No abstract

The twice-weekly HDR regimen may improve the local control rate with fewer complications.

Purpose. To evaluate the educational effect of the Japanese Society of Interventional Radiology 7th Academic Summer Seminar from a technical perspective. Materials and Methods. Nineteen trainees participated in the seminar. The seminar consisted of vertebroplasty trainings using swine with the single-plane landmark method and with the ISOcenter Puncture (ISOP) method. All trainees were advised by an instructor as they operated the instruments and punctured the vertebra. For each trainee, the accuracy in the final position of the needle tip of the initial puncture in each swine training was evaluated. Results. Error in the final position of the needle tip of ≥5 mm from the target puncture site occurred in the lateral direction in 42% (8/19) of trainees with the landmark method and 5% (1/19) with the ISOP method. No error ≥5 mm occurred in the vertical or anteroposterior directions. In terms of puncture accuracy, error in the lateral direction was significantly lower with the ISOP method than with the landmark method (2.2 ± 1.5 mm versus 5.6 ± 3.2 mm). Conclusion. This seminar was effective training for trocar placement for beginners. The puncture was more accurate with the ISOP method than with the landmark method.

Abstract. The diagnosis of ipsilateral breast tumor recurrence (IBTR) after breast-conserving therapy is of great interest to breast physicians. The present study compared the utility of grayscale sonography standardized by a breast imaging reporting and data system (BI-RADS) and power Doppler sonography for differentiating between benign scar formation and IBTR after breast-conserving therapy. Gray-scale sonography detected 83 solid breast lesions classified as BI-RADS categories 3-5 in 272 patients after breast-conserving therapy, and these lesions were entered into the study (53 lesions as category 3, probably benign; 30 lesions as categories 4-5, suspected malignancy). Power Doppler sonography revealed intratumoral flow in 19 of 83 solid breast lesions. BI-RADS category 3 was accepted as probably benign and BI-RADS categories 4-5 were considered as suspicious for breast tumor recurrence in the gray-scale ultrasound criteria. Positive and negative intratumoral flow were employed as suspicious for breast tumor recurrence and probably benign, respectively, in the power Doppler sonography criteria. Sensitivity was higher for power Doppler sonography (94.7±10.0%) than for gray-scale sonography (57.9±22.2%). Specificity was also higher for power Doppler sonography (98.4±3.0%) than for gray-scale sonography (70.3±0.6%). These results suggest that power Doppler sonography can complement gray-scale sonography standardized by BI-RADS in differentiating between IBTR and benign scar lesions. IntroductionIn the mid-1980s, the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-06 trial demonstrated no difference in survival between mastectomy versus lumpectomy followed by radiation (1). Recently, breast-conserving therapy (BCT), defined as lumpectomy followed by whole-breast irradiation, has become the most common therapeutic option for breast cancer (2-4). Approximately 10-15% of patients undergoing BCT for operable breast cancer develop locoregional recurrence within 10 years (5-7). Patients with ipsilateral breast tumor recurrence (IBTR) without simultaneous distant metastases are considered as good candidates for salvage mastectomy (8,9) or repeat BCT (8,10). However, IBTR is considered to represent one predictor of systemic recurrence and breast cancer-related death after BCT (11). The diagnosis of IBTR after BCT is thus of great interest to breast physicians. BCT is less radical and has a more favorable psychological impact on patients, but frequently results in postoperative changes (12-18). Such changes may include both IBTR and benign situations such as scarring, reparative changes, accumulation of exudate or liquid, post-irradiation mastitis and fibrosis (12-18). The value of both mammography and ultrasonography after BCT is limited, as scars tend to be indistinguishable from IBTR (16,17). According to , ultrasonography was markedly more sensitive than mammography for detecting benign abnormalities after BCT (ultrasonography, 95.7%; mammography, 72.3%). However, ultrasound-guided biopsy is reportedly ...

Adult-onset Still's disease (AOSD) is a cause of fever unknown origin. The clinical manifestations of AOSD include a high spiking fever, evanescent maculopapular rash, polyarthralgias associated with leukocytosis, and abnormal liver tests. We present serial Ga-67 scintigraphic findings in a young male with persistent remittent fever and the final diagnosis of AOSD. Repeated Ga-67 scintigraphic studies demonstrated diffusely increased activity in the bone marrow, hepatosplenomegaly, and pericarditis in proportion to the severity of the disease. Awareness of the Ga-67 scintigraphic imaging findings of AOSD could help narrow the differential diagnosis among the long list in fever of unknown origin.