Measurements and Evaluation of Proximal Femoral Bone Mineral Density with Dual Energy X-ray Absorptiometry

Proximal femoral bone mineral density (BMD) can be measured by dual energy X-ray absorptiometry method in the neck, trochanter, intertrochanter, total and Ward's triangle area. Ward's triangle area of the proximal femur is a smaller area to measure than the others, and the position varies, depending on the status of inner rotation of the target leg. In this study, the measurements of the proximal femoral BMD in women were carried out on the neck, trochanter, intertrochanter, total and Ward's triangle area with the, subjects' legs turned 15 degrees toward the inside. The Ward's BMD were measured using Ward's cognitive method, in which the measured BMD were compared among age groups of 50-59, 60-69, 70-79 and 80-89 to determine whether this process could reveal decreased femoral BMD in elderly women. The correlation between BMD and age was tested using the Pearson correlation coefficient. In all measured parts, the BMD of women age 50-59 were significantly higher than those of women age 80-89. The correlations between BMD and age were negative in all measured parts, and the most negative correlation was between age and Ward's BMD. The study using Ward's cognitive method showed an inverse correlation between Ward's BMD and age in women

Accuracy assessment methods of tissue marker clip placement after 11-gauge vacuum-assisted stereotactic breast biopsy: comparison of measurements using direct and conventional methods

BACKGROUND:　 The objective of the study was to compare direct measurement with a conventional method for evaluation of clip placement in stereotactic vacuum-assisted breast biopsy (ST-VAB) and to evaluate the accuracy of clip placement using the direct method.　 METHODS:　 Accuracy of clip placement was assessed by measuring the distance from a residual calcification of a targeted calcification clustered to a clip on a mammogram after ST-VAB. Distances in the craniocaudal (CC) and mediolateral oblique (MLO) views were measured in 28 subjects with mammograms recorded twice or more after ST-VAB. The difference in the distance between the first and second measurements was defined as the reproducibility and was compared with that from a conventional method using a mask system with overlap of transparent film on the mammogram. The 3D clip-to-calcification distance was measured using the direct method in 71 subjects.　 RESULTS:　 The reproducibility of the direct method was higher than that of the conventional method in CC and MLO views (P = 0.002, P < 0.001). The median 3D clip-to-calcification distance was 2.8 mm, with an interquartile range of 2.0-4.8 mm and a range of 1.1-36.3 mm.　 CONCLUSION:　 The direct method used in this study was more accurate than the conventional method, and gave a median 3D distance of 2.8 mm between the calcification and clip

Sonographic analysis of hyoid bone movement during swallowing

金沢大学医薬保健研究域保健学系Purpose: Videofluoroscopy is generally considered a "gold standard" technique; however t technique exposes subjects to radiation. Ultrasonography is applied widely in clinical practice because of low cost, safety of the technique, and absence of radiation exposure. The aim of this study was to evaluate hyoid bone movement trajectories during swallowing in healthy subjects using ultrasonography.Subject and Methods: Data were obtained from 15 healthy volunteers (mean age: 34.9± 9.3).The subjects were divided into 3 groups: 5 subjects in their 20s, 5 subjects in their 30s and 5 subjects in their 40s. The subjects were examined while sitting in an upright position, with the back against a wall to control movement. The transducer was placed in a longitudinal scan above the larynx. The hyoid bone was identified on the scan as a high echoic area with posterior acoustic shadow. Then, the subjects swallowed 5 mL of mineral water, with a measurement frequency of 5 times. The digital-ultrasonographic recordings were viewed at 30 frames/s for 3 seconds. Results: The movement was divided into 4 phases: A, slowly ascending phase; B, rapidly ascending phase; C, temporary pause phase (position of maximum rise); D, rapid and slow descending shifts toward the resting position phase. We easily visualized the hyoid bone trajectory using ultrasonography. In all cases, ultrasonographic analysis of the hyoid bone was confirmed to have a similar trajectory as determined with videofluoroscopy. Ultrasonography can accurately determine swallowing duration and trajectory of hyoid bone movement. There was a significant difference in swallowing duration between the 20s groups and 30s groups and between the 20s groups and 40s groups (P < 0.05). However, the difference between the 30s group and 40s group was not significant (P=0.87).Conclusion: The results show that the dynamic phase image of the hyoid bone movement can be revealed by ultrasonographic visualization. © 2009 Springer Berlin Heidelberg

