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Horikoshi H.,Gunma Prefectural Cancer Center | Kikuchi A.,Kanazawa University | Onoguchi M.,Kanazawa University | Sjostrand K.,Technical University of Denmark | Edenbrandt L.,Gothenburg University
Annals of Nuclear Medicine | Year: 2012

Aim Computer-aided diagnosis (CAD) software for bone scintigrams have recently been introduced as a clinical quality assurance tool. The purpose of this study was to compare the diagnostic accuracy of two CAD systems, one based on a European and one on a Japanese training database, in a group of bone scans from Japanese patients. Method The two CAD software are trained to interpret bone scans using training databases consisting of bone scans with the desired interpretation, metastatic disease or not. One software was trained using 795 bone scans from European patients and the other with 904 bone scans from Japanese patients. The two CAD softwares were evaluated using the same group of 257 Japanese patients, who underwent bone scintigraphy because of suspected metastases of malignant tumors in 2009. The final diagnostic results made by clinicians were used as gold standard. Results The Japanese CAD software showed a higher specificity and accuracy compared to the European CAD software [81 vs. 57 % (p<0.05) and 82 vs. 61 % (p<0.05), respectively]. The sensitivity was 90 % for the Japanese CAD software and 83 % for the European CAD software (n.s). Conclusion The CAD software trained with a Japanese database showed significantly higher performance than the corresponding CAD software trained with a European database for the analysis of bone scans from Japanese patients. These results could at least partly be caused by the physical differences between Japanese and European patients resulting in less influence of attenuation in Japanese patients and possible different judgement of count intensities of hot spots © The Author(s) 2012.

Maruyama A.,Tokyo Medical and Dental University | Tsunoda A.,Tokyo Medical and Dental University | Takahashi M.,Tokyo Medical and Dental University | Kishimoto S.,Tokyo Medical and Dental University | Suzuki M.,Gunma Prefectural Cancer Center
American Journal of Otolaryngology - Head and Neck Medicine and Surgery | Year: 2014

Most tumors arising in the nasopharynx are malignant and frequently develop otitis media with effusion (OME). On the contrary, benign nasopharyngeal tumors are very rare, and pleomorphic adenoma, which is a benign mixed tumor of the nasopharynx, is also rarely encountered. We herein report a case of nasopharyngeal pleomorphic adenoma which initially presented as OME. This tumor completely blocked the orifice of the Eustachian tube but was removed by a combination of transnasal and transoral endoscopic resection. A defect in the mucous membrane was covered with polyglycolic acid sheet and fibrin glue. Mucous membrane completely covered the exposed tubal cartilage without adhesion near the tubal orifice. OME and hearing loss completely subsided 3 months after the surgery. She was disease-free 2 years after the surgery. Use of polyglycolic acid sheet could be a feasible mesh for closure of surgical defect without scarring, and it also led to healing of OME. © 2014 Elsevier Inc.

Fujita A.,Gunma Prefectural Cancer Center
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2011

A 70-year-old man visited the Department of Head and Neck Surgery with a chief complaint of dysphagia. A tumor was observed in the epiglottis and vocal cord, and was diagnosed as squamous cell carcinoma by biopsy. Computed tomography (CT) showed a tumor mainly in the vocal cord. CT scans revealed a tumor centered on the vocal cord, with bilateral cervical lymph node metastases and a well-circumscribed 20-mm tumor in the anterior mediastinum. Fluorodeoxyglucose-positron emission tomography (FDG-PET) showed uptake in the primary lesion, left cervical lymph nodes, and anterior mediastinal tumor, which suggested a lymph node metastasis but did not exclude thymoma. The patient underwent video-assisted thoracic surgery (VATS) resection of the anterior mediastinal tumor with total laryngectomy, total thyroidectomy, and bilateral cervical lymph node dissection. The final pathological diagnosis was laryngeal cancer (glottic cancer, pT4aN2M1, pStage IVC) with thymic metastasis (presenting as an anterior mediastinal tumor). Thymic metastasis of laryngeal cancer is rare, and appears difficult to preoperatively differentiate from other mediastinal tumors.

Fujita A.,Gunma Prefectural Cancer Center
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2011

Elastofibroma is a tumor that is localized mainly at the subscapular region. We report 2 cases of subscapular elastofibromas. Case 1, 75-year-old woman was seen at the hospital because of a left dorsal tumor. Computed tomography (CT) scan revealed the tumor of 6 cm in diameter in the inferior angle of left scapula. The patient underwent excision of the tumor. Case 2, 90-year-old man underwent excision a tumor of 5 cm in diameter in the inferior angle of right scapula simultaneously with the operation of right lung cancer. Histological examinations showed increased elastic fiber with elastica van Gieson staining. These specimens confirmed the diagnosis of elastofibroma There have been no signs of recurrence after surgery.

Horikoshi H.,Gunma Prefectural Cancer Center
Japanese Journal of Clinical Radiology | Year: 2016

Accurate evaluation of the presence and extent of metastatic bone tumors is crucial to proper staging and treatment. Various imaging techniques are available for the evaluation of metastatic bone tumors, including plain film radiographs, CT, scintigraphy, MR imaging and PET/CT. Scintigraphy is the most commonly used imaging technique for the staging and evaluation of bone metastases. Recently, it is possible to indicate automated BSI by using CAD and evaluate the response of therapy by BSI change. In this article, the utility of CAD and fusion imaging using multi-modalities will be reviewed.

