to patient characteristics and cardiac event-free survival using the Kaplan-Meier method. RR was detected frequently in the inferoposterior wall, septal portion of the anterior wall, and septum. The two groups showed signi_cant differences in rates of heart failure (P ＜ 0.01), hypertrophic cardiomyopathy (P ＜ 0.05), and wall motion abnormality (P ＜ 0.05), but not in the rate of event occurrence. The study demonstrated that RR on 201Tl SPECT could indicate the existence of myocardial damage ; however, it would not be a factor that determines the prognosis

Variation in myxoid liposarcoma: Clinicopathological examination of four cases with detectable TLS-CHOP or EWS-CHOP fusion transcripts whose histopathological diagnosis was other than myxoid liposarcoma

Liposarcomas are separated into clinicopathological entities by a characteristic morphological spectrum and distinctive genetic changes. Myxoid liposarcoma (MLS) represents one such entity with specific chromosomal translocations leading to the generation of fusion genes, the human translocation liposarcoma (TLS)-CCAAT/enhancer binding protein (C/EBP) homologous protein (CHOP) or the Ewing sarcoma (EWS)-CHOP. In the present study, four cases of liposarcoma with detection of TLS-CHOP or EWS-CHOP, whose postoperative diagnosis was other than MLS (one well-differentiated liposarcoma, two de-differentiated liposarcomas and one unclassified) were examined for medical records, imaging data and histopathology. Clinical records demonstrated that three of the four cases were considerably difficult to diagnose definitively, and histopathological re-examination pointed out areas of myxomatous change as a minor component (<10%). Their dominant components (>90%) resembled pleomorphic sarcoma, pleomorphic malignant fibrous histiocytoma and monophasic synovial sarcoma. The current cases may represent an extreme variant of the morphological spectrum within MLS. In cases of difficulty in making definitive diagnosis of soft tissue sarcoma by standard histopathological examination and identification of myxoid stroma even as a minor component, analyzing TLS-CHOP and EWS-CHOP fusion genes may aid the diagnosis of unusual MLS

Prospective comparison of various radiological response criteria and pathological response to preoperative chemotherapy and survival in operable high-grade soft tissue sarcomas in the Japan Clinical Oncology Group study JCOG0304

Abstract Background Soft tissue sarcomas (STS) are rare malignant tumors. The efficacy of preoperative chemotherapy for STS is evaluated using various tumor size-based radiological response criteria. However, it is still unclear which set of criteria would show the best association with pathological response and survival of the patients with STS. Methods We compared radiological responses to preoperative chemotherapy for operable STS by the Response Evaluation Criteria in Solid Tumors (RECIST), modified RECIST, World Health Organization criteria, Japanese Orthopaedic Association criteria, and modified Choi criteria and analyzed the association with pathological response and survival using the data from the Japan Clinical Oncology Group (JCOG) study JCOG0304, a phase II clinical trial evaluating the efficacy of perioperative chemotherapy for STS in the extremities. Results Seventy eligible patients in JCOG0304 were analyzed. The results demonstrated that none of the size-based radiological response criteria showed significant association with pathological response to preoperative chemotherapy for STS. The difference between overall survival of the patients assessed as partial response and stable disease/progressive disease by RECIST was not significant (hazard ratio 1.37, p = 0.63), and calculated C-index was 0.50. All other response criteria also could not exhibit significant association between radiological responses and survival. Conclusion In the present study, none of the radiological response criteria analyzed demonstrated association of response to preoperative chemotherapy with pathological response or survival of the patients with operable STS. Further prospective investigation is required to develop criteria to evaluate not only tumor shrinkage but biological effects of preoperative chemotherapy for the patients with localized STS. Trial registration UMIN Clinical Trials Registry C000000096. Registered 30 August, 2005 (retrospectively registered)