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Background: In adrenal vein sampling, selecting the right adrenal vein is technically difficult and it is important to evaluate the right adrenal vein anatomy before adrenal vein sampling. The advanced monoenergetic reconstruction technique has recently become available and we hypothesized that this technique may be useful. Purpose: To evaluate the usefulness of the advanced monoenergetic reconstruction technique in dual-energy computed tomography (CT; advanced monoenergetic images) for evaluation of vascular anatomy before adrenal vein sampling. Material and Methods: Twenty-one patients underwent three-phase (20, 30, and 70 s) contrast-enhanced CT before adrenal vein sampling. Advanced monoenergetic images were reconstructed at 40 keV and analyzed objectively and subjectively in comparison with the standard 120-kVp images. As objective evaluation, the signal-to-noise ratio and contrast-to-noise ratio of the right adrenal vein were assessed. As subjective evaluation, two radiologists assessed the delineation of the right adrenal vein using a 5-point Likert scale (1 = poor, 5 = excellent). Furthermore, the technical success rate of adrenal vein sampling and procedure time were also evaluated. Results: There was no difference in the signal-to-noise ratio between the two groups. The contrast-to-noise ratios of the right adrenal vein of advanced monoenergetic images were higher than those of the standard images (P < 0.05). The Likert scores of advanced monoenergetic images were higher than those of the standard images (P < 0.05). The technical success rate of adrenal vein sampling was 95% (20/21) and the median of procedure time was 103 min (range = 59–197 min). Conclusion: Advanced monoenergetic imaging appears to be useful in the delineation of the right adrenal vein before adrenal vein sampling. [ABSTRACT FROM AUTHOR]

Background: Preoperative transcatheter arterial embolization for hypervascular bone and soft tissue tumors plays an important role in reducing intraoperative blood loss (IBL).Purpose: To evaluate the use of a gelatin sponge in preoperative transcatheter arterial embolization for hypervascular bone and soft tissue tumors in the pelvis or extremities.Material and Methods: Thirty-seven patients (21 men, 16 women; median age, 61 years; age range, 23-79 years) underwent preoperative transcatheter arterial embolization between April 2004 and January 2015. Medical records and images were reviewed, and the technical success rate, clinical success rate, and complications were evaluated. Technical success was defined as a devascularization rate of 75% or higher, and clinical success was defined as intraoperative blood loss (IBL) <1500 mL in cases undergoing surgery within 3 days of transarterial embolization and <3000 mL in cases operated 4 or more days later.Results: Tumor sizes were in the range of 2.0-13.0 cm (median, 5.0 cm). The devascularization rate was decreased by >75% at follow-up angiography in all cases, and the technical success rate was 100 % (37/37). The median IBL was 491 mL (range, 30-3800 mL), and the clinical success rate was 89% (33/37). The minor complication of local pain was observed in 13 out of 37 cases (35%) during or after embolization, but was controllable by an analgesic.Conclusion: Preoperative transarterial embolization using a gelatin sponge appears to be feasible and safe, and may contribute to decreasing IBL. [ABSTRACT FROM AUTHOR]

Background: The accuracy of 18F-2-deoxy-fluoro-D-glucose positron emission tomography (FDG-PET) for diagnosing nodal status in patients with lung cancer was initially reported as excellent, but, with increasing experience, the problem of false-positive and false-negative assessments has been observed. Purpose: To evaluate the accuracy of FDG-PET for diagnosing nodal status in lung cancer patients with pathologically proven N2 lymph nodes and compare it with that of computed tomography (CT). Material and Methods: Nineteen pN2 patients (13 males and six females) with primary lung cancer undergoing preoperative CT and FDG-PET were investigated. Lymph nodes were considered to be positive when uptake higher than the surrounding mediastinal level was visually observed. Slight symmetrical mediastinal uptake was considered to be negative, representing benign physiological accumulation. Radiological and pathological correlation was investigated, and the association between FDG accumulation and the size of metastatic lymph nodes and metastatic lesions was evaluated. Results: Of the 19 patients, nodal stage determined by using FDG-PET was cN0 in four (21%) cases, cN1 in three (16%), cN2 in nine (47%), and cN3 in three (16%). On CT, nodal stage was cN0 in three (16%) cases, cN1 in seven (37%), cN2 in eight (42%), and cN3 in one (5%). Thus, FDG-PET provided correct N-staging in 47%, under-staging in 37%, and overstaging in 16%. CT staging was correct in 42%, underestimated in 53%, and overestimated in 5%. The maximum area of metastatic foci was 15.8 ±21.3 mm2 (mean ± SD) in false-negative nodes and 75.0±56.3 mm2 in true-positive nodes ( P<0.0001). Conclusion: Diagnostic accuracy of FDG-PET (47%) was low and similar to that of CT (42%). The possibility of false-negative as well as false-positive findings should be recognized in interpreting PET images. Micrometastasis appeared to be the greatest cause of false-negative findings. [ABSTRACT FROM AUTHOR]