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A patient registration system is mandatory for establishing the scientific credibility of the multi-center clinical trials. The Japan Interventional Radiology in Oncology Study Group (JIVROSG) was organized in 2002 to establish evidence supporting the procedures used in interventional radiology. The Internet Data and Information Center for Medical Research (INDICE), provided by the University Hospital Medical Information Network(UMIN), has been utilized for patient registration in the clinical trials of JIVROSG. In this study, the safety and efficacy of UMIN-INDICE were evaluated. From 2002 to 2010, 18 clinical trials, including one international trial, were conducted. A total of 736 patients were enrolled from 51 institutions. No significant trouble was encountered during this period. A questionnaire survey demonstrated that 90% of participating researchers could use this system without difficulties. UMIN-INDICE may contribute to promoting clinical trials as an infrastructure of multicenter studies.

Recent technological development has allowed expanding applications of radiofrequency ablation (RFA) for malignant tumor therapy. We report a case with a spinal metastatic tumor treated with combination of percutaneous vertebroplasty (PVP) that provides pain relief and spinal stabilization and RFA. A 68-year-old male who had undergone resection of left ureteric carcinoma was referred to our hospital with lower back pain due to the fifth lumbar (L5) vertebral metastatic tumor. Conventional radiation therapy was discontinued because of pneumonia. One year later, the patient was admitted again with weakness of the right knee and foot and severe pain of the back and the right lower extremity. Radiographs demonstrated a compressive fracture of the L5 vertebra predominantly on the right side. CT and MRI showed a tumor of the L5 body invading the right pedicle, the intervertebral foramen, and the retroperitoneal space. RFA was performed in the ventral part of the L5 body, and then around the right L5/the first sacral intervertebral foramen. Temperature and time for ablation ranged from 74 degrees C to 95 degrees C and from 11 min. to 30 min., respectively. Next, PVP was performed by the right transpedicular approach. Bone cement was injected into the L5 body and the pedicle by an amount of 3.0 ml in total without technical complications. Postoperatively, visual analogue scale demonstrated decreased pain degree from 10 cm to 5.4 cm. Combined treatment with RFA and PVP is a feasible and promising procedure for spinal metastatic tumors. Further evaluation is necessary to confirm its long-term efficacy.

Radiochromic film (RC-film) is of great interest as a film-type dosimeter for radiation oncology applications. We present a two-dimensional image-based evaluation of the measurement accuracy of a commercial RC-film product (Gafchromic MD-55-2 film, ISP TECHNOLOGIES, Inc.) by using a commercial Laser Densitometer (Model 1710, Computerized Medical Systems, Inc.) as an optical density imaging system. The coefficient of variation of the density (pixel-value) in one sample was approximately 3% to 11% at 3 Gy or less, and 3% or less at 4 to 60 Gy. Although the coefficient of variation between three samples at the same dose was about 14% at 1 Gy, it decreased as the dose increased, reaching several percent. In 1 to 6 Gy samples, geometric imaging artifacts [interference (moire) patterns] were observed, and it was found that scan-sampling pitch influenced the accuracy of measurement of the density of the sample. To improve the accuracy of density measurement, sufficient knowledge about characteristic features of the density measuring system is essential.

We performed radiofrequency ablation (RFA) for 14 patients with hepatocellular carcinoma (HCC) between May 2001 and March 2002. The underlying hepatic disease was type C liver cirrhosis in all patients. Seven patients had a solitary lesion, and 7 patients had multiple lesions. RFA was chosen for the primary tumor in 5 cases and for a recurrent tumor in 9 cases. Three cases of well differentiated HCC were included. Transcatheter arterial embolization (TAE) was performed in 10 cases simultaneously. Nine patients received RFA under general anesthesia (open laparotomy: 5 cases, transthoracic: 1 case, CT guided: 2 cases, US guided: 1 case) and 5 patients under local anesthesia (CT guided: 2 cases, US guided: 3 cases). RFA was performed for 12 minutes in each session and the mean number of sessions per patient was 3.2. Excellent ablation was achieved in all cases according CT evaluation, and no additional therapy was needed. No recurrences have been found in any cases so far. RFA for HCC achieved excellent therapeutic effect in combination with other therapies as multimodal therapy.