Predicting sentinel lymph node metastasis in breast cancer with lymphoscintigraphy

金沢大学医薬保健研究域保健学系Objective: Lymphoscintigraphy is an effective method for detecting sentinel lymph nodes (SLNs). However, the rate and degree of SLN detection is not uniform. We quantified SLNs detected with lymphoscintigraphy, and investigated correlations with factors that may influence detection. We then attempted to predict SLN metastasis from lymph node counts, comparing the predictions to subsequent biopsy results. Methods: We assessed lymph node counts in 100 breast cancer patients in whom a single SLN was detected with a fixed lymphoscintigraphy procedure. We examined correlations between the counts and factors known to influence lymphoscintigraphic SLN detection (age, body mass index, tumor size, and presence or absence of metastasis), and determined reference values (lymph node counts of 10.0, 19.4 and 53.0) which were used to predict SLN metastasis in 100 subsequent patients. The predictions were then compared with the SLN biopsy findings. Results: SLN counts correlated strongly with the presence or absence of metastasis, with metastasis-positive lymph nodes showing significantly lower counts than negative nodes (p < 0.001). Prediction of SLN metastasis achieved a 100% positive predictive value at a reference value of 10.0, and a 100% negative predictive value at a reference value of 53.0. At a reference value of 19.4, the sensitivity, specificity, and diagnostic accuracy were 77.8, 73.2, and 74.0%, respectively. Conclusions: The SLN counts detected with lymphoscintigraphy were significantly lower in metastasis-positive lymph nodes than in metastasis-negative lymph nodes. This suggests that prediction of SLN metastasis in breast cancer is possible using lymphoscintigraphy. © 2010 The Japanese Society of Nuclear Medicine

Relationship between Bone Mineral Density and Body Composition Estimated by Dual-Energy X-ray Absorptiometry : Comparison between Groups Aged 20-39 and 40-59 Years

Bone mineral density (BMD) is affected by lean body mass and body weight to various degrees in the course of aging. The attempt of this study is to determine the optimal time to begin prevention of osteoporosis. In this study, female hospital employees aged 20-59 years were divided into 2 age groups, 20-39 years and 40-59 years based on age at peak BMD, and the relations of total BMD, subtotal BMD and lumbar spine BMD to lean body mass and body weight were examined in both groups. Subtotal BMD was calculated by subtracting head BMD from total BMD along with whole body measurement. While persistent positive correlations were found among all factors in the 20-39-year-old group, subtotal BMD and lumbar spine BMD were positively correlated to lean body mass in the 40-59-year-old group. Thus, lean body mass and body weight appeared to exert a profound influence on subtotal BMD in those aged 20-39 years, but lean body mass in those aged 40-59 years. Lean body mass appears to provide the best prediction of subsequent development of osteoporosis

Intensities of incident and transmitted ultraviolet-a rays through gafchromic films

Gafchromic films have been applied to X-ray dosimetry in diagnostic radiology. To correct nonuniformity errors in Gafchromic films, X-rays in the double-exposure technique can be replaced with ultraviolet (UV)-A rays. Intensities of the incident and transmitted UV-A rays were measured. However, it is unclear whether the chemical color change of Gafchromic films affects the UV-A transmission intensity. Gafchromic EBT3 films were suitable to be used in this study because non-UV protection layers are present on both sides of the film. The film is placed between UV-A ray light-emitting diodes and a probe of a UV meter. Gafchromic EBT3 films were irradiated by UV-A rays for up to 60 min. Data for analysis were obtained in the subsequent 60 min. Images from before and after UV-A irradiation were subtracted. When using 375 nm UV-A, the mean ± standard deviation (SD) of the pixel values in the subtracted image was remarkably high (11,194.15 ± 586.63). However, the UV-A transmissivity remained constant throughout the 60 min irradiation period. The mean ± SD UV-A transmission intensity was 184.48 ± 0.50 μm/cm2. Our findings demonstrate that color density changes in Gafchromic EBT3 films do not affect their UV-A transmission. Therefore, Gafchromic films were irradiated by UV-A rays as a preexposure