• Title/Summary/Keyword: MRI Modalities

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Clinical Outcomes of Intracranial Nonvestibular Schwannomas Treated with Linac-Based Stereotactic Radiosurgery and Radiotherapy

  • Puataweepong, Putipun;Dhanachai, Mantana;Hansasuta, Ake;Saetia, Kriangsak;Dangprasert, Somjai;Sitathanee, Chomporn;Yongvithisatid, Pornpan
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3271-3276
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    • 2016
  • Background: Intracranial nonvestibular schwannomas arising from various cranial nerves excluding CN VIII are uncommon. Recently, stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (SRT) have been widely reported as effective treatment modalities for nonvestibular schwannomas. The purpose of this study was to study the long term clinical outcome for nonvestibular schwannomas treated with both X-Knife and CyberKnife (CK) radiosurgery at one institution. Materials and Methods: From 2004 to 2013, fifty-two nonvestibular schwannoma patients were included in this study, 33 patients (63%) were treated with CK, and 19 (37%) were treated with X-Knife. The majority of the tumors were jugular foramen schwannomas (38%) and trigeminal schwannomas (27%). HSRT was given for 45 patients (86%), whereas CSRT was for 6 (12%) and SRS for 1 (2%). Results: The median pretreatment volume was $9.4cm^3$ (range, $0.57-52cm^3$). With the median follow up time of 36 months (range, 3-135), the 3 and 5 year progression free survival was 94 % and 88%, respectively. Tumor size was decreased in 13 (25%), stable in 29 (56%), and increased in 10 (19%). Among the latter, 3 (30%) required additional treatment because of neurologic deterioration. No patient was found to develop any new cranial nerve deficit after SRS/SRT. Conclusions: These data confirmed that SRS/SRT provide high tumor control rates with low complications. Large volume tumors and cystic expansion after radiation should be carefully followed up with neurological examination and MRI, because it may frequently cause neurological deterioration requiring further surgery.

Clinical Experiences of Arteriovenous Fistula on The Face (안면부에 발생한 동정맥루의 치험례)

  • Choi, Soo Jong;Oh, Heung Chan;Bae, Yong Chan;Nam, Su Bong;Moon, Jae Sul;Oh, Chang Keun;Kim, Chang Won
    • Archives of Plastic Surgery
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    • v.34 no.3
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    • pp.399-402
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    • 2007
  • Purpose: Arteriovenous fistula is one of high flow vascular malformations. Recently, arteriovenous fistula has been regarded as one of the type of arteriovenous malformations. The patients were diagnosed as arteriovenous malformation Schobinger clinical stage II. Even though arteriovenous fistula rarely occurs on head and neck, treatment of that is difficult due to frequent recurrence. In treating the arteriovenous fistula, chemical embolization, surgical excision and other treatment modalities were used, but the results were not satisfactory. The authors experienced three cases of arteriovenous fistula and treated them with surgical excision. Methods: In cases, warmth, enlargement, pulsation, thrill, and bruit were found. For the accurate evaluation before the operation, angiography and MRI were checked in advance. Incision was made on the site of pulsation. The artery and vein connected to the arteriovenous fistula were dissected widely, individually ligated, and divided. And then the entire mass was totally removed. Results: All surgical sites were healed well without complications and there was no evidence of recurrence in all cases up to for 2 years of follow-up examination. Conclusion: The arteriovenous fistula on face is a very rare disease and has difficulties in treatment. The authors experienced three cases of arteriovenous fistula with complete surgical removal and no recurrence was found in all cases.

Development of 3-D Radiosurgery Planning System Using IBM Personal Computer (IBM Personal Computer를 이용한 3차원적 뇌정위 방사선 수술계획 시스템의 개발)

  • Suh Tae-Suk;Suh Doug-Young;Park Charn Il;Ha Sung Whan;Kang Wee Saing;Park Sung Hun;Yoon Sei Chul
    • Radiation Oncology Journal
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    • v.11 no.1
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    • pp.167-174
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    • 1993
  • Recently, stereotactic radiosurgery plan is required with the information of 3-D image and dose distribution. A project has been doing if developing LINAC based stereotactic radiosurgery since April 1991. The purpose of this research is to develop 3-D radiosurgery planning system using personal computer. The procedure of this research is based on two steps. The first step is to develop 3-D localization system, which input the image information of the patient, coordinate transformation, the position and shape of target, and patient contour into computer system using CT image and stereotactic frame. The second step is to develop 3-D dose planning system, which compute dose distribution on image plane, display on high resolution monitor both isodose distribution and patient image simultaneously and develop menu-driven planning system. This prototype of radiosurgery planning system was applied recently for several clinical cases. It was shown that our planning system is fast, accurate and efficient while making it possible to handle various kinds of image modalities such as angiography, CT and MRI. It makes it possible to develop general 3-D planning system using beam's eye view or CT simulation in radiation therapy in future.