Shirai K.,Gunma Prefectural Cancer Center
Journal of radiation research | Year: 2013

Esophageal cancer patients are often associated with multiple primary cancers (MPC). The aim of this study is to evaluate the effect of MPC on prognosis in esophageal cancer patients treated by radiotherapy. Between 2001 and 2008, esophageal cancer patients treated by definitive radiotherapy at Gunma Cancer Center were retrospectively reviewed. Exclusion criteria were preoperative or postoperative radiotherapy, palliative radiotherapy, follow-up of <6 months, radiation dose of <50 Gy and no information on MPC. We analyzed 167 esophageal cancer patients and 56 (33.5%) were associated with MPC. Gastric cancer was the most frequent tumor (38.2%), followed by head and neck cancer (26.5%). Median follow-up time was 31.5 months (range 6.1-87.3 months). Patients with MPC included more stage I/II esophageal cancer than those without MPC (66.1% vs. 36.9%, P < 0.01). The 5-year overall survival rate for esophageal cancer with MPC was relatively better than those without MPC (46.1% vs. 26.7%), although the difference did not reach statistical significance in univariate analysis (P = 0.09). Stage I/II esophageal cancer patients had a significantly better overall survival than stage III/IV patients (P < 0.01). Among esophageal cancer patients with MPC, there was no difference in overall survival between antecedent and synchronous cancer (P = 0.59). Our study indicated that the prognosis of esophageal cancer patients treated by radiotherapy was primarily determined by the clinical stage itself, but not the presence of MPC.

Kikuchi A.,Kanazawa University | Onoguchi M.,Kanazawa University | Horikoshi H.,Gunma Prefectural Cancer Center | Sjostrand K.,Technical University of Denmark | Edenbrandt L.,Gothenburg University
Nuclear Medicine Communications | Year: 2012

AIM: Automated segmentation of the skeleton is the first step for quantitative analysis and computer-aided diagnosis (CAD) of whole-body bone scans. The purpose of this study was to examine the influence of differences in skeletal atlas on the automated segmentation of skeletons in a Japanese patient group. METHODS: The study was based on a bone scan CAD system that included a skeletal atlas obtained using 10 normal bone scans from European patients and 23 normal bone scans from Japanese patients. These were incorporated into the CAD system. The performance of the skeletal segmentation, based on either the European or the Japanese Atlas, was evaluated independently by three observers in a group of 50 randomly selected bone scans from Japanese patients. RESULTS: The skeletal segmentation was classified as correct in 41-44 of the 50 cases by the three observers using the Japanese atlas. The corresponding results were 15-18 of the 50 cases using the European atlas, and this difference was statistically significant (P<0.001). The anatomical areas most commonly classified as not correct were the skull, cervical vertebrae, and ribs. CONCLUSION: Automated segmentation of the skeleton in a Japanese patient group was more successful when the CAD system based on a Japanese atlas was used than when the corresponding system based on a European atlas was used. The results of this study indicate that it is of value to use a skeletal atlas based on normal Japanese bone scans in a CAD system for Japanese patients. © 2012 Wolters Kluwer Health | Lippincott Williams &Wilkins.

Ojima H.,Gunma Prefectural Cancer Center
BMJ case reports | Year: 2012

We report our experience with four patients presenting with spontaneous pneumomediastinum (SPM) within a 3-month period. The patients (three male and one female, aged 15-17 years) were hospitalised with SPM. All patients were kept under observation, successfully treated and followed up for several years, with no recurrences reported. Two patients had histories of asthma, while the other two developed SPM during sporting activities. SPM carries the possibility of being latent. For symptoms such as chest pain without evidence of pneumothorax in young people, it is necessary to always consider SPM and make the diagnosis accordingly.

Ebara T.,Gunma Prefectural Cancer Center
Japanese Journal of Clinical Radiology | Year: 2016

This study evaluated 26 cervical esophageal carcinoma patients treated with concurrent chemoradiotherapy (CCRT). Patients were stage 0-II in 6 patients and III in 20. The overall survival rate at 2 and 5 years was 47% and 30%, respectively. All patients with stage 0-II were surviving more than 2 years without disease. Twelve recurrences were recognized. Among them 10 were recurred at the primary site. CCRT can be curative treatment for early stage cervical esophageal carcinomas. To improve local control is necessary for better prognosis.

Higashi T.,University of Tokyo | Nakamura F.,Kyoto University | Saruki N.,Gunma Prefectural Cancer Center | Sobue T.,Osaka University
Japanese Journal of Clinical Oncology | Year: 2013

Ensuring the quality of care is a major objective of cancer control policy. The Cancer Control Act 2006 placed responsibility on the Japanese government to maintain the quality of cancer care nationwide. To function as centers providing high-quality care, designated cancer care hospitals (397 hospitals as of April 2012) were instituted nationwide. Although they meet the structural standards, such as the presence of radiation equipment and palliative care teams, it remains unclear whether the designation has led to appropriate provision of care and optimal patient outcomes. A national system to examine the processes and outcomes of cancer care is under development. In 2007 and 2008, the Japanese Association of Clinical Cancer Centers publicly disclosed the 5-year survival of their member facilities with strict data quality standards, including sufficient follow-up of patients' vital status. The network of designated cancer care hospitals will follow this lead to provide a national outcome monitoring system. The processes of care have also been addressed by a government-funded research project. With the collaboration of clinical experts, 206 quality indicators have been developed for five major cancers in Japan (breast, colorectal, liver, lung and stomach) and palliative care. Each indicator described the target patients and standards of care for the patients, the provision of which was considered an aspect of quality. In 2012, the Cancer Registry Chapter of the Association of Prefectural Designated Cancer Care Hospitals instituted quality measurement using these indicators. These activities will soon lead to effective quality monitoring and improvement in Japan. © 2013 The Author. Published by Oxford University Press. All rights reserved.

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