High‐b‐value diffusion‐weighted MR imaging of hepatocellular lesions: Estimation of grade of malignancy of hepatocellular carcinoma

Purpose:

To evaluate the effectiveness of diffusion‐weighted magnetic resonance imaging (DWI) in estimating the grade of malignancy of hepatocellular carcinoma.

Materials and Methods:

Dynamic contrast‐enhanced computed tomography (CE‐CT) and DWI (b value, 1000 s/mm²) were performed on 73 patients. Using DW images, the lesions were classified as “visible” or “invisible.” The apparent diffusion coefficient (ADC) of the lesions was measured. Furthermore, the lesions were classified as hypervascular or iso‐hypovascular using arterial phase CE‐CT images. The image findings for each lesion type were compared.

Results:

The 73 patients had 98 hepatocellular lesions, of which 12 were histologically diagnosed as dysplastic nodules; 39, well‐differentiated HCCs; 33, moderately differentiated HCCs; and 14, poorly differentiated HCCs. The mean ADC values of moderately poorly‐differentiated HCCs were significantly lower than well‐differentiated HCCs and dysplastic nodules (P < 0.01). On DW images, >90% of moderately (30/33) and poorly differentiated HCCs (13/14) were visible, while 51% of well‐differentiated HCCs (20/39) and all dysplastic nodules were invisible. Of 22 iso‐hypovascular lesions, 4 were visible on DW images and were poorly differentiated HCCs, whereas 18 were invisible and were dysplastic nodules (12/18) or well‐differentiated HCCs (6/18).

Conclusion:

A combination of hypovascularity and visibility on DW images can help distinguish poorly differentiated HCCs from low‐grade hepatocellular lesions (dysplastic nodules and well‐differentiated HCCs). J. Magn. Reson. Imaging 2009;30:1005–1011. © 2009 Wiley‐Liss, Inc.     

The role of thallium-201 single photon emission tomography in the investigation and characterisation of brain tumours in man and their response to treatment

The aim of this study was to characterise brain tumour type and treatment response in relation to the uptake of thallium-201.²⁰¹Tl single photon emission tomography (SPET) was performed in 58 patients with brain tumours. Fifty-six patients were utilised for the statistical comparison of the early and delayed²⁰¹Tl indices expressed as the ratio of tumour to contralateral cerebral hemisphere uptake. The retention index of²⁰¹Tl in the tumour tissue calculated from the early and delayed scans was also analysed. Furthermore, in 56 patients with 58 brain tumours, a comparison was made of the diagnostic value of high²⁰¹Tl uptake and gadolinium diethylene triamine penta-acetic acid (Gd-DTPA) enhancement on MRI scans. Although high²⁰¹Tl uptake was observed in viable malignant gliomas, brain metastases, meningiomas and malignant teratoma, the viable malignant gliomas could not be differentiated from brain metastases and extracerebral tumours by means of²⁰¹Tl indices.²⁰¹Tl SPET failed to diagnose a viable ring-enhanced tumour with a thin rim and small tumours of less than 1.5 cm in diameter visualised by Gd-DTPA-enhanced MRI. In spite of this,²⁰¹Tl SPET appears to be effective for determination of the malignant viability of tumours     

Message from the Editor-in-Chief

Another fruitful year has passed, and I am pleased to shareour achievements in 2006, and to discuss our developments for2007 with the readers of Japanese Journal of Clinical Oncology(JJCO) The Year 2006 Impact Factor and Submissions The year 2006 was a memorable year for the JJCO, as its impactfactor increased dramatically, and exceeded 1.0 for the firsttime. The 2005 Impact Factor marked 1.316, which is a big leapfrom     

Benign body-surface tumors in children

We reviewed 138 benign body-surface tumors in children under the age of 16 years that were surgically resected at the Medical Center for Sick Children, Fukuoka City, from 1980 to 1987. The male-to-female ratio was 0.81, and 60% of the patients were less than 3 years old. Hemangioma was the commonest tumor and was followed by lymphangioma, dermoid and epidermoid tumors, pilomatrixoma, and lipoma. A total of 46% of the tumors were found on the scalp, face, and neck. Lipomas were distributed evenly over the body and had the largest mean diameter. This study describes some of the characteristics of benign body-surface tumors in children.Department of Pediatric Surger, Faculty of Medicine, Kyushu University, Maedashi 3-1-1, Higashiku, Fukuoka 812, Japan Offprint requests to: M. Kubota's present address     

Basic Fibroblast Growth Factor as a Candidate Tumor Marker for Renal Cell Carcinoma

The present investigation was conducted to determine serum levels of basic fibroblast growth factor (FGF) by enzyme immunoassay in patients with various urogenital tumors. Renal cell carcinoma had a higher tendency (28 of 52, 53.8%) toward increased serum levels of basic FGF than any of the other urogenital tumors, and increased serum basic FGF was detected more frequently in patients with advanced renal cell carcinoma. Analysis of histological pattern indicated that renal cell carcinoma with a solid or tubular component is more likely to produce basic FGF. However, no significant difference was seen between the percentage of clear cell type tumor patients with increased serum basic FGF (50.0%) and the percentage of granular cell type tumor patients with increased serum basic FGF (66.7%). Five of 8 patients with renal cell carcinoma who underwent selective renal venous sampling before nephrectomy showed increased serum basic FGF in the renal vein from the affected kidney. After resection of the affected kidney to remove the cancer, serum basic FGF disappeared within 2 weeks. However, residual huge tumor or postoperative disease prolonged the increased levels of basic FGF in 2 patients, indicating that basic FGF is produced from and secreted by tumor tissue itself. These findings suggest that serum basic FGF can be useful in the diagnosis, and in evaluating the prognosis, of patients with renal cell carcinoma.     

Solitary Intraperitoneal Recurrence of α-Fetoprotein-Producing Gastric Carcinoma: Report of a Case

Abstact A solitary recurrence of gastric carcinoma in the peritoneal cavity is extremely rare. We herein present a case of solitary intraperitoneal recurrence in a patient with α-fetoprotein (AFP)-producing gastric carcinoma. As far as we can determine, this is the first report of such a form of recurrence in a patient with gastric carcinoma who underwent a successful resection. A review of our eight patients who had AFP-producing gastric carcinoma showed a frequent association with hepatic metastasis and a poor prognosis as has been reported previously. Our patient received intra-arterial chemotherapy with low-dose cisplatin and 5-fluorouracil to prevent hepatic recurrence, but eventually developed multiple hepatic metastases after ceasing this therapy. Therefore, adjuvant intra-arterial chemotherapy may have altered the site of first recurrence in this patient. Received: June 6, 2001 / Accepted: November 20, 2001     

Paraovarian cyst with torsion in children

Paraovarian cyst is very uncommon in children, and its preoperative diagnosis is difficult. This report describes 2 cases of surgically proven paraovarian cyst with torsion. It is important to be aware of torsion as a complication of paraovarian cyst. J Pediatr Surg 37:937-940.