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$^{18}$F-Fluoride-PET in Skeletal Imaging ($^{18}$F-Fluoride-PET을 이용한 골격계 영상)

  • Jeon, Tae-Joo
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.4
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    • pp.253-258
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    • 2009
  • Bone scintigraphy using $^{99m}$Tc-labeled phosphate agents has long been the standard evaluation method for whole skeletal system. However, recent shortage of $^{99m}$Tc supply and advanced positron emission tomography (PET) technology evoked the attention to surrogate radiopharmaceuticals and imaging modalities for bone. Actually, fluorine-18 ($^{18}$F) was the first bone seeking radiotracer before the introduction of $^{99m}$Tc-labeled agents even though its clinical application failed to become pervasive anymore after the rapid spread of Anger type gamma camera systems in early 1970s. However, rapidly developed PET technology made us refocus on the usefulness of $^{18}$F as a PET tracer. Early study comparing $^{18}$F-Na PET scan and planar bone scintigraphy reported that PET has higher sensitivity and specificity in the diagnosis of metastatic bone lesions than planar bone scan. Subsequent reports comparing between PET and both planar and SPECT bone image also revealed better results of PET scan in similar study groups. Rapid clinical application of PET/CT also accumulated considerable amount of experiences in skeletal evaluation and this modality is known to have better diagnostic power than stand alone PET system as well as bone scan. Furthermore $^{18}$F-Na PET/CT revealed better or at least equal results in detection of primary and metastatic bone lesions compared with CT and MRI. Therefore, it is obvious that $^{18}$F-Na PET/CT has potential to become new imaging modality for practical skeletal evaluation so continuous and careful evaluation of this modality and radiopharmaceutical must be required.

Temporomandibular Disorder Caused by Nasopharyngeal Cancer (비인두암종에 의한 측두하악장애)

  • Byun, Young-Sub;Kim, Ki-Seo;Ahn, Hyung-Joon;Choi, Jong-Hoon;Kwon, Jeong-Seung
    • Journal of Oral Medicine and Pain
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    • v.33 no.4
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    • pp.395-399
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    • 2008
  • Orofacial pain and limited range of mouth opening as symptoms of temporomandibular disorder are mainly triggered by the structural and/or functional changes of temporomandibular joint and related structure itself. But careful diagnostic evaluation should be needed because they may be occurred by another pathologic conditions such as neoplasm in head and neck region. If there would be atypical pain characteristics or clinical features, systemic comorbid symptoms, or poor response to treatment, advanced imaging modalities such as CT or MRI will be mandatory for differential diagnosis. We experienced the case which was diagnosed as nasopharyngeal cancer mimicking temporomandibular disorder, and reviewed clinical considerations for proper differential diagnosis.

Accuracy Evaluation of Three-Dimensional Multimodal Image Registration Using a Brain Phantom (뇌팬톰을 이용한 삼차원 다중영상정합의 정확성 평가)

  • 진호상;송주영;주라형;정수교;최보영;이형구;서태석
    • Journal of Biomedical Engineering Research
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    • v.25 no.1
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    • pp.33-41
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    • 2004
  • Accuracy of registration between images acquired from various medical image modalities is one of the critical issues in radiation treatment planing. In this study, a method of accuracy evaluation of image registration using a homemade brain phantom was investigated. Chamfer matching of CT-MR and CT-SPECT imaging was applied for the multimodal image registration. The accuracy of image correlation was evaluated by comparing the center points of the inserted targets of the phantom. The three dimensional root-mean-square translation deviations of the CT-MR and CT-SPECT registration were 2.1${\pm}$0.8 mm and 2.8${\pm}$1.4 mm, respectively. The rotational errors were < 2$^{\circ}$ for the three orthogonal axes. These errors were within a reasonable margin compared with the previous phantom studies. A visual inspection of the superimposed CT-MR and CT- SPECT images also showed good matching results.

Mesenteric and Omental Cysts in Children (소아기의 장간막 및 대망 낭종)

  • Sung, Kwan-Su;Chung, Jae-Hee;Lee, Do-Sang;An, Chang-Hyuk;Song, Young-Tack
    • Advances in pediatric surgery
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    • v.8 no.2
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    • pp.138-142
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    • 2002
  • Mesenteric and omental cysts are rare intra-abdominal lesions in childhood, and may present various clinical features such as an asymptomatic mass or an acute abdomen. Therefore, these entities are frequently misdiagnosed preoperatively or are found only incidentally at operation for other conditions. We analyzed our experiences of 19 cases in a 19 year period from 1981 to 1999, at College of Medicine, Catholic University of Korea. There were 12 boys and 7 girls with a mean age of 4.8 years (range, 3 days to 15 years). Common presenting symptoms were abdominal pain (47%), abdominal distension (31%), abdominal mass (24%), vomiting (15%) and fever (10%). Ultrasonography was the most preferred method of diagnosis. Other diagnostic modalities include CT, MRI, and abdominal ascites tapping in selected patients. Location of the mesenteric cysts was small bowel mesentery in nine, the right mesocolon and retroperitoneum in one, the left mesocolon in one, and the jejunum, sigmoid-colon mesentery in one. Most of the patients underwent cyst excision, but six patients required concomitant bowel resection for complete removal of the lesions, and two patients underwent unroofing and simple aspiration respectively. There was one mortality case due to sepsis.

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Traumatic Pseudoaneurysm of the Superficial Temporal Artery diagnosed with 3-Dimensional Computed Tomography Angiography: Two Cases Report (3차원 컴퓨터단층촬영 혈관조영술을 이용하여 진단한 외상성 천측두동맥 가성동맥류의 치험례)

  • Kwon, Ho;Hwang, Dong Yeon;Jung, Sung-No;Yim, Young Min;Shin, Ok Ran
    • Archives of Plastic Surgery
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    • v.34 no.2
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    • pp.265-268
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    • 2007
  • Purpose: Superficial temporal artery(STA) aneurysms are very rare and mostly occur as pseudoaneurysms secondary to trauma. Clinical diagnosis of STA pseudoaneurysm is based on a history of trauma or surgery to frontotemporal region, which presents with pulsatile mass. To confirm diagnosis, many imaging strategies can be used such as digital subtraction angiography, sonography, CT and MRI. But, these imaging modalities are invasive or inaccurate or expensive. Thus, we used 3D CT angiography to confirm STA aneurysm and to get accurate information. Methods: We have experienced two cases of pulsatile mass on the temporal area, suspected as STA pseudoaneurysms. On the basis of clinical information, we performed 3D CT angiography to get more accurate information about this pulsatile mass and to confirm diagnosis. On the basis of information from 3D CT angiography, we performed operation. Results: The lesions were diagnosed as pseudoaneurysm of superficial temporal artery by 3D CT angiography, and surgically resected safely without any complication on the basis of information from 3D CT angiography. 3D CT angiography was excellent diagnostic method for detecting STA pseudoaneurysms, and effectively showed many information about pseudoanerysms such as relationship between the aneurysms and surrounding structures, and its size. Conclusion: We could effectively diagnose and treat on the basis of information from 3D CT angiography. We present our cases with a brief review of the literature related to STA traumatic pseudoaneurysms.

A Case of Monocular Partial Oculomotor Nerve Palsy in a Patient with Midbrain Hemorrhage (중뇌 출혈 환자에서 나타난 단안의 부분 동안신경마비 여환 치험 1례)

  • Lee, Hyun-Joong;Lee, Bo-Yun;Lee, Young-eun;Yang, Seung-Bo;Cho, Seung-Yeon;Park, Jung-Mi;Ko, Chang-Nam;Park, Seong-Uk
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.16 no.1
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    • pp.103-109
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    • 2015
  • This report is about a case of monocular partial oculomotor nerve palsy in a patient with midbrain hemorrhage. The patient developed diplopia while driving. The Brain MRI film demonstrated a hemorrhage in the right midbrain and left corona radiata and microbleedings in both cerebral and cerebellar hemispheres, basal ganglia, midbrain, pons. We used Korean medicine treatment modalities including acupuncture, electroacupuncture, pharmacoacupuncture and herb medicines. As a result, limitation of upward gaze was recovered to about 90% of normal range.

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Prediction of overall survival for patients with malignant glioma using convolutional neural network (합성곱 신경망 모델을 이용한 악성 뇌교종 환자 예후 예측)

  • Kwon, Junmo;Park, Hyunjin
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2022.10a
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    • pp.297-299
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    • 2022
  • Malignant glioma has a poor prognosis with the reported median survival of between 6 months to 14 months. Thus, it is crucial to predict the accurate survival of patients with malignant glioma. In this paper, we propose a convolutional neural network to predict the overall survival and age of the patients. A total of four MRI modalities, T1, T1-contrast enhanced, T2, and fluid-attenuated inversion recovery, which effectively capture spatial characteristics of malignant glioma, were used as input images. Age is an important factor impacting the overall survival, thus incorporating it into the model will thereby improve the performance of the proposed model. Our model successfully predicted overall survival and age of the patients with pearson correlation coefficients of 0.1748 and 0.3056, respectively.

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